Don't like paying for health care? Don't get sick, don't grow old, and don't visit doctors.
I rarely get sick and I couldn't stop growing old, but I do visit doctors regularly to check on how well I am. For a man my age, the verdicts have been that I am in pretty good shape. But they have also been concerned about my heart.
This year a cardiologist determined I should be seen by surgeons. The verdict was that I needed a valve replacement. Four months later I am slowly getting back to the activity level I once had.
But if had to pay all the costs that have been incurred, I would probably be back in the hospital with a stroke. If I had to pay all the costs, I would probably have to sell my house.
As it is, I pay a few dollars for this, a couple hundred for that, and on and on. The max I could pay is $5,000. I'm not there yet, but I would say that lots of minimum wage workers would have a hard time making those payments.
Posted to http://www.nytimes.com/2017/08/07/opinion/healthcare-single-payer-children.html?comments#permid=23604618.
Showing posts with label co-pay. Show all posts
Showing posts with label co-pay. Show all posts
Monday, August 07, 2017
Monday, March 19, 2012
A little reason for the high cost of U.S. health care
Some months ago I injured my shoulder with repetitive activity. After it didn't get better for several weeks, I went to my doctor about it. As I signed in, I paid my $10 co-pay for the visit. Even though he decided that it was only stressed tissue, he had me get an x-ray also. Today, my insurance company sent me an "explanation of benefits".
The "amount you owe" is a $9.22 co-pay for the x-ray.
I have two questions.
First, why wasn't I asked to make a second co-pay at the time of my visit? This also happens when I have the ultrasound check of my heart. The cardiology department asks only for a $10 co-pay for the doctor visit, but I always get billed for a co-pay for the ultrasound.
Second, how much does it cost the clinic and the insurance company and Medicare to calculate all this, move the information among themselves, and mail me an "explanation of benefits? I bet it is far more than the co-pay and probably a good chunk of the total cost.
The good side is that I have been getting this care without "prior approval", from the insurance company or Medicare. Others are not so fortunate. Read "Deadly Spin" by Wendell Potter. Some might die because an insurance company came between them and their doctors.
The "amount you owe" is a $9.22 co-pay for the x-ray.
I have two questions.
First, why wasn't I asked to make a second co-pay at the time of my visit? This also happens when I have the ultrasound check of my heart. The cardiology department asks only for a $10 co-pay for the doctor visit, but I always get billed for a co-pay for the ultrasound.
Second, how much does it cost the clinic and the insurance company and Medicare to calculate all this, move the information among themselves, and mail me an "explanation of benefits? I bet it is far more than the co-pay and probably a good chunk of the total cost.
The good side is that I have been getting this care without "prior approval", from the insurance company or Medicare. Others are not so fortunate. Read "Deadly Spin" by Wendell Potter. Some might die because an insurance company came between them and their doctors.
Wednesday, August 12, 2009
One of the many hidden costs of healthcare
Every month I receive a statement from the medical center we use. Part of me says to ignore it unless it says "Pay this amount". After all, why should I? The agent that sold us the Medicare supplement said, "You will never see another medical bill."
He exaggerated a bit because there are certain optional services that are not covered by Medicare, supplemental insurance, or other insurance programs. Like contact lenses. Insurance will cover glasses, but not contact lenses. At least for us who use them by choice.
In fact, optometrists offices will not turn over contact lenses until the patient has paid for them. I was surprised one year to see that the cost of contact lenses was passed on to Medicare even though I had paid for them. When I called the medical center office about this, I was told that they sent it on for deniability. I gave up trying to argue with a non-profit bureaucrat. Fortunately, this pass on has not occurred again.
However, the cost of the "contact lens evalution" is both not covered and not immediately passed on to the patient. It has run from $32 to $36 over the last few years. One year the medical center wrote it off before even charging me, one year I paid it after a few months without even being billed for it, and other years I wait until I'm billed for it.
On my July statement I was finally billed for the May 2008 contact lens evaluation. I paid the $35 without question. The cost for my May 2009 contact lens evaluation was carried forward on the June and July statements. The August statement is due in a few days. I bet the $36 for this year's evaluation will still be carried forward.
One of the marks of a successful organization is good cash flow. That is get payments due as soon as possible; then you have cash to pay your own bills and invest in new equipment, and so forth. $30-something may not be much in the big scheme of things, but how many of these little charges are floating around without being billed? How many larger charges are waiting on various non-profit, corporate, and government bureaucracies waiting for a judgement?
Here is the first place to "wring efficiencies" out of the system.
He exaggerated a bit because there are certain optional services that are not covered by Medicare, supplemental insurance, or other insurance programs. Like contact lenses. Insurance will cover glasses, but not contact lenses. At least for us who use them by choice.
In fact, optometrists offices will not turn over contact lenses until the patient has paid for them. I was surprised one year to see that the cost of contact lenses was passed on to Medicare even though I had paid for them. When I called the medical center office about this, I was told that they sent it on for deniability. I gave up trying to argue with a non-profit bureaucrat. Fortunately, this pass on has not occurred again.
However, the cost of the "contact lens evalution" is both not covered and not immediately passed on to the patient. It has run from $32 to $36 over the last few years. One year the medical center wrote it off before even charging me, one year I paid it after a few months without even being billed for it, and other years I wait until I'm billed for it.
On my July statement I was finally billed for the May 2008 contact lens evaluation. I paid the $35 without question. The cost for my May 2009 contact lens evaluation was carried forward on the June and July statements. The August statement is due in a few days. I bet the $36 for this year's evaluation will still be carried forward.
One of the marks of a successful organization is good cash flow. That is get payments due as soon as possible; then you have cash to pay your own bills and invest in new equipment, and so forth. $30-something may not be much in the big scheme of things, but how many of these little charges are floating around without being billed? How many larger charges are waiting on various non-profit, corporate, and government bureaucracies waiting for a judgement?
Here is the first place to "wring efficiencies" out of the system.
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