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Thanks, but no thanks.
Thanks, but no thanks.
\"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.
@smartmuffin: @keepher: Uninsured people are regularly charged several times what insured patients are.
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.
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@spanky: They are BILLED several times as much, but not all of them pay it, because being poor is a common reason for being uninsured.
@johnva: Right, not all of them pay for emergent care charges, but a good portion more would if they were being charged the same or similar rates as the insured are. The more ridiculously high the bills are, the more likely someone is to take the hit to their credit or declare bankruptcy. And at the rates the uninsured are charged for ER visits, it is all but impossible for most people to pay in any reasonable amount of time. If 'ability to pay full, inflated prices for an ER visit' is the standard for poor, 99% of Americans are probably poor.
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.
@spanky: Right, I'm not disagreeing with any of that. I'm just pointing out that being billed a lot is not always the same as paying a lot. That means that a lot of \"charity care\" for the uninsured gets passed on to all of us via higher prices (including to other uninsured people). So having universal insurance would likely lower the price of insurance for those of us who DO have insurance (whether that insurance were obtained via government or the private sector), in theory. Unfortunately, that's only true in practice if there is true competition in insurance, which isn't the case.
@johnva: Mostly agreed.
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.
@spanky: It's not so much \"blame\" as just recognition of some of the screwed up economics in our system. I don't blame the uninsured; they're just trying to get decent care at a price they can afford. But the more people become uninsured, the more the price of health insurance will become unsustainable, which means we will have...more uninsured.
@smartmuffin: Actually the bill does get paid, by everyone that has insurance.
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.
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
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-257922-100x100.png\")
@Whtthfgg: Did you read what you were even posting? That's admission for INPATIENT treatment of nose bleed. That price includes 3 nights at a hospital. For a nose bleed that doesn't stop bleeding for 3 days.
@Whtthfgg: Sure, you'll pay that price if you check yourself into a hospital. Go to a normal physician and not the emergency room and the cost is only $171.00
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
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@Whtthfgg: i call shenanigans on 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.
@the_wiggle: In 2006, while uninsured, I had a pretty bad oil burn on my hand and had to go to the ER. Total cost for one roll of gauze, 5 disposable chemical ice packs, and one small sample-size jar of a silver nitrate burn cream? $1800.
I believe those fees.
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What's really needed, in the absence of health care reform (or perhaps in place of it) is for self-insurance products to be offered to individuals.
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!
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Sounds interesting, but I'm getting a 500 error when I try to get to the site. Must be getting slammed right now.
Aetna (my insurance provider) has a service like this. I found out about it *after* scheduling my most recent procedure, but you better believe I'll be using it from now on.
That's great. Showing people actual costs and letting them shop around is great. It almost makes it sound like medical procedures are a good or service not a free give away. If this catches on it might make doctors compete and actually lower costs or find more efficient ways of running their businesses.
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@NICU: Except that the prices are by and large set by the insurance companies, but thanks for playing.
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@Eyebrows McGee (now with more baby!): To say nothing of the fact that if I ran across a parent who spent the three hours it'd take to compare local hospitals, doctors, materials, support staff, labs and ambulance providers, then enter it into a spreadsheet chart with graphs, while their four-year-old daughter with her noggin split open bled to death, that parent would need a hospital once I was done with them.
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Interesting.
I just looked up heart valve replacement surgery, which my late son underwent last summer. Healthcare Blue Book listed it as $34,622 in my area (including 9 days admission.) My son passed away less than 2 days after the surgery. Total cost: $160,000+
@ageekymom: I'm sorry for your son. The hospital bill was for all the meds, anesthetic, the rent on the hospital room, and everything else he racked up in the hospital for two days. The site is listing just the cost of the procedure.
@BytheSea: No, the site listed doctor's fees, room for 9 days, meds, etc. I'm sure the cost of the neurologist to determine the extent of the brain damage he suffered also contributed greatly to the cost.
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.
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@ageekymom: My condolences on your loss, a. It's particularly appalling that they're trying to make the financial insult compete with it for horror.
It'd be great if this could work as a bargaining chip against insurers' claims of \"usual and customary\" coverage by demonstrating that their theorized amount is neither.
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@the_wiggle: I wonder if they arethey jacking up prices because usually \"someone else is paying\" so the recipient doesn't care how expensive it is? If so, that's a problem that could get worse with nationalized health-care.
@nytmare: Why would it get worse? The only difference would be who backs the insurance. And there is no reason that nationalized health insurance couldn't include copays, deductibles, or other features to discourage that. It wouldn't have to work any differently.
@johnva: Because you're now insuring millions of people that are currently uninsured. So it gets worse because the overcharging happens millions of times more than it happened before.
@TheFlamingoKing: So we should just deny millions of people healthcare because they might \"overuse\" it if we gave them access to it, just like the people that do have access to it now?
Also, frivolous use of healthcare accounts for only a minor portion of aggregate healthcare costs. Most costs are consumed by chronic disease.
@johnva: No, it's OK, jump to some more conclusions why don't you?
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?
This sounds like it could be cool (IF it is impartial, which I'm not convinced of), but a quick couple of searches for recent procedures of mine shows that a) it isn't very comprehensive on the services it covers; b) the prices they quote seem to bear little to no resemblance to reality, just by looking at a comparison of some recent tests I've had; and c) it doesn't seem very nuanced, in that it doesn't allow for many subcategories or complicating factors that would be billed for in reality, nor does it explain precisely what their numbers are for. Just giving a number for a test isn't all that useful, because that's not how providers actually bill.
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'd like to see a law passed that said any money saved by patients is removed from the salary bonus pool of insurance executives and paid as a bounty to sick peoples' families instead.
Let the magic of the marketplace begin!
@Trai_Dep: Oh, Trai_Dep, there isn't a situation in the world that couldn't be solved by spending just a little bit more of someone else's money, huh? Not a single time where someone actually earns a large salary or bonus - let's take it by force instead!
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?
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@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?
@econobiker: Precisely.
The more a patient saves, the less it comes out of the insurance exec's bonuses, not doctors or hospitals, or the tax payer.
What could be more fair?
@Trai_Dep: I don't know, maybe just about anything that didn't involve forced redistribution of someone's possessions because you personally feel they make too much money?
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.
I was suspicious about the thin information on the company on their website, and knowing the insurance industry's history of using front organizations I decided to dig a little bit. Especially since \"consumer directed healthcare\" is the health insurance industry's business for the future (read: their idea for shifting more costs to patients).
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.
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i have a lovely stack of medical receipts to compare. this is a fun game
i especially like the button where you can click to print a detailed pricing agreement [available under some of the hospital admission pages]
good luck getting the hospital to sign that!
\"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]
.. hahahahaha!
@veg-o-matic: If they were primarily offering reviews it would be one thing, but when comparing prices only, it's hard to be partial without it being obvious.
@veg-o-matic: i guess the only way to be impartial nowadays is to be everybody's whore