Upgrade to enjoy this feature!
Vital MX fantasy is free to play, but Premium users receive great benefits. Premium benefits include:
- View and download rider stats
- Pick trends
- Create a private league
- And more!
Only $10 for all 2026 SX, MX, and SMX series.
"Blue Cross and Blue Shield of Texas, the state's largest insurer, has asked for rate hikes of nearly 60 percent for next year in three popular HMO plans, filings with federal regulators show."
http://www.houstonchronicle.com/news/houston-texas/texas/article/Blue-C…
Georgie is completely right though. The majority of the patients we see are on Medicaid and could either have to pay out of pocket to simply fix themselves by going to Walgreens, or they could go to the ER for free and waste thousands of tax payer dollars. These patients have no incentive to take care of themselves because they have free access to a doctor 24/7. They usually either come in for silly stuff or they have chronic conditions that they don't take care of.
The shitty part is that patients who have private insurance are less likely to seek medical attention when they need it because they're scared of their huge bill even though they are the ones paying for all the Medicaid waste. Ouch
I alway joke that we should take down the ER sign and just call it the Medicaid clinic because that's all we do. I work on Tuesday. I will try to remember to keep a tally of how many patients I see that are on Medicaid compared to how many people with private insurance.
American health care underserves and is over priced.
Rx prices are the highest in the developed world. Again, the fox is hanging out with the guard dogs in Washington.
The entire discussion on affordable care was misguided. It should have been about health care costs, not who pays.
That said why the fuk is America the only developed country without health care? Because the leaches selling it want to make every damm cent they can no matter what and buy their way into having their way.
Ban lobbying. Period. No corporate donations to politicians. Boo fuking hoo for them.
Opinions from someone with 4 doctors in family.
You can be as efficient as you want. My hospital is doing "cost repositioning" that's what they call so the nurses won't organize a union and go on strike.
The hospitals are desperately cutting costs, even refusing to do certain tests that CMS has deemed not to pay for. They won't pay for a bladder infection. So that means, no more urine cultures because we know that creamy shit is infected why put it on paper so CMS can say nope! Was your fault they got infected in your hospital. Not that their comorbidities actually can't prevent infection because some are so sick.
If people would take accountability for themselves the system would fix itself. These people refuse to help themselves. The people that do it right, like go to urgent care instead of an Ed if their doctor can't see them reduce overall costs. BUT THERE ARENT MANY OF US.
Watch the videos on obesity in America. If you get sick. Septic sick and you're normal weight, you still have a hard time recovering. If you're obese. Morbidly obese. Good luck because sepsis will be your least worry. After that's fixed it will be a plethora of problems.
Unnecessary surgeries don't help either. Like gastric bypass. What a great way to sentence someone to years and years of admissions for gastric obstructions. Which leads to sepsis. Leads to confusion. Leads to bed sores. Leads to tracheostomies....all because of an unnecessary surgery.
I should write a book about all the shit that goes on. Not from an evil hospital stand point, but from the victimized, unaccountable patient.
And it pisses me off when you got a good person trying to do it right that avoids the hospital until they got stage 4 cancer and it's too late. But you got shitheads in the ED every day for a runny nose and rash because--hey it's free!!
It comes down to the leaches Ruin it for everyone. They suck the industry dry so the industry has to charge more for services. Can't fix that until you fix the people. Get them off fraudulentlent assistance. Please!!!!!!! Or make them do something. SOMETHING.
The Shop
Free shipping: VITALMX
Luxon 4-Post Bar Mounts
$189.95 - $239.95
DeCal Works Huge Plastic Inventory of UFO and Polisport kits.
I've been living and working in the Philippines for the last 5 years. On Easter this year I had a pretty bad get-off coming up short on a double. Beat me up pretty bad.
Went to the emergency room of one of the finest hospitals in metro Manila (compares to ANY hospital I've seen in the US). Because of the fact I hurt literally everywhere I was X-ray'd from head to toe, probably 40+ images. X-rays revealed a broken arm (Ulna) about 3" down from the elbow and a broken wrist (scaphoid). Everything else was just contusions, hematomas, bruising etc.
To get a better look at the broken bones I was given a CT scan and then was admitted to a private room in the hospital that was like a really nice hotel room with a couch and table for visitors and of course the hospital bed.
Spent 4 days and three nights in the hospital. Had reconstructive surgery including two pins, two screws and some wire to fix the Ulna. Cast for the wrist. All necessary meds, IV's, anesthesia for the surgery etc.
Total cost = 261,000 PESOS.....thats about $5300 USD before insurance coverage.
How much ya think this little adventure would have cost me back home in Ohio?
Are you digging into their financial information because you alter your level of care based on their ability to pay or their levels of insurance? Are you determining how they came about having that insurance?
I find your level of involvement in your patients' financial affairs a bit strange.
I don't care what the doctor orders for anyone. I follow orders, I dont decide what their plan of care will be. The only thing I have a problem with is when someone has had 40 cat scans in a year because it is a waste of time and resources, and greatly increases the patients risk of cancer. They get scanned every time they come in to the ER because the doctor has to rule out conditions that threaten their life.
They are supposed to follow up with a primary doctor but so many of them don't because it is easier to just come to us when they run out of pain medication.
That's a load of shit. We provide the same care to everyone. We can't refuse it. The patient can. But we cannot refuse to treat patients. We could care less if they have insurance or not. We still get paid. But every year we know our benefits and raises will be moderately adjusted to off set the costs of Mr. 40-cat-scans-in-one-year. Who didn't pay for any of it.
Can you see why we get pissed off ? The healthcare worker gets screwed twice. We provide care for free. Then we get our wages and benefits cut because the hospital is crying about their doctors, nurses and environmental service people not making money for the hospital. So the freeloaders getting us coming in. And the suits in hospital systems get us going out. The suits "cost-reposition" (A clever PC term used that really means "take it from the docs and nurses" but that's ok it sounds nice and nobody thinks twice about it) and the Suits...CEO, chief nursing officer, chief finance officer etc wtc still get their huge raises and bonuses by repositioning costs to the largest employer demographics (doctors and nurses) But at the bedside, We are the worlds largest bitch that can't compete when the government intervenes with all the bogus regulation. The nurse and staff physicians pay the most because they're the majority of the employees in the hospital. So you take some from the doctors and nurses you're saving millions upon millions a year. This profession sucks. Takes a special person to continue to do it, we actually do care about people but can you blame us for getting disgruntled ?!
Easiest way to explain what bedside Nurses and staff doctors are:
They are the "middle class" in hospitals. As in America the middle class pays for everything. We pay for the CEOs bonuses and we pay for the FREE care through cost repositioning, decreased staffing and other things to name a few.
Maybe what's worse is hospitals eliminating positions that aren't bedside. They can't figure out how to stay out of the red. So they're forced to fire people. How in the hell has the ACA helped us as a country ?! It didn't create jobs. It eliminated them. It didn't get cheaper. It got insanely expensive. Still people aren't insured. But now everyone gets to pay more taxes to the government if they're not insured. It's all a ploy to get us dependent on the government. And when single payer goes full bore into effect and Uncle Sam tells me I'm only worth $15 an hour. Just like the burger flippers, I'm done. I'm out. Done. As will most of the other qualified and experienced healthcare workers.
You think it's bad now ? You wait. The healthcare employees aren't the demons, the citizen cheating the system are the demons. The untold demon. The unreported on demon. Yet the media will try to crucify Prince's doctor for prescribing. Well prince consumed. He's a prime example of the PROBLEM as it relates to patients
Niloz: in Ohio they might not of scanned you in a ct. Radiation isn't the best for you. But who knows. Room and board probably would of been around $4000. The surgery $6,000. The scans $1200. X rays: $200x40 $8000. Meds: who knows. Anesthesia bill: 1500-3000ish?These are rough guesstimates. Why are hospital rooms made to look like 5 star hotel rooms ? To attract people that can pay. But those that don't pay still get the same rooms.....
Did you have your own nurse anesthetist or was there one doctor floating between 7 cases in the philipeans ? I'm not sure but what do you think is safer? That's rhetorical. It's hard to compare different countries, impossible really. How many philipeans die from reduced access to care in their country ? The poor philipeaneans....etc. probably ten fold over the poor that die here related to access of care. I'm just speculating though. I bet more die of heroin here than all those combined in philipeans that actually get to a hospital. And the heroin abusers have stand alone ERs all over the United States to hit. Aha, look where that brings us...back to accountability of the most devastating factor in the American human existence! The citizens self destruct themselves and ruin it for those that are truly sick and get dealt a bad hand.
Nurses and doctors do way more than Just bedside care. They're very involved with MANY MANY MANY aspects of care that go unnoticed. Without us, the patient would notice REAL fast. And so would the bottom line in hospitals.
However, anytime something happens the nurse or doc is blamed. like Ebola. If you think for one second hospitals were ready for Ebola the you're stupid. If you think the nurses had the right equipment. You're naive. If you think they were trained properly--yea right.
My point is the first people to care are at the bedside. Yet they're the first ones to get burned by the media, executives....and the public. Like the nurse that got Ebola caring for a patient. Oh it's her fault! That rotten nurse. She didn't care she just went in there and blatantly did everything in her power to not provide care safely. Not the case. It's all the Unknown bullshit that put us at risk. And we keep dealing with it. Adding more responsibility year after year after year. There's a bubble blowing up. It's gonna pop. But....when it does let's Blame the nurse and staff doctor ! Not the terrible liberal policies that caused it. They cut corners in the name of reimbursement! Burn those healthcare bedside workers!!!!
If I woke up 19 years old again I think I'd get into a trade. Wouldn't even deal with college or healthcare knowing now what I didn't know then. Most Everything that is taught to kids in high school and college is a blatant lie. I had one great professor who had a NOBAMA sticker on his podium. I hated him because of it. But the guy was right. And his conservative teaching was scoffed at. But now it makes sense to me. But when I was 20 I thought he was a stingy bastard with a cold heart.
I have talked with a few doctors and hear them saying similar things to what you are saying.
These are things I think would make a better system. I am curious what you think because what your saying makes sense to me.
Regulation: Limit, get a hold of out of control class action lawsuits against Hospitals and Physicians. Allow Insurance Companies to sell in any state and compete more easily. Allow Insurance to sell catastrophic policies with high deductibles and allow unlimited tax deductible HSA accounts to cover the deductibles and medical bills out of pocket.
I don't know all the regulation on Insurance Companies but my guess is that the large Companies lobby for regulation that they can absorb easily and that prevents smaller start up Companies from entering the market and competing. The free market is very flexible and innovative and provides great service when its not regulated and manipulated to death by Govt.
Do away with laws that require any Company regardless of size to have to provide insurance to employees. This would put more money in peoples pocket and allow them to shop for there own insurance that fits there needs, and allow them to take that policy wherever they want. This would put people in the position to have make choices and understand there insurance and force the Insurance market to be more competitive. This would be a huge cost and burden off the backs of Business. It would be an instant boost to the economy and Jobs.
I also don't know all the regulation of Doctors, Nurses, Hospitals, etc. but I hear what you are saying, and from what I understand there are a lot of politics in Medicine with the AMA, Unions, etc. that don't help costs or to provide better healthcare.
As far as people that cant afford Insurance or costs for care. There are many ways that could be worked out. But right now there are lots of people that think they should not have to pay for their own medical care. The most important thing in life if you want to be around for awhile is to take care of your health. But many people will make a 400 dollar a month car payment, pay for tattoos, concert tickets, dirt bikes, whatever. But then they have a fit when once every few years they have to pay a few thousand dollars for health services for what is supposed to be the most important thing.
If most people had something more like a catastrophic policy with a high deductible like 5, 10, even 20K . And a HSA account. And then paid out of pocket for all but the big surgeries, etc. People would be a lot smarter where and how they spend there money and it would put leverage on Doctors, Hospitals, and Insurance Companies to compete and provide better and more affordable service. This would also open people eyes to being more responsible for there own health.
The problem is you can't force people to take care of themselves. And you can't force them to be accountable and you can't force them to believe it's not a god given right for healthcare. But you can force everyone to pay a penalty tax.
I am considering opening a private practice one day with a buddy whose a doctor. You pay us up front January 1st say $3,000!" Cash. And you can come in and see us anytime for one year. We will assess, diagnose and prescribe medication. Lab work would be flat fee of $50 per visit. This would just be an outpatient family practice office. That gives them access to a doctor constantly but still doesn't cover them if they need to be admitted as an inpatient.
But the more government regulates I think having a personal doctor with a cash deal for services is where primary care will be going for those outside of Medicaid and Medicare. I'm not sure though. I don't even know if $3,000 is reasonable. Or would I need 5,000 to break even? 200 accounts at $3,000 is 500,000. But then I'd need employees. And provide healthcare and....oh boy. Atleast we got incentive to start a small business in America these days....maybe not lol. I've got a lot to learn. Haven't even scratched the surface of this problem....the people need fix this, not the government.
Pit Row
So you're thinking of taking a lump sum of cash from prospective patients at the beginning of the year?.....maybe you could refer to it as a sort of "premium payment"......and for receiving that you would promise them....or maybe give them assurance....or lets just say you would "insure" them that they would get health care at a less expensive cost than if they didn't pay you at the beginning of the year. That sounds great! You ought to do that before anyone else thinks about it and the government steps in and requires you be bonded, licensed and regulated.
But, you go there you have to include motocross racers also.
Guys don't have to ride, just as a fat woman doesn't need a rack of Bon bons.
No, greedy higher ups, greedy medicine manufacturers, greedy lawyers getting astronomical judgements which in turn cause astronomical greedy insurance rates, greedy medical schools and professors that restrict the numbers of those wanting to become doctors in the first place.
Slash all that, by law or deregulation.
That's a start.
I see my fiancé get called into the OR at all hours of the night to remove needles from heroin addicts arms. Who won't pay. That come back with another needle and infection two weeks later. That's he type of crap we see regularly.
If we can waste resources figuring out regulation for what won't be paid for....then why can't we figure out who actually could be able to work ?
I drive through the hood daily on my way home from work. Lots of people standing on the corner. Lots of people sitting outside in the project development. Are some of them available for work ? Could they be ? The IRS will knock your door down over taxes but there's no rules against work evasion...or atleast it's more lacks laqs lackadaisicall (sp) but again I might be seeing that wrong. Not being a smart ass either. Just voicing opinion.
The whole country is screwed. Not one person or idea can fix it. So I don't know doc. I'm sure you call it how you see it. But in your area what are you seeing ?
We can't trust these patients with any amount of pain medications because they will over dose if we give them too many pills, so we have to give them one days worth of pain medications and instruct them to follow up. They never follow up and come back as soon as they run out of medications.
It is a completely broken system and no politician is going to be able to fix it because they are too out of touch to realize what needs to be done.
My wife works on the business side of the medical field, and to be honest her job shouldn't even need to exist but with all the levels of admin now it's a necessity. And the numbers that she talks about would be obscene even if you removed a couple of zeros from the end.
Why would you need to see a doctor nearly daily for years and how and why should that be affordable? In what other business do you somehow just have the right to receive services for free? The body can do amazing things. It doesn't need an old man in a white coat to keep it alive.
If you opened a restaurant and you had to give people food regardless of their ability to pay then what do you think would happen to the cost of your food for the people that had to pay the bill?
Sometimes, they would stay, so we had to admit to the ER. They next would order food. I cant make this shit up. Avg fee just step in ambulance , about $1500, if they stayed to be checked in, another $1500, not including anything else.About $3k per person,$6k total. Remember, those numbers are the bare minimum. If they wanted narcotics, they mention the two magic words, chest pain. Did I mention they do this several times a week? EMTLA law says no matter what, you have to see them. Where did common sense go? Sorry for the ramble.
I have surgical icu experience, Float to medical and nuero as well. And pick up in pacu extra to pay for my wedding. Ha.
In every aspect of the hospital there is major fuckery going on. There are patients stuck in the icu because insurance won't pay for them to go to a long term acute care facility (LTAC) unless they're on a ventilator for 24 hours. They won't pay for them to stay in the icu either. So too sick to leave to a lower level of care, but not sick enough to go to a facikity designed to care for chronicly sick individuals. These patients beg us to keep them on the vent for 24 hours so the insurance will pay for them to go a LTAC. And it comes down to caregivers hands being tied. It's so hard to even provide great care to these people with all the leashes they put on us. I wish it were different. I don't know how to fix it, but I know it's broken.
I work for a major hospital system. We get patients from all over the world. From these other countries people rave and praise that their socialized medicine is absolutely awesome. So then why are Saudis, flying to America to get care ? Why are swedes telling me at the bedside socialized medicine is terrble....the quality isn't there so they have to fly to America...a city in Ohio of all places and be worked up for aggressive bowel treatments/ transplant procedures/ necessary procedures To have a shot at living a quality life.
IF ITS SO GREAT, Why don't these people stay there and use their socialized system that they're provided ?
If they're super sick or have the ability to become super sick you're not fixing the addiction, so to prevent withdrawal give them what they need. After they're more stable try to get them consulted with psych and into a rehab type of treatment. Withdrawal on top of sepsis or something systemic is a recipe for death. So another example of trying any means necessary to save people.
People that get into healthcare do so with good intentions and just get bogged down. But we still muscle through and hope and have faith in humanity. That's what keeps me going. If I can help one decent person for 80 that abuse it, I'm ok with it. But at some point the bubble will pop and there won't be any of us left.
Post a reply to: Health Insurance