This isn't me. I just saw this post over on Bogleheads. I hope he's okay but can you imagine sending out an urgent message like this, presumably from your cell phone, while you are on your way to the ER?
I have no idea what his physical problem is but I can feel his pain as far as his financial worries go. I once had to take my daughter to the ER when she broke her elbow and we had no insurance at all. The bills kept coming from third parties for services rendered of which I had no clue what they even were. And who was to say whether the price they were billing for whatever they did was even fair?
Just thought this was an excellent example of how our health care system (or lack thereof) really is a complete mess.
ochotona wrote:Anyone who defends the health status quo is a guillable heartless fool. Healthcare is F-U capitalism.
Capitalism is the system under which you pay your own way rather than making others pay for you.
The current system is riddled with cronyism and government intrusion, and has roughly the same relationship to capitalism as does Mao's little red book.
ochotona wrote:Anyone who defends the health status quo is a guillable heartless fool. Healthcare is F-U capitalism.
Capitalism is the system under which you pay your own way rather than making others pay for you.
The current system is riddled with cronyism and government intrusion, and has roughly the same relationship to capitalism as does Mao's little red book.
I would love a really capitalist healthcare system with price transparency, intense competition for patient dollars, quality standards, consumer rip-off protections, and the like. I did EVERYTHING right for my procedure in 2016, I picked only in-network hospital and doctor, and I STILL got a $3300 "surprise" bill!
Sadly, there's not much you can do. You'd have to ask individually about every MD that crosses your path: the anesthesiologist, radiologist, ER physician, etc. Some of these you will never see and may not even know their name until the bill arrives. And, if you are in need of all these services, chances are you're in no shape to be investigating while a patient in an ER gurney wearing a skimpy hospital gown.
Completely agree with the assessment of our health care system.
WiseOne wrote:Sadly, there's not much you can do. You'd have to ask individually about every MD that crosses your path: the anesthesiologist, radiologist, ER physician, etc. Some of these you will never see and may not even know their name until the bill arrives. And, if you are in need of all these services, chances are you're in no shape to be investigating while a patient in an ER gurney wearing a skimpy hospital gown.
Completely agree with the assessment of our health care system.
I'm giving up on being my family chief healthcare procurement officer, and I'm going back to Kelsey-Seybold Clinic, now that my insurance pays for it again, where every doc is in-house and there are no surprises.
ochotona wrote:I would love a really capitalist healthcare system with price transparency, intense competition for patient dollars, quality standards, consumer rip-off protections, and the like. I did EVERYTHING right for my procedure in 2016, I picked only in-network hospital and doctor, and I STILL got a $3300 "surprise" bill!
WiseOne wrote:Sadly, there's not much you can do. You'd have to ask individually about every MD that crosses your path: the anesthesiologist, radiologist, ER physician, etc. Some of these you will never see and may not even know their name until the bill arrives. And, if you are in need of all these services, chances are you're in no shape to be investigating while a patient in an ER gurney wearing a skimpy hospital gown.
Completely agree with the assessment of our health care system.
So maybe I'm being nit-picky here, but I don't see that a capitalist health care system necessarily eliminates the issues WiseOne mentions. It seems that what is really needed is a vast cultural shift on the part of both providers and consumers. (I don't expect one to occur, though.)
Having a capitalistic health care system means that the patient would be the customer, which means that consumer sovereignty would reign, as it does in every other capitalistic market.
Libertarian666 wrote:Having a capitalistic health care system means that the patient would be the customer, which means that consumer sovereignty would reign, as it does in every other capitalistic market.
I agree in principle with your libertarian view of health care but lately I'm becoming more of a pragmatist than a libertarian. The majority of voters are now in favor of some form of government run universal healthcare system as evidenced by Obama winning two elections. Polls don't show that voters are against the idea - they just want it run more efficiently. I think it is therefore inevitable that it's going to happen some day and if that be true, we might as well get on with it in my opinion. I think resisting the inevitable only results in making the current hodge-podge of a system even worse.
Health insurance is pretty close to a complete racket.
If you have it, then you think you "save" a lot of money, but you don't. If you were self-pay you'd get services even more cheaply.
The only insurance that's worthwhile is the same as any other kind of insurance: catastrophic insurance that makes sure you don't lose your shirt if something really awful happens. Of course that's now illegal.
I suppose you could scribble on the admitting forms and on all consent forms: "I give my consent to receive services from only preferred providers contracted with ____ Insurance Company." At least it would give you an argument.
Xan wrote:Health insurance is pretty close to a complete racket.
If you have it, then you think you "save" a lot of money, but you don't. If you were self-pay you'd get services even more cheaply.
Back when I was self-employed and decided to take the chance of being without health insurance for a couple of years because the premiums had gotten so expensive, I learned that this was true. My daughter got strep throat which turned into scarlet fever so I had to take her to the doctor and apparently there was a lot of it going around at the time. I saw them open a refrigerator door where they were keeping the medicine used to treat it and there were two trays clearly marked for people with health insurance and people without it. My daughter's came from the latter tray and I paid less for it by what I think was probably a significant amount. It worked perfectly well and her symptoms started clearing up quickly.
This left me wondering what was the actual difference between those two trays? As far as efficacy, I suspect there was none. As far as what could be billed to the insurance company, I suspect there was a lot.
If we had universal health insurance there would have been only one tray for all and it seems to be the common belief among conservative and libertarian minded folks that government involvement would make that tray even more expensive for every body and it might get so bad that it wouldn't even be available at all. Maybe that's true and there have been many government debacles that lead us to believe that, but why is it written in stone that it has to be that way? How was it that the term "good enough for government work" originally meant the exact opposite of what it means today? The Hoover Dam was completed on time and under budget. The speed at which Americans responded to the attack at Pearl Harbor to defeat the Japanese and Germans in WWII is something that is astounding to read about. We landed a man on the moon in 1969 years before the projected date.
So how is that we can't provide universal health care in an efficient manner for all American citizens? There may be a good answer to that question and it may be true but it makes me wonder why.
Very good question, farjean2. Why do our layers of government mostly suck so badly. I exclude Harris County TX from that condemnation, they did a great job during the hurricane.
Kriegsspiel wrote:My advice to that bogleheads poster; go back in time and join the military. Or join it now, if you can. Then use VA hospitals.
Do VA hospitals have ERs? A former Vietnam buddy that I recently established contact with online told me he uses the VA and everything you hear about the quality of service is BS. In my city, I have a lot of friends who are in the medical profession, most of them nurses, and they tell me to stay away. Not sure who to believe.
VA's are almost comical when it comes to quality of care. They make good sources for medical school spoof plays, but as a patient you probably don't want to go there with any serious condition. Go for the pharmacy benefits, though.
My favorite ever VA story from medical school: a friend of mine came in one morning and saw a rather unusual vital sign record. The readings went like this:
RR20, BP 120/70, P80, T98
RR20, BP 120/70, P80, T96
RR20, BP 120/70, P80, T94
RR20, BP 120/70, P80, T90
RR20, BP 120/70, P80, T86
etc.
It was a patient who died overnight. The nurse took the patient's temperature on schedule, but couldn't get any of the other vitals so she made them up.
(Key: RR = respiratory rate, BP = blood pressure, P = pulse, T = temperature)
Kriegsspiel wrote:My advice to that bogleheads poster; go back in time and join the military. Or join it now, if you can. Then use VA hospitals.
Do VA hospitals have ERs? A former Vietnam buddy that I recently established contact with online told me he uses the VA and everything you hear about the quality of service is BS. In my city, I have a lot of friends who are in the medical profession, most of them nurses, and they tell me to stay away. Not sure who to believe.
Sure do. When my appendix exploded I drove myself to a VA ER and they did a fine job gutting me. No complaints.
WiseOne wrote:VA's are almost comical when it comes to quality of care. They make good sources for medical school spoof plays, but as a patient you probably don't want to go there with any serious condition. Go for the pharmacy benefits, though.
My favorite ever VA story from medical school: a friend of mine came in one morning and saw a rather unusual vital sign record. The readings went like this:
RR20, BP 120/70, P80, T98
RR20, BP 120/70, P80, T96
RR20, BP 120/70, P80, T94
RR20, BP 120/70, P80, T90
RR20, BP 120/70, P80, T86
etc.
It was a patient who died overnight. The nurse took the patient's temperature on schedule, but couldn't get any of the other vitals so she made them up.
(Key: RR = respiratory rate, BP = blood pressure, P = pulse, T = temperature)
Xan wrote:Health insurance is pretty close to a complete racket.
If you have it, then you think you "save" a lot of money, but you don't. If you were self-pay you'd get services even more cheaply.
Back when I was self-employed and decided to take the chance of being without health insurance for a couple of years because the premiums had gotten so expensive, I learned that this was true. My daughter got strep throat which turned into scarlet fever so I had to take her to the doctor and apparently there was a lot of it going around at the time. I saw them open a refrigerator door where they were keeping the medicine used to treat it and there were two trays clearly marked for people with health insurance and people without it. My daughter's came from the latter tray and I paid less for it by what I think was probably a significant amount. It worked perfectly well and her symptoms started clearing up quickly.
This left me wondering what was the actual difference between those two trays? As far as efficacy, I suspect there was none. As far as what could be billed to the insurance company, I suspect there was a lot.
If we had universal health insurance there would have been only one tray for all and it seems to be the common belief among conservative and libertarian minded folks that government involvement would make that tray even more expensive for every body and it might get so bad that it wouldn't even be available at all. Maybe that's true and there have been many government debacles that lead us to believe that, but why is it written in stone that it has to be that way? How was it that the term "good enough for government work" originally meant the exact opposite of what it means today? The Hoover Dam was completed on time and under budget. The speed at which Americans responded to the attack at Pearl Harbor to defeat the Japanese and Germans in WWII is something that is astounding to read about. We landed a man on the moon in 1969 years before the projected date.
So how is that we can't provide universal health care in an efficient manner for all American citizens? There may be a good answer to that question and it may be true but it makes me wonder why.
Some people can afford expensive cars while others can't. That is a crime against humanity.
Why can't we provide universal auto care in an efficient manner for all American citizens?
Libertarian666 wrote:
Some people can afford expensive cars while others can't. That is a crime against humanity.
Why can't we provide universal auto care in an efficient manner for all American citizens?
I don't think very many voters think that not providing expensive cars to everyone is a crime against humanity. More and more seem to be thinking that not providing healthcare to everyone is.
Libertarian666 wrote:
Some people can afford expensive cars while others can't. That is a crime against humanity.
Why can't we provide universal auto care in an efficient manner for all American citizens?
I don't think very many voters think that not providing expensive cars to everyone is a crime against humanity. More and more seem to be thinking that not providing healthcare to everyone is.
Both of those scenarios are equally valid.
It's just that the brainwashing about health care is much more thorough.
Brainwashing?? Expensive cars are a luxury that you can choose not to indulge in, and you'd get by just fine. But health care is something everyone might potentially need, and for serious issues it's not exactly a choice. You might tinker around the edges with risk factors, but as long as you are a live human being you risk developing a serious and treatable health problem.
I agree with you that for the low levels of the health care system, i.e. routine office visits, common labs & studies, we seriously need to return to the cash-based, completely transparent system that used to be in place before insurance started invading this market. Currently, the only check on a doctor who overbills is oversight by Medicare and insurance companies. In the former case, it's not consistent enough. In the latter case, it's kind of a sledgehammer approach that results in valid care being denied. And both impose extreme (and expensive) overhead. If overbilling were to happen in the free market, people would simply gravitate to less expensive doctors - or decide that the overbiller was worth paying for. In which case it's not really overbilling. Problem fixed with little to no overhead!
It does make sense for government to step in for serious, expensive problems. In a twist on MediumTex care, I'd suggest making government health coverage hinge on diagnoses & severity rather than the usual method of calculating deductibles. Because, in order to calculate amount spent you have to track and justify every office visit no matter how trivial, which gets you right back to the current system with all its problems. If someone were to turn up with, say, multiple sclerosis or Crohn's disease, you can argue that these conditions should be covered as soon as they're diagnosed. A case of diabetes and even some of its complications such as peripheral neuropathy can be managed under the cash system, but a diabetic with hard to control blood sugars who needs an insulin pump, or one that develops serious vascular complications requiring surgery, would invoke the government coverage.
WiseOne wrote:Brainwashing?? Expensive cars are a luxury that you can choose not to indulge in, and you'd get by just fine. But health care is something everyone might potentially need, and for serious issues it's not exactly a choice. You might tinker around the edges with risk factors, but as long as you are a live human being you risk developing a serious and treatable health problem.
I agree with you that for the low levels of the health care system, i.e. routine office visits, common labs & studies, we seriously need to return to the cash-based, completely transparent system that used to be in place before insurance started invading this market. Currently, the only check on a doctor who overbills is oversight by Medicare and insurance companies. In the former case, it's not consistent enough. In the latter case, it's kind of a sledgehammer approach that results in valid care being denied. And both impose extreme (and expensive) overhead. If overbilling were to happen in the free market, people would simply gravitate to less expensive doctors - or decide that the overbiller was worth paying for. In which case it's not really overbilling. Problem fixed with little to no overhead!
It does make sense for government to step in for serious, expensive problems. In a twist on MediumTex care, I'd suggest making government health coverage hinge on diagnoses & severity rather than the usual method of calculating deductibles. Because, in order to calculate amount spent you have to track and justify every office visit no matter how trivial, which gets you right back to the current system with all its problems. If someone were to turn up with, say, multiple sclerosis or Crohn's disease, you can argue that these conditions should be covered as soon as they're diagnosed. A case of diabetes and even some of its complications such as peripheral neuropathy can be managed under the cash system, but a diabetic with hard to control blood sugars who needs an insulin pump, or one that develops serious vascular complications requiring surgery, would invoke the government coverage.
Health care cost almost nothing until the mid 20th century. It now costs a fortune, largely due to State intrusion.
Why is it that everything provided by the free market, including cosmetic surgery, gets cheaper in real terms over time, whereas everything provided at taxpayer expense gets more expensive over time?
Libertarian666 wrote:Health care cost almost nothing until the mid 20th century. It now costs a fortune, largely due to State intrusion.
Why is it that everything provided by the free market, including cosmetic surgery, gets cheaper in real terms over time, whereas everything provided at taxpayer expense gets more expensive over time?
It is because the State is evil.
Partially true, yes. Meaning, overhead due to ever-increasing third-party control over the medical process, all nominally to curb excesses by doctors. Wonder if just letting doctors overbill would be cheaper :-). There is a medical safety argument too, but I doubt it would stand up to serious scrutiny.
However - you do have to remember that in the mid-20th century, medicine was very, very limited compared to what we can do today. There was no CT or MRI at that time, for example, and the only brain imaging techniques that didn't require opening up the skull for a direct look were skull X rays and pneumoencephalograms - a painful procedure involving injecting air into the CSF spaces and then doing an X ray. Very happy not to be going back to that!
Ironically, 3 days after starting this thread I found myself at an Urgent Care facility this morning. The reason was because I was having stabbing pains in my shoulder for several days and then bumps started breaking out in the same spot. Thought maybe a spider had bitten me in my sleep or something.
The diagnosis took all of 2 seconds. Shingles. Should have gotten that vaccination.
farjean2 wrote:Ironically, 3 days after starting this thread I found myself at an Urgent Care facility this morning. The reason was because I was having stabbing pains in my shoulder for several days and then bumps started breaking out in the same spot. Thought maybe a spider had bitten me in my sleep or something.
The diagnosis took all of 2 seconds. Shingles. Should have gotten that vaccination.
In my opinion, no, you should NOT have gotten that vaccination!
I got the vaccination... then I got shingles.
The same has happened to everyone that my wife and I know, who has gotten the vaccination.
In fact, there is a class action suit against the makers of that vaccine.
