Those nice "job creators" who sell insurance

  1. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: Those nice

    Majority of patients know exactly what they pay...$10 ov copay, $250 deductible. I always know what I have to pay for all services I've ever had done. My hernia surgery...paid my deductible. That was hard.

     
  2. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: Those nice

    "P.P.O.’s negotiate their discount off the hospital’s chargemaster price."

     

    So we agree insurance companies provide a discount off of the hospital chargemaster.

    So how is it that through BCBS, the company was paying $10K per visit for dialysis patients (which is obviously a discounted rate off the chargemaster) YET when the company went self-insured the hospital gave an even bigger discount (additional 90%) off their chargemaster for this company?! Right...of course they did. What a load of bull.

    There are hospitals that do give a discount to those who self pay...but the discount typically not as deep as what insurance companies get. And it certainly isn't ever going to be 90% lower.

     

     

     
  3. This post has been removed.

     
  4. You have chosen to ignore posts from miscricket. Show miscricket's posts

    Re: Those nice

    I am all for transparency of costs. When someone goes to the doctor or the hospital they should know exactly what things cost.

    Case in point..my nephew and his wife have a very high deductable. This results in them getting billed for and paying for a lot of things out of pocket.

    Last year, when their daughter was bitten by a dog, they took her to the Umass Medical Center in Worcester . A couple of weeks later, they got the bill for service. UMMC had billed them $240.00 for antibiotic ointment...$240 for a tube of bacitracin that costs around $5 in a pharmacy. When my nephew's wife called she was told this was the standard charge when they bill insurance. They would not adjust the charge until my nephew's wife threatened to contact the Globe.

    I think when people have better information..it makes them better consumers.

    "It is not down in any map...trueplaces never are...." ( Melville)

     
  5. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: Those nice

    In response to miscricket's comment:

    I am all for transparency of costs. When someone goes to the doctor or the hospital they should know exactly what things cost.

    Case in point..my nephew and his wife have a very high deductable. This results in them getting billed for and paying for a lot of things out of pocket.

    Last year, when their daughter was bitten by a dog, they took her to the Umass Medical Center in Worcester . A couple of weeks later, they got the bill for service. UMMC had billed them $240.00 for antibiotic ointment...$240 for a tube of bacitracin that costs around $5 in a pharmacy. When my nephew's wife called she was told this was the standard charge when they bill insurance. They would not adjust the charge until my nephew's wife threatened to contact the Globe.

    I think when people have better information..it makes them better consumers.

    "It is not down in any map...trueplaces never are...." ( Melville)



    All the hospital did was put bacitracin on? Guess they know next time to stay home and open the bathroom cabinet for a tube that costs $5.00

     
  6. You have chosen to ignore posts from miscricket. Show miscricket's posts

    Re: Those nice

    In response to FortySixAndTwo's comment:

     

    In response to miscricket's comment:

     

     

     

    I am all for transparency of costs. When someone goes to the doctor or the hospital they should know exactly what things cost.

    Case in point..my nephew and his wife have a very high deductable. This results in them getting billed for and paying for a lot of things out of pocket.

    Last year, when their daughter was bitten by a dog, they took her to the Umass Medical Center in Worcester . A couple of weeks later, they got the bill for service. UMMC had billed them $240.00 for antibiotic ointment...$240 for a tube of bacitracin that costs around $5 in a pharmacy. When my nephew's wife called she was told this was the standard charge when they bill insurance. They would not adjust the charge until my nephew's wife threatened to contact the Globe.

    I think when people have better information..it makes them better consumers.

    "It is not down in any map...trueplaces never are...." ( Melville)

     

     



    All the hospital did was put bacitracin on? Guess they know next time to stay home and open the bathroom cabinet for a tube that costs $5.00

     

     

     




    That's all they did. They were told to go to the hospital by the police because of the situation with the dog.

     

    The point is..the charge for the ointment was over the top and this is why transparency is important. If as the hospital employee hinted..it was their practice to charge that amount of money for a $5 tube of ointment...then who knows what else they are overcharging for. I mean..the goal is to control costs..right? This was an out of control cost.

    By the way...that charge was in addition to an ER charge of $300  and a Dr. charge of $500...so...$1000.00 for a dog bite that only required cleaning.

     
  7. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: Those nice

    In response to miscricket's comment:

     

    In response to FortySixAndTwo's comment:

     

    In response to miscricket's comment:

     

     

     

    I am all for transparency of costs. When someone goes to the doctor or the hospital they should know exactly what things cost.

    Case in point..my nephew and his wife have a very high deductable. This results in them getting billed for and paying for a lot of things out of pocket.

    Last year, when their daughter was bitten by a dog, they took her to the Umass Medical Center in Worcester . A couple of weeks later, they got the bill for service. UMMC had billed them $240.00 for antibiotic ointment...$240 for a tube of bacitracin that costs around $5 in a pharmacy. When my nephew's wife called she was told this was the standard charge when they bill insurance. They would not adjust the charge until my nephew's wife threatened to contact the Globe.

    I think when people have better information..it makes them better consumers.

    "It is not down in any map...trueplaces never are...." ( Melville)

     

     



    All the hospital did was put bacitracin on? Guess they know next time to stay home and open the bathroom cabinet for a tube that costs $5.00

     

     

     




    That's all they did. They were told to go to the hospital by the police because of the situation with the dog.

     

    The point is..the charge for the ointment was over the top and this is why transparency is important. If as the hospital employee hinted..it was their practice to charge that amount of money for a $5 tube of ointment...then who knows what else they are overcharging for. I mean..the goal is to control costs..right? This was an out of control cost.

    By the way...that charge was in addition to an ER charge of $300  and a Dr. charge of $500...so...$1000.00 for a dog bite that only required cleaning.

     



    Do you know which hospital? I might be able to get their charge master.

    Ah never mind...re-read your post. 

     

     
  8. You have chosen to ignore posts from BilltheKat. Show BilltheKat's posts

    Re: Those nice

    In response to FortySixAndTwo's comment:

     

    In response to miscricket's comment:

     

     

     

    In response to FortySixAndTwo's comment:

     

    In response to miscricket's comment:

     

     

     

    I am all for transparency of costs. When someone goes to the doctor or the hospital they should know exactly what things cost.

    Case in point..my nephew and his wife have a very high deductable. This results in them getting billed for and paying for a lot of things out of pocket.

    Last year, when their daughter was bitten by a dog, they took her to the Umass Medical Center in Worcester . A couple of weeks later, they got the bill for service. UMMC had billed them $240.00 for antibiotic ointment...$240 for a tube of bacitracin that costs around $5 in a pharmacy. When my nephew's wife called she was told this was the standard charge when they bill insurance. They would not adjust the charge until my nephew's wife threatened to contact the Globe.

    I think when people have better information..it makes them better consumers.

    "It is not down in any map...trueplaces never are...." ( Melville)

     

     



    All the hospital did was put bacitracin on? Guess they know next time to stay home and open the bathroom cabinet for a tube that costs $5.00

     

     

     




    That's all they did. They were told to go to the hospital by the police because of the situation with the dog.

     

    The point is..the charge for the ointment was over the top and this is why transparency is important. If as the hospital employee hinted..it was their practice to charge that amount of money for a $5 tube of ointment...then who knows what else they are overcharging for. I mean..the goal is to control costs..right? This was an out of control cost.

    By the way...that charge was in addition to an ER charge of $300  and a Dr. charge of $500...so...$1000.00 for a dog bite that only required cleaning.

     

     



    Do you know which hospital? I might be able to get their charge master.

     

     

     

     



    "Last year, when their daughter was bitten by a dog, they took her to the Umass Medical Center in Worcester ."

     

    My guess is the Umass Medical Center in Worcester

     
  9. You have chosen to ignore posts from Hansoribrother. Show Hansoribrother's posts

    Re: Those nice

    In response to WhatDoYouWantNow's comment:

    In response to chiefhowie's comment:

    [QUOTE]

     

    the Gov an't gonna fix it?

     



    Not without single-payer.

     

    The government could try price controls but those have worked out for the better pretty close to ...oh...zero times ever. And insurers would invariably find some way around them.

     

     

     

    Insurers shop for providers to put on their plans. The people paying insurers don't pay attention or try to have any real input in what the insurers are paying providers. And the person actually using the care pays whatever the plan tells them to.

    It's a system dripping with waste, dysfunction, and corruption.

    The health care market is one of the very few times a free market system fails.

    [/QUOTE]

    The health care system is nothing even close to a free market and hasn't been for decades. That is just a blatantly ignorant statement.

    The government owns the VA system. It owns a large protion of the health care insurance market through Medicare and Medicaid. It regualtes to death the rest of the insurance market. It tells hospitals how to bill for their services and much, much more.

     

     
  10. This post has been removed.

     
  11. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: Those nice

    In response to WhatDoYouWantNow's comment:

    In response to chiefhowie's comment:

    [QUOTE]

     

    the Gov an't gonna fix it?

     



    Not without single-payer.

     

    The government could try price controls but those have worked out for the better pretty close to ...oh...zero times ever. And insurers would invariably find some way around them.

     

     

     

    Insurers shop for providers to put on their plans. The people paying insurers don't pay attention or try to have any real input in what the insurers are paying providers. And the person actually using the care pays whatever the plan tells them to.

    It's a system dripping with waste, dysfunction, and corruption.

    The health care market is one of the very few times a free market system fails.

    [/QUOTE]

    Single payer doesn't fix it either, at least not without rationing.

    the optimal thing government could do for health care insurance is get out of the way.

     
  12. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: Those nice

    In response to A_Concerned_Citizen's comment:

    In response to Hansoribrother's comment:

     

    [QUOTE]

     

    It tells hospitals how to bill for their services and much, much more.

     

     

     




     

    Care to elaborate on how the big, bad, boogeyman under every neo-con's bed "tells hospitals how to bill for their services"?

    Maybe show some concrete evidence of such a crazy conspiracy notion.

     

    [/QUOTE]

    You don't seem to know much about this Obamacare you are so fond of.  

    Here's dso me info on how it is changing how hospitals bill for their services.

    http://www.modernhealthcare.com/article/20130706/MAGAZINE/307069951

     

     
  13. You have chosen to ignore posts from tvoter. Show tvoter's posts

    Re: Those nice

    I get detailed summaries from my carrier that states what each cost was, how much it was and how much was paid by insurance and what is left that I owe.

     
  14. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: Those nice

    In response to tvoter's comment:

    I get detailed summaries from my carrier that states what each cost was, how much it was and how much was paid by insurance and what is left that I owe.



    Anyone who says they have no idea what they would have to pay obviously never bothered to read what their plan benefits are. I knew exactly what I had to pay when I had hernia surgery. I knew what I had to pay when I went to the ER to get stitches. I knew what I had to pay every time I had x-rays for various injuries over the years. I knew what I had to pay when I got a tetanus shot when I was bitten. It's no secret....unless ya don't read the benefits doc.

     

     
  15. You have chosen to ignore posts from miscricket. Show miscricket's posts

    Re: Those nice

    In response to FortySixAndTwo's comment:

    In response to tvoter's comment:

    [QUOTE]

     

    I get detailed summaries from my carrier that states what each cost was, how much it was and how much was paid by insurance and what is left that I owe.

     



    Anyone who says they have no idea what they would have to pay obviously never bothered to read what their plan benefits are. I knew exactly what I had to pay when I had hernia surgery. I knew what I had to pay when I went to the ER to get stitches. I knew what I had to pay every time I had x-rays for various injuries over the years. I knew what I had to pay when I got a tetanus shot when I was bitten. It's no secret....unless ya don't read the benefits doc.

     

     

    [/QUOTE]


    Pinkie..I think there are two lines of thought going on here. In the first..you are correct. With health insurance..most people know what they are expected to pay for certain services. Due to the nature of most insurance plans people know exactly what they are going to pay for a doctor appointment, a surgery, a prescription, etc.

    I think the issue myself and some others on this thread is the not really knowing what health care providers are actually charging for a service. For example, if I have surgery that requires overnight in a hospital, I know that my out of pocket cost for that will be $500. What I don't know is how much the hospital is charging my insurance company for those services.  How can people understand the value of their insurance product when most times they don't know how much money is exchanging hands. This is where transparency of costs would be valuable. If people actually knew what was being charged..maybe they would shop around for certain non emergency services.

     
  16. This post has been removed.

     
  17. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: Those nice

    In response to chiefhowie's comment:

    It's all about the books. income vs expends.

    Like the 5$ meds in your cabinet. $100 in hospital for overhead cost.

     at Mount Auburn ER one time > Nurse said of 20 People entered ER, only 3 with INS. She laughed said your INS will pay for the others. Mass health pays about 10%

    Most Hospitals don't have a savings accounts. 

    Want to lower Ins cost > pass a losser pays in law suites Bill.




    Hard to turn patients without insurance away when the law says you can't.

    Also hard to complain about those "nice job creators who sell insurance" when Obama makes you buy their product.

     
  18. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: Those nice

    In response to WhatDoYouWantNow's comment:

    In response to tvoter's comment:

    [QUOTE]

     

    I get detailed summaries from my carrier that states what each cost was, how much it was and how much was paid by insurance and what is left that I owe.

     




    Does the entity providing your insurance even know the rates the insurer has contracted to pay to each and every provider who takes that insurance for the services rendered to you? Do you?

     

    Has the entity providing your insurance ever tried to negoiate - let alone are they in a position to negotiate - what that insurer pays to providers for the services rendered to you?

     

     

    That's the point. It's not about you personally knowing what your silly co-pay is. It's about the fact that the market has utterly failed at the first step: the actual negotiations that determine how much an insurer pays each of the providers in its network for the services rendered to you.

    The triangular set-up of the insurance market is why it fails.

    [/QUOTE]

    The market has not failed, because it hasn't been tried.  The entire health insurance industry is a game rigged by government regulation.  Obamacare doesn't fix that, it amplifies it.

    If you mean by the triangular relationship, insurer/employer/customer, you are partially right.  You need to add government regulaton to the begining of that, unless you think healthcare and helathcare insureance is underregulated, which would be an insane notion.

     
  19. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: Those nice

    In response to miscricket's comment:

    In response to FortySixAndTwo's comment:

    [QUOTE]

     

    In response to tvoter's comment:

     

    [QUOTE]

     

     

    I get detailed summaries from my carrier that states what each cost was, how much it was and how much was paid by insurance and what is left that I owe.

     

     



    Anyone who says they have no idea what they would have to pay obviously never bothered to read what their plan benefits are. I knew exactly what I had to pay when I had hernia surgery. I knew what I had to pay when I went to the ER to get stitches. I knew what I had to pay every time I had x-rays for various injuries over the years. I knew what I had to pay when I got a tetanus shot when I was bitten. It's no secret....unless ya don't read the benefits doc.

     

     

     

     

    [/QUOTE]


    Pinkie..I think there are two lines of thought going on here. In the first..you are correct. With health insurance..most people know what they are expected to pay for certain services. Due to the nature of most insurance plans people know exactly what they are going to pay for a doctor appointment, a surgery, a prescription, etc.

     

    I think the issue myself and some others on this thread is the not really knowing what health care providers are actually charging for a service. For example, if I have surgery that requires overnight in a hospital, I know that my out of pocket cost for that will be $500. What I don't know is how much the hospital is charging my insurance company for those services.  How can people understand the value of their insurance product when most times they don't know how much money is exchanging hands. This is where transparency of costs would be valuable. If people actually knew what was being charged..maybe they would shop around for certain non emergency services.

    [/QUOTE]

    I totally hear you.

    I know the value of my insurance plan when all I had to pay was $250 for hernia surgery. I didn't have to know the actual charges to know I got a damn sweet deal. Between surgeon, nurses, anesthesiologist, OR room/time, supplies, instruments, meds and so on I can pretty much figure out it was a hell of a lot more than the $250 I paid.

    I have no issue with charges being transparent. I just know since all I'm paying is the $250 that I'm not going to waste my time trying to figure out which hospital will be the cheapest. Others may want to which is great for them. To each his/her own.

     

     

     
  20. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: Those nice

    In response to FortySixAndTwo's comment:

    In response to miscricket's comment:

    [QUOTE]

     

    In response to FortySixAndTwo's comment:

     

    [QUOTE]

     

     

    In response to tvoter's comment:

     

     

    [QUOTE]

     

     

     

    I get detailed summaries from my carrier that states what each cost was, how much it was and how much was paid by insurance and what is left that I owe.

     

     

     



    Anyone who says they have no idea what they would have to pay obviously never bothered to read what their plan benefits are. I knew exactly what I had to pay when I had hernia surgery. I knew what I had to pay when I went to the ER to get stitches. I knew what I had to pay every time I had x-rays for various injuries over the years. I knew what I had to pay when I got a tetanus shot when I was bitten. It's no secret....unless ya don't read the benefits doc.

     

     

     

     

     

     

    [/QUOTE]


    Pinkie..I think there are two lines of thought going on here. In the first..you are correct. With health insurance..most people know what they are expected to pay for certain services. Due to the nature of most insurance plans people know exactly what they are going to pay for a doctor appointment, a surgery, a prescription, etc.

     

     

    I think the issue myself and some others on this thread is the not really knowing what health care providers are actually charging for a service. For example, if I have surgery that requires overnight in a hospital, I know that my out of pocket cost for that will be $500. What I don't know is how much the hospital is charging my insurance company for those services.  How can people understand the value of their insurance product when most times they don't know how much money is exchanging hands. This is where transparency of costs would be valuable. If people actually knew what was being charged..maybe they would shop around for certain non emergency services.

     

    [/QUOTE]

    I totally hear you.

     

    I know the value of my insurance plan when all I had to pay was $250 for hernia surgery. I didn't have to know the actual charges to know I got a damn sweet deal. Between surgeon, nurses, anesthesiologist, OR room/time, supplies, instruments, meds and so on I can pretty much figure out it was a hell of a lot more than the $250 I paid.

    I have no issue with charges being transparent. I just know since all I'm paying is the $250 that I'm not going to waste my time trying to figure out which hospital will be the cheapest. Others may want to which is great for them. To each his/her own.

     

     

    [/QUOTE]

    The thing is, if you paid out of pocket, the total cost, while higher to you, would likely be lower overall.  That you don't want to shop around, feel you need to shop around, well, that's part of the problem, not part of the solution.

     
  21. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: Those nice

    In response to chiefhowie's comment:

    It's all about the books. income vs expends.

    Like the 5$ meds in your cabinet. $100 in hospital for overhead cost.

     at Mount Auburn ER one time > Nurse said of 20 People entered ER, only 3 with INS. She laughed said your INS will pay for the others. Mass health pays about 10%

    Most Hospitals don't have a savings accounts. 

    Want to lower Ins cost > pass a losser pays in law suites Bill.



    Well, seeingthat you mention medications:  I don't se the progressives complaining about the "for profit" drug stores.  Isn't it a moral crime for a drug store to charge for medications?

     

Share