Posted by GOMER, a resident of the Danville neighborhood, on Aug 7, 2012 at 10:42 am
The problem is that the charges are all inflated and phoney -- they bear next to no relationship to what will actually be paid by insurance.
I had a hip replaced five years ago -- in one noon and out the next evening. No complications, no unusual meds, one night in the H: the bill I was shown was $87,000+ smackers with completely opaque information. What's more, my surgeon -- the guy who Really added the value, soon thereafter left town because he said he could no longer afford raising a family in the Bay Area. And he was doing over 200 hips/year -- pretty clearly he wasn't getting paid enough.
The current system is completely SNAFU'd and FUBAR. I do not believe you CAN be a really intelligent consumer, because neither the insurance companies nor the medical establishment seems to want you to know costs, nor how much of my bill goes to subsidize those who can't pay.
I am hopeful that the cost-control aspects of ACA will have some helpful impact.
Posted by Rick, a resident of the Danville neighborhood, on Aug 7, 2012 at 7:38 pm
The "affordable Care Act" aka Obamacare--would not have ALLOWED gomer to HAVE the surgery. Under Obamacare---that ALL FEDERAL workers are EXEMPTED from---if your cardiac pacemaker needs battery replacement--it ain't gonna happen if you are over 60. Let them die----soylent green IS Obamacare.
Posted by Julia, a resident of the Alamo neighborhood, on Aug 9, 2012 at 10:19 am
To Mike...Mike why don't you tell us the rest of the story. You know the real end of that statement, but you and the rest of the folks love to direct us to comments that make us only focus on your statement. Come Mike tell us...the hospital billed the insurance company $100,000.00 and Mike how much did the doctor bill the Insurance company. Now that just half the story....tell them Mike and be honest.
Okay, you have no guts to tell us the rest of the story. The Insurance company sends you (Mike) and EOS (Explanation of Services). It tells the insurance company reduced the hospital by 75% and the doctor bill by almost 80%...NOW THAT'S THE REAL REST OF THE STORY.
And for those that do not believe this fact, you are living in a cave. I experienced those 100's of thousands of dollars in bills and I also am very aware how much the insurance reduces what they pay the hospital and the doctor services.
Posted by Dave, a resident of the Danville neighborhood, on Aug 9, 2012 at 12:50 pm
Mr. Alderman makes it all sound so simple. However, often you cannot find out the various costs associated with medical procedures beforehand. They simply will not tell you. Or they will tell you that it will depend on how the surgery goes once it starts.
Our health (insurance) system is broken. What other conclusion can you reach when hundreds of thousands of people each year have to declare bankruptcy because they are unable to pay the their medical bills that were (for whatever reason) not covered by insurance? That is simply unacceptable in a country as wealthy as ours.
Posted by Sharon, a resident of the Danville neighborhood, on Aug 9, 2012 at 4:22 pm
@Julia, I think you might want to give Mike a chance to respond to questions before you accuse him of lacking the guts to do so. My guess is that he made the complete statement that is meaningful to him - you are free to add your $.02, but why the low blow?
BTW - I believe you mean "EOB" referring to the explanation of benefits provided by insurance companies. I'm not sure what an "EOS" refers to.
Posted by Julia, a resident of the Alamo neighborhood, on Aug 10, 2012 at 12:12 pm
Thank you Sharon...you make one correct statement...it is EOB (Explanation Of Benefits).
I stand by what I said to Mike and I hope the shoe doesn't fit for you and your experience with medical cost.
Everyone that deals with medical expenses and insurance knows the hospital and the doctors do not get what they are bills for.
That is a fact...Well the statement that Mike said was not the full story. So tell us the full story Mike. Sharon seems to be on your side...so made her proud of you and tell us. Tell us more about that $100,000.00 bill from the hospital and most of all tell us how much the Ins paid the hospital???? By the way Sharon. the low blow as you call it was to get his attention....which it didn't...but it got yours. Thank you Sharon for listening and thank you for responding. That's what keep the Danville Express publication active. If it wasn't for you and I chatting about this...who needs the Danville Express.
Again, thank you for listening, Julia Pardini from Alamo