Let's talk healthcare

[TheSpecialist]

I recently had shoulder surgery, and yesterday I got a bill from the Anesthesiologist. I only have to pay $10.00.

I read the breakdown of charges and was shocked. This is one of the biggest scams and problems with our healthcare system.

They billed the following:

Shoulder Arthroscopy/Surgery 1875.00
Nerve Block Inj Brachial Plexus 800.00
Echo Guide For BIOPSY 268.00

The echo guide was use to place the nerve block, and was sitting in the prep room, the used it for like 5 minutes maybe 10.

Here is how the bill was paid:

BcBs payment:

Surgery 862.80
Nerve Block 71.93
Echo Guide 48.51

BcBs writeoff :

Surgery 1012.20
Nerve Block 718.07
Echo 219.49


All told my insurance payed 983.24 and was billed 2943.00 for services

The Anesthesiologist wrote off 1949.76, and are billing me for $10.

Now I don't care about $10.00, what bugs me is that they obviously grossly overcharge for services. Because they must have made money to accept the negotiated payment from BcBs and this is why our healthcare system, and health insurance system suck. This needs to be fixed in order for the US to move ahead.

[scottw]

Originally Posted by TheSpecialist

I am not a public employee, and my health care is paid 100%. .

Originally Posted by TheSpecialist

I recently had shoulder surgery, and yesterday I got a bill from the Anesthesiologist. I only have to pay $10.00.

I read the breakdown of charges and was shocked. This is one of the biggest scams and problems with our healthcare system.

They billed the following:

Shoulder Arthroscopy/Surgery 1875.00
Nerve Block Inj Brachial Plexus 800.00
Echo Guide For BIOPSY 268.00



Now I don't care about $10.00

,

hilarious I thought for sure you were going to complain about having to pay the $10

[UserRemoved1]

That's cheap I'm surprised it wasn't 10x that!

[FormerUser]

I wouldn't worry about a thing.

Didn't you hear?Obama fixed EVERYTHING.Its all cake and rose pedals now.

[Fly Rod]

under Obama care if it were in effect now you would have paid more out of pocket.

[TheSpecialist]

I am surprised that no one is pi$$ed that the public is getting screwed by doctors and hospitals as much as they are by insurance companies.

This is where need to focus things in order to fix the healthcare problem.
The hospitals and doctor fees should bee fixed across the board for those that have insurance and those that don't. Also insurance company A should not have to pay lower fees than insurance company B. The fees should be standardized and should also be regulated like utility companies and car insurance is.

No I was not mad about the $10.00. I guess there is alot of blame put on the unions, when there is plenty of blame to go around. Most people complain, but never offer substantive plans to fix things.

[Raven]

i work at it full time... trying to beat the reaper

next year any operation is $500 out of pocket instead of $150

so basically
the only thing we can afford to do is DIE.

[UserRemoved1]

Bill if that was me 6 months ago it would have all come out of my pocket. I was paying almost 900 a month. $10k deductible. Self employed.

Unions have great insurance but you sure pay for it in dues etc.

[TheSpecialist]

Originally Posted by #^&#^&#^&#^&#^&#^&#^&#^&#^&#^&#^&

Bill if that was me 6 months ago it would have all come out of my pocket. I was paying almost 900 a month. $10k deductible. Self employed.

Unions have great insurance but you sure pay for it in dues etc.

Scott that sucks.

The point I am trying to make is Look at what the doctor actually billed for, and then the amount that was accepted. Knowing these two amounts, and that the doctor and hospital need to make a profit, don't you think that the public is being gouged? Your bill probably would have been different than mine, and a person without insurance would have paid the full amount. If they set their fees across the board for everyone no matter who you are, then everyones insurance would be alot cheaper.

[PRBuzz]

Originally Posted by Raven

so basically
the only thing we can afford to do is DIE.

Have you seen how expensive it is to DIE? Think Dr's screw the patient, try morticians putting you in a box to put in the ground. Go cremation!

[TheSpecialist]

Originally Posted by PRBuzz

Have you seen how expensive it is to DIE? Think Dr's screw the patient, try morticians putting you in a box to put in the ground. Go cremation!

I think they should just drag out into the deep woods and call it a day..

[The Dad Fisherman]

Originally Posted by PRBuzz

Have you seen how expensive it is to DIE? Think Dr's screw the patient, try morticians putting you in a box to put in the ground. Go cremation!

I told my wife when I go I don't care if the box they put me in says "Florida Oranges" on the side......Go Cheap...I won't complain

[UserRemoved1]

Bill I said this here before in a previous health care thread. I think Docs should be "assigned" to a pool of people. Let them specialize in one area, whatever. You have one PCP and he's paid per year to administer your care for whatever it takes. No billing the insurance company $700 dollars for a hand brace. You can buy the SAME thing at walgreens for $39.00

No more billing $700 for advil or tylenol. You get assigned a hospital, they get paid a flat payment for each individual. No more driving 50 miles to go to a hospital you like more but are more expensive. You got a local hospital that would be paid much like your pcp. Incentivize it for keeping people out of the hospital somehow.


In your instance these rates are pre-determined in the contracts with individual doctors. I think they do it this way on purpose. If the insurance kicks the payment back you pay the elevated rates. They don't #^&#^&#^&#^&er either and that's not right.

System is broke. Cept no-one will stand up and fix it. Ma was the leader in this o'bamacare bull#^&#^&#^&#^&. The Ma system is flawed worse now than it was before they passed all this crap.

Rates should have gone down when 300,000 additional people were added to the pool in the first year. I believe I saw recently it was 1 million added. Why haven't the rates gone down? I have watched this unfold over the last 10-12 years now. The insurance companies lobbied for this in Ma. They got a free bone from Romney back then, took it and ran.

He CAME from an insurance company....

I don't need to pay $125 a month for prescriptions. My family doesn't use the stuff. Once to twice a year typically.

You should be allowed to manage your own costs.

[UserRemoved1]

Here you go Bill. If that graph don't make you go holy sheet I don't know what would.

Is Top-Dollar Treatment Getting Americans the Best Health Care in the World? | The Rundown News Blog | PBS NewsHour | PBS

"In every country surveyed, patients who have a "medical home" -- an accessible primary care practice that knows their medical history and helps coordinate care -- reported better coordination, fewer medical errors and test duplication, and greater satisfaction with care than those without one."

I just said this.

[Saltheart]

Someone without insurance would have had to pay the whole original amount because they don't get the Blue Cross discounts , etc. The guy who most needs the discounts gets none!

[PRBuzz]

Remember insurance companies are the classic 99% (more like 80%) business model: 99% pay and get nothing back.

Medical service paybacks are all negotiated between the providers and insurance companies (each ins. co. likely reimburses differently) to "usual and customary" for a given area of the country, procedure ,etc.

[TheSpecialist]

Originally Posted by PRBuzz

Remember insurance companies are the classic 99% (more like 80%) business model: 99% pay and get nothing back.

Medical service paybacks are all negotiated between the providers and insurance companies (each ins. co. likely reimburses differently) to "usual and customary" for a given area of the country, procedure ,etc.

Obviously the hospitals and doctors are making a good profit by doing this, and are gouging everyone else. It's not like you can shop around for a better price...

[Fishpart]

I have been saying for years that I could afford to self insure if I could get away with paying what BCBS pays instead of what is actually billed..

[PaulS]

Originally Posted by Fishpart

I have been saying for years that I could afford to self insure if I could get away with paying what BCBS pays instead of what is actually billed..

Do you think you can pay the cost of a monthly hemophilia drug, the cost of preemies or the cost of a severe burn?

[UserRemoved1]

You'd have a better chance if the stuff wasn't inflated so much.

Pharmaceutical companies want a bar code on your forehead. It would make them more money.

Originally Posted by PaulS

Do you think you can pay the cost of a monthly hemophilia drug, the cost of preemies or the cost of a severe burn?

[JohnnyD]

Originally Posted by TheSpecialist

Obviously the hospitals and doctors are making a good profit by doing this, and are gouging everyone else. It's not like you can shop around for a better price...

If you are a self pay, that's exactly what you can do but people don't know it.

[TheSpecialist]

Originally Posted by JohnnyD

If you are a self pay, that's exactly what you can do but people don't know it.

Maybe you can, but I doubt the Doctor knows what the charges are, and you would need to talk to who ever does the billing.

The point here is that if there is room for the insurance companies to negotiate a lower payment,and the doctor and hospital still make a profit, then why isn't that the set rate they charge for everyone nonetheless.

If we had a set rate medical system, it would bring the cost of healthcare down for everyone, and it could also bring down the cost of insurance.

[Fishpart]

Originally Posted by PaulS

Do you think you can pay the cost of a monthly hemophilia drug, the cost of preemies or the cost of a severe burn?

Probably not, but when I see on my insurance statement they payed as little as 10 percent in some cases healthcare doesn't seem so unaffordable. Luckily I have healthy kids and the way the risk pool works in many ways I am paying for at least part of your list which is OK because what you listed are all afflictions where the victim clearly can't help themselves....

[PaulS]

Insur. companies get those disc. b/c they promise the facility a certain amount of business. Your not going to get those disc. if you can't promise someone business. The larger the insurance company, generally the larger the disc. (b/c they can promise more business). That is why smaller insurance companies frequently can't compete.

You hit the nail on the head, most of us are paying for someone else's illness - unless you have that illness, then someone else is helping to pay for you.

[The Dad Fisherman]

Get rid of frivolous lawsuits and I bet healthcare would go down too....

[fishbones]

Originally Posted by The Dad Fisherman

Get rid of frivolous lawsuits and I bet healthcare would go down too....

It's a big part of it. The malpractice insurance physicians are required to have is ridiculous. Most ethical doctors aren't making as much money as a lot of people think. Their costs are through the roof as compared to a few years ago.

[PaulS]

Lawsuits aren't as big of a part of it as you think. I think I have something at work which gives an est. If I have it, I'll put the $ up tom. I wonder what % profit those companies make though.

[Raider Ronnie]

Originally Posted by PRBuzz

Have you seen how expensive it is to DIE? Think Dr's screw the patient, try morticians putting you in a box to put in the ground. Go cremation!

No way I'm getting cremated !
They say that being set on fire is about the most painful thing that can happen to you.
Tell me you don't feel it !
Haven't met 1 person who came back and said any different.
I'm going down in my boat.
No way in hell I'm letting my wife's next husband enjoy my boat !

[The Dad Fisherman]

Viking funeral.......set me adrift and shoot flaming arrows at me until I sink in a ball of flames

[Raven]

can we strap some fireworks to the boat too
so you''ll go out with a colorful BANG....

then other dude's fishin can't point to the sky
and exclaim there go's TDF one hell of a guy

man his cranberry brew was great.....
in fact i have some right here
a toast... ---->>>snort<<<----