This decision is going to make it tough for this company to survive due to the black eye they just gave themselves. If this were a property and casualty carrier, this would generate a lot of regulatory scrutiny for red-lining.
Stush – I disagree. They have 47 million subscribers in the private market and must be doing well. Otherwise, they would be getting out of there, too. They are simply the first company to realize that they are being adversely selected against.
With regards to the red-lining comment, they are not red-lining by pulling out of an entire market. There are many P&C carriers that do not write in certain states or write certain lines of coverage because of the poor expected losses. I think Obamacare is a “take all comers” program and there is no underwriting taking place. If so, this means the healthy 45 year old pays the same rate as the chronically ill 45 year old.
Stush- UnitedHealth’s exit from most of the exchanges is the result of a $475M loss in 2015 and projected loss of $525 this year for a total of $1B loss over two years. There is no -red-lining issue with the ACA. 25% of the enrollees are signing up when they are already sick plus the costs of all enrollees is 22% greater compared to those with employment based insurance. United Health has been asking for changes to the law for sometime which have been dismissed by the bureaucrats.
I wasn’t aware of a free healthcare program. I’ve heard Senator Sanders speak about single-payer. Which, of course just means the government pays and we pay into the gov’t via taxes. We are the only first world country who can’t figure out this whole healthcare thing. Partly due to the fact there are some out there who don’t even want to help others. But yet, claim to be Christians. To those, oxy moron much?
Captain…. just a personal comment…. I had a hard time getting into my foot/ankle doctor recently. When I finally got an appointment the waiting room was filled with Canadians who get work done in the United States that they can’t get in Canada (bunions and corrective ankle surgery) without a 5 year wait. Then I took my father to his orthopedic surgeon to follow-up on a knee replacement that he had done last year and again – waiting room filled with Canadians that can’t get knee replacement nor hip replacement surgery without about a 5 year wait. This is the national health plan we want to follow??? I agree we need changes here, but the future does not look bright.
Hmmmmm… Some people ignore the street level research (Asking Joe average) and just blindly follow what ever the govt puts out there.
People from all over the world – not just Canada – come to the US for medical treatment because it is the best in the world. From what I am told by actual people, its a real problem to get timely medical treatment in Canada. medical People are paid 09 – 05 and have no incentive to go above and beyond because their govt says so.
I know my folks were Canadian as they brought a grey market with them. That was a pain the a#$ getting insured. Every year same thing – NO SUCH VECH from Underwriting. Me: “Yes there is. I seen it. I took pictures of it and sent them to you.”
Underwriting “Oh, ok”.
April 20, 2016 at 11:41 pm
Captain Planet says:
Like or Dislike:
3
8
Hmmmmmmm,
Yes, I think we will find horror stories from any country. I have close friends whose parents chose to become citizens because their kids wanted to go to college in the US. They wanted to be close to them. Their #1 complaint? The US healthcare process. They didn’t have an issue with the waiting issues your Canadians did. By the way, how did you know they were Canadian? Did you ask to see some ID or something?
Hmmmmm,
I decided to call Ed and Carol, the Canadians I am speaking about, and they said there is no such thing as a mandatory 5 year wait for surgery. In their words, “sounds like someone is using scare tactics to belittle our healthcare system in Canada. Simply not true.”
I just reread his post. He dont say anything about a mandatory 5 year wait. He simply stated that the wait is 5 years.
April 22, 2016 at 12:54 pm
Captain Planet says:
Like or Dislike:
0
7
FFA,
You are right, Ed and Carol used “mandatory”. I called them here during lunch and they confirmed, they’ve never waited anywhere close to even a year for health services, surgeries included. Said they’d love to know who is waiting that long and where. Called it balderdash.
April 20, 2016 at 3:30 pm
integrity matters says:
Well-loved. Like or Dislike:
22
2
Earth to Planet – free healthcare is not free. Everyone still pays for it. Just like free college is not free. Guess what..??…eventually the money runs out (See Greece).
By the way, there are more ways to help people than to be forced to pay for their healthcare. The Christians I know are far more generous in helping people around the entire world than the non-Christians I know.
Careful with the moron accusations. You might end up looking like one.
Earth to Integrity Matters, please actually read my post:
“I wasn’t aware of a free healthcare program. I’ve heard Senator Sanders speak about single-payer. Which, of course just means the government pays and we pay into the gov’t via taxes.”
Careful with the moron accusations of looking like one. You just mind end up looking like one.
The Greece problem is an entitlement issue, not a currency issue. Greece is in jeopardy of losing the ability to use the Euro as their currency because of their fiscal problems…due to all the “free” stuff and pensions they have to pay.
April 25, 2016 at 11:00 am
UW says:
Like or Dislike:
3
2
Integrity, Planet is right, Greece’s problems are greatly exacerbated by their currency situation. It’s not surprising one of the few posts here showing an actual understanding of economics is down voted to oblivion.
Greece has debt problems and huge tax evasion problems, but there situation is in no way comparable to the US because we have control of our currency and they don’t. If they had control of their currency in the worst case they could create money to pay their debt, deal with the one-time inflation and slowly pull back their money supply as they fixed other problems, or just leave it weaker, which has benefits. That is easy to do and what the US can do.
Instead they are on the Euro and cannot control the supply of money. They have to pay in what is essentially foreign denominated currency so as their economy crashes the real terms of their debt imcreases. Usually they would decline and the value of their money would decline through inflation, meaning their debt was paid off in less money in real terms, but fully in nominal terms, but it would be gone and they wouldn’t have to suffer through 20+ years of garbage policies imposed on them. As it was they declined and had to pay off with a currency based on the strength of the economies in Germany, the UK, etc., where it would make little sense for them to agree to deflating the currency to help with Greece’s debt. It’s one of the big problems with a currency union.
Also, your statement “the money runs out” is simply wrong. We control our money supply and it is literally infinite. It can decrease in value, but cannot run out. The US is not a state, nor a household, treating the nation’s monetary system as if it were one is wrong. There is no indication the US is anywhere near danger levels with our debt based on the markets, interest rates, and demand for our debt.
The countries in Europe that saw problems and needed bailed out tended to spend less on entitlements than their northern European neighbors. Their problem was a huge influx in capital during the boom which poured out when the bust came, but everything stayed at precrash levels – eg wages. Investors know/fear Greece will have problems paying debt so they essentially crash the bond market in a bank run and it becomes a self-fulfilling prophecy. If their debt was sovereign denominated they could at worst print money to pay their outstanding bonds and there would be little chance of what is basically a bank run. That’s what the US can do and Greece cannot do. Also, non-EU members with higher spending on entitlements did not face the huge crash, largely because they control their own currency.
April 20, 2016 at 1:26 pm
FFA says:
Well-loved. Like or Dislike:
17
0
The way the article reads it going to be easier for them to survive. They are losing a losing proposition. Fully expect BCBS & Aetna and the rest to do the same. All that will be left is OBamas start ups which over half have failed and the one in IL is about to.
Smart move making this statement. Now, their off exchange policies will remain the lowest price seeing they are getting off the sinking ship.
FFA, what we feared most about this signature legislation is coming to fruition. Companies pulling out, fewer choices for healthcare and poor care in many places. I don’t know about your area, but we have a lot of docs in the box places now, many who don’t even accept insurance and people are just paying cash to them for less than emergency care. They are hiring a lot of foreign doctors who will work for less while the American doctors keep closing practices or selling out to large practices. The worst example I have seen on companies losing their shirt is Blue Cross in North Carolina. The chronically sick filed $700+ million in claims and Blue Cross collected $70 million in premiums counting the subsidies. The whole premise of “Affordability” was one of the biggest lies told. You just can’t throw those chronically sick in the pool of the healthy at the same rate and come out. What a joke.
This is the classic example of adverse selection, higher risk filing most claims and lower risk subsidizing or dumping the policy due to increases in premiums. This is a bad for insurer if only have high risk left and eventually the insurer could go bankrupt over it. I see why the insurer is pulling out.
“The Patient Protection and Affordable Care Act, President Barack Obama’s signature domestic policy achievement”…
This statement sums up what a failure Obama has been. If this is his “signature domestic policy achievement”, it’s no wonder we have serious problems in this country.
May God help us if Hilliary or Bernie get elected.
integrity, I am sure you remember the Progressive Left on this blog trying to justify this idiotic legislation for the past 6 years. Not one Conservative idea was accepted, they put in all the mandates, loaded up the law with numerous taxes to penalize people for not buying it, got 6 million policies cancelled (on purpose) after the President said, if you like your policy, you can keep it, if you like your doctor, you can keep him and the granddaddy of them all, the average family will save up to $2,500 per year on premiums. This law along with Climate Change being our biggest threat to national security is the legacy of Obama. Sure glad he is a short timer.
Agent – Yes, I remember all of the bold face lies Obama and the rest of the democrats told. I even remember the bribes it took, with the democrats that were opposed to it initially, to get them to vote for it.
Even with that, Hilliary is still doubling down on this atrocious legislation.
County Line, there are some on this blog who actually voted for him twice. The big mess created in the first term wasn’t enough, so they did it again. How misguided is that?
and there are some on this blog who actually think a two-term president is considered a “short timer” even though that’s the longest any president is able to stay in that position.
April 22, 2016 at 12:30 pm
Connie says:
Like or Dislike:
3
0
To Confused – I’m pretty sure when people here refer to Obama as a “short timer,” they’re not talking about the number of terms he can serve, but the fact that he has only a few months left in office.
But wait, I thought Beck, Hannity, and the pill popper all said he wanted to be king and wasn’t going to leave The White House. What happened to President Obama turning into a dictator? I am sorely going to miss listening to the likes of those guys and Savage ranting about our President once his second term is complete. It’s seriously a laugh riot, all the conspiracies. President Obama better hurry up, he doesn’t have much time to grab all the guns and start his re-education at the vacant Walmarts in Texas. Tick-tock, tick-tock…
Connie, good for you. Short timer is an old military term for people about to get out of the service when their hitch is up. When it gets down to months, the person is referred to as a short timer. This is a foreign concept to left leaning trolls.
UHC leaving the exchanges comes as no surprise. After all, it makes no sense for any business model to stay the course in spite of the growing ocean of red ink.
The keyword here is business. Those who champion Obamacare argue that medical care should have nothing to do with a business model. It seems in their eyes, business and the pursuit of profit is inherently evil and should never enter the health care equation.
But the ACA champions choose to ignore the main reason our medical technology and care is the envy of the world: Successful Business Models. Obamacare ignores this, and in fact seems aimed at running business models completely out of the picture.
Then to serve all, none will be served well. We will be forced into The Left’s great pipe dream; the proverbial Single Payer System. At that point will all have what the Canadians are desperate to escape.
By forcing the ACA down our throats, The Left threw the 90% of us under the bus to gain the everlasting vote of the supposedly un-served 10%.
I’ve said from the very beginning that Obama and the left’s real agenda is to tear down the free market approach to healthcare so they can misappropriate the Billions of dollars that are within that system.
If the Social Security system that was originally put in place and funded by the baby boomers had been left alone and not stolen for other government purposes, there would be plenty of money to help the 10% of society that cannot afford healthcare.
Good one integrity. This is just a wealth re-distribution system along Karl Marx’s ideas. We have a Socialist/Marxist for a President. By the way, the chronically ill should never have been allowed to be lumped in with the healthy on rate making. We had Pools for them and if the government wanted to subsidize them, fine. Don’t ruin healthcare for everyone else to cater to them. What we may end up with is a form of Medicaid which is also bad and low paid foreign doctors treating people like cattle.
Yogi, on top of that, Al Gore cast the deciding vote in the Senate to tax Social Security benefits that working folks paid into all their working lives on taxable income. The Progressives have never seen a tax they didn’t like and just love their tax revenue stream so they can spend it unwisely on their give a ways.
and the state of Texas loves getting free money from the federal government to make it seem like they’re not operating with a deficit. think texas would be happy if the fed didn’t give them that revenue stream?
April 21, 2016 at 5:55 pm
Yogi Polar Berra says:
Like or Dislike:
6
1
@confused; you seem to be confusing ‘taxes’ with ‘Texas’. But let me humor you momentarily before I return to the topic…. Texas is NOT the only state that receives money from the Federal Govt. But, I suspect state governments would quickly learn to operate their state and balance their budgets if NO such federal aid were given. The latter is the system I prefer, as it is the most efficient, economically speaking. I can’t spend more than the max on my credit card before my spending is curtailed because I don’t have the Feds bailing me out. Think what would happen if subsidies and aid were available to all in our nation…. we’d be more like Europe, e.g. Greece, or like Venezuela, or, well, I think you get the picture…
Without Federal aid for anything but absolutely necessary projects such as cross country roads that run through them, I think ALL states would eventually learn to spend wisely, balance their budgets, and would be happy in the long run, Texas included.
April 22, 2016 at 8:06 am
confused says:
Like or Dislike:
4
3
I’m with you Yogi. Most states take Federal Gov’t money. I was just pointing out Agent’s hypocrisy: he claims Texas always has a balanced budget and other states should be able to do the same easily, then rails against the gov’t giving out money. Just trying to show he dislikes the gov’t taking money to send anywhere else for any reason, except if it’s going to his state so they don’t operate with a deficit.
April 20, 2016 at 4:57 pm
FFA says:
Like or Dislike:
6
2
Agent, no one is even talking this up any more. even Libby (before her departure) realized what a failure this is. They all beat the drum for a Canadian style health care. Problem with that is when we want the best health care in the world, we will have no where to go.
Now that agents that took part have been betrayed because of the massive losses posted, people are now stuck with the 800 pin heads in some foreign country getting advice on their policies.
FFA, you are right, but I am waiting on the now infamous Ron to chime in and say we should just accept his Single Payer system because only government can solve this problem. With what we have seen about government bureaucracy in action, we would have a national VA system and I am sure you have seen the horror stories on them.
In the sales field the oldest strategy is to disturb the buyer into seeing the problem, and then selling them the solution.
With the un-ACA, Big Guv set the stage to drive out private insurers and affordable premiums. They did so knowing they would become the resource the masses to turn to fix the problem. Talk about Slick Sales Practices–this is the grand-daddy of them all!
Ron advocates us sending our premium money to the govt and have them pay the carriers. Sounds like another middle man that serves the purpose of jacking up costs.
The hospitals are already doing enough damage setting exorbitant prices based on which way the wind is blowing. I could get an ACL replacement from Hospital One at $5,000 or at Hospital Two, 5 miles down the road, for $15,000. They’ll both accept my insurance paying $2,500 but if I don’t have insurance, they won’t negotiate with me. Maybe — THAT’S A BIG MAYBE — the gov’t will be able to set a national price for services that fluctuates solely by the area’s cost of living (e.g. NYC surgery would be more expensive than the same in a small one-doctor office in Nebraska.)
Are the prices set by hospitals exorbitant because they are price gouging for profit, or just trying to cover their costs and stay solvent? Inquiring minds want to know.
I’m not a health insurance pro, but recall med malpractice insurance premiums are costs that must be covered by hospitals, doctors, and other practitioners. Does anyone know where med mal premiums are cheap? Anyone? Bueller? Anyone? Finally, does anyone recall why bedpan mutuals were set up in the late 1970s?
April 21, 2016 at 6:15 pm
Agent says:
Like or Dislike:
4
1
Yogi, Texas did do Med Mal Tort Reform some time ago and the result is the rates have come down for doctors, hospitals. Operations have to be a lot cheaper here than in the liberal N/E who don’t know what Tort Reform is. Doctors have been flocking here for a while now although I don’t like seeing all the foreign doctors now being hired. Most don’t speak good English and they are replacing American doctors who were fed up and closing their practice.
April 22, 2016 at 9:37 am
Yogi Polar Berra says:
Like or Dislike:
1
1
Tort laws and litigiousness variances explain some regional cost variance. But how much? What else is driving costs that can be reduced, somehow, instead of subsidizing it to higher levels? Scripts? Physical therapy? Diagnostics/ tests used only for law suit avoidance? Other stuff? Anyone? Bueller?
Only $5k for an ACL replacement? Where? Sign me up for 2; on my back paws!
April 22, 2016 at 10:11 am
Rosenblatt says:
Like or Dislike:
3
0
Yogi – my numbers for ACL surgery were for example only; I did not mean to imply those are the actual costs. There have been a couple of studies recently that showed hospitals charge whatever they feel like irrespective of costs/expenses. I’m sure they factor insurance (which is expensive) and overhead, but primarily, there’s no rhyme or reason to their billed amount.
You asked “What else is driving costs that can be reduced?” and herein lies the issue I raised. We don’t know! The hospital chargemasters can set any price for any reason and unless you’re in CA, they don’t have to justify their decisions. The chargemaster can easily say “all our expenses including insurance costs $5,000 – but I’ll bill the patient $25,000 because I don’t have to justify to anyone where I got that number from.”
Couple of relevant paragraphs from one (hopefully neutral) source:
“ASKED BY A WALL STREET JOURNAL REPORTER to explain how U.S. hospitals price their services, William McGowan, chief financial officer of the University of California, Davis, Health System and thirty-year veteran of hospital financing, responded: “There is no method to this madness.”
“With the exception of California, which now requires hospitals to make their chargemasters public, hospitals are not required to post their chargemasters for public view. It may be just as well. If the sample chargemaster posted by California’s state government is any guide, prospective patients would be hard put to make sense of these price lists.”
Your point is well taken and I have also had a problem with that. I believe and except some disparity because it can be justified (i.e. better doctors, better care and reputation, overhead), but some situations seem excessive.
Regarding the uninsured having to pay more and unable to negotiate a lower rate, I can somewhat understand the economics with that (not that I entirely agree with it). People buy insurance to protect themselves when they have an issue and the law of large numbers works in that scenario for the lower prices. Some uninsured people choose not to buy insurance because they feel they don’t or won’t need it. They are not technically part of the “large numbers” that the providers can regularly rely on, thus they fall into a higher cost category.
An analogy (albeit, not the best one) is like paying for routine maintenance on your car. We pay a little every few months for oil changes to prolong the life of the engine. For those that don’t do that, they are facing a much larger bill when they have to replace their engine or buy a new car.
I am opposed to setting prices. I think the quality of care eventually suffers because it promotes mediocrity. It might work for some procedures, but I’d rather have someone who is above average and pay them more than someone who can just get the job done.
April 22, 2016 at 10:36 am
Yogi Polar Berra says:
Like or Dislike:
4
1
Thanks, Rosenblatt; that was very informative, and what I suspected was the case. At the very least, I thought costs were accounted for and passed back through charges that reflected the underlying costs. Perhaps one solution is to audit the doctors bills more aggressively to see where $ could be saved.
Aside from the audits, the market for med services should be able to drive down the $15k ACL costs closer to $5k ACL costs ( OK, I now know those were example costs! ) AS LONG AS potential patients have a way to do ‘comparison shopping’ by accessing costs for procedures that must be publicly disclosed.
There’s a lot of work to do on cost control, whether by audits or by implementing med service market info websites, which wasn’t done by (lazy, incompetent, arrogant, etc.) Dems and Grubers who wrote and enacted ACA.
April 22, 2016 at 11:43 am
Rosenblatt says:
Like or Dislike:
0
0
You know guys (or girls, or however you identify :), sometimes I love talking to people on this site. This is definitely one of those times!
I agree with you two: prices should be set commensurate with the quality of care provided by the facility, location and doctor. I’m with you IM: I’d pay an extra to have Dr. Huxtible deliver my child rather than cheaping out and letting Dr. Nick Riveria do it. I also agree prices should not be set in stone. The main issue I have, which you two understand, is when prices are so high for apparently no reason except to pad the hospitals revenue.
You want to mark up an ACL operation for 20% like contractors do, okay. You want to mark it up 2,000% – that’s an issue. Too bad the biggest issue is nobody really knows what the base price is for that operation, so they literally can get away with charging anything without justification!
Building off your car analogy, IM – I get your point, but how you worded it is slightly different than the way I see this hospital issue. Say the two folks needed their engines replaced – assume same car, their engines are in the same state of disrepair, no other work has to be done, same body shop, and the engine costs $10K. Now consider neither guy knows how much the engine costs. Why should oil change insured guy only have to pay $12K but the guy who didn’t change the oil have to pay $20K? It’s the same “operation”, same length of repair, and the lack of oil change didn’t make that car’s engine any more damaged (I know that’s not how it works with cars, but I wanted to stick to your analogy).
I agree we have a lot to do on cost control – and the best way is probably through audits, but I doubt hospitals would ever allow that lest folks catch on to their shenanigans. Ideally there’d be a range the hospitals can charge (e.g. ACL replacement in metro areas costs between $7,500 and $12,000) and they’d have to keep costs between those values unless they do something that falls outside of that TCP code.
While I don’t want this conversation to drag into the pro’s & con’s of the ACA, I’ll just state this simply so you know I’m not ignoring the point: I think more states should’ve approved the Medicare/Medicaid expansion, but that’s as far as I’m willing to go in support of the ACA.
April 22, 2016 at 1:44 pm
FFA says:
Like or Dislike:
1
0
I would think that the carriers paying the bills have significant power over the charges. When my wife had knee surgery after her accident, they billed the Car Insurance $68,000. By the time the auto carrier got that bill, my $25,000 limit was exhausted so they sent the same bill to blue cross who negotiated it below $20,000.
On another note, with the huge medical expense I incurred last year due the the PPACA and being the sole worker in the House of 6, I was below the poverty level. For the first time in my life, I am entitled to start sticking my hands in someone elses pockets. Ya f’n ho!!!! I’m feeling the bern!
April 22, 2016 at 2:16 pm
FFA says:
Like or Dislike:
1
0
Rose, dont worry about the Pros side of that conversation. No one supports this any more.
April 22, 2016 at 3:21 pm
Rosenblatt says:
Like or Dislike:
0
0
Sorry to hear about your situation (and Agent’s below). Going to the hospital is stressful enough, one shouldn’t have to worry about these other pain points at the same time.
Agreed that carriers have more power. Still, hospitals bill the same amount regardless of payee – they rarely negotiate with patients yet always do with carriers. Especially since the ‘fictional’ charges are usually above reasonable and customary rates, it frustrates me they won’t even agree to begin negotiations with individuals.
As for you collecting, I doubt I’ll see you buying a Ferrari or a Louis Vitton purse with your check, so go for it! I hope my two cents help (literally & figuratively :)
April 22, 2016 at 3:23 pm
Rosenblatt says:
Like or Dislike:
0
0
**hits self in head** END bold format next time, dummy! Only rarely & always were supposed to have that.
April 22, 2016 at 3:49 pm
FFA says:
Like or Dislike:
1
0
It (the hospital bill) made me wonder why the Auto Carries dont negotiate. Maybe use a network to gain bargaining power.
If anyone is in claims in this forum, can you answer that question? Curious as to what effect that would have on auto rates.
April 24, 2016 at 6:21 pm
Rosenblatt says:
Like or Dislike:
0
0
I was in auto claims – most states allow, and medical providers will, negotiate No Fault, PIP and Bodily Injury medical bills.
April 22, 2016 at 2:51 pm
Agent says:
Like or Dislike:
1
0
FFA, I came back in to a rousing conversation about hospital billing,etc. My wife has had 5 tests this week for ongoing problems with Vertigo, nausea among other things. I don’t want to see the bills on the MRI, MRA, Echocardiagram, ENT doctor tests etc. Also, don’t wish off on your worst enemy how terrible these test are when they are done simultaneously. She came out of the combined MRI/MRA this morning shaking and her nerves were shot. Hopefully, we will see the results Monday to see what the plan will be. Hopefully, a solution can be found and the problem solved. My guess is that it is arterial in nature with a blockage.
FFA, the drug formularies used have been reduced and many drugs taken off the approved list. My wife has had the same problem. No generic, big problem. One of our friends was prescribed a drug costing $700 per month. She has refused to take that and is suffering now since nothing has been found to be effective. Thank you OBAMACARE! Another great improvement of healthcare in the US.
FFA, I am happy I was wrong about my wife’s problems. It turned out that the numerous tests did not reveal a tumor or any arterial problem. The bad news is that it is something I have never heard of, Meniere’s Disease which is a debilitating condition of the inner ear which causes the Vertigo, Nausea etc. No treatment can cure it, but they can control the symptoms with medication and treatments. Hopefully, it can be managed so she can resume normal activities.
FFA, I know you have had some issues with your wife and had a lot of out of pocket expenses. Rosenblatt says hospitals don’t negotiate with patients. I beg to disagree. 1. When they have one of these unfortunate Obamacare patients with large deductibles and out of pocket expenses, they often put them on monthly pay plans or they would never get paid because the patients just don’t have the money. 2. Hospitals don’t get paid on their exhorbitant charges, but only a fraction of it. I have seen them and not long ago saw a bill for $70,000 from the hospital. They actually received about $10,000 and was glad to get it.
Did you misread my post not in bold? It is a lot more than rarely since people do not have the money and their plan has huge deductibles and out of pocket expenses.
Yeah Agent, I read your post. I understand you think it happens more than rarely, but you didn’t say that.
Can you explain how “Rosenblatt says hospitals don’t negotiate with patients” really means “Rosenblatt says hospitals rarely negotiate with patients”? (emphasis added)
If you’re going to write “Rosenblatt says….” I respectfully request you make the subsequent statement factual.
April 25, 2016 at 5:16 pm
Captain Planet says:
Like or Dislike:
0
1
Agent and facts? Oh, that’s rich!
April 26, 2016 at 11:40 am
Rosenblatt says:
Like or Dislike:
0
1
It’s worth a shot, Captain. It’d be nice if Agent wrote “Rosenblatt said…” and it was actually something I said. Don’t think that’s too much to ask, even of him!
April 26, 2016 at 12:07 pm
Agent says:
Like or Dislike:
1
0
Rosenblatt says that hospitals “rarely” negotiate with individuals, patently false. Every hospital has a business office to negotiate bills the individual has run up for services. Rosenblatt will continue to parse words in every post even when he is wrong.
April 26, 2016 at 12:29 pm
Rosenblatt says:
Like or Dislike:
0
0
Well, at least you quoted me correctly this time – thank you.
April 26, 2016 at 1:58 pm
confused says:
Like or Dislike:
0
1
parse – to analyze (a sentence)
no wonder agent has poor reading comprehension skills. he thinks parsing is a bad thing! that explains a lot
April 26, 2016 at 1:58 pm
Captain Planet says:
Like or Dislike:
0
1
Are they negotiating the costs or the billing method? I haven’t heard much of the former but plenty of the latter.
April 26, 2016 at 2:29 pm
Rosenblatt says:
Like or Dislike:
1
1
My hospitals rarely negotiate with patients comment was directed towards the amount of the bill.
I don’t consider a conversation akin to, “you owe us $10,000 – but we’ll let you pay $1,000 a month for 10 months” to be a negotiation.
I am not sure which of those Agent was talking about, so I’ll let him speak for himself.
April 26, 2016 at 3:52 pm
Agent says:
Like or Dislike:
1
1
Rosenblatt says his hospitals rarely negotiate with patients. He must have sorry hospitals to deal with up there in the blue N/E.
Hospitals in our area negotiate both the price and the pay plan, which comes in handy for the unfortunate policyholders of Obamacare and the uninsured. The idea is to get paid something, not nothing. By the way, the Docs in the Box mainly charge bills and get paid cash for services since they don’t take insurance and Medicare patients. They also put people on pay plans if the charges are more than the budget of the poor that use them.
By the way, if I have to repeat everything you say just to respond, I will decline from now on. I can’t stand a word parser.
This decision is going to make it tough for this company to survive due to the black eye they just gave themselves. If this were a property and casualty carrier, this would generate a lot of regulatory scrutiny for red-lining.
Stush – I disagree. They have 47 million subscribers in the private market and must be doing well. Otherwise, they would be getting out of there, too. They are simply the first company to realize that they are being adversely selected against.
With regards to the red-lining comment, they are not red-lining by pulling out of an entire market. There are many P&C carriers that do not write in certain states or write certain lines of coverage because of the poor expected losses. I think Obamacare is a “take all comers” program and there is no underwriting taking place. If so, this means the healthy 45 year old pays the same rate as the chronically ill 45 year old.
Thanks for a better look at this, I admit that I jumped too quickly. I made assumptions that you have pointed out do not hold up.
Stush- UnitedHealth’s exit from most of the exchanges is the result of a $475M loss in 2015 and projected loss of $525 this year for a total of $1B loss over two years. There is no -red-lining issue with the ACA. 25% of the enrollees are signing up when they are already sick plus the costs of all enrollees is 22% greater compared to those with employment based insurance. United Health has been asking for changes to the law for sometime which have been dismissed by the bureaucrats.
I am not worried about it, Bernie will fix this when he gives free healthcare to all.
Hidden due to low comment rating. Click here to see.
Captain…. just a personal comment…. I had a hard time getting into my foot/ankle doctor recently. When I finally got an appointment the waiting room was filled with Canadians who get work done in the United States that they can’t get in Canada (bunions and corrective ankle surgery) without a 5 year wait. Then I took my father to his orthopedic surgeon to follow-up on a knee replacement that he had done last year and again – waiting room filled with Canadians that can’t get knee replacement nor hip replacement surgery without about a 5 year wait. This is the national health plan we want to follow??? I agree we need changes here, but the future does not look bright.
Hmmmmm… Some people ignore the street level research (Asking Joe average) and just blindly follow what ever the govt puts out there.
People from all over the world – not just Canada – come to the US for medical treatment because it is the best in the world. From what I am told by actual people, its a real problem to get timely medical treatment in Canada. medical People are paid 09 – 05 and have no incentive to go above and beyond because their govt says so.
I know my folks were Canadian as they brought a grey market with them. That was a pain the a#$ getting insured. Every year same thing – NO SUCH VECH from Underwriting. Me: “Yes there is. I seen it. I took pictures of it and sent them to you.”
Underwriting “Oh, ok”.
Hmmmmmmm,
Yes, I think we will find horror stories from any country. I have close friends whose parents chose to become citizens because their kids wanted to go to college in the US. They wanted to be close to them. Their #1 complaint? The US healthcare process. They didn’t have an issue with the waiting issues your Canadians did. By the way, how did you know they were Canadian? Did you ask to see some ID or something?
Hmmmmm,
I decided to call Ed and Carol, the Canadians I am speaking about, and they said there is no such thing as a mandatory 5 year wait for surgery. In their words, “sounds like someone is using scare tactics to belittle our healthcare system in Canada. Simply not true.”
I just reread his post. He dont say anything about a mandatory 5 year wait. He simply stated that the wait is 5 years.
FFA,
You are right, Ed and Carol used “mandatory”. I called them here during lunch and they confirmed, they’ve never waited anywhere close to even a year for health services, surgeries included. Said they’d love to know who is waiting that long and where. Called it balderdash.
Earth to Planet – free healthcare is not free. Everyone still pays for it. Just like free college is not free. Guess what..??…eventually the money runs out (See Greece).
By the way, there are more ways to help people than to be forced to pay for their healthcare. The Christians I know are far more generous in helping people around the entire world than the non-Christians I know.
Careful with the moron accusations. You might end up looking like one.
Earth to Integrity Matters, please actually read my post:
“I wasn’t aware of a free healthcare program. I’ve heard Senator Sanders speak about single-payer. Which, of course just means the government pays and we pay into the gov’t via taxes.”
Careful with the moron accusations of looking like one. You just mind end up looking like one.
*might
My apologies. You did acknowledge that we pay via taxes. My oversight.
Also, you cannot compare the US to Greece. We control our own currency, Greece does not. You are comparing apples to gyros.
The Greece problem is an entitlement issue, not a currency issue. Greece is in jeopardy of losing the ability to use the Euro as their currency because of their fiscal problems…due to all the “free” stuff and pensions they have to pay.
Integrity, Planet is right, Greece’s problems are greatly exacerbated by their currency situation. It’s not surprising one of the few posts here showing an actual understanding of economics is down voted to oblivion.
Greece has debt problems and huge tax evasion problems, but there situation is in no way comparable to the US because we have control of our currency and they don’t. If they had control of their currency in the worst case they could create money to pay their debt, deal with the one-time inflation and slowly pull back their money supply as they fixed other problems, or just leave it weaker, which has benefits. That is easy to do and what the US can do.
Instead they are on the Euro and cannot control the supply of money. They have to pay in what is essentially foreign denominated currency so as their economy crashes the real terms of their debt imcreases. Usually they would decline and the value of their money would decline through inflation, meaning their debt was paid off in less money in real terms, but fully in nominal terms, but it would be gone and they wouldn’t have to suffer through 20+ years of garbage policies imposed on them. As it was they declined and had to pay off with a currency based on the strength of the economies in Germany, the UK, etc., where it would make little sense for them to agree to deflating the currency to help with Greece’s debt. It’s one of the big problems with a currency union.
Also, your statement “the money runs out” is simply wrong. We control our money supply and it is literally infinite. It can decrease in value, but cannot run out. The US is not a state, nor a household, treating the nation’s monetary system as if it were one is wrong. There is no indication the US is anywhere near danger levels with our debt based on the markets, interest rates, and demand for our debt.
The countries in Europe that saw problems and needed bailed out tended to spend less on entitlements than their northern European neighbors. Their problem was a huge influx in capital during the boom which poured out when the bust came, but everything stayed at precrash levels – eg wages. Investors know/fear Greece will have problems paying debt so they essentially crash the bond market in a bank run and it becomes a self-fulfilling prophecy. If their debt was sovereign denominated they could at worst print money to pay their outstanding bonds and there would be little chance of what is basically a bank run. That’s what the US can do and Greece cannot do. Also, non-EU members with higher spending on entitlements did not face the huge crash, largely because they control their own currency.
The way the article reads it going to be easier for them to survive. They are losing a losing proposition. Fully expect BCBS & Aetna and the rest to do the same. All that will be left is OBamas start ups which over half have failed and the one in IL is about to.
Smart move making this statement. Now, their off exchange policies will remain the lowest price seeing they are getting off the sinking ship.
FFA, what we feared most about this signature legislation is coming to fruition. Companies pulling out, fewer choices for healthcare and poor care in many places. I don’t know about your area, but we have a lot of docs in the box places now, many who don’t even accept insurance and people are just paying cash to them for less than emergency care. They are hiring a lot of foreign doctors who will work for less while the American doctors keep closing practices or selling out to large practices. The worst example I have seen on companies losing their shirt is Blue Cross in North Carolina. The chronically sick filed $700+ million in claims and Blue Cross collected $70 million in premiums counting the subsidies. The whole premise of “Affordability” was one of the biggest lies told. You just can’t throw those chronically sick in the pool of the healthy at the same rate and come out. What a joke.
This is the classic example of adverse selection, higher risk filing most claims and lower risk subsidizing or dumping the policy due to increases in premiums. This is a bad for insurer if only have high risk left and eventually the insurer could go bankrupt over it. I see why the insurer is pulling out.
“The Patient Protection and Affordable Care Act, President Barack Obama’s signature domestic policy achievement”…
This statement sums up what a failure Obama has been. If this is his “signature domestic policy achievement”, it’s no wonder we have serious problems in this country.
May God help us if Hilliary or Bernie get elected.
integrity, I am sure you remember the Progressive Left on this blog trying to justify this idiotic legislation for the past 6 years. Not one Conservative idea was accepted, they put in all the mandates, loaded up the law with numerous taxes to penalize people for not buying it, got 6 million policies cancelled (on purpose) after the President said, if you like your policy, you can keep it, if you like your doctor, you can keep him and the granddaddy of them all, the average family will save up to $2,500 per year on premiums. This law along with Climate Change being our biggest threat to national security is the legacy of Obama. Sure glad he is a short timer.
Agent – Yes, I remember all of the bold face lies Obama and the rest of the democrats told. I even remember the bribes it took, with the democrats that were opposed to it initially, to get them to vote for it.
Even with that, Hilliary is still doubling down on this atrocious legislation.
I have heard Bert & Bernie both say they were gong to gut the Cadi tax. That is stopping short of saying they will wipe it off the books.
Too bad our Imposter In Chief wasn’t a shorter timer…..
County Line, there are some on this blog who actually voted for him twice. The big mess created in the first term wasn’t enough, so they did it again. How misguided is that?
and there are some on this blog who actually think a two-term president is considered a “short timer” even though that’s the longest any president is able to stay in that position.
To Confused – I’m pretty sure when people here refer to Obama as a “short timer,” they’re not talking about the number of terms he can serve, but the fact that he has only a few months left in office.
But wait, I thought Beck, Hannity, and the pill popper all said he wanted to be king and wasn’t going to leave The White House. What happened to President Obama turning into a dictator? I am sorely going to miss listening to the likes of those guys and Savage ranting about our President once his second term is complete. It’s seriously a laugh riot, all the conspiracies. President Obama better hurry up, he doesn’t have much time to grab all the guns and start his re-education at the vacant Walmarts in Texas. Tick-tock, tick-tock…
Connie, good for you. Short timer is an old military term for people about to get out of the service when their hitch is up. When it gets down to months, the person is referred to as a short timer. This is a foreign concept to left leaning trolls.
UHC leaving the exchanges comes as no surprise. After all, it makes no sense for any business model to stay the course in spite of the growing ocean of red ink.
The keyword here is business. Those who champion Obamacare argue that medical care should have nothing to do with a business model. It seems in their eyes, business and the pursuit of profit is inherently evil and should never enter the health care equation.
But the ACA champions choose to ignore the main reason our medical technology and care is the envy of the world: Successful Business Models. Obamacare ignores this, and in fact seems aimed at running business models completely out of the picture.
Then to serve all, none will be served well. We will be forced into The Left’s great pipe dream; the proverbial Single Payer System. At that point will all have what the Canadians are desperate to escape.
By forcing the ACA down our throats, The Left threw the 90% of us under the bus to gain the everlasting vote of the supposedly un-served 10%.
Excellent comment and points, County Line!
I’ve said from the very beginning that Obama and the left’s real agenda is to tear down the free market approach to healthcare so they can misappropriate the Billions of dollars that are within that system.
If the Social Security system that was originally put in place and funded by the baby boomers had been left alone and not stolen for other government purposes, there would be plenty of money to help the 10% of society that cannot afford healthcare.
Good one integrity. This is just a wealth re-distribution system along Karl Marx’s ideas. We have a Socialist/Marxist for a President. By the way, the chronically ill should never have been allowed to be lumped in with the healthy on rate making. We had Pools for them and if the government wanted to subsidize them, fine. Don’t ruin healthcare for everyone else to cater to them. What we may end up with is a form of Medicaid which is also bad and low paid foreign doctors treating people like cattle.
Lyndon Johnson raided the Soc Sec lockbox in 1965 to fund his Medicare & Medicaid social engineering ‘experiments’.
When Rep. Herger (R-CA) got his 1999 bill passed in The House to restore the Soc Sec lock box, the Senate Democrats filibustered it into oblivion.
Again using a line borrowed from Oliver Hardy: “This is another fine mess you’ve gotten us (me) into, Nancy (Stanley)!”.
Yogi, on top of that, Al Gore cast the deciding vote in the Senate to tax Social Security benefits that working folks paid into all their working lives on taxable income. The Progressives have never seen a tax they didn’t like and just love their tax revenue stream so they can spend it unwisely on their give a ways.
and the state of Texas loves getting free money from the federal government to make it seem like they’re not operating with a deficit. think texas would be happy if the fed didn’t give them that revenue stream?
@confused; you seem to be confusing ‘taxes’ with ‘Texas’. But let me humor you momentarily before I return to the topic…. Texas is NOT the only state that receives money from the Federal Govt. But, I suspect state governments would quickly learn to operate their state and balance their budgets if NO such federal aid were given. The latter is the system I prefer, as it is the most efficient, economically speaking. I can’t spend more than the max on my credit card before my spending is curtailed because I don’t have the Feds bailing me out. Think what would happen if subsidies and aid were available to all in our nation…. we’d be more like Europe, e.g. Greece, or like Venezuela, or, well, I think you get the picture…
Without Federal aid for anything but absolutely necessary projects such as cross country roads that run through them, I think ALL states would eventually learn to spend wisely, balance their budgets, and would be happy in the long run, Texas included.
I’m with you Yogi. Most states take Federal Gov’t money. I was just pointing out Agent’s hypocrisy: he claims Texas always has a balanced budget and other states should be able to do the same easily, then rails against the gov’t giving out money. Just trying to show he dislikes the gov’t taking money to send anywhere else for any reason, except if it’s going to his state so they don’t operate with a deficit.
Agent, no one is even talking this up any more. even Libby (before her departure) realized what a failure this is. They all beat the drum for a Canadian style health care. Problem with that is when we want the best health care in the world, we will have no where to go.
Now that agents that took part have been betrayed because of the massive losses posted, people are now stuck with the 800 pin heads in some foreign country getting advice on their policies.
FFA, you are right, but I am waiting on the now infamous Ron to chime in and say we should just accept his Single Payer system because only government can solve this problem. With what we have seen about government bureaucracy in action, we would have a national VA system and I am sure you have seen the horror stories on them.
In the sales field the oldest strategy is to disturb the buyer into seeing the problem, and then selling them the solution.
With the un-ACA, Big Guv set the stage to drive out private insurers and affordable premiums. They did so knowing they would become the resource the masses to turn to fix the problem. Talk about Slick Sales Practices–this is the grand-daddy of them all!
Ron advocates us sending our premium money to the govt and have them pay the carriers. Sounds like another middle man that serves the purpose of jacking up costs.
The hospitals are already doing enough damage setting exorbitant prices based on which way the wind is blowing. I could get an ACL replacement from Hospital One at $5,000 or at Hospital Two, 5 miles down the road, for $15,000. They’ll both accept my insurance paying $2,500 but if I don’t have insurance, they won’t negotiate with me. Maybe — THAT’S A BIG MAYBE — the gov’t will be able to set a national price for services that fluctuates solely by the area’s cost of living (e.g. NYC surgery would be more expensive than the same in a small one-doctor office in Nebraska.)
Are the prices set by hospitals exorbitant because they are price gouging for profit, or just trying to cover their costs and stay solvent? Inquiring minds want to know.
I’m not a health insurance pro, but recall med malpractice insurance premiums are costs that must be covered by hospitals, doctors, and other practitioners. Does anyone know where med mal premiums are cheap? Anyone? Bueller? Anyone? Finally, does anyone recall why bedpan mutuals were set up in the late 1970s?
Yogi, Texas did do Med Mal Tort Reform some time ago and the result is the rates have come down for doctors, hospitals. Operations have to be a lot cheaper here than in the liberal N/E who don’t know what Tort Reform is. Doctors have been flocking here for a while now although I don’t like seeing all the foreign doctors now being hired. Most don’t speak good English and they are replacing American doctors who were fed up and closing their practice.
Tort laws and litigiousness variances explain some regional cost variance. But how much? What else is driving costs that can be reduced, somehow, instead of subsidizing it to higher levels? Scripts? Physical therapy? Diagnostics/ tests used only for law suit avoidance? Other stuff? Anyone? Bueller?
Only $5k for an ACL replacement? Where? Sign me up for 2; on my back paws!
Yogi – my numbers for ACL surgery were for example only; I did not mean to imply those are the actual costs. There have been a couple of studies recently that showed hospitals charge whatever they feel like irrespective of costs/expenses. I’m sure they factor insurance (which is expensive) and overhead, but primarily, there’s no rhyme or reason to their billed amount.
You asked “What else is driving costs that can be reduced?” and herein lies the issue I raised. We don’t know! The hospital chargemasters can set any price for any reason and unless you’re in CA, they don’t have to justify their decisions. The chargemaster can easily say “all our expenses including insurance costs $5,000 – but I’ll bill the patient $25,000 because I don’t have to justify to anyone where I got that number from.”
Couple of relevant paragraphs from one (hopefully neutral) source:
“ASKED BY A WALL STREET JOURNAL REPORTER to explain how U.S. hospitals price their services, William McGowan, chief financial officer of the University of California, Davis, Health System and thirty-year veteran of hospital financing, responded: “There is no method to this madness.”
“With the exception of California, which now requires hospitals to make their chargemasters public, hospitals are not required to post their chargemasters for public view. It may be just as well. If the sample chargemaster posted by California’s state government is any guide, prospective patients would be hard put to make sense of these price lists.”
http://content.healthaffairs.org/content/25/1/57.full
Rosenblatt,
Your point is well taken and I have also had a problem with that. I believe and except some disparity because it can be justified (i.e. better doctors, better care and reputation, overhead), but some situations seem excessive.
Regarding the uninsured having to pay more and unable to negotiate a lower rate, I can somewhat understand the economics with that (not that I entirely agree with it). People buy insurance to protect themselves when they have an issue and the law of large numbers works in that scenario for the lower prices. Some uninsured people choose not to buy insurance because they feel they don’t or won’t need it. They are not technically part of the “large numbers” that the providers can regularly rely on, thus they fall into a higher cost category.
An analogy (albeit, not the best one) is like paying for routine maintenance on your car. We pay a little every few months for oil changes to prolong the life of the engine. For those that don’t do that, they are facing a much larger bill when they have to replace their engine or buy a new car.
I am opposed to setting prices. I think the quality of care eventually suffers because it promotes mediocrity. It might work for some procedures, but I’d rather have someone who is above average and pay them more than someone who can just get the job done.
Thanks, Rosenblatt; that was very informative, and what I suspected was the case. At the very least, I thought costs were accounted for and passed back through charges that reflected the underlying costs. Perhaps one solution is to audit the doctors bills more aggressively to see where $ could be saved.
Aside from the audits, the market for med services should be able to drive down the $15k ACL costs closer to $5k ACL costs ( OK, I now know those were example costs! ) AS LONG AS potential patients have a way to do ‘comparison shopping’ by accessing costs for procedures that must be publicly disclosed.
There’s a lot of work to do on cost control, whether by audits or by implementing med service market info websites, which wasn’t done by (lazy, incompetent, arrogant, etc.) Dems and Grubers who wrote and enacted ACA.
You know guys (or girls, or however you identify :), sometimes I love talking to people on this site. This is definitely one of those times!
I agree with you two: prices should be set commensurate with the quality of care provided by the facility, location and doctor. I’m with you IM: I’d pay an extra to have Dr. Huxtible deliver my child rather than cheaping out and letting Dr. Nick Riveria do it. I also agree prices should not be set in stone. The main issue I have, which you two understand, is when prices are so high for apparently no reason except to pad the hospitals revenue.
You want to mark up an ACL operation for 20% like contractors do, okay. You want to mark it up 2,000% – that’s an issue. Too bad the biggest issue is nobody really knows what the base price is for that operation, so they literally can get away with charging anything without justification!
Building off your car analogy, IM – I get your point, but how you worded it is slightly different than the way I see this hospital issue. Say the two folks needed their engines replaced – assume same car, their engines are in the same state of disrepair, no other work has to be done, same body shop, and the engine costs $10K. Now consider neither guy knows how much the engine costs. Why should oil change insured guy only have to pay $12K but the guy who didn’t change the oil have to pay $20K? It’s the same “operation”, same length of repair, and the lack of oil change didn’t make that car’s engine any more damaged (I know that’s not how it works with cars, but I wanted to stick to your analogy).
I agree we have a lot to do on cost control – and the best way is probably through audits, but I doubt hospitals would ever allow that lest folks catch on to their shenanigans. Ideally there’d be a range the hospitals can charge (e.g. ACL replacement in metro areas costs between $7,500 and $12,000) and they’d have to keep costs between those values unless they do something that falls outside of that TCP code.
While I don’t want this conversation to drag into the pro’s & con’s of the ACA, I’ll just state this simply so you know I’m not ignoring the point: I think more states should’ve approved the Medicare/Medicaid expansion, but that’s as far as I’m willing to go in support of the ACA.
I would think that the carriers paying the bills have significant power over the charges. When my wife had knee surgery after her accident, they billed the Car Insurance $68,000. By the time the auto carrier got that bill, my $25,000 limit was exhausted so they sent the same bill to blue cross who negotiated it below $20,000.
On another note, with the huge medical expense I incurred last year due the the PPACA and being the sole worker in the House of 6, I was below the poverty level. For the first time in my life, I am entitled to start sticking my hands in someone elses pockets. Ya f’n ho!!!! I’m feeling the bern!
Rose, dont worry about the Pros side of that conversation. No one supports this any more.
Sorry to hear about your situation (and Agent’s below). Going to the hospital is stressful enough, one shouldn’t have to worry about these other pain points at the same time.
Agreed that carriers have more power. Still, hospitals bill the same amount regardless of payee – they rarely negotiate with patients yet always do with carriers. Especially since the ‘fictional’ charges are usually above reasonable and customary rates, it frustrates me they won’t even agree to begin negotiations with individuals.
As for you collecting, I doubt I’ll see you buying a Ferrari or a Louis Vitton purse with your check, so go for it! I hope my two cents help (literally & figuratively :)
**hits self in head** END bold format next time, dummy! Only rarely & always were supposed to have that.
It (the hospital bill) made me wonder why the Auto Carries dont negotiate. Maybe use a network to gain bargaining power.
If anyone is in claims in this forum, can you answer that question? Curious as to what effect that would have on auto rates.
I was in auto claims – most states allow, and medical providers will, negotiate No Fault, PIP and Bodily Injury medical bills.
FFA, I came back in to a rousing conversation about hospital billing,etc. My wife has had 5 tests this week for ongoing problems with Vertigo, nausea among other things. I don’t want to see the bills on the MRI, MRA, Echocardiagram, ENT doctor tests etc. Also, don’t wish off on your worst enemy how terrible these test are when they are done simultaneously. She came out of the combined MRI/MRA this morning shaking and her nerves were shot. Hopefully, we will see the results Monday to see what the plan will be. Hopefully, a solution can be found and the problem solved. My guess is that it is arterial in nature with a blockage.
UGHHHHH. Best of luck.
According to The Market Place, my wifes pain meds have been cut off and they recommend treatment that is not covered (imagine that).
She has run out of the meds now and I get to deal with the WD’s. Fun fun fun, eh? And who said that the govt wont dictate treatment?
FFA, the drug formularies used have been reduced and many drugs taken off the approved list. My wife has had the same problem. No generic, big problem. One of our friends was prescribed a drug costing $700 per month. She has refused to take that and is suffering now since nothing has been found to be effective. Thank you OBAMACARE! Another great improvement of healthcare in the US.
FFA, I am happy I was wrong about my wife’s problems. It turned out that the numerous tests did not reveal a tumor or any arterial problem. The bad news is that it is something I have never heard of, Meniere’s Disease which is a debilitating condition of the inner ear which causes the Vertigo, Nausea etc. No treatment can cure it, but they can control the symptoms with medication and treatments. Hopefully, it can be managed so she can resume normal activities.
FFA, I know you have had some issues with your wife and had a lot of out of pocket expenses. Rosenblatt says hospitals don’t negotiate with patients. I beg to disagree. 1. When they have one of these unfortunate Obamacare patients with large deductibles and out of pocket expenses, they often put them on monthly pay plans or they would never get paid because the patients just don’t have the money. 2. Hospitals don’t get paid on their exhorbitant charges, but only a fraction of it. I have seen them and not long ago saw a bill for $70,000 from the hospital. They actually received about $10,000 and was glad to get it.
How did you misread what I put in bold? Take two — they rarely negotiate with patients. Never said they don’t, just said it’s rare.
Did you misread my post not in bold? It is a lot more than rarely since people do not have the money and their plan has huge deductibles and out of pocket expenses.
Yeah Agent, I read your post. I understand you think it happens more than rarely, but you didn’t say that.
Can you explain how “Rosenblatt says hospitals don’t negotiate with patients” really means “Rosenblatt says hospitals rarely negotiate with patients”? (emphasis added)
Do not & rarely have different meanings, right?
If you’re going to write “Rosenblatt says….” I respectfully request you make the subsequent statement factual.
Agent and facts? Oh, that’s rich!
It’s worth a shot, Captain. It’d be nice if Agent wrote “Rosenblatt said…” and it was actually something I said. Don’t think that’s too much to ask, even of him!
Rosenblatt says that hospitals “rarely” negotiate with individuals, patently false. Every hospital has a business office to negotiate bills the individual has run up for services. Rosenblatt will continue to parse words in every post even when he is wrong.
Well, at least you quoted me correctly this time – thank you.
parse – to analyze (a sentence)
no wonder agent has poor reading comprehension skills. he thinks parsing is a bad thing! that explains a lot
Are they negotiating the costs or the billing method? I haven’t heard much of the former but plenty of the latter.
My hospitals rarely negotiate with patients comment was directed towards the amount of the bill.
I don’t consider a conversation akin to, “you owe us $10,000 – but we’ll let you pay $1,000 a month for 10 months” to be a negotiation.
I am not sure which of those Agent was talking about, so I’ll let him speak for himself.
Rosenblatt says his hospitals rarely negotiate with patients. He must have sorry hospitals to deal with up there in the blue N/E.
Hospitals in our area negotiate both the price and the pay plan, which comes in handy for the unfortunate policyholders of Obamacare and the uninsured. The idea is to get paid something, not nothing. By the way, the Docs in the Box mainly charge bills and get paid cash for services since they don’t take insurance and Medicare patients. They also put people on pay plans if the charges are more than the budget of the poor that use them.
By the way, if I have to repeat everything you say just to respond, I will decline from now on. I can’t stand a word parser.
I do not live in a blue north east state. At least you quoted me correctly though, so I once again thank you for that.