No, Illinois. Sorry I called your comments about co-pays "whining." That was snarky of me. BTW, I have a PRIVATE INSURANCE plan too. United Healthcare Medicare Advantage. Traded as UNH on the NYSE. My premium is paid to UNH by the U.S. taxpayer. So much for PRIVATE INSURANCE.
There are a few doctors and clinics operating that way. Cheap and sustainable.
I recall paying $5 to $6 to see a doctor back in the late 50's. That translates to about $45 today. My doctor bills $225 per visit.
Sorry?
I just recently decided to eliminate the "s" word from my vocabulary:
after I heard these lines from "Cat On A Hot Tin Roof":
"Whatever you did, don't apologize.
Just don't do it again.
If you didn't do it, start doing it."
;)
Yup. Sneaky buggers.
Depending on what I'm there for, my doctor charges between $48 and something like $75; not too far from your numbers.
For the items I billed for, which were numerous, private pay was always the highest by far. There was no limit on the price ceiling. If Medicare paid $18 the clinic might charge $100. Private was where you "made up" for other loses. IIRC, it was particularly true for blood work. Some reagents are expensive and Medicare B reimbursement was really low so we had to jack them as high as we could to afford the reagents. Sad but true. We had a small lab so we couldn't buy reagents like the big labs do. Unfortunately, The lab eventually went out of business. It was really sad because we had to let a good person go. Some Medicare Part B reimbursement was tricky but Part A *was* a cash cow. Looking back it was almost like legalized crime. You all should be happy it ain't like that no more but now the reimbursement is so low, for part B at least, many docs are going to have to drop Medicare and Medicaid and only except private pay or go under. Them times they are a changin'. No more free ride.
"My own family was poor when I was kid, although I didn't know it; I just thought we were broke. What we managed to escape in 1966 in Squaresville, Ohio was not poverty. We had that. What we managed to escape is help."
-PJ O'Rourke
Well one does not preclude the other (grin).
gonjah wrote in news:2vmdnQLglZiXCAnSnZ2dnUVZ snipped-for-privacy@posted.toastnet:
Which medical care institution or physician practice charges private patients the same as Medicare reimburses them?? The bills I have seen were generally several times what Medicare reimburses.
Good line. Don't think I'll use Williams' drug and alcohol loaded characters as my guides for conduct though. Maybe Ann Landers or Miss Manners work better for that. But my mama taught me enough - when I remember.
Yeah......See the post I did below about labs. I did so much "pricing" I get fuzzy about exactly how I did each item over the years. That was over nine years ago. The point is we raised pricing when Medicare raised prices (except for room and board and that was as needed.) As I recall, I'd post the Medicare price and use a factor like 1.8 and enter that into the computer to set the private or private insurance rate. But for some items, like labs, there wasn't a factor. It was just the highest the owner thought we could charge. It was probably left to my discretion.
There is a point here. Instead of national health insurance where the govt hands out more money, there are simple steps that could be taken to make the free market work in healthcare just like it does in so many other markets. That list of procedures should be required to be posted on the web by every hospital and service provider. Then we would have PRICE DISCOVERY.
CBS news just had a story on a study done in California that looked at the cost of an apendectomy without complications. The cost ran from $1500 to $182,000. The median was around $35,000. Under Medicare the govt pays $7500. Now if you had the cost posted for the procedure, you could find out approximately how much it should cost BEFORE you went and had the procedure. Then you could choose your hospital accordingly.
Just a simple thing, but it's a very reasonable one, that could be easily implemented and is long overdue. How many bureaucracies do we have at the federal and state level for consumer protection? Yet we don't have a requirement that hospitals, test facilities, etc provide prices?
But when you are in urgent need of an appendectomy you don't have time to shop around, and maybe the cheapest one doesn't accept your insurance plan.
A TV program a couple weeks back quoted an economist who is in general a supporter of the "free market" but said that it doesn't work for health care: if you are considering buying a car, you can shop around, decide on the Ford or the Chevy or the Nissan. or decide not to buy one at all; but if you need open-heart surgery your choices are limited and you don't have the option of simply walking away.
Perce
But the vast majority of the insurance expenditures are NOT for emergency procedures and you have plenty of time to shop around.
Exactly. Even with an appendicitis, in most cases you'd have 30 mins for you or someone else to take a look on the web at the hospital options. I sure would before I just go in blind. And even if the lowest cost one doesn't accept your insurance, there might be other ones that do that are still a lot less than where you would wind up if you just went to the most convenient.
The whole point obviously goes beyond this. When you have price discovery you enable the free market to work. It doesn't require everyone to find and get the lowest price. People looking at the prices posted will result in business being lost by the hospitals with prices that are out of line. That brings pressure on those hospitals to reduce prices.
That economist perhaps has not given it much thought.
When you shop for a car, you take the bad with the good, you don't buy an engine here, a transmission there, and a body somewhere else; you buy a finished product (perhaps you don't like the particular transmission, but you like the engine and the body, so you buy the car).
In a free market, you would shop the same way for health insurance. One plan might have high co-payments, but lower premiums. Another might cover elective surgery, while others might not. One might cover preexisting conditions, while others don't. So you pick the one that best suits your needs (and part of that is a crap-shoot, because you don't really know what your future needs will be).
The problem is that some people will not buy insurance, either because they like to gamble, or they lack money. When these people need care, the medical community is ethically bound to provide it, and someone else gets stuck paying for it. So how do we solve this problem? Perhaps a government program to pay the costs, and require some sort of public service by the non-insured to make up the loss.
To me, a major problem with health care is that the government, through mediwhatever, is the biggest insurer, and dictates how much they will pay and what procedures they will cover. If the actual cost of a procedure is $500, the government can pay $100, and require that the provider accept that as full payment. (Other insurers act pretty much the same way). The government also requires that the full $500 be billed to everyone, so if you don't have insurance, you are on the hook for the full $500, unless the provider writes it off as a bad debt or a charitable act. And of course the government programs do not have to answer to shareholders, so they can run up huge losses with impunity. Private insurers have to be profitable, or they go out of business. And if they mistreat the policy holder, they can be sued; the government is generally immune to being sued.
Drive in discount surgery? ^_^
TDD
About five years ago my doctor wanted me to do a "sleep study". I thought was a waste of time and money, so asked how much it would cost. No one would (could) tell me how much it would cost; "why do you care, your insurance will pay for it". I finally did it but it was a waste of money and I still don't know what it cost.
BS. the hospitals will just stop performing non-profitable surgeries. They will eventually closed down the emergency room and finally since they now have more time, staff and resources, they will concentrate on serving the very rich. The end result is that the only place to get the non-profitable surgeries will be at facilities that aren't good enough to attract the rich client and therefore not profitable enough to attract the best staff, much less the competent staff.
and then the rich will start suing the lower-tier hospitals because they weren't able to rush there to get an emergency in-grown toe-nail fixed
sosted will result in business being lost by the
That is already happening. MCaid prices have shrunk to so far below costs that hospitals are refusing to take non-emergency cases for MCaid payment. Last year there was a survey in one of the Emergency Medicine Medicine Journals showing that 97% of ED docs had had at least one patient come to their ED because they were on MCaid and couldn't find a doc who would treat them. You are also seeing more and more docs, especially the specialists but also Primary Care, who are not accepting new MCare patients. Should be getting a lot worse as the changes brought about by Obamacare begin to kick in. The government program already pay 60 cents or less for every dollar the Evil Insurance Companies do on comparable treatments. That, too, will get worse.
oh, it's not always about docs not treating, it's about the fact that if you aren't in some form of HMO, how do you get treated for an URGENT problem when the doctors office is closed. Around here some of the hospitals are triaging to urgent care or emergency care which must be saving them something
Then those patients aren't using the available help available from such places as Senior Centers that have Medicare Specialists. I availed myself of their services and it should be making my medical care better than it has ever been
could be, but probably not
Have the surgery done at doc in the box? Hey, discount surgery sounds interesting.
Christopher A. Young Learn more about Jesus
Drive in discount surgery? ^_^
TDD
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