sb wrote:
There ARE ways that health care could be made a lot more affordable. Health care is not a free market - it should be. Those who pay cash are very often charged far more than providers accept from Medicare and insurance companies. I have always found that to be not only wrong but reprehensible. Why should you be billed $3,000 for a CT scan that an insurance company pays $450 for? Our local hospitals charge $350 for a simple EKG - but if I did one in my office when I was in private practice, insurance companies paid me $35. So that is what I charged my cash-paying patients. Drugs are the same way - the pharmacy benefit management companies (PBMs) negotiate kickbacks to insurance companies from drug companies for putting their product as a "preferred" product on their formulary. The drug companies then offer coupons to reduce copayments - good only for those with insurance. So the Lyrica that will cost your $450 per month cash may only cost the insurance company $200 - and the customers of the insurance company, who are told that they have to pay a $75 copayment for this expensive medication, get a coupon for $50 off each month for a year. This is all hidden from the consumer, and is somehow considered a legal business practice.
I have proposed for years that there should be an "uninsured patient protection act" which says that the cash price for a medication or medical procedure/service should never be more than 10% higher than the lowest discounted price for insurance companies. That would make health care far more fair to everyone.
There ARE ways that health care could be made a lo... (
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I totally agree with your thoughts. I managed the health insurance for the company I worked for. When a injury occurred on the job and it was obvious there would be no long term affects to the injury, I would pay the medical bill directly so our mod factor would stay as low as possible. Because I knew what our insurance would pay, that's what I sent to the medical provider. Most uninsured people would not get very far with negotiating the charges. So for a lot of people their bills end up non collectable.
DaveO wrote:
Gee, what about my car?
Who cares about your car. There should be a right to healthcare, not a right for a car.
mjmoore17 wrote:
Who cares about your car. There should be a right to healthcare, not a right for a car.
You seem unable to see any sort of an analogy. Why am I not surprised.
sb wrote:
There ARE ways that health care could be made a lot more affordable. Health care is not a free market - it should be. Those who pay cash are very often charged far more than providers accept from Medicare and insurance companies. I have always found that to be not only wrong but reprehensible. Why should you be billed $3,000 for a CT scan that an insurance company pays $450 for? Our local hospitals charge $350 for a simple EKG - but if I did one in my office when I was in private practice, insurance companies paid me $35. So that is what I charged my cash-paying patients. Drugs are the same way - the pharmacy benefit management companies (PBMs) negotiate kickbacks to insurance companies from drug companies for putting their product as a "preferred" product on their formulary. The drug companies then offer coupons to reduce copayments - good only for those with insurance. So the Lyrica that will cost your $450 per month cash may only cost the insurance company $200 - and the customers of the insurance company, who are told that they have to pay a $75 copayment for this expensive medication, get a coupon for $50 off each month for a year. This is all hidden from the consumer, and is somehow considered a legal business practice.
I have proposed for years that there should be an "uninsured patient protection act" which says that the cash price for a medication or medical procedure/service should never be more than 10% higher than the lowest discounted price for insurance companies. That would make health care far more fair to everyone.
There ARE ways that health care could be made a lo... (
show quote)
The majority of physicians and hospital use a simple formula. 350% of what Medicare pays for a service is the base charge. That is what deductibles and self-pay bills are set from. Commercial insurance or managed care plans fight for contracted rates of 95% to 110% of Medicare. It used to be that Medicare was the worst pay or, now it is the standard.
State Medicaid is non-negotiable for the most part since you cannot deny them care in a hospital. That rate is everywhere from 10% of Medicare to the actual Medicare rate. No attempts at fairness in the system.
Working middle-class insured patients are expected to pay less than poor uninsured self pay patients.
They are all billed the same rate but patient balances are then adjusted to reflect the expected payment due from patient.
DaveO wrote:
You seem unable to see any sort of an analogy. Why am I not surprised.
I will not pay for your dog’s insurance either, sorry.
mjmoore17 wrote:
I will not pay for your dog’s insurance either, sorry.
Pity that you are unable to follow and understand the responses, but you appear to have difficulties on many threads, so no surprise there.
DaveO wrote:
Pity that you are unable to follow and understand the responses, but you appear to have difficulties on many threads, so no surprise there.
Nice deflection. Tools of a poor mind.
mjmoore17 wrote:
Nice deflection. Tools of a poor mind.
Yeah, your tools are really sharp. You literally discuss cars and dogs, make no attempt to understand and I'm deflecting? Coming from you that's no surprise. A true chess champion.
boberic
Loc: Quiet Corner, Connecticut. Ex long Islander
mjmoore17 wrote:
Who cares about your car. There should be a right to healthcare, not a right for a car.
A right to healthcare? wherE exactly in the constitution is that mentioned? And there is no right to own a car. About a yeAr ago I had a rectal bleed,.Was in critical conddition. 11 units of blood and hypovolemic shock. Fortunitately the bleed stopped. And I recovered. I wonder what a governmental health insurance woukld do about covering those very expensive resources on a 74 year old.
boberic wrote:
A right to healthcare? wherE exactly in the constitution is that mentioned? And there is no right to own a car.
Are Medicare, Medicaid, Social Security...mentioned in the Constitution or is it just a convenient crutch?
DaveO wrote:
Yeah, your tools are really sharp. You literally discuss cars and dogs, make no attempt to understand and I'm deflecting? Coming from you that's no surprise. A true chess champion.
If you mean, no attempt to agree, you are correct.
DaveO wrote:
Are Medicare, Medicaid, Social Security...mentioned in the Constitution or is it just a convenient crutch?
Cars were not mentioned in the constitution, was that just a convenient crutch?
boberic
Loc: Quiet Corner, Connecticut. Ex long Islander
DaveO wrote:
Are Medicare, Medicaid, Social Security...mentioned in the Constitution or is it just a convenient crutch?
There is no right to any of those things either. They are part of a law passed by congress. And they are not mandatory.
boberic wrote:
There is no right to any of those things either. They are part of a law passed by congress. And they are not mandatory.
So you passed elementary school history. Any other basics to pass on real quick. Proud of you.
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