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Old 10-06-2016, 12:51 PM   #6881
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+1. I went to a doctor a month ago.. 1st visit no exams, nothing done. 10 minute visit. I get the bill. 375 bucks of which the insurance paid 100.. 175 for a new patient fee and paperwork. Not joking.
This is exactly the problem. Everyone talks about entitlement this and that of young people of poor people. What about these ******* doctors that think they are entitled to charge us whatever they want just because they are doctors. And not do anything to get paid for it.

I went to the emergency room with my son a couple years back. I had insurance. He had a fever for two days straight and was throwing up constantly so I really had no choice. A nurse, not a doctor, took care of him. We were there for two hours in a hospital room. She was there with him for 15 minutes and got someone to give him a suppository for the fever and a pill for the vomiting. Recommended lots of liquids because dehydration, yada yada.

$500 out of pocket to hospital for bed. ~$1200 bill later from hospital and $600 bill from nurse of which we paid close to $1000. We had insurance mind you. $1500 out of pocket because it was an emergency visit to the hospital. Two hours. Three year old kid. A pill and a suppository.
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Old 10-06-2016, 12:52 PM   #6882
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Like the Scandinavian countries I've heard of.
Small, concentrated populations (so not nearly the infrastructure expenses we have) + immense wealth in natural resources. NYC has a larger population than the entire country of Norway by a few million.

For instance, Norway has the World's largest sovereign wealth fund in the world (yes more than any of the middle east countries)
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Old 10-06-2016, 12:54 PM   #6883
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Not too long ago one of my republican friends shared this article about how obamacare will be going up and how it will fail soon... the entire article was based on a video... a video that was made in the end of 2012 saying how obamacare is suppose to fail. That said the article was complete garbage and the baboon that wrote it didnt bother checking when the video was made that he based his entire article on. Sorry if i am skeptical but i dont believe the "insurance will go up 5000000000000000000000000% unless we do this" articles.
Listen, I'm not worried about the future. I'm concentrating on the here and now. RIGHT NOW, the health industry is raping us. Forget about the future.
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Old 10-06-2016, 01:02 PM   #6884
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Small, concentrated populations (so not nearly the infrastructure expenses we have) + immense wealth in natural resources. NYC has a larger population than the entire country of Norway by a few million.

For instance, Norway has the World's largest sovereign wealth fund in the world (yes more than any of the middle east countries)
Which just goes to show that our gov't is the problem in thinking that they can solve the health care issue the way they did. Or better said, pay off the health care industry the way they did.

So if 100 million working Americans that don't pay into the federal system started paying at least something into it, the gov't could either find a way to fix the system or find a way to keep stealing from it. So maybe my thinking in getting everyone to pay is not much of a solution at all? In full cynic mode right now.

I wonder if Norway has health care lobbyists in there gov't house all the time? Yes, serious question.
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Old 10-06-2016, 01:03 PM   #6885
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This is exactly the problem. Everyone talks about entitlement this and that of young people of poor people. What about these ******* doctors that think they are entitled to charge us whatever they want just because they are doctors. And not do anything to get paid for it.

I went to the emergency room with my son a couple years back. I had insurance. He had a fever for two days straight and was throwing up constantly so I really had no choice. A nurse, not a doctor, took care of him. We were there for two hours in a hospital room. She was there with him for 15 minutes and got someone to give him a suppository for the fever and a pill for the vomiting. Recommended lots of liquids because dehydration, yada yada.

$500 out of pocket to hospital for bed. ~$1200 bill later from hospital and $600 bill from nurse of which we paid close to $1000. We had insurance mind you. $1500 out of pocket because it was an emergency visit to the hospital. Two hours. Three year old kid. A pill and a suppository.
Let me give you another example here. about 3 years ago I lost my dad. Obviously I had an ambulance come in. They took him to the hospital. Total call - 35 minutes. Next day an ambulance took his body to the coronary so they can do an autopsy 6 miles total no services provided other than transport. 2 months later i got the bill. The first one was 3150. Second one was 2900. Now paramedics make 15 buck an hour so where do the other money go? Oh and he had insurance at the time of death.
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Old 10-06-2016, 01:08 PM   #6886
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there's a good Sowell quote here:

It's is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that the we can afford to pay for doctors, hospitals, medication and a gov't bureaucracy to administer it.

there's another I like:

The first lesson of economics is scarcity: there is never enough of anything to fully satisfy all those who want it. The first lesson of politics is to disregard the first lesson of economics.
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Old 10-06-2016, 01:08 PM   #6887
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I'm sorry for your loss. And sorry that you had to pay for him to pass away.

I'm all for capitalism and everyone making a buck but this has to stop.

A few years back I read that automotive parts manufacturers were being fined with a $25 million (or was it billion?) penalty for price fixing. Why can't they apply this to health care? Maybe the automotive guys didn't get enough lobbyists in Washington or forgot to make a payment?
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Old 10-06-2016, 01:33 PM   #6888
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I'm sorry for your loss. And sorry that you had to pay for him to pass away.

I'm all for capitalism and everyone making a buck but this has to stop.

A few years back I read that automotive parts manufacturers were being fined with a $25 million (or was it billion?) penalty for price fixing. Why can't they apply this to health care? Maybe the automotive guys didn't get enough lobbyists in Washington or forgot to make a payment?
Because people aren't ball joints? There are a lot more variables when working with organics versus mechanics.

That isn't to say that the healthcare (including insurance) situation isn't SNAFUBAR. Insurance being a tax-free fringe benefit has made it commonplace, and employers had been steadily improving the coverage offered to attract and retain employees. Coverage is now so good that people are price-insensitive when it comes to their medical needs, and the insurance reimbursement agreements have made it impossible to compare pricing between providers. Patients have been demand more and more advanced services be performed, because **** it, this is why I have insurance! Providers bill more and more because equipment for the services demanded my patients is expensive, and because the patient is insulated from the costs by insurance there are no downward price pressures. It isn't like you can shop around after you have a heart attack. They also have to pay for all the services provided to people who can't/won't/don't pay.
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Old 10-06-2016, 01:44 PM   #6889
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1) Health care cost are up in large part to Federal rules and "insurance" company shenanigans. When I was a child, a doctor's office consisted of a receptionist, nurse, and Dr. Now that office has to support about 4 other people to care of regulations and insurance filing and fighting.
2)"Insurance" is now a misnomer. Now companies pay for well health, routine office visits. It is not an insurance against catastrophic loss, but simply a healthcare system (unless you have major medical only), in my case, medical, dental, and vision care provided to me by my company.
3) The "benefits" offered by my company are highly dictated by regulations... "Pregnancy must be treated as any other illness" is one of the first, ridiculous ones I encountered. If pregnancy is not a normal bodily function of all mammals, then I don't know what is.
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Old 10-06-2016, 01:46 PM   #6890
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A few years back I read that automotive parts manufacturers were being fined with a $25 million (or was it billion?) penalty for price fixing. Why can't they apply this to health care?
Because of the fact that We The People have come to assume that health insurance is a normal thing that gets used for everyday medical needs. This creates a layer of abstraction between the service and the cost of the payment.


When I need to get an oil change, or buy new tires for my car, do I expect my car insurance to cover that?

Or if I hire someone to paint my house, or I call a plumber to fix a leaky pipe, do I expect my homeowner's insurance to cover that?


Of course not- that would be stupid.


So why is it that when I walk into CVS to get a flu shot, or into the dentist's office for a routine exam & cleaning, the first thing they ask me for is my insurance card?


That's the problem- the vast majority of us came been conditioned to view healthcare-related goods and services as something which exist outside of normal economic reality.
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Old 10-06-2016, 01:58 PM   #6891
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So your argument is that there is no price fixing and that instead costs are rising due to overuse of the system?

And since most people don't pay the ones that do have to pay for the ones that don't?

You know, I'm 44 years old, and I don't remember my parents facing this situation when I was a kid. Something happened from then to now.

So I think I will believe what my eyes are seeing. They see a system that is rigged and the gov't is sponsoring it.
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Old 10-06-2016, 04:46 PM   #6892
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Pay no attention to healthcare costs; the American Medical Association is your friend; without it, you would be dead, and your life is far more valuable than you think!
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Old 10-06-2016, 04:58 PM   #6893
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This is merely an anecdote but I will share:

A couple years back I had a sinus infection. I had no insurance at the time.

I went to my doctor and told him that I was currently in a cash poor situation and had no insurance. He billed me $65 for the doctors visit and $1 for the walmart generic antibiotics. I asked him how much he would have charged if I had insurance - he said $135. This was the same doctor I had when I had insurance and my co-pay for insurance was $35. I am not saying that the services that I received for $65 were always the same level of services I received for $35, but that in his office, the price of complying with insurance stuff cost him a minimum of $70/visit.

I also left with a handful of free samples of stuff that helped with other symptoms of the sinus infection.

By the way, it turned out that the sinus infection was beyond what the antibiotics could handle since I waited so long. I had to get a more powerful variety that cost $100 out of pocket (no insurance).

Either way, it colored my view of the healthcare industry. (and I work for the largest hospital system in the state).
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Old 10-06-2016, 07:12 PM   #6894
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Prior to World War II, most Americans paid for their own medical care, either directly to the provider, or beginning in the 1930s, through the Blue Cross nonprofit health insurance entities which were created to offer guaranteed service for a fixed fee. Back then, health insurance really was insurance - providing coverage only for major items like hospitalizations that people could not afford to pay for themselves. All other expenses were paid out-of-pocket directly to the provider.


During World War II, the federal government was wary of post-war inflation. The administration saw the terrible devastation hyperinflation wreaked on post-World War I Germany and they were determined to hold it at bay through wage and price controls which they instituted during the war. In reaction to the wage controls, many labor groups planned to go on strike en masse. In order to avert the strike, in a concession to the labor groups, the War Labor Board exempted employer-paid health benefits from wage controls and income tax.


This historical accident created a tax advantage that drove enormous demand for employer-provided health insurance plans over the previously more common individual health insurance. Employers received a 100% tax deduction while the benefits employees received were exempt from federal, state, and city taxation.
The Result


As early as the 1940s, when the U.S. presidential administration tried to end the tax break and reform healthcare, the employer-provided health industry was already dug-in. In addition, labor groups preferred the employer-provided health insurance model. By the mid-1960s, employer-provided health insurance was almost universal.
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Old 10-06-2016, 07:55 PM   #6895
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This is merely an anecdote but I will share:

A couple years back I had a sinus infection. I had no insurance at the time.

I went to my doctor and told him that I was currently in a cash poor situation and had no insurance. He billed me $65 for the doctors visit and $1 for the walmart generic antibiotics. I asked him how much he would have charged if I had insurance - he said $135. This was the same doctor I had when I had insurance and my co-pay for insurance was $35. I am not saying that the services that I received for $65 were always the same level of services I received for $35, but that in his office, the price of complying with insurance stuff cost him a minimum of $70/visit.

I also left with a handful of free samples of stuff that helped with other symptoms of the sinus infection.

By the way, it turned out that the sinus infection was beyond what the antibiotics could handle since I waited so long. I had to get a more powerful variety that cost $100 out of pocket (no insurance).

Either way, it colored my view of the healthcare industry. (and I work for the largest hospital system in the state).
What he didn't mention is insurance doesn't pay $100 for your visit ($135 minus your $35 copay). They pay ~1/3rd of that bill so he has to "charge" $135 to collect $68... and he probably has 1 person on his staff (assuming an average size office) that handles nothing but coding bills for insurance companies.

I really wonder if we'll start to see more doctor's offices go cash only as people are moving to higher and higher deductibles (to fight the cost of insurance). It would massively simplify things and the doctor could then charge a normal rate.
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Old 10-07-2016, 08:28 AM   #6896
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Not only do they only reimburse part of the bill to the doctor's office, but they also heavily influence what kind of tests/procedures can be performed and how much they can charge for them.
Another problem with health care costs is how litigious our society is. The amount of malpractice insurance a doctor has to have, just-in-case, is absurd. There are many nurses that bring home more than the average doctor for this reason.
In America, you are one accident away from bankruptcy. Either from medical bills, being sued, or both. And that is true if you have insurance or not.
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Old 10-07-2016, 10:07 AM   #6897
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Not only do they only reimburse part of the bill to the doctor's office, but they also heavily influence what kind of tests/procedures can be performed and how much they can charge for them.
Another problem with health care costs is how litigious our society is. The amount of malpractice insurance a doctor has to have, just-in-case, is absurd. There are many nurses that bring home more than the average doctor for this reason.
In America, you are one accident away from bankruptcy. Either from medical bills, being sued, or both. And that is true if you have insurance or not.
Average salaries: Healthcare Occupations : Occupational Outlook Handbook : U.S. Bureau of Labor Statistics

Insurance costs are only one small factor IMO but if you actually look at the profits of the insurance business they certainly aren't in danger of going under any time soon. Maybe laws need to be 'tweaked' but i'd guess the cost of insurance wouldn't drop at all.

IMO the real problem is the lack of real competition. Sure, most cities have multiple hospitals but the real access to them is being controlled by the doctor groups being bought up by those same hospital groups, no real published prices for a given procedure and no bargaining power for the consumer to argue the price (only after the fact).

Most of the health care companies have grown fat in the mid section with "managers" at pretty substantial salaries ($107K average) given they typically are what we in manufacturing would term as "non-productive" employees. When you have no real competitor to measure against, and the laws are stacked in your favor the result you get is what we have. With the ACA the consumer has been put smack in the middle of it all. And I happen to think the ACA was well intended until our lawmakers/lobbyists got hold of it.

Then, pass a law preventing the single largest buyer of prescription drugs (Medicare) to negotiate pricing...

Sorry, it's fucked up...
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Old 10-07-2016, 12:03 PM   #6898
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Let me give you another example here. about 3 years ago I lost my dad. Obviously I had an ambulance come in. They took him to the hospital. Total call - 35 minutes. Next day an ambulance took his body to the coronary so they can do an autopsy 6 miles total no services provided other than transport. 2 months later i got the bill. The first one was 3150. Second one was 2900. Now paramedics make 15 buck an hour so where do the other money go? Oh and he had insurance at the time of death.
Woah. I'm guessing the first ambulance ride was needed. Once pronounced dead they should have used a removal service. I'm not sure I would pay that second bill, I'd probably fight it.
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Old 10-07-2016, 12:18 PM   #6899
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Woah. I'm guessing the first ambulance ride was needed. Once pronounced dead they should have used a removal service. I'm not sure I would pay that second bill, I'd probably fight it.
We fought the 2nd one. They dismissed both.
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Old 10-07-2016, 12:20 PM   #6900
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1. Trial attorneys are one reason for the higher prices. Why does it cost more to see a doc and get a pill than it did in the '70s? Multi-million dollar malpractice lawsuits didn't exist in the '60s. You want lower prices? Vote for tort reform.

2. Insurance versus paying cash is the another reason. There's an extra hand reaching for every piece of pie.

3. Government requires that any insurance offered by employers covers certain things. Mental health, drug and alcohol counseling, routine procedures, ADHD and such, preventative care, minor wounds and sniffles, rehabilitative care are all required to be covered instead of just catastrophic care. Most of those things are required by law. And the govt keeps adding things and requiring more people have all of this care insured, driving up the cost every year. Stroke, heart attack, major surgery, loss of a limb used to be the only time people used insurance. Even the birth of a child was done as cash billing in the '70s. Many people used midwives (and still do) and only went to a hospital if it was thought to be a risky pregnancy.

To that point I offer July 6, 2016 as a very recent example:
Quote:
WASHINGTON—The House passed legislation Wednesday to overhaul the nation’s mental health system...

It would also boost requirements for private insurers to cover mental health care on an equal footing with physical health, and open official studies on other areas that Mr. Murphy says could support changes in the future.
Who is going to be required to cover more mental health care issues?
Private insurers?
Certainly they won't pass those costs on to us...
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