I never agreed with Peta until today.

il Munduato said:
Well the current commercial insurance landscape definitely favors the wealthy
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I know a lot of people that wouldn't be considered "wealthy" that aren't off put buy their health insurance. I can see why those that can't pay for insurance would want to be subsidized.
il Munduato said:
When you dial 911 it shouldn't matter if a police car, fire truck or ambulance responds.
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It matters to me. If my house is on fire, my preference is for the fire truck to show up first If the fire department needs additional services, that's also fine lots of flashing lights creates excitement. When the house across the street had a chimney fire that escaped the confines of the chimney, sound of fire truck siren was first and most important; 2nd was our open front door; Red cross crisis team was 3rd most important to them.
il Munduato said:
In my opinion public health and safety should not be a for profit business
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I've never lived where public health and safety were for profit. Different construct than individual medical insurance.
il Munduato said:
When it comes to healthcare explain to me how making rich investors, richer is a better use of funds than paying doctors, nurses and money towards research.
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I seperate the healthcare industry from payment assistance industry.
il Munduato said:
The Public Option would allow citizens to buy into Medicare.
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I disagree with cutting the Medicare system line having paid into it for 38 years.
il Munduato said:
If insurance companies are so great at what they do... Let us have the public option.
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I agree with you as long as it isn't funded by federal income tax dollars and doesn't let people "cut in line" on the existing people that have paid into Medicare for years.

If I haven't wrote it to you, sorry you are having a bad experience with either the healthcare and/or insurance industry.
 
Roamers said:
I know a lot of people that wouldn't be considered "wealthy" that aren't off put buy their health insurance. I can see why those that can't pay for insurance would want to be subsidized.

It matters to me. If my house is on fire, my preference is for the fire truck to show up first If the fire department needs additional services, that's also fine lots of flashing lights creates excitement. When the house across the street had a chimney fire that escaped the confines of the chimney, sound of fire truck siren was first and most important; 2nd was our open front door; Red cross crisis team was 3rd most important to them.

I've never lived where public health and safety were for profit. Different construct than individual medical insurance.

I seperate the healthcare industry from payment assistance industry.

I disagree with cutting the Medicare system line having paid into it for 38 years.

I agree with you as long as it isn't funded by federal income tax dollars and doesn't let people "cut in line" on the existing people that have paid into Medicare for years.

If I haven't wrote it to you, sorry you are having a bad experience with either the healthcare and/or insurance industry.
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... and this is why I refrain from trying to educate.
 
il Munduato said:
... and this is why I refrain from trying to educate.
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This has been fun, but obviously it is unlikely we will agree on this topic. That's ok. Best of luck on your finding an acceptable solution.

Consider Canada or Europe if that is what you think would be best for you. If you choose Canada, stay near the border; when my brother has in private practice he had numerous patients from accross the border (cardiologist.)

Also have a couple of members on another forum that cross the border to Mexico for less important health care
 
Roamers said:
Negotiating a discount helps me pay much less.

As I indicated, concentrate on those that charge, not those that help pay.
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Let me give you two real life examples

1) Years ago our daughter needed to have outpatient surgery, we understood it was not covered by insurance so after a lot of work (it is next to impossible to get in advance pricing), we managed to get an advanced quote from the surgeon, the anesthesiologist, and the hospital for the use of the operating room for two hours.
The hospital quoted us $3000 for that.

A week before the operation we found out she actually met a criteria that would make her operation covered by our insurance, so we had the surgery processed through them.

After surgery, the Hospital filed a claim for $18,000 with the insurance, the insurance reduced it to $12,000, and as we had a $6000 deductible, we ended up having to pay $6,000 out of pocket instead of the $3,000 the hospital had quoted……


2) Another time I needed a Scanner for a kidney stone. This is literally a 10mn procedure, you go in lay down spend a couple of minute in and leave.
My doctor who was part of the local hospital sent me to a facility run by the hospital. I had investigated other facilities and one had actually managed to give me a price of $1,500. We could not get pricing from the doctor, but I trusted the system and went.

The hospital facility sent a claim to the insurance for $10,500 (for a 10mn procedure), the insurance took it down to $6,000 which was my deductible, and so I paid $6,000 for something that should have cost me $1,500.

And FYI, if I had done it in France without any insurance, the price would have been $200............................

I have an endless number of these personal experiences with the US healthcare system. You are free to think you are being treated fairly, but if you do (and except for medicare), you either live in an exception, or are grossly mistaken.
 
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scrambler said:
Let me give you two real life examples

And FYI, if I had done it in France without any insurance, the price would have been $200............................

I have an endless number of these personal experiences with the US healthcare system. You are free to think you are being treated fairly, but if you do, you are grossly mistaken (except for medicare).
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That sucks; I can see not all insurance is the same. And as you documented, it's a charger (hospital) problem, not payment assistance (insurance) problem.

Did you try after seeing the insurance claim "never mind, I'll pay out of pocket instead"? I've had a few meds that were cheaper with GoodRx than they were with my UHC inurance (pre Medicare) and pharmacy just switched billing to the lower cost.

I've had the same procedure (cardioversion) with UHC pre Medicare and on Medicare; same price since 1st in 2020 and most recent in 2024. So it's not just "better on Medicare negotiated prices."

I can imagine it would cost less in France since they do the "prepsid with your tax $" thing for healthcare don't they?
 
Believe me I tried everything ....
Every time we have medical bills I need to spend days and hours trying to correct "errors" that are always to the benefit of the insurance...

In France, if You are local with Social Security, it covers 60-70% of the cost, and you have a complementary insurance that costs you may be $50 a month to cover the rest (100% coverage), no network, no restricted coverage, no games....

BUT, even if you have no insurance and no social security, the full unsubsidized price is still at least 10 times less than in the US often way less for big ticket items.
Basically, you can buy an airline ticket and a hotel, and still pay way less than what you would pay with insurance in the US.

There is simply no justification for what the pricing have become here other than massive greed and inefficiency.

Education, Heathcare and justice are the pillars of a functional society, these should always be equally accessible regardless of revenue. In the US this is not the case, healthcare being the worst offender.
 
scrambler said:
Let me give you two real life examples

1) Years ago our daughter needed to have outpatient surgery, we understood it was not covered by insurance so after a lot of work (it is next to impossible to get in advance pricing), we managed to get an advanced quote from the surgeon, the anesthesiologist, and the hospital for the use of the operating room for two hours.
The hospital quoted us $3000 for that.

A week before the operation we found out she actually met a criteria that would make her operation covered by our insurance, so we had the surgery processed through them.

After surgery, the Hospital filed a claim for $18,000 with the insurance, the insurance reduced it to $12,000, and as we had a $6000 deductible, we ended up having to pay $6,000 out of pocket instead of the $3,000 the hospital had quoted……


2) Another time I needed a Scanner for a kidney stone. This is literally a 10mn procedure, you go in lay down spend a couple of minute in and leave.
My doctor who was part of the local hospital sent me to a facility run by the hospital. I had investigated other facilities and one had actually managed to give me a price of $1,500. We could not get pricing from the doctor, but I trusted the system and went.

The hospital facility sent a claim to the insurance for $10,500 (for a 10mn procedure), the insurance took it down to $6,000 which was my deductible, and so I paid $6,000 for something that should have cost me $1,500.

And FYI, if I had done it in France without any insurance, the price would have been $200............................

I have an endless number of these personal experiences with the US healthcare system. You are free to think you are being treated fairly, but if you do (and except for medicare), you either live in an exception, or are grossly mistaken.
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I've had several somewhat similar though not to the same extreme experiences. Typically a bill doesn't get paid because the insurance company says it wasn't billed correctly to be covered. Though they insist on billing me and having me coordinate with insurance.. I tell both parties to not involve me in the discussion as I paid my premium. Insurance companies find any undotted "i" and often change billing practices just to have an excuse not to pay.
I then flat out tell the hospital/doctor.. I am not paying you and I consider the mater closed. You want to go to court, I'll be more than happy to explain to the court, the media and any other sympathetic ear.
The bill within a few weeks disappears.
 
il Munduato said:
Not at all... This never happens with Medicare.
Insurance companies are playing the.... Let's wear everyone out trying to get paid game.
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Hopefully Original Medicare doesn't pay willy nilly; DOGE will fix that if needed.

I review my UHC Medicare Advantage (same b4 I started Medicare) online statements to make sure the provider isn't charging me more than allowed. I have seen provider's charges "in process" for several months because someone "fat fingered" a code and it wasn't being accepted. . . . always resolved without issue. Periodically receive bill from provider with my share (never been wrong) and an outstanding "being reviwed by insurance".

Again, YMMV . . . .must really suck working with some providers/insurers.
 
Roamers said:
Do some reasearch on the cost of liability insurance for a physician in the US.
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No it does not explain it. If a price can go from $1,500 to $11,000 for the exact same service in the exact same area, someone is screwing you.

As for the liability insurance yes, it is a very small part of the problem, but there would be ways to control it. Unfortunately nothing is being done because some powerful lobbies profit from it.
 
scrambler said:
If a price can go from $1,500 to $11,000 for the exact same service in the exact same area, someone is screwing you
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Slightly different case, but similar potential reason: i just got quotes for AL wrapping the jamb before a new garage door install. They varied from $300 to $1400. The high price folks said "we're pretty busy right now, but what do you need."

In your example, won't try to guess why such a difference; perhaps someone just didn't want your business. I know when we owned a business, we had a "douche" multiplier that was used periodically. Or if we were busy, prices went up.

I can get an "estimate" for any procedure (that I checked) from in and out of network providers. I don't recall ever seeing a difference of more than a few % which doesn't surprise me because the same insurance companies negotiate prices with all of them.

It would be interesting to see what the circumstances are for those that are having issues like some of you describe; truly know of nobody with complaints like I'm reading here.
 
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