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To make this perfectly clear, I didn't pay $700 for the tetanus shot, my insurance company paid it because I have good insurance that pays 100% of my emergency room bill. That doesn't blind me to the fact that there is a lot of monkey business going on here. Just because everything seems perfect in your world, that doesn't mean the world is perfect. It just means that you haven't realized that you're being screwed yet.
An MRI might be the only affordable thing in Japan, which has a much higher cost of living than the US.
PS: an MRI under my plan is $50
Weave
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"I got mine, the rest of you can fuck off and die for all I care."
What a country!
For all you citizens of socialist countries that are under the illusion that your socialized healthcare is "free", I've got some waterfront property down the street from me for sale.
For those of you that think this healthcare bill is going to be a good thing for our country, all I can say is you're clueless. This bullshit isn't about healthcare AT ALL. It's about a power grab by the democrats.
And I'm pretty certain I know as much,or more, about healthcare and the health insurance business as anyone on this board.
MR
(Tucson, AZ)
You're showing your ignorance of this subject when you rag on insurance companies for "making too much money." The profit margins of health insurance companies are some of the thinnest of any of the products you buy/consume.
It's the job of the rich to pay for everyone else's shit. And toys. And insurance. And cars. And food. And whatever else politicians want to promise them.
If you're going to throw this kind of crap out there on the table, go find us some data that every doc is making (or thinks he should make) a mil. Same for the others you listed.
And it sounds like you're the new arbiter of who gets to make what in this country? Or is that the job of all the other folks on this board? I guess you all will be setting salaries for everyone in every industry in the USA now.....
What a joke.
Our system has problems, no doubt. But the fix (or at least what we know of it) being proposed is crap. We're in the mess we're in because the government interjected itself into healthcare 40 years ago. The real fix is for the government to get the hell out of the way, and let the free market work.
Searching out and paying for good insurance is wise. Somehow I doubt you will only be out $800 for any procedure you encounter...just on the face, that kind of insurance is pretty much unobtainable. I'd guess you are exaggerating at a minimum. But, supposing it is...what are you going to say when they reject your claim because you failed to disclose a hangnail 20 years ago?
You probably don't realize this because it's hard to see the world in a mirror, but, most on here are doing pretty well for themselves. Educated, professionals, business owners, etc.
And nothing you said has anything to do with the systemic problems in the health care system. You have taken care of yourself...great...what happens when that policy is no longer available?
http://www.takecarehealth.com/...me-to-take-care.aspx
http://www.takecarehealth.com/what-we-treat.aspx#vaccinations
Tetanus shot (booster) is $45.
A new CNN poll finds that more than 80% of Americans are satisfied with the quality of their health care.
That's misleading to say the least. Quality of health care in the U.S. isn't the primary concern for most with insurance. Even without insurance. We have good doctors and hospitals etc. Of course, you won't find many people that have spent time in a hospital that don't have something to complain about...but, Americans like to complain in general.
The problem is in the cost of that health care.
Pit Row
Now tell me how do you explain a $700 tetanus shot?
The bill is $700, but no one, and I mean no one, ever pays that. Insurance companies that are not contracted with the hospital pay either "reasonable and customary" or a percent of billed charges (HEY! That's why the bill was so inflated!!). Companies with a contract pay the contracted amount. For an ED visit that's maybe $200 for something as simple as what you had. Traditional FFS Medicare pays the rate mandated by the federal government. Same for traditional FFS Medicaid. Managed Medicare (advantage plans) and managed Medicaid programs are private companies that use contracted/non contracted models as described above.
If you had incurred that visit/charges without insurance, the hospital would've ultimately given you the "cash" rate (almost always the Medicare FFS rate), and even then maybe worked the charges down more. Do you have to ask/negotiate this? Probably. Should you have to do this? Probably not. But guess what...the whole concept of "percent of billed charges" was hatched out of the way Medicare originally paid for inpatient care back in the late 70' thru the late 80's. It promoted (and to this day, still does!) the upward creep of charge masters so that the hospital/facilities will get higher reimbursements.
What else has a big influence on that $700 ED bill?
How about uncompensated care in general. I don't have the numbers off the top of my head, but it's big. Very big.
Defensive medicine....yes, it's big. Definitely bigger than 1% of total healthcare costs (Nerd) if it's correctly calculated. And for numbers sake, let's just say it IS 1%. That's only somewhere in the neighborhood of $2-2.5 billion!!! I'd say we need to address tort reform and eliminate at least a chunk of defensive medicine.
Improper utilization of ED's for primary care. Did you look around at the other folks in the ED when you were there? Heck, maybe 1/10th of them actually clinically belonged there. The others could've been in a PCP's office/Urgent Care being treated.
And I've only just begun.....now you guys see why I've avoided getting into these threads on this topic. The issue is unfuckingbelievably complicated, by a zillion moving parts. Is it broken? I don't think I'd call it broken, but it needs some significant tweaking. Gotta get another Diet Mt Dew now, and maybe I'll post what the Russell Plan would look like, if I were the Health Care Czar.....
I definatly feel medical coverage isn't a god given right but to think there's no gouging in the industry is crazy.
Of course, if we eliminate insurance and the buyer is on the hook for the tab...nobody would become a doctor because you wouldn't make enough to pay for med school in a career.
I would use every available means to entice/drive/cajole the populace into Health Savings Accounts. For those that don't know about them, they are are an account where you can contribute, pretax, up to 3000 for single/5950 couple to an account that is used to buy healthcare services. This is then linked to a high deductible, "catastrophic" insurance plan that kicks in when your expenses during one year exceed $2000 single/$4000 family. When these plans are offered through your employer, most of them pay a significant portion (or all) of the premium for the health plan, and some even contribute a portion of the savings allocation. If you're funding it on your own, remember that the contributions are pretax.
THE most important thing HSA's do, is to incentivize the patient to begin asking what the cost is for each thing he buys in the healthcare delivery system. From the doctors visits, to the prescriptions he writes, to which lab he's going to use, which radiology provider he'll get his xrays from.....in essence, he'll actually do what he does for every other thing he spends his money on. The patient/consumer will look for value before spending his money. Imagine that....looking for value in how you spend your healthcare dollars. In the current system, you pretty much completely offload that responsibility to the insurance company.
Along with a newfound focus by the consumer on cost, will be a focus on obtaining satisfaction from the provider with the care rendered. The doctor, who in the present system is "assigned" patients by the insurance companies, will suddenly shift his focus from meeting their criteria, to meeting YOUR criteria! Novel concept. Heck, maybe you won't have to wait an hour and a half to see the doc every time you hit his office. And if you do, nothing will keep you from taking your money/business to the good doc down the street. Accountability.... a concept I can appreciate.
How does this all work otherwise?? Lets say you have a good "health" year and only spend $1000 dollars on your doctors visits and prescriptions. The balance you contributed sits there earning interest (you have the option of investing it as you see fit). Let's say you have a bad "health" year (swizcore?!?). Your cost is only the deductible of 2000/4000. If that happens the first year, then you didn't save much to roll into the next. But if you're a smart consumer, it will begin to grow after a couple of years, and the 'dent' of a bad health year will be less and less. And as your knowledge of how the plan functions increases, you'll become a better health care consumer/shopper. The provider network is also going to become more responsive to the consumer demand for quality/timely/appropriate care delivery.
Ultimately, the biggest problem in our healthcare system is the total disconnect from the consumer and the provider. Third party payment mechanisms have divorced the two, and taken free market forces completely out of play. Get this back into the equation and we'll be on our way to less expensive, more widely available healthcare for everyone.
Now....if this all sounds like a good concept, I want to ask you this question. Why is it that the bill currently sitting before the Senate essentially guts HSA's? I'll tell you why....it's because these guys don't really want to bring consumers and providers back together. That would be an affirmation of capitalism and free market theory. These 'jokers' don't want this at all....their stated desire (at least the democrats) is single payor. And they clearly want you to be dependent on the government for your healthcare. That's a fact.
It's a huge percentage of our GDP. It's always a major voting issue.
That's also one of the nice parts about our system. If we don't like how it's being run, we can always elect somebody else to do it.
And save the socialist name calling bullshit. Your government already spends more per capita for your publicly funded care than we do to run our whole system. Without granting universal coverage. Why is that?
How can we be the socialists when you guys spend more government money per citizen on your public system than we do on our entire universal coverage system? Seems a tad contradictory, no?
anyway, what you are talking about might be what come out of our pocket, but our national health insurance program pay the rest, 70%. $210 in this case.
just to let you know, our national health insurance program isn't working. we have almost zero illegals, but have tons of selfish bureaucrats. but can't imagine being without one.
There are no shortage of contributers on Vital from the socialist health care countries (meaning pretty much every one other than the U.S.) ,and yet, NOT ONE has come on here and said "gee, I wish we had your system here"
Having sampled both your system and the NHS for both minor and major matters, I can say that ours is much more entitled to use the word 'care'.
The biggest downfall of the Canadian system is extended wait times for diagnostic tests like MRI's other than that aspect I much prefer our system.
My son busted his femur in Oklahoma in 2004, end cost to my travel insurance was 40k. I was happy with his care but it certainly was not better/more advanced than he would have received at home. In fact our Otho Doc commented on the fact they repaired the femur in a much more conservative method which increased recovery time significantly.
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