Rukh O'Rorke
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Post by Rukh O'Rorke on Mar 2, 2017 12:43:08 GMT -5
I agree that there isn't an end game where we get an awesome outcome. Too many people have an unrealistic expectation for healthcare in our country. There are TONS of solutions out there but a lot of people need to adjust their view of what acceptable care is. We can go to a single payer/nationalized/universal health system. That means that EVERYONE has to pay into it, though. That means that care can be refused if someone doesn't have coverage. That means that we need to also have tort reform so doctors can actually stay in business since they won't have horrendous malpractice premiums to pay. Side note: Did you know that the average salary of a VP of Sales is $150K and the average salary of a Family Physician is $170K? I don't know that a Sales VP has nearly the responsibility a Family Physician does, but I do know that malpractice insurance can run around $15-20K per year. (Links are given below for those interested.) As a society, we have to accept that twisting your knee while roller blading means that you can receive emergency care to address the swelling but you'll have to wait three to six months for the MRI to see what the damage was. Emergency rooms need to be able to turn away non-emergent patients, i.e. I've had a sore throat for three days and am coming here for treatment because I don't have insurance. These are just a couple of barriers people don't want to deal with or set into place, so we continue to flounder with what we have. There are some simple answers but those answers don't meet our (collective) approval. link 1link 2link 3Your premises don't hang together. Everyone is paying it for now. Private insurance gets billed $500, and pays out $438.50 due to agreements, etc. Medicare gets billed $500 and pays out $45, and Medicaid pays 28.92 for the same billable. Then there a couple in the mix that don't have insurance/cash payers, or ins denies for whatever, and then it is never paid. Those of us with private insurance are paying for all of that right now. Through our premiums, through our taxes, etc. Then there is the person with few resources, just hanging on, etc. Finally they collapse and have highly expensive care, lose their job and on medicaid and their last few years are wildly expensive, for something that may have been easy and treatable years earlier. We are all paying for that as well. Why is anyone refused, if everyone has coverage? Why is a garden variety soar throat in the ER without insurance, if everyone has coverage? Why is there a 3-6 month wait for an MRI - just because - Why?
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thyme4change
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Post by thyme4change on Mar 2, 2017 12:52:15 GMT -5
I still think standardizing plans across insurance companies would also help increase competition and decrease premiums. Right now, it's really not easy to find your exact plan and compare what you are paying with what it would cost at another company....but if the plans were numbers and you could easily compare that same number plan; it makes it extremely simple to figure out if you could get the same coverage for cheaper at another company. Making it that easy would also mean insurance companies would have to be more price conscious in the premiums they charge. It's like going into a grocery store and seeing I can buy the same thing from a competitor for cheaper. What about apple to apple shopping for procedures. Hysterectomy here or hospital across town might be less expensive and just as effective. Show me what you can do , how much it will cost me and let me compare. I was reading aomething and they said the problem with price shopping is that people don't actually want discount medical services, especially of a large portion of it is being paid by someone else. I would never chose a hospital because it was the cheapest, and I may very well chose the hospital that is most expensive - because it must be better. Even my primary care - why would I take my kids to the guy who advertises on the back of the bus with the slogan "If you find a price cheaper than mine, your next vaccine is free!" No! I'm going to the premium doctor. It would be a marketing ploy to raise your rates, and costs would go up, not down.
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Rukh O'Rorke
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Post by Rukh O'Rorke on Mar 2, 2017 13:05:56 GMT -5
What about apple to apple shopping for procedures. Hysterectomy here or hospital across town might be less expensive and just as effective. Show me what you can do , how much it will cost me and let me compare. I was reading aomething and they said the problem with price shopping is that people don't actually want discount medical services, especially of a large portion of it is being paid by someone else. I would never chose a hospital because it was the cheapest, and I may very well chose the hospital that is most expensive - because it must be better. Even my primary care - why would I take my kids to the guy who advertises on the back of the bus with the slogan "If you find a price cheaper than mine, your next vaccine is free!" No! I'm going to the premium doctor. It would be a marketing ploy to raise your rates, and costs would go up, not down. Good point. I think there may be room for some cost comparisons, but for health care, it isn't going to be a large enough factor to make the difference some think.
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spartyparty
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Post by spartyparty on Mar 2, 2017 13:13:55 GMT -5
What about apple to apple shopping for procedures. Hysterectomy here or hospital across town might be less expensive and just as effective. Show me what you can do , how much it will cost me and let me compare. When DH was in excruitating pain and needed back surgery, there is no way, he'd have gone around from one surgeron to another shopping. He needed surgerry asap. Healthcare isn't like buying tires. 50% off vasectomies! Book your appointment online now! Use coupon code snipsnip20 to save an extra 20% at checkout!
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buystoys
Junior Associate
Joined: Mar 30, 2012 4:58:12 GMT -5
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Post by buystoys on Mar 2, 2017 13:16:23 GMT -5
I agree that there isn't an end game where we get an awesome outcome. Too many people have an unrealistic expectation for healthcare in our country. There are TONS of solutions out there but a lot of people need to adjust their view of what acceptable care is. We can go to a single payer/nationalized/universal health system. That means that EVERYONE has to pay into it, though. That means that care can be refused if someone doesn't have coverage. That means that we need to also have tort reform so doctors can actually stay in business since they won't have horrendous malpractice premiums to pay. Side note: Did you know that the average salary of a VP of Sales is $150K and the average salary of a Family Physician is $170K? I don't know that a Sales VP has nearly the responsibility a Family Physician does, but I do know that malpractice insurance can run around $15-20K per year. (Links are given below for those interested.) As a society, we have to accept that twisting your knee while roller blading means that you can receive emergency care to address the swelling but you'll have to wait three to six months for the MRI to see what the damage was. Emergency rooms need to be able to turn away non-emergent patients, i.e. I've had a sore throat for three days and am coming here for treatment because I don't have insurance. These are just a couple of barriers people don't want to deal with or set into place, so we continue to flounder with what we have. There are some simple answers but those answers don't meet our (collective) approval. link 1link 2link 3Your premises don't hang together. Everyone is paying it for now. Private insurance gets billed $500, and pays out $438.50 due to agreements, etc. Medicare gets billed $500 and pays out $45, and Medicaid pays 28.92 for the same billable. Then there a couple in the mix that don't have insurance/cash payers, or ins denies for whatever, and then it is never paid. Those of us with private insurance are paying for all of that right now. Through our premiums, through our taxes, etc. Then there is the person with few resources, just hanging on, etc. Finally they collapse and have highly expensive care, lose their job and on medicaid and their last few years are wildly expensive, for something that may have been easy and treatable years earlier. We are all paying for that as well. Why is anyone refused, if everyone has coverage? Why is a garden variety soar throat in the ER without insurance, if everyone has coverage? Why is there a 3-6 month wait for an MRI - just because - Why? Not everyone is paying for coverage now. There are plenty of people who don't pay for insurance yet use Emergency room services. My "premise" is that if we as a nation want coverage for everyone, then everyone needs to pay for coverage and we need to be willing to accept that it is far too expensive to be everything to everyone 24/7. If you will also read my posting made later you will see that I stated that if it was possible to have the type of care Americans have come to expect at a cost other countries pay, then someone, somewhere, would already be doing it. If you can show me any country that has nationalized care without MRI waiting lists for non-emergency procedures, I'd love to see it.
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djAdvocate
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Post by djAdvocate on Mar 2, 2017 13:35:13 GMT -5
Your premises don't hang together. Everyone is paying it for now. Private insurance gets billed $500, and pays out $438.50 due to agreements, etc. Medicare gets billed $500 and pays out $45, and Medicaid pays 28.92 for the same billable. Then there a couple in the mix that don't have insurance/cash payers, or ins denies for whatever, and then it is never paid. Those of us with private insurance are paying for all of that right now. Through our premiums, through our taxes, etc. Then there is the person with few resources, just hanging on, etc. Finally they collapse and have highly expensive care, lose their job and on medicaid and their last few years are wildly expensive, for something that may have been easy and treatable years earlier. We are all paying for that as well. Why is anyone refused, if everyone has coverage? Why is a garden variety soar throat in the ER without insurance, if everyone has coverage? Why is there a 3-6 month wait for an MRI - just because - Why? Not everyone is paying for coverage now. There are plenty of people who don't pay for insurance yet use Emergency room services. My "premise" is that if we as a nation want coverage for everyone, then everyone needs to pay for coverage and we need to be willing to accept that it is far too expensive to be everything to everyone 24/7. If you will also read my posting made later you will see that I stated that if it was possible to have the type of care Americans have come to expect at a cost other countries pay, then someone, somewhere, would already be doing it. If you can show me any country that has nationalized care without MRI waiting lists for non-emergency procedures, I'd love to see it. this was the main objective of the ACA, imo. to put skin in the game. and people fucking HATE it. so, moving forward, what does the funding mechanism look like, buystoys?
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Deleted
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Post by Deleted on Mar 2, 2017 13:40:19 GMT -5
When DH was in excruitating pain and needed back surgery, there is no way, he'd have gone around from one surgeron to another shopping. He needed surgerry asap. Healthcare isn't like buying tires. 50% off vasectomies! Book your appointment online now! Use coupon code snipsnip20 to save an extra 20% at checkout! LOL, reminds me when I had LASIK in 2011. I went to the Dr that had been doing it 25 years at a premium price and had a great experience. My friend went to the one with the ad on the radio with a twofer, he ended up with a burst blood vessel and a follow up procedure.
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Rukh O'Rorke
Senior Associate
Joined: Jul 4, 2016 13:31:15 GMT -5
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Post by Rukh O'Rorke on Mar 2, 2017 13:40:50 GMT -5
Your premises don't hang together. Everyone is paying it for now. Private insurance gets billed $500, and pays out $438.50 due to agreements, etc. Medicare gets billed $500 and pays out $45, and Medicaid pays 28.92 for the same billable. Then there a couple in the mix that don't have insurance/cash payers, or ins denies for whatever, and then it is never paid. Those of us with private insurance are paying for all of that right now. Through our premiums, through our taxes, etc. Then there is the person with few resources, just hanging on, etc. Finally they collapse and have highly expensive care, lose their job and on medicaid and their last few years are wildly expensive, for something that may have been easy and treatable years earlier. We are all paying for that as well. Why is anyone refused, if everyone has coverage? Why is a garden variety soar throat in the ER without insurance, if everyone has coverage? Why is there a 3-6 month wait for an MRI - just because - Why? Not everyone is paying for coverage now. There are plenty of people who don't pay for insurance yet use Emergency room services. My "premise" is that if we as a nation want coverage for everyone, then everyone needs to pay for coverage and we need to be willing to accept that it is far too expensive to be everything to everyone 24/7. If you will also read my posting made later you will see that I stated that if it was possible to have the type of care Americans have come to expect at a cost other countries pay, then someone, somewhere, would already be doing it. If you can show me any country that has nationalized care without MRI waiting lists for non-emergency procedures, I'd love to see it. That's what I said. And who is paying for it now? The patient is not, but if you think it not being paid by us, it is. It's the same thing. However, if everyone was covered for routine and acute care - there may be a lot less ER visits in total. Which may save money. There is nothing about waiting 3-6 months for an MRI that makes it less expensive. If something needs treatment/surgery - waiting could cost more money in overall patient expenses, including time off work, STD, etc. If other countries have those waits - there is no reason to follow that example. It may be due to a shortage of qualified persons to do the test, or a shortage of equipment. And - fun fact! MRI invented in the USA by an Armenian American!
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thyme4change
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Post by thyme4change on Mar 2, 2017 13:56:12 GMT -5
Not everyone is paying for coverage now. There are plenty of people who don't pay for insurance yet use Emergency room services. My "premise" is that if we as a nation want coverage for everyone, then everyone needs to pay for coverage and we need to be willing to accept that it is far too expensive to be everything to everyone 24/7. If you will also read my posting made later you will see that I stated that if it was possible to have the type of care Americans have come to expect at a cost other countries pay, then someone, somewhere, would already be doing it. If you can show me any country that has nationalized care without MRI waiting lists for non-emergency procedures, I'd love to see it. That's what I said. And who is paying for it now? The patient is not, but if you think it not being paid by us, it is. It's the same thing. However, if everyone was covered for routine and acute care - there may be a lot less ER visits in total. Which may save money. There is nothing about waiting 3-6 months for an MRI that makes it less expensive. If something needs treatment/surgery - waiting could cost more money in overall patient expenses, including time off work, STD, etc. If other countries have those waits - there is no reason to follow that example. It may be due to a shortage of qualified persons to do the test, or a shortage of equipment. And - fun fact! MRI invented in the USA by an Armenian American! I think the wait time comes from having less machines and keeping them going all the time, instead of many machines that may sit idle at times.
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spartyparty
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Post by spartyparty on Mar 2, 2017 13:58:54 GMT -5
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spartyparty
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Post by spartyparty on Mar 2, 2017 14:02:16 GMT -5
healthcarebluebook.com/page_ProcedureDetails.aspx?cftid=287&g=Vasectomy&directsearch=trueMy employer provided me access to this site and actually has a lot more info available to review, but there is this disclaimer: "The Fair Price is calculated from actual amounts health plans have paid on claims. Some services show “bundled” pricing, which means there are multiple parts to the Fair Price. These usually include facility, physician and anesthesiologist fees, and can be viewed individually in the Fair Price Details. It’s always a good idea to request a price estimate from the provider and compare it to the Fair Price before your procedure. The information on this website is not a price guarantee. There is no guarantee that any specific provider will charge a specific rate or that specific services will be covered under your benefit plan. "
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ken a.k.a OMK
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They killed Kenny, the bastards.
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Post by ken a.k.a OMK on Mar 2, 2017 14:02:30 GMT -5
My doctor approved an MRI and I was scheduled 2 days later.
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Rukh O'Rorke
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Post by Rukh O'Rorke on Mar 2, 2017 14:30:01 GMT -5
My doctor approved an MRI and I was scheduled 2 days later. When I had one, my doc gave a xeroxed list of MRI centers. So I picked the closest and made appt. seemed reasonable time wise. I could have called and gone elsewhere. So, no need to think everything would needs be a huge government tangle.
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Deleted
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Post by Deleted on Mar 2, 2017 14:39:48 GMT -5
When DH was in excruitating pain and needed back surgery, there is no way, he'd have gone around from one surgeron to another shopping. He needed surgerry asap. Healthcare isn't like buying tires. 50% off vasectomies! Book your appointment online now! Use coupon code snipsnip20 to save an extra 20% at checkout! Just saying comparisons would be helpful to lower actual medical costs not just insurance costs. When I go for an office visit to get the same antibiotic I always use to clear up a sinus infection I would have no problem going to a Dr. that charges less for an office call . I'd get the same prescription. Not everything is an emergency. People put off procedures for months/years for many reasons. When that is possible it could be similar to tire shopping.
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buystoys
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Post by buystoys on Mar 2, 2017 14:40:09 GMT -5
Not everyone is paying for coverage now. There are plenty of people who don't pay for insurance yet use Emergency room services. My "premise" is that if we as a nation want coverage for everyone, then everyone needs to pay for coverage and we need to be willing to accept that it is far too expensive to be everything to everyone 24/7. If you will also read my posting made later you will see that I stated that if it was possible to have the type of care Americans have come to expect at a cost other countries pay, then someone, somewhere, would already be doing it. If you can show me any country that has nationalized care without MRI waiting lists for non-emergency procedures, I'd love to see it. this was the main objective of the ACA, imo. to put skin in the game. and people fucking HATE it. so, moving forward, what does the funding mechanism look like, buystoys ? Well, if I knew that, I'd be getting well paid, right? Honestly, that's why I said the first question that has to be answered is what is the level of care we all expect? That will determine what funds are needed and then how to fund the program can be answered. Is it a combination of employer contributions (such as amounts equal to what they pay for employee coverage now) and individual contributions (similar to amounts we now pay for individual coverage) ratcheted down because there's a much larger pool now? However we fund it, I'd prefer it NOT require constant input from Federal resources as we've already seen how that becomes unsustainable with ACA and horrifically expensive with Medicare.
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thyme4change
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Post by thyme4change on Mar 2, 2017 14:42:20 GMT -5
50% off vasectomies! Book your appointment online now! Use coupon code snipsnip20 to save an extra 20% at checkout! Just saying comparisons would be helpful to lower actual medical costs not just insurance costs. When I go for an office visit to get the same antibiotic I always use to clear up a sinus infection I would have no problem going to a Dr. that charges less for an office call . I'd get the same prescription. Not everything is an emergency. People put off procedures for months/years for many reasons. When that is possible it could be similar to tire shopping. But, why would you? Have 2 doctors with 2 sets of records just to save the insurance company $20??
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Deleted
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Post by Deleted on Mar 2, 2017 14:47:15 GMT -5
Just saying comparisons would be helpful to lower actual medical costs not just insurance costs. When I go for an office visit to get the same antibiotic I always use to clear up a sinus infection I would have no problem going to a Dr. that charges less for an office call . I'd get the same prescription. Not everything is an emergency. People put off procedures for months/years for many reasons. When that is possible it could be similar to tire shopping. But, why would you? Have 2 doctors with 2 sets of records just to save the insurance company $20?? What? No. I'd go with the less expensive Dr. to get the same treatment I got from former pricier Dr. and eventually better competition created in the marketplace.
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Tiny
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Post by Tiny on Mar 2, 2017 14:52:13 GMT -5
Well, yes, because the conversation always go: Get rid of it, without any sort of ideas or brainstorming or anything on how to provide insurance to people who are NOT covered by insurance from their employer, their parents, or their spouse.
Yes, get rid of the ACA - but what then happens to the millions of people that were USING IT!!
I'm wondering if repealing the ACA will also bump the age of coverable dependents back down to 18 (or in school of some sort) versus being able to keep your kids on your employer's insurance until they are 26.... OR if they are just going to repeal PARTS of the ACA.
I would think that since Trump is saying how awful the unemployment is (94 MILLION!!!!) that the next wave of college graduates aren't going to be able to find jobs that provide insurance so there will be even more people without health insurance - beyond the 20 million using the ACA directly.
You do know that that figure the Donald stated was out of context...another lie given at his address..12 of them...listed and explained in threads here..though to be quick..in that 95 million...large amount folks not looking for work...seniors...students...folks taking care of kids and home and yes the unemployable..sick...addicks...homeless. Yes, I know Trump's 94 million unemployed isn't a fact. I'm a victim of Poe's Law.... I was trying to parody why Trump might be concerned about the demise of the ACA with no replacement.
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ken a.k.a OMK
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They killed Kenny, the bastards.
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Post by ken a.k.a OMK on Mar 2, 2017 14:53:49 GMT -5
I don't comment much on the ACA because it doesn't affect me as retired military. Bob base is also but maybe his situation is different. I know I'm lucky to have low premiums (it was $400 a year for both of us until we became medicare age and started paying $200 a month to them), no deductible and mostly free meds. I hope some parts of ACA remain like coverage for previous conditions. Most of the complaints I hear are about cost. That has to be addressed.
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imawino
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Post by imawino on Mar 2, 2017 14:55:33 GMT -5
50% off vasectomies! Book your appointment online now! Use coupon code snipsnip20 to save an extra 20% at checkout! Just saying comparisons would be helpful to lower actual medical costs not just insurance costs. When I go for an office visit to get the same antibiotic I always use to clear up a sinus infection I would have no problem going to a Dr. that charges less for an office call . I'd get the same prescription. Not everything is an emergency. People put off procedures for months/years for many reasons. When that is possible it could be similar to tire shopping. Doctors don't generally agree to see new patients on the spur of the moment, nor do they often write prescriptions for new patients without some sort of comprehensive exam. It would almost certainly be more cost and time efficient to see your regular doctor. I can't conceive of a time when I would be willing to spend a day calling around to doctor's offices, hoping that the person who answers the phone has accurate information for charges for each procedure, and waiting to get a "new patient" appointment for the doctor that will see me for a few buck less. And that's if I actually had weeks to wait. If it's an emergency, I am definitely not bargain shopping. If you are actually just talking about changing your primary care doctor permanently, that is a different discussion than what you said above. And again, if you are changing your doctor permanently, is the biggest deciding factor price?
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thyme4change
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Post by thyme4change on Mar 2, 2017 14:56:55 GMT -5
So, you would switch all your medical care to a discount doctor?
I wouldn't. I have no incentive to go to a doctor that I perceive to have less quality. My co-pay is the same.
And, even if you convince me otherwise, you would have to convince 300 million other people.
Plus, you could call now and ask them what they charge for a cash appointment. If they both contract with your insurance company, they get the same rate.
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imawino
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Post by imawino on Mar 2, 2017 15:03:27 GMT -5
So, you would switch all your medical care to a discount doctor? I wouldn't. I have no incentive to go to a doctor that I perceive to have less quality. My co-pay is the same. And, even if you convince me otherwise, you would have to convince 300 million other people. Plus, you could call now and ask them what they charge for a cash appointment. If they both contract with your insurance company, they get the same rate. That's a good point. Unless you are paying in cash it doesn't matter what they charge. The insurance company sets the rate it reimburses for each procedure code, and that's what they get paid. Plus my copay.
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buystoys
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Post by buystoys on Mar 2, 2017 15:05:29 GMT -5
Not everyone is paying for coverage now. There are plenty of people who don't pay for insurance yet use Emergency room services. My "premise" is that if we as a nation want coverage for everyone, then everyone needs to pay for coverage and we need to be willing to accept that it is far too expensive to be everything to everyone 24/7. If you will also read my posting made later you will see that I stated that if it was possible to have the type of care Americans have come to expect at a cost other countries pay, then someone, somewhere, would already be doing it. If you can show me any country that has nationalized care without MRI waiting lists for non-emergency procedures, I'd love to see it. That's what I said. And who is paying for it now? The patient is not, but if you think it not being paid by us, it is. It's the same thing. However, if everyone was covered for routine and acute care - there may be a lot less ER visits in total. Which may save money. There is nothing about waiting 3-6 months for an MRI that makes it less expensive. If something needs treatment/surgery - waiting could cost more money in overall patient expenses, including time off work, STD, etc. If other countries have those waits - there is no reason to follow that example. It may be due to a shortage of qualified persons to do the test, or a shortage of equipment. And - fun fact! MRI invented in the USA by an Armenian American! I don't believe I said that the care is not being paid for and I understand quite well that it is us who DO foot the bill. Here's an example: Ms. A has a sore throat. Ms. A doesn't have the money for her co-pay with her doctor, so she doesn't go there. Ms. A doesn't have the money for her co-pay with Urgent Care, so she doesn't go there. Ms. A then goes to an ER because they will provide service without collecting her co-pay first. Do we change the rules and say that emergency care isn't provided? Or do we use the same sequence of events but Ms. A is not here legally and doesn't have insurance at all. Do we change the rules and say that emergency care isn't provided? Another wrinkle on Ms. A is that maybe she just doesn't believe medical insurance is worth it, so isn't paying for her coverage. Again, do we change the rules and say that emergency care isn't provided? I don't believe that we will ever see a scenario where all people have medical coverage. That is why I've said more than once that we need to FIRST determine what level of care our society is willing to consider acceptable. MRI: Well, you DO know that MRI machines are kind of expensive, right? And if we are going to a national/universal/whatever you want to call it type of care, then inherently we will see less willingness to invest in the purchase of expensive equipment as rapidly as we do now. If you only have 2 MRI machines available to a population of, say, 1,000,000 people, you won't be able to perform as many exams as you could with 5 MRI machines covering that same population. Again, when your pool of dollars is limited (and ours right now is NOT) then we all have to accept changes in care parameters. The first MRI patent in the U.S. was awarded to Damadian, but there are some people who would say that Lauterbur and Mansfield should receive credit for providing the research that made Damadian's patent a realistic imaging tool. Without Mansfield's echo-planar technique, imaging would take so long to be produced that much of our current methodology wouldn't exist.
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buystoys
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Post by buystoys on Mar 2, 2017 15:09:08 GMT -5
I don't comment much on the ACA because it doesn't affect me as retired military. Bob base is also but maybe his situation is different. I know I'm lucky to have low premiums (it was $400 a year for both of us until we became medicare age and started paying $200 a month to them), no deductible and mostly free meds. I hope some parts of ACA remain like coverage for previous conditions. Most of the complaints I hear are about cost. That has to be addressed. Yes, cost is one piece of it. Lack of coverage selection is the bigger piece of it. I can't get a doctor's appointment without waiting 3-6 weeks. I got to choose my doctor from a list of three. I can't say I prefer going here for testing because I have to go to only one location as that's the only one covered by my plan. As I said before, I only have one company to choose from and they will only offer an HMO plan for my county. I have worse coverage and about twice the price once you include my deductibles than I did even three years ago.
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Tiny
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Post by Tiny on Mar 2, 2017 15:12:29 GMT -5
What about apple to apple shopping for procedures. Hysterectomy here or hospital across town might be less expensive and just as effective. Show me what you can do , how much it will cost me and let me compare. I was reading aomething and they said the problem with price shopping is that people don't actually want discount medical services, especially of a large portion of it is being paid by someone else. I would never chose a hospital because it was the cheapest, and I may very well chose the hospital that is most expensive - because it must be better. Even my primary care - why would I take my kids to the guy who advertises on the back of the bus with the slogan "If you find a price cheaper than mine, your next vaccine is free!" No! I'm going to the premium doctor. It would be a marketing ploy to raise your rates, and costs would go up, not down. The problem is that you have no idea if the "premium" doctor is charging you something reasonable for the services he is providing or not. What if your premium doctor is charging $500 (because he can -- because no one has a clue if it's too expensive or not) while the handful of other equally qualified, pleasant, good looking doctors a bit further up the road are charging $250 for the EXACT SAME THING?
I don't think the whole "shopping around for healthcare" is about finding the lowest price - it's about actually being able to COMPARE pricing.
I tried to find out how much a colonoscopy would cost me... I couldn't get a straight answer out of my insurance if they'd cover the procedure or not... So, I went down the rabbit hole of trying to find out the prices of all the pieces that would be billed to my insurance... it was the most frustrating and fruitless thing I've ever attempted. I couldn't get an answer. So, I had the colonoscopy with NO IDEA OF HOW MUCH I"D ULTIMATELY PAY... I live in a place with MANY good hospitals... and there was no way I could "shop around" or "compare" prices between the various hospitals. I highly doubt there's a one price across all the hospitals. The final cost billed to my insurance was just under 15K. I have no idea if that was a "good price" or I (actually the insurance company) got ripped off and the cost should have only been 10K (or even less) if I had gone to one of the other good hospitals in my area.
That's the problem... you have to choose healthcare on 'faith' - you get to choose based on Marketing and Location. It's all "touchy feely" and not based on any sort of "fact". You have no idea how much "healthcare" actually costs or the ability of the doctors.
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buystoys
Junior Associate
Joined: Mar 30, 2012 4:58:12 GMT -5
Posts: 5,650
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Post by buystoys on Mar 2, 2017 15:17:11 GMT -5
My doctor approved an MRI and I was scheduled 2 days later. When I had one, my doc gave a xeroxed list of MRI centers. So I picked the closest and made appt. seemed reasonable time wise. I could have called and gone elsewhere. So, no need to think everything would needs be a huge government tangle. And you are fortunate because you have options many others don't. I can't just pick an MRI center and go have a test. I have to have my doctor first get the test authorized then wait for my insurance company to call me and tell me it's authorized. The insurance company tells me where I can go for the exam. If it's in my town, that's great! If it's in the next town over, not so great but that's where I go! It could take three or four weeks to actually get the test performed with all the paperwork and calling involved. Serious question for you though, Rukh O'Rorke. Have you ever worked in the medical field or do you know people who do? Because I was a medical professional for almost 20 years. There's a lot more behind what happens than you're speaking of. I suspect you've had very good coverage with few limitations on your policy and maybe you're just not aware of how difficult it can be to navigate the current system. And even as smoothly as things seem to run when you're outside looking in, there are HUGE paperwork tangles for every single patient and every single exam even today. It looks a lot easier because of technology availability, but there are plenty of bumps that most people never see.
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Tiny
Senior Associate
Joined: Dec 29, 2010 21:22:34 GMT -5
Posts: 13,373
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Post by Tiny on Mar 2, 2017 15:21:38 GMT -5
So, you would switch all your medical care to a discount doctor? I wouldn't. I have no incentive to go to a doctor that I perceive to have less quality. My co-pay is the same. And, even if you convince me otherwise, you would have to convince 300 million other people. Plus, you could call now and ask them what they charge for a cash appointment. If they both contract with your insurance company, they get the same rate. I know this isn't directed to me - but if I knew I'd pay less out of pocket by going to the lower cost "medical group A/Hospital A" for basic services versus the "medical group B/Hospital B" AND I was sufficiently certain that both groups provided reasonable care - (I live in an area with LOTS of medical/hospital choices) I'd go to the "lower cost" medical group/hospital. I know not everywhere has as many choices as I have...
It's kind of like how I won't buy vegetables at my local Jewel (which is attempting to be a high end grocery - they have crappy overpriced veggies) just to be able to say "I buy at Jewel!" it's a status thing. - but I will buy veggies at the local Aldi. The Aldi moves a lot of veggies -- they have a wide variety at very reasonable prices and they are almost always fresh (haven't been on the store floor for days or stuck in the back for weeks before being put out).
I'd be willing to buy some facets of 'health care' for a lower price - as long as I had some way to compare the services and the prices.
(ok, I have a friend who feels that her $50 flu shot given to her by her doctor is somehow better than the $20 flu shot she could have gotten if she'd gone to walgreens. OK, she's a delicate flower and I'm sure her doctor fawned and tsk'ed and made her feel all warm and fuzzy and special before the nurse came in and gave her the shot... She wouldn't get that at Walgreens. )
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imawino
Junior Associate
Joined: Dec 17, 2010 22:58:16 GMT -5
Posts: 5,359
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Post by imawino on Mar 2, 2017 15:24:24 GMT -5
I was reading aomething and they said the problem with price shopping is that people don't actually want discount medical services, especially of a large portion of it is being paid by someone else. I would never chose a hospital because it was the cheapest, and I may very well chose the hospital that is most expensive - because it must be better. Even my primary care - why would I take my kids to the guy who advertises on the back of the bus with the slogan "If you find a price cheaper than mine, your next vaccine is free!" No! I'm going to the premium doctor. It would be a marketing ploy to raise your rates, and costs would go up, not down. The problem is that you have no idea if the "premium" doctor is charging you something reasonable for the services he is providing or not. What if your premium doctor is charging $500 (because he can -- because no one has a clue if it's too expensive or not) while the handful of other equally qualified, pleasant, good looking doctors a bit further up the road are charging $250 for the EXACT SAME THING?
I don't think the whole "shopping around for healthcare" is about finding the lowest price - it's about actually being able to COMPARE pricing.
I tried to find out how much a colonoscopy would cost me... I couldn't get a straight answer out of my insurance if they'd cover the procedure or not... So, I went down the rabbit hole of trying to find out the prices of all the pieces that would be billed to my insurance... it was the most frustrating and fruitless thing I've ever attempted. I couldn't get an answer. So, I had the colonoscopy with NO IDEA OF HOW MUCH I"D ULTIMATELY PAY... I live in a place with MANY good hospitals... and there was no way I could "shop around" or "compare" prices between the various hospitals. I highly doubt there's a one price across all the hospitals. The final cost billed to my insurance was just under 15K. I have no idea if that was a "good price" or I (actually the insurance company) got ripped off and the cost should have only been 10K (or even less) if I had gone to one of the other good hospitals in my area.
That's the problem... you have to choose healthcare on 'faith' - you get to choose based on Marketing and Location. It's all "touchy feely" and not based on any sort of "fact". You have no idea how much "healthcare" actually costs or the ability of the doctors.
Price shopping for medical procedures is something that sounds like it should be easy but is oftentimes impossible. It would be great if every doctor just posted a price sheet, but that's not how it works.
But don't worry, your insurance company absolutely knows whether they were getting ripped off! And in all likelihood, they only paid out about $6k, regardless of whether the bill was 10k or 15k.
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thyme4change
Community Leader
Joined: Dec 26, 2010 13:54:08 GMT -5
Posts: 40,439
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Post by thyme4change on Mar 2, 2017 15:39:37 GMT -5
So, you would switch all your medical care to a discount doctor? I wouldn't. I have no incentive to go to a doctor that I perceive to have less quality. My co-pay is the same. And, even if you convince me otherwise, you would have to convince 300 million other people. Plus, you could call now and ask them what they charge for a cash appointment. If they both contract with your insurance company, they get the same rate. I know this isn't directed to me - but if I knew I'd pay less out of pocket by going to the lower cost "medical group A/Hospital A" for basic services versus the "medical group B/Hospital B" AND I was sufficiently certain that both groups provided reasonable care - (I live in an area with LOTS of medical/hospital choices) I'd go to the "lower cost" medical group/hospital. I know not everywhere has as many choices as I have...
It's kind of like how I won't buy vegetables at my local Jewel (which is attempting to be a high end grocery - they have crappy overpriced veggies) just to be able to say "I buy at Jewel!" it's a status thing. - but I will buy veggies at the local Aldi. The Aldi moves a lot of veggies -- they have a wide variety at very reasonable prices and they are almost always fresh (haven't been on the store floor for days or stuck in the back for weeks before being put out).
I'd be willing to buy some facets of 'health care' for a lower price - as long as I had some way to compare the services and the prices.
(ok, I have a friend who feels that her $50 flu shot given to her by her doctor is somehow better than the $20 flu shot she could have gotten if she'd gone to walgreens. OK, she's a delicate flower and I'm sure her doctor fawned and tsk'ed and made her feel all warm and fuzzy and special before the nurse came in and gave her the shot... She wouldn't get that at Walgreens. )
I went to Walgreens and they said I had to pay out of pocket, and wait for a long time with a bunch of weirdos. I go to my dr now. I don't know what the insurance Co pays her, but it is included with my annual, so I don't get an extra co-pay. It is nicer, cleaner and more private.
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buystoys
Junior Associate
Joined: Mar 30, 2012 4:58:12 GMT -5
Posts: 5,650
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Post by buystoys on Mar 2, 2017 15:42:47 GMT -5
I know this isn't directed to me - but if I knew I'd pay less out of pocket by going to the lower cost "medical group A/Hospital A" for basic services versus the "medical group B/Hospital B" AND I was sufficiently certain that both groups provided reasonable care - (I live in an area with LOTS of medical/hospital choices) I'd go to the "lower cost" medical group/hospital. I know not everywhere has as many choices as I have...
It's kind of like how I won't buy vegetables at my local Jewel (which is attempting to be a high end grocery - they have crappy overpriced veggies) just to be able to say "I buy at Jewel!" it's a status thing. - but I will buy veggies at the local Aldi. The Aldi moves a lot of veggies -- they have a wide variety at very reasonable prices and they are almost always fresh (haven't been on the store floor for days or stuck in the back for weeks before being put out).
I'd be willing to buy some facets of 'health care' for a lower price - as long as I had some way to compare the services and the prices.
(ok, I have a friend who feels that her $50 flu shot given to her by her doctor is somehow better than the $20 flu shot she could have gotten if she'd gone to walgreens. OK, she's a delicate flower and I'm sure her doctor fawned and tsk'ed and made her feel all warm and fuzzy and special before the nurse came in and gave her the shot... She wouldn't get that at Walgreens. )
I went to Walgreens and they said I had to pay out of pocket, and wait for a long time with a bunch of weirdos. I go to my dr now. I don't know what the insurance Co pays her, but it is included with my annual, so I don't get an extra co-pay. It is nicer, cleaner and more private. Funny! I go to Walgreens because I don't have to pay for it whereas if I went to my doctor, it's not covered by my insurance and it's $50.
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