Completely true @lookingforward . But why should the stent patient have to pay for the ER if he has a planned surgery?
God forbid something goes awry while you are under anesthesia undergoing a procedure in that surgical center… An ambulance will whisk you away to the hospital, and you will be SOL.
Problem with transparent pricing is that it doesn’t help those with very restrictive networks. What good is it to me if some provider offers MRI for $1000 if my insurer will decline to cover it at all? I’m going to go to the in-network provider that charges my insurer $3000 and triggers a $1000 copay from me, because at least this way my $1000 payment gets applied to reduce the remainder of my OOP max.
“semi annual x rays of teeth”
No-one should be getting x-rays of teeth every 6 months without a specific reason. Away from the cost and waste, who needs the extra radiation exposure.
I do agree that more pricing transparency is needed regardless of the health care model.
If people weren’t paying $700 a month per individual with a 6,000 deductible, the savings could be used for routine healthcare.
You don’t use your car insurance for an oil change.
“If people weren’t paying $700 a month per individual with a 6,000 deductible, the savings could be used for routine healthcare.”
People currently on ACA with subsidies based on income aren’t paying that, however, and won’t be able to afford insurance with the tax credit being talked about.
The car analogy doesn’t work for me. Apples and oranges. Not relevant to this discussion.
“But why should the stent patient have to pay for the ER if he has a planned surgery?”
He wouldn’t, unless there were some emergency. Not everything is planned.
How many are aware of Healthcarebluebook.com? My area shows a fair price for a cardiac stent at 24k, incl surgeon and anesthesia-related. It shows an overnight is not included (not always required.) But other info is available for those costs. Of course, every procedure I reference in the past is a bit different, but ball park.
I checked knee MRI, as one example of a simpler procedure: $788. With this caveat: “Prices for MRI and CT scans have some of the greatest price variances in healthcare. The most important factor impacting the cost of your care will be which facility you use. Some imaging centers charge three to five times more than other centers. Hospitals are usually the most expensive, and “free-standing” (non-hospital) centers are usually less expensive.”
Plus, with my ins carrier, I can check individual facilities/the docs in those. Now, most of us don’t know the details, eg, with or without contrast, certain other medically necessary specs that can run up price. But I raise this because popping in a number like 3k creates fears that may or may not apply. Much more so, for the 120k stent procedure.
YMMV.
The costs of primary care particularly could come down also. Doctors would not have to hire extra clerks to handle the insurance claims if more people were just paying for routine care without involving insurance.
My ACA-compliant plan through BCBS cost me about $70/month and I had (I think) a 1k deductible that luckily I was healthy enough at the time to not hit.
At the time, I was a young invincible- exactly the people that need to be paying in… and exactly the people who will drop out since we can’t pay for it on top of student loans without subsidies (which go away for us under the most recent proposal).
I think the car analogy does work. We aren’t buying health warranties, we need to have some skin in the game. Thats part of the problem with people not paying attention to the cost of something. If I went car shopping and someone else is footing the bill, I for sure would be getting something with all of the options! As it is, I don’t have heated seats or remote start or even Sirius radio because I would have to pay for it! And then I pay to maintain it to the best of my ability and if I have an accident I have insurance to kick in.
p.s. you’re right, I am kind of a crank today
@lookingforward I haven’t heard of that but will be poking around on it tonight. Have you found it to be fairly accurate?
Many cannot afford 700/month. If you’re saying, that 8400 annual charge for premiums could be used toward actual med expenses, many still could not afford the care they need.
This really boils down, to me, to do we care about what others need or just our own wants? I’ve used the example before that my area doesn’t have hurricanes, wild fires, etc, that others do- and yet, the large pool of our taxes includes costs for these in other areas.
Threebeans, at a time when I was on an HSA, I found it reassuring in many cases- to know, eg, that something is generally priced at 1.5k, not 5k. Or that test D1 needed generally ran around $300. I did have a CT that turned out to be more than I expected, but I was not aware of all the procedure codes, going in. (One isn’t always aware.) There is always a caveat. You could go in for X and they see they need to biopsy, one or more spots, which would change the billing. But don’t forget, also, that our insurers can help control charges, via negotiated caps. I wouldn’t want to be without that support.
But as I said, I used HCBB along with my insurer’s tables.
Other types of insurance apply to discretionary goods. That’s the difference.
I choose to buy a car instead of relying on other means of transportation. I choose to buy a house, or start a business that requires certain insurance purchases, etc
I did not choose to be born. I did not choose the genes that affect my health. There is not much I can do to avoid many (even most) of the things that may happen to me that will require expensive healthcare. Having a body that will require health care is not a choice. It’s an inescapable fact.
You can’t say the same about any other type of insurance.
@“Cardinal Fang” Medicaid coverage would still be available if a person’s condition is considered a disability, so mental health services will be covered for my son.
As far as ACA insurance goes, I have to pay the full cost for my daughter’s therapist and psychiatrist, anyway, because we won’t reach her deductible. It won’t make a difference whether mental health is covered under the new program.
@prospect1 I agree to an extent. We also need food and shelter but no one argues we should try to pay our own way for those.
The bill released last week, as well as the latest amendment, allows states not to cover mental health in Medicaid, starting in January of 2020, I’m sorry to say. The essential benefits are eliminated for Medicaid.
The bill also removes the provision of Medicaid that allows it to be retroactively applied.
One title today said something like, “with changes, the new health bill could cover aromatherapy but not chemotherapy”. The point being that bare bone insurance can leave out something like cancer coverage but include whatever window dressing makes it sound good. No one wants to think they WILL get cancer.
Sigh… we need single payer but if not, then we need a public option. At least for those areas that only have one company offering individual coverage now.
We also need to mandate that coverage be across all of the US. Recently a drunk driver ran into people at a Mardi Gras parade. One victim who was seriously hurt is from NY and his insurance doesn’t cover anything out of state! He lives in the Bronx and could easily have been hurt in CT, NJ or even PA but nope, can’t be covered there.
I’m hoping that all of this flailing about leads to some clarity and consensus that points to healthcare being an essential part of life that does not stop at the border of a state, territory, bodily organ or condition.
The CBO has released the latest score on the amended health care bill. It’s pretty much the same as the last CBO score: 14 million people would lose health coverage next year, rising to 24 million in 2026. Average insurance premiums would go up substantially next year. The bill would save the government $327 billion over ten years.
The new score is the same: 14 million lose insurance next year, 24 million in 2026, premiums would go up next year. The only difference is the savings to the government. It is now lower, only $150 billion over ten years. (Note: this is the bill before the latest rumored changes of removing essential benefits. We don’t know how that would be scored.)
Some states/counties require caloric and nutritional info to be publicly available. Why is it so difficult to get pricing for medical care? It is unreasonable to me that it is so difficult to obtain for example the cost of my RX but I only can find out my share of the cost. Lab fees have huge amounts attached to them but generally insurer pays 80-90-100% of the contracted price. It’s hard to know what the cash price would be, so hard to intelligently compare.
When we were married in the 1980s, we had my insurance plan’s and H’s. Both plans HAD coverage for all the things that are now possibly going to be tossed as regular benefits without having to pay extra or buy a rider. When we had our two kids, we paid $10 for the dad tyvek coverall when S was born but dad forgot to put on. We brought it back and he used it when D was born 2 years later. For the two babies, our total out-of-pocket was $0.
To me, it benefits society if mom’s get good prenatal care and have the healthiest babies possible, which sure beats the alternatives. There is a lot that can happpen to affect the long term health of mom and baby if shortcuts are taken and if we as a society decide not to provide this as a benefit for all women.
@threebeans, I can choose to get my food from the dollar menu; I can choose to live in the cheapest part of town in an inexpensive state; I can budget and plan for my meals and housing. I have control over those things. Most of us do, at least to some extent.
I cannot choose what health issues will befall me; I cannot plan for them or predict them or budget for them. Getting cancer, or early Alzheimer’s, or Parkinson’s, or even getting hit by a bus is largely a crapshoot. A huge, expensive, bankruptcy-inducing, family-ruining crapshoot.
This is why healthcare is much more analogous to police protection. An expensive medical situation is more like being the random victim of a crime than it is like choosing a BMW vs public transportation.