What is up with Dr's office not taking self pay patients?

[Mama Geek]

Is this only going to get worse?

[Jean in Newcastle]

Some doctors are going the other way - to only taking self pay patients.  

[QueenCat]

Do you mean they won't see you if you CAN pay right then & there, in full? That's crazy!

[Mama Geek]

Do you mean they won't see you if you CAN pay right then & there, in full? That's crazy!

Yep!  I could even write a check if they don't take a credit card.  We ran into this when I was pregnant in trying to find an OB/GYN.  I don't know how many I called before I found 1 that would see me, fortunately for me he was extremely good.

[JumpyTheFrog]

It makes no sense to me. Cash patients don't require any staff to file insurance claims or get insurance approval. If I were a doctor, I'd want only cash patients.

[Guest]

I'm having the same experience and got shockingly horrible service from an eye doctor who was excellent in the earlier part of the millennium.

 

 

[G5052]

It seems to go every which way here.  Some practices are indeed only taking self-pay patients now, some are giving a discount to self-pay, and some are treating everybody the same.

 

We've also noticed that the doctors are billing faster, and requiring payment sooner.  Twice in the last week, we were told to pay our balance or future appointments would be cancelled, whether we had received the bill yet or not.

 

Sigh.

[Danestress]

I wonder if it becomes a problem in the long run to have a patient whose payment isn't even partially backed by an insurance company. It's great if someone can pay for an office visit, but if they develop a chronic or expensive problem, they may become less able to just pay up, and it must be hard to "fire" patients who are ill and uninsured.

[StephanieZ]

My guess is that self-pay often becomes no-pay when the bill is large. Once the doctor accepts you as a patient, getting rid of you when you become very sick but unable to pay becomes very difficult.

 

I'm not saying it is right, but I would bet dollars to donuts that is the main issue.

 

Alternately, it may be something like accepting section 8 housing vouchers conversation on another thread . . . Many, but not all, self pay patients are too poor to afford insurance, so they are more likely to have a hard time paying the bill and may be a pita to deal with overall.

 

Not to mention that most doctors have very little idea how much their services cost. So, it is a pita to deal with a client who needs to know if he the work up the doctor is recommending costs $500 or $5000 because the doctor really has no idea and has no interest in knowing nor in using staff time to figure it out in advance or deal with the hysteria when someone gets an unexpected 5k bill.

[elegantlion]

Not to mention that most doctors have very little idea how much their services cost. So, it is a pita to deal with a client who needs to know if he the work up the doctor is recommending costs $500 or $5000 because the doctor really has no idea and has no interest in knowing nor in using staff time to figure it out in advance or deal with the hysteria when someone gets an unexpected 5k bill.

 

We ran into this in the ER several years ago. We questioned the necessity of some tests for ds, which were way overkill for what we took him in for, in our opinion. The ER doctor only "allowed" us to skip those once she called our primary doctor (at 10:30pm) who also said they weren't necessary. We had money to pay, but no insurance at the time. 

 

Most people don't hire a contractor without going over the details with a fine tooth comb, yet medical care is supposed to be accepted without question. 

[Jean in Newcastle]

This drives me batty and is exactly why I hate when people get all excited about the "consumer driven health plans" (AKA health savings accounts paired with insanely high deductible plans that don't cover pretty much anything).  There is no such thing in my experience.

My HSA was wonderful.  It is paired with an insurance company which does the usual lowering of costs for you by having contracted amounts.  I got excellent coverage at a rate I could actually afford.  The govt. has now closed that option for me and I will now be required to have substandard coverage at a rate that I can no longer afford.  

[FaithManor]

We offered $10,000 up front to two different hospitals in order to get dd's desperately needed tests

started...WAY more than enough for MRI, Petscan, and oncology consultation and she was refused

testing and treatment. There are no words that can adequately express my hatred for our current medical

system. We are looking at the possibility of contracting for her care in another country. I'd like to

send one particular hospital administrator a bouquet of sour grapes with skull and cross bones wnd

wilted weeds. I doubt he'd care since it is apparent that he has no soul.

 

Faith

[Jean in Newcastle]

It didn't work so well for us.  We were always told we could shop around for services.  When I went to "shop around" for a very minimal surgical procedure for my son nobody would tell me their rates/fees.  Not the insurance company and not the surgery centers.  When all was said and done, the 5 minutes procedure followed by a one hour recovery period set us back $8000.  When I inquired as to why it was so expensive, I was told the insurance company doesn't have a discount with them so their allowed amount was whatever they bill for.  Nobody could tell me that ahead of time.

That's strange.  I just went to preferred providers.  For extra procedures I would call ahead for authorization just like with a "normal" policy.  It was still expensive but the low insurance premiums balanced out the higher out-of-pocket costs. I had run my numbers using the high deductible as my medical cost for the year to see how that matched up against a trad. plan and even with us maxing out the coverage we came out ahead.  This was good because a couple of years, including this year, we actually met the deductible.   Then the insurance co. paid 100% after that.  

[AimeeM]

I can see the hassle, honestly.

When I take my children to the pediatrician, there's no need to go over which lab the lab work is going to, how much it will cost, what tests are being run at the lab, paying THEM (the lab) up front on top of the visit cost, etc; same would go for radiology. Even with routine well checks, there is usually a vaccination given, or blood drawn, requiring the use of an outside party.

[creekland]

Every doctor and office (except one) that we've gone to has given a discount for self-pay, and this goes up to last month for us.  The discounts have ranged from 25% to 50%.  I hope what you've experienced doesn't become "normal!"

 

Health care sure is becoming "weird" lately.

[redsquirrel]

When I went looking for doctors when we moved here I'd first ask if they were taking new patients.  I was often told, "Depends on which insurance you have."  Really, they couldn't give me a straight answer.  It depended entirely on whether or not they liked my insurance. 

 

that has been my experience my entire adult life. When looking for a new doctor, first you find out if they are taking new patients, then you find out if they accept your insurance.

 

My current family doctor did take our insurance when we started in his practice but then he stopped taking it. It 'covers' a whole lot but pays the doctors less than Medicaid. Hence, no one in town takes it. But, it was super cheap so we kept it. Now we are in the process of switching to a slightly more expensive option but everyone in the area takes it. We could have switched at any time in the past 10 years, but we couldn't afford it. Now, the price of the other two plans offered by the university have come down so we are switching to a plan someone actually accepts.

 

 

The concern that a future medical expense might exceed what the patient can pay is probably the driving force. Seeing as unpaid medical bills are one of the leading causes of bad credit and bankruptcy lots of people are not paying those bills themselves. It might be more hassle than it is worth. Plus, once you are a patient it can be difficult to stop treating you just because you can't pay.

[Excelsior! Academy]

Every doctor and office (except one) that we've gone to has given a discount for self-pay, and this goes up to last month for us.  The discounts have ranged from 25% to 50%.  I hope what you've experienced doesn't become "normal!"

 

Health care sure is becoming "weird" lately.

 

 

This has been my experience as well.  We usually get a discount, sometimes substantial.  My nephew broke his arm badly a year or so ago.  It required an overnight stay to Children's due to a concern of nerve damage.  We explained that we had no insurance.  They told me it didn't matter, they treat everyone the same.  We later paid cash at a discounted rate.

 

The only comment I have ever gotten was "I'm sorry!" when we explain we have no insurance.  They automatically assume you are derelict and can't afford it not that there is a possibility you may have chosen not to have it.

 

[Tiffnkids]

They automatically assume you are derelict and can't afford it not that there is a possibility you may have chosen not to have it.

[GSOchristie]

They were a "preferred provider".

 

What "saved" us with that our deductible was not that crazy at the time ($2500) and the company gave us $2000 in the HSA to start with. This was when HSAs first came out. So because we met the deductible the insurance kicked in and paid 80% and then we had the $2000. But that was it for the year. An hour and 5 minutes and all the money for any medical whatever was gone.

 

He had his tear duct probed. So this seriously was not a big deal. Didn't forget it because the bill was so shocking and it was on his first birthday!

I am glad you posted this. Piper had a clogged tear duct and our dr wanted to just what you had done. I didn't bring it up at the 1 year appt because I *knew* it would be ridiculously expensive to fix. It cleared up on its own by the time she was 2. I had forgotten all about all the fretting I did over that stupid tear duct.

[Mama Geek]

I really think that doctors having to deal with health insurance would be a much bigger headache than people who ask how much things will cost or coming up with the costs of the services or discussing whether or not tests are necessary.  If this were the case why would other doctors give cash discounts or do cash only at discounted rates?

 

I might believe that they don't want to have to start refusing to see someone they have diagnosed with something serious that the person couldn't afford to treat.  

[MooCow]

My HSA was wonderful. It is paired with an insurance company which does the usual lowering of costs for you by having contracted amounts. I got excellent coverage at a rate I could actually afford. The govt. has now closed that option for me and I will now be required to have substandard coverage at a rate that I can no longer afford.

Similar here also.

[GSOchristie]

I tried to get a quote last year about a procedure I had to have done on my eye. I called the billing office at Chapel Hill, had to get all the specific codes from the opthamologist, and it took them two days to come back with a price, around $500. I decided to have the procedure done because $500 was worth my peace of mind. I almost fell out of my chair when I got the bill for $1,100! I never would have gone for that much, it was like a 0.1% chance something was really wrong. I still get mad thinking about it.

[Parrothead]

It really is a messed up system.  I read an article about a year ago about a young couple shopping for an OB for the newly pregnant wife.  Seems they could not get a doctor or the hospitals in their city to give a firm price on the cost of a vaginal birth.  The excuses all boiled down to the inability of the doctor to see the future.  Because nobody could say what unexpected things might happen they could only get a figure of somewhere between $4,000 and $40,000

[AmyontheFarm]

I suddenly am very happy I live in Canada.  Although, everyone here says your hospitals are like spas compared to ours.  This household has had 4 MRI's 3 Cat Scans and 7 different operations.  If I had to pay for all those at the time, well, it wouldn't be good.

[Catherine]

This has been my experience as well.  We usually get a discount, sometimes substantial.  My nephew broke his arm badly a year or so ago.  It required an overnight stay to Children's due to a concern of nerve damage.  We explained that we had no insurance.  They told me it didn't matter, they treat everyone the same.  We later paid cash at a discounted rate.

 

The only comment I have ever gotten was "I'm sorry!" when we explain we have no insurance.  They automatically assume you are derelict and can't afford it not that there is a possibility you may have chosen not to have it.

This is because it was an emergency. All emergency care is required of doctors and hospitals regardless of ability to pay, so there was no question in his case of what to do.

 

When hospitals are in the position of providing care that is elective, non-emergency, they will behave very differently. Most hospitals have huge, huge amounts of bad debt, particularly those in high poverty areas. They must make up those costs any way they can, and most get funds from their states to offset part of it. The rest of the offset comes from insured patients. Believe me when I say, the vast majority of "self-pay" patients pay nothing at all for the care they get. So hospitals will scrutinize anyone who is uninsured very closely, because their experience has been that most of those people don't, or can't, pay them anything.

[Murphy101]

I suddenly am very happy I live in Canada. Although, everyone here says your hospitals are like spas compared to ours. This household has had 4 MRI's 3 Cat Scans and 7 different operations. If I had to pay for all those at the time, well, it wouldn't be good.

I'm curious about this "spa" concept.

 

It was commented in passing during my recent 6 day stay at the hospital that I was lucky to have a private room. In my entire adult life, I've never not had a private room myself. I've had some pretty awful care at times over the years, but always a private room. So dh and I responded that if I hadn't had a private room, we'd have endured the discomfort of leaving and going to another hospital that had reasonable accommodations. My fil commented that in Europe/canada I'd have to go home for that then. (ETA: but my dh has commented that the hospital he visited in Costa Rica was ritz-like. He sooo wishes we could move to Costa Rica. It's his favorite place he's traveled so far.)

 

I found that interesting. I mean, of course if you are in the middle of dying, you'll put privacy 20 or priorities back. That's way most people don't expect a private room in the emergency department. A bunch of curtains between beds is enough. But when possible, most people I think would feel very uncomfortable sleeping in a room with total strangers, everyone half naked with a hospital gown, yk? And it's not like our hospitals are quiet havens of healing rest to begin with.

 

But spas? Idk. My experience has not been spa-like. But then again, I've never been to a spa. lol

 

What do they say about our hospitals that makes them sound like spas? Curious.

[AmyontheFarm]

This is why my parents say it is spa like.

 

When my mum had her knee replaced, for a bunch of reasons, the Canadian dr's sent her to Michigan to be operated on.  She was in a room by herself, with a nurse coming in to check on her every 15 minutes or so.  My Dad was encouraged to stay with her.  The TV actually worked with more channels then we had at home.  The food was hot and good.  Every person who came in contact with my Mum stopped and asked her if she needed anything and how they could make her stay more pleasant.  The room was beautiful and not puke green colored and generally the whole hospital was just beautiful.

 

When my Dad had his knee replaced in Canada, they sent him up from the operating room, without his morphine IV set up, his C-Pap machine was still in it's case, and not attached or on his face.  My Mum wasn't allowed to see him for 2 hours after his surgery and when she did, that's when she realized he had No drugs in him and was struggling to breath because of the lack of C-pap machine.  My Mum had to start screaming to get help and even then it took another 30 mins for them to hook up the IV.  My mom hooked up the C-pap machine herself.  My dad was 4 to a room, one who had MRSA and another who had a stomach flu.  The nurse came once an hour or so and if someone else needed help then my dad might wait another hour before they got back to him.  My mom had to go get a jug for my dad to pee into.  She was told she couldn't stay and she told the nurse she wasn't leaving, period.  The nurse threatened to call security and my Mom asked to see her boss, explained what had happened before and they let her stay.  Nurse was ticked off and lacked professionalism.

 

Same operation, to different countries, two different patients, two different experiences.

[Murphy101]

Holy cow. I don't think the Michigan hospital was a spa so much as that Canadian hospital was freaking unhealthy and awful.

 

If it matters, other than the 4 to a room thing, the rest could happen here too.

[umsami]

DH is a physician and he always offers the Medicare rates to self-pay patients.  If your doctor doesn't and you're self-pay, ask.  

 

(Not all will… back when I was pregnant with DS3, we didn't have health insurance. Nobody would see me and I was high risk.  High Risk OB wanted $2000 cash per appointment.  Normal OB wanted a check for $5k before they'd see me.  Luckily, my normal endocrinologist told me he'd work with me via email to manage my gestational diabetes.  I also found a direct-entry midwife who was willing to take me for prenatal care.)

 

As for wards vs. private rooms… that used to be the norm in the US…but things started to change in the late 70s/early 80s.  It's far more economical to care for multiple patients in a ward, vs. having private rooms.  I'd take wards vs. private rooms any day with national health insurance vs. having to worry about co-pays, co-insurance, bankruptcy, pre-existing conditions (thankfully no longer an issue), etc.

[umsami]

I tried to get a quote last year about a procedure I had to have done on my eye. I called the billing office at Chapel Hill, had to get all the specific codes from the opthamologist, and it took them two days to come back with a price, around $500. I decided to have the procedure done because $500 was worth my peace of mind. I almost fell out of my chair when I got the bill for $1,100! I never would have gone for that much, it was like a 0.1% chance something was really wrong. I still get mad thinking about it.

 

I would have gone back to the billing dept. and say this is the price I was quoted.

[umsami]

Two things if you are self-pay.

 

Acessa Labs offers direct-order labs.  Basically they contract through LabCorp.  Very easy.  Most states they can write the lab orders for you, so if you know you need to get your HbA1c checked quarterly, but can't always afford your endocrinologist appt, you can do it directly.

 

http://www.accesalabs.com

 

 

If you find yourself in the hospital or facing major care, see if the hospital has any sort of charity dept.  Often times, if you work with them, they will write off a good portion of your bill.  Here's an example of one hospital's scale rates based on income:

http://www.lenoxhillhospital.org/serving.aspx?id=440

[LostSurprise]

I've wondered about the acceptance of Cash patients with the Affordable Care Act. Until this year, I've always seen them accepted and often a discount given for paying immediately (our dentist also does a discount for people who pay cash the day they receive treatment). 

 

 

We use an HSA with a "high deductible plan." It works very well for us. The low deductible plans I've seen available to us are not cost-effective. Perhaps if we had no reoccurring medical concerns here and either couldn't (living paycheck to paycheck) or didn't want to think about medical costs it would be a good option. As it is it's so expensive you're really paying the difference in deductible to the insurance company, whether you use it or not. Over the years the difference in deductible between low deductible and high deductible plans has eroded considerably. I think when we made the switch a few years ago it wasn't more than a $1000 difference between the HSA plan and the low deductible plan. The 2 plans were almost the same last year when we signed up. The difference is that with the HSA we can put away money for medical expenses that is not absorbed by the insurance company at the end of the year if we don't use it (like Flex plans are). It isn't taxed. It's sitting in an account waiting to be used. For a family with constant medical concerns that's very helpful. The money put into the account now will be used next year when we're reaching our deductible. 

 

At least that's how it's been until now. I've heard that HSA accounts are much more limited with the Affordable Care Act. Hopefully, it will be enough. 

[vonfirmath]

Holy cow. I don't think the Michigan hospital was a spa so much as that Canadian hospital was freaking unhealthy and awful.

 

If it matters, other than the 4 to a room thing, the rest could happen here too.

 

With DS, we were 2 to a room in recovery. I didn't think it was horrible.

[Murphy101]

 As for wards vs. private rooms… that used to be the norm in the US…but things started to change in the late 70s/early 80s.  It's far more economical to care for multiple patients in a ward, vs. having private rooms.  I'd take wards vs. private rooms any day with national health insurance vs. having to worry about co-pays, co-insurance, bankruptcy, pre-existing conditions (thankfully no longer an issue), etc.

I would not want a ward style and I don't think it has to be either that or the POC system we have.

 

If for no other reason than I can't comprehend how any aspect of HIPPA can be followed with a stranger/another patient 3 feet away. Several times during my stay quite a bit of private information was being discussed. My address, ssn, sexual activity, abuse (they always ask those questions. Is your husband abusing you? Are you sexually active/could you be pregnant?)

 

With DS, we were 2 to a room in recovery. I didn't think it was horrible.

Ah but that is completely luck of the draw. And recovery is not the same as a hospital room. Recovery is usually a very brief time, less than 2 hours. Most recovery rooms are curtain divided ward style here. You aren't spending a week there.

[redsquirrel]

The only time I have ever had a room to myself and nurses checking on me constantly was when I had given birth to my eldest son prematurely. I thought I was just in a really nice room, but it turns out that in that hospital, if you had a very sick baby, they treated you with kid gloves. I was very grateful that they didn't put me in a room with a mom and a health baby. I think that would have pushed me over the edge at a time when I was just hanging on. As it was, there were women at full term walking around in labor all over the place and I kept crying every time I saw them. FWIW, the food was absolutely terrible. Not that I could eat, but the terrible food gave me good cover for being so upset that I couldn't eat a thing.

 

For something like surgery on a knee etc, I would expect several people in a room and all of that.

[creekland]

Several times during my stay quite a bit of private information was being discussed. My address, ssn, sexual activity, abuse (they always ask those questions. Is your husband abusing you? Are you sexually active/could you be pregnant?)

 

 

One does have to get a laugh out of some of those questions...

 

"What's your sexual orientation?  Are you sexually active?"

 

My first instinct was to respond, "You have my chart, you see that I'm married with three biological kids.  GUESS!"  

 

Even students in my lower level Bio classes would be able to get that question right...

 

Then MY next question would be something to the effect of, "And what in the world does this have to do with a BRAIN TUMOR???"  Family history?  Understandable.  Some of the rest?  Uh...

 

Ok, in a private room I'll play along as I did learn manners in my youth - and really - the answers shouldn't surprise anyone.  In a ward or elsewhere, it would be touchy/doubtful - just because.

[Liz CA]

Some doctors are going the other way - to only taking self pay patients.  

 

Maybe we are slowly reverting back to the days when transactions were between patient and physician without insurance companies...I know I am dreaming but it was nice while it lasted. :)

 

[Murphy101]

The only time I have ever had a room to myself and nurses checking on me constantly was when I had given birth to my eldest son prematurely. I thought I was just in a really nice room, but it turns out that in that hospital, if you had a very sick baby, they treated you with kid gloves. I was very grateful that they didn't put me in a room with a mom and a health baby. I think that would have pushed me over the edge at a time when I was just hanging on. As it was, there were women at full term walking around in labor all over the place and I kept crying every time I saw them. FWIW, the food was absolutely terrible. Not that I could eat, but the terrible food gave me good cover for being so upset that I couldn't eat a thing.

 

For something like surgery on a knee etc, I would expect several people in a room and all of that.

I remember one of my sisters complaining that they were roomed with a lady who had lost her baby. So they are in their bed feeding and cooing over their healthy bouncing baby and the woman in the bed next to them is bawling because her baby died. I was all, wt_? Seriously?! But apparently it was the norm 25+ years ago.

 

Out patient stuff is usually more like a recovery room set up.

 

But any admitted stays should be private IMO. It's not like the rooms are hotel suites. It's usually just big enough for the hospital bed and for a person to walk around 3 sides of it and an itty bathroom off the side.

 

Oh that reminds me, my fil was impressed I had my own bathroom. Again, I've never not had my own bathroom.

 

I'm not normally a germaphobe, but in a hospital. Yes I am. I will get very upset if I don't see frequent hand washing, sanitizer, glove changing and daily cleaning of the facilities. That's hard enough to keep track of just for myself and visitors. How do you handle that when the people coming in are not visiting you or the other patient doesn't notice or care as much? *shudder*

[Murphy101]

Maybe we are slowly reverting back to the days when transactions were between patient and physician without insurance companies...I know I am dreaming but it was nice while it lasted. :)

 

I sure hope so.

[vonfirmath]

I would not want a ward style and I don't think it has to be either that or the POC system we have.

 

If for no other reason than I can't comprehend how any aspect of HIPPA can be followed with a stranger/another patient 3 feet away. Several times during my stay quite a bit of private information was being discussed. My address, ssn, sexual activity, abuse (they always ask those questions. Is your husband abusing you? Are you sexually active/could you be pregnant?)

 

 

Ah but that is completely luck of the draw. And recovery is not the same as a hospital room. Recovery is usually a very brief time, less than 2 hours. Most recovery rooms are curtain divided ward style here. You aren't spending a week there.

 

Maybe I didn't call it the right thing. I spent 2.5 days there.

[kewb]

Soap box warning:  Pretty much every specialist my dh goes to do not take insurance and payment is due at time of visit. No cash/check/credit card - no service. This way they eliminate the billing hassle.  They will also go over the cost of any testing they are requesting so together you can make a decision on which tests need to be done at this time.

 

I saw this in play long before the affordable health care act.  Insurance companies are just using it as an excuse to do what they do for their bottom line.  Doctors are responding in the way they see fit to maintain their practice.

 

All the drama and hand wringing and finger pointing is no different from all the Bush bashing (as we all know everything is his fault) and blaming Clinton for the epidemic of oral sex (since no one ever engaged in that act prior to him becoming president)

 

To answer the original question-I see an upswing the other way-doctors not accepting any insurance.

[Danestress]

Then along came the HMOs and they practically forced people to go there every other week.

What? We hardly ever see doctors outside of our normal yearly visits. Maybe once a year each outside of that. Unjinx.

[Joker]

Holy cow. I don't think the Michigan hospital was a spa so much as that Canadian hospital was freaking unhealthy and awful.

 

If it matters, other than the 4 to a room thing, the rest could happen here too.

 

When I delivered my first, there were four beds in my room. Luckily, I only had to share my room with three other new moms and babies for one night, and then it was just one other new mom/baby and myself the second night. I did get a private room with my second delivery but I had to pay more.

 

My mom has had several surgeries and always shared a room with another patient. Her last surgery required a seven day stay after the surgery and she was never in a room alone.

 

I've always thought having a private room was a luxury here. I'm in the US.

[Murphy101]

Ick. No thanks. Much as I love my dh, there's nights when I don't want to share a room even with him. Privacy is way up there on my list. Like right below not dying. Well maybe third.

 

Otoh, I suppose that's one way to keep costs down from 2 sides of the candle. One end is cheaper facilities and the other is make people like me have to be near deaths door before they'll be willing to enter the hospital doors.

 

Is the room sharing why they are strict about not having company with you? We've always insisted on having someone stay with whoever is in the hospital. My recent stay was a rare exception.

[Joker]

Ick. No thanks. Much as I love my dh, there's nights when I don't want to share a room even with him. Privacy is way up there on my list. Like right below not dying. Well maybe third.

 

Otoh, I suppose that's one way to keep costs down from 2 sides of the candle. One end is cheaper facilities and the other is make people like me have to be near deaths door before they'll be willing to enter the hospital doors.

 

Is the room sharing why they are strict about not having company with you? We've always insisted on having someone stay with whoever is in the hospital. My recent stay was a rare exception.

My dh always stayed with me and the other moms had someone with them as well. The chairs next to each bed reclined and that's where they slept.

 

[Murphy101]

My dh always stayed with me and the other moms had someone with them as well. The chairs next to each bed reclined and that's where they slept.

Do the babies stay with the moms the entire time? What if one mom is none too happy to listen to someone's baby scream and doesn't want her own baby rooming in, much less someone else's?

 

What if the husband of the roomy is a sex offender or whatever other type of criminal? I'm just contemplating all the ways forcing room sharing could go to court and I gotta tell you it's not taking much imagination.

[bolt.]

Babies who are healthy are always kept with their moms -- unless mom is medically incapable of providing care for the baby (ie sleeping off anaesthetic). This in not considered optional. A hospital is not a daycare, therefore they do not provide babysitting unless it is medically nessisary. Medical care is the ONLY service provided by our hospitals.

 

Newborns do cry, but are generally comforted and nursed, so the shared experience of disturbing one another (frequently but briefly) isn't terrible. If your baby is allowed to make noise, why should you resent another healthy baby doing the same thing nearby?

 

You would ring for a nurse or security if you found your room mate or their visitors threatening. This is the same way you would react in any doctor's office or waiting room, or whatever if someone threatened you. I can see how it can be threatening to be ill/incapacitated in a place that is not private -- but that's what a hospital is.

 

Most rooms are for four patients: two on each side of the door, with curtain dividers. The beds are spaced about 6 or 8 feet apart. Maternity is an exception, because, of the 4 people, only two require full sized beds. The babies get bassinets. Overnight visitors are unusual (except in maternity), And i think they might actually be forbiden -- some places have restricted visiting hours. Labour-and-delivery rooms are private.

 

Mothers who have suffered loss are not cared for in the maternity ward, because that's just cruel.

[Haiku]

Every doctor and office (except one) that we've gone to has given a discount for self-pay, and this goes up to last month for us.  The discounts have ranged from 25% to 50%. 

 

In my experience, it's not actually a discount. What I have seen is this: the rate the provider charges is, for example, $100 for service X. The insurance company negotiates to pay $15 for the service. The provider gives a 50% discount for self-pay, so the person with no insurance pays over 300% more than the insured person's insurance pays. We get those "Explanation of Benefits" papers every time one of my kids sneezes, it seems, and you can look on them to see the charged rate versus the negotiated rate. At my son's pulmonologist, uninsured patients pay over 400% more than those with insurance, even after the "discount."

 

I recently had minor surgery on my foot. The bill was around $700. Our insurance company paid $89, and I paid a $20 co-pay and $9 in co-insurance.

[creekland]

In my experience, it's not actually a discount. What I have seen is this: the rate the provider charges is, for example, $100 for service X. The insurance company negotiates to pay $15 for the service. The provider gives a 50% discount for self-pay, so the person with no insurance pays over 300% more than the insured person's insurance pays. We get those "Explanation of Benefits" papers every time one of my kids sneezes, it seems, and you can look on them to see the charged rate versus the negotiated rate. At my son's pulmonologist, uninsured patients pay over 400% more than those with insurance, even after the "discount."

 

I recently had minor surgery on my foot. The bill was around $700. Our insurance company paid $89, and I paid a $20 co-pay and $9 in co-insurance.

 

But you need to factor in the cost of insurance - whether you pay it or whether an employer or the state (or whoever) pays it - someone does.

 

For us, looking at insurance when ACA loomed (health shares get a legal exemption, so it doesn't affect us, but just to compare), I used one of those comparison calculators.

 

For our family (no subsidies), we'd need to pay $790/month, then have 30% OOP (silver plan) up until an annual OOP of $12,700.

 

With our health share we pay $370/month and have 100% coverage for incidents over $300.

 

We SAVE $420 per month every single month we don't need anything.  Most months we don't need anything.  So, if we paid $50 for service X vs $15, we still paid less than if we'd gone with insurance - AND the doctor/hospital got the extra money rather than the insurance company.  I prefer that.  I kind of doubt the hospital/doctor broke even if they got paid $15.  The only one who "profits" in that scenario is the insurance company.

 

With the minor surgery on the foot we'd have paid $300 (health share would kick in for the rest - or - with a 50% discount we'd have just paid the entire $350).  It would still have been less expensive for us than going the insurance route - and again - the doctor or hospital would have received the (extra) $$ vs the insurance company.  It's a win-win.

 

I'm of the firm belief that health care costs for all would come down - and care could stay high - if we could get rid of "for-profit" insurance (and even medicare) and go with health share types of programs for all (more would need to be created, of course, as those that exist are not appropriate for all).  I suppose it's a socialist idea, but then again, I feel health care is a right, not a privilege, so even though I'm a rather staunch Libertarian on most issues, this is one where I'm not.

 

We (as a population) win nothing when our medical institutions struggle to pay bills while insurance companies have high paid CEOs, etc.

 

For those who never "see" the insurance cost because their employer covers it... see if you can find out how much the employer pays, then imagine that amount as a raise.  That's how much folks are losing.  Since it's "invisible," most don't realize it exists.  Switch to self-employment and compare costs for yourself and things are quite different when one runs ALL the numbers.

[Haiku]

I'm of the firm belief that health care costs for all would come down - and care could stay high - if we could get rid of "for-profit" insurance (and even medicare) and go with health share types of programs for all (more would need to be created, of course, as those that exist are not appropriate for all).  I suppose it's a socialist idea, but then again, I feel health care is a right, not a privilege, so even though I'm a rather staunch Libertarian on most issues, this is one where I'm not.

 

I don't have any experience with a health share program, so I can't comment on that, but I agree with you on the ideas that we need to dump for-profit insurance and that health care is a right, not a privilege. This may be the first time we've ever agreed on something.  :cheers2:

 

You are right that the cost of insurance is a huge factor in the absolute price of healthcare. For us, going without insurance was never an option because one of our children has HIV, Hep B, chronic anemia, and depression, and another has asthma, needs speech/occupational/physical therapy, and has chronic ear issues/hearing loss. We consume far more health care than we pay for, but even we were in the position of my husband needing to switch jobs because the insurance had become so unaffordable to us. At one point our insurance cost $1800 a month, and that year we spent more than 50% of my husband's gross pay on health care expenses. It was insane.