171–180 of 189 posts
Back when I was uninsured I was very frustrated that no one anywhere ever knew how much anything cost, and frequently gave false information.
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If you read the full article, he explains that there was an underlying medical cause and that the second hospital found it.
Ah I didn't see that part. Now I do seem like an ass.
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How do the doctors get paid if the patient is only paying $17 per visit?
The fixed cost per visit is not a payment for treatment, but a tax; it's notionally there to stop people using the system excessively. (See also the prescription tax in England, although there the average cost of a prescribed medicine <= the prescription tax. Here in Scotland we abolished the NHS prescription tax a year ago; the system didn't subsequently collapse under the weight of freeloaders asking for prescripti…
Helpful mostly to people with chronic conditions (IIRC unemployment/disability benefits tend to include relief of prescription charges).
I was quite happy with the prepayment scheme, so really the only difference is I now pay them £60/yr (quarterly cards, oh the optimism) less directly.
As an additional pointless anecdote, I do actually get a prescription for Paracetamol, since it means I can get it in boxes of 100 rather than the stupid 16/32 purchase limit for OTC sales. It's easier for my doctor to tick the box than write a short note for the pharmacist, it seems.
My wife recently had some tests done. Hospital's receptionist forgot to add insurance information to wife's profile, so accordingly to hospital's records she was uninsured. Month later we receive bill for ~$1,400. After quick googling we find that if she would go to any local hospital and pay up front with cash, it would cost her maximum ~$400. Obviously, she went back to hospital to find out what's wrong with them (…
hospital owned by insurance company, so it is very wrong Wait what? How on earth is that allowed to happen!
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I'll be honest. I don't get why hospitals continue to play the game. If I were running the place, I'd just pull out of Medicare. It seems that they're afraid of the millions of dollars of lost revenue, without considering the greater sum of expenses that they'd free up.
I sincerely doubt that the bean-counters at hospital are losing a ton of money on medicare but are too confused by the large 'revenue' figure to subtract a larger 'expenses' figure and realize they're making a loss. As a matter of fact, I can't recall ever reading an op/ed or anything by a hospital administrator complaining that they're being fleeced by medicare and losing a bunch of money on it. But I've seen a bill…
But they can't very well give you a bill that with a line item that says "shifted costs from the old guy in bay 3 - $900".
My wife is the manager of budget and reimbursement at a hospital, and from many conversations with her, I can imagine that this article is accurate. However, if I were writing this, I would have given greater emphasis to the effect that Medicare has on these problems. The article does mention that Medicare typically pays fees that are below actual cost for the procedures, and that hospitals must therefore increase ch…
Here is a good article about how wildly Medicare costs can vary from place to place: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_... The second highest reimbursement district in the country is in Texas, which passed a draconinan tort reform law back in the 90s (if memory serves), so you can't blame courts or defensive medicine directly.
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In what hypothetical world? It sounds like the hospitals in the US couldn't care less how much they charge people since they'll just sue you into oblivion if you don't pay. What's the difference between a $1K deductible and a $10K one? How's that going to make one bit of difference? Consumers have no say in how much the procedures cost. There's no "price pressure" from anyone but the group buyers, those being the ins…
In what hypothetical world? In the world joezydeco lives in. Apparently high deductible plans have already caused hospitals to change their procedures. Consumers have no say in how much the procedures cost. Consumers now have an incentive to shop around or try alternate treatments. With a low deductible plan, their only incentive is to find the doctor they like the best or the hospital closest to their house.
When I'm rushed to the hospital after a taxi runs me down on my motorcycle, I'm not in a position to shop around.
When I'm sick with a flu and subsequent sinus infection, barely able to perform basic daily tasks without mental exhaustion, I'm in no position to shop around.
The wannabe-libertarian ideal doesn't work for healthcare.
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...when you measure things like life expectancy, Britons are as healthy as Americans. That gives you an idea of how much money is going down the tubes due to administrative inefficiency. It's hardly clear the money is going down the tubes due to administrative inefficiency. It might just be spent on unnecessary medicine, and costs might be higher in the US. According to one fairly decent source, administrative ineffi…
A couple things, first off, if costs are higher in the US, they shouldn't be, we're not living in a radically different reality in the UK. Market forces should be lowering those costs, but they're not, because the actual cost centers are completely insulated from any market whatsoever by the insurance system. RE: administrative inefficiency, from my limited experience (laying off teachers in local gov't back in 2004…
Most doctors offices have given me anywhere from an immediate 20-50% discount for immediate payment. I even got a 66% discount last year for paying before the procedure.
The reasoning behind it is simple..
If you did $100 of work and weren't going to get paid for 3-6 months, you would charge more than $100. There's the time value of money. If you have to spend a lot of time and effort to get that money, you would charge significantly more. If you knew that you would have to give up some of what you asked for, you would charge more. (When I worked in a hospital, we had one person that her only job was to call and argue with insurance companies.)
Now.. on the flip side. If you did $100 of work and were used to Net-90 or even Net-30, what discount would you accept to get the money now? And not just now but with zero arguing, effort, etc?
Oh.. and with an HSA, I have consistently gotten same day appointments when there's a "two week wait" for people paying with insurance.
In that case, it's simple cash flow management.. if you have one slot open and you can take a customer that will pay 3-6 months later but only with lots of effort OR a guy who will pay less but before they leave the office, which would you take?
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Taking advantage of the predicament of others is not capitalism; it is price gouging. It would be one thing if the consumer were able to compare prices and other aspects of the product and make a choice based on the consumer's values (of which price may not be the most important thing). This is a bit more like a gas station charging 10x more during a hurricane evacuation.
Price gouging is an aspect of capitalism. Demand goes up, price goes up. Without market interference, this should force demand down. Health care can't be forced down by price (at least, life saving health care), so you either have to stop providing care to those that need it but can't pay, or pass along the costs to others.
I'm not saying those approaches don't have flow on effects, because they do but they can be used to lower costs. Don't assume price cannot be controlled by governments or industry, because it can be, and is.