Medical costs

[Deere Dude]

My oldest son took his middle son (12 YO) to the ER because of what they thought was an appendix attack, but the ER said he just needed to go poop. A couple days later he had to go back again for the same thing and certainly had appendicitis and guess what, he finds out he had to go poo again. He is on Obama care but he had to pay $3500 as the copay or deductible and Uncle Sam had to fork over $6500. The wife is to quick to go to the ER and I would hope they would keep ex-lax handy as a precaution for the next time/ I told my boy I have a very hard time forking over $15 for a copay much less that amount.

 

[Deere Dude]

My next door neighbor is a retired auto mechanic and when his insurance payments 8-10 years ago went from $400 a month to $800 he decided that as long as he had a fairly high net worth from owning shops and businesses he would just forgo insurance.

A few months later his wife got breasts cancer and that put him back $300,000. He was able to pay it and not sure what he does now, but in hindsight he maybe should have paid it.

 

[check]

Wow. Makes me afraid to even visit Florida (where we used to have a condo). Up here none of that stuff would cost a dime.

 

[oosik]

Year and a half ago I tripped and fell on my hand. I was fortunate - trimming up a LARGE P. pine I had just fallen - avoided getting tangled up with the running chain saw. I did bugger up my ring finger. To this day, it will not open/close as much as the other fingers.So when I go in for my routine diabetic check up, Dr notices and asks about finger. He listens to story and asks why I didn't go to ER or come into clinic. I told him - as long as I still have function in the finger, its OK, and besides with my high deductible I can't afford the trip. Its been a tad over a year and a half - the finger continues to improve.

 

[Snobdds]

Since I'm an Actuary in the Healthcare Industry, one of the things I do is set prices for medical reimbursements.

This is fascinating to me. This shows that the ER is still the first thing people think about when deciding on care. We as Insurance people are trying to steer people away from ER's for acute care and into urgent care clinics for situations like this. We give the urgent care higher reimbursements to offset the patient's out of pocket cost. The cost reimbursements to hospitals are very complex due to Obamacare and the standards attached to them. A hospital does not receive full reimbursement until a window of time is exhausted to make sure other visits are not needed. The government has quality of care initiatives to make sure someone is cured and not readmitted. The hospital then gets to charge more to fund this period where they don't get reimbursement but stil need money for cash flow. It's the craziest thing.

As consumers of healthcare, always try and use urgent care clinics as they will be the cheapest out of pocket for the consumer.

 

[hawkeye08]

If only urgent care clinics were open more hours..

 

[ning]

Year and a half ago I tripped and fell on my hand. I was fortunate - trimming up a LARGE P. pine I had just fallen - avoided getting tangled up with the running chain saw. I did bugger up my ring finger. To this day, it will not open/close as much as the other fingers.So when I go in for my routine diabetic check up, Dr notices and asks about finger. He listens to story and asks why I didn't go to ER or come into clinic. I told him - as long as I still have function in the finger, its OK, and besides with my high deductible I can't afford the trip. Its been a tad over a year and a half - the finger continues to improve.

One halloween I cut my the back of my right index finger (I had a big sword on my back, and I don't recall what I was doing when I got cut...). I don't usually bleed much, and didn't this time either, but after it had healed over I realized my last knuckle didn't bend as far on that finger as it used to - not nearly. I did self-PT and kept bending it and gradually have gotten most of its range back; I'll be damned if I go to the ER for something that's obviously not life-threatening; if I can stop the bleeding myself and there's nothing obviously broken under it - forget it.

 

[/pine]

Call it what you want but the only way they will ever bring the high cost of health care down is to take shareholders and corporate profits out of the equation...

Another factor is the extreme high cost of malpractice insurance...one way to reduce that is to take away contingency fees from lawyers...if injured parties did not have to give up 40%-50% of their settlements to the stinking lawyers the payouts would not have to be so substantial...limit the scumbags to 10% and justified costs...

 

[LD1]

If only urgent care clinics were open more hours..

Yea.....not any options around here at 11PM other than the ER.

 

[ultrarunner]

Dad was pistol whipped and shot at during a botched robbery... did a number on his face and he drove himself to the Doctor's Office... the Doctors office was incensed and told him to go to the ER... it was quite a bill but he has Medicare and Supplement... so in the end the payment was very little out of pocket.

Dad said back in the day the family Doc would have just stitched you up or set the broken bone and sent you on your way...

When a boulder smashed my foot I was hobbling around and the Podiatrist happened to see me hobble by and said I need to get an x-ray... my insurance refused to pay since I did not go to the ER... I fought it tooth and nail and finally they did pay 80% of the Podiatrist Charge...

Medical Billing makes little sense... Providers can go months without payment OR payment is made and then 9 many months later ask for it back...

Urgent Care can be a better alternative.

Growing up many had Kaiser HMO here... they were basically covered so many visits to the ER and Doc... no reason no to be checked out... just to be safe was the thinking.

One of the neighbor kids was constipated.... they have a high deductible plan as they are self employed... 2k per month premium and the New Years ER Hospital stay with ambulance transfer was out of pocket 12k when all was said and done... the local trauma center said it was short staffed being New Years so they transferred to Childrens... would no allow the parent to drive and insisted on an Ambulance... said if something went wrong against medical advice it could be child endangerment... thinking was appendix...

Seen first hand elective surgery where a co-pay is collected up front... many refuse because they have no intention of paying anyway but having to pay up front means they walk out... again, elective surgery.

The ER are closing everywhere around here... how can you stay open when many never pay?