DailyDirt: How Much Is That MRI In The Window?
from the urls-we-dig-up dept
We've discussed some healthcare nightmares previously, focusing on how the prices of medical procedures are oftentimes a surprise and far from transparent. This problem continues to plague people suffering from various injuries or illnesses -- but there are some projects trying to increase the transparency of medical pricing. However, just knowing the pricing before a bill comes isn't the final solution (at all). Here are just a few more links on this situation.- KQED has started a PriceCheck campaign to crowdsource the charged prices for common medical procedures that actual patients have been billed. Early results show that a procedure like a mammogram can vary from $125 to $801. [url]
- A Canadian couple was charged nearly $1 million for giving birth in the US. Blue Cross said it denied them coverage due to a pre-existing condition. [url]
- There may be mounting pressure for price transparency as more patients pay more of their own healthcare costs, and as the Centers for Medicare and Medicaid Services (CMS) makes more prices public knowledge. Chargemaster prices are becoming more widely known, but those prices may not reflect what anyone actually pays. Healthcare Bluebook is another effort that aims to create a price list for procedures (akin to the way used cars prices are published). [url]
- Medical price transparency might not benefit low-income folks if prices become more uniform and procedures simply become unavailable for those who can't afford them. This doesn't mean we shouldn't try to get more price transparency, but that we should also prepare for the unintended consequences that can be foreseen. [url]
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Filed Under: chargemaster, crowdsourcing, health, healthcare, medical billing, price transparency, pricecheck
Companies: blue cross, cms, healthcare bluebook, kqed
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Wait, isn't the ACA supposed to prevent insurance companies from denying coverage due to pre-existing conditions? Wasn't that specifically touted as one of the benefits that Obamacare would bring?
As I've said before, medical "insurance"... isn't. It behaves nothing like any other form of insurance we know. (Just imagine if you got into a fender bender, and you had to be careful where you took your car to get fixed up because Ralph's Collision Repair was in your network but John's Body Shop was not!) If we truly want to fix the health care crisis in this country, there are two things we need to do first and foremost:
1. Get rid of medical "insurance" as we know it. Nuke the whole concept from orbit; it's actively contributing to the problem.
2. Get rid of pharmaceutical patents. They're granted (and defended) on a fraudulent rationale: that the patent protection is necessary to recoup high R&D costs. In actuality, in many, many cases, most of this research is already paid for by We The People; the price gouging that patent protection affords the pharma companies is simply double-dipping.
Destroy those two concepts, and the rest will be able to work itself out without too much trouble.
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The Canadian system covers them while in Canada, but only so much while travelling abroad. For that we get travel insurance.
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This is what happens within the EU.
Travel insurance would then only be covering things like emergency transport (which would not have been needed in this case).
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DUH!!!!
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Now when the cops kill someone, we know that at minimum that life was worth a million dollars.
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The insurance system over there in the US just breeds high medical care costs. If you didn't have insurance companies picking up the bill you would soon see healthcare costs plummet.
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Not true. The insurance companies are able to negotiate down prices, so they end up paying much less than you or I ever could for the exact same service.
Yes, it's very unfair, but that's the system. It's no different than joining AAA, which will protect you from predatory car towing operators at the moment when you are especially vulnerable. Hospitals are just as predatory, if not more so, and that's why you need an insurance company to keep the hospital from robbing you via exorbitant prices that insurance companies never have to pay.
Sure, it's basically a protection racket, but just like when dealing with Chicago gangsters, paying for 'protection' is better than the alternative.
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But a comprehensive goverment organised health system like the UK's NHS is able to negotiate down prices much more effectively than even an insurance comapny can. This is why UK healthcare costs us half what US healthcare costs (as a percentage of GDP) AND it covers everyone AND outcomes are better for most people.
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Not true; it's rather the opposite in fact.
Q: What you call the person who pays all the bills?
A: Boss
The first and most important thing to keep in mind is that medical "insurance" is not an insurance product at all; it doesn't operate anything like an actual insurance product. What it is is something far more sinister: the mechanism by which the financial industry took over the health care industry.
Insurance is calling the shots now, in a very real way. By determining what procedures are and are not covered, they decide what treatments are and are not available, and ultimately, in many cases, can literally wield the power of choosing "who lives and who dies."
Exorbitant pricing is a big part of this. It's a twist on classical anti-competitive behavior. They don't negotiate prices down; they negotiate them up for everyone else, to price the competition (people trying to obtain health care without going through them) out of the market.
This is so much worse than a protection racket. This is... imagine if Al Capone and his cronies ended up as the Mayor and City Council of Chicago. It's a wholly illegitimate and evil system, and the only satisfactory resolution will be to remove them from power. With them literally holding the power of life and death in their hands, and driven by profit motive rather than any form of compassion, virtue or basic human decency, it literally is "us or them." It's just that most of us haven't realized that yet.
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A: Boss"
Right on the nose.
When I first started my own business, I found a book that I still count as the only business book that's worth a damn. It's a very slim volume filled with the lessons that the author learned over his many decades of entrepreneurship.
One of those lessons is: it's better to get a nickel each from 100 people than 100 nickels from a single person. When one entity is funding you, they inevitably feel that they own you in some way -- because they do. If they stop giving you nickels, you're done. When you are funded by 100 people, no single person has that sense of ownership -- and you can lose any of them without being hurt.
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https://thepiratebay.cr/
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Non-profits
Whenever there's a story about health insurance companies, a lot of people try to claim that non-profits are somehow better than for-profit companies since it's in their mandate not to make a profit.
However, this is completely false: yes, the non-profit companies can't declare a profit on their taxes, but this just means they have to spend all money they take in. Has anyone thought about how non-profit insurance companies can afford to build new wings on a hospital or pay their CEO $10 million a year? That's the money that would normally have been declared as profit.
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While it's true that there are nonprofits which are predatory in nature, as a general true the for-profit companies are far more likely to be predatory.
For that reason, sight unseen, I will have more trust in the nonprofit than the for-profit.
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Hospice
The Doctor told me my bedridden, dementia-stricken aunt qualified for hospice. I thought maybe it would be nice for her to have another person visit her now and then. The doctor didn't say anything about the cost and probably didn't even know the cost.
Six months after this started I saw the hospice company's billing to medicare. The hospice company received about $45K from medicare for about 20 hours of total service, most of which was for a non-skilled social worker to sit with her for 20 minutes now and then.
As soon as medicare decided my aunt had hit the limit for this kind of service and wouldn't pay any more, the hospice company decided she really didn't need hospice anymore. My aunt died a few months later without them being around.
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The doctor almost certainly didn't know the cost. My wife has been a nurse for most of her life and is full of the little insights you get when you work in a field. One of them is that hospital doctors almost never know the price of anything the do or recommend. They don't do billing, the price doesn't appear on any of their paperwork, etc.
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