RedWifey delivered our third child a month ago. Natural delivery, no drugs, no complications, no stitches/trauma, in the delivery room less than three hours and only used the most basic of supplies. Then moved to a small private room for about 36 hours, most with no IV. She just took some Motrin every few hours and had three square meals. Checked out and went home.
The pre-insurance bill came in this week -- over seven thousand dollars.
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The pre-insurance bill came in this week -- over seven thousand dollars.
I had a 1 week hospital stay in Philly after breaking my femur. The total cost was $26 000, with $7500 itemised for my operation. The daily rate for my room (3 other patients in the same room) was close to $1000. And that was a little over 20 years ago.
I had a 1 week hospital stay in Philly after breaking my femur. The total cost was $26 000, with $7500 itemised for my operation. The daily rate for my room (3 other patients in the same room) was close to $1000. And that was a little over 20 years ago.
I was born in 1947 at Morton Plant Hospital in Clearwater, Florida.
My mother spent five days in the Hospital which was normal back in those days.
The total bill came to $111.00.
That included the Doctors $10.00 delivery fee.
My parents had BCBS which paid 80% of the 111 bucks.
The pre-insurance bill came in this week -- over seven thousand dollars.
Interesting. My wife's best friend just had a baby in Japan and there you have to pay a whopping $400 total cost for giving birth and one night in the hospital, and about $30 for each office visit during pregnancy.
Yay 'Merican health care system! We win!
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Working "hard," or the perception of working hard, doesn't really mean anything. Sweating, vomiting, and breathing hard could be a good workout or a tropical disease kicking in.-Dan John
Add to that my wife recently had to go to the dentist in Japan to have a crown recapped. She is not covered by national insurance there anymore and had to pay 100% of the costs for the procedure.
$50.
America, it's time to stop swallowing the corporate health care/GOP propaganda.
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Working "hard," or the perception of working hard, doesn't really mean anything. Sweating, vomiting, and breathing hard could be a good workout or a tropical disease kicking in.-Dan John
And if you did not have insurance the hospital would turn you over to a collection agency to collect the whole amount.
That isn't entirely accurate. My husband just had outpatient surgey and our insurance decided after looking through more of our records considered it a preexisting and denied the whole claim. The hospital and the surgeon both worked with us discounting the bills to lower than what they would of received from the insurance and set us up on a payment plan we could afford.
Interesting. My wife's best friend just had a baby in Japan and there you have to pay a whopping $400 total cost for giving birth and one night in the hospital, and about $30 for each office visit during pregnancy.
Yay 'Merican health care system! We win!
I think we paid about $200-300 for a semi-private room after Christine gave birth, and I don't think we paid anything for the office visits. But close to 50% of my income is eaten up by taxes, i.e., you don't get something for nothing.
Nevertheless, I've been pretty clear in my opinion that the US would be well to adopt a hybrid system similar to what is seen in much of the West despite the deeply historically ingrained misgivings regarding expanding the role of government.
But you were FREE to pay that much, that's what you Socialist Commie Nazis don't get. In America you have the FREEDOM to be sodomized by health care costs, not like these other countries where people pay sane costs for better treatment.
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That isn't entirely accurate. My husband just had outpatient surgey and our insurance decided after looking through more of our records considered it a preexisting and denied the whole claim. The hospital and the surgeon both worked with us discounting the bills to lower than what they would of received from the insurance and set us up on a payment plan we could afford.
Glad you lucked out. My brother did not.
ps - he switched from a union job with benefits - to self employment - so he could look after his MS wife, and work around her schedule and needs.
I think we paid about $200-300 for a semi-private room after Christine gave birth, and I don't think we paid anything for the office visits. But close to 50% of my income is eaten up by taxes, i.e., you don't get something for nothing.
That's a key problem - here nobody wants to increase taxes to do this. The public doesn't want to pay and politicians don't have the balls to do raise them.
Quote:
Nevertheless, I've been pretty clear in my opinion that the US would be well to adopt a hybrid system similar to what is seen in much of the West despite the deeply historically ingrained misgivings regarding expanding the role of government.
I agree with everything you said there.
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"A government big enough to give you everything you want is a government big enough to take from you everything you have."
New York tax filers reporting more than $375,000 a year in earned income may end up paying nearly 60% of their wages in taxes to the government under a Barack Obama presidency, economists who have analyzed his plan said.
I wouldn't be at the 60% but I'm already at 50%. And for that, I DON'T get health care.
So I'm already paying what you pay, without the benefit!
But I'm happy to know 50% of the country pays ZERO while I pay 50% out of my paycheck. That just makes me feel warm and cozy inside.
Here’s a questions that has vexed conservatives for decades: Why isn’t there a huge tax revolt in Europe? Citizens in most European countries pay much higher taxes than we do in the United States, but virtually no substantial tax revolt movements exist in these countries. They should be marching in the streets by the millions demanding large tax cuts – but they aren’t. Why is that the case? The answer probably has much to do with the fact that people in Europe can recognize more easily the inherent connection between the taxes they pay and the benefits they receive. The benefits of government programs in these countries are much more obvious than they are in the United States – and so the taxes that pay for them are not resented as much. The European social welfare state is so much more extensive than what we have in the U.S. that it is impossible for citizens to not notice all the valuable things they are getting for their taxes.
T.R. Reid, in his book The United States of Europe, tells a story which illustrates this point very well. He lived in Great Britain for years, and at first he was stunned by the 17.5% tax that was added to virtually every purchase he made. “I kept wondering: Why do the Brits put up with a tax that high?” He came to understand the answer to this question when his youngest daughter had to go to the emergency room with a severely infected ear. After a wait of fifteen minutes, his daughter was seen and given effective treatment. Grateful, he went to pay the bill only to have the nurse proudly announce to him that “There won’t be a bill to pay. We do it a bit differently here. In the National Health Service, we don’t charge for medical treatment.” And suddenly he “got it” about the taxes:
Had the same minor medical crisis occurred in American, we would surely have received the same level of professional treatment. But we would have received something else along with it: a wad of bills. Having had a similar experience in emergency wards in the United States, I would expect that treatment like we got a St. Mary’s in London would have brought bills of about $200 from the hospital, another $150 or so from the doctor, and another $100 from some lab technician. And I would likely have faced a three-month battle with an insurance company trying to get the bills paid. In Britain, there was no need to argue with the insurance company over the bill, because there was no bill (and consequently, no insurance company). As we left the hospital, my wife said quietly, “Now I see why we pay that 17.5 percent."5
And beside universal health care, the typical European also gets a lot more for their taxes – including a free university education, paid maternity and paternity leaves for everyone, clean and efficient public transportation, retirement security for all, and so on. So ironically, the reason many people in the U.S. hate taxes more than Europeans may be because we pay so little in them and get comparatively so little for them in return. If we paid more taxes like the Europeans do, and then got many more important and obvious social and economic benefits, we would probably see the connections between taxes and government benefits more clearly – and so resent our taxes less. Strange but true.
Nationwide, 64.4 million people under age 65 are in families that will spend more than 10 percent of their pre-tax family income on health care in 2009, and 82.6 percent of those people are insured-an increase of 22.7 million such people since 2000.
And getting more denied claims and poorer services for it.
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Working "hard," or the perception of working hard, doesn't really mean anything. Sweating, vomiting, and breathing hard could be a good workout or a tropical disease kicking in.-Dan John
The U.S. medical system is hugely expensive and is not providing as good care to its citizens as socialized systems are in Canada and Europe--that will be a chief argument the Obama Administration employs to justify its new government health insurance plan for the 46 million Americans who are uninsured. The White House will further argue that competition from a public (i.e., government) company will force private insurers to cease underwriting the currently wasteful system. The Administration will also emphasize the alleged horrors of the status quo, claiming, for instance, that most personal bankruptcies in this country are caused by health care debts and that every year nearly 20,000 people die in the U.S. because they are uninsured.
Before swallowing these arguments, you should read a paper recently issued by the National Center for Policy Analysis: "Health Care Reform: Do Other Countries Have the Answers?''. This paper gives a quick rebuttal to the notion that the U.S. health care system fails because of rising costs, inadequate quality of care and incomplete access. For those who want more information, the paper's footnotes will provide plenty of sources with which to find it. Article Controls
Does the U.S. spend too much on health care? When comparing apples with apples and stethoscopes with stethoscopes, the reality is that in most areas--other than diagnostic equipment and research on new medicines--the U.S. actually does not devote more resources per capita than do socialized nations. But "the U.S. compares favorably when real resources are measured rather than monetary accounts. ... Countries account for long-term care and out-of-pocket spending differently. The accounting treatment of overhead and capital costs also varies." Moreover, "the U.S. has been neither worse nor better than the rest of the developed world at controlling expenditure growth." Our outlays grow at the same pace as everyone else's.
In certain areas, such as medical diagnostic equipment, we do have greater spending. Britain has only a fraction of the number of CT and MRI scanners per patient population that the U.S. has. U.S. cancer patients have much better survival rates than do those in Europe.
Moreover, the way in which other countries save money is by cheating their patients of care: "International spending comparisons typically ignore costs generated by limits on supply." Dialysis patients in 2002--04, for instance, had to wait 62 days for access in Canada versus 16 days in the U.S. Waiting lists for elective surgery, such as hip replacement, are notoriously long in other countries. These delays don't show up in spending for health care, but "waiting for care has economic costs in terms of sick pay and lost productivity, as well as negative health consequences."
One big rap against the U.S. is its infant mortality rates. At first glance we look like a laggard: Our rates are notoriously higher than those of other major industrial countries. Amazingly, however, it turns out that the gap exists partly because of the way in which live births are defined. In some countries an infant who dies soon after birth is, incredibly, not considered a live birth for statistical purposes! Social scientist Nicholas Eberstadt "finds that U.S. infants, stratified by birth weight, have a high[er] likelihood of survival."
Life expectancy? The differences are not related to medical care but "to such lifestyle choices as diet, exercise and smoking." Longevity in a state such as Minnesota or Utah is more than a match for those in, say, Norway or Britain. When you figure in all of Europe--the prosperous and the poorer areas--and compare groups by income and ethnicity, life expectancy in the U.S. suddenly looks good.
Now consider effective treatment of major afflictions: The U.S. beats others hands down. Americans with diseases such as cancer, diabetes and hypertension all have better health care outcomes than do their counterparts in Europe. "U.S. women have a 63% chance of living at least five years after a cancer diagnosis, compared with 56% for European women. Men in the U.S. have a five-year survival rate of 66%, compared with 47% for European men." Are medical bills causing bankruptcies? Only in a minority of cases: 17% versus the popularized number of 50%. If people were allowed to buy true catastrophic health insurance--with limits on out-of-pocket expenses--the policy would be very affordable and would take care of most of those folks who are now being hit with bankruptcy-causing bills. As for the myth that socialized medicine is free, patients in most other developed countries pay more out-of-pocket health care costs than do patients in the U.S.!
When it comes to health care for low-income families versus that of their better-off peers, the poor in the U.S. suffer no more than their counterparts do in Canada and Europe.
The problem with health care is that patients don't control the resources--third parties do. Thus, there is no marketplace pressure for productivity or innovative ways of improving delivery. In those areas in which patients write the checks for medical care, productivity proliferates. Cosmetic surgery is a prime example. Unless the need for a procedure is a result of a disease or an accident, such procedures are paid for by the patient, not an insurer. "The real price of cosmetic surgery has declined over the past 15 years, despite substantial technological progress and a sixfold increase in demand."
Health Savings Accounts, properly implemented, would go a long way toward bringing about an entrepreneurial revolution in health care, one in which Americans would get more and better medicines and treatments for less.
I had $15k in bills not covered by insurance and I am paying every penny of it. I can see what was discounted for my insurance company but I don't get those discounts.
I've read a lot of this topic (but not all). It amazes me how badly Americans get screwed by the insurance companies and still line up to defend them.
I tore my Achilles tendon and saw a doctor on a Wednesday (I went to the doctor/clinic of my choosing), was referred to a surgeon on Thursday (I would have seen him Thursday but he was in surgery), and on Friday I had an operation to have it sugically repaired. Total cost: $18.00 for some pain killers.
While many people like a lot of things that America has to offer, no one with government health care outside of the US defends your health care system. That should tell you something. If you really are the greatest country in the world, then you should at least be able to offer affordable health care to all your citizens just like many other countries do.
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I want to be pushing weights when I'm 70 instead of a walker in an old folk's home.
Man that's amazing. You just got fucked over by the extant health-care system and you still defend it?
Yeah, I can't believe the people who get screwed by the U.S. system yet still defend it. It's like a battered wife who defends the husband that beats her.
My wife is originally from the U.K. She has personally experienced both systems. She tells me the U.K. system wins hands down.
"Free market" systems of health care don't work very well because health care is not subject to the typical supply and demand forces that other goods and services are subject to. Second, a national system simply makes more logical sense. Insurance is essentially a system where everyone pools their money into a pot; money is then withdrawn from pot to take care of the sick. It only makes sense that a system that requires everyone to put into the pot (a national system) would be much more efficient and able to provide health care to everyone, versus a bunch of little private pots where the number of people contributing to each little pot is limited (and the fact that the insurance company is trying to profit from that little pot as well).
Political parties don't help the U.S. situation. I can't stand the two-party system in the U.S. Every issue becomes dichotomized, evidence-based thinking goes out the window, and nothing can get done.
I wouldn't be at the 60% but I'm already at 50%. And for that, I DON'T get health care.
So I'm already paying what you pay, without the benefit!
Maybe Russ can clarify, but I think Russ is talking about his average tax rate rather than his marginal tax rate. So if he makes $300k, then after taxes he takes home $150k.
You (NFL) are posting things about marginal tax rates so if you make more than a certain level (say $200k) then your subsequent earnings are taxed at the higher rate (say from 30% to 50%). So if you make $300k, you will take home $190K ( 200K*.30 + 100K*.50) which is still about 63% of your current or 37% lost in taxes.
Again, Russ can clarify this, but it seems you two are talking about two different things.
Yes, but in the U.S. we are such a welfare state, it IS possible to get nothing for something!
But I'm happy to know 50% of the country pays ZERO while I pay 50% out of my paycheck. That just makes me feel warm and cozy inside.
You have a very narrow and misleading view on taxes. You throw that statistic out without any acknowledgement of wealth trends and distributions, tax percentages, or other taxes/fees (and their tax incidences) overall, and externalities that affect the composition of welfare in this country.
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"The strongest steel goes through the hottest fires."-Anonymous
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Another little gem to start your Monday off with a bang.
Quote:
Employees face 'shockingly higher' health costs
It's open enrollment time. As employees nationwide peruse their benefit options, experts say prepare for 'shockingly' higher costs.
NEW YORK (CNNMoney.com) -- It's open enrollment time at work. Prepare yourself. Starting in 2010, your employer is making sure that when it comes to paying for your health care, you're going to be sharing much more of the burden.
"The headline is greater cost sharing," said Tom Billet, senior consultant with human resources consultancy Watson Wyatt. "That means higher [employee] contributions, higher deductibles, or both," he said.
In 2010, employers are "putting everything on the table," implementing benefit changes aimed at making workers more aware of the actual cost of services," said Paul Fronstin, director of the health research program at the Employee Benefit Research Institute (EBRI), a public policy research group.
Barry Schilmeister, health care consultant with Mercer, a global firm specializing in employee benefits, agrees.
"Most people are shielded from the true cost of care because all they pay when they go to the doctor is a $15 to $20 co-pay," he said. "To me the catch phrase in 2010 will be 'Taking responsibility.' "
Consumer advocates, however, aren't thrilled with these declarations.
"We recognize that this is a hard economy," said Cheryl Fish-Parcham, deputy director of health policy with Families USA, a health care consumer advocacy group.
"We know that medical debt is growing. We know that [employer-based] coverage is thinning," said Fish-Parcham. "This is a really difficult environment for everyone. That's why we're all looking forward to health reform."
Here's what to expect
So how are employers tweaking health care benefits options in 2010? Here's the rundown:
Higher out-of-pocket costs. "Employers and employees will face shockingly higher [health care] costs," warned Helen Darling, president of the National Business Group on Health, whose members include Fortune 500 companies such as American Express (AXP, Fortune 500), Coca-Cola (KO, Fortune 500) and IBM (IBM, Fortune 500).
Companies are raising deductibles, co-payments and employee out-of-pocket limits. "In better economic times, employers are better able to shoulder the [health care cost] burden. Not as much now," said Billet, who estimates that costs could increase between 10 to 20% for insured workers.
Besides the economy, Billet said other underlying factors driving up health care costs include aging of the population, greater use of technology in health care and government cost-shifting.
"Medicare and Medicaid typically pays providers less than the actual cost of care," he said, adding that providers make up the difference by raising their rates to their insured clients.
Co-pay to co-insurance. Darling said companies have been shifting over the past five years from a co-pay, a flat dollar fee ranging between $10 and $35 that employees pay at each doctor visit, to a to co-insurance model.
With co-insurance, employees pay a percentage of the total medical expense. Experts say co-insurance rates are typically split 80-20 or 70-30 between the health plan and the insured worker.
"By changing to co-insurance, people are more aware of costs and the hope is that they'll be more careful about how they spend their [health care] dollars," said Schilmeister.
Billet, whose corporate clients include Time Warner (TWX, Fortune 500), the parent company of CNNMoney.com, said co-insurance used to be the norm prior to the advent of health management organizations (HMO). "So it's almost like a back to the future," he said. Time Warner is shifting from a co-pay to a co-insurance model next year.
Fewer options. Big companies are reconfiguring their options, reducing the number of HMOs and offering them only in specific geographic areas, or cutting back on the number of health plans, said Billet. "If a company previously offered a high, medium and low-cost option, now many companies are eliminating the higher-price ones," he said.
"I don't think there's a groundswell of this happening, but employers are looking to save money wherever they can," said Schilmeister. "You can expect that if your company offered two similar HMOs, they will drop the more expensive one."
He added that many consumers may be forced to switch doctors as a result of the consolidation of health plans.
EBRI's Fronstin offered a different perspective. "Fewer options may be a good thing," he said. "Sometimes people get overwhelmed by too many choices and in the process they don't make the best choices for themselves."
Consumer-directed health plans. About 20% of large employers offer consumer-directed health plans (CDHP), up sharply from 14% last year, according to Mercer.
These plans, which couple catastrophic illness coverage with employee-funded health savings accounts (HSA) or health reimbursement accounts (HRA), are 20% less expensive than traditional preferred provider organizations (PPOs) and HMOs, said Schilmeister. CDHPs usually have much lower premiums, although the deductibles are higher than other options. Some employers do help workers with the high deductibles by contributing money into their HSAs.
Still, Schilmeister said CDHPs probably make more sense for a healthy worker who doesn't utilize medical care frequently. Otherwise they can be expensive for employees.
"Be careful with these," said Fish-Parcham. "If employers aren't funding your HSA, it can become a huge problem especially for lower-income workers."
Closer scrutiny of dependent coverage. Experts say you should expect companies to impose a "surcharge" on your premiums if you have a working spouse who has access to other health care coverage. "Virtually all big companies are doing eligibility audits now," said Darling.
Incentives to stay healthy. A healthy worker is a less expensive investment for an employer. So expect to see incentives such as lower premiums or even gift cards if you take a health assessment test or join a weight loss or smoking cessation program.
Families USA's Fish-Parcham said she likes incentives designed to keep workers healthy provided that those incentives are not tied to employees' health plans.
"We're very concerned that employers are imposing higher premiums on people based on their health condition that may be outside of their control," she said.
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Never underestimate the predictability of stupidity.
I know you're always going to see stories like this, but I did have one question. In it, they talk about him looking for work. Even if he had found a job wouldn't a new health care provider considered his wife's cancer pre-existing? (I'm assuming that the army coverage does not.)
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In March, he was laid off from his job as a raw materials coordinator for a plastics company called PolyOne, where he'd worked for 20 years. His severance package had provided several months' salary, but by August the paychecks were winding down. Soon the cost of his family health coverage was going to triple, then a few months after that, nearly triple again. They needed coverage so Mom could fight her cancer.
Dad's solution: a four-year hitch in the Army.
Any economists willing to take a look at this and evaluate it? The basic claim is that new health care costs will be revenue neutral. Healthier people will work (and pay taxes) longer, the cost to Medicare of unhealthy people landing in that system with lots of health care to be taken care of, and the growth of the economy by more workers employed to look after the currently uncovered.
ps - I still think we ought to have a goal of reducing health care costs as a percent of the GNP, but how does this all address that goal?
60 minutes had an interesting piece about Medicare fraud last night. If the numbers they quote are accurate then 10% of the money paid by Medicare is paid on fraudulent claims. Here's the link, it's the first segment (probably about 15 minutes).
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