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Insured price $2,758, cash price $521

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

#91

Post by jopsen »

evrydayhustling wrote: post #71
avocado4 wrote: post #41

Earlier quoted context omitted.

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…

That forum is amazing! Thanks for the primary source! That said, two quibbles/questions: Those same threads have logins like "indebt4life" and "kids2feed", which matches what I've heard from doctor friends: the length and cost of medical training and insurance are so brutal that the folks gatekeeping are themselves in an unhealthy lifestyle and don't want it to get worse. In other words, and benefits of gatekeeping a…

> My experience has been that the crazy bills are for stuff , not people.

That could just be an accounting trick, since you're more willing to pay for stuff than people.

(On topic: obviously, there's many reasons for costs, doctors isn't the only one)

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

#92

Post by robocat »

aianus wrote: post #29
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.

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…

> Also, the opportunity cost of sitting around with a broken hip waiting to be seen

This example is bad. New Zealander here: a broken hip will be fixed in reasonable time, and I think if you have private insurance it likely would be diagnosed, fixed, and recuperated in the same hospital.

Private insurance does help if you need a hip replacement. On public, you will wait for a long time, and you will be in pain for a long time. Private is much more proactive at replacing a hip early.

However hip replacement is that common that I strongly suspect you would be financially better off paying for it when you need it (whether poor or rich).

If you are from the US, you should take care before projecting any experience you have of hospitals upon other first world countries. I think your system is so severely broken you cannot reasonably model anything about a foreign system.

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

#93

Post by paulddraper »

pnutjam wrote: post #22
pkaye wrote: post #2

My understanding is the insured patients are subsidizing all the others covered by medicare, medicaid or those uninsured.

But god forbid we make that official with some sort of oversight and functional standard system.

God knows there is a ton of oversight.

(As anyone who starts an insurance company can attest to.)

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

#94

Post by dragonwriter »

tdhoot wrote: post #37
Stratoscope wrote: post #31

Earlier quoted context omitted.

I don't quite see the connection. It seems unlikely that my doctor and his assistant would treat heart arrhythmia the same as a sore finger. And no one said I couldn't have an X-ray. They merely offered me a faster and less expensive diagnostic procedure at my own option.

I think it depends on the efficacy of the cheaper procedure. It's rare for the cheaper procedure to be as accurate as the more expensive one. If you knew the tuning fork was 80% accurate and an x-ray 100% accurate, would you still take it? I'd personally pay extra to make sure I was diagnosed correctly.

From the initial story the tuning fork would be followed up by an x-ray on a positive result; so you don't really care about overall accuracy but false negative rate (since a higher false positive rate than x-ray is immaterial, since the follow-up x-ray constraints the false positive rate.)

While the exact test done may not be common, its very common for any of a variety of broadly similar (in that they work by inducing motion which will almost certainly be quite painful if there is a fracture and but usually be tolerable otherwise) "does this hurt" tests to be used in a similar role with suspected fractures, and an x-ray only ordered if they indicate a likely fracture.

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

#95

Post by dragonwriter »

robocat wrote: post #65
tdhoot wrote: post #37

Earlier quoted context omitted.

I think it depends on the efficacy of the cheaper procedure. It's rare for the cheaper procedure to be as accurate as the more expensive one. If you knew the tuning fork was 80% accurate and an x-ray 100% accurate, would you still take it? I'd personally pay extra to make sure I was diagnosed correctly.

It depends upon the medical issue, how much you can afford, and how much you know about the downsides if you should have the issue. If it looks straight, a hairline fracture will heal properly if unstressed for a few weeks. Probably not a huge risk if wrong. You could constrain a broken finger yourself if you are any good at looking up information and applying it.

> If it looks straight, a hairline fracture will heal properly if unstressed for a few weeks.

If the fracture isn't diagnosed and the person is one who tends to engage in the kinds of activities that lead to a suspected potential fracture of the bone in question, it probably won't be unstressed for a few weeks.

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

#96

Post by crazygringo »

(American here.) Funny, my last several doctors visits the cash price has always been higher than the negotiated price.

These are all for services in the $150-300 range, and I was told upfront what the cash price would be, but they couldn't tell me what my negotiated plan rate was. (I inquired because I have a high deductible plan so I'll pay in the end no matter what.)

The negotiated prices were all at least 1/3 lower, and the most expensive one turned out to be free because it was classified as preventitive.

So it's even worse because you never know. It's certainly not a rule at all that cash prices are lower.

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

#97

Post by nonbel »

rlpb wrote: post #81
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 individua…

https://en.wikipedia.org/wiki/Chargemaster

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

#98

Post by throwaway100773 »

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…

Well said. I get a lot of flak from, well, pretty much everyone for pointing out that your neighborhood doctor is likely a scam artist. Clearly I’m generalizing but just suggesting it may be the case is usually met with undue skepticism.

Not to mention, having an inside look at med school gives you a different perspective on the motivations of most rising doctors. It’s rarely about anything but lifestyle and money. I mean, they are people too, but most med students I’ve met are looking out for number one first, and anything else is a distant second.

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

#99

Post by mehrdadn »

wikibob wrote: post #67
mehrdadn wrote: post #53

Earlier quoted context omitted.

> 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. Why not at least pay a portion of it that you would have felt was sensible?

By paying even $0.01 you acknowledge the validity of the debt and then it’s much easier for them to sue you and get a judgement.

Wait really? How so? It's not like they would otherwise lack sufficient evidence to show you showed up and received care, right? I would've thought acknowledging would just restart the clock, which would've made no difference here.

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

#100

Post by OrgNet »

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…

with my insurance, it cost you about the same for healthcare whether you are insured or not... (not including the insurance costs or government fines for lack of insurance)... mainly because they give a discount to the uninsured....
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