I have an issue with doctors offices not believing me when i tell them that my insurance will not be covering anything. This got me in a tight spot when I needed blood work done and I asked how much it was going to cost me before I would consent to the test. The doctors office told me that the insurance would cover it even though I repeatedly told them it would not. Then they told me that they checked with the insurance company and had confirmation that it was covered.

So naive me believed them and when through with the test without ever getting the cost estimate I asked for. I assumed when a doctors office tells you that they checked on something it would be the truth. About 6 months later i get a bill for $400 for the blood work. I called the doctors office and the insurance company. Turns out the doctors office never checked with the insurance company but were very surprised it was not covered. I still got stuck with the bill (which i fortunately was able to pay for with savings) and now I check with the insurance company myself first and demand a cost estimate before any medical visit or procedure. Live and learn.

I have heard from others with less insurance that they can often negotiate down, sometimes to the insurance company’s rate. I have also heard of people getting “divorces” to protect the family assets. One parent becomes poor and the other keeps the house, investments etc. so they can get treatment. The hospital (at least ours) doesn’t refuse treatment thankfully. My rule of thumb: try not to get sick…

Consumer choice is not a necessary feature of truly free capitalism – it may optionally be present, if no one supplier has yet managed to crush all its competitors.

Likewise, preferential rates for certain large purchasers are absolutely a feature of free market capitalism – every vendor is free to negotiate rates with every purchaser. Of course, the big vendors only negotiate with the ones that are big enough to have clout (insurance companies), and those big purchasers can then roll their reduced purchase rates in with other services (the insurance itself) and resell them, making the services seem more attractive.

The features you describe as being mandatory – consumer choice, a pricing scheme that extends bulk purchase rates to all purchasers – are exactly antithetical to a free market system. They’re possible only in a heavily-regulated market – a market full of antitrust laws, price controls, and a raft of other regulations, and a heavy bureaucracy to enforce them.

3. Patient pays $1000 deductable.
4. Patient yells at doctor at follow-up visit about how HE (not the hospital) gouged him and must fly to work every morning in his personal helicopter.

I agree with the poster who asked for a free-market solution to this mess. There is no such thing as free healthcare. You can pay for it at the front desk at the time of service or through higher taxes (since nobody will cut spending on unnecessary wars) or through the invisible tax of inflation. If the government inserts themselves into the process, you’ll also have to foot the bill for their bureaucracy. If we actually individually paid for our healthcare (just like we pay for our car repairs, dental work, legal fees, food, etc.) then all the incentives would align. People with lifestyle-induced diseases (a HUGE portion of or expenses) would have more of a direct incentive to take care of themselves. The prices would come down because hospitals and doctors would need to publish their fees and we’d eliminate the massive waste of money that pays for all the billers, coders, insurance companies and so on. If healthcare becomes “free” get ready for infinite demand.

Just to be clear, we should still have health insurance but it should be for catastrophic illness. Just like your car insurance covers hitting a pole but not the oil change.

The one “good” (?!?) consequence, I suppose, would be that rural areas would get more doctors. After all, why stay in a competitive city environment when you can go someplace more remote and charge anything you want?

If this same procedure was done in a hospital the bill would have been 7-15,000 and my portion would have been at least $500.

I am amazed how much “discount” the insurance companies get for the services.

Just to be clear, we should still have health insurance but it should be for catastrophic illness. Just like your car insurance covers hitting a pole but not the oil change.

Insurance would cover replacement of the engine if it seized up due to lack of oil changes. Besides, health insurance and auto insurance is an awful comparison. You can total out a car. How do you total out a life?

I’m not saying making the government write a big blank check to the medical providers is the right way to go, but I don’t think what we have now is really the best system in the world either.

Gotta love those Death Panels!

Chinny Racoon: just think, your health care could be as good as your now-privatized rail service.

Grant Hamilton: “Meaningful tort reform”? You fell for that one too? “Tort reform” is code for “making a bunch of changes in the legal system that will relieve large corporations of liability for the demonstrable harm they do to individuals.”

If you want proof, look into all the circulating stories about ridiculous jury awards in personal injury lawsuits. It’s not just that the stories are false or falsified (though it’s been repeatedly demonstrated that they are); it’s that they’re professionally written and circulated. The “personal injury lawsuits are a ripoff” meme has been a fully funded professional astroturf campaign for decades now.

I can’t believe you didn’t know that.

even the originator of the concept of capitalism was for regulated capitalism to keep a fair level playing field.

markets do not regulate themselves despite the myth of free markets being self correcting. many people in the US are duped into believing in a form of capitalism promoted by large corporations seeking less regulations so they can dominate a marketplace and remove all competition.

Trust me, I’m living in this system now.

Just to be clear, we should still have health insurance but it should be for catastrophic illness. Just like your car insurance covers hitting a pole but not the oil change.

That’s a bad analogy. Catastrophic-only coverage would still leave a huge range of highly expensive medical services uncovered. There are far too many people today without coverage who can’t afford the $100+ it costs to go to their GP. Then there are imaging services like CT scans that can easily cost thousands. The result is that they simply don’t go to the doctor.

Without coverage for primary diagnostic services, GP visits, etc., I’m afraid the rate of people using catastrophic-only insurance would skyrocket, as conditions that could have been detected with a simple GP visit and a scan go undiagnosed and untreated until they become…well…catastrophic.

You really could make an entire website just for American healthcare nightmare stories like this.

Nightmare stories…? Sound too much like fantasy. I think HORROR is more appropriate considering all the true-life pain, anguish and actual deaths involved.

Anyway… here you go…

http://www.michaelmoore.com/words/mikes-letter/send-me-your-health-care-horror-stories-an-appeal-from-michael-moore

Congressman Grayson: Stories Of Those Who Died Because They Didn’t Have Health Insurance pt.1

http://www.youtube.com/watch?v=8hcwtM8fD9A

(Risky = Medicare can say “we want the discount you gave those people, since it is less than what we paid you. Therefore you owe us 3 times the difference going back X years. Oh, and stop practicing medicine until we figure this out. And you might want to get a criminal lawyer because the supplemental insurance that covered these patients has decided that’s insurance fraud, in addition to the civil liability that we have assigned. Oh, and since you are being investigated for fraud, the medical board has temporarily suspend your license until we get this all worked out.”
)

It’s crazy. The irony is that Medicare does a pretty good job of administering healthcare. They have 1% overhead vs.the 15-30% overhead of a private insurance company. You rarely hear of Medicare not paying for a treatment, just private insurers.

More on this here:

http://www.wpta.org/reimbursement/WPTA%20Cash%20Discounts%20Article.pdf

If you have a problem that can be taken care of in an office, you are better going to a place that doesn’t take insurance and bargain. I’m a doctor. I’ve done it. Most of my patients in that practice were working class and uninsured. I met the market price and they are happy and come back.

It’s clear that this is somewhat possible, as certain rich celebrities have hired doctors directly to administer their medical “needs”. If there was a structure to manage “doctors for short hire” for such situations, it would throw the established hospital regime on its ear for all situations not specifically requiring hospital stays.

My experience is that CMS is a very, very sharp organization, and Medicare is very well run indeed. Compared to the private payers that I’ve dealt with (professionally and personally), I’d happily buy into a federalized health care scheme run with the same degree of effectiveness that CMS and its partners bring to the table.

But here’s a copy of her bill: $0.

The NHS in Britain is one of the pinnacles of civilization.

If he was Canadian, he would have been made to wait until the dentures “left naturally”. Trust me, I’m living in this system now.

Total BS. I’m living in canada right now as well and have never had to wait for any of my medical care. I’ve walked into the ER several times and had immediate free treatment. Even though i am a US citizen. It is the best health care i have ever received. Having extensive experience in both systems, I can unquestionably state that the Canadian system is far superior. The world health organization agrees as well which is why Canada ranks 6th and the US 29th.

Either you are a republican/conservative from the US trying to dupe people, or the experiences you have had are more a testament to services in your local area, not Canada as a whole.

If you want proof, look into all the circulating stories about ridiculous jury awards in personal injury lawsuits.

My favorite is the infamous myth that someone out there got fabulously rich by spilling McDonald’s coffee on her lap and experiencing mild discomfort as a result. There are so many things wrong with the way that story is usually told that it’s hard to know where to start.

Is it Pepsi Blue I smell?

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