Strange but health care cost wrapped up in our products and labor costs are said to be one reason we can not compete well. Yet repubs fight so hard to keep the status as it is. The health corps and insurance companies are big into campaign donations and lobbying. But every other company should line up on the other side to take the costs off their back. Yet even auto companies have failed to do so. I do not get it.
Wait. Isn’t the reason there’s relatively little money in medicine these days (at least, for the doctors) the fact that malpractice insurance is so prohibitive? I have read that medical bills passed on to patients are far more reflective of insurance rates than any vast greed on the part of private medicine.
Surely, then, rather than installing a complete paradigm-shifting financial burden on 300,000,000 people which is not going to work for quite some time, this is really a matter of tort reform? I mean, Jesus, we all know George Kaplan’s CIA Factbook “stats” are far too vague to actually mean anything regarding this country’s medical care. Medical care in this country is good. Excellent, in fact.
But the insurance rates passed on to you by your insurer are sky-high because they have to cover the costs of the malpractice insurance, which is influenced to a great degree by crap lawsuits.
So shouldn’t we TRY to face down the bugbears in our own system before we throw it out the window (baby included)?
The other thing I worry about is who, EXACTLY, is going to be paying? The costs are still there in a socialized system. Somebody is paying, but I’ve never understood who. And won’t insurance rates remain unchanged?
(Yes, I fully expect to be dragged through acres of shit for this post, where I will no doubt pick up several forms of enteric parasites. Wonder what that’s going to cost to treat?)
Maybe I am missing something or maybe you are. THE SAME paperwork is going to be required for national healthcare. Same waiting for authorizations, (Probably longer). How do you figure this will take less people?
I think you’re mistakenly thinking that government healthcare is just going to pay without any oversight. It won’t. It can’t. There will only be so much money to go around and there will be countless phone calls from healthcare providers fighting for it for their particular patients. My prediction is it will be a lot worse, not better in the claims, authorization and payment aspect of the process.
It’s the cost of living in our regulation-phobic society. Instead of having regulations that, once followed, could relieve some of the liability, there is no protocol which one can follow to not be held liable.
Obama really ought to push tort reform in a serious way too. We need to stop expecting a big paycheck when somebody screws up at their job. Everyone makes mistakes. It’s so ridiculous that doctors are expected to be perfect. Hell, even when they are perfect (doing everything that could have been done within reason) they are still vunerable.
Why?
If you set up your national healthcare system so that there are standard protocols for treatment, then you don’t need to seek authorisation every time you treat a patient.
In the UK we have NICE (National Institute for Health and Clinical Excellence) which assembles panels of specialist doctors to establish guidelines for treatment. These guidelines are then applied by doctors treating patients throughout the country. As new drugs and procedures are developed they are evaluated and if the evidence is there to support their use they are adopted and guidelines are amended.
Yes, because that’s sooo much worse than the $2000* bill we got when I took Owls to the ER** for what turned out to be a very bad headache.
I’m from Canada, and even after a year and a half here I’m still trying to get my head around the costs of healthcare in the US. I’m on two separate anti-depressants–one name brand, one generic. Here, they cost me $40 and $15 a month, respectively, after insurance. In Canada, they were costing me $40 a month, combined, before private insurance.
Here, I have the knowledge that every trip I take to my GP will cost me at least a small co-pay, and I don’t want to know what it would cost without insurance. In Canada, I never paid a dime and was always able to get in within the day if needed.
Medical care isn’t a luxury–it is a necessity for maintaining a reasonable quality of life, or in some cases life itself. The idea that anyone would be withheld medical care on the basis of finances is a horrendous thought to me. And what do you think happens if they receive care and then can’t pay? You pay through your own bills, and they go bankrupt. Why not just pay for it in the first place, and avoid the extra suffering they’d have to go through when they can’t afford it themselves? The US system in completely inhumane to my eyes, and frankly I’m a little disgusted that anyone would defend it.
I’m not going to say that Canada’s system is perfect–its not, and there are better examples to emulate. But I would take it any day over the US system.
*Before insurance. We only paid about a third of that ourselves.
**It was too late at night to get to a clinic.
I have some experience with the financial end of the medical system as I work for a small Savings & Loan company. I look at credit reports every day, you would be shocked at all the delinquent medical charges that people have. Bankruptcies, civil judgements, liens, collections because they can not afford charges that our system imposes on them. If you have no insurance or a medical cost is not covered, the hospital or physician will bill you immediately and if you can’t pay these charges are sent to collection agencies that will file judgements and ruin your credit for all time. A few of our account holders have lost their homes because of medical expenses they could not afford. I guess they should have just accepted death.
No, because currently, thousands of different insurers impose unique billing requirements. This one wants data X in postion Y; this other one wants something else. The great promise of HIPAA - to simplify billing - has fallen short. It takes an army of people to navigate the minutia of each insurer’s requirements and to maintain the systems that provide the data. If there were a single payer (and again, I’m not 100% certain I’d be behind that), there would be one set of requirements to satisfy. We would generate one type of bill and deal with one set of coding requirements. Granted, the feds are not known for their internal efficiency, but apart from whatever other result it may have, a single-payer UHC system would be much more efficient for providers than what we have now.
My point was stating a fact, not saying it won’t work. Some people are going to have to make sacrifices so everyone can be insured. If you have nothing or like me pay 700 per month in premiums for my family, it is worth it. If you are suffering with lower back pain or have a painful gall bladder that isn’t an emergency and expect your new card to let you get that fixed right away, it isn’t going to happen.
However, if you want to get a qtip our of your ear or are on death’s door, you’ll be all set.
The same type of people that can afford to pay for their “elective” surgeries there are going to be able to get them here. The rest of us will be on waiting lists. People that have paid their premiums month after month or have the benefit offered free from their employer will be sacrificing care. There is no way around that. These are normal people…not people that expect top shelf medical care. If they have an illness or acute injury…they will be all set. If they are used to handing their PPO card to their favorite orthopedic for a knee injection with a weeks notice …not going to be that easy anymore.
It will be better for some and worse for others.
Except, of course, for the 50 million people who don’t have insurance and have limited or no access to said medical care. IF you are insured your medical is excellent. If you are NOT insured you might as well be living in a third world shithole. Do you not understand that? Or that “shithole medical care” is a fact of life for approximatley one out of six Americans?
Who pays for the roads where you live?
Who pays for the fire department and the police department?
You do understand that your taxes and my taxes and everyone else’s taxes are what pays for this, yes? Please tell me you understand that?
Under nationalized healthcare taxes pay for healthcare, just like taxes pay for the fire department and the police.
Nope - insurance premiums go away. You pay for your healthcare through your taxes, either a standard payroll deduction like the withholding your already have for state and federal income tax, social security taxes, and so forth. If you’re an independent contractor or the like you’ll pay quarterly, just as you do now. Sure, you’ll probably see a rise in the taxes but you won’t be paying ANY insurance companies premiums for healthcare. Or, if it makes it easier for you, instead of making out a check to Aetna or Blue Cross or whatever you’d make the check out to someone else - the IRS.
Why is this so hard for people to comprehend?
Sure, the American system is really good. It’s a lot easier to be really good when you ignore a third of the population. If you care that the bottom third of the population doesn’t have access to appropriate care, lives with chronic illness, loses their home, goes bankrupt, and often dies unnecessarily, then the system is much harder to see as “good.” Of course, many people have the attitude of “I got mine, fuck you.”
I have what John McCain would call a “gold plated, Cadillac” policy. (Well, it doesn’t cover hair implants, but it did pay 100% when my wife had acupuncture to try to get her breech baby to turn around, but I digress.) It costs me almost nothing. But you know what I do pay for? I pay when poor people have to go to the ER for a cold because they can’t afford to pay in advance for a doctor visit. My property value goes down when my neighbor loses his home. I pay higher prices when people go bankrupt. My doctor’s office will give you a 25% discount if you pay cash up front. They determined that insurance billing is 25% of their cost. I pay for that too.
Americans pay all kinds of hidden costs resulting from the “best healthcare system in the world.” And in spite of all the money that we pay, millions of poor people still get fucked every day. I would prefer a system in which we still pay out our ass, like we do now, but at least didn’t leave the poor to die because they couldn’t afford the “best healthcare in the world.”
Right now in the Chicago area typical office charges to see a general practitioner or internist without insurance are $100 to $150. Prolonged visits, medications, and tests are in addition to that sum, which only gets you in to talk to the doctor and nothing beyond that.
Just FYI - see my thread about my recent MRSA infection which I had to seek treatment for despite a lack of insurance.
It might have changed; I know for sure we were explicitly told that under the quirky student-ish visa we were there under, we were not eligible for NHS care. I believe that, unless you’re married or on a traditional work permit/HSMP visa, your visa must be good for at least 12 months to be eligible for the NHS.
Actually it very possibly has changed. I just found out this morning that the British government killed the visa program I was there through (and thus they just killed my immediate post-graduation plans, damnit.)
Seems to me your talking about your experience being involved in or witnessing an inefficient business.
There are very few payers that are not electronic in this day and age. Claims are entered and if they are entered into the system CORRECTLY, a button is pushed and all claims for that period are filed. Yes, SOME carriers require a different number here or there which is entered into the system one time and not again unless it is changed. MOST carriers base their fee schedule and coding guidelines on Medicare and accept each claim as long as it is clean for Medicare processing.
Seems to me that certain people that work with you are snowing a lot of people to keep their jobs. That army isn’t required now in an efficient system and won’t be required then.
Thousands of claims go out through my businesses every week and the same thousands will be going out no matter which payer ultimately foots the bill. Again, my fear is more paperwork for authorizations for medical necessity…not less.
If I may beg everyone’s indulgence for a moment, I’d like to ask a few quick hypothetical questions to help me ascertain how medical care is doled out to Americans without insurance. In none of the scenario’s below do I have health insurance.
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I’m a guy in my mid twenties living alone. I have a wisdom tooth coming through which is causing intense pain.
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I’m a sixty year old man who needs hip replacement surgery.
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I’m a middle aged guy who has been diagnosed with cancer that will kill me unless I get treatment quickly.
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I’m an elderly guy without insurance who received emergency life saving treatment after a heart attack. I was operated on, spent a week recouperating in intensive care and was then released. Will I be presented with a bill? If so, how much do you reckon I’d be charged?
Thanks in advance
Do Denmark, Ireland, or Portugal have socialized medicine? Maybe those countries need to switch to a system more similar to that of the United States?
Then every healthcare organization in which I have worked is in exactly the same boat.
I have never seen such a system in practice. An awful lot of work goes into making that button work.
Then a hell of a lot of people a lot smarter than me are also being snowed. Yes, that army isn’t required in an “efficient system”. We do not have an efficient system. I deal with billing issues every day at one of the largest healthcare providers in this city. The US system is a clusterfuck.
I believe they all do. Although I don’t see why they would choose to switch to a U.S. style insurance system when a French or Canadian style single-payer system would be so much more beneficial.
The problem with this conversation, as I see it, is that there are some posters (Rand Rover being a prime example) who seem to believe that UHC simply cannot work, and that the very idea of a single-payer system orchestrated by a central authority outperforming a system governed by ineffable market forces is prima facie absurd. I know full well that there are plenty of countries with UHC who are outperformed by the U.S. That doesn’t surprise me in the least. America is, after all, the richest country in the world.
However, if UHC is so cumbersome and inefficient, and if UHC provides such a disincentive to taking responsibility for one’s own wellbeing, why is America being outperformed at all? Why are the citizens of some nations with “socialised” systems (France, Canada, Spain, and Great Britain being but a few) healthier, living longer, and enjoying lower infant mortality rates? These are enormous benchmarks. You can’t sweep under the rug America’s abject failure to keep abreast with her more “socialist” first world neighbours in these categories. How is this possible?
If you go to the emergency room, they’ll diagnose this and give you a prescription for medication that you would need to take to a pharmacy to get filled on your own dime.
As far as I understand it, you’re out of luck.
If it’s something that requires hospitalization, they will hospitalize you without you demonstrating ability to pay. But individual doctors and outpatient treatment are usually different.
Yes, you’ll get a bill. My guess would be $150,000 (assuming you mean bypass surgery).
ETA: That’s probably a low-ball estimate. I think we were quoted for bypass surgery alone at about $150,000.
I’ll give you my similar experience on this.
I’m a full time employee and pay a considerable amount (taken from ym paycheck) for health insurance.
It does not cover dental procedures.
Before my current employment I had no insurance, so it had been several years since my last visit to the dentist, simply because I could not afford it. I decided, even if it wasn’t covered, my tooth was killing me and I had to go. I spent over $2,000 getting a root canal and filling some cavities + cleaning.
Right now, I’m in pain again. Turns out the endodontist missed a root. I’ve been in pain for 6 months now simply because I cannot afford another root canal. I’m waiting for my year end bonus to kick in in two months so that I can afford to go. In the meantime, I’m hoping and praying that infection doesn’t cause serious problems and require me to go in on an emergency basis, 'cause them I might as well move my stuff out to the curb.