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  1. #41
    Steve Smith's Avatar
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    It would appear that most of the money changing hands in the US medical system ends up with the insurance companies.

    I think you to remove the insurance companies from the system.


    Steve.
    "People who say things won't work are a dime a dozen. People who figure out how to make things work are worth a fortune" - Dave Rat.

  2. #42

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    Found the original thread of PE discussing retirement plans, and I misquoted him as saying most had chosen the cash out option. Reading that old thread made me realize Kodak is either doing very well protecting the employee pensions, or we haven't begun to hear the worst of it.

  3. #43
    Ken Nadvornick's Avatar
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    Quote Originally Posted by Steve Smith View Post
    It would appear that most of the money changing hands in the US medical system ends up with the insurance companies.
    "Capitalism is savagery."



    Ken
    "They are the proof that something was there and no longer is. Like a stain. And the stillness of them is boggling. You can turn away but when you come back they’ll still be there looking at you."

    — Diane Arbus, March 15, 1971, in response to a request for a brief statement about photographs

  4. #44

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    Steve ... nearly every hospital in this area is going broke because of the cost of emergency services
    to the uninsured, and this is one of the most affluent parts of the country. More payroll is spent in
    the office haggling with insurance companies than payroll for doctors and nurses. Some surgeons aren't even getting paid. It's even worse in private practice. A private insurance plan for a family
    can be double per month of a home mortgage - and then they can dump you when you real need it.
    But to be fair to the ins co's - they need all that money so they can pay their buddies in congress
    to prevent change. (My wife is in medicine and we're right in the middle of the mess!)

  5. #45
    Pioneer's Avatar
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    Ain't life grand!

    Nobody seems to be making any money. Not the Companies providing the benefits. Not the Insurance Companies who insure the benefits. Not the hospitals who are providing the services. Not the Government who oversees the entire mess.

    So tell me...where is all the damn money going??? I sure ain't getting any of it!! All I get are the bills and the taxes.

  6. #46
    Photo Engineer's Avatar
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    I said nothing in my last post about uninsured. I merely stated that we have the best (and fastest responding) medical care system in the world, and that is obvious when we get "guests" from everywhere world-wide that take advantage of it.

    For those who think insurance companies are getting the lion's share, remember that Medicare is low overhead and pays for a lot of our medical care over 65.

    PE

  7. #47
    Ken Nadvornick's Avatar
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    Quote Originally Posted by Photo Engineer View Post
    I said nothing in my last post about uninsured.
    No, you didn't. But those 50+ million uninsured really are the 800-pound silent gorilla in the room, aren't they?

    If we have to completely ignore one-sixth of the entire population of the United States—simply say nothing about them as if they didn't exist—in order to make the case that we have the best overall medical system in the world, then what that says morally and ethically about us is far worse than what it says about them.

    They do count.

    And the fact that they do not have any medical access to anything other than hideously expensive, and most of the time hideously inappropriate, emergency trauma room care is financially killing us all. Individuals and businesses. If we can't bring ourselves to do the sane thing and reform this upside down system—and do it fast—then the only other viable option would be to repeal the laws that require hospital emergency rooms to treat everyone to the point of stabiliztion. Then when they show up at the door just tell them instead to go find a quiet place under a freeway bridge somewhere and tough it out.

    And when their problems are more severe than the sniffles, you know what that means...

    Ken
    "They are the proof that something was there and no longer is. Like a stain. And the stillness of them is boggling. You can turn away but when you come back they’ll still be there looking at you."

    — Diane Arbus, March 15, 1971, in response to a request for a brief statement about photographs

  8. #48

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    Quote Originally Posted by BrianShaw View Post
    Thanks Sal.
    +1

  9. #49

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    Quote Originally Posted by Ken Nadvornick View Post
    The total overall cost for that broken elbow, including eventual rehabilitation, came to just over $100,000. It did include entry into the system via emergency trauma care.

    Payable costs between providers and insurance companies are tightly negotiated and controlled. Generally, providers bill at one level, but agree to accept negotiated fee settlements that limit out-of-pocket costs to the insured at a much lower level. So you actually pay the costs via higher insurance premiums and not direct provider reimbursement. Our out-of-pocket was about $4,000. That was a 96% reduction for us. Not too bad. However, to cover the shortfall my employer's cost of his employee's medical insurance premiums are insanely high. This limits his ability to expand and hire.

    And because insured patients pay so little out-of-pocket—and uninsured patients almost nothing—there is no visibility of the problem. And no incentive, when feasibile, to shop around for lower costs. It's always somebody else's (the insurance company's) money, so why worry? Except that the insurance companies get that money from us.

    It's not a ripoff. In the absence of reform, this is how the system has evolved and works. We deny access to millions, thus forcing them into the most expensive levels of emergency care possible, then spread that unneccesary extra expense to those who do have insurance via insurance company premium structures. In other words, we all pay far more than is necessary to get much lower levels of care (stabilization only) than are actually required.

    Something has got to change before we bankrupt this entire country.

    Ken

    How could a broken arm cost substantially more than emergency surgery and a delivered baby?? My wife was on the operating table less than 30 minutes after me rushing her to the ER. Our baby was delivered immediately and several surgeons did exploratory surgery to try to find out what was causing her such massive pain. Her entire abdomen was examined by the surgeons.

    She had several weeks of recovery care due to the extensive nature of the surgery done on her.

  10. #50

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    My current company bypasses health insurance companies completely. They self insure all employees up to around 50,000 dollars/year. If you exceed that then a separate policy kicks in for extreme cases. Result? The "premiums" that I pay are less than HALF of what I paid at my last company, which used a traditional health insurance company. Coverage is the same or better as are the copayments.

    Why cant more companies do this?



 

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