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Insured price $2,758, cash price $521

latimes.com

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Re: Insured price $2,758, cash price $521

#81

Post by rlpb »

johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

I have read elsewhere, but cannot find a reference right now, that insurers typically pay only a percentage of any bill and expect the provider to accept it in final settlement. The percentage gets negotiated around.

If this is true, then it makes sense that the providers inflate their original bills so that when they get the proportional settlement, the amount they receive is reasonable.

The claim was that individuals settling directly are merely caught in the crossfire.

If this is true, then it's not the providers being unreasonable.

Re: Insured price $2,758, cash price $521

#82

Post by ceejayoz »

Shivetya wrote: post #49
johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

if you are upset over their pay imagine how you must feel about those in public service, let alone their pensions. you can pull down those numbers being a city manager and get over 100k in pension to boot! the medical profession is not easy and i don't begrudge them their fees.

> you can pull down those numbers being a city manager

Where? NYC's mayor doesn't even make those numbers.

Re: Insured price $2,758, cash price $521

#83

Post by seanmcdirmid »

velcrovan wrote: post #59
aianus wrote: post #29

Earlier quoted context omitted.

As mentioned below, the price doesn't matter when nobody is available to see you. Also, the opportunity cost of sitting around with a broken hip waiting to be seen can be higher than going to a privatized country/province and paying for the surgery, in which case you're a super-sucker who paid extra taxes for decades just to end up paying out of pocket for surgery anyways. Anyways, the US system is probably worse ove…

Funny, I have a sister in Canada and a sister in Switzerland, neither of them have had trouble getting ultrasounds. My wife's grandmother is also in Canada and was treated the same day for her broken hip. I'm really sick of being told things are impossible in the US that are normal in other developed countries.

Interesting to note that Switzerland has a system of mandatory health insurance that Obama care was partially based on.

Re: Insured price $2,758, cash price $521

#84

Post by dragonwriter »

erikig wrote: post #15
Stratoscope wrote: post #9

Beyond opaque and variable pricing for the same service, there is also the question of whether something simpler would do the trick. Some years ago, I thought I might have broken my finger. I went to the doctor and it was actually the physician's assistant who saw me. I'd explained at the front desk that I had a high-deductible policy and I would be paying in full for the visit. The PA said "Usually we would send som…

Out of curiosity, why would it hurt a lot more if a bone was broken?

Because instead of being a smooth unit the bone has broken edges, and with vibration its moving rapidly within the surrounding flesh; its kind of like having an electric knife embedded in your flesh.

Re: Insured price $2,758, cash price $521

#85

Post by johnwheeler »

cwilkes wrote: post #73
johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

If it was so easy to diagnose then why didn’t you do it yourself? What you are paying for is piece of mind and expert advice. What would you do if someone wanted your expert advice on something you told them your fee and then solved their problem in 5 minutes and they balked at paying you? This is the old saw about $1 for the work and $999 to know where to hit the machine with a hammer.

OK, following your logic, when is too much, too much? Remember that prices are not disclosed before treatment. Would a million dollar bill be reasonable?

Re: Insured price $2,758, cash price $521

#86

Post by heymijo »

avocado4 wrote: post #41
johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

https://www.politico.com/agenda/story/2017/10/25/doctors-sal... Providers are the core problem. Various doctor associations (AMA et al) have strangled supply side of healthcare through State licensure and scope of practice laws. Just read medical forums to get an idea of what an average doctor thinks about competition in the form of midlevels: https://www.auntminnie.com/Forum/tm.aspx?m=581583 "Don’t teach your mid le…

> Various doctor associations (AMA et al) have strangled supply side of healthcare

To add more details to this here's something I recently read about the supply constraint and its origins.

> Then as now, Medicare reimbursed hospitals for a significant share of residents’ salaries. The Balanced Budget Act established limits on those reimbursements, effectively fixing the number of funded residents at 1996 levels. (In 1999 Congress amended the limit for rural hospitals only, increasing the numbers of funded residents at those hospitals to 130 percent of 1996 levels.) Essentially, the law stipulated that if a hospital wanted to expand its pool of residents, Medicare would not pay for it.

How could such a provision make it through Congress? Lawmakers received cover from the American Medical Association (AMA), the Association of American Medical Colleges, and other major stakeholders in American medicine who endorsed caps on funding for residents and other graduate medical education programs. In March 1997, months before the Balanced Budget Act was enacted, the AMA even suggested reducing the number of U.S. residency positions by approximately 25 percent — from 25,000 to fewer than 19,000. “The United States is on the verge of a serious oversupply of physicians,” said the AMA and other physicians’ groups in a joint statement. Since most states require at least some residency training for medical licensure, reducing the number of residency positions would curtail the supply of doctors in the U.S.

Fast forward two decades, and what once seemed like a glut now looks like a shortage. The growth in the number of residency positions — and thus the number of doctors — slowed after the passage of the Balanced Budget Act. From 1997 to 2002, the number of residents in the U.S. increased by just 0.1 percent. Although the number of positions has increased since then, each year thousands of residency applicants fail to secure a position. Factor in an aging population and a projected increase in demand for health care services, and the U.S. is now forecasted to experience a shortage of 46,900 to 121,900 physicians by 2032. Absent a meaningful response from Congress, it will be doctors — particularly residents — and their patients who pay the price.

https://undark.org/2019/07/25/looming-doctor-shortage/

Re: Insured price $2,758, cash price $521

#87

Post by Retra »

cwilkes wrote: post #73
johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

If it was so easy to diagnose then why didn’t you do it yourself? What you are paying for is piece of mind and expert advice. What would you do if someone wanted your expert advice on something you told them your fee and then solved their problem in 5 minutes and they balked at paying you? This is the old saw about $1 for the work and $999 to know where to hit the machine with a hammer.

If they knew the costs before being charged, you could make a stronger argument. As it is, they are not being charged for expertise, but for being ignorant of the costs.

Re: Insured price $2,758, cash price $521

#88

Post by ceejayoz »

en4bz wrote: post #19
astrodust wrote: post #8

Wouldn't it be nice to have an ultrasound and not know the price, nor care? That's what countries with single-payer are like. America needs to give up on this nonsense. There should be riots.

Except you often have to wait weeks for non-life threatening issues. In the US you can get imaging done same or next day.

It's hardly unusual to wait weeks for non-life threatening issues in the US, especially for specialists or in rural areas.

https://www.aan.com/PressRoom/Home/PressRelease/1178

> Previous studies have shown that the average wait times to see a neurologist are increasing. The average wait time for a new patient to see a neurologist in 2012 was 35 business days, up from 28 business days in 2010. The average wait for a follow-up visit in 2012 was 30 days, up from 26 days in 2010.

https://www.beckershospitalreview.com/hospital-physician-rel...

> The average wait for a new patient seeking an appointment with a dermatologist in a major metropolitan area is 32.3 days, according to a recent survey conducted by Merritt Hawkins.

Re: Insured price $2,758, cash price $521

#89

Post by ikeboy »

>The near-total lack of transparency in healthcare pricing is a key reason we have the highest costs in the world — roughly twice what people in other developed countries pay.

Nope. We pay around what you'd expect given our consumption in other areas. See https://randomcriticalanalysis.com/2018/11/19/why-everything...

Re: Insured price $2,758, cash price $521

#90

Post by beebmam »

rpmisms wrote: post #14
Stratoscope wrote: post #9

Beyond opaque and variable pricing for the same service, there is also the question of whether something simpler would do the trick. Some years ago, I thought I might have broken my finger. I went to the doctor and it was actually the physician's assistant who saw me. I'd explained at the front desk that I had a high-deductible policy and I would be paying in full for the visit. The PA said "Usually we would send som…

That's extremely cool, and has my gears turning about how to encourage that kind of behavior.

That ISN'T cool, that's quite dangerous, because if it was indeed broken, that may cause harm. Rule #1 of being a doctor is violated.

X-ray imaging on a finger is virtually harmless. Using a tuning fork to vibrate a potentially broken bone and causing a patient to feel pain is not harmless.

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