16ga.com ~ View topic

Member Joined: 09 Dec 2005 Posts: 989 Location: Las Vegas

One year ago I wasn't able to walk around the block much less hunt birds or fly fish. All the doc's here said there was nothing to be done. Found a guy in Orange County, CA., had the surgery there last July, and I'w walking out the door now for a 10:45 tee time! I had to pay my share but it's all relevant! I'd kiss the ground that surgeon walks on!

Matt

Member Joined: 28 Oct 2005 Posts: 665 Location: Louisiana

Intimately familiar with these concerns--from both sides. Don't forget to thank your friendly personal injury attorney and your rapacious insurer. Crying or Very sad

I work in the health care industry, ie as a hospital pharmacist, and agree the bills are absurd.

Hospitals, clinics, and physicians need to be able to charge reasonable prices and be paid thusly. Part of the problem, I understand, originated with medicare, when they would pay a percentage of usual and customary fees, causing doctors and hospital to start charging higher fees so that they could collect what they needed(wanted). This along with an increasing 3rd party payer, insurance, has caused an unending upward spiral in prices.

That coupled with new, very very expensive high-tech diagnostic and surgical equipment has compounded the problem. Hospital routeinly buy and replace equipment to have the latest and best. I see that trend in our small rural hospital.

Staffing is also a critical element. We have to cover most departments 24/7 365 days a year. Pharmacists are in short supply that we only have two pharmacists in our hospital to provide this coverage. We work a 12 hour day and pull call the nights we work and have a 2 week rotating schedule so generally we do not pull too many days without a break. Downside is my boss is taking vacation next month and we have been unable to find a qualified relief person so I am going to have to work 18 days without a break. Then there is nursing, housekeeping, and some clerical staff providing this level of coverage.

Next is the ER. By law if someone comes through the door, we cannot refuse treatment reguardless of their financial status, even if it means a lengthy hospital stay. Honestly, in my opinion this amounts to an unfair taxation on those of us earning wages and paying for our insurance( back to that again) or the poor person who acutally pays the full price out of pocket without negotiating the prices( it happens). Even though some of our tax dollars help pay, higher prices help offset the cost on indigent care.

Jeff jkingrph has it pegged for those of us in the small communities and rural areas.

One by one the smaller rural hospitals are closing up, due to inability to make the $$ work. Between the rising number of indigents demanding their "rights" to anything and everything, insurance companies, medicare, ($2800 for a house visit, check on an elderly lady to see if they are ok, and trim her toenails billed and allowed by medicare), fraud, overbilling (kind of like overbooking on the airlines), lawyers, doctors lifestyle expectations, malpractice insurance, did i mention lawyers, the working taxpaying people of this great, wonderful and generous nation are being ripped off every day at an ever increasing rate.

Rant over.

Just my opinion, you may have had different results, or be in one of the favored tax brackets (either lower or higher) than those of us in the taxpaying, working middle class.

We can't all be on the wagon, someone has to pull (produce)

I think i'll go by a new to me gun, maybe i'll feel better, and if i get to shoot it some i'll feel even better.

Oh wait, i have to finish that quarterly self employment tax thing for the IRS, and send the quarterly unemployment tax report and check to the state, and.....

well, now the rant is over...

rayb

Member Joined: 01 Feb 2006 Posts: 450 Location: Indiana

Recheck your bill. Many time the insurance has already discussed with hospital and have settled on the price in full. The hospital will send you a bill anyway which alot of people get scared at what they see and look right past what the insurance settled with. When the insurance settles its usually means paid in full and you owe nothing except the deducitable to the insurance or hospital. This is called double billing but the hospital calls it mutipule statements.
I had a heart attack two years ago. My bill for three days was 125000.00 All I had to pay was 2000.00 and thats all. O yes they tried to double bill me for what the difference the insurance settled for and once I let the insurance know that was the end of that.
The hospital get to write the difference off any. What a scam. Good luck

Joined: 23 Mar 2007 Posts: 5 Location: Carroll County, Oh.

Perhaps some of the Canadian members can tell us about their socialized medical care better than I. My limited knowledge is the care is very basic, emergencies are cared for and out the door you go. If you want more in depth or prompt care you still must have insurance coverage paid out if pocket(yours or employer). People die waiting on heart surgeries sometimes 18 months after the initial heart attack. With the upcoming elections we will be hearing more and more about socialized med. in the U.S. do want it? My knowledge(?) comes from a trip to a hospital several years ago for a skiing injury as well as talking to a friends daughter and son-in-law both work in hosp. in Toronto.

Guest

With all due respect to those with more knowlege of the medical field, I think the basic problem here is that whoever owns or bills for the outpatient surgery center is trying to push an over-sized choke tube into my bore end, sans lube.

Not be harsh, but one more time: The two docs have been paid. The labs have been paid. My insurance has paid the outpatient surg center nearly $5K.

How much more can they need for their overhead, nursing time and supplies for an outpatient procedure? Screw 'em. And I'm not rural, I can practically wiz into Chicago (or for that matter, most of NW Indiana) from where I live.

If I seem cheesed off, it's 'cause I got the same bill in the mail again today, am playing phone tag with the local office manager who said she'd get it resolved. And she asked in a voice mail today that I fax over my statement of benefits .... which I did March 23. Tomorrow, I'm faxing and calling to confirm receipt. If they don't get it, I'm leaving work, driving it over and politely remind them I had to take time off my job to deliver a one-page document that they can't seem to keep track of.

Who knows, maybe they're a good company but a tad like Browning: It takes them a while to grab hold of both ears, pull hard and wait for the loud popping noise before they can get properly to work.