Time: Bitter Pill: Why Medical Bills Are Killing Us

[gbear]

Not to sound insensitive to your issues, but consider who would be in charge. Have you been to DMV lately? Heard about how American public schools are around 25th in the world (or whatever the current numbers are), are you impressed with our justice sytem or the way the wars have been handled?

The US government has given me no reason to have confidence that they can mange my healthcare, but that's just my two cents...

In fact, I have many time considered exactly this question. I'd refer you to page 9. Single payer does not mean exclusively government run. From the example used: A data center run by BCBS, to an auditor (also private) to a payment center (private) backed up by a recovery system allowing firms to audit past payments for over payments with 80-90% of what is reclaimed going back to the government and 10-20% going to those who found the problem. Government role in medicare is to set up contracts, set up payment rates, and pay. Single payer need not be the mismanaged mess of a states's or county's DMV.

Get away from the chargemaster system currently in place. Can anyone really claim this is more efficient than medicare?

[rictus58]

I'm lucky in that I have no horror storied with regards to health care or medical billing. The "worst" was when I went to the Dr. because I had constant Tenitus from a cold I had. The Dr. Asked if I smoked. I said here and there. she asked if I was interested in smoking cessation. I said no. a total of 25 seconds of conversation about it. Then I get billed by the insurance company for $100 for smoking cessation counseling...which they don't cover. I had to fight that one. I neither asked for, nor received counseling.

[SkinsHokieFan]

This part was interesting to me

Somehow plastic surgery is much cheaper today, but hospitals far more expensive.

2. Medical Technology’s Perverse Economics
Unlike those of almost any other area we can think of, the dynamics of the medical marketplace seem to be such that the advance of technology has made medical care more expensive, not less. First, it appears to encourage more procedures and treatment by making them easier and more convenient. (This is especially true for procedures like arthroscopic surgery.) Second, there is little patient pushback against higher costs because it seems to (and often does) result in safer, better care and because the customer getting the treatment is either not going to pay for it or not going to know the price until after the fact.

Beyond the hospitals’ and doctors’ obvious economic incentives to use the equipment and the manufacturers’ equally obvious incentives to sell it, there’s a legal incentive at work. Giving Janice S. a nuclear-imaging test instead of the lower-tech, less expensive stress test was the safer thing to do — a belt-and-suspenders approach that would let the hospital and doctor say they pulled out all the stops in case Janice S. died of a heart attack after she was sent home.

“We use the CT scan because it’s a great defense,” says the CEO of another hospital not far from Stamford. “For example, if anyone has fallen or done anything around their head — hell, if they even say the word head — we do it to be safe. We can’t be sued for doing too much.”

His rationale speaks to the real cost issue associated with medical-malpractice litigation. It’s not as much about the verdicts or settlements (or considerable malpractice-insurance premiums) that hospitals and doctors pay as it is about what they do to avoid being sued. And some no doubt claim they are ordering more tests to avoid being sued when it is actually an excuse for hiking profits. The most practical malpractice-reform proposals would not limit awards for victims but would allow doctors to use what’s called a safe-harbor defense. Under safe harbor, a defendant doctor or hospital could argue that the care provided was within the bounds of what peers have established as reasonable under the circumstances. The typical plaintiff argument that doing something more, like a nuclear-imaging test, might have saved the patient would then be less likely to prevail.

When Obamacare was being debated, Republicans pushed this kind of commonsense malpractice-tort reform. But the stranglehold that plaintiffs’ lawyers have traditionally had on Democrats prevailed, and neither a safe-harbor provision nor any other malpractice reform was included.

Read more: http://healthland.time.com/2013/02/2...#ixzz2LeBsMehU

[Lombardi's_kid_brother]

What is not clearly delineated in itemized fashion is the uninsured patient who gets exactly identical care...for free.

These 'highlights' of overages make no sense. Seriously, when the entire country receives healthcare, insured or not, costs need to be accounted for somewhere.[COLOR="Gold"]

Yea...that's not true.

You cannot deny a patient emergency care. But that is defined as up to stabilization. And hospitals have gotten pretty good at defining that.

What hospitals are terrible at is identifying uninsured patients. If you give a patient a $20K bill and never bothered to check their insurance status, I don't have much sympathy.

[SkinsHokieFan]

The other conclusion I draw from this article....I should start applying for jobs in the INOVA health system and get out of gov't contracting

[The Evil Genius]

The US government has given me no reason to have confidence that they can mange my healthcare, but that's just my two cents...

So instead you will leave it to profit-driven we only care about the bottom line private industries?

Does that make any more sense?

The insurance industry is seriously ****ed, unless you are the lucky one in it making a killing.

[Corcaigh]

Then I get billed by the insurance company for $100 for smoking cessation counseling...which they don't cover. I had to fight that one. I neither asked for, nor received counseling.

That is fraud. I have seen multiple examples of it personally but people accept this as normal here from their healthcare providers.

If the US healthcare system was an auto shop and you brought your car in because of a starting issue, the first thing they would do is change the oil and charge you five thousand dollars for it. And $400 extra for the mechanic's uniform.

[rictus58]

That is fraud. I have seen multiple examples of it personally but people accept this as normal here from their healthcare providers.

If the US healthcare system was an auto shop and you brought your car in because of a starting issue, the first thing they would do is change the oil and charge you five thousand dollars for it. And $400 extra for the mechanic's uniform.

The sad part was when I called the Dr's office, they said this happens "a lot".

[twa]

Yea...that's not true.

You cannot deny a patient emergency care. But that is defined as up to stabilization. And hospitals have gotten pretty good at defining that.

.

and a patient admitted for stabilization that requires critical continuing care cannot just be discharged

ergo

we also provide many free health services that are not emergency care....billions upon billions of it

add

what's the answer?
http://www.kevinmd.com/blog/2010/11/...ical-care.html

When does the duty to provide emergency medical care end?

Because other U.S. courts of appeals disagree with the Sixth Circuit on the point, Providence Hospital took its case to the Supreme Court. Since there is a serious risk of being assessed civil damages (either by the federal government or in a private lawsuit), the hospital argued, the court should clear up the legal obligations that the Act imposes. It also contended that the Act should mean the same thing everywhere in the country. The hospital has a good chance that the Supreme Court will agree to hear the case, since the Court quite often chooses cases where the lower courts are in conflict.

[pjfootballer]

Yea...that's not true.

You cannot deny a patient emergency care. But that is defined as up to stabilization. And hospitals have gotten pretty good at defining that.

What hospitals are terrible at is identifying uninsured patients. If you give a patient a $20K bill and never bothered to check their insurance status, I don't have much sympathy.

Hospitals know they are uninsured, but when the ER doctor decides the patient needs to be admitted, the hosptial can't overide the doctor's decision. The ER doctor will get paid, but the attending doctor on the floor gets screwed as does the hospital.

[Bang]

we also provide many free health services that are not emergency care....billions upon billions of it

At who's prices?
If i operated the way they do, i could say you owe me billions for the stick of gum i gave you.

If a guy says he's getting screwed out of his monopolized zillion% markup, i don't have a single ounce of sympathy for him.

~Bang

[twa]

At who's prices?

If a guy says he's getting screwed out of his monopolized zillion% markup, i don't have a single ounce of sympathy for him.

~Bang

even if it is planned parenthood billing you (govt) for referring someone for a service they do not provide?

[Larry]

Deleted post. Don't feed the troll.

[twa]

what do mammograms have to do with abortion Larry?

Oh look Larry is derailing another thread

[Heisenberg]

what do mammograms have to do with abortion Larry?

Oh look Larry is derailing another thread

You are seriously, by far, the worst poster I have ever encountered on these boards. There is hardly ever a thread that you don't feel the need to come in and derail with your strawman arguments and ridiculous over-the-top bull**** that have little or nothing to do with the topic. Others are too kind when they refer to you as a troll.