Health Care...Whats Wrong With This Program?
 

The system is broken and I need to vent.

2 weeks ago I cut the top of my hand doing a household project (not even working on the boat). I needed to get it stitched up. It was late Sunday afternoon, my Dr. was not in and the Doc in the box places were closed. We live in a small community so the next choice was the local community hospital emergency room.

Long story short, I drive myself in spend approx. 45 minutes getting patched up by a PA. and six (6) stitches later I am gone.

Yesterday I get the bill from the hospital......$1700.00.

You read right SEVENTEEN HUNDRED DOLLARS.

Now since I have coverage the contract rate is $850.00.

In my own mine a fair rate would be $200-300.

Am I wrong or is the system broken.

Re: Health Care...Whats Wrong With This Program?
 

One of my brothers broke his ankle recently. He was laid off from his job of 15 years and had lost his work health insurance. Emergency room would only wrap it and sent him away because he had no insurance. He ended up getting a doctor to set and cast for $12,000.00 plus $2500.00 for emergency room.

Re: Health Care...Whats Wrong With This Program?
 

You need to move up my way.Hospitals can't refuse anyone to the emergency room.

It "ain't" a pretty sight if you have to go to one.I recently suffered from chest pains,so after having one heart attack already,I figured i should go to the emergency room at one of the biggest hospitals in the area.

I got there at 10.00am and was looked at,around 2.00pm,and was released at 9.00pm.
Most of this was because I had to wait for all the riff raf,and assorted dirtbags,like drug addicts and criminals to be attended too.
I'm serious when i say that there were at least ten incoherent addicts,and two criminals with police guards with them,not to mention a few "homeless" thrown into the mix.
You know who's paying for all this great medical,that they're getting.

Now, on the good side of medical care.
Yesterday I saw a Neurosurgeon,(one of the best in the state),for some back problems,and got phenomenal treatment,along with appointments to pain mgmt clinics,and x rays done immediately.
All this because I have health insurance that my employer and I pay for.

I shudder to think of what kind of care that i would have got if i was under some Obama government health care system.I'd probably still be waiting to be seen by some lousy govt. doctor.God forbid.
I think everyone agrees that we need good health care,but I'm leery of any politician deciding how it will be done.Why don't they just give us the same health care that they get.

They are such scum,hell they don't even pay their taxes,change is comin all right,and it "ain't"good.

Re: Health Care...Whats Wrong With This Program?
 

island trader, you are right, i spend 6 weeks surfing in nicaragua this summer and my friend cut his foot real nice on the reef one day, drove him to the local pharmacia/clinic, 4 or 5 stitches were $45 and we were on our way, doc did a great job, hardest part was keeping it clean afterwards, so the moral of this story, yes the system is broken... sew yourself up next time.

Re: Health Care...Whats Wrong With This Program?
 

Island Trader,
I know a local EMT. He said 4/5 calls they get are people who want the ambulance to come check their blood pressure or their kid has a skinned knee.

A Catholic hospital will never turn you away. ER's are SCARY PLACES. Everyone in my family is a doctor except me so I know the inside scoop. You paid for the 5 people before you that couldn't pay.

Insurance companies as well as most lawyers suck the big hairy one. State farm just cancelled homeowners policies in florida. They took in 10 billion in premiums and paid out 6.5 billion and they are crying poor.

RANT over. [img]/forum/images/graemlins/tongue.gif[/img]

Re: Health Care...Whats Wrong With This Program?
 

"Insurance companies as well as most lawyers suck the big hairy one." Now there's an understatement.

Steve
(Dr. steve)

Re: Health Care...Whats Wrong With This Program?
 

"Health Care Provider" = HEALTH CARE EXTORTIONIST!!

Terry, as you know, I was treated for prostate cancer last year. Although it was a very aggressive type (8 on a scale of 10) at about stage 3, I was fortunate enough to have a world class state-of-the-art radiation facility just 3 miles from my house, and treatment appears to have been very successful with PSA dropping from over 17 to 0 after treatment, and still zero nine months later . . . these are results normally associated with major surgery, but with none of the surgical risk, pain and bad side effects.

As good a story as that is, the cost numbers are staggering! (ONE OF EVERY FIVE OF YOU GUYS READING THIS WILL GET TO EXPERIENCE IT, SO LISTEN UP FOLKS! This disease can WIPE YOU OUT financially if you don't have insurance! If you have a male blood relative that's had it, the odds are even higher!)

If you're on medicare, you get a statement from them listing:
The "Amount Charged"
The "Amount Approved" by medicare; they pay 85% of approved, and you get to pay the rest, unless you have supplemental policy. As far as I know, the extortionists get to WRITE OFF whatever medicare doesn't approve. (Where is the incentive to PREVENT them from charging insane fee's they know they'll never collect (EXCEPT FROM THE UNINSURED), just to create a big tax break!!)

Just for grins, I tallied up the totals for my treatment:

Total Amount CHARGED: $103,567
Total Amount APPROVED (by medicare): $49,133 ($54,434 "written off")
Total Amount Paid by Insurance: over $47,000 (medicare) + ~$7370 (by private insurance - covers my insurance premium for next 5 years!)
Total out-of-pocket cost: $1800 (I have a high deductible to keep premiums low!)

Now, if I DID'T have insurance and was under age 65, the Health Care Extortionists would be coming after me for over $100,000 instead of the measly $1800!!! There are 2 big messages in all this:

1. If you're over 50, get your PSA checked every year AND MAKE A PLOT OF IT, don't count on the Dr. to watch it! (I made up an Excel spreadsheet that will do the plots if you plug in your data; PM me with your e-mail address if you want a copy.) Although PSA levels under about 4.0-4.5 are considered "normal", and many non-cancer related things can drive it over that, it's the trend from year to year that's much more important! If you wait until Dr. finds something with everyone's favorite digital exam, it's almost too late!

2. Although it's nice to have a big fat IRA nest egg (very problematic given today's market!), GOOD health insurance should be a MUCH higher priority!

I'm not knocking the Doctors . . . most are very dedicated, not in it for the money, and they provide the finest health care in the world (for those who can afford it!). It's the for-profit health care extortionists, the big drug and insurance companies, and their CEO's that have created a system that puts all U.S. companies at a serious competitive disadvantage compared to the rest of the world! Anyone who thinks this is an isolated case should see Michael Moore's movie, "Sicko". I don't care for his politics or tactic's, but he hit the bulls-eye with this one! Even folks who HAVE insurance are at risk, and they don't even realize it! Need to fix this or USA will become a third world country in short order!

Gosh, I feel so much better . . . guess I'll get off the soapbox now! Denny

Re: Health Care...Whats Wrong With This Program?
 

Ditto on that one.

Terry I guess I got a deal. Horse sliced open my scalp couple months ago....cost about $450 at the urgent care facility. That included cleaning the wound, 8 staples, and a tetanus shot from a cute Persian nurse!

Bigshrimpin how much your kidney stones cost ya? :D

strick

Re: Health Care...Whats Wrong With This Program?
 

mr strick
howe com u not do da repair yerself. u gotz the nohow. maybee u needs a redneck nurse lik my cusin bettie. she sewd ups my budie frank wit 4lb mono line after da hog bit it

see ya sam

http://farm3.static.flickr.com/2316/...7703366c52.jpg

Re: Health Care...Whats Wrong With This Program?
 

You're right about the system being broken and about how even if you have insurance your still at a risk of being bankrupted. Just because you have insruance doesn't meant that company will pay all the claims submitted. Bushwakcer stated.

Case in point; my mother and her cancer treatments. She was diagnosed with Stage IV Liposarcoma. A very, very rare cancer and unfortunately one that doesn't manifest symptoms until its late in the game. Anyway, the insurance company was a "good company" and quite large, but they refused to give her any other treatments other then a particularly taxing form of chemo or hospice care to "make her comfortable" In the meantime we found out about different treatment options that would have prolonged life or possibly sent the cancer to remission.........they refused to cover those treatments stating that in their medical officer's opinion she is not likely to survive the next 6 months (and they literally told me that).

Anyway, although I cured the greater powers for giving her that disease I thank them for how she passed. Before her she suffered, before she went through any chemo she died in her sleep in her own bed.

There's no guaranteed way of making sure the insurance companies will do as they promise because of deregulation of the industry over the past few years. We can only hope the government will step in and restrict how these companies are abusing us.

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Sam- it was on top of my head...and I'm afraid of needles. Send Bettie on over I'll put her to work :D

strick

Re: Health Care...Whats Wrong With This Program?
 

Strick,

This is what I thought it was going to cost. Matter of fact that is all I am going to pay.

Re: Health Care...Whats Wrong With This Program?
 

Okay, somebody pushed one of my "HOT" buttons.

The doctors are NOT making the money they used to make. A lot of the money is going to insurance companies, 3rd party billing offices and to the government in taxes.

I have a friend of mine who is a primary care physician - Internal Medicine. He has one other doctor working for him who recently immigrated from India, (even though he is actually from Turkey.) He also employs 4 registered nurses, 2 LPN's, and three office staff.
He own his clinic here in suburban/rural Florida, and most of his patients are senior citizens, many of whom are on Medicare.

Two years ago, we were playing golf together, and he told me that of the 11 people who worked at his clinic, 3 had higher personal incomes than he did. The clinic grossed slightly more less than 1.4 million dollars in 2006, and his personal income was just under 80,000.
Of the 1.4 million, over 400 grand went into malpractice insurance for himself and the clinic. Another 340K went to the government in taxes. Medical and office supplies and materials were another 100K. He paid the other doctor a salary of 130K (from which he had to pay his own malpractice insurance of $60K), the Nurse Practitioners got about 90K each, and the rest went to the other staff. He was left with just 80K.

On the other hand, My son went to the emergency room from school with a broken finger right after the first of the year. As we had not met our deductible, we were charged for everything directly.

Here are the costs as originally listed:
Emergency room "Fee" = $485
Emergency room physicians fee to see him = $365
Radiology Group's Xray costs = $65
Emergency room physician's fee to look at xray (no radiologist available) = $410
Emergency room physician's Diagnosis Fee = $110
Emergency room physician's fee to splint and tape finger = $325
Hospital's fee for nurse to splint and tape finger = $85
Cost of aluminum and foam finger splint = $115
Cost of tape to secure splint = $18
Cost of elastic bandage to wrap hand and wrist = $31
Cost of chemical "cold pak" = $44
Miscellaneous emergency room "supplies" surcharge = $19

Total Hospital charges = $797
Total Radiology Charges = $65
Total Emergency room physician's fees = $1190

Total time spent at hospital = 55 minutes

Last week, the billing office for the ER physician agreed to eliminate the charge for splinting and wrapping my son's finger, especially as she didn't actually do it, an ER nurse did it. The also agreed to reduce the total of all the rest of the unbundled services to $475, after I had the church attorney inform their 3rd party billing office in Atlanta that "Unbundling" of medical charges is illegal in Florida, and in fact is a felony. (Like they didn't know it already) When went to her office and spoke with the ER physician directly (wearing my black clericals), she said she had no idea that her billing company was unbundling charges for her services, and claimed not to have known that they billed us for services she had not actually provided. She said the billing company gets 30% of all monies collected on her behalf.

I'm still pissed off at paying $115 for the same foam and aluminum splint that costs $18 for a 3-pak at Walgreens. :mad:

On the other hand, we have met the deductible for my son this year already, and more than half the family deductible

Re: Health Care...Whats Wrong With This Program?
 

Two trips to the ER!! Twin 4mm kidney stones. One last Sunday and the second on Tuesday. Friggin most panful thing ever!! I was peeing blood on the second . . . otherwise I wouldn't have gone back (well maybe . . . just for the pain killers). Only $50 co-pay each trip Blue Cross and Blue Shield. Although . . . It did cost me two days of lost wages, b/c I'm a contractor (for an insurance company :) ). Single guy insurance is much cheaper than the family plans. Well . . . if you tally up the 12 years of monthly insurance premiums ($5000/year my contribution 10% + employers contribution 90%) and figure that I haven't had any health care procedures other than this . . . the insurance company is making out pretty well.

Re: Health Care...Whats Wrong With This Program?
 

Don’t get me started. (Too late, I just did.)

Having various occupations, sporting interests, and hobbies that are considered risky or even dangerous, as well as an adrenaline junkie’s apparent non-concern for self preservation, I’ve had more than my fair share of “run ins” with hospitals, ERs, clinics, doctors, dentists (hockey before face masks put my dentist’s kid through college!) etc. With 7 broken bones, over 200 stitches, too many torn muscles/ ligaments to recall, and a couple concussions (or was it 6? Ha!) to my credit, there are plenty stories of health care ineptitude for me to relay.

Being found unconscious in a pool of my own blood 2 hours after being taken to Balboa Naval Hospital for treatment of a not too serious “knuckle meets grinding wheel” incident was a good one. But since my wallet wasn’t affected and military health care has a completely different set of rules, I’ll tell ya this “beauty”.

One Sunday in August 2003 I tucked the front wheel in turn 1A of Loudon racetrack, bounced on my right shoulder and slid off the track and out of the race (was in the lead too….bitch.). Cornerworkers and EMTs checked me out, determined that I didn’t have a concussion but offered to take me to the hospital anyway, “just in case”. I wasn’t too banged up and politely refused. Packed up my bike and went home.

Shoulder and back were pretty sore and sleeping was interrupted, but that’s to be expected. Wed. AM while driving to work I sneezed and it felt like King Arthur had just stuck Excalibur in my upper back! “OMG! That really hurts!”

Mass General was 3 blocks from the job site so I walked over and at 6:45 AM, checked in to the ER “I think I broke my shoulder blade.” Plunked down the $20 co-pay and took a seat. I was the only one waiting. “This should be quick.”

At 8:25 after watching a dozen or so cases of the “sniffles” admitted before me, I was taken up two flights to a nurses station/ examination wing and was told (not asked) by the humungous woman behind the desk to “Wait over there.”.
8:35 Gave a cigarette to the janitor who asked me for one.
9:10 An orderly brought me in to the exam room. “Remove your shirt and the Nurse Practitioner will be right with you.”
9:30 The NP came in. She asked what happened, etc.
“Are you in pain?”
“Only when I breathe.”
“Hmm…..this bump on your back is probably a broken rib. There isn’t much we can do for it. You’ll have to go easy for a while and let it heal on it’s own. I can give you some painkillers though. Oh, I’m sorry. It hurts when I touch it?”
“Noooo. The tears about to stream down my face are from my recalling a lost love.”
“Ha Ha. You have a pretty good sense of humor for someone with a broken bone. We need X-Rays to confirm. I’ll get back to you as soon as I get the results. ”

9:40 Back to my “not so comfy” seat at the nurses station. No magazines or TV, but there were 3 girls and 1 guy in a small office chatting about their weekends (past and upcoming), significant others, how they could avoid working on Labor Day, blah, blah, blah that I eavesdropped on for entertainment. When they started laughing and saying “I can beat that.” I leaned around the corner to see that they were all playing some sort of game together on their computers! I silently wished that their boss would walk in and catch them all goofing off.
10:30ish Asked the rather large nurse’s aid at her lofty perch where I could get a cup of coffee and a snack.
10:30ish and one half second, “You can’t eat or drink during treatment.” (From her expression, you’d think I’d asked to eat her offspring.)
10:40ish Quietly asked the janitor where I could get a cup of coffee. He rolled his eyes, gave a disdainful glance towards “The Queen” at her overstrained lofty perch and asked, “How you take it?”
“Black is fine.”
10:45ish Janitor returned with a cup of coffee cleverly concealed in a newspaper.

11:10 An orderly brought me to X-Ray where I met two techs who I’d already seen today. Yup, you guessed it. They were two of the “goof offs”. I was tempted to ask who had the highest score on the game they were playing but feared retribution.
The digital machine (nothing but the best for Mass. General!) was a first for me and showed the images nearly instantly and with amazing clarity. They were even color. (Cool technology)
“Oh yeah, that’s certainly a broken rib. But we have to send it to the radiologist to confirm.”
“Radiologist?! I’m just a stupid construction worker but even I can see, let alone FEEL, that I have a broken rib (it was so misaligned that one could NOT miss it.). Can’t you just show it to the NP so I can get out of here?”
“Sorry, Hospital rules.”
11: 20 Back in the “not so comfy” chair (I swear it was still warm!) and watched “The Queen” rule over her domain. Between chomping on Doritos and gulping Pepsi, she called her kids 3 times, gossiped with her “court” nearly constantly, applied nail polish, and even fielded a call from the cable company (she wanted to upgrade her package to include HBO).
12:00 I suddenly realized that during the entire time I spent in this area I call the nurses station/ examination wing (with 6 exam rooms and about 20 personnel) not a single other patient had come or gone. I was the only one! I’d been there over three hours (plus 1 and 1/2 in admissions), had spent a grand total of twenty minutes actually being attended to, was denied the chance to eat, and hadn’t had a smoke. The low blood sugar and lack of nicotine was getting to me (if not for the kind janitor, caffeine depravation would have been the catalyst that put me in jail!). I’d had enough.

12:01 Told “Jabba the Queen” that I was going outside for a cigarette.
“You can’t leave until the NP signs you out. And if you try to I’ll call security.”
“Then please call her to sign me out.”
“She went to lunch and won’t be …”
“I’ll see her when I get back.”
“YOU CAN’T….”
“I can. And I am. Call security, I don’t care.”
12:35 Returned from smoking two butts (needed them both) and eating 3 candy bars from a vending machine in the lobby. “The Queen” wasn’t on her throne (Lunch? The family size bag of Doritos wasn’t enough?) so I asked her substitute (a new face) if the NP had returned.
“She’s at lunch.”
“Please ask her to come get me as soon as she returns, will ya? I’ve been here all day.”
With a doubting look she said, “I’ll try to remember.” Total apathy.
Back to my “not so comfy” chair.

1:20 Was woken up by the janitor (remember him?) with “ You’re STILL HERE?! What you here for anyway?”
I told him.
“Have you been seen yet?”
“Yeah, waiting for the NP to look at my X-Rays and release me.”
“When did you go to X-Ray?”
“ Right about when I finished the coffee you brought me. Thanks again.”
His jawed dropped.
He went over to “The Queen” (now back from lunch) and said, “That guy’s been here since before I started my shift! What the hell’s taking so long?”
“Umm…..I think we’re waiting for his X-Rays.”
“Then call X-Ray and see where they are.”
“That’s not my job.”
Then he called her a “useless *&*^%$ “ came back to me, asked my name, and said he’d be right back.

1:25 He returned in a huff with my X-Rays, asked me to come with him, threw the X-Rays on “The Queen’s “ lap, and said, “Here’s his X-Rays. Call the NP.”
“I don’t know where….”
“THEN GET OFF YOUR FAT ASS AND FIND HER!!!......NOW!”
Wow! Dude was p!$$ed!
If I hadn’t witnessed it, I would never believe that someone who displaced so much atmosphere could actually run! (Well, “waddle really fast” is more accurate.) Watching her jiggle down the hall and feeling the floor vibrate with her every step caused me to laugh, which really made my rib hurt and I was chuckling and “owing” at the same time.
The janitor asked “You okay?” (He wasn’t laughing.)
“Yeah, I’ll be alright. Seeing you make her jump is worth the pain.” Then he chuckled a little too and told me how little he thinks of the help, that “The Queen” had been asking for it for weeks, and he sees this sort of thing far too often. “Been working here 22 years. If I was boss around here, I’d fire 90% of them. Man I can’t wait till retirement.”

1: 30 The NP came down the hall at a trot (“Her Highness”, wheezing heavily, was far behind ) “I’m so sorry. I thought some one else must have signed you out.” (I think she was trying to cover for the Queen somehow.)
“Can I pleeeease leave now?”
“Almost. That’s one nasty break. I’m surprised you didn’t puncture the lung. And you still could, so be careful. If you cough any blood call for help immediately. Also, your body’s going to “short stroke” your breathing to ease the pain and there’s a slight chance of that causing the lung to collapse. So force yourself to inhale deeply for 5 minutes each half hour the next few weeks. It’ll hurt, but you have to do it. Here’s a script for Percocet. Here’s my card, call me if you need anything. I’m really sorry this took so long.” (She meant it too.)
“Thanks Doc. Thanks Buddy” (The janitor.)
And glaring at “The (still breathing heavy) Queen” I said, “I’d ask for a lollipop but I know they’re all gone.”

6 weeks later I get the bill. $1800 of which I had to pay $360 (insurance covered the rest).
“Oh No. No, no, no, no, NO! Six and a half hours of waiting for twenty minutes of diagnosis and no real treatment? Hmmm… lessee now…. 1800 times three is…….. $5400 per hour?!?!
No. HELL No. I ain’t paying.”

I wrote letters telling this tale to my insurance company (said they were crazy to pay what they had) and the hospital (told them that one of the world’s most premier hospitals is a model of inefficiency, ineptitude and fecklessness. “The best treatment I received was from the guy who sweeps the floors!”)
Much to my amazement, I received a handwritten apology! And didn’t have to pay!

It’s not the professionals (MDs, NPs, RNs, etc.) nearly every one I’ve dealt with was great. The guy that closed my face/nose (goalie stick, 30 plus stitches) so finely that the scar barely shows (he even managed to blend it into my “laugh line”) is truly gifted. The guy that spent 22 hours re-attaching my buddy’s severed hand (log splitter, I actually caught the hand….not pretty) so precisely that he has 95% usage of it is, in my eyes, one step down from The Almighty Himself! The problem is with the insurance companies and low level staff who think they’re in a position of authority. It’s sickening. (No pun intended.)

SO, unless I’m bleeding profusely, I’m “going Rambo” and sewing myself up from now on (Brigade Quartermasters sells excellent suture kits). Any thing serious and I’m putting a collar around my neck, getting down on all fours and going to the veterinarian! I might even bark and growl for effect. (Hey Strick, do you make house calls?)

Didn’t mean to be so long winded. Thanks for letting me vent.

Re: Health Care...Whats Wrong With This Program?
 

WOW! I like the janitor.

For all you who get stuck in ER's waiting for the staff who are busy playing video games, or watching the latest episode of "House" on reruns, here's a tip from my wife, who is a nurse and works in a hospital. She absolutely HATES working with inefficient jerks who think they are there just for a job, as opposed to those who are there to care for people:

The name of the Hospital CEO, and the Chief Medical Director for every hospital in the US in public information, and 99% of them have listed phone numbers. If they work for a non-profit hospital, they MUST have public contact information listed.

So, after you've watched the intake nurse lose her 32nd game of Minesweeper, call the CEO or the Chief from your cell phone, and show him the photo you just took while you were waiting for someone to help you. My sister-in-law did this when my then 7 yr. old niece had been waiting untreated and unexamined in the ER in Providence R.I. for 3 hours with bilateral pneumonia, and was subsequently found to have a blood oxygen level of 71%. The Chief Medical officer for the hospital really didn't like being awakened at 1:30 a.m. to learn his empty ER couldn't even see one sick little girl because no aide could be found to transport the child to xray, and union rules forbade the triage nurses doing it. Their entire 4 day hospital stay and treatment was FREE, except for the doctor's fee's which were only $80, a $20 copay per day.

The moral of the story: Don't be afraid to make some noise. Call the CEO, call the Medical Chief, call the Chaplain = SHAKE THE BLOODY HIERARCHAL TREE!! It really, really works. On the other hand, if they are really busy, be patient with the triage process. Some hospitals really do work hard to help.

BTW, when they tell you your cell phone call will "interfere" with medical or diagnostic equipment, that's a lie. That was only true for some old analog cell phones, which were finally phased out completely in 2006. No, repeat NO, digital cell phones interfere with any medical equipment if you disable Bluetooth communication temporarily. And Bluetooth has a maximum spherical range of 50' in open air, and about 25' in a steel reinforced building. (Nor do cell phone calls interfere with aircraft navigational equipment anymore, either, as long as Bluetooth is disabled. But the law was passed banning their use in flight in the days of analog devices)

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Hookdude, that was priceless. The story would make for a good short movie. You could be the next Michael Moore.

Kinda cool how you saved your buddies hand.