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Health Care Reform is Dead

Adventurous

Starshine Bro
Mar 19, 2014
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Crawlorado

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
Cross-post from today's GMT and a reason why I have a hard time envisioning staying in this country so long as we continue to rely upon for profit insurers and a medical industry that isn't even remotely transparent about the costs of service. I'm young and healthy, I can't imagine the burden for older folks.



The bill came yesterday for the wife's trip to the clinic last month for a UTI. Her PCP was unable to see her that day and she tried to get an apt at a Planned Parenthood to no avail, so we had to settle for going to a local clinic that told her over the phone it was a $175 fee to be seen. We were there for 20 minutes, she peed in a cup, a doctor came in to give her a prescription for antibiotics and we were on our way.

That apparently becomes, in out of pocket terms:
Doctor fee = $197
Urology lab = $75
Clinic fee = $4,600

Almost $5,000 out of pocket billed to me for a single urine test, 20 minutes sitting in a bed, and a prescription. This better be a fuck of of epic proportions on their end otherwise I'll be seeking every single possible avenue, legal or otherwise. That's ridiculous beyond ridiculous.
Whatever happened with this?
 

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
As I see bills rolling in from my broken thumb I notice 2 things. I have no visibility to what things are going to cost and there is no consistency from hospital to hospital.

My latest MRI cost (my insurance) $1200. Last time I took a ride in the tube of dystopian noises it cost $8K. Mind boggling how the same process can cost more than 6 times from one hospital to another. The $8K ride was in an emergency situation so I guess the law of supply and demand so I guess my demand was a hell of a lot higher.

When I went in for hand surgery I was told that my anesthesia was offered through a different doctor and will be billed separately. I have no idea if my insurance will cover it or how much it would cost. I was offered the opportunity to make some phone calls to check but it was literally 5 minutes before I went into surgery. I would have had to reschedule and possibly pay cancellation fees if I was going to check.
 

Adventurous

Starshine Bro
Mar 19, 2014
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Crawlorado
Whatever happened with this?
We are now in the process of contesting the charges. The clinic has confirmed that the billing charge is correct and maintains that they have always been an ER and that the person my wife spoke to must have been mistaken (oopsies, my bad, now you owe $5K!). Of course it took 30 days to verify that the billing code was correct, another 30 days to submit a dispute, and another 30 days for them to make a decision on the matter. So at the present we are still on the hook for a $5K bill and I have a bad feeling that they DGAF what the woman who answered the phone said about the visit fee.
 

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
We are now in the process of contesting the charges. The clinic has confirmed that the billing charge is correct and maintains that they have always been an ER and that the person my wife spoke to must have been mistaken (oopsies, my bad, now you owe $5K!). Of course it took 30 days to verify that the billing code was correct, another 30 days to submit a dispute, and another 30 days for them to make a decision on the matter. So at the present we are still on the hook for a $5K bill and I have a bad feeling that they DGAF what the woman who answered the phone said about the visit fee.

At least it gives you time to collect 500,000 ass pennies.
 

Adventurous

Starshine Bro
Mar 19, 2014
10,921
10,062
Crawlorado
As I see bills rolling in from my broken thumb I notice 2 things. I have no visibility to what things are going to cost and there is no consistency from hospital to hospital.

My latest MRI cost (my insurance) $1200. Last time I took a ride in the tube of dystopian noises it cost $8K. Mind boggling how the same process can cost more than 6 times from one hospital to another. The $8K ride was in an emergency situation so I guess the law of supply and demand so I guess my demand was a hell of a lot higher.

When I went in for hand surgery I was told that my anesthesia was offered through a different doctor and will be billed separately. I have no idea if my insurance will cover it or how much it would cost. I was offered the opportunity to make some phone calls to check but it was literally 5 minutes before I went into surgery. I would have had to reschedule and possibly pay cancellation fees if I was going to check.
So long as healthcare providers and insurers can conceal and manipulate the cost of care, healthcare costs will continue their meteoric growth rate (and of course the asinine burden of end-of-life care which is only going to increase as the baby boomer generation ages and begins needing this treatment).

https://www.theatlantic.com/health/archive/2015/05/the-agony-of-surprise-medical-bills/393785/

It shouldn't take a master's education in health policy to be able to decipher and understand the costs associated with any given procedure. It's downright disingenuous and inane to claim that people should be more responsible in reducing the cost of their healthcare and burden to the system when it's almost literally impossible to do so.

It is, as I'm sure both parties would agree, an unsustainable situation. Perhaps I'm just not smart enough or well versed in the nuances of health policy, but I can't see a solution that doesn't involve single payer.
 
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Jm_

sled dog's bollocks
Jan 14, 2002
20,416
10,890
AK
When I went in for hand surgery I was told that my anesthesia was offered through a different doctor and will be billed separately. I have no idea if my insurance will cover it or how much it would cost. I was offered the opportunity to make some phone calls to check but it was literally 5 minutes before I went into surgery. I would have had to reschedule and possibly pay cancellation fees if I was going to check.
You might have a pretty solid legal case against them for that.
 

Jm_

sled dog's bollocks
Jan 14, 2002
20,416
10,890
AK
So long as healthcare providers and insurers can conceal and manipulate the cost of care, healthcare costs will continue their meteoric growth rate (and of course the asinine burden of end-of-life care which is only going to increase as the baby boomer generation ages and begins needing this treatment).

https://www.theatlantic.com/health/archive/2015/05/the-agony-of-surprise-medical-bills/393785/

It shouldn't take a master's education in health policy to be able to decipher and understand the costs associated with any given procedure. It's downright disingenuous and inane to claim that people should be more responsible in reducing the cost of their healthcare and burden to the system when it's almost literally impossible to do so.

It is, as I'm sure both parties would agree, an unsustainable situation. Perhaps I'm just not smart enough or well versed in the nuances of health policy, but I can't see a solution that doesn't involve single payer.
Who knew health care was so complex?
 

Adventurous

Starshine Bro
Mar 19, 2014
10,921
10,062
Crawlorado
I'm greatly enjoying hearing that _________ (insert program that benefits minorities or poor people) is socialism and immoral but the "redistribution" of Medicaid funds helps to "increase parity". Yea, OKAY Lindsay Graham. GFY.
 

Montana rider

Tom Sawyer
Mar 14, 2005
1,974
2,709
it's clearly not over yet (looking at you Collins, Murkowski, and Paul) but a bummer McCain couldn't do a reprise of this...


and a Zapruder version:


Watching that rat-fucker McConnell melt as he realizes what just happened made watching CSPAN almost worthwhile last go round...
 
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StiHacka

Compensating for something
Jan 4, 2013
21,560
12,509
In hell. Welcome!
When I went in for hand surgery I was told that my anesthesia was offered through a different doctor and will be billed separately. I have no idea if my insurance will cover it or how much it would cost. I was offered the opportunity to make some phone calls to check but it was literally 5 minutes before I went into surgery. I would have had to reschedule and possibly pay cancellation fees if I was going to check.
This is a pretty standard practice here is mazzholistan, with the exception of the part that you have been notified and able to make some calls before the surgery began. I got bitten by this bullshit, too - here in Mass, pretty much all the physicians in the ERs are contractors and out of networks. They'll only tell you that when you get the bill.
 

Toshi

butthole powerwashing evangelist
Oct 23, 2001
40,082
8,982
This is a pretty standard practice here is mazzholistan, with the exception of the part that you have been notified and able to make some calls before the surgery began. I got bitten by this bullshit, too - here in Mass, pretty much all the physicians in the ERs are contractors and out of networks. They'll only tell you that when you get the bill.
Old but relevant

https://mobile.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?referer=http://www.motherjones.com/kevin-drum/2014/09/great-out-0f-network-scam-eating-patients-alive-and-its-supposed/
 

Adventurous

Starshine Bro
Mar 19, 2014
10,921
10,062
Crawlorado
So Doc, as one of the few folks round these parts who can actually speak first hand to the healthcare industry and it's billing practices, how do we get out of this mess? Is single payer the only way? Seems to the rest of us who didn't know healthcare could be this complicated that so long as there's a healthy profit to be made, there will continue to be this cycle of back channel deals and a lack of transparency that screws the consumer.
 

StiHacka

Compensating for something
Jan 4, 2013
21,560
12,509
In hell. Welcome!
Aaand the distilled root cause of the issue: The surprise charges can be especially significant because, as in Mr. Drier’s case, they may involve out-of-network providers who bill 20 to 40 times the usual local rates and often collect the full amount, or a substantial portion.

I hope those fuckers will all burn in hell, no sympathy for these greedy predators whatsoever.
 

StiHacka

Compensating for something
Jan 4, 2013
21,560
12,509
In hell. Welcome!
So Doc, as one of the few folks round these parts who can actually speak first hand to the healthcare industry and it's billing practices, how do we get out of this mess? Is single payer the only way? Seems to the rest of us who didn't know healthcare could be this complicated that so long as there's a healthy profit to be made, there will continue to be this cycle of back channel deals and a lack of transparency that screws the consumer.
It could start with a much simpler legalization that would require that no care is catered by out-of-network or not-covered-by-existing insurance without an explicit consent of the patient. But, how would those poor fuckers pay for their country club membership and 57ft boats? There's too much lobbying in place, just like with the broken dental care system caused by the power of the American Dental Association.
 

Toshi

butthole powerwashing evangelist
Oct 23, 2001
40,082
8,982
I think single payer is the answer. Has to be national, though, else the destitute will flock to states with it.
 

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
All my bills have come in for surgery. Luckily everything was covered by insurance. "Billed" amount was about $5500 but with discounts actual cost was a little more than half that. Pretty damn cheap IMO. That covered a surgeon, two nurses, anesthesiologist, operating room and associated equipment for an hour plus pre-op and post-op care. All less than it costs for Adventurous's wife to get an antibiotic prescription.

Despite what I would consider to be significant event the insurance company is still making a good profit on my policy this year.
 

AngryMetalsmith

Business is good, thanks for asking
Jun 4, 2006
22,244
13,106
I have no idea where I am
All my bills have come in for surgery. Luckily everything was covered by insurance. "Billed" amount was about $5500 but with discounts actual cost was a little more than half that. Pretty damn cheap IMO. That covered a surgeon, two nurses, anesthesiologist, operating room and associated equipment for an hour plus pre-op and post-op care. All less than it costs for Adventurous's wife to get an antibiotic prescription.

Despite what I would consider to be significant event the insurance company is still making a good profit on my policy this year.
$5500, is that the total cost billed to your insurer ?

My ER visit and follow up shots for rabies was around $8K billed to my insurance company. No surgery, just needles, lots and lots of icky, creepy fucking needles, NEEDLES. Fucking feral cats...
 

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
$5500, is that the total cost billed to your insurer ?

My ER visit and follow up shots for rabies was around $8K billed to my insurance company. No surgery, just needles, lots and lots of icky, creepy fucking needles, NEEDLES. Fucking feral cats...
That was list price. Actual cost was less than $4k.
 

JohnE

filthy rascist
May 13, 2005
13,562
2,208
Front Range, dude...
I was seen "on the economy" while in Germany several times. Never was the treatment anything less than exemplary, nor were the facilities anything less than perfect. I lost track of how many MRIs I had, and shudder to think what they would have cost here in the States. My daughter was born in a German hospital, and the post natal care that she got, after being 30+ days premature and having a tiny hole in her heart, was incredible. The point here, is why do so many other countries get health care right, while we cannot?

The answer is the pharma and medical lobbies who refuse to loosen their grips on both our wallets and our elected officials. The medical problems that Americans face are no different than other countries (Exception being the obesity epidemic...) yet other countries regulate pharma and watch over doctors to ensure they arent rucking fidciculous.

I know, nothingnew that hasnt been detailed many times over in this and many other threads...
 

Jm_

sled dog's bollocks
Jan 14, 2002
20,416
10,890
AK
The answer is the pharma and medical lobbies who refuse to loosen their grips on both our wallets and our elected officials. The medical problems that Americans face are no different than other countries (Exception being the obesity epidemic...) yet other countries regulate pharma and watch over doctors to ensure they arent rucking fidciculous.

I know, nothingnew that hasnt been detailed many times over in this and many other threads...
Exactly this. Once business is formed, it cannot be destroyed. Think of the jerbs.