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The Cost of an ACL Injury

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Re: The Cost of an ACL Injury

#171

Post by rexreed »

pyre wrote: post #169
rexreed wrote: post #167

Earlier quoted context omitted.

When an ACL costs $68k in California and $20k in Illinois and $32K in Delaware, you know that it's not an issue with simply the cost of getting medical training. Something else (I agree, something a lot more complicated than simply the cost of education or differencies in country-specific medical practices) is at work. I think we actually agree here - the dramatic rise in health care costs doesn't have a single root…

It's difficult to see which factors are contributing without a similar breakdown for a similar procedure from somewhere else. Are doctor's costs more expensive in CA due to the increased cost of living? Ditto for administrators, driving up the hospital costs? Is it due to a scarcity of hospital beds / operating tables that the hospital charges 'what the market will bear' in more densely populated regions?

Sounds like a study worth funding - if that data doesn't already exist!

Re: The Cost of an ACL Injury

#173

Post by smalltalk »

jon-wood wrote: post #155
sp332 wrote: post #113

Earlier quoted context omitted.

How can you guarantee the health of a person? Doesn't that incentivize risky activities? If someone else will pay to stitch you up if you get injured, or cover your drugs if you get sick, or keep you going in your old age if you make terrible long-term lifestyle choices: wouldn't that skew the overall population toward cheaper, more convenient, or more fun decisions at the expense of the state?

I live in the UK, so all my medical costs are covered by the state. However, I still don't go base jumping. Even if the costs are covered, I still don't want to spend six months in traction after I break my back because the parachute didn't open. Similarly almost all the people I know either don't smoke, or want to stop smoking, because even if you can do it free of charge lung cancer just isn't much fun.

You mean your medical costs are covered by taxes you pay and taxes other people (and corporations) in the UK pay and the costs of medical research and development that might benefit you are paid by people in the US.

Re: The Cost of an ACL Injury

#174

Post by atgm »

kqr2 wrote: post #110
larrys wrote: post #81

Earlier quoted context omitted.

"with insurance only for real medical emergencies" You then have people putting off preventive care, tests etc and then you have to cover a bigger problem down the line. I'll give you an example. You are a landlord with a tenant and you tell the tenant "you have to take care of minor repairs I will cover anything major". As a result they don't do normal maintenance either because they forget, don't care, who knows. T…

The idea is to have the right incentives in place. The premium for medical emergency insurance would go down as you are more proactive in your healthcare. For example, by having an annual physical, maintaining your weight, etc. you would get a discount.

> The idea is to have the right incentives in place.

The recent article about Finland's baby box was a great example of this and their infant mortality statistics show that it worked.

Re: The Cost of an ACL Injury

#175

Post by TheCoelacanth »

dclowd9901 wrote: post #114
rayiner wrote: post #82

Earlier quoted context omitted.

Medical liability costs are about $55 billion in the U.S., or about 2.4% of overall costs: http://www.hsph.harvard.edu/news/press-releases/medical-liab... . There are debates about how much "defensive medicine" adds to the cost, but those aren't all that relevant here since the costs presented are exclusive of additional tests, etc.

Overall costs: 2.291 Trillion $7,638 per person per year. That just can't be right. I and 90% of the people I know haven't made a significant trip to the dr or hospital in years. Where the fuck is that money going?

Try getting even a relatively minor health problem like appendicitis and you can go through several times that much in one day. Healthcare would be much cheaper if only we didn't have to deal with all of the sick people.

Re: The Cost of an ACL Injury

#177

Post by rsanders »

DanBC wrote: post #34
stonemetal wrote: post #33

Earlier quoted context omitted.

Did you include the cost of having a trained medical professional administer them? The cost of hospital aspirin isn't the pill it is the doc deciding to give them to you and the nurse who dispenses the pills( don't forget the billing person who charged you for the pills, the staff lawyer who was retained just in case you sue over the aspirin, and the payout to the last guy who sued and won). As with every service ind…

Is the cost of staff included in the cost of the meds, or elsewhere? Are they double-billing for staff costs?

If you read the recent Time cover story about medical costs, you'll see examples of people being recursively double-billed for items, at least according to the Medicare guidelines. e.g., and my memory's a little fuzzy on the specifics, but I believe one case was being billed for the operating room, then billed for the prep kit (which is supposed to be included in the room charge), then billed for every individual item in the prep kit.

If I hire a contractor to do something and he charges $X/hour, I don't expect him to mark up the materials he might use, too. I'm already paying for his time and expertise. I shouldn't also be paying the drywall for his expertise.

Re: The Cost of an ACL Injury

#178

Post by rsanders »

smartician wrote: post #128
tsycho wrote: post #125

(I am slightly hesitant to publicly share info like this, but what the heck...for science!) I tore my ACL 1.5 years ago playing soccer, and went through a similar surgery as the OP at NYU Langone Medical Center in New York. Interestingly, my final bill for the surgery (including the same things as the OP) was almost the same - $67k and change. However, more importantly, the actual amount paid to the doctor/hospital e…

The way understand it, yes, the uninsured person would receive the $67k bill, but can then go and negotiate to lower the amount payable. Insurance companies just did that negotiation beforehand and have a standing agreement with the provider. All of this reeks of huge inefficiencies to me. There are people at both the insurance companies as well as at every health care service provider whose full time job is to negot…

I've been in this situation, and there is no comparison at all. Nobody but the very wealthy can afford to pay out of pocket for healthcare. A single, minor injury can cost you $50,000 - $100,000. A chronic condition, cancer treatment, or major surgery can easily head north of $1 million.

Sure, you can try to negotiate pretty much anything. But what kind of leverage do you think you have? Insurance companies can put many millions of dollars of revenue at risk with the threat of dropping a stubborn healthcare provider from their network.

In contrast, your negotiation position is A) please? and B) I may be forced to declare bankruptcy, in which case you may or may not get your money. If you have enough assets, then option B is basically another form of A: "please, don't take away my house or the savings I've spent my life earning." The bigger your bill, the greater the incentive to deal with the annoyance involved in collecting from you. The likely consequence of your personal financial ruin doesn't enter into their calculations.

Re: The Cost of an ACL Injury

#179

Post by pkulak »

dragonwriter wrote: post #91
pkulak wrote: post #46

It seems to me that the balance of power has shifted far over to the providers and away from the insurance companies. Would allowing more mergers give them more bargaining power and bring these costs down? Or is that just too simple?

> It seems to me that the balance of power has shifted far over to the providers and away from the insurance companies. That's because you are looking at an accounting of the nominal charges , and not what the insurance actually paid . If you look at what the insurance actually paid based on those nominal charges, you'll see that the balance of power isn't where you think it is.

Oh yes it is! I know exactly what my insurance company's negotiated prices are (because I pay them!) and they are astronomical. I just had an emergency visit and the nominal charge was $1700. The negotiated charge was $1500. That's _nothing_. I added up the medicare schedule prices for the entire visit and it was about $350. So, yes, a large insurance plan (like medicare) seems to be able to negotiate far better than my insurance company.
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