Where is all the money going?

Discussion in 'Healthcare/Insurance/Govt Healthcare' started by auditor0007, Sep 1, 2009.

  1. auditor0007
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    auditor0007 Gold Member

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    I can get a phlebotomy for $75.00. Insurance companies pay hospitals up to $1000 for this procedure. I can get a set of lab tests for $150. Insurance comapanies pay between $500 and $700 for the same set of lab tests. I can get an abdominal ultrasound for $200. Insurance companies pay hospitals around $1000 for the same abdominal ultrasound.

    Where is all this money going and why are insurance companies paying so much? Why are patients being charged so much to begin with if a patient can have these same procedures/tests done at a fraction of the cost?

    One big problem is that hospitals want to be the ones to provide us with all the services we need. You would think that having all services under one roof would lead to lower costs, but it does not. Hospitals have the highest overheads of any source in the medical field.

    I don't know what the answer is, but we are being overcharged for just about every medical procedure out there, and nobody is questioning where all that excess money is going. If I can go out and find good healthcare at 20% to 25% of what it would cost me through the insurance companies, then I have to ask where all this other money is going, because it's not going to healthcare. But you can bet that someone is getting rich off of it all.
     
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  2. KittenKoder
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    KittenKoder Senior Member

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    Where the hell can you get blood work from a hospital for only $150?
     
  3. AllieBaba
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    AllieBaba BANNED

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    I can.

    The thing is, hospitals take a huge hit from ppl they serve who don't pay. So when someone with insurance comes in, they're all over it.

    I have insurance but use a free clinic....and my insurance pays for it. I don't have many health issues, but I have 3 meds to take a day...one for thyroid, one anti-anxietal (which is optional, I don't use it about 2 wks out of the month) and one for spinal degenerative disease (naproxen) which works best if I take it twice a day, every day.

    I have to go into the clinic at least 2 x a month or they won't refill my scrips. I pay a co-pay each time, and my insurance pays the rest. It's not a huge co-pay or anything, but still, crap, it pisses me off. I've had the same dosage of xanax (it's tiny, .5 mg) the same dosage of Naproxen for YEARS...and the stupid thyroid I've already had the blood tested and retested...it shouldn't require anything more than a yearly check.

    So why the hell do I have to go in over and over? Just give me a scrip for a year and have done with it.

    It pisses off the drug store, too. Because every single time I call them for a refill, they have to have a call in from the clinic, which means I have to call the clinic, then the clinic says I have to come in...or doesn't get it through until the next day, which really SUCKS when you're 20 miles from the drug store..which closes at 1 p.m. on weekdays and you only are in that town 2 x a week.

    And believe me, if I run out of the thyroid after about 3 days it's beddie-bye time and if I run out of the xanax when I need it, it's anxiety attack time, which isn't funny, as anyone who's ever suffered it knows. It means days of insommnia, extreme anxiety (think what it feels like the morning after someone you love dies, or you're fired for killing someone on the job, and that's what it feels like every day, even though that hasn't happened).

    Ok, rant over. I'll stand by for snotty responses.
     
  4. AllieBaba
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    AllieBaba BANNED

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    That means you, Dis. It's time to say I'm a man-hating lesbian. I can take it.
     
  5. Vel
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    Vel Gold Member

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    Those are great questions none of which seem to be addressed by HR3200. The politicians can't seem to get past insurance. It seems to be the end all be all for them. Because insurance pays for the majority of peoples healthcare costs, most people don't even know or ask what the price of a doctors visit is right now. They only know what their co-pay is.
    I just went through part of the scenario you just described a few months ago. I hadn't yet met the deductable for my insurance and needed an ultrasound. If I'd had it at the doctor's office, they were going to bill my insurance company almost $700.00 ( which since I'd not met deductable, I would have had to pay ). I had them schedule the ultrasound at a private Imaging Center and the price was $236.00.
     
  6. auditor0007
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    auditor0007 Gold Member

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    I ordered these tests through an online company. I ordered the tests I needed, which were the tests my doctor had ordered. I did not need the doctor's orders to order the tests however. After I paid for the tests, they sent me a requisition order to go to one of the same labs that doctors use. That lab drew my blood; it took all of five minutes. Two days later, I received my results through E-mail.

    Following are the tests they provided me with;

    Comp. Metabolic Panel (14)

    Glucose, Serum
    BUN
    Creatinine, Serum
    BUN/Creeatinine Ratio
    Potassium, Serum
    Chloride, Serum
    Carbon Dioxide, Total
    Calcium, Serum
    Protein, Total, Serum
    Albumin, Serum
    Globulin, Total
    A/G Ratio
    Bilirubin, Total
    Alkaline Phosphatase, S
    AST (SGOT)
    ALT (SGPT)

    Lipid Panel

    Cholesterol, Total
    Triglycerides
    HDL Cholesterol
    VLDL Cholesterol Cal
    LDL Cholesterol Calc

    Iron and TIBC

    Iron Bind. Cap (TIBC)
    UIBC
    Iron, Serum
    Iron Saturation

    AFP, Serum, Tumor Marker
    CPC Immulite methodology

    Ferritin, Serum

    Obviously, if I had these tests done through the hospital, I would not have had them done for $150. It would be more like $750. But that is my point.
     
  7. KittenKoder
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    KittenKoder Senior Member

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    Okay, that's the part I missed, your point. My bad. Hospitals charge a lot more, even a clinic doesn't charge as much as they do, because of red tape, they have higher insurance rates (protection against lawsuits and required by law) so they have to jack up their prices. I mean they charged me $150 just for seeing a nurse once without insurance. Most people don't actually "follow the money", they just look on the surface, if they did follow the money to the top they'd realize that the FDA and government regulations are what's really controlling the costs. Think of it as a ladder, each person on the next rung has to pay all the costs of the one on the previous plus any profit they try to make, the FDA and government is at the start, but the doctors can't charge too much more (though I think they do over charge a bit anyway) if they have someone negotiating the prices for us, like insurance companies, but without the competition of the insurance companies they can charge you whatever they want, and you'll pay or the government will.
     
  8. auditor0007
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    auditor0007 Gold Member

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    Just another example. It seems to me that we are overpaying for just about everything when it comes to healthcare. In most cases, we don't question it, because we just want whatever needs to be done to be kept simple. We're happy paying our little co-pay and on we go, rather than questioning everything as we should.

    The only way any of this will change is if people have to pay for the basics themselves. For the average person, most of our healthcare costs are the basics. As many problems as I have, I can pay out of pocket for my own treatment and tests and my costs are around $1500 per year. With insurance, I would end up paying the full $2500 deductible plus my premiums plus some above my deductible.

    Of course there is more to my rants. The way things are now, you can't set up a HSA unless you also have a high deductible insurance policy. I can't get a reasonably prices insurance policy period because of pre-existing conditions, so I can't set up an HSA to reduce my tax burden. But that's another story all together.
     
  9. KittenKoder
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    KittenKoder Senior Member

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    Yep, people are too complacent about their healthcare across the board, when they go to see a doctor they just take what they are prescribed without even questioning that, also any procedures ordered they just suffer through without asking why. Or sometimes the reverse happens and when a doctor ignores something they just forget about it. Whatever happened to the "second opinion"?

    This can go on and on. :lol:
     

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