Robert wrote:Judas Maccabeus wrote:I am glad that God protected you, but not all of us are that blessed. Many of us are one major illness away from financial ruin, and for many of us, bankruptcy is not an option. Josh is right, the room to negotiate a lower price on bills is likely long past. You are just so constrained as to how much you charge, you really can't just negotiate wily nilly. My advice is to find a not-for-profit and try to see what financial counseling can do for you, before you have a bill you can't pay.
My son-in-law was electrocuted trimming trees 2 years ago. My daughter negotiated one million down to $100,000. Then she got financial assistance for that 100,000 and was able to get Medicaid and disability.
Not long gone to me. I helped talk her through it from our experiences. The hospitals and doctors do not WANT to write that stuff off, but it can be done. if they made it easy, everyone would do it. It has to be hard, but for my daughter's efforts of months working on this, the saved over $900,000.
This is why I strongly suggested that you chose a not-for profit, and get to financial counseling ASAP. Not-for-profits have an obligation to preform charity care in exchange for their not-for profit status. They did not change the rate they charged, they used the 900,000 to offset this obligation, which, BTW has to be reported to the IRS, to make sure they are actually doing it.
Robert wrote: speak from experience. Long gone and recent. We have and an x-ray at a hospital and was charged $300. We know. We paid the bill.
Off site MRI centers were in our area in Indiana. They were doing MRI for $300-$500. Maybe I am remembering the low end wrong. But I know they were advertising $500 MRI. To me, that is close to the same price.
Depends on what KIND of an X-Ray and what KIND of an MRI. You can bet that they are listing the price of the least expensive one in their charge master. I am sure many if not most are more expensive. For comparison, the least costly Nuclear Medicine test I do costs about 46$. The most expensive, and most frequent one I do now is an FDG PET/CT whole body, which has a price of $3446. I could advertise that you could get a test for 46$, and it would be the truth.......unless you really needed a PET/CT.
Robert wrote:When in the hospital, they will dispense your prescriptions from their pharmacy and charge about 10x the amount you can buy them at the pharmacy. You can take your own to keep the price down, but they make it very hard to do that so they can charge more. Again, it takes effort, but you can keep the cost down.
I could not conceive of the chaos and unnecessary deaths that would occur if you let patients administer their meds brought from home. There is a valid reason for this. Everyone up an down the line needs to know what was taken and when. If this is not the case, I would not want to be responsible for the adverse reactions and drug interactions that would occur. A really bad deal all around. A hospital would be crazy to allow this on a routine basis
Robert wrote:I do not begrudge the hospitals for charging the rates they do. I am saying we can do things to keep a lot of that cost down. NEVER get a test or lab work done at a hospital unless there is no other option.
Likely a good idea, unless the test is a high complexity test, or there is a chance you may have a reaction from the Iodinated contrast agent. Than you are better off in the hospital.
Robert wrote:The HSA program is geared to start getting consumers to start shopping around. If you are spending your own money, it is worth the time and effort. If you are spending the insurance money, you don't really care how much it costs. Just like those who call for government to pay, it is easier to spend someone else's money then spend your own.
You did not need that knee replacement, did you?
Judas Maccabeus wrote:There is little competition, because very few people are willing to go through 4 years of college, than 4 years of med school, than a 3-4 year residency, than go through 2-3 more years of fellowship training BEFORE THEY MAKE A SINGLE DIME OVER THEIR MINIMAL LIVING EXPENSES.
Robert wrote:I have no issue with GP and other doctors making good salaries. What I remember was a GP had one nurse and MAYBE one bookkeeper. They would care for all their patients. Today, you go into a doctor's office and they have 4 bookkeepers, several nurses, and one doctor. This means it is taking a lot more money to do all the bookkeeping that the government requires then it used to. Want to bring down medical costs? Reduce(improve) regulations and reporting, and you will take a big chunk out of the cost.
Most of that administrative overhead is caused by the fact that you have literally dozens of different insurance companies with hundreds of different policies, all with varying rules, and all with different requirements and forms.
The way to get rid of this overhead is either a single payor system, where you have only one insurance to deal with, or a universal multi-payor system, with an all payor model (like most of Europe, except the UK). Germany, in particular uses this system, with much success.