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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

#221

Post by mherdeg »

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…

> 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 accrue to the school and hospital complex more than the individual practirioners.

This really depends on the forums you read. If you hang out on the whitecoatinvestor forums you'll see that there are plenty of folks who are getting by just fine on their $600k annual salaries and may even be retiring early.

Reading those forums it's clear that there are challenges (not buying a doctor house, avoiding loan debt, budgeting like a resident even once you're in your real earning years) but there are plenty of opportunities, in some disciplines, to be happy with an eight-figure lifetime earnings and a balanced lifestyle.

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

#223

Post by pjdemers »

zaroth wrote: post #213
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…

IME an uncorrected 103°F fever is really no big deal. If you are already on Tylenol and Ibuprofen and still at 103 that’s a bit more interesting. Parent pro-tip, Ibuprofen has always been way more effective and also longer lasting than Tylenol at reducing fever in my kids. I have a similar story from when my first child was diagnosed with T1D. The entire treatment consisted of administering 1 unit of subq insulin and…

Stanford Hospital used to turn you over to collections if you didn't pay. And I use the word collections loosely here. The guys who showed up at my house were basically bikers with a license to carry. Scary dudes. I had to call the cops because they wouldn't leave my property. The cops had to pull their guns to get the "collectors" to leave. Oh, and after all the billing was sorted out, I didn't owe any money. They were just try to scare me into paying tens of thousands of dollars. One day, a big hospital is going to get indicted under RICO, and it will be well deserved.

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

#225

Post by nonbel »

lotsofpulp wrote: post #214
nonbel wrote: post #206

Earlier quoted context omitted.

Then they are just quoting you the "insurance price". Think about it, how could it possibly be more expensive to cut out the middle man?

Because you don’t want to deal with the type of person that doesn’t have insurance. They may be more likely to not pay, or otherwise unpleasant to deal with.

> They may be more likely to not pay, or otherwise unpleasant to deal with.

This sounds like the typical experience with insurance companies...

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

#226

Post by sjg007 »

minikites wrote: post #13
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.

Americans in general are in love with the idea of the "just world". If someone gets sick, it's because they did something to deserve it. If we treat their illness for free, they won't learn. Additionally, lots of employers also love holding their employees hostage via healthcare and they spend millions lobbying to this end.

Yep, your comment is underrated. Employees need to protest though.. these rising deductibles and coinsurance out of pocket costs are getting out of hand.

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

#227

Post by beachy »

zanny wrote: post #216
beachy wrote: post #132

Earlier quoted context omitted.

Here's a contrasting story. On holiday in Rarotonga, our 2 year old got a chest infection. We made it way up the hill to the hospital. A stray dog watched from the side of the road as we drive into the parking area. No one in sight. Eventually we saw someone who pointed us to a building wherein sat the duty doctor. Super efficient, trained in new Zealand, she examined the sprog, diagnosed him and gave us the appropri…

To be fair that isn't the whole story and doesn't really make for a convincing argument to the contrary. Doctors should be paid well, and in the case of the Cook Islands I assume they have public institutions providing doctors and medicine. In which case, tax payers are paying for it. Which is almost always the most ethical way to do it, and the only really right way we have working practicably in the world today, bu…

It wasn't meant to be a convincing argument to the contrary - merely a contrasting story.

And certainly if I had a rare cancer I would rather be in the Mayo Clinic, as long as my insurance was all lined up.

Certainly these are difficult problems to grapple with, and bewildering to people outside the US - the current situation and also the extreme proposals currently being touted.

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

#228

Post by crazygringo »

nonbel wrote: post #206
crazygringo wrote: post #184

Earlier quoted context omitted.

They didn't have to check that, and certainly didn't. They knew the prices off the top of their head. The doctor had no idea what health plan I had or even if I had one -- they leave that up to their staff to sort out, they couldn't care less personally.

Then they are just quoting you the "insurance price". Think about it, how could it possibly be more expensive to cut out the middle man?

Um, no. My original comment explained, their cash prices are higher than the prices through insurance. (Also there's no single "insurance price", they're different for each plan they accept.)

And honestly, that's supposed to be one of the points of insurance prices, that they negotiate prices down by providing volume.

So there are clearly different economic factors at play, in different doctor's offices and hospitals. I'm just making the point it's not always the case that the cash price is cheaper -- it can be more.

I don't need to "think about it", it's just the facts.

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

#229

Post by fountainofage »

lotsofpulp wrote: post #209
m0zg wrote: post #145

Earlier quoted context omitted.

It's not just the cost of training. In the US there's implicit expectation that becoming a doctor is a way to become wealthy, similar in earning potential to becoming a lawyer. There's no such expectation in most other countries which are often used in arguments for how socialized medicine "costs less". Their doctors make a fraction of what US doctors do, so of course it "costs less". Right now in the US you'd be "so…

There better be a $300k+ payday at the end of a doctor’s training, otherwise I don’t see how the gauntlet they get put through is worth sacrificing their best years (20s and early 30s).

The thinking is also that the gauntlet is just plain wrong, so that would go away as well once their cartel (AMA) loses its power.

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

#230

Post by Gatsky »

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…

Thanks for your comment. Typically for HN it has inspired a lot of doctor bashing. The person reading Dr forums to find the ‘truth’ is particularly laughable, like making generalisations about young men from reading 4chan.

There are countries where healthcare is free, and doctors get paid well (eg Australia, Canada), and student debt is dramatically less. So you have the wrong idea why you paid so much, the real reason being that American Healthcare is a complex system in catastrophic failure mode.

I’ll give you a perfect example - at the American Society of Clinical Oncology Annual Scientific Meeting this year, the biggest and most important oncology meeting in the world where original research is presented, one of the plenary abstracts was a study showing that Medicaid expansion reduced racial disparities in oncology care. To someone in a single payer system this is blindingly obvious (if you have insurance you get better care), but in the US this counts for groundbreaking research. That is how backward US healthcare is, sadly. From the outside looking in, it is obvious that this is the case.

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