Everything they use does not cost that much but they still charge a ridiculous amount to use it. I recently went to a urologist where they used a hand held ultrasound device to scan my bladder, which took about 30 seconds. A couple weeks later I got a bill from them for over $200 for 'office surgery' and my EOB showed my insurance only paid $60 for this procedure. I called them to see what I had done that was considered 'office surgery' and I was told the ultrasound was classified that way for billing purposes. this was nothing that even resembled 'surgery.' I had to pay the difference, along with my $45 copay.
Republicans need to stop targeting patients and start targeting providers
- Thread starter Gubba Bump Shrimp
- Start date
Buy your own then...$19,500
https://www.medcorpllc.com/ge-vivid-e.html?gclid=CI6A2_CL2tICFcW4wAodXb0Klw
Instead of guessing and making stuff up, why not go dig a little.
Start with a simple example. A knee replacement here costs a lot more in the US than in other countries. Why? Where does the money go?
The lions share of it goes to the hospital and the doctor. That is the big cost difference.
You are overly focused on profits. The delta in non rx medical care often doesn't accrue as business profit - lots of hospitals are not for profit. It accrues as higher costs. Paying a doctor 400k instead of 150k. Having a surgery be in patient instead of outpatient. Having it in a newly built medical palace instead of in the old hospital that was just fine. Etc.
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If you want health care to cost 20-30 percent less, there are going to be some sensible limits on the system. The average American family would be better off paying 2000 less a year for health care with the sorts of mild limits that are in place in these countries. Waiting two weeks for carpal tunnel surgery is not the end of the world. Being limited to the cholesterol drug on which the government negotiated the best price is not the end of the world.
Note that that is not uncommon for people to have supplemental insurance or access to private providers in many countries that act as top ups. The government provides for a minimum level of benefits that you are free to supplement.
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There's also dead weight loss associated with all of this billing and eligibility insanity. Our administrative system is bloated with costs
Well she would call in sick, she was sick, she would just go down to the Texmex boarder. The family he is in construction but he also goes down there to get supplies, he says construction supplies are cheaper also, he and his family take two cars and a trailer then the drive back in just the truck and trailer, then sometime in the next two weeks the car shows up somebody drives it back but not sure who?
Must be shorter than in America because they live a lot longer and are not dying in line.
My sister is a Nurse Practitioner can do almost anything a doctor can do, in fact works for a doctor in a very nice office in NWA. Most of the time when you make an appointment to see him you are going to see her, and then both of them profit off of it. She make way into the 6 figures, no large medical school bills. But even she talks about the waste she see everyday, in fact their office brings in so much money the doctor is always adding on and trying to figure out ways to keep more of it. She said they purchased some scanner for over $50,000 about a year ago and still have not hired anybody that can operate it just sits there but they got a nice tax break on it.
You don't wait in line if you are dying. You wait in line to be seen by specialists and to have maintenance surgeries. You also wait longer at the ER in a lot of countries if you're not having a heart attack, stroke, etc. The underlying rates at which these procedures are provided are generally consistent (they aren't telling people no, we won't replace your hip.) They are just managing the flow of patients better so they can use their capacity for providing care in a more cost efficient manner.
Because I'm lucky enough to be a top 10% earner in this country and the rules are bent in my favor.
Insurance companies dont compete. Tbats fantasy. Its like oil companies. They are in collusion
You are only partially correct. I've seen more than a few times in this thread the misunderstanding that the provider (the Doctor) and their fees that are the main culprit when it comes to the high cost of medicine. Unfortunately, the people that are being screwed in today's health care system are the patient, and (wait for it...) the doctor. The federal government, and its partner the insurance industry are the problem. The Fed and its Medicare reporting mandates (which are adopted by the insurance industry) have driven the cost of practicing medicine to unacceptable levels for many doctors. I'm guessing that many of you have no idea what an ICD code is, or the complexity involved with proper use of the codes required for reimbursement. Mistakes in coding literally can result in thousands in lost fees. Further, the insurance industry specializes in looking for these mistakes and bouncing claims requiring many cycles of re-submission. Who does the resubmission? The expensive team of administrators that doctors must now employ to ensure that they get repaid.
I noticed that you wanted to use total knee replacement as an example. Total knees are now part of a bundled payment model - essentially medicare pays 25k for the procedure. Out of this 25k the hospital gets its cut, doctors (anesthesiologist, ortho, etc.) get a cut, cost of the device, physical therapy, home care, etc. If there is a problem and a patient is readmitted then there is a medicare penalty to pay. Bundled payments are a big reason why fewer hospitals are not for profit, but are instead owned by for-profit entities. Honestly, they don't give a damn that there are too few nurses to care for patients, etc. - it is all about the bottom line.
Doctors are retiring early in record numbers because the art, vocation, and practice of medicine that many signed up for is no longer the reality. Have you ever wondered why your annual physical used to be a one hour session where the doctor took time to ask about your family, life, etc. Now it is 30 - 45 minutes and the conversation is driven by a questionnaire provided by the insurer - don't fill out the questionnaire, you don't get paid.
My doctor just switched to a concierge model - no insurance, and I signed-up. I am fortunate that I can afford this option, and honestly it is sad that government overreach, and insurer greed have lead us to this point.
Yes, I am generally conservative, but healthcare will not be fixed until both sides agree to de-politicize the problem, and focus on a new solution. The ACA while having a few good points is overall a disaster, however the Republican plan doesn't seem to be a great solution either. The real fix would be to start from scratch, take the time needed (2 years, 3 years, etc.) to craft a plan that benefits the patient, encourages providers to treat/heal, and allow the supporting business (Pharma, equip mfg, etc.) to profit from their research and production. A pipe dream, I know...
Our system is a waste and has been since the 80s. Why cant we see how others do it and use those good things?
Yes, the Medical-industrial complex doesn't make any meaningful PROFIT in PREVENTIVE CARE but in serving or managing 'SICK-CARE' by charging for tests, imaging and surgeries on patients with Health Insurance ( private or public) up to 2/3rd of which may NOT really medically indicated ( studies by RAND & Fraser Institute-Canada in 90s!)
'More is better' encouraged by BIG Pharma and even Patients demand them! Physicians counseling for better life style - Prevention, nutrition, exercise, stress management may get least or ZILCH!
Most of the CPT codes ( out of 16000+) are for' DOING THINGS' (insert wires, tubes etc..) after you get sick vs for Preventive care! The more the provider does ( tests, imaging or Surgeries) the more one earns under 'fee per service' even after discount etc from Insurers!
This why it's sad to see what republicans came up with when they've had 7 years to figure out what is wrong with Obamacare and what is pretty good and they couldn't come up with anything better than this!
I am with you that the admin burden is high, but we also pay our providers more as take home pay. It's more than just the doctor - Rx companies are providers. Hospitals building palaces are providers.
I have a philosophical difference from you about not for profit hospitals. The average NFP hospital is part of a massive health system that is effectively run an awful lot like a for profit. The days of hospitals being small providers who serve a local community are dying or dead in most of the US. The % of care the average NFP system awards as charity care is pretty low - often lower than the value of their property tax exemption. Hospital care has been a big business in the US for a long time.
The "profit" from these systems accrues as spending on capital goods or as pay for employees.
Hospital consolidation has been going on for a long time - the idea that it is taking place because Medicare bundles what it pays for a knee replacement is silly. It's not like BJC and Mercy came about in the last 5-10 years. I do agree that the complexity of the insurance and billing is a material reason why the systems have merged - the scale lets you spread the costs of your billing systems/expertise out and it gives you more heft when negotiating with private insurance carriers.
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