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Have Bar, Will Travel
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9,677 Posts
Quesion I always want to see discussed but nobody wants to.

How much admin cost padding is placed in most hospitals so as to float out the costs of the ER for non-residents and other nonsense issues.?

you know they itemized bill hospitals don't want to give you and make you ask for usually twice for discussion with insurnace will have the infamous 9 dollar tylenol or whatever. Compound that with a 35 dollar vitamin or ________. so makes you figure the "anethesia" at 1543 is probably equally inflated but you have no real way of knowing.

Now if there was some alleviation of the ER nonsense and the non-resident thing etc and I don't know you forced the providers to shape up. That seems like it would save some significant year over year dollars in operating expense passed on to the system.

Incidentally those are items from the "itemized" bill I argued over for the birth of our second child. total cost out of pocket to me on the first set of bills - 6834 dollars - after asking for an itemized bill and comparing with what cigna said it should cost came down to 3692. So it's that wrong because why - and how many people just blinding accept the hospital bill is __________ without any thought of questioning a bill that only has a balance number.

That base nonsense would fix alot of the adjustment in my eyes. OH and NOT ONE BIT OF THAT covered any cost of the OB/GYN. Not one. Her bill was separate - reviewed well on the front end - agreed to by Cigna - paid over 8 months by me vs the normal visits - to the point that we apparently overpaid a bit and they refunded it back within 2 weeks. Methodist healthcare - still arguing with them over dollars. Offspring 2 is almost 5 months, 18 days old. BS pure unadulterated BS.
 

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Registered
2005 Pontiac GTO
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521 Posts
Wow, we had zero out-of-pocket costs for each of our 4 kids. I figured that's what health insurance is supposed to cover, as well as check-ups and shots. The insurance company wanted to deny certain charges they deemed unnecessary for our 2nd kid, but they were related to him being born with the cord wrapped around his neck and no response. Nurse hit a big red button on the wall and a bunch of nurses and doctors flooded into the room within seconds! My wife and I didn't have a clue what was going on until he was basically brought to life.
 

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Tu stultus es
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27,106 Posts
Discussion Starter #25

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Have Bar, Will Travel
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9,677 Posts
Wait... you made ANOTHER ONE???
Right? With the same woman?
I had a thread for it back in february I suppose I could post up a pic at some point.

anywho.

but yes and it seems yes to both questions. Worse I now have 2 daughters so that whole cursed life thing is probably partially true.
 

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Have Bar, Will Travel
Joined
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9,677 Posts
Wow, we had zero out-of-pocket costs for each of our 4 kids. I figured that's what health insurance is supposed to cover, as well as check-ups and shots. The insurance company wanted to deny certain charges they deemed unnecessary for our 2nd kid, but they were related to him being born with the cord wrapped around his neck and no response. Nurse hit a big red button on the wall and a bunch of nurses and doctors flooded into the room within seconds! My wife and I didn't have a clue what was going on until he was basically brought to life.
today's crap and the plan I have made it go sort of like this.

OB visit 3 - cigna sends me an e-mail saying they are here to help . . . . and the normal out of pocket cost to me will be 6,000 dollars. Not nationwide, not on average - as in at this particular hospital in my area vs different dollars at choices 2 and 3.

OB requirement is to have _________ dollars as their standard delivery fee with any extra need to be handled after the fact. If I recall correctly it was something like 1,200 dollars off the top. SO break that up in 6 payments paid on top of the copay remainder of each visit. Turns out it was closer to 850 and I got the overage back. TO be fair they didn't really even press the issue if we hadn't paid all of it by D Day. Eitherway they were about the only good piece of this ordeal.

Hospital at week 30 when we "pre-registered" for the event required a 25% deposit up from of the supposed 6000 dollars. I called their business office and complained after having first called Cigna to see what standard policy is supposed to be - Cigna said I should have to pay a deposit of less than 200 dollars. Big gap there isn't it. End result I paid them 540 up front how that number comes to be I have no idea.

whole things over and the 3 days we are in the hospital I still think any minute they are going to shake me down for more money before we can leave.

month later I get the first bill 6834. Call Cigna, what should it be? "We haven't received a final and haven't paid out on this event yet . . . . " Don't pay them anything until we get an itemized final statement.

Call Methodist - Que? "your insurnace has rejected this claim because you didn't use a qualified OB clinic She was still talking when I hung up.

Call different number - "That's what you owe us since you didn't pay the full deposit and you will get another bill once we get the final from your OB and any other support staff . . . .

3 months later - final statement one calls for a remainder of 7460 ish with some large fee for anesthesia, and another large fee for natal ICU - which wasn't used at all that I know of and other bits. Cigna to their credit stuck to their verse that my out of pocket should only be 3216 after having paid the OB and other transactions they had. Methodist sent the whole thing to collections and I get calls and odd notes for a consolidated recovery systems which is methodist healthcare's OWN debt collector agency. As far as I can tell.

If it doesn't get resolved this month and I don't get a letter and final receipt showing paid in full and removal from my credit report I'm suing them.

3 years ago with the first offspring it was stated up front the cost would be __________ I think it was 6200 back then. part of that was the OB which we paid in advance through their office - the after bill from the hospital was still just a balance number but after 2 rounds of itemized bill and cigna statement it was a whopping 2700 or so as my out of pocket remainder which I was able to pay monthly for a year. If there is a flaw it starts at the providers more so than any doctors I've used.
 

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2010 Camaro SS Owner
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408 Posts
So quick story- okay you all know better. Anyhoo... I go to this Camaro meet up in Kingston Ontario about a month ago. One of the attendees is a guy I’ve known from these meets for almost 10 years. He’s from Alberta, Canada- like WAY the fuck out there and while he usually makes a long drive/vacation out of it adding around 7000 kilometers to his odometer, he flies in instead to hang with us. A bit odd but I get that it’s a LONG drive and a lot of time so I just kind of let it slide. Instantly I know something is up when I see him and by day two at 1 am it’s just me and him in the parking lot (because I dragged him from the party room to there) and now sobbing he tells me he’s been diagnosed with stage 2 lung cancer- never smoked a day in his life. Even worse, he hasn’t told his wife or family or ANYONE other than me right then. He has some esophagus ulcer type issue as well and told his wife the (chemo) meds he was on were for that when he’s really puking from the chemo meds and it’s tearing up his throat. So what’s the treatment plan? Chemo for 4-6 MONTHS until they can schedule a potential surgery to remove the malignant mass. Yah for free Canadian healthcare. Woohoo, right? It could easily spread and he’ll be counting the days until he’s dead. Now picture this guy is 6-3/265 and he’s now on the ground in immense pain (stomach) from the chemo meds in nearly a fetal position and has been hiding that pain and disappearing when it would hit. Begs me to go in so he can “deal with it” but no way was I leaving him in that state laying in a parking lot. So now you all get the issue(s) and the time and severity of what’s transpiring... let’s not forget the next step of the Canadian healthcare system is see us again in four months if you’re still around.
Over the next two hours I’ve convinced him to fight and fight hard but more important, that he can’t fight alone and he has to have the support of his wife and family. By the morning they know and instead of going to London, Ontario to visit his Mom like he planned on the return trip, he’s flying to London, England courtesy of his well-to-do sister- and her husband has him scheduled to see the top oncologist in London. Immediate “in”, surgery in days if it’s decided that’s the best immediate course of action BUT... oh shit, 100% out of pocket. Well damn- he’d rather be broke and alive so here we go.

He gets admitted, x-rays confirm the mass, surgery is scheduled, final lab results come back and... benign.. and, wait, what? WTF did you just say? It’s benign? Ya, just a mass and should be removed but at this point go do it back in Canada where it’s paid for. Thanks for playing the you’ve been mis-diagnosed by the all-hailed Canadian healthcare system, put on chemo meds for two months making you feel like you wish you actually were dead and causing you massive depression in the meantime game.

To top it all off, Canadian doctors are covered by government supplied malpractice insurance and all cases are fought so hard there’s little chance of winning. And when (if) you do, the Canadian version of SCOTUS has already capped damages to a comparable minimum of ours from what he tells me. But HELL YES, let’s copy their healthcare model here, right?
 

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DW can't take a J... or a D
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2,280 Posts
I’m sure there are many things to complain about universal healthcare, but misdiagnoses isn’t one. Those happen everywhere and aren’t unique to single-payer plans.
It very well can be. Standard of Care with a suspicious mass is a biopsy to evaluate pathology. Would have been immediately evident whether or not it required chemotherapy.

Possible the doc jumped to treatment because of a potential delay in obtaining a biopsy (i.e., wait time for an interventional radiologist or gastroenterologist).
 

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Here for the Gangbang
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2,057 Posts
In fairness, malpractice suit payouts SHOULD be capped. Most of that money goes to the attorneys anyhow.

If a doctor is found guilty of malpractice, they simply shouldn't be permitted to practice any more.
 

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2010 Camaro SS Owner
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408 Posts
In fairness, malpractice suit payouts SHOULD be capped. Most of that money goes to the attorneys anyhow.

If a doctor is found guilty of malpractice, they simply shouldn't be permitted to practice any more.
Agreed to an extent. I have a much Yuger problem with the guy who got $2.6m from a jury because a doc left a surgical sponge in his gut than I would with a guy like this getting $10m for the misdiagnosis, mental anguish, and administration of an unnecessary drug that causes violent and painful side effects for two straight months.
 

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DW can't take a J... or a D
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2,280 Posts
As if infected surgical sponges requiring additional surgery, and untold pain and anguish don't fall in the same ballpark as your friend? If you'll be honest (lol), if you heard about that dude on the news and he got $10M, you'd be shitting mad about that too.
 

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Here for the Gangbang
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2,057 Posts
We're always more emotionally invested when the person involved is in our MonkeySphere. The bigger picture, though, shouldn't change.
 

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2010 Camaro SS Owner
Joined
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408 Posts
As if infected surgical sponges requiring additional surgery, and untold pain and anguish don't fall in the same ballpark as your friend? If you'll be honest (lol), if you heard about that dude on the news and he got $10M, you'd be shitting mad about that too.
We're always more emotionally invested when the person involved is in our MonkeySphere. The bigger picture, though, shouldn't change.
Agreed- to both. I really wasn't considering that a sponge would cause an infection and could actually cause a lot of pain; more a "something doesn't feel right doc..." Oh shit we left a sponge in there.
 

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Have Bar, Will Travel
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9,677 Posts
In fairness, malpractice suit payouts SHOULD be capped. Most of that money goes to the attorneys anyhow.

If a doctor is found guilty of malpractice, they simply shouldn't be permitted to practice any more.
I don't know maybe lawyer fees in general should be capped. I mean when I was in a car accident I was told the lawyer would get 40% of the settlement dollars. regardless of what the value turned into.

Seems like a general cap on lawyer fees would help maybe there should be a national Legal Aid coverage.
 

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The Entenmann's Shim-Sham
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12,143 Posts
So quick story- okay you all know better. Anyhoo... I go to this Camaro meet up in Kingston Ontario about a month ago. One of the attendees is a guy I’ve known from these meets for almost 10 years. He’s from Alberta, Canada- like WAY the smurf out there and while he usually makes a long drive/vacation out of it adding around 7000 kilometers to his odometer, he flies in instead to hang with us. A bit odd but I get that it’s a LONG drive and a lot of time so I just kind of let it slide. Instantly I know something is up when I see him and by day two at 1 am it’s just me and him in the parking lot (because I dragged him from the party room to there) and now sobbing he tells me he’s been diagnosed with stage 2 lung cancer- never smoked a day in his life. Even worse, he hasn’t told his wife or family or ANYONE other than me right then. He has some esophagus ulcer type issue as well and told his wife the (chemo) meds he was on were for that when he’s really puking from the chemo meds and it’s tearing up his throat. So what’s the treatment plan? Chemo for 4-6 MONTHS until they can schedule a potential surgery to remove the malignant mass. Yah for free Canadian healthcare. Woohoo, right? It could easily spread and he’ll be counting the days until he’s dead. Now picture this guy is 6-3/265 and he’s now on the ground in immense pain (stomach) from the chemo meds in nearly a fetal position and has been hiding that pain and disappearing when it would hit. Begs me to go in so he can “deal with it” but no way was I leaving him in that state laying in a parking lot. So now you all get the issue(s) and the time and severity of what’s transpiring... let’s not forget the next step of the Canadian healthcare system is see us again in four months if you’re still around.
Over the next two hours I’ve convinced him to fight and fight hard but more important, that he can’t fight alone and he has to have the support of his wife and family. By the morning they know and instead of going to London, Ontario to visit his Mom like he planned on the return trip, he’s flying to London, England courtesy of his well-to-do sister- and her husband has him scheduled to see the top oncologist in London. Immediate “in”, surgery in days if it’s decided that’s the best immediate course of action BUT... oh shit, 100% out of pocket. Well damn- he’d rather be broke and alive so here we go.

He gets admitted, x-rays confirm the mass, surgery is scheduled, final lab results come back and... benign.. and, wait, what? WTF did you just say? It’s benign? Ya, just a mass and should be removed but at this point go do it back in Canada where it’s paid for. Thanks for playing the you’ve been mis-diagnosed by the all-hailed Canadian healthcare system, put on chemo meds for two months making you feel like you wish you actually were dead and causing you massive depression in the meantime game.

To top it all off, Canadian doctors are covered by government supplied malpractice insurance and all cases are fought so hard there’s little chance of winning. And when (if) you do, the Canadian version of SCOTUS has already capped damages to a comparable minimum of ours from what he tells me. But HELL YES, let’s copy their healthcare model here, right?
You are aware that England also has a national healthcare system, right? Also, your example of "rich dude with connections pulled strings to get relative to the front of the line" isn't exactly a fair comparison.
 

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Born in a class 5 hurricane
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11,430 Posts
You are aware that England also has a national healthcare system, right? Also, your example of "rich dude with connections pulled strings to get relative to the front of the line" isn't exactly a fair comparison.
I believe the national healthcare system spawned two systems, a public one and a private one for those with the money to afford it. So the rich guy didn't pull strings but pulled out his wallet.

I also believe Canada took steps to prevent a secondary system from developing there when they nationalized their healthcare.
 

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Have Bar, Will Travel
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9,677 Posts
yes the wondrous English healthcare system that in the 90's spawned the new tourism trade of tourist surgery in India because it's better care, faster, and for less out of pocket.

I suspect we will be so successful people will be flocking to Brazil for surgeries that aren't butt and boop implants.

wow. Anyone that's every been in Europe in general for a period of time will tell you they don't like their system. Be in English, french or german.
 
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