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International Forum Discuss Record 4.4M Britons waiting for non-urgent surgery, gov't figures show at the Political Forums; Originally Posted by ShivaTD Under Obamacare, the only Obama era medical program we can cite, the medical decisions are made ...

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  #11 (permalink)  
Old 08-14-2019, 08:43 AM
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Default Re: Record 4.4M Britons waiting for non-urgent surgery, gov't figures show

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Originally Posted by ShivaTD View Post
Under Obamacare, the only Obama era medical program we can cite, the medical decisions are made by the patient and their doctor and not by bureaucrats. Where did the idea that bureaucrats were making the decisions come from?

Political elites, such as members of Congress, have always had their own medical insurance program that's better than anyone else's.

Here's an interesting idea. Perhaps in addressing health insurance for all Americans we should cover all Americans with a health insurance program that's as good or better than what the political elites are receiving now. Now there's an idea. Treat the American people better than the politicians.
Why don't we ALL save a bundle and eliminate the stranglehold insurance companies currently have?

As a comparative: I needed xrays for my back - chiropractic issues. My Chiro suggested two things: Go through my insurance, and it would cost me about $150, since it would be applied to my deductible, or pay $50 cash with no insurance involvement.

Guess which one I chose?

Same chiro - pay cash, adjustment is $40. Insurance claim? $60 co-pay.

Is the point clearer now?
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Old 08-14-2019, 10:25 AM
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Default Re: Record 4.4M Britons waiting for non-urgent surgery, gov't figures show

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Originally Posted by lurch907 View Post
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BTW I'm covered by the VA because of military disabilities and so far it's taken me about 20 weeks for non-urgent surgery I've had and that's using the outsourcing of the surgery because of understaffing of doctors at the VA. I'm in my 3rd year of waiting for hip replacement because it wasn't considered as absolutely necessary when first identified.
More evidence in support of keeping gov't as far away from my healthcare and insurance decisions as possible.
Even with the VA the government does not intervene in the medical decisions made by my physician.

There's no question about "insurance" covering the hip replacement surgery now that it's become an issue for me physically. The only problem that's delaying the surgery is the failure of Congress to fund the necessary medical staff and facilities to provide the surgery in a timely manner.

With proper funding and staffing the VA would have performed the surgery several weeks ago.

Question: How much does someone with private health insurance have to come up with out of pocket for hip replacement surgery? I've read the average cost is about $32,000 so with a an 80/20 plan that would cost the patient at about $6,000 plus. To have both hips replaced that would be $12,000 plus. That's a lot of money where I come from.

My out of pocket costs for both hips to be replaced with the VA = ZERO DOLLARS.
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Old 08-14-2019, 03:37 PM
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Default Re: Record 4.4M Britons waiting for non-urgent surgery, gov't figures show

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Originally Posted by ShivaTD View Post
Even with the VA the government does not intervene in the medical decisions made by my physician.

There's no question about "insurance" covering the hip replacement surgery now that it's become an issue for me physically. The only problem that's delaying the surgery is the failure of Congress to fund the necessary medical staff and facilities to provide the surgery in a timely manner.

With proper funding and staffing the VA would have performed the surgery several weeks ago.

Question: How much does someone with private health insurance have to come up with out of pocket for hip replacement surgery? I've read the average cost is about $32,000 so with a an 80/20 plan that would cost the patient at about $6,000 plus. To have both hips replaced that would be $12,000 plus. That's a lot of money where I come from.

My out of pocket costs for both hips to be replaced with the VA = ZERO DOLLARS.
I'll pay the 6 grand and not wait three years. Btw, my family has dealt with the VA enough to know that all the funding and staffing in the world won't fix the gov't bureaucratic bravo sierra that is the actual reason behind the absurd wait times.
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Old 08-14-2019, 11:02 PM
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Default Re: Record 4.4M Britons waiting for non-urgent surgery, gov't figures show

Quote:
Originally Posted by GottaGo View Post
Why don't we ALL save a bundle and eliminate the stranglehold insurance companies currently have?

As a comparative: I needed xrays for my back - chiropractic issues. My Chiro suggested two things: Go through my insurance, and it would cost me about $150, since it would be applied to my deductible, or pay $50 cash with no insurance involvement.

Guess which one I chose?

Same chiro - pay cash, adjustment is $40. Insurance claim? $60 co-pay.

Is the point clearer now?
Slow down. You or your insurance company is going to receive a bill from the chiropractor and while you bill could be discounted because of the cash payment the discount wouldn't be that great. I've used private clinics that offered a 20% discount if I paid cash (and then submitted my bill to my insurance company for reimbursement).

From what you've presented it sounds like your chiropractor was ripping the insurance company off by way over billing them for the services provided. I could see the chiropractor charging the insurance company $60 or maybe even $70 to cover the costs and delays of billing but charging well over double what they charged you? That's robbery.

Of course this addresses a $50 medical charge and not a $64,000 medical charge that I'd expect to pay for my double hip replacement.
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"I always had a rule, if the White House is dirty on the inside, it's dirty on the outside." ShivaTD

Based upon the corruption, brutality, inhumanity, immorality, dishonesty, and incompetence of the Trump administration the White House is the dirtiest house in America and there's no known cleanser that with remove the stains of the Trump Administration.
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Old 08-14-2019, 11:10 PM
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Default Re: Record 4.4M Britons waiting for non-urgent surgery, gov't figures show

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Originally Posted by lurch907 View Post
I'll pay the 6 grand and not wait three years. Btw, my family has dealt with the VA enough to know that all the funding andstaffing in the world won't fix the gov't bureaucratic bravo sierra that is the actual reason behind the absurd wait times.
I wasn't in pain for those three years. We notices the problem of the deteriorating hip joint three years ago with x-rays but without any pain it wasn't a medical problem at that time. When it began to actually hurt the surgery was approved immediately.

The Phoenix VA, that I've gone to a couple of times, had a problem when they tried to cover-up the wait times because of a lack of staffing. They didn't want to appear like the problem existed instead of accurately reporting the problem that understaffing was causing.

My CBOC (community based outpatient clinic) is supposed to have a minimum of three MD's plus additional nurses, medical staff, and office workers but it's often only had one. Based upon the actual case load there should be four MD's. We currently have two but the wait times can be up to two months for non-urgent care. You can see a nurse within a day but the doctors are booked from the minute they walk in until the minute they leave.

That's a staffing problem that only funding can fix.
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"I always had a rule, if a restaurant is dirty on the outside, it's dirty on the inside." Donald Trump

"I always had a rule, if the White House is dirty on the inside, it's dirty on the outside." ShivaTD

Based upon the corruption, brutality, inhumanity, immorality, dishonesty, and incompetence of the Trump administration the White House is the dirtiest house in America and there's no known cleanser that with remove the stains of the Trump Administration.
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Old 08-15-2019, 09:10 AM
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Default Re: Record 4.4M Britons waiting for non-urgent surgery, gov't figures show

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Originally Posted by ShivaTD View Post
Slow down. You or your insurance company is going to receive a bill from the chiropractor and while you bill could be discounted because of the cash payment the discount wouldn't be that great. I've used private clinics that offered a 20% discount if I paid cash (and then submitted my bill to my insurance company for reimbursement).

From what you've presented it sounds like your chiropractor was ripping the insurance company off by way over billing them for the services provided. I could see the chiropractor charging the insurance company $60 or maybe even $70 to cover the costs and delays of billing but charging well over double what they charged you? That's robbery.

Of course this addresses a $50 medical charge and not a $64,000 medical charge that I'd expect to pay for my double hip replacement.
False. I've been going to the same Chiropractor for 15 years... never once has he submitted a bill to the insurance company. As to the xrays at a different facility called Outpatient Services - I signed a paper that specifically stated that I acknowledge that charges would not be submitted to my insurance, and that I had no expectation they would submit the charges to my insurance.

Facilities charge more for services to submit to insurance because of the knockdown of their prices (negotiated prices w/insurance company) and the administrative end of filing, following up and validating payment received. Pay cash, it's done with no extra then a run to the bank.

This is the reality. I know what is submitted to my insurance, so no, neither chiro nor xray facility submitted to my insurance.

Back to the fact that eliminating the requirement of insurance for every little thing, and saving it for the serious stuff will reduce costs. I don't need my insurance for a trip to a clinic to get an antibiotic for an infection. $25, prescription in hand. $15 pay under GoodRX, done. Using insurance, $35-50 copay, pharmacy $15 copay for scrip, then it gets submitted to insurance for reimbursement of hugely over inflated charges of $300+.

In reality, most people aren't stupid, they have just let the insurance companies slowly convince them that they are absolutely necessary for everything in their lives.
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Old 08-16-2019, 08:44 AM
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Default Re: Record 4.4M Britons waiting for non-urgent surgery, gov't figures show

Quote:
Originally Posted by GottaGo View Post
Why don't we ALL save a bundle and eliminate the stranglehold insurance companies currently have?

As a comparative: I needed xrays for my back - chiropractic issues. My Chiro suggested two things: Go through my insurance, and it would cost me about $150, since it would be applied to my deductible, or pay $50 cash with no insurance involvement.

Guess which one I chose?

Same chiro - pay cash, adjustment is $40. Insurance claim? $60 co-pay.

Is the point clearer now?
Without knowing your estimated medical expenses for the year, the total deductible, out of pocket maximum and factoring in your premium it's difficult to say if you got a better deal paying your chiropractor directly or for the xray in cash. If you have a high deductible catastrophic care plan and you don't anticipate exceeding the deductible it might make sense to pay cash. If you have a low deductible and anticipate high medical expenses it might make sense to process an insurance claim. Still other factors are out of pocket maximums on your policy and the ratio of premium to utilization cost.

Obamacare administrators were surprised at the popularity of the most expensive gold plans among early enrollees. They had predicted most people would opt for the less expensive bronze plans. It turned out people with significant health issues were attracted to the lower deductible and lower out of pocket maximums offered in the gold plan. Insurance companies took a beating for the miscalculation.
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