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 What to do???

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Slide



Age : 55
Location : Benton, Louisiana
Registration date : 2011-11-23

PostSubject: Re: What to do???   Mon Jan 14, 2013 3:24 pm

I don't see our government being efficient in running much of anything.

They have run insurance programs and without being able to access fees to other insurers or receive federal or state funding through tax dollars they can not pay their claims.
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bosun1

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Location : fly over country
Registration date : 2012-10-23

PostSubject: Re: What to do???   Mon Jan 14, 2013 3:52 pm

I smoke, I pay excise taxes on my intake. If/when it affects my health, according to the media I should get lung cancer. Not really treatable as far as I know so it's a relatively short and fatal illness. Short equals fairly cheap for the insurers. I assume medicare pays for old age related diseases like dementia so we'll leave those out of the conversation. Now for the younger people there are things like dialysis, kidney transplants, heart transplants/bypass surgery, etc. More expensive for the insurers. If they can find a popular reason to raise their rates (and profits) they will.
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puros_bran
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Location : Brandenburg, Ky
Registration date : 2007-12-10

PostSubject: Re: What to do???   Mon Jan 14, 2013 4:05 pm

Don't be ridiculous.. we need to charge those affected with Advanced Chronos Syndrome(old age) at a rate of at least 3x normal rate. That craps fatal!
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Puff Daddy
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Age : 53
Location : South of heaven
Registration date : 2007-12-09

PostSubject: Re: What to do???   Mon Jan 14, 2013 4:09 pm

Jefe, with all due respect, I've had quite a few discussions with a fellow who has been a hospital administrator for decades. What I said absolutely, positively does happen with regularity. It is the norm.

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jefe1037

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Age : 35
Location : West Chicagoland
Registration date : 2012-02-07

PostSubject: Re: What to do???   Mon Jan 14, 2013 4:27 pm

Puff, most of the guys I talk to are in private practice. I assume that I am less informed than you in this case. Thanks for the extra info.
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Puff Daddy
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Age : 53
Location : South of heaven
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PostSubject: Re: What to do???   Mon Jan 14, 2013 5:13 pm

Sorry Jefe, I didn't mean to sound short, I got interrupted by a 6 year old and abbreviated my answer. Shoulda just waited and started over.

Your experience is certainly as valid as any other first hand conversation with a direct insider and gave a good insight. My discussions with an administator revealed a system where the hospitals collect one tier of compensation from one tier of insurer (private big corp), another tier of compensation from another insurer (state,or federal program), and yet another from the self paying patient. The self pay individual pays the highest because the collections people go after them, whereas the state and private insurers negotiate packages.

The ripoff comes in the extreme case high cost being used as the starting point and negotiations going down from there. It's like the ambulance ride my wife took a couple of years back when one of the girls got real sick and I was away with our only vehicle at the time. It was pretty urgent and the docs said she did the right thing. The ambulance was already sitting at the hospital 3 blocks away from here as they had just dropped off a patient when they got the call. They drove here 3 blocks, took them there 3 blocks away, total time, maybe 15 minutes. The ambulance bill was $1700.00. Now, we have a pretty serious medical plan, covers just about everything with little to no copay, so our insurer covered it all, but I'll bet you anything they did not pay $1700.00. No doubt it was negotiated down. If I were on the hook for it, I'm sure there would be no negotiating.

What the docs actually get in private practice is probably a whole separate can of worms.

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Puff Daddy
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Age : 53
Location : South of heaven
Registration date : 2007-12-09

PostSubject: Re: What to do???   Mon Jan 14, 2013 5:22 pm

puros_bran wrote:
The 'law' requiring you to purchase health insurance by federal mandate is illegal.

All I can say about that is, good luck. They made it a law, supreme court didn't throw it out, it is not illegal.

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Slide



Age : 55
Location : Benton, Louisiana
Registration date : 2011-11-23

PostSubject: Re: What to do???   Mon Jan 14, 2013 6:07 pm

PD - my thoughts

The extreme high cost is set by the medical side of things. (The medical industry would argue attorneys are at fault.)

The insurance companies use their bargaining power represented by having many policies and the check book. Lower fees are negotiated and accepted to get a piece of that pie. Most Doctors I know hate insurance companies because they do review the bills for staking and charges outside of usual and customary. I don't see reducing the bills of the medical provider as collusion.

Medicare and Medicaid pay the least of all. Plus they can audit files and arbitrarily change the rules and fine the providers based on violations. They take a small random sampling and assume that a percentage of cases billed have these same errors. It appears that they offset their cost by fining the providers.

Some Doctors refuse to play ball with the government insurance programs. They work in much the same way that the IRS does.

I totally agree that if anything the uninsured cash patient should be charged at the very least no more than the lowest paid insurance program. Same thing with prescription medicine.

My thoughts only. No offense is intended to you, Doctors or lawyers....
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i.keenum

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Age : 27
Location : coast of mississippi
Registration date : 2011-06-12

PostSubject: Re: What to do???   Tue Jan 15, 2013 12:16 am

I got family plan but didn't have to do a questionare or take a physical. Is that something they make you do at a certain age?
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jefe1037

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Age : 35
Location : West Chicagoland
Registration date : 2012-02-07

PostSubject: Re: What to do???   Tue Jan 15, 2013 3:25 am

PD: re: the ambulance ride:

Food for thought for you: I had my first child while insured by BCBS PPO and ended up paying about 6k out of pocket, but the insurance companies "Covered" about 44 grand of other expenses.

A coworker had her child (different hospital, equal quality care, similar procedure and stays) and she was uninsured -- by choice. She saves up money and has a "pillow fund" for emergencies, and had saved up a couple of extra bucks for the baby. When letting hospital administrators know that she was paying cash up front, they were actually HAPPY. They started slashing prices like it was Walmart. she paid only $8,000. now, chronic diseases aside, and preventative care being as important as it is, this got me thinking. I probably still got the better deal, but not the significant savings that I assumed insurance afforded me.

From what I can tell, this is mostly a bunch of money shuffling.
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jefe1037

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Age : 35
Location : West Chicagoland
Registration date : 2012-02-07

PostSubject: Re: What to do???   Tue Jan 15, 2013 3:26 am

i.keenum wrote:
I got family plan but didn't have to do a questionare or take a physical. Is that something they make you do at a certain age?

Wait til you start getting your physicals as you get a little older. No grown man can be prepared for THAT test.
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Slartibartfast

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Age : 50
Location : California
Registration date : 2011-09-25

PostSubject: Re: What to do???   Tue Jan 15, 2013 11:43 am

jefe1037 wrote:
Wait til you start getting your physicals as you get a little older. No grown man can be prepared for THAT test.



Ooohhh...klahoma!







elephant



http://www.youtube.com/watch?v=l1enmyAmpik



Classic! lol!lol!lol!
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bosun1

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Location : fly over country
Registration date : 2012-10-23

PostSubject: Re: What to do???   Tue Jan 15, 2013 2:14 pm

It would be nice to get a cost up front. Doc writes down what you need, you call three local providers for a quote, specifying that you are paying cash with no insurance. Then get the quotes in writing, like getting a new clutch in your car. I would imagine the Doc 'recommends' the hospital, makes the appointment for you, then gets a kick-back -- OH! I mean a "referral fee". The hospital over charges like hell because the insurers are only going to pay so much. If they accept the insurer then they accept the amount that they will get re-imbursed. Plus it helps pay for the people who go to the emergency room and are never heard from again..
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sand18f

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Age : 67
Location : Southern Appalachia
Registration date : 2011-01-17

PostSubject: Re: What to do???   Sat Jan 19, 2013 4:12 pm

I pray that no one has to experience the Veterans Health Care System. No
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puros_bran
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Location : Brandenburg, Ky
Registration date : 2007-12-10

PostSubject: Re: What to do???   Sat Jan 19, 2013 4:34 pm

Mad Mad Mad Mad Mad Mad Mad Mad VA is a benefit to our Vets.. It's how we show them love and appreciation. Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad


It's so effed its not even a joke. I didn't think it was possibly to hate an entity.. but I hate VA.. and I hate the people that think the VA is the proper way to take care of the veterans.

ANYONE who has dealt with the VA would march on Washington for just suggesting the Federal Government can handle administrating someones medical care!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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bosun1

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Location : fly over country
Registration date : 2012-10-23

PostSubject: Re: What to do???   Sat Jan 19, 2013 10:52 pm

puros_bran wrote:
Mad Mad Mad Mad Mad Mad Mad Mad VA is a benefit to our Vets.. It's how we show them love and appreciation. Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad Mad




ANYONE who has dealt with the VA would march on Washington for just suggesting the Federal Government can handle administrating someones medical care!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Last time the vets marched on Washington was shortly after WW1. The had the army come in, break up their camp and 'disband' them...
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