[pianotech] Medical costs (OT!) was:billing dilemma

Susan Kline skline at peak.org
Wed Nov 3 10:28:26 MDT 2010


Mike, you are right that that's what the insurance companies do. But I 
object to the idea that I in some way am a freeloader. I did exactly 
what the advisers from the hospital suggested that I do, and I accepted 
their very first offer immediately. I believe I paid all the costs which 
they incurred on my behalf, or maybe a small amount more.

By paying in a lump sum, I saved them a lot of billing expenses, waiting 
time, (and sometimes possibly legal costs) which "normal" payment 
options like insurance probably saddle them with.

I'm done with this topic.

Susan

On 11/3/2010 5:19 AM, Mike Spalding wrote:
> That part was paid by the same people who pay the part the insurance 
> companies don't pay.  Look at any EOB (explanation of benefits) from 
> the insurance companies - there's the amount billed, then the 
> discounted amount the insurance company has negotiated (bullied) with 
> the provider.  In the case of hospital surgery bills, the discounted 
> amount can be as little as 1/3 the original amount billed.  Don't 
> attack Susan for doing, in a small way, what every insurance company 
> does in a very big way.
>
> Mike
>
> On 11/2/2010 4:05 PM, David Love wrote:
>> Susan:
>>
>> Just one question. When you negotiated that hospital bill down to 30k 
>> who paid the part you couldn't pay?
>>
>>
>>
>> David Love
>> www.davidlovepianos.com
>>
>> ------------------------------------------------------------------------
>> *From: * Susan Kline <skline at peak.org>
>> *Sender: * pianotech-bounces at ptg.org
>> *Date: *Tue, 02 Nov 2010 13:36:35 -0700
>> *To: *<pianotech at ptg.org>
>> *ReplyTo: * pianotech at ptg.org
>> *Subject: *Re: [pianotech] Medical costs (OT!) was:billing dilemma
>>
>> Will, you bring up one of the fatal errors in how conventional health 
>> insurance worked before the health care bill passed (flawed as it is 
>> by corporate pressures from all sides).
>>
>> An insurance pool, to work right, has to have the largest possible 
>> number of people in it. It should be affordable enough that many 
>> people pay in, but the catastrophes happen to only a few of them, so 
>> the system stays in the black. Insuring for a routine and expected 
>> expense is madness, because it balloons the costs to several times 
>> what they would be if people just paid out of pocket. I remember when 
>> dental insurance became common. Suddenly the fees for my dental care 
>> tripled, though I didn't do a single thing to cost the dentist a 
>> penny more than before.
>>
>> What we need is not more insurance. We need more health, so that 
>> major medical costs only happen to a few people, instead of almost 
>> all of them. Plus we need efficiency, with doctors on salary. They 
>> should be forbidden to take kickbacks for prescribing drugs, as many 
>> now do. They should not be paid by the procedure, since this 
>> multiplies procedures, some of which are dangerous and most of which 
>> are expensive. They should be protected from needing expensive 
>> malpractice insurance. Instead of victims getting huge money 
>> settlements paid for by malpractice insurance, doctors who are truly 
>> incompetent should have their licenses revoked. There could be a 
>> public fund to reimburse victims, so that half the proceeds wouldn't 
>> line lawyers' pockets.
>>
>> The "pre-existing condition" cherry picking just dumps huge segments 
>> of the population to fend for themselves. Often this is absolutely 
>> not their fault. Many of them work and take reasonable care of 
>> themselves and have money and are willing to fund their medical 
>> coverage, if it could be made efficient enough that the premiums 
>> weren't an invitation to bankruptcy. In the present situation, they 
>> can't find a way into the system.
>>
>> What we have now is a hodge-podge of exceptions and ad-hoc ways of 
>> getting people treated when they are not in the shrinking pool of 
>> those privileged enough to be insured (through work for major 
>> companies, extreme wealth, or being young healthy and employed). You 
>> see the disconnect? Those who most need health care are the very ones 
>> closed out from obtaining it.
>>
>> This is why every industrialized country (EVEN BRAZIL!!) has some 
>> form of universal coverage or a hybrid public-private setup. Adults 
>> were in charge. They saw that leaving people with no access to 
>> routine health care led to much higher expenses when they were in the 
>> final stages of fatal but preventable diseases. It was a lot cheaper 
>> and more humane just to be sure that everyone could get a certain 
>> basic amount of care.
>>
>> We needed the public option really badly. But people fuming from Fox 
>> News "entertainment" (read "tissue of lies") brought guns to public 
>> meetings, screamed at the top of their lungs, and all the rest of it. 
>> Obama and the Democrats blinked.
>>
>> Okay, one more point and I'll shut up about politics. I see people 
>> saying with fervor that they don't want to pay for the health care of 
>> people who have all sorts of bad habits, eat junk food, smoke, etc. 
>> Might I point out that they are already paying for it in the present 
>> system? Anyone can go to an emergency room and they have to be 
>> treated, though they have to go through the gauntlet of waiting in 
>> terrible conditions in the major city hospitals crowded with other 
>> uninsured people. (What are you advocating? Sending someone having a 
>> heart attack out to die on the sidewalk?) A universal system would 
>> provide a way that everyone would pay something, means-tested for the 
>> poorest, so that those people now  crowding and stressing the system 
>> could be treated early in a civilized uncrowded non-emergency 
>> setting, and they could help pay for their treatment.
>>
>> On the other hand, people complain that no one should be forced to 
>> buy insurance. I am one of those who didn't buy insurance for thirty 
>> years, but if the system had been fair and equitable and efficient, I 
>> would have rushed to buy in. I don't imagine those who avoid being 
>> insured also avoid using the hospital when they have a medical 
>> crisis. If they had paid a little in for years before the crisis, the 
>> system might have been able to take care of them and still stay in 
>> the black.
>>
>> We heard all these arguments before Medicare was passed. But then 
>> last year Fox News's campaign to derail the health care bill inspired 
>> the elderly at town hall meetings to shout that Obama "should keep 
>> his hands off our Medicare!!" You can't really have it both ways.
>>
>> Susan Kline
>>
>>
>>
>> On 11/2/2010 2:52 AM, William Truitt wrote:
>>>
>>> You make me ashamed of myself, Terry.  You are, of course, correct.  
>>> Health insurance is for 18 to 24 year old young women with no prior 
>>> medically disqualifying history (we’ll overlook the medical crime of 
>>> being born just this once) (not for men in that age group, they get 
>>> drunk and fall off buildings) and the very wealthy.
>>>
>>> My prediction is that when the wealthy can’t afford health insurance 
>>> either, they will become Nazi-Facist-Commie-Socialists too.
>>>
>>> Will
>>>
>>> *From:*pianotech-bounces at ptg.org [mailto:pianotech-bounces at ptg.org] 
>>> *On Behalf Of *Terry Farrell
>>> *Sent:* Monday, November 01, 2010 10:58 PM
>>> *To:* pianotech at ptg.org
>>> *Subject:* Re: [pianotech] Medical costs (OT!) was:billing 
>>> dilemmawith pitch raises
>>>
>>> Nice comments Will, but one glaring error:
>>>
>>> On Nov 1, 2010, at 10:16 PM, William Truitt wrote: "...this is how 
>>> private health insurance works also.  Everybody pays into a pool so 
>>> that the individuals who need to take from the system can get the 
>>> care they need when they need it, at least in theory."
>>>
>>> I would argue against this Will. In universal health insurance, 
>>> everybody pays into the pool via taxes. In private health insurance 
>>> only those who are healthy pay into the pool, unless of course, the 
>>> odd situation arises that the insurance company can't find a way to 
>>> disqualify someone who has a medical issue........
>>>
>>> Terry Farrell
>>>
>>>
>>
>

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