We have strayed form the topic (mea culpa )but while insurance comanies are part of the equation they are just paying (some) of what the providers charge. ER staffing companies charging many $ thousands for a ER visit that are very often out of network and the hospital management that allows this are more to blame If have ever looked at the costs charged for people that have no insurance you might want to support Medicare for All or something along those lines as most of the rest of the non 3rd world has. Or not. I am glad I at least have medicare now to limit expenses. OK <Yammer OFF "">
Might want to read what Medicare for all really involves such as elimination of all private health coverage and insurance companies. In essence single payer with the gov in charge of your choice. No thanks. Some of us have paid into the Medicare fund for 40 years or more to be part of the group.
The thing is the bottom line is the bottom line. Hospitals and clinics need to end the year in the black as do insurance companies. Same as car dealers. So matters not if they charge 50% mark up on a pill or part, they’d just have to adjust the cost somewhere else. If you don’t end in the black, then you aren’t in business unless the government takes over the shop. Of course then the 60% of the public paying taxes pays for it, Maybe you haven’t noticed that lots of pills or the ingredients for them are made in China or India to save money. Same as those high demand face masks. So with a virus hitting, there is a pending shortage. Life is tough, wear a helmet.
Insurance companies pay less in reimbursements than they did prior to the ACA being passed. Think about it like this. You’re a mechanic who used to charge $120 an hour. Then customers say, “no we’re only paying you $85 an hour” and it’s the only way you can get work in the shop. Parts are the same price or more expensive. This is essentially what’s happened to hospitals. They can charge whatever they want, but it doesn’t matter. The insurance is going to reimburse what they will.
Do you mean how the ER physician’s are employed by a separate group? That’s been standard for decades. Our counties biggest hospital has had the ER physician’s employer be separate since the 50s. Insurance does cover at least part of that separate bill. Keep in mind as far as in network/out of network goes…when you have a true emergency (like needing an appendectomy) many insurance companies waive the out of network fees or will if you appeal.
I can only answer for my hospital (a non-profit), we do not send “full price” bills to those without insurance, and we have dedicated financial case managers in our ER that help get them applied to our hospital’s assistance fund and also help them get started on filling out medical assistance applications. But that being said, I do support Medicare for All.
To get this moving back towards vehicles, I recently discovered that down in Tennessee they have an extremely high occurrence of strokes combined with a very rural population, many people who are 45+ minutes away from a hospital, so the University of Tennessee (possibly Vanderbilt too) has a dedicated Stroke Ambulance which has a portable CT scanner on board along with a Neurologist who is certified to give IV TPA (essentially a clot busting medication) if the patient meets the criteria to receive it while they are en route to the hospital, helping to improve outcomes in stroke care
1 Like
My pension provides PPO health insurance. When forced into Medicare by insurance and our government, my insurance which is now a combination of the two provides worse coverage. My younger wife still gets the better private insurance only coverage. Plus, I really don’t enjoy paying extra for others to get a break. I’m not lucky to have private coverage provided, I earned it, the hard way.
Thanks Medicare!
We have several Canadian Snow Bird friends (and part-time residents) here in Florida. The government there already restricts the time they can be here and their National health system “owns them”. They have to fly back to Canada sometimes in order to keep their coverage. What a waste of money and resources. One of these Canadians got sick and because of extended treatment needed, that would be cost prohibitive here under the Government healthcare, the couple had to sell their Sun Coast house and stay in Canada. The government healthcare is not very “portable” or user friendly
“I’m from the government and I’m here to help.”
Be careful what you wish for!
CSA
Someone recently posted a chart reflecting the increasing costs of various living expenses and I wonder how providers can actually justify healthcare increases. 50 years ago the local full service hospital charged $17.50 per night for a semi-private room and $27.50 for a private. Today the statewide average is $1,408 and the local hospital offers no public access to their rate which I feel certain is above the state average.
When any business can lobby to protect itself from scrutiny of any kind and charge “all the market will bear” it’s basically a legalized Mafia. Dontchaknow?
With those price’s and that phone number you are going back a few year’s you will not see any thing like that again.
agreed. factor inflation plus how much more care is added to a hospital stay now vs then, it’s not surprising how much more a room is per day
1 Like
As far as insurance go’s I remember one time I got hurt on the job and had to go to the ER there was a mixup in the paperwork they sent me the bill I called them and told them it was covered under workmans comp they sent me another bill to turn in to the company that bill was 75 percent higher than the first one
When it becomes a workmans comp claim there is an insane increase in the amount of paperwork, documentation, labwork, etc…now 75% more? I have no answer for that, it could be depending on what specialized testing workmans comp requires. And again, I would be shocked if the hospital gets exactly what they bill for. My guess is that it’s a set amount per the state.
You are possibly right as you are working in the medical field I did not need specialized testing as it was for a broken foot.
Wow, that’s deliberately misleading.
Even before Canada nationalized health insurance, Canadian citizens were required to spend at least six months of the year in Canada in order to maintain their Canadian citizenship. This is only coincidentally linked to their system of nationalized health insurance.
…and make no mistake (deliberate or accidental), Canada doesn’t have “government healthcare;” they have nationalized health insurance.
Now that I’ve corrected your misleading and factually inaccurate post, can we get back to discussing cars?
3 Likes
They don’t. But by grossly overstating the charges, they can be assured to get the maximum allowed.
And I believe one of the most highly profitable employees in hospitals today are the coders.
I have to bite my tongue here, but please: more cars. Thanks.