IT'S TIME FOR UNIVERSAL HEALTH CARE

Cycloptichorn wrote:

Gee Miller, I guess that whole lifetime of work in the Medical industry has left you without any knowledge of how things actually work, according to Hokie. If only we all had realized long ago that Medicaid and Medicare were the reasons our costs as a nation went up, on average, 20% or so a year for the last 5 or 6 years.

Cycloptichorn

Where would this nation be, if we didn't have Medicare and Medicaid to help seniors and the poverty-stricken?

Do we really want 90 year old seniors dying from starvation in the streets of our major cities?

...what is required to keep the industry going. ...

And as far as the nonsense posted in this forum on "formularies", anyone with medical experience knows, that hospitals have formulary committees that meet on a regular basis and have the right and obligation to change formularies at any time, without consultation with an insurance company.

Miller wrote:

And as far as the nonsense posted in this forum on "formularies", anyone with medical experience knows, that hospitals have formulary committees that meet on a regular basis and have the right and obligation to change formularies at any time, without consultation with an insurance company.

It's hardly nonsense. The hospital can do whatever they want. But the insurance company will only pay for what is approved on THEIR formulary, regardless of what the hospital wants to administer.

USAFHokie80 wrote:

Cycloptichorn wrote:

Gee Miller, I guess that whole lifetime of work in the Medical industry has left you without any knowledge of how things actually work, according to Hokie. If only we all had realized long ago that Medicaid and Medicare were the reasons our costs as a nation went up, on average, 20% or so a year for the last 5 or 6 years.

Cycloptichorn

Obviously medicare and medicaid aren't the only reason, but they are a driving one.

And for the record, I am in the medical industry myself. As well as my boyfriend and the majority of our friends. So I have a pretty good idea of how this all works. It would serve you well to do some research beyond googleing for the 0.0000385 seconds or however long it took.

I have been. Perhaps you could point out the evidence that would support your position and counteract mine; I apparently am in desperate need of it, and you appear to be in the exact position to offer it. I await eagerly.

Cycloptichorn

Cycloptichorn wrote:

USAFHokie80 wrote:

Cycloptichorn wrote:

Gee Miller, I guess that whole lifetime of work in the Medical industry has left you without any knowledge of how things actually work, according to Hokie. If only we all had realized long ago that Medicaid and Medicare were the reasons our costs as a nation went up, on average, 20% or so a year for the last 5 or 6 years.

Cycloptichorn

Obviously medicare and medicaid aren't the only reason, but they are a driving one.

And for the record, I am in the medical industry myself. As well as my boyfriend and the majority of our friends. So I have a pretty good idea of how this all works. It would serve you well to do some research beyond googleing for the 0.0000385 seconds or however long it took.

I have been. Perhaps you could point out the evidence that would support your position and counteract mine; I apparently am in desperate need of it, and you appear to be in the exact position to offer it. I await eagerly.

Cycloptichorn

Maybe you should ask a physician about productivity and RVU thresholds. Ask about formularies and how billing is done.

Which by the way, you didn't answer. Since you told me I was wrong, I'd like you to tell me how hospitals produce a bill.

USAFHokie80 wrote:

Miller wrote:

And as far as the nonsense posted in this forum on "formularies", anyone with medical experience knows, that hospitals have formulary committees that meet on a regular basis and have the right and obligation to change formularies at any time, without consultation with an insurance company.

It's hardly nonsense. The hospital can do whatever they want. But the insurance company will only pay for what is approved on THEIR formulary, regardless of what the hospital wants to administer.

And the patient, privy to practically none of this information, is just expected to grin and bear it?

Jeez, you don't see a problem with this scenario?

Cycloptichorn

USAFHokie80 wrote:

Cycloptichorn wrote:

USAFHokie80 wrote:

Cycloptichorn wrote:

Gee Miller, I guess that whole lifetime of work in the Medical industry has left you without any knowledge of how things actually work, according to Hokie. If only we all had realized long ago that Medicaid and Medicare were the reasons our costs as a nation went up, on average, 20% or so a year for the last 5 or 6 years.

Cycloptichorn

Obviously medicare and medicaid aren't the only reason, but they are a driving one.

And for the record, I am in the medical industry myself. As well as my boyfriend and the majority of our friends. So I have a pretty good idea of how this all works. It would serve you well to do some research beyond googleing for the 0.0000385 seconds or however long it took.

I have been. Perhaps you could point out the evidence that would support your position and counteract mine; I apparently am in desperate need of it, and you appear to be in the exact position to offer it. I await eagerly.

Cycloptichorn

Maybe you should ask a physician about productivity and RVU thresholds. Ask about formularies and how billing is done.

Which by the way, you didn't answer. Since you told me I was wrong, I'd like you to tell me how hospitals produce a bill.

I did tell you. They bill for each and every item and procedure and unit of service they think they can get away with making the patient or the insurance pay. I have no doubt that some hospitals are more scrupulous than others, but basically that's how it works.

Cycloptichorn

See Miller's response above, Hokie.

The insurance company shouldn't get to pick and choose which medicines the doctor prescribes for the patient. My parents have/had no way of knowing which ones would be covered and which ones' wouldn't; you think they sat there in the post-op room and called the insurance company just to make sure?

I think that the hospitals and insurance companies both bill for each and every piece of work they think they can actually get away with - whether it is legitimate or not. They have every incentive to do so and no incentive not to do so; in the end, they both see a net gain in profits by doing so, and if someone calls them on it (like we did) then they just charge for what actually happened. There's literally no downside to the practice.

I know exactly how the health care insurance industry works - they use the money you give them, every month, as an investment. When they get lower returns on the investment, rates go up. This is the cause of the precipitous rate rises you've seen over the last several years; during the late 90's, when everyone was making money hand over fist, the various health insurance companies of America did quite poorly in their investments. As many of them are publicly traded, they have to keep showing returns... ergo, costs go up.

It's not complicated to figure out the swindle, unless you aren't trying.

Cycloptichorn

Cycloptichorn wrote:

USAFHokie80 wrote:

Cycloptichorn wrote:

USAFHokie80 wrote:

Cycloptichorn wrote:

Gee Miller, I guess that whole lifetime of work in the Medical industry has left you without any knowledge of how things actually work, according to Hokie. If only we all had realized long ago that Medicaid and Medicare were the reasons our costs as a nation went up, on average, 20% or so a year for the last 5 or 6 years.

Cycloptichorn

Obviously medicare and medicaid aren't the only reason, but they are a driving one.

And for the record, I am in the medical industry myself. As well as my boyfriend and the majority of our friends. So I have a pretty good idea of how this all works. It would serve you well to do some research beyond googleing for the 0.0000385 seconds or however long it took.

I have been. Perhaps you could point out the evidence that would support your position and counteract mine; I apparently am in desperate need of it, and you appear to be in the exact position to offer it. I await eagerly.

Cycloptichorn

Maybe you should ask a physician about productivity and RVU thresholds. Ask about formularies and how billing is done.

Which by the way, you didn't answer. Since you told me I was wrong, I'd like you to tell me how hospitals produce a bill.

I did tell you. They bill for each and every item and procedure and unit of service they think they can get away with making the patient or the insurance pay. I have no doubt that some hospitals are more scrupulous than others, but basically that's how it works.

Cycloptichorn

So you think they just add extraneous things to a bill, that aren't on the patient's chart ?

USAFHokie80 wrote:

Cycloptichorn wrote:

USAFHokie80 wrote:

Cycloptichorn wrote:

USAFHokie80 wrote:

Cycloptichorn wrote:

Gee Miller, I guess that whole lifetime of work in the Medical industry has left you without any knowledge of how things actually work, according to Hokie. If only we all had realized long ago that Medicaid and Medicare were the reasons our costs as a nation went up, on average, 20% or so a year for the last 5 or 6 years.

Cycloptichorn

Obviously medicare and medicaid aren't the only reason, but they are a driving one.

And for the record, I am in the medical industry myself. As well as my boyfriend and the majority of our friends. So I have a pretty good idea of how this all works. It would serve you well to do some research beyond googleing for the 0.0000385 seconds or however long it took.

I have been. Perhaps you could point out the evidence that would support your position and counteract mine; I apparently am in desperate need of it, and you appear to be in the exact position to offer it. I await eagerly.

Cycloptichorn

Maybe you should ask a physician about productivity and RVU thresholds. Ask about formularies and how billing is done.

Which by the way, you didn't answer. Since you told me I was wrong, I'd like you to tell me how hospitals produce a bill.

I did tell you. They bill for each and every item and procedure and unit of service they think they can get away with making the patient or the insurance pay. I have no doubt that some hospitals are more scrupulous than others, but basically that's how it works.

Cycloptichorn

So you think they just add extraneous things to a bill, that aren't on the patient's chart ?

I don't just think, I know for a fact that this is commonly and regularly done. I have a lifetime of watching my family and friends deal with it. And it makes logical sense for the hospitals to do so - tell me, what is the downside of them doing so?

I understand that as an employee of the industry you have a vested interest in protecting and projecting an image of fairness, but deep down, I think you know that there's a lot of truth in what I'm saying.

The patient's chart is a starting point, not an end point, for determining the amount which will be billed. Start with what was actually done, and go from there.

Cycloptichorn

By the way, the insurance companies and hospitals and the way billing is done is HEAVILY regulated by the government through various agencies... So if you're complaining about all these things now, what do you think will happen when the gov't takes full control?

By the way, the insurance companies and hospitals and the way billing is done is HEAVILY regulated by the government through various agencies... So if you're complaining about all these things now, what do you think will happen when the govt takes full control?

So you think they just add extraneous things to a bill, that aren't on the patient's chart ?

You said that your father's stuff was 10 years ago... That was well before the proliferation of computers into most medical facilities. Clerical errors were common.

See, this is my point... You'll criticize a system, having NO idea how it actually works or some of the actual problems in it... but then when someone tells you about them you refuse to believe them.

So, say my doctor says that I need a surgery and I get it. My insurance company then decides not to pay for it and I'm stuck with a 50,000 bill. What you're saying that I should do to solve this problem is find another insurance company who doesn't screw over their customers......but what do I do about this $50,000 bill? Hire a $10,000 lawyer to go up against the $500,000 lawyers that the insurance company has? Spend 10 years in court after losing my house, car, etc?