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New patrick.net clone: fixhealthcare.us

By Patrick following x   2018 Jan 31, 5:51pm 1,597 views   38 comments   watch   sfw   quote     share    


http://fixhealthcare.us/
It's only about my four proposals that are the minimum necessary for US healthcare to recover from its terminal decline:

1. Set emergency room prices by law to exactly some annually fixed government-approved amounts. No exceptions. There can never be a free market for emergency care.
2. Require short clear written presentation of all non-emergency medical costs before treatment. No exceptions. If patient does not sign, patient does not owe. If patient does sign, it's a legally binding contract.
3. Require all medical providers to publish clear and complete current annual price lists on the web for every medical billing code. No exceptions, no changes in the current calendar year. Let the people shop!
4. Require each medical provider to charge its own published prices to every patient equally, regardless of whether the patient has insurance or not. No exceptions. It is not fair for a provider charge some patients more than others for the exact same thing. I do not mean that different providers should have to charge the same as each other, only that any one provider should charge the same price to all of its patients for the same service. No more of "we don't like people like you, so our price is higher for your kind".

Please write your Congressman and propose these changes. Please call them the "fixhealthcare.us" changes.

Please check it out, comment, donate if you can. I'm going to put in all US Congressmen and get to work on lobbying them, and on opposing their re-election if they oppose this simple fair rules.
1   krc   ignore (0)   2018 Jan 31, 7:24pm   ↑ like (1)   ↓ dislike (0)   quote        

1-3 makes sense. 4 does not and is seemingly contradictory with 3. If all services and piece costs are listed, and yet the total is the same, who cares? Do you really think that car mechanic A and mechanic B will do the same job for the same price? Granted, they should be close or have an explanation of why. If you want 4 then you will need a heavy hand to regulate that - and then why not go single payer and have government run it all. And, all this will mean is there is no incentive for doctors to improve their techniques (use robotics to minimize scars, etc..) since they get paid the same rate anyway. Not worth taking the time to learn and invest - just go with the SOP in each case. Can you imagine how to price out a new technique and what is "comparable"?

Frankly, if we did away with insurance, people would shop aggressively on procedures, etc... But, with insurance, it is pretty darn complicated to determine your final bill.

One more point you might make (and this happened to me). It should be the responsibility of the service provider (ie surgery center) to ensure that any additional doctors required are also covered under the customer's insurance. I had some work done on my knee. I got clearance from my insurance validating the doctor was in network, the surgery center costs would be covered, the outpatient care and PT was covered in an approved facility, etc... What I didn't know was that the anesthesiologist (who I didn't know, and came in last minute) was not covered by my insurance. I did have a fight with the medical group and they relented, but really only did that because I "knew some folks". Word it however you want. :)
2   Strategist   ignore (1)   2018 Jan 31, 7:43pm   ↑ like (1)   ↓ dislike (0)   quote        

Patrick says
1. Set emergency room prices by law to the Medicare-approved amounts for everyone. No exceptions. There can never be a free market for emergency care.
2. Require short clear written presentation of all non-emergency medical costs before treatment. No exceptions. If patient does not sign, patient does not owe.
3. Require all medical providers to publish clear current annual price lists on the web for every medical billing code. No exceptions, no changes in the current calendar year. Let the people shop!
4. Require all medical providers to charge everyone the same price for the same treatment, regardless of whether they have insurance or not. No exceptions. It is not fair to charge some more than others for the exact same thing.


I would agree for some kind price control even though I am a capitalist pig. But the problem goes beyond that. Too many ER's make losses even with ridiculous prices, and would simply shut down with further losses due to price controls.
Fundamental changes need to take place with regards to lawsuits, and defensive medicine which result in unnecessary tests and expenses.
3   Patrick   ignore (0)   2018 Jan 31, 8:01pm   ↑ like (0)   ↓ dislike (0)   quote        

krc says
If all services and piece costs are listed, and yet the total is the same, who cares?


Maybe I didn't state it clearly enough. I just mean this:

Patient A should pay exactly the same as patient B if both of them get the same treatment.

Strategist says
I would agree for some kind price control even though I am a capitalist pig.


For emergency care, it's a scandal that we do not have any price controls. They can literally charge you whatever they feel like charging you while you have zero choice in the matter. And they do charge you whatever they feel like. And then you are obligated to pay it. It's the only service that works like this.

Strategist says
Too many ER's make losses even with ridiculous prices, and would simply shut down with further losses due to price controls.


Is there a shortage of emergency rooms?
4   Patrick   ignore (0)   2018 Jan 31, 8:03pm   ↑ like (0)   ↓ dislike (0)   quote        

BTW, I do not mean that different providers have to charge the same as each other, only that any one provider has to charge the same price to all of its patients for the same service.

I updated the original post to clarify this.
5   anonymous   ignore (null)   2018 Jan 31, 8:12pm   ↑ like (1)   ↓ dislike (0)   quote        

1. HCPCS and CPT codes are set by CMS.
Emergency "care" is a free market for richer counties. For example, in Monterey County (California), an estimated 80% of PCPs are boutique practices. Only 20% accept any insurances. Your average Carmel resident will gladly pay any where between $500 to $2000 for a personalized visit at any time as oppose to going to the ER. As you know, nothing can control this. It's just a market. If you are referring to the Emergency "Room," free market is irrelevant because no sane business would want to be in that business. It always loses money for the hospital and that's why I have pump up my elective surgery numbers to off set those losses.
2. I agree.
3. CPT/HCPCS codes are set by CMS. People are fully allowed to shop around. Problem is there is not enough providers that people actually can rely on (ie. board certified providers that practice evidence based medicine as opposed to "alternative medicine"). I'm assuming you are not referring to Cosmetic/Aesthetic practices. Those patients SHOP all the time.
4. I totally agree. I would be richer if this is true. I charge non insured patients 50% of what I charge private and government insurances. For example, if I perform a laparoscopic appendectomy, CPT code 44970. I can bill $1,000 to the insurances, but Medicare or BC/BS could care less. Medicare will pay $622.45 (charge is set every year) for Merced County in California (it varies a little depending on location). As for my cash only patients, you have to lower your prices significantly. By the way, if you "underbill" Medicare, you will get audited by CMS and before you know it, OIG is raiding your clinic. Fucked up right?

In the end, I understand why people are frustrated and it doesn't make sense. Even my fellow colleagues that only do clinical work don't understand the finances behind the scenes.

I will chime in my 2 cents. I think all your points made above are good but I like to keep it simple. I don't have solutions for all the problems but I have one instantaneous fix:

Anyone on any type of government assisted health insurance cannot sue the hospital or physician. The number of providers will triple right there. Patient access to outpatient care will go up SIGNIFICANTLY. ER will have less burden. Preventive medicine will be king and everyone wins. Despite the perception, I could give two shits if I make $0 from an emergency procedure. I just don't want to LOSE money and have a terrible mark on your medical license. What happens is that patients sue for everything. Not worth my trouble. I rather use my memorized legal jargon to push this patient to another hospital.
6   anonymous   ignore (null)   2018 Jan 31, 8:13pm   ↑ like (1)   ↓ dislike (0)   quote        

Robotics surgery and laparoscopic surgery use same sized incisions. What you refer to as adhesions or scars, is irrelevant. Robotics surgery drive up health care costs. We use it advertise and get more patients. As a laparoscopic surgeon specializing in gastric bypasses, colectomies, inguinal hernias I can tell you that the joke in the operating is those using the da Vinci like to sit at a desk versus scrubbing. Also we all know that if you can't operate laparoscopically (older surgeons), you use the da Vinci. Why? The robots hand doesn't shake and it simulates operating an open case which most surgeons are use too.

I will try explain my point number 4. If I charged a cash patient the same as I charge an insurance, they will never pay. It's too expensive. So you charge what you think they can afford. I think you are misunderstanding me. I'm not proposing any regulation in 4.

I would LOVE single payer. It will do away with malpractice and liability and alot of OVERHEAD. I don't have to deal with 20 insurances with 20 different billing rules. It's just one rule. That's better. That's why I don't think it will ever happen. You are up against the lawyer lobbyists and health insurance lobbyist. Good luck my friend.

I would LOVE it if there were no insurances. I can fire my coding, billing staff, half my administration. My profit margin would double and the patient would pay way less. I just fucking get paid directly. Win Win for everyone. But as you know, that will never happen.

I lost you on the Mechanic argument. But I guess what you are saying is that not every surgeon or physician is the same. Of course. That's why I would goto a surgeon with a good reputation and is not a butcher. I will pay more for his service too.

There is an incentive to improve. You will get left behind and the other guy will get more patients and hence more income. Im assuming you are promoting choice.

For your last point, i think your surgery center is unscrupulous. I worked at several hospitals small and big. I started a solo practice from ground up. I coded my own EMR. The only way to have a good reputation is complete transparency with not just pricing but with EVERYTHING. Sometimes discouraging the patient from having unnecessary services. It is the standard for the staff to provide exactly how much your out of pocket is. They are also suppose to get auth for everything including anesthesia.

My last 3 points:
Like your view on everything else on this website which I thoroughly enjoy, it's a supply and demand issue.
Despite the good intentions of the ACA, they failed to offer more residency spots. They need to increase supply. Allow more NP or PA for primary care.
They failed at malpractice reform. Scoff if you like, I don't know ANY provider that sees a patient for money. Sure some are dicks, but in order to treat someone, there naturally comes some desire to help someone.
7   anonymous   ignore (null)   2018 Jan 31, 8:13pm   ↑ like (0)   ↓ dislike (0)   quote        

Is there a shortage of emergency rooms?

No. But they only exist because CMS requires it of any hospital taking Medicare. If you don't take Medicare, you can do what every you want.
8   Patrick   ignore (0)   2018 Jan 31, 8:21pm   ↑ like (0)   ↓ dislike (0)   quote        

OK, emergency rooms need to exist. So they need to have prices set by some part of the government at a level that allows them to exist.

anon_aa218 says
Emergency "care" is a free market for richer counties.


If there is a free market, meaning people have enough time to consider various prices from various providers, then it's not an emergency. I'm talking about situations where people really do not have time to shop. That's the non-market case where prices need to be fixed.
9   anonymous   ignore (null)   2018 Jan 31, 8:26pm   ↑ like (0)   ↓ dislike (0)   quote        

Patrick says
Strategist says
Too many ER's make losses even with ridiculous prices, and would simply shut down with further losses due to price controls.


Is there a shortage of emergency rooms?


I have read about Trauma centers and emergency rooms shutting down due to losses.
I'm quite sure this happens in high crime neighborhoods where very few have health insurance.
-------
I really don't think anyone knows how to solve the ridiculous health costs that is unique to America. Something is fucked up, and fucked up bad.
I do know corrupt politicians, corrupt health care providers, and corrupt drug manufacturers are all in on this.
Fucking scumbags.
10   anonymous   ignore (null)   2018 Jan 31, 8:33pm   ↑ like (0)   ↓ dislike (0)   quote        

Medicare or any insurance will only reimburse a set contractual amount to the hospital and physician no matter how much they charge. It's irrelevant. Now what I think you are trying to say is:

What if I have a shitty private insurance with high deductible?
or
What if I don't have insurance?

Hospitals tend to bill $100 per pill of Tylenol. They try to make up their massive losses by relying on most patient's complacency by not arguing your bill. If you bring up the $100 tylenol, they will knock it off.

Now I can tell you a little secret. You get your surgery done. $20000 bill comes. Guess what, you already got the product (the service). So just steal it. Hospitals write off you not paying your bill all the time. They may send you to collections. But everyone here is smart, they already have a credit card, a car, and a house. Also they have auto pay on CC, increasing your credit score even if it gets hit. We are the last to get paid if EVER.
11   Patrick   ignore (0)   2018 Jan 31, 8:37pm   ↑ like (0)   ↓ dislike (0)   quote        

Two questions:

1. How can doctors be more assured of getting paid? They could try to charge in advance, but would lose out to doctors that charge later (and take losses).
2. How can I move this conversation to my new http://fixhealthcare.us/ with the least trouble for you all? I could copy all the users to there so no current user would have to re-register.
12   anonymous   ignore (null)   2018 Jan 31, 8:43pm   ↑ like (0)   ↓ dislike (0)   quote        

Keep it simple.

Malpractice reform:
You cannot sue if you rely on tax payer dollars.
13   Patrick   ignore (0)   2018 Jan 31, 8:58pm   ↑ like (1)   ↓ dislike (0)   quote        

anon_aa218 says
Malpractice reform:
You cannot sue if you rely on tax payer dollars.


I agree we need malpractice reform, but why should poor people dependent on government money have less of a right to sue?

Maybe there's some better to solution unscrupulous lawyers (and patients) extracting settlements from doctors.
14   WookieMan   ignore (0)   2018 Jan 31, 8:58pm   ↑ like (1)   ↓ dislike (0)   quote        

anon_aa218 says
Keep it simple.

Malpractice reform:
You cannot sue if you rely on tax payer dollars.

On the surface this completely makes sense. What happens though when someone on government assistance has the wrong diabetic foot amputated? Should they not be allowed recourse? I have no idea, but doubt an amputation of this sort would happen in an ER atmosphere, but just throwing out a hypothetical.
15   Strategist   ignore (1)   2018 Jan 31, 8:59pm   ↑ like (1)   ↓ dislike (0)   quote        

anon_fd7ee says
Patrick says
Strategist says
Too many ER's make losses even with ridiculous prices, and would simply shut down with further losses due to price controls.


Is there a shortage of emergency rooms?


I have read about Trauma centers and emergency rooms shutting down due to losses.
I'm quite sure this happens in high crime neighborhoods where very few have health insurance.
-------
I really don't think anyone knows how to solve the ridiculous health costs that is unique to America. Something is fucked up, and fucked up bad.
I do know corrupt politicians, corrupt health care providers, and corrupt drug manufacturers are all in on this.
Fucking scumbags.


Forgot to log in.
16   krc   ignore (0)   2018 Jan 31, 9:00pm   ↑ like (1)   ↓ dislike (0)   quote        

You could copy users across. Or wait for this thread to slow down and copy over...

As to the point on the anesthesiologist, yes, I should have "also" gotten approval for that as well. Totally agree. I did not realize that this could be out of network - I don't think that is an unreasonable assumption. And sitting there ready to go under I frankly wasn't worried about it at that time as I thought I had done my due diligence. I just assumed (faulty) that that whatever doctor/medical group you are working with should point out that this additional resource would not be in network even if they are in the same medical "group" - which seems weird. But, I think the argument was that the anesthesiologist works with many different surgery centers and travels from one to another as the need arises. Would have been nice to have known this up front...

As to dealing with cash-only patients, does that work for major surgeries or tests as well? Or is that for more simple stuff? As to litigation, I wonder if anyone knows how much the insurance companies make? Must be a lot of money and I wonder what they really pay out...
https://www.thedoctors.com/

I am fine with the re-wording of (4).
17   anonymous   ignore (null)   2018 Jan 31, 9:13pm   ↑ like (0)   ↓ dislike (0)   quote        

Strategist says
Too many ER's make losses even with ridiculous prices, and would simply shut down with further losses due to price controls.


ER's take losses because they are required to treat everyone, no matter if they have insurance or can pay. Eventually someone has to pay those costs or they get passed on the people who can actually pay.

..."The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay, but since its enactment in 1986 has remained an unfunded mandate.

The burden of uncompensated care is growing, closing many emergency departments, decreasing resources for everyone and threatening the ability of emergency departments to care for all patients. "

https://www.acep.org/news-media-top-banner/emtala/#sm.0001b27hgy19ezethu44u8x87vi3s
18   anonymous   ignore (null)   2018 Jan 31, 9:14pm   ↑ like (0)   ↓ dislike (0)   quote        

Thanks for bringing that up.
These are called "Sentinel Events" in hospital speak.
The physician and hospital would get reported to the Medical Board and CMS. The hospital can lose their "accreditation" and take a huge fine. Although I cannot guarantee an actual trial, but I am confident of a very handsome settlement. The physician will most likely lose his/her privileges at the hospital or fired if he/her is an employee. He/she will never be able to get another job unless you goto Alaska or the Middle East.
There are SO MANY other things that deters one from making such an egregious mistake. Not to mention the guilt you will have for the rest of your life.
19   Strategist   ignore (1)   2018 Jan 31, 9:36pm   ↑ like (0)   ↓ dislike (0)   quote        

anon_afe70 says
Strategist says
Too many ER's make losses even with ridiculous prices, and would simply shut down with further losses due to price controls.


ER's take losses because they are required to treat everyone, no matter if they have insurance or can pay. Eventually someone has to pay those costs or they get passed on the people who can actually pay.

..."The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay, but since its enactment in 1986 has remained an unfunded mandate.

The burden of uncompensated care is growing, closing many emergency departments, decreasing resources for everyone and threatening the ability of emergency departments to care for all patients. "


So what's the solution?
20   anonymous   ignore (null)   2018 Jan 31, 10:08pm   ↑ like (0)   ↓ dislike (0)   quote        

Response to krc:

The Anesthesiologist does that ON PURPOSE. It's bad practice and assholish. The surgery center should have told you. That being said, I will semi defend the bartender, they really got shafted on there reimbursements.
21   steverbeaver   ignore (1)   2018 Jan 31, 11:04pm   ↑ like (1)   ↓ dislike (0)   quote        

TBH I didn't read above in detail, though. Some thoughts on this, though I intend to review above later:
1. Price ceilings for "unconscious victims".
2. Presented price within 10% or $10k, whichever is less for conscious victims in English only. Lawyer on site for support to explain for fee.
3. Acknowledgement forms and promise to pay.
4. Payment insurance premium.
5. Lower the rent-seeking ceiling via standard "grade of quality" / target "licensing"
6. TORT REFORM
22   anonymous   ignore (null)   2018 Feb 1, 6:48am   ↑ like (1)   ↓ dislike (0)   quote        

I like your motivation to exponentially spread your forum software.

But I didn't join this site because of its layout.

I joined because of your logic against buying an overpriced home, when I bought a home.

Your advice kept me focused on the first digit of my home price; I kept it at 1 when equal homes had a 3.

Thank you for that. I owe you 20 years of my life.
23   BlueSardine   ignore (2)   2018 Feb 1, 7:27am   ↑ like (1)   ↓ dislike (0)   quote        

Auto post comments here to FHC.
Auto signup commenters here to FHC
Auto email commenters here link to FHC for bookmarking

Patrick says
How can I move this conversation to my new http://fixhealthcare.us/ with the least trouble for you all?
24   MrMagic   ignore (11)   2018 Feb 1, 7:56am   ↑ like (1)   ↓ dislike (2)   quote        

Strategist says
So what's the solution?


Good question. There's two sides to that issue.

First side, says that everyone should be treated in the ER (compassionate care) no matter their ability to pay. Some feel that healthcare is a "Right" and everyone should get FREE healthcare (go as Bernie), and shouldn't need to pay for ER services and treatment.

Second side, why should FREE treatment be given in a ER to anyone? Why should other people have to absorb this free treatment costs and service for people who don't pay. Why can't I drive into the gas station and get free gas, why can't I go to a car dealer an get a free car, why can't I go into a restaurant and get a free 7 course meal? So, why should ER treatment be free? Some say people should bring out their Visa or Mastercard to pay for treatment if they show up at the ER, and pay for services just like any other service.

Two different views that will get different opinions from different people.

The bottom line, giving free treatment in the ER passes on that expense to all insured people and other who do pay their bills.
25   BlueSardine   ignore (2)   2018 Feb 1, 8:11am   ↑ like (0)   ↓ dislike (0)   quote        

Those examples are not life threatening.
Government should cover ER costs with a tax on everything That is detrimental to good health not a large tax but a tax.
Cost savings to hospitals with this policy should be passed on to the government to improve funding of emergency Room care and lowering the tax on everybody

Sniper says
Why can't I drive into the gas station and get free gas, why can't I go to a car dealer an get a free car, why can't I go into a restaurant and get a free 7 course meal? So, why should ER treatment be free?
26   MrMagic   ignore (11)   2018 Feb 1, 8:20am   ↑ like (2)   ↓ dislike (1)   quote        

BlueSardine says
Those examples are not life threatening.


Not every free treatment at the ER is life threatening.

anon_afe70 says
is a federal law that requires anyone coming to an emergency department to be stabilized and treated,


"stabilized and treated" can be subjective, depending on the person.

BlueSardine says
That is detrimental to good health not a large tax but a tax.


Who's going to determine that? Fat people may think eating 6 Twinkees is important to their health.

Aren't certain people taxed enough now? How do you tax the 47% who are paying federal taxes now?

Or, do we do what the Libbies want and tax the 1%ers 150% of their income and redistribute their wealth to pay for this?
27   BlueSardine   ignore (2)   2018 Feb 1, 9:42am   ↑ like (0)   ↓ dislike (0)   quote        

An "emergency" by definition is life threatening.
Granted all people who use the ER are not in life threatening situations.
Maybe separate out the true life threatening, and government covers them. Easy to do via diagnosis. Make the fakers pay.

Sniper says
BlueSardine says
Those examples are not life threatening.


Not every free treatment at the ER is life threatening.
28   BlueSardine   ignore (2)   2018 Feb 1, 9:43am   ↑ like (0)   ↓ dislike (0)   quote        

Surgeon general.

Sniper says
Who's going to determine that?
29   anonymous   ignore (null)   2018 Feb 1, 9:45am   ↑ like (0)   ↓ dislike (0)   quote        

This is unfortunately just mental masturbation.

The reason health care DELIVERY is NOT a RIGHT is because health care is not happiness or property. The delivery of health care requires another human being. Automatically by default, it is not a right since it is dependent on the servitude of another human.

Health CARE is a right. I have the right eat right, exercise, and pursue good health.
30   BlueSardine   ignore (2)   2018 Feb 1, 9:45am   ↑ like (0)   ↓ dislike (0)   quote        

Yes they are.
Tax the things that put people into the ER.
The people that consume or participate in such things are the ones paying the tax.
"Government should cover ER costs with a tax on everything That is detrimental to good health not a large tax but a tax."

Sniper says
Aren't certain people taxed enough now? How do you tax the 47% who are paying federal taxes now?
31   BlueSardine   ignore (2)   2018 Feb 1, 9:46am   ↑ like (0)   ↓ dislike (0)   quote        

"Government should cover ER costs with a tax on everything That is detrimental to good health not a large tax but a tax."

Sniper says
Or, do we do what the Libbies want and tax the 1%ers 150% of their income and redistribute their wealth to pay for this?
32   WookieMan   ignore (0)   2018 Feb 1, 10:02am   ↑ like (1)   ↓ dislike (0)   quote        

BlueSardine says
Granted all people who use the ER are not in life threatening situations.

Totally anecdotal and not going to produce evidence to back it up. But my 2 ER visits I was astonished at some of the people I saw come through the door. There were people there literally for a cold.

First time I came in with 3rd degree burns. Must have been a quiet night, didn't really see any BS that night. This was a Chicago suburban hospital. So I'm not sure I have 2 good anecdotal stories, just one. Sorry to mislead out the gate here.

Second time, and mind you I'm a healthy weight and lifestyle guy for the most part, but was having chest pains about 6 years ago and didn't want to dick around with it. I unfortunately was in Chicago, the city proper at the time. So to the ER I went.

I couldn't believe what I saw. 90% of the people there had ZERO business being in an ER. And the nurses and front desk people knew it too. There was literally about 30 people sitting in the waiting room. Mind you this for sure wasn't families waiting on someone. These were people there waiting to get in for some "ailment." You couldn't imagine the look on everyone's faces when the white guy walks in with chest pains and gets walked back immediately.

I was there for about 5 hours with them running blood work every half hour, hooking me up to machines, doing chest Xrays, etc. The only close to true emergency in those 5 hours was a kid that broke his leg at some sporting event. This wasn't Stroger, the main ER for the Chicago gang bangers and that type of shit, but was still a major Chicago ER operation on the northwest side of the city nonetheless. I had never realized how bad of an issue it was, people just showing up for the most minor things at a fucking ER.

In hindsight I kind of felt bad I was even there, but I'm not going to just "man up" if I think I could be having a heart attack. All was well, clean blood work and all that BS, as if any of you care. Rather strange looking back on it.
33   MrMagic   ignore (11)   2018 Feb 1, 12:49pm   ↑ like (2)   ↓ dislike (2)   quote        

BlueSardine says
An "emergency" by definition is life threatening.
Granted all people who use the ER are not in life threatening situations.


Right, probably over 3/4 aren't life threatening, they're just too lazy to wait for the walk in Medi Center to open up in the morning.

WookieMan says
I couldn't believe what I saw. 90% of the people there had ZERO business being in an ER. And the nurses and front desk people knew it too. There was literally about 30 people sitting in the waiting room. Mind you this for sure wasn't families waiting on someone. These were people there waiting to get in for some "ailment."


Yet, they all have to be treated by someone in the ER, which really raises costs for the hospital to staff the ER. Many will want FREE treatment.

There should be a new policy for ERs, if you're bleeding, you get to enter, if not, swipe your Visa or Mastercharge before you enter. This way you can have as much treatment as your open available credit on your card.

BlueSardine says
Tax the things that put people into the ER.
The people that consume or participate in such things are the ones paying the tax.


Will Never happen.

That's why I proposed the credit card method. It would be just like pre-paying for a hotel room, concert tickets, airline tickets, Amazon order, etc.

Case solved.
34   MrMagic   ignore (11)   2018 Feb 1, 1:54pm   ↑ like (4)   ↓ dislike (2)   quote        

BlueSardine says
An "emergency" by definition is life threatening.
Granted all people who use the ER are not in life threatening situations.


Some interesting stats:

Annual Emergency Department Visits:

Number of visits: 141.4 million
Number of injury-related visits: 40.0 million
Number of visits per 100 persons: 45.1
Number of emergency department visits resulting in hospital admission: 11.2 million
Number of emergency department visits resulting in admission to critical care unit: 1.8 million
Percent of visits resulting in hospital admission: 7.9%
https://www.cdc.gov/nchs/fastats/emergency-department.htm

Based on those numbers, it looks like 1% would be a life or death situation, if they're getting admitted to critical care and 8% are admitted for overnight or minor treatment.

Now, look at payer sources-

Nationwide ED visits by insurance:
• Private insurance as the expected payment source: 29 percent
• Medicaid or Children's Health Insurance Program: 35 percent
• Medicare: 18 percent
• No insurance: 14 percent
• Unknown insurance: 13 percent
https://www.beckershospitalreview.com/hospital-management-administration/25-facts-and-statistics-on-emergency-departments-in-the-us.html

So, it appears that over 2/3rds of people are getting either FREE or government paid healthcare. So, the call for government provided FREE healthcare (ala Bernie "Socialist" Sanders) is already here for the majority of the population.

And look how screwed up the healthcare industry actually is in the country.... Do people really want the government to control all 100%??
35   WookieMan   ignore (0)   2018 Feb 1, 2:54pm   ↑ like (0)   ↓ dislike (0)   quote        

I do have the solution for all this though. It's unconventional and focuses more on men's health. Which if you take away child birth, men are probably a higher percentage of health issues and costs versus women. Let be honest here, most or at least a lot of men don't take care of themselves. I guess I've been out in public recently as well, fuck, most women don't take care of themselves either. But let's give this a shot either way.

This will be hard in the #(pound)metoo era, no doubt. I think we're up for the challenge and don't need Bezo's or Buffet either. If you know them, we could use some seed money for sure though.

We need a Hooter's type hospital. Hell a topless joint would be even better. Gotta be the hot AND smart one's though. Not just hot and no brains since this is our health and all. Although the dumb one's are probably okay at the front desk and billing department. I'd venture to guess men would stay on top of their health on an annual basis. Hell maybe semi annually or even weekly for the real depraved bastards.

Shit, who am I kidding. If something like this worked you'd think they'd do a restaurant or something like that...
36   MrMagic   ignore (11)   2018 Feb 1, 6:55pm   ↑ like (4)   ↓ dislike (2)   quote        

Sniper says
• Medicaid or Children's Health Insurance Program: 35 percent


Another point, notice the payor source with the highest percentage?? Medicaid.

When people get something for FREE, they use more of it! How many of those Medicaid ER visits could have been handled in the neighborhood walk in clinic, instead of the expensive ER, for a lot lower costs?

When you're NOT paying the bill, who cares how much it costs!

Now apply that to Single payer, healthcare for all 320 million people..... Get it yet??

Here's another fun fact:, 155 million people are on private ins plans, but they make up 29% of ER visits.
57 million are on Medicaid or CHIP, and they make up 35% of ER visits.
53 million are on Medicare, and they make up 18% of ER visits (and these are people mostly over 65 years old with more health issues).

See a problem yet?
37   Hircus   ignore (0)   2018 Feb 1, 9:24pm   ↑ like (0)   ↓ dislike (0)   quote        

krc says


One more point you might make (and this happened to me). It should be the responsibility of the service provider (ie surgery center) to ensure that any additional doctors required are also covered under the customer's insurance. I had some work done on my knee. I got clearance from my insurance validating the doctor was in network, the surgery center costs would be covered, the outpatient care and PT was covered in an approved facility, etc... What I didn't know was that the anesthesiologist (who I didn't know, and came in last minute) was not covered by my insurance.


This just happened to my brother. He had his gall bladder taken out, and asked them over and over to make sure his insurance would cover it. They assured him it did. But, after he woke up they said they had to call in a last-minute, out-of-network anesthesiologist ..... and so he owed many thousands on the bill.

I feel like hospitals would do a much better job of not "accidentally" doing this crap if they had some skin in the game for the out of network bill should they screw up on organizing personnel. It's seems unrealistic for anyone but the hospital to be responsible for assembling an in-network team.
38   WookieMan   ignore (0)   2018 Feb 1, 9:55pm   ↑ like (0)   ↓ dislike (0)   quote        

goat says
They assured him it did. But, after he woke up they said they had to call in a last-minute, out-of-network anesthesiologist


First off, fuck gall bladders. If there was a god, why did he create the most fucking useless organ in the body? Aaahhhh, fuck, let's just remove that organ because it's making you feel like absolute shit. Said no other organ in the body. (The appendix can get fucked too)

Not sure this would work, but any chance you just throw the charge on the credit card and then dispute it? I'm not saying this would work, but I'm pretty sure I could get out of the charge if I went about it this way.




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