cut on my eye

BroKen_H said:
Weird..
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It is weird. I suspect many physicians give deals out to the out of pocket crowd and I wouldn't draw a sweeping conclusion from jimi's singular experience; but if and when doctors are charging insured customers less it's definitely due to the bargaining power of the insurance company.
 
nave said:
Do you bitch about the fact that the hardware store bought those safety goggles you didn't use for wholesale and then turned around and charged you retail? Because the reason that happened is the same one that explains why the doctor charges the consumer with the insurance plan less than the guy without it. In both cases, it's bargaining power at work.
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No I don't bitch about the hardware store making a retail profit off goggles.
Why?
Because the price of the goggles are clearly posted so I know what I will be charged before I'm on the hook to pay. Also, I can figure out quickly if they are gouging me because I can see the same goggles for sale in walmart.com, ebay, homedepot.com, lowes.com, and a staggering array of other places. The hardware store can be a little higher because they offer convenience and service. If they are way out of line they will go out of business. If they wouldn't disclose price upfront and made people obligate to buy before they knew what the would be charged.....like medical providers do....they would cease to do any business whatsoever. You're right about insurance companies bargaining power getting the price down. In a nut shell the insurance company....let's say blue cross...puts it to them like this; "$2700 for that c-scan? You people are out of your minds. Blue cross will approve $600 for that test and not a penny more. If you don't like that we will send our thousands of policy holders to the vast array of hospitals that do like it and agree to it. You will then be listed as out of network and avoided like the plague. Have a nice day :) " When blue cross tries to cut them too deep the medical providers temporarily quit accepting blue cross and policy holders get panic stricken and a renegotiation happens. And round and round they go.
The price is kept competitive that way.
I say thank God SOMEBODY is questioning these racketeering bastards that will bankrupt an uninsured person over amounts they won't even think about charging, much less actually collecting, from an insured person.
 
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Now let me ask you a question nave...
Should medical providers be allowed to charge everyone a different price for the same procedure while at the same time refusing to disclose to theses people exactly what price they will be charging?
 
nave said:
... but if and when doctors are charging insured customers less it's definitely due to the bargaining power of the insurance company.
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They don't call it Bargaining Power, they call it the Negotiated Rate or Contract Rate. Insurance companies set a price for every procedure then they tell the doctors, "If you want our customers, you'll accept our rates." It should be called Extortion Rate. The insurance companies are making a killing doing this. :mad:

When I was out of work for 8 months and had no insurance, I was able to wheel and deal with one doctor for a much lower rate than she usually charged. That was a long time ago. I'd like to think my current doc would do the same, but I'm not sure.
 
jimistone said:
No I don't bitch about the hardware store making a retail profit off goggles.
Why?
Because the price of the goggles are clearly posted so I know what I will be charged before I'm on the hook to pay. Also, I can figure out quickly if they are gouging me because I can see the same goggles for sale in walmart.com, ebay, homedepot.com, lowes.com, and a staggering array of other places. The hardware store can be a little higher because they offer convenience and service. If they are way out of line they will go out of business. If they wouldn't disclose price upfront and made people obligate to buy before they knew what the would be charged.....like medical providers do....they would cease to do any business whatsoever. You're right about insurance companies bargaining power getting the price down. In a nut shell the insurance company....let's say blue cross...puts it to them like this; "$2700 for that c-scan? You people are out of your minds. Blue cross will approve $600 for that test and not a penny more. If you don't like that we will send our thousands of policy holders to the vast array of hospitals that do like it and agree to it. You will then be listed as out of network and avoided like the plague. Have a nice day :) " When blue cross tries to cut them too deep the medical providers temporarily quit accepting blue cross and policy holders get panic stricken and a renegotiation happens. And round and round they go.
The price is kept competitive that way.
I say thank God SOMEBODY is questioning these racketeering bastards that will bankrupt an uninsured person over amounts they won't even think about charging, much less actually collecting, from an insured person.
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This is exactly why a centralised insurance system and as a result a single or significantly large service buyer is a good idea such as the NHS. They have a LOT of bargaining power when taking on the Pharmaceutical and Healthcare private sector and suppliers. Also in the case of the NHS, profit is not the primary motive whereas reducing costs is.
 
Chili said:
They don't call it Bargaining Power, they call it the Negotiated Rate or Contract Rate.
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Eh, Semantics. They actually do call it bargaining power, though. Economists, anyway. Negotiating is surely a good synonym. Don't make me quote Wikipedia!
 
jimistone said:
Now let me ask you a question nave...
Should medical providers be allowed to charge everyone a different price for the same procedure while at the same time refusing to disclose to theses people exactly what price they will be charging?
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No.
 
Make no mistake. Insurance companies are in it to make money, but so are the medical providers. The only policies insurance companies make a killing off of are limited benefit policies that have specific benifit scheduals. Major medical policies are dogs for instance companies and agents were discouraged from writing them. Life, homeowners, and auto are where the profits are. Heathcote providers try to max out the health policy rates go up, healthy policy holders jump ship, rates go up more, more heath people jump ship, company pulls the plan, sick policy holders get screwed.
A lot of companies got out of the medical insurance business. Sine Obama care I dunno
 
What many forget here is it is called the United States of America. That means, each state has a certain amount of power. That is why we don't have a national police, each state has its own legislative body, etc. Since the creation of the US it has always been a debate of how much power the federal government should have.

The power of the federal government was the premise behind the civil war and why the south was able to secede. A national health care law becomes as much a constitutional issue as any thing else.

The US federal government was originally suppose to do just a few things, negotiate with foreign powers, have a standing army, regulate interstate commerce and make sure the constitution is enforced to all members. During the New Orleans crisis, GB could not legally send in troops to the state of Louisiana until after an invitation by the governor. This is a hold over from the days when the country was young and the founding fathers were trying to avoid a dictator or a king.

As messed up as it seems, I like our form of government and want to keep it. If other people in different countries like their central government, cool, but we in the US don't want it. Each state should care for their people as they see fit.
 
I think the lesson we should all take away from this (in our capitalist republic) is that when you go to the doctor for whatever reason, you should ask up front what the costs will be for their services. If you ask in advance and get a good idea from them what the insurance will cover, you can plan and budget to get the service done, or postpone until you can afford it. The doctor's will obviously hard sell on the bit M word, but a meteor MIGHT be coming to land on the doctor's office as you speak; a car MIGHT go completely out of control and hit you on your way out of the office. Any number of things MIGHT happen. Their service is no different than anyone else'. Negotiate the price if you can, put it off till you can afford it if you must, but make sure you know in advance.
Personally? Sometimes it's hard to keep a logical and level head when I'm in pain or anxious about what something is, but really, in the long run, do I want to be overrun by debt for the rest of my life just to live a year longer? Hard call. Hope I don't have to make that decision today or tomorrow...
 
DM60 said:
The power of the federal government was the premise behind the civil war and why the south was able to secede. A national health care law becomes as much a constitutional issue as any thing else.
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So the south was trying to leave because the big bad North was banning slavery? Is that how it happened?
 
DM60 said:
The US federal government was originally suppose to do just a few things, negotiate with foreign powers, have a standing army, regulate interstate commerce and make sure the constitution is enforced to all members. During the New Orleans crisis, GB could not legally send in troops to the state of Louisiana until after an invitation by the governor. This is a hold over from the days when the country was young and the founding fathers were trying to avoid a dictator or a king.

As messed up as it seems, I like our form of government and want to keep it. If other people in different countries like their central government, cool, but we in the US don't want it. Each state should care for their people as they see fit.
Click to expand...

Healthcare is quite obviously interstate commerce. Part of the reason why people in the US pay more for healthcare is lack of efficiency in our. Other countries have more efficient centralized systems. 1 bureau. 1 CFO. 1 billing directorate. 1 IT directorate. 1 help desk directorate etc. You would replace that with 50 of each. It makes no sense. Having 50 fiefdoms each with different regulations, and 50 sets of corporations who are actually just a few corporations set up to interpret 50 completely different sets of laws is inefficient and has proven to be ineffective. (This is an understatement).

And actually people in the US do want Obamacare and centralized healthcare as evidenced by the fact that the Democrats campaigned on this very issue and proceeded to win 60 seats in the Senate, a huge majority in the House, and the White house. And then Obama was re-elected after that.
 
Jimmy sorry for your hassles... I grew up in construction and stood behind a tile saw and a grinder for most of the first 40 years of my life...goggles smoggles..most of us never wore them...the first thing we'd do when we bought a new Makita grinder was remove the safety guard... I know..lame...but in all those years I never met a guy who "lost an eye" ...a few fingers yes... I have had a boatload of tile chips in my eyes over the years...and scratched them ...they heal up... Not recommending not to use eye protection just saying at least in the wild west days of non union non regulated safety..construction where I lived ...it was rare some one was wearing eye protection..so don't beat your self up too much on that one...you were just unlucky.

In regards to our system...the system sucks...took the wife in for an emergency visit because she passed out.... They ran some test and blood work ...never admited...with The "New and Improved" "ASSffordable Care Act" ( not so much) or as we call it in Cali "Covered California" we found out what wasn't covered real quick...Holy Shit! Fricking test that should cost $20 costing $400...With PPO insurance the bill quickly sailed past $5G's...I mean for really basic shit...blood test and a few xrays... What we discovered was the new way they handle it is, before the insurance pays one dime, before we get to enjoy any of the "insurance negotiated pricing" benefits we must pay in full the $2000 deductible.. based on the regular rape em fee's...previously the negotiated rates were what we paid and once we met the deductible the full 80% coverage kicked in...no longer the case...cough up the $2,000 and then the discounts start... bastards!...Worse yet once we chose to try the "covered california " system even though the list showed all our doctors and clinics that we had used in the past as part of the program...slowly one by one we found that most had opted out of accepting the "New and Improved" insurance

The U.S. Medical system is a bureaucratic cluster fuck as is the FDA. Best advice I ever got from a retired American doctor I was sitting next to on a flight one time..."Don't get sick"

because of family I am stuck here till I expire ( by choice ) but I hate the medical system..I am totally against a "national program" like the UK / Canada and totally for a free market system..which is not what we have in the U.S.

The cost of treatment here has spun out of control...and it's not just because doctors and drug companies are greedy evil bastards...on the contrary I am sure most start out with altruistic goals...It's our legal system and the vicious circle ..ridiculous malpractice suits that put the evil ones in a position of guarded protection...enter insurance companies...the modern day legal "Crime Bosses" who'll provide doctors and health care facilities "protection" from the evil lawyers. Then big settlements...the malpractice insurance goes up and the rates the doctors and healthcare facilities go up...all in a vicious circle of CYA from the lawyers..


But I'm not bitter! :thumbs up:


Looks like Malaysia is the #1 place to go to get worked on...
 
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TAE said:
Jimmy sorry for your hassles... I grew up in construction and stood behind a tile saw and a grinder for most of the first 40 years of my life...goggles smoggles..most of us never wore them...the first thing we'd do when we bought a new Makita grinder was remove the safety guard... I know..lame...but in all those years I never met a guy who "lost an eye" ...a few fingers yes... I have had a boatload of tile chips in my eyes over the years...and scratched them ...they heal up... Not recommending not to use eye protection just saying at least in the wild west days of non union non regulated safety..construction where I lived ...it was rare some one was wearing eye protection..so don't beat your self up too much on that one...you were just unlucky.

In regards to our system...the system sucks...took the wife in for an emergency visit because she passed out.... They ran some test and blood work ...never admited...with The "New and Improved" "ASSffordable Care Act" ( not so much) or as we call it in Cali "Covered California" we found out what wasn't covered real quick...Holy Shit! Fricking test that should cost $20 costing $400...With PPO insurance the bill quickly sailed past $5G's...I mean for really basic shit...blood test and a few xrays... What we discovered was the new way they handle it is, before the insurance pays one dime, before we get to enjoy any of the "insurance negotiated pricing" benefits we must pay in full the $2000 deductible.. based on the regular rape em fee's...previously the negotiated rates were what we paid and once we met the deductible the full 80% coverage kicked in...no longer the case...cough up the $2,000 and then the discounts start... bastards!...Worse yet once we chose to try the "covered california " system even though the list showed all our doctors and clinics that we had used in the past as part of the program...slowly one by one we found that most had opted out of accepting the "New and Improved" insurance

The U.S. Medical system is a bureaucratic cluster fuck as is the FDA. Best advice I ever got from a retired American doctor I was sitting next to on a flight one time..."Don't get sick"

because of family I am stuck here till I expire ( by choice ) but I hate the medical system..I am totally against a "national program" like the UK / Canada and totally for a free market system..which is not what we have in the U.S.

The cost of treatment here has spun out of control...and it's not just because doctors and drug companies are greedy evil bastards...on the contrary I am sure most start out with altruistic goals...It's our legal system and the vicious circle ..ridiculous malpractice suits that put the evil ones in a position of guarded protection...enter insurance companies...the modern day legal "Crime Bosses" who'll provide doctors and health care facilities "protection" from the evil lawyers. Then big settlements...the malpractice insurance goes up and the rates the doctors and healthcare facilities go up...all in a vicious circle of CYA from the lawyers..


But I'm not bitter! :thumbs up:


Looks like Malaysia is the #1 place to go to get worked on...
Click to expand...

Yeah, I not beating myself up. I actually thought I had something in my eye...if I had have known it was only a cut I probably would have just let it heal and used some anti biotic eye drops I have in the medicine cabinet...I would have $400 right now to blow on music gear.
Have you noticed how doctors are such drama queens?
Everything is serious. Every pain and sensation is potentially life threatening and should have $3000 worth of testing because....
Hey, you can't put a price on good health! (Unless you're a doctor or hospital and then the price you put on good health is astronomical.)

Every speck of dust in you eye can.....
CAUSE YOU TO LOSE YOU VISION! OH MY GOD MAN....GIVE ME $500 QUICK BEFORE YOU GO BLIND!!!
Hehehehe...
Oh the drama queen doctors.
 
jimistone said:
Yeah, I not beating myself up. I actually thought I had something in my eye...if I had have known it was only a cut I probably would have just let it heal and used some anti biotic eye drops I have in the medicine cabinet...I would have $400 right now to blow on music gear.
Have you noticed how doctors are such drama queens?
Everything is serious. Every pain and sensation is potentially life threatening and should have $3000 worth of testing because....
Hey, you can't put a price on good health! (Unless you're a doctor or hospital and then the price you put on good health is astronomical.)

Every speck of dust in you eye can.....
CAUSE YOU TO LOSE YOU VISION! OH MY GOD MAN....GIVE ME $500 QUICK BEFORE YOU GO BLIND!!!
Hehehehe...
Oh the drama queen doctors.
Click to expand...

Your health service is fucked.
 
On top of being drama queens they are pompous fuckers.
"What did you just ask me? How much will this procedure cost you? Really...commoners are going to ask me some tacky vulgar question about price? How dare they!!!!. Do these imbeciles not realize that I use my Godlike gift of healing to better mankind and a price should not, can not, and will not be put on that! I tell you what Mr redneck cheapskate unhealthy, don't give a fuck about your health, dickhead fuck face, ass hole, uneducated, piece of shit, dirt bag, fucking chump change bastard....GET OUT OF MY FUCKING OFFICE AND DON'T LET THE DOOR HIT YOU IN THE ASS!!!!"



"...I can't believe he actually asked me, up front, what I charge....and the idiot actually though I was going to tell him.....

Moron"
 
They are glad to talk price after they get you on the hook for a bill though...
"Yes Mr Jones, I understand your concern. $5000 is a substantial amount and I believe this testing will lead us to an educated treat mentioned option. They price of the testing was costly due to the special dye we have to use that costs us $600 an ounce. Luckily, we nogociated the price down to that level because it would normally the price of that dye is $1200 an ounce. Don't worry about a thing Mr Jones because my secretary will discuss several payment options depending on how much you can put down on the bill.....What's that Mr Jones?...how much will the second round of tests cost? Mr Jones what I want you to do is please try to lower your stress level and concern yourself with fighting thus illness instead of the coat of your treatment. OK. You know if this potentially fatal debilitating illness gets the better of you they price isn't really going to matter much is it? I'm going to do everything in my power to save your life Mr Jones and a price really can't be put on that...wouldn't you agree?"

Lol
 
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