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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

#121

Post by alexhutcheson »

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…

In my experience, X-rays at urgent care centers are only ~$100. Hospitals are much more expensive and variable, though.

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

#122

Post by leetbulb »

beebmam wrote: post #90
rpmisms wrote: post #14

Earlier quoted context omitted.

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.

Sure it's dangerous, but $400 out of pocket for an xray of your finger is also quite ridiculous. If my finger wasn't obviously broken, I'd probably take my chances with a tuning fork, too.

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

#123

Post by teej »

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…

> The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen.

To be fair, the doctor also cleared your child of having a life threatening emergency. That is one of the critical jobs of an emergency medicine physician and it’s part of what you pay for.

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

#124

Post by tandem_bike »

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…

Everything you say is true. Modern healthcare is so expensive and inefficient because its built around the demands and capabilities of the past. Usually I hate it when people say something is fundamentally broken, but healthcare really is.

The time has come for a complete overhaul of the system. No more primary care doctors. They can be replaced by software and patient service representatives.

Diagnostic services should be the front line of healthcare. You should be able to get whatever diagnostic test you want, whenever you want.

All prices must be 100% transparent to the patient before any services are rendered. Opaque pricing allows for arbitrarily high pricing.

Huge increases in medical school enrollments. Removal of arbitrary licensing caps.

So much more needs to be done but this is a start.

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

#125

Post by clairity »

skadamou wrote: post #68
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…

Those numbers do seem to be a bit higher than the national salary averages for physicians [1]. However, physician pay only amounts to something like 8% of total health care costs [2]. I'm not saying that doctor pay at Vanderbilt isn't driving up their healthcare costs but this doesn't seem to be the whole story when it comes to national healthcare costs. [1] https://www.merritthawkins.com/news-and-insights/blog/job-s…

to wit, as with teachers, i don’t mind doctors and other medical professionals getting paid well, but the AMA restricting supply to increase salaries is anticompetitive and wrong-headed. i also don’t mind medical devices, labs, and even drug companies getting a decent (but not exorbitant) return.

i’m less sympathetic to high administrator pay among medical networks, the whole medical records/billing industry, as well as the medical insurance industry. that feels like a very high tax burdened onto healthcare.

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

#126

Post by gwbas1c »

point78 wrote: post #35
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…

Well as screwed up as the system is one little part of why prices are so high is to cover when people don't pay.

Not true at all.

The reason why prices are so high is because of the complicated billing system that each insurance provider has. Medical providers have to create positions just for people to bill insurance.

It's gotten to the point where single-payer health care will be cheaper just because of the paperwork it'll save. (Not that I personally advocate for single-payer. We can also lower costs by correctly regulating private insurance.)

By the way, if you're into economics, look into Adam Smith's Wealth of Nations. Kings used to do the same things to keep peasants busy while they profited. This is no different.

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

#127

Post by Spooky23 »

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…

Most offensive to me is that a nurse practitioner seeing you may result in the same bill, although she makes $100k.

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

#128

Post by arbuge »

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…

> Everyone is always asking why US healthcare is so expensive. People blame it on the insurance companies and the hospitals, but my theory is it’s the providers. I worked at Vanderbilt on their payroll system, and I would regularly see general practitioners making $350,000 a year, and this was 15 years ago! It wasn’t uncommon to see teaching doctors getting paid a million dollars.

I agree it's the providers which are most at fault. Hospitals (as well as drug companies) are providers too though not just doctors. It's hospitals that are charging $4,000 a night for a hospital room and $50 for 2 tylenol which you can pick up at Walgreens for $4 for a 24-pack. Actual examples from my hospital bill when I had my appendix removed a few years ago. The total came to about $50k, of which I believe the portion that went to doctors and surgeons was about $10-15k.

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

#129

Post by kaibee »

devoply wrote: post #11
dantheman wrote: post #5

Earlier quoted context omitted.

The 80/20 Rule could be one reason -- the more they spend on health care, the more they can spend on other things. https://www.healthcare.gov/health-care-law-protections/rate-...

Sounds like the government needs to sue both insurance companies and hospitals for collusion to stop this.

It's extremely unlikely that there's actual collusion. But actors acting in their selfish best interest can definitely look like collusion.

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

#130

Post by refurb »

gwbas1c wrote: post #126
point78 wrote: post #35

Earlier quoted context omitted.

Well as screwed up as the system is one little part of why prices are so high is to cover when people don't pay.

Not true at all. The reason why prices are so high is because of the complicated billing system that each insurance provider has. Medical providers have to create positions just for people to bill insurance. It's gotten to the point where single-payer health care will be cheaper just because of the paperwork it'll save. (Not that I personally advocate for single-payer. We can also lower costs by correctly regulating…

Medical providers have to create positions just for people to bill insurance

It's the same in Canada. Billing doesn't go away under single payer. Sure it's likely less complex, but someone still needs to do it.

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