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01-26-2008, 06:40 PM   #1
Sojourn
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Hospital bills

I know we've discussed this before, but I never cease to be amazed, after a hospital stay, how much I still have to pay even with insurance. My insurance at my current job isn't as good as my last, but in both cases, I still end up owing thousands of dollars. This time it may be more like $7,000 as opposed to the $5,000 with the better insurance. The most recent surgery was more major so that's probably part of the cause also. And I'm adding all the services including radiology, anesthesia, GI, surgeon, hospital, and whatever else they can come up with. I wish they could just put it all on one bill.

I know without the insurance it could probably easily be $20,000-$30,000, but I still feel like insurance should save me from owing thousands of dollars. I don't want to get into a health care debate, just venting.
01-26-2008, 07:03 PM   #2
Ilysha
 
Agreed. I have decent insurance, but my last hospital stay put me out a few thousand, and I know that I will be paying $2000 this year copay for remicade, even though my insurance will cover 90%. It's incredibly frustrating. Have you seen the movie Sicko? It really does put the whole U.S. healthcare system to shame.

Thanks for the vent opportunity!
-Ilysha
01-26-2008, 07:30 PM   #3
Sojourn
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I haven't seen Sicko, but suppose I should. From what I read, there's a lot of truth in it with a few exaggerations.

Basically, a major hospital stay for the average wage earner in the U.S., with insurance, will still cause bankruptcy or considerable hardship.
01-26-2008, 09:24 PM   #4
saidinstouch
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Your policy should have a maximum out of pocket expense for any given year...at least if its a ppo that limits your responsibility. You might want to check if your policy has a limit like that, its the only thing that made my remicade infusions reasonably priced. But yeah, it can get out of hand in a hurry without a decent insurance policy.
01-27-2008, 12:41 PM   #5
Kev
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I havent' seen sicko, and I myself have vented on the 'Canadian' health care mire, but there seems to be extremes in countries like the US and Canada. Neither is a best, not even better case scenario. I like that I can get into see any doctor free of charge, and go to a hospital/clinic, etc., free of charge. But so can people with either imaginary or fake symptoms (as a P.I., I've witnessed more than few). The problem is, here in my little part of the world, 48% of our taxes go to pay medical care. Why? Stupid things like staff acting as receptionists in a hospital or clinic have to be nurses first? does that make sense? minimum wage position is actually costing top scale salary figures. Ambulatory patients, who are 'permited' to walk the grounds of the hospital w/o nurse supervision; can't be transported to another medical facility w/o being in an ambulance with 2 licensed paramedics. Why? Why not a taxi, or a relative? It is totally 'STUPID' Beauracry (sp?). I saw 2 computer techs' replacing 15" CRT computer screens with 17" LCD flatscreens. Since that was my field, I asked them 'WHY' Did it involve a special software package that required those new displays. answer! no, the flatscreens just took up less space. Whose Joe Genius rational was that? Idiotic!!! Every one they replaced, they simply pulled off the top of the computer underneath. Put the new one in same place. No added room gained. The space taken up was the computer, not the display screen. At the time, a 15" CRT cost between $150 - $200 CAD per (and with typical lifespan of 10 yrs) Replacements were between $700 - $900, but with equiv. lifespan. They turfed working equip with yrs left in it, gained no desk space, and spent thousands of dollars with absolutely no benefit to the staff, nor the patients. Beauracracy! It really pisses me off... And dont' even get me started on insurance companies who know/catch somebody cheating the system, but let them off rather than prosecute cause it costs too much, or is too embarrassing, or they might lose.

I'm just venting too! Just hate to see ordinary common sense displaced by all of the paper pushers, bean counters, beauracrats, and other useless people. Wish they'd get sick.
__________________
KEV

Dx'd July, 2006
Meds: Flagyl, Cipro, Pred, AZA.. to no effect
Low Dose Naltrexone Nov 2007 - May 2014
Remicade June 17th, 2014

Last edited by Kev; 01-27-2008 at 12:44 PM.
01-27-2008, 02:08 PM   #6
Ilysha
 
Wow--I guess the Candian system isn't perfect either. France anyone?

Yes, Sicko I'm certain has exaggerations and should not be taken as 100 truth, but it really does synopsize what is wrong with the U.S. health care system quite well. I'd say it's a worthwhile rental if nothing else...
01-27-2008, 08:39 PM   #7
Sojourn
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These are my bills so far from the surgery and so far I owe $3794.24. I plan to contest the $1,235 for anesthesia that was denied for whatever reason. But what I'm really worried about is the $35,384.26 bill from the hospital that has not been settled yet. It seems to be taking a long time.




Gi Of ****, Llc
Medical
11/1/07 to 11/5/07

Total Cost of Service: $222.00
Claim Processing Status: Complete
Member Responsibility: $179.38

*****, Dale R, MD
Medical
10/31/07

Total Cost of Service: $7,400.00
Claim Processing Status: Complete
Member Responsibility: $2,140.24

****, John B, Do, Pc
Medical
10/31/07

Total Cost of Service: $1,235.00
Claim Processing Status: Denied
Member Responsibility: $1,235.00

****** Regional Hospital
Medical
10/31/07 to 11/5/07

Total Cost of Service: $35,384.26
Claim Processing Status: In Progress
Member Responsibility:

Gi Of *****, Llc
Medical
10/31/07

Total Cost of Service: $288.00
Claim Processing Status: Complete
Member Responsibility: $240.25
01-27-2008, 11:09 PM   #8
KCMike
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From what I have seen and read there is no perfect healthcare system anywhere in the world but I don't have too many complaints. Hey, they may have free medical care in Cuba but who wants to live under a communist regime.

Where I used to work(500+ employees) my cost for health insurance was $389 USD/month. No deductibles. My wife had an emergency c-section. The total cost of the delivery/surgery/4 days in the hospital was around $20,000.
Our cost was $0.

Since then I have changed jobs and work for a much smaller company(around 20 employees). I am pay $500/month for health insurance. I had a resection in October 2006. The total cost of all of tests(CT scans/colonoscopy/xrays, bloodwork...etc) + surgery and 5 days hospital stay was around $48,000. My cost was only $2000. It's all about what kind of deal your company can work out with the insurance companies. For larger companies they get better deals than the smaller ones.

In the US money talks. It is a flawed system. I agree that no one should be denied healthcare but if we were to have some form of socialized medicine in the US I would be paying more per month because our taxes will increase substantially to cover those that don't currently have health insurance. The middle class will get screwed the most because there are more of us.

The politicians promise to make sure that everyone will have healthcare but they don't say how they're going to pay for it. The easiest way is to increase taxes.

Doctors are rich, pharmaceutical companies spend more money on advertising than the entire GDP of some small countries and I see hospitals adding more space all over the metro area. I think they should help absorb some of the costs. There is just too much greed.
01-27-2008, 11:17 PM   #9
KCMike
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I also forgot to mention that I don't see many insurance companies filing for bancruptcy either. Those basta**s increase the rates every year no matter what. I wonder if I worked for one of those companies if I would get a good health insurance plan.
01-28-2008, 12:53 PM   #10
Babe123
 
we get free health care under the NHS in the UK.

but if you want to go private it costs you.
x
01-28-2008, 02:28 PM   #11
tmcuddles
 
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I guess I should feel lucky that my first ever hospital visit for Crohn's only cost me $550 of like $12,000 or so. The only positive I ever saw to that was claiming it all on income taxes, prescription copays, office copays, any hospital visit over the last year ... I hope for a refund somewhere.
01-28-2008, 08:35 PM   #12
billy0510
 
Well this is one dept that i cant complain. I'm currently union laborer with great benefits. My total medical claims in 2007 $48,256 Medical $4,200 Prescriptions, total out of pocket 1100 medical ( my Max ill pay for each person in my family) $0 Prescription (750 Max per person). I know allot of people don't like or believe in unions but i am proud to be union strong. They keep corporations fair and benefits reasonable.
01-28-2008, 09:53 PM   #13
Creepy Lurker
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Babe123 said:
we get free health care under the NHS in the UK.

but if you want to go private it costs you.
x
The downside of this is that NHS patients are somewhat treated as second class.

For instance, I have a friend who also has Crohn's. As a private patient, she saw a consultant at every appointment rather than an SHO or nurse-specialist, had numerous scans MRI and ultrasound scans (as well as the usual colonoscopies) and had genetic profiling to determine if she had a genetic variant of Crohn's.

I, on the other hand, has a single colonoscopy. I heard nothing for at least six months.
01-29-2008, 06:03 PM   #14
Kev
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Yeah, Creepy Lurker, there's a two tiered med system in Canada too. My 2nd foray to the ER, back when I had both my provincial health coverage AND private insurance thru work... Patient ahead of my in the ER was in far worse shape. Had all the appearances of pending heart attack (and he had extensive history of this).
Problem was he had no private coverage. He was told he would be observed and released, as they had no beds for him (w/o private insurance, ward bed is all he qualified for).. When they came to me... I was prepared for the same, sad story... sorry, no beds. But thanks to my private insurance, they found room for me in the inn... plus personal TV, free newspaper, all those essentials. The sad part is, is it isn't based yea/nay on a persons health... It seems like those who've got private insurance get better care... but mostly what they have is an insurance company who can/will pay for all those extra tests, scopes, scans, etc.. It's not a case of.. well, this bloke has all this coverage, lets give him the absolute best care possible... It's more a case of lets' bill the insurance company for every last penny we possibly can.. If the patient benefits, fine. If the patient just becomes a glorified pin cushion for best billing practice, that is just fine too! He may even get cured.... like, accidents are known to happen!!
01-29-2008, 09:16 PM   #15
KCMike
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Hey billy,

More power to you man. I definitely think unions have their place. I was in the GCIU(Graphics Communications International Union Local 235) which was part of the printing and publishing industry in the late 80's and early 90's.

We had great benefits but come contract time we all were sweating bullets. The owners of the companies and the union had some major battles during contract negotiations. The 80's were very prosperous for everyone but the 90's weren't so good. The industry was transitioning from conventional methods to digital(filmless) printing.

The union was at fault for basically ignoring the technology and most of the "skilled" craftsmen were let go because they had no training on computers which was basically replacing them. In order for the owners to stay in business they had to incorporate the technology but many of those companies went bankrupt.

I unfortunately worked for one that didn't survive. The union is still around but most of the skilled people and smaller graphics shops are gone. I was lucky enough to have a fully vested pension so I'm guaranteed a decent monthly check when I retire. Hopefully I'll live long enough for that. If not my wife gets a lump sum payout.

I still work in the industry but my wages haven't kept up with inflation. My health coverage is good but it costs me a lot more money to have it.
01-30-2008, 04:16 AM   #16
Sojourn
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I just left my job and the union. This insurance that I'm citing here is with the union job. The biggest problem is the deductibles. I've gone back to my old non-union job with better insurance at about the same cost.

I'm sure it can vary from union to union, but this particular one hasn't negotiated the greatest health benefits. Though it is particularly good on prescriptions. My Humira bill is already over $5000 and the insurance has covered all of it. I'll be on this insurance the next 3 months through COBRA until the insurance on my current job becomes effective. Then the Humira will cost $50 a month.
01-31-2008, 12:54 PM   #17
Babe123
 
Creepy Lurker said:
The downside of this is that NHS patients are somewhat treated as second class.

For instance, I have a friend who also has Crohn's. As a private patient, she saw a consultant at every appointment rather than an SHO or nurse-specialist, had numerous scans MRI and ultrasound scans (as well as the usual colonoscopies) and had genetic profiling to determine if she had a genetic variant of Crohn's.

I, on the other hand, has a single colonoscopy. I heard nothing for at least six months.
that is true... i was in hospital for eight days... they kept telling me i could go home but kept me in... the nurses kept jabbing needles into my arms wrong so i was covered in bruises and i had to they were friendly though.

x
02-03-2008, 04:59 PM   #18
Sojourn
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Well, I guess that union insurance wasn't so bad after all. It looks like they paid the whole hospital bill after negotiating significantly lower.

******* Regional Hospital

Total Cost of Service: $35,384.26
Member responsibility: $0.00
***** Insurance Responsibility: $6,450.00

So it looks like I'm only going to be out a couple thousand from the peripheral bills. That's a big relief. But I'm still almost out $5000 only from August of this year.
To all of you young people, make sure you get a job with insurance when you're off of your parents plan.

Total Cost for Health Care Services: $59,077.44
Total Member Responsibility: $4,406.79
02-03-2008, 05:59 PM   #19
Kev
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Raises the question how the union was able to negotiate such a lower bill. Like, I am guessing that the hospital either has to make up the shortfall (somehow) else they really padded the bill to begin with (that I can believe, but isn't it illegal, and if this is a common practice, why isn't some money hungry law firm somewhere not filing a class action suit for all the folks who've been overbilled - a sure fire win) OR those inflated bills are inflated because 'groups' are somehow getting major discounts - meaning Joe Average is really getting... well, you know, the proverbial threaded fastener method. Something stinks!!

Having said that, congrats to you... theres' a big relief I bet
02-03-2008, 06:18 PM   #20
Sojourn
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It was not directly the union, but the insurance that the union got the company to give its employees. So it was the insurance company that negotiated the lower rate, and yes, if you don't have insurance, you really get screwed.

The insurance companies are able to negotiate them lower because of all the business they do with the hospitals. Usually, the larger the insurance company, the better rate they get. If you don't have insurance, you can usually get it a little lower, but nothing like what the insurance companies get.

It is really messed up. People that don't have insurance, who are usually worse off, get the full bill.
02-03-2008, 06:54 PM   #21
Kev
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So, in short, those paying the least are getting the best medical care, and those who pay the most get the least (only what they can afford). Yeah, it's messed up
02-03-2008, 08:07 PM   #22
Sojourn
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Kev said:
So, in short, those paying the least are getting the best medical care, and those who pay the most get the least (only what they can afford). Yeah, it's messed up
Pretty much. You are punished if you don't have insurance, and it may be no fault of your own.

Average wage earners cannot pay that kind of money. They end up filing medical bankruptcy. But with a chronic disease, I don't what they do, how many times you can file medical bankruptcy?

A lot of the time those without insurance just don't get the care they need. If you go into the emergency room, you will be kept from dying, but you don't get diagnosed or treated on a continuous basis.

When I first went into the hospital for Crohn's, I didn't know I had Crohn's and didn't have insurance. I had to get a job with insurance, and then wait 3 months for it to take effect, so I could go to the GI and get a colonoscopy to get a diagnosis.
02-03-2008, 08:12 PM   #23
Kev
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I dunno what the law is there, but here, a person can file personal bankruptcy once, and only once. Corporate bankruptcy has no limits. Go figure. It actually benefits some folks here to create a corp., pay the fees, and funnel all they own thru it. And here, once you have a condition, any condition, it becomes impossible to get insurance that will cover any of the associated costs, regardless of passage of time. A pre-existing condition gives the insurance companise an 'out'

Last edited by Kev; 02-03-2008 at 08:15 PM.
02-03-2008, 08:40 PM   #24
Sojourn
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Yeah, I don't know. I know there used to be no limit for personal bankruptcies here, but some new laws were passed recently making it more difficult to qualify.
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