I don't agree with denying health care. This issue is hardly about "denying" care, it's about people choosing not to get care because they can't afford it, or getting care and then not being able to afford it. In both cases, the question is cost of care, and not the quality or denial thereof.

My position is that mandating that the taxpayers pay for millions of uninsured people that currently can't afford healthcare doesn't do anything about nytmare's point about recipients not caring how expensive it is. Nothing in this proposal addresses the issue that people have no incentive to limit their health care costs, and rarely have even the slightest information on what those costs are anyway.

Also, how are the uninsured, that can't afford insurance today, suddenly going to be able to afford copays or deductibles?

If you can't see the irony in calling taking money from only some portion of the populace and giving it to some other portion of the populace "fair", I don't know what else to say to help.

"Binding Price Estimate
Agreement

Healthcare Provider / Facility (hereinafter "Provider"): ____________________________

Patient (hereinafter "Patient"): _______________________________________

Service/Product: Admission for Diabetes

According to the Healthcare Blue Book, the fair price for consumers who pay healthcare providers with cash at the time of service or product delivery is ____$5,205______. Price is for a 4 day admission. More days charged at $1848 per day. Fewer days will reduce price by $1848 per day."

etc, etc.... [by the way, my last admission to the hospital for my diabetes was $2700 a day. but the price went up because i insisted on bathing and changing my sheets each day and that gets billed too]

@TheFlamingoKing: The for-profit health insurance industry got created out of the not-for-profit health insurance industry with other people's money so why not reverse the trend?

@johnva: Awesome- always follow the money.

@humphrmi: You just laid out your business plan. Now make millions...

Also, frivolous use of healthcare accounts for only a minor portion of aggregate healthcare costs. Most costs are consumed by chronic disease.

Physician Services
Service: Control Nose Bleed - Procedure to treat nose bleed.
Fee: $171
Fee Details: Procedure fee.
Pricing Agreement: Printable Detailed Pricing Agreement
Total Fee: $171

@johnva:

Job well done

Why don't I ever hear solutions that involve something you have to do or sacrifice, rather than the ways you intend to force someone else to sacrifice by having the government stick a gun in their face?

It just makes my butt itch when I see people blaming the uninsured for the cost of their medical bills, when in some contexts (pretty much all non-emergent care), it's the uninsured who are subsidizing them. And not only do they pay much higher costs, but they pay at the time of service, so the administrative costs are much, much less.

And even in the case of emergent care, many people don't realize that uninsured patients get even more outrageous bills than they do for medical treatment. If they were charged at the same rate, a much higher percentage of them would pay. But when hospitals send out bills for ridiculous eleventy bajillion dollars amounts, it's predictable that a lot more people are going to default than they would were they charged fair market rates.

I found this: [investing.businessweek.com]
It's a profile of Jeffrey Rice, CEO of CareOperative, LLC, the company running this site. He appears to have extensive ties to the health insurance industry, including having served as an executive for several of them.

So while I wouldn't say this is conclusive evidence that something is fishy here, I would take this company's claims with a grain of salt.

And your argument doesn't apply to non-emergent care at all, because uninsured patients pay at the time of service. So for regular doctor visits, preventative care, and pretty much everything short of ER visits, the uninsured are subsidizing the insurance companies by paying higher rates.

They probably won't get much action in Maryland.
Maryland is last all-payer state: the states sets the rates so there is no price competition. (a procedure at Hopkins cost the same as having it done at a small suburban hospital). That means 100% reimbursement rate (minus some flat discounts, not contracted rates), even for Medicare. (Pays 94% of fee for service)

People will get frustrated when searching for cheaper services :)

Note: this does not include individual profees (doctor's fees per individual or doctor's group)

I have seen, in real life, the exact same radiology service billed to an insurance company for one-tenth the price they charged an uninsured patient. One tenth. I'm pretty sure that was unusually high, but charging the uninsured double or triple seems pretty standard.

So uninsured patients who receive non-emergent care are subsidizing insured patients.

And you have to wonder how many more uninsured patients would pay their emergency medical bills if they were being billed at the same or similar rates that the insured are.

Sorry about your son. I think your situation illustrates the problem with the concept of this website. They quote a price, but don't tell you where there information is coming from. Also, they are not able to calculate costs for individual situations such as your son's where complicating factors would likely elevate the costs dramatically.

I believe those fees.

a standard nose bleed does NOT cost more than kleenex & steady pressure to treat.

and unless you are just gushing buckets, a simple chemo-cauterization does not cost that much either.

mark up for the sake of make up is a HUGE part of the current medical mess.

Having a medical background I read my statement of treatment post gall bladder surgery. The more I read the more I realized I should be dead because the over dose of drugs was incredible. The reason for this? People without insurance. The hospitals, doctors' offices, clinics are making up much of the shortfall through our insurance companies.

Bet if I was uninusred, had to have the surgery the bottom line total would be about half of what was paid through my insurance company.

What the heck do I mean by that?

When a company decides to self-insure, they're basically betting that the aggregate cost of just simply paying medical care for their employees is less than paying premiums for insurance.

However they hedge their bet: big insurance companies offer self-insurance plans, whereby the negotiated managed-care prices that the insurance company has already established with their network providers also apply to the self-insured program participants too.

So basically, they offer a fee-based service to self-insured companies, where they (the insurance company) process claims and pay them based on their negotiated rates, and then receive all the claims that they paid reimbursed back to them from the company, with an extra percentage for their trouble.

It basically boils down to self-insured companies getting the benefit of managed care costs.

And those insurance companies that offer self-insurance plans *could* offer those same rates to us, individuals, if they wanted to. But even with a fee, it's not worth it to them.

So what ends up happening is, the doctors have a multi-tier rate system: if you say you're self-pay or have a high deductible, they charge you the *premium* rate because you're not part of a negotiated rate plan. A $400 procedure becomes $500 or $600.

So my point is, this website would be great if it (1) showed the rates that managed-care patients pay, and (2) you could negotiate those rates with your providers, just like the managed-care insurance companies do, or alternatively it would be great if you could, as a self-insured person, sign up for managed care rates for a small, affordable premium.

Huh? What.... oh, sorry. I must have fallen asleep here at the keyboard, I was dreaming!

from the site...Wowzers.....lol

Nose Bleed


Hospital Services

Service: Nose Bleed - Admission for inpatient treatment of Nose Bleed
Fee: $6,444
Fee Details: Price is for a 3 day admission. More days charged at $2148 per day. Fewer days will reduce price by $2148 per day.
Pricing Agreement: Printable Detailed Pricing Agreement
Total Fee: $6,444

"If this site takes off, it'll be one more sign of how much we're screwed."

You're right. We're much better off with all the uninsured just using the ER as their primary care doctor and then not paying the bill.

@veg-o-matic: i guess the only way to be impartial nowadays is to be everybody's whore

Who pays for the Healthcare Blue Book site?

The Healthcare Blue Book site is paid for by selling advertising on the site to companies that provide health related products and services. We have advertising for many different types of products and services which keeps us impartial.

.. hahahahaha!