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Old 11-12-2015, 05:01 PM   #61
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The two parts of medical cost I hear about is doctors salaries and malpractice. But they combined are way less than 15% of total healthcare cost. Malpractice was about 3% I believe.... Now defensive medical care used to prevent successful lawsuits I am sure is not part of that though. It is just hard to wrap your arms around the whole wasteful process... I havent...
Yeah, I've heard that "defensive medicine" is actually the main component of the cost of a litigious society on the health care system. Of course, one person's "prudent precautions" are another person's "unnecessary defensive medicine".

That said, the cost containment problems go much deeper than any one thing. One group of people seems to focus on insurance company and drug company profits, the other on a lawsuit-happy system, but even if you took all those out of the total that the USA spends on health care, it would *still* be a lot more per capita than just about anyone else on the planet pays, and by a fairly wide margin. Our cost problems are systemic and go far beyond any particular action group's pet bogeymen.
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Old 11-12-2015, 05:21 PM   #62
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The problem is that still could happen... IOW, say you went to an out of network facility and they deemed it not an emergency.... they might not pay it.... now, I could be 100% wrong on this.... but you do hear horror stories....
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I can speak to this. In our case, our emergency required care in another state, and the out of network hospital provided care in the ER and in the ICU for six days. I called our insurance company within hours of admission to inform them of the situation, and they assured me that we had coverage.

It sounds silly now to admit this, but I thought that we were required to write a check to our insurance company for the amount of the deductible. It took several explanations for it to sink in that as far as our insurance company was concerned, our deductible had been met. We were responsible for any bills from the out of network provider. So, we waited through several billing cycles to receive our final bill, and just this morning, I called their billing office to see if I could negotiate a cash payment. We settled on an amount that is less than our deductible. Not having ever had to deal with hospital bills before, I was pleasantly surprised at the ease with which this was handled.

I don't know if this is relevant, but our insurer, and the out of network hospital both used Epic software, so we were easily able to transfer records from the out of network hospital to our local health care provider. Amazing.
Likely not relevant, but thanks for plugging the company my son works for (software developer).
BTW, what kind of tandem do you ride? I have a Trek.
I worried quite a bit when I spent 5 days or so in the hospital and came out with a shiny pacemaker (not ACA). I blew my deductible (covered by HRA). The entire year was less than $250 out of our pockets. Doubt I'll ever have a plan like that again.
I'm amazed at what some hospital charges are... but I think they plan of concessions. you know... all the "agreed upon rates".
I'm glad it worked out well for you.
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Help! My health Ins is about to double!
Old 11-12-2015, 05:34 PM   #63
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Help! My health Ins is about to double!

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Yeah, I've heard that "defensive medicine" is actually the main component of the cost of a litigious society on the health care system. Of course, one person's "prudent precautions" are another person's "unnecessary defensive medicine".

That said, the cost containment problems go much deeper than any one thing. One group of people seems to focus on insurance company and drug company profits, the other on a lawsuit-happy system, but even if you took all those out of the total that the USA spends on health care, it would *still* be a lot more per capita than just about anyone else on the planet pays, and by a fairly wide margin. Our cost problems are systemic and go far beyond any particular action group's pet bogeymen.

I was on the treadmill today reading a Fortune Magazine article on healthcare costs today. I do not know if this is a "bogus stat" or not as I do not know the cumulative populations of the countries cited. But article said we spend more than 2x as much cost in medical care as France, England, Germany, Italy, and Spain combined.


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Old 11-12-2015, 05:35 PM   #64
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[QUOTE=bingybear;1656733]Likely not relevant, but thanks for plugging the company my son works for (software developer).


Interesting! Big employer of students coming out of UW, but boy, they can expect to work "epic" hours!

BTW, what kind of tandem do you ride? I have a Trek.


We bought a daVinci in 2009. Used to have a Cannondale that I *really didn't like* to ride. As the stoker, I appreciate not having to adhere to the captain's cadence : ) We are a much happier tandem team if the stoker can coast while the captain pedals to his heart's content : )
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Old 11-12-2015, 05:51 PM   #65
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I don't know if there are any Western European readers of this forum but I personally would love to hear first hand accounts from folks that have actual real experience with the health system in those countries. Reason for my question is that there's got to be something better than the crazy system we got here in the USA and there is so much smoke being blown @ these shores that the only thing I would trust is first person accounts.
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Old 11-12-2015, 05:59 PM   #66
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The OP doesn't have a pre-existing condition. And doesn't qualify for the subsidies.

So basically he gets to chip in to help pay for the people in those two categories.

I can see why people in those two categories like the ACA. I can also see why everyone else is pretty upset about it.
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Old 11-12-2015, 06:06 PM   #67
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But article said we spend more than 2x as much cost in medical care as France, England, Germany, Italy, and Spain combined.
Per capita? That's really what matters. We probably spend 10,000 times what San Marino does....
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Old 11-12-2015, 06:07 PM   #68
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I don't know if there are any Western European readers of this forum but I personally would love to hear first hand accounts from folks that have actual real experience with the health system in those countries. Reason for my question is that there's got to be something better than the crazy system we got here in the USA and there is so much smoke being blown @ these shores that the only thing I would trust is first person accounts.

One of my best friends wives was born and raised in England before moving across the pond several decades ago. Parents stayed resided in England. She is a devout advocate of national healthcare. Her father had several joint replacements and she said he was very pleased with the process there.She did say that he probably had to wait a few weeks more there than here to get it done since it wasn't a medical necessity.


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Old 11-12-2015, 06:12 PM   #69
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[QUOTE=Tandemlovers;1656736]
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Likely not relevant, but thanks for plugging the company my son works for (software developer).


Interesting! Big employer of students coming out of UW, but boy, they can expect to work "epic" hours!

BTW, what kind of tandem do you ride? I have a Trek.


We bought a daVinci in 2009. Used to have a Cannondale that I *really didn't like* to ride. As the stoker, I appreciate not having to adhere to the captain's cadence : ) We are a much happier tandem team if the stoker can coast while the captain pedals to his heart's content : )
The epic hours don't compare to my ATT/Lucent hours. For me 100 hour weeks were common. DaVinci is a nice bike. DW would like part of that.. Still hates the speed I'm willing to go.
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Old 11-12-2015, 06:17 PM   #70
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We live in Canada. There are challenges with our health care system but overall people are very happy. Every poll has shown an 80 percent plus approval rating. We hope to include prescription drugs, we call it Pharmacare' over the next five to six years. It has been a recommendation by our medical associations for a number of years. We are the only western country that does not include prescription drugs in our healthcare plan. The drug companies and insurance companies are against it so I figure it must be a good idea!

We have no concerns about being placed into personal bankruptcy by health care costs. Health care or monthly health care premiums did not come into play when I retired early at 58. We did not have to consider it. We pay our health care through taxes, and in some cases, low premiums. My daughter recently had significant issues with her pregnancy. More than once she was airlifted from her home hospital in a northern community to hospital in city. She spent weeks in the hospital with multiple specialist involved. We only had to concern ourselves her health and the health of the child. Absolutely zero direct, including the medevac, cost to her. Same with my father who had multiple heart surgeries, pacemaker, etc.

I believe that the difference is that we view healthcare as a basic right of all citizens. The notion that health care should be linked to one's employment or employer benefits is completely foreign to us and we do not understand the logic of it. For us, medicare is no different than police/fire protection or having clean water coming out of our taps. Some call our system socialized medicine yet those same people don't refer to our police/fire/water etc. systems as socialized in a contemptuous way. I do not understand this given the parallels.

As I recall, we are about at a 12percent GDP cost of healthcare with outcomes that are similar or better than the US depending on the line item. I believe that our per capita spend on healthcare is significantly less. This is the same as western Europe and Australia. But our number is not yet increasing at a unmanageable rate. Some people in Canada view our system as substandard to some of those in Europe. I cannot comment on this.
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Old 11-12-2015, 06:18 PM   #71
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I don't know if there are any Western European readers of this forum but I personally would love to hear first hand accounts from folks that have actual real experience with the health system in those countries. Reason for my question is that there's got to be something better than the crazy system we got here in the USA and there is so much smoke being blown @ these shores that the only thing I would trust is first person accounts.
I lived in England for 2 years. I got care when I needed it. Doctor was covered, medications were affordable. I knew people with cancer and heart problems that were treated in reasonable time frames... and covered. I don't live there now, but it seemed to work reasonably without breaking the individual's savings.
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Old 11-12-2015, 06:24 PM   #72
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I don't know if there are any Western European readers of this forum but I personally would love to hear first hand accounts from folks that have actual real experience with the health system in those countries. Reason for my question is that there's got to be something better than the crazy system we got here in the USA and there is so much smoke being blown @ these shores that the only thing I would trust is first person accounts.
Not in Western Europe, but my brief experience with the US health care system was "interesting". I worked for a US firm which (unsurprisingly) engaged a US insurance company to provide medical insurance for its employees worldwide.

We always took the worldwide coverage option which excluded the US and Caribbean as the premiums were a lot lower and we had no plans to visit the US (except on business which was covered on a separate plan).
As a partner, I had to pay the premiums myself. When Obamacare took effect (i) the premiums went up by 97% and (ii) a whole bunch of new/increased co-pays, caps and deductibles were introduced and (iii) the policy was re-written with the descriptions of what was covered/excluded being much longer. Bear in mind this was for coverage of non-US persons outside the US.

Fortunately, we were eligible to join DW's employee plan offered by a European insurer. The premiums went back to slightly above the old level and the deductibles, caps and co-pays were either removed or set at much more pleasant levels. The exact savings would have depended on what claims we had to make, but the net-to-us cost of health care about halved by getting out of the US system. We also got a comparatively plain-English explanation of what was covered/not covered and a very helpful help-line which meant we spent less time and experienced less stress in dealing with claims.

If we had not been able to switch to the European insurer, we were considering ditching the US policy and just buying a local policy that covered major events and paying for the small stuff as we went and/or relying on the Hong Kong public health system (which I would rate as adequate rather than good or bad).
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Old 11-12-2015, 06:42 PM   #73
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Per capita? That's really what matters. We probably spend 10,000 times what San Marino does....

Im assuming that was the assumption though it just said total healthcare cost. I did a quick tally and was surprised. Total population of the 5 countries was 316 million and US is about 310. I would never have thought Spain's population was nearly the same as France and UK.


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Old 11-12-2015, 06:52 PM   #74
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Has anyone who's cost have gone up dramatically considered switching to one of the christian healthcare ministries to save on cost? I realize it's technically not 'insurance' but it is ACA compliant. If my health care premiums were at the level some have quoted I'd probably give it a serious look.
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Old 11-12-2015, 07:01 PM   #75
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Just want to point out that it is not only defensive medicine that creates the high cost of health care...

As an example before, a joint replacement here cost $50K and somewhere in Europe cost $12K... there is not difference in the operation.... so all the extra fee goes to pay for something that is not needed....


I do not know who to blame... but I suspect it is a bit from everybody that creates the problem... we just see a small part and make assumptions.... and from what you read it seems almost everybody in the system is just about to go out of business because they cannot make money....
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Old 11-12-2015, 07:06 PM   #76
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The two parts of medical cost I hear about is doctors salaries and malpractice. But they combined are way less than 15% of total healthcare cost. Malpractice was about 3% I believe.... Now defensive medical care used to prevent successful lawsuits I am sure is not part of that though. It is just hard to wrap your arms around the whole wasteful process... I havent...


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The study to which I referred here Help! My health Ins is about to double! included the cost of everything related to medical malpractice including defensive medicine costs. 2.4% was the number the Harvard experts came up with. Significant but clearly not a major driver of costs.
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Old 11-12-2015, 07:08 PM   #77
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as I think Churchill said... the Americans will make the right choice after trying everything else.
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Old 11-12-2015, 07:11 PM   #78
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[QUOTE=bingybear;1656753]
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The epic hours don't compare to my ATT/Lucent hours. For me 100 hour weeks were common. DaVinci is a nice bike. DW would like part of that.. Still hates the speed I'm willing to go.

bingybear, happy stoker = happy captain : )
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Old 11-12-2015, 07:14 PM   #79
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The study to which I referred here Help! My health Ins is about to double! included the cost of everything related to medical malpractice including defensive medicine costs. 2.4% was the number the Harvard experts came up with. Significant but clearly not a major driver of costs.

Wow, that just makes the question even more confounding on where the money is going, doesn't it.


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Old 11-12-2015, 07:25 PM   #80
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We live in Canada. There are challenges with our health care system but overall people are very happy. Every poll has shown an 80 percent plus approval rating. We hope to include prescription drugs, we call it Pharmacare' over the next five to six years. It has been a recommendation by our medical associations for a number of years. We are the only western country that does not include prescription drugs in our healthcare plan. The drug companies and insurance companies are against it so I figure it must be a good idea!

We have no concerns about being placed into personal bankruptcy by health care costs. Health care or monthly health care premiums did not come into play when I retired early at 58. We did not have to consider it. We pay our health care through taxes, and in some cases, low premiums. My daughter recently had significant issues with her pregnancy. More than once she was airlifted from her home hospital in a northern community to hospital in city. She spent weeks in the hospital with multiple specialist involved. We only had to concern ourselves her health and the health of the child. Absolutely zero direct, including the medevac, cost to her. Same with my father who had multiple heart surgeries, pacemaker, etc.

I believe that the difference is that we view healthcare as a basic right of all citizens. The notion that health care should be linked to one's employment or employer benefits is completely foreign to us and we do not understand the logic of it. For us, medicare is no different than police/fire protection or having clean water coming out of our taps. Some call our system socialized medicine yet those same people don't refer to our police/fire/water etc. systems as socialized in a contemptuous way. I do not understand this given the parallels.

As I recall, we are about at a 12percent GDP cost of healthcare with outcomes that are similar or better than the US depending on the line item. I believe that our per capita spend on healthcare is significantly less. This is the same as western Europe and Australia. But our number is not yet increasing at a unmanageable rate. Some people in Canada view our system as substandard to some of those in Europe. I cannot comment on this.
All my relatives live in Canada and their experience is similar to yours. I have taken my mother to the doctor there and the experience is equivalent to that in the US but without the paperwork and copays. I've sat in with her during visits and the GP's manner is caring and very professional. She has had a hip and two knee replacements and has been hospitalized for heart attack and stroke. As a senior, she gets low drug costs and with her supplemental insurance as part of a widow's pension benefit, most things not covered by the government plan are covered to 85%. She's had access to all the latest drugs and is on Eliquis for afib after trying Pradaxa which had side effects. AFAIK, she pays a couple of bucks for that prescription. Now she does require a referral to see a specialist but that's also pretty common in this country.
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