Who here knows the actual cost of their health care?

[JS80]

Originally posted by: Via
There was a story in the Chicago Tribune a while back about how a guy in his 50s was in debilitating pain and was approved for back surgery.

After the surgey was performed his insurance company reversed it's decision and declined to cover it. The cost was around $160,000.

After this whole mess became public the company waffled and ended up paying.



Why does a back surgery cost 160,000 motherfucking dollars?

Surgeons need to pay their BMW lease and country club membership motherfucka

 

[Pliablemoose]

Originally posted by: Brovane

Yeah as if I am going to ask a doctor as they stick a tube down my newborn's throat and get her breathing again. What do you charge for this? Are you charges reasonable and customary?

Anesthesia groups are notorious for this too, PPO hospital etc, but they contract the Anesthesia group.

One of my friends owns an anesthesia group, they refuse to join any PPO groups because they'd lose $, they can charge up the ass for their services, and no-one thinks to ask if the Anesthesiologist is part of the PPO.

Another stunt they pull is that if Medicare doesn't cover a method of anesthesia, they have them sign a contract that they'll pay for the uncovered service, they make them sign the contract minutes prior to the procedure after the prep the night before, and after they're in the hospital gown and on the stretcher, ready to go to the fucking OR.

The dude makes >$500K/year pulling this shit.

 

[JS80]

Originally posted by: Pliablemoose

Originally posted by: Brovane

Yeah as if I am going to ask a doctor as they stick a tube down my newborn's throat and get her breathing again. What do you charge for this? Are you charges reasonable and customary?

Anesthesia groups are notorious for this too, PPO hospital etc, but they contract the Anesthesia group.

One of my friends owns an anesthesia group, they refuse to join any PPO groups because they'd lose $, they can charge up the ass for their services, and no-one thinks to ask if the Anesthesiologist is part of the PPO.

Another stunt they pull is that if Medicare doesn't cover a method of anesthesia, they have them sign a contract that they'll pay for the uncovered service, they make them sign the contract minutes prior to the procedure after the prep the night before, and after they're in the hospital gown and on the stretcher, ready to go to the fucking OR.

The dude makes >$500K/year pulling this shit.

Doctors need to pay their BMW lease and country club membership motherfucka

 

[Brovane]

Originally posted by: Pliablemoose

Originally posted by: Brovane

Yeah as if I am going to ask a doctor as they stick a tube down my newborn's throat and get her breathing again. What do you charge for this? Are you charges reasonable and customary?

Anesthesia groups are notorious for this too, PPO hospital etc, but they contract the Anesthesia group.

One of my friends owns an anesthesia group, they refuse to join any PPO groups because they'd lose $, they can charge up the ass for their services, and no-one thinks to ask if the Anesthesiologist is part of the PPO.

Another stunt they pull is that if Medicare doesn't cover a method of anesthesia, they have them sign a contract that they'll pay for the uncovered service, they make them sign the contract minutes prior to the procedure after the prep the night before, and after they're in the hospital gown and on the stretcher, ready to go to the fucking OR.

The dude makes >$500K/year pulling this shit.

BOHICA

 

[rchiu]

Originally posted by: ohnoes

Originally posted by: Brovane
In my Opinion the entire thing is a racket.

Earlier this year my wife went in to have her thyroid removed and spent 2 nights in the hospital. We have Aetna PPO. The hospital charge was $24k however the network negotiated amount was $3.7, WTF? How can there be such a huge disrepenancy? So if I was paying cash you would charge me $24k? Also the hospitals just about make it impossible to shop for price unless you are doing a ellective procedure like plastic surgery.

This is what my Dr. friend says also. The hospital bills out at a really high rate, but the insurance companies negotiates only to pay a % of that rate. In the no insurance case, what'll actually end up happening is they'll charge you the full amount, and if you can't pay, they sell your bill for a % of its face value to a collections agency, which then go after you.

From what he says, the reason that the rates are so high is partly 1) they know insurance companies won't pay face value and 2) ER's, uninsured people, and end-of-life care raise costs for everyone. My take is that its really #2 that's the problem. Apparently, everyone in the medical community knows a fraction of the patients account for the majority of the bills. When he does urgent life saving procedures (especially those from the ER), there's never any discussion of cost or who's going to pay for it. It's just a matter of doing everything they can to save that guy's life. The hospital then has to go recoup those costs from everyone else who can pay.

Just as an example, he told me that they buy propofol at <$1/vial, but bill it out at $40-50, of which they only expect to collect ~$10.

Well that's why many countries are able to control cost with single payer system. You get one payer that covers everyone and is able to negotiate price for everyone. No one is un covered. Hospital don't have excuse to charge bullshit amount to account for those not covered. No more additional layers like collections agencies.

The thing with the current US system is that there are too many people with different situations. Some with health insurance, some don't. Some have certain things covered, some don't and they might not even know it. Some doctors are in some network, some hospitals are in some network. Some network has more specialists in some area....all these complication and confusion make it hard for healthcare provider to charge consistent prices, and hard for people to know what the real price is and should be.

 

[zephyrprime]

Originally posted by: Brovane
In my Opinion the entire thing is a racket.

Earlier this year my wife went in to have her thyroid removed and spent 2 nights in the hospital. We have Aetna PPO. The hospital charge was $24k however the network negotiated amount was $3.7, WTF? How can there be such a huge disrepenancy? So if I was paying cash you would charge me $24k? Also the hospitals just about make it impossible to shop for price unless you are doing a ellective procedure like plastic surgery.

Because of the messed up way the system is, the medical care provider has every incentive to ask for some outlandishly high price. They're just trying to maximize the amount of money they get. The insurer then has every incentive to not pay enough. They have every incentive to not pay. The capitalist pricing system isn't working well in the medical industry.

And the reason is simple. All insurance by it very nature is socialist and not capitalist in nature. I don't think Obama's plan goes far enough in addressing the irrational elements of the healthcare system. It worries too much about universal coverage and not enough about costs. The traditional insurance model simply does not work for health care.

Maybe if we sold medical care as a bundled service including insurance, the pricing would be more rational.