How important are your health benies??

[MarshCappa]

Originally Posted by PaulS

So how do you justify the outrageous costs you charge?????? Was my 4 stiches and 10 min. with a Dr. really worth $1,295?? Did the tetnous shot really cost $29.95???

1st of all I don't charge you anything. 2nd of all costs are based on what insurance comapnies actually pay vs what the hospital charges. It's not a good system but it's the only way a hospital can stay in business and YES this is a business which people don't realize. Anyone running a business can appreciate time and money. Hospitals have the most overhead of any business but need to staff for anything that may walk thru the door. So in reality your stitches charge has built into it the RN, Techs, Administrative, and whatever else is involved in the process that you never see or interact with. Take a look at your EOB(explanation of beneifts) from your insurance company for that visit and you'll see what the plan actually paid to the hospital. You'll be amazed. Do you know what the hospital does with the remaining UNPAID balance? They write it off as the Contractual Allowance" Like I said it's a business and the way our current health care delivery system works in our country. I'm not saying it's right but it's reality and if hospitals don't charge the way they do they won't stay in business too long and then you'd have to drive a lot further and wait in even longer lines for your care.

[fishpoopoo]

1) the bill you get from this hospital is always inflated. little known factoid if you can't afford to pay your bill: everything is negotiable.

2) hospitals have to charge some people more to cover the costs of many people who can't afford to pay at all.

[RickBomba]

Yup, when I worked for myself I paid $79 a week for just health, just for me, my business partner paid $100 a week towards it, too, that's $720 a month just for health insurance.
Right now, through Bugaboo, I pay $22 a week for full health and dental, it's sweet...went through all sorts of crazy doctors visits this time last year...I had to pay the co pays and like another $50.
Later,
Rick

[PaulS]

Originally Posted by MarshCappa

1st of all I don't charge you anything. 2nd of all costs are based on what insurance comapnies actually pay vs what the hospital charges. It's not a good system but it's the only way a hospital can stay in business and YES this is a business which people don't realize. Anyone running a business can appreciate time and money. Hospitals have the most overhead of any business but need to staff for anything that may walk thru the door. So in reality your stitches charge has built into it the RN, Techs, Administrative, and whatever else is involved in the process that you never see or interact with. Take a look at your EOB(explanation of beneifts) from your insurance company for that visit and you'll see what the plan actually paid to the hospital. You'll be amazed. Do you know what the hospital does with the remaining UNPAID balance? They write it off as the Contractual Allowance" Like I said it's a business and the way our current health care delivery system works in our country. I'm not saying it's right but it's reality and if hospitals don't charge the way they do they won't stay in business too long and then you'd have to drive a lot further and wait in even longer lines for your care.

So I'm paying for something that I didn't use??? I agree that the hospitals have a lot of overhead but how is that the ins. co. fault?

When Pfizer stops trials on a drug and writes off $800m. do they add that cost to another drug or when Exxon stops development of a oil field, they don't add the cost to another field.

There is currently overcapacity in the medical industry and in certain areas hosptitals s/b closed (NYC wants to close 8-10 I think).

The $1295 was the from the EOB. I don't think ins. would be able to negotiate a disc. on an emerg. room service

[MarshCappa]

Originally Posted by PaulS

So I'm paying for something that I didn't use??? I agree that the hospitals have a lot of overhead but how is that the ins. co. fault?

When Pfizer stops trials on a drug and writes off $800m. do they add that cost to another drug or when Exxon stops development of a oil field, they don't add the cost to another field.

There is currently overcapacity in the medical industry and in certain areas hosptitals s/b closed (NYC wants to close 8-10 I think).

The $1295 was the from the EOB. I don't think ins. would be able to negotiate a disc. on an emerg. room service

This will be a never ending thread/debate. It's our current system and unless Canada or some other country with national health insurance invades us and puts us under their rule it will NEVER change. People way smarter than me have been trying to make it better and have made little to no progress. Just wait for EMR(Electronic Medical Record) debate/implementation. That is going to put national insurance on the back burner while they come up with a way to interface with everyone's computer systems!!!!!!!!!!!

[PaulS]

Originally Posted by MarshCappa

People way smarter than me

You could have said "People way smarter than you and I" and I wouldn't have gotten upset.

[MarshCappa]

That's cool PaulS This is a touchy subject with some people. Most of my professional career has been in healthcare and I've spoken to hundreds of patients and families about the importance of knowing your health plans benefits inside and out. The ironic thing about that last statement is I'm totally out of healthcare now and in the high tech industry but you can't totally get it out of your system. No pun intended. If there's anything I can answer about health insurance or our current delivery system I will certainly try to help. Otherwise, being married to an RN and having two young kids that are constantly seeing the MD for various minor ailments is the closest I get to the system these days. I was getting burned out in my career from having to deal with a system that is tough on everyone, just like all the previously mentioned comments on this thread so a change was needed to keep my sanity.

[TheSpecialist]

Employee benefits typically cost companies 3X what your salary is.

Your employer is supposed to provide you with something telling you what they pay monthly for your insurance. My company sends a document to my house 1 time every year and on it it say's that companies are required to do it. My company pays about 1800/ month for my family coverage. I pay 0. This is why I belong to a union. Health insurance is such an important issue to us, that we would strike over it, and have done so in the past. One reason we went on strike in 98 because they want retirees to start paying a huge portion of theirs.

As a side note, I think one reason health care cost, and insurance rates are so exspensive has to do with useless procedures. Does anyone elses dentist send them a letter around October letting them know the year is almost over, and they have x amount of benefits that have been unused and will dissapear if not used by the end of the year, but to hurry up as appointments are running out?

[PaulS]

Originally Posted by TheSpecialist

As a side note, I think one reason health care cost, and insurance rates are so exspensive has to do with useless procedures. Does anyone elses dentist send them a letter around October letting them know the year is almost over, and they have x amount of benefits that have been unused and will dissapear if not used by the end of the year, but to hurry up as appointments are running out?

That certainly has something to do with it. There is also the mentality of "I paid for it, I'm going to use it", also Dr. who have exp. machines (cat scans) tend to have patients who ave. more procedures that others, hosp/ins. comp. expenses, needless tests so that Drs. don't get sued for missing a diagnosis but probably the biggest exp. (which also effects S. Security when you think about it) is the general advances in medicine which keeps people alive longer. For ex. someone w/a serious illness would die fairly quickly. Now they are helicoptered to a trauma center and 6 weeks and $1,000,000 later, they come out and live until 90 years old.