Problem with health care costs in US

[nprcowboy 533]

So anyone who is insured look at what's billed to insurance for surgery? I know US self pay for everything can be between 15k and 30k or so. Mexico is under 10k. Since I'm insured I saw what my insurance was billed and will pay for my surgery....... $97,000. Ridiculous, no wonder insurance costs are thru the roof. This needs to be regulated

[nprcowboy 533]

Same surgeon same hospital and self pay was around 30k but use insurance and they bill 97k,nuts

[Jason In Houston 93]

From what I've seen on labs, office visits, and an EGD, the billed rates are sky high, but the contractually negotiated rates are only about 1 / 10th that amount.

[Elode 8,093]

My bill was 39,000+ that's what the hospital billed my insurance but the insurance company Has a set price they will pay the hospital, the hospital won't get 39,000 they get what they have agreed upon. I paid 600 for everything so whatever! Ha!

[SeahawksFan 444]

I self paid for my lap sleeve but my hernia repair was billed to my insurance for $80K. I thought that was pretty crazy since they were already in there but you are all right they only pay a certain amount of that at a negotiated rate. Everything I pay for I use my health savings account so it's almost like getting a 30% discount. At least that's what I tell myself

~LA

[Jersrose43 837]

So anyone who is insured look at what's billed to insurance for surgery? I know US self pay for everything can be between 15k and 30k or so. Mexico is under 10k. Since I'm insured I saw what my insurance was billed and will pay for my surgery....... $97,000. Ridiculous, no wonder insurance costs are thru the roof. This needs to be regulated

Amen. I always say obamacare didn't go far enough!!!

[Dr-Patient 831]

Don't blame the physicians. The hospitals and insurance companies are so in cahoots with each other!

Insurance companies will pay hospitals crazy fees, but if your surgeon has his own place, his own surgery center, etc, the insurance companies will give them hell to even pay $10K for the facility.

I LOVE the noble, pure calling of physicians to practice medicine; there is nothing better than for a patient to entrust their very person to you, and you care for them and make your fellow man better/healthier than when they first presented. My God. But for the past 20years, the profession has been violated and invaded by big business.

I'm an "old school, Marcus Welby-type " doc (female, though), so I'm terribly pained by all of what has happened to my very noble profession. On behalf of many, I say... sorry.

Edited January 15, 2015 by Dr-Patient

[CountryGirl5584 115]

I work at a gastroenterologists office where we perform EGD's and colonoscopies. The amount of money we bill out is no where near what we get paid. Unfortunately insurance plans are getting worse instead of better and the people that are suffering are the physicians and the patients. Insurances are covering less and less and most of the financial burden falls on the patient. It's actually quite disgusting. My office for example can't accept some of the Obamacare plans because we didn't participate in certain plans for a certain amount of time. Obamacare doesn't help the average Joe. It's horrible.

[nprcowboy 533]

Obama are also caused my company offered plans to double over last 2 years

[nprcowboy 533]

Obamacare

[Jersrose43 837]

That didn't cause the rates to double. The reason if you are an employer of 100 or more they look at all the claims and recalculate actual costs

The company also could have decided that in past they were covering 100% of all premium costs and now will only cover 70% of them.

They blame obamacare because it's a usefully timed reason

[imsoglad56 402]

That didn't cause the rates to double. The reason if you are an employer of 100 or more they look at all the claims and recalculate actual costs

The company also could have decided that in past they were covering 100% of all premium costs and now will only cover 70% of them.

They blame obamacare because it's a usefully timed reason

Or maybe because, you know, it caused it.

[Jersrose43 837]

Or maybe because, you know, it caused it.

Nope. Obamacare requires certain added basic coverages for all insurances. But beyond that it does not affect an employer sponsored health coverage.

When you have more than 100 employees you have self funding for employer groups and that means that premiums are based on what your employees are actually having done and insurance paying for.

Has nothing to do with obamacare

The insurance can't charge you more based on all their customers having more surgeries, more heart attacks, more cancer. It will be dependant on your employers specific experience.

So if last year they spent 10m and this year 100 people got cancer, 50 had heart attacks and 50 had weight loss surgery, then next year they're going to figure out that you will spend 50million and calculate the cost of premiums from there.

[nprcowboy 533]

Either way Obamacare stinks and caused, because even if employers use as excuse it still impacts us because they now have an excuse to raise rates or cover less

[Jersrose43 837]

Either way Obamacare stinks and caused, because even if employers use as excuse it still impacts us because they now have an excuse to raise rates or cover less

Obamacare needs to go further. It needs to put some controls on charges.

Hubby went to ER a couple months ago torn calf. Misdiagnosed. Xray taken. Charge for the lovely 4 hours we spent here - $1350 including X-ray. Next day MRI shows calf tear. Not a sprain

I went to the ER exactly one week later for a tendon tear. Different hospital as I didn't want wrong fish. Well Misdiagnosed!! Was told plantar fasciitis.

No X-rays or tests. Sent home either an rx. Hospital charge $2000 plus

Total time 1 hour in/out

Thank god my insurance paid $500 and $750 respectively. But still. Had it been January I'd have had to pay that thanks to a ridiculous &4500 deductible.

Obamacare needs to set straightforward rate controls.

Hubby had more services (the xray) but got charged less!

Arg!