In reality, everyone in the US is being screwed, in that we’re paying much more than other countries, getting worse outcomes and accepting the situation as it is rathe than fighting to overturn it.
You mean you were deliberately being excessively literal for disingenuous purposes, because that’s all you got, wealth creator.
If you believe you will be young healthy and male forever, your are getting a great deal. Of course only the terminally stupid would believe such a thing.
Why didn’t he just e-prescribe them? That would have saved you a LOT of trouble.
One thing I’ve learned about US conservatives (coworkers and family, plus conservative media) is that they will gladly pay extra to make sure that someone else doesn’t get something for free.
In fact, many would pay extra
Just to make sure that some other people suffer.
No, you were being a smart ass, disingenuous little pissant. You know it, everyone here knows it. Fuck off.
…its called “out-of-pocket expenses”, which “represents the share of the expenses that the insured party must pay directly to the health care provider, without a third-party (insurer, or government).” This has always been the case (especially here on the dope) when comparing healthcare costs between countries. “Out of the pocket” is a reasonable measure of the financial burden of a healthcare system.
The reality is that if you live in America you will probably pay a lot out-of-pocket, and if you live in a country with universal healthcare you probably won’t pay a lot, if anything, at all. In Glee’s case, they paid zero. Last time I was in hospital for a week I paid for a taxi there and back and that was it.
But that really isn’t what happened here.
It’s not as if we haven’t heard some variation of “so the doctors, nurses, ambulance drivers, etc. all work for free” here at the dope every heathcare debate since the dawn of time. Is this your first time here? Well congrats. Now you know.
The fact that you pay about the same as I do in taxes for healthcare, THEN you have to pay for insurance on top, and THEN you probably have to pay even more out-of-pocket, and that you seem to be perfectly fine with this, really says it all.
Proponents of “socialism” and Universal Healthcare point out to people like you that we pay significantly less to provide universal coverage for better outcomes but none of that matters to you. You think “what we said is stupid” but the reality is that you simply haven’t been paying attention.
Ah, a Trump supporter. 
But apparently you didn’t know what I meant, because you posted a silly scenario of nobody being paid.
Also I think you need to look up ‘courtesy’ in a dictionary, because you just wanted to be nasty.
One of the interesting things about being an American relocated to Europe: Out of any ten everyday realities, five or six will be significantly better and more advanced than the US (e.g. modernized banking practices, some form of proportional representation in government), a couple will basically be at parity with the US (e.g. traffic is traffic no matter where you are), and then one or two things will lag behind the US and be more difficult for no apparent reason (e.g. if an appliance breaks it takes days if not weeks to get a repair person to visit).
Nearly everything about health care here is superior to the US, but then you run into a weird little speed bump like this, i.e. “for some reason they still haven’t figured out how to get the doctors to communicate electronically with the pharmacies, and you still need a paper scrip.”
It’s annoying, but the net tradeoff is still worth it.
TBF, my NHS GP practice is doing this now, mainly because they’ve got too many patients and too few doctors, except I have to fill out a bloody ‘e-consult’ form - I don’t even get to talk to a real person. Last time I did this, I got an email a few hours later telling me they’d assessed my condition and recommended I try the pharmacy instead. Which I already had (and they couldn’t help). I just want to speak to a human being!
I encountered “Nurse Navigators” when I was on my cancer odyssey, but their main job was dealing with insurance companies. They did their job, because I never had to battle with any of them regarding payment, although I did request an itemized bill for my surgeries and questioned one charge, which turned out to be legitimate.
Thanks. I think I was extra touchy because I had just fired Ironwood Cancer Center out here - the surgeon may have been able to raise the dead, but the office continually made mistakes so 2 days before my surgery, I pulled the plug on them. And now, with this whateveritis in my boob, hanging over my head since March, I wasn’t in the mood for anything to slow me down. But have found a new oncology service, and the navigator is no longer an issue or if she is, I am in a calmer place.
Hope everything goes well.
Our family has recently had an extended period of worry and uncertainty for a similar reason and we also had to go through a process of triage and assessment. The “not knowing” is bad enough, and there is always the suspicion that you should be talking directly to the doctors but everything was made easier by at least having competent, professional calming voices taking you through the process and explaining what happens next and why. I hope that’s the sort of treatment you get as well.
Hey guess what? I went for my annual physical and I’m back in the same ping pong battle between the greedy bastards in my physicians “Business Office” and the health “insurance” company.
An annual physical is supposed to be covered without copays or deductibles. So how did I get a bill for $484?
Because on the intake form (when you “pre-check in”) I listed the conditions I’ve suffered from for almost 30 years. That magically changed the visit from a “preventative” to a “diagnostic and treatment” even though there was no change in the treatment I’m receiving for one and not receiving for the other.
The practice was acquired by a bigger group three years ago and we do this dance every year. Eventually they will negotiate it down to some much smaller amount and I’ll just pay it. But I will spend hours on the phone before that happens.
And yes, a twenty minute “long” visit is now $573 (insurance paid $89 for a reason I couldn’t understand) Twenty years ago it was $92, and my copay was $20. In the exact same office, with the exact same doctor. That is almost quadruple the cost AFTER adjusting for inflation.
These are the NEGOTIATED prices between the insurance company and the physician group.
I noticed that when we had “consumerism” in health insurance starting 10-15 years ago, where annual deductibles skyrocketed, the insurance companies lost interest in negotiating reasonable prices for routine care. Because they weren’t paying for it, you were.
So now they can have $573 office visits and negotiate hard on the hospitalization side.
Can you find out your patient responsibility beforehand?
Depending on the condition, continued treatment could fall under diagnostic care. For example, managing diabetes or asthma is diagnostic care even if it is routine. Generally speaking, preventative doesn’t cover management. There’s some exceptions for marketplace plans and specific counseling such as for obesity. If you’re seeing a specialist who manages your chronic conditions and your PCP just tacked on E&M for the $$$ then point this out to your insurer, so you (and they) don’t have to pay twice for the same treatment.
Not disputing your continued pitting, just thinking about how to avoid it next year.
~Max
This is not the insurance carrier’s fault. This is entirely on the office. No matter what else they treat if the primary code is for a physical with a diagnostic code of Z00.00 if no new abnormal problems are found or Z00’01 if there is a new problem found then if you are in the US and covered by commercial insurance than the ACA guarantees a yearly physical with no copay.
In terms of diagnostic codes, they should be using 99395 if you are 18-39 and 99396 if you are 40-64. They are also ripping you off somehow. No way is insurance paying $400+ for that. Reimbursement for these codes should be <$250.
If they need to manage chronic conditions they can do it at another visit if they are that greedy.
Also I hate that I know this.
I’m anal that way. Absolutely nothing gets done until I know and accept the fees. That’s for a “yearly” exam (every seven years) or if I’m hospitalized. Doctor notices something while listening to my heart and wants to do a quick EKG? Sure, but first what is the charge and is it covered? I can call the number on my insurance card to check if the doctor isn’t certain.
Remember, the doctor is working for you. If your lawn care guy decided your lawn needs a special treatment would you be comfortable receiving a bill with an extra $1500 charge?
I think if everyone had this attitude things might be different.
God I love the VA and the fact that I’m fully covered by them. I go to the doctor and there’s no paperwork, no fees, no hassle.
I would gladly take the stupid amounts of money I’m paying for health insurance (not for me, but the wife needs coverage) and pay it in taxes so everyone could have the same kind of healthcare that I get.
I’m a retired Federal employee which comes with lifetime Federal health system coverage. When I turned 65 and went on Medicare my federal health coverage became my secondary coverer. Between the two of them, the only health care expenses I’ve had have been the cost of my prescriptions. At some point last year out of curiosity I went through my records to see how my Medicare and FEHB premiums compared to what my medical costs would have been without them. Things like one of my heart treatments would have cost me about $90.,000.00 convinced me that I was certainly getting my money’s worth.
It’s funny, some of the video games I play (particularly mobile games) are fond of “microtransactions” where they try to sell you something within the game itself, whether it is an outfit for your character or a boost to get through the game faster. And one tactic they use is to quote an outrageous price and then make it seem like you are getting a really good deal. “This hat shaped like a bunny normally costs $200 but with a 90% discount it can be yours for only $20!!!” And then the player just sees, wow I can save $180 if I buy this now, not realizing that they are buying a stupid little hat for $20 that has never been sold for any other price.
I wonder if a similar tactic is used where these outrageous amounts show up on medical bills but nobody ever actually expects the patient to really pay them. It either gets shuffled around with insurance providers who “negotiate” something more reasonable or there is some other “discount”.
As an example, the first time I ever had a kidney stone, I had just lost my job a couple of months before. I had absolutely no medical insurance and was living as best I could off of unemployment checks as I tried to find another job. It was really bad (so far the worst I’ve ever had, knock on wood) and I had no idea what was wrong. When I went in to the ER I was in agony, they have to give me morphine and do an MRI to find what was wrong. The bill was something astronomical, and I told the hospital that there was no way I could come close to paying it because I was unemployed. They told me that all I had to do was bring in proof of my unemployment benefits (which was easy to do) and all I had to pay was a relatively small amount each month for a year and then it was paid off. The rest was written off; I suspect it was some program from the state or federal government to compensate the hospital for helping a poor person.
Anyway, sometimes I wonder if those crazy prices are some kind of financial game. I know sometimes people get massive bills and really are on the hook for them, but often it seems like it’s some weird illusion.