OT: Health care struck down

Page 13 of 16  
wrote:

? What ? I would have to know exactly what the procedure was and what the billing entries were. Remember, you are not billed for the procedure, you are billed for the governments defined billing elements of that procedure. A very big and confusing difference to most people. Hell, I work with it every damn day and it still is confusing at times.
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wrote:

Which you say vary, not based on the required procedure but how things were billed. Identical procedures get different billing.

Nonsense does get confusing. ...generally that's the point.
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wrote:

If a clinical test can be determined utilizing more that one method, they may both derive the same result as far as the doctor is concerned but they utilize totally different methods to obtain the result. Because they use different methods the billing codes will be different and the resulting costs will be determined by the billing codes associated with the method and the result.

It's seems that way at times but I wouldn't say it is nonsense but that it is way overly complex which lends to a lot of mistakes that wouldn't be necessary if it were simplified some. The problem is that it is not getting simpler but far more complex every year. In the next three years the entire healthcare system is going to be forced to implement an entirely new diagnosis coding system. The current system, called ICD9 contains something like 17,000 different disease code. Yes, 17 thousand different codes that must be properly coded for every bill to both the government payers and the private payers. The government has mandated a total replacement of ICD9 with a new system called ICD10. Now, we go from 17,000 codes to over 140,000 codes that must be accurately assigned by the physician but entered and validated. You want to try and work with that many diagnosis codes? The amount of training involved for the coders is going to cost millions and take months.
But hey, we figure it will at minimum double the number of coders we will need so it will benefit the employment situation.
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wrote:

I have high experience with hospital bills being more than one for the same visit - such as physician bill coming in separately from the bill from the hospital, both in positive $$$-$$$$ just to get a few stitches after from merely my worst bike crash in a few years. (With worst of that being a largely-confined-to-dermis lacceration merely great enough to do better with a few stitches.)
For that matter, I even know a hospital that states such fact with signs posted in its emergency room waiting area.
My take - modified from what my favorite client tells me - for justice, get a hooker or a "call girl". To get screwed - go to court. I would modify - to get screwed more than once, get treated or worse-still "admitted" at a hospital without a "Cadillac" health insurance policy that members of politically-powerful unions or such union-"locals" disproportionately enjoy.
--
- Don Klipstein ( snipped-for-privacy@misty.com)

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snipped-for-privacy@manx.misty.com (Don Klipstein) wrote:

But even in your Hooker scenario, you still have multiple bills. One to the escort for professional services. One to the motel for their "operating theatre". One to the local gas station or pharmacy for the condoms. Same basic principle (on many levels) as health care. (grin).
--
"Even I realized that money was to politicians what the ecalyptus tree is to
koala bears: food, water, shelter and something to crap on."
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Kurt Ullman wrote:

Still, you've got to admire the hooker business model: You've got it. You sell it. You've still got it.
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h wrote:

In your dreams! Most of that crap is a direct result of your ignorant government burro-craps and their mindless regulations.
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On Feb 7, 10:25pm, " snipped-for-privacy@att.bizzzzzzzzzzzz"

net> wrote:

NO, that is the way your government has mandated that it be billed.

By the way, neither your cardiologist or your GP makes anything off of tests performed by the laboratory or other entity.

Yes, they found something. Something very serious. Most times they find nothing.
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wrote:

Oh, so the government never perpetrates fraud. Gotcha.

No, but they certainly make money off the consultation later. They have no incentive to save money, not to mention shifting costs from their malpractice premiums to my pocket.

My cardiologist also had the point that if they did find an "answer" no one would care. He certainly wouldn't do anything.
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You are mostly right, it is so highly regulated and controled by the government that it can't be called "free market" at all.

While there is not one price schedule for all patients across providers, it is required that all patients be billed the same regardless of rather they are self-pay, insurance or government pay. What is billed and what is collected are two totally different things though and there can be allowance for self-pay by a discount. This is the only business or industry or service that I know of that collecting $.25 cents on every dollar billed is considered to be good.

And most people never look at those summaries.

And many times the provider will not even bother because the cost of the billing and collection process will exceed the collectable amount. On average the percentage charges by the companies that handle the billing and collections for medical providers is in the 15-20% range. It would be substantially higher if they had to bill each individual and collect from the individual instead of the insurance companies.

I would like to agree with you but in reality much of the current system is a direct result of the government involvement and rules established by Medicare, Medicaid, and a host of other often overlapping government regulations. Hell, much of the reason for the high billing amount of the current system goes back to the Carter price controls which essentially taught providers to increase their prices by the maximum allowable regardless of rather they needed to or not. If they didnn't, they would be penalized if they did need to raise prices.

There are some admitted problems but they could and should be addressed individually rather than this throw out the whole thing and try an experiment that could and in my opinion would be far worse for everybody. There have been many great ideas submitted over the years that were disgarded without consideration because they did not conform to the long term goal of a government controlled socialist system. I sure don't agree that the solution is to force people to buy something that they may or may not need or want. Its bad enough to force people to pay for a system for over 40 years before they have any opportunity to benefit from it...if they live that long and they can find a provider to accept it.
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On Sun, 6 Feb 2011 20:21:23 -0800 (PST), BobR

and yet govts where it's TOTALLY Regulated with a single payer system...are more efficient than our private etnerprise system, with private health insurance

you keep repeating this as if it's a buddhist mantra
yet you forget that OTHERcountries have SINGLE PROVIDER SYSTEMS where the govt owns EVERYTHING in healthcare. yet they're more efficient.
and a host of other often

and about 30% of all insurance paperwork is done to deny claims.

you keep making the case for MORE govt regulation. not less
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BULLSHIT and you know it...or at least you should know it.

I keep hoping that I can get it through you thick skull but I guess its hopeless.

That is not a proven fact by any reliable source but you keep repeating it as if it were.

Total fabricated lie. You pulled that one straight out of your ass and it smells like it too.

No, that is your only view and therefore your only conclusion. More Government is not part of the solution, it is the major part of the problem.
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nope.... he is right
you don't like it you can go kill yourself or sumthin
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On Mon, 7 Feb 2011 14:36:56 -0800 (PST), BobR

well that's a well reasoned argument. your use of facts is underwhelming

all you have to do
is present the evidence
a right wing mantra is not evidence
where is your evidence?

really? how about the CIA??
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html?countryName=Greenland&countryCode=gl&regionCode=na&rank 1#gl
country life expectancy medical system
japan 82 socialized australia 82 socialized canada 82 socialized france 81 socialized sweden 81 socialized
my fingers are tired

a cliche. the right spews this like a drunk vomits after a dose of antabuse
it has as much truth
i gave my evidence and my references
where are yours?
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I have concluded that you don't want facts and ignore them when presented so why bother. Its a waste of my time and you sure as hell aren't worth it.

You don't want or care about evidence, if you did you would have already looked it up and researched it on your own.

They should be, they have been trying to keep up with your bullshit.

I gave you multiple references but you ignored them as I had expected you to do.
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On Mon, 7 Feb 2011 20:07:28 -0800 (PST), BobR

ah. ANOTHER evidence packed response.
your evidence? the word "BULLSHIT!"
and that's pretty much it

ah. so you DONT have evidence.
thanks. i already knew that. and your excuse is jus a cover for the fact you have no facts

ah. i gave you FACTS
you response with your BEST ARGUMENT: "BULLSHIT"
yep. as detailed a response as the right wing can muster

here is your ENTIRE original post
WHERE is there a SINGLE REFERENCE?? you say there are MULTIPLE references. there's not a SINGLE ONE:

You are mostly right, it is so highly regulated and controled by the government that it can't be called "free market" at all.

While there is not one price schedule for all patients across providers, it is required that all patients be billed the same regardless of rather they are self-pay, insurance or government pay. What is billed and what is collected are two totally different things though and there can be allowance for self-pay by a discount. This is the only business or industry or service that I know of that collecting $.25 cents on every dollar billed is considered to be good.

And most people never look at those summaries.

And many times the provider will not even bother because the cost of the billing and collection process will exceed the collectable amount. On average the percentage charges by the companies that handle the billing and collections for medical providers is in the 15-20% range. It would be substantially higher if they had to bill each individual and collect from the individual instead of the insurance companies.

I would like to agree with you but in reality much of the current system is a direct result of the government involvement and rules established by Medicare, Medicaid, and a host of other often overlapping government regulations. Hell, much of the reason for the high billing amount of the current system goes back to the Carter price controls which essentially taught providers to increase their prices by the maximum allowable regardless of rather they needed to or not. If they didnn't, they would be penalized if they did need to raise prices.

There are some admitted problems but they could and should be addressed individually rather than this throw out the whole thing and try an experiment that could and in my opinion would be far worse for everybody. There have been many great ideas submitted over the years that were disgarded without consideration because they did not conform to the long term goal of a government controlled socialist system. I sure don't agree that the solution is to force people to buy something that they may or may not need or want. Its bad enough to force people to pay for a system for over 40 years before they have any opportunity to benefit from it...if they live that long and they can find a provider to accept it.
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wrote:

we also see the cost of our medical care in our weekly paychecks

yep you're absolutey right.
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The out-of-pocket part of health expenditures (including the o-o-p part of the premium) is only about 20%. When someone else pays 80% of the costs, there is no free market. Then there is the added weirdness of it being part of an employment contract with the inducement to use as much as possible to not leave any "on the table". THEN there is the added weirdness of not really having insurance. If insurance is defined as taking a rare yet expensive risk and spreding over many people, then we really haven't had insurance since the demise of the old major medical.

You can't put that entirely on Kaiser. It was a nice way around price and wage controls during WWII when the Feds were getting heat from all areas. Kaiser just decided to keep the money in house so they could provide it cheaper. Sorta like a Company Store.

--
"Even I realized that money was to politicians what the ecalyptus tree is to
koala bears: food, water, shelter and something to crap on."
  Click to see the full signature.
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Based on your ignorance of healthcare in general it was an easy mistake to make. So you volunteer, good for you. That sure hasn't helped to make you any expert.

Been in the reporting, billing, and compliance for over 20 years.

No, you presented your opinions but have not presented anything resembling evidence.

Same for you but all you have done is claim that our system is 40-70% more expensive. Guess that would be right if compared to systems that for the most part are so slow to provide care that often times it is not needed by the time is could have been obtained.

You must subscribe to the "Don't confuse me with the facts, my mind is already made up." belief. If you were really interested in evidence it would only take you a few minutes to do a google search and read the many articles that are readily available that fully document the many many problems with the healthcare systems in England, Canada, and elsewhere. They document issues such as poor quality of care, long wait times for specialists if at all, and the growing burden on their governments to maintain a system that continually needs a greater share of government funds. They also document many of the reasons that healthcare in the US appears to cost so much more than in other countries. For instance, the US performs more than double the number of organ transplants of any other country in the world. The survival rate for cancer is the highest in the US. There is more than a little evidence for anyone who wants the truth but none for those who won't even open their mind to the posibility that they could be wrong. Personally, I don't have the time nor the patience to try and educate someone who has proven they don't want to learn anything.
It only took me a couple of minutes to find these but there are many many more.
http://www.studentnewsdaily.com/commentary/the-cost-of-free-government-health-care /
http://www.heartland.org/policybot/results/15034/Canadian_Health_Care_Is_No_Model_for_US.html
http://www.telegraph.co.uk/news/uknews/1560849/UK-cancer-survival-rate-lowest-in-Europe.html
"THE GRASS IS ALWAYS GREENER ON THE OTHER SIDE OF THE FENCE" until you get on the other side that is.
My father-in-law developed leukemia many years ago. It was a very aggressive form of leukemia that was caught early enough that he was sent to a specialist within days of seeing his primary care physician. The next day he was checked into the hospital undergoing treatment, very expensive treatment but because he got immediate access to the specialist and the hospital he was able to get the treatment to give him another 5 years of life. In Canada, Great Briton, and a host of other countries he would have died within weeks but wouldn't have cost the healthcare system any money. I guess that is the cheaper healthcare you want for yourself and your family. Are you aware that the cancer survival rate in the US is the highest in the world? Probably not.
My 85 year old mother is also still alive and enjoying life having been a double cancer survivor and is now doing very well three years after a triple bypass that would either have been delayed until she died or denied entirely depending on where you want to compare. The same is true for my mother-in-law who has a blood disorder requiring weekly transfusions. It is true, our healthcare cost could be greatly reduced if we just let them die.
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On Sun, 6 Feb 2011 19:43:19 -0800 (PST), BobR

ah. a mistake.
so you've never done it so you dont know if this happens regularly or not
gotcha
and you're goalpost moving. your assertion was that i was not involved in healthcare.
so you were wrong..
gotcha twice

and learned nothing i see.

so you say. and yet you havent presented ANY evidence showing OUR healthcare system is MORE efficient than other countries with LOWER healtccare costs...
yep. ironclad argument you got there

and how slow is healthcare if
you have no health insurance?
and you keep backpedaling
FIRST you denied our costs were higher
you werre wrong
THEN you said it was due to factors like obesity
you were wrong
NOW you're saying we have to wait longer...in spite of the fact people w/o insurance have an INFINITE wait and you ahve NO proof our wait times are longer
do you beep when you back up like that?

and yet their people live as long as we do. they cover EVERYONE. their costs are LOWER
They document issues such as poor quality of care, long

and yet our healthcare costs are HIGHER
you keep saying ours are LOWER. you keep saying our quality is HIGHER
WRONG on both counts. WRONG. WRONG
go ahead. keep saying it. i'm just gonna keep ramming the facts down your throat.
They also document many of the reasons

and yet their people live as long...or longer than we do.
The survival

and yet their people live as long as we do. t hey cover everyone. their costs are lower

i agree that if you're 90 and have 2 days to live you can live 2 days and 3 hours with the extra $100,000 healthcare you get
and, AGAIN, WHERE IS THE PROOF THAT THEIR HEALTHCARE IS WORSE?
where is it?
we spend MORE money
insure FEWER people
and the outcomes are pretty much the same
WHERE IS THE EFFICIENY in private enterprise??
wherer is your EVIDENCE??
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