Quote
U.S. Healthcare Costs Exposed Hospital billing records revealed
#1
Posted 2013-May-08, 07:20
#2
Posted 2013-May-08, 08:12
Winstonm, on 2013-May-08, 07:20, said:
Yeah, their "list prices" are grossly inflated. That they make no effort to recover any of the difference between that and the insurance payout shows that they know it is a shell game. Compare an auto body shop: if your insurance covers less than their price, they charge you the balance.
Hotels do something similar - just look on the back of your room door for the "list price". Almost always it is much more than you are paying. They do this so they can jack up the price for certain dates/events without running afoul of price gouging laws. And all they had to do was print up some slips of paper and stick them on the doors.
-gwnn
#3
Posted 2013-May-08, 08:30
I go to a clinic because my foot gets lacerated on some broken glass. The physician or PA stitches it up. I give the front desk a co-payment. The clinic submits a bill to the insurance company. They agree to pay 'x'. I get a bill for the balance. I have no idea what this difference is when I enter the clinic, and its likely that different physicians would bill differently, and the insurance company would probably have different payment levels, depending on how the laceration is classified.
I hope 2014 is different.
Winner - BBO Challenge bracket #6 - February, 2017.
#4
Posted 2013-May-08, 12:19
#5
Posted 2013-May-08, 12:19
Phil, on 2013-May-08, 08:30, said:
I go to a clinic because my foot gets lacerated on some broken glass. The physician or PA stitches it up. I give the front desk a co-payment. The clinic submits a bill to the insurance company. They agree to pay 'x'. I get a bill for the balance. I have no idea what this difference is when I enter the clinic, and its likely that different physicians would bill differently, and the insurance company would probably have different payment levels, depending on how the laceration is classified.
I hope 2014 is different.
A few years ago I had a cat scan done - nothing found - and the bill showed an initial charge of $3000 that was negotiated to $900 by the insurance company. The question I had then and still have is if the hospital can afford to provide a cat scan for $900 why is there a discrepancy depending on the payer?
It seems a single payer or some kind of limited paying group should be able to negate these differences.
#6
Posted 2013-May-08, 12:58
Winstonm, on 2013-May-08, 12:19, said:
Indeed.
I wonder if this evolved from price negotiations between the providers and insurers. The insurers bargain the price down. The providers, wanting to get the original amount, raise the asking price to allow for some "discounting". The insurers eventually figure this out and go for more discount .. which the providers figure out, and raise their start point even more. And so on. So the gap just gets larger and larger.
I wonder, if self insured people are actually paying those inflated rates, or what happens with that.
-gwnn
#7
Posted 2013-May-08, 15:01
billw55, on 2013-May-08, 12:58, said:
I wonder if this evolved from price negotiations between the providers and insurers. The insurers bargain the price down. The providers, wanting to get the original amount, raise the asking price to allow for some "discounting". The insurers eventually figure this out and go for more discount .. which the providers figure out, and raise their start point even more. And so on. So the gap just gets larger and larger.
I wonder, if self insured people are actually paying those inflated rates, or what happens with that.
Self insured are not paying those inflated prices - but those inflated prices show up as debt in the bankruptcy proceedings.
#8
Posted 2013-May-08, 15:20
#9
Posted 2013-May-08, 19:02
At any rate, I have been spending a lot more time with doctors lately. The pricing is a mess. I am not at all sure who the villain is, if anyone, but it's a mess. Not that I have been hit hard, at least not yet. I have medicare, and I have a good supplement. For many years I was paying out a lot and needing little. Now I am very pleased to present my plastic and walk away with a modest co-pay. But the money has to come from somewhere. I rarely have a clue as to the amount.
I learned long ago not to take studies at face value. The Post has a similar article about this study. I barely skimmed it, but I thought I might want to wait for the rebuttal before climbing aboard.
This all goes back a ways. My father died in 1977 and I had some bills to pay. I got bills from doctors that I had never heard of for procedures I did not understand. Mostly I just trusted the system and wrote the checks. The one exception was a doc who sent an incorrect bill. I called the office and they agreed it was incorrect. I said send me a correct one and I will pay it. They re-sent the incorrect one. This repeated a few times until I wrote to them and said if they ever sent a correct bill they would get a check by return mail .They never sent a correct bill, I never sent a check.
Anyway, as near as I can tell, the pricing is totally irrational. It has caused me some grief, but mostly with regard to what procedures should be done when and by whom.
#10
Posted 2013-May-09, 00:14
again this seems to be where everyone hates to agree on a method of failure. Where failure in the short run leads to something better in the long run.
given trial and error..in the short run ...people die...but in other run people die but people hide or accept it.
I mean see vamps comments where people think they are lucky, very lucky\ compared to the confusion in the usa, today.
#11
Posted 2013-May-09, 00:33
Have any bbo posters ever walked out of a uk or europe doctor office? Have you ever walked away on the basis of poor service?
If not why not?
#12
Posted 2013-May-09, 02:18
mike777, on 2013-May-09, 00:33, said:
Have any bbo posters ever walked out of a uk or europe doctor office? Have you ever walked away on the basis of poor service?
If not why not?
yes, but it obviously happens a lot less often than it would if medical services had been ordinary commercial services. I once got upset with my gp and called a competitor asking to be transfered to them. They wouldn't take me. They said they needed very good reasons to take a patient that is already listed with a different local gp. I think it is some kind of peer loyalty, although I suppose it could also be based on the idea that a patient that easily gets upset with gp's is best avoided. I am not sure if all (or most) Dutch gp's would have that attitude. Nor if it would be the same in the UK. In Denmark it is not a problem to change from one gp to another, nobody would ask you to give a motivation.
#13
Posted 2013-May-09, 04:58
helene_t, on 2013-May-09, 02:18, said:
In Canada they ask and are very reluctant to "move in on another doctor's territory". Asking for a second opinion is fine but they don't like people switching primary providers. Or at least that's been my experience.
#14
Posted 2013-May-09, 06:11
Two facts emerge about U.S. healthcare. 1) It is the most costly in the world. 2) It does not provide superior care.
#15
Posted 2013-May-09, 06:18
Some plumbers are better than other plumbers. No one doubts that. It is the same with doctors. I want the better plumber, and I want the better doctor.
#16
Posted 2013-May-09, 07:01
kenberg, on 2013-May-09, 06:18, said:
Some plumbers are better than other plumbers. No one doubts that. It is the same with doctors. I want the better plumber, and I want the better doctor.
Physicians are not required to accept Medicare. With the recent decrease in allowable charges for physicians, the number of choices for physicians who accept Medicare has again decreased.
#17
Posted 2013-May-09, 08:32
As we look at costs, I used to think that it was the tort lobby that was one of the reasons for high costs. In California, however, medical malpractice is capped at damages of $250K and has been that way for over 20 years.
I know this because a friend of mine recently had routine open heart surgery. He stroked out in post-op, because the phlebotomist wasn't watching the store.
Winner - BBO Challenge bracket #6 - February, 2017.
#18
Posted 2013-May-09, 08:41
#19
Posted 2013-May-09, 09:03
We were covered by a very good health insurance plan which picked up everything. Nevertheless, I did receive a bill from the hospital. Besides the fact that the bill was about 60 pages long, the thing that struck me was the tab - over $6 million. The insurance company wound up paying about $1.2 million if I recall correctly.
This also reminds me of a commercial that ran several years ago. A patient needed surgery for some unspecified condition. When asked about it, the surgeon said "He has money coming out of the gazoo!" or something to that effect. In other words, the hospital was more than willing to do whatever was necessary because the patient had unlimited funds.
#20
Posted 2013-May-09, 09:23
Phil, on 2013-May-09, 08:32, said:
As we look at costs, I used to think that it was the tort lobby that was one of the reasons for high costs. In California, however, medical malpractice is capped at damages of $250K and has been that way for over 20 years.
I know this because a friend of mine recently had routine open heart surgery. He stroked out in post-op, because the phlebotomist wasn't watching the store.
Speaking from a biased viewpoint (as I am an attorney), the reason for the high costs is incompetent medical personell, not greedy tort lawyers. If the courts and juries were not finding in favor of the plaintiffs (essentially stating that the medical personell were incompetent) then the awards would not be so large.