lpetrich
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Sure. I'd be interested.
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Grossly High Hospital-Bill Markups
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Jimmy Higgins
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BWAHAHAHAHAHA!!!!!!!
Last time I checked:
Doctors... work for the hospital.
Testing Equipment... already exists at the hospital.
Staff... work for the hospital.
Medication, utensils, are actual live expenses that wouldn't have been used if someone who couldn't pay didn't show up.
So it seems like the largest expenses for a hospital are the fucking things at the hospital, like staff and equipment and rooms. That shit is already there... that is what costs the money! Whether a butt is in bed or not, that bed is being (has been) paid for. Hospitals cost a lot of money to run. It is a natural thing, whether people get free care or not.
Swammerdami
Squadron Leader
In the early 1990's during the one year I had a TV, I happened to catch part of a Senate hearing (about HillaryCare) on CSPAN. Ted Kennedy had called the CEO's of McDonald's and Pizza to explain why they didn't provide their employees with health insurance and didn't want to. (I don't remember if the CEO came from Pizza Hut or some other Pizza company; I'll just call him Pizza CEO.) I'll paint Pizza CEO's remarks Green and paint Kennedy's remarks Blue. Can 28-year old CSPAN segments be found on YouTube? I'll just paraphrase some of the remarks.
The McDonald's CEO had a prior engagement, so offered to send the company's CFO instead. Perhaps the CFO would have had better financial insights than the CEO, but gathering information didn't seem to be Kennedy's priority. Instead he left the 2nd witness chair empty, placing a paper bag on the table instead, a bag with a BigMac and french fries. Every time Pizza CEO had an intelligent answer for which Kennedy had no rebuttal, Kennedy would turn to the BigMac and Fries and complain for the umpteenth time that McDonalds didn't deign to appear. He seemed hugely insulted that McDonald's could spare only their CFO to discuss finances with Chairman Teddy.
BTW, Pizza DID provide health insurance, CEO explained, but only to employees who'd worked full-time for 12 months, or some such. This seemed reasonable to me, especially since — though Pizza CEO didn't make this argument — otherwise a chronically ill person could work just a little and get free care from Pizza.
Don't you think it's immoral for you not to provide your employees with health care? Kennedy intoned like a rabid preacher from a B-movie.
Hunh? Is there really a logical reason an employer should provide health insurance? They're already providing money. I provide my barber with money; does that make me morally obligated to provide him with a blow job?
(Morality has nothing to do with it.) Those other companies are obligated by a covenant they agreed to. Pizza CEO's answers were always calm and objective; he didn't say anything like "Morality has nothing to do with it." That's what I would have said, probably part of the reason why he's a CEO and I'm a hermit retired to the jungle. Pizza buyers were price-sensitive; raise the wages, raise the prices, customers stay home, he'd have to lay off workers. Whom does that help?
Aha! Kennedy thought he'd cornered Pizza into a logic paradox. Your competitors will have to raise their prices also. You won't lose customers.
(Wrong again!) Our main competitor isn't other cheap fast-food restaurants. Our competitor is Mom or Dad cooking Macaroni and cheese at home. This seemed like a good point. Ted Kennedy had no answer for it since he told the cameras to turn to the BigMac and fries which he ranted at some more.
Immorality? Some taxation and wage-control decisions by the Federal government in the 1940's and 1950's "painted the country into a foolish corner" where health care came from employer instead of government. Morality had NOTHING to do with it. Immorality is when you walk away from a drowning woman and don't bother to notify police until you sober up.
Every time I hear someone praise the youngest Kennedy brother I think about the time he ranted against the BigMac-and-fries because Pizza CEO was too smart for him. I hate to say it, but I'm afraid many on the left went away with the opposite impression, and thought Kennedy was the winner of that "debate", the way he intoned Immoral! with the Bostonian accent of a Puritan preacher.
~ ~ ~ ~ ~ ~ ~
I've never had health insurance. When others bought their medicine for $80 ($10 co-pay and $70 from insurer) I had to pay $115. If Hillary really wanted to help the uninsured she could have forced the pharmacy to sell to me for the $80 price. (When I try to explain this to the average pharmacist, he thinks I'm trying to get the $10 price and don't understand "insurance.")
Would mandating such fair pricing — canceling the "negotiation power" of big insurers — be contrary to Capitalist Freedom where Job Creators are allowed and encouraged to fleece customers anyway they can? Sure! But every part of HillaryCare (or ObamaCare) would attack those so-called freedoms anyway. Why not a simple change that would immediately help the uninsured?
lpetrich
Contributor
I think that something like the German system might be good for the US. It's the oldest of universal-insurance schemes, dating back to the late 19th cy. and Chancellor Otto von Bismarck. It's essentially a set of private nonprofit insurance companies whose coverage is independent of one's employment. For more details on Bismarckcare, as I like to call it: Germany | Commonwealth Fund Bismarckcare seems to be what Obamacare is intended to be.
Bismarckcare could have these selling points: the insurance companies are capitalist and Chancellor Bismarck was a conservative.
Health care systems by country goes into a lot of detail. But it's worth noting that government insurance systems like Canada's do not necessarily exclude insurance companies. It's also worth noting that the UK's National Health Service is a sort of national HMO, and not just an insurance system.
Bismarckcare could have these selling points: the insurance companies are capitalist and Chancellor Bismarck was a conservative.
Health care systems by country goes into a lot of detail. But it's worth noting that government insurance systems like Canada's do not necessarily exclude insurance companies. It's also worth noting that the UK's National Health Service is a sort of national HMO, and not just an insurance system.
Alcoholic Actuary
Veteran Member
Timely article: https://www.npr.org/sections/heala-hospital-asked-these-parents-to-pay-45,843-a-month-for-their-babys-nicu-stay
Basically, this couple got a $550k bill even though they had insurance. In the end everything was resolved and the bill was knocked down to a payable amount, but it took 6 months and a reporter investigation to get to that point. A cautionary tale for anyone who thinks negotiated free market prices are a well-oiled machine.
aa
Basically, this couple got a $550k bill even though they had insurance. In the end everything was resolved and the bill was knocked down to a payable amount, but it took 6 months and a reporter investigation to get to that point. A cautionary tale for anyone who thinks negotiated free market prices are a well-oiled machine.
aa
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From the classic British series "Yes Minister" - How to run a hospital
And so we can just use it without paying? That equipment wears out, those doctors will leave if they don't get their paychecks.
Pick a fair value for what it costs. Lots of patients don't pay, those costs don't go away. Under our system the cost ends up shifted to the ones who can pay.
Yeah, in the days before the ACA I was thinking the government should mandate all insurance companies offer an "insurance" plan with an infinite deductible. The monthly cost would be low--the customer would get the negotiated rates and the crap removal that insurance companies do, but would pay their own bills. (And, yes, crap removal is still very much required. Doc, you had no reason at all to run those tests and try to bill thousands of dollars. The insurance quite rightly saw they were unjustified and paid $0--we wouldn't have even known except I was looking through the claims for a different bill. The only reason I can think of is that Medicare doesn't do that kind of review so you get away with it often enough to make it worthwhile.)
Hate to disappoint, but that was a bill for TWO MONTHS of intensive care for an infant that went to the wrong insurance company, so it was rejected and the system automatically billed the family before someone could catch the CLERICAL ERROR on what dates were to be billed to which insurance companies, since there were two different ones at different times during treatment.
Furthermore, making this story amazingly less interesting, the mother WORKED AS AN INSURANCE AGENT, and was completely aware of the nature of the error, what her coverage was, and at no time was the least bit concerned about it... but it SURE MAKES A HELL OF A HEADLINE! which is all that matters now a days anyway.
Alcoholic Actuary
Veteran Member
I already said all that. It was resolved, but it took half a year. And I doubt you could conclude she wasn't concerned about it. Could you imagine trying to shop for a house or car with an unresolved $550k collection?
aa
Was she looking for a house? Unresolved dept does not automatically affect your credit rating... it must first be resolved via legal judgement (often by default because the debtor is unresponsive). But simply working with the creditor prevents this from being an issue.
I have heard, but cannot confirm, that medical services debt is the hardest for creditors to get a legal judgement on... possibly due to these exact situations.... You REALLY need to ignore letters in the mail entirely and for quite a while before house-hunting becomes an issue.
Also, I don't know if you have gotten a mortgage before, but I have 3 times in my life. 2 of those times I had to write a letter to the bank explaining 1 item on my credit report, and also 1 time I had to explain a certain recurring charge in my checking account (it was my rent at the time - it included utility usage so the amount fluctuated monthly, raising a flag). The item on my credit report just needed an explanation adn they were happy with it.