HOW do they justify these costs?

[mrsilv04]

Originally Posted By: SecondMonkey

Originally Posted By: mrsilv04
Is it possible that may have cost $2500, because it was done at 8pm on New Year's Eve, because some guy was in a hurry and demanded that it needed to be done right then....?

Not even slightly. Hospitals are open 24/7/365, and this isn't the first new years I've spent there. I demanded nothing, my highly devoted doctor did this as a favor for me because he knows I'm miserable. I cannot say enough about how great a doctor he is. Most of the other specialists I've been to lately are uncaring jerks.

PS - my dad recently had to go to the ER at the same hospital and have a cat scan as well, same $2500 fee, and that was under emergency circumstances. (plus a few extra million in other fees)

Last year I had to have an ultrasound on my "boys", and that was only like $600.

And, for 2500 bucks, couldn't they AT LEAST put a velcro strap on the back of that freakin' sheet they make you wear? Is there a reason my butt needs to hang out?

Would have you waited three months, to have gotten it for half that price?

There's a little bit of denial here, when you state that you "demanded nothing". You wanted it to be done in 2009, and that's when you got it.

Now, you have the nerve to complain about the price....when you aren't even writing the check for $2500 to cover the cost.

If your wife had been pregnant and had been in a car wreck and they wanted to check on your unborn child, would have ANY of the cost even entered your mind at that point?

How much does an MRI machine cost? What is its lifespan? What is its yearly maintenance? How much did the training cost for the person who ran it that night?

Why don't you do the right thing and call the hospital billing department, and ask them for a cash price for the services that they rendered to you that night, and write them out a check yourself. Then, you're not the problem anymore... but become part of the SOLUTION.

You're not looking at the big picture, sir. You're focusing on one thing (the cost).... and you're not even paying for that either.

 

[SecondMonkey]

Originally Posted By: ToyotaNSaturn
Since insurance companies pay just about anything that is charged if "covered", then the sky is the limit.

I'm starting to wonder why the insurance companies don't try to go after the doctors/hospitals themselves. They're getting raped.

 

[SecondMonkey]

Originally Posted By: mrsilv04
Would have you waited three months, to have gotten it for $1500?

No, because that is not, and never was an option.

It cost the same wether I wait 1 day or 10 years. You are WAY off base here. The cost of the service had NOTHING to do with the time it was rendered.

Originally Posted By: mrsilv04
Why don't you do the right thing and call the hospital billing department, and ask them for a cash price for the services that they rendered to you that night, and write them out a check yourself. Then, you're not the problem anymore... but become part of the SOLUTION.

Ahem, I have been paying health insurance premiums my entire life, and this is why. I DO NOT owe anybody any money for any reason WHAT SO EVER! That has NOTHING to do with "the problem".

The "right thing" would have been for the insurance company to pay for it whether it was Dec. 31st or January 5th.

 

[mrsilv04]

Originally Posted By: SecondMonkey
Originally Posted By: mrsilv04
Would have you waited three months, to have gotten it for $1500?

No, because that is not, and never was an option.

It cost the same wether I wait 1 day or 10 years. You are WAY off base here. The cost of the service had NOTHING to do with the time it was rendered.


Sorry, I'm not the one who is way off base.

You could have found another hospital in another area or state that would have done it cheaper. There are also private clinics that have their own MRI machines that would likely negotiate their pricing structure.

I'm waiting for you to call the hospital billing department for a cash price for the services that were rendered that evening.

Just wait until you have to wait weeks for one. The problem is, it may be a lot sooner than you think.

 

[SecondMonkey]

Originally Posted By: mrsilv04
Sorry, I'm not the one who is way off base.

I guess you're entirely off the planet then. You have no idea what you're talking about, and I'm sure nobody here agrees with you. You're going to be waiting a while, because I'm not paying the hospital a cent! (nor do I owe them one!) I didn't even want the scan for, the doctor insisted.

The cash price is likely higher than the insurance price, which makes the entire thing all the more ridiculous.

Originally Posted By: mrsilv04
You could have found another hospital in another area or state that would have done it cheaper. There are also private clinics that have their own MRI machines that would likely negotiate their pricing structure.

Not likely. I didn't go to the fanciest place in town and let's face it, no matter where you shop the cost of a new flatscreen TV is within $100 of eachother. Additionally my insurance only covers certain facilities. Furthermore it was a cat scan, not an MRI, so that shows how much attention you've been paying.

 

[CivicFan]

Originally Posted By: SecondMonkey
The cash price is likely higher than the insurance price, which makes the entire thing all the more ridiculous.


That is one of the saddest realities of the health care in the US. The ones who can least afford it are charged the most.

 

[mrsilv04]

The cash price is likely higher than the insurance price, which makes the entire thing all the more ridiculous.[/quote]

Would you care to explain to us exactly HOW a cash price would end up being higher than what a hospital would bill an insurance company for?

 

[SecondMonkey]

Originally Posted By: mrsilv04
would you care to explain to us exactly HOW a cash price would end up being higher than what a hospital would bill an insurance company for?

You've obviously never done this before. Insurance companies negotiate bulk deals with health care providers, as an individual, you get charged more. This is extremely common knowledge.

 

[Virtuoso]

Because insurance companies have huge bargaining power..much like the buying power of Wal-Mart, so to speak. Cash customers don't.

 

[Gary Allan]

Quote:
Being in this business first-hand, I can assure you that it would lower costs substantially year #1. When malpractice insurance runs well into to 6-figures, even into 7 figures, that's a TON for any doctor to absorb in the yearly budget.


I disagree. If malpractice insurance was really constructed to assign the penalty where the liability was, then rates would be lower for good doctors.

TORT would just mean that more damage could be done due to incompetence without redress. That's it.


The cost would not go down. Riskier procedures without risk.

The ONLY cost reductions to come from the medical community have been in the form of reduced services. That is, lower value for lower costs. Never has there been ONE instance of true cost reduction or reduced share of the GDP.

When medicare put limits on payments, what occurred? More routine procedures. Cost per medicare patient (on average) increased. Raise the bridge ..lower the river. Every step of the way the Insurance:Legal:Medical cartels have won. We've lost and are somehow supposed to be grateful for having our health held hostage for money and blame anyone and everyone except the people rigging the bill and putting their thumb on the scale.

Nope. Not buying it at all.

 

[ToyotaNSaturn]

Originally Posted By: CivicFan
Originally Posted By: SecondMonkey
The cash price is likely higher than the insurance price, which makes the entire thing all the more ridiculous.


That is one of the saddest realities of the health care in the US. The ones who can least afford it are charged the most.


Actually it's the other way around. Hospitals & health care places do work with people to pay and often give discounts for cash up front. I had this experience last year, a friend, who owes a TON due to health issues--is given discounts to pay early via cash, a very famous talk radio guy was given 30% discount if he paid cash. He wasn't given a discount because of his name, it's because he plopped down the $10K or so for the procedure. I wasn't given a cash-option discount because I was special, it was because it's policy. Likewise for my friend.

While ins co's do make bulk deals, health care places like the form of $$ that all other businesses do...payment up front. And they're willing to give the person an instant coupon to do so.

 

[Virtuoso]

Not all hospitals operate this way. Bergan Mercy in Omaha was not willing to cut me a deal when my daugther needed chest X-Rays.

 

[ToyotaNSaturn]

Gary, you don't have to "buy" it, it's free! And really, if you crunched the numbers that we deal with, you'd see it the same way I do. Try absorbing nearly 7 figures worth of insurance (and the ever-encroaching red tape) into a small business, which is what most doctors are--you'll find that the consumer gets those expenses passed on to them one way or another. Cut expenses, cut the price to the consumer. It's quite simple. it's just good business sense.

Your concern is justified up to the point of using the legal system as a hammock. Some doctors do that, overwhelmingly most don't. The exceptions aren't the rule here...

 

[SecondMonkey]

Originally Posted By: ToyotaNSaturn
While ins co's do make bulk deals, health care places like the form of $$ that all other businesses do...payment up front. And they're willing to give the person an instant coupon to do so.

Sometimes. There are many, many, many cases of people without insurance who have to pay more for the same procedure entirely themselves. Most people would be on a payment plan for anything major. So yeah, if you're freakin' rich, then you might get a deal. But then you should have good insurance anyway. Another problem.

 

[ToyotaNSaturn]

Originally Posted By: Virtuoso
Not all hospitals operate this way. Bergan Mercy in Omaha was not willing to cut me a deal when my daugther needed chest X-Rays.


That sucks. Can you choose another hospital if you ever need service again?

 

[CivicFan]

duplicate post

 

[CivicFan]

Originally Posted By: CivicFan
Actually it's the other way around. Hospitals & health care places do work with people to pay and often give discounts for cash up front. I had this experience last year, a friend, who owes a TON due to health issues--is given discounts to pay early via cash, a very famous talk radio guy was given 30% discount if he paid cash. He wasn't given a discount because of his name, it's because he plopped down the $10K or so for the procedure. I wasn't given a cash-option discount because I was special, it was because it's policy. Likewise for my friend.

While ins co's do make bulk deals, health care places like the form of $$ that all other businesses do...payment up front. And they're willing to give the person an instant coupon to do so.

A typical discount for cash payment is 5%. The insurance companies, depending on their size, can get up to 45% discount.

One or two outlier examples like yours or your friend's are not the norm. If someone with little bargaining power can get 30% discount, the big boys will demand even more discount when it's time to renegotiate the contracts. Which, in turn, will result in higher gross charges when the prices are raised.

That said, the collection rate for self insured persons is low because most of them have no means to pay the bills and deplete their financial means or go bankrupt before the bill is collected.

 

[CivicFan]

Originally Posted By: SecondMonkey
I happen to have a lot of health issues. I saw one of my specialists on Dec. 29 and he ordered a cat scan of my belly.

Problem: insurance deductible of $2600 starts Jan. 1. Already paid up until Dec. 31. First I have to say I have the best doctor EVER, I let him know this issue, and he personally did everything he could to get me in before the end of the year. Nobody gets an appointment in 2 days. On new year's eve the dcotor himself called me at 8:00PM to tell me they were waiting at the hospital for me. This guy makes six figures many times over, he should have been drinking champaign on a beach somewhere on new years.

Anyway, insurance paid for it, mostly...but I got the total charge today: $2500 for a simple cat scan! How can they possibly justify that? If it had been a day later I would have had to pay every penny.

For those that haven't had your cat scanned recently, let me explain: They brought me to the back and gave me the latest in hospital fashon to wear. Then I laid down in the machine, it moved me back and fourth a few times, and then I left. Total time maybe 15 minutes. Most of it is computer controlled.

Ok, I understand cat scan machines are expensive, but they've got people lined up shooting through this machine 24/7. Also I understand doctors need expensive malpractice insurance these days, but what could I possibly sue for during a cat scan? There was nothing sharp involved. No drugs.

I just don't get it. I know radiologists spend a lot of time in school and should get paid well. I can spend about a half hour talking to my specialist for about $200. WHY does it cost more than TEN TIMES that to LAY ON A TABLE for a few minutes in the same building?! Who's butt are they pulling this number out of? I can rent a Ferrari and professional race driver for 15 minutes for less than that...


Here is how they justify it:

1. it's a free market and you can charge whatever you want. The equilibrium price is the price that they currently charge.

2. The prices are high because the prices are not the real prices. The gross charge has nothing to do with the actual money they get. The actual money the provider gets is 35 to 40% lower than what they charge.

3. The amount of discount depends on the bargaining power of the payer which really is not the concern of the provider.

4. The insurance companies try to pass on as much as they can to the patient to discourage frivolous tests such as CAT scans, etc.

 

[KrisZ]

Originally Posted By: CivicFan
Originally Posted By: SecondMonkey
The cash price is likely higher than the insurance price, which makes the entire thing all the more ridiculous.


That is one of the saddest realities of the health care in the US. The ones who can least afford it are charged the most.


Reading stories like this one and having talked to my cousins that live in US, your health care system is totally and utterly FUBAR'ed, and I just don't understand people defending the system. It favors the rich and big corporations while denying the basics for human survival, by artificially inflating the prices, for the poor.

Countries like Canada, Australia and others have a nationalized health care system and while not perfect, it is 100 times better than the one in US. This is not the case of supply and demand. Health is not a car, or a house, you don't choose to get sick, or to be born with a terminal desease, so why defend a system that denyies the basics for our survival to people that can't afford the bills?

Shop around for a better CAT scan price, and some consider this normal? I guess the corporate culture is really engraved in some people’s minds, and they are willing to sacrifice anything in the name of profit.

 

[Gary Allan]

Quote:
Try absorbing nearly 7 figures worth of insurance (and the ever-encroaching red tape) into a small business, which is what most doctors are--you'll find that the consumer gets those expenses passed on to them one way or another. Cut expenses, cut the price to the consumer. It's quite simple. it's just good business sense.


I assure you that the elimination of all malpractice would result in NO REDUCTION in medical costs. There has never been ONE RETREAT in compensation for doctors. There has merely been increased numbers of patients that they need to service to attain that level of compensation. The entire process has been constructed to "bring" the money to the doctor. The more we attempt to reduce the costs, the more the system constructs mechanisms to fight it.

They win.