Health Care...Whats Wrong With This Program?

[Islandtrader]

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.

[hermco]

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.

[bigeasy1]

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.

[PressureDrop]

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.

[Briguy]

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]

[rockdoc]

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

Steve
(Dr. steve)

[Bushwacker]

"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

[strick]

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

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?

strick

[Spidercrab]

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!

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

[GradySailfish]

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.