Proposed Health Care = you need a license just to live: RANT

Joined: 08 Jul 2003 Posts: 6309

Found the original story.

http://www.nwfdailynews.com/news/says-18814-bill-victoria.html

Nofs friend's abulance ride highlights thr problem with pay per service . That 500 sounds high especially if a county service but when you need an ambulance do you have time to shop...

If I read the bill Mags posted correctly that's from a ' FOR PROFIT hospital ' . And judging by the tests it almost looks like they were guessing at what was wrong.

Some things to note on that bill:
-211,000$ Total Bill
-160,000$ Pharmacy bill including 155,000$ for ESMOLOL
-2100$ just for going to the ICU
-3200$ for the Emergency Room
-16,000$ for Laboratory TESTS
-35,000$ in treatments
-4-253$ drug screens ?
-650$ for Tylenol
-Doctor's Services only came out to 1,400$

I don't know if this person 'volunteered' to go here but when you are in need how the heck can you ' shop ' for medical care .My thing if the County or local municipality dictates what hospital you should go in an emergency then that same government authority should have say on the billing and possibly even the funding which in turn should give more control over the billing. And this is an excellent example of how the ' medical mafia ' is exploiting a la carte pricing - there are no value meals here .

But again thats part of the problem. If you want a la carte pricing fine but do NOT pad the prices or bill to make up for the costs of services some where else . It's bad enough this is going for profit but this makes identifying the true costs and problems more difficult.

I also saw a poster try to justify the bill by saying things like it takes someone to administer and ship the drugs . Administration of the drugs should built in to the Doctor and Nursing costs . The shipping of the drugs should be built into the vendor or supply budget of the hospital . But this logic is more proof that the medical industry is shifting costs around making almost immpossible to identify the cost they probably don't want you to know about.

Joined: 26 Aug 2005 Posts: 1707

Joined: 22 Dec 2007 Posts: 461

Maybe a better idea for this could be to not get into the medical industry but the supply of it. If the government operated supply stores around hospitals so competitive pricing would exist and these would look more obvious.

Maybe a program that would waive tuition debt if someone worked for a few years at some sort of government non profit hospitals near by other hospitals.

Or better yet simply teach health in schools to the point where everyone knows how to treat everything. If a given skill is taught to everyone eventually it goes down in value.

Right now you are reading what I typed. 35 years ago people would actually pay money for someone to type handwritten notes into text. Now there's people not even out of grade school that can type. I know it can be nearly apples and oranges but there should be ways of bringing down the price via competition.

Why not a priceline.com for costs? Why not a anglie's list for this?

Joined: 06 Jul 2003 Posts: 8380 Location: Central CA

Nobody has actually explained to me yet why health care has to be a for profit industry in the first place. Why not look at that aspect of it instead of always trying to find some way to help the rich get richer off of people suffering.

Only industrialized country in the world where profits and the amount of money you can afford determine the level of health care you receive... and where the ones who could afford it the absolute most get it for free anyway.

What's next? The water industry? The air industry?

Joined: 22 Dec 2007 Posts: 461

Well nearly anything that is considered a business is something that people will try to make money on.

Without asking anything personal I'm sure anyone here has dealt with the loss of a loved one. Even going beyond nursing home care funerals are expensive. It wasn't until a number of years ago that people even had competition on say coffins (as weird as that sounds there are some that do sell somewhat on the internet). All caskets do the same purpose but yet there's high amounts of prices. Digging a hole in the ground is something simple but when it's slapped onto a funeral it's a "grave digger" and thus costs quite a bit more.

Same goes with other things. If you order a large cake and then say it's for a wedding the price will skyrocket.

Heck that also reminds me somewhere in the house I have some really old glass bottles that were used for medicine or at least what they called medicine...probably snake oil stuff from the late 1800's.

I'm not sure if I mensioned it before but one theory I have as to why there's more national health care systems in Europe than elseware is that they've had more ethnic and civic stife than other areas. ww 1, ww 2, franco prussian...stuff going back hundreads of years. Whereas in north america the largest war was the civil war and after that what lingered was segragation.

Joined: 08 Jul 2003 Posts: 6309

' for profit ' - Nofs - what's next the water industry ?
uh-oh http://finance.yahoo.com/q/pr?s=SMWNX

When it comes to billing and costs for HEALTH CARE there is profit in a capitalist competition based system and there is also ' profiting ' off a rigged system where the health care INDUSTRY GOUGES the patient,insurance companies and government on a daily basis.

If these hospitals and health care systems or what ever the heck they call themselves want government subsidiares,insurance as in Medicare and Medicade or government kickbacks in the form of all local municipal ambulance being directed their way the health care industry should take what ever cost controls the government implements.

The cost of healt care has been at the point of negating any effects of the quality of life it is supposed to improve by throwing patients,governments and insurance companies into financial stress & bankruptcy. Many patients won't even be able to participate in life after just one illness.

AGAIN the whole thing comes down to COSTS and if that means non profit or government regulated care or an actual capitalist competition based system then do it. But I do not think throwing $$$ at the medical mafia for health care ' protection ' is the answer .

Joined: 26 Aug 2005 Posts: 1707

Joined: 22 Dec 2007 Posts: 461

well the trouble is that if it using massachusetts as a template then it hasn't gone down in price.

http://www.thebostonchannel.com/video/20010298/index.html

this is the only real independent tv show on a major network in the boston area

One thing the show is that it doesn't make sense to have medical staffing spread out. The time between say seeing a specialist can be long. Why shouldn't a few specialists share the same building as a general practicioner?

the 3rd portion talks about how there's more money in specialty care rather than a general practice. I can see something similar with police. There's more money to be made in being in a swat team than just a local policeman. In addition there is the community model vs the professional. Community means the police become someone of the community and walks the beat etc. Professional means they wait until there's significant problems and send out swat and cars everywhere..

there's a businessweek article that is on the mass state plan. Basically there's going to be a tweaking in terms of fees. currently there's reimbursing for every medical procedure and doctors visit. It will now be changed to a yearly fee so there's no incentive to overtreat the patient. There is also going to be a proposal for imilinating subsidies for 30K leal immigrants. In mass the increase in state spending on health insurance since the reforms is 42% however in Main that did something similar they had no const constraights and it rose 74% since 2005 and their uninsured rate is hardly above prereform levels.

I think that there will be some adjustments here or there as time goes on.

Joined: 08 Jul 2003 Posts: 6309

I keep on hearing the emergency room visits are driving costs because people are using them for primary care .

But is ' the use ' of the ER by uninsured patients a choice ? Why shouldn't a hospital have 24 hour walk in clinics ? Is it really the lack of general practitioners ? If patients do go to the ER shouldn't a hospital have a g p doc available for NON emergency conditions and bill as such ? Are the hospitals the ones that have decided to make the ER THEIR entry point into the health system for basic care ?

And by the same token an emergency like an accident where the police and fire make the decision for you why should you get stuck with an excessive bill from basically a rigged or no choice/competition decision making process ?

Would the alternative of more clinic type settings help offset and reduce ER costs . As much as many hospitals complain those ER visits work in their favor many a time . I think many hospitals have decided to use an ER for triage .

Joined: 06 Jul 2003 Posts: 8380 Location: Central CA

Sorry Mags... I disagree with you a little on it all coming down to COST. While this is a large factor in the manipulation of the figures to favor one side or the other, the bottom line is, and always will be, the obscene profits for the health care "industry".

As for our weasely assed politicians, the one bit of total hypocrisy always left out of these discussions: If our beloved political leaders are so fricking lily white and have ONLY the best interests of the unwashed masses at heart... Why do we not hear a fricking thing about them giving up their OWN public option... which is probably more like yours than it is my own?

Every goddamned one of them has the very health care system, bought and paid for by the very fricking taxpayers they claim that they're "protecting" from themselves... the very public option they are ranting and raving in order to deny the rest of the citizenry because it "costs too much".

Fricking elite, entitlement ridden narrow minded self centered little bastards and their fricking "let 'em eat cake" attitudes is what will keep the real facts in this segment of the general obstructionism being carried out by the corporate lackeys in our congress from ever being known or understood fully by commoners like you and me.

My own public option... Medicare... which is about the best the masses could really hope for... costs me $87 a month out of my tiny little Social Security stipend but even so, I'm far better off than the majority of working class Americans are today.

No, with all due respect, I don't believe it comes down absolutely to COST. I believe it comes down absolutely to PROFIT and that the desire to maximize profit by maximizing cost while minimizing service is the real culprit here.

You're totally right in that the cost has to be brought under control but a lot of that need for cost control wouldn't be a factor if it weren't for the generalized greed of the people involved in providing health care, from the insurance companies to the drug companies and sadly in many cases, to the medical profession itself.

I still remember the humiliation I felt when, on my first visit after my retirement, the doctor I had gone to for 25 years had some clerk tell me he could no longer see me as a patient because the medical group he belonged to... a corporation... did not accept MediCare patients because MediCare had rate caps and there was no money in it... and that was 20 years ago. It's worse now.

Joined: 22 Dec 2007 Posts: 461

I remember showing a dental insurance card to a dentists office and they acted as if it was a library card or to further belittle it implied that it's only a discount card!

Also to note about those 30K legal immigrants that are having their care taken away that's actually because it's part of a system with the federal government. The feds didn't raise the cap for the number that could be covered. Basically when the state gave coverage it was getting money from the federal government to pay for it. It would cost the state money to cover it that it would not get paid back to cover those 30K.

Joined: 26 Aug 2005 Posts: 1707

Joined: 08 Jul 2003 Posts: 6309

Mags - always follow the money

Following the money here by comparing some hospital systems or health care providers and medical insurance companies

http://finance.yahoo.com/q/co?s=lpnt -for a hospital system/health care providers

Average net margin = 8.33%

Average revenue = $2.75 BILLION to 11 BILLION

Net Income $110 Million to $275 Million

http://finance.yahoo.com/q/co?s=AET for health insurance co's.

Average net margin = 4.16%

Average revenue = $ 19 BILLION to $83 BILLION

Net Income = $400 Million to $3 BILLION

The Hospital Systems have higher net margins or make more money percentage wise but the Insurance Companies take in more $$$. I think there is more competition for health providers than insurance companies . And yet with that extra competition the providers seem to do better margin wise almost doubling the margins of the insurance companies.

These comparisons are just a slice of the market/competition. There are alot of private health care providers to account including doctors with private practice that bill insurance companies.

I still say a big part of the problem is the costs or bills the providers make to the patients/insurance companies-I think they see all those available dollars. That's why the insurance companies spend money people/job to question the bills/treatment and that's why the providers hire people to fill out the forms just right as to maximize reimbursements.

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