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The New Coffee Room

  1. TNCR
  2. General Discussion
  3. Pretty soon you're talking about real money

Pretty soon you're talking about real money

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  • X xenon

    @Copper Is there cost competition on standard of care?

    I thought there would be tiered healthcare in the U.S. when I moved here (as in better stuff for people who had more money and better insurance). But if you're insured, everyone seems to get the "gold standard of care". Your insurance just tells you how much out of pocket you're going to pay.

    And the U.S. definitely has the best of the best in terms of equipment, drugs and services. (doesn't always equate into best healthcare outcomes though)

    A lot of this perspective is from listening to a recent talk by Vivian Lee

    The interesting insight for me is that on standard of care - typically physicians aren't looking at cost effectiveness, they're looking at efficacy.

    We have physicians here - I'd love to hear from @George-K if he ever thought about treatments and made decisions on the dimension of how much they would cost?

    There's competition in the system - but not necessarily in the places that are driving the cost increases.

    CopperC Offline
    CopperC Offline
    Copper
    wrote on last edited by
    #51

    @xenon said in Pretty soon you're talking about real money:

    @Copper Is there cost competition on standard of care?

    There's competition in the system - but not necessarily in the places that are driving the cost increases.

    Of course there is competition.

    And of course the better doctors cost more.

    Here is a program I used up until last year.

    It was not covered by insurance, I paid for it myself so I could have access to the doctor I wanted. Believe me, this was a cost increase.

    https://learnmore.mdvip.com/live-your-best-new?utm_source=google&utm_medium=cpc&st-t=google_&mdvip_campaign=Branded-+Top+Docs+CATCH+ALL&mdvip_term=%2Bvip+md&gclid=EAIaIQobChMIxJOE-7Th6gIVYQiICR3slg_nEAAYASAAEgLYz_D_BwE&gclsrc=aw.ds

    X 1 Reply Last reply
    • CopperC Copper

      @xenon said in Pretty soon you're talking about real money:

      @Copper Is there cost competition on standard of care?

      There's competition in the system - but not necessarily in the places that are driving the cost increases.

      Of course there is competition.

      And of course the better doctors cost more.

      Here is a program I used up until last year.

      It was not covered by insurance, I paid for it myself so I could have access to the doctor I wanted. Believe me, this was a cost increase.

      https://learnmore.mdvip.com/live-your-best-new?utm_source=google&utm_medium=cpc&st-t=google_&mdvip_campaign=Branded-+Top+Docs+CATCH+ALL&mdvip_term=%2Bvip+md&gclid=EAIaIQobChMIxJOE-7Th6gIVYQiICR3slg_nEAAYASAAEgLYz_D_BwE&gclsrc=aw.ds

      X Offline
      X Offline
      xenon
      wrote on last edited by
      #52

      @Copper The most expensive thing we've done in the U.S. is have kids.

      In SF our OB gyn's resume was ridiculous (Harvard, Standard med school, head of OB at UCSF... lots of other prestigious positions).

      In Seattle our OB was fantastic - but a bit more "normal" on the qualifications and earlier in her career (we actually loved her, since she had more time to spend with us).

      Don't know what they cost - wasn't any different for us.

      1 Reply Last reply
      • CopperC Offline
        CopperC Offline
        Copper
        wrote on last edited by
        #53

        I don't doubt it.

        One doctor's story doesn't define the USA healthcare system.

        And, by the way, there is no such thing as the USA healthcare system.

        1 Reply Last reply
        • 89th8 Offline
          89th8 Offline
          89th
          wrote on last edited by
          #54

          @Horace thanks for the update. So you paid the $1,400. What else do you expect to pay out of pocket from here forward?

          1 Reply Last reply
          • HoraceH Offline
            HoraceH Offline
            Horace
            wrote on last edited by
            #55

            That was just for the surgery center facility. There is another bill for the surgeon, another for the anesthesiologist. Those are all covered directly by my health insurance but there's always a portion I am responsible for, even after the deductible is covered. I figure the whole thumb thing will cost me about 10-15k out of pocket when it's all done.

            Education is extremely important.

            JollyJ 1 Reply Last reply
            • 89th8 Offline
              89th8 Offline
              89th
              wrote on last edited by
              #56

              Ah I see, kind of like dental insurance on special procedures (like an implant) but way bigger bills.

              1 Reply Last reply
              • HoraceH Horace

                That was just for the surgery center facility. There is another bill for the surgeon, another for the anesthesiologist. Those are all covered directly by my health insurance but there's always a portion I am responsible for, even after the deductible is covered. I figure the whole thumb thing will cost me about 10-15k out of pocket when it's all done.

                JollyJ Offline
                JollyJ Offline
                Jolly
                wrote on last edited by
                #57

                @Horace said in Pretty soon you're talking about real money:

                That was just for the surgery center facility. There is another bill for the surgeon, another for the anesthesiologist. Those are all covered directly by my health insurance but there's always a portion I am responsible for, even after the deductible is covered. I figure the whole thumb thing will cost me about 10-15k out of pocket when it's all done.

                If they are in network, that would seem to be a bit high for your part. Have you received your EOB's on their services?

                “Cry havoc and let slip the DOGE of war!”

                Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton

                1 Reply Last reply
                • HoraceH Offline
                  HoraceH Offline
                  Horace
                  wrote on last edited by
                  #58

                  I mean across all three surgeries and including all doctor visits, physical therapy, etc.

                  Education is extremely important.

                  1 Reply Last reply
                  • taiwan_girlT Offline
                    taiwan_girlT Offline
                    taiwan_girl
                    wrote on last edited by
                    #59

                    @jon-nyc Dont know if you would be willing to share, but what was the gross cost for your medical procedure?

                    1 Reply Last reply
                    • jon-nycJ Offline
                      jon-nycJ Offline
                      jon-nyc
                      wrote on last edited by jon-nyc
                      #60

                      Around 900k.

                      But that’s everything, all the visits before and after, special tests (a heart cath can be 10-15k and I’ve had 4 of them), rehab and ‘prehab’, surgery, ICU time, hospital time, etc.

                      Only non-witches get due process.

                      • Cotton Mather, Salem Massachusetts, 1692
                      1 Reply Last reply
                      • jon-nycJ Offline
                        jon-nycJ Offline
                        jon-nyc
                        wrote on last edited by jon-nyc
                        #61

                        I don’t know what I spent, it was probably capped at a few grand per year for co-pays.

                        We even had some reimbursement for relocation, but I was listed long enough that we burned through it. So I probably spent 20-30k of my own money (over, say, 2014-16) if I had to guess.

                        Most of it didn’t feel like medical bills. Like buying a home oxygen concentrator or paying rent or renting furniture.

                        Only non-witches get due process.

                        • Cotton Mather, Salem Massachusetts, 1692
                        1 Reply Last reply
                        • 89th8 Offline
                          89th8 Offline
                          89th
                          wrote on last edited by
                          #62

                          @Horace I require 1x update plz

                          HoraceH 1 Reply Last reply
                          • 89th8 89th

                            @Horace I require 1x update plz

                            HoraceH Offline
                            HoraceH Offline
                            Horace
                            wrote on last edited by
                            #63

                            @89th I paid the $1433 and am now hoping the 98k bill just magically disappears. I received no receipt of payment, though the woman on the phone said she'd send me one. Nor have I ever received a bill. The only bill received so far is the one sent to my insurance company. So basically the process is that this surgery center sends a huge out of network bill to the insurer, gets pennies on the dollar for it, and accepts some other "small" amount from the patient. I have to trust the system that the balance of the 98k bill is not legally passed on to me. Having seen no paper yet, I really don't know.

                            Education is extremely important.

                            1 Reply Last reply
                            • RainmanR Offline
                              RainmanR Offline
                              Rainman
                              wrote on last edited by
                              #64

                              Horace said, "I have to trust the system..."

                              No kidding. He actually said that. Look at his post!
                              It looks like his typing, far as I can tell.

                              Scary, might be Covid-20 or something.
                              Too much sun? Bad water. Drunk on Jon. Found religion.

                              Ax, help him help him!! Soon he'll be drowning in trust, and then, blam! No return from utopia.

                              1 Reply Last reply
                              • Doctor PhibesD Online
                                Doctor PhibesD Online
                                Doctor Phibes
                                wrote on last edited by
                                #65

                                You either trust the system or you move to Canada.

                                I was only joking

                                1 Reply Last reply
                                • 89th8 Offline
                                  89th8 Offline
                                  89th
                                  wrote on last edited by
                                  #66

                                  Thanks @Horace what an almost unbelievable lack of paper records given the amounts you’re talking about.

                                  1 Reply Last reply
                                  • Doctor PhibesD Online
                                    Doctor PhibesD Online
                                    Doctor Phibes
                                    wrote on last edited by
                                    #67

                                    It's unbelievable that we have to live with this shit.

                                    You get a bill for $100K, and are told 'not to worry, it's an administrative error'.

                                    Yeah, that just fills me with confidence. I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                                    I was only joking

                                    Catseye3C 1 Reply Last reply
                                    • Doctor PhibesD Doctor Phibes

                                      It's unbelievable that we have to live with this shit.

                                      You get a bill for $100K, and are told 'not to worry, it's an administrative error'.

                                      Yeah, that just fills me with confidence. I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                                      Catseye3C Offline
                                      Catseye3C Offline
                                      Catseye3
                                      wrote on last edited by
                                      #68

                                      @Doctor-Phibes said in Pretty soon you're talking about real money:

                                      I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                                      OR SURGEON to nurse: "Remind me again, which side is the appendix on? Left or right?"

                                      (With apologies to Bach. 😬 )

                                      Success is measured by your discipline and inner peace. – Mike Ditka

                                      RainmanR 1 Reply Last reply
                                      • Catseye3C Catseye3

                                        @Doctor-Phibes said in Pretty soon you're talking about real money:

                                        I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                                        OR SURGEON to nurse: "Remind me again, which side is the appendix on? Left or right?"

                                        (With apologies to Bach. 😬 )

                                        RainmanR Offline
                                        RainmanR Offline
                                        Rainman
                                        wrote on last edited by
                                        #69

                                        @Catseye3 said in Pretty soon you're talking about real money:

                                        @Doctor-Phibes said in Pretty soon you're talking about real money:

                                        I really hope the same people doing the accounting aren't the same ones wielding the scalpels.

                                        OR SURGEON to nurse: "Remind me again, which side is the appendix on? Left or right?"

                                        (With apologies to Bach. 😬 )

                                        Why are you apologizing to Bach?
                                        Don't tell me he did it again!

                                        1 Reply Last reply
                                        • bachophileB Offline
                                          bachophileB Offline
                                          bachophile
                                          wrote on last edited by
                                          #70

                                          Situs inversus.

                                          Look it up

                                          George KG 1 Reply Last reply
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