We previously discussed the ridiculous and dishonest health care system with hospitals charge absurd amounts in a system designed for padded and dishonest billing. The latest example comes from a family on vacation to San Francisco who took their two-year-old son into the emergency room of Zuckerberg San Francisco General Hospital after he hit his head. After a brief check up, Jeong-whan was cleared by doctors and, after a brief nap, he was released. The family was hit two years later with an $18,000 bill.
The family said that they simply took the boy into the ER because he was inconsolable. However, doctors found no injury and he fell asleep in the arms of his mother. Two years later, they were charged for a the 3 hour and 22 minute visit, including a charge of $15,666 for something called “trauma activation” or “a trauma response fee.”
Hospitals tack on a trauma fee as payment for assembling a team to deal with a patient.
Vox has an excellent article on this case.
As discussed earlier, my family had a similar experience when my son Benjamin had a concussion from playing college sports. He was asked to fill out a form once every couple days on his condition and drop it off at the doctor’s office. He never saw a doctor, but we received a bill for thousands, including repeated charges $350 for visits with doctors who never met him. He was never hospitalized or taken to the emergency room. He was never given any medication. Yet we were charged many thousands of dollars. It took my wife literally dozens of calls before she was told that the school insurance would cover the costs. Again, the overcharging by the doctor who never met Ben was never addressed.
However, this is nothing new. It is part of a medical system where ridiculously inflated bills are the norm. After all of the promised “reforms,” little has changed in this inherently dishonest system of overcharging and holdouts for consumers. Some, particularly elderly patients, simply pay while the rest of us have to spend hours getting the companies to honor their policies. I have spoken with many doctors who are appalled by the system. Yet, Congress continues to receive millions from health care companies and has repeatedly failed to address this corrupt and abusive system.
Professor Turley….spot on! I especially feel for the elderly who simply pay what they are asked to pay. My mother constantly got bills that were incorrect, thankfully she had me to set things right and never paid incorrect bills. However, many of her friends were not so lucky.
Also, these people are not responsible for any payment if they got the bill years later. Health care providers must file claims in a timely basis, usually within 30 days.
When health insurance pays, you still pay for it. That cost gets tossed onto the mountain of other costs that contribute to the calculus to determine premiums, deductibles, and copays. In fact, the very existence of health insurance helped to drive up the cost of care in the first place.
If everyone had to pay at point of service, in cash, and hospitals charged $18,000 for a few hours, spent sleeping in the arms of a parent, then how many people would seek those services? How long would the hospital stay open?
On the other hand, such slush funds do finance a lot of R&D, but it is a system that is being abused. In addition, hospitals tack on every possible fee to cover all of their own costs of doing business.
It really is time for reform…effective reform, which would start with putting Obamacare into a box, and then into a bigger box, and tossing it into the Abyss of the Ocean.
My husband had out-patient surgery recently. When going through pre-op they put a pair of socks on him. He had socks on, but it had to be these particular socks. After the surgery as my husband was dressing the nurse put the socks in his bag. He said he didn’t want them (we have lots of these socks at home from other hospital visits). In denying them he told her this and said we had no need to pay for more. She said “take them” you’ve already been billed for them when she got them. I said we should have brought one of the other pairs and was told they couldn’t be used anyway, wouldn’t be considered sanitary. The hospitals will always win!
Went to an ER while visiting sister in Michigan. High fever,chest pain,back pain,uncontrollable shaking. ER doctor sent bill $400. Paid it. Oh, that was uninsured rate. When they found out I had insurance, billed them. Now I owe $1,300 because of co-insurance. Really. I have to pay $1,300 because I have insurance. I pay for insurance and now more. I could see a couple hundred more but$1,300 more!,! Really. How unfair.
Every time the government involves itself in the business of healthcare things get worse. Obamacare was a known failure before it was ever passed. People stated the reasons why it would fail in advance of passage and they were right on target. Obamacare made things worse for those with private insurance to such an extent that it became nearly worthless for the middle class along with being a huge expense. Healthcare is expensive and involves a lot of emotions but the solutions to the major problems aren’t that difficult to understand. People spend their money on themselves better than third parties do.
Allan, you have public health provision everywhere in the occidental world because there were some serious deficiencies in fee-for-service supplemented with private philanthropy. See Ronald Reagan’s criticism of the incipient Medicaid and Medicare programs, offered in 1965. Reagan did not make a case against publicly funded medical care, but against the specific legislation in question. Instead of railing about ‘the government’, you might ask how these programs might be structured in a more salutary fashion.
DSS, the government has chosen to be an active player in the healthcare sector and that has been disastrous. The government can act as a passive player where it doesn’t significantly affect the marketplace. It does that in all sectors of the economy.
There are those that need almost total help and for that type of need, the government can provide a safety net. Insurance expands the ability of one to afford expensive care and that need not be significantly involved with government. Some might need a little extra help in the form of subsidies that also do not need to significantly affect the marketplace.
I don’t think the concepts behind a functioning health care marketplace are that difficult to understand nor is appropriately limited government discussed by Hayek some 75+ years ago.
I’m not sure where your problem arises regarding anything I say on this subject. I believe you are a statistician. If so you might be interested in some of the papers by Mark Litow. I don’t necessarily agree with everything he says but he creates a better comparison between government run healthcare for over 65 (Medicare) and private insurance. I provide this just in case you believe Medicae for all is the way to go. Litow just deals with one part of the debate.
If you wish I am more than happy to discuss this subject in depth. You are a smart guy so maybe you will have some new ideas I haven’t heard before.
There is a tangle of trouble. ‘Disaster’ is your preferred rhetorical flourish, not a social reality.
I don’t think the concepts behind a functioning health care marketplace are that difficult to understand nor is appropriately limited government discussed by Hayek some 75+ years ago.
You’re giving no evidence that you understand former or current problems. Hayek isn’t helping you here.
Disaster is when prices spiral out of control while actual quality of workmanship declines. What provides the healthcare industry with improved quality is technology. However, we have not effectively learned how to control the costs of all this technology. What we are seeing outside of technological advances is higher prices, reduced access and lower quality.
“You’re giving no evidence that you understand former or current problems. ”
One cannot provide satisfactory discussion to a vacuum. Since the subject is so vast you can provide a bit of substance by pointing out an element that you feel requires discussion. Otherwise, you are just blowing air.
Disaster is when prices spiral out of control while actual quality of workmanship declines.
The quality of workmanship isn’t demonstrably declining. Neither are allocations to the medical sector ‘spiraling’. The revenue stream in ‘health care and social assistance’ accounted for 6% of gross output in 1997 and accounts for 7.2% today. It was a great deal lower in 1940 than it is now, but it’s difficult to credit Milton Friedman’s contention that the ratio would have remained fixed without public subsidies or 3d party payments. Health care is not the only sector which accounts for a larger share of the economy. Real estate’s relative importance grew considerably between 1947 and 1985 as did that of finance from 1947 to 1998. Megan McArdle pointed out a while back that spending on veterinary services had tracked that of medical services for long periods of time in the absence of public subsidies or 3d party payments.
You’ve got a number of tasks at hand: promoting real prices and price transparency, erecting stable actuarial pools, addressing distributional concerns, repairing the damage employer-provided benefits have done to the labor market, and constraining the impact of the medical sector on public budgets. Reflexive complaints about ‘the government’ do not address any of these questions.
“The quality of workmanship isn’t demonstrably declining.”
How do you know? You don’t.
“Neither are allocations to the medical sector ‘spiraling’. The revenue stream in ‘health care and social assistance’ accounted for 6% of gross output in 1997 and accounts for 7.2% today.”
Specifically which allocations are you talking about? Healthcare costs as a percent of GDP have been rising tremendously over the years. The dollar costs have dramatically risen while the benefits have not proportionally risen. We can use a whole slew of metrics and we can even ask the patient.
“Health care is not the only sector which accounts for a larger share of the economy.”
The costs to treat a dying patient where there is no benefit to life have spiraled to massive costs that neither helps the patient or the nation. That is just one example. Your comparisons to real estate are somewhat ludicrous because we don’t utilize involuntary pooling in real estate development.
“Reflexive complaints about ‘the government’ do not address any of these questions”
In a vacuum, they don’t, but you are trying to deal in a vacuum adding things like comparisons to real estate that don’t make sense. Without question, the government has dramatically altered the environment with regard to healthcare and is a large part of the reason prices are so high. Do you wish to disagree with that and debate it? The tax code created a lot of the problems we face today.
I will be glad to deal with any of things you have discussed. I don’t find most of these things so problematic though the politics is extremely difficult.
Allan and TS to Dance,…
I’m not sure where my comments on health care costs posted relative to your exchange….I don’t have time to review the 400-500 comments here to locate that part of this thread, so my comments may be way out of sequence.
DDS, I was hoping that you would chime in further. You developed a few points without expansion of them when stating the tasks at hand.
1)”promoting real prices.”
Are you stating that the government is the only one able to set prices? Are you saying we have real prices today?
2)”price transparency”
Of what importance is price transparency to the consumer if third-party payer prevents the consumer from price shopping.
3)”erecting stable actuarial pools”
That is a non-problem. That is what insurance companies do. “addressing distributional concerns”
4)”addressing distributional concerns”
Do you think the government is the only one that can do that?
5)”repairing the damage employer-provided benefits have done to the labor market”
Doing nothing doesn’t repair the problem.
6)”constraining the impact of the medical sector on public budgets. ”
That is one of the reasons the government needs to distance itself from the healthcare sector.
7)”Reflexive complaints about ‘the government’ do not address any of these questions”
There is nothing reflexive in my complaints, but when I listen to this type of list without explanation I wonder about what nerve I have hit.
If you’ve been to the VA…you clearly have a picture of how universal health care would be (but worse). No thank you.
Shannon,…
At least 50% of U.S. healthcare costs are funded by the government.
In the case of the VA, also facilities are owned ( maybe leased in some cases) by the government.
The doctors and nurses are most government employees, but there is some private contracting on some cases.
I have made the point several times that if government-funded single payer systems produce enormous administrative cost savings, why hasn’t the c.50% shift to government funded systems already produced these imaginary savings?
I have stated that we might see some small administrative cost savings with a single payer system.
But our government systems that are essentially single payer systems; MediCare, MediCaid, CHIPS, the VA, etc….. do not produce any significant administrative cost savings.
In facts, health care costs exploded in the decades following the establishment of MediCare and MediCaid.
Quality and choice are two other issues, but I won’t get into that ( again) right now.
“I have stated that we might see some small administrative cost savings with a single payer system.”
Tom, the administrative cost savings with single-payer are quite small if existent. If one includes fraud as part of administrative costs then Medicare administrative costs go through the roof. It costs money to prevent fraud. Single-payer is a fraud unless the one pushing it can correct the problems with Medicare and the VA. When we compare Medicare administrative expenses to private insurance administrative expenses we are comparing apples to oranges and not even including all the costs Medicare enables. Additionally, the calculation generally used for the comparison is fallacious and no business in their right mind would use such a calculation in determining similar business expenses.
It just got more complicated when Ocare started. If you worked or retired from a very big company you really got screwed. We had excellent benefits; we weren’t planning any more additions to the family. With Ocare it didn’t matter, you were insured for having more children whether you liked it or not.
My biggest issue was the lying by Obama himself.”Keep your doctor” “keep your plan”. That had to be the single biggest lie by any President ever. Then the mastermind, “we never could have done it if the American people hadn’t been too dumb to figure it out”!
Put that man’s statement in every GOP ad this election season. Voters would turn away from Nancy in droves!
Do you really think that if government had no involvement with healthcare, and that hospitals were even less restrained than they are now, that costs would come down? Why?
And, how do you explain the situation in the rest of the developed world, where there is more government involvement than we have, and costs are less, with better outcomes?
They don’t have ‘better outcomes’. ‘Costs’ aren’t ‘less’, either. Social allocation is less.
Jay S.,
These single payer systems in other countries have ( mostly) been on place for generations.
They established fairly rigid pricing restraint in their systems.
You don’t see the kind of fees charged by service providers in the U.S., or the high levels of per capita spending, in almost all of the single payer systems.
That is not because of massive savings in administrative costs; it is because they have tighter cost controls/ lower reimbursement to providers.
I used the example of the big income gap between American doctors and those in Canada.
The MD income gap isn’t the only factor accounting for lower costs in Canada, but it is a major factor, and one of the most significant differences between the two systems.
The high health care costs in are largely a result of higher reimbursement rates.
The MD income gap is one of the clearer examples of that lower reimbursement.
The high costs in the U.S. are firmly embedded in our system.
For example, when MediCare was established, the U.S. did not mimic the other countries strict, lower price controls.
Higher reimbursement rates to providers are a (mostly) unique feature of government-funded health care in the U.S.
You will find that, almost across the board, that other countries basically provided universal health care at lower costs because of lower reimbursement rate; i.e., the government pays a set, lower amount on allowable charges.
The AMA strongly opposed the establishment of MediCare.
LBJ met with their leadership and turned them around pretty fast…they mostly dropped, or modified, their opposition.
The selling points to the AMA and other providers ( primarily hospitals) were higher volume, less reimbursed care, and no tight price controls relative to those seen in other systems.
So I think you have to go back to the beginning, when these single payer systems were put in place in other countries with fairly tight price controls.
That was lacking when we established MediCare, and generally reimbursement rates went up at a greater rate for decades.
You might get cooperation from a specialist who is in an established single payer system, and whose income is $200,000 a year.
You are not likely see the American specialists go along with a drop in income from $350,000 to the $200,000 paid in other countries.
Should be less UNreimbursed care after MediCare was put in place…providers knew they’d get paid by the government if a patient could not pay.
Tom, physician fees are not the real cause of our healthcare costs. They amount to a steady less than 20% of the bill and they are the ones actually providing healthcare. Physician fees include all sorts of providers including chiropractors. If one was to totally get rid of physician profit one wouldn’t do that much to reduce costs since we could approximate that ~50% of their receivables go to overhead and another large chunk goes to taxes.
A lot of the costs are creations of government.
Allan,…
I used the example of MD income disparity in response to one of Isaac’s earlier comments.
It is one of the most clear examples of lower reimbursement rates in Canada, and most other countries.
But reimbursement rates for virtually ALL health care services ( CT Scans, MRI’s, Lab Tests, Hospital Bills) are substantially higher in the U.S.
I think you’re saying that doctor bill account for about 20% of total U.S. health care expenditures.
I think it’s far higher than 20%, but I’ll revisit some recent data on that.
Tom, the bill is lower than 20% and has been remarkably almost the same share year after year. We have superspecialists that charge phenomenal rates, but when one looks at the generalists and practitioners most of us see we can compare hourly incomes adjusting for external variable costs such as education, taxes, retirement etc and we find that the hourly rate isn’t that much higher.
Tom, I don’t know if you have heard of Uwe Reinhardt (Jackson Hole etc.). I had a bunch of discussions with him mostly disagreeing due to his socialist tendencies, but I always kept this letter of his to the NYTimes because here he was right.
http://query.nytimes.com/gst/fullpage.html?res=9B00EEDE163AF936A3575BC0A9619C8B63
What Doctors Make, and Why
Published: August 5, 2007
To the Editor:
In ”Sending Back the Doctor’s Bill” (Week in Review, July 29), you compare the incomes of American physicians with those earned by doctors in other countries and suggest that American doctors seem overpaid. A more relevant benchmark, however, would seem to be the earnings of the American talent pool from which American doctors must be recruited.
Any college graduate bright enough to get into medical school surely would be able to get a high-paying job on Wall Street. The obverse is not necessarily true. Against that benchmark, every American doctor can be said to be sorely underpaid.
Besides, cutting doctors’ take-home pay would not really solve the American cost crisis. The total amount Americans pay their physicians collectively represents only about 20 percent of total national health spending. Of this total, close to half is absorbed by the physicians’ practice expenses, including malpractice premiums, but excluding the amortization of college and medical-school debt.
This makes the physicians’ collective take-home pay only about 10 percent of total national health spending. If we somehow managed to cut that take-home pay by, say, 20 percent, we would reduce total national health spending by only 2 percent, in return for a wholly demoralized medical profession to which we so often look to save our lives. It strikes me as a poor strategy.
Physicians are the central decision makers in health care. A superior strategy might be to pay them very well for helping us reduce unwarranted health spending elsewhere.
Uwe E. Reinhardt
Princeton, N.J., July 30, 2007
The writer is a professor of political economy at Princeton University.
An example how this maybe currently reflected is in today’s world is the siphoning of STEM students for their ability to apply math to wall street. Many times more salary on wall street than solving the world’s problems.
There are questions as to whether or not our brightest should end up in medical school (or on Wall Street). Our economic future depends on our productiveness and our technology. Many physicians are quite bright in the sciences. The question is where would they be most productive for the nation?
You are right.
Michael and Allan, One option rarely discussed is ” medical tourism”.
There are said to be excelleng foreign facilities that can perform surgeries, etc. for a fraction ( c.20-30% of what it would cost in the U.S.
It hasn’t seemed to really take off, but it seems to me that some ” outside the box” thinking” needs to take place in discussing health care costs.
There are probably a high number of qualified foreign MDs who would like to come to the U.S. to practise.
I don’t know the details, but there also seems to strong restrictions on “importing doctors”.
Much of Cuba’s annual GDP comes from exporting MDs.
It was surprizing to me just how large a part of the Cuban rconomy this is.
The MDs are paid a pittance, and the state pockets most of the revenue.
It can lower the ampunt and quality of healthcare for Cubans, but I haven’t seen any mass protests in Cuba😏.
If we had handled the medical sector correctly instead of it being a giant cost it could have been a cash cow, far more than it is today and could have helped to offset a lot of our medical costs.
We could utilize medical tourism in other countries but for the fact, the socialists have placed the insurers, hospitals, and middlemen in the position of control. Elective surgeries that are not reimbursed have led to significant medical tourism where along with their plastic surgery people also have a vacation.
We have a huge number of foreign doctors in the country today and all quickly adjust to the higher standard of living offered here and charge accordingly.
Allan,
I have noticed a number of highly qualified Indian MDs.
But I don’t know if they actually came from India, are ethnic Indians born as citizens in the U.S., or where they went to med school.
Do you have a number, rough percentages, for the foreign citizens who practised in their native country, but now practise here?
I know their are some Americans who get their MD degrees abroad…..I don’t know how if it’s difficult for them to get licensed to practise here.
One guy I knew made it thru a foreign med. school, but was weeded out of the profession during his internship or
residency.
FMG’s need to pass a test and do their residencies here in the US. Same for Americans graduating from a foreign medical school. I don’t have the exact statistics.
The government has diluted the availability of physicians in the US with all their garbage including the electronic medical record debacle. Between that and dealing with managed care physicians seem to be spending more time than ever on things that do not help the patient.
Thanks for the info, Allan.
Jay, tell you mother, wife, daughter or granddaughter about the situation in the rest of the world if they ever get breast cancer.
From the well respected CONCORD study (excluding Cuba):
Breast cancer survival: US #1 England # 21
They cannot be sued. Our costs are so high because some where down the road a patient sues a doctor and juries award huge amounts of dollars. If we got Tort Reform, suing doctors wouldn’t happen here. The threat of suits is why many doctors have chosen to retire. Fewer doctors is definitely a serious problem.
Often the true value of your “insurance” policy, is the deal they cut with the providers. The providers can bill whatever they want but are contractually permitted to only accept a pre-arranged price per service. This basically costs the insurance nothing but the policy holder does not pay the artificially inflated price. The prices are raised to dizzying heights to give the impression you are getting a deal.
And if you don’t have insurance, or the bill somehow is outside the policy coverage, the sky’s the limit.
America’s healthcare: predatory medical monopolies. Healthcare is wiping out the future Federal Budget faster than the endless warmongering.
Don’t lawyers charge for work done, even when they’re not with their clients? Don’t lawyers have overhead costs? Hospitals don’t?
Rosemary,..
– I understand what you’re getting at.
But let’s use the lawyer example.
You’re thinking about contesting a speeding ticket. You call your lawyer, and in a 5 minute phone conversation he advises you to just pay it.
Let’s say another client is represented by your lawyer and that client is charged with vehicular homicide.
Obviously, there will be a lot more billable hours in the latter case.
The lawyers office overhead is there in both cases. And the lawyer’s charges should cover that overhead and produce a decent income.
Does that office over justify charging you $1,000 for your 5 minute phone consulation?
That would be all out of proportion to the any justifiable charge.
The fact that there are overhead expenses in running a practice does not reasonably give the service provider carte blanch rights to charge “whatever”.
The client facing the more serious vehicular homicide charge will obviously be facing significant legal fees.
That only makes sense.
In the same way, a minor complaint or malady involving minimal treatment in an ER will cost, or “should cost”, far less than a patient severely injured in a car wreck.
And understandably so.
The fact that there’s overhead doesn’t justify outrageous charges for anyone who goes to an ER and gets a fast, uncomplicated, straightfirward diagnosis and minimal treatment.
Tom, Hospital bills are near meaningless. Even the hospitals don’t have a firm understanding of their profit centers. ER’s can be losers or winners. An ER can lose money yet earn money for the hospital. Hospitals seem to keep multiple sets of books. If one wants to evaluate a hospital’s profitability, don’t look at the bills. Instead look at what the hospital actually receives. When a hospital says how much charity it performed don’t at the write-offs. Look at what the comparable payments would have been or look at just the expenses. The games being played are tremendous and patients are being ripped off by everyone concerned. The number of rent seekers is tremendous and they have increased the cost of medicine tremendously. All one has to do is ask why can an identical CT scan cost $300 at one place and $3,000 at another. Sometimes insurer’s pay very high amounts for things that cost much less. Why? Because we are all being forced into the same game and an insurer’s profit is very similar to cost plus. This would not be if the government wasn’t so involved but it is so we pay large amounts for very little.
Allan,
…
– The wildly divergent prices charged that you cited are examples of a lack of “capitalism/ free market” characterisics.
In virtually ANY other purchase of goods or services, price competition (and transparency) is important, and available, to most people.
The lack of those characteristics is a major reason for runaway health care costs.
” The wildly divergent prices charged that you cited are examples of a lack of “capitalism/ free market” characterisics.”
Of course and the original sin was the tax deduction provided to employers that offered insurance to their employees which created third-party payer for employees (virtually take it or leave it). The third-party payer has created abominable pricing and has not permitted a good marketplace to work. It is said to reduce costs but one of the reasons employer-sponsored insurance reduces costs is because when a person becomes ill they frequently cannot work and then lose their insurance. They then became private payers and screwed up that market as well.
The solution is simple. Go to square one and end the tax deduction in a tax neutral fashion or provide the tax deduction to the individual (definitely not as good as ending the deduction). Trump is permitting individuals to join together but though marginally helpful I don’t think that solves the problem.
Price transparency is good but doesn’t work in an environment where we are all forced to essentially buy the same type of insurance. The insurance market has to be opened up. Let me give you an example. I carry an Epi-Pen. The list price went up to $800. My insurer pays somewhere between $400 and $600. I know there is a Candian version that costs only $200 but it is not on the plan. I won’t buy the cheaper product because my copay is only $74 and I get no reimbursement from the purchasing the less expensive device. That doesn’t make much sense until one realizes that middlemen are making out like bandits, the insurer earns in a somewhat proportional manner a percentage of the premium and my $800 Epi-Pen is divided up among the members of my pool.
If Insurers were free to insure based upon a free marketplace and the insured were free to buy based on a free marketplace suddenly that $800 would matter and the insurer to lower its price would be buying the Candian version (sold in the US) or the American version at a reduced price. Prices would plummet. Transparency only helps if that transparency is accompanied by benefits and that requires a freer market.
A few things:
Why did it take two years to bill them?
Another example of what happens with a third-party payor system. Same with student loans. Take the consumer out of the picture and see the prices go sky-high.
Question, Prof. Turley, did the insurance pay every thing billed for your son? The “contracts” these facilities have with insurance companies are where the potential for disparate charges occurs.
The fact that this couple were uninsured visitors doesn’t help them. In 2003, while living abroad, I had to have a CAT scan after a skiing accident. The hospital (in an internationally known ski resort) charged me $5,000 because to them I was uninsured. Someone with insurance would have paid $1,000. My accident insurance paid the fee and I soon discovered that international visitors are a major source on money for this hospital…and continues to be.
Bottom line, the system, as Prof. Turley points out, was never “reformed.” It just got worse since now we pay double out-of-pocket (including premiums, deductibles, and co-insurance) than before (U)ACA.
Another scam that health care providers conduct is that they will hold off billing the insurer and send a bill and multiple threatening reminders if necessary directly to the patient. After the patient pays, then the provider bills the insurer, getting paid twice for the same service. All too often the patient simply pays and keep silent about it. The provider depends on the lack of sophistication of its patients, hoping that the patients pay without complaint.
Each state has a insurance regulatory agency which should be notified whenever this occurs. Undoubtedly, the provider will claim that a mistake has been made. However, repeated instances reported to the regulatory agency will alert the agency that something is amiss despite the providers denials and corrective action will be taken.
The first thing doctors like to operate on is your wallet!
Just ask for an itemized bill and then nail them over that.
Sometimes trying to extract that from a hospital is harder than pulling a tooth from a lion without anesthesia.
On average my bills are 40% of your bills and not just in Medicine. Plus I live in a much safer environment. My formerly middle class retirement income reduced to an upper lower class retirement income now brings me an upper middle living experience in retirement. The answer. Move south across the border at least 100 miles south of the border and then talk to one of the one million gringos who live here full time
As for the Medicare? costed me $100 per month in 1988 and now who knows but I haven’t seen a Cost of Liiving allowance worth mentioning as it whatever all went to Medicare. Which I have never used. But it’s required to get my retirement pay.
Who said mordida didn’t exist north of the border? Being in that system did protect me from being fined under ACA though. no trial, no jury just straight confiscation without explanation This last year did a lot to help my budget recover but not enough to take the chance of living in a nation that sooner or later will once again vote in higher taxes and fifty other fees courtesy of the war monger party.
Meanwhile i work with the so called Phantom Army and hey didn’t we do a great job in 2016? That doubling of the personal exemption for example made up for fully half of the 30% loss in buying power of the dollar we didn’t enjoy under the previous administration.
And best part is… counter revolutions are legal.
If by warmonger Party you mean Republicans, you couldn’t be further from the truth. Republicans spend a lot on war equipment while planning to never have to use them. We have the best military in the world. No one wants to fight us. If Kim or Putin had been stupid enough to launch a missile attack, their countries would be annihilated before theirs got here. We might use some of the equipment as a reminder that we have more.
According to the Vox article their travel insurance would pay 5K.– which is MORE than enough IMO. They should just not pay the rest of that ridiculous bill. Given that they live in S Korea good luck on the hospital collecting.
Thanks, Autumn. I’ll check the VOX article for more details.
Anyone wish to contest tat War Monger Party accusation prepare to be embarrassed jus tlet me know I’ll post the whole thing again.
Now as for the center? It’s not the distance between two parties it’s the location of in a Constitutional Republic the Constitution. Fictionary definitions don’t count.
Pass a law that as part of truth in advertising any hospital or health care provider can not charge more than prevailing market rates as established by Medicare (usual, customary and reasonable) unless the customer has authorized the expense before any action is taken. At least the customer will know what they are getting into. It won’t work in every case but it would be a start.
Before any treatment is provided, my hospital requires consumers to sign a document agreeing to pay all fees, without knowing what the fees will be. Seems like an unenforceable contract to me – signed under duress and lacking specifics, however I’m not a lawyer.
Since when do doctors allow anyone with even a concussion take a nap? No CT scan…nada? The bill is as outrageous as their care!
If insurance reimbursement was involved, I wonder if the health insurance provider saw red flags, and contested the charges.
Of at least worked with the parents on challenging the amount.
If they had “Cadillac coverage” and their insurer simply wrote out a check, it’s one more indication of how screwed up our health care system is.
And why it’s screwed up.
A relative had a bad cold, possibly bronchitis, and he called to see his doctor, who was in his “network” of providers.
The MD’s schedule was booked up for some time, and the office worker who answered the phone advised him to “just go to the ER” at another in network hospital.
My relative thought about it, called his insurer, and told them they’d probably be getting a very large bill for an unnecessary ER visit.
Within an hour or so, his doctor’s office called him back and said that they “found” an opening, and could see him in a day of two.
The out of pocket cost to my relative would have been similar for a $ 150 office call, or a $2,000-$3,000 ER visit.
Not many people would go to the trouble he went to in avoiding a waste of money….there’s no shortage of examples of apathy when “it all costs about the same”—to the patient.
The lack of transparency about what different services cost, and the lack of interest and incentive on the part of the patient to utilize cost-effective options, is one factor contributing to the health care cost problem.
Fortunately that doesn’t happen here.
It is due mainly to this attitude that make health care system NOT affordable by most people.
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The only country that treats healthcare as a commodity, what the market will bear. The US ranks 25th in the world for quality of health care and next to last in efficiency of dollars spent for services rendered. The first step is to accept that this is wrong. The next step is to accept that it can be changed. Or we can simply go on taking it with no vaseline. Oh, wait until you get the bill for the vaseline. America’s shame, big Pharma, hospitals for profit, 1200 insurance companies, employers that offer health care benefits to keep wages down, etc own our country.
The rationale they give is basically hospitals and trauma staff are expensive to maintain and we maintain them for the entire community but someone has to pay.
So it’s really stupid to foist the cost for the community resource on the few individuals using it.
It would be like having a city fire station but making the people with fires bear the cost.
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That said, their costs are still ridiculous and show no independent oversight.
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Taxpayers should be paying these bills and administrators should be accountable and transparent for the costs.
The failure of the US health care system is among the many casualties of predatory capitalism.
Are you accusing Obama of using capitalism? If he did, he didn’t know it.