Aa
LP cost
I think the amount billed to my insurance is ridiculous. Can anyone tell me how much the hospital portion of the LP as an outpatient normally is (I will keep in mind prices obviously vary by region, but I thought I was in a lower cost area)? I'm going to call and get an itemized bill, but while waiting I was curious...
These amounts are ludicrous. A physician is certainly worth being highly paid for their expertise, education and training. And let's face it, it's huge responsibility. That being said, I do expect a doctor to 'pay attention' to us when in their care. Many of us have been brushed aside------yet they get paid. I don't know about you, but I don't get paid if I don't do my job.
I do think that some of these rates are ridiculous. One thing that hasn't been covered is the increased cost of malpractice insurance. This costs probably 100k a year. Patients sue all the time; some for legitimate reasons, many are not legitimate. All of the doctors, hospitals and/or clinics have to pay individually. We are a litigious country.
Then doctors often practice 'Defensive Medicine" due to the high rise of malpractice suits. They will order more tests then necessary to keep their malpractice rates lower. Again, because of those who sue.
The family therapist rates are ridiculous. His/Her insurance is nothing compared to the medical community.
Doctors are already 'opting out' of Medicare because reimbursements have actually gone down.
Our health system is a mess.
Why do people say we have the best healthcare in the world, I just don't get it.
Red
I do think that some of these rates are ridiculous. One thing that hasn't been covered is the increased cost of malpractice insurance. This costs probably 100k a year. Patients sue all the time; some for legitimate reasons, many are not legitimate. All of the doctors, hospitals and/or clinics have to pay individually. We are a litigious country.
Then doctors often practice 'Defensive Medicine" due to the high rise of malpractice suits. They will order more tests then necessary to keep their malpractice rates lower. Again, because of those who sue.
The family therapist rates are ridiculous. His/Her insurance is nothing compared to the medical community.
Doctors are already 'opting out' of Medicare because reimbursements have actually gone down.
Our health system is a mess.
Why do people say we have the best healthcare in the world, I just don't get it.
Red
LuLu makes a good point in explaining some of the intricacies of health insurance here in the US:
"One other point that someone made up there - our system is very confusing because of that negotiated payment amount that insurance companies set with the providers."
"Basically, it is a one-sided agreement. The insurance company says XX procedure is going to be worth $$ amount. No matter what is billed for XX, the insurance only pays $$."
I personally find it shocking some of the negotiated rates for doctor's visits and don't know how they can stay in practice. I'm not sure how often these rates are negotiated, but here are some of the doctor visit charges and amounts actually received, including the co-pay:
Neurologist Charge $264 Received $119
ENT $ 95 $ 73
Hematologist $155 $ 80
Internist $155 $125
Family Therapist $100 $ 60
My Internist/PCP must have recently negotiated her rate, because the rate before was much lower. It's sad to see a family therapist getting close to the same amount as medical doctors with advanced degrees and practices that involve significant staffing requirements and equipment.
When I was growing up, we used to think that doctors were rich. When you look at the cost of education on top of the cost of running a business against what they are reimbursed, that is no longer the case.
"One other point that someone made up there - our system is very confusing because of that negotiated payment amount that insurance companies set with the providers."
"Basically, it is a one-sided agreement. The insurance company says XX procedure is going to be worth $$ amount. No matter what is billed for XX, the insurance only pays $$."
I personally find it shocking some of the negotiated rates for doctor's visits and don't know how they can stay in practice. I'm not sure how often these rates are negotiated, but here are some of the doctor visit charges and amounts actually received, including the co-pay:
Neurologist Charge $264 Received $119
ENT $ 95 $ 73
Hematologist $155 $ 80
Internist $155 $125
Family Therapist $100 $ 60
My Internist/PCP must have recently negotiated her rate, because the rate before was much lower. It's sad to see a family therapist getting close to the same amount as medical doctors with advanced degrees and practices that involve significant staffing requirements and equipment.
When I was growing up, we used to think that doctors were rich. When you look at the cost of education on top of the cost of running a business against what they are reimbursed, that is no longer the case.
Lulu,
Your guess was pretty close except the $18,000 was how much less Medicare paid versus the total bill. Out of the $63K I had a copay of about $2000 total for doctors and hospital bills and it took me 3 years to pay that off.
When I was using Medicare for my health care typically for a doctor visit was about $125 and Medicare would pay the doctor $80 and I would end up paying $16 of that.
Unfortunately before the Medicare RX plan came into effect I had to pay full price for all of my medications. As a result I went close to $50,000 in debt in order to get my medications over the first 15 years of being disabled.This was mostly due to having a $1300 per month for medications for several years. Right now through the VA my medicine costs me about $200 per month.
I think the most outrageous thing I found in the way of health care was when I lived in Connecticut. Just prior to my daughter needing a tonsillectomy the state passed a new law that allowed hospitals to charge more for a day surgery if the patient ended up having to spend the night in the hospital that was not based on actual cost but the normal costs for intensive care. My daughter ended up spending the night so there was an extra $8000 on the bill which increased my copay significantly. The only reason they kept my daughter was because she hadn't come out of the Anesthesia enough by 5PM.
Dennis
Your guess was pretty close except the $18,000 was how much less Medicare paid versus the total bill. Out of the $63K I had a copay of about $2000 total for doctors and hospital bills and it took me 3 years to pay that off.
When I was using Medicare for my health care typically for a doctor visit was about $125 and Medicare would pay the doctor $80 and I would end up paying $16 of that.
Unfortunately before the Medicare RX plan came into effect I had to pay full price for all of my medications. As a result I went close to $50,000 in debt in order to get my medications over the first 15 years of being disabled.This was mostly due to having a $1300 per month for medications for several years. Right now through the VA my medicine costs me about $200 per month.
I think the most outrageous thing I found in the way of health care was when I lived in Connecticut. Just prior to my daughter needing a tonsillectomy the state passed a new law that allowed hospitals to charge more for a day surgery if the patient ended up having to spend the night in the hospital that was not based on actual cost but the normal costs for intensive care. My daughter ended up spending the night so there was an extra $8000 on the bill which increased my copay significantly. The only reason they kept my daughter was because she hadn't come out of the Anesthesia enough by 5PM.
Dennis
By now I'm sure all of you with universal health care in the UK, AUS, and elsewhere are giving quiet thanks. The weird thing about this is even though we are kicking around these gigantic dollar figures, the reality is the providers don't get that amount. So that "only 63,000 turns into maybe $18,000" (just a guess!) and then you factor in what part of that is our share to pay.
The patient's share is figured according to the insurance plan you are on. There is almost always a maximum amount a pateint will have to pay out of pocket, if you have reasonable insurance. The biggest problem is when you don't have insurance, or a lousy one. From all of our examples you can see how that can quickly cause financial insolvency if you are not among the fortunate to have good insurance and have a catastropic illness like MS or cancer.
You usually get good insurance by paying quite a bit in premiums. The higher your costs up front for the insurance, the less out of pocket you would usually be paying in the end if you use the medical services.
You can see that it is a crazy environment here when this procedure, done in different settings and different ways can range from $500 to $40,000. Yes, it's nuts!
This makes my head spin. Lu
The patient's share is figured according to the insurance plan you are on. There is almost always a maximum amount a pateint will have to pay out of pocket, if you have reasonable insurance. The biggest problem is when you don't have insurance, or a lousy one. From all of our examples you can see how that can quickly cause financial insolvency if you are not among the fortunate to have good insurance and have a catastropic illness like MS or cancer.
You usually get good insurance by paying quite a bit in premiums. The higher your costs up front for the insurance, the less out of pocket you would usually be paying in the end if you use the medical services.
You can see that it is a crazy environment here when this procedure, done in different settings and different ways can range from $500 to $40,000. Yes, it's nuts!
This makes my head spin. Lu
Hey my part of my recent gallbladder is over $3000 and I am still getting bills. We pay over 10 percent of our income to my medical with out hospitals and ER. Our income has been cut in half since 2001 and I do not qualify for disability. I will not get assistance from the government for twenty years. Ironically I got MS as a child but the documentation, my navy health record has was burned in a house fire. I do not worry what is fair,
Alex
Alex
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