The cost of medicine

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Boadicea
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The cost of medicine

Unread post by Boadicea »

I'm a certified medical biller/coder/auditor by trade...I've been doing this since around 1995...I've seen a lot and watched the cost of medicine go through the roof. A lot of the cost is due to the government and liability insurance, in my opinion. When the Administrative Simplification Act was passed, cost skyrocketed.

I recently had a colonoscopy...nothing wrong. It's just that time.

I arrived at Crestwood hospital at 6 am....left at 8:15 am....had a great experience. Staff was fantastic. Loved the Propofol anesthesia.

Looked at the bill today. The surgeon's part was about $1000.00. My insurance will pay 808.00 for a screening colonoscopy. I pay nothing.

The facility fee was 13244.57...Crestwood *might* get a thousand out of BCBS of NJ. They will have to write off around 12 grand. Again, I will have to pay zero.

Had this been a problem colonoscopy, I would have had to pay 20%...as it was, they did find two polyps, which were noncancerous, PTL.

I will say I have great insurance that Mr. B and his company pay around 22k a year in premiums. People who don't have great insurance or no insurance at all will pay the full bill. Later this summer, I am having gastric sleeve surgery and will have to pay around 2500 out of pocket with my insurance picking up the rest.

Even though I understand the cost of medicine...it really is out of control. I don't see it getting any better either. Socialized medicine will not solve this either, in my opinion. All socialized medicine will do is further ration health care and the people still won't be able to get the care they need.

What a mess.
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Re: The cost of medicine

Unread post by Muddling Through »

Boadicea wrote: June 8th, 2021, 8:23 am I'm a certified medical biller/coder/auditor by trade...I've been doing this since around 1995...I've seen a lot and watched the cost of medicine go through the roof. A lot of the cost is due to the government and liability insurance, in my opinion. When the Administrative Simplification Act was passed, cost skyrocketed.

I recently had a colonoscopy...nothing wrong. It's just that time.

I arrived at Crestwood hospital at 6 am....left at 8:15 am....had a great experience. Staff was fantastic. Loved the Propofol anesthesia.

Looked at the bill today. The surgeon's part was about $1000.00. My insurance will pay 808.00 for a screening colonoscopy. I pay nothing.

The facility fee was 13244.57...Crestwood *might* get a thousand out of BCBS of NJ. They will have to write off around 12 grand. Again, I will have to pay zero.

Had this been a problem colonoscopy, I would have had to pay 20%...as it was, they did find two polyps, which were noncancerous, PTL.

I will say I have great insurance that Mr. B and his company pay around 22k a year in premiums. People who don't have great insurance or no insurance at all will pay the full bill. Later this summer, I am having gastric sleeve surgery and will have to pay around 2500 out of pocket with my insurance picking up the rest.

Even though I understand the cost of medicine...it really is out of control. I don't see it getting any better either. Socialized medicine will not solve this either, in my opinion. All socialized medicine will do is further ration health care and the people still won't be able to get the care they need.

What a mess.
$13K and change for 2 hours? Geez. I had my procedure a few years back; probably due for a repeat. I better start collecting bottles and cans.......... :mrgreen:
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Re: The cost of medicine

Unread post by Boadicea »

Muddling Through wrote: June 8th, 2021, 10:30 am $13K and change for 2 hours? Geez. I had my procedure a few years back; probably due for a repeat. I better start collecting bottles and cans.......... :mrgreen:
I was surprised. I know all the fees for the physician side, but not the facility. I dread to see the cost for my other surgery when it happens.
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Re: The cost of medicine

Unread post by Muddling Through »

Boadicea wrote: June 8th, 2021, 11:45 am I was surprised. I know all the fees for the physician side, but not the facility. I dread to see the cost for my other surgery when it happens.
I concur. Obviously there needs to be some kind of reconciliation. There's no way a person w/ limited means could ever pay that amount for a relatively minor outpatient procedure. The Medicare For All advocates are either unaware or in denial that Medicare/Medicaid has never in it's history paid a doctor/facility for the actual cost of the procedures they "cover". Cost shifting to private insurance/private payers can only kick the can so far down the road.
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Re: The cost of medicine

Unread post by Cynical »

Boadicea wrote: June 8th, 2021, 8:23 am Even though I understand the cost of medicine...it really is out of control. I don't see it getting any better either. Socialized medicine will not solve this either, in my opinion. All socialized medicine will do is further ration health care and the people still won't be able to get the care they need.

What a mess.
I've been in the health insurance industry for more then 20 years and I've loaded a LOT of hospital contracts into the software that my employer uses and the prices keep going up. Trying to socialize health care will force medical providers to retire and facilities to close, they simply won't be able to pay the bills on what they get paid now.

I don't see a fix, there is simply too much money involved across the board. The medical schools aren't going to lower their rates and professors aren't going to lower their salaries,so any new medical provider is in significant debt before they even graduate and they will want to charge as much as they can to pay off their debt.

What you might see is people going overseas to get major procedures done.
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Re: The cost of medicine

Unread post by Vercingetorix »

Boadicea wrote: June 8th, 2021, 8:23 am I'm a certified medical biller/coder/auditor by trade...I've been doing this since around 1995...I've seen a lot and watched the cost of medicine go through the roof. A lot of the cost is due to the government and liability insurance, in my opinion. When the Administrative Simplification Act was passed, cost skyrocketed.

I recently had a colonoscopy...nothing wrong. It's just that time.

I arrived at Crestwood hospital at 6 am....left at 8:15 am....had a great experience. Staff was fantastic. Loved the Propofol anesthesia.

Looked at the bill today. The surgeon's part was about $1000.00. My insurance will pay 808.00 for a screening colonoscopy. I pay nothing.

The facility fee was 13244.57...Crestwood *might* get a thousand out of BCBS of NJ. They will have to write off around 12 grand. Again, I will have to pay zero.

Had this been a problem colonoscopy, I would have had to pay 20%...as it was, they did find two polyps, which were noncancerous, PTL.

I will say I have great insurance that Mr. B and his company pay around 22k a year in premiums. People who don't have great insurance or no insurance at all will pay the full bill. Later this summer, I am having gastric sleeve surgery and will have to pay around 2500 out of pocket with my insurance picking up the rest.

Even though I understand the cost of medicine...it really is out of control. I don't see it getting any better either. Socialized medicine will not solve this either, in my opinion. All socialized medicine will do is further ration health care and the people still won't be able to get the care they need.

What a mess.
Eliminate health insurance and make doctors and facilities set their own prices. Costs will fall to the average conaumer's ability to pay
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Re: The cost of medicine

Unread post by oflguy »

Boadicea wrote: June 8th, 2021, 8:23 am I'm a certified medical biller/coder/auditor by trade...I've been doing this since around 1995...I've seen a lot and watched the cost of medicine go through the roof. A lot of the cost is due to the government and liability insurance, in my opinion. When the Administrative Simplification Act was passed, cost skyrocketed.

I recently had a colonoscopy...nothing wrong. It's just that time.

I arrived at Crestwood hospital at 6 am....left at 8:15 am....had a great experience. Staff was fantastic. Loved the Propofol anesthesia.

Looked at the bill today. The surgeon's part was about $1000.00. My insurance will pay 808.00 for a screening colonoscopy. I pay nothing.

The facility fee was 13244.57...Crestwood *might* get a thousand out of BCBS of NJ. They will have to write off around 12 grand. Again, I will have to pay zero.

Had this been a problem colonoscopy, I would have had to pay 20%...as it was, they did find two polyps, which were noncancerous, PTL.

I will say I have great insurance that Mr. B and his company pay around 22k a year in premiums. People who don't have great insurance or no insurance at all will pay the full bill. Later this summer, I am having gastric sleeve surgery and will have to pay around 2500 out of pocket with my insurance picking up the rest.

Even though I understand the cost of medicine...it really is out of control. I don't see it getting any better either. Socialized medicine will not solve this either, in my opinion. All socialized medicine will do is further ration health care and the people still won't be able to get the care they need.

What a mess.
Several years ago I had shoulder surgery. Before I entered surgery, I took my clothes off and put on a gown in a tiny room. I was not allowed to leave my clothes in the room (they locked them up in a locker somewhere else) and was there about 10 minutes. Maybe 15 minutes tops. Someone did come in and take my blood pressure. The cost on the bill for that room? Over $1,000. That works out to over $100 per minute and they didn't have to clean it.
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Re: The cost of medicine

Unread post by JudgeRoyBean »

Boadicea wrote: June 8th, 2021, 8:23 am What a mess.
the primary problem IS insurance.
these businesses are all co-dependents, they feed off of one another.
if there was no insurance, no human being could pay such ridiculous charges, and they would all go broke of they didn't get pricing inside the realm of reality.
Damn near every single argument with the communist left revolves around some attempt of theirs to limit, restrict, or steal the property or freedom of free people.
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Re: The cost of medicine

Unread post by Boadicea »

JudgeRoyBean wrote: June 9th, 2021, 10:07 pm the primary problem IS insurance.
these businesses are all co-dependents, they feed off of one another.
if there was no insurance, no human being could pay such ridiculous charges, and they would all go broke of they didn't get pricing inside the realm of reality.
A lot of people would die then. People who are on dialysis could not afford to stay on dialysis, even at markedly lower prices.
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Re: The cost of medicine

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Boadicea wrote: June 10th, 2021, 7:17 am A lot of people would die then. People who are on dialysis could not afford to stay on dialysis, even at markedly lower prices.
i dont think that is necessarily the case.
we get told continually that ONE of the reasons for such high prices is because of those who cannot pay, and those under-runs are absorbed and recovered from actual paying customers. and that doesn't change the fact that the largest contributing factor to the insane prices is driven by the fact that people with insurance have to pay very little or nothing. there is very little market pressure on prices
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Re: The cost of medicine

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JudgeRoyBean wrote: June 10th, 2021, 7:27 am i dont think that is necessarily the case.
we get told continually that ONE of the reasons for such high prices is because of those who cannot pay, and those under-runs are absorbed and recovered from actual paying customers. and that doesn't change the fact that the largest contributing factor to the insane prices is driven by the fact that people with insurance have to pay very little or nothing. there is very little market pressure on prices
There will always be poor people, regardless of a socialist society or not. Poor people tend to get sicker easier and for longer periods of time. It could be argued that because they can't afford medical care, they wait until they are critical before seeking help. Poor people and most people, because people don't save for things like this, would not be able to pay regardless of the cost. In my experience, people who have a large medical deductible are never able to pay it, because they play the odds and think they won't get sick. It wouldn't be any different in a society with no insurance. People would not have the money put away for a sickness. Heck, in my practice, people won't even put away the money for a 50.00 copayment, but they have that Iphone12....

Most people don't even have 1000.00 in savings. If a car breaks down, or the frig goes out, most people are screwed because of poor planning. I don't see any difference here with medical treatment.
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Re: The cost of medicine

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Boadicea wrote: June 10th, 2021, 7:44 am It wouldn't be any different in a society with no insurance
that is my point. and as a consequence of no insurance companies being involved, 80% (pick a number, I'm guessing here) of the money spent today would be back in the pockets of people who earned it instead of being paid out in insurance premiums.
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Re: The cost of medicine

Unread post by Vercingetorix »

Boadicea wrote: June 10th, 2021, 7:17 am A lot of people would die then. People who are on dialysis could not afford to stay on dialysis, even at markedly lower prices.
The price would have to be set to the market. The supplies needed for dialysis would have to be market priced as well. The cost of medical labor would stagnate as well.
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Re: The cost of medicine

Unread post by Vercingetorix »

Boadicea wrote: June 10th, 2021, 7:44 am There will always be poor people, regardless of a socialist society or not. Poor people tend to get sicker easier and for longer periods of time. It could be argued that because they can't afford medical care, they wait until they are critical before seeking help. Poor people and most people, because people don't save for things like this, would not be able to pay regardless of the cost. In my experience, people who have a large medical deductible are never able to pay it, because they play the odds and think they won't get sick. It wouldn't be any different in a society with no insurance. People would not have the money put away for a sickness. Heck, in my practice, people won't even put away the money for a 50.00 copayment, but they have that Iphone12....

Most people don't even have 1000.00 in savings. If a car breaks down, or the frig goes out, most people are screwed because of poor planning. I don't see any difference here with medical treatment.
WIdespread medical coverage was not even a "thing," until the late 1960's. For those who can't pay they used to have free clinics and doctors in the old days worked like lawyers. A certain amount of their work was "pro bono."

In the end, we can't keep everyone from dying. This is why government insurance schemes are really about power. If they can control your health, they can contro about any part of behavior. They can tell you what to eat, what activities you can partake in, etc. ad nauseum.
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Re: The cost of medicine

Unread post by oflguy »

Cynical wrote: June 8th, 2021, 2:53 pm I've been in the health insurance industry for more then 20 years and I've loaded a LOT of hospital contracts into the software that my employer uses and the prices keep going up. Trying to socialize health care will force medical providers to retire and facilities to close, they simply won't be able to pay the bills on what they get paid now.

I don't see a fix, there is simply too much money involved across the board. The medical schools aren't going to lower their rates and professors aren't going to lower their salaries,so any new medical provider is in significant debt before they even graduate and they will want to charge as much as they can to pay off their debt.

What you might see is people going overseas to get major procedures done.
One of my sons graduated from medical school. My wife and I foot the bill for 4 years of undergraduate school at 20+ thousand a year, but we told him he would have to get student loans for medical school, which he did. Upon graduation, he owed over $270,000. Next was 4 years of residency. Residents don't make much money, I know, I saw his check stub once. (and they work them to death). After residency, he did another year of training in his specialty, again out of town and making peanuts. All the while he was not paying down his school debt but the interest was accumulating.

By then, he was 13 years into school after leaving high school with no to little compensation for the intense studying and training, all the while running up debt for out of town living.

When he finally was hired by a hospital as a surgeon, he was making very good money - enough to compensate him for all the years he, my wife and I, scrimped and pinched pennies for him.

But he was not the only one. I have other children that are doctors and lawyers. They all experienced similar trials and tribulations. Its not easy (although the lawyer had the easiest route. He did not do a "residency" but he was not making much in the first couple of years while he learned his trade in a law firm.)

The malpractice insurance is one of the biggest reasons we pay so much for healthcare.

I blame the lawyer for that :shock:
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