Insurance doesn't even cover the $4,000 E Plebnista fee. As Yr Wonkette has mentioned once or twice, we are a total fanboi of Vox's Sarah Kliff, who is one of the absolute best reporters on health policy. Monday, to go along with a couple of neat new projects she's launching, she published a
I have a Primary Urgent Care near me. It charges $200 per visit, during which they get you a diagnosis and prescriptions, and they can take x-rays there which are a little more expensive, but not exorbitant & crazy. If you have a serious problem, they will call an ambulance for you. It's good to be able to get a professional opinion that you DEFINITELY SHOULD go to the hospital when you are broke and just not SURE if the thing that's wrong with you is that bad.
But it's all suddenly very simple when you get the bill. Why is the price unknowable to the consumer only before the procedure? There is a process for determining the price. The discount rate has already been negotiated with the insurer. The hospital and providers involved have already set the prices for stuff and services. Somebody somewhere's job it is to create the bill. Why is this person unavailable for consult? Where the FUCK ELSE do we find out the price of something AFTER we buy it?????Can't the biller pretend to create the bill. Act as if the patient has received the treatment, in a simulation phase? Computers can do that now, right? Simulate things before they happen?
I'm covered by Medicaid and United Health. My state expanded Medicaid.
However, the last time I had an accident (not in a car; I don't drive), I was uninsured, or as the medical profession euphemistically calls it, self-insured. I did NOT go to the ER; I knew better. I went home, where I could research knee injury specialists. I knew damned well nothing would show up on an X-ray. I made an appointment with The Jock Doc, so-called because knee and ankle injuries are a specialty, and he's the orthopedist for a local professional hockey team. The appointment was two weeks hence, and I was invited to PA for a cousins' day-after-Thanksgiving lunch one week before the appointment, so I sent the then-boyfriend to buy me a knee brace from a surgical supply place in Westchester. Younger sister lent me a cane. I had a good time at our lunch, despite pain and lack of sleep.
Meanwhile, I started taking supplements and OTC Chinese herbal medicine; I'm trained so I know what to take. I kept every receipt.
The orthopedist's office isn't all that far from home; I took the bus. Of course, I was given an X-ray which showed absolutely nothing. The initial visit cost $150. The X-ray was $375. Because it was inconclusive, Doc told me to get an MRI. He thought the meniscus might be folded, which would have required surgery. This is the good part of the story. Doc's Physician's Assistant gave me a list of everyone who does the MRI, with addresses and phone numbers. I called all to get the price, which ranged from $500 payable only in cash or by personal check (the option I took), to $1,500 at the place in the same building as the orthopedist. I already had made an appointment to return for the MRI result.
Doc put the MRI film on the light box and asked what jumped out at me (he knew I was trained in anatomy and physiology). I pointed to a bright white section. He said, "First, this is not a surgical case." (Hearing that, although I hadn't slept through the night in weeks and was still in intense pain, I could have thrown a party and danced.) "Yes, that's the worst of the injuries; it's a bad contusion (bone bruise) and will be the slowest to heal." I had multiple tibial fractures from the impact, and three torn ligaments. I needed at least 8 weeks of twice weekly PT. The PA wrote my prescriptions (opiates and physical therapy).
Again, the PA stepped up. He presented me with a list of all the PT places, including one on the same floor as Doc's office. I called all of them for prices, ending with the one closest to home. That turned out to be the most affordable; $50/session, everything included. Others were $100 and more, and many charged by individual services -- exercises, equipment, ultrasound, laser. The PT was terrific; so was the sports medicine doctor she worked for. Those sessions could have cost me over triple elsewhere, and I would have had to travel to all of them. Instead, I walked there and back.
I bought my own TENS pack and hydrocollator, and used them for an hour twice a day (vs. 15 minutes twice a week during PT). I did all the prescribed exercises twice daily as well. Because I comparison shopped, everything together (brace, hydrocollator, TENS pack, PT, doctor visits, supplements, TCM remedy) totaled $5,500.
When my attorney settled the case, apart from the (small) settlement, I got $5,000 to cover the medical expenses, which almost did it.
I'm glad to now be covered. Had I needed surgery, I'd have joined the ranks of the medically bankrupt. Thank you, Benny, for being such a great PA.
Healthcare finance in hospitals is one of the most fucked up systems ever created. Cost, charge, and what hospitals actually get paid are completely unrelated numbers. (Full disclosure, I work for one) I can speak to the $7 dollar bandaid and $10 dollar Tylenol charges. Hospitals incur a lot of expenses that can't be billed for. The people who file your medical records. The person at the switchboard who answers the calls and directs you to the right person to talk to. The people in billing (irony). The IT staff. Security. And so on. Drug charges are part of how hospitals make up those costs, because we can bill for those. Same with bandaids, lab tests, MRIs, etc. That's why costs vary so much, each institution has to decide how those costs get covered. I'm not saying it's a good system. But the charges are part of the whole market based idiocy, and a single payer system that doesn't address those costs doesn't fix that.
If it were to happen now, I'd just have to make sure the hospital and doctor were in network and accept Medicaid patients. If it had happened then, I'd likely be dead.
Total body scan in the Netherlands. €1390,-Consists of:MRI Skull/brain MRI attributing vessels to the brainCT hart CT lungsMRI upper bodyMRI pesvisInclusive are cost for the doctor and contrast fluid.
Other costs:All lab researchPakketprijs: € 150,=
Administration cost € 15,= (total cost under € 200,=) € 38,50 (total cost over € 200,=)
Partial scans:CT hart € 320,00
CT lungs € 320,00
CT density bone structure: € 260,00
MRI Male pelvis/prostate: € 400,00
MRI skull/brain: € 360,00
MRI female pelvis: € 400,00
MRI Upper part vertebrae: € 400,00
MRI Lower part vertebrae: € 400,00
MRI upper body: € 400,00
MRI Brain damage packet: € 480,00
No where near what you Americans pay. Greetings from the Netherlands.
The system stinks, I agree. I have no idea what Medicaid is like in NJ; I'm only familiar with NYC. The clinic where my primary works is ten minutes away on foot, and I've gotten excellent care there. The waiting room is a bit of a snakepit; I wear a mask when it's cold and flu season because children aren't careful about where they sneeze and cough. I've been sent for tests (colonoscopy, sonography) to some of the best medical facilities in the city. When I needed meds, my co-pay was quite low. It should be this stress-free for everyone.
I have other stressors in my life, like long-term unemployment with no benefits, stretching EBT so I don't run out of food, etc., but medical care is not among them.
My (toxic, and now all but cut from my life) mom had lung cancer a couple years ago. They did the surgery to remove a lobe of her lung, and even though she mercifully had fantastic insurance and Medicare, we still got to see what was billed.
Box of shitty Kleenex? $10Bed linens: $50Meal service: couple hundred bucks (for a week worth of meals)
I'll say this again: I went to the ER last year with a broken ankle (brought in in a fire dept vehicle btw), then went back 4 times to the hospital to keep track of bone repair, then remove the cast. I paid a total of 80 euros. Daily nurse viaits for anticoagulant shots for 6 weeks cost me 100. Reeducation (12 hours) cost me less than 100. With my previous company's healthcare plan i'd have paid zero.
I have poor reactions to certain medications, in fact I have an ambulance visit to the hospital bill right now because I had a reaction to an allergy shot. Going to a walk in clinic is difficult for me because I don't know if the medicine prescribed will give me a reaction. I go see my GP faithfully because she understands my issues. I am very grateful I have insurance because the last time I had surgery the dressings cost $400 for five bandages I could have purchased for a fraction of the cost at CVS.
Oh God, where to begin. The profit motive MUST GO, this is where socialism would fill the bill nicely. Also, so much of this has to do with the ridiculous negotiating strategies; what the providers charge vs what is actually paid. It makes it LOOK like your insurance carrier is a hero, but no one ever asked where the goddamn cost accounting originated in the first place.
I have a Primary Urgent Care near me. It charges $200 per visit, during which they get you a diagnosis and prescriptions, and they can take x-rays there which are a little more expensive, but not exorbitant & crazy. If you have a serious problem, they will call an ambulance for you. It's good to be able to get a professional opinion that you DEFINITELY SHOULD go to the hospital when you are broke and just not SURE if the thing that's wrong with you is that bad.
But it's all suddenly very simple when you get the bill. Why is the price unknowable to the consumer only before the procedure? There is a process for determining the price. The discount rate has already been negotiated with the insurer. The hospital and providers involved have already set the prices for stuff and services. Somebody somewhere's job it is to create the bill. Why is this person unavailable for consult? Where the FUCK ELSE do we find out the price of something AFTER we buy it?????Can't the biller pretend to create the bill. Act as if the patient has received the treatment, in a simulation phase? Computers can do that now, right? Simulate things before they happen?
I'm covered by Medicaid and United Health. My state expanded Medicaid.
However, the last time I had an accident (not in a car; I don't drive), I was uninsured, or as the medical profession euphemistically calls it, self-insured. I did NOT go to the ER; I knew better. I went home, where I could research knee injury specialists. I knew damned well nothing would show up on an X-ray. I made an appointment with The Jock Doc, so-called because knee and ankle injuries are a specialty, and he's the orthopedist for a local professional hockey team. The appointment was two weeks hence, and I was invited to PA for a cousins' day-after-Thanksgiving lunch one week before the appointment, so I sent the then-boyfriend to buy me a knee brace from a surgical supply place in Westchester. Younger sister lent me a cane. I had a good time at our lunch, despite pain and lack of sleep.
Meanwhile, I started taking supplements and OTC Chinese herbal medicine; I'm trained so I know what to take. I kept every receipt.
The orthopedist's office isn't all that far from home; I took the bus. Of course, I was given an X-ray which showed absolutely nothing. The initial visit cost $150. The X-ray was $375. Because it was inconclusive, Doc told me to get an MRI. He thought the meniscus might be folded, which would have required surgery. This is the good part of the story. Doc's Physician's Assistant gave me a list of everyone who does the MRI, with addresses and phone numbers. I called all to get the price, which ranged from $500 payable only in cash or by personal check (the option I took), to $1,500 at the place in the same building as the orthopedist. I already had made an appointment to return for the MRI result.
Doc put the MRI film on the light box and asked what jumped out at me (he knew I was trained in anatomy and physiology). I pointed to a bright white section. He said, "First, this is not a surgical case." (Hearing that, although I hadn't slept through the night in weeks and was still in intense pain, I could have thrown a party and danced.) "Yes, that's the worst of the injuries; it's a bad contusion (bone bruise) and will be the slowest to heal." I had multiple tibial fractures from the impact, and three torn ligaments. I needed at least 8 weeks of twice weekly PT. The PA wrote my prescriptions (opiates and physical therapy).
Again, the PA stepped up. He presented me with a list of all the PT places, including one on the same floor as Doc's office. I called all of them for prices, ending with the one closest to home. That turned out to be the most affordable; $50/session, everything included. Others were $100 and more, and many charged by individual services -- exercises, equipment, ultrasound, laser. The PT was terrific; so was the sports medicine doctor she worked for. Those sessions could have cost me over triple elsewhere, and I would have had to travel to all of them. Instead, I walked there and back.
I bought my own TENS pack and hydrocollator, and used them for an hour twice a day (vs. 15 minutes twice a week during PT). I did all the prescribed exercises twice daily as well. Because I comparison shopped, everything together (brace, hydrocollator, TENS pack, PT, doctor visits, supplements, TCM remedy) totaled $5,500.
When my attorney settled the case, apart from the (small) settlement, I got $5,000 to cover the medical expenses, which almost did it.
I'm glad to now be covered. Had I needed surgery, I'd have joined the ranks of the medically bankrupt. Thank you, Benny, for being such a great PA.
Healthcare finance in hospitals is one of the most fucked up systems ever created. Cost, charge, and what hospitals actually get paid are completely unrelated numbers. (Full disclosure, I work for one) I can speak to the $7 dollar bandaid and $10 dollar Tylenol charges. Hospitals incur a lot of expenses that can't be billed for. The people who file your medical records. The person at the switchboard who answers the calls and directs you to the right person to talk to. The people in billing (irony). The IT staff. Security. And so on. Drug charges are part of how hospitals make up those costs, because we can bill for those. Same with bandaids, lab tests, MRIs, etc. That's why costs vary so much, each institution has to decide how those costs get covered. I'm not saying it's a good system. But the charges are part of the whole market based idiocy, and a single payer system that doesn't address those costs doesn't fix that.
When someone asks you, do you have a degree in medical billing? You say YES.
Comparison shopping is great. But.....What happens when you get in an accident and break your spine?
If it were to happen now, I'd just have to make sure the hospital and doctor were in network and accept Medicaid patients. If it had happened then, I'd likely be dead.
Total body scan in the Netherlands. €1390,-Consists of:MRI Skull/brain MRI attributing vessels to the brainCT hart CT lungsMRI upper bodyMRI pesvisInclusive are cost for the doctor and contrast fluid.
Other costs:All lab researchPakketprijs: € 150,=
Administration cost € 15,= (total cost under € 200,=) € 38,50 (total cost over € 200,=)
Partial scans:CT hart € 320,00
CT lungs € 320,00
CT density bone structure: € 260,00
MRI Male pelvis/prostate: € 400,00
MRI skull/brain: € 360,00
MRI female pelvis: € 400,00
MRI Upper part vertebrae: € 400,00
MRI Lower part vertebrae: € 400,00
MRI upper body: € 400,00
MRI Brain damage packet: € 480,00
No where near what you Americans pay. Greetings from the Netherlands.
How sweet it is. https://uploads.disquscdn.c...
The system stinks, I agree. I have no idea what Medicaid is like in NJ; I'm only familiar with NYC. The clinic where my primary works is ten minutes away on foot, and I've gotten excellent care there. The waiting room is a bit of a snakepit; I wear a mask when it's cold and flu season because children aren't careful about where they sneeze and cough. I've been sent for tests (colonoscopy, sonography) to some of the best medical facilities in the city. When I needed meds, my co-pay was quite low. It should be this stress-free for everyone.
I have other stressors in my life, like long-term unemployment with no benefits, stretching EBT so I don't run out of food, etc., but medical care is not among them.
My (toxic, and now all but cut from my life) mom had lung cancer a couple years ago. They did the surgery to remove a lobe of her lung, and even though she mercifully had fantastic insurance and Medicare, we still got to see what was billed.
Box of shitty Kleenex? $10Bed linens: $50Meal service: couple hundred bucks (for a week worth of meals)
And the list goes on.
I'll say this again: I went to the ER last year with a broken ankle (brought in in a fire dept vehicle btw), then went back 4 times to the hospital to keep track of bone repair, then remove the cast. I paid a total of 80 euros. Daily nurse viaits for anticoagulant shots for 6 weeks cost me 100. Reeducation (12 hours) cost me less than 100. With my previous company's healthcare plan i'd have paid zero.
America is so fucking weird.
Socialism is bad.
I have poor reactions to certain medications, in fact I have an ambulance visit to the hospital bill right now because I had a reaction to an allergy shot. Going to a walk in clinic is difficult for me because I don't know if the medicine prescribed will give me a reaction. I go see my GP faithfully because she understands my issues. I am very grateful I have insurance because the last time I had surgery the dressings cost $400 for five bandages I could have purchased for a fraction of the cost at CVS.
Sure, but if it was free people would go and have more accidents. This way promotes personal responsibility.
Oh God, where to begin. The profit motive MUST GO, this is where socialism would fill the bill nicely. Also, so much of this has to do with the ridiculous negotiating strategies; what the providers charge vs what is actually paid. It makes it LOOK like your insurance carrier is a hero, but no one ever asked where the goddamn cost accounting originated in the first place.