Bug58

This first one is a blog by a doctor who decided to look into why health CARE is so expensive.

"My approach to the problem was unusual. Most people studying health care are external experts who look from the outside in. Since I’m a practicing physician, I could go from the inside out. Instead of trying to address any of the above arguments, I decided I would try answer what I thought was an obvious question that no one else appeared to be asking: What do all the products of health care actually cost? How much does an x-ray really cost? A CT scan or an MRI? Are all prescription medications really expensive? How much do they really cost?

Even though these might seem like obvious questions, very few people appear to know the answers. Almost no one, including most doctors, has the slightest idea what much of what we do actually costs. So I started looking at the problem privately: myself, my patients, the other physicians in my area.

Why don’t we know these costs? To start with, unlike any other business in America, almost all of the financial transactions in health care are hidden from the providers as well as the patients. We doctors order tests, procedures and medications to manage our patients, but very few of us have any idea how much any of those things cost. Patients rarely pay directly for these services and the payment for any service varies substantially from different payers. Billing charges for a medical service typically have little relation to the actual cost of the service or even to the expected reimbursement rate for that service.

Hospitals have separate billing departments that are far removed from anyone ordering or performing tests or procedures. No one directly involved with patient care has any notion of the charge or reimbursement for their service. Most private doctors’ offices don’t even bill their own patients—they contract billing companies, who just send them a check each month from the total amount collected, leaving them no notion of the actual charge or payment for any individual service they provided.

So for years we’ve been discussing the total cost of a system where almost all of the individual costs of that system are completely hidden from us. Is it any wonder the cost of health care in the US has mystified so many?

The goal of this website is to provide the results of all of my research as well as to untangle and explain as much about the US health care system as I can. The website itself contains many different sections that deal with the cost of different aspects of healthcare: medications, office visits, hospitalizations, tests, procedures and insurance. There are also sections that provide an extensive financial analysis of some of the industries in health care and several reference sections that provide hundreds of links to all of the sources and data I use."

That is just a preview of what he was looking at..you can read the rest of here, along with the various additional information he provides from his own research (he is based in California, so his numbers might be different than those in Utah, Pennsylvania, Wisconsin or any where else around the country).

http://truecostofhealthcare.net/introduction/


On another note...if you have been prescribed a lot of medications and you find them expensive..read this and you may be able to save..

http://www.kiplinger.com//article/insurance/T027-C011-S002-how-to-save-on-prescriptions.html

Ve'hoe

Insurance,,,, lawyers, and politicians is why it is so expensive,,,, and they think those same three groups will ever fix it???

Obamacare, like Chief Justice Roberts said,,, was a TAX,,,,, and it has been nothing else.....

America Only Loc: From the right hand of God

A tax and then some...it has been insane...made by insane idiots and forced upon everyone!

Morgan

Thanks Bug ,good post and points, I've mentioned that we can't discuss healthcare unless everyone is at the table, so far all we have are the insurance companies the government and us, where are the hospitals/health centers, along with the pharmaceuticals?

Ve'hoe

right where obama and the demorats left them,,,

Bug58

Why do you think the government or even insurance companies needs to be involved in the discussions and decisions of you and your doctors at all??

Aren't you and your doctors fully capable of making those decisions for you and your family? If not, why not?

Morgan

I didn't say the government needed to be, but they've pushed their way in haven't they, and maybe they needed to, as insurance companies never had a standard, they went hog wild with people paying for nothing when it came to a claim, the reason Obama bit his tongue when he said you can keep your insurance, not realizing once there was a minimum standard people fell off their insurance. It was the old insurance game, and we were the pawns.

As far as me and my doctor, where have you been when the insurance company refuses to pay for a a claim based on what the doctor had written what is needed, your comment now surprises me.

The discussion I'm talking about is not between my doctor and I, it is the inflated costs of health care all around, the people on the constant losing end are the people and their ability(or lack of) to pay for the high cost health care, I suppose those with terminal illness should go home and simply make their final plans. People who get some kind of health care paid for, as people working for the government or large companies don't have many worries,unless of course they get laid off and how many has that happened to here in the great state of America but people who are self employed are those who have the most difficult time to find good policies that don't bankrupt them.

Now we'll get less coverage and this surplus falls back to the people who can afford Cadillac health care plans.

I have a post "winner and losers of the new AHCA", you could check out, it simply lays out the planned changes.

Bug58

You do realize many if not most doctors actually accept CASH payments and those are typically less than what the co-pay is for the insurance company.

My sister and I were talking about that today, she needed stitches, cash price $120--- insurance deductible w/ co-pay $450--she told them she had no insurance and would be paying cash, they even asked her if she would like to make payment arraignments if she couldn't afford the entire bill that day.

So don't believe the lies that people can't see a doctor or get treatment from a doctor even w/ Pre-existing conditions..ITS A LIE sold to you by the Third PARTY PAYER SYSTEM (Insurance companies) who demand more money from your pocket.


Why do YOU ASSUME people who work for large companies have it good?? My husband's insurance at work IF HE could afford it, is around $1000 a MONTH, $500 a PAYDAY given He is paid bi-weekly. That does NOT include co-pays and deductibles (you know that $5000 that needs to be paid BEFORE the insurance even KICKS in to PAY ANY OF IT) over $17,000 a year, and that is HIS portion not including the companies. So what the hell are you talking about???

BUT I can go to a doctor PAY HIM $160 a month for my husband and I, we can get same day appointments. You can get a CT-scan for $250 as opposed to the $2500 the insurance cost. We can get blood work for $95 as opposed to the $200 w/ insurance. Many of the tests and screenings and other things he does are INCLUDED in the $160 a month. Don't need any insurance for that..We can carry a high deductible insurance policy in case of emergencies..which is still less than the $1000 a month for the company insurance.

But no, we don't NEED the government involved at all, which is why they need to REPEAL and NOT replace the ACA.

Here are a few links YOU can read for yourself that can tell you more about the COST of Cash payments for medical care.


"Patients pay a monthly membership fee — typically $50 to $80. In exchange, they get a more generous allocation of appointments, sometimes for the same day or the day after they called. Appointments usually last longer than the average seven minutes per insurance-based visit. Doctors are often accessible via phone, email or Internet chat and some even make house calls.

At some practices, there are no additional copays. Routine tests and procedures are included. At others (usually charging a lower membership fee), certain services are provided at a significantly discounted rate, or a small fee may be charged if patients request more time with the doctor. Privately insured patients may seek reimbursement for such costs on their own."

http://www.aarp.org/health/health-insurance/info-08-2013/direct-primary-care.html

"The insurance game is played by having patients return time and again in order to deal with their health issues, necessitating different level office codes and repetitive copay amounts. In a direct pay practice, time is allocated to address most issues in one visit and physicians have the time to spend with their patients in a more efficient manner. Over time, copay amounts for several visits actually are more expensive for the patient than in a direct pay to physician model. Patients may still submit the physician’s charges to their insurance for reimbursement should they desire."

http://www.kevinmd.com/blog/2013/08/beauty-direct-pay-physicians.html


"When I started a cash-only, direct-pay practice nine years ago, my reasons were simple: spend more time with my patients, provide better care, and live a better life.

I was uncomfortable signing insurance contracts that limited my ability to care for my patients. I was unwilling to sign an employment contract that required me to see a patient every 7.5 minutes, or lose a productivity bonus.

Interested in low cost? How about a patient reducing her expenses managing her diabetes from $5,000 per year to less than $500?"

http://www.kevinmd.com/blog/2010/08/primary-care-direct-pay-model-works.html


"For Ryan Neuhofel, a family doctor in Lawrence, Kan., launched his direct-pay practice, NeuCare Family Medicine, in December 2011. He says his payment decision was based on his dissatisfaction with the health-care system and the interactions he witnessed between patient and doctors.

Individual patients pay $30 to $40 a month while families pay $100 a month. That fee gets them unlimited visits without a co-pay, free routine lab work and testing. He also saves patients money on medications by offering them at wholesale prices. “Medicine at wholesale is 70% to 90% cheaper than at a pharmacy. “A lot of patients save $100, $200 or $300 a month on medication alone.”

http://www.foxbusiness.com/features/2014/04/15/rise-direct-pay-doctors-good-news-for-patients.html

So again, stop buying the BS that they can't get medical care merely because they have a pre-existing condition, and if they need the insurance for the emergencies then they can get that too.


https://www.usatoday.com/story/news/nation-now/2015/11/15/direct-pay-health-care/75837484/

Bug58

Ve'hoe

"Obama, bit his tongue???" are you kidding me??

How did senator obama with a net worth of around 2 million,,,, emerge from the presidency 8 years later with a net worth of $40 million???

There is your answer, it was a scam,,,, now it is being dismantled,,,, after that money went to obama and his friends in the democrat party.........

Morgan

No I'm not kidding, that's what was(is) one of the biggest problems in health care, that many people were paying for insurance but when it came down to it they had nothing in real coverage, there wasn't any check on insurance companies, they had a free ride, they were the scammers, and I'm sure they still are where ever they can, at least the disreputable ones.

Your point with Obama making money during his term is valid, but not just with Obama but almost every other president before him...and yes that is a problem. The same for our representatives, I'm all for getting money out of politics. How many representatives would go onto politics if that were the case and be there for the cause?

As far as dismantling of that I don't see that happening at all, Trump has already made money for his position, it is unethical what he's been doing using his own hotels, and putting his family in positions in the white house. It is inappropriate for the same reason many companies don't allow relations working in the same work place, not to mention their experience and approval for the positions.

These issues you speak of are on both sides of the fence.

Ve'hoe

No, they really are not,,, your defense of obamas corruption "everyone did it" is as juvenile....as it is untrue...

And, despite his promise to be the most transparent and honest regime in history,, he wasnt.

As president,,, as the leader of the free world, he is responsible for everything that he did, or didnt do.... and he stole and lied,,,,,,,,

As for trump and his family,,,, you are wrong, the kennedys did the same,, the bush's, and the clintons........



Lest you conveniently forget again,,,, and only hold the conditional morality, when YOUR guy isnt in the white house stealing, lying, and cheating,, for his own profit.........

Morgan

I say it because I've taken the time to research the presidents going in and going out and they all do very well.

Back on topic I've also have seen the payouts to this present health care committee some are making almost a half a mill. With that incentive do you really think we are going to get a fair health care plan, lets start with Mac McConnell he's a Humana man. Here are some other numbers to look at on why the people won't get a fair shake until we cut out the Bribes.


Campaign Contributions from this industry

View totals by: Client/Parent | Subsidiary/Affiliate
Client/Parent Total
Blue Cross/Blue Shield $3,730,000
Prudential Financial $2,642,500
USAA $1,980,000
America's Health Insurance Plans $1,650,000
Property Casualty Insurers Assn/America $1,380,000
Nationwide $1,200,000
New York Life Insurance $1,160,000
Cigna Corp $1,150,000
Massachusetts Mutual Life Insurance $1,130,000
AFLAC Inc $1,050,000
Northwestern Mutual $1,030,000
American Council of Life Insurers $948,000
Chubb INA $900,000
MetLife Inc $840,000
State Farm Insurance $762,000
Loews Corp $742,029
Travelers Companies $710,000
Association for Advanced Life Underwriting $708,692
Allstate Insurance $680,000
Zurich Financial Services $670,000
Genworth Financial $640,263
eHealth Inc $640,000
Primerica Inc $640,000
Guardian Life Insurance $610,000
Allianz $600,000
National Assn of Insurance & Financial Advisors $565,000
Lincoln National Corp $540,000
Hartford Financial Services $530,000
AEGON NV $530,000
Liberty Mutual $480,000
Reinsurance Assn of America $440,000
National Assn/Mutual Insurance Companies $430,000
Alliance for Community Health Plans $410,000
Council of Insurance Agents & Brokers $406,000
American International Group $390,000
Swiss Reinsurance $380,000
Manulife Financial $360,000
National Assn of Health Underwriters $330,000
American Insurance Assn $330,000
Lloyd's of London $300,000
AON plc $270,000
Indep Insurance Agents & Brokers/America $250,000
WR Berkley Corp $250,000
Marsh & McLennan $240,000
Unum Group $230,000
Medical Card Systems $190,000
Pacific Mutual Holding $190,000
Old Mutual $180,000
CUNA Mutual Group $156,387
American Fidelity Assurance $150,000
Prudential PLC $150,000
American Family Mutual Insurance $140,000
Committee of Annuity Insurers $140,000
Mutual of Omaha $139,000
Cincinnati Financial $130,000
Ambac Financial Group $130,000
Assurant Inc $120,000
National Assn of Dental Plans $120,000
Moda Health $110,000
Physician Insurers Assn of America $100,000
Thrivent Financial for Lutherans $100,000
Self-Insurance Institute of America $100,000
Arch Capital Group $100,000
Vision Service Plan $97,250
CareSource $90,000
AXA $80,000
Hixme $75,000
Medicare & Medicaid Advantage Products Assn of PR $70,000
Triple-S Management $60,000
Assn of Bermuda Insurers & Reinsurers $60,000
Allsup Inc $60,000
Healthfirst $50,000
Conifer Health Solutions $50,000
Continental Casualty Co $50,000
XL America $50,000
Willis Group $50,000
New American Economy Action Fund $50,000
Priority Health $40,000
MBIA Inc $40,000
National Assn of Surety Bond Producers $40,000
Dai-Ichi Life $40,000
Assn of Catastrophe Adjusters $40,000
Argonaut Group $40,000
American Academy of Actuaries $36,000
American Equity Investmt Life Holding Co $30,000
American Fraternal Alliance $30,000
Alliance of Nonprofits for Insurance $30,000
Arthur J Gallagher & Co $30,000
American Student Assistance $30,000
Consumer Credit Industry Assn $30,000
Caremore Health Plan $30,000
CNO Financial Group $30,000
Vermont Captive Insurance Assn $30,000
UnitedHealth Group $30,000
Surety & Fidelity Assn of America $30,000
RenaissanceRe Holdings $30,000
Securian Financial Group $30,000
United Concordia Companies $25,000
UCare Minnesota $20,000
Sedgwick Inc $20,000
TIG Insurance $20,000
Thomas Rutherford $20,000
Carpenters' Benefit Plans $20,000
Cooperative of American Physicians $20,000
HSA Council $20,000
Guaranteed Asset Protection Alliance $20,000
Doctors' Co $20,000
California Earthquake Authority $20,000
American Financial Group $20,000
United Auto Workers $18,000
RenRe North America Holdings $15,000
First Care Health Plans $15,000
eHealthInsurance $10,000
FCCI Mutual $10,000
International Group of P&I Clubs $10,000
CNS Corp $10,000
Brickstreet Mutual Insurance $10,000
Athene Holding $10,000
USI Insurance Services $10,000
XL Capital $10,000
Neighborhood Health Plan of Rhode Island $10,000
Poulton Assoc $7,500
National Structured Settlements Trade Assn $7,000
Proctor Financial $5,000
Munich Reinsurance America $5,000

Morgan

Yes you're correct in self payers paying less, as I've been there too but its not that simple. One reason hospitals charge insures more is to compensate for the loss from private payers. This analogy for self pay is debatable once someone has a long term, terminal disease such as cancer, also the treatment might differ, the private payer possibly not getting the best option.

I agree with you we should be told our costs along with our options.

Ve'hoe

NO, you havent, you are lying,,,,

Obama created this monstrosity,,, took bribes,,, lied and screwed all you who voted for him.. with no vote, no discussion,
no debate....... and then told you it was a lie,,,,,,,,,

The rest of your bullshit is just propaganda,,,,, unless you answer what I originally asked,, how obama made $40 million as president,,,, instead of deflecting and lying.....