Medical Insurance - Another Bigger Problem!!

John,
Congratulations....and FYI, I do not find your "pushy" at all....ha, ha

It's all about service...how "we" let this system get to this point is beyond me. What other service industry can get away treating their customers in this manner? None, that I know of.

Can you imagine calling your car mechanic and he tells you that you cannot get in until July! You would find another...right? So why not with doctors?

I had an experience where I broke my wrist, and needed specialist care...After a month of surgery, five cast changes, xrays etc. I was due to leave the US, even though I still had a small cast on. When I told the dr this would be the last time he would see me, he went nuts, telling me the "he wasn't finished with me" ,and I could not leave. Two days later I was on the plane.

Oh, the stories we could tell.

Billy
Web-site www.geocities.com/ba264
 
I see many areas in my folks financial life that need attention,
medical insurance being just one. My Dad thinks he has it all under control, but he doesn't and plus he is spending way too much money for what he gets, not only in the medical/insurance area, but elsewhere as
well. He doesn't shop around and he doesn't negotiate,
whereas I do both relentlessly. On the other hand,
unlike unclemick, there is little cutting into my ER time.
They don't ask for advice and I rarely offer any. In that
sense we are hoping Charles de Gaulle was right.

John Galt
 
Let me "float" this idea....

We "outlaw" insurance...you go to the dr, you pay cash. They must post their prices on a menu, for visits, drugs, everything..sort of like a restaurant menu. Then if you do not like the prices at one, you can go to another.

There could be many variations of this idea, that could include medical accounts.

Any ideas as to what would happen to their prices?

Billy
Web-site www.geocities.com/ba264
 
Hey Billy,

It's pretty much the way they do it here in Thailand. When I go to see the doc, I always ask "So, what will this cost me?" They never bat an eye and give me a remarkably close "estimate" of their services.

Man, do I love Thailand :)

Lance
 
Hey Billy,

I liked the article and I agree with you that a cash payment system would definitely be a good thing for US health care.

But…

IMHO, your way ahead of the troops on this one (troops being John Q. Public.) My take is that most Americans are jealously protective of and addicted to their $10 co-pay health insurance plans-and they won’t change readily. Sure, some thing’s gotta change but I see that taking a long, long time. Yes, there are (was 43 million the number?) uninsured US citizens, but there are a lot more who do have coverage.

Personally, I think most folks are pretty risk adverse. Case in point: ever buy a $500 television and the sales guy hits you up to but the “Extended Warranty” coverage, for a cool $59.95? OK, I’m making these numbers up but hopefully you’ll consider my point that the coverage was over priced-and probably not necessary. But many people opt for security to avoid the “big repair bill.”

The ER community seems to be supportive of accepting changes in health care, but, gosh, maybe it’s because we pay our own way…


 
Sorry for the weird stuff in these two posts; I do not know what I did wrong.



Hey Billy,

I liked the article and I agree with you that a cash payment system would definitely be a good thing for US health care.

But,

IMHO, your way ahead of the troops on this one (troops being John Q. Public) My take is that most Americans are jealously protective of and addicted to their $10 co-pay health insurance plans-and they will not change readily. Sure, some thing has gotta change but I see that taking a long, long time. Yes, there are (was 43 million the number) uninsured US citizens, but there are a lot more who do have coverage.

Personally, I think most folks are pretty risk adverse. Case in point: ever buy a $500 television and the sales guy hits you up to but the Extended Warranty coverage, for a cool $59.95? OK, I am making these numbers up but hopefully you will consider my point that the coverage was over priced-and probably not necessary. But many people opt for security to avoid the big repair bill.

The ER community seems to be supportive of accepting changes in health care, but, gosh, maybe it is because we pay our own way.
 
Re. those "extended warranties", I made a small
mistake recently when we bought our condo in Texas.
As usual, the sellers signed the form to verify that
everything was in working order. Plus the realtor suggested I write the offer so that the sellers paid for
a long term warranty on all built in appliances. I
thought with that much going for me I did not even have
to see if the place had running water. Guess what??
So far I have fixed the water heater, garbage disposal
and the dish washer, none of which worked when I bought it. Obviously I can't go back to the seller.
Plus, I pay a $50.00 deductible fee for each separate
problem and the repairs are good for 30 days only.
Then I am on the hook for another $50.00. If it seems
too good to be true, it probably is.

John Galt
 
Hey John, I can understand your taking the coverage when the seller paid the premiums. I hope that you have better luck with the appliances in your property.

But I'm sure you bought the place right and you WILL recoup -and then some- on sale day :)

All the best,

Lance
 
Hi Lance. Yes, we will make out just fine on the condo.
But, if I had been more attentive, I might have used
the information to squeeze more money out of the
sellers. Always looking for an edge..............

John Galt
 
TH:

Regarding car warranties.
They are very similar to small company health policies that were peddled years ago.

They covered everything but skin and contents. ;)
 
I guess the existential question is: would that be better coverage if you're thin skinned or thick skinned?

Or as the buddhist told the hot dog vendor "make me one with everything" :p
 
More on Doctors and Cash

This from NBC
Doctors launch cash-only practices
Under new system, physicians are 'charging less and making more'

By Anne Thompson
Correspondent
NBC News
Updated: 8:23 p.m. ET May 19, 2004
In one Seattle doctor’s office, cash is king. There are no insurance cards, little paperwork and, ultimately, better medicine, says Dr. Vern Cherewatenko.

advertisement

“I really only have one person that I’m responsible for now, and that’s the patient that’s in front of me, and it allows that patient to get all the care that they want from me," he adds.

Six years ago, Cherewatenko was drowning in paperwork and red ink, accepting more than 300 different insurance plans with 7,500 different medical codes.

“We were losing $80,000 a month. We were inundated with paperwork. What we found is the more patients we saw, the more money we lost, and it was devastating,” he says.

'Charging less and making more'
Unable to survive, Cherewatenko discovered what he says is a better way — a cash-only practice that’s grown into a national network of 1,600 doctors.

“We have lowered our fees anywhere from 30 percent to 50 percent on some of our services which is incredible,” he says. “And it’s really charging less and making more.”

Steve Nord used to belong to an HMO, but he’s traded it in for a cheaper policy that only covers catastrophic illness, opting to save on premiums and pay for his own routine medical care. “It just made sense because there was no hassle,” says Nord. “I just figured I could save more money that way and pay as you go.”

Cash is simple, but is it a real solution to the nation’s health care crisis? Analysts say it’s only an answer for those who are very healthy or very wealthy.

Dr. Bob Blendon, professor of health policy at Harvard University, estimates that only 5 percent to 10 percent of Americans can benefit from such a system.

“It’s not really an answer for people who get sick, have large medical bills, need X-rays and drugs. Somebody has to pay for that, and those people are really going to need insurance coverage,” Blendon says.

Billy
Web-site www.geocities.com/ba264
 
I posted on this a while ago. Theres actually a doctor network thats been formed and there are several doctors working in it down here in northern cal.
 
Re. AARP health insurance...........We have it. We like it.

John Galt
 
Not availible in LA. Saw a Nightline report where the person who pays cash - pays 2.5 times the HMO or insurance rate in many cases. Now our resident serial killer got a trial postponment while he got free medical care at taxpapers expense. Hmmmm?
 
When paying with cash, you need to ask for the UCR price. "Usual Customary and Resonable". That's the price the insurance co's negotiate. It might take a little effort, but hey, it's worth it.

Billy
Web-site www.geocities.com/ba264
 
? What if your only income is stocks and bonds - can you still get an HSA?
Click to expand...

This website has a good explanation of HSA. Click on the 'Feautured Product' on the left hand side. It also provides quotes for HSA-qualified policies side by side with non-HSA policies.

http://www.ehealthinsurance.com/ehi/index.html

Based on my research you don't have to be employed to contribute to a HSA account. My problem is still trying to work out the total saving/cost of a HSA policy (tax deducted on distributions) vs. a lower upfront cost and better terms of a non HSA policy. Being ER means a much lower tax income rate so does this count for as much as someone who is either self employed or is employed by a company with partial or no health benefits.
 
My father's badly broken leg landed him in the hospital for 6 days. He only has medicare. Not near enough to cover the stay. He is sweating it out big time. He procrastinated too long in buying a supplemental policy. Its still on his desk unsigned. At 70 yrs old he may never fully recover, both physically and financially.
Click to expand...
It is my understanding that if the facility accepts Medicare assignment that they can only require the patient to cover the $876 Medicare deductible ... http://www.cms.hhs.gov/manuals/102_policy/bp102index.asp

I still get HC ins as a retiree benefit so they pick up the deductible. My dad was in and out of SNF's and acute care his last 5 months... between AARP / Air Force / and Medicare, he only had to pay one deductible one time
 
Personally, I wanted to buy "disaster" health
insurance with a $10,000 deductible (or more).
This was my plan from the start of ER. Thanks to a whole bunch of unforseen circumstances, pretty soon
I couldn't find anyone to cover me, or if I did, I couldn't
pay the premiums. Thought about "going bare" but
didn't have the guts for that. Maybe if I had been
closer to Medicare, I might have rolled the dice.

John Galt
 
the same questions remain when considering LTC insurance. Think I'll wait until I'm closer to 60 and then pick it up during open enrollment
 
Re. LTC insurance and related issues, I have spent some time researching this. My parents have no LTC insurance and there is no chance we could explore
the problems and prospects together. No, I must sit by and wait for a crisis. Even then I suspect I will have
trouble getting myself involved. My folks trust me.
It's that old "loss of control" bugbear. BTW, once things start to go downhill fast, my dopey estranged brother
will reappear on the scene. So, I'll have to deal with
my parenst problems and his involvement at the same time. Not a very appealing prospect. No one else around to do it, unfortunately.

John Galt
 
John

LTC without insurance is another slice of govt. that's a world unto it's own - it's bad when one of a couple has to go to a nursing home, and even worst when the last surving parent goes. My mother refuses to grasp the three year look back rule(5 for trusts) and the fact that LA has estate recovery for wills/estates. The old loss of control - Depression ERA mentality again. She's under the illusion there will be something left for my sister in her will. I've explained to her that the govt. is first in line for anything over 2k - no matter what her will says. Sticky area to say the least.
 
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