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scaredyKat
Member
Member # 25560
Default  Posted: 8:57 PM, November 4th (Monday)

One requires medical care, say a serious illness, an emergency of some kind? How do people get the care they need? Do hospitals eat the cost? Under what circumstances will they give charity care?

I'm needing some ammunition here for an argument...


Me-BS-60-Can't tell you how painful it was to change this number!
HIM-SAFWH-63
Damn autocorrect is responsible for the silly errors, sorry!

Posts: 3278 | Registered: Sep 2009 | From: In my head
StrongerOne
Member
Member # 36915
Default  Posted: 10:29 PM, November 4th (Monday)

You go to the ER. You get cared for. At some point they send you away. You may not get all the care you would get if you had insurance. And in any case, you still owe money. Lots and lots and lots of money. A major factor in bankruptcy in this country is medical bills.

Here are examples from my own experience as to why you want health insurance.
1. In getting approved for life insurance increase, I have to get an EKG. Just a formality, they say. Not if you have a wierd EKG! Which I didn't know before. Get it checked out because now I can't get life insurance, and if I have to buy my own health insurance w a job change I'm screwed. See my doc for another EKG, other tests = $$. Referred to cardiologist who, after tests, says, you have a wierd EKG but you have no heart problems. Here's a letter you can use for insurance. = $$$$

2. Seven year old son has strange issues at well child check up. Sees specialists. Has MRI. Hustled off to oncologist. Six years of chemo, outpatient surgery, specialists, MRI, other lab work, emergency room visits, etc etc. We're talking SIX FIGURE bills. Hassle with insurance company but they come through, thank god, because we do not earn six figures.

If we had to pay out of pocket, there was an 18 month stretch where the chemo alone was $50 K a month (doesn't include all the other bills). This is a kid who has never spent a night in the hospital -- all outpatient. We consider ourselves very fortunate.

We would consider ourselves homeless if we did not have health insurance, and I do not exaggerate.

Get health insurance. Please.

[This message edited by StrongerOne at 10:30 PM, November 4th (Monday)]


DDay Feb 2011.
In R.

Posts: 840 | Registered: Sep 2012
TrustedHer
Member
Member # 23328
Default  Posted: 10:31 PM, November 4th (Monday)

Due to a federal law known as EMTALA, if you show up at an emergency room in need of treatment (or in active labor), they are required to treat you, whether you can pay or not.

That doesn't necessarily mean take care of your condition, it means stabilize you and refer you to "normal" treatment.

This is one of the reasons for the high prices of medical care. About 50 to 80 percent of the ER patients won't pay a dime, and the rest of us pick up the difference.

Hospitals have an entire army of counselors who know the ins and outs of costs, subsidies, charity, medicaid, etc., so they can find ways to get the follow-up care taken care of. Of course, those counselors get paid, too, which adds to the overall cost.

Hospitals budget a certain amount of charity care, and that varies depending on the hospital, and whether it's for-profit, not-for-profit, county, religious, etc. Also, doctors who are here on J-1 visas are required to justify their visa by providing a certain amount of charity or pro bono work. There are a lot of J-1 doctors.

If you get the treatment, and get a bill, and refuse to pay, the worst they do is pursue you through collection agencies.

They write off millions in bad debt every year.


Take care of yourself. There's a great future out there. It won't come to you; you have to go to it.

Posts: 5115 | Registered: Mar 2009 | From: DeepInTheHeartOf, TX
Kajem
Member
Member # 36134
Default  Posted: 11:25 PM, November 4th (Monday)

Many years ago we had an insurance glitch-the renewal did not start right away, we had a weekend without insurance. I delivered (by emergency c-section) DD. We were covered when insurance started up, 48 hours AFTER she was born! I was looking at $80.000 in hospital bills. They wrote off over half immediately, set up a payment plan $125 a month and in 2 years time adjusted the balance several times. We paid about $10,000, they wrote off the rest. We weren't bad debt-never showed I our credit rating.

It was a stressful time for me, I had 4 young children and was afraid to take them to the ER in case we were refused treatment and needed it. Nice to know that isn't going to happen.


I trust you is a better compliment than I love you, because you may not trust the person you love, but you can always love the person you trust. - Unknown
Relationships are like sharing a book, it doesn't work if you're not on the same page.

Posts: 4847 | Registered: Jul 2012 | From: Florida
neverendinghurt
Member
Member # 15859
Default  Posted: 1:45 AM, November 5th (Tuesday)

Those "written off" debts get passed onto everyone else.


The life of every man is a diary in which he means to write one story, and writes another; and his humblest hour is when he compares the volume as it is with what he vowed to make it.
James M. Barrie

Posts: 26034 | Registered: Aug 2007 | From: Seattle
scaredyKat
Member
Member # 25560
Default  Posted: 2:01 AM, November 5th (Tuesday)

All good points. Keep 'em coming...I need to win this disagreement with a family member. It's not political, but practical and moral. Thanks.


Me-BS-60-Can't tell you how painful it was to change this number!
HIM-SAFWH-63
Damn autocorrect is responsible for the silly errors, sorry!

Posts: 3278 | Registered: Sep 2009 | From: In my head
NaiveAgain
Member
Member # 20849
Default  Posted: 2:03 AM, November 5th (Tuesday)

How do people get the care they need?
Many don't and that is why they end up in the hospital in serious condition.

Without insurance, most won't go see a doctor until the illness is so severe it lands them in the hospital.

Public hospitals have to take care of anyone who is seriously ill but private hospitals do not and many will not. Many will reroute patients to other hospitals or there are some that will throw the patient out once they cannot pay or their insurance runs out.

Charity care is given on a financial need basis. If you are in need of hospitalization and you are considered "financially disadvantaged" many times public hospitals will write off the bill or will pro-rate it for the patient.

However, hospitals only treat the medical emergency and if you end up with a chronic illness, it can be very difficult to find any after-care. Some pharmaceutical companies, though, will help you with the affordability of their product if you show financial need and have a doctor show that you need their medication.


Original WS D-Day July 10, 2008. Kept lying, he is gone.
New WS (2 EA's, no PA) 12-3-13
If you don't like where you are, then change it. You are not a tree.

Posts: 15100 | Registered: Aug 2008 | From: Ohio
Pentup
Member
Member # 20563
Default  Posted: 9:12 AM, November 5th (Tuesday)

Think a broken arm is an emergency? Not necessarily. The ER will often not cast it and refer to an ortho. Believe me, the doctors office that sets that arm. They are going to get paid or your credit will take a big hit.

A slip in ice resulting in a torn rotator cuff? Could result in a surgery that costs $40,000. It is an output procedure. Or you will live withit until you can almost can not move your arm and it will hurt always.

My frustration is when folks have a new car, iPhone, smoke heavily and can not "afford" insurance.

Backing out now so I do not violate guidelines.


Me- BS
Him- FWS (I hope- F)

Posts: 6421 | Registered: Aug 2008 | From: Not Oz
tushnurse
Member
Member # 21101
Default  Posted: 12:50 PM, November 5th (Tuesday)

ScaredyKat - I assume we are talking here in the USA.

It is true that EMTALA prevents hospitals from turning folks away in the ER, or once that patient is admitted. Once in the hospital here come the Case Managers/Social Workers and their team. They help to determine why you don't have health insurance.
Usually you fall into one of these categories.

1. Unemployed, and can't afford it on your own, but are looking for work, and will get it as soon as you do get work.

2. Too sick to work, too uneducated to navigate the system on your own, or lack the drive to, and actually will qualify for some sort of government assistance.

3. The guy that makes good money, is fairly healthy and just chooses to go without it.

For #1 the Hospitals will assist the patient in working out a payment plan, and place them on a charitable payment system, which is usually much less than what the insurance companies are billed. These folks usually get assistance with other things too while there, an application for food stamps, info on how to get any maintenance meds for free, housing and utility assistance etc.

#2. These folks are usually walked through the Medicaid applications, and placed in the "Medicaid Pending" catagory. The hospital holds billing or does not expect payment from the patient until the Pending is resolved to either on Medicaid, or Medicaid ineligbile. These are the ones that the hospital ends up eating the cost, because these are frequently the folks that don't have an extra cent to their name, and are getting government assistance for other things already.

3. This guy is probably a real genius UNLESS he gets Cancer, or some other ongoing illness. This guy knows that he can Barter his costs, and does, and pays for his healthcare. Often this ends up being a win win for everyone. He pays for just the services he needs, not monthly premiums, and copays, and deductibles, and the hospital, or MD, or service he is using doesn't have to submit billing to insurance, deal with denials, and wait for payment which often takes more than 90 days on complicated claims.

Of course under the "Affordable Healthcare Act" scenario number 3 is now illegal for the patient.


Me: FBS
Him: FWS
Kids: 15 & 17
Married for 22 years now, was 16 at the time. .
D-Day Sept 26 2008
Fully R'd, and Happy Happy Happy

Posts: 7797 | Registered: Oct 2008 | From: St. Louis
StrongerOne
Member
Member # 36915
Default  Posted: 8:32 PM, November 5th (Tuesday)

Tush nurse (love yr username btw!),
#3 is in good shape as long as he is fortunate and reasonably healthy. Unexpected serious and/or chronic illness, expensive. (Cancer obviously, but also diabetes, migraine, fibromyalgia ...) Sports injury, say, can be expensive in the short term (ER or ortho, cast or boot or brace, minor surgery) and in the long run too (continuing pain, physical therapy, likelihood of reinjury). Anything weird or mysterious that requires multiple visits to multiple specialists -- expensive. Psychiatric problems -- expensive. For example, my sister is BP, difficult to control with meds and lots of IC needed -- her XH didn't file for divorce until she had a job with good health insurance, despite the fact that she had a longterm EA. If he hadn't she would have been in a very bad place. (The man was a saint and my sister was a fool, but that's a different story!). And, everybody gets older. Older = even routine health care gets more expensive, and more things are likely to go wrong.

I'll add too that you don't have to be old for unexpected expensive things to happen. There's my son, for example. There's the college student I work with, who had an idiopathic collapsed lung last month. There's my twenty-something colleague who has the BRCA gene and a mom who died young of breast cancer. Even a bout of food poisoning can rack up scary bills -- college friend was hospitalized because she became badly dehydrated.

[This message edited by StrongerOne at 8:44 PM, November 5th (Tuesday)]


DDay Feb 2011.
In R.

Posts: 840 | Registered: Sep 2012
rachelc
Member
Member # 30314
Default  Posted: 6:08 AM, November 7th (Thursday)

our 24 year old married DD is without health insurance. Her husband has it at his job but to add her would be too expensive for them. So, they are rolling the dice. And breaking the law.
My husband texted them both this last night and he hates it that her husband isn't making health insurance a priority for his DD. She has lost two jobs in the last year and just works part time.
Hubby is sick about it. I say let them fail, what can we do anyway?

His caretaking needs are out of control and she is being very naive.
oh well...


his Ddays: 2/10, 7/11
my Ddays: 1/12, 4/12 broken NC 12/12

me: 48
him: 51
4 kiddos in lower 20's

“Slide the weight from your shoulders and move forward. You are afraid you might forget, but you never will. You will forgive and remember."


Posts: 4501 | Registered: Dec 2010
Lucky2HaveMe
Member
Member # 13333
Default  Posted: 6:29 AM, November 7th (Thursday)

Rachelc - you can carry your dd on your insurance until she is 26 even if she is married. Would that be a possibility for you?

Healthcare shouldn't be tied to employment. The medical care you receive should not be dependent upon the job you have or how much money you have.

Stopping cause this can quickly go against the guidelines if I continue!


Indian wisdom says our lives are rivers. We are born somewhere small and quiet and we move toward a place we cannot see, but only imagine. From Tending Roses

Posts: 5999 | Registered: Jan 2007 | From: WNY
authenticnow
Moderator
Member # 16024
Default  Posted: 6:35 AM, November 7th (Thursday)

RachelC,

Our DS is on our insurance and isn't a student and doesn't live with us. Lucky is right, this will be until he turns 26.


Take up your space (and do it well).

"That's the thing about pain, it demands to be felt."


Posts: 36620 | Registered: Sep 2007
tushnurse
Member
Member # 21101
Default  Posted: 7:24 AM, November 7th (Thursday)

Rachelc they are correct you can carry her, and it is probably cheaper for you all to put her on your plan, esp if you are already pay for family. I would just as her to pay for her % of the premium.


Me: FBS
Him: FWS
Kids: 15 & 17
Married for 22 years now, was 16 at the time. .
D-Day Sept 26 2008
Fully R'd, and Happy Happy Happy

Posts: 7797 | Registered: Oct 2008 | From: St. Louis
rachelc
Member
Member # 30314
Default  Posted: 10:23 AM, November 7th (Thursday)

omg - really!! Thank you. we will look into this.


his Ddays: 2/10, 7/11
my Ddays: 1/12, 4/12 broken NC 12/12

me: 48
him: 51
4 kiddos in lower 20's

“Slide the weight from your shoulders and move forward. You are afraid you might forget, but you never will. You will forgive and remember."


Posts: 4501 | Registered: Dec 2010
Skye
Member
Member # 325
Default  Posted: 10:44 AM, November 7th (Thursday)

Was about to offer RachelC the same advice, but in a pm in case it was thought political!

Posts: 5610 | Registered: Jul 2002
sisoon
Member
Member # 31240
Default  Posted: 11:51 AM, November 7th (Thursday)

On paying your own way without insurance...

I had outpatient rotator cuff surgery a few years ago, pre-Medicare. IIRC, the total bill was about $25K-$30K. My employer-provided insurance paid about $8500. I paid about $1500.

If I paid my own way, I expect I might have gotten them down to $10,000 (the sum of what my insurance and I paid), but most people don't seem to fight hospitals very effectively.

You can't control what nasty microbes you get exposed to, and you can't control the driver or bike rider who hits you. And there's no way to reduce the probability of a stroke or heart attack to zero.

You probably can't entirely avoid the ER - your doctor's offices are probably open for 1/4-1/3 of a week - the probability is, if you have an emergency, your doc's office will be closed, and you'll be directed to an emergency room.

Too many self-insured people end up using hospitals. When the demands on their finances are too great, the rest of us pick up the tab.

Of course insurance companies make money. That means more money is collected from insures to pay for health care on average than is actually paid out. The problem is that just a little bad luck without insurance can bankrupt most of us.


fBH (me) - 65+, fWW (her) - 65+, Married 45+, together since 1965
DDay - 12/2010
Recovered, not yet fully R'ed
I share my own experience because it's the only experience I know, not because I'm a good model.

Posts: 9757 | Registered: Feb 2011 | From: Chicago area
Eranda
Member
Member # 6010
Default  Posted: 8:59 PM, November 7th (Thursday)

Every single person in America should read this:

http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf

We need to understand WHY our health care costs are so astronomical, and what can and should be done to keep them in check.

Until people understand how medical services are billed, a discussion about health insurance in any form is useless. Discussing health insurance without first controlling costs is ludicrous.

With that said... a number of years ago I had a tubal ligation in a local hospital. I had company health insurance that covered it. I paid my premiums. I expected to be billed for 10% of the cost, as per my health insurance contract.

A few months after the procedure, I got a bill in the mail for $11k. The bill said that my insurance wasn't valid. Of course I called the hospital and told them that I did indeed have valid insurance. Turns out they had billed my OLD insurance company in error, and the old company denied the claim, of course.

So I gave them the correct information, and waited. A month later, I get a bill in the mail for $11k. I call the hospital and they say that my current insurance denied the claim because it wasn't submitted within the time frame they require. I called the insurance company and they said that was bullshit- that as long as you had valid insurance on the day of the procedure, they had to cover it. I called the hospital back and gave them the contact number of the person to get in touch with for information about how to re-submit the claim.

A month later, I called to make sure everything was OK because I hadn't gotten a bill for my portion of the cost. They said that they insurance had denied the claim AGAIN, and that they hospital had just "written off" the costs.

I asked why on earth they would do that, because I HAD insurance that was legally obligated to pay that bill per the contract and the premiums I'd paid. They lady from the hospital told me that I shouldn't worry about it because my bill was now $0. I said I didn't care about that, I had paid premiums for a YEAR so that my bills would be PAID. That in effect, the insurance company had violated the contract by taking my money and not paying for my treatment. That the hospital was entitled to that money for services they provided and that I had already paid to cover.

And the lady from the hospital just kept asking me why was I concerned since my bill was now $0?

Absolutely maddening.

And don't fool yourselves by thinking that "everyone" pays the costs of uninsured patients who go to the ER. Oftentimes the actual costs to the hospital are very low, and they use those inflated write-offs to maintain their non-profit status.


My Blog: http://allofthewaystohell.com/

Posts: 4222 | Registered: Dec 2004 | From: eastern PA
sisoon
Member
Member # 31240
Default  Posted: 11:38 AM, November 8th (Friday)

Wow, Eranda.

Similar experience - my Mom went to an ER when she was visiting us from out-of-state. She gave the hospital her insurance card to copy. The @#$% hospital kept billing our local Blue Cross, who, of course, kept denying the claim. It took several letters and phone calls to get the idiots off her back. But that was only a tenth of what they wrote off in your case.

This sort of incompetence is compounded by the fact that when hospitals write bills off, they get to call it charity.

Thanks for the link to the article. You're right - it's an article that we all ought to read by next Halloween.

Oh, yeah. After my rotator cuff surgery, I had a respiratory infection on a weekend and was directed to the ER. My bill included $136 for 2 generic Tylenol-3 tablets.... I left with a script for 20 Tylenol-3, which I filled for less than $10.

[This message edited by sisoon at 2:19 PM, November 8th (Friday)]


fBH (me) - 65+, fWW (her) - 65+, Married 45+, together since 1965
DDay - 12/2010
Recovered, not yet fully R'ed
I share my own experience because it's the only experience I know, not because I'm a good model.

Posts: 9757 | Registered: Feb 2011 | From: Chicago area
Cally60
Member
Member # 23437
Default  Posted: 4:16 PM, November 8th (Friday)

To those who are interested in this, I highly recommend the recent documentary The Waiting Room. (Netflix now has it on DVD.)

It was filmed in the ER department of Highland hospital in Oakland, California, which is in an area where many of the local residents don't have insurance.


Posts: 2083 | Registered: Mar 2009
wifehad5
Moderator
Member # 15162
Default  Posted: 4:36 PM, November 8th (Friday)

The bill said that my insurance wasn't valid. Of course I called the hospital and told them that I did indeed have valid insurance. Turns out they had billed my OLD insurance company in error, and the old company denied the claim, of course.

I don't think this is anything new. When I was a kid, I had to have quite a few surgeries. I was covered under my Dad's insurance, but my Mom had BCBS that was secondary coverage. The hospital continually ignored my Dad's insurance and always billed BCBS first, which would be denied

It took well over a year to get straightened out.


FBH - 42
FWW - 43 (BrokenRoad)
2 kids 7&12

The people you do your life with shape the life you live


Posts: 36469 | Registered: Jun 2007 | From: Michigan
StrongerOne
Member
Member # 36915
Default  Posted: 4:50 PM, November 8th (Friday)

Yes, insurance and hospital billing screw ups have been around since the dinosaurs

When I was in grad school (when dinosaurs roamed the earth), i had insurance provided through the university. U has a med school and hospital. So this is all right in the neighborhood, literally and financially.

Go in for minor health issue. I get EOBs, but no bill. I call. No bill -- don't worry, don't pay until you get the bill. Nice idea, until it went to collections...

One hospital and associated lab near us screwed up insurance claims with so many errors on our son's claims that we had to laugh about it (we also stopped going there): wrong name. Wrong policy number. Wrong date of birth several times -- once he was apparently a newborn (in fourth grade!) and once he was 58 years old. Wrong procedure billed for (in general, 8 year old boys do not need obstetric care).

[This message edited by StrongerOne at 4:52 PM, November 8th (Friday)]


DDay Feb 2011.
In R.

Posts: 840 | Registered: Sep 2012
karmahappens
Member
Member # 35846
Default  Posted: 5:33 PM, November 8th (Friday)

My MIL worked at a dry cleaners for many years. They employeed a woman under the table who was not a legal immigrant. Her sister had mass health and the entire family of women ( six that we knew of) all shared her card and took on her identity when making hospital trips.

Both my kids, DD 23 and DS 25 are on our insurance....like the others said, until 26

[This message edited by karmahappens at 5:34 PM, November 8th (Friday)]


“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom”
Anaïs Nin
Me: 45
Him: 47
Dday 8/2007
We have R'd

Posts: 3772 | Registered: Jun 2012 | From: Massachusetts
karmahappens
Member
Member # 35846
Default  Posted: 5:48 PM, November 8th (Friday)

sorry for t/j

rachel go here

http://www.aphis.usda.gov/mrpbs/hr/benefits/downloads/faq_health_reform.pdf


“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom”
Anaïs Nin
Me: 45
Him: 47
Dday 8/2007
We have R'd

Posts: 3772 | Registered: Jun 2012 | From: Massachusetts
scaredyKat
Member
Member # 25560
Default  Posted: 5:50 PM, November 8th (Friday)

T/j NP... I'm enjoying the conversation. I have some stories of my own along the same lines...


Me-BS-60-Can't tell you how painful it was to change this number!
HIM-SAFWH-63
Damn autocorrect is responsible for the silly errors, sorry!

Posts: 3278 | Registered: Sep 2009 | From: In my head
karmahappens
Member
Member # 35846
Default  Posted: 6:42 PM, November 8th (Friday)

I have some stories of my own along the same lines...

It makes me


“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom”
Anaïs Nin
Me: 45
Him: 47
Dday 8/2007
We have R'd

Posts: 3772 | Registered: Jun 2012 | From: Massachusetts
sisoon
Member
Member # 31240
Default  Posted: 1:19 PM, November 9th (Saturday)

The link posted originally is to a copy of the Time magazine article from a couple of years ago.

Most of us know hospital billing only from our own experience. The article is an overview of the problems and the causes.

I urge everyone to gird up their loins and read it. And, if you find the article disturbing, pass it on to people who can make a difference.


fBH (me) - 65+, fWW (her) - 65+, Married 45+, together since 1965
DDay - 12/2010
Recovered, not yet fully R'ed
I share my own experience because it's the only experience I know, not because I'm a good model.

Posts: 9757 | Registered: Feb 2011 | From: Chicago area
StillGoing
Member
Member # 28571
Default  Posted: 7:54 PM, November 10th (Sunday)

Our son was considered a pre-existing condition the insurance didn't want to cover.. the hospital bills for his birth. That was a lawl.

If you do not have insurance, you do not get basic or preventative care. You do not get access to medication unless you are covered under a government plan or they have a generic you can afford (one of mine does not have a generic and a 1 month supply at a 1/3 dose costs $500, so without insurance I do not have those meds). Without insurance some doctors offices, if they are kind, will cut a deal for direct pay when it comes to basic and preventative care, but those bills mount quickly and if you are in a position where insurance is a problem, then a hundred bucks here, fifty there, three hundred for something else is probably going to be a major issue.

If you are seriously injured and do not leave the hospital AMA before the costs get into the 5 digits you are still responsible for those bills unless the hospital elects to voluntarily cut some deal. They're likely to sell or farm out delinquent payments to collections or finance departments, who can and likely will bring you to court, for which you will have to pay as well. If you happen to have a job that pays crap and offers no insurance they can take a % from your wages, which you probably couldn't afford before anyway. So the best thing to do is declare bankruptcy and fuck over everyone else involved so you don't get fucked over for life. As an anecdote, the worst I heard was a woman who was shot during a home invasion and was subsequently terminated because she couldn't perform her job function, and losing her job meant losing her insurance, which meant all those bills that piled up because things like shattered bones thanks to bullets don't get all healed up with a single Cure Light Wounds and tend to require weeks and months of treatment, but when your insurance runs out a week in, that sucks. She declared bankruptcy from what I heard.


The insurance my company uses has a magic deductible. By magic I mean they turn a profit.

A family deductible is $3500. That, however, has to be cumulative for a single member before it is cleared for the entire family. We have the 4 of us here and that means one of us has to hit the 3500 ceiling before the deductible is cleared for everyone. A few years ago during a particularly bad year we paid out of pocket more than ten grand before that was met. On top of that they take more than five grand a year out of my pay; ultimately I worked out that of the 15,000 in medical bills we paid, they covered less than what they took out of my paycheck for the year, which meant at the end, we quite literally paid an insurance company for the privilege of being sick.

That's not even looking at the horse shit where they intentionally refuse coverage on things they blatantly should cover just to see what they can get away with not paying.

The problem is not the hospitals, doctors or healthcare industry, it is 100% with the insurance industry, which does not have to adhere to the same regulations healthcare does, but gets most of the exemptions and benefits.


“Fate is a fickle bitch who dotes on irony.”

Posts: 7363 | Registered: May 2010 | From: USA
Pentup
Member
Member # 20563
Default  Posted: 9:02 AM, November 11th (Monday)

I beg to differ. It is not solely on the insurance companies. There needs to be torte reform on malpractice and serious consequences for bad/dangerous healthcare staff. Kansas has/had? A good model for this. Until GOOD physicians can practice to the best of their ability without being sued or under threat of suit, then unnecessary testing, etc will continue to occur. Until those who are scamming insurance and disability for injuries that really do not prevent them from working at some level are held accountable, then everyone who works within the systems are going to pay.

There does need to be reform, but it needs to be in many areas, not just one. Personally, I think it starts with realistic expectations, self care, personal responsibility and knowledge by the consumer. (I do not work for an insurance company. ).

I know I am in a minority, but I do not think full service healthcare is a right. Nor do I think basic healthcare is a privilege.


Me- BS
Him- FWS (I hope- F)

Posts: 6421 | Registered: Aug 2008 | From: Not Oz
sisoon
Member
Member # 31240
Default  Posted: 2:30 PM, November 11th (Monday)

Sorry, the last I heard, the Congressional Budget Office and other economists who look at medical costs estimate malpractice at 1%-2% of the total medical costs. It's a trivial part of the equation, and protecting docs against malpractice claims will result in only a trivial cost savings, if any.

Health insurance for large groups can be quite good. The health insurance market for individuals can be treacherous. For example, individuals whose policies are cancelled because they don't comply with the ACA are being enrolled automatically in the insurer's high cost plans, even though much cheaper and often better policies are available through the exchanges, although that doesn't help right now if you have to use the Federal exchange.

Not only are individual consumers terribly disadvantaged in the health insurance market, small medical practices and sole practitioners are also terribly disadvantaged, with insurers squeezing them with low reimbursements and hospitals trying to swallow up their practices.

Health care finance and delivery in the US is a system run amok.


fBH (me) - 65+, fWW (her) - 65+, Married 45+, together since 1965
DDay - 12/2010
Recovered, not yet fully R'ed
I share my own experience because it's the only experience I know, not because I'm a good model.

Posts: 9757 | Registered: Feb 2011 | From: Chicago area
Pentup
Member
Member # 20563
Default  Posted: 2:36 PM, November 11th (Monday)

Sisoon, I would like to compare how economists got those numbers to what I know to be related to quality of care across the nation. Under reporting, not coding medical errors, and families who opt to not pursue I think would dramatically change any numbers if there were reforms I place to challenge bad medicine without a malpractice suit.

I agree with your other comments, but do not believe that the issues I pointed out are trivial to the economic equation.

Going to back out because I am veering off the original question and I do not want to t/j.


Me- BS
Him- FWS (I hope- F)

Posts: 6421 | Registered: Aug 2008 | From: Not Oz
Snapdragon
Member
Member # 4286
Default  Posted: 2:47 PM, November 11th (Monday)

When I was 21 yrs old I had to have emergency laparoscopy for an ovarian cyst.

It took me FIVE YEARS to pay it off. Each area of the procedure had their own bill. I had to pay $10/mo on each one. I was barely making over minimum wage as a medical assistant. My employer did not offer health insurance. I did not get paid for my time off.

Anesthesia
Surgeon
Hospital
Pathology
Radiology

That's $50/mo. I was only bringing home $600.

No one wrote off a damn dime or gave me any discount. I was charged full price. Those with insurance got charged a fraction due to negotiations with the insurance companies. If I didn't pay it would have gone to collection and impacted my credit score.

Never, ever got without health insurance!


Divorced - recovered and hoping to help.

"We're not broken, just bent, and we can learn to love again" ~Pink


Posts: 3070 | Registered: May 2004 | From: Midwest
itainteasy
Member
Member # 31094
Default  Posted: 8:30 AM, November 12th (Tuesday)

Every hospital is different with their Charity care programs.

My fiance had to apply for charity care. First requirement was applying for Medicaid. He was denied. Charity care was then approved. His six figure hospital stay was reduced to almost free.

He also negotiated a self pay rate with his physicians for the after care he needed.

But yes, insurance is a must.
2 more months and I can include him on mine under the Domestic Partership clause my company offers. Thank God.


Posts: 3300 | Registered: Feb 2011 | From: NWPA
NaiveAgain
Member
Member # 20849
Default  Posted: 12:30 PM, November 12th (Tuesday)

When I was still with my WS, he got bit by a brown recluse. He was working down south, so I flew down to be with him in the hospital. His leg had swelled and was turning colors.

The hospital decided they needed to check his heart along with treating his leg. They ran him thru about 4 different tests, including an overnight stay because they needed to do one of the tests in the morning. We kept telling them we did not have insurance, how much was all this going to cost, and why did they keep checking his heart when all the reports came back normal.

After they did finally treat him with IV antibiotics for the spider bite, we got a bill for $12K. I called them, I wrote them, I wrote the BBB, and I wrote a letter to the governor of the state. I wrote the hospital that we did not ask for the heart tests, and after the first one came back fine, there was no need to keep going. I told them I felt they were doing unnecessary tests and we were not going to pay them. In the end, they wrote off the entire bill, because I finally got to the point where I was looking into lawyers.


Original WS D-Day July 10, 2008. Kept lying, he is gone.
New WS (2 EA's, no PA) 12-3-13
If you don't like where you are, then change it. You are not a tree.

Posts: 15100 | Registered: Aug 2008 | From: Ohio
Topic Posts: 34