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U.S. health care's widespread overbilling problem

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Re: U.S. health care's widespread overbilling problem

#241

Post by dingo_bat »

harisenbon wrote: post #154
beat wrote: post #149

Earlier quoted context omitted.

The core difference between the American health insurance model and the Japanese model (which costs half as much and has better outcomes) is fixed pricing. In Japan, a government commission sets prices for every medical product and procedure, tuning the prices to insure profitability, while preventing profiteering. In America, price negotiation is done between providers and insurance carriers. This has a few obvious…

I'm heading back from Japan today, and my family got a bunch of checkups and medical stuff done while we were here. Even without insurance all our procedures cost total less than ~$100 apiece. The most expensive thing I've ever had in japan was my full body workup last year for $500. It included: stomach ultrasound, 5 blood tests, eye exam, MRI(brain) and barium scan. All without insurance. By comparison, in the US I…

> I was charged $1200 to get my daughters arm cast changed (no xray, just a nurse changing the cast),

I hope the nurse got paid at least half of that.

Re: U.S. health care's widespread overbilling problem

#242

Post by [deleted] »

troyvit wrote: post #43
EvanAnderson wrote: post #11

Earlier quoted context omitted.

An an anecdote: I've been on a high-deductible plan for nearly 13 years. I have been regularly met with shock and incredulity that I could possibly want to know the cost of a procedure. My wife and I have spent, collectively, hours on the telephone trying to get answers. It's particularly galling when we get "guilt trip" treatment for asking about costs for procedures for our young daughter. We have been met with bot…

That's hilarious. They are making the health of your wife and daughter a profit center yet they act offended when you want to know the cost.

[deleted]

Re: U.S. health care's widespread overbilling problem

#243

Post by silasrude »

bmelton wrote: post #186
ams6110 wrote: post #170

Earlier quoted context omitted.

Don't Medicare and Medicaid pay fixed prices? And aren't they generally below cost for the provider? So they have to "make up the difference" by charging private insurers and cash payers more?

Sure, but that's why participation rate varies pretty wildly from one practice to the next on whether or not they accept Medicare or Medicaid. If a doctor doesn't like the rates Medic[are|aid] are paying, they're free to not accept Medic[are|aid] patients.

Unless they are emergency room patients. :)

Re: U.S. health care's widespread overbilling problem

#244

Post by bonzini »

u801e wrote: post #173
bonzini wrote: post #115

Earlier quoted context omitted.

> Our society is very rapidly evolving to consider any healthcare cost of any kind to be an insurmountable burden that no normal person could ever be expected to pay On the other hand, if prices are not managed properly, premiums get higher and higher. So even if insurance pays, you should care that prices are reasonable.

Car insurance doesn't cover routine maintenance, for example. So the prices for things like oil changes are relatively reasonable. If we had to go through insurance for things like that, then I'm willing to bet that the price of the service would increase substantially and auto insurance premiums would go up quite a bit as well.

Thatv may be true but, for healthcare, there is an important difference in favor of you: a car is replaceable, a life isn't.

If you don't do routine maintenance, the engine breaks down and _you_ have to pay for it.

If you don't do routine checkups, you get sick and insurance has to pay---and also, if you die those sweet premiums stop coming to them. Insurance actually has a vested interest in paying for your checkups and screenings, just like in countries with socialized healthcare.

Re: U.S. health care's widespread overbilling problem

#245

Post by code_duck »

AngeloAnolin wrote: post #108
code_duck wrote: post #94

My friend's wife resigned from a nursing position over this issue. A superior asked her to falsify billing records to say they were providing a higher level of care than they actually were, and she refused.

Instead of resigning, wouldn't it have been better if she exposed the malpractice? Or would the consequences on her part damage her so much that their lives would be destroyed? Ethics would dictate she would fight otherwise.

Due to the corruption and other factors, she didn't wish to work for them any longer. I don't recall all the specifics, but I believe she did file a complaint with the state. Hopefully the company was investigated.

Re: U.S. health care's widespread overbilling problem

#246

Post by alphanumeric0 »

Dove wrote: post #136
alphanumeric0 wrote: post #39

I would like to ditch insurance and find a doctor who would allow me to pay a monthly subscription fee, much like a gym membership, for preventative care. Isn't the primary purpose of insurance for exceptional and accidental situations? If that's true, then why am I using it for predictable monthly expenses?

What you are looking for is called Direct Primary Care. It exists in nearly every major city in the US at this point, and is very affordable. https://www.youtube.com/watch?v=bGZaRnC1wNg to hear one doctor talk about how this works out in practice. Google Direct Primary Care + your city/state to see what's available. It's SERIOUSLY better than the mainstream option. I've been doing it for nearly a decade now, and woul…

Wow that's great, thanks for the tip.

Re: U.S. health care's widespread overbilling problem

#247

Post by taurath »

alistairSH wrote: post #119
EvanAnderson wrote: post #11

Earlier quoted context omitted.

An an anecdote: I've been on a high-deductible plan for nearly 13 years. I have been regularly met with shock and incredulity that I could possibly want to know the cost of a procedure. My wife and I have spent, collectively, hours on the telephone trying to get answers. It's particularly galling when we get "guilt trip" treatment for asking about costs for procedures for our young daughter. We have been met with bot…

The average person I know has employer-provided insurance and doesn't think a bit about the costs of procedures. While that has been true for decades, in my experience, those employer-provided plans are beginning to transfer some of the cost to the consumer through higher deductibles and copays. My last few visits to the doctor tend to support this, as in both cases, the doctor offered cost-saving options and advice.

And if you have major surgery even on a "platinum" level plan you are still on the hook for tens of thousands of dollars. Fuck the system, its calcified nonsense at every step.

Re: U.S. health care's widespread overbilling problem

#248

Post by Broken_Hippo »

firebird84 wrote: post #34
mfoy_ wrote: post #19

It's also telling when the hospital gives you different bills depending on if you're insured or not. If you're insured they charge waaay more. They give you a more "realistic" bill if you are uninsured. It's a ridiculous system.

My experience is the opposite. The uninsured receive absurd bills because the hospital doesn't actually expect them to pay. The sell the debt to collections and get a big tax writeoff with little relation to reality.

This has been my experience as well. My understanding was that they technically bill the uninsured the same basic amount they bill the insurances, prior to them applying the "insurance discounts".

I've often thought this could be solved by legislation (something like the uninsured cannot pay more than the lowest insurance + copay amount), but lots of folks are against such price controls.

Re: U.S. health care's widespread overbilling problem

#249

Post by Broken_Hippo »

arethuza wrote: post #104
jazzyk wrote: post #98

Earlier quoted context omitted.

I have lived in the US for 27+ years and I think Americans tend to be very generous, a lot of people donate their time and money to charities, churches, etc. They just don't want to give their money to a bunch of bureaucrats, who spend it mostly on themselves, and seem to multiply like rabbits.

Do you have any evidence that socialized health care systems have more bureaucrats? [NB I'm just out of a UK NHS hospital so therefore feeling very warm and fuzzy about our favourite chunk of socialism].

I think that basically, the "bureaucrats" of the government become the "employees" of the companies, and are somehow not counted as bureaucrats, even though they form a private, less efficient bureaucracy that has more trouble providing basic services for a decent price (like home nursing).

Re: U.S. health care's widespread overbilling problem

#250

Post by drdaeman »

rsync wrote: post #223
drdaeman wrote: post #187

Earlier quoted context omitted.

> I'm sure there are rare people here and there that care how much a mile of highway costs No offense meant, but I find this attitude really odd. I'm not from US and only have an overall idea how things work there, but I wonder... Isn't that still your money, even if you pay $0 directly and the rest comes from the shared pool your insurance payments or taxes are also in? I just tend to believe there ain't no such thi…

"Isn't that still your money, even if you pay $0 directly and the rest comes from the shared pool your insurance payments or taxes are also in?" Well, please do read the first sentence of my reply - I do care and I do wish that price transparency were extant. Further, as a net tax payer , in California no less, I am quite interested in the actual costs of things like road paving and bridge building and subway tunneli…

Ouch. Sorry, seems that I misunderstood your post. My apologies.
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