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Jeffrey Singer: The Man Who Was Treated for $17,000 Less
The Wall Street Journal ^ | August 21, 2013 | JEFFREY A. SINGER

Posted on 08/22/2013 7:55:12 AM PDT by Hojczyk

When the man arrived at the hospital for surgery, the admitting clerk reviewed the terms of his policy and estimated the amount of his bill that would be paid by insurance. She asked him to pay his estimated portion in advance. (More hospitals are doing that now because too often patients don't pay their portions of the bills after insurance has paid.)

The insurance policy, the clerk said, would pay up to $2,500 for the surgeon—more than enough—and up to $2,500 for the hospital's charges for the operating room, nursing, recovery room, etc. The estimated hospital charge was $23,000. She asked him to pay roughly $20,000 upfront to cover the estimated balance.

Most people are unaware that if they don't use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the "list" price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.

I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance

(Excerpt) Read more at online.wsj.com ...


TOPICS: Editorial
KEYWORDS: healthcare; healthinsurance; obamacare
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1 posted on 08/22/2013 7:55:12 AM PDT by Hojczyk
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To: Hojczyk

Great example! We need a free market!

Get the govt out of health insurance, it only causes prices to rise.


2 posted on 08/22/2013 8:01:53 AM PDT by Ray76 (Common sense immigration reform: Enforce Existing Law)
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To: Hojczyk

I helped a friend get a prescription

They originally filled it with a name brand medicine, for $400, and told her her ‘co-pay’ would be $40. They thought she had insurance through a certain company.

When she told them she had no insurance, they re-filled it with a generic brand for $25. (made by the same manufacturer, without the name brand bottle)

People have NO INCENTIVE to shop around, even when it would have saved her $15 more. the pharmacy would not have told her about the other medicine by their own volition.

Only in an idiotic system like ours is this possible.


3 posted on 08/22/2013 8:02:10 AM PDT by Mr. K (Lies, Damned Lies, Statistics, and then Democrat Talking Points.)
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To: Hojczyk

So it is insurance that creates the cost problem in medical treatment. The government solution is to force everyone to buy insurance. Makes total sense! If your only goal is to put the government in charge.


4 posted on 08/22/2013 8:04:18 AM PDT by scottteng (Tax government employees til they quit and find something useful to do)
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To: Ray76
Get the govt out of health insurance, it only causes prices to rise.

That and quality to fall through the floor.

5 posted on 08/22/2013 8:05:24 AM PDT by Standing Wolf (No tyrant should ever be allowed to die of natural causes.)
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To: Hojczyk
ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?

Oh, they've already learned. What they learned is that to control health-care is to control life.

Slavery, anyone?!

6 posted on 08/22/2013 8:05:42 AM PDT by DakotaGator (Weep for the lost Republic! And keep your powder dry!!)
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To: scottteng

Don’t get me started on prescriptions. I have finally arranged life so that most of mine are on the dreaded Walmart $10 list. Except for the one that I have to order from Canada to get a decent price.


7 posted on 08/22/2013 8:06:52 AM PDT by scottteng (Tax government employees til they quit and find something useful to do)
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sfl


8 posted on 08/22/2013 8:08:15 AM PDT by phockthis (http://www.supremelaw.org/fedzone11/index.htm ...)
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To: Ray76

This is what the GOP needs to talk about

put together a list of all these stories and use that as a basis for ‘change’ to the health care system

starting with putting the shopping around for bargains back in the consumers hands

FIRST and MOST IMPORTANT: When you go to a hospital or pharmacy you pay a PERCENTAGE, not a ‘co-pay’ (fixed amount that is the same no matter where you go). That way you can shop for the place that will minimize your costs.

SECOND- ALL insurance policies are for catastrophic illnessed only. I dont expect my car insurance to pay every time I go get my oil changed or spark plugs- even if I want my oil changed every week or 12 sets of new spark plugs per year. I want them to pay only when there is an accidetn. (companies are REQUIRED by the government to pay for all things)

THIRD- Shoot all medical malpractice lawyers... wait- did I say that out loud?


9 posted on 08/22/2013 8:18:45 AM PDT by Mr. K (Lies, Damned Lies, Statistics, and then Democrat Talking Points.)
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To: Hojczyk

Bookmark.


10 posted on 08/22/2013 8:26:33 AM PDT by SunTzuWu
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To: scottteng
I have finally arranged life so that most of mine are on the dreaded Walmart $10 list. Except for the one that I have to order from Canada to get a decent price.

I just looked at the Walmart $10 list on their website. It shows the dosages (pill sizes) available, but does not show the daily quantities used. If you take (for example) three 500mg pills a day is the cost $10 for 90 days? Or is the cost $30 for 90 days?

11 posted on 08/22/2013 8:28:49 AM PDT by Senator_Blutarski
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To: Mr. K
THIRD- Shoot all medical malpractice lawyers

Don't shoot all of them. Doctors are very good at covering up acts of gross negligence committed by their colleagues. It's rare, but it happens.

So keep just a few medical malpractice lawyers around to keep the doctors honest.

12 posted on 08/22/2013 8:30:08 AM PDT by Leaning Right
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To: scottteng
So it is insurance that creates the cost problem in medical treatment.

I believe the situation is more complex. If it were just the insurance companies, they'd be making enormous profits. They are profitable, but not to the extent that one would think.

The problem is a combination of cost shifting (paying for people who don't pay, or who are bad insurance risks) and the presence of multiple middle-men.

The great Ludwig von Mises wrote in his "Human Action" that the failure of socialism was one of ineffiency due to the fact that prices were centralized and thereby inhibited the natural pricing mediaton of supply and demand.

If you look at US medicine, not only now, but for the past generation, you'll see that no one knows what anything costs. It all depends on who you ask, and what pricing club is your vehicle for interacting with the vendor. That fits von Mises' observation very well.

13 posted on 08/22/2013 8:34:44 AM PDT by Pearls Before Swine
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To: Hojczyk

wow


14 posted on 08/22/2013 8:36:22 AM PDT by GeronL
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To: scottteng

insurance inflates the price the same way college loans inflate the price of college tuition


15 posted on 08/22/2013 8:43:38 AM PDT by GeronL
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To: Ray76
“Great example! We need a free market!”

Yes, but what we are getting is so very different. In modern medicine physician fees are not the major expense. If all physicians worked for free, and nothing else at all changed, we would still see steadily increasing costs and care that is way too expensive for all but the wealthiest to pay out of pocket.

Obamacare is resulting in centralization of medical care into large hospital systems, so physicians like the ones involved in this article have less and less options to ‘shop around’ for facilities that will give their patients a break on cost. Further, private physicians are giving up on staying independent, and are joining these big hospital systems. The result is that we are creating a bureaucratic medical monopoly in which physicians have little voice, and competition is diminished.

Further, the ability of physicians to create unique new facilities, targeted to specific medical needs, has been suppressed by law. This is very problematic, and hurts the consumer, IMHO. If a bunch of oncologists, hematologists, oncological surgeons, hospitalists, and other related practitioners and allied health care personnel want to start a stand alone cancer treatment hospital, in which focused care results in better care and decreased costs, they will have a very hard time. The same would be true for cardiologists and cardiothoracic and vascular surgeons joining together to start a heart/cardiovascular hospital. These types of ventures could be very efficient, and thus increase quality at the same time they decrease costs. But they are suppressed.

Market principles are most definitely not at play.

16 posted on 08/22/2013 8:48:10 AM PDT by pieceofthepuzzle
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To: Hojczyk

Should be Economics 101 to any Freeper!

Anything subsidized, which removes market forces, will become not only more expensive, but GREATLY more expensive.

A safer and much cheaper plan would be ONLY catastrophic insurance to cover, and here an honest discussion could take place, anything over 5%, 10%, 50%, 75% of your yearly income.

Once an appropriate number is agreed to, market forces would work at suppressing costs below that target number.

If you don’t have skin in the game (dangerous statement given our president) you do not pay as much attention to costs.

Just in the last month we went over 2 dentist bills only to discover that the 2 separate dentists had agreed to the insurance reimbursement for a covered procedure per their contract, then proceeded to charge us $230 and $260 more than they had agreed upon.

We had to do our own analysis as even our Insurance provider (which, believe it or not, my wife works for) could not figure out what the hell the dentists were doing.

Seems this is the racket they are all playing hoping people will just pay and not question so they end up with way more money than the procedure was to have cost.

Both dentists admitted their “ERROR” and have refunded the over charge but I guarantee you the vast majority of their other patients are being gouged by this practice.

CHECK EVERY BILL like you are paying for it, because you are regardless of insurance coverage.


17 posted on 08/22/2013 8:49:29 AM PDT by Wurlitzer (Nothing says "ignorance" like Islam! 969)
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To: Hojczyk

I used to think that “School Administrators” were the highest paid “migrant workers” in the country, but based on what I have seen with hospitals, I think that I need to add “Hospital Administrators” to the list. Just as in education, how do you justify paying some jerk $500k per year to “run” a hospital?


18 posted on 08/22/2013 8:53:03 AM PDT by vette6387
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To: Senator_Blutarski

it does depend I have one that I take 2X per day and the 180 pills I need for the 90 days is charged at $10 I used to take a time release version of the same med that is still outrageously expensive. I have had them charge me $20 for an eyedrop because they said my script spec’d too much for 90 days but the price was still reasonable compared to list. I have been through ordering from Mexico, Canada, changing meds to get decent prices you have to have a physician that is willing to adjust your meds to suit your purse. Walgreens has a decent program too but it costs a membership fee. I still maintain it because there is one drug that is $30 through their program that is over $60 at walmart.


19 posted on 08/22/2013 8:56:13 AM PDT by scottteng (Tax government employees til they quit and find something useful to do)
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To: Mr. K

My insurance policy through my former employer required a $10.00 co-pay for prescriptions. I left my job and did not continue my insurance. When I got my prescriptions filled, same drugs, same quanity, the cost was $8.25 each.


20 posted on 08/22/2013 9:00:17 AM PDT by dirtymac (Now is the time for all good men to come to the aid of their country.)
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