July 07, 2009

Healthcare Sanity

This whole issue goes back to there is no methodology to pricing in healthcare. There used to be, back in the day. You went to see the ol’ Doc and he gave you a bill. Doctors today do not even know what they charge, if you ask a doctor what it costs for a simple procedure they have no idea. My company’s dental plan has a list to say what they will pay for each procedure. If they say that they will pay $100 for an extraction, and my dentist charges $120, I know I owe $20. But If I go in to the doctor for a checkup, I pay $25 for my copay, and then all kinds of gyrations have to happen between the Dr office, the Clinic, the hospital, my insurance, my employer, me, etc. Meanwhile I have no idea what an office visit actually costs. A lot of the costs a Doctor incurs are associated with Billing and Insurance. SO it costs the Doctors a lot of money just to bill and get paid for their services. The problem is no one knows what it costs. The Dr. doesn’t know, the patient doesn’t know, the insurance may know, but they aren’t saying. How will the American people know if any reform is saving them money if they do not know how much it costs in the first place? Not only do I not know what my Doctor charges, I do not know what my insurance costs. I know what gets withheld from my check, but my company also pays MOST of the premium. This is a ludicrous system, and the government is only trying to make it more complicated.

The biggest problem with our system is the Insurance stands between the patient and the doctor. This is not how car insurance works, this is not how home insurance works. How cool would it be if before you had a knee surgery you got three estimates, or if you just got a quote from your doctor, and then compared that to what your insurance said they would pay for that procedure? Then at least you would know. What if the insurance cut you a check like homeowner’s insurance does when you need a new roof? Let me make a claim and get my money to pay my doctor.

What if your company disclosed what they paid for your premium so you would know what it cost? What if Doctor’s had to disclose their prices? What if the Government had to pay the going rate instead of whatever they choose for Medicaid? The idea that the Government will dictate prices is BAD. Bad idea, government dictating prices always causes corruption and loss of service.

The insurance should be the backup for the patient, not the parent, negotiating and paying the bills. A person’s medical care should be an informed decision. But everything in our system is set up to ensure that we aren’t informed. *gasp* it should be an issue of personal responsibility and freedom.

I agree totally with the administration, the whole system is BROKEN. That is where our agreement ends. The broken part of the system is that the doctors and the insurance companies are engaged in trench warfare and the casualty is the patient. Insurance is largely a racket. Doctors are less concerned with patient care in many cases than they are about waiting room turnover, time management, and making money. Lawyers get involved in the mess too, as Doctors are terrified of making any mistake whatsoever. But to suggest that the government can FIX anything is ridiculous, ludicrous, laughable, and absurd. Government does not fix anything, and they do not produce anything. Government will not increase competition OR keep anyone honest. That would be like an alcoholic keeping people out of the liquor store. What Government knows about honesty could fit in the period at the end of this sentence Notice I didn’t put a period at the end of that sentence. Government reduces competition, and increases corruption.

SHOW ME ONE POSITIVE THING THE GOVERNMENT DOES BETTER THAN PRIVATE INDUSTRY.

Does this look like a reasonable process flow?

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Comments (9)

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This can be put very simply: once upon a time, you went to your doctor, and paid him. Now you give insurance money, copays, then you have to get your doctors approval for hospital visit in the middle of the night when you are having a massive heart attack. There are 1000 hands in the cookie jar that you put money in to pay your doctor.

Now I support going back to the time when you pay your doctor and your pills. Competition would encourage both better and cheaper care. Times were simple then.
3 replies · active 821 weeks ago
blackandgoldfan's avatar

blackandgoldfan · 821 weeks ago

SHOW ME ONE POSITIVE THING THE GOVERNMENT DOES BETTER THAN PRIVATE INDUSTRY.

They can positively screw up the country!!! :-)
Waste time and money. That was easy one.
Thanks... I walked into both of those.
You're absolutely right, and I have to tell you that the trend for insurance plans is going back to the old deductible and then payment at 80% plan. The insurance companies found that with the low copays the costs of healthcare actually went up! When it only cost you a $10 copay, people were going to the doctor for everything. Since the patient was paying less, they used it more, but the overall cost was going up as a result. Taking the patient out of the cost equation has been proven not to work, and now the movement is to get them involved again.

By the way 60 cents of every dollar for health care is administrative costs. Isn't that crazy!
2 replies · active 820 weeks ago
so what will that mean when Daddy Obama and Nanny Pelosi are paying for our healthcare? Zero copays...what will that do to ER wait times, Medical costs, doctor quality, and general quality of life?
The same thing they have done with Congress and the daily White House press conference. They will make it a giant overpaid undervalued circus Obama will make a great clown and Pelosi will be the male woman. Barney Frank will be a circus elephant and Harry Reid will be his trainer. Charlie Wrangel will be in charge of admissions and Arlen Specter will change colors every 5 minutes. Circus freaks all.
You know, that's an excellent point. As a manufacturer what do you want to do in order to sell your product? Make it inexpensive and make it easy to get. This works because though your costs may go up because you have to manufacture more in order to meet the need, your profits are going up as well.

Since the government would not be making any profit on healthcare, making it cheap and easy would increase the product usage, theregy increasing the costs while bringing in no additional money to cover it.

Hmmmmmm, sounds like a blog topic.
1 reply · active 820 weeks ago
Ahh but you have really hit the nail on the head. By making it crappy and more expensive and harder to get they will achieve their true goal:

Thinning the Herd.

Goes back to the "are they really that stupid, or is this what they want/are they evil" question.

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