Article on Health Care in Consumer Reports

[Corporate ORphan]

Anyone see the article on Health Care costs in the JUly Consumer Reports?? It was pretty scary. I know they try and find worst case scenarios but..... they made it sound like even with insurance you have to be careful and then you still can be on the hook for a bundle! Especially, in an emergency situation or going out of network.

I thought having a HD plan with 0% co-pay after the deductible would protect our assets. SOunds like even if you are careful to go in network, you can still be liable for a bundle if an out of network doctor gets involved without your knowledge.

At the end of the article they quoted a health care advocate who said the bottom line is the hospitals know that the insurance companies will just pay so much and the consumer will be on the hook for the rest.

I left the libary pretty much in a daze that you could ring up such high costs even with insurance.

 

[JOHNNIE36]

I've not seen the report as I no longer get Consumers Report in printed form, just the online version. I am going to check this out as I'm always interested in other health care plans. We have Blue Cross Clue Shield medicare advantage plan (called Florida Blue). I know it's very important to stay in network and Florida Blue has one of the largest networks of providers in the state. The other thing that is important in my opinion is the maximum out of pocket cost which for this year is $4750 each (excluding prescription drugs).

 

[M Paquette]

I thought having a HD plan with 0% co-pay after the deductible would protect our assets. SOunds like even if you are careful to go in network, you can still be liable for a bundle if an out of network doctor gets involved without your knowledge.

We were bitten by this a few times. Out of network anesthetist, consult with radiologist, and during the Great UHC/Quest Diagnostics kerfluffle, no labs within 40 miles that would take our insurance. This added thousands of dollars to the cost of our youngest daughters birth, and to the cost of correcting another medical problem for a family member.

We finally jumped to a HMO that operates all their own facilities (Kaiser Permanente), which also opened up possibilities for post-work health coverage via COBRA, Cal-COBRA, and conversion (post COBRA to individual coverage without new underwriting, for a price...) if we were unable to be underwritten for individual coverage. This has turned out very well for us in both quality of service and predictability of costs.

 

[Gone4Good]

SOunds like even if you are careful to go in network, you can still be liable for a bundle if an out of network doctor gets involved without your knowledge.

Tis true.

In-network hospital, doesn't mean in-network doctor. In-network doctor doesn't mean in-network lab. In-network surgeon doesn't mean in-network anesthesiologist. In-network everything doesn't mean the related charges are "ordinary and customary."

More ways to get you than we can possibly count, let alone plan for.

Oh, and try asking the hospital about any of this before hand and see what kind of response you get.

 

[JOHNNIE36]

Tis true.

In-network hospital, doesn't mean in-network doctor. In-network doctor doesn't mean in-network lab. In-network surgeon doesn't mean in-network anesthesiologist. In-network everything doesn't mean the related charges are "ordinary and customary."

More ways to get you than we can possibly count, let alone plan for.

Oh, and try asking the hospital about any of this before hand and see what kind of response you get.

Try talking to a hospital before or after the service. Ever get a copy of the complete and final bell? No way can you understand or decipher the dang thing. I know one thing though; if you press them hard enough, they will just write it off. They know they're getting you some other place.

 

[meierlde]

I've not seen the report as I no longer get Consumers Report in printed form, just the online version. I am going to check this out as I'm always interested in other health care plans. We have Blue Cross Clue Shield medicare advantage plan (called Florida Blue). I know it's very important to stay in network and Florida Blue has one of the largest networks of providers in the state. The other thing that is important in my opinion is the maximum out of pocket cost which for this year is $4750 each (excluding prescription drugs).

If as you hint you are on medicare, then all hospitals are in network, (part a), and further the price charged for physicians is set by CMS.(Centers for Medicare services). This is why so many physicians won't take medicare patients the rates are to low.

 

[JOHNNIE36]

If as you hint you are on medicare, then all hospitals are in network, (part a), and further the price charged for physicians is set by CMS.(Centers for Medicare services). This is why so many physicians won't take medicare patients the rates are to low.

I stated that we have a Medicare Advantage plan. All the physicians, specialists, hospitals, etc. that are part of Florida Blue, accept the equalivent of Medicare approved charges (fees).

 

[meierlde]

I stated that we have a Medicare Advantage plan. All the physicians, specialists, hospitals, etc. that are part of Florida Blue, accept the equalivent of Medicare approved charges (fees).

Actually that is true of all physicians in general if they take a medicare patient by law they can only charge the medicare fees. So essentially in medicare if a physician accepts medicare they are in network. No need to check if in the Blue network. Of course medicare advantage is different, what I said is true of traditional medicare. So of course that is an advantage/disadvantage of medicare advantage.

 

[JOHNNIE36]

Actually that is true of all physicians in general if they take a medicare patient by law they can only charge the medicare fees. So essentially in medicare if a physician accepts medicare they are in network. No need to check if in the Blue network. Of course medicare advantage is different, what I said is true of traditional medicare. So of course that is an advantage/disadvantage of medicare advantage.

True meierlde. I thought you were assuming I was on the traditional medicare plan.

 

[obgyn65]

A few years ago, researchers from Harvard found that about 60% of all personal bankruptcies were caused by health issues. And most of those who filed for bankruptcy (about 75%) had healthcare insurance. A national disgrace IMO.

I left the libary pretty much in a daze that you could ring up such high costs even with insurance.

 

[rescueme]

A national disgrace IMO.

It is? What's are the options?

A system (like Canada) which doesen't allow private health insurance, and folks wait (sometimes for years) for a condition to be corrected? Heck, that's why you have a lot of cross-border medical activity (not tied to cost, but just trying to get a problem corrected).

A system (like Austraila) which does allow for supplemental private insurance in addition to the public plan? That still costs $$$.

A system like the U.S. that has private insurance that (depending on plan) allows you to get a doctor/specialist in a timely manner to meet your needs?

Not to get into a political discussion, but any option does not necessarily combine both low (personal) cost and timely "service", of the places I've seen. There is no easy answer.

 

[obgyn65]

I cannot answer this without getting political. I agree with you there is no easy answer, but I have seen too many people suffer.

There is no easy answer.

 

[Mulligan]

A few years ago, researchers from Harvard found that about 60% of all personal bankruptcies were caused by health issues. And most of those who filed for bankruptcy (about 75%) had healthcare insurance. A national disgrace IMO.

Not trying to disagree or even defend our current system, but isn't it possible there are other variables in play? Some of these bankruptcies could be caused by the loss of income during health issue or even loss of job. No amount of health insurance is going to cover up the problem of people scraping by paycheck to paycheck and then suddenly not bringing in a paycheck from a health issue or injury.

 

[67walkon]

I'm curious-have a few years before Medicare kicks in for me and 7 for my wife.

Right now, health insurance, through my sort of part time but lucrative job, costs the employer about $14,400 a year for the two of us and one college aged child. It is a BCBS product. I'm exploring options, one of which is to take over the insurance and reimbursing the employer.

What happens when I hit 65? How much will the medicare really cost, part a and b and all that? Any estimates?

 

[REWahoo]

What happens when I hit 65? How much will the medicare really cost, part a and b and all that? Any estimates?

Currently Part A costs $0, Part B $100/mo - more if you have a high income. Part D (drugs) + a Medigap policy (covers deductibles) currently runs from $60 to upwards of $300/mo depending on what bells & whistles you choose.

A few years down the road, who knows.

 

[ERD50]

A few years ago, researchers from Harvard found that about 60% of all personal bankruptcies were caused by health issues. And most of those who filed for bankruptcy (about 75%) had healthcare insurance. A national disgrace IMO.

As I recall, that study was de-bunked. If at the time of bankruptcy, the person had an outstanding medical bill, regardless of amount, it was declared as a 'cause' of bankruptcy. Or something like that. I've got a bill due at the end of the month, so I guess I'd qualify if I gambled my money away in the mean time.


edit/add: found the study: http://bit.ly/swQjk6

from the abstract - emph mine...

BACKGROUND: Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened.

METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as “medical” based on debtors’ stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.

RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; ...

So that's a pretty lax criteria - I imagine if someone gambled away $100,000 and had a $10,000 medical bill, their 'stated reason' for bankruptcy would likely be the medical bill.


-ERD50

 

[Khufu]

It is? What's are the options?

A system (like Canada) which doesen't allow private health insurance, and folks wait (sometimes for years) for a condition to be corrected? Heck, that's why you have a lot of cross-border medical activity (not tied to cost, but just trying to get a problem corrected).

Not true.

1. The number of Canadians making medical trips to the US is too small to be measured.
2. Canadians overwhelmingly approve of their medical system.
3. The number of Californians alone who cross the border into Mexico every year for treatment on the other hand, is quite measurable: around 1 million per year:
Nearly 1 million Californians seek medical care in Mexico annually | UCLA Center for Health Policy Research


What are the options? Just look at any fully developed country, all of which provide medical coverage to the entire population. In Germany it is strictly regulated private insurance companies. In the UK it is the National Health Service. In Switzerland it is private insurance companies that are not permitted to make a profit. In France, rated the best health care in the world by the WHO, it is universal health care financed by national health insurance. In Singapore, the healthiest population on earth, it is a system of compulsory insurance premiums and price controls.

The US is number one in cost (by a wide margin) and number 37 in quality, as measured by the WHO. You really can't imagine anything better than US healthcare? REally?

 

[Brat]

Recently I was treated for breast cancer and am now receiving statements from both Medicare and my health insurer. The charges are stunning.

 

[youbet]

Currently Part A costs $0, Part B $100/mo - more if you have a high income. Part D (drugs) + a Medigap policy (covers deductibles) currently runs from $60 to upwards of $300/mo depending on what bells & whistles you choose.

Part D also comes equipped with a higher premium penalty for those who LBYM'd, invested and now have a higher income in retirement. Supplemental policies are, amazingly, the same price for all (for the time being).

 

[youbet]

The number of Californians alone who cross the border into Mexico every year for treatment on the other hand, is quite measurable: around 1 million per year:

Although the "Californians" going to Mexico for medical treatment (includes dental) includes folks of Mexican decent returning "home" for treatment.

 

[M Paquette]

Although the "Californians" going to Mexico for medical treatment (includes dental) includes folks of Mexican decent returning "home" for treatment.

Along with about half the population of San Diego...

 

[Nords]

Recently I was treated for breast cancer and am now receiving statements from both Medicare and my health insurer. The charges are stunning.

"20%" doesn't seem like much until it's converted into dollars, does it? Those supplemental Medicare insurance premiums seem like a waste of money for a lot of years, but it pays back pretty quickly for a major issue.

Although the "Californians" going to Mexico for medical treatment (includes dental) includes folks of Mexican decent returning "home" for treatment.

There seems to be a pretty significant migration northward into Houston's Texas Medical Center.