Are Medical Bills from a Parallel Universe?

2

Comments

  • soiset
    soiset Posts: 724
    edited February 2009
    shack wrote: »
    Thank God it is a different universe. I certainly don't want someone with the training of an auto mechanic or paint and body technician being the person who has my physical well being in their hands. NO offense to the people that do those things, because there is definitely skill and training involved. But there is no comparison. You can get the skills necessary to be a pretty good painter in a few courses at the local tech school. Even a RN reqires 4 years of nursing school and serious testing and accredidation to do the job. That medical doctor who spent 20 minutes looking and diagnosing your chart spent 4 years in undergraduate school, 4 years in medical school, 2-4 years as an intern and possibly more to specialize in the particular specialty. Even though it was not a hospital, the clinic goes through extensive and expensive acredidation and license proceedures just to open and stay open. As stated earlier insurance is out the roof. Those pieces of equipment no matter how old must meet stringent requirments and maintenace schedules. The tolerances for any piece of medical gear are much stricter than spray paint equipment.

    If the painter screws up the paint job it can be fixed. Mess up a sleep study and it really can cost a life. Sleep apnea if not diagnosed properly can kill a person.

    Again, I'm glad my medical care is part of a different universe than my auto mechanic. My health means a whole lot more to me than my car.

    I've said already that I thought some premium was reasonable for medical expenses. But if medicine is so unique in its difficulty, requirements, and importance, how do we determine what is reasonable?

    As a structural engineer, my education, training, and liability approaches that of a physician (hell, exceeds it in some circumstances), but if I complete a job with the same level of difficulty and liability as that sleep study and charge $2900, well...

    And how do you account for the $1700 markup (more than 100%) just because of the different billing source?! If we just take the bill and say, "Oh, it's a medical expense, nothing is unreasonable because we are talking about human life and someone with a lot of education," then what is the result? What about seat belt manufacturers? Should we expect to pay $2000 for a car seat belt because there's a chem E, and a mat. E, and an auto E, involved in the design, and the manufacturing facility must meet industry criteria, and human lives are at stake?

    If I design a building meant for a 200 person occupancy, that should it experience catastrophic collapse, most would die, should I be paid a million dollars for that design?
  • shack
    shack Posts: 11,154
    edited February 2009
    bobman1235 wrote:
    I don't want to drag this too far off the rail, but are you absolutely crazy?

    I thought the post was so far off base I couldn't even put together a coherent response (nor did I really want to).

    However I agree with most of what you posted (and that in and of itself is somewhat scary ;) )
    "Just because you’re offended doesn’t mean you’re right." - Ricky Gervais

    "For those who believe, no proof is necessary. For those who don't believe, no proof is possible." - Stuart Chase

    "Consistency requires you to be as ignorant today as you were a year ago." - Bernard Berenson
  • brettw22
    brettw22 Posts: 7,624
    edited February 2009
    While I feel bad for your situation, I have to also ask why you would just blindly submit to testing without discussing the up front costs...........ESPECIALLY if you know that you're going to be out of pocket for a minimum of $2k........

    I think the price charged is ridiculous, but at the same time, it's your responsibility to mitigate your expenses.......
    comment comment comment comment. bitchy.
  • soiset
    soiset Posts: 724
    edited February 2009
    But here's why I think it is so expensive: The necessary and sufficient causes are 1) we have medical insurance, and 2) attitudes such as that expressed by Shack above, which say essentially no expense is unreasonable because of the nature of the service. Combine those two things (both are required) and you end up with VERY expensive medical care.

    Other things contribute, of course, non-paying patients, malpractice lawsuits, unscrupulous pharm corps, top-heavy hospital administration, etc., but essentially it is a demonstration of classical economics: because of insurance and people's perspective on the importance of health care, costs are not controlled as they would be in most other industries.

    I'm partly at fault for this high bill, for the above two reasons. I didn't shop around for a provider of the study (I should have researched beforehand to learn that there are optional sleep-study centers) and I was going in with the idea that my health really doesn't have a price. But, frankly, it does.

    I recently severely sprained my ankle. Everyone assumed that I would go or had gone to a doctor about it, but I had not, because I view medical practice as unnecessarily complicated and expensive. Had I gone to the doctor, they would have insisted on xrays, which would have shown what I was pretty confident of - that the bone was not broken. They have to insist on xrays because of the potential for malpractice suits. I would have gotten a prescription for 800 mg ibuprofen, which is silly considering the big bottle of 200 mg tablets I have in the cabinet. And they would have given me an ankle brace/splint to stabilize and protect my ankle. All this would have cost a fortune.

    Instead, I got on line, and researched ankle injuries, and made an informal diagnosis. I applied the PRINCE methods, and bought some crutches and a couple of ankle braces to use in stages of recovery. Total cost to me: about $100, and I didn't have to go through a doctor wrenching my ankle around and asking if it hurt through my screams.

    What would the bill have been if I'd gone to the doctor? $2,000? $3,000, $10,000? You'd think that there would be some way of predicting it with some kind of accuracy by looking at the reasonable costs involved, but because it involves the medical industry, there isn't.

    So, I have adopted an extreme reluctance to involve doctors or hospitals, because I believe the whole system is ROTTEN. Of course there could be an instance in which I have no option but to suffer through it, but as long as I can help it, by preventative medicine and self-help, I will stay the hell away from it.
  • soiset
    soiset Posts: 724
    edited February 2009
    brettw22 wrote: »
    While I feel bad for your situation, I have to also ask why you would just blindly submit to testing without discussing the up front costs...........ESPECIALLY if you know that you're going to be out of pocket for a minimum of $2k........

    I think the price charged is ridiculous, but at the same time, it's your responsibility to mitigate your expenses.......

    Oh, you're right, and I've been kicking myself with my non-sprained foot. But I was just rolling along thinking about what would be "reasonable." How stupid of me.
  • bobman1235
    bobman1235 Posts: 10,822
    edited February 2009
    shack wrote: »
    I thought the post was so far off base I couldn't even put together a coherent response (nor did I really want to).

    However I agree with most of what you posted (and that in and of itself is somewhat scary ;) )

    Eh, even I don't agree with most of what i said, sometimes I can't make my brain say what I want ot say and it comes out all wrong.
    If you will it, dude, it is no dream.
  • shack
    shack Posts: 11,154
    edited February 2009
    soiset wrote:
    2) attitudes such as that expressed by Shack above, which say essentially no expense is unreasonable because of the nature of the service.

    Nice twist...because it IS NOT what I said. I said I understand the cost structure and while I may not like what the cost is...I know where it goes. While you may think it is exorbitant, until you have seen the financial statements of a medical clinic or group of medical doctors you really have no basis for your statements. Among my clients I have a large group of orthopedic surgeons, a pediatric group, a large Radiology group, Anesthesiologists, Gastroenterologists, Allergists, Family practice, Internists to name a few. I also have individual physician clients from almost all specialties. I know in great detail what it costs them to practice medicine and what they make because I spend a great deal of time with their financial statements. Knowing and understanding if they have the ability to repay the loans I have to them is my job. The doctors make a very good living (family practice and pediatricians still make a good income, but not as much as the specialists). But a lot of what you consider to be excess profit is spread around. The equipment manufacturers, the insurers, the regulators, the employees, the government, etc...all get some of that and none are making the huge windfalls you believe. And yes, as I've stated before...those who pay for their own care, whether in cash of through insurance...pay for all of those who don't. As bobman1235 said, we do have a form of socialized medicine as a result.

    My contention is I am glad the knowledge and technology is available...even at the high cost. I have friends that live in other parts of the world where low cost socialized medicine is the norm. For the basics, where everyone gets a certain level of care...it is excellent. Beyond that, if you need something "special"...good luck. It isn't happening...unless they can afford to come to the US where the treatment and care is available...albeit at a cost.
    "Just because you’re offended doesn’t mean you’re right." - Ricky Gervais

    "For those who believe, no proof is necessary. For those who don't believe, no proof is possible." - Stuart Chase

    "Consistency requires you to be as ignorant today as you were a year ago." - Bernard Berenson
  • soiset
    soiset Posts: 724
    edited February 2009
    shack wrote: »
    Nice twist...because it IS NOT what I said. I said I understand the cost structure and while I may not like what the cost is...I know where it goes. While you may think it is exorbitant, until you have seen the financial statements of a medical clinic or group of medical doctors you really have no basis for your statements. Among my clients I have a large group of orthopedic surgeons, a pediatric group, a large Radiology group, Anesthesiologists, Gastroenterologists, Allergists, Family practice, Internists to name a few. I also have individual physician clients from almost all specialties. I know in great detail what it costs them to practice medicine and what they make because I spend a great deal of time with their financial statements. Knowing and understanding if they have the ability to repay the loans I have to them is my job. The doctors make a very good living (family practice and pediatricians still make a good income, but not as much as the specialists). But a lot of what you consider to be excess profit is spread around. The equipment manufacturers, the insurers, the regulators, the employees, the government, etc...all get some of that and none are making the huge windfalls you believe. And yes, as I've stated before...those who pay for their own care, whether in cash of through insurance...pay for all of those who don't. As bobman1235 said, we do have a form of socialized medicine as a result.

    My contention is I am glad the knowledge and technology is available...even at the high cost. I have friends that live in other parts of the world where low cost socialized medicine is the norm. For the basics, where everyone gets a certain level of care...it is excellent. Beyond that, if you need something "special"...good luck. It isn't happening...unless they can afford to come to the US where the treatment and care is available...albeit at a cost.

    Two things again, though: you have not addressed where the 150% markup comes from just for the re-directed billing. Also, I'm not complaining about the doctor's pay - as I said, a doctor may have been involved for all of 20 minutes in the whole thing. So, yes, the money is being spread around quite a bit. If we give the doctor $200 for his 20 minute interpretation, he's making cash at a hell of a clip, and we haven't even approached the sum of the bill.

    To give an idea of how simple this whole procedure is, most sleep clinics offer an alternative of doing the study at home, in one's own bed. They just hand over the small amount of equipment required, you take it home, and wire yourself up when you go to bed. You take the recorder back to the clinic, and they give you the analysis.

    Whoever is getting the money (and I would guess that most of it is going to executives/administrators who never come near any of the work involved) my point is that $2866 is a ridiculous fee for such a simple, cheap service. The ROTTEN state of affairs is rather conclusively demonstrated by the MASSIVE markup just to re-direct the billing.

    eta: As more evidence, in my calling around I found the Southwestern Neuroscience Institute, where they charge $850 for the first test, $950 for the second. I would say that $850 is still a hell of a lot for what little was done, but let's just call that the premium for health care. The bill I got is 3.37 times that. Again, more conclusive evidence that someone is soaking up a hell of a lot of cash for doing nothing at all.
  • soiset
    soiset Posts: 724
    edited February 2009
    shack wrote: »
    ...While you may think it is exorbitant, until you have seen the financial statements of a medical clinic or group of medical doctors you really have no basis for your statements...

    Just look at the argument you are making. What if you walked into a salon, got a hair cut, and they handed you a bill for $700. You'd say that was outrageous. But the salon manager defends the bill with the same reasoning you use. They are spreading that money all over the known universe, after all. Does that make the fee reasonable? No, of course it doesn't. But they can show you that the scissor manufacture's rep gets $50, and the comb company gets $50, and the shampoo testing facility gets $35, and the salon manager gets $100, and the barber gets $60, and the guy who sweeps the floor at night gets $20, and on and on and on. So now you understand where the money goes. Does that make it reasonable?
  • Shizelbs
    Shizelbs Posts: 7,433
    edited February 2009
    soiset wrote: »
    "Reasonable" in what context? In the context of medical billing? Maybe, but that's my point: it's not reasonable in any other context, but it doesn't have to be, because they operate in a parallel universe.

    Sorry, yes, reasonable in the medical context. You are paying for supplies, overhead, staff, the physician (interpretation, diagnosis, referal, their expertise, compensation for spending the best years of their life with a nose in a textbook).

    Now, that being said, I see no reason why you can't renegotiate your bill down to the $1500 they would have charged you if you presented without insurance.
  • soiset
    soiset Posts: 724
    edited February 2009
    Shizelbs wrote: »
    Sorry, yes, reasonable in the medical context. You are paying for supplies, overhead, staff, the physician (interpretation, diagnosis, referal, their expertise, compensation for spending the best years of their life with a nose in a textbook).

    Now, that being said, I see no reason why you can't renegotiate your bill down to the $1500 they would have charged you if you presented without insurance.

    I'm going to try for that amount. I'll post results. But again, this very clearly demonstrates that somebody is dunking a bucket into the till.

    By the way, that isn't the uninsured amount, but the "walk-in" amount. The uninsured amount can be lower - most places have some sort of sliding scale.
  • Shizelbs
    Shizelbs Posts: 7,433
    edited February 2009
    Well, whatever the qualification for the $1500, I imagine with some persistance you can negotiate your bill down quite a bit.
  • shack
    shack Posts: 11,154
    edited February 2009
    soiset wrote:
    To give an idea of how simple this whole procedure is, most sleep clinics offer an alternative of doing the study at home, in one's own bed. They just hand over the small amount of equipment required, you take it home, and wire yourself up when you go to bed. You take the recorder back to the clinic, and they give you the analysis.

    I know the proceedure. When I took my test it took a minimum of 45 minutes to an hour to hook all of the electrodes up. I went in at 8:00PM and left at 7:00AM the next morning. I was on video and being observed by a technician the entire time. After about 4 hours of sleep they woke me and hooked me up to a CPAP machine and monitored me for the rest of the night. I also had a couple of pre-test visits and I kept a sleep diary for 3 or 4 weeks prior to the test. My total as I recall was very near what you paid for and this was at least 6 years ago. I figure the overhead, the cost of the equipment, the pre and post test analysis, pre and post test visits, the doctor's time (and experise) the nurse and technician who monitored me, administration, insurance, etc,etc, etc were well worth the price paid by me in the form of insurance premiums and co-insurance payments by me. IMO the some of the best medical expenses I have ever incurred.

    I'm not sure I would want a test I could administer myself. The test may be streamlined now and not as complicated. From friends I have talked to that have had the proceedure done...that is not the case in this area. Around here 30 minutes in a MRI will set you back $1,000+ with less time and effort involved than a sleep study.

    There may very well be a time when you can shop for all medical services. As you have shown...YOU could have done so and maybe saved a lot of money. You didn't. If money was a concern it is certainly something you could have considered.

    When you mentioned painting your truck...you failed to mention that you could just have easily found someone to do it MUCH cheaper than $2,900. On the other hand, as someone who tinkers with old cars some, $2,900 would not even get you the primer coat for some of the jobs my Mustang buddies put on their cars. It is not unusual for them to pay double that amount for a what they consider to be a quality job.

    What I paid for the service and results I recieved was worth every cent. For you that evidently was not the case. Either way...

    Don't worry about what you spent...it's gone. Get the CPAP machine and get on with your life. I hope it makes the huge difference that it did for me. Good luck.
    "Just because you’re offended doesn’t mean you’re right." - Ricky Gervais

    "For those who believe, no proof is necessary. For those who don't believe, no proof is possible." - Stuart Chase

    "Consistency requires you to be as ignorant today as you were a year ago." - Bernard Berenson
  • WilliamM2
    WilliamM2 Posts: 4,771
    edited February 2009
    I also have a high deductible ($2500). I had MRI's, CAT scans, and several other tests last year due to problems with my shoulders and neck, there was also physical therapy and spinal injections. I ended up hitting the max out of pocket of $5000.

    Wouldn't be so bad, if I had had any results from all this, but here it is just over one year later, and I still have the same problem. I have four damaged discs in my upper back/neck, and it is impinging on the nerves that lead to my shoulders. Not a candidate for surgery they said...although now that it's a new year, and I have to meet the deductible all over again, they now think maybe I should have surgery.:rolleyes:

    I did learn one trick through all of this. All of these test were done through the local Hospital, after a couple of months of paying my bills in full, a friend told me to set up a payment plan, and offer the smallest payment possible. After the first payment is made, the following bill will offer a 25% discount to pay in full, and I pay it off. Wish I had known from the beginning, would have saved about $400 more than I did.
  • soiset
    soiset Posts: 724
    edited February 2009
    shack wrote: »
    I know the proceedure. When I took my test it took a minimum of 45 minutes to an hour to hook all of the electrodes up. I went in at 8:00PM and left at 7:00AM the next morning. I was on video and being observed by a technician the entire time. After about 4 hours of sleep they woke me and hooked me up to a CPAP machine and monitored me for the rest of the night. I also had a couple of pre-test visits and I kept a sleep diary for 3 or 4 weeks prior to the test. My total as I recall was very near what you paid for and this was at least 6 years ago. I figure the overhead, the cost of the equipment, the pre and post test analysis, pre and post test visits, the doctor's time (and experise) the nurse and technician who monitored me, administration, insurance, etc,etc, etc were well worth the price paid by me in the form of insurance premiums and co-insurance payments by me. IMO the some of the best medical expenses I have ever incurred.

    I'm not sure I would want a test I could administer myself. The test may be streamlined now and not as complicated. From friends I have talked to that have had the proceedure done...that is not the case in this area. Around here 30 minutes in a MRI will set you back $1,000+ with less time and effort involved than a sleep study.

    There may very well be a time when you can shop for all medical services. As you have shown...YOU could have done so and maybe saved a lot of money. You didn't. If money was a concern it is certainly something you could have considered.

    When you mentioned painting your truck...you failed to mention that you could just have easily found someone to do it MUCH cheaper than $2,900. On the other hand, as someone who tinkers with old cars some, $2,900 would not even get you the primer coat for some of the jobs my Mustang buddies put on their cars. It is not unusual for them to pay double that amount for a what they consider to be a quality job.

    What I paid for the service and results I recieved was worth every cent. For you that evidently was not the case. Either way...

    Don't worry about what you spent...it's gone. Get the CPAP machine and get on with your life. I hope it makes the huge difference that it did for me. Good luck.

    I think you missed the part where I said I only got the first part done. No CPAP titration. I went in at 10 and left at 5. Apparently they only do both at once for special cases with a very high freq of events. The second part would cost just as much or more (it has everywhere I've looked). So, $2866 for part one, $3000 or more for part two. My point stands - someone is soaking up a hell of a lot of money for nothing at all.

    And I haven't spent it yet. I just got the bill.

    eta: an MRI machine costs a bajillion dollars and uses a hell of a lot of electricity. Neither is the case with any of the equipment in the sleep study.
  • soiset
    soiset Posts: 724
    edited February 2009
    WilliamM2 wrote: »
    I also have a high deductible ($2500). I had MRI's, CAT scans, and several other tests last year due to problems with my shoulders and neck, there was also physical therapy and spinal injections. I ended up hitting the max out of pocket of $5000.

    Wouldn't be so bad, if I had had any results from all this, but here it is just over one year later, and I still have the same problem. I have four damaged discs in my upper back/neck, and it is impinging on the nerves that lead to my shoulders. Not a candidate for surgery they said...although now that it's a new year, and I have to meet the deductible all over again, they now think maybe I should have surgery.:rolleyes:

    I did learn one trick through all of this. All of these test were done through the local Hospital, after a couple of months of paying my bills in full, a friend told me to set up a payment plan, and offer the smallest payment possible. After the first payment is made, the following bill will offer a 25% discount to pay in full, and I pay it off. Wish I had known from the beginning, would have saved about $400 more than I did.

    From my reading online, it is very common to get a reduced bill if you promise to make a fuss. Payment plans, collection services, whatever, all are costs they don't want to incur -given the properties of their parallel universe, it would cost $1000 just to set up the payment plan.

    Regarding the unsuccessful treatment: in medicine, results don't count. I need to find a business like that. Engineering sure isn't.
  • WilliamM2
    WilliamM2 Posts: 4,771
    edited February 2009
    soiset wrote: »
    From my reading online, it is very common to get a reduced bill if you promise to make a fuss.

    I didn't even have to make a fuss. It's all done online. Instead of choosing "pay full amount", I choose "make minimum payment", and pay it. Then I get a bill in the mail that offers 25% off the balance if I pay in full. You have to call them and pay with CC, you can't do that part online.

    Seems dishonest to me, I had paid over $1600 before I found out about this. The way I see it, they penalized me for paying in full when the first bill arrived. Why not just offer the discount at that time?
  • Hobbyguy
    Hobbyguy Posts: 317
    edited February 2009
    Most people would agree that that fee is unreasonable. I feel for you.
    What do most people think an orthopaedic surgeon should make a year and
    what do people think that we actually make?
  • Shizelbs
    Shizelbs Posts: 7,433
    edited February 2009
    I know I don't want a system in place where the smartest and most talented people are unwilling to pursue medicine due to lack of fair compensation.
  • shack
    shack Posts: 11,154
    edited February 2009
    Hobbyguy wrote: »
    Most people would agree that that fee is unreasonable. I feel for you.
    What do most people think an orthopaedic surgeon should make a year and
    what do people think that we actually make?

    Like any other profession they can make a wide range of income. I know some that make as little as $150,000 to as much as $2,500,000 annually from their practice. A lot depends on what they do, how much time they spend in surgery and how good they are.
    "Just because you’re offended doesn’t mean you’re right." - Ricky Gervais

    "For those who believe, no proof is necessary. For those who don't believe, no proof is possible." - Stuart Chase

    "Consistency requires you to be as ignorant today as you were a year ago." - Bernard Berenson
  • Hobbyguy
    Hobbyguy Posts: 317
    edited February 2009
    By the way that is not how I would have taken care of your ankle...you are referring to an ER physician or a family doctor. Many insurance companies do not allow patients to make appointments to an orthopaedic surgeon without seeing their primary care physician. This is wrong. I would have asked for a detailed history including medical and mechanism of injury. The mechanism is an important clue in any associated injuries. I would have examined your hip, then knee, then ankle and foot (associated injuries can occur up the leg). If I found bony tenderness, instability, or abnormal masses then I would have ordered an x-ray. I do not order this for medical-legal reasons...I dictate well and can defend my care. I would not recommend NSAIDs since there is an increasing body of evidence that these delay healing of bone, tendon, muscle, and ligaments. Most of the time an ankle sprain requires little care but I have picked up numerous other problems and patients have the certainty that I have gone over their musculoskeletal system with a fine comb and ruled out more serious problems.
  • soiset
    soiset Posts: 724
    edited February 2009
    Hobbyguy wrote: »
    By the way that is not how I would have taken care of your ankle...you are referring to an ER physician or a family doctor. Many insurance companies do not allow patients to make appointments to an orthopaedic surgeon without seeing their primary care physician. This is wrong. I would have asked for a detailed history including medical and mechanism of injury. The mechanism is an important clue in any associated injuries. I would have examined your hip, then knee, then ankle and foot (associated injuries can occur up the leg). If I found bony tenderness, instability, or abnormal masses then I would have ordered an x-ray. I do not order this for medical-legal reasons...I dictate well and can defend my care. I would not recommend NSAIDs since there is an increasing body of evidence that these delay healing of bone, tendon, muscle, and ligaments. Most of the time an ankle sprain requires little care but I have picked up numerous other problems and patients have the certainty that I have gone over their musculoskeletal system with a fine comb and ruled out more serious problems.

    Oh great, I just took another 400 mg of ibuprofen. I suppose, then, that soon PRINCE will become PRICE(?)

    It makes sense to me that people should be able to self-diagnose well enough to direct themselves to the appropriate specialist. But, it just seems as if the requirement to see the GP first is just another way to add in 10 more layers of paychecks to the system. Plus, the system doesn't give a damn about the patient's time.

    And on that note, why is it so acceptable for MD's, PD's, and the like to keep their patients waiting for so long, so often? I don't think there is any other industry where that kind of treatment would be tolerated.
  • soiset
    soiset Posts: 724
    edited February 2009
    Shizelbs wrote: »
    I know I don't want a system in place where the smartest and most talented people are unwilling to pursue medicine due to lack of fair compensation.

    I would rephrase that: I don't want to live in a place where SMART and TALENTED people who REALLY WANT TO PRACTICE MEDICINE are unwilling to do so due to lack of fair compensation. We do live in a place where the greatest potential teachers avoid it because a teacher's salary is not enough to live on. We do live in a place with a chronic shortage of engineers, which is really about to get a lot worse, because the "return on investment" is so poor, financially and in other ways.

    I don't know too many starving MD's. If you are making $120,000 doing what you enjoy doing, that's plenty (in most areas). Now, vet meds, they really can hurt, and truly go into it for the love of the profession.

    But the problem isn't whether an MD makes $90,000 or $150,000 per year- that's chump change in the health care industry scheme. What about those 75 other people who are the beneficiaries of long-term efforts to inject their positions into the stream of paper-pushers that get a piece of your bill?

    There is just so much money available, because of the nature of the health insurance business, that everybody wants to get into the system so they can have a piece. It's like a 19th century gold rush.

    Because people who are insured don't "feel" the price of medicine the way they do other services, and because they believe, in a sense, that medicine is techno-magic, and because, well, it's their health and well-being at stake, all normal scale is lost, and the system bloats and swells as more an more people squeeze into that giant bag of money.

    The normal economic controls that we expect to operate in a more rational system don't function on health care. There are way, way too many people involved in what is usually, essentially, just between you and your doctor. So the system is grossly inefficient.

    I think it will have to be dismantled and re-constructed in a more logical structure to improve it. But doing so would mean a LOT of people would be out of jobs, and execs/admins would have to give up their million dollar salaries and superfat bonuses.
  • Hobbyguy
    Hobbyguy Posts: 317
    edited February 2009
    It is PRICE not PRINCE.
    The requirement to see the GP first is an insurance rule.
    Believe me we don't like our patients to wait. The problem is that it is impossible to predict how much time a patient needs. What happens so frequently to me is I help a patient with their problem and they are so pleased that they then say while I'm here could you take a look at...
    Many patients consider me to be their friend and also just want to chat....it is a skill to direct them to why they are here.
    I have to take call....emergencies also cut into clinic time
    it is not easy what we do...
  • Shizelbs
    Shizelbs Posts: 7,433
    edited February 2009
    soiset wrote: »

    And on that note, why is it so acceptable for MD's, PD's, and the like to keep their patients waiting for so long, so often? I don't think there is any other industry where that kind of treatment would be tolerated.

    Supply and demand. They are super busy and an overwhelming amount is asked of them.
  • bobman1235
    bobman1235 Posts: 10,822
    edited February 2009
    The amount of ignorance in this thread is truly staggering. You guys really think doctors are just out to screw you over while they go out golfing huh? You should probably meet a doctor in person some time, and watch what they have to go through to get to where they are before you think they're cheating you and making you wait just to piss you off.
    If you will it, dude, it is no dream.
  • soiset
    soiset Posts: 724
    edited February 2009
    bobman1235 wrote: »
    The amount of ignorance in this thread is truly staggering. You guys really think doctors are just out to screw you over while they go out golfing huh? You should probably meet a doctor in person some time, and watch what they have to go through to get to where they are before you think they're cheating you and making you wait just to piss you off.

    You have somehow read things in this thread that haven't actually been written.

    ETA: My mom, an RN, has pretty much the same assessment of the billing system. She herself has protested outrageously high med bills, and when finally given an itemized list of charges, has found long lists of charges that should never have been there. When she went to the insurance co with her findings, they simply shrugged it off. There is something circular in this racket.
  • snow
    snow Posts: 4,337
    edited February 2009
    Wow Soiset you should get the whiner of the month club award. First off you elected to drop your insurance to where there was a $2000.00 premium. You then decide that you have a problem that has been ongoing for 20 years and want to do something about it. The costs of setting up a care facility is enormous just the machines, hospital grade this and that everywhere are all specailty items they cant be bought at home depot. Not only do you have the doctors costs but all the support staff costs in addition to building costs ongoing training for these care providers accountants malpractice insurance non paying patients etc all have to be added into the bill that was gaven to you. Yes it was expensive but it costs a hell of a lot more than you would think to run even a small clinic.

    If this machine they sell you fixes a chronic 20 year old problem for $2900.00 I would be estatic.

    Just my 2 cents



    REGARDS SNOW
    Well, I just pulled off the impossible by doing a double-blind comparison all by myself, purely by virtue of the fact that I completely and stupidly forgot what I did last. I guess that getting old does have its advantages after all :D
  • soiset
    soiset Posts: 724
    edited February 2009
    snow wrote: »
    Wow Soiset you should get the whiner of the month club award. First off you elected to drop your insurance to where there was a $2000.00 premium. You then decide that you have a problem that has been ongoing for 20 years and want to do something about it. The costs of setting up a care facility is enormous just the machines, hospital grade this and that everywhere are all specailty items they cant be bought at home depot. Not only do you have the doctors costs but all the support staff costs in addition to building costs ongoing training for these care providers accountants malpractice insurance non paying patients etc all have to be added into the bill that was gaven to you. Yes it was expensive but it costs a hell of a lot more than you would think to run even a small clinic.

    If this machine they sell you fixes a chronic 20 year old problem for $2900.00 I would be estatic.

    Just my 2 cents




    REGARDS SNOW

    Your two cents are worth less than that, as apparently you have failed to absorb the essential fiscal details revealed in this thread before responding. Basically, an $850 service billed at $2900. In addition, that fee is far less than what would be half of the "fix." It's all in the thread, just try reading it.
  • cnh
    cnh Posts: 13,284
    edited February 2009
    bobman1235 wrote: »
    The amount of ignorance in this thread is truly staggering. You guys really think doctors are just out to screw you over while they go out golfing huh? You should probably meet a doctor in person some time, and watch what they have to go through to get to where they are before you think they're cheating you and making you wait just to piss you off.

    How would it be if the AMA was not allowed to control the number of Doctors allowed to practise in the U.S.?

    Might that give us better care, more competition, lower prices, less waiting!

    Why do we allow the AMA such power when there are thousands of bright, compassionate and caring men and women who would be excellent doctors. I've met lots of doctors, a lot. My personal physician is a woman, not a male! Because I've met so many 'wonderful' MALE M.D.s. There's a guy who I'm going to have to sue for his arrogance and incompetence, his two colleagues suffer from the same problem.

    Are there great Doctors? Yes! Surely, but our system does not encourage 'service' but something else. Recently my mother was made to wait six weeks for a 5 minute appointment which was unnecessary and had her travelling over 2 and half hours to Phillie in an ambulance for a consultation that could have been done without her. She had to wait for an hour and a half and then had another 2 and a half hours back. One day later she contracted Pneumonia and almost died!

    If you like that story, I have about a dozen more! And dozens of friends that could fill a few books with such horrors?

    Just like any profession, there are good caring people and A-holes.

    But for God's sake lift that Doctor cap the AMA is strangling us with!

    cnh
    Currently orbiting Bowie's Blackstar.!

    Polk Lsi-7s, Def Tech 8" sub, HK 3490, HK HD 990 (CDP/DAC), AKG Q701s
    [sig. changed on a monthly basis as I rotate in and out of my stash]