Don't forget that the 3rd leading cause of death in America is a trip to the hospital.

ScArY

Our governments suck at everything. Thats why they should do less. Unfortunately the majority of people in the u.s. love the warm embrace of collectivism,

aTmAg said:

---

This is government's fault.

1) Doctors and hospitals can charge whatever they want because they know insurance will pay for it.
2) #1 happened because they are tied to employers and are difficult for their customers to "fire" and they can just pass the cost on.
3) #2 happened because it is excluded from income tax, so it behooves employers provide it to maximize compensation for employees without the tax hit.
4) #3 happened because FDR froze salaries encouraging employers to provide health insurance to get around it, and taxing that was politically untenable.

---

I don't need another reason to hate fdr, thank you vey much!

I never realized I could charge whatever I wanted for my exam and surgeries. Why the hell am I killing myself trying to see 35-40 people a day when I could just see 5 for a thousand dollars a pop?

Don't I feel silly?

agdoc2001 said:

---

I never realized I could charge whatever I wanted for my exam and surgeries. Why the hell am I killing myself trying to see 35-40 people a day when I could just see 5 for a thousand dollars a pop?

Don't I feel silly?

---

Shhhhhh...... You know TexAgs. Docs over charge, make 5k for 15 in stitches, pull min 100k/dy. You must easily be pulling in 200k/dy.

If my wife read this thread, she probably thinks I am supporting 10 other women.

ABATTBQ11 said:

---

BusterAg said:

---

ABATTBQ11 said:

---

Seamaster said:

---

Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

---

"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

---

This is crap.

When you go to a restaurant, you don't ask for a price for dinner upfront before you order. You order, and then you pay for what you get, and the prices are provided prior to your order.

There are zero reasons why medicine can't be the same way. Sure, you don't know how much your stay is going to cost you when you go to the ER, but you will know how much you are going to get charged for every service you consume.

---

This is crap.

When you go to a restaurant, you don't ask for a price up front before you order because they're on the menu and you pick what you want. If you go the ER, you're not picking from a menu. If your wife is giving birth and so of a sudden needs a c-section, it's not like you get to say, "No, no. Put her labor on hold, were going down the street because their c-sections are cheaper, unless you guys want to price match."

---

#1 - Don't you have any kids? Your example of labor is a terrible one to make your point. Labor is one of the most controllable medical expenses there is. By the time we got to the third trimester for both of my daughters, we knew what Dr was going to deliver, how much the hospital stay was going to be, the type of room my wife was going to recover in, and had already started payments on the procedure. We DEFINATELY price shopped here, and chose the level of care that we wanted for our budget. Labor is a perfect counter-example to the point you are trying to make.

Here is the truth:
The only real reason for price ambiguity is so that the provider of the services can maximize price discrimination, and charge one set of customers different than it charges a different set of customers. They take advantage of two things:
1) the urgency of the situation so that cost is the furthest thing from your mind when you are receiving services; and
2) The fact that most of the cost of the service was already paid for by the consumer in the form of ridiculously priced health insurance. The person receiving the care is not likely going to be paying the majority of the bill. Either their insurance is going to pay it, or the consumer is not going to pay for it at all.

There is no reason why you cannot publish a public price sheet for everything that you do, and charge people the same for everything that you do, and the only thing that changes is they types of services that are provided person to person.

The question should not be whether or not that MRI is going to cost $1,000 or $5,000, the amount for the MRI should be fixed. The question is whether or not I really need that MRI.

The "economic choices" in healthcare vary wildly. If a person goes to the ER because of a true emergency, there is little opportunity to make "economic choices" in order to save a life or preserve quality of life. On the other hand, if you tell a teenager that smoking, drinking, and junk food today will cost them $1000/month in medical treatment when they are 50 due to obesity, heart disease, and lung cancer they might make an "economic choice"

Medaggie said:

---

agracer said:

---

ABATTBQ11 said:

---

BusterAg said:

---

ABATTBQ11 said:

---

Seamaster said:

---

Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

---

"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

---

This is crap.

When you go to a restaurant, you don't ask for a price for dinner upfront before you order. You order, and then you pay for what you get, and the prices are provided prior to your order.

There are zero reasons why medicine can't be the same way. Sure, you don't know how much your stay is going to cost you when you go to the ER, but you will know how much you are going to get charged for every service you consume.

---

This is crap.

When you go to a restaurant, you don't ask for a price up front before you order because they're on the menu and you pick what you want. If you go the ER, you're not picking from a menu. If your wife is giving birth and so of a sudden needs a c-section, it's not like you get to say, "No, no. Put her labor on hold, were going down the street because their c-sections are cheaper, unless you guys want to price match."

---

This is crap. If I walk into an ER with chest pain you're going to start asking questions, probably hook me up to a monitor and order some tests. There is no reason whatsoever someone cannot tell me what those tests will cost. Yes, what happens after the tests may may be set in stone, but a lot of that up front costs should be known. And even after the tests you'll have a pretty good idea what is going on and know the next steps are going to be X, Y and maybe Z. Again, no reason someone can't tell me those X, Y, and Z costs or at least a good approximation.

and WTF does a CAT scan at the hospital cost 10x the amount as at a stand alone image center? There is no reason for that huge difference.

---

You are trying to tell a story without knowing the details nor how the details makes your story fiction.

One of the details you are missing in the ER is EMTALA and required Medical screening exams. ERs are required to fulfill minimum evaluations to rule out emergencies without discussion of costs. If you walk into the ER, doc is required to do an MSE. If you walk out, your insurance still gets billed. Doc and staff has spent time/charting/resources to evaluate you. 3K please.

Also, what cost are you asking for? Is it the uninsured cost? The medicare cost? The medicaid cost? The Oscar plan costs? The UNH cost? The BCBS cost? The other 100+ insurance carrier costs?

Ahhhh, you have BCBS? Do you want the BCBS gold plan cost? The blue plan costs? The medicare plan costs? or the other 20 variants?

Ahhh, you have the BCBS gold plan costs.... Do you want the high deductible costs? The high copay costs? The other 10 variations of the plan?

Ahhhh you have the BCBS gold plan with high deductible..... Do you have the 5K deductible, the $10K deductible, or the $20K deductible?


Ahhhh you have the BCBS gold plan with high deductible at 10K..... Do you have 10K left, do you have 5K left, do you have 1K left, or have you used up all your deductible?


Let me get back to you in 2 hrs to let you know what your out of pocket costs will be for this blood draw, EKG, and CXR......

Hey conscientious pt, you will need a CT scan and some meds. Let me run the CT scan, 5 meds you are getting, the monitoring, the tylenol, the other 20 charges. and give you a price for each.

10 hrs later we finally get prices for about 40 charges to you. The waiting room now have 50 people deep because now it took me 15 hrs to get you home and flip the room rather than 3 hrs.


Problem with these threads is everyone thinks they are neurosurgeons and can do brain surgery because they know a family member who had brain surgery. You know just enough to think you can do brain surgery but the complexity is more than you can imagine. Our current structure/law/practice of medicine/uncertainty of medicine makes giving you a firm number impossible.

---

And herein lies the problem. The insurance company had way too many fingers in the pie.

There should be one cost for any service from the hospital and my insurance should be there for disasters, just like my car insurance.

Separate the doctors and insurance company , and get the Feds out of there as well, and suddenly the healthcare overhead costs will drop 90% and I can decide with my doctor what treatment options (as in non emergency type events). And even in emergency situations there will be some more transparency in the costs.

Also, not trying to be adverse here, I think we all agree the system is broken, the government screwed it up and it's such a mess that we (as in the common folk) will just keep getting screwed. The rich and politicians will be just fine…

Truth right there. Once government is involved everything gets skewed out of proportion

redseven94 said:

---

We spend 2x Canada per capita on healthcare. And objectively they have better health results than us.

People will argue "wait times" but have you considered we have low wait times bc we make needed medical procedures too expensive which then effectively reduces "demand" which reduces my wait times?"

Just a thought.

---

And Canada has 10x the waits. Do you realize some Canadians are coming to America for cancer treatment bc the wait in Canada would be so long they'd be dead before they get treatment? Lots of Canadians are now buying private health insurance so they can actually get it to see a doctor.

The Canadian system sucks and anyone who try's to tout it as something special needs to pull their head out of their backside

Somebody has to pay for the "healthcare is a human right" freeloaders across the system. That somebody includes producers and their insurers.

Someone on a different thread made the comment that at least part of the issue is our current society feeling like we have to squeeze every last year/day out of the aging population's life, when they are obviously not truly "living" and are miserable. As heartless as that is, there seems to be some truth to it.

How many people are guilty of keeping their elderly parent with dementia and myriad other miserable health problems on life support, and not for the parent's sake, but because the child just doesn't want to let them go?

Saw an episode of The Pitt where an older brother & sister insisted on overriding their dad's DNR order and intubating him despite the doctor telling them it would be painful and confusing for their father. But they selfishly pushed forward anyway. Made me so mad.

Likewise, I can remember when my own grandmother was in the nursing home struggling with her failing health and dementia. All she wanted to do was eat cookies and watch TV. Yet one of my aunts was insistent that the staff take away all sweets....cookies, ice cream, sweet tea, etc bc it wasn't "healthy" for my grandma. The woman was 84 damn years old and miserable! Let her have her damn sweets! She earned them! If she dies because she ate cookies instead of steamed broccoli, I'm sure my grandmother would still choose to go out that way.

I know I sure as hell don't want to live the last years of my life in misery. I'd rather my husband put a pillow over my head in my sleep than prolong my painful existence.

AJ02 said:

---

Someone on a different thread made the comment that at least part of the issue is our current society feeling like we have to squeeze every last year/day out of the aging population's life, when they are obviously not truly "living" and are miserable. As heartless as that is, there seems to be some truth to it.

How many people are guilty of keeping their elderly parent with dementia and myriad other miserable health problems on life support, and not for the parent's sake, but because the child just doesn't want to let them go?

Saw an episode of The Pitt where an older brother & sister insisted on overriding their dad's DNR order and intubating him despite the doctor telling them it would be painful and confusing for their father. But they selfishly pushed forward anyway. Made me so mad.

Likewise, I can remember when my own grandmother was in the nursing home struggling with her failing health and dementia. All she wanted to do was eat cookies and watch TV. Yet one of my aunts was insistent that the staff take away all sweets....cookies, ice cream, sweet tea, etc bc it wasn't "healthy" for my grandma. The woman was 84 damn years old and miserable! Let her have her damn sweets! She earned them! If she dies because she ate cookies instead of steamed broccoli, I'm sure my grandmother would still choose to go out that way.

I know I sure as hell don't want to live the last years of my life in misery. I'd rather my husband put a pillow over my head in my sleep than prolong my painful existence.

---

Amen to that. I watched my grandparents basically deteriorate from 80 to 90 in a nursing home. The last year was abuse in my opinion. They couldn't walk, talk, feed themselves, etc but kept hanging on. Thankfully they passed within weeks of each other after 72 years of marriage.

The Collective said:

---

The whole insurance thing sucks.

---

Insurance and Taxes. Intentionally over-complicated. Yet government agencies can just be wrong to the tune of billions and no harm no foul.

$12-13k to remove a giant embedded splinter in my finger last year. My part was a few hundred.

What would it be like if we reduced the tax code to say "if you earned $x amount, you pay y% in taxes". Remove all the options for write offs and deductions that really only the wealthier people who have money to hire accountants can ever take advantage of.

Honestly asking. Would it be a net positive or negative?

AJ02 said:

---

What would it be like if we reduced the tax code to say "if you earned $x amount, you pay y% in taxes". Remove all the options for write offs and deductions that really only the wealthier people who have money to hire accountants can ever take advantage of.

Honestly asking. Would it be a net positive or negative?

---

Too easy, they wouldn't be able to penalize enough people for trying their best but getting it wrong. They want you to be wrong, and/or late.

redseven94 said:

---

Muy said:

---

Highway6 said:

---

Thanks Obama

---

But everyone is healthier, saving money, and can keep their doctor, right?!!!

---

14M people have a basic health insurance policy made you less healthy?

---

Takes thousands from my pocket. That causes me to be less healthy.

agracer said:

---

Medaggie said:

---

agracer said:

---

ABATTBQ11 said:

---

BusterAg said:

---

ABATTBQ11 said:

---

Seamaster said:

---

Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

---

"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

---

This is crap.

When you go to a restaurant, you don't ask for a price for dinner upfront before you order. You order, and then you pay for what you get, and the prices are provided prior to your order.

There are zero reasons why medicine can't be the same way. Sure, you don't know how much your stay is going to cost you when you go to the ER, but you will know how much you are going to get charged for every service you consume.

---

This is crap.

When you go to a restaurant, you don't ask for a price up front before you order because they're on the menu and you pick what you want. If you go the ER, you're not picking from a menu. If your wife is giving birth and so of a sudden needs a c-section, it's not like you get to say, "No, no. Put her labor on hold, were going down the street because their c-sections are cheaper, unless you guys want to price match."

---

This is crap. If I walk into an ER with chest pain you're going to start asking questions, probably hook me up to a monitor and order some tests. There is no reason whatsoever someone cannot tell me what those tests will cost. Yes, what happens after the tests may may be set in stone, but a lot of that up front costs should be known. And even after the tests you'll have a pretty good idea what is going on and know the next steps are going to be X, Y and maybe Z. Again, no reason someone can't tell me those X, Y, and Z costs or at least a good approximation.

and WTF does a CAT scan at the hospital cost 10x the amount as at a stand alone image center? There is no reason for that huge difference.

---

You are trying to tell a story without knowing the details nor how the details makes your story fiction.

One of the details you are missing in the ER is EMTALA and required Medical screening exams. ERs are required to fulfill minimum evaluations to rule out emergencies without discussion of costs. If you walk into the ER, doc is required to do an MSE. If you walk out, your insurance still gets billed. Doc and staff has spent time/charting/resources to evaluate you. 3K please.

Also, what cost are you asking for? Is it the uninsured cost? The medicare cost? The medicaid cost? The Oscar plan costs? The UNH cost? The BCBS cost? The other 100+ insurance carrier costs?

Ahhhh, you have BCBS? Do you want the BCBS gold plan cost? The blue plan costs? The medicare plan costs? or the other 20 variants?

Ahhh, you have the BCBS gold plan costs.... Do you want the high deductible costs? The high copay costs? The other 10 variations of the plan?

Ahhhh you have the BCBS gold plan with high deductible..... Do you have the 5K deductible, the $10K deductible, or the $20K deductible?


Ahhhh you have the BCBS gold plan with high deductible at 10K..... Do you have 10K left, do you have 5K left, do you have 1K left, or have you used up all your deductible?


Let me get back to you in 2 hrs to let you know what your out of pocket costs will be for this blood draw, EKG, and CXR......

Hey conscientious pt, you will need a CT scan and some meds. Let me run the CT scan, 5 meds you are getting, the monitoring, the tylenol, the other 20 charges. and give you a price for each.

10 hrs later we finally get prices for about 40 charges to you. The waiting room now have 50 people deep because now it took me 15 hrs to get you home and flip the room rather than 3 hrs.


Problem with these threads is everyone thinks they are neurosurgeons and can do brain surgery because they know a family member who had brain surgery. You know just enough to think you can do brain surgery but the complexity is more than you can imagine. Our current structure/law/practice of medicine/uncertainty of medicine makes giving you a firm number impossible.

---

And herein lies the problem. The insurance company had way too many fingers in the pie.

There should be one cost for any service from the hospital and my insurance should be there for disasters, just like my car insurance.

Separate the doctors and insurance company , and get the Feds out of there as well, and suddenly the healthcare overhead costs will drop 90% and I can decide with my doctor what treatment options (as in non emergency type events). And even in emergency situations there will be some more transparency in the costs.

Also, not trying to be adverse here, I think we all agree the system is broken, the government screwed it up and it's such a mess that we (as in the common folk) will just keep getting screwed.

---

This is it right here.

The government has taken the market segment that should be most interested in efficient pricing of healthcare (older folks primarily) and given the goods and services to them for free via Medicare and Medicaid.

This is an insane way to operate a market- I'm not surprised that nobody knows what the true price of healthcare-related goods and services. It's not a free market at all. If we had a law entitling every kid aged 6-12 5 free packages of Oreos a month, I'd expect the same frustrations about the price of Oreos. We will be on this train till America decides to fully stop having the government pay for healthcare.

And we really should stop calling the product we name "health insurance" as we do. Most people use that service as "help with paying medical expenses." Not even remotely the same thing as insurance. Once we understand that, some things start to make more sense

Medaggie said:

---

agdoc2001 said:

---

I never realized I could charge whatever I wanted for my exam and surgeries. Why the hell am I killing myself trying to see 35-40 people a day when I could just see 5 for a thousand dollars a pop?

Don't I feel silly?

---

Shhhhhh...... You know TexAgs. Docs over charge, make 5k for 15 in stitches, pull min 100k/dy. You must easily be pulling in 200k/dy.

If my wife read this thread, she probably thinks I am supporting 10 other women.

---

Can't deny that medical billing is a goofy practice. Cancer treatment billed in a year was $750k, actual insurance payout was only $250k. Wonder what the cash price would've been.

If a person has to be a professional in the industry to understand why charges are the way they are in a service as universal as healthcare then something is very wrong with the billing practices.


That said my doctor friend would've roasted me for going to a hospital ER for a wound requiring 4 stitches. Basically says if you're not at risk of dying go to an urgent care.

Paul Pierce Ag said:

---

agracer said:

---

Medaggie said:

---

agracer said:

---

ABATTBQ11 said:

---

BusterAg said:

---

ABATTBQ11 said:

---

Seamaster said:

---

Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

---

"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

---

This is crap.

When you go to a restaurant, you don't ask for a price for dinner upfront before you order. You order, and then you pay for what you get, and the prices are provided prior to your order.

There are zero reasons why medicine can't be the same way. Sure, you don't know how much your stay is going to cost you when you go to the ER, but you will know how much you are going to get charged for every service you consume.

---

This is crap.

When you go to a restaurant, you don't ask for a price up front before you order because they're on the menu and you pick what you want. If you go the ER, you're not picking from a menu. If your wife is giving birth and so of a sudden needs a c-section, it's not like you get to say, "No, no. Put her labor on hold, were going down the street because their c-sections are cheaper, unless you guys want to price match."

---

This is crap. If I walk into an ER with chest pain you're going to start asking questions, probably hook me up to a monitor and order some tests. There is no reason whatsoever someone cannot tell me what those tests will cost. Yes, what happens after the tests may may be set in stone, but a lot of that up front costs should be known. And even after the tests you'll have a pretty good idea what is going on and know the next steps are going to be X, Y and maybe Z. Again, no reason someone can't tell me those X, Y, and Z costs or at least a good approximation.

and WTF does a CAT scan at the hospital cost 10x the amount as at a stand alone image center? There is no reason for that huge difference.

---

You are trying to tell a story without knowing the details nor how the details makes your story fiction.

One of the details you are missing in the ER is EMTALA and required Medical screening exams. ERs are required to fulfill minimum evaluations to rule out emergencies without discussion of costs. If you walk into the ER, doc is required to do an MSE. If you walk out, your insurance still gets billed. Doc and staff has spent time/charting/resources to evaluate you. 3K please.

Also, what cost are you asking for? Is it the uninsured cost? The medicare cost? The medicaid cost? The Oscar plan costs? The UNH cost? The BCBS cost? The other 100+ insurance carrier costs?

Ahhhh, you have BCBS? Do you want the BCBS gold plan cost? The blue plan costs? The medicare plan costs? or the other 20 variants?

Ahhh, you have the BCBS gold plan costs.... Do you want the high deductible costs? The high copay costs? The other 10 variations of the plan?

Ahhhh you have the BCBS gold plan with high deductible..... Do you have the 5K deductible, the $10K deductible, or the $20K deductible?


Ahhhh you have the BCBS gold plan with high deductible at 10K..... Do you have 10K left, do you have 5K left, do you have 1K left, or have you used up all your deductible?


Let me get back to you in 2 hrs to let you know what your out of pocket costs will be for this blood draw, EKG, and CXR......

Hey conscientious pt, you will need a CT scan and some meds. Let me run the CT scan, 5 meds you are getting, the monitoring, the tylenol, the other 20 charges. and give you a price for each.

10 hrs later we finally get prices for about 40 charges to you. The waiting room now have 50 people deep because now it took me 15 hrs to get you home and flip the room rather than 3 hrs.


Problem with these threads is everyone thinks they are neurosurgeons and can do brain surgery because they know a family member who had brain surgery. You know just enough to think you can do brain surgery but the complexity is more than you can imagine. Our current structure/law/practice of medicine/uncertainty of medicine makes giving you a firm number impossible.

---

And herein lies the problem. The insurance company had way too many fingers in the pie.

There should be one cost for any service from the hospital and my insurance should be there for disasters, just like my car insurance.

Separate the doctors and insurance company , and get the Feds out of there as well, and suddenly the healthcare overhead costs will drop 90% and I can decide with my doctor what treatment options (as in non emergency type events). And even in emergency situations there will be some more transparency in the costs.

Also, not trying to be adverse here, I think we all agree the system is broken, the government screwed it up and it's such a mess that we (as in the common folk) will just keep getting screwed.

---

This is it right here.

The government has taken the market segment that should be most interested in efficient pricing of healthcare (older folks primarily) and given the goods and services to them for free via Medicare and Medicaid.

This is an insane way to operate a market- I'm not surprised that nobody knows what the true price of healthcare-related goods and services. It's not a free market at all. If we had a law entitling every kid aged 6-12 5 free packages of Oreos a month, I'd expect the same frustrations about the price of Oreos. We will be on this train till America decides to fully stop having the government pay for healthcare.

And we really should stop calling the product we name "health insurance" as we do. Most people use that service as "help with paying medical expenses." Not even remotely the same thing as insurance. Once we understand that, some things start to make more sense

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Medical community did it to themselves. Insurance refused to cover old people, so the government did. Hospitals charge millions for services for those without insurance, but get 80% + of their bill erased due to "contracted rates" by insurance companies. These folks operate in a monopolistic environment and are just daring the government to provide single payer.

There is a reason our billing is a total **** bag. It's the same reason the health care lobby is one of the biggest.

Yea, it sucks.

Quote:

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Can't deny that medical billing is a goofy practice. Cancer treatment billed in a year was $750k, actual insurance payout was only $250k. Wonder what the cash price would've been.

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If they billed insurance for $750k, your initial bill would be over a million. Then, whatever you could "negotiate" would be settled for.

Before negotiations even start, their first question to you would be "how much you got?"

I agree, insurance has made this infinitely too complicated and UNLESS you take them out there will never be transparency. Our billers who checks you in have ZERO way of telling you what it will be out of pocket. We may know your copay but that is about it. We only find out after we send your COMPLETED chart then wait 7+ dys before we know what your out of pocket cost will be.

This is like the chicken and the egg. We don't know until we file/send chart. The insurance don't know until we send the chart.

Took time out of your $200k/day pay check to let us know this tidbit!?










;-)

hph6203 said:

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If a person has to be a professional in the industry to understand why charges are the way they are in a service as universal as healthcare then something is very wrong with the billing practices.

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I would say I am as close to a professional as it gets and I still get confused. Rules/Laws changes all the time. What we thought was working today gets completely changed tomorrow. Then we get the dreaded letter, "Sorry your charge was denied due to insufficient File ABC"...... What is File ABC? Insurance "The new process that we never told anyone"...... Add on another 3 month wait for payment.

Guess what, Staff gets their pay as scheduled while the practice eats the delays. In no other field can I think where payments regularly are 6+ months delayed and many times rejected without recourse.

Imagine if you sold a widget and your buyer told you.... sorry dude, I know we got the widgets but we just won't be paying that bill because you forgot to dot the "i" and now its too late to file charges. Oh yea..... we need another 100 widgets sent to us ASAP.

Well you know. I make 200K a day so I can spend 15min typing on TexAgs. Oh well, I will have to survive on only 195K today.

Medaggie said:

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Well you know. I make 200K a day so I can spend 15min typing on TexAgs. Oh well, I will have to survive on only 195K today.

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Which insurance company are you going to bill for that 15 min?

Why in the hell would anyone go to the doctor to get stitches taken out? A pair of finger nail clippers and tweezers is all you need. .

I know I had a procedure where I had to be put under and they wanted 225,000 (insurance paid 224k+) just for an anesthesiologist. It's simply unreal how expensive everything is.

Old_Ag_91 said:

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I know I had a procedure where I had to be put under and they wanted 225,000 (insurance paid 224k+) just for an anesthesiologist. It's simply unreal how expensive everything is.

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What kind of insurance do you have? Never seen anything like this.

hph6203 said:

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Medaggie said:

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agdoc2001 said:

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I never realized I could charge whatever I wanted for my exam and surgeries. Why the hell am I killing myself trying to see 35-40 people a day when I could just see 5 for a thousand dollars a pop?

Don't I feel silly?

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Shhhhhh...... You know TexAgs. Docs over charge, make 5k for 15 in stitches, pull min 100k/dy. You must easily be pulling in 200k/dy.

If my wife read this thread, she probably thinks I am supporting 10 other women.

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Can't deny that medical billing is a goofy practice. Cancer treatment billed in a year was $750k, actual insurance payout was only $250k. Wonder what the cash price would've been.

If a person has to be a professional in the industry to understand why charges are the way they are in a service as universal as healthcare then something is very wrong with the billing practices.


That said my doctor friend would've roasted me for going to a hospital ER for a wound requiring 4 stitches. Basically says if you're not at risk of dying go to an urgent care.

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Gotta pay for all the illegal alien leaches that show up to the ER with a case of the sniffles.

Who doesn't take their own stitches out?

Blue cross blue shield of Arkansas

Science Denier said:

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Paul Pierce Ag said:

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agracer said:

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Medaggie said:

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agracer said:

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ABATTBQ11 said:

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BusterAg said:

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ABATTBQ11 said:

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Seamaster said:

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Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

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"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

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This is crap.

When you go to a restaurant, you don't ask for a price for dinner upfront before you order. You order, and then you pay for what you get, and the prices are provided prior to your order.

There are zero reasons why medicine can't be the same way. Sure, you don't know how much your stay is going to cost you when you go to the ER, but you will know how much you are going to get charged for every service you consume.

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This is crap.

When you go to a restaurant, you don't ask for a price up front before you order because they're on the menu and you pick what you want. If you go the ER, you're not picking from a menu. If your wife is giving birth and so of a sudden needs a c-section, it's not like you get to say, "No, no. Put her labor on hold, were going down the street because their c-sections are cheaper, unless you guys want to price match."

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This is crap. If I walk into an ER with chest pain you're going to start asking questions, probably hook me up to a monitor and order some tests. There is no reason whatsoever someone cannot tell me what those tests will cost. Yes, what happens after the tests may may be set in stone, but a lot of that up front costs should be known. And even after the tests you'll have a pretty good idea what is going on and know the next steps are going to be X, Y and maybe Z. Again, no reason someone can't tell me those X, Y, and Z costs or at least a good approximation.

and WTF does a CAT scan at the hospital cost 10x the amount as at a stand alone image center? There is no reason for that huge difference.

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You are trying to tell a story without knowing the details nor how the details makes your story fiction.

One of the details you are missing in the ER is EMTALA and required Medical screening exams. ERs are required to fulfill minimum evaluations to rule out emergencies without discussion of costs. If you walk into the ER, doc is required to do an MSE. If you walk out, your insurance still gets billed. Doc and staff has spent time/charting/resources to evaluate you. 3K please.

Also, what cost are you asking for? Is it the uninsured cost? The medicare cost? The medicaid cost? The Oscar plan costs? The UNH cost? The BCBS cost? The other 100+ insurance carrier costs?

Ahhhh, you have BCBS? Do you want the BCBS gold plan cost? The blue plan costs? The medicare plan costs? or the other 20 variants?

Ahhh, you have the BCBS gold plan costs.... Do you want the high deductible costs? The high copay costs? The other 10 variations of the plan?

Ahhhh you have the BCBS gold plan with high deductible..... Do you have the 5K deductible, the $10K deductible, or the $20K deductible?


Ahhhh you have the BCBS gold plan with high deductible at 10K..... Do you have 10K left, do you have 5K left, do you have 1K left, or have you used up all your deductible?


Let me get back to you in 2 hrs to let you know what your out of pocket costs will be for this blood draw, EKG, and CXR......

Hey conscientious pt, you will need a CT scan and some meds. Let me run the CT scan, 5 meds you are getting, the monitoring, the tylenol, the other 20 charges. and give you a price for each.

10 hrs later we finally get prices for about 40 charges to you. The waiting room now have 50 people deep because now it took me 15 hrs to get you home and flip the room rather than 3 hrs.


Problem with these threads is everyone thinks they are neurosurgeons and can do brain surgery because they know a family member who had brain surgery. You know just enough to think you can do brain surgery but the complexity is more than you can imagine. Our current structure/law/practice of medicine/uncertainty of medicine makes giving you a firm number impossible.

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And herein lies the problem. The insurance company had way too many fingers in the pie.

There should be one cost for any service from the hospital and my insurance should be there for disasters, just like my car insurance.

Separate the doctors and insurance company , and get the Feds out of there as well, and suddenly the healthcare overhead costs will drop 90% and I can decide with my doctor what treatment options (as in non emergency type events). And even in emergency situations there will be some more transparency in the costs.

Also, not trying to be adverse here, I think we all agree the system is broken, the government screwed it up and it's such a mess that we (as in the common folk) will just keep getting screwed.

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This is it right here.

The government has taken the market segment that should be most interested in efficient pricing of healthcare (older folks primarily) and given the goods and services to them for free via Medicare and Medicaid.

This is an insane way to operate a market- I'm not surprised that nobody knows what the true price of healthcare-related goods and services. It's not a free market at all. If we had a law entitling every kid aged 6-12 5 free packages of Oreos a month, I'd expect the same frustrations about the price of Oreos. We will be on this train till America decides to fully stop having the government pay for healthcare.

And we really should stop calling the product we name "health insurance" as we do. Most people use that service as "help with paying medical expenses." Not even remotely the same thing as insurance. Once we understand that, some things start to make more sense

---

Medical community did it to themselves. Insurance refused to cover old people, so the government did. Hospitals charge millions for services for those without insurance, but get 80% + of their bill erased due to "contracted rates" by insurance companies. These folks operate in a monopolistic environment and are just daring the government to provide single payer.

There is a reason our billing is a total **** bag. It's the same reason the health care lobby is one of the biggest.

Yea, it sucks.

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I think there are a lot of issues with the medical community, but the problems we have with pricing/billing are not their fault.

They were right to refuse to insure old people- old people aren't primarily asking for potential help with expenses that might occur in the future, they're asking for actual help paying for medical expenses happening right now and more that are planned. That's not insurance

So the government comes in and subsidizes healthcare for our elderly. Since they're usually the largest segment of the market for healthcare, this takes a huge amount of info out of the market, and everyone gets screwed. The crazy pricing/billing structure is a result of this lost info

TexasRebel said:

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Who doesn't take their own stitches out?

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Dalton did his own staples I. roadhouse!