Stupid Things Said At The Democratic Debate

[oncemoreuntothejimbreech]

(07-03-2019, 02:22 PM)Belsnickel Wrote: Price fixing isn't necessarily the answer. Better government involvement not just in regulation but in research and investment could help with the costs we are seeing. There are a lot of variables that contribute to these prices and they don't require price fixing.

That would help with the cost of pharmaceuticals and medical devices such as hip joints, but not much else.

Take my shoulder surgery for a torn labrum and rotator cuff. After insurance, my portion was over $2000 for the surgery and over $2000 for the doctor to do the surgery. What you suggest wouldn't reduce the greatest portion of my bill at all.

The really cool thing was the MRI was wrong (or the interpretation of the MRI was wrong, rather) and nothing was torn and I didn't need the labrum or rotator cuff repaired.

The total was obviously more than than $4000 because that doesn't include the anesthesiologist's fees or the price of the anesthesia meds. Or any of the office visits before and after or the physical therapy visits or the adjuvant PT therapies like iontophotesis.

[Belsnickel]

(07-03-2019, 02:56 PM)oncemoreuntothejimbreech Wrote: That would help with the cost of pharmaceuticals and medical devices such as hip joints, but not much else.

Take my shoulder surgery for a torn labrum and rotator cuff. After insurance, my portion was over $2000 for the surgery and over $2000 for the doctor to do the surgery. What you suggest wouldn't reduce the greatest portion of my bill at all.

The really cool thing was the MRI was wrong (or the interpretation of the MRI was wrong, rather) and nothing was torn and I didn't need the labrum or rotator cuff repaired.

The total was obviously more than than $4000 because that doesn't include the anesthesiologist's fees or the price of the anesthesia meds. Or any of the office visits before and after or the physical therapy visits or the adjuvant PT therapies like iontophotesis.

What goes into the costs for something like that? The equipment used, the devices and medicines, but also the licensing costs, education costs, liability costs, etc., etc., etc. There are so many factors not just in direct costs, but in overhead and other things that make up the labor costs involved. I'd have to really see a good analysis on the costs to suggest policies and this isn't something I have researched a ton, just some surface level things. This is, of course, not taking into account the need for hospitals to build in a buffer with their costs to help offset the uncollectable amounts from patients lacking insurance.

[NATI BENGALS]

I wonder if a piece of the high health care cost puzzle has anything to do with doctors coming out of school with sky high student debt? Gotta charge more to pay down that debt and still have the income expected of being a Dr.

[NATI BENGALS]

(07-03-2019, 02:22 PM)Belsnickel Wrote: Price fixing isn't necessarily the answer. Better government involvement not just in regulation but in research and investment could help with the costs we are seeing. There are a lot of variables that contribute to these prices and they don't require price fixing.

Delaney made a comment on this during the debate that concerned me. 

Talking about hospitals would close if they had to bill everybody at the medicare level. 

Apparently it was false. But i dont think it was a trump like lie. There may have been some actual research and reasoning behind the comment and he didnt say it just because.
https://www.pbs.org/newshour/politics/fact-check-delaneys-debate-claim-that-medicare-for-all-will-shutter-hospitals-goes-overboard

[GMDino]

(07-03-2019, 03:26 PM)NATI BENGALS Wrote: I wonder if a piece of the high health care cost puzzle has anything to do with doctors coming out of school with sky high student debt? Gotta charge more to pay down that debt and still have the income expected of being a Dr.

Oh my word yes.

My college roommate is a doctor now.

We had a discussion about how he has to charge (round numbers here) $75 to collect $50 from the system.  So he has to charge EVERYONE $75 or it would be Medicare fraud.  And he really only wanted to charge $50.00.  

So I, being the problem solver that I am, suggested he just charge everyone $50 and settle for the 37.50 he'd get from Medicare.

His answer was "Do you know how much I owe in school bills?!  I need $50 from everyone." 

Nonetheless he WOULD charge less if he could...according to him.

[oncemoreuntothejimbreech]

(07-03-2019, 03:11 PM)Belsnickel Wrote: What goes into the costs for something like that? The equipment used, the devices and medicines, but also the licensing costs, education costs, liability costs, etc., etc., etc. There are so many factors not just in direct costs, but in overhead and other things that make up the labor costs involved. I'd have to really see a good analysis on the costs to suggest policies and this isn't something I have researched a ton, just some surface level things. This is, of course, not taking into account the need for hospitals to build in a buffer with their costs to help offset the uncollectable amounts from patients lacking insurance.

I will tell you before I agreed to have the surgery I asked for my total out of pocket expenses and was quoted $1054. Just one bill was almost $5000. That wasn't the only bill for the surgery. Eventually I stopped paying because they couldn't explain the charges. They sued me. I counter sued them. Their billing department was so complicated their lawyer sued on behalf of the wrong client for the wrong amount. Eventually they agreed to settle in exchange for me signing a NDA. After the lawyer collected his fee I was left in the red for a surgery I didn't need.

They tried to claim I should have asked my insurance company for the total out of pocket expense. I answered, but I asked you. They replied they couldn't give me an accurate quote because they didnt know what the surgeon was going to do before the surgery. I answered how could I ask my insurance company for a quote if you can't tell me what you're going to charge me for? And what are the charges to not to repair a labrum and rotator cuff which aren't torn and don't even require surgery?

Where I work we were purchased by a larger hospital group. Billing and electronic medical record keeping is different. I can't even tell a self pay patient how much something costs before I do it and it gets entered into the EMR.

Can you imagine going to the grocery store and not knowing the prices until after your items are scanned? That's what our healthcare system is like only everybody pays different prices for the same item.

[oncemoreuntothejimbreech]

(07-03-2019, 03:42 PM)GMDino Wrote: Oh my word yes.

My college roommate is a doctor now.

We had a discussion about how he has to charge (round numbers here) $75 to collect $50 from the system.  So he has to charge EVERYONE $75 or it would be Medicare fraud.  And he really only wanted to charge $50.00.  

So I, being the problem solver that I am, suggested he just charge everyone $50 and settle for the 37.50 he'd get from Medicare.

His answer was "Do you know how much I owe in school bills?!  I need $50 from everyone." 

Nonetheless he WOULD charge less if he could...according to him.

Prices are negotiated between the insurance carrier and the medical providers. No one is dictating prices to Medicare. But, large networks can negotiate better prices, with BCBS of GA for example, by refusing to accept it and all their clients are out of network and decide to change insurance. Thus the insurance company loses revenue. Same applies to larger insurance carriers. They can dictate prices if most of the patients in an area have their insurance and if the providers don't accept their reimbursement rates the provider will lose patients and suffer financially.

That's why there is a trend for big companies buying up smaller companies to increase their negotiating leverage.

So patients with different insurance carriers pay different prices for the same services.

Plus there is the constant price creep your friend described. He has to charge more for something because the insurance company tries to reimburse for less. They nickel and dime you on everything. Thus both the provider and the insurance carriers need large billing and coding departments to maximize their respective revenue.

[*Nately120*]

(07-02-2019, 10:32 PM)BFritz21 Wrote: What I heard most from this debate was "we'll give away FREE EVERYTHING!"

Free EVERYTHING?  Does that include that free border wall Trump can't follow-up on?

[CJD]

(07-03-2019, 12:04 PM)Aquapod770 Wrote: I guess that could work, but unfortunately I think it will drive private insurance costs higher. The medicare/medicaid plans are already bloated with so much regulation it can get a little ridiculous. My current insurance premium is only $35 per two-week paycheck. I wouldn't mind going this route, but I feel it may complicate a problem and do little to alleviate health care costs. I do think it would drive us to a single payer system, which is the end goal for a lot of people. 

It's a long list, and from 2014, but there is a lot of information about medicare reimbursements in here. 
https://www.beckershospitalreview.com/finance/100-things-to-know-about-medicare-reimbursement.html

Holy shit haha. I completely understand why you'd be weary of this option. I don't know how you got that insurance premium.

I took my company's second to lowest tier of insurance (there are 4 options) and my premium is $215.00 per 2 week pay period for my wife and I (it would be ~$95.00 for just me). My company also stopped providing this health bonus rebate last year. It used to give me like a 50 dollar rebate each pay period because my wife and I have normal blood pressure, glucose, cholesterol rates etc. I can only imagine the premium is going to continue to rise over time.

And it would have been even worse if we went with my wife's company's plan (something to the tune of $400.00 per 2 week pay period.)

If I only had to pay $70.00 per pay period for the two of us, I'd be weary of Medicare for All as well .

[Belsnickel]

(07-03-2019, 07:58 PM)Crazyjdawg Wrote: Holy shit haha. I completely understand why you'd be weary of this option. I don't know how you got that insurance premium.

I took my company's second to lowest tier of insurance (there are 4 options) and my premium is $215.00 per 2 week pay period for my wife and I (it would be ~$95.00 for just me). My company also stopped providing this health bonus rebate last year. It used to give me like a 50 dollar rebate each pay period because my wife and I have normal blood pressure, glucose, cholesterol rates etc. I can only imagine the premium is going to continue to rise over time.

And it would have been even worse if we went with my wife's company's plan (something to the tune of $400.00 per 2 week pay period.)

If I only had to pay $70.00 per pay period for the two of us, I'd be weary of Medicare for All as well .

Some employers pay a larger portion of your premium than others depending on what they are willing to pay.

[oncemoreuntothejimbreech]

(07-03-2019, 07:25 PM)Nately120 Wrote: Free EVERYTHING?  Does that include that free border wall Trump can't follow-up on?

Or $120 million dollar drones?

[oncemoreuntothejimbreech]

(07-03-2019, 07:58 PM)Crazyjdawg Wrote: Holy shit haha. I completely understand why you'd be weary of this option. I don't know how you got that insurance premium.

I took my company's second to lowest tier of insurance (there are 4 options) and my premium is $215.00 per 2 week pay period for my wife and I (it would be ~$95.00 for just me). My company also stopped providing this health bonus rebate last year. It used to give me like a 50 dollar rebate each pay period because my wife and I have normal blood pressure, glucose, cholesterol rates etc. I can only imagine the premium is going to continue to rise over time.

And it would have been even worse if we went with my wife's company's plan (something to the tune of $400.00 per 2 week pay period.)

If I only had to pay $70.00 per pay period for the two of us, I'd be weary of Medicare for All as well .

You're lucky your employer covers your spouse. My wife has a job which offers her employer sponsored health insurance so my employer won't offer her coverage under my family plan. So I have to pay the family rate for my daughter and I. While my wife pays for an individual plan for herself. Different companies, plans, premiums, deductibles, co-pays, networks, prescription tiers. Just another way corporations have reduced their contribution to the middle class' healthcare benefits during the past twenty years.

[CJD]

(07-03-2019, 09:42 PM)oncemoreuntothejimbreech Wrote: You're lucky your employer covers your spouse. My wife has a job which offers her employer sponsored health insurance so my employer won't offer her coverage under my family plan. So I have to pay the family rate for my daughter and I. While my wife pays for an individual plan for herself. Different companies, plans, premiums, deductibles, co-pays, networks, prescription tiers. Just another way corporations have reduced their contribution to the middle class' healthcare benefits during the past twenty years.

Yea, I was lucky that they allow it. They just charge me a 50 dollar per pay check surcharge for having her on.

Her insurance was even worse, as I said, they had it as like 100 for just her but 400 for the two of us. They had absolutely no interest in covering spouses haha.

[BakertheBeast]

(07-03-2019, 09:53 AM)Belsnickel Wrote: I'm just going to caution this line of posting because it is getting into the territory of personal attacks. Let's not go there.

You're the only one going there.