N-3 Healthcare Vent

[duff_duffy]

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

[R3awak3n]

Although I think the healthcare system needs a lot of work here, I think that if you are one of the lucky few to have good health insurance and live in a big city, it is pretty good. I recently got awesome health insurance since my wife is now working for a big corporation. I went from paying $450/month (cheapest health insurance I could find in NYC) for insurance that had $7000 deductible to have a really low deductible with a good company that all doctors want to be in.

I needed a gastro appointment and got it within 3 days, in the next week I have an endoscopy scheduled, thigns move fast... this is in NYC, I tried to get an appointment upstate and was at least 3 weeks wait.

[MattTuck]

Without knowing the details, this sounds like something called balance billing. Where you go into a hospital that you think you're covered by your insurance, but then the hospital doesn't have the doctors to cover all the shifts, and so they contract out to a service that provides doctors to cover the needed shifts. Those doctors don't necessarily have relationships with insurers, but they don't tell you, and you don't find out until the bill comes.

If this is the case, you should talk to your insurer, and the hospital, and make a stink about it, threaten to call your congress person.

It is a deceptive bait and switch practice, as far as I'm concerned.

[ftf]

Originally Posted by duff_duffy

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

Yes it sucks, I have great health insurance for now at least, and it still sucks. Also the US has poor outcomes even though we pay far more than the rest of the world.

[fa63]

Sorry to hear this. The healthcare system here does suck indeed.

I suggest inquiring about the charges then negotiating your balance, if you haven't paid it off in full yet. I was appalled by the charges my father incurred after a visit to the ER, so I demanded detailed bills then negotiated a much reduced amount. And when I say much reduced, I mean it.

Good luck.

Originally Posted by duff_duffy

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

[ripvanrando]

$28,000+ per year in premiums and can only use providers in NJ and they must be in my plan. No out of network use. If you use an out of network doctor, any and all associated services are on you.

It is so horrible that I am going overseas for surgery.

[BobbyJones]

Some food for thought:

Not only is there a lack of price transparency on the provider side of healthcare, there is also a certain stigma here in the US for the recipient to actually ask what the costs are involved. (when given the opportunity in a non-emergency situation of course).

What other service or good do you just walk in and say "tell me what I need, here's a blank check" Your last dream bike doesn't count. Or your plumber.

The rise in healthcare costs are unavoidable but thinking as consumers instead of patients we can be more informed and make different choices. With a little persistence it may result in an industry shift that'll benefit everyone in the long run.

I thought this article in the Times was a good overview of challenges with links to tons of other references for learning more.

[MagicHour]

So sorry.

Part of me wishes for a national strike on our healthcare system - ie all consumers to stand up and say, "ENOUGH, the money stops until this mess is fixed". Of course I know that's not feasible, people would die, and would never happen, but at what point to say enough to:

• lack of transparency
• price gouging of all services, pharmaceuticals, devices
• annual 25-30% insurance premium increases with shrinking benefits and denied procedures
• narrow networks
• PBM rebates
• etc
• etc

I read this earlier today re: our healthcare system "they just don't want more of your money, they want ALL your money"
....end rant

[Louis]

Well, the fact that the US has the "Greatest Healthcare System in the World" surely makes for all the OP's problems.

[Rekalcitrant]

An old colleague of mine, who is a bioethicist, used to say that the USA has the distinction of being the one country that has found a way to combine extremely high expenditures on health care with terrible overall outcomes—I gather we are at or near the bottom of the developed world on many measures. As a Canadian living in the USA I sometimes find myself explaining to people here that in much of the rest of the world people don’t carry around day-to-day anxiety about potential sickness or injury being financially devastating, aren’t scared to go to the ER, don’t lose sleep deciding whether to replace their kid’s epipen when the price goes through the roof, and so on. To my mind this is an enormous social cost and it’s scandalous that people are willing to put up with it. Yes, there are issues with every health care system, but I think this is a clear case where delusions about American exceptionalism and a commitment to the free market being untouchable are causing an incredible amount of suffering. I don’t usually post about these things—and I have excellent health insurance through my employer—but this is an issue where I think there needs to be serious change.

[ripvanrando]

Originally Posted by BobbyJones

Some food for thought:

Not only is there a lack of price transparency on the provider side of healthcare, there is also a certain stigma here in the US for the recipient to actually ask what the costs are involved. (when given the opportunity in a non-emergency situation of course).

What other service or good do you just walk in and say "tell me what I need, here's a blank check" Your last dream bike doesn't count. Or your plumber.

The rise in healthcare costs are unavoidable but thinking as consumers instead of patients we can be more informed and make different choices. With a little persistence it may result in an industry shift that'll benefit everyone in the long run.

I thought this article in the Times was a good overview of challenges with links to tons of other references for learning more.

I need cervical spine surgery and found an excellent out of network Neurosurgeon (almost no NS takes insurance in NJ, they all banded together). I agreed to pay him out of pocket and he would do the surgery in a hospital that is 100% covered by my BCBS plan. BCBS refused to cover anything because I picked my own surgeon. We contacted the hospital and Anaesthesiologist and other service providers many times. NOT a single one responded. We just wanted to know a price. I needed to know whether this was going to be $80,000 or $200,000.

What these providers do is bill insurance say $80,000 as a surgical fee but if it is Medicare, they might get $1700. If an insurance case, they might get $3500. If out of pocket, they get your house.

[paredown]

Sorry about the bikes!

The OP should broaden the initial statement--'don't go to the ER if you can possibly avoid it'. A construction fall--and I delivered myself to the Emergency--cost over $40,000--and yes, they performed CYA procedures that I specifically questioned--multiple x-rays of a knee and hand that were incidentally banged on the way down--the back was the real injury.

Out of pocket for that wiped out my part-time earnings for that year.

Worse yet, the next time I decided to 'tough it out' because of the price and the crappy treatment and did not go the ER for what turned out to be a lacerated kidney (also a fall). I was supremely lucky did not cost me a kidney or worse.

Meanwhile, if you sit and listen in the ER for a few hours, you realize that a large percentage of the people who are being treated have no/limited health care, and treat the Emergency as the local community health care provider--and those costs are swallowed by the hospitals. Those people have no other choice, because we don't have community clinics etc and universal Health Care access.

There is no "health care market"--there are no prices posted, no transparency and no consumer sovereignty. All the tricks they use male my blood boil--like the "consultant" who wanders in and asks you three questions, and turns out to be an out of network specialist and bills you...

That said, my last experiences have been mainly at a super well-run hospital where at least the service is very good and the doctors are great.

[MattTuck]

Originally Posted by BobbyJones

...
The rise in healthcare costs are unavoidable but thinking as consumers instead of patients we can be more informed and make different choices. With a little persistence it may result in an industry shift that'll benefit everyone in the long run.

Agree with mostly everything else you said, but I disagree that rising healthcare costs are unavoidable. Perhaps under the current system, there are challenges to lowering them. But, there is a quotation out there, that is a bit of a tautological statement, "That which is unsustainable will go away." Really, just the definition of unsustainable. The current system is made up of increasingly larger and larger cartels trying to gain size advantages over their adversaries. (payers vs. providers)

The "affordable" care act could have done more for healthcare affordability with 2 sentences than anything in history.

1. All providers shall generate, upon request of a patient, a quote for all services that the provider has suggested to the patient. (with some language about how long it can take to generate the quote, how long the quote has to be honored, and what happens if complications occur during the services)

2. All providers must submit to a publicly available database, for each set of services, what was the average/median/mean price quote, actual charge, and success rate.

[fa63]

Originally Posted by Rekalcitrant

much of the rest of the world people don’t carry around day-to-day anxiety about potential sickness or injury being financially devastating, aren’t scared to go to the ER, don’t lose sleep deciding whether to replace their kid’s epipen when the price goes through the roof, and so on. To my mind this is an enormous social cost and it’s scandalous that people are willing to put up with it. Yes, there are issues with every health care system, but I think this is a clear case where delusions about American exceptionalism and a commitment to the free market being untouchable are causing an incredible amount of suffering.

Amen.

[oldpotatoe]

Originally Posted by duff_duffy

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

As long as the health care 'system' in the US is a for profit system, regulated and controlled by insurance companies and with lobbyists(check to see what some big health care CEOs are paid) who has most of congress in their pocket, expect the above.

I have medicare..premiums for me and wife are about $400 per month...I've had a trip to ER and 3 days in hospital(pulmonary embolism), 3 Rx that are $10 per pill($40 per day) and I pay NADA out of pocket. If Government health care works for me, it 'should' work for all. The US system is a YUGE mess(connection intended)...

medicare for all......