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#339679 - 22/11/2010 14:33 Re: Gaming the system (was: Re: Election Results...) [Re: JeffS]
Tim
veteran

Registered: 25/04/2000
Posts: 1522
Loc: Arizona
Originally Posted By: JeffS
I've definitely had doctors prescribe us some very expensive medication when other medication would do- often the insurance company pushes back, which DOES end up with a more cost efficient treatment, but meanwhile the patient is caught in the middle waiting for the treatment while the doctor and insurance get their ducks in a row.

How long does that usually take? I get knee injections twice a year that takes less than a week to get authorized (I don't know how the cost of those compare to your costs, though).

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#339680 - 22/11/2010 14:59 Re: Gaming the system (was: Re: Election Results...) [Re: Tim]
tanstaafl.
carpal tunnel

Registered: 08/07/1999
Posts: 5539
Loc: Ajijic, Mexico
Originally Posted By: Tim
When my orthopedic doctor wanted MRIs of my knees, I had an appointment within the hour. The cost of that was $10 (for a scan on both knees, so it took a while).

No, the cost to you was $10. You can bet that the clinic running the MRI machine received at least $1,000, more likely $2,000 for the procedure.

tanstaafl.
_________________________
"There Ain't No Such Thing As A Free Lunch"

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#339682 - 22/11/2010 16:04 Re: Gaming the system (was: Re: Election Results...) [Re: Tim]
JeffS
carpal tunnel

Registered: 14/01/2002
Posts: 2858
Loc: Atlanta, GA
Originally Posted By: Tim
Originally Posted By: JeffS
I've definitely had doctors prescribe us some very expensive medication when other medication would do- often the insurance company pushes back, which DOES end up with a more cost efficient treatment, but meanwhile the patient is caught in the middle waiting for the treatment while the doctor and insurance get their ducks in a row.

How long does that usually take? I get knee injections twice a year that takes less than a week to get authorized (I don't know how the cost of those compare to your costs, though).
We haven't had too many problems with the big operations. My Wife's pain doctor is pretty aware in advance of what issues may arise with the insurance. In fact, with her current pain doctor we haven't had too many problems at all- but with previous doctors my wife would get a pain prescription and at the point of getting it filled we get push back so we have to call the doctor (who has gone home for the evening). Even if it takes an evening to get things resolved, I get the choice of just paying myself or watching my wife cry in pain while this stuff gets worked out. Usually it's the former, I'll admit.
_________________________
-Jeff
Rome did not create a great empire by having meetings; they did it by killing all those who opposed them.

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#339683 - 22/11/2010 16:13 Re: Gaming the system (was: Re: Election Results...) [Re: JeffS]
JeffS
carpal tunnel

Registered: 14/01/2002
Posts: 2858
Loc: Atlanta, GA
Just to say what I might not have said earlier a little more clearly: as long as insurance means "I play a $15 co-pay and I get to see whatever doctor I want (in my network) and I pay $10 and get any drug I want" you do not have incentives for doctors and pharmacies to compete on price. Ultimately the consumer DOES pay, but the effect (rising health care costs) is removed from the cause (I used expansive services and treatments) and you are a slave to the choices of those whom share your plan- even if you do use a cheaper pharmacy, if everyone else goes the expensive route your premiums will get higher.

And these rising costs DO effect those without insurance because those prices are being set to cater to those with insurance (though often doctors have different prices for those without insurance).

Or at least I assume that's the way it works. I have no direct knowledge- it just seems to me that in a system where the consumer does not make choices based on price those setting the prices are free to jack them as high as they can.
_________________________
-Jeff
Rome did not create a great empire by having meetings; they did it by killing all those who opposed them.

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#339684 - 22/11/2010 16:21 Re: Gaming the system (was: Re: Election Results...) [Re: tanstaafl.]
canuckInOR
carpal tunnel

Registered: 13/02/2002
Posts: 3212
Loc: Portland, OR
Originally Posted By: tanstaafl.
When she was still working in California, she went to Guadalajara for dental work (two tooth implants) and the cost including the round trip plane tickets was less than her insurance co-pay would have been had she done the work in California.

You know your country's health care system sucks when other countries can promote medical tourism.

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#339685 - 22/11/2010 16:34 Re: Gaming the system (was: Re: Election Results...) [Re: canuckInOR]
Tim
veteran

Registered: 25/04/2000
Posts: 1522
Loc: Arizona
Originally Posted By: canuckInOR
Originally Posted By: tanstaafl.
When she was still working in California, she went to Guadalajara for dental work (two tooth implants) and the cost including the round trip plane tickets was less than her insurance co-pay would have been had she done the work in California.

You know your country's health care system sucks when other countries can promote medical tourism.

Around here, the hospitals get really full from about Oct - April or so because of all the folks who migrate south from Canada for the winter. A lot of that is for elective stuff that is cheaper here than they can get it back home.


Edited by Tim (22/11/2010 16:35)

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#339686 - 22/11/2010 17:35 Re: Gaming the system (was: Re: Election Results...) [Re: Tim]
canuckInOR
carpal tunnel

Registered: 13/02/2002
Posts: 3212
Loc: Portland, OR
Originally Posted By: Tim
Originally Posted By: canuckInOR
Originally Posted By: tanstaafl.
When she was still working in California, she went to Guadalajara for dental work (two tooth implants) and the cost including the round trip plane tickets was less than her insurance co-pay would have been had she done the work in California.

You know your country's health care system sucks when other countries can promote medical tourism.

Around here, the hospitals get really full from about Oct - April or so because of all the folks who migrate south from Canada for the winter. A lot of that is for elective stuff that is cheaper here than they can get it back home.

That's not the same as medical tourism, though, where the express purpose of the travel is to have medical procedures done. If those snowbirds weren't already traveling to/living in the US, and paying for an American health insurance policy, do you really think they'd come just for the elective stuff? I seriously doubt it; I know I sure wouldn't. That's not to say that there aren't problems with the Canadian system -- there are. But I've said it before, and I'll say it again... I'd rather be faced with those problems, than the problems in the US system.

*sigh*

Look at this thread. All I wanted to know was whether or not all the constitutional amendments adding rights to hunt and fish were knee-jerk reactions to something... crazy

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#339687 - 22/11/2010 17:40 Re: Gaming the system (was: Re: Election Results...) [Re: canuckInOR]
JBjorgen
carpal tunnel

Registered: 19/01/2002
Posts: 3582
Loc: Columbus, OH
Originally Posted By: tanstaafl.
When she was still working in California, she went to Guadalajara for dental work (two tooth implants) and the cost including the round trip plane tickets was less than her insurance co-pay would have been had she done the work in California.


We routinely get 45 min. consults with the doctor for the same price as our $30 copay was in the US. And he's not in a hurry. He's willing to listen to all of our concerns and explain to us his opinion on each of them. Quite refreshing really.

I believe each of our ultrasounds for our baby cost $50. Same equipment we had at our state of the art OB in Chandler, AZ. One of the big reasons we decided to have the baby here. Cost less than a fifth of what the first one cost in the US.
_________________________
~ John

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#339689 - 22/11/2010 18:09 Re: Gaming the system (was: Re: Election Results...) [Re: JeffS]
wfaulk
carpal tunnel

Registered: 25/12/2000
Posts: 16706
Loc: Raleigh, NC US
I'm pretty sure that I've had prescriptions where the pharmacy charged more than the insurance company would allow and I got stuck with the overage. It's pretty rare, though. More common, in my experience, is where the cost is actually below my plan's copay and I get it cheaper.

But you're right, I don't do pharmacy comparison shopping. At the same time, I don't really have a good way to. It's not like I ever really see the final cost at all, from either the pharmacy or the insurance company. I think that if I ask for a report from the pharmacy it will show me the actual final cost, but I'm not even sure of that.
_________________________
Bitt Faulk

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#339695 - 23/11/2010 07:52 Re: Gaming the system (was: Re: Election Results...) [Re: JBjorgen]
Roger
carpal tunnel

Registered: 18/01/2000
Posts: 5680
Loc: London, UK
Originally Posted By: JBjorgen
I believe each of our ultrasounds for our baby cost $50.


Free here, but £3 if you want a copy of the scan to take home.
_________________________
-- roger

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#339698 - 23/11/2010 12:12 Re: Gaming the system (was: Re: Election Results...) [Re: Roger]
JBjorgen
carpal tunnel

Registered: 19/01/2002
Posts: 3582
Loc: Columbus, OH
Free Free, or Government-subsidized free? Likely the latter.

To everyone who posts their healthcare costs after insurance or government subsidizing: stop and think real hard for a minute. This is not the same smile You can't compare these when talking about inexpensive healthcare unless you include what the insurance company or government is paying too. Now stop thinking and go back to your regularly scheduled activities.
_________________________
~ John

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#339699 - 23/11/2010 15:39 Re: Gaming the system (was: Re: Election Results...) [Re: JBjorgen]
peter
carpal tunnel

Registered: 13/07/2000
Posts: 4172
Loc: Cambridge, England
Originally Posted By: JBjorgen
You can't compare these when talking about inexpensive healthcare unless you include what the insurance company or government is paying too.

In the particular case of ultrasounds, you probably can't compare it even then; procedures that aren't treatments in themselves but which can stave off big-ticket medical complications further down the line, could believably be provided for free even if profit were the only motive.

Peter

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#339701 - 23/11/2010 17:24 Re: Gaming the system (was: Re: Election Results...) [Re: peter]
larry818
old hand

Registered: 01/10/2002
Posts: 1033
Loc: Fullerton, Calif.
Don't lose sight of the fact that we pay more taxes than any country with national health care. We just don't get anything we want for those taxes...

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#339709 - 23/11/2010 19:35 Re: Gaming the system (was: Re: Election Results...) [Re: peter]
tanstaafl.
carpal tunnel

Registered: 08/07/1999
Posts: 5539
Loc: Ajijic, Mexico
Originally Posted By: peter
procedures that aren't treatments in themselves but which can stave off big-ticket medical complications further down the line, could believably be provided for free even if profit were the only motive.

Incredibly, my health insurance company (and perhaps others?) specifically excludes coverage for preventative care.

At first I thought this was financial lunacy on the part of the insurance company, but then my skepticism kicked in and I thought that it might be to their advantage to have sick (i.e., expensive) people die quickly before they ran up too many bills.

tanstaafl.
_________________________
"There Ain't No Such Thing As A Free Lunch"

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#339716 - 24/11/2010 02:16 Re: Gaming the system (was: Re: Election Results...) [Re: peter]
JBjorgen
carpal tunnel

Registered: 19/01/2002
Posts: 3582
Loc: Columbus, OH
Originally Posted By: peter

In the particular case of ultrasounds, you probably can't compare it even then; procedures that aren't treatments in themselves but which can stave off big-ticket medical complications further down the line, could believably be provided for free even if profit were the only motive.


Good point. I've never heard of anyone actually doing it though (not that that means anything). Probably place too much of a premium on the technician's time. Of course ultrasounds can also be diagnostic, as in the case of my wife's kidney stones (also $50).
_________________________
~ John

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