So a man posts his hospital bill online of $11,119.53 (with insurance). How do you feel about this?

ketsuko
reply to post by Flatfish

 

And single payer doesn't remove the problem. It's just price controls. Price controls do not remove the other problems and only create issues that lead to rationing and erosion of service.

And we'll still be paying through the nose via our taxes and with a VAT thrown in for good measure. I dont' know about you, but I can't afford a 10 or 20% cost of living hike.

I know you say it doesn't remove the problem, but the empirical evidence seems to show quite the opposite. Here's an interesting article you may want to check out regarding this very subject;

www.boston.com...

Shorthand: green indicates better performance, yellow average performance, and red worse performance. The U.S. has the highest number of reds and the lowest number of greens of any nation in this selection of nations belonging to the Organization for Economic Cooperation and Development (OECD).

Because the U.S. spends as much as 50% more per person on health care than the average of our leading peer nations, we might expect to do better or at least as well as our international peers. Not so.

Unless spending the most and getting the poorest results is the ultimate goal, I'd say our current system is a total failure compared to most of the rest of the industrialized world.

Furthermore, single-payer is much more than price controls. It's the rededication of huge sums of what is currently unproductive money, (in terms of providing healthcare) currently being paid into our for-profit system that is not utilized to provide healthcare.

Instead, it's squandered away on things like multi-million dollar CEO salaries & bonuses, advertising, entire departments who's job it is to find a reason to deny your claims, profit margins, dividends to shareholders, etc...

Having looked at the bill posted lets break this down as it should be as each charge appears:

The first thing that I noticed, is that the total amount that is charged is: $55,020.00
The insurance company covered all but: $11,119.53
So he asked to pay a fifth of the total charges from the hospital for what all happened.
So before we all get upset, that that breaks down to the following:
Room and Board: 975.20 This is for his stay in the hospital and the food that he ate. As we do not know how long he was in the hospital, but they do give and offer 3 meals a day. This means that there is the cost of the nurses on staff, the janitors, the housekeeping, the cooks, the people bringing up the meals as well. And such highly skilled people do not come cheaply, being on call to come running at the first sign of trouble, or even if he should call them. Do you honestly think that a person making say 9 dollars an hour would be willing to come running if you are in trouble, or called them immediately at any time?

Pharmacy: 484.12 dollars. That means every medication he needed, along with the people who are filling the prescriptions, and making sure it is delivered up to him as well. This also includes any special medications as well. Most of the best antibiotics are very expensive, and they also have to double check to make sure it is not going to interact with other medications, or that he is not allergic to such.

Labs: 281.60. I think that one would want the best person in the lab, to make sure of everything, from analyzing the blood, to making sure that there are no hidden surprises either.

Recovery room: 1500.36 for being in a bed, with constant attention. If anything were to go wrong, there would be staff right there to take care of any problems, especially if there were complications from the anesthetic or from the surgery as well.

Medical equipment: 1285.75 This is going to pay for use of equipment that is very expensive to purchase. And here again, it requires someone to monitor, fix, and maintain, all of that cost is not cheap.

And one can go on and on down the list. Insurance these days are not going to cover all expenses or aspects of the expense that would be incurred. Nor is it going to protect the hospital and its staff from the most expensive part of their practice, the malpractice insurance, and attorneys.

So the question is when it comes to hospital bills like this, why are we so shocked at the cost? Medications are expensive, and if we get sick, we would want to know that we are getting the best care in the world, yet are shocked that the best means that one has to pay for such, it is not cheap and ultimately there is costs involved with such.

JohnnyCanuck

MBMASON
Yet another reason I'm happy I live in Canada. In November I had artifical disc replacement surgery completely free of course. It cost between 35,000 to 45,000 in the states.

Hell of a deal! I had to pay $32 for my(successful) prostate cancer treatment. Hospital parking, eh?

For most of us in the First World, discussions like this are simply surreal!

Your right! I didn't factor in the parking, it cost us maybe around $40. What a rip!
I honestly don't mind the high taxes, it doesn't really seem to effect my life in any overly negative way.

Also I forgot in the run up to the surgery I had, I had 3 MRI's, several X-rays and dozens of doctors and specialist appointments. And I didn't even have to become a meth cook to pay for it!

sdcigarpig
So the question is when it comes to hospital bills like this, why are we so shocked at the cost? Medications are expensive, and if we get sick, we would want to know that we are getting the best care in the world, yet are shocked that the best means that one has to pay for such, it is not cheap and ultimately there is costs involved with such

I don't know too many people who complain about the "legitimate" cost of hospitalization, it's just that I'm not sure there is such a thing anymore. At least, not here in America.

Other than St. Jude Children's Research Hospital, I'm not aware of an american hospital that doesn't overcharge in one way or another. I'm sure there has to be some out there, I'm just not aware of them and I'll bet their numbers are few.

On the other hand, stories like these are now common in almost every american community.

www.emaxhealth.com...

The National Health Care Anti-Fraud Association (NHCAA) notes that in 2007, a total of $2.26 trillion was spent on health care in the United States, with more than 4 billion health insurance claims being processed. A conservative estimate from the NHCAA is that 3 percent of all health care spending, or $68 billion, is lost to health care fraud.
Estimates from government and law enforcement agencies, including the Federal Bureau of Investigation, say the loss due to health care fraud is even higher, as much as 10 percent of the US annual health care expenditure, or $226 billion, which is likely a low estimate and will only continue to rise.

www.kaiserhealthnews.org...

For the price she was charged for her insulin during her 18 hour stay at St. Luke's Hospital, Zachor would have enough to cover her out-of-pocket expenses for a three-month supply under her private Medicare Advantage plan if she had been home. The tab for one water pill to control high blood pressure could buy a three-week supply. And the bill for one calcium tablet could have purchased enough for three weeks from the national chain pharmacy where she gets them over-the-counter.

Excessive drug prices have also surprised seniors in other parts of the country:

--In Missouri, several Medicare observation patients were billed $18 for one baby aspirin, said Ruth Dockins, a senior advocate at the Southeast Missouri Area Agency on Aging.

--Pearl Beras, 85, of Boca Raton, Fla., said in an interview that her hospital charged $71 for one blood pressure pill for which her neighborhood pharmacy charges 16 cents.

--In California, a hospital billed several Medicare observation patients $111 for one pill that reduces nausea; for the same price, they could have bought 95 of the pills at a local pharmacy, said Tamara McKee, program manager for the Health Insurance Counseling and Advocacy Program at the Alliance on Aging in Monterey County, Calif., who handled at least 20 complaints last year from Medicare beneficiaries about excessive hospital drug bills.

Check out this video, it's a real eye opener that once aired on Anderson Cooper 360.

reply to post by Flatfish


Look, I'm not defending insurance companies, but for single-payer, you trade them for one massive government control structure and bureaucracy. This is just as bad, and in this country just as corrupt. In this country, the average public sector employee makes 1/3 more than their average private sector counterpart. So, questions of CEO salary aside, you are talking about instituting a massive bureaucracy to manage the system comprised of people who are paid far more with much better benefits, including pensions that the tax payers must pay for.

Let's not forget that Britain's NHS is one of the top five employers on the planet, and Britain is a tiny island compared to the US. Now just imagine what size that monstrosity would be in the US ... and then consider that once you institute it, there is no recourse for the citizens to any other system. Period. So if you are getting a bad deal, then you are SOL (unless you are filthy rich or elite, of course), and there are plenty of accounts of citizens who get a raw deal from their single payer systems.

How about we go back to when there were no middle men between you and the doctors and other providers and people just expected that by and large it was their responsibility to pay for their own basic health care? Why is it so evil or barbaric to expect that if you want a checkup, you pay for it? Because I guarantee you that if the insurers and the government were removed as middle men brokers, the prices would come down very, very quickly. The doctors don't like dealing with them any more than we do.

jrod

The biggest problem is the entire procedure+hospital expenses should have only been say $5,000. The inflated cost of health care is ridiculous, as is being forced to pay for insurance that will still leave one with a huge bill after any significant medical expense.

I'm not necessarily disagreeing with you, as I mostly agree; however, I wonder where you pulled the $5000 amount from?

The way I see it, they have to pay nurses, surgeons, anesthesiologist, facility use costs, equipment costs, medical liability insurance, etc...etc...etc...

Tort reform would go a long way in curbing medical costs...so would making medical school more affordable and open to more applicants. It'd be nice too if the government would step in and set reasonable cap prices on all medical procedures....only allow necessary costs (those I listed above), but remove profit from the equation...nobody should profit off the suffering of another human being.

reply to post by WhiteAlice


Our healthcare system in this country is a joke. Health and Insurance Industry are at the top when it comes to lobbying. They are the kings of crony capitalism.

One way to combat these ridiculous prices is to have a huge billboard inside the hospital waiting area listing the prices of most operations and procedures so that some power is given back to the consumer. Hospitals would have to compete driving prices down.

As it is now, it is theft to pad the pockets of the greedy top men in the industries.

I would be curious to see how much money some of the top people pull in, in the insurance industry

reply to post by LeatherNLace

$5k is about the average price of breast implants.

Crazy how elective cosmetic surgeries that are not covered by insurance are somewhat reasonably priced, where life saving procedures covered by insurance are outrageously priced.

ketsuko
[
How about we go back to when there were no middle men between you and the doctors and other providers and people just expected that by and large it was their responsibility to pay for their own basic health care?

And what happend if someones fall on hard times (job loss can happen at any time) and they fall ill? Or they have a condidtion that costs millions a year to get treated yet they are on less than $100k a year? So say tough go die quietly?

dp

ketsuko
reply to post by Flatfish

 

Look, I'm not defending insurance companies, but for single-payer, you trade them for one massive government control structure and bureaucracy. This is just as bad, and in this country just as corrupt. In this country, the average public sector employee makes 1/3 more than their average private sector counterpart. So, questions of CEO salary aside, you are talking about instituting a massive bureaucracy to manage the system comprised of people who are paid far more with much better benefits, including pensions that the tax payers must pay for.

IMO, the wage disparity you speak of is primarily due to the total stagnation of wages & benefits in the private sector, but despite this disparity, Medicare proves to have one of the lowest levels of administrative cost for any healthcare plans offered in America. Go figure!

ketsuko
Let's not forget that Britain's NHS is one of the top five employers on the planet, and Britain is a tiny island compared to the US. Now just imagine what size that monstrosity would be in the US ... and then consider that once you institute it, there is no recourse for the citizens to any other system. Period. So if you are getting a bad deal, then you are SOL (unless you are filthy rich or elite, of course), and there are plenty of accounts of citizens who get a raw deal from their single payer systems.

If I'm not mistaken, Walmart and McDonald's falls in that same category of largest employers on the planet and look how their employees are treated. They're not even paid subsistence level wages. They're openly encouraged by their employers to apply for public assistance.

Few if any, have any medical coverage at all. Most end up in the emergency room getting the most expensive, least efficient healthcare available, on the taxpayer's dime.

I'll just bet there's even more accounts of people working for companies like these who are getting a much "rawer deal" than anyone who is covered by any single-payer plan on the planet.

So when you talk about the planet's largest employers, just know that in my opinion those that qualify as "corporate entities" are usually the largest welfare queens on the planet as well. They are purely profit driven and any cost they can pass off onto the taxpaying public is more profit for the company.

ketsuko
How about we go back to when there were no middle men between you and the doctors and other providers and people just expected that by and large it was their responsibility to pay for their own basic health care? Why is it so evil or barbaric to expect that if you want a checkup, you pay for it? Because I guarantee you that if the insurers and the government were removed as middle men brokers, the prices would come down very, very quickly. The doctors don't like dealing with them any more than we do.

And I guess the poor who don't have any money can pay for their healthcare with chickens like Michele Bachman proposed. Is that what you mean by prices coming down quickly?

jacobe001
reply to post by WhiteAlice

 

Our healthcare system in this country is a joke. Health and Insurance Industry are at the top when it comes to lobbying. They are the kings of crony capitalism.

One way to combat these ridiculous prices is to have a huge billboard inside the hospital waiting area listing the prices of most operations and procedures so that some power is given back to the consumer. Hospitals would have to compete driving prices down.

As it is now, it is theft to pad the pockets of the greedy top men in the industries.

I would be curious to see how much money some of the top people pull in, in the insurance industry

Maybe this will help;

www.creators.com...

Modern Healthcare, a leading health industry trade journal, published its annual executive compensation survey this week. Topping the list is Stephen Hemsley, quoted above, who gave a speech to the Detroit Economic Club last year questioning the value Americans receive for all that health spending.

His take for 2009: $106 million — $7.5 million in salary and benefits and $98.5 million in stock options.

Mr. Hemsley is not alone. The CEOs at insurance giants Cigna, Humana, Aetna, Coventry Health Systems and WellPoint all took home between $10 million and about $18 million. Many of those companies already have announced double-digit premium increases for next year.

In all, the CEOs of America's 10 largest health insurance companies made $228.1 million in salary and stock options during 2009, according to the liberal advocacy group Health Care For America Now.

They found that health care CEOs received an average compensation of $10.5 million last year. That's 40 percent more than the average for all S&P 500 companies — 77 percent higher than chief executives at financial services companies.

reply to post by jacobe001


I think that would be entirely appropriate as well. When I was considering whether to get the other tests done or not, one of the things that I tried doing was finding out the actual price of the tests. The only one that I managed to get a price from Providence on was for the MRI and that was over $3000. It was incredibly difficult just to obtain that one single test price. In my letter to Providence in an assistance request, I made sure to remark that if I had known how much these tests would have cost, I would have never agreed to having them done. Instead, I was simply sent to the lab department--no idea of what I would be charged for the tests. The phlebotomist, after asking me about insurance, handed me a form to fill out to request assistance and really urged me to fill it out to get assistance. He thought for sure that they would cover all of my costs and cover me for one year based on how unhealthy I looked and all the tests requested. Well, they didn't.

It's really pretty remarkable that, healthcare being one of the largest expenses for a family around next to buying a house or car, they do not have any kind of price listing at all for the majority of tests/services. How hard would it be for them to print even a reasonable estimate for those things so that at least the consumer is well informed? I sometimes suspect that the reason why they get away with not posting such things is because of that HIppocratic oath. Money isn't supposed to be a factor in health care; ergo, inserting pricing would make it a factor. Kind of a perversion of an oath that the rest of us did not take.

It's even more infuriating when those tests come up normal and you don't get to go in for any follow ups on abnormal results because you find out just how much it's going to cost you. Whenever I'm dealing with that particular bill, I can't help but think "why the hell did I even bother?" Oh yeah, it's because I was having very serious problems....

Sigh.

reply to post by Flatfish


Funny how I missed references to all those dead people who couldn't pay for doctors lying around in the gutters that are littered all throughout my history before the advent of either insurance or big government to hold my hand and take care of me.

The point is that somehow most people got what they needed.

People found a way to make it work rather than being forced into systems that were overlarge and did not work for them.

MBMASON

JohnnyCanuck
Hell of a deal! I had to pay $32 for my(successful) prostate cancer treatment. Hospital parking, eh?

Your right! I didn't factor in the parking, it cost us maybe around $40. What a rip!
I honestly don't mind the high taxes, it doesn't really seem to effect my life in any overly negative way.

I only throw in the parking fee as an irony. Fact is, ATS got me to quit squawking about hospital parking fees...if that's the worst cost I have to face...jeez, beats the US system!

ketsuko
reply to post by WhiteAlice

 

I've heard stories about IHS that would curl your toes. It's hit or miss much like your public school district.

"Heard stories"--well isn't that what one would call hearsay? I'm coming from firsthand experience over the course of a year and a half for myself, personally, and 7 years total for my children. The tribe that I was living with was the Navajo, which is the largest tribe within the US. If there were going to be issues, then those issues would've been very apparent within the Navajo's IHS. However, it was great. Zero bad experiences and I have nothing but praise for the quality of care and expediency of services rendered up until 2008. Now I do know that recently, the move was made to privatize IHS and, in particular, the very hospital that my family and I received care through. In the last year, since this privatization, two of my Navajo family members have died and one was awfully young to go so soon from cancer.

You should probably stick to subjects that you know or have direct experience with than comment on things that may be outside of your general knowledge and based on anecdote. Though I will say, the fact that IHS has been recently privatized in an effort to "reduce costs" actually makes your anecdote and my firsthand experience paint a different picture. Non-privatized governmental healthcare was better than the privatized variant.
www.navajotimes.com...

Here's a report from 2004 that includes, on page 4, differences in various rates between the Navajo and the US. Deaths due to alcohol, diabetes, and influenza are going to be higher than normal given the genetic predispositions of the Navajo in regards to the first two and the continuous presence of plague and hantavirus within the area. These are all hot topic health issue areas within the Navajo Nation.

www.tribalconnections.org...

ketsuko
reply to post by Flatfish

 

Let's not forget that Britain's NHS is one of the top five employers on the planet, and Britain is a tiny island compared to the US. Now just imagine what size that monstrosity would be in the US ... and then consider that once you institute it, there is no recourse for the citizens to any other system. Period. So if you are getting a bad deal, then you are SOL (unless you are filthy rich or elite, of course), and there are plenty of accounts of citizens who get a raw deal from their single payer systems.

No.

No. No. No.

It is not true.

We have recourse to other systems. We can have comprehensive health insurance or we can buy single treatments, from major invasive surgery to individual vaccines and cholesterol tests. Going by the discussion on this board, it's more affordable than in the States.

People on the whole stay within the NHS because it works for the vast majority of people the vast majority of the time.

With the exception of North Korea, this is true of every nation which has socialised medicine.

What's more, not every system is as huge as the NHS, which is itself increasingly decentralised. The French system, for example, is based on private providers working within a government tariff. Again, patients are free to step outside the system and pay for priority treatment.

I don't know if it's an American Exceptionalism thing or a general Panglossian view of life in the US, but you'd have a far more effective debate if you bothered to find out the truth about the world outside.

For those of you who haven't seen it, this is the comic strip of Breaking Bad set in most countries in the world.

reply to post by Whodathunkdatcheese


Beat me to the punch there - the Yanks seem to have been fed a whole load of crap with regards to the NHS (or any other "Government system for that matter).

Most people in the UK will also have access to a private health insurance through their employer, usually at no extra cost (or a minor deduction per month). If not, then they can still elect to go private anyway if they have the cash.

Many NHS operations are carried out in Private hospitals and many private operations are done in NHS hospitals. The system is no where near as centralised or "choice restricting" as they seem to think it is.

I have private health from my employer, but have never used it - not once. There was never a need. If something is urgent (such as cancer) the NHS will treat you very quickly anyway (I believe there is a 2 week target to diagnose and begin treatment) and if it isn't urgent, I don't mind waiting a few weeks (between 6-8) for my op.

I had my knee looked at on the NHS last year, been bugging me for years since a Rugby injury when I was younger and I was sent down to the Hospital by my GP, scanned and diagnosed within a day. Had to wait a few weeks for the OP, but hey, I had been putting off for years anyway.

reply to post by stumason


Funny Americans seem to be little it and fear it until one falls ill over here and see how it works first hand then they can stop gushing about it,

American brain washing at work here i think.