One problem is hospitals are always trying to one-up the next hosital by having the latest, greatest MRI or CT machine. It cost a big sack of money to buy one. Here they are in use all the time. I have gone in late at night to have CT done, because its less crowded. Wonder what happens to the units that are only a few years old? I bet they get E36 M3 canned instead of giving to a local free clinic.
Ian F wrote: I love the "This is not a Bill" statements I'll get in the mail. The 'charged' amount is usually something insane - say $2000 for something. Then some time later, you get a statement from the insurance saying how much they're paying and what your responsibility will (or won't) be, the total typically less than 50% of the previous letter amount. Then you get a bill from the Dr. for that amount. I'm convinced it's some sort of tax shame.
Well what it is (from my internal viewpoint)... Is the provider (doctor/facility) jacking up their billed amounts sky-high in order to force the insurance companies to agree to a higher contracted "allowed amount" or "usual and customary charge."
It's the whole thing where if you want to get $1000 for a car on Craigslist, you ask for $1500, dude offers you $500, and you arrive at your $1000.
They then have to put their sky-high billed charge on there in order to cover their asses from being bitch-slapped by the Insurance Provider Relations department of the state they're contracted in, because if they get wind that they're charging a different amount, negotiations weren't exactly legitimate.
spitfirebill wrote: Wonder what happens to the units that are only a few years old? I bet they get E36 M3 canned instead of giving to a local free clinic.
The one that was in the hospital I worked at got bought by another hospital. We went to like a 50 slice machine from a 24-32 slice deal. I heard it was a 3 million difference between the two numbers.
92CelicaHalfTrac wrote: It's the whole thing where if you want to get $1000 for a car on Craigslist, you ask for $1500, dude offers you $500, and you arrive at your $1000.
I get that and it would make sense, but the amounts often aren't that linear. Instead it'll be more like $1500 and they take $250.
Ian F wrote:92CelicaHalfTrac wrote: It's the whole thing where if you want to get $1000 for a car on Craigslist, you ask for $1500, dude offers you $500, and you arrive at your $1000.I get that and it would make sense, but the amounts often aren't that linear. Instead it'll be more like $1500 and they take $250.
Nope it's sure not, that was just oversimplified. What likely happened there was they came in trying to play their game, and insurance told them "You're taking $250 or you're dropping off "preferred provider" status and going out of network."
92CelicaHalfTrac wrote:Ian F wrote: I love the "This is not a Bill" statements I'll get in the mail. The 'charged' amount is usually something insane - say $2000 for something. Then some time later, you get a statement from the insurance saying how much they're paying and what your responsibility will (or won't) be, the total typically less than 50% of the previous letter amount. Then you get a bill from the Dr. for that amount. I'm convinced it's some sort of tax shame.Well what it is (from my internal viewpoint)... Is the provider (doctor/facility) jacking up their billed amounts sky-high in order to force the insurance companies to agree to a higher contracted "allowed amount" or "usual and customary charge." It's the whole thing where if you want to get $1000 for a car on Craigslist, you ask for $1500, dude offers you $500, and you arrive at your $1000. They then have to put their sky-high billed charge on there in order to cover their asses from being bitch-slapped by the Insurance Provider Relations department of the state they're contracted in, because if they get wind that they're charging a different amount, negotiations weren't exactly legitimate.
Exactly. Personally, I think you're a sucker if you pay for killer insurance. Catastrophic coverage + high deductible (don't be a dumb berkeley and keep money in savings,) and find a GOOD doctor with excellent cash rates.
You're damned right the insurance/hospital business is a racket. While my father in law was on his deathbed, they were still running every test imaginable to get those bills sky-high.
I choose not to participate.
poopshovel wrote:92CelicaHalfTrac wrote:Exactly. Personally, I think you're a sucker if you pay for killer insurance. Catastrophic coverage + high deductible (don't be a dumb berkeley and keep money in savings,) and find a GOOD doctor with excellent cash rates. You're damned right the insurance/hospital business is a racket. While my father in law was on his deathbed, they were still running every test imaginable to get those bills sky-high. I choose not to participate.Ian F wrote: I love the "This is not a Bill" statements I'll get in the mail. The 'charged' amount is usually something insane - say $2000 for something. Then some time later, you get a statement from the insurance saying how much they're paying and what your responsibility will (or won't) be, the total typically less than 50% of the previous letter amount. Then you get a bill from the Dr. for that amount. I'm convinced it's some sort of tax shame.Well what it is (from my internal viewpoint)... Is the provider (doctor/facility) jacking up their billed amounts sky-high in order to force the insurance companies to agree to a higher contracted "allowed amount" or "usual and customary charge." It's the whole thing where if you want to get $1000 for a car on Craigslist, you ask for $1500, dude offers you $500, and you arrive at your $1000. They then have to put their sky-high billed charge on there in order to cover their asses from being bitch-slapped by the Insurance Provider Relations department of the state they're contracted in, because if they get wind that they're charging a different amount, negotiations weren't exactly legitimate.
Bingo!!! What you're doing is actually treating insurance.... like INSURANCE, not a damn warranty. In 99% of cases, it's cheaper in the end to do that.
I've found a good compromise (if your employer offers it) is an HRA. Rolls over every year, it's employer funded (which does mean that you can't just use it for anything you want), and is usually cheap. Typically will come paired with a high deductible/out of pocket, but if you get a head start with a light year or two of expenses or NO expenses, you're likely covered with enough built up on the HRA to cover EVERYTHING a terrible year could throw at you.
I have enough in mine at this point to cover my deductible and out of pocket for myself AND SWMBO for the next two years. I'd be hard pressed to put this amount of money back in savings, and if i did, i would have spent it. 
^Same here, we have an HSA at work, company adds money and so do I.
Don't quite have the out-of-pocket max in there yet, but should be close by the end of the year.
We have a choice of HSA/high deductible plan or traditional. After running the numbers, the deal at my job is that if you are healthy an HSA will save you money (good luck predicting health/accident issues btw). Mrs. Oldtin has some health issues that are predictable, so I can expect to max out the out of pocket every year. In that scenario an HSA will cost me an extra $2500/year. Our employer is pushing everyone to the HSA model - so I've got another year or two before I take yet another good sized hit on health costs. Ultimately what I think is that health insurance will shift from employers to individuals and will happen in the not too distant future. Overall - Poopie's got it right.
And remember - insurance only adds admin costs and spreads the risk around. Statistically, you're better off keeping control of as much of your money as possible as long as possible.
Here's another true-life view on health insurance. Last year my wife was diagnosed with a swollen aorta threatening to tear. Emergency helicopter ride to Denver, followed by 5 1/2 hours of open heart surgery, plus followup care: Initial bills totalling $330,000. Settled by Blue Cross for $225,000. Our share: $5000 out of pocket. That right there more than pays for all of the health insurance premiums I will pay in my entire life. Helicopter ride alone was $46,000, we had to pay $250.
You won't hear me complaining about my premiums, ever again. But it sure makes you wonder how anyone without insurance could handle that situation, other than accepting death.
BTW, she's fine, fully recovered after replacement of the aortal valve and about 2 inches of aorta. We still live at 9000 feet elevation, she still hikes and gathers and helps cut firewood in the summer and fall. We're good.
Dr. Hess wrote: Yeah. 15 years ago they were one large. I guess all this technology stuff gets more expensive over time, huh? I mean, the machine probably isn't paid for yet, right? Magnets need so much maintenance.
Well, the rooms that they are in are encased in copper.
HiTempguy wrote: MRI's here... "free".
Yup, because once your spot on the wait list is up, you're either dead or you're feeling better!
While HSA's work for healthy people who have the ability to save thousands into a bank account each year. They won't work for people who are poor, have/develop a chronic illness, or people who are well off but deeply indebt possibly due to an upside down mortgage.
In which case these people will either end up on government assistance or indebted further due to medical expenses.
I'm not saying HSA's are bad. They're good for some but don't work for everyone.
Medical bills prompt more than 60 percent of U.S. bankruptcies
Trans_Maro wrote:HiTempguy wrote: MRI's here... "free".Yup, because once your spot on the wait list is up, you're either dead or you're feeling better!
Ha ha. What a great cynical response!
Here's a wiki on healthcare in England.
"Although the NHS has a high level of popular public support within the country, the national press is often highly critical of it and this may have affected perceptions of the service within the country as a whole and outside. An independent survey conducted in 2004 found that users of the NHS often expressed very high levels satisfaction about their personal experience of the medical services they received. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP; 87% of hospital outpatients were satisfied with the service they received; and 70% of Accident and Emergency department users reported being satisfied."
English citizens seem to be ok with their healthcare.
Xceler8x wrote:Trans_Maro wrote:Ha ha. What a great cynical response! Here's a wiki on healthcare in England. "Although the NHS has a high level of popular public support within the country, the national press is often highly critical of it and this may have affected perceptions of the service within the country as a whole and outside. An independent survey conducted in 2004 found that users of the NHS often expressed very high levels satisfaction about their personal experience of the medical services they received. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP; 87% of hospital outpatients were satisfied with the service they received; and 70% of Accident and Emergency department users reported being satisfied." English citizens seem to be ok with their healthcare.HiTempguy wrote: MRI's here... "free".Yup, because once your spot on the wait list is up, you're either dead or you're feeling better!
They're also satisfied with their teeth. 
Xceler8x wrote: While HSA's work for healthy people who have the ability to save thousands into a bank account each year. They won't work for people who are poor, have/develop a chronic illness, or people who are well off but deeply indebt possibly due to an upside down mortgage. In which case these people will either end up on government assistance or indebted further due to medical expenses. I'm not saying HSA's are bad. They're good for some but don't work for everyone. Medical bills prompt more than 60 percent of U.S. bankruptcies
People who are poor qualify for Medicaid, and get better treatment that those of us with insurance. And the good news for those who could afford coverage but decided to blow it on a car instead is that they're alive, and the hospital can't seize their assets. Sometimes bankruptcy is a good thing.
It's tragic. It sucks. But it beats the hell out of debtor's prison.
When I step back and look at my own extended family, I see three groups of people. Those that are un/under employed, have no money, and are covered by the government because they cant pay, I have two siblings and a neice that are all thankful for this coverage, and they'll tell you that. Those that are old, retired, and are covered by the government because they have no money and even if they did, they cost way way too much. My grandparents in their 80's have astronomical expenses just to maintain them at this point. Then there are those in the middle who work, either get insurance at work or hope they can pay out of pocket, and for the most part fund the health care of the other two groups.
The poor group and the old group are growing, the working group is shrinking, proportionately. This all seems exceptionally poorly thought out.
Xceler8x wrote: While HSA's work for healthy people who have the ability to save thousands into a bank account each year. They won't work for people who are poor, have/develop a chronic illness, or people who are well off but deeply indebt possibly due to an upside down mortgage. In which case these people will either end up on government assistance or indebted further due to medical expenses. I'm not saying HSA's are bad. They're good for some but don't work for everyone.
FSAs were originally supposed to be just like HSA's in that you didn't have to be enrolled in a particular plan, and the funds COULD roll over... The only differences were supposed to be that FSA allowed you to borrow against your income, tax free, with a cap in place, whereas the HSA was tax free only for liquid deposits and a higher cap. but it didn't make it thru congress intact.
wonder why...
Interesting article in consumer reports this month: Common tests you probably don't need. Topping the list are Xrays, MRIs, and CT scans for lower back pain and headaches.
Trans_Maro wrote: Yup, because once your spot on the wait list is up, you're either dead or you're feeling better!
Actually, I think the system is perfectly fine. People who need the treatment NOW get it. People who can wait, wait. Pretty simple concept, cost/time effective.
Edit- In Canada, we have better health care and it costs less per capita compared to the US. Doing something right...
HiTempguy wrote: Edit- In Canada, we have better health care and it costs less per capita compared to the US. Doing something right...
Yeah. Thats why I flew my Mom and I down to the Mayo Clinic a few years ago...We got a Canadian years worth of specialist appointments in 4 days. All we had to do was pay.
It was soooo nice.
HiTempguy wrote: Actually, I think the system is perfectly fine. People who need the treatment NOW get it. People who can wait, wait. Pretty simple concept, cost/time effective. Edit- In Canada, we have better health care and it costs less per capita compared to the US. Doing something right...
Yes, but it doesn't work.
I know folks that regularly fly to the US for medical care because of how far behind our medical system is.
I know a woman with breast cancer who was told by the Canadian medical system that she would need a double mastectomy. She flew to the US and was treated with radiation and chemo and no need for surgery.
My mother has been an ER nurse at one of Canadas busiest hospitals for 30 years, even she thinks the system is screwed. Hospitals in Canada aren't even clean anymore thanks to contracting out the cleaning and laundry services to the lowest bidder.
Streetwiseguy wrote: It was soooo nice.
Oh yea, old people? AFAIK, they get put further back in the que. Youngin's get quicker access to specialists.
Sorry, but I totally agree with the fact that a 15 year old kid gets looked at first before a 60+ year old person. Again, it just makes sense.
In reply to HiTempguy:
Nice.
I'm 53. So where does that put me? Worth less than the 15 y/o because I have less life expectancy remaining?
I have a 14 y/o daughter who is completely dependent on me for support. In your world view, if I get really sick I should be kicked to the end of the line to possibly croak before I'm seen based solely on my age. Who takes care of her then?
US healthcare is expensive as hell, I'll agree with that 100%. My stepbrother in the accident back in February just got the bill from the hospital (doesn't include rehab and other stuff, just the hospital): $1,200.000.00. 
OBTW: he's the same age as me.
But like him I can get patched up and back to supporting my daughter quick.
Seems like age and world view dictate what people think of their gov't run healthcare. The Canexican has family (young liberals) who love the Canadian system. The same people think he's lying when he says "I can go to walmart and get a prescription for antibiotics for $4," but whatever. He also has a family member who had a berkeleying leg amputated after going to multiple Paki (cheap) doctors who kept prescribing antibiotics and telling her to HTFU.
My take away: Gov't paid doctors are great when you don't need them. Me? I'd rather pay my insurance premiums like a big boy and stick it to the insurance company when I need a million bucks worth of treatment, not stick my neighbors for the tab or trust some mouth breather DMV worker turned medical professional to decide whether I live or die. Would any of you berkeleyers pay a million bucks to keep me alive? Yeah, didn't think so.
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