My health insurance just got cancelled

Not me.....

I stay healthy and have not had a "script" for anything in 30 years...
You are lucky until you are not. I never had anything seriously wrong with me until the time I did. Well over $100,000 later I'm healthy again, at least for now.
 
It isn't just the low income folks that can't afford a broken arm anymore. My daughter broke her arm over the summer. Total cost billed from the hospital was just over $40,000. People focus too much on the cost of insurance and not enough on the outrageous fees that some places are charging for medical care.

Yet some people think that a 100k sublimit on a aircraft insurance policy is sufficient.

What was the total paid (insurance and out of pocket) after re-pricing through your insurance company ?
 
Talking point memes, democrats think everyone who points out how crummy their policies are are stupid.



My insurance is not junk and has risen by at least 20% per year for the last 6 years. To bring that number down to a more reasonable 10 to 15% I have had to accept higher co- pays and deductibles.



Again, without stating all the benefits of the old policies, the changes don't matter.

And, for the last 30 years, health insurance rates have been increasing, nothing novel the last few years.
 
Clearly you have no idea what's really going on.



I roll off of COBRA from a prior job in a few weeks and (doing a start-up) I have to find other coverage. The coverage under COBRA - which means the participant pays 100% of the unsubsidized cost - was an HSA plan. Any new plan I get - including spousal coverage from another employer - will be a minimum of 125% more for less coverage, and may be 3 times as much (for a policy on the exchange with similar but still less coverage than I have now).



All of these are policies that comply with the minimum standards of the ACA. They are all written by well-known insurers (current policy is UHC).



Worse, it is nearly impossible to compare the plans, and it appears that the insurers are making sure that you can't compare them. Aside from different ways of calculating deductibles, coverages, included items, and drug benefits, none of the policy writers can/will provide a list of negotiated pricing on covered drugs until you sigh up. That means that one cannot compare between a policy that has a $10-per-script-filled generic drug cost and a policy that covers 80% of the generic drug cost. Use a generic drug that has a negotiated price of $5/30 days and you'll pay more with the $10/fill policy as opposed to the 80% after deductible policy.



Further, I had the chance to compare spousal coverage between a couple of employers. One employer has unsubsidized pricing that encourages use of HSA policies... another employer has unsubsidized pricing that encourages PPO and ends up being $1000 more for HSA. Both UHC. Generally, coverage on the exchanges for similar policies is 10-15% higher. Subsidies are for employee-coverage only at the minimum required by law.



Bottom line is that a substantial portion of the money I will save each month when I sell the plane will go to the increased cost of health insurance.



The ACA made things harder to obtain, harder to compare, and more expensive. And it will get even worse as the "Cadillac tax" rolls in. Oh, and drug companies are making it worse as pricing is skyrocketing on some drugs (recent news article about topical drugs).



Health care is a mess. It's even worse than cell phone/telecom/airline pricing.



I'm a big believer in free and open markets where information is available and allows rational decisions. At the moment, I am becoming less confident that the health care marketplace meets the standards. ACA did not make things better. There are those in DC that hoped (and still hope) that the ACA will fail to ensure government single payer.


So, you are rolling from an old employer based group plan to a different type of plan?

Sounds like you are moving from apples to oranges.

Guess what? The price of apples is different than the price of oranges.
 
Right, like forced maternity coverage for a 55 year-old couple ...


Yeah, because the insurance companies allocate the same risk of pregnancy happening to a 55 year old as they do a 23 year old.
 
Rising premiums are only the most visible part of increasing costs. I have anecdotal experience suggesting denial of coverage is an increasing problem, at least among people close to me. We may all have "junk plans" and not be aware.

The plan we're offered at work (I'm not on it) recently denied a coworker coverage for surgery to corect a spinal problem which threatens to leave him paralyzed if untreated. The insurance company is holding firm on first trying pain medications which the doctors insist will not solve his problem.

Regarding what self-employed people do, I was self-employed for years and covered by my wife's plan. (She has a federal government job.) I'd bet many small business people are covered this way.

I wanted to pay out-of-pocket for a Humphries Visual Field test after an eye surgery, specifically so my provider would not apply some diagnosis code which would later complicate my FAA medical. He could not tell me what the procedure cost, because it hadn't been negotiated with an insurance company.

This will sound cold, but without at least some people unable to afford health insurance, costs will skyrocket. Economists will tell you that if you attempt to guarantee any service to 100% of the population, an important downward pressure on price will be removed, and costs will rise.

Another missing market control on price is the fact nobody knows or cares what procedures cost, including the providers! They only want to know if it's covered. Keeping prices secret is a sure bet to keep them rising.

NBC News did a story tonight on software used at the University of Utah Medical Center which tracked costs and helped management identify best practices, as judged both on cost and patient outcome. They've been able to cut costs 30% and shorten recovery times for patients, and are barraged with inquiries from other healthcare networks asking how to do it. The idea that this discipline, used in other large industries for decades, is considered revolutionary in healthcare, is a real forehead-slapper.
 
I think the only real solution in the long run is single-payer. The free-market does not work for health care. We already have single-payer for police and fire protection and that works quite well.


You described that insurance was the problem because it hid the real costs from the consumer of the product, and then argued for the largest insurance policy ever created in the history of the country.

So which is it?

It appears the social engineering is working from here.

By the way, most PDs aren't but FDs and paramedics/ambulances have been starting to or are already charging well above and beyond for services. That "single payer" system started to collapse at least ten years ago. I suspect eventually you'll get a bill for PD services, too.

Emergency services simply aren't and haven't been 100% taxpayer funded for a long time now. Most folks don't find this out until something happens and they get a bill.

South Metro Station 35, the station on the entrance road to KAPA, arguably one of the busiest GA airports in the country, wouldn't have a crash-fire-rescue truck if a multimillionaire hadn't donated one to the district years ago. They were struggling to find the funds to repair and re-certify the FLIR on it a few years ago.

Wasn't in the FD budget, and that's a department that covers many many counties of a major metropolitan area... They couldn't cost justify even repairing the donated million dollar vehicle, let alone buying one in the first place.

Have family and friends that have sat on fire department Boards for decades. They're all broke and taxation isn't actually feeding the money to them like it once did. That money is still being collected, but it's becoming popular with politicians to siphon it off from traditional government handled services into pet projects.

They often do so to make the department look even poorer than it should be to qualify for larger Federal grants, which can be made via funny money and fake loans, instead of actually being accounted for in a budget.

All the Boards can do is play along and at least hope to buy the best safety gear for the crews that they can, and contract a collections agency to ride hard on anyone who actually needs their "government" services. Send that bill, wait 30 days, hand the bill off to a collections agency for a percentage of the take, and there you have modern FD and Paramedic services.

It hasn't been "single payer" for a very long time. A four mile hospital/ER transport runs about $1K/mile billed to the recipient of the service around here. FD services for an out of district car wreck run anywhere from $1000-$3000.
 
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Another missing market control on price is the fact nobody knows or cares what procedures cost, including the providers! They only want to know if it's covered. Keeping prices secret is a sure bet to keep them rising.

The list price or 'charges' are not really a secret. Any facility will be able to tell you their charges for the different procedures. In the great majority of cases, that top line number is meaningless as the final payment is governed by a contract between the insurer and the provider. The insurers treat those contracted rates as a trade secret and the provider may or may not be allowed to provide information about the contracted rate. Most prices end up being a percentage of the medicare rates, and those are public record.

To get the actual cost for a procedure you have to:
- find out from your provider what procedure is proposed and have him or his business office give you the CPT code
- contact the insurance company, press '8' and talk to about 25 people until someone can give you the contracted rate for a particular facility.
- find out what other services are necessary (OR charges, anesthesia charges).


I wish it was easier. I would gladly put up a sign behind the counter:

- Initial consult $150
- Follow-up visit $85
- Visual field test $110
- pre-op testing $180
- cataract surgery $1250
.
.

take cash or credit card on the day of service and leave it up to you to sort it out with your employer, insurance company, the department of health or whomever on how much of that bill you get reimbursed. Nobody could complain that the price is a secret, the consumer could price-shop and everyone would be much happier. Right ?
 
Again, without stating all the benefits of the old policies, the changes don't matter.

And, for the last 30 years, health insurance rates have been increasing, nothing novel the last few years.

So, you are rolling from an old employer based group plan to a different type of plan?

Sounds like you are moving from apples to oranges.

Guess what? The price of apples is different than the price of oranges.
$7500 deductible, 100% co-insurance in network, 10 billion limitation.

Insurance cost is increasing and I am getting older so I expect it to increase some.

I was self employed and remain self employed, no changes on my end.

What if I like apples? What happened to if I like my apple I can keep my apple? The price of apples just exploded (for me).
 
Wait?



WHAT???



If that was sarcasm, an emoticon might have made it clearer.



Something as a rebuttal to bumper sticker nonsense about pregnant 55 year olds does not require an emoticon to indicate sarcasm.
 
$7500 deductible, 100% co-insurance in network, 10 billion limitation.

Insurance cost is increasing and I am getting older so I expect it to increase some.

I was self employed and remain self employed, no changes on my end.

What if I like apples? What happened to if I like my apple I can keep my apple? The price of apples just exploded (for me).


Problem was, the "junk" apples were ripping off people, with no real benefits, AND leaving those of us who purchased oranges to clean up the messes at the hospitals caused by "junk" apples.

In many cases, "junk" apples were worse than no apples.
 
Problem was, the "junk" apples were ripping off people, with no real benefits, AND leaving those of us who purchased oranges to clean up the messes at the hospitals caused by "junk" apples.

In many cases, "junk" apples were worse than no apples.

That's bull****.

Those with high deductible plans and a good income/assets didn't leave any mess to clean up. They got their bills and paid them, taking advantage of their insurers pricing power.

The people with high deductible plans still have high deductible plans, except that their plan now covers a pap-smear and a $120 physical once a year.
 
I paid much less than I do now for an ACA plan. However, until recently, it was impossible to even buy insurance in my home state because of a pre-existing condition..

Here's a problem with the health insurance discussion.

Can you buy car insurance for a wrecked car? Should you be able to?

Can you buy home fire insurance for a house that has already burned down?

Too many people confuse health care with health insurance.
 
Here's a problem with the health insurance discussion.

Can you buy car insurance for a wrecked car? Should you be able to?

Can you buy home fire insurance for a house that has already burned down?

Should your car insurance pay for oil-changes and spark plugs ?
Should your car insurance pay to replace a worn out engine once your car has reached the end of its useful life ?
 
400%. Means nothing without knowing the original policy vs the new one.

No policies are going up 400%.

Gotta compare apples to apples.


Sent from my iPhone using Tapatalk

Pure bull****, JoseCuervo.
My costs for health insurance (a "platinum plan") went from $283.00 a month to $1,400.00 a month, in 2011, to $2,700.00 month in 2012. For exactly the same plan. My long term health care went from $4,000, a year to $8,000.00 a year. Lucky for me I'm now old and on Medicare. My wife is 6 years younger than I am. Her insurance was completely cancelled out from under her 2 years ago. The only plan we could get for her last year was a high deductible plan. The cost of that plan increased 300% this year.
We are not broken down old cripples. We have no pre-existing conditions, run 5 to 6 miles a day and work out at the gym 5 days a week, don't drink, don't smoke, don't do drugs. So why did the cost go up as soon as Obama started dicking with the medical industry?

Obama has destroyed health care in this country.
 
Single white male, 52 yoa. Self employed. Had the same policy for years, fortunately I've never used it for more than a teeth cleaning twice a year. I was paying $325 w/ BCBS.

After they got done with me this year I was told the policy I had was no longer available and the for the near same policy it was over $550 a month..

To continue a policy in the $325-375 range and still meet the Obama criteria I would have much less coverage and much higher deductibles. Now unless I get run over by a train for major coverage I'm SOL.

So glad Obama and our government is watching out for me.

As my significant other goes to work every night at the local hospital and she sees "trailer trash crack heads" coming to the hospital and wanting pain pills, a warm bed and free meals. These crack-heads know what to say to get whatever they need, they know what to say to get admitted for over-night, they know the hospital staff on a first name basis because they come in every week. THEY know what pills to ask for and what dosage the hospital will give them and what gives them the best "High"..It's pathetic. Oh yeah, they don't have insurance, but they get the same treatment we do.

The best story was the other night while working she mentioned to a patient that it had been a long night shift. He said, "Well you just need to quit, I can tell you how to get on disability and get a crazy check, it's easy".

I guess our system really is messed up !!

Glad to know Obama care is helping someone!
 
The list price or 'charges' are not really a secret. Any facility will be able to tell you their charges for the different procedures. In the great majority of cases, that top line number is meaningless as the final payment is governed by a contract between the insurer and the provider. The insurers treat those contracted rates as a trade secret and the provider may or may not be allowed to provide information about the contracted rate. Most prices end up being a percentage of the medicare rates, and those are public record.

To get the actual cost for a procedure you have to:
- find out from your provider what procedure is proposed and have him or his business office give you the CPT code
- contact the insurance company, press '8' and talk to about 25 people until someone can give you the contracted rate for a particular facility.
- find out what other services are necessary (OR charges, anesthesia charges).


I wish it was easier. I would gladly put up a sign behind the counter:

- Initial consult $150
- Follow-up visit $85
- Visual field test $110
- pre-op testing $180
- cataract surgery $1250
.
.

take cash or credit card on the day of service and leave it up to you to sort it out with your employer, insurance company, the department of health or whomever on how much of that bill you get reimbursed. Nobody could complain that the price is a secret, the consumer could price-shop and everyone would be much happier. Right ?


I've never had any luck getting base prices from hospitals. They seem to either not know (certainly the doctors don't), pretend not to know, conveniently overlook the costs for all the useless tests and other **** they tack on to pad the bills for simple procedures, or some combination of the above. It typically takes dozens of phone calls to the business offices of the hospital, the doctor(s), the insurance company, and the outside lab(s) if any; and you still don't get an accurate price at the end -- even assuming that everything goes exactly according to plan with no complications or other findings that result in extra costs (biopsies of polyps found during a colonoscopy, etc.).

The corruption that prevails in the hospital industry challenges my Libertarian sensibilities. It's the one essential service that is already conducted in such a despicable manner that even the government would have a hard time making it worse. That's not to say that wouldn't in the end, but they'd have to work at it.

I love doctors, nurses, and other health care providers, by the way. I just hate hospitals. I rate their business practices and ethics slightly below those of mobsters and loan sharks. At least a Shylock will tell you up front how much a loan is going to cost you in the end.

Rich
 
So what are you going to do when a doctor finally gives you a prescription ? Get it filled or just ignore it ?

Depends on how serious the condition is, and if the script is for one of those HIGHLY advertised drugs we see on TV which has side effects worse then the condition itself...

Just look at alot of people nowadays... They have shelves full of pill bottles for every kind of malady......

America is completely over medicated and cadillac plans and government insurance policies liberal RX plans lead to excess... IMHO..
 
So, you are rolling from an old employer based group plan to a different type of plan?

Sounds like you are moving from apples to oranges.

Guess what? The price of apples is different than the price of oranges.

That's a BS answer. Even comparing last year's rates to this year's rates on the very same plan show a substantial increase. I have concluded that you are just trolling.

Bottom line is this, based on my analysis: most employer and exchange (including exchanges) are set up so that a couple (two people) will pay somewhere between $10,000 and $11,000 per year for their medical care. Maybe more, maybe less depending on the employer subsidy.

There is no good way to compare plans upfront as pricing for the actual service provider is opaque. That includes scripts.

Adding regulation doesn't help at this stage as it tends to increase the cost and the industry has enough muscle to use regulation to force out lower cost providers and newcomers.
 
The people with high deductible plans still have high deductible plans, except that their plan now covers a pap-smear and a $120 physical once a year.
Can I use the money for the physical to cover my AME's class 3 medical cost?
 
It's possible to get base prices. It's up to your legislature.

If you need an non-emergent in-patient or out-patient procedure, any Maryland hospital will be able to provide you in advance a detailed estimate of hospital charges, what percent your insurance is expected to pay, and offer you a discount for cash payment of your portion up front. It's our law, and it works. BTDT.

Doctor charges are unfortunately not part of the system. They had the political clout to be excluded from the program.
 
It isn't just the low income folks that can't afford a broken arm anymore. My daughter broke her arm over the summer. Total cost billed from the hospital was just over $40,000. People focus too much on the cost of insurance and not enough on the outrageous fees that some places are charging for medical care.

Keith

When I was a child, I hurt my arm playing ball. My dad took me to the ER. They x-rayed my arm, found that it wasn't broken, and sent me home with advice to put ice on it and take aspirin for the pain.

Several years ago, my goddaughter was staying with Jeanette and I. While riding her bike she got her pant leg caught in the chain, fell, and banged her arm against the curb.

After spouting a stream of obscenities that I heard through the open window, she untangled herself and was walking into the house as I was walking out the door to check on her. She had a bruise and tenderness on her forearm, but no distortion and full mobility.

I was 99 percent sure there was no fracture, but I decided to take her to the ER anyway. This was more to shut Jeanette up than because I thought it was really necessary, quite frankly. If I'd suffered the same injury I'd have taken an aspirin and iced it down. But I put her arm in a sling and drove to the hospital, anyway.

Because my goddaughter lived out-of-state and the local hospital wasn't in-network, the hospital and doctors initially sent the bills to me to be submitted to the insurance company. They came out to about $27K -- and her arm wasn't even broken. A good percentage of the bill was for **** that wasn't even necessary, in my opinion, for any reason other than to pad the bill. Or maybe it was defensive medicine due to too many ambulance-chasing lawyers, but either way, it was unnecessary and expensive.

For example, she had been wearing a helmet during the accident and was fully alert with zero evidence of head or spine injury when we arrived at the hospital. She'd walked in. There was no dizziness, no gait problems, no pain except at the bruise site, and no reason to suspect anything but, at worst, a fractured ulna. But the hospital backboarded her and put her neck in a c-collar as soon as we walked in, removed them about ten minutes later, and charged healthily for both "procedures."

They also insisted on an MRI (or maybe it was a CT scan, I forget) of her head, as well as imaging of her shoulder, neck, and spine, even though she had no complaints of shoulder, neck, or spine pain or any other reason to suspect anything other than, remotely possibly, a fracture of the ulna.

They also performed a child abuse examination, despite there being no evidence of child abuse. I mean, she still had the grease marks from the bicycle chain on her pants and socks. It was obvious what had happened. But not to the hospital social worker who grilled her about whether she'd really fallen off her bicycle (and for whose grilling the hospital generously billed).

They also did about $1,800.00 worth of lab work, including drug and alcohol testing. (She was 10 at the time.) I demanded and received an itemized list, and the tests they did, aside from being unnecessary, would have cost less than a hundred bucks at Quest Diagnostics.

When all was said and done, they told me she had a bruise on her forearm, applied an ice pack (for which they charged me more than a hundred bucks), and gave me a prescription for a "painkiller" to be filled at the hospital pharmacy. It was for Tylenol.

I tossed it in the trash and took her home. I didn't even want to think about what their pharmacy would have charged for the acetaminophen. But when I got the bill, they'd charged me for it anyway -- at about $10.00 per pill.

So in the end, the result and advice were the same as when I'd hurt my arm playing ball, with the exception of Tylenol being prescribed instead of aspirin. And the cost.

I know the thread is about insurance, not hospitals. But you really can't separate the two. I have no great love for the insurance industry, but what are they supposed to do when hospitals push tens of thousands in unnecessary procedures every time some kid walks in with a bruise from a bicycle tumble?

It's a racket. It's a bigger racket than the Sicilian and Russian mobs combined. It's a racket worthy of history's biggest RICO indictment. But the hospital industry gets away with it, every single minute of every day, and even manages to maintain an altruistic persona in the process.

It really does make me sick -- no irony intended.

Rich
 
Problem was, the "junk" apples were ripping off people, with no real benefits, AND leaving those of us who purchased oranges to clean up the messes at the hospitals caused by "junk" apples.

In many cases, "junk" apples were worse than no apples.


400%. Means nothing without knowing the original policy vs the new one.

No policies are going up 400%.

Gotta compare apples to apples.


Sent from my iPhone using Tapatalk


This is what happened to me and one of my employees at my business.

Old PPO-------------$2500 deductible, max per family $5000
employee- $400
spouse-----$400
children----$225--one charge for up to 5 kids
$1025



Renew PPO-------$6250 deductible, max per family $12,500.
Employee-$485
Spouse----$485
child 1-----$192--19yrs
child 2-----$175--13yrs
child 3-----$175--11yrs
child 4-----$175--7yrs
pediatric dental-$241---this is for every plan holder whether they have a pediatric child or not.... a tax that goes to fund obumercare...
-------------$1928

As a side not my insurance agent has been warning me of this change and all the problems associated with the market place plans, which he does not recommend. My premiums at work have been going up at least 25-35 percent a year since the inception of obummercare.

None of our local physicians will take any of the obummercare (market place, California care) plans that are offered.
 
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Here's some interesting fall-out; Our doctor dropped out, as in, went to a "concierge" model. Left his multi-physcian practice. Doesn't muck with health insurance - he will print the form for us, to send to BC/BS for out of network reimbursement, but that's it.

He was burning out, trying to see enough patients to make a buck, doing his paper work at night, etc. Never had enough time to spend with patients, or with his family.

We pay him a flat fee for the year. Unlimited visits, same day, usually, if we need to. Relaxed environment. For years I couldn't use him as my primary, since he's an endocrinologist - but he's also a great doctor, and so he is my primary now.

Not all his patients could make the switch with him, and that bothers him. But not as much as having to practice assembly line medicine, and working 70 hours a week.

His office overhead is much lower (no need for the clericals and insurance processors), and his bottom line is healthy, and he has time to do the job correctly.

He points to the hospitals as the primary culprits, and the terribly flawed ACA as a close runner up.
 
Too many people confuse health care with health insurance.

On purpose, by Democrats who use it as a propaganda point against Republicans (e.g., "Those evil RICH Republicans don't want little Julio to have access to health care.")
 
No doubt that Cuervo sucks at some government teat. No one who isn't a raging leftist or insurance company big shot can support O-"care"
 
It's possible to get base prices. It's up to your legislature.

If you need an non-emergent in-patient or out-patient procedure, any Maryland hospital will be able to provide you in advance a detailed estimate of hospital charges, what percent your insurance is expected to pay, and offer you a discount for cash payment of your portion up front. It's our law, and it works. BTDT.

Doctor charges are unfortunately not part of the system. They had the political clout to be excluded from the program.
What the hospitals have done in some places is to put the ER doctors into an "independent" group and give them an exclusive deal (sometimes with payment to the hospital) to be the ER docs. They charge independently. This increases billings and gets around both transparency and negotiated pricing.
 
The list price or 'charges' are not really a secret. Any facility will be able to tell you their charges for the different procedures. In the great majority of cases, that top line number is meaningless as the final payment is governed by a contract between the insurer and the provider. The insurers treat those contracted rates as a trade secret and the provider may or may not be allowed to provide information about the contracted rate. Most prices end up being a percentage of the medicare rates, and those are public record.

To get the actual cost for a procedure you have to:
- find out from your provider what procedure is proposed and have him or his business office give you the CPT code
- contact the insurance company, press '8' and talk to about 25 people until someone can give you the contracted rate for a particular facility.
- find out what other services are necessary (OR charges, anesthesia charges).


I wish it was easier. I would gladly put up a sign behind the counter:

- Initial consult $150
- Follow-up visit $85
- Visual field test $110
- pre-op testing $180
- cataract surgery $1250
.
.

take cash or credit card on the day of service and leave it up to you to sort it out with your employer, insurance company, the department of health or whomever on how much of that bill you get reimbursed. Nobody could complain that the price is a secret, the consumer could price-shop and everyone would be much happier. Right ?
My doc basically does that...and my insurance won't pay a penny until I meet the annual deductible because he's out of network.

He's out of network because he thinks preventative care is important, and the insurance company doesn't (much as they like to claim otherwise).

My insurance premium didn't go up this year...they simply reduced the coverages. Kinda like candy bars...they make 'em smaller for the same price, then raise the price 30%, then make the bar bigger again so they can tell you you're getting 25% more for FREE!:mad2:
 
NOT HEALTH-RELATED unless you fall off it: For Dave Taylor: I know you've been to the top of it, but thought you might like to see it from another angle.
I just spotted your name before I was to shut down the PC and leave my studio.
LARGE FILES: Right click and open in a new window. And I'll accept the flames and beatings but I don't have time to reduce the files. Trusting you and(Janet ??) are well. Also, thought you might enjoy seeing "trees" again(that being an inside joke).

HR
 

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What the hospitals have done in some places is to put the ER doctors into an "independent" group and give them an exclusive deal (sometimes with payment to the hospital) to be the ER docs. They charge independently. This increases billings and gets around both transparency and negotiated pricing.

I work for a hospital system that went from a split system between physicians and the hospital to something called 'provider based billing' where the hospital bills for both, hospital and professional services.The reason we went that way is because it increased the amounts recoverable from insurance and patients. The ER docs were not 'put' into an independent group, they are independent because that's how it classically worked at a hospital. The hospital provides the technical and nursing services, the physicians provide the professional services. Most hospitals I have privileges at require me to be network provider for all the plans they are network providers for.
 
When I was a child, I hurt my arm playing ball. My dad took me to the ER. They x-rayed my arm, found that it wasn't broken, and sent me home with advice to put ice on it and take aspirin for the pain.

Several years ago, my goddaughter was staying with Jeanette and I. While riding her bike she got her p.
.
.
.
.
biggest RICO indictment. But the hospital industry gets away with it, every single minute of every day, and even manages to maintain an altruistic persona in the process.

It really does make me sick -- no irony intended.

Rich

Sounds about right for an out of network hospital experience in NY or NJ.

Like so many stories, this one starts with 'because someone in Albany wrote a law'.

For example the child abuse thing. Not reporting a suspected case of child abuse is a class A misdemeanor. Otoh if they report a case and it is unfounded, they are shielded from civil and criminal liability. What did you think they are going to do ?
 
I mean, this was all unexpected. When has it ever not reduced costs to add a bloated and inefficient government bureaucracy onto an existing bloated and inefficient bureaucracy? That has made things better every most zero times it has been tried in the past.
 
For example the child abuse thing. Not reporting a suspected case of child abuse is a class A misdemeanor. Otoh if they report a case and it is unfounded, they are shielded from civil and criminal liability. What did you think they are going to do ?

When one my kids was little, and was playing with a neighbor's dog, they both went to pick up a ball at the same time and bumped heads. I couldn't figure out if a tooth or a claw snagged her, but it was pretty obvious she needed stitches along the bridge of her nose.

I made the mistake of taking her in, I should have let my wife do it. The nurses immediately started questioning me about how it happened and it was pretty easy to tell they thought I did it. As soon as I said "dog", they were on the phone with animal control.

I can understand it. It's no fun when it's you, though.
 
I mean, this was all unexpected. When has it ever not reduced costs to add a bloated and inefficient government bureaucracy onto an existing bloated and inefficient bureaucracy? That has made things better every most zero times it has been tried in the past.

If only someone had seen this coming...

oh wait...

:mad2:
 
No doubt that Cuervo sucks at some government teat. No one who isn't a raging leftist or insurance company big shot can support O-"care"


I likely pay far more in income taxes than you do.

I likely pay far more in health insurance premiums than you do, as I pay 100% for my employees.

And, yes, I support everyone having health insurance. I hate competing against businesses who don't cover employees and put them on uninsured or Medicaid roles.

But, make up whatever narrative you need to fill good about yourself.


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