The US Healthcare Mass Debate

[pErvinalia]

In 1080? God how old are you?

[Scot Dutchy]

[Tero]

Presumably birth control is out of pocket:

....suggested that she and her family would be a good fit for Medi-Share, a nonprofit insurance alternative based in Florida in which members share each other’s health care costs. There was a catch, though. The plan was run by a non-profit religious ministry.

Insurance experts also worry that consumers don’t realize there’s no guarantee that their medical bills will be covered, or that there’s no prohibition against discriminating against individuals because of pre-existing conditions, a bedrock protection of Obamacare. And when customers’ have complaints, there is no regulatory agency to appeal to as there is with traditional insurance that gets heavy oversight from states.

https://www.politico.com/magazine/story ... are-216933

Haha, needs REGULATION!

[Tero]

Lots of jobs created on the one hand 1) filing health claims and 2) denying healthcare claims. Yay America!

The education and health services industry led job growth in the U.S. economy over the month of January with a 38,000 gain, according to the Bureau of Labor Statistics. Health care and social assistance accounted for two-thirds of the addition, with continued growth in ambulatory services and hospital employment.

https://www.cnbc.com/2018/02/02/heres-t ... lainternal

[Rum]

Trump with his usual sensitivity and diplomacy..not to mention lies.

http://www.bbc.co.uk/news/uk-politics-42943768

President Trump: NHS 'going broke and not working'

US President Donald Trump has claimed the NHS is "going broke and not working" as he targeted rival Democrats pushing for a universal health system.

In his tweet he also said "thousands of people are marching" about it.

This was believed to be a reference to a Save the NHS march on Downing Street on Saturday demanding more funding for the health service.

UK Health Secretary Jeremy Hunt hit back on Twitter, saying he was "proud" of the UK's system.

President Trump's tweet came after ex-UKIP leader Nigel Farage appeared on Fox And Friends, one of the president's favourite shows, talking about the weekend march.

"Dems want to greatly raise taxes for really bad and non-personal medical care," Mr Trump tweeted.

In response, Mr Hunt said that while he "disagreed with claims made on that march", no-one wanted "to live in a system where 28 million people have no cover".

He added: "NHS may have challenges but I'm proud to be from the country that invented universal coverage - where all get care no matter the size of their bank balance."

Labour leader Jeremy Corbyn - the leader of the UK opposition - also hit back, saying: "People were marching because we love our NHS and hate what the Tories are doing to it."

He added: "Healthcare is a human right."

@realDonaldTrump
The Democrats are pushing for Universal HealthCare while thousands of people are marching in the UK because their U system is going broke and not working. Dems want to greatly raise taxes for really bad and non-personal medical care. No thanks!

12:11 PM - Feb 5, 2018
End of Twitter post by @realDonaldTrump
Skip Twitter post by @Jeremy_Hunt

Jeremy Hunt
✔
@Jeremy_Hunt
I may disagree with claims made on that march but not ONE of them wants to live in a system where 28m people have no cover. NHS may have challenges but I’m proud to be from the country that invented universal coverage - where all get care no matter the size of their bank balance https://twitter.com/realdonaldtrump/sta ... 4818450432 …

1:19 PM - Feb 5, 2018
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Jeremy Corbyn
✔
@jeremycorbyn
Wrong. People were marching because we love our NHS and hate what the Tories are doing to it. Healthcare is a human right. https://twitter.com/realdonaldtrump/sta ... 4818450432 …

1:44 PM - Feb 5, 2018
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NHS funding has been hotly debated in the UK as hospitals struggle to cope with the pressure on resources.

A panel set up by the Liberal Democrats - the fourth largest party in the Commons - has called for a ring-fenced tax to fund the service, saying an extra £4bn was needed for next year and an additional £2.5bn for both 2019 and 2020.

Lib Dem leader Sir Vince Cable urged the US president to read the study, "to find out how to fund a universal healthcare system".

The government says NHS funding "is at a record high".

Mr Farage said the NHS was "at breaking point due to a population crisis", adding: "We haven't got enough hospitals, doctors or facilities to cope."

The British television presenter Piers Morgan, who calls President Trump a friend and who interviewed him last week, did not agree with the tweet:

Skip Twitter post by @piersmorgan

Piers Morgan
✔
@piersmorgan
Wrong, Mr President.
Our NHS is a wonderful, albeit imperfect, health system - and the envy of the world.
By comparison, the US healthcare system is a sick joke & the envy of no-one. https://twitter.com/realDonaldTrump/sta ... 4818450432 …

2:04 PM - Feb 5, 2018
704 704 Replies 1,109 1,109 Retweets 4,471 4,471 likes

[Feck]

I told y'all and they STILL voted for the golfist bastard .

[Scot Dutchy]

Trump does not understand (whenever does he) the NHS is not working because it is out of date and underfunded on purpose.

[Tero]

That's the standard right wing process
1 cut funding to x
2 scream that x, started by Democrats, is not working because Government is running it!
3 cut rest of funding to x, because "it failed"

[Tero]

They are at it again:
Fox

The Trump administration moved Tuesday to allow health insurers to sell lower-cost, less-comprehensive medical plans as an alternative to those required under ObamaCare – in a plan that drew swift protest from congressional Democrats.

The proposed regulations would allow insurers to sell individual consumers "short-term" policies that can last up to 12 months, have fewer benefits, and come with lower premiums.

The plans also would come with a disclaimer that they don't meet the Affordable Care Act's consumer protection requirements, such as guaranteed coverage. Insurers could also charge consumers more if an individual's medical history discloses health problems, or more likely, deny them coverage.

Insurance for healthy people ONLY.

Same
https://www.npr.org/sections/health-sho ... r-benefits

[Tero]

Just for 42. Stefan is some kind of Canadian Trumpist. The doctor claims to run a hospital without an administrator. He must have an accountant and a lawyer, though.
https://youtu.be/m4Y8vGuBkrk

Oklahoma center
https://surgerycenterok.com/

If the procedure you believe you require is not listed on this website, feel free to call our contact number to inquire about availability and pricing. The prices listed are not negotiable and are available only to those who pay the entire amount in advance. We are able to offer these prices due to the lack of expense in processing the claims and the absence of risk for non-payment. Alternative payment arrangements can be made with human resource departments or divisions of self-insured entities if necessary. Once again, if you are scheduled for surgery at our facility and insurance is to be filed by us, these prices listed on our website do not apply to you.

One of a handful of hospitals running outside the cartel. If they have to file a claim, the price is higher. if you go in and pay cash, that is the listed price.

[Tero]

Of course, they can only take care of elective or non emergency surgeries. Many cancers cannot be cured in a week long visit to Oklahoma.

[Tero]

”The government” could ruin this guy’s business. He gets maybe half his income from regular insurance, half with the cash only patients. Even though he hates insurance.

You could go in there and pay cash and get some paperwork for your procedures. You’ve paid for it. Then Medicare could decide to pay you back, as long as it is below the going rate.

He would be forced to raise his rates as they would be his only income. No room for lucrative insured patients.

[Tero]

Wisconsin governor bails out on the holiest of the Republican missions:
https://www.politico.com/story/2018/02/ ... sin-358043
He is SO banned from the Republican governors club! Helping the sick and poor!

[Tero]

By tampering with ACA, Republicans have reduced pool of insured while still costing the gov’t more:
Because government premium subsidies rise in tandem with premium increases, the cost of subsidies borne by the government will rise by $33.3 billion next year, or 9.3% — to $391.4 billion from $358.1 billion under existing law.
The mechanism by which the GOP policies will crater the individual insurance market isn't hard to understand. Both major initiatives — eliminating the individual mandate and offering bare-bones policies — siphon younger, healthier consumers out of the individual market.
LA Times

[Tero]

Tips on using ER

Bill # 1 - From the hospital. This usually includes an emergency department charge which varies based on the complexity of your visit. These range from level 1 (perhaps a suture removal) to a level 2 (a wound check on sutures done the day before or an abscessed that was incised and drained 2 days ago) to a level 3 (a cold or back injury for which no medications were administered in the ED and no tests were done) to a level 4 (perhaps a UTI that was given IV antibiotics in the ED) to a level 5 (a work-up for chest pain, belly pain, shortness of breath, or altered mental status.) If you are really ill, there is an additional "critical care" charge. There are additional charges for procedures such as CPR, intubation, or suturing. This charge does not include the services of the doctor, but does include the IV tubing, placing the IV, drawing blood, nursing observations, respiratory therapists, monitors, housekeeping, linens, electricity, heating, crackers and juice, warm blankets, etc etc etc.

The typical amount for a level 4-5 visit that is freely negotiated between the hospital and a good insurance company is probably something around $2K.

The hospital bill also usually includes a charge for any x-rays, CT scans, ultrasounds, or MRIs, a charge for any labs done, and a charge for any medications given. This could easily be another $1-3K, more for an extensive evaluation like multiple CT scans. This does not include the services of a radiologist or pathologist if required.

Emergency care is expensive to provide. There are a great deal of compliance and legal issues, highly trained staff, expensive equipment, consultants, and 24/7/365 availability of all that.

Bill # 2 - From the emergency physician. First there is an emergency visit charge using the same level 1-5 + critical care levels. This includes the doctor's history and physical, counseling, recommendations, prescriptions, work notes, charting, calling consultants, transferring you to other hospitals, talking to your primary doctor, reviewing old records calling an admitting physician etc. About 25% of the work I do for a given patient is visible to the patient so sometimes it feels like "all they did for me was give me a prescription for ibuprofen." If there was a billable procedure done (sutures, intubation, cardioversion, fracture reduction, abscess I&D, CPR, etc) there is an additional charge. Sometimes, the procedure charge is more than the visit charge. A typical level 5 physician bill might be $200-300 after insurance company negotiation. It's $175-200 for Medicare. Procedures are highly variable. Putting a breathing tube in to save your life is $146 when Medicare is paying. A little laceration on your scalp might be $100 when Medicare is paying.

Bill # 3 - From the radiologist. The hospital charges for the tech and machine. The radiologist charges for her expertise reading it. A typical fee to read a single CT might be $250 (Medicare) and up to twice that with a private insurance company.

Bill # 4 - If you were seen by another physician in the ED (a consultant) they will also send you a bill for their consultation and possibly any procedures they do.

As you can see, it doesn't take much to get the bill for a single ED visit into the $5K range for something where there wasn't even anything serious going on. Just like a single hospital admission, surgery, or delivery will hit the max out of pocket for the year on many insurance plans, so will a single emergency department visit. It's just really expensive stuff.

Fifth, nobody you interact with at the hospital at the time of your visit has any idea how much anything costs. Part of that is the whole price transparency thing. Those who know the price don't want the front line workers to know it.

https://www.bogleheads.org/forum/viewto ... b#p3730622