Healthcare Bill Ridiculousness

[Bluegoat]

Just sharing my personal anecdote.  DD had to go to the emergency for a concussion.  I knew she was probably okay but she had all the signs that say "go in" so we went in.  We went in, they did a CT scan, they gave her a pain shot and an anti-nausea pill.  We went home.  Under two hours.

 

First bill was from the hospital and included the CT scan, $2900.  Then I received a radiology bill for $200 for reading the CT scan.  This all happened back on Dec 4th.  I *just now*, over three months later, for the first time got a bill for "emergency room physician charge" of $1269.  Seriously, for just, what?  Obviously this did not include overhead, because I'm being billed from the hospital already.  $1269.

 

Yet nobody wants to address the grossly inflated prices that charge everyone differently depending who they are and what insurance they have (or do not have) and have no basis in actual cost.  What about a congressional bill to address that?  This kind of crap is a huge part of the problem, but not a peep.

 

And no, you can't "shop around" when you are going to the emergency room at 9 pm for heaven's sake.  Yes I will be calling to negotiate. But why should my price vary that much on how good a negotiator I am?  Healthcare should not be like a street vendor where you start out with some totally made up price they know you are never going to pay.  This whole system is ridiculous and no one is addressing the core problems.

 

Wow!

 

FWIW, I have never heard of anyone I know here in Canada going for a scan in a scenario like that.  It strikes me as major overkill.

[FaithManor]

The biggest military budget in the world?

 

Although to be fair very few of those statistics are apples to apples comparisons.

I should have qualified it. Comparing developed nations. Yes. We rank up there with Iran, Saudi Arabia, etc.

 

Those nations providing for their citizenry in terms of healthcare and decent education are spending their tax dollars elsewhere. The difference between the US and France in military spending is huge, and France is one of the bigger spenders on military in Europe.

 

You can check the world fact book for comparisons.

[Bluegoat]

I embarrassingly brought my kids twice to an emergency room in Germany (both for playground accidents - dd1 vs. monkey bars too close together - bonked her head when she dropped down between them -  and dd2 vs. see-saw - fell off and split her nose).  

 

Both times, the bill was about $50, or maybe it was Euros,  But my ER deductible for my insurance at that time was $75 - so either way their whole bill was less than my deductible would have been in the US.  :glare:

 

Yeah, I recently was traveling in a different province here in Canada, and had to use a walk-in-clinic on a holiday (Canada day).  So, I had to pay up front and then send in the receipt when I got home (which I didn't bother with in the end.)  It was $50 for the visit - testing for a UTI plus it would have covered the lab work to see if it was a resistant infection, though I told her not to bother since I would be gone by the time the results came in.

 

My stepdad sometimes has patients that end up having procedures done in the US when travelling, and his eyes tend to pop at the cost - I remember one lady who had an eye surgery that would have cost the system around $1000 here, they billed over half a million. 

 

What this shows is that the same care costs less elsewhere, it isn't just that taxes are paying at point of service.

[SKL]

I'm the first person to agree that we pay many times the actual value for relatively routine medical care as well as for higher education in the USA.

 

I don't want to throw out the baby with the bathwater though.

 

We do the big things really well, and we do a good job on many aspects of healthcare.  Also, I remember the days, not that long ago, when you could afford to pay for routine care out of pocket, because a simple physical (for example) cost $15.  That was possible without the government taking over then, so why isn't it possible now?  It is; we just have to be willing to give it a serious try.

 

Though, I admit it's a bit ironic to ask Congress to find a solution that doesn't involve too much government.

[creekland]

What this shows is that the same care costs less elsewhere, it isn't just that taxes are paying at point of service.

 

All our insurance CEOs need to make their millions somehow.  Then there are stockholders, and insurance overhead costs, etc.  Then add in the millions for the drug companies (still CEOs, not necessarily actual research costs).

 

http://medcitynews.com/2015/06/what-were-the-top-healthcare-ceo-salaries-last-year/

 

"Wendell Potter, former public relations executive for Cigna, where CEO David Cordani raked in a $14.5 million salary in 2014, said, “There’s no doubt that one of the reasons why Americans pay more for health insurance and for healthcare than people in any other country in the world is because of this high executive compensation.â€"

 

I'll admit to wondering why anyone needs to earn more than 1 million dollars per year (or even that much), but that's just me I suppose.  These are also only top execs.  What do all the folks in the next step down earn (VPs and similar)?

 

Our country would save a bit if we'd admit that fat cats don't really need that much - esp from health issues.

[TravelingChris]

It is also the hospital executives earning gigantic salaries- over 1 million a lot of times.  That article up thread said the system is insane.  The only people paying mostly reasonable prices are Medicare and Tricare.  Medicaid sometimes pays reasonable and sometimes way too low depending on state and service.  As to drug prices, everyone pays too much except for some drugs if you self-pay since the cost is lower than everyone else's co-pay.  Although Medicare and Tricare pay less for drugs than the pharmacy charges normallly, they are not allowed by congress to negotiate prices so for that category it is almost certain that even Medicare and Tricare pay too much for drugs.

[boscopup]

My last pregnancy, my OB sent off a urine sample to be drug tested (without my knowledge). We got a bill from a lab in another state saying that our insurance wouldn't cover it due to being out of network. The drug testing cost $2400! We did end up getting it covered mostly, but it was still considered out of network. I wasn't told the sample was being sent out, so I wasn't given an option to see if the lab was in network. Why they send it out of state anyway is beyond me. What insurance company would consider that in network? The whole thing was stupid on many levels, and the charge was ridiculous. Obviously, I won't be seeing that OB again.

 

When I lived in Canada for a couple years as a student, I had to have outpatient surgery. The total bill, which I paid out of pocket? $300. The charge just to consult with a doctor before outpatient surgery would be that much here. :p

 

My dad got cellulitis while visiting my brother in Canada and had to go to the ER and stay in the hospital a few days. He's had the same issue here in the US. In Canada, he had excellent care, was seen quickly in the ER, and the bill a fraction of the cost of the same exact treatment here in the US.

 

I think here in the US we are shackled by insurance companies. My family's insurance premium is over $1200/month (and that's with the employer paying a big part). I'm lucky that our deductible isn't that high. Most people in this country have a much higher deductible, and many can't afford that deductible on top of the high premium.

[TravelingChris]

IN that article, it said the people who get really screwed by the system are the people with no insurance or with totally inadequate insurance.  I didn't realize that people had such lousy insurances I guess because the only plans I ever saw were ones offered by my employers and they had no bad insurance choices.  By bad insurance choices, I am talking about plans with really low payments or maximums.  Like some plans apparently will pay a maximum of 2000 a day in the hospital for everything that could happen to you there,  That is way too low for almost any hospital stay and then there are others with 50000 or 85000 maximums-  even one surgery can go through that quickly let alone if you get cancer, have a heart attack that needs more care, have a bad case of pneumonia like the man in the article, etc.  The other thing that I didn't know is that if you have inadequate insurance, that insurance doesn't go to bat for you- they just pay their portion and you are left with the rest- which in the cases of the article were over 100000 sometimes way over.   With my Tricare, the hospital or doctor or medical service bills some crazy prices (usually)like INR check is billed as 75 and then Tricare says that is too much to charge, we pay 15 dollars and the patient pays 2.00., or something like that.  My doctor visits are much more in line with real prices - they charge 95 and Tricare pays 75.   BUt anything to do with the hospital like my INR or any lab test or same day surgery is the same- Tricare pays only a small portion of what they charge so no $3 tylenol payment and such things.  In the article, people were being billed for blankets that they don't get to keep at over the full price you can buy retail and you know they aren't buying retail.

[Bluegoat]

It is also the hospital executives earning gigantic salaries- over 1 million a lot of times.  That article up thread said the system is insane.  The only people paying mostly reasonable prices are Medicare and Tricare.  Medicaid sometimes pays reasonable and sometimes way too low depending on state and service.  As to drug prices, everyone pays too much except for some drugs if you self-pay since the cost is lower than everyone else's co-pay.  Although Medicare and Tricare pay less for drugs than the pharmacy charges normallly, they are not allowed by congress to negotiate prices so for that category it is almost certain that even Medicare and Tricare pay too much for drugs.

 

Wow!  My sister is the chief information officer for the health region that covers our whole province - she gets less than $200,000 a year, I think.  Her boss is under $300,000.

[FaithManor]

While I think CEO compensation at places like GM and HP are ridiculously high, I don't have the kind of problem with it that I have with Drug companies, Medical Tech companies, and hospitals. There is a moral issue. This kind of compensation being used to drive up healthcare costs to the moon and back kills people. Plain and simple. It kills. A not insignificant number of people cannot afford high deductibles, $1000+ a month for premiums, claims that don't get processed or are rejected over STUPID criteria, and the like.

 

So someone thinks they should make $14.5 million causing other people to die.

 

Not a fan of said person. Kind of wonder about that Dante's Inferno thing......

 

If you want to drive up the cost of a car or an iphone, so be it. Drive up the cost of a pacemaker? Ya....I have a moral issue.

 

The company that makes ACTH which is a hormone that stops infantile spasms and saves lives was purchased in the late 1950's from a German company for less than $60,000.00. Approximately 6000 infants per year need it. The 30 day treatment plan? Wait for it!

 

$750,000.00 

 

It costs less than $100 per shot to manufacture, actually right around $25.00. They charge $21,000-25,000 per shot depending on region. There isn't an insurance company in the land that will pay that, and kids would die without it so non profits like St. Jude's, the Shriners, etc. fund raise so hospitals can offer it to their patients. 1000% percent mark up. And they've been doing this for decades.

 

Times 6000 children, 4.5 billion on a drug that was already developed and tested that costs them $25.00 per dose to manufacture.

 

Dante didn't know he needed to add a layer called "drug company executives step this way so you can mine granite with a teaspoon in the flames for all eternity"!

 

After raising prices on epi pens to the moon, the CEO took a HUGE pay increase. How nice for her!  :smash:  :smash:  :smash:  :banghead:  :banghead:  :banghead:

 

I don't give a darn anymore about "free market" or capitalism. It isn't all its jacked up to be.

Edited March 16, 2017 by FaithManor

[creekland]

Wow!  My sister is the chief information officer for the health region that covers our whole province - she gets less than $200,000 a year, I think.  Her boss is under $300,000.

 

And see?  I could easily live on that income.  It's more than double what we make now and we get along just fine.  It's also approx four times our (US) national average household income, so no one is being cheated with those wages.

 

Even those who live in high housing areas would see the cost of housing reduced if incomes were more in line for more people.

[Bluegoat]

And see?  I could easily live on that income.  It's more than double what we make now and we get along just fine.  It's also approx four times our (US) national average household income, so no one is being cheated with those wages.

 

Even those who live in high housing areas would see the cost of housing reduced if incomes were more in line for more people.

 

This is just it.

 

My step-dad is a GP, my sister has a good job.  They have good health care and can retire, nice places to live, they can go on exotic vacations or have expensive hobbies or live in an expensive house - probably not all three.  They live like the upper middle class.  Growing up when my step-dad was not as far along in his career, we were plain old middle class on a doctors salary, which is fine too.

 

I don't quite get what it is people think should be going on in these people's lives.  I know in my province, we could probablt stand to pay doctors a bit more or restructure it - at the moment we have a nasty lot in power that are trying to cut all public servants and making a mess, and I suspect they are going to be terffed out next election.  Historically the doctors have tried hard to work with the province to be affordable, because they care about people having access to good care, so it really isn't on them in this case.

 

What kind of people want to make millions when others can't afford basic healthcare?

[creekland]

What kind of people want to make millions when others can't afford basic healthcare?

 

Not my kind... but they've duped many into thinking they have the right to do so - and hey - wouldn't you want it too if you could be "me?"  So folks buy into the belief that perhaps they can hit it big and be rich.  Some do, of course, but it's akin to getting that winning lottery ticket.  The vast majority won't and just continue to subsidize super unnecessary wealth because - you know - unrestrained capitalism.  That's where it's at.  "If 'I' got there I wouldn't want restraints," (they think - not realizing they could actually live perfectly well with much less and still be wealthy).

 

THEN add in that the folks in the health industry are getting there while others die to support them.  As Faith said earlier.  This isn't a luxury item or even something as simple as a cell phone.  It's lives.

[goldberry]

IN that article, it said the people who get really screwed by the system are the people with no insurance or with totally inadequate insurance.  I didn't realize that people had such lousy insurances I guess because the only plans I ever saw were ones offered by my employers and they had no bad insurance choices.  By bad insurance choices, I am talking about plans with really low payments or maximums.  Like some plans apparently will pay a maximum of 2000 a day in the hospital for everything that could happen to you there,  

 

That part (allowing plans that were really lousy) did change with ACA, which is what lead to people losing their plans and being really mad.  I personally was on an "inadequate" plan that was discontinued.  I didn't have it because I wanted it, but because it was all I could really afford.  I wished I could have afforded decent coverage.  I suffered financially, but I recognized that trying to fix these problems is a messy process.

 

The ACA addressed the part of these inadequate plans ripping people off and leaving patients and healthcare facilities with unpaid bills, but did nothing to address the expensive premiums.  Well, subsidies for some helped, but the core of the expenses remained the same.

 

That will change with whatever new law they come up with, because they want to be able to say "premiums went down!"  That's disingenuous though, because premiums for decent coverage will stay the same or continue to go up, but the inadequate plans for cheaper will be available again.  The line is "you should be able to buy only coverage you want!" and maybe that is true for some people, but for most people it's "I will buy the best I can afford, but I just can't afford very much".  You will still have people getting screwed with coverage limits.  This affects the overall pricing, because "unpaid bills" are what the providers use as an excuse for charging crazy high prices to everyone they can.

 

We need AFFORDABLE and ADEQUATE coverage.

[goldberry]

Not a fan of said person. Kind of wonder about that Dante's Inferno thing......

 

To the first, heck yeah!  (I have some very uncharitable thoughts as well toward those people...)

 

 

 

What kind of people want to make millions when others can't afford basic healthcare?

 

 

Not my kind... but they've duped many into thinking they have the right to do so - and hey - wouldn't you want it too if you could be "me?"  

 

To Bluegoat, what Creekland said....  They DO have a right to do so under the current system, and by allowing it we are saying we are okay with it.  As long as healthcare is treated as a for-profit business, the same as any other capitalistic enterprise, by definition they are doing exactly what they are supposed to do.  Maximizing profit for themselves, their company, their shareholders.  There is no reason to expect anything different.  And yet people seem to think that somehow a for-profit enterprise will ever behave like it has a conscience or moral values or act in someone else's best interest.

 

It's not going to happen.  

Edited March 16, 2017 by goldberry

[SKL]

That part (allowing plans that were really lousy) did change with ACA, which is what lead to people losing their plans and being really mad.  I personally was on an "inadequate" plan that was discontinued.  I didn't have it because I wanted it, but because it was all I could really afford.  I wished I could have afforded decent coverage.  I suffered financially, but I recognized that trying to fix these problems is a messy process.

 

The ACA addressed the part of these inadequate plans ripping people off and leaving patients and healthcare facilities with unpaid bills, but did nothing to address the expensive premiums.  Well, subsidies for some helped, but the core of the expenses remained the same.

 

That will change with whatever new law they come up with, because they want to be able to say "premiums went down!"  That's disingenuous though, because premiums for decent coverage will stay the same or continue to go up, but the inadequate plans for cheaper will be available again.  The line is "you should be able to buy only coverage you want!" and maybe that is true for some people, but for most people it's "I will buy the best I can afford, but I just can't afford very much".  You will still have people getting screwed with coverage limits.  This affects the overall pricing, because "unpaid bills" are what the providers use as an excuse for charging crazy high prices to everyone they can.

 

We need AFFORDABLE and ADEQUATE coverage.

 

Unfortunately, people with adequate plans also lost their plans.

 

 

[Guest]

What kind of people want to make millions when others can't afford basic healthcare?

From what I am seeing, its people who have grown up in areas where there is no middle class and inadequate public schools and very high taxes. If they can't homeschool, they need go make enough for private school for the children as the current scenario of declaring their child 'the other' in public school is not their cup of tea. I am rural. Very few doctors out here, as the indigent go to the ER rather than the sliding scale clinic, and the upper middle class and the seniors go to the city. No doctor can cover the rent on medicare and medicaid patients only...taxes are way too high...individual practices are rare now, they have gone to groups to share overhead.

[FaithManor]

From what I am seeing, its people who have grown up in areas where there is no middle class and inadequate public schools and very high taxes. If they can't homeschool, they need go make enough for private school for the children as the current scenario of declaring their child 'the other' in public school is not their cup of tea. I am rural. Very few doctors out here, as the indigent go to the ER rather than the sliding scale clinic, and the upper middle class and the seniors go to the city. No doctor can cover the rent on medicare and medicaid patients only...taxes are way too high...individual practices are rare now, they have gone to groups to share overhead.

Same here. It was getting really bad until one of the better, big city hospitals decided to invest in the area. They bought one of the county hospitals, turned it into an extension of theirs, send their specialists here two times per month, send surgeons here, and invested in a sliding scale clinic. A triage nurse decides who gets into the ER and who goes over to the clinic which is open all night. They made good offers to the docs to work in the area.

 

The very BAD thing is if your insurance plan does not consider this hospital organization to be in network.

 

Lumping everyone together, having a few receptionists instead of each doc having his own, sharing RN's and labs, getting it all in just a few buildings has definitely made it more cost effective.

[unsinkable]

 

 

The company that makes ACTH which is a hormone that stops infantile spasms and saves lives was purchased in the late 1950's from a German company for less than $60,000.00. Approximately 6000 infants per year need it. The 30 day treatment plan? Wait for it!

 

$750,000.00

 

It costs less than $100 per shot to manufacture, actually right around $25.00. They charge $21,000-25,000 per shot depending on region. There isn't an insurance company in the land that will pay that, and kids would die without it so non profits like St. Jude's, the Shriners, etc. fund raise so hospitals can offer it to their patients. 1000% percent mark up. And they've been doing this for decades.

 

Times 6000 children, 4.5 billion on a drug that was already developed and tested that costs them $25.00 per dose to manufacture.

 

Your numbers are way off if you are talking about Infantile Spasms and Questcor. Questcor (now Mallinckrodt) DID raise the price of Acthar (ACTH) an astronomical amount. They also bought the rights to a competing drug (Synacthen Depot, and raised that price an outrageous amount, too), and that purchase got them in trouble with the FTC.

 

However, the average treatment with Acthar now costs about $125,000, not $750,000. Acthar is usually only used for a limited time bc of the very serious side effects associated with its use. Questcor tries to justify the expense by saying it is an orphan drug with very few cases diagnosed per year in US. (I think Questcor has said less than 1000 cases per year).

 

Infantile Spasms ARE very rare, and very serious. It is a horrible, heart-breaking disesase. Epilepsy sites usually state about 2500 cases per year. It is hard to catch at first and I've heard it said most pediatricians might see a couple cases in their lifetime of practice.

 

Questcor claims that patients that cannot pay are given the drug for free, and that they also help with patients' co-pays (according the national media accounts).

 

The situation is complex bc in the 1990s the then-manufacturer wanted to discontinue the drug but didn't because it is the first line drug of choice for IS. It was losing millions of dollars a year producing the drug when it sold to Questcor in 2001. Questcor raised the price of Acthar upon acquisition, into the hundreds of dollars a vial, but still claimed to be losing money. It was in 2007 that the price made huge jump to $28000 (it is higher now) a vial. It hasn't been decades at this price.

 

Anyway, this is a serious enough situation without using false erroneous facts. It doesn't help to spread misinformation.

Edited March 16, 2017 by unsinkable

[HTRMom]

To be fair, France chooses not to have a real military because they assume that we've got it covered. Europe is taking advantage of us and we allow it because we like the power.

 

 

Sent from my iPhone using Tapatalk

[creekland]

From what I am seeing, its people who have grown up in areas where there is no middle class and inadequate public schools and very high taxes. If they can't homeschool, they need go make enough for private school for the children as the current scenario of declaring their child 'the other' in public school is not their cup of tea.

 

I rarely see those making millions coming from this type of background - or any other where they grew up among "average" people (socio-economic average).  I see it far more when they themselves come from an already upper middle class or wealthy family and honestly have no clue how "the other half" lives.

 

When I went to a super wealthy private school in FL for my 10th grade year (on scholarship), there were fellow students - my new peers academically - who had no idea how typical folks lived.  I got asked how much my dad made (18K at the time) and one literally whistled remarking, "We have a picture in our living room that cost more than that."  To them, ocean-front large houses, weekend trips to private islands, having a few hundred to spend on a school field trip, getting custom made clothing or sports equipment was all "normal."  I was very much an "exchange student" showing them the other side - part of the other side.  We never went hungry.  I had clothes from a thrift store and no budget to eat out for lunch like they did (allowed at this school), but as soon as they realized that, they always paid for my lunch so I could be included.  Their hearts were generally good at that age (15-16), but their knowledge was lacking.  If there had been no "exchange student" their knowledge would still be lacking.  Middle son sees that fairly often at college - some have no monetary restrictions at all.  Want a new computer - go get it - the best, of course.  Isn't that how everyone lives?  Need a tutor - hire one - at $80/hour.  The free tutoring provided by the college is scoffed at.

 

They are the folks who tend to grow up thinking nothing of making millions from any source.  They have little interaction with the minions getting them there.  I was the groom at the stable where some rode and kept their 30K dollar ponies.  Except for my friends and one or two of their parents, no one else boarding at this barn paid me any attention unless they needed something for their horse.

[creekland]

To be fair, France chooses not to have a real military because they assume that we've got it covered. Europe is taking advantage of us and we allow it because we like the power.

 

Some of us aren't convinced the US needs to spend nearly as much as it does on the military... and don't think other countries need to up their spending to compensate either.  I think we annoy huge amounts of the world by trying to run the whole planet.  I suspect we'd have far better chances at peace by helping the poor among countries - and not just by giving them money, but by helping with infrastructure (using local labor - trained if need be), etc.  That would come at a fraction of the cost.

[Barb_]

It is also the hospital executives earning gigantic salaries- over 1 million a lot of times.

No they don't, unless you're talking about heads of entire systems. Executives at the institutional level aren't making anywhere near that much. My husband is a regional CFO and makes a quarter of that with three decades of experience.

[Barb_]

And see? I could easily live on that income. It's more than double what we make now and we get along just fine. It's also approx four times our (US) national average household income, so no one is being cheated with those wages.

 

Even those who live in high housing areas would see the cost of housing reduced if incomes were more in line for more people.

$200k-$300k That is exactly what executives make in middle to high cost of living areas. Hospitals in lower cost areas pay around $120-$150k depending on area and experience.

[creekland]

$200k-$300k That is exactly what executives make in middle to high cost of living areas. Hospitals in lower cost areas pay around $120-$150k depending on area and experience.

 

Bluegoat said her sister was the CIO for the health region that covered the entire Province - not just a local area for a handful of hospitals.  Her boss is still under 300K.

[TCB]

I belong to medical sharing, so am essentially self pay. I called and asked billing the self pay rate to see my doctor to see if I had the flu. They said it depended on how long the doctor was with me, what tests, etc...but that the self pay rate was a 50% discount. However, my minimal charge would be $250 and maximum $500. I asked, just for the doctor to do a flu swab and she was sure that was 50% off the regular charge?! Yes! When I had insurance, the charge for something like that to insurance was around $100 and I just paid a co-pay.

 

Dh has insurance through work and goes to the same medical group. He went in for something different a month later, but was with the MD more time than I would have been had I just had a simple MD visit. He has a small co-pay in his plan. The bill to insurance for that was $119. So a 50% discount for something simple is $250-$500 for self pay, but a standard $119 charge to insurance companies for the insured??? I am shopping for a new doctor!

 

This is exactly what is so crazy about the whole system! And the fact that they tell you a bold-faced lie like "You're getting a 50% discount."

[Paige]

We aren't getting much for our taxes compared to other nations. The problem is not the amount or rate so much as what is done with it.

Germany and France may have high tax rates, but they get a lot back which offsets the tax rate by a bunch. Low college tuition, good healthcare access and treatment, decent primary education, worker protections, public transport, elderly services,....

 

 

 

We are getting a humongous military industrial complex.

 

I think what we need is a Truman. We need someone with strong military credentials who will come in and say, "Enough." My DH is military too, so it's not like I'm anti-military. I just think we need some perspective.

[Paige]

I was talking to one of my DDs providers about the crazy costs I see on the bill, self pay customers, etc. He said that the providers have to charge huge "standard" rates because the insurance would only pay a small fraction of what they charge people with no insurance. The negotiated insurance rate would be something like 20% of their "normal" charge. Since most of their patients had insurance, if they wanted to stay open, they couldn't just charge what a reasonable charge would be because they'd get so little. They had to charge an inflated, pretend, price to make sure they made what they needed when the insurances paid their fraction. It was bad for the self pay, and the provider felt bad, but he couldn't see any way around it without refusing to accept any insurance. 

 

It's a backwards ridiculous system designed to encourage all kinds of fraud. 

[Barb_]

Bluegoat said her sister was the CIO for the health region that covered the entire Province - not just a local area for a handful of hospitals. Her boss is still under 300K.

Yeah I shouldn't have quoted you. What I meant was, what her sister was paid is province is in line with what regional people are paid here. The figure Chris quoted really only refers to the heads of the entire organization. Which is bad enough, but I wanted to make sure we were starting with accurate assumptions. Sorry, I'm on my way to the airport and rushing. I hope that cleared up the confusion I caused and didn't make it worse, lol

[Guest]

I rarely see those making millions coming from this type of background - or any other where they grew up among "average" people (socio-economic average). I see it far more when they themselves come from an already upper middle class or wealthy family and honestly have no clue how "the other half" lives.

 

When I went to a super wealthy private school in FL for my 10th grade year (on scholarship), there were fellow students - my new peers academically - who had no idea how typical folks lived. I got asked how much my dad made (18K at the time) and one literally whistled remarking, "We have a picture in our living room that cost more than that." To them, ocean-front large houses, weekend trips to private islands, having a few hundred to spend on a school field trip, getting custom made clothing or sports equipment was all "normal." I was very much an "exchange student" showing them the other side - part of the other side. We never went hungry. I had clothes from a thrift store and no budget to eat out for lunch like they did (allowed at this school), but as soon as they realized that, they always paid for my lunch so I could be included. Their hearts were generally good at that age (15-16), but their knowledge was lacking. If there had been no "exchange student" their knowledge would still be lacking. Middle son sees that fairly often at college - some have no monetary restrictions at all. Want a new computer - go get it - the best, of course. Isn't that how everyone lives? Need a tutor - hire one - at $80/hour. The free tutoring provided by the college is scoffed at.

 

They are the folks who tend to grow up thinking nothing of making millions from any source. They have little interaction with the minions getting them there. I was the groom at the stable where some rode and kept their 30K dollar ponies. Except for my friends and one or two of their parents, no one else boarding at this barn paid me any attention unless they needed something for their horse.

My doctors are a combo. The older hometown guys - rural- are sons of Doctors and grew up in the country club set amongst poverty. Their children go to private school now that they have been othered. The type you describe may practice here In the initial career stage, but they don't live here after boarding school.

 

As far as wealthy college kids, laptops are pocket change. Ferrari products are the item of conspicuous consumption at my dc's college. Its so amazing how talking cars and insurance expands one's social network.

Edited March 16, 2017 by Heigh Ho

[Twolittleboys]

Well, German taxes are 40% of their GDP. So they're definitely paying for healthcare.

Actually, health insurance (mandatory) is around 14.6 % of income up to a certain income level (around $5000 a month). Income over that amount does not count - so the most someone would pay a month would be about $650 a month. If you are an employee half of the insurance cost is taken out of your paycheck, the other half is paid by the employer (though of course it is factored into the employment cost of the employer). Dependents (kids, spouses with no income) are included (so you pay the same for one person or more).

 

It is kind of a lot, but does cover most everything. Maybe not some alternative treatments or every doctor etc. but I have never had to pay more than a couple of dollars in copays. We are generally healthy but my father had cancer and spent around six weeks in hospitals, my mother was in and out of hospital for six months and we have had a couple of emergency room visit/overnight hospital stays/ambulance rides with the kids. I have never had to pay more than maybe a couple of hundred if that.

 

They are also paying for the kid's braces (well, we are paying some extra because we want a different kind but the insurance company is paying around $6000 per kid).

 

I feel so bad for people who have to worry about paying hospital bills etc. Our healthcare system isn't perfect but honestly I would not trade it for the US model for anything.

[creekland]

I was talking to one of my DDs providers about the crazy costs I see on the bill, self pay customers, etc. He said that the providers have to charge huge "standard" rates because the insurance would only pay a small fraction of what they charge people with no insurance. The negotiated insurance rate would be something like 20% of their "normal" charge. Since most of their patients had insurance, if they wanted to stay open, they couldn't just charge what a reasonable charge would be because they'd get so little. They had to charge an inflated, pretend, price to make sure they made what they needed when the insurances paid their fraction. It was bad for the self pay, and the provider felt bad, but he couldn't see any way around it without refusing to accept any insurance. 

 

It's a backwards ridiculous system designed to encourage all kinds of fraud. 

 

This doesn't happen everywhere.  My youngest had a knee injury, so went to a Walk In Orthopedic doctor to get it looked at and x-rayed.  The visit came to $500 and some.  His school (at the time) required insurance, so he had it, but didn't mention it to them.  We got the bill - with a reduction for self-pay.  Since we had paid for insurance, I insisted it go through insurance first.  The reduction for self pay was put back on, so the original price was the same.  Insurance paid their part leaving us with about $170 left over to pay.  We paid that.

 

I don't doubt it happens, but not everywhere - or perhaps not with urgent care places?

 

FWIW, if we hadn't had to pay extra for insurance we wouldn't have as that was somewhere around $1500 for a student for the year.  With the health share we belong to the whole thing would have been covered at no additional cost to us.  Technically we could have submitted the $170 to our health share and they'd have paid that too, but we aren't hard up, so saw no need.  His extra insurance cost us the $1500 + $170 for the year.   :glare:   Fortunately, now his college lets us skip insurance and just go with health share.

 

 

My doctors are a combo. The older hometown guys - rural- are sons of Doctors and grew up in the country club set amongst poverty. Their children go to private school now that they have been othered. The type you describe may practice here In the initial career stage, but they don't live here after boarding school.

 

As far as wealthy college kids, laptops are pocket change. Ferrari products are the item of conspicuous consumption at my dc's college. Its so amazing how talking cars and insurance expands one's social network.

 

I haven't come across any super wealthy doctors TBH.  They're probably out there, but my friends' parents were mainly businessmen of some sort - a few corporate lawyers, but still related to business.  Doctors have "working wealth" sometimes - usually more than the rest of us for sure, but still usually on a budget - just a higher one. They weren't those living in ocean front large homes.  Businessmen (including CEOs, etc) have uber wealth.

 

And yes, laptops being pocket change was my point.  One of my new peers had her sister get married the summer before school.  Her family rented a large cruise ship (the whole thing) for the wedding, cruised to Europe, and flew the guests home on a chartered jet.  The wedding couple spent their honeymoon on a private island.  I'll admit I was a bit shaky mentally listening to this story on the first day of school - there in my thrift store clothes (no uniforms at this school except for gym).  However, for the most part, once I proved I could keep up with them academically and was a decent study partner the kids accepted me well.  I had limited contact with their parents, but the kids didn't mind sharing what they did.

[Matryoshka]

To Bluegoat, what Creekland said....  They DO have a right to do so under the current system, and by allowing it we are saying we are okay with it.  As long as healthcare is treated as a for-profit business, the same as any other capitalistic enterprise, by definition they are doing exactly what they are supposed to do.  Maximizing profit for themselves, their company, their shareholders.  There is no reason to expect anything different.  And yet people seem to think that somehow a for-profit enterprise will ever behave like it has a conscience or moral values or act in someone else's best interest.

 

It's not going to happen.  

 

Here's the problem...

 

[Garga]

Deleted because I got political because I didn't realize this was the chat board. 

Edited March 17, 2017 by Garga

[SKL]

I've always thought I wanted the kind of healthcare that the other countries have (England, Canada, etc.).

 

But recently (well, just in the past 10 minutes actually) I've been thinking: what if we had government controlled healthcare right now under the Trump administration. His government controls everything.

 

What would stop the Trump administration from making laws that certain people would not be covered? Doctors who treat people from certain countries or treat people who are of certain religions could be denied payment?

 

Look, I hate the way our health insurance works right now. Hate it. I've always longed for what the other countries have. But, could that be a HUGE disaster if you get someone in charge who wants to stop a group from getting coverage? Would that sort of thing happen?

 

People said the same thing 8 years ago.

 

But we don't want to get political.  :)

 

[rdj2027]

Aren't Medicaid, Medicare and Tricare next to ACA all government run health care programs?

[Barb_]

People said the same thing 8 years ago.

 

But we don't want to get political. :)

 

No one was worried about the government cutting funding for healthcare 8 years ago.

 

8 years ago no one was cutting:

 

The EPA

The State Department

Health and Human Services

Labor Department

Agricultural Department

Transportation Department

IRS

Commerce Department

School Programs

National Endowment for the Arts

PBS

 

...pretty much everything that makes life worth living while beefing the military, police and security. Sort of like communist Russia. That went well.

 

Seriously, apples and oranges.

[Garga]

People said the same thing 8 years ago.

 

But we don't want to get political.  :)

 

 

 

Whoops!  Didn't realize this was The Chat Board.  Sorry.