Blue Cross & Shield is finally motivated to make cost data available for the masses. They put a tool online that allows you to see what a procedure should actually cost
http://www.bcbsnc.com/content/providersearch/treatments/index.htm#/
Having 3 close relatives that earn their incomes from the medical business, I’m really aware that the cost of medicine has become “whatever we think we can make someone pay”. Cost shifting is rampant and the most inexperienced doctors think they should make upper middle class livings (unlike $75 a month doctors in Cuba)
So I live in zip code 28226 and checked on the cost of my upcoming hysterectomy within 250 miles.
The range goes from about $4,415 to $27,883. There is a very clear pattern that Novant (who 2 of my relatives work for) is gouging Blue Cross. They have gone around the state buying up the local hospitals and putting them in their “system”, and then charging 3x as much. Presumably the money left over after paying the interest on the borrowed money and executive salaries was spent on sponsoring the Christmas parade in Charlotte.
Just because an entity is a 501(3)c nonprofit doesn’t mean there isn’t lots of money to be made.
Duke Medical Center I would cut some slack – they are the university hospital where really complicated or dangerous cases go – so their higher costs might reflect that.
So with this transparency, will Novant cut their prices, or will the small hospitals start charging $30,000?
Vision insurance is just as much of a fraud. 5-10 years ago I would pay $10 co-pay for a checkup and $250-300 for a new pair of frames and lenses. Over the past 5 years I have seen the cost escalate WAY beyond inflation. I still have the $10 co-pay for a checkup, but my premiums have doubled, and the worst part is the lenses and frames. The cost for JUST lenses (in my existing frames) is over $900 (which the insurance “pays” more than half, leaving my out of pocket around $300 — the same price I used to pay TOTAL -including frames- just a few years ago. If I opt for my every other year “free” frames covered by insurance then add another $50-500 onto my out of pocket costs. The other thing I can’t figure out is lens order time, back in the “gold old days” of 5-10 years ago I would receive my new lenses in 24 hours or less (sometimes WHILE I WAITED in the Doctor’s office). Now it takes 7-10 business days to get the lenses back. This seems to be true of all providers that I have checked with. I’m wondering if ALL the lenses are now being manufactured in Mexico or some other 2nd or 3rd world country. These “eyecare providers” probably pay this foreign entity $10 for lenses that they then charge $500-1000 for.
/rant off
To pile on, when I was still in Connecticut, I had befriended a troubled woman (or vice versa). She was addicted to pain medication and had spent time in prison. She was on probation mainly to keep the probation officer employed. She was on Medicaid and Social Security Disability.
One day she asked me to take her to her doctor’s appointment. After forgetting she had the appointment and getting too late to go, she asked that I take her to the eyeglass place. Her six months was up and Medicaid would now pay for another pair of glasses. There was nothing wrong with the pair of glasses she had on. I was still wearing the 12 year old pair I got at Walmart in 1998 (that I still have). She needed the new pair because she wanted a pair that “looked better”. She asked my opinion about which she should “buy” – I told her that I was the wrong person to ask about things like that. She would not have liked my real answer.
Probably not far off the mark Foyle… exploding prices and collapsing QA/QC. Seems like another racket to me: fleece the $ystem, exploit 3rd world labor.
My partner recently tried to update her prescription lenses. Whereas five years ago, the lenses were ready in a few days, this time it took over 3 weeks. When the lenses finally did arrive, fabrication was wrong with flawed lenses. She decided to just keep her current glasses for the time being. If she didn’t have astigmatism, I think she would just do what I’ve been doing… go to the dollar store or Walmart, and pick out a few pairs of prefab glasses: a pair for reading, and a pair for the computer, driving, etc. There is a fair selection of generic frames, and you can test them on the spot. Price $3 to $8.
Exhibit #2:
Just after Thanksgiving my dad had to be hospitalized for a few days (kidney issues, etc)… he’s 76. He was admitted between 3-4 pm on a Wednesday. When he was ready to go home on Friday at 3 pm, they held him until 6 pm… probably so the hospital could bill Blue Cross/Shield for another full day. For all we know, they billed the insurance for 4 days… and that’s just the ‘room’.
Based on what I’ve heard about this hospital (owned & operated by HCA Healthcare), the basic bill was probably >$20k… but wait, there’s more…
He had 10-12 doctors ‘visiting’ him during the two days he was there: 3 were his regular docs (GP, kidney specialist, oncologist), while the other 7-9 were ‘unknowns’ other than they would show up, talk for a minute, sign his sheet, and then abruptly leave. (i.e. gouging the system for ‘billable visits’). His biggest complaint was that nobody would tell him anything: “Doctors come and go, nurses hook me up to IV’s, give me pills, but nobody will tell me what’s going on. It’s my body!”
Another recent development is the sleight of hand going on in emergency rooms. You have an emergency and go there after checking and confirming that the ER is “in network” and covered – only to get an outrageous bill because a doctor who is not “in network” says he “consulted”.
My 4 day hospitalization in 2009 was instructive on many things. I was essentially strapped down to the bed with an IV in my arm to knock me out fast if I got combative. The phone required using a credit card to make a call, and my wallet was locked in the safe. They made no effort to call my sister whose information I gave to the ambulance people.
When Friday came, the insurance company got pushy. Hospitals don’t discharge patients on the weekend, so if you are not booted out by Friday, they’ll get billed for 3 more days. They made no effort to help me return home – I went home in a taxi in a hospital gown with no clothes.
The bill (which I saw briefly) included 4 physical therapy treatments. There were no such things – my only contact was as they were rushing me toward the door the PT person came to the room (after the alarm to detect if I tried to walk was removed) – she had me take a few steps, declared I was OK and signed off on releasing me. She never even touched me or did any assessment.
My hope was that by living near my niece who is a recently hatched doctor that in a similar situation she would be my advocate to extricate me from a similar situation. I can see now from a variety of interactions that she instead will be there pushing me to cooperate and be sucked in deeper.
I’ve told her bluntly that the only reason I have health insurance is to protect me from hospitals looting my bank account – that it doesn’t mean my consumption of health care or opinions about health care are changing. My total medical expenses for 2014 were $0.00
Having now fully exposed myself as a non-believer in the religion of Modern Medicine, I’m now an official outcast. Thanksgiving and Christmas came and went without so much as an “Are you still alive?” email, phone call or text message.
Oh, I left out the important part – on Thursday, one of the weekend regulars showed up in the ward. He had a bunch of chronic problems and liked the holistic treatment they offered – with massage therapy and good meals on the weekend. I was awakened around 2 AM by a group of friends having a loud visit to check on him. I feel confident he was a Medicaid patient.
Art, it seems we are two peas in a pod with regard to relatives who are ‘members’ of healthcare Club Med.
My sister works in elder/home care, she’s been in the biz for 15-20 years. Once very libertarian, but now an Obama advocate completely sold on the package deal.
Two months -prior- to our dad’s hospitalization & ER incident, I had convinced her to visit him (first time in 8+ years, but only because I said his health was fragile). Before her flight, I called and asked her to assess his situation, counting on her ‘experience’. e.g. prognosis, treatment options, insurance coverage, condition, etc.
She did -not- look into anything, said: “he will share if he wants to.” Well, he’s 76, stubborn, mild dementia, and cancer. She might have helped his quality of life, and saved the family a lot of worry, angst, and grief over these past 4 months… and kept him out of the hospital.
Nonetheless, I sent her a card for Christmas (as usual). Same result as you received from your niece: no email, no call, no text, nothing. The truth is, this is what I’ve come to expect from those who are fully vested in the regime and their approach towards ‘non-believers’…
Ostracism.
Your experience/observation with ER and subsequent ‘imprisonment’, ‘restraint’, and ‘release’ very much resembles what my dad encountered 6 weeks ago…
‘Extricate’ is the perfect word to describe the task.
I suggested a couple times to her (before she was totally sucked into the religion) that she read “Confessions of a Medical Heretic” by Dr Robert Mendelsohn, particularly if she actually wants to understand my point of view on medicine. I might just as wellhave suggested a Southern Baptist to read the Quran. An important way to learn is to challenge the things you think you believe. Reading the Quran should make your own faith stronger if it’s real or at least better prepare you for understanding motivations of others you may come in conflict with.
The book is significantly dated now due to technology and lawyers as patient advocates. His premise is that Medicine has usurped religion with doctors being the infallible dispensers of absolute knowledge, when the reality is they frequently are just guessing and put on the facade of authority, knowing that most maladies just go away, and those that don’t the doctor can’t change the outcome.
Having stated the problem pretty well, his solution to cope with Modern Medicine and extricate yourself doesn’t provide any answers. His solution is to live in the Jewish culture and have a close family – and have a family member with you at all times, constantly asking the nurses and doctors what they are doing and why.
There are things where medicine is important, but even there if you’re looking at longer time frames and not individuals, it might be counterproductive. Women die in childbirth a lot. So we develop the C-Section and fetal heart monitors to prevent the mother and/or child from dying. But the long term effect is that with each generation of women, more and more of them will be unable to give birth normally, perhaps because their pelvis is too small for the baby to pass through. Yes, I know I’m dancing around the fringes of Eugenics, or perhaps “anti Eugenics”. It’s normal to want to try to save the runt of a litter of puppies, but dogs understand natural things more clearly.
http://www.pbs.org/newshour/updates/when-to-say-no-to-a-c-section/