Health Care Rant

[SheikYerbuti]

So I get a bill from the insurance company for the Shiekette's last 2 office visits. She calls the insurance company:

 

Shiekette: Why am I getting billed for 2 visits? I've been going to this doctor for years and its always been covered.

Insurance moran: Oh, your doctor dropped out of our network. . . in JANUARY.

Shiekette: Why wasn't I told this 9 months ago?

Insurance moran:

 

Next phone call. . .this time to the doctor's office:

 

Shiekette: I was just told that you guys have been out of my network since January. Is this true?

Receptionist moran: Yes, it is.

Shiekette: Why didn't you tell me this before I had TWO office visits that weren't covered?

Receptionist moran: Yeah. . . they should have let you know that.

Shiekette: WHO IS THE "THEY" IN THAT SENTENCE?

Receptionist moran:

 

 

Tell me again how the healthcare system we have is the best option. . .

[dmarc117]

sounds to me like a lack of communication from your doctor.

[Big Country]

Well, really the blame lies entirely with Sheikette. Had she not gone to the doctor, then this would be a non-issue.

[H8tank]

Who pays for the oil change in your car? You or Geico?

[Azazello1313]

So I get a bill from the insurance company for the Shiekette's last 2 office visits. She calls the insurance company:

 

Shiekette: Why am I getting billed for 2 visits? I've been going to this doctor for years and its always been covered.

Insurance moran: Oh, your doctor dropped out of our network. . . in JANUARY.

Shiekette: Why wasn't I told this 9 months ago?

Insurance moran:

 

Next phone call. . .this time to the doctor's office:

 

Shiekette: I was just told that you guys have been out of my network since January. Is this true?

Receptionist moran: Yes, it is.

Shiekette: Why didn't you tell me this before I had TWO office visits that weren't covered?

Receptionist moran: Yeah. . . they should have let you know that.

Shiekette: WHO IS THE "THEY" IN THAT SENTENCE?

Receptionist moran:

 

 

Tell me again how the healthcare system we have is the best option. . .

 

you are right. clearly the solution to this kind of paperwork/communication SNAFU is to create a hugh new government bureaucracy to handle it.

[CaP'N GRuNGe]

you are right. clearly the solution to this kind of paperwork/communication SNAFU is to create a hugh new government bureaucracy to handle it.

 

Yep. One where the overhead cost is only like 3% compared to private insurers. Good idea.

[Mark5]

Same thing has happened to me. You have to ask (or check your insurance online with Doctors in my network) EACH time before you. They can drop out and in at ANY time without notifying you. My response was "oh well, you got my 20 bucks and thats ALL your getting" Never got a bill after that.

[Ursa Majoris]

Damn glad my doc didn't drop out of network unexpectedly. The bill was 200 grand.

[Jimmy Neutron]

That problem is not indicative of bad healthcare, just bad communication.

 

Yep. One where the overhead cost is only like 3% compared to private insurers. Good idea.

 

A government program with 3% overhead? Only if they're doing their own accounting.

[Ursa Majoris]

That problem is not indicative of bad healthcare, just bad communication.

 

 

 

A government program with 3% overhead? Only if they're doing their own accounting.

Not exactly 3% but nevertheless............

 

January 14, 2004

A study by researchers at Harvard Medical School and Public Citizen finds that health care bureaucracy last year cost the United States $399.4 billion.

 

The study estimates that national health insurance (NHI) could save at least $286 billion annually on paperwork, enough to cover all of the uninsured and to provide full prescription drug coverage for everyone in the United States.

 

The study, to be published in the forthcoming International Journal of Health Services was based on the most comprehensive analysis to date of health administration spending, including data on the administrative costs of health insurers, employers' health benefit programs, hospitals, nursing homes, home care agencies, physicians and other practitioners in the United States and Canada.

 

The authors found that bureaucracy accounts for at least 31 percent of total U.S. health spending compared to 16.7 percent in Canada. They also found that administration has grown far faster in the United States than in Canada.

 

Consumer Affairs

[Jimmy Neutron]

Not exactly 3% but nevertheless............

 

Consumer Affairs

We already have government health care. The VA, Medicare, Medicaid - this is the kind of expensive, poor quality health care the government provides. My pops gets free health care from the VA, but hasn't set foot in a VA facility since 1970. At work we deliver medical supplies to VA hospitals and I understand why my dad passes on this "benefit."

 

The government does not do these things efficiently or well.

[Ursa Majoris]

We already have government health care. The VA, Medicare, Medicaid - this is the kind of expensive, poor quality health care the government provides. My pops gets free health care from the VA, but hasn't set foot in a VA facility since 1970. At work we deliver medical supplies to VA hospitals and I understand why my dad passes on this "benefit."

 

The government does not do these things efficiently or well.

Well you would think then that the highly efficient private insurance system would skew the costs downward, firmly in favor of the US over the entirely state-run Canadian system, wouldn't you? Doesn't seem to be the case though. Here's some more from the same report:

 

Last week, the government reported that health spending accounts for a record 15 percent of the nation's economy and that health care spending shot up by 9.3 percent in 2002. Insurance overhead (one component of administrative costs) rose by a whopping 16.8 percent in 2002, after a 12.5 percent increase in 2001, making it the fastest growing component of health expenditure over the past three years. Hence the figures in the Harvard/Public Citizen Report (which was completed before release of these latest government figures), may understate true administrative costs.

 

The authors of the International Journal of Health Services study attributed the high U.S. administrative costs to three factors. First, private insurers have high overhead in both nations but play a much bigger role in the United States.

 

Second, The United States' fragmented payment system drives up administrative costs for doctors and hospitals, who must deal with hundreds of different insurance plans (for example, at least 755 in Seattle alone), each with different coverage and payment rules, referral networks, etc.

 

In Canada, doctors bill a single insurance plan, using a single simple form, and hospitals receive a lump sum budget, much as a fire department is paid in the United States. Finally, the increasing business orientation of U.S. hospitals and insurers has expanded bureaucracy.

 

Fact is, Jim, that's it's not the government pushing the price up through inefficiency, it's the insurance racket. You can deny it all you want (and I know you want to because it diametrically opposes your anti-government attitude) but the data are very stark - we pay lots more than anyone else because our private system is a towering bureacracy of waste and inefficiency.

[SheikYerbuti]

This is exactly where I was hoping this thread would go. . . seriously.

 

 

[Azazello1313]

Well you would think then that the highly efficient private insurance system would skew the costs downward, firmly in favor of the US over the entirely state-run Canadian system, wouldn't you? Doesn't seem to be the case though. Here's some more from the same report:

 

 

 

Fact is, Jim, that's it's not the government pushing the price up through inefficiency, it's the insurance racket. You can deny it all you want (and I know you want to because it diametrically opposes your anti-government attitude) but the data are very stark - we pay lots more than anyone else because our private system is a towering bureacracy of waste and inefficiency.

 

right....so the government creates a huge bungling mess of regulation for patients and providers (and taxpayers) to deal with and pay for, and you turn around and say the government has nothing to do with it, it's all the fault of private industry.

[Ursa Majoris]

right....so the government creates a huge bungling mess of regulation for patients and providers (and taxpayers) to deal with and pay for, and you turn around and say the government has nothing to do with it, it's all the fault of private industry.

So the US Government is three times less efficient than the Canadian Government. None of the inefficient overhead (37%!!!!) is down to the private insurance system, it's all the government's fault.

 

Gotcha.

[Jimmy Neutron]

Well you would think then that the highly efficient private insurance system would skew the costs downward, firmly in favor of the US over the entirely state-run Canadian system, wouldn't you? Doesn't seem to be the case though. Here's some more from the same report:

 

Fact is, Jim, that's it's not the government pushing the price up through inefficiency, it's the insurance racket. You can deny it all you want (and I know you want to because it diametrically opposes your anti-government attitude) but the data are very stark - we pay lots more than anyone else because our private system is a towering bureacracy of waste and inefficiency.

 

If we actually had free market health care without a lot of intrusion from the government, we'd be lightyears ahead of where we are today. A lot of that paperwork and administration is to meet government requirements.

 

Private industry (when left to its own devices) actually does a good job of keeping admin expense in check, though perhaps in cycles.

 

right....so the government creates a huge bungling mess of regulation for patients and providers (and taxpayers) to deal with and pay for, and you turn around and say the government has nothing to do with it, it's all the fault of private industry.

 

Az beat me to it.

 

Congress passed the HMO Act of 1973 (thereabouts) that really kicked off the mess we now have. Again - this mess was largely induced by government regulation, not the greedy creation of the private sector.

[Pope Flick]

This is exactly where I was hoping this thread would go. . . seriously.

 

 

 

 

One thing I can tell you from experience is that if you want to pay cash out on this, the Dr should cut you a steep 60-70% discount. All you have to do is ask. I had some insurance issues last year and when I went to have a few procedures done they go that route quite quickly. One was even retroactive due to a miscommunication. They are willing. If you can get it down to a little over your copay you it might be worth it to drop the fight and move on.

[Jimmy Neutron]

One thing I can tell you from experience is that if you want to pay cash out on this, the Dr should cut you a steep 60-70% discount. All you have to do is ask. I had some insurance issues last year and when I went to have a few procedures done they go that route quite quickly. One was even retroactive due to a miscommunication. They are willing. If you can get it down to a little over your copay you it might be worth it to drop the fight and move on.

 

Yeah, they will. My daughter had her apendix out last July - fully insured. Cost - $13.9k.

 

Our friend's son has his apendix out this July, nearly same age - same hospital, same doc - uninsured - $5.8k.

 

No complications in either case, both one-night stays.

[keggerz]

on a slightly different note....has anyone actually had a doctor see them at the time of their actual appointment?

 

today mine was scheduled for 2:30 they say come in a half hour early to fill out some paperwork since it will be your first visit here....when do I finally get called? 4 O'Fn Clock

[Pope Flick]

Yeah, they will. My daughter had her apendix out last July - fully insured. Cost - $13.9k.

 

Our friend's son has his apendix out this July, nearly same age - same hospital, same doc - uninsured - $5.8k.

 

No complications in either case, both one-night stays.

 

 

I'm not sure what an appendectomy involves these days, but they could have shaved off even more if the doctor/surgeon would have allowed him to be treaed as an outpatient if he came through the operation fine. They can do the surgery first thing, and then observe you all day since you've paid for a 'day's stay' but with some surgeries they can outpatient you if you're not running a fever, etc.

[Jimmy Neutron]

I'm not sure what an appendectomy involves these days, but they could have shaved off even more if the doctor/surgeon would have allowed him to be treaed as an outpatient if he came through the operation fine. They can do the surgery first thing, and then observe you all day since you've paid for a 'day's stay' but with some surgeries they can outpatient you if you're not running a fever, etc.

 

The doc told us that normally they take the appendix through a scope, but in both cases they removed the appendix through a regular incision. I think that's why both kids stayed overnight.

[Jimmy Neutron]

on a slightly different note....has anyone actually had a doctor see them at the time of their actual appointment?

 

today mine was scheduled for 2:30 they say come in a half hour early to fill out some paperwork since it will be your first visit here....when do I finally get called? 4 O'Fn Clock

 

I wait 10 minutes and leave if I'm not "invited back."

[keggerz]

I wait 10 minutes and leave if I'm not "invited back."

but I needed more drugs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

for my back

Edited September 4, 2008 by keggerz

[Jimmy Neutron]

but I needed more drugs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

for my back

 

You can't have an Rx called in?

[westvirginia]

Well you would think then that the highly efficient private insurance system would skew the costs downward, firmly in favor of the US over the entirely state-run Canadian system, wouldn't you? Doesn't seem to be the case though. Here's some more from the same report:

 

 

 

Fact is, Jim, that's it's not the government pushing the price up through inefficiency, it's the insurance racket. You can deny it all you want (and I know you want to because it diametrically opposes your anti-government attitude) but the data are very stark - we pay lots more than anyone else because our private system is a towering bureacracy of waste and inefficiency.

 

 

Looking at the Pentagon, our schools, and most construction projects - do you TRULY believe the system would be more effecient under the government? Really?