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Author Topic: Medical Bills  (Read 2971 times)
kathyp
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« Reply #20 on: January 13, 2012, 03:06:14 PM »

insurance pools already exist.  i suggest, and others have, that this is a way for those who would normally be dependent on the state, to buy limited coverage that they pay for.  yes, to some extent the cost would be passed on to others, but it would be less cost than is currently passed on.  for one thing, you'd be able to do away with much of the government bureaucracy that sucks up tax dollars before it gives more tax dollars to the poor.  
because people would be paying for the services they use, they would be less apt to abuse them.  same goes for doing away with insurance for routine care.  less abuse, more competition, we all pay for our own.....less cost.

you seem to think that the medical system is out to get you.  remember, they are forced to care for anyone who walks in the door reguardless of insurance or ability to pay.  the guy with no insurance and chest pain gets the same workup and the guy with good insurance or cash in his pocket.  you pay for that.  

what we have, is not efficient or cost effective.  what the government offers, will be a disaster.  we need to think outside the box and people need to be more responsible for their own.  

what would be your solution?
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.....The greatest changes occur in their country without their cooperation. They are not even aware of precisely what has taken place. They suspect it; they have heard of the event by chance. More than that, they are unconcerned with the fortunes of their village, the safety of their streets, the fate of their church and its vestry. They think that such things have nothing to do with them, that they belong to a powerful stranger called “the government.” They enjoy these goods as tenants, without a sense of ownership, and never give a thought to how they might be improved.....

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« Reply #21 on: January 13, 2012, 05:37:59 PM »

You have pretty much proved my point that the current system is broken and un-sustainable.  Fewer and fewer people are paying into the system and more and more people are collecting.  As iddee says, the shrinking pool is also paying for the uninsured as well as the accelerating costs of an aging population.  The pool of younger healthy workers isn’t an infinite ATM machine; they can’t continue to support everybody. 

The current system makes no logical sense; it’s financially un-sustainable.  Yet the Republicans won’t budge to make ANY changes?   That makes no sense.

I tend to agree with iddee that keeping costs under control would be the optimum solution.  Making all the patients feel some real financial pain in medical visits would be a good start.  I know plenty of people with insurance that run to the doctor at the first sniffle and wastes countless hours of doctor’s times.  You can tell these people there is no cure for the common cold virus until you’re blue in the face and they still run to the doctor and get antibiotics EVERYTIME (which of course have no effect on viruses).   While that is a very wasteful use of resources, I believe the majority of medical costs still arise from REAL ailments in the aging population.  You can’t make a bad gall bladder go away.  There seems no way to keep the costs of REAL ailments in check.

Since there seems to be no way to bring the costs under control, the only other viable solution is to make EVERYBODY pay for this system.  You, me, welfare people, everybody.  That makes the pool bigger and keeps the boat afloat for while longer.  That is what Obama care does, it makes everybody (especially the young healthy people) pay into the system to keep the pool funds >= the 15% of GDP we’re spending on medical care every year.


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iddee
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« Reply #22 on: January 13, 2012, 06:52:51 PM »

""You can’t make a bad gall bladder go away.""

No, but you can see a problem with that gall bladder operation costing 135 times what it did 20 years ago, when inflation is less than double.

Get the sniffle visits cut out and let only the sick get treated. You know, only those who are sick enough to be willing to pay what they have before getting help. There should never be a free visit to a doctor.
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kathyp
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« Reply #23 on: January 13, 2012, 07:53:47 PM »

Quote
The pool of younger healthy workers isn’t an infinite ATM machine; they can’t continue to support everybody.


welcome to conservatism, my son  evil

Quote
Yet the Republicans won’t budge to make ANY changes?

in fact, they offered (i think 3) different plans that this admin refused to look at.  what would you like them to do?

Quote
Since there seems to be no way to bring the costs under control, the only other viable solution is to make EVERYBODY pay for this system.  You, me, welfare people, everybody.  That makes the pool bigger and keeps the boat afloat for while longer.  That is what Obama care does, it makes everybody (especially the young healthy people) pay into the system to keep the pool funds >= the 15% of GDP we’re spending on medical care every year.

how do you figure that? if you already have 47% not paying federal taxes, and you have given out all kinds of wavers to companies so that they can opt out, seems to me you end up in even worse shape with this plan.
which is the goal
because
they don't want an insurance plan.  they want a health care system that is government run.  universal health care is the goal and Obama has said so. 

we have pointed out ways to bring cost down, and quickly.  you don't like those ideas, but they will work and you will retain choice and quality.
-----------
tell me how the Obama plan works....WAIT!  i'll save you the trouble.  no one knows how it works.  the thing was a slog to read and a huge part of it was "to be determined by the secretary of health and human services".  a huge bunch of money was dumped on it up front and the things they thought people would love was started up front.  the rest? to be determined.....
and yes....i read it.  that's part of my life i'll never get back  hissy fit

no one is arguing that medical cost are really high.  however, spreading the cost around some more is not how you fix it.  England has a population of around 65 million people.  the NHS was (don't know if it is still) the 3rd largest employer in the world.  not the country.  the world.  why?  because that's what government does.  they can't afford it.  they can't fix it because it's "a right" now and the care for many thing is both crappy and rationed.  that's what you will spread around, not more affordable, or better care.
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.....The greatest changes occur in their country without their cooperation. They are not even aware of precisely what has taken place. They suspect it; they have heard of the event by chance. More than that, they are unconcerned with the fortunes of their village, the safety of their streets, the fate of their church and its vestry. They think that such things have nothing to do with them, that they belong to a powerful stranger called “the government.” They enjoy these goods as tenants, without a sense of ownership, and never give a thought to how they might be improved.....

 Alexis de Tocqueville
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« Reply #24 on: January 15, 2012, 01:58:09 AM »

... $41,000 to have a gall bladder removed... That was what the hospital billed my Dad to have his gall bladder removed... insurance covered most of that, but ultimately SOMEBODY paid this exorbitant price...

Medical insurance companies have steep discount deals with hospitals.  These discounts commonly are in the 80% range.  So the insurance company may have paid less than 12 grand to settle your pop's medical bill.  Much less if he had a 80-20 or similar insurance co-pay.  The hospital’s billing rates frightens us into buying medical insurance and then the hospital cuts a special deal with the insurance companies and settles for less, maybe way less.

I still have the recipe for my last daughter.  She was born in 1981.  I paid the doctor bill every month when my wife saw the doctor.  I negotiated a cash deal in advance with the hospital for the delivery so this amount was only the hospital bill, no doctors' bills were involved.  $1,800 for 4 days in the hospital for my wife and infant daughter, the delivery room, the operating room and an operation to tie my wife's tubes.  I also have the recipe from my father's 2 week stay in a Catholic hospital ward from the mid 50s.  His or our part of the hospital bill was $14 or a dollar a day.  I know he had medical insurance I just don't know how much.

The Hill-Burton Act passed by Congress in the late 40s was the slippery slope that lead to an avalanche in medical costs by creating perverse (perverted) incentives for hospitals and doctors.     
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luvin honey
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« Reply #25 on: January 19, 2012, 05:43:47 PM »

yup, it's expensive.  what if you had the option of only paying for the care you needed for the year, and paying much less for a catastrophic insurance policy?  bet you wouldn't spend 11 thousand dollars for the care you used!
Our portion of the policy cost us about $4000. The rabies shots that were covered by that policy (after deductible) were $4000 PER family member (4 in our family).
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iddee
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« Reply #26 on: January 19, 2012, 06:05:57 PM »

And if we could find the actual cost of manufacturing that vaccine, what do you think it would be? 15, maybe 20 dollars? Maybe even less?

Then they charge 4000 plus deductible to administer it? That is what I am referring to. We need to reduce medical charges, not find ways to pay them as they soar totally out of the universe. If there was no ins. and no gov. interference, the bills for your family would likely total less than a hundred dollars for the rabies shots.
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"Listen to the mustn'ts, child. Listen to the don'ts. Listen to the shouldn'ts, the impossibles, the won'ts. Listen to the never haves, then listen close to me . . . Anything can happen, child. Anything can be"

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kathyp
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« Reply #27 on: January 19, 2012, 07:42:27 PM »

you need only look at things that are not covered by insurance to see how it works.  laser eye surgery and many cosmetic surgeries as example.  when the procedure first comes out, it can be pretty expensive.  as more docs compete to do whatever it is, the cost comes down.  the technology also improves. 

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.....The greatest changes occur in their country without their cooperation. They are not even aware of precisely what has taken place. They suspect it; they have heard of the event by chance. More than that, they are unconcerned with the fortunes of their village, the safety of their streets, the fate of their church and its vestry. They think that such things have nothing to do with them, that they belong to a powerful stranger called “the government.” They enjoy these goods as tenants, without a sense of ownership, and never give a thought to how they might be improved.....

 Alexis de Tocqueville
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« Reply #28 on: January 19, 2012, 07:57:26 PM »

Ouch!  Ouch!  Lovin Honey why are you getting rabies treatment if I might ask?  I would like to avoid a similar fate  grin

I’m not up to date on my rabies knowledge, but I expected the treatment (vaccine) would have been off patent protection by now.  One of the reasons why the meds are sooooo expensive is because there is no competition because they’re under patent protection for 17+ years.  The original intent of patents was to give an inventor enough time to recoup their development costs and make a fair profit.   Any more it does seem like a license to steal in many cases. 

I can see legitimate reasons for meds costing way more than the chemicals to make them.  Somebody has to pay all the medical researchers and very high costs of getting FDA approval.   How do you decide what is a fair markup and what is thievery though?   
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iddee
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« Reply #29 on: January 19, 2012, 09:37:00 PM »

 
Would you consider this a fair markup?


Celebrex 100 mg
Consumer price (100 tablets): $130.27
Cost of general active ingredients: $0.60
Percent markup: 21,712%

Claritin 10 mg
Consumer Price (100 tablets): $215.17
Cost of general active ingredients: $0.71
Percent markup: 30,306%

Keflex 250 mg
Consumer Price (100 tablets): $157.39
Cost of general active ingredients: $1.88
Percent markup: 8,372%  


http://www.anxiety-and-depression-solutions.com/articles/conventional/pharmaceutical/realdrugcosts.php
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"Listen to the mustn'ts, child. Listen to the don'ts. Listen to the shouldn'ts, the impossibles, the won'ts. Listen to the never haves, then listen close to me . . . Anything can happen, child. Anything can be"

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luvin honey
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« Reply #30 on: January 19, 2012, 11:03:18 PM »

Ouch!  Ouch!  Lovin Honey why are you getting rabies treatment if I might ask?  I would like to avoid a similar fate  grin
Repeated indoor bat exposures, including waking up with one about 6" from my face. Tongue
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luvin honey
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« Reply #31 on: January 19, 2012, 11:04:42 PM »


Would you consider this a fair markup?


Celebrex 100 mg
Consumer price (100 tablets): $130.27
Cost of general active ingredients: $0.60
Percent markup: 21,712%

Claritin 10 mg
Consumer Price (100 tablets): $215.17
Cost of general active ingredients: $0.71
Percent markup: 30,306%

Keflex 250 mg
Consumer Price (100 tablets): $157.39
Cost of general active ingredients: $1.88
Percent markup: 8,372%  


http://www.anxiety-and-depression-solutions.com/articles/conventional/pharmaceutical/realdrugcosts.php

Idee, active ingredients are probably the tiniest portion of their costs.

I have a brother in law who works for a company that does testing on food and pharmaceuticals. That would be just ONE huge expense beyond active ingredients. R&D would be another enormous one.

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The pedigree of honey
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kathyp
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« Reply #32 on: January 20, 2012, 12:32:11 AM »

and that's a problem we have with how hard it is to get drugs to market.  in the effort to "protect us", it cost companies billions to research, test, and bring through the FDA process.  i am all for safe drugs, but i think we have gone a bit overboard. 

 drugs that are used in other countries are not brought here, or if they are, they have to go through the whole clearance phase even when there is a long history and record for the drug.

the FDA has become another obstructive alphabet agency like the EPA.  so many regulations, fees, and hoops that it's a wonder anything ever gets done.
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.....The greatest changes occur in their country without their cooperation. They are not even aware of precisely what has taken place. They suspect it; they have heard of the event by chance. More than that, they are unconcerned with the fortunes of their village, the safety of their streets, the fate of their church and its vestry. They think that such things have nothing to do with them, that they belong to a powerful stranger called “the government.” They enjoy these goods as tenants, without a sense of ownership, and never give a thought to how they might be improved.....

 Alexis de Tocqueville
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« Reply #33 on: January 22, 2012, 06:38:57 PM »

Here ia a short list of things that have already been signed into law by President Obama. Some of these  will cause medical bills to cost more.
1. A 156 percent increase in the federal excise tax on tobacco
2. Obamacare Individual Mandate Excise Tax
3. Obamacare Employer Mandate Tax
4. Obamacare Surtax on Investment Income
5. Obamacare Excise Tax on Comprehensive Health Insurance Plans
6. Obamacare Hike in Medicare Payroll Tax
7. Obamacare Medicine Cabinet Tax
8. Obamacare HSA Withdrawal Tax Hike
9. Obamacare Flexible Spending Account Cap – aka “Special Needs Kids Tax”
10. Obamacare Tax on Medical Device Manufacturers
11. Obamacare “Haircut” for Medical Itemized Deduction from 7.5% to 10% of AGI
12. Obamacare Tax on Indoor Tanning Services
13. Obamacare elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D
14. Obamacare Blue Cross/Blue Shield Tax Hike
15. Obamacare Excise Tax on Charitable Hospitals
16. Obamacare Tax on Innovator Drug Companies
17. Obamacare Tax on Health Insurers
18. Obamacare $500,000 Annual Executive Compensation Limit for Health Insurance Executives
19. Obamacare Employer Reporting of Insurance on W-2
20. Obamacare “Black liquor” tax hike
21. Obamacare Codification of the “economic substance doctrine
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JackM
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« Reply #34 on: January 23, 2012, 08:45:11 AM »

$41,000 for 1 hour of “work”? 
You do not take into account the years of education all those folks in that OR suite have in combination, then there are the certifications.  You can bet all those folks carry malpractice, if they don't they are fools.

Frankly I think 41 grand is a deal.  Does that include the hospital fees.  That makes it an even better deal.  The anesthesiologist has the highest insurance rate, probably 20% of his fee to the patient....yes, 20%.  Thank all the lawsuits for that.

The scope for the lap runs in the 100's of thousands of dollars.  Sure it can  be reused....it has to be to make it profitable.  Support staff, pharmacists, nurses, nurses aids, housekeepers, kitchen staff.

Put things in perspective.  I have been involved in medicine for the last 30 years in one facet or another.  I am not a doctor or nurse for a reason.  Up all friggin night, pay stinks, responsibility heavy, certifications up the wazoo, man you got on my wrong side with that statement.  Litigation is why medicine is so darned expensive.

You want to revamp medical costs reign in litigation and put a ceiling on rewards.  Weed out the repeaters and make them get re-educated.  Big $$ rewards for issues needs to stop.  Life is hard folks, and it sucks often too...that is the way it is and nobody is going to ever change that.
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JackM
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« Reply #35 on: January 23, 2012, 08:47:40 AM »

Here ia a short list of things that have already been signed into law by President Obama. Some of these  will cause medical bills to cost more.
1. A 156 percent increase in the federal excise tax on tobacco
2. Obamacare Individual Mandate Excise Tax
3. Obamacare Employer Mandate Tax
4. Obamacare Surtax on Investment Income
5. Obamacare Excise Tax on Comprehensive Health Insurance Plans
6. Obamacare Hike in Medicare Payroll Tax
7. Obamacare Medicine Cabinet Tax
8. Obamacare HSA Withdrawal Tax Hike
9. Obamacare Flexible Spending Account Cap – aka “Special Needs Kids Tax”
10. Obamacare Tax on Medical Device Manufacturers
11. Obamacare “Haircut” for Medical Itemized Deduction from 7.5% to 10% of AGI
12. Obamacare Tax on Indoor Tanning Services
13. Obamacare elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D
14. Obamacare Blue Cross/Blue Shield Tax Hike
15. Obamacare Excise Tax on Charitable Hospitals
16. Obamacare Tax on Innovator Drug Companies
17. Obamacare Tax on Health Insurers
18. Obamacare $500,000 Annual Executive Compensation Limit for Health Insurance Executives
19. Obamacare Employer Reporting of Insurance on W-2
20. Obamacare “Black liquor” tax hike
21. Obamacare Codification of the “economic substance doctrine


And when you get right down to it, businesses will pay those fees and that is a big portion of why the economy is not recovering.
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« Reply #36 on: January 23, 2012, 09:07:33 AM »

Up all friggin night, pay stinks, responsibility heavy, certifications up the wazoo, man you got on my wrong side with that statement.

All of the above for the job that Ive been doing for over 15 years and $41,000 is more than I get paid for a year. Everyone always throws the education costs of Doctors around whenever this discussion comes about, but Ive never saw one hurting for anything shortly after med school. This forum has heard me whine about me having two shoulders rebuilt last year-mine was on Workers Comp and I was prescribed 3 days a week of physical therapy for 16 weeks. Another guy that had it the same day I did, on his own dime ,was prescribed a total of 6 visits. Period. I'm not a 99%'er but some things have got way out of control and no, I don't have an answer on how to solve it.
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kathyp
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« Reply #37 on: January 23, 2012, 10:54:58 AM »

Quote
All of the above for the job that Ive been doing for over 15 years and $41,000 is more than I get paid for a year. Everyone always throws the education costs of Doctors around whenever this discussion comes about, but Ive never saw one hurting for anything shortly after med school

did someone force you to take the job that you have? 

it is true that doctors are paid above average when they finally finish school.  all told, it takes around 12 years to get there.  when done, the average debt is over 150,000 dollars.  it can be much higher depending on school and specialty.  yes, with a good income, they can pay off that debt and not break the bank.  however, there are not to many jobs that require you take that kind of investment risk.  12 years of education and big debt.

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.....The greatest changes occur in their country without their cooperation. They are not even aware of precisely what has taken place. They suspect it; they have heard of the event by chance. More than that, they are unconcerned with the fortunes of their village, the safety of their streets, the fate of their church and its vestry. They think that such things have nothing to do with them, that they belong to a powerful stranger called “the government.” They enjoy these goods as tenants, without a sense of ownership, and never give a thought to how they might be improved.....

 Alexis de Tocqueville
kingbee
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« Reply #38 on: February 02, 2012, 02:43:52 AM »

... active ingredients are probably the tiniest portion of their costs... I have a brother in law who works for a company that does testing on food and pharmaceuticals. That would be just ONE huge expense beyond active ingredients. R&D would be another enormous one...

Product liability insurance would likely be a still larger cost.
Legal fees would likely be an even larger expense.  Look in your local yellow pages, chances are that the listings for attorneys is the largest single listing in your local phone book.  Some lawyers and law firms have multiple full page adds.  Depending on the size of the city or town, the cost for a full page yellow page add can run into the 5 figure range...... per page ..... EVERY month..... and they advertise in multiple..... phone books.  Don't let a lawyer tell you it doesn't pay to advertise.   
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