Shouldn't this be illegal? - Page 2 - U.S. Politics Online: A Political Discussion Forum

EAL · #16 (**permalink**) 01-09-2008

Quote:

Originally Posted by Otter

No. You also can't sue your vet for much beyond the market value of your animal, if they screw up. Additionally, your vet works longer hours for considerably less pay than your average human doctor, and probably dosen't have an MRI, unless you are going to a university associated teaching hospital.

Bingo. See what happens to health care costs when a cartel like the FDA or AMA isn't entrenched in everything that goes on? A vet works as long as he wants to btw - I'm sure doctors in many fields work longer hours.

You've also highlighted the problems that ambulance chasers like John Edwards have brought to the table. The cost of malpractice insurance is a big opportunity for reform. I'm all for accountability, but things have obviously gone too far.

As for the availability of specialized services, compare the U.S. partly private health care system to Canada's totally socialist system.

In the U.S. there are 3.7 open heart surgery centers per million residents, in Canada its 1.6.

In the U.S. there are 6.1 installed MRI units per 1 million citizens, in Canada, there are 1.8.

In the U.S. there are 15.3 CT scanning centers per million, in Canada there are 8 per million.

In the U.S. there are 6.6 Cardiac catheridization centers per million, in Canada there are 2.8.

This is why Canadians may get good health care, but they have to wait forever to get it. In any case, privitization is not the cause for rationed health care, socialism is.

If vets needed MRIs to serve their customer's wants, they'd have MRIs.

Otter · #17 (**permalink**) 01-09-2008

Quote:

Originally Posted by EAL

Bingo. See what happens to health care costs when a cartel like the FDA or AMA isn't entrenched in everything that goes on? A vet works as long as he wants to btw - I'm sure doctors in many fields work longer hours.

You've also highlighted the problems that ambulance chasers like John Edwards have brought to the table. The cost of malpractice insurance is a big opportunity for reform. I'm all for accountability, but things have obviously gone too far.

As for the availability of specialized services, compare the U.S. partly private health care system to Canada's totally socialist system.

In the U.S. there are 3.7 open heart surgery centers per million residents, in Canada its 1.6.

In the U.S. there are 6.1 installed MRI units per 1 million citizens, in Canada, there are 1.8.

In the U.S. there are 15.3 CT scanning centers per million, in Canada there are 8 per million.

In the U.S. there are 6.6 Cardiac catheridization centers per million, in Canada there are 2.8.

This is why Canadians may get good health care, but they have to wait forever to get it. In any case, privitization is not the cause for rationed health care, socialism is.

If vets needed MRIs to serve their customer's wants, they'd have MRIs.

I don't know whether having more CT and MRI's ot there means your heath care is better; it might mean that they get ordered more often to cover someone's ass.
My classmates work an average of 80 hours per week, and not because they wanted to. Frequently it's because they have student loans as big as the folk comong from med school, but make half as much per hour. It's also just because that's what's expected of a new grad; it's part of the culture.
(Me? I went into pathology and research, so I don't count.)

chassisman · #18 (**permalink**) 01-09-2008

Quote:

Originally Posted by Otter

I don't know whether having more CT and MRI's ot there means your heath care is better; it might mean that they get ordered more often to cover someone's ass.
My classmates work an average of 80 hours per week, and not because they wanted to. Frequently it's because they have student loans as big as the folk comong from med school, but make half as much per hour. It's also just because that's what's expected of a new grad; it's part of the culture.
(Me? I went into pathology and research, so I don't count.)

Patient: Doc, my knee hurts.

Doc: We need to get an MRI done, do you have insurance?

Patient: Yes, I do , but I have a $2500 deductable.

Doc: Gee, thats too bad, here's a scrip for an anti inflamitory.

They order that shit like its lunch when you have insurance.

Otter · #19 (**permalink**) 01-09-2008

Quote:

Originally Posted by EAL

If vets needed MRIs to serve their customer's wants, they'd have MRIs.

But only if the clients could pay for it. Pet insurance hasn't really caught on. It runs 300$ for a CT scan (or it was, 2 years ago) on a small animal, here. I don't know what the MRI costs because it's new and I don't work in that part of the hospital. Not that many people will pay that just to get a diagnosis on their animal, but I bet you'd want one if you started having suspicious headaches. Most people also aren't willing to deny a CT scan for a kid with a brain tumor, even if their parents aren't insured. So we have this bizarre, unweildy hybrid of privitized and socialized health care, with a completely impenatrable body of law surrounding it. I don't think many people will argue that it's a disaster, only about how to fix it.

EAL · #20 (**permalink**) 01-09-2008

Quote:

Originally Posted by Otter

I don't know whether having more CT and MRI's ot there means your heath care is better;

Huh? It certainly does to someone with a brain tumor who's being told he has to wait four months until he can get an MRI.

Are you really questioning whether more access to medical care is good for a patient? Is that your position LOL? If so:

Impugn · #21 (**permalink**) 01-09-2008

Quote:

Originally Posted by chassisman

Certainly you don't think that all people who have heath insurance have or can afford that level of coverage, do you? You must be a UAW member. Obviously you don't pay for that yourself.

If you think I am kidding you, see what your insurance paid the hospital and then call for that cash price. I would say you would be shocked, but seeing as you have the rolls royce plan, I guess you wouldn't care either way.

Regular old HMO. Payroll deductions every pay period out of my check. Primary care physician. Referrals to specialists required when needed. No deductibles. Same old same old. No union membership required.

Other than co-pays and small dental deductibles, I haven't paid squat above my payroll deduction for years.*

So, I don't get the premise of the original post. If my health care insurance has agreed with the health care provider to pay a certain amount for a given procedure (i.e. MRI)...great. If that is below what Joe Cash pays walking in off the street, I don't understand the beef, as my health care company presumably has volume numbers and risk management on their side when negotiating with health care providers. If that is above what Joe Cash pays, well, I certainly don't understand the beef, either...although I might question why the insurance companies are willing to overcompensate for the procedure.

Why would you pay $1000 as an insured patient when, in your example, you can pay just the $200 deductible...if you needed a subsequent procedure, your deductible would already be satisfied.

I hardly think my current health care insurance is of "Rolls-Royce" caliber. In fact, I'm tired of the referrals and am changing over to a PPO plan...it will cost me double (out of my pay), but the freedom is worth it.

EDIT: *when I was properly insured. That is a whole separate story.

erikvv · #22 (**permalink**) 01-09-2008

Quote:

Originally Posted by EAL

Bingo. See what happens to health care costs when a cartel like the FDA or AMA isn't entrenched in everything that goes on? A vet works as long as he wants to btw - I'm sure doctors in many fields work longer hours.

You've also highlighted the problems that ambulance chasers like John Edwards have brought to the table. The cost of malpractice insurance is a big opportunity for reform. I'm all for accountability, but things have obviously gone too far.

As for the availability of specialized services, compare the U.S. partly private health care system to Canada's totally socialist system.

In the U.S. there are 3.7 open heart surgery centers per million residents, in Canada its 1.6.

In the U.S. there are 6.1 installed MRI units per 1 million citizens, in Canada, there are 1.8.

In the U.S. there are 15.3 CT scanning centers per million, in Canada there are 8 per million.

In the U.S. there are 6.6 Cardiac catheridization centers per million, in Canada there are 2.8.

This is why Canadians may get good health care, but they have to wait forever to get it. In any case, privitization is not the cause for rationed health care, socialism is.

If vets needed MRIs to serve their customer's wants, they'd have MRIs.

Your statistics dont say anything about the actual number of treatments. Perhaps in the US there are more small clinics while in Canada there are bigger hospitals?

Otter · #23 (**permalink**) 01-09-2008

Quote:

Originally Posted by EAL

Huh? It certainly does to someone with a brain tumor who's being told he has to wait four months until he can get an MRI.

Are you really questioning whether more access to medical care is good for a patient? Is that your position LOL? If so:

I haven't heard of someone with a brain tumor waiting very long for a CT. (they are just as good as an MRI for diagnosis of brain tumors).

No, I was just pointing out that there are alternative explanantions for the disparity in mumbers. I am interested in the differences between human and veterinary medicine, partly because they represent two different extremes; vet med is entirely free market; if it isn't economical, it isn't done. This means that vets don't have insurance companies telling us how to practice medicine (or lawyers either, but that's a seperate issue). *that's* what is best for the patient; for the medical profession to be able to diagnose and treat the patient to the best of their ability, the way they are trained. Not how an insurance company has determined is best for their stock, or a lawyer has determined most minimises the legal risk. Vets can do this to some degree, but then, it's not uncommon to euthanize a patient because the client can't pay for the treatment. I don't think we want human medicine to be precisely like this; we'd be turning people away from the ER if they couldn't write a check up front (which is how most vet emergency services operate). But it is an interesting contrast, and there should be a functional middle ground somewhere.

Impugn · #24 (**permalink**) 01-09-2008

Cripes. As predictable as starting a thread about [real] football. Guaranteed that some soccer weenies will chime in.

Why does a question RE: health care insurance in the U.S. invariably lead to an argument between Americans and socialists?

I'm still trying to figure out why the original poster has a problem with the hospital taking the insurance company for a ride or (if you prefer to view it this way) cutting the uninsured-guy-off-the-street a price break.

JHC · #25 (**permalink**) 01-09-2008

I'm not sure but I don't think you're getting the whole story, Chassi.

Hospitals in particular, have a strange way of billing. They WANT to be paid a certain amount but, by law, they can't get anything above what the contract with the insurance company states.
The hospital will send a full bill to the insurance company regardless of the contract and let the insurance company sort out what is actually payable - this is called an adjustment.
Periodically, the contracts are renegotiated and what does the hospital use in negotiation?, they use those unadjusted bills as leverage and claim that they're taking a beating.

So even though you may see what the hospital or doctor is attempting to bill your insurance company, what really counts is what your insurance company pays.

I believe the exact reverse of what you think is happening is actually happening - as one poster stated; Insurance companies have negotiated prices that are probably substantially less than what would be charged to an uninsured person.

Lets say you have insurance but you tell the hospital that you don't so you can get what you think is a better price. Then you submit your direct bill from the hospital to your insurance company for reimbursement - they're probably going to deny a good chunk of that bill just like they would had the bill come directly from the hospital.
And you'd be stuck with the remainder plus your deductible and copay.

chassisman · #26 (**permalink**) 01-09-2008

Quote:

Originally Posted by Impugn

Regular old HMO. Payroll deductions every pay period out of my check. Primary care physician. Referrals to specialists required when needed. No deductibles. Same old same old. No union membership required.

Other than co-pays and small dental deductibles, I haven't paid squat above my payroll deduction for years.*

So, I don't get the premise of the original post. If my health care insurance has agreed with the health care provider to pay a certain amount for a given procedure (i.e. MRI)...great. If that is below what Joe Cash pays walking in off the street, I don't understand the beef, as my health care company presumably has volume numbers and risk management on their side when negotiating with health care providers. If that is above what Joe Cash pays, well, I certainly don't understand the beef, either...although I might question why the insurance companies are willing to overcompensate for the procedure.

Why would you pay $1000 as an insured patient when, in your example, you can pay just the $200 deductible...if you needed a subsequent procedure, your deductible would already be satisfied.

I hardly think my current health care insurance is of "Rolls-Royce" caliber. In fact, I'm tired of the referrals and am changing over to a PPO plan...it will cost me double (out of my pay), but the freedom is worth it.

EDIT: *when I was properly insured. That is a whole separate story.

For starters, most of the people I know who have health insurance thru their employer DO NOT have zero deductible. Consider yourself blessed.

Quote:

For workers in plans with a general plan deductible, the average annual deductibles for single coverage are $352 for workers enrolled in HMOs, $473 for workers enrolled in PPOs, $553 for workers enrolled in POS plans, and $1,715 for workers enrolled in HDHP/SOs.

http://www.kff.org/insurance/7527/upload/7528.pdf

Secondly, look back at my post, Joe Cash is paying less for the procedure than your insurance comapny is. You say you pay for part of your premiums, so how do you feel about paying more than you should for your coverage? If Joe Cash can get it for $750, why should your insurance company pay the hospital double or triple that and pass the costs on to you and your employer?

chassisman · #27 (**permalink**) 01-09-2008

Quote:

Originally Posted by JHC

I'm not sure but I don't think you're getting the whole story, Chassi.

Hospitals in particular, have a strange way of billing. They WANT to be paid a certain amount but, by law, they can't get anything above what the contract with the insurance company states.
The hospital will send a full bill to the insurance company regardless of the contract and let the insurance company sort out what is actually payable - this is called an adjustment.
Periodically, the contracts are renegotiated and what does the hospital use in negotiation?, they use those unadjusted bills as leverage and claim that they're taking a beating.

So even though you may see what the hospital or doctor is attempting to bill your insurance company, what really counts is what your insurance company pays.

I believe the exact reverse of what you think is happening is actually happening - as one poster stated; Insurance companies have negotiated prices that are probably substantially less than what would be charged to an uninsured person.

Lets say you have insurance but you tell the hospital that you don't so you can get what you think is a better price. Then you submit your direct bill from the hospital to your insurance company for reimbursement - they're probably going to deny a good chunk of that bill just like they would had the bill come directly from the hospital.
And you'd be stuck with the remainder plus your deductible and copay.

I fully understand negotiated prices between the hospital and the ins co.
My wife and I each had the same test at the same facility. Hers was cash (pre-existing condition) mine was insurance. I hadn't met my deductable yet so I had to pay all of the negotiated price. Hers was $500, mine was double that. Blue Cross Blue Shield's negotiated price was (slightly more than) double the cash price.
Why do you think you hear thru media that treatment of America's uninsured is driving up the cost of heath care? Obviously, hospitals and heath care facilities pass these costs on to insurance companies and untimately to employers, employees, and the self insured.

EAL · #28 (**permalink**) 01-09-2008

Quote:

Originally Posted by Otter

But it is an interesting contrast, and there should be a functional middle ground somewhere.

I'll say again what I said in another thread. I'd be interested in seeing the viability of a hybrid system where emergency and catastrophic care is taxpayer funded and government run, but everything else - routine, preventative, family practice type stuff is strictly - and I mean strictly private sector with no government interference at all.

If someone is run over by a car, there's no time to flip through the yellow pages, they should be treated sufficiently to save their life and avoid further injury.

However, I don't want to pay for other people taking up the time of a physician every time they get a runny nose or a headache.

Deregulating and privatizing these sectors of the health care would bring prices down and ensure market demand is met. It would cut costs for the consumer for a number of other reasons too.

If I'm worried about my cholesterol now, I have to go make an appointment to see a doctor. That's at least a $100 there. She orders bloodwork - another big chunk of change. Then I have to pay for a follow up visit to the doctor so she can read the results to me. Under a deregulated free market system I go to the mega Wal Mart and get my blood drawn and they email me the results. I google cholesterol count and see where I stand and choose whether I need to get on medication. If I decide I do, I take my results to the doctor and she prescribes meds. For this, I'd be able to call around doctor to doctor looking for the one who either knows the most about cholesterol or who'll see me about it cheapest.

Another thing: Last I knew, if a tree falls on my car, and I claim it on my insurance, the insurance company makes me get at least three quotes from different body shops and I have to go with the cheapest. With medical stuff, there's none of that. That's another difference.

JHC · #29 (**permalink**) 01-09-2008

Quote:

Originally Posted by chassisman

I fully understand negotiated prices between the hospital and the ins co.
My wife and I each had the same test at the same facility. Hers was cash (pre-existing condition) mine was insurance. I hadn't met my deductable yet so I had to pay all of the negotiated price. Hers was $500, mine was double that. Blue Cross Blue Shield's negotiated price was (slightly more than) double the cash price.

Interesting.

I took a little break and typed the following into GOOGLE: "do hospitals charge more to insurance companies than individuals"

Here is what came back and I haven't read any of them:

Quote:

US Hospitals Charge Uninsureds More, Study Says
But patients without health insurance, about 45 million people in the U.S., .... Not only do hospitals charge more for the uninsured, but an awful lot of ...

Quote:

Untied We Stand-Health Insurance Unattainable, Unaffordable
If you can’t afford insurance, you certainly can’t afford to pay five times more than insurance companies do. And yet, if you’re “self-insured” (meaning it ...

Quote:

Hospitals Charge Uninsured and “Self-Pay” Patients More than Double What Insured Patients Pay
Hospitals do not charge every patient the same price for medical care. ... more for hospital care than those covered by health insurance and more than 3 ...

Quote:

Why Hospitals Overcharge the Uninsured
When an insurance carrier foots a hospital bill, the company ... charged an average 139 percent more than the charge insurance companies ended up paying for ...

Quote:

Health Insurance, by John C Goodman, The Precise Encyclopedia of...Hospitals discovered that by manipulating the charges, ... There are more than 240 different health-related professions in the United States, ranging from ...

Quote:

New York State Hospitals Charge Uninsured Patients Twice As MuchThe reason why uninsured individuals pay more is because insurance ... of care they receive - hospitals have to charge more than the actual cost of services ...

Quote:

Originally Posted by chassisman

Why do you think you hear thru media that treatment of America's uninsured is driving up the cost of heath care? Obviously, hospitals and heath care facilities pass these costs on to insurance companies and untimately to employers, employees, and the self insured.

What I understood, thru the media and other sources, is that people who have no insurance and can't afford to pay for their health care out of pocket, used to declare bankruptcy at a higher rate than anyone else for any other reason until the bankruptcy laws changed. I guess they just go broke now.
I honestly don't think that the uninsureds failure to pay is as significant a factor as some other things when it comes to the extreme cost of health care in the US.
Patients with no money are unlikely to receive the benefits of those with money. All that fancy equipment etc...
Just a thought.

EAL · #30 (**permalink**) 01-09-2008

Quote:

Originally Posted by erikvv