Page 2 of 3 FirstFirst 123 LastLast
Results 21 to 40 of 50
  1. #21  
    Quote Originally Posted by davidra View Post
    If you want to regurgitate your Fox talking points, please start your own thread that I can ignore. This thread was not about Obama, not about his wife taking a trip, and not about political polls. How do I know that you haven't read the article? Because you would agree with much of it, but you are too lazy to even read it.

    Try for just a tad bit of reason about the topic that was raised. I know it's a struggle, but just give it a try.
    Well doc, I owe you an apology (something you don't know how to do, I might add), because despite the ridiculous length of the article, I did read the article and it was actually quite good. The odd thing, is it said what I have been saying to you for quite some time and yet everytime I brought it up you would launch into your normal comments about me being stupid and uninformed. I really think you don't read my comments.

    When I mentioned to you many, many, many months ago that my primary doctor tried to arrange a thalium stress test for an odd EKG I had, but I questioned it and instead went for a second opinion from a cardiologist, you accused me of basically thinking I knew more than the doctor. Of course, the cardiologist explained that I instead had an extremely strong heart and a thalium stress test was not needed. How much was a thalium stress test? Over $2100 and 3 hours of my time (my primary care doctor was quite surprised a thalium test cost that much, lol). Oh sure, I had to pay $350 for the cardiologist visit, but, it did save me some money in the long run. And yes, it saved ME money because I have an HSA plan that means I'm motivated, yes MOTIVATED, to watch what some doctors are trying to get from me so they can get all kinds of goodies. From your article you wanted me to read:

    “In El Paso, if you took a random doctor and looked at his tax returns eighty-five per cent of his income would come from the usual practice of medicine,” he said. But in McAllen, the administrator thought, that percentage would be a lot less.
    He knew of doctors who owned strip malls, orange groves, apartment complexes—or imaging centers, surgery centers, or another part of the hospital they directed patients to. They had “entrepreneurial spirit,” he said. They were innovative and aggressive in finding ways to increase revenues from patient care. “There’s no lack of work ethic,” he said. But he had often seen financial considerations drive the decisions doctors made for patients—the tests they ordered, the doctors and hospitals they recommended—and it bothered him. Several doctors who were unhappy about the direction medicine had taken in McAllen told me the same thing. “It’s a machine, my friend,” one surgeon explained.


    I could give you other personal examples of where a doctor over charged me or tried to get me to take a more expensive medication, but you probably aren't reading this and if you did read it, you would likely again call me stupid and uninformed and accuse me of hating obama. If you are reading this, I'm glad to see that I'm not the only one who has pointed at doctors as being a big part of the problem, and apparently you are now open to this as being an issue. Now, do I think insurance companies can clean up their act? You bet they can. First, they need to really hold doctors and hospital's feet to the fire on getting deeper discounts for procedures. I'm still mad about my $804 back brace (and that is after the discount, lol). And I will be fighting the $200 the doctor charged me for the back brace "fitting". This $200 charge, which the insurance company rightly didn't pay for, involved a little assistant telling me how to put it on (all of 5 minutes, tops). And yes, while it will barely put a tiny dent in our premiums, insurance companies need to reduce the pay to CEOs. However, let me state, this is something that insurance companies need to do on their own, not have the government mandate it. And while I have not seen this personally in my or my client's claim issues, insurance companies need to stop looking like they are trying to deny claims that should be covered. And by the way, I'm not referring to instances where a person didn't read their policy and a procedure was excluded. I get a kick out of people who call me and tell me they have found a contract that is half the price and yet has better benefits. I can always guarantee you that they missed the part about caps or other restrictions, it is very sad when people don't read what they buy.

    Anyway....these things can be solved without having to go to the extreme of a public option. But glad you are agreeing that doctors and hospitals are to blame as well. Welcome to reality.
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

    "It's good to be the King" - Mel Brooks, History of the World, Part 1

    "I would rather have a German division in front of me than a French one behind me." General George S. Patton
  2.    #22  
    Quote Originally Posted by clemgrad85 View Post
    Well doc, I owe you an apology (something you don't know how to do, I might add), because despite the ridiculous length of the article, I did read the article and it was actually quite good. The odd thing, is it said what I have been saying to you for quite some time and yet everytime I brought it up you would launch into your normal comments about me being stupid and uninformed. I really think you don't read my comments.

    When I mentioned to you many, many, many months ago that my primary doctor tried to arrange a thalium stress test for an odd EKG I had, but I questioned it and instead went for a second opinion from a cardiologist, you accused me of basically thinking I knew more than the doctor. Of course, the cardiologist explained that I instead had an extremely strong heart and a thalium stress test was not needed. How much was a thalium stress test? Over $2100 and 3 hours of my time (my primary care doctor was quite surprised a thalium test cost that much, lol). Oh sure, I had to pay $350 for the cardiologist visit, but, it did save me some money in the long run. And yes, it saved ME money because I have an HSA plan that means I'm motivated, yes MOTIVATED, to watch what some doctors are trying to get from me so they can get all kinds of goodies. From your article you wanted me to read:

    “In El Paso, if you took a random doctor and looked at his tax returns eighty-five per cent of his income would come from the usual practice of medicine,” he said. But in McAllen, the administrator thought, that percentage would be a lot less.
    He knew of doctors who owned strip malls, orange groves, apartment complexes—or imaging centers, surgery centers, or another part of the hospital they directed patients to. They had “entrepreneurial spirit,” he said. They were innovative and aggressive in finding ways to increase revenues from patient care. “There’s no lack of work ethic,” he said. But he had often seen financial considerations drive the decisions doctors made for patients—the tests they ordered, the doctors and hospitals they recommended—and it bothered him. Several doctors who were unhappy about the direction medicine had taken in McAllen told me the same thing. “It’s a machine, my friend,” one surgeon explained.

    I could give you other personal examples of where a doctor over charged me or tried to get me to take a more expensive medication, but you probably aren't reading this and if you did read it, you would likely again call me stupid and uninformed and accuse me of hating obama. If you are reading this, I'm glad to see that I'm not the only one who has pointed at doctors as being a big part of the problem, and apparently you are now open to this as being an issue. Now, do I think insurance companies can clean up their act? You bet they can. First, they need to really hold doctors and hospital's feet to the fire on getting deeper discounts for procedures. I'm still mad about my $804 back brace (and that is after the discount, lol). And I will be fighting the $200 the doctor charged me for the back brace "fitting". This $200 charge, which the insurance company rightly didn't pay for, involved a little assistant telling me how to put it on (all of 5 minutes, tops). And yes, while it will barely put a tiny dent in our premiums, insurance companies need to reduce the pay to CEOs. However, let me state, this is something that insurance companies need to do on their own, not have the government mandate it. And while I have not seen this personally in my or my client's claim issues, insurance companies need to stop looking like they are trying to deny claims that should be covered. And by the way, I'm not referring to instances where a person didn't read their policy and a procedure was excluded. I get a kick out of people who call me and tell me they have found a contract that is half the price and yet has better benefits. I can always guarantee you that they missed the part about caps or other restrictions, it is very sad when people don't read what they buy.

    Anyway....these things can be solved without having to go to the extreme of a public option. But glad you are agreeing that doctors and hospitals are to blame as well. Welcome to reality.
    Clearly you have me confused with someone else. I have never criticized anyone for wanting a second opinion. I have consistenly said that doctors are inadequately trained in cost control. In fact, I have spent the majority of my professional life trying to train doctors to be cost effective. I have been teaching evidence based medicine for almost thirty years, so please don't try and paint me as exactly the opposite of what I am. My guiding philosophy has been that there are excessively used tests, procedures, and that only by significant education and some controls (which, by the way, you seem to be opposed to) can we begin to get a handle on health care costs.

    So given we are in agreement on that fact, now are you willing to agree that there should be controls over what doctors order? And that those controls should be based on what is been shown to be effective? Or are you willing to continue to pay doctors in McAllen, whether through private or public insurance, to continue to practice in the excessive manner they have been? That is what I've been trying to get those protectionists to understand....the Agency for Healthcare Quality and Research is the group that evaluates the cost-effectiveness of health care, but you and your ilk consider their recommendations (mammography, for example) to be "government control of health care"...even though the people on the panels making the recommendations do not work for the government. Try dealing with this problem without injecting politics. If the knee-jerk yahoos would leave politics out of this and rely on science, we would have better, more cost-effective care.
  3. #23  
    davidra, would you say that wasteful testing and such ks mostly to avoid malpractice suits?

    also, aren't you making the case for individuals paying their own costs rather than central payers? If I'm writing checks directly for each treatment, I will be frugal and active in decisions about my health... Wouldn't that drive cost down like it does in other areas where people pay directly?

    I think we should have to pay our taxes that way too. If we all had to write out a check every week to pay tax rather than payroll with holding, we would all feel the cost and care more about what congress spends it on.

    like clinton used to say, we need more 'personal accountability' to prevent ecess - as he reformed welfare...
  4.    #24  
    Quote Originally Posted by sweaner View Post
    That IS NOT the free market! The free market would be that only if the patients were the ones actually paying the bills. That is 1/2 of a free market.

    If people went to a supermarket, and the bill was paid by a 3rd party, don't you think the fish man would load the carts up with lobster? And don't you think the shopper would gladly take it home?
    As was pointed out, at one level it makes no difference who has to pay, if the charges are excessive and result in no improvement. You may have the knowledge base to determine that tilapia is just fine instead of lobster. You may not have the knowledge base to determine whether or not you need an MRI after spraining your knee. You rely on someone else to make that decision. You suggest that the best way to control these costs is by you negotiating directly with the doctor about whether or not you need an MRI? Good luck with that. And underlying your approach is the concept that doctors will compete with each other for your business by lowering their prices? Good luck with that as well.
  5.    #25  
    Quote Originally Posted by Workerb33 View Post
    davidra, would you say that wasteful testing and such ks mostly to avoid malpractice suits?

    also, aren't you making the case for individuals paying their own costs rather than central payers? If I'm writing checks directly for each treatment, I will be frugal and active in decisions about my health... Wouldn't that drive cost down like it does in other areas where people pay directly?

    I think we should have to pay our taxes that way too. If we all had to write out a check every week to pay tax rather than payroll with holding, we would all feel the cost and care more about what congress spends it on.

    like clinton used to say, we need more 'personal accountability' to prevent ecess - as he reformed welfare...
    As was pointed out in the article Texas has the most restrictive tort reform in the country. The McAllen doctors raised defensive medicine as an excuse, then realized that malpractice suits were essentially non-existant. Tort reform is nothing but a talking point. It has never been shown to decrease premiums or to lower costs. As I've said many times before I am not opposed to it; I just am confident it will make no difference. It is lack of education about and attention to efficacy and costs that can lower costs. A friend of mine, many years ago in NC, did a study in which he made residents go down to the financial counselor's office with every patient when they were discharged and go over the patient's bill. The costs per patient went down significantly after residents started doing this. When the program stopped, they started slowly going back up. And as I mentioned in my previous post, if the charges are excessive, it makes no difference who pays.
  6. #26  
    Quote Originally Posted by davidra View Post
    As was pointed out, at one level it makes no difference who has to pay, if the charges are excessive and result in no improvement. You may have the knowledge base to determine that tilapia is just fine instead of lobster. You may not have the knowledge base to determine whether or not you need an MRI after spraining your knee. You rely on someone else to make that decision. You suggest that the best way to control these costs is by you negotiating directly with the doctor about whether or not you need an MRI? Good luck with that. And underlying your approach is the concept that doctors will compete with each other for your business by lowering their prices? Good luck with that as well.
    but if it's my money, I will either get that knowledge, or spend more than I need to - but limited to not spending more than I have available (from my earnings, insurance coverage, etc) but I wouldn't be able to waste YOUR money.

    I'm not against insurance for the poor, so don't chase that red herring. I'm just saying that when we are a participant in paying the bills, we are motivated to learn, engage, and be smart about how money gets spent on our behalf...

    no one cares more about how your money gets spent than you. Same for me. I care more about how my money is spent than anyone else will...
  7. #27  
    if your friend had that review with the patient BEFORE the treatment and the patient were paying them (or a portion) directly, I guaranty it would drive down costs.

    I can see your point that doctors lose touch with costs, but you have to see that patients also lose touch when all they see is a co-pay.
  8.    #28  
    Quote Originally Posted by Workerb33 View Post
    but if it's my money, I will either get that knowledge, or spend more than I need to - but limited to not spending more than I have available (from my earnings, insurance coverage, etc) but I wouldn't be able to waste YOUR money.

    I'm not against insurance for the poor, so don't chase that red herring. I'm just saying that when we are a participant in paying the bills, we are motivated to learn, engage, and be smart about how money gets spent on our behalf...

    no one cares more about how your money gets spent than you. Same for me. I care more about how my money is spent than anyone else will...
    I don't mean to deny anyone the right to educate themselves, but we're talking about an educational level that is beyond the vast majority of the population. Last year, in the same issue of the New England Journal of Medicine, there were two large randomized controlled trials that evaluated the utility of PSA screening. They reached somewhat differing conclusions. The problem was they varied, with regard to things like how long they followed patients, and what the PSA cutoff was for biopsy, etc. Not to debate your ability to learn, but I suspect that not many people would be able to reach a firm conclusion with regard to whether or not they should be screened based on them reading those articles. That leaves you two options: believe what the doctor says, or rely on expert panels of people who do understand the subtleties. The complexities involved in these decisions is significant.

    And feel free to ask any doctor what the quality of the information is that patients bring in from the web, when trying to educate themselves.
  9. #29  
    I would assume that a PSA test isn't that expensive. But if I needed something really expensive, I'm sure going to ask what the probability of success is before I approve the cost. Heck, I do that on car repairs. The point is I am responsible for finding educated advice.

    sy symms says 'an educated consumer is the best customer'. I don't need a medical degree, but I can sure get educated opinions from those that do.

    you can expect a PM from me before I make any medical decisions... (smile).
  10. Targon's Avatar
    Posts
    502 Posts
    Global Posts
    716 Global Posts
    #30  
    The mistake that most people make in this area is that they don't look at the reason for the high costs of health care. Medicare is just an insurance program, and if you look at INSURANCE as the reason for problems, you have missed the source of all of these problems.


    So, look at where costs come from....

    First up, you have med school, which isn't cheap.

    Then you have malpractice insurance, which isn't cheap.

    Then you have the expenses that any office space would have, from employees to utilities, lease prices, and supplies.


    Now, I put it to you that health INSURANCE would not be needed if doctors could provide the service without all the overhead involved here. If you eliminate the cost of med school and malpractice insurance, most would feel that a highly trained and qualified doctor should be getting around $200,000/year as a fair income, but that would mean not needing to pay malpractice insurance or the full price of med school.

    So, my solution to how to make this a viable reality:

    First, if a doctor goes to med school in this country and practices in this country for 30 years, med school will be paid for, and they don't have to pay for it. If a doctor wants to practice in another country or save people in a third world country, then THEY should pay for med school since they are not providing service to the people of the USA. Obviously there is a danger if an accident keeps them from practicing medicine for the first 30 years after med school, but that is the risk that they have to take.

    Next, doctors should be immune to malpractice lawsuits, unless there are clear signs that the doctor is not competent to practice medicine(drinking or under the influence of drugs). Everyone can have a good or bad day on the job, so only gross incompetence should open the doors for a lawsuit. Basically, if a patient dies in an operating room, the doctor shouldn't have to worry about lawsuits. Hospitals should also be free of the threat of lawsuits, again, as long as there is no clear evidence of gross incompetence(mold in the ceiling or walls would obviously be grounds for a lawsuit).


    If you take these two things into account, it would drop the cost of health care by such a huge amount that most people wouldn't need insurance at all, and you would only want insurance for times like the need for an operation. If the hospitals and other health care facilities were also protected, with their expenses kept down, that would also help with the costs.


    Obviously, all of these things would end up costing taxpayer money, but if you could get a checkup for $50 without the need for insurance, wouldn't that be better than mandating that everyone has insurance and still has to pay the $50 for the same checkup? The reduction in regulatory overhead would also save millions upon millions, if not billions of dollars a year from government oversight and such, so could potentially pay for itself if done right. This isn't just political BS trying to claim it will pay for itself, it really would happen since you remove entire layers of government from the situation.


    So, how's that for a way to deal with health care? The issue of providing care to illegal immigrants I leave out since that would just branch the discussion off on a tangent rather than staying on track.
  11.    #31  
    Quote Originally Posted by Targon View Post
    The mistake that most people make in this area is that they don't look at the reason for the high costs of health care. Medicare is just an insurance program, and if you look at INSURANCE as the reason for problems, you have missed the source of all of these problems.


    So, look at where costs come from....

    First up, you have med school, which isn't cheap.

    Then you have malpractice insurance, which isn't cheap.

    Then you have the expenses that any office space would have, from employees to utilities, lease prices, and supplies.


    Now, I put it to you that health INSURANCE would not be needed if doctors could provide the service without all the overhead involved here. If you eliminate the cost of med school and malpractice insurance, most would feel that a highly trained and qualified doctor should be getting around $200,000/year as a fair income, but that would mean not needing to pay malpractice insurance or the full price of med school.

    So, my solution to how to make this a viable reality:

    First, if a doctor goes to med school in this country and practices in this country for 30 years, med school will be paid for, and they don't have to pay for it. If a doctor wants to practice in another country or save people in a third world country, then THEY should pay for med school since they are not providing service to the people of the USA. Obviously there is a danger if an accident keeps them from practicing medicine for the first 30 years after med school, but that is the risk that they have to take.

    Next, doctors should be immune to malpractice lawsuits, unless there are clear signs that the doctor is not competent to practice medicine(drinking or under the influence of drugs). Everyone can have a good or bad day on the job, so only gross incompetence should open the doors for a lawsuit. Basically, if a patient dies in an operating room, the doctor shouldn't have to worry about lawsuits. Hospitals should also be free of the threat of lawsuits, again, as long as there is no clear evidence of gross incompetence(mold in the ceiling or walls would obviously be grounds for a lawsuit).


    If you take these two things into account, it would drop the cost of health care by such a huge amount that most people wouldn't need insurance at all, and you would only want insurance for times like the need for an operation. If the hospitals and other health care facilities were also protected, with their expenses kept down, that would also help with the costs.


    Obviously, all of these things would end up costing taxpayer money, but if you could get a checkup for $50 without the need for insurance, wouldn't that be better than mandating that everyone has insurance and still has to pay the $50 for the same checkup? The reduction in regulatory overhead would also save millions upon millions, if not billions of dollars a year from government oversight and such, so could potentially pay for itself if done right. This isn't just political BS trying to claim it will pay for itself, it really would happen since you remove entire layers of government from the situation.


    So, how's that for a way to deal with health care? The issue of providing care to illegal immigrants I leave out since that would just branch the discussion off on a tangent rather than staying on track.
    Here's the problem. The average med student graduates with about a $100,000 debt. Some have none, some have more. It does not take that long to pay that amount back, although students tend to use the size of their loans to justify some career choices. That is not a major cause of increased health care costs. And as I've already noticed, essentially doing away with malpractice suits in Texas made no difference in costs. There is absolutely no evidence anywhere that relieving malpractice suits will lower costs. In fact, in state institutions, and in most private ones associated with universities, all doctors have sovereign immunity. I cannot be sued for more than $250,000, which is nothing, and the state will provide the legal support. Yet the costs in academic institutions are way out of line with even private practice. No matter how politically appealing it is to the conservatives to blame those nasty trial lawyers, denying malpractice suits will have a minimal effect, if any, on costs.

    Are you suggesting that physicians should be employed? How will you "legislate" that their income should be around $200K per year? Should a primary care doc get paid the same as a neurosurgeon? What about the overhead you mentioned? Billing persons? Lab techs? They all need to be paid.

    Sorry....those suggestions just will not begin to solve the problem, IMHO.
  12.    #32  
    Quote Originally Posted by Workerb33 View Post
    I would assume that a PSA test isn't that expensive. But if I needed something really expensive, I'm sure going to ask what the probability of success is before I approve the cost. Heck, I do that on car repairs. The point is I am responsible for finding educated advice.

    sy symms says 'an educated consumer is the best customer'. I don't need a medical degree, but I can sure get educated opinions from those that do.

    you can expect a PM from me before I make any medical decisions... (smile).

    Ahh, but here's the mistake you make, and in some ways the root of the problem. Yes....a PSA costs around $100. The question is how accurate it it? If it has a high sensitivity, which is necessary for all screening tests, it will be incorrectly positive in a high number of people (as many as 75% of all positive PSA tests are false positive). When you get a positive test, the next test is a transrectal biopsy, guided by ultrasound. With the procedure, pathology and equipment costs, now you're talking about $2-3000. And three-fourths of those people you subject to those procedures did not need them in the first place, because they don't have prostate cancer. And you can't decide whether or not you want the followup procedure after you have a positive result; no doctor is going to want to ignore a positive test. That needs to be decided before the first test is ever done.

    And possibly most disturbing of all, it may be that even if you are diagnosed with prostate cancer, and undergo robotic prostatectomy, it's not for sure that it prolonged your life or made you healthier. Not sure I am explaining this so it is clear, but these days there is no such thing as an inexpensive test, because of the subsequent downstream costs that may occur. Even what appears to be an easy decision is really not.
  13. Maturin's Avatar
    Posts
    165 Posts
    Global Posts
    166 Global Posts
    #33  
    Thanks for the link and the good read, davidra. I'll be sharing it wish a couple people.
    But as much as this article tries to simplify things, it really serves to illustrate that there is no easy, simple fix.

    The best we can do is look at what is working the best, figure out why then adjust to make that the norm. Then when even better examples emerge, have the flexibility to embrace them and make them the new norm.
    HP Touchpad: I just cant quit you, baby.
  14.    #34  
    Quote Originally Posted by Maturin View Post
    Thanks for the link and the good read, davidra. I'll be sharing it wish a couple people.
    But as much as this article tries to simplify things, it really serves to illustrate that there is no easy, simple fix.

    The best we can do is look at what is working the best, figure out why then adjust to make that the norm. Then when even better examples emerge, have the flexibility to embrace them and make them the new norm.
    You are exactly right, but I don't think Gawande tries to simplify things as much as point out the logical first step in controlling health care costs. As he mentions in the article, and as I've been told since I was very young, the most expensive piece of equipment is the doctor's pen. Without some kind of logical cost control, the other stuff will essentially get nowhere. Now it just so happens that from my eyes, the most logical way to deal with controlling costs is through a single payor plan, but that won't work, and will go bankrupt, if we don't control costs.
  15. #35  
    Quote Originally Posted by davidra View Post
    Clearly you have me confused with someone else. I have never criticized anyone for wanting a second opinion. I have consistenly said that doctors are inadequately trained in cost control. In fact, I have spent the majority of my professional life trying to train doctors to be cost effective. I have been teaching evidence based medicine for almost thirty years, so please don't try and paint me as exactly the opposite of what I am. My guiding philosophy has been that there are excessively used tests, procedures, and that only by significant education and some controls (which, by the way, you seem to be opposed to) can we begin to get a handle on health care costs.

    So given we are in agreement on that fact, now are you willing to agree that there should be controls over what doctors order? And that those controls should be based on what is been shown to be effective? Or are you willing to continue to pay doctors in McAllen, whether through private or public insurance, to continue to practice in the excessive manner they have been? That is what I've been trying to get those protectionists to understand....the Agency for Healthcare Quality and Research is the group that evaluates the cost-effectiveness of health care, but you and your ilk consider their recommendations (mammography, for example) to be "government control of health care"...even though the people on the panels making the recommendations do not work for the government. Try dealing with this problem without injecting politics. If the knee-jerk yahoos would leave politics out of this and rely on science, we would have better, more cost-effective care.
    Good doc....it would depend on who is doing the approval of procedures. I think you would quickly say it shouldn't be the insurance company....and you know I don't want the government making such decisions....so who would control what doctors can or can't order? I'm not sure why you think I would be against that, but, gotta be careful on who is making those decisions and who in turn controls that "board".
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

    "It's good to be the King" - Mel Brooks, History of the World, Part 1

    "I would rather have a German division in front of me than a French one behind me." General George S. Patton
  16. #36  
    Quote Originally Posted by Workerb33 View Post
    but if it's my money, I will either get that knowledge, or spend more than I need to - but limited to not spending more than I have available (from my earnings, insurance coverage, etc) but I wouldn't be able to waste YOUR money.

    I'm not against insurance for the poor, so don't chase that red herring. I'm just saying that when we are a participant in paying the bills, we are motivated to learn, engage, and be smart about how money gets spent on our behalf...

    no one cares more about how your money gets spent than you. Same for me. I care more about how my money is spent than anyone else will...
    As one who has an HSA plan, I can assure you I check my EOB's quite carefully. Before my recent surgery, I asked the doctor's office if the anesthesiologist was in my network, and they assured me they were. Well, while in my pre-op, I inquired again and they (the hospital) made a call and well, the anesthesiologist wasn't in the network. So, I got on the phone with them and they said since I had no choice in the matter (that is, choosing an anesthesiologist group in my network) they would work with me on this. Since I knew this would effect my wallet, I had the interest in verifying this. My doctor really has no interest in checking on this. It really isn't that difficult to check on these things prior to getting surprised when your bill arrives.

    Of course, in looking over the hospital bill (about $20,000), I honestly don't know if these charges are high or low. At least in this situation, the network will dictate the reimbursement as they are in the network. But when you are responsible for the first $4000 of expenses (my deductible), I am watching that money even more closely and will ask questions. Wouldn't I do this if I was buying a car or a home? $4000 is a lot of money to me.

    And yes, it is similar for taxes. When you have to cut a check each quarter to Uncle Sam, you definitely have a better "feel" for how much you really pay in taxes.
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

    "It's good to be the King" - Mel Brooks, History of the World, Part 1

    "I would rather have a German division in front of me than a French one behind me." General George S. Patton
  17. #37  
    Quote Originally Posted by davidra View Post
    Now it just so happens that from my eyes, the most logical way to deal with controlling costs is through a single payor plan, but that won't work, and will go bankrupt, if we don't control costs.
    WOW.....who are you? I leave for more than a month and you actually admit a single payor plan would go bankrupt? Look at you getting all logical and realistic. But you did leave out the main reason as for why a single payor plan would likely go bankrupt, and that's the government would be in charge.
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

    "It's good to be the King" - Mel Brooks, History of the World, Part 1

    "I would rather have a German division in front of me than a French one behind me." General George S. Patton
  18. #38  
    hmmm ya wipe out the high cost of say those nasty lawyers,, or this or that or the next thing.. i point to one little comparision. off shoring of your jobs. hmmm one of the big *****es i have read in these forums is unions and how bad they are... well many corps offshored their plants.. where they pay nothing and i do mean nothing.. and yet. the prices remain high.. i would suggest, however humbly, that it matters not what you cut, what you discount, what ever, you have people who want more and more. if they cant charge for a MRI, then they will find a way to charge for something else at equally grossly high rates... hmm does no one here remember 20,000.00 ashtrays, or 4,000.00 hammers.. comon people.. perhaps govt is not as perfect as you would like, perhaps YOU think they can not control costs, perhaps, just perhaps, if it was mandated, forced, by law, omg, more govt intervention, this sort of gouging will end.
    Life is short, Play hard, and enjoy every moment as if it was your last.
  19. Micael's Avatar
    Posts
    736 Posts
    Global Posts
    739 Global Posts
    #39  
    Quote Originally Posted by clemgrad85 View Post
    WOW.....who are you? I leave for more than a month and you actually admit a single payor plan would go bankrupt? Look at you getting all logical and realistic. But you did leave out the main reason as for why a single payor plan would likely go bankrupt, and that's the government would be in charge.
    Would be? They already are, and it's too late. The monkey done pulled out that cork and it ain't going back in....
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  20. #40  
    Quote Originally Posted by Workerb33 View Post
    I would assume that a PSA test isn't that expensive. But if I needed something really expensive, I'm sure going to ask what the probability of success is before I approve the cost. Heck, I do that on car repairs. The point is I am responsible for finding educated advice.
    You'll also ask about other options that may be cheaper and/or get other opinions from other doctors. The bit in the article where it mentions that it "doesn't matter who writes the check" assumes that the entity writing the check is going to pay whatever is sent to them and has the resources to pay whatever bill they're sent. If the Feds & insurance companies keep paying for unnecessary tests, doctors will keep on doing them. My sister did some of her medical training in Ireland and one of the things that she noticed is that other nations spend more time on "patient interview" type instruction compared to the US. Apparently this helps doctors do a better job of trying to come up with an initial diagnosis without having to resort to a bunch of tests that may or may not be needed.
Page 2 of 3 FirstFirst 123 LastLast

Tags for this Thread

Posting Permissions