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Thread: Ill tell you why people want natl health care...

  1. #71
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    I agree that cost sharing (i.e. covering expenses of uninsured care) and malpractice are significant contributors to rising costs. However, there are several others that are probably more expensive.

    1) Technology. This is the one area where technology actually increases the cost of care dramatically. That is because there is no cost differential for using older technology. For example, you can buy a 27" LCD TV today for half the cost of that TV 6 years ago as today's expensive TVs are much larger with more features. However, you cannot get a less expensive CT scan with an older 32-slice scanner instead of the more expensive 64-slice machines because the older machines are rapidly replaced by new designs. In addition, we are use more technology to make diagnoses for conditions that were once diagnosed with physical exam or simple tests. This is manifest by the 10X increase in the used of CT and MRI over the past decade.

    2) Prescription Drugs. Pharmaceutical companies have done a great job marketing new drug. On the other hand, Americans do a poor job of using less expensive generic drugs that effectively treat the same conditions.

    3) Aging Population. The baby boomers are aging and entering the stage of life where parts wear out. This increase in demand results in higher costs.

  2. #72
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    Talking

    I'm just gonna drop dead some day - take THAT, ObamaKare!!!
    - Either you're part of the problem or you're part of the solution or you're just part of the landscape - Sam (Robert DeNiro) in, "Ronin" -

  3. #73
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    So I got my bill today. $7300, and due date is on the 26th of this month. Statement date is the 16th. No itemization of costs at all.





    Just called the hospital, got transferred to billing, and all that number does is go to a pre recorded message saying you can pay it online.
    Last edited by Belmont31R; 08-22-11 at 14:28.

  4. #74
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    Quote Originally Posted by pilotguyo540 View Post
    I hate hospitals too. I cant freaking stand the bull shit and condescension. The price tag is unbearable and unsustainable. Insurance companies are the medical equivalent of welfare these days, if I have my facts straight. My dad swears by the Mexican system of paying reasonable prices for services rendered, without hoops to jump through. My step mom was very ill from a lower GI blockage. They spent $400 in Mexico for 5 star service with a smile, and saved my step mom's life after dropping $2000 here in the US for some basic, inconclusive testing.

    I think under government control, it will only get worse. Just my take.
    That's nice. If American hospitals were able to get away with some of the things their Mexican counterparts are able to do (like cherry-picking patients on their ability to pay), service in the United States would dramatically improve. Too bad, by law, they cannot do that.

    American hospitals are busy treating the 20,000,000+ illegals that Mexican hospitals would turn away because of their inability to pay. That's on top of the millions more legal folks here who don't have insurance.


    As such, the people who can pay here have it stuck to them to try to make up the loss generated by treating tens of millions of people who can't (or more likely simply won't) pay.



    People who believe nationalized healthcare (or as the Obongo Admin. has done, nationalized, forced insurance) will make this situation better are, quite simply, ****ing retarded.

  5. #75
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    Quote Originally Posted by Redmanfms View Post
    That's nice. If American hospitals were able to get away with some of the things their Mexican counterparts are able to do (like cherry-picking patients on their ability to pay), service in the United States would dramatically improve. Too bad, by law, they cannot do that.

    American hospitals are busy treating the 20,000,000+ illegals that Mexican hospitals would turn away because of their inability to pay. That's on top of the millions more legal folks here who don't have insurance.


    As such, the people who can pay here have it stuck to them to try to make up the loss generated by treating tens of millions of people who can't (or more likely simply won't) pay.



    People who believe nationalized healthcare (or as the Obongo Admin. has done, nationalized, forced insurance) will make this situation better are, quite simply, ****ing retarded.


    Theres no good solution to this. I just posted they sent me a bill for what I got, and they are giving me 4 days to pay it.


    There needs to be better structure to this, and I think a lot of it is because of hospitals own actions. Im not talking about the docs and nurses. Im talking about the administrators, owners, whatever.


    Id rather them have a price list, and Ill gladly sign away any liability as long as I don't get stuck for 7300 for a CT scan and 5 minutes with a doctor. No wonder people don't pay their bills. I bet MOST of the population could not come up with 7300 dollars in 4 days. No other type of business operates with a scheme of people finding out after the fact what its going to cost them. Imagine if you took your car to get a part fixed, and they wouldn't tell you how much its going to cost. Then 2 weeks later you get a bill in the mail for 20k, and if you don't pay it within 4 days we'll put it on your credit report. Oh and if you call us all you get is a pre recorded message saying you can pay it online.


    I think gov health care in this country is a terrible idea yet Im at a loss as to why hospitals are put out as victims when they are legally devoid of any free market capitalist controls consumers have in every other business in this country. The urgent care center my family goes to operates the right way where they will tell you what it costs to be seen, and at each step of the way. Blood test? That will be 13, and you pay in cash or insurance at the end of the visit.


    Another thing that irks me is self pay people pay WAY higher rates than insurance. No wonder people don't pay their bills. A business can write those losses off on their taxes, and the more losses the more tax breaks.

  6. #76
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    Quote Originally Posted by rob_s View Post

    Natural Selection? Yes.
    Edited. Probably too harsh.

    I don't think you truly understand what you are proposing.
    Last edited by Redmanfms; 08-22-11 at 15:44.

  7. #77
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    Quote Originally Posted by Belmont31R View Post
    Another thing that irks me is self pay people pay WAY higher rates than insurance. No wonder people don't pay their bills. A business can write those losses off on their taxes, and the more losses the more tax breaks.
    Best way to do it is to get catastrophic insurance so you get the negotiated prices for services and drugs with a really high deductible through your insurance and then put the savings between the cost of that and regular insurance into a health care savings account. I ended up saving several thousand dollars a year going to catastrophic only.
    Last edited by BrianS; 08-22-11 at 15:42. Reason: put copay when I meant to say deductible

  8. #78
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    Quote Originally Posted by Belmont31R View Post
    Theres no good solution to this.
    I agree, though lanesmith offered some very good suggestions.



    Another thing that irks me is self pay people pay WAY higher rates than insurance. No wonder people don't pay their bills. A business can write those losses off on their taxes, and the more losses the more tax breaks.
    That isn't entirely true, because most people never see the actual rate the insurance company is paying. Also, most insurance doesn't let you simply walk in to any healthcare provider and seek treatment, they have lists of plan providers with whom the company has negotiated a "group rate" of sorts. Buying in bulk counts in the medical world too. Doctors are usually more willing to work out lower rates that are still profitable for them since they are so used to uninsured folks stiffing them and being massively underpaid by Medicare/aid.



    It sucks that government manipulation has brought us to this, but that is simply the way it is.

    BTW, no offense, but even as a young relatively healthy man, you're being stupid not having insurance. Had I not had insurance a couple years ago when I had a serious bout of kidney stones my bill for the surgery to remove a 9.2mm stone that was blocking my ureter would have been nearly $30,000 (and that's what the insurance company was billed, might have been even more if I was uninsured).

    Given this experience and that bill, you might consider investing in some insurance and chalk it up as a "teachable moment."

  9. #79
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    My wife has two kinds of insurance and my kids have insurance. Just not me.

  10. #80
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    Quote Originally Posted by Belmont31R View Post
    Theres no good solution to this. I just posted they sent me a bill for what I got, and they are giving me 4 days to pay it.


    There needs to be better structure to this, and I think a lot of it is because of hospitals own actions. Im not talking about the docs and nurses. Im talking about the administrators, owners, whatever.


    Id rather them have a price list, and Ill gladly sign away any liability as long as I don't get stuck for 7300 for a CT scan and 5 minutes with a doctor. No wonder people don't pay their bills. I bet MOST of the population could not come up with 7300 dollars in 4 days. No other type of business operates with a scheme of people finding out after the fact what its going to cost them. Imagine if you took your car to get a part fixed, and they wouldn't tell you how much its going to cost. Then 2 weeks later you get a bill in the mail for 20k, and if you don't pay it within 4 days we'll put it on your credit report. Oh and if you call us all you get is a pre recorded message saying you can pay it online.


    I think gov health care in this country is a terrible idea yet Im at a loss as to why hospitals are put out as victims when they are legally devoid of any free market capitalist controls consumers have in every other business in this country. The urgent care center my family goes to operates the right way where they will tell you what it costs to be seen, and at each step of the way. Blood test? That will be 13, and you pay in cash or insurance at the end of the visit.


    Another thing that irks me is self pay people pay WAY higher rates than insurance. No wonder people don't pay their bills. A business can write those losses off on their taxes, and the more losses the more tax breaks.
    The federal EMTALA (Emergency Medical Treatment and Active Labor Act) prevents us from offering a price list to most patients presenting to the emergency department. That is to say, we are required to provide a medical screening exam (which may include physical examination, lab tests, and any necessary imaging tests) to identify an emergency medical condition (any illness that risks life/limb or organ function) to any person requesting care. Allowing state malpractice laws to regulate the quality of the exam, EMTALA is vague about what that exam includes for a particular complaint, and only says that the exam must be fairly consistent with common practice for similar situations (i.e. I can't order a bunch of tests for the insured but only a few tests for the uninsured).

    We must then stabilize any found emergency condition which may include admission to the hospital or transfer to an appropriate higher level of care. Although EMTALA allows us to collect billing information while the evaluation and stabilization is taking place, we cannot require payment or use previously unpaid bills as an excuse delay or stop the evaluation. This point is very important - we cannot delay the exam to collect billing information without being in violation. EMTALA has gone so far as to say that any hospital behavior that might discourage an uninsured person from seeking care such as publishing high costs or even encouraging excessive wait times (i.e. closing beds when staffing is available so that uninsured elope without care) is a violation. There have been instances of hospitals being in violation for publishing inaccurately long wait times (i.e. we can't seen you for 4 hours when the wait is actually 1 hour).

    Therefore, we would be committing a violation to present you with a cost menu and withholding the exam while you decide what tests you want. That single violation is at least $50K and may threaten the providers ability to participate in Medicare/Medicaid - essentially ending their career in medicine. EMTALA violations come out of the doctors pocket and are not covered by malpractice insurance.

    In your case, you presented with severe abdominal pain which opens the door to any number of emergency conditions such as appendicitis, abdominal aortic aneurysm, hollow viscous perforation, acute cholecystitis, etc. The hospital staff is then required to perform a medical evaluation that at most institutions will require labs, likely some imaging, and medications. Had the hospital presented you with a cost list and then waited for you to decide, they would be guilty of an EMTALA violation for delaying your medical screening exam. While the waiver that you describe may afford some state malpractice coverage, it offers no federal EMTALA protection for the providers.

    If people with libertarian beliefs don't like this law and want to be consistent with their beliefs, then stop going to emergency departments for problems that have been brewing for weeks. Instead, save your money and go get the tests you need through a clinic that can offer a price list because they are not subjected to EMTALA. If you can't afford one of these clinics, then you should have made some better choices with your life and I'll see you on the other side. People who use the ED for their convenience are supporting an unconstitutional law and contributing to the rising costs of healthcare.
    Last edited by Sensei; 08-22-11 at 16:41.

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