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The cost of two weeks in an pediatric/infant ICU

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Re: The cost of two weeks in an pediatric/infant ICU

#241

Post by cloudfifty »

Y_Y wrote: post #236
cloudfifty wrote: post #184

Earlier quoted context omitted.

> On the private system, I can see a consultant in one month instead of six, or get a surgery in three months instead of three years. This is all for non-emergency care of course. Have you considered that you are essentially jumping in line just because you have a larger wallet than other people?

Yes. I find it difficult to deal with morally. Fwiw, I'm not particularly well-off, and I only spend about two weeks' worth of take-home pay a year on my insurance.

My intention was not to flame you individually, but to emphasize that the argument "well, the lines are shorter" is pretty shallow without some background information on what that means in practice.

Re: The cost of two weeks in an pediatric/infant ICU

#242

Post by iammisc »

Jenk wrote: post #24
tiahura wrote: post #10

Earlier quoted context omitted.

Your comment misses the point. There are two reasons why this bill is so high: 1. Some doctors and some hospitals are make tremendous amount of money - hospital revenue is about $1T and doctor revenue is about .5T. 2. This country has an insatiable demand for expensive healthcare. There’s no country with universal coverage where a child with little chance for survival would have received this level of care.

The UK gives this level of care to many people routinely.

And yet, while many american insurers cover expensive gene therapies, European autorhities simply pretend the drugs are unsafe and refuse to cover them.

This sort of thing goes both ways

Re: The cost of two weeks in an pediatric/infant ICU

#243

Post by Y_Y »

hef19898 wrote: post #213
Y_Y wrote: post #202

Earlier quoted context omitted.

When you say they don't have any issues, do you mean it doesn't happen? I'm more familiar with the Spanish, Irish and UK systems. I tried to find a nice document giving numbers for what I was describing, but most of what I can find is anecdotal, and the official reports are weren't quantitative. Here's an article from an Irish newspaper last year that gives a rough guess (though of course there are other factors): ht…

Waiting times do happen, usually end of quarters when the quarterly budget runs out. No issues in so far as these waiting times don't affect emergency procedures. And no, I don't see a direct link between public health care and wait times. The German issues are mostly caused by a bloated bureaucracy.

I think we're pretty much in agreement then. Emergency procedures don't have long waiting times in any of these nice European countries. (Of course, even in the US they will give some urgent life-saving care to someone who can't pay.)

I also think that these (some several year) wait times aren't unavoidable. Management of these national public health systems is fabulously complicated and difficult and expensive, but it could certainly be done much better. In the end I think a country that really wanted to, and was willing to pay, could have a public system at least as good as what a 1%er in the US gets.

Re: The cost of two weeks in an pediatric/infant ICU

#244

Post by runako »

boopboopbadoop wrote: post #217
runako wrote: post #190

Earlier quoted context omitted.

> Do you plan to retire? What will happen then? When people retire, they are automatically covered by the socialized Medicare insurance program. Medicare is extremely popular among its recipients, many of whom nonetheless oppose socialized medicine for the general populace.

I wasn’t aware of that. Is there a minimum age to qualify? I remember hearing some stories coming out of the 2016 election similar to what you mentioned, the hypocrisy/irony is palpable.

Medicare is available to Americans 65 and over, regardless of income or assets.

One of the proposed means to improve our healthcare system is to reduce that age from 65, potentially to as low as 0.

Re: The cost of two weeks in an pediatric/infant ICU

#245

Post by Jenk »

iammisc wrote: post #242
Jenk wrote: post #24

Earlier quoted context omitted.

The UK gives this level of care to many people routinely.

And yet, while many american insurers cover expensive gene therapies, European autorhities simply pretend the drugs are unsafe and refuse to cover them. This sort of thing goes both ways

Gene therapy is available on the NHS in the UK.

And the American system that is systematically bankrupting sick people for profit is a damn sight less perfect than the European authorities issues.

Yes, it goes both ways, but it goes much further one way over the other.

Re: The cost of two weeks in an pediatric/infant ICU

#246

Post by TheCondor »

PragmaticPulp wrote: post #20

For those unfamiliar with the weirdness of the US insurance system: Nobody pays the prices on these bills. This is a pre-insurance bill with inflated values: > Why am I sharing one of her (pre-insurance) bills? Insurance companies have negotiated maximum allowed prices for every line item on this bill. Different insurance companies will have different negotiated rates. The insurance companies will pay either the mini…

By “nobody” do you mean literally nobody or nobody that isn’t otherwise marginalized?

There is such a thing as medical induced bankruptcy in the US. There are bill collectors who collect medical debt. I would be utterly shocked if those prebills were not used to scare and shock certain groups of people. Nor would I be surprised if there are modern indentured servants paying off an impossible debt based upon them in some jurisdictions in the US.

Maybe generally, if you’re employed, white, speak English, etc… you’ll never pay that stuff

Re: The cost of two weeks in an pediatric/infant ICU

#247

Post by whocares2345 »

tyingq wrote: post #215
whocares2345 wrote: post #199

Earlier quoted context omitted.

Maybe, just maybe it also includes the cost of actually administering it by a professional and? Scotty aint gonna beam it into ya… So once it’s negotiated down to $800 - it’s mostly labor of people involved in the process of taking it from pharmacy all the way inside you

>Maybe, just maybe it also includes the cost of actually administering it by a professional Nope. That's a separate line item. Appreciate the weird sarcasm though, as if I thought it would be magically administered for free? > resp tx initial or subsequent qty 33@$318 total $ 10,494 (note: "tx" == therapy) Also, 3ml takes 5 to 15 minutes to administer. So, even if I'm generous, that respiratory therapist costs $1272/…

No it’s not a separate line item.

The administration part includes getting the instruction to do so, retrieving medicine from storage, going to the patient, administering the drug, going back to nursing station and filling in the paper work for the action (there are actually several forms to be filled out). So in reality it takes more like 40 min per IV.

Re: The cost of two weeks in an pediatric/infant ICU

#248

Post by whocares2345 »

stackbutterflow wrote: post #197
whocares2345 wrote: post #105

Earlier quoted context omitted.

Probably because it’s not a real bill? These numbers bear no relation to money and nobody cares about them. The actual bill will be sent to insurance company, it will be 25-35% of this number, which is realistic given the cost of ultra modern equipment and high salaries for doctors. You will pay up to your maximum out of pocket, which is the real number you look at when shopping for a plan. Insurance for people who k…

If no one ever pays those bills why bother making these numbers up? Why not charge $5B? Or even $3T for that matter. Wouldn't it save everyone time and money to give the right price first? What is the purpose of this game?

You can find an detailed answer to that in thread, in short - making sure that the negotiated price is that asking price is never less than real negotiated price

Re: The cost of two weeks in an pediatric/infant ICU

#249

Post by hef19898 »

Y_Y wrote: post #243
hef19898 wrote: post #213

Earlier quoted context omitted.

Waiting times do happen, usually end of quarters when the quarterly budget runs out. No issues in so far as these waiting times don't affect emergency procedures. And no, I don't see a direct link between public health care and wait times. The German issues are mostly caused by a bloated bureaucracy.

I think we're pretty much in agreement then. Emergency procedures don't have long waiting times in any of these nice European countries. (Of course, even in the US they will give some urgent life-saving care to someone who can't pay.) I also think that these (some several year) wait times aren't unavoidable. Management of these national public health systems is fabulously complicated and difficult and expensive, but…

Absolutely in agreement. IMHO in Germany the main reason is budget, defined quarterly. So of course a Doctor might push out appointments to the next quarter if he can when he ran out of budget already. And the ratio by which doctors practices are assigned and planned. That leads to an abundance in cities and a shortage elsewhere. And that imbalances cam, and do, drive wait times up. Going from experience so, it got better.

Theoretically I could switch to Germany's private insurance scheme. I have no willingness to do so.

Re: The cost of two weeks in an pediatric/infant ICU

#250

Post by opwieurposiu »

IggleSniggle wrote: post #133
skeletal88 wrote: post #109

Earlier quoted context omitted.

The obligatory comment about how crazy this is on many levels. 1. You are being charged prices that you are not expected to pay, but need to negotiate on 2. When you go to a doctor to have a procedure or have an emergency then you don't know what you are paying. In normal countries there is A price list, which is THE price list for all hospitals that are part of the national health care system. If they want to have a…

Just out of curiosity, which normal countries do you have experience with in this regard?

We took a baby to the hospital while in NZ. Thought baby had chicken pox, turned out to be just "Hand Foot Mouth" which is not as bad. There was a big price list on the wall at check in. Paid $70 up front and baby got to see a german doktor, all done in half an hour. I think the price was cheaper or even free if you were a NZ citizen.
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