Posted on 09/08/2012 11:04:18 AM PDT by SeekAndFind
My wife had open heart surgery in May,2 weeks in the cardiac ICU after surgery.You don’t want to know what the total bill was.
Yes...definitely part of the problem. The solution that hospitals use is called “cost shifting,” and that is one reason for the high costs to insurers and the public. Otherwise, hospitals would have to close their doors.
It used to be illegals were the reason but now, illegals and insurance companies never want to pay, so the billing is adjusted accordingly to force the uninsured citizen using hospital services to pay the bulk of expenses.
Problem solved.
Insurance is a part of the problem. The rates they pay are significantly less than the list price but that alone will not solve the problem.
The govt regulations the healthcare industry has to comply with is truly amazing.
Health insurance didn’t come into widespread use till the 60s and 70s.
If they had to pay the first $5000, they would demand itemized bills that weren't just based on the fraudulent DRGs the government uses, which were never intended to be used for billing purposes.
Which explains why health care costs were only 5% of GDP in the 50s, but are almost 20% now.
Insurance paid the majority of the bill (I had open heart surgery for removal of a Myxoma tumor).
Some of the bill was written off by the Clinic because one of their doctors screwed up a routine heart cath so bad I required 3 additional surgeries to repair the damage, two months on a wound vac, and a visit from a home health nurse every other day for the duration of the wound vac.
And I’m still being seen by their vascular dept for that mess.
Why? Because there is no effective market in health care, and there is inelastic demand for a great deal of health care which is provided by state-granted monopolies and oligopolies with unregulated prices. The best treatment for virtually every ailment, whether a drug or a medical device or sometimes even a surgical procedure if it requires specialized equipment, is sold under a grant of monopoly called a patent. All medical services are provided only by licensed physicians or licensed nurse-practioners — a state-created oligopoly which functions more like a monopoly because the notion of “reasonable and customary charges” masks price collusion.
The fact that there are socially desirable reasons for the monopolies and oligopolies (encouraging innovation and quality control) does not change the distortion they create in pricing. In other cases where there is a socially useful reason for granting a monopoly (not needing to make multiple easements for multiple companies to deliver water, electricity...) the state-granted monopoly, called a utility, has its rates regulated in the public interest.
What have you got against cakes?
My brother had an emergency appendectomy four weeks ago. He walked into the emergency room at 11:00 am, was diagnosed, had surgery, and released by 6:00 pm. Total bill — $22,500.
One of the huge cost drivers in health care is the number of people involved in health care who are paid by the system but not actually providing health care services directly to a patient. In a manufacturing environment, companies are constantly looking for ways to minimize direct costs and eliminate “indirect” costs. In the current US system we are attacking direct costs by reducing doctor pay while dramatically increasing the number of bureaucrats and administrators who add no value to the patient.
Think about Michelle Obama. She earned $317,000 per year as a Vice President of Community and External Affairs for a Chicago hospital. What value did she provide for the average patient seeking medical care at the hospital?
On top of Loser Pays, I would modify that with a contingency form of loser pays.
That ism the attorney is on a contingency whether your case wins or loses. So he gets 40% contingency if you both win, and is on the hook for 40% contingency of the ‘loser pays’ if you both lose.
Fair, after all, is fair.
The feds released 700 pages of clarification on one of their regs a couple weeks ago. In the next two months they will release a “mega-reg” which is expected to be thousands of pages.
This on top of everything else.
Hospitals have high fees because they have to make up for the regulations, lawsuits, and non-payers. Insurance companies add in a tremendous amount of overhead but they are not the only problem.
Yes people who don’t see their bill do tend to over use services, but that doesn’t impact hospital fees. The hospitals are required to use those DRGs.
Dying'll cost you way more. ;^)
If you are a private payer, negotiate.
Its not that the hospitals charge the government and insurers a lower rate, that is just what they get paid. Insurers mimic the government on payment rates.
Thus, the government has created a game, wherein you must inflate the bill to come close to getting paid. And guess what, it is illegal to charge different rates than what the charge is for Medicare.
So, if you are a private payer, arrange to have it discounted down, with a nod and a wink before hand, or go to a non-Medicare provider and negotiate a price beforehand.
“This is expensive, but most is the hospital markup.”
you do understand that the hospital markups on things is to pay for:
first and foremost: liability insurance
the pharmacist/techs who dispense and deliver the drugs to the area you are located in
the nurses who administer the drugs
the technicians who draw your blood and run the machines to do the tests
the x-ray/ct scan/ mri techs who perform the procedures
the housekeepers who clean your room
the maintenance men who keep everything mechanical/electrical working safely
the kitchen workers who prepare and serve your meals
the electricity, gas and water used
i know there are probably a thousand more things i haven’t listed that are necessary for things to function while you are in hospital/er that you are not billed for
i know you probably think that is what your daily room rate is for, but that rate barely covers the nurses’ salary, esp in icu/er where the nurse patient ratio is low
“This is expensive, but most is the hospital markup.”
you do understand that the hospital markups on things is to pay for:
first and foremost: liability insurance
the pharmacist/techs who dispense and deliver the drugs to the area you are located in
the nurses who administer the drugs
the technicians who draw your blood and run the machines to do the tests
the x-ray/ct scan/ mri techs who perform the procedures
the housekeepers who clean your room
the maintenance men who keep everything mechanical/electrical working safely
the kitchen workers who prepare and serve your meals
the electricity, gas and water used
i know there are probably a thousand more things i haven’t listed that are necessary for things to function while you are in hospital/er that you are not billed for
i know you probably think that is what your daily room rate is for, but that rate barely covers the nurses’ salary, esp in icu/er where the nurse patient ratio is low
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