OT: Health Care Hell

[oldpotatoe]

Originally Posted by Likes2ridefar

Certainly no means an expert nor looked into it deeply, but most of the profits, at least at Aetna, are from real estate investments and not directly from the insurance premiums.

Point is if you have a 'middle man', whether they be for profit or not, it adds another layer of cost. Remove the middle men, reduce cost(I know it's not that simple but..in some ways it is)...pay a company wth a CEO with a house in mailbu, among many and $2500 suits..well..you get the idea.
"Big Health Insurance" has a legion of lobbyists with swimming pools full of bribe money for various state and federal legislatures and the guys in the 'big chair'...including the one who lives very part time in DC...

[romalor]

Damn , I knew things were bad in the US but still not that bad.
I agree with those of you saying you have good health care, the issue is more with insurance, finance and banking.

It's very much different here in Europe, where we have a mixed system , with a bit of both ( planification and high public employement numbers and private jobs ). Mostly public healt care.

We all should look up at what northern european countries are doing. But we also have a dying middle class.

You have to have a high social capital society, high trust for that kind of stuff to work. It's less and less the case.

Potential issues I see in us for public healtcare, are rampant obesity for you , bad life hygiena etc. As well as opioid crisis ( google sackler family )

[sailorboy]

Originally Posted by nortx-Dave

That hasn't been my experience here in Texas. I retired from the Army 5 years ago and in 2017 separated my shoulder after an unfortunate collision with a dog. Initial evaluations, xrays, pre-op appointments, surgery, follow-ups and a couple of appointments with PT all generously covered by TRICARE. And all the providers were hand picked by me.

I was an Occupational Therapist in the Army. I have to agree with Sailorboy. Military healthcare was a joy to work in, but once I retired, I found I couldn't deal with civilian healthcare systems and insurance.

Frozen joints are truly difficult to treat. I have to say though a good detailed home program is crucial to recovery.

Hey Dave, welcome. I would think we have had some mutual professional connections if not ourselves some time ago as I started Army SP corps in '93. Anyhow, I think you hit on some variability within the Tricare system. Any insurance for the price Tricare charges is WAAAY better than nothing and many of the 'survival' insurance policies out there in the private sector, but it really galls me that everyday hard working people of this country don't get the same opportunity for reasonably-priced coverage that those of us who served are entitled to. And let's be honest, the vast majority of us (who served) aren't entitled to it because of some heroic actions of the military. Many of us just stuck it out for the long haul. My fellow citizens who also worked hard and sacrificed for this country in the construction or education sectors for example, also deserve similar peace of mind that comes with coverage for themselves and/or their families. It's not even a partisan issue anymore imho. It's common decency. I'm really not trying to make it seem political, but I'm still waiting for the Republican plan that will replace the ACA that is under constant threat and vindictive attacks. Where is the "better, cheaper, most amazing" alternative that we were promised? I'll even settle for a rough outline of it that we can all discuss...but I'm still waiting

[sailorboy]

Originally Posted by romalor

Potential issues I see in us for public healtcare, are rampant obesity for you , bad life hygiena etc. As well as opioid crisis ( google sackler family )

Totally agree. It's not like anyone should take pleasure in fat-shaming, but these are the people chronically making poor choices that will likely bring the house of cards down on the rest of us. And all in the shadow of the former first lady's healthy food initiative for schools being ceremonially dismantled (on her birthday no less) just as a statement against 'nanny-state' influence on personal choices. Yes, it's expensive to subsidize whole foods for school children nationwide. So is emergency room care for obesity-related illness.

[oldpotatoe]

Any insurance for the price Tricare charges is WAAAY better than nothing and many of the 'survival' insurance policies out there in the private sector, but it really galls me that everyday hard working people of this country don't get the same opportunity for reasonably-priced coverage that those of us who served are entitled to.

Guess who else gets 'government health care, ala TriCare'?..congress..and the guy in the big chair..face it, it's a political football and even tho making the guy on main street hurt, to make the 'other side' come crawling back for a deal hasn't worked..the guy who gets hurt is...the guys and gals on main street.
Too much money, too many lobbyists, too much ego...

Tricare, like medicare for all, works great..send the insurance fat cats back to their estates in Florida..

[mdeth1313]

Originally Posted by oldpotatoe

Guess who else gets 'government health care, ala TriCare'?..congress..and the guy in the big chair..face it, it's a political football and even tho making the guy on main street hurt, to make the 'other side' come crawling back for a deal hasn't worked..the guy who gets hurt is...the guys and gals on main street.
Too much money, too many lobbyists, too much ego...

Tricare, like medicare for all, works great..send the insurance fat cats back to their estates in Florida..

First break out the wooden boards like they did in China.

[Johnnysmooth]

Originally Posted by Mikej

You guys know that Medicare pays virtually 27 percent of the billed amount, right? All of us with insurance paying 90k for a broken collarbone are picking up the rest - that’s why it works so good. Also, most big companies are self insured so the s add mount they claim they pay isn’t really the amount.
https://www.nerdwallet.com/blog/heal...pital-bills-2/

Folks, I work in the healthcare industry and have a pretty good handle on the mechanizations at work.

That $90k quoted number is something that all healthcare orgs do - provide some extremely high number based on what's called the charge master. The charge master is completely fabricated and has no basis in reality of true costs of delivered career but is simply used to begin negotiations btwn a provider and insurer.

Unfortunately for the consumer, or uninsured, providers use the charge master to bill out directly. No one should ever, ever accept and pay that charge.

[Jaybee]

Originally Posted by Johnnysmooth

Folks, I work in the healthcare industry and have a pretty good handle on the mechanizations at work.

That $90k quoted number is something that all healthcare orgs do - provide some extremely high number based on what's called the charge master. The charge master is completely fabricated and has no basis in reality of true costs of delivered career but is simply used to begin negotiations btwn a provider and insurer.

Unfortunately for the consumer, or uninsured, providers use the charge master to bill out directly. No one should ever, ever accept and pay that charge.

This is crazy. I've never heard of this before, but the borderline fraud is not surprising. How many millions of people just pay that inflated number or assume they are financially effed with the resultant stress, etc. My family has been fortunate never to have a huge medical bill to fight over, but that day is coming - when, not if.

[2LeftCleats]

I view the billed amount the same as a sticker price on a car. No one pays that. As mentioned, it's the starting point in negotiations. When you get the Explanation of Benefit (EOB), it shows the billed amount and then what the insurer actually is going to pay. It tends to make the insurer look like the hero (Wow, look how much they saved me!), but it's all smoke and mirrors. Unfortunately, if you have no insurance you may get billed for the entire amount. As pointed out, usually you can negotiate that down, but sometimes not. Not surprising that medical expenses are a, if not the, leading cause of personal bankruptcy.

[buddybikes]

Problem is this is AFTER your service, not negotiating before you buy the car. Lot harder to negotiate.

[polar8]

Originally Posted by steveandbarb1

Problem is this is AFTER your service, not negotiating before you buy the car. Lot harder to negotiate.

Not always easy to do i.e. when you're seriously injured

[ftf]

People shouldn't have to negotiate for healthcare, period.

[oldpotatoe]

Originally Posted by Johnnysmooth

Folks, I work in the healthcare industry and have a pretty good handle on the mechanizations at work.

That $90k quoted number is something that all healthcare orgs do - provide some extremely high number based on what's called the charge master. The charge master is completely fabricated and has no basis in reality of true costs of delivered career but is simply used to begin negotiations btwn a provider and insurer.

Unfortunately for the consumer, or uninsured, providers use the charge master to bill out directly. No one should ever, ever accept and pay that charge.

Pretty much sums up how completed farged up health care coverage IS in the US..from the 'horse's mouth'...

I've had "government health care" my entire life, dad in USAF, me in USN, now on medicare and have NEVER been disappointed. It works, can work for everybody, as it does for how many other 'industrialized' nations? Becoming homeless because you get sick should be CRIMINAL..not commonplace. AND before somebody yells, 'your taxes will go up', yup, but the resulting $ you pay each year will GO DOWN with 'medicare for all', but for people like that Norquist weirdo, 'taxes' is a four letter word.

NOBODY should accept these fat-heads in various legislatures, who are bribed with YUGE amount of $..VOTE, for the above and a plethora of other reasons...

First break out the wooden boards like they did in China.

huh?

[HenryA]

So, the Trump administration tried:

https://www.hhs.gov/about/news/2019/...americans.html

And the hospitals sued:

https://khn.org/morning-breakout/in-...sparency-rule/

[rnhood]

He did what he could however, it will take Congress to make changes in any health care laws. And they are apparently too busy to do it. We need to elect younger members to Congress, but for some reason people keep electing the same crowd. That swamp we have to drain, it’s outside the reach of the President.