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10b4me
Ice climber
Soon 2B Arizona
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May 19, 2013 - 05:21pm PT
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My mom's last ambulance ride (2.5 miles): $875
Have often wondered why fire departments charge for taking someone to a hospital.
Don't we pay taxes for that?
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DanaB
climber
CT
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May 19, 2013 - 05:23pm PT
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Hello,
Hope you're healing well and completely. Never nice to get hurt.
Serious question: What do you think would have been a fair price for the services you received?
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Paul Martzen
Trad climber
Fresno
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May 19, 2013 - 05:25pm PT
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The Obama administration just released a list of hospital charges fort the 100 most common treatments. Costs are all over the board and seem to be set pretty much arbitrarily.
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html
NPR has several informative stories related to these costs.
This is TALK OF THE NATION. I'm Neal Conan in Washington. One hospital outside Dallas charges a little over 14 grand for pneumonia treatment. Another hospital a few miles down the same street charges more than twice as much, over $38,000. Why? Why has it taken so long for those prices to be made public? And now that they're out, how is that going to change health care?
Today the Obama administration published the prices hospitals charge for the 100 most common procedures, and the discrepancies are staggering. Here in Washington, one hospital charges $69,000 for a joint replacement. You can pay less than half of that just across town.
http://www.npr.org/2013/05/08/182295999/dramatically-different-health-care-cost-go-public
http://www.npr.org/blogs/health/2013/05/10/182916297/dramatically-different-medicare-bills-set-hospitals-thinking
It seems to me that there may be a strong correlation between increasing use of medical insurance and increasing medical costs.
If everyone paid for medical care out of pocket, then few could afford really expensive care. Hospitals and caregivers would have to charge only what the people could pay. With increased use of medical insurance in the last 30 years, there has been created a huge pool of money held in reserve by the insurance companies. This money becomes a target. Hospitals and caregivers have an economic obligation to try and get as much of that money as possible by raising prices. Any money that they don't get just stays with the insurance company.
The people with insurance have an incentive to use more medical care since they are paying so much money for premiums. So doctors find procedures that they can charge more money for.
As medical prices go through the stratosphere, individuals realize that they will go bankrupt if they have to pay on their own. So fear drives more and more people to paying the high premiums for insurance. Since we are paying such high premiums we want more medical care to justify the expense. Insurance companies have more and more money in their coffers and hospitals have even more incentive to try and get as much of that money as possible.
It seems like a vicious circle that can only end in some sort of collapse. But maybe not before most of us are bankrupt or in debtors prisons.
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Jon Beck
Trad climber
Oceanside
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May 19, 2013 - 05:36pm PT
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I was in a car wreck a few years ago. I was pretty banged up but walked away. EMTs tried to get me to go to the hospital. I wisely refused, still surprised I did not get some BS bill from them exchanging ten words with me
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'Pass the Pitons' Pete
Big Wall climber
like Ontario, Canada, eh?
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May 19, 2013 - 05:37pm PT
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This sort of notion is inconceivable to me!
Up here in the Great White North, it's basically free. You have to pay for your ambulance ride, crutches and cast, but not really anything else. Well, except your beer and wine, which is basically double the price you Merricans pay. And everything else you buy - add sales tax of 13%. And then of course, there's income tax [for those who actually work and generate income]. So they tax your up here, nearly to death, but at least when you're dying, it's free.
Note to any hot single Merrican girls - if you marry a Hoser, you can get free health care coverage, too.
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Reilly
Mountain climber
The Other Monrovia- CA
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May 19, 2013 - 06:25pm PT
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Yeah, Pete, but she'll have to come back down here if she wants to attend
a Cup final, eh? :-o
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SCseagoat
Trad climber
Santa Cruz
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May 19, 2013 - 06:55pm PT
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Have often wondered why fire departments charge for taking someone to a hospital.
Back where my Dad lives (Pa) if you call an ambulance and DON'T go to the hospital you are charged...if you go, no charge...at his age it's something about Medicare...
I go to Stanford for my oncology follow up and when I go to the imaging center for CT scans I feel like I'm going to a spa...Japanese screened private rooms, computers in every room, recliners, and an escort in a lovely red jacket to take you from the waiting room to your private waiting room. It's nice not to be herded like cattle, but this seems way over the top. And each scan???? 25K. Luckily I have insurance and pay 10% but my out of pocket max gets met pretty quickly so often I don't end up paying. But I do pay my own insurance since I retired early at $1000 per month...but thank gawd I kept it up.
Susan
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ron gomez
Trad climber
fallbrook,ca
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May 19, 2013 - 07:06pm PT
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Dave, call the billing dept., negotiate the bill down to about 1/4 the cost, this is about the standard insurance reimbursement on the dollar. Tell them that's what insurance standards are and pay it off if you can. NEVER pay the first billing, they will always negotiate a lower number and are usually happy just to get the bill paid in full.
Hope yer getting better, were you riding with that "Tapes" dude? Have him pick up the bill!
Peace
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mrtropy
Trad climber
Nor Cal
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May 19, 2013 - 08:24pm PT
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I see the NPR story already posted, it was very interesting. Insurance companies never pay the stated rate.
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Brandon-
climber
The Granite State.
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May 19, 2013 - 08:35pm PT
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Yeah, Pete, but she'll have to come back down here if she wants to attend
a Cup final, eh? :-o
Now that's funny. Thanks for the chuckle.
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LilaBiene
Trad climber
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May 19, 2013 - 09:29pm PT
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About 5 years ago I wound up in the ER with severe nausea (I couldn't stand up without nearly passing out). I had insurance (or so I thought - turned out it was canceled after-the-fact, effective one month earlier). I was there for about 1.5 hours, on a bed in a hallway. Ultrasound showed I was pregnant with the muppet, and they gave me two anti-nausea pills for the next day and sent me on my way.
A week or so later, the bills started streaming in...in total, my 1.5 hours at the ER cost over $10,000. I was in shock!
I called the billing department and explained that I was not in a position to pay and that I couldn't for the life of me understand over $10,000 in bills for 1.5 hours (of which maybe 15 total were spent in the presence of any nurse). In less than a minute, they knocked it down to a little over $1k. Just like that.
Makes you wonder.
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DanaB
climber
CT
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May 19, 2013 - 10:08pm PT
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What would be fair prices for some of these services?
How would those figures be determined?
How do the hospitals, ambulance services, and other deliverers of health care set their fees?
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Holdplease2
Big Wall climber
Yosemite area
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May 19, 2013 - 10:26pm PT
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The best thing you can do is to make sure that you don't have any income, assets or any savings. This way you can walk into hospitals "when the time comes" and be handed the best care on earth and never have to pay a dime.
Too bad so sad if you actually worked, invested, planned, and saved. They will take it all. Or just don't go get medical care.
Kate
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Ghost
climber
A long way from where I started
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May 19, 2013 - 10:55pm PT
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You can get great basic healthcare in Chile.
Or Canada. Or Sweden. Or Japan. Or France. Or Germany, or...
... or any other first-world country except the US.
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Mimi
climber
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May 19, 2013 - 11:18pm PT
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The overcharges are used to cover the people that don't or can't pay. Take from the ones who can pay to cover the losses. Goes for insurance companies and hospitals.
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pud
climber
Sportbikeville & Yucca brevifolia
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May 19, 2013 - 11:41pm PT
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Sounds about right Dave.
When they hauled me off the track @ Willow Springs and dropped me at the Lancaster urgent scare, it was well over $12k after two hours in that place + the $2,500 fifteen mile ambulance ride
Grade III AC separation right shoulder. They wanted to perform surgery right then.
As soon as the cat scan of my skull came back ok, I hobbled out of that place, pronto.
It works like this:
They charge astronomical prices then 'adjust' them to merely expensive when covered by decent insurance. If you don't have insurance, you pay the high price.
Wayne
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Largo
Sport climber
The Big Wide Open Face
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May 19, 2013 - 11:52pm PT
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This would be called price gouging in any other field. It can't last.
JL
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Jon Beck
Trad climber
Oceanside
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May 20, 2013 - 12:04am PT
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I have been practicing consumer law for almost 20 years. Insane medical bills, even for insured people, are routine. If you get stuck with a huge bill you can not possibly pay there are a few things you should know.
Statute of limitation is generally 4 years in California, means they have 4 years to sue you. The time runs from the date services were rendered.
They can not reach your wages, bank account or assets unless they sue you and get a judgment
If they fail to sue you in the four years then the expiration of the statute of limitations is a good defense to a late filed lawsuit. They could louse your credit for 3 more years, after 7 years from the date of services it drops off your credit like it never happened.
I can not recall ever seeing someone sued on a medical bill in San Diego. I know it happens in other places, and maybe here, I just do not see it here.
In CA you can own considerable assets and still be judgment proof. Retirement accounts, IRAs, 401(k)s are all generally untouchable. Up to 150k equity in a home could be untouchable. All household goods, a car, clothing are all generally untouchable.
For big, but not impossible bills I have seen people pay 5 dollars a month and the collectors leave them alone.
This is a very broad generalization and every state has its own peculiar rules, and even within California your mileage may vary.
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Gimp
Trad climber
Grand Junction
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May 20, 2013 - 12:36am PT
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Huge cost in medicine is "administrative" costs. I have spent most of my career in hospital based surgical practice, and everyday it seems there are more administrative types sitting in what were patient rooms now converted to offices, wandering around in suits and skirts, or having catered breakfast and lunch meetings.
Private surgery centers control this type of metastatic growth much better than hospitals, which is how they keep cosst down.
All the people not really providing patient care should be the first thing trimmed IMO.
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Reilly
Mountain climber
The Other Monrovia- CA
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Gimp, as you know much of that admin stuff is due to the guvmint and their
insane 'coding' requirements. If you miss dotting one 'i' or crossing one 't'
you might not get paid by medi-whatevah. But, of course, hospitals and
insurers can use that excuse to their advantage.
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