Sorry, I Have To Vent

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  #1  
Old 02-23-11, 07:35 PM
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Sorry, I Have To Vent

My little sister went to the doctor the other day with indigestion. Talked to the doc for about 5 minutes, no tests were done, doc just says to cut down on caffeine.

She gets the bill...$220 for an office call.

Sister calls the doc and asks why it was so expensive. "The office call price is based on what the doctor does."

SAY WHAT?

What the heck would the price be if they actually had to do something? And people wonder why insurance is so expensive.

I just don't get it.
 
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  #2  
Old 02-23-11, 08:27 PM
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Might be a baseline fee and then goes up from there. I would find another doctor. Some are $70 for a vist no matter what unless you need tests. one i went to was $70 and had blood work done no extra charge no insurance.
 
  #3  
Old 02-24-11, 04:37 AM
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Seems a little steep to me, but without knowing their total overhead, a bit hard to judge. I agree with flirty; that was probably the base rate charged whether you're in the office 10 minutes or 45 minutes. I have the same discussion from time to time, "It's only four blocks to my house and took less than 10 minutes; why is the tow so much ($45)." The time and/or distance has almost zero effect on the expense of running the business. I confess I have no idea what the base rate without insurance is for our doc's office. I usually get less than five minutes with the doc himself, but by then I've been weighed and had vitals done by one of the nurses, followed by a game of 20 questions with one of the PA's. All adds up.
 
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Old 02-27-11, 05:49 PM
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  #5  
Old 02-28-11, 09:46 AM
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So don't get mad at me I'm just the messanger, but as a Canadian with virtually free 1st class health care for one and all, it boggles my mind why so many Americans were against what your President was trying to offer. BTW before anyone rants about wait times my personal experience with a tumor, MRI and surgery, all at a world class hospitial was, 5 weeks from diagnosis to discharge, All free. Broken leg? child birth? sniffles? All free.
 
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Old 02-28-11, 12:42 PM
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Well, from my point of view, for starters the US is not Canada. Canada has what, about 1/10 the population of the US (had to look that up, wasn't really sure)? And what kind of federal budget $$$ does Canada run? National debt load? Unemployment rate? Existing expensive federal programs? Illegal immigrant population? I think most people who are skittish about universal health care here are worried that it wil be run by the same people running Social Security, Medicare, Medicaid, et al. "Free" is a relative term; you're paying for it in some way, shape, or form.
 
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Old 02-28-11, 02:16 PM
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I think TG hit it on the head. It isn't the fact we wouldn't welcome "FREE" health care, but TANSTAAFL. You have to pay for it somehow, and we don't have the budget for it, nor the way to raise the money.

Edit: Oh, There Ain't No Such Thing As A Free Lunch
 
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Old 02-28-11, 03:03 PM
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Larry, you had me confused until I read your edit

It would be nice if we all had medical insurance but it has to be paid for somehow...... and with what little I know about the new health care bills - I've not seen anything that addresses the root of the problem - the high cost of medical care.
 
  #9  
Old 03-01-11, 04:04 PM
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... I've not seen anything that addresses the root of the problem - the high cost of medical care.
Exactly, and that is the elephant in the room that NOBODY will talk about. We hear over and over about the high cost of insurance but not a peep about $220+ office calls etc.

It should be quite interesting to see how this pans out. Unfortunately, I don't think I'll be around long enough to see it.
 
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Old 03-02-11, 04:14 AM
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You know what is weird? We recently dropped dental insurance on our policy where my wife works due to the cost of premiums out weighing the cost yearly (over a 10 year period) of procedures we had done. Up until now, the bill was sent through insurance, they determined what was the obligation of the provider, and me. For instance, the dentist would charge $119 for a cleaning. My part usually ran about $45. That's OK. Now the total cost for the same cleaning is $54 with no insurance. Is there one price for insurance bearing clients, and another price sheet for those without?? Verrrrry interesting.
 
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Old 03-02-11, 04:27 AM
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I think you'll find similar things happen at doctors' offices, hospitals, etc. Whenever we get an EOB it'll show the "list" price of the service, let's say $500 just for a round number. After this number is the "contracted", or discount price, i.e. what the medical facility has agreed to charge the insurance company which is maybe $200. Lastly the co-pay is shown.

One of my theories is that there is a tax loophole or advantage whereby the difference between the "list" price and the contracted discount price is somehow written off as a "loss". Any CPA's out there to comment?
 
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Old 03-02-11, 04:41 AM
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Larry, I like your dentist prices! I had a tooth pulled awhile back and was going to make another appointment to have my teeth cleaned until I found out that would $175
My teeth don't need cleaning that bad
 
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Old 03-02-11, 04:55 AM
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Yeah, using those figures, if we pay $50 per month in premiums, go see the dentist twice a year each, that's only $216 of the $600 in premiums. Granted having a filling, or other work is more expensive, but the $384 left over compounded can cover that over a few year's. We take care of our teeth, so we just don't have problems, yet
Ooh, $175, that hurts my teeth to think of it!
 
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Old 03-02-11, 11:59 AM
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It is even more depressing to see stories where an off the shelf item can be bought for $10 and Medicare insurance get charged $120 and pays it. Did anyone wonder why these programs are in trouble?

If the health care professionals can accept a much lower fee from the insurance company why does someone without insurance need to pay the full price?
 
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Old 03-02-11, 01:46 PM
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If the health care professionals can accept a much lower fee from the insurance company why does someone without insurance need to pay the full price?
Indeed, something I've wondered for years. I wrote here a few years ago when my daughter had her baby and the bill was (guessing here) was 14k yet when all was said and done, the insurance only had to pay 8k. Mystery to me.
 
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Old 03-02-11, 02:04 PM
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I can talk about the other side of this - in the last ten years, I've seen the amount I collect from the average patient go down by 1/3. This is not taking inflation into account, this is just dollars to dollars. The reason for this is the insurance companies keep declaring procedures are worth less and less or not allowing them at all anymore. The reason I may have a price significantly higher than what the insurance company allows is so they get the impression they are slicing me deeply, which is the only way we providers can think of to get them to raise their reimbursements. There is no write-off for this amount, as I run the business on cash based accounting and therefore delcare what I get paid. Were I on accrual, there would be a write-off but it would offset the full price I had declared in my income, so no net gain to me. Also, my 'average' is less than 20% of the number quoted above, though I'm in a different specialty.

If someone does not have insurance, my costs are lower so my fees are lower, I do not charge them the 'list' price for the procedure.
 
  #17  
Old 03-02-11, 07:07 PM
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Originally Posted by pcboss View Post
It is even more depressing to see stories where an off the shelf item can be bought for $10 and Medicare insurance get charged $120 and pays it.
I'm not sure that is true. I have Medicare and generally the doctor or hospital charges one price and then Medicare reduces the charge and I pay 20% of the reduced charge. A few years ago when I cut the tip of my thumb off the ER bill was somewhere around $1500, after Medicare reduced the bill, my 20% was in the neighborhood of $70
 
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Old 03-02-11, 07:24 PM
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Originally Posted by pcboss View Post
It is even more depressing to see stories where an off the shelf item can be bought for $10 and Medicare insurance get charged $120 and pays it. Did anyone wonder why these programs are in trouble?
Medicare admits overpaying for common items like wheelchairs - Sun Sentinel
 
  #19  
Old 03-02-11, 10:12 PM
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I agree there is no free lunch.

The culture is differenent in Canada though. I'm 55 and can't imagine paying for a doctor's visit or a test. WTH? I consider cost about as much as I think whether I have on clean underwear.
Im happy but Im not so naive as to say its the absolute right way.

My BIL is now an American and lives in Seattle. He pays thousands/yr for his health plan that is still is not as good as what he had for free(?) back in Canada. He *****es all the time.

However, our taxes would boggle your mind. Plus our social programs would make you shudder. For ex we get 3 weeks holidays when we start work. I pay over 40% of my income for taxes, Canada Pension etc.

United States folks would revolt over that!

My wife is a nurse and states that anyone needing urgent treatment is done quick. She works in Day Surgery and Pre Admission so she has a clue. My Daughter is a nurse in ER, as is my sister. They think its a good system but they see plenty of abuse. Dont tell my wife you smoke and then ***** about health care!!!!

I waited over a year for my knee and shoulder. Annoying but I could function. My Dadhad cancer and was within hours.

I did not need to consider cost when deciding whether to take my infant daughter to the doc

Buuuuut I dont think this will fly for years in the states as its such a total change for you. The states has a strong "look after yourself" mentality.

Universal Health Care is expensive. Not all of you will benefit in your lifetime. Thats a fact.

Your taxes will rise. Is it worth it? I think so.

I respect , appreciate and applaud the US attitude. It made you one of the greatest countries on the planet. Us Canucks drafted in your success for sure.

So who am I to judge ........but.... I'm blissfully happy in my little world.
 

Last edited by mjd2k; 03-02-11 at 10:29 PM.
  #20  
Old 04-01-11, 09:28 PM
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Originally Posted by fairplay View Post
So don't get mad at me I'm just the messanger, but as a Canadian with virtually free 1st class health care for one and all, it boggles my mind why so many Americans were against what your President was trying to offer. BTW before anyone rants about wait times my personal experience with a tumor, MRI and surgery, all at a world class hospitial was, 5 weeks from diagnosis to discharge, All free. Broken leg? child birth? sniffles? All free.
Free you say? c'mon......nothin's free! you ALL pay for it in higher taxes and higher and higher and higher it goes while breaking the backs of small business owners and putting privately owned insurance companies out of business and growing government who has NO ability to balance a budget. It also makes more and more people dependent on big government but hey....it's FREE!
 
  #21  
Old 04-02-11, 03:09 AM
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Last fall I got a letter from medicare stating that in 2011 a colonoscopy would be free. Since I was overdue for one, I had it done. I was a little shocked when I got bills totaling $300 for the procedure. I went to the Medicare website and found where they said the test was now free - right above where they said you only have to pay 20% or 25% depending on where it was done. Who knew FREE would cost so much
 
  #22  
Old 04-02-11, 04:13 AM
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Went for pre-op yesterday for my left knee replacement. Luckily with wifey's insurance at the hospital my deductible was $1500, but I had paid half of that during the year with other goofy stuff. Only had to come up with $900 for a $53,000 knee . Better yet, right knee in a few months, no pay. I like that!! Wednesday is the magic day, and I can't wait!! 1 to 10 pain scale, I live in a constant 8, so doctor can't induce more than I already have.
 
  #23  
Old 04-03-11, 10:20 AM
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Chandler, knee is next on my list but hope not for a few years. Keep us updated. Curious if you will still be able to play hockey after the op.
 
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Old 04-03-11, 10:31 AM
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Mr Mackay, Cant argue with your points but virtually of us Canucks are so dumb we have lived lifetimes not worrying that we have the problems you outline. . As they say in my favorite commerical "if you don't think about it, it makes sense"
 
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Old 04-03-11, 11:16 AM
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Mjd2k, I'll let you know on Thursday. Believe me, you'll KNOW when to do it. It got to where Synvisc One was having no effect, and I was solely supporting the Aleeve drug company. Gotta figure, all I'll have is site pain with a little muscle stretching. No knee pain as the knee will be in the trash can.
 
  #26  
Old 04-03-11, 12:29 PM
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I support you Larry...I'll be looking at the same thing in the (not too near, I hope) future. Can't believe it will be that simple. I know when I had my shoulder repair I was either doped up and asleep or in some real intense pain (til the drugs kicked in again) for about 10 days. And I've been married 3 times...so I know pain...lol.
 
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Old 04-03-11, 01:25 PM
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New technique. They used to cut you 12" down the front of the knee, cut the quadracep, lay it and the kneecap down and do the surgery. Bring the quad up and tack it in place to grow back. Usually a 3 month recovery time.
Now, they move the incision over interior 2", make it 4" long, flip the kneecap and quad over to do the surgery, flip it back and sew up the incision. No muscle or ligament trauma.
We'll see how it goes. Thanks for the well wishes. Now, If I can figure out how to run a company for two days while I am in the hospital.........
 
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Old 04-04-11, 03:12 AM
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Did I just hear Larry's crew say "party time"

Hopefully you've trained them well and they have a good work ethic.
 
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Old 04-04-11, 04:17 AM
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Yeah, I've got one (my main guy) who I call my "piano builder". Young kid who will not take "so so" for an answer. Crown molding that I would leave for you to caulk and paint he would have nothing to do with it. It must fit perfectly! His math, including geometry is impressive. Gotta feel good about that. Putting up wainscoting with chair rail, his wainscoting must be perfect with laser level . "Hey, Jorge, You will cover the joint with 3" chair rail!!!" No matter. I live with it.
Don't worry, I'll have my computer and cell phone with me. They can't stray far!!

Sorry Baldwin, didn't mean to tangent your thread!!
 
  #30  
Old 04-04-11, 10:03 AM
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No problem, I find it very interesting. My BIL (50s) had his knee done last summer. I asked him when he was gonna do the other one, "NEVER." He's not happy.

Seems they have to do it over again. Every now and then the knee feels like it is gonna give out, not good when you install garage doors for a living. The doctor said they have to put in a bigger washer or bushing or something like that. My sister thinks he is having these problems because he's so bow-legged.

Good luck with yours!
 
  #31  
Old 04-04-11, 01:56 PM
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Doc told me I need one but not quite yet. When I do, I'm getting both done at the same time. That way I can get a 2" extension. I'm just over 5'6" so I may as well get that done at the same time. Makes sense right?
 
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Old 04-08-11, 06:17 PM
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OK, two days post op. Aside from being given Hydromorphone (Dilaudid), which is 5 times stronger than morphine, the initial pain from the surgery recovery room to my room took 4 hefty people to hold me down. They said I was throwing them like pillows. All the sage advice "you need to lay down and be quiet, or you can't be in that much pain?" didn't seem to help any. I'm home, in my own bed/recliner and just have to work out the muscle kinks a little.
Where is my Lortab.......goodnight.
 
  #33  
Old 04-09-11, 10:14 AM
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Nice to be home eh? I was gonna mention the pain is a bit intense at first, didn't want to scare ya. It'll get better and be well worth it in the long run.

Just wait till them rehab people start yanking on it, "you have to bend it." When they say it might hurt a 'little', you best bite down on a 2x4.
 
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Old 04-09-11, 12:05 PM
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Baldwin, I don't think you could have talked me out of it, anyway. I have a very high threshold of pain, and my wife couldn't understand why I was throwing people if they gave me good "stuff".
Oh, yeah, PT "lady", we'll call her Gretchen, came by yesterday, and started me on her regimen. Just like you said, "ooh, it's gonna hurt a little". 2x4 my grits, better be cold rolled.
Much better mobility today. Top of leg above knee felt really swollen, but I put some Hell Fire Analgesic on it and it has reduced it somewhat.
Nice to be home again, Toto.
 
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