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  1. groovy's Avatar
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    #281  
    Quote Originally Posted by davidra View Post
    He listened to the insurance industry too much, according to Daschle. Regardless, I just hope that every company that pulls out at this point without even having a clue what their bottom line will look like is immediately dropped from participation in any exchange. And if they all pull out, so much the better as far as I'm concerned. What's important is that everyone is covered. Listening to the insurance industry would not accomplish that in any way. Frankly I think the best outcome is an attempt at a self-supporting public option and let real competition take place, but I really doubt that will happen. The only other option, if companies continue to drop out is a single payor system with the expansion of Medicare. Those companies that stay in the fight would be able to offer higher-level options to those who want to buy them. The others would be excluded. Sounds good to me.
    One might argue that was the plan all along. It just happened too soon so they had to slip in some exemptions. So, let's replay this whole debate from the beginning and every time someone says "it's not a single payor plan" or "if you're happy with your plan you don't have to change" we can call them naive (of course, giving them the benefit of the doubt that they're not just being dishonest).
  2. #282  
    hmmm spoke to a friend of mine yesterday, her husband has cancer, 2nd kick at the cat with it so to speak. They were told by a doctor that a big fancy hospital down in Texas was the best place for this type of cancer, in fact all cancer. So, they hop on a jet and fly down, making all the appointments they needed prior, based on a referal from this doctor. Well, you can imagine, they dont have insurance down where you all are.
    Now for the following they got quoted a price, 3 rounds of chemo, one MRI, and one real quick op to confirm that everything worked. they got told it would be approximately 163,000.00 US. Now comes the part that scared the hell out of me and them, they go for the pre chemo appointment, they were told to bring a cheque, as they had to pay for most of it up front. They went prepared, for a large sum. The sum they were told to expect was about 100 K US, the rest payable upon completion. Well boys an girls, it was 500,000.00 US dollars, by the way, all payable up front. They were told that even people with money tend to leave upon hearing the amount. This couple are fairly well off, 163 k was bad enough, 500 K well that is just highway robbery. Some here wonder why you have the new health care system, and wonder why a lot of the western world has universal health care. To argue that is what the free market willl allow is BS to the extreme. in the name of profit, people are being forced out of homes looseing everything they own, just to stay alive. You wonder why so many people of far less means want obama care. i can think of 500,000.00 reasons in just this one little example. oh by the way, the referal doc was also on the list to be paid, buried way down near the bottom. ps they got the care here in canada, and it cost them nothing other than a few missed heart beats in Texas.
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  3. Micael's Avatar
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    #283  
    They're probably talking about M.D. Anderson Cancer Center, and it's a top shelf cancer research hospital. One of the top 3 on the planet. I can't speak to your friends treatment or costs, but I do know that many of the treatments they offer there are cutting edge and very expensive. There's a tremendous amount of cost around drugs and treatments if they're brand new or experimental. The protocols are very strict and, just in terms of manpower to perform, can be costly. But the prices drop as they are mass produced. I would guess that what they were quoted on was not the 'run of the mill' tests and procedures that should cost much less at a standard treatment center. But I'm just guessing.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  4. groovy's Avatar
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    #284  
    Canada has top shelf cancer centers too but there's a good reason people cross borders and pay large sums to go to MDACC.
  5. #285  
    Perhaps micael, but comon 500 k.. that is pretty steep.. by anyones standard. I can share this, the treatment he got was the same, exactly the same. Even the docs down in Texas claimed the one he got in Toronto was at the same level. He was seen and started treatment within in 2 days of arriving back in canada..
    the one other thing i was told, they charge people without insurance MORE, to off set the cost of the low income people in Texas hmmm sounds about right,, 163 k to 500 k price jump that is pretty out there..
    Last edited by xForsaken; 10/08/2010 at 04:50 PM.
    Life is short, Play hard, and enjoy every moment as if it was your last.
  6. #286  
    Quote Originally Posted by xForsaken View Post
    Perhaps micael, but comon 500 k.. that is pretty steep.. by anyones standard. I can share this, the treatment he got was the same, exactly the same. Even the docs down in Texas claimed the one he got in Toronto was at the same level. He was seen and started treatment within in 2 days of arriving back in canada..
    the one other thing i was told, they charge people without insurance MORE, to off set the cost of the low income people in Texas hmmm sounds about right,, 163 k to 500 k price jump that is pretty out there..
    Something to pass on to your friends, if they want to cross to the States for care look at clinics in the Midwest instead of the South.
  7. #287  
    Quote Originally Posted by xForsaken View Post
    Perhaps micael, but comon 500 k.. that is pretty steep.. by anyones standard. I can share this, the treatment he got was the same, exactly the same. Even the docs down in Texas claimed the one he got in Toronto was at the same level. He was seen and started treatment within in 2 days of arriving back in canada..
    the one other thing i was told, they charge people without insurance MORE, to off set the cost of the low income people in Texas hmmm sounds about right,, 163 k to 500 k price jump that is pretty out there..
    Insurance companies pay negotiated rates to the hospitals and doctors. When you're uninsured, you're charged considerably more than they would ever collect from an insured patient. Then the hospitals write-off the amount that you couldn't afford and talk about how much money they're losing.

    I had cancer treatments last year and was shocked at how little my insurance company actually paid. It amounted to about 10% of what the hospital billed them for. The doctors were paid much higher percentages however.
  8. #288  
    Quote Originally Posted by groovy View Post
    there's a good reason people cross borders and pay large sums to go to MDACC.
    One key reason is that our federal government subsidizes MDACC to the tune of 200 million a year, in addition to 50 million awarded over 2010-2012 from the federal stimulus program.

    MD Anderson keeps No. 1 cancer ranking in US News & World Report annual survey

    Private funding is important, but without federal NIH funding for clinical and basic health research and infrastructure for med centers like MDACC around the country we would not have the advances that make us the technological leader in health care we are. People who whine about the stimulus not doing anything or who go on about how government doesn't work should remember that NIH funded federal tax dollars played a huge part in getting us where we are today in being world leaders in medical technology

    Unfortunately, those who confuse this high level of technology we have in the medical field with our ability to deliver it just don't seem to understand that's like comparing apples and oranges and one does not make up for the other. The best therapy in the world means nothing to someone with dropped health coverage. We need to direct the same focus and innovation on improving health care delivery that we do in promoting health care technology before we can truly say we have the best health care in the world.
    Last edited by cellmatrix; 10/09/2010 at 01:43 PM. Reason: a very helpful clarification from our kind moderator, mr. groovy
  9. groovy's Avatar
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    #289  
    Quote Originally Posted by cellmatrix View Post
    One key reason is that our federal government subsidizes MDAC to the tune of a half billion a year, 50 million of that from the stimulus program.

    MD Anderson keeps No. 1 cancer ranking in US News & World Report annual survey

    Private funding is important, but without federal NIH funding for clinical and basic health research and infrastructure for med centers like MDAC around the country we would not have the advances that make us the technological leader in health care we are. People who whine about the stimulus not doing anything or who go on about how government doesn't work should remember that NIH funded federal tax dollars got us where we are today in being world leaders in medical technology.
    I think you may have misread that article.
  10. #290  
    Quote Originally Posted by groovy View Post
    I think you may have misread that article.
    MDACC's own figures drives home my point quite nicely. Of the 500 million total annual research budget, about 200 million comes from the federal government*. Even without the 2010 stimulus funding, this nevertheless makes the federal government, far and away, the top source of biomedical research funding at MD Anderson, just like it is for leading medical centers across the country.

    So I just find it amusing when people highlight advanced medical centers like MD Anderson, as the triumph of our 'private' health care system, without realizing that these centers' advances are in large part dependent on federal government spending.

    Facts and History - Quick Facts 2010 - MD Anderson Cancer Center

    *corrected figures from post 288, thanks to groovy
  11. #291  
    Quote Originally Posted by zentraed View Post
    Insurance companies pay negotiated rates to the hospitals and doctors. When you're uninsured, you're charged considerably more than they would ever collect from an insured patient. Then the hospitals write-off the amount that you couldn't afford and talk about how much money they're losing.

    I had cancer treatments last year and was shocked at how little my insurance company actually paid. It amounted to about 10% of what the hospital billed them for. The doctors were paid much higher percentages however.
    Exactly right. My back surgery (I know, I know....no where near cancer treatment) was billed at around $20k and the insurance company paid $12k. I too am always amazed at the difference between billed and the negotiated rate for almost all procedures.
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  12. groovy's Avatar
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    #292  
    Quote Originally Posted by cellmatrix View Post
    So I just find it amusing when people highlight advanced medical centers like MD Anderson, as the triumph of our 'private' health care system, without realizing that these centers' advances are in large part dependent on federal government spending.

    Facts and History - Quick Facts 2010 - MD Anderson Cancer Center

    *corrected figures from post 288, thanks to groovy
    Seems to me your point has two sides. Yes, the fed hands out research grants and institutions like MD Anderson win them because they demonstrate that can produce results. The can produce results because they can attract the top clinicians and researchers. They attract top people because they have the reputation and money. They have the reputation because they spent their money wisely. They have money because they bill for services. Maybe it's kind of a chicken and egg thing but you don't get $200 million in grants just because you ask.
    Last edited by groovy; 10/10/2010 at 01:13 AM.
  13.    #293  
    Quote Originally Posted by groovy View Post
    Seems to me your point has two sides. Yes, the fed hands out research grants and institutions like MD Anderson win them because they demonstrate that can produce results. The can produce results because they can attract the top clinicians and researchers. They attract top people because they have the reputation and money. They have the reputation because they spent their money wisely. They have money because they bill for services. Maybe it's kind of a chicken and egg thing but you don't get $200 million in grants just because you ask.

    Really? Do you even know that M.D.Anderson is not a private hospital, but in fact is part of the University of Texas? It is no more private than any university medical center, of which there are many, including many other specialty cancer centers. That means that the faculty who work there are supported in part by the taxpayers of Texas as well as the NIH. Not exactly a great example of the brilliance of private medicine. For that you can look at HCA/Columbia and their former CEO with a history of the largest Medicare fraud in history, who may be elected the next governor of Florida.
  14. groovy's Avatar
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    #294  
    Quote Originally Posted by davidra View Post
    Really? Do you even know that M.D.Anderson is not a private hospital, but in fact is part of the University of Texas? It is no more private than any university medical center, of which there are many, including many other specialty cancer centers. That means that the faculty who work there are supported in part by the taxpayers of Texas as well as the NIH. Not exactly a great example of the brilliance of private medicine. For that you can look at HCA/Columbia and their former CEO with a history of the largest Medicare fraud in history, who may be elected the next governor of Florida.
    emphasis mine.

    That's a mighty big qualifier there, davidra. While true, tell me what covers the vast majority of their total operating costs. And what percentage come from the state of Texas.
  15.    #295  
    Quote Originally Posted by groovy View Post
    emphasis mine.

    That's a mighty big qualifier there, davidra. While true, tell me what covers the vast majority of their total operating costs. And what percentage come from the state of Texas.
    Like most state-funded medical institutions, a relatively small percent comes from the state. According to the web, only 6%. But that's 6% of $2.8 billion ($171 million). At institutions I have worked in, it's about the same, maybe slightly more. The majority of the rest is supported by grants (yes, that nasty old government) and even more by philanthropy (which is also true in most other cancer centers), and by clinical care I(which is the majority). The doctors are all state employees; they work for the State of Texas. Like other nationally known institutions like Mayo, Cleveland Clinic and others, they have expanded into more privately supported satellites. Those are also largely supported by grants with the single exception of Mayo which has a very different business model. But it's not those rare highly rated partially private entitities that are the problem; it's the highly for profit motivated HCA/Columbia type entities that refuse to take Medicaid patients and dump them on the caring hospitals that aren't as concerned about their profit line as they are in taking care of people.
    Last edited by davidra; 10/10/2010 at 02:59 PM.
  16. #296  
    Quote Originally Posted by groovy View Post
    Seems to me your point has two sides. Yes, the fed hands out research grants and institutions like MD Anderson win them because they demonstrate that can produce results. The can produce results because they can attract the top clinicians and researchers. They attract top people because they have the reputation and money. They have the reputation because they spent their money wisely. They have money because they bill for services. Maybe it's kind of a chicken and egg thing but you don't get $200 million in grants just because you ask.
    Fiscal responsibility, hiring good personnel and billing through private health insurance reimbursement is what all med centers do. But research and teaching cost extra, and if centers like MDACC did not get subsidized by government funding, they could not compete financially with non-academic centers who do no research and little teaching, thats a fact.

    So again I would argue that what sets places like MDACC apart, what makes people on this forum brag about them as an example of how good our health care system is, has very little to do with our private health insurance system and quite a lot to do with how they are subsidized by your and my tax dollars.

    Its a prime example of government intervention having a very positive impact on health care here in America.
  17. #297  
    I work at Kaiser Permanente and I already see this ridiculous bill impacting my coworkers and myself. This healthcare reform bill is 100% unconstitutional. The federal government was put in place to ONLY govern interstate law, NEVER to make laws and regulations that would govern the states. our founding fathers would be appalled, disgusted and ashamed that the federal government has as much power as it does. I live in California, where we are constantly fighting the feds and it shouldn't be like this. Each state is supposed to create their own rules, regulations and laws without interference from the the higher powers. WORD.
  18.    #298  
    Quote Originally Posted by blue duck butter View Post
    I work at Kaiser Permanente and I already see this ridiculous bill impacting my coworkers and myself. This healthcare reform bill is 100% unconstitutional. The federal government was put in place to ONLY govern interstate law, NEVER to make laws and regulations that would govern the states. our founding fathers would be appalled, disgusted and ashamed that the federal government has as much power as it does. I live in California, where we are constantly fighting the feds and it shouldn't be like this. Each state is supposed to create their own rules, regulations and laws without interference from the the higher powers. WORD.
    And you work for Kaiser? That must be this Kaiser....

    Kaiser Permanente has a long history of supporting affordable access to high-quality health care. From our earliest days providing health care to workers in the Kaiser shipyards of World War II to our current programs that provide subsidized coverage to those in economic distress, care-and-coverage-for-all has been central to our mission.
    Assuming the reconciliation bill passes the Senate and the President signs the health care reform legislation into law, reform will make history and improve lives in some important ways. Thirty-two million Americans, who today find themselves outside the system, will finally have needed access to vital preventive services and chronic disease management. Medicare will reward high-quality health care for the first time in its history, as a first important step in fixing a health care system that has long rewarded the provision of more care instead of better care. Guaranteeing health care coverage and connecting financial incentives to high-quality care are watershed changes in the U.S. health care system that will substantially improve the lives of Americans.
    This legislation also would establish a number of important principles that, over time and with continued refinement, should improve the functioning of the health insurance market and health care delivery system. These include the belief that health coverage should be universal, an obligation to obtain coverage creates a corresponding obligation to make coverage available; health plans should compete based on quality, service and efficiency, not the avoidance of risk; consumers should have a broad choice of plans through exchanges and the data to make informed choices; and care delivery systems should be paid in a manner that rewards improved performance on quality and efficiency.
    Or this Kaiser statement:

    The Passage of Health Care Reform

    The new health care reform law has the potential to improve lives in some important ways. Thirty-two million Americans, who today find themselves outside the system, will finally have access to vital preventive services and care for their chronic conditions. Medicare will reward high-quality health care for the first time in its history. This is a first important step in fixing a health care system that has long rewarded the provision of more care instead of better care. Guaranteeing health care coverage and connecting financial incentives to high-quality care are watershed changes in the U.S. health care system that will substantially improve the lives of Americans.
    Kaiser Permanente Comments on House Passage of the Health Care & Education Affordability Reconciliation Act and the Patient Protection and Affordable Care Act | Kaiser Permanente News Center


    Kaiser Permanente Health Care Reform

    Sounds like you may want to find somewhere else to work. Kaiser has been very supportive of health care reform. Good luck with your search.
  19. #299  
    Lets face it, YOUR health, the health of your family and friends should NOT be subject to the (greed) free market. Yes they should be able to make some money.
    I would compare your health system this way; you are hanging by your fingernails from a cliff, you will die if you are not handed a rope. I am standing there with the rope, and for a LARGE price, will give it to you.
    That folks is health care in America.
    Life is short, Play hard, and enjoy every moment as if it was your last.
  20. Micael's Avatar
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    #300  
    Quote Originally Posted by blue duck butter View Post
    I work at Kaiser Permanente and I already see this ridiculous bill impacting my coworkers and myself. This healthcare reform bill is 100% unconstitutional. The federal government was put in place to ONLY govern interstate law, NEVER to make laws and regulations that would govern the states. our founding fathers would be appalled, disgusted and ashamed that the federal government has as much power as it does. I live in California, where we are constantly fighting the feds and it shouldn't be like this. Each state is supposed to create their own rules, regulations and laws without interference from the the higher powers. WORD.
    Well said!
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.

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