dropstep wrote: Its a mess for sure. Obamacare has just made it more exspensive.
Since we are already pouring the cement for the patio, can we upgrade to stamped concrete? It just adds a touch of class.
dropstep wrote: Its a mess for sure. Obamacare has just made it more exspensive.
Since we are already pouring the cement for the patio, can we upgrade to stamped concrete? It just adds a touch of class.
NEALSMO wrote:dropstep wrote: Its a mess for sure. Obamacare has just made it more exspensive.Since we are already pouring the cement for the patio, can we upgrade to stamped concrete? It just adds a touch of class.
I forgot this is the zero politics forum. Guess i should have just said prices are on an upward trajectory.
I'm in FL. I had a heart attack earlier this year and no insurance. Won't get into why no ins because ya know, political. Anyway, I got a neighbor to drive me to emergency room (because no ins and ambulance rides are expensive). Walked in, signed in, and told desk people I had no insurance and thought I was having heart attack because of family history and symptoms. They walked me immediately to ICU room where triage determined I was correct. Surgical team was called who must arrive within 10 minutes. During 10 minutes they shoved a bunch of forms at me to read and sign. Of course if you think you're dying you just sign anything. Called a couple relatives to tell them I might be dying. I again mentioned no insurance and was told they'll fix anybody they can and then worry about money later. Surgical team arrived, a couple stents installed, back in ICU recovery within 90 minutes of signing in at the desk (which is their standard.
Well now is later. I've got a big stack of bills with DUE NOW on them that exceed my liquid assets. Just sold the Twin Cam Nova but you can see my garage for the other cars that will be available for purchase eventually. Couldn't work at all for a couple months yet still have all the regular life maintenance bills. I've spent most of the past couple days calling billing centers regarding all the bills other than the hospital bill. I've already applied for financial review about the hospital bill. I call every two weeks about the hospital bill and the reply is "wait another two to three weeks" for a decision. Nice to be alive but......
The costs are crazy. If I get my bills straightened out before this thread gets locked I'll share them.
I'm along the same line of thinking Ian is. I told the hospital people and doctors they shoulda just kicked me to the curb.
Seems weird she's doing the go fund me thing before the operation. Not to sound like I don't sympathize, but what are the odds on surviving a combined heart/lung transplant if she has a disease that's killing her? And a million seems high even if she has no insurance.
Not mine no association. But I was it last night then saw this thread and figured I would dump some gas on the fire
In reply to bearmtnmartin:
We have fairly good healthcare insurance through SWMBO, who is a federal employee. It's not cheap for a family of 6, but it's less than it would be through most other employers for comparable coverage.
Doctor visits, including the walk-in clinics, are $25 each. My daughter went to the doctor last summer, IIRC for some female problems, and after the doctor checked her out he sent her across the parking lot to get a test run at the hospital next door(they're both part of the same hospital group). Because that test was performed in the Emergency department, we received a bill for $200 after our insurance for the ER visit its self, in addition to the test she had performed.
One other thing not brought up yet are PPOs - Preferred Provider Organizations. Basically, you chose an insurance plan that's affiliated with one of your(hopefully) local hospital networks. When you visit them, and their doctors(who aren't always one in the same), you get the predetermined discounted rate that usually results in fairly low out-of-pocket expenses. However, if you need to see a doctor who is outside of their network it will cost you $$$, unless you can get a preauthorization from your insurer.
It can be very tricky though. For example, the hospital we used was named Carle. Sometimes Care would contract with doctors from another area hospital named Provena. So just because your appointment was with a doctor inside of a Carle facility, it would not mean that doctor was in-network, which could result in significant unexpected costs. Of course these details are typically somewhere on either your insurer's or the provider's website, but it takes some work by the patient to research it and figure it all out. From my experience there is a fairly high number of people who are not capable of doing that, or understanding it, for a number of reasons. So it can definitely become a huge issue.
NOT A TA wrote: Seems weird she's doing the go fund me thing before the operation. Not to sound like I don't sympathize, but what are the odds on surviving a combined heart/lung transplant if she has a disease that's killing her? And a million seems high even if she has no insurance.
First of all, it really sucks that you're going through that. I'm truly sorry, and agree completely with you that medical costs are outrageous, with no sign of improvement on the horizon.
That being said, I'm not surprised at all that she's asking for that much. You had a fairly routine surgery that took 90 minutes and in exchange you received bills that exceed your total assets. Based on that, I don't really think 1 million seems high for several hours of surgery that's going to involve an R/R on several vital organs. If anything, it might be a little low.
Without getting too political...
We have a government that has acted in the best interest of the highest bidder and not the people of the United States so we have neither an open free market solution nor a single payer government solution.
To describe it I will steal a quote from Lt. Lockhart in Full Metal Jacket: https://www.youtube.com/embed/Db_qXKBle08?rel=0
In reply to NOT A TA:
FYI, if you pay a medical bill in partial, it stays out of collections I believe.
My Mom pays like $5/mo because her bills are close to seven figures in total.
In reply to Pete Gossett:
Speaking from recent experience, the pricing tools on provider websites are pretty crap. I had an ultrasound done on my kidneys a couple weeks ago. Capital Blue Cross (Once you figure out where the tool is) said it was 150 dollars. Actual price: $78.
Vasectomy was a few months ago. CBC tool price: $350. Actual price: $483.
So basically it gets you into the ball park... by +/- 50%, you know rounding error.
In so far as costs go. I had this conversation a little while ago where I may have suggested several Scandinavian countries may have the right idea for healthcare. The retort was that their tax rate is something like 60%. So I did math.
My effective tax rate at my previous job was 25% (Federal) for my family of 3. California state tax was a bit over 11% for my tax bracket. Add in various bits of sales tax and property tax and we're sitting probably close to 40% of my taxable income being taken in taxes even using 401k contributions as a shield. Now the kicker, I paid $668 dollars per month for my medical coverage then there's the out of pocket which was capped to $5k in network.
I was very likely closing in on the mid 50% area if I only go in quarterly checkups of one of my issues and emergencies. Honestly if I'm paying that much anyway I'd rather it go to covering more people rather than the hunt for ever increasing dividends.
Edit: It doesn't help that people like the US Congress more than insurers and drug companies.
STM317 wrote:NOT A TA wrote: Seems weird she's doing the go fund me thing before the operation. Not to sound like I don't sympathize, but what are the odds on surviving a combined heart/lung transplant if she has a disease that's killing her? And a million seems high even if she has no insurance.First of all, it really sucks that you're going through that. I'm truly sorry, and agree completely with you that medical costs are outrageous, with no sign of improvement on the horizon. That being said, I'm not surprised at all that she's asking for that much. You had a fairly routine surgery that took 90 minutes and in exchange you received bills that exceed your total assets. Based on that, I don't really think 1 million seems high for several hours of surgery that's going to involve an R/R on several vital organs. If anything, it might be a little low.
Long story but I already lost my life savings so entering the ER I had very little cash available. That's why I wrote LIQUID assets.
If she has no insurance, her hospital bill that she would actually be expected to have to pay would be roughly 10-20% of what they come up with (based on my experiences) meaning her gross bill would probably be 5-10 million before self pay deductions etc..
I would agree that a heart/lung operation could easily result in an initial bill of a million but she wouldn't have to pay that. We don't have any information about how she arrived at that number to beg for.
Huckleberry wrote: Without getting too political... We have a government that has acted in the best interest of the highest bidder and not the people of the United States so we have neither an open free market solution nor a single payer government solution. To describe it I will steal a quote from Lt. Lockhart in Full Metal Jacket: https://www.youtube.com/embed/Db_qXKBle08?rel=0
After spending 16 years in management in a healthcare system - this ^^^^. For those wanting to retract current insurance laws expecting price decreases - they will not come. Decreasing the pool of healthy folks in the insurance market will do the opposite. Doing nothing - will increase the costs of care as networks and carriers narrow their focus to maximize their own revenue/manage costs. Letting everything crash and going full blown single payer will increase your taxes and perceived costs. Things will not go back to the way they were. Lessons here - have a job with insurance. Don't be poor. Don't get sick or injured because it will make you poor. You'll probably be fine - trust me 
My son had a similar set of procedures 17 years ago and the US price at the time was around $600,000.00.
The0retical wrote: In reply to Pete Gossett: Speaking from recent experience, the pricing tools on provider websites are pretty crap. I had an ultrasound done on my kidneys a couple weeks ago. Capital Blue Cross (Once you figure out where the tool is) said it was 150 dollars. Actual price: $78. Vasectomy was a few months ago. CBC tool price: $350. Actual price: $483. So basically it gets you into the ball park... by +/- 50%, you know rounding error. In so far as costs go. I had this conversation a little while ago where I may have suggested several Scandinavian countries may have the right idea for healthcare. The retort was that their tax rate is something like 60%. So I did math. My effective tax rate at my previous job was 25% (Federal) for my family of 3. California state tax was a bit over 11% for my tax bracket. Add in various bits of sales tax and property tax and we're sitting probably close to 40% of my taxable income being taken in taxes even using 401k contributions as a shield. Now the kicker, I paid $668 dollars per month for my medical coverage then there's the out of pocket which was capped to $5k in network. I was very likely closing in on the mid 50% area if I only go in quarterly checkups of one of my issues and emergencies. Honestly if I'm paying that much anyway I'd rather it go to covering more people rather than the hunt for ever increasing dividends. Edit: It doesn't help that people like the US Congress more than insurers and drug companies.
The difference between the Scandinavian countries and us is the people get something in return for their tax dollars. We pay very close to the same percentage in little nickel/dime ways that add up but we just get more Freedom™, oh... and war stuff.
Huckleberry wrote:The0retical wrote: In reply to Pete Gossett: Speaking from recent experience, the pricing tools on provider websites are pretty crap. I had an ultrasound done on my kidneys a couple weeks ago. Capital Blue Cross (Once you figure out where the tool is) said it was 150 dollars. Actual price: $78. Vasectomy was a few months ago. CBC tool price: $350. Actual price: $483. So basically it gets you into the ball park... by +/- 50%, you know rounding error. In so far as costs go. I had this conversation a little while ago where I may have suggested several Scandinavian countries may have the right idea for healthcare. The retort was that their tax rate is something like 60%. So I did math. My effective tax rate at my previous job was 25% (Federal) for my family of 3. California state tax was a bit over 11% for my tax bracket. Add in various bits of sales tax and property tax and we're sitting probably close to 40% of my taxable income being taken in taxes even using 401k contributions as a shield. Now the kicker, I paid $668 dollars per month for my medical coverage then there's the out of pocket which was capped to $5k in network. I was very likely closing in on the mid 50% area if I only go in quarterly checkups of one of my issues and emergencies. Honestly if I'm paying that much anyway I'd rather it go to covering more people rather than the hunt for ever increasing dividends. Edit: It doesn't help that people like the US Congress more than insurers and drug companies.The difference between the Scandinavian countries and us is the people get something in return for their tax dollars. We pay very close to the same percentage in little nickel/dime ways that add up but we just get more Freedom™, oh... and war stuff.
Without patio-ing, there is another aspect here. If we didn't spend our dollars on our military, the rest of the first world would need to spend a lot more on their own militaries to keep themselves safe.
tuna55 wrote:Huckleberry wrote: The difference between the Scandinavian countries and us is the people get something in return for their tax dollars. We pay very close to the same percentage in little nickel/dime ways that add up but we just get more Freedom™, oh... and war stuff.Without patio-ing, there is another aspect here. If we didn't spend our dollars on our military, the rest of the first world would need to spend a lot more on their own militaries to keep themselves safe.
True, but it wouldn't be anywhere close to a direct 1:1 price shift, you might see other countries collectively having to pick up maybe 1/10th of what the US leaves off. The US military isn't just big enough for a reasonable level of defense and deterrence. It's big enough to single-handedly put a stop to a second outbreak of WW2. And that costs mad mad money, regardless of how much value anyone personally sees in it.
My entire family just about works in medical, so I have a bit of insight. My wife works for an internist, and they will treat you without insurance and bill you in an emergency, and he has even written off bills for people that cannot afford them, even the surgical procedures. Having said that, it is not as much of a profit center as you might imagine. They need to make $90 per patient to break even. Medicare pays $25. You can do the math to figure out who pays the bills.
My son is a medflight paramedic. These flights are not covered by most insurance plans, even medicare and Medicaid. One local flight amounts to roughly $50k in expenses. They have to charge this so there is even the ability to fly as one in 20 pays the bill for the rest. Is there a better way, probably, but we would need to change a ton of laws, including liability insurance to be able to supply this service.
We also have a family friend that owns the largest hospital in the area. It is also not the money maker you might imagine. He says on a good year, if they break even, they are doing well. I can't remember exactly how much is written off every year from folks that can't pay their bill, but it is something like $10 million. They cannot by law refuse to treat you. There are plenty of under insured people as well, and those expenses get passed along to the insurance of others. If you negotiate a cash transaction, your costs are substantially less, maybe something in the neighborhood of 75% less depending on what you need done.
The biggest problem we have is the govt. meddling in health care and mucking it up with no real understanding about what they are doing. I don't want to get political either, but I blame this on everyone in govt., no red or blue, everyone. They need to get off their duffs, work together and come up with something that works. Healthcare shouldn't be political. Insurance companies themselves are no angels either.
Right now this is a bit of sore spot with me as my sister had to have treatment for a condition that was life threatening. She has decent insurance through the state system, but they were not going to cover it. Out of pocket it was near $200k. Eventually they covered it, but it was no cake walk getting to that point. By contrast, the same treatment in India was only $30k, and she was booked to head there before the insurance company relented. She had a great doctor that actually went to the local insurance company in person to plead her case. All doctors aren't bad.
It's the out-of-control costs. It seems like anyone involved in the health care field is looking for a home run profit on every event or procedure. From the CEOs who back in the day were content to earn a very comfortable living of say $200,000 a year but now feel entitled to high 7 figures on down. Add in the ridiculous mark-ups on anything "hospital grade" (outlets and light switches that cost a buck at Home Depot become %60-$80 with a magic green dot on them). Costs are just out of control.
To put it in perspective a buddy of mine was traveling this past winter, in Cambodia he was stricken with Dengue Fever. Three days in the hospital, a real hospital with doctors, nurses, labs, IVs, antibiotics, the whole deal. When he was being discharged they presented him with his bill, inclusive for the entire stay? $275 USD What would that visit have set him back stateside? I'm guessing somewhere between nice 5 series and 3 bed/2 bath ranch money.
In reply to GameboyRMH:
Having worked for a pretty major DoD contractor in one of the most reviled areas of defense contracting (even by military industrial complex standards.) I think we can stand to scale it back a bit. Or at least put some controls on costs. I did get paid pretty well for being an A&P though.
Okay that's it on that subject.
In reply to racerdave600:
That's why we'll never get away from subsidizing those without insurance. We either pay higher insurance premiums to cover the those who can't afford to pay the whole premium or we pay more for medical care because we have to make up for all those who can't pay their bills at all.
Pre-UnACA, the wife's insurance plan was fantastic. $5 prescription co-pays for name-brand, no-deductible for generic. $0 copay doctor visits, $50 copay emergency room. Max out of pocket per year for the two of us $2500.
Bring in the UnACA and that was considered a "cadillac plan" that was subject to extra taxation. So the school district changed. Now our OOP is $5k per person, $20 generic, $75 name brand, $50 doctor visits and 10% of emergency room visits. On top of that the premiums have now quadrupled.
Basically, the UnACA may have been good for some, but hell for others. A lot of people in the same income brackets( DINKS, 75-150k/yr household income) as us seemed to have experienced the same, at least locally. I, personally, can't wait for it to go away.
NEALSMO wrote: In reply to racerdave600: That's why we'll never get away from subsidizing those without insurance. We either pay higher insurance premiums to cover the those who can't afford to pay the whole premium or we pay more for medical care because we have to make up for all those who can't pay their bills at all.
This. Sadly, many don't understand that nothing is free. That money comes from somewhere. Canadians pay it up front in higher taxes on everything and longer wait times. We pay it on the back end when we need it. We're all still paying for it, just how and when.
I agree with KyAllroad. The billing/costs at the providers are out of control and unpredictable. So, you need a procedure done, they try to get as much out of you as they can. It's like ransom. You want to live, the price is "one million dollars ¯_(ツ)_/¯". Oh, we've been asking for one million dollars for a few months, you don't have one million dollars. How about $500,000, can you get that? And on down.
Ask how much things cost in a hospital upfront and see how uncomfortable things get. They often can't or won't say. That's why those online cost estimates for healthcare don't work. Different providers will charge wildly varying amounts for the same procedure. I'm talking about providers within a few miles of each other in the same metro, not a thousand miles away. There is no ballpark on costs. We quickly learned to shop prices on things like MRIs, but I don't think a lot of people know you don't have to go to the one your doc tells you to or in that same hospital system. You can often get them for half price across the street.
This discussion is a little bit personal because there have been some cases of cancer in my family. Someone close to me has received treatment that has assuredly prolonged life, but the costs have run well into the six figures. Another person in my family chose to forgo similar treatment and died rapidly. I strongly suspect this was a conscious choice not to financially ruin his family.
I see a business opportunity for the Canadians. With the business model and infrastructure already in place, combined with the already massive buying power for supplies, if OHIP were to expand into the USA as a for profit venture, they would have the effect on the US health industry of a Walmart moving into a small town and decimating the local merchants. Nobody would be able to compete. Insurance companies would fall like flies and hospitals would be compelled to join up or go down the tubes.
Single payer like OHIP is far from perfect, but it does provide modern life sustaining medical services to those that need them without ruining them financially.
oldtin wrote: Letting everything crash and going full blown single payer will increase your taxes and perceived costs.
Assuming a full gut job and proper rebuild of the system, I'm not sure how the math could work out that way. We already spend more than everybody else.
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