Health care (not political)

[Ted_Wolff]

Question: How often have your doctors, or even nurses, discussed costs with you?

I can't say I ever remember once going to the doctor that they have done this when they've said I need this or that procedure, test, medication, whatever. And I've heard plenty others say similarly.

Yet when I went to the dentist recently everyone was very up front with the different options I could choose from, how much things would cost, and checked with my insurance to precisely determine who would pay what.

Now, in all the hoopla over health care reform, you never hear of problems containing dentistry or optometry costs. They're hospital costs. Yet in my experience I have never encountered a doctor or nurse who said, "Well this is going to cost..." as if they're worried about something being too expensive for someone.

 

[MikeyVassallo]

This is a great question, however knowing and working with doctors on a daily basis I can tell you right away the answer is because they don't know or care how much it costs.

In a hospital you have 3 different scenarios: Outpatient Procedures, Inpatient Procedures and ER visits. Those are the three largest revenue makers. With an Outpatient visits when the visit is scheduled there is most assuredly a transaction of either insurance information or personal credit card/check or other method of payment before the patient even arrives for the procedure.

In an inpatient situation the patient usually meets with a clerk after the services are provided and a lot of the time the family of the inpatient handles this. A majority of the time anything done in an inpatient setting will not be billed ala cart (I.E. Labs, CTs, MRIs etc) but billed as a part of a full stay. I would love to say these things are priced fairly, however with the relationship the insurance companies have created with the hospitals it ain't. The real people affected are the people w/o insurance- but this isn't political so I'll leave that for a later topic.

In an ER setting the billing is also done after the treatment is received unless the insurance is taken in triage while the patient is alert.

Honestly Inpatient and ER visits make the least revenue out of the three types of patients. Hospitals cannot refuse service because of lack of ability to pay.

The bottom line, as far hospitals go, the reason you don't hear about cost while you are getting treatment is because that is unimportant at the time you are in need of treatment. Is that the proper way to do it? I don't know. What I do know is that if it were me or one of my loved ones in a situation like that money is the very last thing I'd think of...

As far as private Doctor's offices go, I've never been in one that didn't make me pay for my visit or my labs before they gave me service. No matter if it is copay for my insurance or out of my pocket I've had to pay before sitting on the butcher paper in the little room.

That is just my experience.

 

[Rakon]

Never, it's all FREE!!!!!

 

[De-Ting]

Never, it's all FREE!!!!!

CANADA!!!

 

[Lien]

Never, it's all FREE!!!!!

CANADA!!!

He could be french... pretending to be canadian!

Anywhoooo...

I know it doesn't answer you question but 5 years ago, i was volunteering in a homeless shelter in northen california. Every one there had a history about hospital cost. Do you remember that one scene in sicko where a homeless is kicked out of a hospital half way through an operation because she couldn't afford the bill? All i can say is that it's true... and we did receive calls from a private hospitals to pick up some miserable in the emergency room without any sort of treatment received. It's very sad but i'm bringing politics so...

Personally, i have never been ask if i could afford it (i'm on the San Francisco free health care, yup we got free health care here). One time, a friend of mine in NY told me that a doctor ask if he could afford the bills. He did get treatment and paid the bill but he never went to see that doctor ever again... Guess that doctor was an amateur in business.

But I've always wondered how doctors could see through the homeless. Man what D***s... Sorry, politics!

 

[Chris_Crime]

Canada's free health care doesn't cover dentistry. Calm down.


Since we're talking about homelessness as well, something I found interesting about Medical District here in Dallas is that there's a very large Salvation Army homeless shelter (more like a compound) located directly across the street from one of the larger medical facilities. Some of the sick and ailing homeless just sit along the line of the sidewalk... Pretty smart, actually.


Like Mikey says, I don't think the receptionists will talk payment plans out with you, but expect a bill in the mail if you don't have insurance.

 

[Ted_Wolff]

I do recall one time cost was discussed with me before seeing the doctor for treatment. But that was when I didn't have insurance and the receptionist wanted to know how I was paying (straight up, in payments, what?).

But whenever I've had insurance whether covered by parents or my own, cost has never been an issue. Now, I know treatment can be urgent and there's not time to work out cost. That's obvious. But there are other times where a procedure is not critical to your health, yet cost is never discussed.

In my own case, I went in for a routine physical last summer. I casually mentioned to my doctor (a new one I'd never had before) that I'd long ago been diagnosed with "athletic asthma" but it's never been a serious issue and nothing ever was pursued with it.

So what's this new doctor of mine do? Orders up all the breathing tests he thinks I need. I was in no danger. Heck, I'd been training for a half-marathon all summer just fine. And nowhere in this was cost ever discussed. Granted, I certainly should have asked, looking back. But I just find it striking that noncritical procedures get suggested with no concern for cost.

I'm curious as to how this works in countries with "free" health care. In noncritical situations, do your doctors whimsically call for "the works" without care for cost? I know it's "free," but someone along the way finances it all, whether through taxes or whatever.

 

[MikeyVassallo]

The movie Sicko was bullshit. Just an FYI.

 

[Chris_Crime]

Oh, yeah, absolutely, cost is hardly ever brought up during or at times of treatment. I remember being asked for co-pay but that's about it. I think it's painted that way by people who don't know any better. the media, maybe. Canadians, too. The Canadian media, definitely [your online forum poster].

So what's this new doctor of mine do? Orders up all the breathing tests he thinks I need.

I thought this was just a private practice thing ($cough$), but hospitals do this as well. Every time my grandmother steps foot into a hospital, no matter the reason, they're readying to take her blood. How much blood do they need? The caveat being "better safe than sorry", it still seems money down the drain... someone's money. America's? ....DAMN YOU, OBAMA!

 

[MikeyVassallo]

If you pay a copay that means your insurance is taking care of the bill. As long as you pay the copay it isn't costing you anything else because you already pay for your insurance monthly.

The actual cost of healthcare is all on the insurance side. It isn't something I know a whole lot about, however I heard today that the top 5 insurance companies make over 805 of the profits in the industry and their profits are on the raise.

I know this isn't a political thread- but something has to be done about that.

As far as ordering tests... I mean seriously guys... how on earth do you think they are going to find out what is wrong with you. You know that a Chest XR taking right now is no good in 2 hours. If the Doc wants to see inside your chest to look at your lungs or heart or something else and the CXR is 2 hours old they will need to shoot another one? Your body changes. Blood that you draw in the morning is different than blood you draw in the afternoon.

You do want them to find out what is going on with you, right?

 

[Chris_Crime]

seems like they're in the business of milking each other's teets (the health care industry and the insurance companies)

I passed on the H1N1 stimulus package/vaccine for this very reason (which was "free" to federal employees)


that's not honestly how i feel, you know.. it just seems that way sometimes.

 

[MikeyVassallo]

I posit that you will not find a group of people happier to get rid of insurance companies more than people in the hospital industry.

 

[LinksOcarina]

The movie Sicko was bullshit. Just an FYI.

wow...blasphemy....

Anyway, not too often. I have been lucky and never been to a hospital before for myself, at least. As for my private doctor, it's more about why i'm there with him, and the clerk discusses the cost after the checkup or whatever.

What is a problem is my insurance is crap, thankfully with the new job I have I can get an upgrade in insurance with dental benefits...so it is all good for sure.

 

[schimmel]

The movie Sicko was bullshit. Just an FYI.

wow...blasphemy....

Naw dude that movie was total bullshit. He got some healthcare systems he looked into wrong, and he painted Canada to be this gloriously shiny place where nobody is ever sick and people skip in line while singing "There's no Canada like French Canada!"

 

[Lien]

The movie Sicko was bullshit. Just an FYI.

wow...blasphemy....

Naw dude that movie was total bullshit. He got some healthcare systems he looked into wrong, and he painted Canada to be this gloriously shiny place where nobody is ever sick and people skip in line while singing "There's no Canada like French Canada!"

Darn it! This is supposed to be a politic free topic! It's all my fault, Shouldn't of brought up Sicko. Sorry Ted...

 

[schimmel]

Oh, I wasn't getting political, I just hate Michael Moore. It's not personal politics, I just think he's a complete asshole

 

[Nick_Tan]

That doctors won't discuss the costs or don't know the costs (and that some insurance companies keep them out of the dark) is the primary reason why insurance premiums are so high. Without knowing the price of a treatment, competition and the laws of the free market don't apply, so insurance companies can charge pretty much whatever they want. Just imagine if you could talk to two doctors, get different price quotes, and then have you, the consumer, decide which is better or cost-effective. Those two doctors would want to compete with each other, driving those costs down. But most people in the US don't think of medical care as a market-based system, so they don't ask at all.

Nothing like a little lack of information to be made into a lamb.

 

[MonkeyPox]

They never discuss price because if they told you, most people would say F that and leave. Thus the hospital only gets 500 dollars for your 10 minute visit instead of 3000 + dollars for your treatment with 35 cent pills. That is just bad for business.

 

[MikeyVassallo]

It isn't as nefarious as that... seriously.

 

[Ted_Wolff]

Probably not, but I bet a lot of people would refuse treatment if they knew the price. I would have. I don't need to drop a grand to have something on hospital record for something I personally already knew.