patrick.net

HEY YOU says

elliemae,

Since your here why didn't you get a mental evaluation while in the hospital?

Don't you know that following Patnet will make you looney? Hell,I'm proof.

I'm sure that you meant this to be funny (and it was, a little). But I am part of the vast conspiracy that is able to place patients on a psychiatric hold against their will for up to 72 hours. To qualify for the free stay in a hard bed with shitty-ass food, they need to be a danger to themselves or others. A few years back I worked for a nursing home and the administrator wanted me to send a woman with dementia out to the psych hospital so that they could hold her for three days. After that, she would qualify for Medicare to pay $800 per day for her to receive physical therapy, occupational therapy and speech therapy. It didn't matter that she lacked the cognitive ability to retain anything that she might have learned and that the therapies wouldn't make a bit of difference because they weren't at all necessary... so I refused to sign the forms. She yelled at me, then threatened me with my job. She also threatened to file a report against my professional license. She insisted that the patient might wander out the front door into traffic - which doesn't constitute a "danger to herself or others," (although it did say a lot about a nursing home that admitted a patient who wandered without the ability to monitor her whereabouts). But I digress - her threats didn't work.

For those of you who are movie buffs,,. think of the bank scene from "Leaving Las Vegas." I simply couldn't sign the forms.

She got a nurse to sign the forms, and suspended me a couple of weeks later. She was fired soon after that. But she still works in the industry, ruining people's lives and controlling the elderly by ignoring their rights and treating them subhumanely.

Once Ten Ounce Dumbass fixes our healthcare system with his delightful insights, let's allow him to fix the system that allows a confused elderly woman to be held hostage against her will in order to allow a nursing home to fraudulently bill for services she doesn't need while her family stands by, trusting the word of a deranged woman with a two-year college degree, a license and not an ounce of compassion.

Blurtman says

enormous administrative overhead costs that come from lodging health-care reimbursement in the hands of insurance companies that have no incentive to perform their role efficiently as payment intermediaries.

The base pay of insurance executives, hospital executives and even hospital administrators often far outstrips doctors’ salaries, according to an analysis performed for The New York Times by Compdata Surveys: $584,000 on average for an insurance chief executive officer, $386,000 for a hospital C.E.O. and $237,000 for a hospital administrator, compared with $306,000 for a surgeon and $185,000 for a general doctor.

But all the losers keep harping on salaries of physicians who work a hell of a lot harder to pay for medical school, survive medical school and get through residency.

Mark T. Bertolini, the chief executive of Aetna, earned a salary of about $977,000 in 2012 but a total compensation package of over $36 million, the bulk of it from stocks vested and options he exercised that year. Likewise, Ronald J. Del Mauro, a former president of Barnabas Health, a midsize health system in New Jersey, earned a salary of just $28,000 in 2012, the year he retired, but total compensation of $21.7 million.

And studies suggest that administrative costs make up 20 to 30 percent of the United States health care bill, far higher than in any other country. American insurers, meanwhile, spent $606 per person on administrative costs, more than twice as much as in any other developed country and more than three times as much as many, according to a study by the Commonwealth Fund.

“At large hospitals there are senior V.P.s, V.P.s of this, that and the other,” said Cathy Schoen, senior vice president for policy, research and evaluation at the Commonwealth Fund, a New York-based foundation that focuses on health care. “Each one of them is paid more than before, and more than in any other country.”

She added, “The pay for the top five or 10 executives at insurers is pretty astounding — way more than a highly trained surgeon.”

Again, I know all the willfully ignorant people will just gloss over that fact. The dummies wanted obamacare, without realizing that all they are really doing is enriching the hospitals and insurance execs, while squeezing doctors. Doctors should be willing to take pay cuts if their education is subsidized as it is in all the countries that offer single payer. If this is an incorrect statement, feel free to correct me.

With medical tourism reaching the shores, some people, especially those doing procedures (Orthopedics, Cardiothoracic Surgery) will certainly take a haircut in the next few years.

http://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?_r=0

turtledove says

IVF has a lot of moving parts. I couldn't figure out why clinics didn't just list it broken out in its component parts (monitoring, saline sonogram, retrieval, mock transfer, transfer, laboratory, storage, ICSI, assisted hatching, thawing, etc...) First, not everyone needs everything. Some might require more monitoring than others, for example. What's the big secret? However, NO ONE lists prices

Out of the four I went to (small sample size) only one broke it down; but it's not really an a la carte kind of thing. All of those moving parts are things that are required to ensure an optimal outcome.

Why can't you ever find out the cost of treatment in advance? Then you could shop around and force prices down.

Most of the DPC practices do this. Some surgeons (although rarer) do it as well. Like this guy in Las Vegas

http://www.generalsurgerynews.com/ViewArticle.aspx?d=In+the+News&d_id=69&i=November+2011&i_id=783&a_id=19624

elliemae says

The cost of traveling, difficulty finding providers, etc wouldn't have been worth it.

Correct, because you already have good insurance. Maybe your insurance doesn't have a travel benefit. Even then, it isn't the case that you have to book the ticket and find the provider on your own. Assuming your insurance covers it, or doesn't cover it, you would have a case manager who you call and they would coordinate it for you. Hospitals that cater to foreign travelers, have entire departments designed to handle travel plans and reimbursement. One phone call would basically solve that.

Plus, employer-paid surgeries abroad appear to be taking hold: According to a 2014 survey by HR consulting firm Aon Hewitt, although only 5 percent of employers currently cover those surgeries, 25 percent say they may add this in the next three to five years. Ellis' employer, with 2,500 employees, has saved nearly $11 million on health care since the company started its medical-travel program in 2010, according to benefits director Tim Isenhower.

Also, in many cases (maybe not your specific case), insurers and employers, both public and private, are not only picking up the cost for overseas care — some are even throwing in a cash bonus for the employee. It could be a good idea to discuss this possibility to achieve cost savings with HR/ Management.

The providers are almost certainly more skilled than your providers in St George, UT, by virtue of the fact that they do so many more procedures.

How to pick a doctor/facility:

http://www.aarp.org/health/conditions-treatments/info-2014/medical-tourism-surgery-abroad.2.html

http://www.aarp.org/health/conditions-treatments/info-2014/medical-tourism-surgery-abroad.html

http://www.nbcbayarea.com/news/local/Medical-Tourism-The-Future-of-Healthcare-233414371.html

http://www.darkdaily.com/medical-tourism-continues-to-flourish-as-u-s-patients-seek-lower-cost-healthcare-in-overseas-countries-207#axzz3UQnHGI6j

elliemae says

I blame Obama for that. :)

You had insurance before obama and you have insurance after, not sure what or who there is for you to 'blame'

MMR says

Out of the four I went to (small sample size) only one broke it down; but it's not really an a la carte kind of thing. All of those moving parts are things that are required to ensure an optimal outcome.

Would you mind telling me the clinic? I would love to see how they're doing it. Thx!

This is why I'm a believer in non-profit Accountable Care Organizations (i.e., basically HMOs) as the way to go. Because they're integrated and it's based on a regular premium you pay for care, the ACO is motivated to keep costs down and manage care in the most efficient way possible IF THERE IS COMPETITION. This is why I'm opposed to a single-payer system because they're no competition and you'll have kingdom builders not caring about making things as efficient as possible. ACA is making small strides to push things this direction and is already causing significant stirs in healthcare payers and providers to get more streamlined...I know this, because I live it every day in my job.

You're just making a case for why if the Government is going to meddle in Healthcare then it MUST be a self contained tax funded agency, from education to administering healthcare and medicine. Otherwise they should just stay the fuck out of it.

Anycare is better than this!

MMR says

elliemae says

I blame Obama for that. :)

You had insurance before obama and you have insurance after, not sure what or who there is for you to 'blame'

It was more a commentary on TPB's continual blaming of Obama for the rising cost of everything from his auto insurance to weed.

elliemae says

It was more a commentary on TPB's continual blaming of Obama for the rising cost of everything from his auto insurance to weed.

Weed is cheap in illegal states. We get all of the weed that wasn't good enough to be sold in the dispensairies.

Apparentley there's better weed than the cheap stuff we're getting that makes us googeley eyed stupid.