You GOTTA have insurance

[Dennisrl84]

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.

Did they know you didn't have insurance? Alot of times they will reduce the cost if you do not.

I had a septoplasty about 10 yrs ago. They told me it was $700 (my portion). I was in around 8AM and home by noon. They billed the insurance $49K to include additional items they told me they would only need to do in the event of a problem during surgery despite telling me it went very smooth with no hiccups.

The insurance company only paid like $35K or so. So I get a bill from the surgical center for a few hundred, the anesthesiologist for about $2k and the Surgeon for about $95. I sent them all a letter asking for an itemized bill (which they are required to provide upon request by law). I continued to get send reminders but never an itemized bill. I sent them the same letter and a new letter with the date updated every time. Finally I got a letter saying it was going to collections. I once again sent them the same request with a copy of all the others requests certified mail with a signature required.

Finally the Anesthiologist's office called and explained the unexpected charge. They were friendly and apologetic. Finally the billing specialist asked to put me on hold. She came back and said "I spoke to whoever (I don't recall). They are willing to drop the bill to $75 if you can take care of it over the phone... YES, $2k to $75!!! Because they were so polite and I really didn't want to fight collections I paid them.

The other 2 just disappeared. I never got contacted my any collection agencies and they have never appeared on my credit report. Now it is long past their statue of limitations to request payment. Just proof that they will try and get you to write them a check just to see if you will.

 

[Jcp2]

Did they know you didn't have insurance? Alot of times they will reduce the cost if you do not.

I had a septoplasty about 10 yrs ago. They told me it was $700 (my portion). I was in around 8AM and home by noon. They billed the insurance $49K to include additional items they told me they would only need to do in the event of a problem during surgery despite telling me it went very smooth with no hiccups.

The insurance company only paid like $35K or so. So I get a bill from the surgical center for a few hundred, the anesthesiologist for about $2k and the Surgeon for about $95. I sent them all a letter asking for an itemized bill (which they are required to provide upon request by law). I continued to get send reminders but never an itemized bill. I sent them the same letter and a new letter with the date updated every time. Finally I got a letter saying it was going to collections. I once again sent them the same request with a copy of all the others requests certified mail with a signature required.

Finally the Anesthiologist's office called and explained the unexpected charge. They were friendly and apologetic. Finally the billing specialist asked to put me on hold. She came back and said "I spoke to whoever (I don't recall). They are willing to drop the bill to $75 if you can take care of it over the phone... YES, $2k to $75!!! Because they were so polite and I really didn't want to fight collections I paid them.

The other 2 just disappeared. I never got contacted my any collection agencies and they have never appeared on my credit report. Now it is long past their statue of limitations to request payment. Just proof that they will try and get you to write them a check just to see if you will.

That was 10 years ago when sending patients to collections was an empty threat because everybody “knew” that it was bad for a business reputation. That’s no longer the case.

 

[dmaziuk]

That was 10 years ago when sending patients to collections was an empty threat because everybody “knew” that it was bad for a business reputation. That’s no longer the case.

Yeah, having your work done in Costa Rica by Cuban doctors is good for a business reputation. I bet them businesses thank $DEITY for the pandemic and border closures every day and twice on Sundays.

 

[Dennisrl84]

That was 10 years ago when sending patients to collections was an empty threat because everybody “knew” that it was bad for a business reputation. That’s no longer the case.

I know plenty of Doctors and have oral surgeons, Dentists, GPs and even plastic surgeons as friends. None of them are shy about getting paid.I got a good friend who has even taken in lawnmowers and tools as payment.

They didn't send it to collections because they were fishing for cash and weren't providing itemized receipts because they were just trying to catch up on the loss from what they thought they would get from the insurance and what they did actually get.

What I found funniest is that the actual Surgeon was paid less then the place that simply provided the bed. Like significantly less.

 

[Lorenzoid]

The UK managed to bring in a social health care system, directly after having fought a world war.
Despite the fact that the country was almost bankrupt.
Having fought a world war, needing to rebuild its cities after the destruction caused by the bombing. Find housing and work for the men who returned home. And having to pay the USA for the equipment that had been supplied by the USA to fight the war. (The final payment was made in 2006!)

Despite all that, the NHS came into being on the 5th July 1948.

I don't think the USA has anything like the challenges or economic pressure that the UK was under in 1948.

Just an observation.

The US has long contemplated the idea of "social healthcare," and I believe the US is on a slow but inexorable journey toward that end. FDR was apparently in favor of it, but was persuaded not to pursue it. After WWII the US expanded the Veterans Health Administration, which provides social (i.e., taxpayer-funded) healthcare to veterans. At that juncture, the US could just as well have decided to provide the same program to all Americans, but as you point out, the American economy was in good shape. I guess the thinking was that we especially owed a debt to veterans. And for the rest of America, doctors were affordable, and employers had started providing health insurance during the war as a benefit when wages were controlled. Over the decades, the VA health system has continued to be expanded and tweaked. I don't know about today, but it used to have a poor reputation for outcomes. Some believe it's greatly improved today. I really haven't looked into it. My dad, a WWII veteran (flew B-24 missions out of England), died in a VA hospital, and the biases that left me with 30 years ago are still strong. Anyway, I believe if the same sort of program were available to all Americans, the public pressure to improve it would be greater.

In the US, veterans are entitled to social healthcare through the VA. Retirees have their healthcare costs insured through Medicare, and the very poor through Medicaid. I believe it's only a matter of time before social healthcare in some form reaches the remainder of America. The challenge, as I see it, is how to minimize the bumps on our path there. My employer-provided insurance works well for me, and I'm selfishly in no hurry to give it up. However, I'm willing to tolerate a gradual shift because it beats what I believe is the only other viable alternative, radical change.

 

[boulderjohn]

FDR was apparently in favor of it, but was persuaded not to pursue it.

After watching the PBS 12-part series on the Roosevelts, I came to the conclusion that America would be a very different country if FDR was not forced to avoid pushing certain policies because of political realities. The chief political reality was that we really had three political parties back then--the Republican Party, the northern Democratic Party, and the southern Democratic Party (sometimes called "Dixiecrats"). The southern Democratic party was by then more closely aligned with the Republican Party in philosophy, but they still voted for Democratic candidates because of the association of Republicans with the Civil War and the freeing of the slaves. Roosevelt needed to have the southern Democrats on his side in order to win national elections, so he could not openly push policies that would antagonize them.

The northern Democrats and especially FDR's wife Eleanor wanted a whole slew of measures that FDR favored but knew he could not support for that reason. He promoted what he thought he could get away with and still stay in office, figuring (probably correctly) that if he went too far, he would lose the next election and get nothing at all. Perhaps the best example is federal anti-lynching legislation, which Eleanor fervidly wanted, but which FDR knew he could not support without losing the south. (One southern senator actually said on the senate floor that lynching was necessary to keep the black population in line.) One night Eleanor called to urge him to support another such matter, but she was told he was too sick to take the call. She insisted, and she harangued him for an hour to support a position he simply could not take. When the call ended, his blood pressure was through the roof, and he died the next morning.

With FDR gone, the desire to satisfy southern Democrats ended, and the Democratic Party adopted a civil rights platform in the 1948 convention, leading the Dixiecrats to walk out. Within two decades, the southern Democrats became Republicans, and those two parties merged their ideologies.

 

[Midwesterndvr]

One of the major problems is cost. Reduce the number of insured,Or at least the level of coverage,private/public. Give transparency in billing with tort reforms (in some states). This would put providers in a position to provide care in line with the individuals ability to pay, just like any other service.

 

[Storker]

One of the major problems is cost. Reduce the number of insured,Or at least the level of coverage,private/public. Give transparency in billing with tort reforms (in some states). This would put providers in a position to provide care firefighting, policing, water services and sewage services in line with the individuals ability to pay, just like any other service.

FTFY.

 

[Midwesterndvr]

FTFY.

The difference is those are community services, YOUR healthcare is your responsibility, not a community service.

 

[TuckerIdaho]

The difference is those are community services, YOUR healthcare is your responsibility, not a community service.

The thing is overall community health does have an impact on the cost. What impact do you think fat unhealthy people have on the overall premium of insurance?