|
Post by megop on Sept 28, 2017 19:43:33 GMT
Ok, so its ok for a hospital to charge 78k just for the KNEE in a knee replacement. Not any other charges, not the hospital stay, not the doctors charges, that was just the fee on the bill from the hospital for the 'new' knee. When all charges were totaled for the first week (hospital, rehab, drs etc) of the surgery that happened 3 years years ago the bills totaled closed 500k. I rarely complain anymore about the prices of health insurance after seeing bills for a new knee, new hip, repaired fractured replacement hip, two spine fusions and a cancer diagnosis. There is a lot that needs to be repaired right along with the health insurance industry. There is a great deal of price variance between hospitals even in the same geographic location. It is a requirement that all non-profit hospitals have the ability to provide a general cost estimate to patients for services and procedures. The variations between systems occur for many different reasons including number of procedures performed, payer mix and how much financial assistance they must cover, provider shortages etc. There is a HUGE push right now to make cost transparent and readily available. The difficulty lies within the myriad of whatever existing or non-existing cost-sharing entities the individual has. Cast in point. There was a $65,000 variation between knee replacement costs between the non-profit health system I work for and the for-profit health system 50 miles from here. ETA: another thing that some may not know is supply chain implications as they relate to cost. A hospital who only performs 100 knee replacements a year for example will pay a higher per unit cost to the joint vendor. While another hospital next door, could perform 500 knee replacement procedures and get the exact same joint for much less.
|
|
|
Post by megop on Sept 28, 2017 19:47:02 GMT
I'm in Missouri. States limit Health insurance? is that what you meant to say? It's not insurance, it's a health share, there's a big difference. You can also pick any healthcare provider you want, there's no requirements or groups you have to be in. Yes, I meant Health insurance, not health care. Thanks for the info. It's certainly worth looking into. I think too, one thing to consider, that I fully expect these types of companies will become regulated at some point down the road precisely because of the fraudulent ones entering the market and failing people.
|
|
|
Post by #notLauren on Sept 28, 2017 19:49:21 GMT
I'm thinking that a win-win for a family would be to use one of these organizations and to put the difference between what they pay for the plan and what they'd pay for insurance into a bank account to be used for the self-pay part. At the end of a year, you'd still be far ahead.
|
|
|
Post by megop on Sept 28, 2017 19:55:30 GMT
Actually, I'm well aware of what people report disatisfaction with my hospital thanks to Struder Group survey. You would be surprised. Sigh. It's great you're so sure that the deep dissatisfaction with our health care system is due to lack of private rooms and bad hospital food at one hospital in this giant country of ours. I'm sure all the people complaining about exexorbitant premiums and lack of access to healthcare are really only upset about the beds and food in the hospitals they've stayed at 😂 I think you missed her point entirely. You are talking generally. She was speaking specific to the system she works for. CMS requires patient satisfaction measurement so while these are YOUR thoughts, hospitals are also held accountable by their unique patient base. One thing people have to remember that health care is quickly becoming a consumer product. Many areas are over-bedded and to remain viable, have to compete within spaces like we never have before. Retail options and technology removes more and more past revenue drivers historically used by many brick and mortar hospitals to continue to offer services that have no hope of ever breaking even, but yet still have a moral obligation to keep those services close and local to save lives - this applies to acute care specifically. It's the reason why critical access hospitals are closing every day. As trauma and acute care get further away, good outcomes decline.
|
|
|
Post by megop on Sept 28, 2017 19:59:18 GMT
I'm thinking that a win-win for a family would be to use one of these organizations and to put the difference between what they pay for the plan and what they'd pay for insurance into a bank account to be used for the self-pay part. At the end of a year, you'd still be far ahead. Exactly what HSA's are. And you make a great point. I firmly believe there will not be one answer, but many "customized" answers and that consumers will be in the driver's seat to ultimately pick and chose between a myriad of options that best fit them, their stage of life and their unique situations.
|
|
|
Post by megop on Sept 28, 2017 20:00:40 GMT
And yes, my apologies to all if I get a bit all soap box here. It is my passion.
|
|
|
Post by megop on Sept 28, 2017 20:09:15 GMT
Quick question as I'm just curious regarding how many are aware that providers and hospitals are not required to submit to your insurance companies at all? Most do so that they can manage their accounts receivable more effectively. This requires technology and many employees at the very least. There is cost associated with that especially if there are denial issues due to a coding error, or a patient brings in an older insurance card, or has moved and provides us an updated address yet has not notified their insurance company etc. etc. It can take months of negotiating, which we do, on behalf of our patients. Perhaps you've seen them as there are now physician offices that will not provide that service any longer due to the costs associated.
It's so super complicated that to me, it will take years and years to not only transition how people pay for their care, but also how they feel about it from a consumer perspective.
|
|
|
Post by compwalla on Sept 28, 2017 20:46:55 GMT
While that sounds great in theory, the reality is that when one half pays all the taxes and the other half pays none (because those who do pay federal taxes ALSO pay consumption taxes) and the half that pays none screams about how others aren't paying their "fair share" there ends up being a whole lot of resentment all around. Every adult in this country needs to have a financial stake in making things better. If you pay nothing, you have no financial interest. So, even if we have a progressive tax, everyone should be paying "something". The only time you should look in your neighbor's bowl is to see if he has enough. We should not be a country that screws over people who have less just to mollify the (often racist) butthurt by people who have more. And shame on anyone who gives in to that.
|
|
|
Post by #notLauren on Sept 28, 2017 20:47:32 GMT
As usual; it's the liberal way or the highway. And congrats...you even managed to drag in the 'racist' moniker.
What people like you don't understand is that attitudes and words like this are what helped to elect Donald Trump. You see, people when faced with "my way or the highway" and "you're racist, if you don't agree with me" tend to choose the highway.
|
|
|
Post by jeremysgirl on Sept 28, 2017 20:51:11 GMT
Whoa! It's racist to think everybody should pay taxes?
|
|
|
Post by #notLauren on Sept 28, 2017 20:51:29 GMT
And there is not going to be any conciliation of this country as long as attitudes like yours exist.
All sides have to feel as if they are part of the giving and receiving.
|
|
|
Post by compwalla on Sept 28, 2017 20:51:31 GMT
As usual; it's the liberal way or the highway. And congrats...you even managed to drag in the 'racist' moniker. Caring about other people is liberal? I don't know why people wouldn't want to drive that highway. And yes, often the bitching and moaning about "fairness" is rooted in systemic racism. That dogwhistle is well-worn.
|
|
|
Post by #notLauren on Sept 28, 2017 20:51:53 GMT
Whoa! It's racist to think everybody should pay taxes? Any time you disagree with a particular point of view, you're racist.
|
|
|
Post by #notLauren on Sept 28, 2017 20:53:05 GMT
As usual; it's the liberal way or the highway. And congrats...you even managed to drag in the 'racist' moniker. Caring about other people is liberal? I don't know why people wouldn't want to drive that highway. And yes, often the bitching and moaning about "fairness" is rooted in systemic racism. That dogwhistle is well-worn. Rhetoric. Pure rhetoric.
|
|
|
Post by compwalla on Sept 28, 2017 20:57:12 GMT
Whoa! It's racist to think everybody should pay taxes? People who work already pay into Medicare. They cannot be exempt from this no matter how much or how little they make. So if we had universal medicare, every employed person would be paying for it. Whether they pay income tax is not relevant because generally, the proposed universal health care plans do not use federal income tax; they expand Medicare. When we talk about the people who don't pay federal income tax because they don't make enough, this is appropriated money we use to fund other parts of the federal government, not healthcare. And saying that people who make only 30k a year should pay at least 25% of that income in taxes is inhumane. And yes, when you peel back the layers of argument for such a system, you will often (not always) find racist resentment centered around the mythical welfare queen who is almost always not white and "keeps having babies to stay on welfare" and other such baloney that hasn't been possible in the last twenty years.
|
|
|
Post by burningfeather on Sept 28, 2017 21:00:38 GMT
While that sounds great in theory, the reality is that when one half pays all the taxes and the other half pays none (because those who do pay federal taxes ALSO pay consumption taxes) and the half that pays none screams about how others aren't paying their "fair share" there ends up being a whole lot of resentment all around. Every adult in this country needs to have a financial stake in making things better. If you pay nothing, you have no financial interest. So, even if we have a progressive tax, everyone should be paying "something". The only time you should look in your neighbor's bowl is to see if he has enough. We should not be a country that screws over people who have less just to mollify the (often racist) butthurt by people who have more. And shame on anyone who gives in to that. And yet it's perfectly acceptable to look into your "rich" neighbor's bowl to make sure he doesn't have too much and to reach in to take what he has "for the greater good" even though he may have worked day and night at great self sacrifice to achieve an overly full bowl.
|
|
|
Post by jeremysgirl on Sept 28, 2017 21:00:44 GMT
And apparently uncaring as well. I agree with a progressive income tax. But I do believe everyone should pay something. I disagree with earned income tax credit. It's not because I don't care. I have said on other threads, I would be open to my taxes increasing to pay for universal healthcare if I thought they could pull it off economically. I have been so poor at one time that I qualified for the earned income tax credit. I have been so poor at one time that I had to use food stamps for 6 months. It was a hard pill to swallow. Now that I have more, I give more. I do care about my community and I do give back. Never once have I complained my taxes were too high. But yes, I feel like everyone needs to have a stake in the game.
|
|
|
Post by jeremysgirl on Sept 28, 2017 21:03:44 GMT
Whoa! It's racist to think everybody should pay taxes? People who work already pay into Medicare. They cannot be exempt from this no matter how much or how little they make. So if we had universal medicare, every employed person would be paying for it. Whether they pay income tax is not relevant because generally, the proposed universal health care plans do not use federal income tax; they expand Medicare. When we talk about the people who don't pay federal income tax because they don't make enough, this is appropriated money we use to fund other parts of the federal government, not healthcare. And saying that people who make only 30k a year should pay at least 25% of that income in taxes is inhumane. And yes, when you peel back the layers of argument for such a system, you will often (not always) find racist resentment centered around the mythical welfare queen who is almost always not white and "keeps having babies to stay on welfare" and other such baloney that hasn't been possible in the last twenty years. Never once did I say anyone should pay 25%. I am lower middle class. I don't even think I pay in 25% once all my deductions are figured in. But I feel like everyone needs to have skin in the game. And I find the idea that I'm racist for believing that to be a total smack in my face.
|
|
|
Post by compwalla on Sept 28, 2017 21:07:56 GMT
But yes, I feel like everyone needs to have a stake in the game. I don't know enough about the EIC to really have an educated opinion. I know my family has never qualified, mostly because my husband was active duty and there was never a year where I didn't also work at least part of the year to put us over the line. But I know that it's something a lot of military one-income families depended on when the member was a lower-ranking airman or if they had a bigger family. Is it fair or a net good or what? I am not sure and probably need to learn more. But when it comes to paying for universal healthcare, expanding medicare just makes the most sense to me specifically because we can't argue that everyone doesn't pay in - because they already do. The exception to this tax is extremely narrow and everyone *would* have a stake. I don't think it makes sense to conflate federal income tax with the proposals now being discussed because that's generally not relevant to how they propose to pay for it. **eta** and I never meant to call any specific person - not you or anyone else - a racist. I do say the general argument about it is often rooted in systemic racism.
|
|
|
Post by jenis40 on Sept 28, 2017 22:24:37 GMT
I'm not sure what you think hospital stays are like for most people, but I don't think the deep dissatisfaction with our system is due to lack of access to private rooms and 5 star meals. Most people want good care that won't bankrupt their family. Period. Actually, I'm well aware of what people report disatisfaction with my hospital thanks to Struder Group survey. You would be surprised. And my point is that all of this costs money. Some people will still be unhappy if the government controls it because they won't be getting all the extras in which they feel entitled to. People think nothing of dropping $200 a month + on cellular phones and service, but will complain about having to purchase a $200 medication monthly. As someone who has spent 6 months in hospitals over a two year period I have to think that these surveys can be somewhat misleading. Whenever I took a survey, hospital food always got the lowest marks from me with the caveat that I didn't expect the food to be five star restaurant quality. Hospital food sucks because they're feeding a large number of people with varying nutritional requirements. I always found something I could eat. Basically I always mildly criticized the food but it was a minor, minor part of what I expected from my hospital stays. Overall, I always gave glowing reviews particularly for the nurses and support staff. Those things were far more important to me than room views and meals.
|
|
|
Post by jenis40 on Sept 28, 2017 22:29:37 GMT
Have to say I know someone that complained that her hospital room didn't have a view of Lake Michigan vs. the rooftop view she had, and she complained the hospital had Sprite instead of 7-Up. She sure doesn't complain about the ridiculous premiums though because she has been on Medicaid her entire life, choosing to never work. I know not everyone is like her, but they are definitely out there. I understand that some people complain about stupid things. But it's facile to write off the dissatisfaction with our broken health care system because of those people. Some people will complain about anything. The vast majority of Americans are drowning in, or afraid of drowning in, medical debt. I don't see people demanding private beds and Michelin stars when health care is discussed, which is why I was dismissive of the first person who mentioned that. Perhaps I misread her intent, but it seemed she was trying to dismiss real complaints because someone, somewhere, once complained about their hospital not being posh enough. Most of us just want access to decent health care that won't bankrupt our families. Not everyone tolerates being ill either. Sometimes complaining is just venting about what you're going through because you have no control over it. And sometimes people complain because they're entitled assholes.
|
|
|
Post by megop on Sept 29, 2017 0:22:00 GMT
Actually, I'm well aware of what people report disatisfaction with my hospital thanks to Struder Group survey. You would be surprised. And my point is that all of this costs money. Some people will still be unhappy if the government controls it because they won't be getting all the extras in which they feel entitled to. People think nothing of dropping $200 a month + on cellular phones and service, but will complain about having to purchase a $200 medication monthly. As someone who has spent 6 months in hospitals over a two year period I have to think that these surveys can be somewhat misleading. Whenever I took a survey, hospital food always got the lowest marks from me with the caveat that I didn't expect the food to be five star restaurant quality. Hospital food sucks because they're feeding a large number of people with varying nutritional requirements. I always found something I could eat. Basically I always mildly criticized the food but it was a minor, minor part of what I expected from my hospital stays. Overall, I always gave glowing reviews particularly for the nurses and support staff. Those things were far more important to me than room views and meals. Yet it gets aggregated into a general score that has impacts on reimbursement from government coverage. Just sayin.
|
|
|
Post by ntsf on Sept 29, 2017 0:22:20 GMT
my dh has spent significant time in hospitals.. for the most part.. they all had mediocre to bad food.. except Stanford Medical center.. as good as many restaurants.. and the cafeteria is outstanding.
we have great insurance.. and we have used so much this year,,we are not paying anything for prescriptions, etc. but we still are paying out $10,000 to out of network doctors.. who do things we can't find from in network ones (extremely specialized treatment). fortunately, we can pay it.
|
|
|
Post by megop on Sept 29, 2017 0:26:06 GMT
The only time you should look in your neighbor's bowl is to see if he has enough. We should not be a country that screws over people who have less just to mollify the (often racist) butthurt by people who have more. And shame on anyone who gives in to that. And yet it's perfectly acceptable to look into your "rich" neighbor's bowl to make sure he doesn't have too much and to reach in to take what he has "for the greater good" even though he may have worked day and night at great self sacrifice to achieve an overly full bowl. I'll take this a step further. What if there is a limitation as to how many bowls that be filled in time within the scope of power of the bowl filler? What do you do then?
|
|
|
Post by burningfeather on Sept 29, 2017 0:37:12 GMT
And yet it's perfectly acceptable to look into your "rich" neighbor's bowl to make sure he doesn't have too much and to reach in to take what he has "for the greater good" even though he may have worked day and night at great self sacrifice to achieve an overly full bowl. I'll take this a step further. What if there is a limitation as to how many bowls that be filled in time within the scope of power of the bowl filler? What do you do then? It becomes a situation where those that are producing "more" cannot - or will not - keep up. If I'm trying to fill a hole and I'm working really hard to fill it as quickly and completely as I can and my neighbor is taking dirt from it, at some point, I'm simply going to either wear out and no longer be able to fill my own let alone anyone else's or I'm simply going to say fuck it and just quit because no matter how hard I personally work, I will always be limited as to how far ahead I can get.
|
|
|
Post by mollycoddle on Sept 29, 2017 1:00:12 GMT
I just saw this. Interesting: www.buzzfeed.com/katenocera/the-trump-administration-wont-support-state-obamacare?utm_term=.hkBRPLBjGD#.bnmD1bO2yYFrom the article: "Mitchell said they will now cancel the pre-enrollment events and instead focus efforts on how to get the word out about open enrollment without the help of HHS. “We're regrouping, we're restructuring, we're wondering if we should go direct to consumer rather than trying to work with the navigators,” he said in an interview. “In the absence of any kind of federal marketing, we're working on a plan to go directly to consumers, exploring any kind of partnerships with the one carrier in the state.” In a notice informing participants they would be canceling the events, Mitchell said HHS’s “destructive actions will ultimately reduce enrollment, increase costs and drive up the uninsured rate in Mississippi.” “I didn’t call it sabotage,” Mitchell told BuzzFeed News. “But that’s what it is.” The Trump administration has increasingly been taking a hands-off approach to the Obamacare markets, as Republicans in Congress have failed to repeal the law. In August, HHS announced it was cutting its Obamacare enrollment advertising budget by 90%, from $100 million down to $10 million. The administration is also shutting down healthcare.gov every Sunday from 12 a.m. to 12 p.m. throughout the open enrollment period. Already, Democrats in Congress have raised alarm bells about the Trump administration’s moves, arguing that the White House is trying to sabotage the open enrollment period by decreasing resources for it in an effort to cause the individual markets to fail. And the administration has continued to pay out Obamacare subsidies, but refused to commit to funding them long-term. Insurance companies could set premiums up to 20% higher next year because of fears that the subsidies will be cut off. More broadly, Trump has repeatedly called for letting the Obamacare markets collapse so that Democrats would be forced to negotiate with Republicans. Back in January, Trump signed an executive order on his first day in office directing agencies to delay or waive provisions of Obamacare that would “impose a fiscal burden.” However, this did not lead to a spike in exemptions from paying Obamacare fees. In fact, the total number of exemptions claimed this year is actually down slightly, though that could be a result of normal year-to-year variance. Kate Nocera is the DC Bureau Chief for BuzzFeed’s Washington, DC bureau. Nocera is a recipient of the National Press Foundation's 2014 Dirksen Award for distinguished reporting on Congress. Contact Kate Nocera at kate.nocera@buzzfeed.com. Paul McLeod is a politics reporter for BuzzFeed News and is based in Washington, DC." I don't know if this is why premiums are jumping. But I wonder.
|
|
inkedup
Pearl Clutcher
Posts: 4,837
Jun 26, 2014 5:00:26 GMT
|
Post by inkedup on Sept 29, 2017 1:06:51 GMT
I'll take this a step further. What if there is a limitation as to how many bowls that be filled in time within the scope of power of the bowl filler? What do you do then? It becomes a situation where those that are producing "more" cannot - or will not - keep up. If I'm trying to fill a hole and I'm working really hard to fill it as quickly and completely as I can and my neighbor is taking dirt from it, at some point, I'm simply going to either wear out and no longer be able to fill my own let alone anyone else's or I'm simply going to say fuck it and just quit because no matter how hard I personally work, I will always be limited as to how far ahead I can get. And what about peoople and corporations that aren't paying enough of their share? What about places like Wal Mart, for whom the government acts as a de facto benefit provider? There are too many loopholes in our tax system that are to the benefit of the most wealthy Americans. And churches. Don't get me started on the fact that they don't pay taxes.
|
|
Deleted
Posts: 0
Jun 2, 2024 2:07:56 GMT
|
Post by Deleted on Sept 29, 2017 1:27:17 GMT
Well, if all of my taxes together was 25% and if everyone paid the same percentage of their income into the pool (right now one-half of Americans pay no federal taxes at all), I could live with that. The reason we have graduated taxes is that it's very hard to live on 75% of $30,000 and much easier to live on 75% of $100,000. A larger share is taken from those with higher incomes because it makes a smaller practical dent in their lifestyle than it would for someone earning a smaller income. Low income families do pay taxes; they pay consumption taxes on gas, property, goods, and services. They pay into social security and medicare. They pay little or no income tax because they don't have much income. And REALLY REALLY easy to live on 50% of $5,000,000. I want MORE brackets and higher rates, not less brackets and lower rates. Taking home millions a year and having to pay a few extra hundred thousand?!?!? Cry me a river! But get behind the tears I have for the family of four making $80,000 and taking home $56,000, with the sick kid and the ailing parent. FFS!
|
|
|
Post by jenis40 on Sept 29, 2017 2:33:23 GMT
As someone who has spent 6 months in hospitals over a two year period I have to think that these surveys can be somewhat misleading. Whenever I took a survey, hospital food always got the lowest marks from me with the caveat that I didn't expect the food to be five star restaurant quality. Hospital food sucks because they're feeding a large number of people with varying nutritional requirements. I always found something I could eat. Basically I always mildly criticized the food but it was a minor, minor part of what I expected from my hospital stays. Overall, I always gave glowing reviews particularly for the nurses and support staff. Those things were far more important to me than room views and meals. Yet it gets aggregated into a general score that has impacts on reimbursement from government coverage. Just sayin. I'm not arguing that it does but whoever is putting these numbers together is putting far too much on that aspect in that case. Most severely ill patients that i knew during my bone marrow transplant were far more concerned with access and affordability than room views and food. Someone (not meaning you or the PP) needs a kick in the ass if this is what our healthcare system has decided are determining levels of coverage and payment. Personally my factors were "Am I alive? and Am I broke?"
|
|
|
Post by Clair on Sept 29, 2017 3:00:17 GMT
The reason we have graduated taxes is that it's very hard to live on 75% of $30,000 and much easier to live on 75% of $100,000. A larger share is taken from those with higher incomes because it makes a smaller practical dent in their lifestyle than it would for someone earning a smaller income. Low income families do pay taxes; they pay consumption taxes on gas, property, goods, and services. They pay into social security and medicare. They pay little or no income tax because they don't have much income. And REALLY REALLY easy to live on 50% of $5,000,000. I want MORE brackets and higher rates, not less brackets and lower rates. Taking home millions a year and having to pay a few extra hundred thousand?!?!? Cry me a river! But get behind the tears I have for the family of four making $80,000 and taking home $56,000, with the sick kid and the ailing parent. FFS! I’m about as liberal as they come on most things but it’s comments like yours that really piss me off. I think we shoud pay a graduated tax rate and I support EIC because it’s the right thing to do. I support social programs too - it all can’t be on the backs of high earners. It’s the attitude of make them pay because they can afford it that irritates me. We should pay more but you sound like you want to take it all away.
|
|