You GOTTA have insurance

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Couch

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Messages
11
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10
Location
New Mexico
# of dives
I just don't log dives
Not Scuba related (but a boat was involved, the one on top of my truck) -- I fell off a truck a couple of months ago and broke my arm just below my shoulder. The break required surgical repair -- it was outpatient surgery, I was in the surgical unit for about five hours from when I walked in the door until I walked out. Fortunately for me, I have both Medicare and Medicare supplementary insurance. Yesterday, I got a copy of the bill...$37,000. That does not include the original ER stop and a later referral stop. Those two together were another $1,500.
 
Got to love our health care system....fortunately , I have a work sponsored Cadillac program....otherwise I would be retired!

Heal quickly.
 
Not Scuba related (but a boat was involved, the one on top of my truck) -- I fell off a truck a couple of months ago and broke my arm just below my shoulder. The break required surgical repair -- it was outpatient surgery, I was in the surgical unit for about five hours from when I walked in the door until I walked out. Fortunately for me, I have both Medicare and Medicare supplementary insurance. Yesterday, I got a copy of the bill...$37,000. That does not include the original ER stop and a later referral stop. Those two together were another $1,500.

And is $37,000 what you actually have to pay?
 
And is $37,000 what you actually have to pay?

No. I can't actually tell you what I have to pay, because it's not obvious at this point -- perhaps I do have to pay something and that will arrive in another bill. But, I got a fat packet of paper from Medicare with the $37,000 billing amount shown. As I understand it, from reading online, there is some kind of negotiation between Medicare and the hospital that might reduce the bill -- but the bill may not be reduced if you don't have insurance because you have no power to negotiate. I guess my overall point is, with Medicare and the supplemental plan, I'm sure I can afford whatever any co-pay may be. But if you're one of those healthy young folks who has decided to go without insurance because it's so expensive (and it is -- I'm getting physical therapy for my arm and the therapist, a young single woman, pays $600 a month for her insurance) then you could be setting yourself up for a financial disaster. YMMV.
 
In 1997 I had a ACL reconstruction in my knee. I know medical care has gone up considerably since then.

The hospital bill for use of there equipment and one night over was 10k, that doesn't include the surgeon the anesthesiologists the PT etc.

Yup I'm glad I have "insurance".
 
If I had some way to limit my medical bills to $100k max I wouldn't bother paying my insurance.
 
I just retired at 70, now with Medicare and a supplement. My wife is in her early 50’s and self-employed and we pay $630 a month for her coverage.
 
I can't afford the $8,100 a year for medical insurance for myself and my wife, it was half that before the affordable care act and was better coverage! I have VA coverage for myself and accident insurance for my wife and myself that pays out a set amount per occurrence, that will at least cover part of the bill and still allow us to negotiate cash pricing! Plus the deductible on my companies insurance is another $8,000 before they cover 100%. Last time I had insurance and my wife went to the ER it was still over $3,000 for a CT scan, an ice pack and 5 minutes with the Doctor. If you don't have insurance it may have actually been cheaper as you get cash rates instead of the non negotiable insurance set rates. For instance my wife needed a blood test that we had done at the hospital without insurance and it was $7.50 total for the test. At the time if she had insurance they would have been forced by law to charge her the $35 deductible that the insurance had at the time, now it would be $75 instead of $7.50! I do have the highest DAN coverage for diving and water sports!
 
Firstly, medical insurance should not be tied to employment. It is nonsensical that if you become too ill to work then you can’t afford to get better.
Secondly, the modern American medical schedule makes no sense to most laypersons, and even to the majority of providers because at its very base, built in the seventies, is the phrase “usual and customary”. Insurance companies have negotiated on a fractional multiple of this for many contracts that are now close to half a century old. Every time the fraction decreases from the insurance company side, the provider increases the fee schedule, and in the end the desired result on both sides is a small increase. This is invisible to patients until they have to pay some proportion of the rate as part of a percentage copay, fixed deductible, or all of it if they have no discount at all. Both are much more recent developments within the last two decades. Undoing this contractual tangle is financially risky to any hospital or provider, and the insurers know it.
Thirdly, there has been a proliferation of wonderful but expensive medical technologies that have a lot of patient demand without a solid understanding of the true long term benefit. Except for individuals that are so financially secure as to functionally be completely self insured, most patients are part of some sort of insurance cost sharing pool, whereby any one high cost patient reduces the funds available to the rest of the pool. The easy solution is to raise rates in the following year, thus driving out some lower risk individuals, and decreasing the pool size while increasing pool risk.
 
Not Scuba related (but a boat was involved, the one on top of my truck) -- I fell off a truck a couple of months ago and broke my arm just below my shoulder. The break required surgical repair -- it was outpatient surgery, I was in the surgical unit for about five hours from when I walked in the door until I walked out. Fortunately for me, I have both Medicare and Medicare supplementary insurance. Yesterday, I got a copy of the bill...$37,000. That does not include the original ER stop and a later referral stop. Those two together were another $1,500.
If that had happened in the U.K. the NHS would have provided the treatment free of charge.
 

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