patrick.net

I talked with a guy who had a panic attack in Yosemite, that he thought was a heart attack. They flew him to Modesto by helicopter. He said the tab was over 70K, but he didn't pay it, it was covered by insurance. Insurance has created so many price dislocations in the system, it is Alice in Wonderland pricing. It seems that if you get billed, you shouldn't pay, and then go through protracted negotiations for a "realistic" billing that they will accept, usually a lot less. That way, the absurd price structure is preserved for where it can be charged.

Patrick says

If you are bitten by a raccoon, you can’t really decide not to get the rabies vaccine. It’s literally a life-or-death situation. But the price is incredibly high.

This also literally once-a-lifetime event which affects 0.000000000....0001% of the population. Meanwhile the vaccine needs to be stocked and regularly refreshed at every damn emergency room in the whole damn country. Somebody got to pay for that.

And that $600 bill for clogging the ER with a fucking fingernail clipper "wound" is a stupidity tax, pure and simple. A person with IQ higher than ambient temperature in Celsius should be able to treat a nail clipper scratch w/o running to a fucking medical facility. Nail clipper is not a fucking bowie knife, HELLO!

Still, shouldn't the prices be published somewhere, instead of being secret?

Ceffer says

Insurance has created so many price dislocations in the system, it is Alice in Wonderland pricing. It seems that if you get billed, you shouldn't pay, and then go through protracted negotiations for a "realistic" billing that they will accept, usually a lot less. That way, the absurd price structure is preserved for where it can be charged.

It's almost as if free market capitalism isn't working in this case. Is it possible, that there are some things, such as health care that shouldn't be left to the "market."

They got a free pass when Obama deemed the ER as America's primary care. People were only going to the Hostpital when they were sick.
Obamacare demanded healthy people buy insurance. And those that need even a bandaid on their Finger must be punished in the ER.
And of course those on Obamacare must pay several doctor bills for people they never saw when they go get something as simple as blood work.

Thanks short sighted dimbulb Liberal Freaks!

Tenpoundbass says

They got a free pass when Obama deemed the ER as America's primary care.

That was Reagan, with EMTALA in 1986

https://www.acep.org/life-as-a-physician/ethics--legal/emtala/emtala-fact-sheet/

Tenpoundbass says

They got a free pass when Obama deemed the ER as America's primary care. People were only going to the Hostpital when they were sick.
Obamacare demanded healthy people buy insurance. And those that need even a bandaid on their Finger must be punished in the ER.
And of course those on Obamacare must pay several doctor bills for people they never saw when they go get something as simple as blood work.

AS usual, you make no sense with your gibberish. Same story different year.

IT was probably at least seven years ago that I hypothesized that TPB is a special kind of left wing troll, whose single minded goal is to make right wingers look extremely unintelligent. But nobody can keep up such an excellent act that long.

So the more obvious explanation ? Readers should draw their own conclusions.

DASKAA says

Patrick says

If you are bitten by a raccoon, you can’t really decide not to get the rabies vaccine. It’s literally a life-or-death situation. But the price is incredibly high.

This also literally once-a-lifetime event which affects 0.000000000....0001% of the population. Meanwhile the vaccine needs to be stocked and regularly refreshed at every damn emergency room in the whole damn country. Somebody got to pay for that.

The majority of the waste is not catastrophical treatments. It's unnecessary surgery and medications which strains the system most. And people who can't or won't pay. So they rake their money in with those few who are able and willing to pay for this usury.

For anyone who wants to know how medical care worked for me in mexico, here's my story....One day a got a shard of glass buried deep in my foot...So deep I couldn't dig it out myself...so I went to a doctor friend and he sent me down the street to get a couple of X-rays and also to the nearby drugstore to buy some type of lidocaine I think...He told me to get on the table. cleaned up the area and shot me in the foot with the lidocaine...then he started digging... pulled out 2 chunks of glass...put a couple of stitches in there...sent me for another x-ray to check it out....then he gave me a script for antibiotics and said to get some tylenol for the pain...he charged me about $30... total cost about $70... dealing with the recovery pain after the lidocaine wore off and only had tylenol.............brutal but manageable...this was 5 years ago...my foot is fine...

marcus says

It's almost as if free market capitalism isn't working in this case. Is it possible, that there are some things, such as health care that shouldn't be left to the "market."

This is why Trump wants published prices for common medical procedures. A facility fee would be the type of thing that should be on this list. If people could look up this on their phone, they would go to the lowest priced place in the area.

I was in ER last weekend. I asked for price, was told by everyone who works there that they can’t possibly tell me the price.

Fortwaynemobile says

was told by everyone who works there that they can’t possibly tell me the price.

THat's the OPs point.

I don't think publishing prices is the solution. The solution is single payer. MAking that payer our representative. But the transition no matter what is going to be tough, because of entrenched investment interests in hospitals and health insurance companies, big pharma etc. In fact the transitions away from what we have is so difficult, that it explains the reason for the ACA.

Sadly, at the federal level our government couldn't work together, becasue that might have made Obama a hugely successful President. And we couldn't have that.!

And yes, of course lobbyists, campaign finance and corruption in general are also at the heart of the problem.

Corporations are people ! Got to love those right wing SCOTUS'.

You certainly can't be of the position that publishing prices would be a bad thing. It can only help.

marcus says

It's almost as if free market capitalism isn't working in this case. Is it possible, that there are some things, such as health care that shouldn't be left to the "market."

I hate to agree with you about something, but yes, the system the way it is with the crafty, shape shifting insurance companies creates a bad situation for everybody.

Patrick says

Still, shouldn't the prices be published somewhere, instead of being secret?

Yes, it should. In fact, it's law. Not sure how the medical industry found a way around it.

Single payer isn’t that simple. I’d love it to be simple, but it’s not. Single payer Obamacare just pushes cost onto taxpayers, it doesn’t address them.

It still doesn’t address the damn emergency room racket. They won’t tell me the price even if I pay cash.

marcus says

Fortwaynemobile says

was told by everyone who works there that they can’t possibly tell me the price.

THat's the OPs point.

I don't think publishing prices is the solution. The solution is single payer. MAking that payer our representative. But the transition no matter what is going to be tough, because of entrenched investment interests in hospitals and health insurance companies, big pharma etc. In fact the transitions away from what we have is so difficult, that it explains the reason for the ACA.

Sadly, at the federal level our government couldn't work together, becasue that might have made Obama a hugely successful President. And we couldn't have that.!

And yes, of course lobbyists, campaign finance and corruption in general are also at the heart of the problem.

Corporations are people ! Got to love those right wing SCOTUS'.

Yet illegals can visit ER with impunity.

marcus says

Sadly, at the federal level our government couldn't work together, becasue that might have made Obama a hugely successful President. And we couldn't have that.!

Normal people don't care about who gets called a hugely succesful president...That's the domain of fanatics and special needs people...People care about what is good for themselves.

marcus says

It's almost as if free market capitalism isn't working in this case. Is it possible, that there are some things, such as health care that shouldn't be left to the "market."

The pricing system isn't capitalist, which is the problem.

There is another problem with over-regulation, resulting in the shut down of tons of smaller, charity hospitals and many areas only have one corporate hospital with secret pricing and no reasonable alternative.

theoakman says

You certainly can't be of the position that publishing prices would be a bad thing. It can only help.

I don't think it's the root of the problem. Right now we have a system where most people either have health insrance or an HMO like Kaiser, through their employer, or they buy their own health insurance.

People who buy their own are often going to opt for a major medical plan that covers mostly huge or catastrphic costs, and then they pay for smaller things themselves. Where as people with socalled cadilac plans or HMOS have plans that cover more, and then they have a copay of something like $20 - $30.

From the doctors point of view, it depends on which of these types of providers she caters to, but the billing aspect of it is already a nightmare.

So what would listing prices even mean ? IF it's an independent doctor that offers services to various insurance companies and also connected to a medical school and hospital, how does she list her price ?

The only thing I can imagine is something like this:

Here's is my price for this procedure: $ X

These following insurers pay X, these other insurers pay .70X, medicare pays .60X , the following MAGA insurers don't cover this procedure at all, and I am not currently taking uncovered patients, but if the hospital assigns me uncovered patients a payment plan for price .60X will be negotiated.

So sure, we could have a HUGE battle in congress about listing prices, and what we would get is probably some mess like that. AS long as different insurers have different deals, and corporate hospitals are playing various complex games to keep the system running as it does, I don't see that listing prices is a solution.

But, I can understand that if someone is an independent contractor, buying cheap major medical insurance for themselves and choosing to pay for everything non major out of pocket, that then they would like prices listed.

But we have a royally messed up health system that is not directed towards these patients/customers and their interests. But if we put in place a single payer system, where everyone had more or less the same coverage, with supplemental plans covering the difference for many procedures and out of system doctors, then I could see that listing prices makes sense.

First things first. The way the system is now, what would requiring prices be listed even mean ?

zzyzzx says

This is why Trump wants published prices for common medical procedures.

Sadly, I have not heard Trump mention anything about publishing medical prices since the election.

Someone please remind him about this campaign issue.

OR you could have a price list for people with policies that don't cover that particular procedure. That would be easier to implement. But even then, it messes things up. If they have a lower price that brings in more uncovered patients, do they then have to charge more of a premium to insurance companies to offset. OR if they can't, what is this going to mean? Presumably they have a deal for being in their "Network" that they have to be able to treat up to X number of patients from that insurer. So they can't lower prices so much for non-covered people to cause a problem with that deal. Also, doctors hate having to track down patients to pay their bills.

Don't you see ? Unless there is standardization among insurance companies as to what the insurance costs and what it covers(spreading the cost of people with preexisting conditions among the pools), then price lists can't really be done.

IT's a complex mess, that I don't claim to nearly comprehend. But I can see that listing prices may simply not be doable in the current system.

marcus says

It's almost as if free market capitalism isn't working in this case. Is it possible, that there are some things, such as health care that shouldn't be left to the "market."

There are instances when capitalism fails. Emergency room is one of them.
The huge bills people receive really goes to pay for those who have no insurance.

Strategist says

The huge bills people receive really goes to pay for those who have no insurance.

Well that and the overhead of being staffed to handle much more than what they are typically tasked with. Right ? Think about it. THey don't know when those busiest days or nights are going to be. But they have to be ready for them. Only part of that can be handled with the "on call" system. Also, let's not forget about coverage for malpractice suits.

marcus says

Strategist says

The huge bills people receive really goes to pay for those who have no insurance.

Well that and the overhead of being staffed to handle much more than what they are typically tasked with. Right ? Think about it. THey don't know when those busiest days or nights are going to be. But they have to be ready for them. Only part of that can be handled with the "on call" system. Also, let's not forget about coverage for malpractice suits.

The medical system is fucked up. You can lose your life savings with a single accident or illness in the family.
My dog was in the emergency room twice for a total of 5 days, just a few months ago. The total cost including follow ups and meds was about $8,000. We even had insurance, but they only paid $1,350. Even insurance rips you off. You just can't win.

Single payer pretends to be the silver bullet for this issue, but it's not. Its proponents don't understand the law of unintended consequences: poorer quality doctors, less innovation, less choice, no competition, more gov't bureaucracy/corruption/cost. This country CANNOT afford single payer, period. My belief is that it can only work when you have very tight borders, a very large majority of makers (not takers), and a SMALLER, HEALTHIER and more homogeneous population (like Denmark).

The solution is the integrated health system or HMO like Kaiser, where they own the health plan and provider sides of the house, and there's health competition with others. They're motivated to provide the best care for the money, and the patient is "taken care of" for a predictable cost to their budget.

Kaiser isn't much cheaper than being on a ppo plan. Kaiser is nothing more than an example of the expensive health care we already have.

It doesn't take that much thought to see that single payer can work. In spite of the fact that those enemies, those damn liberals, like it. That alone doesn't make it wrong. IT already fucking works (medicare) for all of the expensive stuff (for pretty much everyone) when old people are dying without even bringing race or work ethic in to it.

Adding on major medical for the rest of us to medicare has got to be cheaper than the current mess, even if it does deprive an entire industry of a fortume it is skimming off of the top.

Don't worry, Kaiser takes medicare.

AS with energy related issues, I really wish this weren't a democrat issue. If the solution to any problem implies that democrats win, we simply CAN NOT HAVE THAT !!!!!!!!!!!!

There isn't any mystery as to what procedures cost, it's kept deliberately opaque by hospitals and insurers who benefit greatly by concealing costs.

Hospitals gouge, which give insurers a reason to raise premiums which they claim they can't avoid because the hospitals gouge.

Be very suspicious of an extremely widespread service that has easily statistically measurable sets of numbers in a capitalist society where the costs are skyrocketing near double digits every year.

This is easily proven: Compare the change in health care costs in Japan or Singapore, versus the United States. The former two experience health care inflation about the same as general inflation. The latter is often 200-300% higher than CPI. And Japan has an incredibly large aging population and a much smaller successive population of young people. Something ain't right.

Medical costs should be more predictable and less varied than Haircuts or Fast Food Hamburgers.

HMOs failed in most states FYI.

marcus says

Kaiser isn't much cheaper than being on a ppo plan. Kaiser is nothing more than an example of the expensive health care we already have.

It doesn't take that much thought to see that single payer can work. In spite of the fact that those enemies, those damn liberals, like it. That alone doesn't make it wrong. IT already fucking works (medicare) for all of the expensive stuff (for pretty much everyone) when old people are dying without even bringing race or work ethic in to it.

Adding on major medical for the rest of us to medicare has got to be cheaper than the current mess, even if it does deprive an entire industry of a fortume it is skimming off of the top.

Don't worry, Kaiser takes medicare.

AS with energy related issues, I really wish this weren't a democrat issue. If the solution to any problem implies that democrats win, we simply CAN NOT HAVE THAT !!!!!!!!!!!!

marcus says

The solution is single payer.

My mother in law is on single payer Medicare. She’s into her third unnecessary surgery and getting ready for two more. She switched doctors a couple years ago and the new guy wanted to get paid for some procedures so convinced her that surgery would take care of her various aches and pains.
Wonder who is paying for all that? It’s free for her!

If people had some skin in the game, they’d be less likely to abuse the medical care. But then we’d need fewer surgeons and medical personnel. Can’t have that.

theoakman says

You certainly can't be of the position that publishing prices would be a bad thing. It can only help.

Anything that fixes our medical system is bad to a socialist.

What's your take on Laser Eye surgery? Those prices are posted regularly and the cost has gone down. Not sure if it's still the case but for a good 10 years, insurance didn't cover it either.

marcus says

Kaiser isn't much cheaper than being on a ppo plan.

.

Where I work, Kaiser costs the same as a PPO plan, but offers way cheaper co-pays and deductables. Now if there were competitive HMO's to Kaiser, we might get a break. But all anyone has to compare to is expensive PPO's.

theoakman says

What's your take on Laser Eye surgery? Those prices are posted regularly and the cost has gone down. Not sure if it's still the case but for a good 10 years, insurance didn't cover it either

Clearly there’s a strong correlation between procedures insurance doesn’t cover and reasonable pricing.
I paid for that procedure out of pocket back when it cost $4000. Worth every penny.

theoakman says

What's your take on Laser Eye surgery? Those prices are posted regularly and the cost has gone down. Not sure if it's still the case but for a good 10 years, insurance didn't cover it either.

Great point. Capitalism works in medical care when it's not in the rotten system.

Patrick says

The other big problem is the daily masturbation to racial issues by the lefties who run the media. They are just going to keep stroking themselves because they love the discord it causes. They absolutely do not want national unity.

Yup. Both Islam and the Radical Left know that Western Civilization, Enlightenment and "Pre-Post Modernity", Rationalism, Communitarianism, and Civic Nationalism have to be defeated to usher in the "Perfect Civilization". Traditional Liberals, Classic Liberals, etc. stand in the way of Progress. Why, we could have Utopia if we could just start from the Year Zero and/or convert all the Kaffirs!

The Siblinghood of Man (Brotherhood being Patriarchal) can be had here on Earth, Gentlemen! It only takes a kindly, guiding, elder Uncle Hand, like that of Jeremy Corbyn, and this could be an Earthly Paradise, with Equity and Social Justice (Equality under the Law and regular Justice being Bourgeois, Capitalist, Patriarchy). It will be the Maternal State of Nature, with all Property in Common, healthy Vegan Dinners, Regular Yoga Exercise, and mandatory Recycling for all!

lostand confused says

Yet illegals can visit ER with impunity.

I think anyone can if you don't care about your credit rating and don't have a legit job.

theoakman says

What's your take on Laser Eye surgery? Those prices are posted regularly and the cost has gone down. Not sure if it's still the case but for a good 10 years, insurance didn't cover it either.

Absolutely lasik and invisalign are perfect examples of capitalism working its magic in medicine. The insurance/hospital/MD/big pharma racket system is socialism, not much to blame capitalism for.

Invisalign now costs less than one month rent for a 2-3 bedroom in SF. Lasik less than a week's rent.