The Problem With Healthcare

So a few months ago I severely sprained my ankle while on vacation. I had to go to emergency room for xrays to make sure it wasn't broken or other damage. Once I got to ER, I got xrays confirming I didn't have a break. There really isn't anything you can do for a sprain except let it heal, so I was given crutches and a walking boot. I didn't even see a physician... just the physician assistant.

Anyway, three month's later I get my bill from hospital. Fortunately, we have great health insurance through my wife's job. The total bill was like $1300.00! After insurance, I owed $216.

I'm still trying to figure WTF cost $1300. My bill says the ER Visit was $657. Ankle Review was $521.00. Emergency MD $121.00 For a total of $1299.00. My insurance paid $855.00. There was an "Adjustment" of $228 and I was stuck with $216.00 bill.

This is why healthcare is so out of control. I was in a hospital room for maybe 30-45 minutes at most. I've stayed in 5 star hotels that cost less than $657.00 for a full night. It don't cost $650 to change the sheet/sterilize room after patient leaves. How much does xray film/technician cost? Radiologist to spend 5 minutes reviewing? I didn't even get any drugs!

This is why healthcare costs are out of control. Hospitals can gouge knowing insurance companies will pay. The insurance companies in turn charge an arm and leg for coverage. Given it was an emergency, it wasn't even like I could go shopping to see if there was a cheaper alternative.

My boot and crutches cost less than $100 at the local drug store.

Just a rant....

a reply to: Edumakated

LOL I feel your pain. be in your same position. Except I got stuck with a $3800 dollar bill that I couldn't pay upfront and then I got sued because I couldn't pay. Party on!

a reply to: Edumakated

It's tort reform, nope
It's the uninsured, nope
It's the hospitals and Dr.'s charging a lot. Yep

Broke my arm here in blighty after slipping on some ice and what did it cost me, taxi to the hospital and I would of walked back but they gave me some morphine and I was a bit light headed and the Mrs wouldn't risk it...spent about £8 on some pain killers (prescription strength and never used them) and that was it...got a cancer scare as the break looked like bone cancer and I had to go to another hospital for tests...about £15 both ways return on the train 3 times once for a pre-op and 2 separate times where they drilled a bit out of my arm. Got fed / watered but would of wished I didn't have to share a room with some guy who could snore the plaster off the wall but that doesn't include the blood tests/MRI/CT/Xrays and whatever else and i probably paid less than a £100 for all of that and all of that was mainly transport to and from the hospitals.

We pay up front with around 10-15% depending as contributions to the system from our wages so its not 'free' just we've slapped in enough to be able to take out normally.

a reply to: Edumakated

Are you familiar with the elderberry tree? Not trying to take away from your thread. Just so you know, Elderberry leaves bruised with say a rock...will fix a sprain in a jiffy.

Again, no need to beat me up, just trying to help. Elderberry grows everywhere fore just that reason friend.

I have come off a mountain walking using elderberry leaves.

Just bruise them and poultice on the spot

a reply to: Edumakated

We pay high insurance because hospitals charge so much because insurance pays out what the hospital bills out.

We do need to break the cycle.

That is the way it is, the costs have gone through the roof. We have a three hundred copay on ER so I would try to go to an outpatient clinic for something like that. That usually runs about 160 with a 20 buck copay. X-rays would run about a $150 or less. That is covered by the insurance too.

The cost of healthcare in this country is way too high, think about all the cost of paperwork and billing alone. Socialized medicine is a lot better in my mind. They usually get paid a little more if they fix you too, the doctors get a bonus for good work. It is the opposite here, if it drags on they get more from the next visit.

It isn't always corruption, the hospitals and doctors support a lot of jobs and have a lot of technology they need to pay for. It is getting insane here in America, I can't understand why everyone can't see that. For profit health care is not the best option, there is too much room for deception and unneeded tests that pay for the wages of hospital personal.

We need to have real factory jobs here, not increase medical jobs.

a reply to: Edumakated


Medical care costs aren't so bad except for the factored in parts unrelated to the actual costs to your care.

Your insurance fairly well paid the actual bill. What you were asked to personally pay was for those that visit the emergency room, also get a bill, but never pay it because they have no insurance, no ability to pay and perhaps no desire to pay, ever. The hospital that wants to keep solvent and they sucker you for what they can't get from other users of their services.

We can complain, but the situation is fairly typical across any service that you can find in this country. You want to complain about something, complain about the tax code that frequently gives people more money then they had collected from their payroll taxes. That practice means the regular taxpayers will have their rates increased to cover the free money given to others by the IRS! Or look at the credit card companies. Billions of dollars are lost by the efforts of dishonest people through the fraudulent use of these loan institutions, but who pays? The honest user in higher fees.

While I agree costs are too high; one thing to keep in mind is that the bill at a hospital is just the opening to a negotiation it is not the set price. Not everyone pays what the bill says and depending on the situation the hospital is happy with that; they just try to get it form the next guy that comes in.

Hospitals and care givers ought to be required to list their service costs readily and actually prior to service. After a critical mass of hospitals and care givers have listed their costs; price indexes can be created by third parties (apps and websites). This will make it easy for the consumer to shop for the best price. Even in emergency situations you can drive yourself over to the cheapest hospital before you know what’s really wrong with you and if that’s what you want.

Of course Hospitals and care givers don't want this cause then they can’t negotiate and raise the price on those willing to pay.

originally posted by: BlueJacket
Are you familiar with the elderberry tree? Not trying to take away from your thread. Just so you know, Elderberry leaves bruised with say a rock...will fix a sprain in a jiffy.

As long as we have a huge, expensive, science-based medical community in place, I'd prefer not to have to treat myself with sticks and twigs, bug poop and witchcraft.

originally posted by: Edumakated
So a few months ago I severely sprained my ankle while on vacation. I had to go to emergency room for xrays to make sure it wasn't broken or other damage. Once I got to ER, I got xrays confirming I didn't have a break. There really isn't anything you can do for a sprain except let it heal, so I was given crutches and a walking boot. I didn't even see a physician... just the physician assistant.

Anyway, three month's later I get my bill from hospital. Fortunately, we have great health insurance through my wife's job. The total bill was like $1300.00! After insurance, I owed $216.

I'm still trying to figure WTF cost $1300. My bill says the ER Visit was $657. Ankle Review was $521.00. Emergency MD $121.00 For a total of $1299.00. My insurance paid $855.00. There was an "Adjustment" of $228 and I was stuck with $216.00 bill.

This is why healthcare is so out of control. I was in a hospital room for maybe 30-45 minutes at most. I've stayed in 5 star hotels that cost less than $657.00 for a full night. It don't cost $650 to change the sheet/sterilize room after patient leaves. How much does xray film/technician cost? Radiologist to spend 5 minutes reviewing? I didn't even get any drugs!

This is why healthcare costs are out of control. Hospitals can gouge knowing insurance companies will pay. The insurance companies in turn charge an arm and leg for coverage. Given it was an emergency, it wasn't even like I could go shopping to see if there was a cheaper alternative.

My boot and crutches cost less than $100 at the local drug store.

Just a rant....

As an x-ray tech I will weigh in here. You are absolutely correct that this is out of control. For a sprained ankle you probably had 3 views taken, an AP, oblique and a lateral. That is usually standard. It probably took them less than 15 minutes to take once you got to Radiology. Some hospitals still use actual film but most have or are switching over to digital. Most of the cost came from a Radiologist reading the films. Most Radiologist do not work for the hospital. They work in a group practice that contracts with the hospital. The Radiologist that read your films probably examined them for about 10 minutes (if that) then dictated their findings. So you paid over $500 for a doctor to look at the images for about 10 minutes. The tech that took the films probably makes about (I'm guessing here) $20/hr. If they use digital, there is no film cost unless they print hard copies. Yeah, it's out of control.

a reply to: Edumakated

You see the same problem in higher education.

Tuition and fees are through the roof because the college is pricing into the government's pocket, not the students'. The government writes all the loans and so long as it will hand them out like candy, who cares what the amount is?

Only the student when the debt starts to come due.

This is the same, insurance is the one paying, not the consumer in most cases, so the hospital prices into their pockets, not yours or mine.

Also keep in mind Service provides routinely charge for the wrong procedures and services. Whether they do this by mistake or on purpose is up to you; but the medical building coding system is crazy complicated and it makes it easy for mistakes or wrong doers to get things wrong.

A few years back my company added a Health Care Spending account system to their healthcare offerings. They took some of the money they normally would pay into our premiums for traditional healthcare insurance; and set up an account that we would have to manage as part of what paid for our service. At the end of the day we received comprisable healthcare at the same out of pocket cost to us; but it did require us to be mindful of the medical bills that had to be paid.

This happened right around the time my wife was peregrinate and gave birth; so lots of different bills from different service providers. I was going crazy keeping track of it all; and then I started to notice that almost every bill had some kind of error. The wrong procedure, the wrong amount of time spent with the doctor, the wrong number of stiches ect ect ect. The mistakes where always in favor of the service provider getting paid more. Over those 9 months and then sum I was on the phone with my insurance and the service providers on a weekly bases correcting the bills. And sometimes I had to get nasty about it or come up with creative ways to prove I was right before the bill got corrected.

One issue we had was that after the delivery we found out my wife’s anesthesiologist was out of network, despite the fact that we went to an in network hospital. We didn’t choose the anesthesiologist they were the one on call and we were not told they were out of network. So we get a huge bill; I submit the claim to my insurance company and they send me a check for 1/5th the cost. When I called up to complain to the insurance company they tell me they actually gave me there in network average price they pay anesthesiologists for the procedure my wife had. And that this particular anesthesiologist was doing something that is notaries for anesthesiologist too do. That is stay out of network; charge outrages fees just to see what the insurance company pays. The insurance rep on the phone advised me to send the check they gave me to the anesthesiologists and not say anything more to them; to let them make the next move and see what happens. They got their check and they never called me back.

originally posted by: seasonal
a reply to: Edumakated

It's tort reform, nope
It's the uninsured, nope
It's the hospitals and Dr.'s charging a lot. Yep

The doctors and hospitals 'charge a lot' because of the overhead they have to carry paying extra office people to keep up with insurance regulations, forms, challenges, etc.

a reply to: intrptr
I think you are overly simplifying a very difficult issue.

There is no competition so a 300$ MRI that is charged in other industrialized nations cost 2500$ here.

The AMA has a strangle hold on where Dr's work, how many, how many major pieces of testing equipment (MRI, CAT). The system is rigged, but now people are starting to notice and ask why, in this globalized econ, are we the only ones getting 3X the cost for the same or inferior quality of health care and drugs.?

a reply to: seasonal

are we the only ones getting 3X the cost for the same or inferior quality of health care and drugs.?

You added drugs, which expands the discussion. I was speaking directly to health care costs to the consumer . That cost is ridiculous because of insurance regulations, the unmentioned 800 [pound gorilla in the room. Hospital, private practice has to hire more people to fill out forms and keep up with ever changing and growing regulations.

That extra cost is passed onto the consumer.

Yes and doctors pay insurance to avoid insurance so that insurance will insure the unensured because insurance everywhere

originally posted by: Edumakated
So a few months ago I severely sprained my ankle while on vacation. I had to go to emergency room for xrays to make sure it wasn't broken or other damage. Once I got to ER, I got xrays confirming I didn't have a break. There really isn't anything you can do for a sprain except let it heal, so I was given crutches and a walking boot. I didn't even see a physician... just the physician assistant.

Anyway, three month's later I get my bill from hospital. Fortunately, we have great health insurance through my wife's job. The total bill was like $1300.00! After insurance, I owed $216.

I'm still trying to figure WTF cost $1300. My bill says the ER Visit was $657. Ankle Review was $521.00. Emergency MD $121.00 For a total of $1299.00. My insurance paid $855.00. There was an "Adjustment" of $228 and I was stuck with $216.00 bill.

This is why healthcare is so out of control. I was in a hospital room for maybe 30-45 minutes at most. I've stayed in 5 star hotels that cost less than $657.00 for a full night. It don't cost $650 to change the sheet/sterilize room after patient leaves. How much does xray film/technician cost? Radiologist to spend 5 minutes reviewing? I didn't even get any drugs!

This is why healthcare costs are out of control. Hospitals can gouge knowing insurance companies will pay. The insurance companies in turn charge an arm and leg for coverage. Given it was an emergency, it wasn't even like I could go shopping to see if there was a cheaper alternative.

My boot and crutches cost less than $100 at the local drug store.

Just a rant....

The whole point of having a cartel or monopoly is so you can charge whatever you want and people will have no choice but to pay it. The problems with our country are not rocket science. The lobbyists force the politicians to pass laws creating cartels and monopolies in exchange for campaign financing.

originally posted by: DBCowboy
a reply to: Edumakated

We pay high insurance because hospitals charge so much because insurance pays out what the hospital bills out.

We do need to break the cycle.

Yep and the incentives are all wrong and against the majority of American people.

Don't have the answers but we need to restructure our healthcare where Corporations and business benefit by keeping people healthy , not the other way around. I also don't think Obamacare with insurance companies in the middle is an answer nor in the right direction.

There is more money in keeping the American public sick and dependent on the system.

I also think its wrong for a country to consider itself a first world leader when its people can't afford to get healtcare.

The whole thing is disgusting and I have seen how it has ruined peoples life including wealthy parents having lost everything they had , once their child got a critical emergency situation that cost millions in operations.

Its saddening. to watch somebody who almost lost a child that will never fully recover also have to worry about being homeless and lose everything they had saved for. All this Despite having insurance and being in the medical field.