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You have health insurance, but you cannot afford surgery? You should have bought HUM stock.

hedgeless_horseman's picture




 

 

Obamacare was signed into law on March 23, 2010.  However, one year earlier in March of 2009, after Obama's election, drafts of the bill were being circulated within the insurance industry, and amongst the staffs of the politicians they helped to get elected. Although Nancy Pelosi is famous for saying, "We have to pass the bill to find out what’s in it,” that was not the case for the insurance company insiders that were actually drafting the bill.

Since the inception of Obamacare, United Healthcare stock has increased more than 340%, and Humana stock has increased more than 440%; this appreciation is in addition to the quarterly dividends HUM has paid since June 28, 2011This impressive feat may come as a surprise to you, dear Zerohedge reader, as I doubt you will have heard about these great American success stories on television.  Can you name the CEOs of Humana, or United Healthcare?  No?  Hmmm.  I wonder why?  One might think President Obama would want to hold up these companies as shining symbols of, "The Recovery."

 

Google chart

 

How do health insurance companies like Humana make money?  They don't provide healthcare!  Very simply, they charge patients premiums, and pay healthcare providers fees.  They are intermediaries, middlemen.  When they charge higher premiums, and pay providers less, or nothing (via high deductibles and high coinsurance), then they are more profitable.  They take this profit and invest it.

Why have United Healthcare, Humana, and the healthcare insurance companies done so well since Obamacare?

  • Have the health insurance companies significantly increased investment returns?  Maybe, but not enough to justify their stock's return vs the broader market.
  • Have the health insurance companies significantly increased covered lives?  No. 
  • Have United Healthcare or Humana significantly increased market share?  No.
  • Have United Healthcare or Humana significantly increased premiums?  Maybe, but not enough to justify the stock price.
  • Have the health insurance companies significantly decreased provider payments?  Yes. 

How?  Just as cereal manufacturers decrease their costs by putting less cereal in the same box but still charge you the same price, health insurers have raised the deductible amounts and co-insurance amounts, but not lowered premiums.

Coinsurance:  A cost-sharing requirement of some insurance plans where the patient assumes a percentage of the costs for covered services after the amount of the deductible has been met.  Coinsurance is described as a ratio, for example 30/70, meaning the patient is responsible for paying 30% and the insurance will pay 70% of the allowable.

Deductible:  The amount paid by the member before insurance will begin to reimburse services.  It is reset annually, and based on the level of benefits or amount of premium paid.  For example, with a $1,000 deductible the patient must pay medical providers for the first $1,000 of allowable expenses incurred by the patient each year, after which costs may be split according to a coinsurance arrangement, and/or may be limited to the patient’s out of pocket expenses.

Premium:  The monthly amount enrollees pay the insurance company to be covered.

 

What is your premium, deductible, and coinsurance?  What were they 6 years ago?  Many, if not most, of the Obamacare plans actually in use today are $5,000 in-network deductibles, $10,000 out-of-network deductibles, and 30% coinsurnace.  Few specialists signed up for the Obamacare plans because of the low fees, so people are likely to have to pay both the $5,000 in-network deductibles, and $10,000 out-of-network deductibles every year before the insurance will begin to reimburse services.

In summary, 1) you are paying more before the insurance company begins to reimburse services, and 2) you are paying a higher percentage of the costs after the insurance company begins to reimburse services, and 3) you are required by law to purchase health insurance...therefore United Healthcare stock has increased more than 340%, and Humana stock has increased more than 440%!   

You have health insurance, but you cannot afford surgery?  You should have bought HUM stock.

 

Just like I said in January of 2013...

Bait and switch.

Obamacare is of, by, and for the healthcare insurers.  It is designed to remove competition and assure profits for healthcare insurers, exactly as the Federal Reserve Act does for the big banks.

HIPAA was not about privacy for the patient.  It is solely to guarantee healthcare insurers access to preexisting conditions.

None of this will change until bribery campaign contributions are reformed.

 

How does Obamacare assure profits for the health insurers? 

The fine print, Section 2718 of the Public Health Services Act, implements the minimum medical loss ratio requirement, aka guaranteed profit requirement.

 

What does this mean for those investing in or practicing healthcare in America?

Well, like I said back in October of 2013...

The following provision, in a nation of deadbeats that cannot put their hands on $2,000 cash for an emergency, when combined with $2,000 deductibles and 70/30 co-pays, is going to be the mother-of-all-unintended-consequences.

Furthermore, health plans from the marketplace could present financial obstacles for physicians, because those health plans are required to have a 90-day grace period for policyholders that do not pay their monthly premiums on time. While other health plans would cut off coverage if a patient did not pay their bill on time, the health plans offered in the marketplace would still indicate the patient was covered during that grace period, and retroactively revoke payments to the physician for treatment provided during that time. In those situations, the doctor would be forced to seek payment from the patient for services already provided.

 

http://www.kaiserhealthnews.org/Stories/2013/October/21/Texas-Doctors-Un...

 

Short providers, long insurers, long collection agencies.

 

The next time you see your congressman, ask how his or her Humana stock is doing.  The next time you pay your health insurance premium, you may want to stuff some money in the mattress, too, so you can afford the deductible and co-insurance.

Peace be with you!

 

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Fri, 09/05/2014 - 13:46 | 5185498 Dr. G
Dr. G's picture

Let's get back to an original point from the article: Medical loss ratio.  This is the amount that the insurance company pays for care, the remaining premium dollars are retained by the insurance company as profit, reserves for a rainy day, business expenses.  Historically, for many years in this country the number was 85%. That is, 15% of your premium was not paid to providers but was held by the insurance company for its own purposes.  Now that ratio is down to 80% (backstopped by Obamacare) and is even lower (75%) in many major metro areas.  Now this would be understandable if premiums were low or decreasing and the insurance company needed the additional percentage to stay open, but premiums, even adjusted for inflation, are higher than ever and the portion retained by the insurance company has skyrocketed. Remember that we're talking about alot of dollars so an additional percentage point is huge.  As I like to say, you don't see any doctor groups on high rise buildings down town but you sure see insurance companies and lawyers offices!

Fri, 09/05/2014 - 12:03 | 5184920 e_goldstein
e_goldstein's picture

I was insured by HUM and had a lien filed against me personally by HUM when I went to the Emergency Room/ Doctor after sustaining spinal damage as a passenger in a car wreck. The lien lasted 3 years while I had to wait for State Farm (the insurance company of the guy who broke my back with his pickup truck) to finally pay up after threatening to sue the shit out of them. 

If corporations are people, then Humana is the spawn of Shylock and Lizzie Borden.



Fri, 09/05/2014 - 11:15 | 5184639 lostintheflood
lostintheflood's picture

dup...

Fri, 09/05/2014 - 11:21 | 5184676 doctor10
doctor10's picture

By defining the "premuim paid" as a "tax" , Chief Justice Roberts effectively released all insurance companies from their benefits obligations.

Try to find exactly who is obligated to what in return for the taxes taken from you.

Its part of prepping the sheep for nationalized "healthcare"

Some of the sheep are just starting to get it.

Fri, 09/05/2014 - 11:17 | 5184655 overmedicatedun...
overmedicatedundersexed's picture

cannabis oil huh? care to document medical lit supporting your claim, would be great if true, but alas I am not expecting you can.

Fri, 09/05/2014 - 11:16 | 5184637 lostintheflood
lostintheflood's picture

the healthiest thing anyone can do for themselves is to eat cannabis oil every day...protects your organs and your brain via your very own endocannabinoid system (every body has one).

 

How cannabis cures cancer.
Antiproliferative - prevents cancer cells from reproducing
Antiangiogenic - prevents formation of new blood vessels needed by tumor to grow
Antimetastatic - prevents cancer from spreading to other organs
Apoptotic - induces cell to seek its own death

Fri, 09/05/2014 - 10:20 | 5184319 tstive
tstive's picture

After having health insurance for 30 years I decided to drop it Sept 1. The premiums are obscene. The deductibles and out-of-pockets are outrageous. Yes, I used to believe you had to have health insurace to avoid a catastrophic financial hit. But the insurance has become the catastrophic financial hit. I will no longer feed the satanic beast with my money. Good ridance! I think I prefer to die than to continue being a part of this illuminati scam. Praise the Lord oh my sole and forget not all his benefits. Who forgives your sins and heals all your diseases. (Psalms 103:3) Amen. 

Fri, 09/05/2014 - 08:22 | 5183688 drdolittle
drdolittle's picture

50% of healthcare costs occur in the final six months of life. Obviously somewhat inflated by last ditch efforts to save lives but also brought on by lack of pass through of costs. If you have no estate and you have medicare and you're 80, why not be sent to the ICU to try to survive pneumonia with sepsis again? It costs you nor your family anything, nothing to lose for you. Why not have the bypass surgery at 80. If that came out of your money or your descendents inheritance ti would factor into your decision making. Same thing for medicare paying for nursing home. Your family might find out they have the means to care for you if they were out the 5k per month themselves. It's a case of having no skin in the game.

Fri, 09/05/2014 - 01:39 | 5183351 damicol
damicol's picture

There is a legal way to escape the filthy scam called obummer care.

Not many people realize this but if you are employed by a foreign employer who provides a plan then you are automatically exempt from obummer care.

No matter that employer has an office in the US or not and the Obummer does NOT force foreign companies to establish minimum coverage.

Like abortion cover for 70 year old men.

We have specifically joined and set up a sheme with a company in the UK running a group scheme that has world wide coverage virtually no deductibles covers pre existing and eyes and dental is worldwide  has a $3.2 million annual limit and is a THIRD the cost of the obummer scam. and it EXEMPTS you from obummer shit and  anyone self employed employed  can join under 37 yr old

They will legally employ under a contract any US citizen who wants to join the  plan which is underwritten by one the biggest listed insurers running group schemes in the UK

link to see details

http://ukasiagroup.biz/iridium-group-health-scheme

Fri, 09/05/2014 - 12:27 | 5185083 forwardho
forwardho's picture

Scheme; to make plans, especially in a devious way or with intent to do something illegal or wrong.

Words do have meaning.

Fri, 09/05/2014 - 08:06 | 5183651 Comte d'herblay
Comte d'herblay's picture

Revised opening sentence:  

"If you are over 37 yrs old, there is no legal way to escape the filthy scam called obummer care, and our plan won't cover you".

Thu, 09/04/2014 - 23:54 | 5183227 theyjustcantstop
theyjustcantstop's picture

3 years ago i told my family doctor he would come into the exam-room in a seiu smock before i die, and i don't have much time left, and hes not laughing anymore.

Fri, 09/05/2014 - 08:06 | 5183652 Comte d'herblay
Comte d'herblay's picture

What's a "seiu" smock?

 

Fri, 09/05/2014 - 08:26 | 5183697 PartysOver
PartysOver's picture

SEIU:  Service Employees Internation Union.   Its an effing union.  Chances are good that all healthcare providers will attempt to be unionized.    Bottom line, healthcare in the USSA will never be as good as it was.   Look at the Vet Admin healthcare and you will see the future for all of us.

Thu, 09/04/2014 - 23:11 | 5183122 Burticus
Burticus's picture

"Health care," as used by the political class, is a brainwashing misnomer.

They are referring to sick treatment and sick treatment insurance.  Each person is solely responsible for maintaning their own health.

Thu, 09/04/2014 - 23:48 | 5183212 Zirpedge
Zirpedge's picture

"War on Terror / GWOT" "War on drugs" "Clean Air Act" "Healthy Forest Initiative" "No Child Left behind" Forgettaboutit

Does anyone actually look past the coverpage or reflect on the success of these initiatives?

 

Thu, 09/04/2014 - 20:06 | 5182551 MeelionDollerBogus
MeelionDollerBogus's picture

http://imgur.com/TQwVbfg

HUM = 5/236 SPY49/30

I suppose that would have been nice to know years ago into today...

But, as ever, it's too late now.

Thu, 09/04/2014 - 19:57 | 5182518 the grateful un...
the grateful unemployed's picture

chill out folks the medicare companies get rich because medicaid is backstopping them, wall street gets rich because bernanke is backstopping them, its a risk free society which is say with no moral basis.

Thu, 09/04/2014 - 19:42 | 5182464 AdvancingTime
AdvancingTime's picture

Healthcare is ridiculously expensive because many people have convinced themselves of  three things: The answers for good health outcomes rest with pills and procedures rather than good diet and exercise. Death at late stages of life is some strange, recent development in human history which justifies and necessitates extreme, exorbitant payouts to delay it for every possible last second.  And last but not least, thinking that mixing all the myriad of "health care" transactions that result from the just mentioned concepts with health insurance as originally conceived to protect a person from unforeseeable, catastrophic events like an accident is a good idea.

Just because we can does not mean we should, healthcare is like a tape worm ever ready and always wanting to grow larger. More on why healthcare is so expensive in the article below.

http://brucewilds.blogspot.com/2013/05/healthcare-going-forward.html

Fri, 09/05/2014 - 08:18 | 5183675 drdolittle
drdolittle's picture

And in some states catastrophic insurance only is illegal. Friends of mine had a kid that survived a childhood cancer. Insurance for the self employed dad to provide for his kid was exorbitantly expensive. They moved to kentucky (from WV) where they can pay cash for routine stuff and buy a catastrophic only plan for the kid. you know, in case of a car accident or recurrent cancer, something that they can't afford cash for.

I think anyone with a brain knew it was all for the health insurance industry. Just like Bush's prescription coverage for medicare enrollees was for big pharma. I'm an ER doc and do my damndest to provide good care for my patients. I'm appalled by the charges presented by my employer for my services (most of the bill is not for my services, it costs more for an ankle xray than for me to take care of an ICU patient for an hour, I can intubate and do a lumbar puncture for less than the cost of said xray). If I thought I could handle the boredom of an office I'd go and have a busy practice in no time, I'm good to my patients and honest. I love the ED though. BTW, ED docs are 4% of the workforce and see 29% of acute care visits and account for 2% of healtcare costs. Chemo for your non chemo responsive lung cancer will cost a lot more. As will your MRI for chronic back pain.

Thu, 09/04/2014 - 20:08 | 5182556 MeelionDollerBogus
MeelionDollerBogus's picture

Even so, healthcare in Canada doesn't cost anywhere near what the USA charges.

Fri, 09/05/2014 - 07:07 | 5183575 disabledvet
disabledvet's picture

We don't have healthcare in the USA. "Has the added value of being true" unfortunately. Doctors and retirees are fleeing the country in droves.

Simply put no one is doing their job anymore and to succeed in America is to get to the point where you can finally leave this hell hole.

Thu, 09/04/2014 - 18:30 | 5182183 shovelhead
shovelhead's picture

They need a cost list of services .

Gall bladder removal cost...One Kidney. Rare blood type? Toss in a half set of dentures.

Etc.

Fri, 09/05/2014 - 11:21 | 5182610 hedgeless_horseman
hedgeless_horseman's picture

 

 

They need a cost list of services

Lawyers? I agree! 

Divorce Papers $250

Pretrial Conference $500

4-hour deposition $1000

Etc...

It will never happen.

With the current pricing system in medicine, however, if you have insurance, it costs the same to go to the best doctor or the worst, so take advantage of this fact.

Thu, 09/04/2014 - 18:29 | 5182179 Vendetta
Vendetta's picture

I knew it was a complete fraud because fraudulent legislation is the ONLY thing that passes into law in the US.   I can't remember a law being passed that actually benefitted the nations' citizenry.

Thu, 09/04/2014 - 19:33 | 5182425 NotApplicable
NotApplicable's picture

Like all others, the Federal Mafia looks after their own interest first. To do otherwise (with power in hand), is beyond rational belief.

Good thing people vote in support of irrationality.

Thu, 09/04/2014 - 18:24 | 5182166 Binko
Binko's picture

We are trending towards becoming a nation where everybody has "insurance" but virtually nobody can seek treatment becauset the deductables and co-pays are so high.

Sick people over here who can't afford treatment and empty hospitals over there. And in the middle is the insurance industry raking in the cash. It would be insanely funny if it wasn't so sad and pathetic.

 

Thu, 09/04/2014 - 17:41 | 5181975 the grateful un...
the grateful unemployed's picture

there is no revelation in this, its always been this way. they sell you insurance you can\t afford to use. the idea is to mandate payment to the insurnace company, when the user cannot meet their portion of the copay, the insurance co transfers you to the state medicaid program. (and they get the bills) for the smart consumer who doesnt have enough to pay for insurance they go directly to medicaid, and keep the monthly premiums in your pocket, but this works because people are too proud to take public health care assistance, and if you're a vet they have effectively scared you away from  the VA by underfunding the system. obama is a con-man, he knew the VA was a fraud, but it worked to his benefit selling his plan. he has fooled a lot of people. mostly however Hum has profited from medicare, a market they entered just recently.

Thu, 09/04/2014 - 17:38 | 5181958 Whatta
Whatta's picture

True story. I live rural and the closest town has a small hospital/ER being about 15 miles away. My wife slices here finger good in a cooking "incident" (ahem...big dummie), and I take her to the ER.

Two stitches....2...ONLY TWO freaking stitches needed. Doctor with us for about 10 minutes tops, in a small town in TX where cost of living is lower than much of the planet Earth.

Over 2700 bucks! WTF'ingF?

Thu, 09/04/2014 - 17:44 | 5181989 the grateful un...
the grateful unemployed's picture

so are you covered? those rates sound as though they are for uninsured, which means somebody else is paying the bill. isnt there an urgent care near you? listen you can buy the same stitch kits they have in the ER for your home, and with a bit of practise you should do just fine.

Thu, 09/04/2014 - 18:06 | 5182049 hedgeless_horseman
hedgeless_horseman's picture

 

 

you should do just fine

Unless she cut a tendon or nerve, or it gets infected, then you will have wished she had seen a doctor for evaluation and treatment.

those rates sound as though they are for uninsured

Uninsured are not charged different rates. Federal regulations require that medical providers charge all of their patients the same fee. Only later are providers allowed to allow less, and make an adjustment, contractually or negotiated.

Fri, 09/05/2014 - 10:13 | 5184293 btdt
btdt's picture

Here is my recent experience. Low income as out of work at the time

Saw doc x abouut elective minor surgery y

as per internet research average price for surgery y about $3K

I live in a high cost areas so was expecting $5k or so

I had insurance with an high deductible, so I asked about discount for cash payment

doc x billing department said the bill would be north of $22K - twenty two thousand dollars

dsicount for cash? nope.

I asked could i get a discount if I cancelled my insurance

answer: THE PRICE WOULD BE ZERO if you were uninsurened

-------------------

So, frankly headless, I don't know where you live but here nobody seems to know nothing about stinking Federales rules.

Thu, 09/04/2014 - 18:42 | 5182224 Imagery
Imagery's picture

You are a fraud sir.....this is the second time on ZH you have made the knowingly false statement:

"Uninsured are not charged different rates. Federal regulations require that medical providers charge all of their patients the same fee. Only later are providers allowed to allow less, and make an adjustment, contractually or negotiated."

THAT is false and you know it!  I PERSONALLY provided you, here on ZH with a similar rebuttal to this, with much reference to prove your diatribe nothing more than that, including, my personal experience (wife) here in Dallas and provided you the Doctor adn facility names!   FACT:  They were charging us 1500% (15x) more for the physician fees and hospital than they charge Aetna, BCBS, and Medicare patients simply becuase we were cash payors and the <un>law allowed them to get away with the fraud. 

Are you an MD trying to protect your fraud?  The Docs and Hospitals are as much a part of this fraud as teh insurers are.  ALL 3 are guilty as is the coopted legislature.  These acts persistent precisely because the Medical Cabal (Docs, Hospitals, and Insurers) have successfully lobbied our US Legislatures to exempt them from the Sherman and Clayton AntiTrust Acts which would convict their asses just like it DOES any other biz engaging in this type behaviour. 

Why should an industry providing something as critical and necessary to human existence as Medical Care be exempted from something so seminal to fairness and antimonopolistic and fraudulent practices as the Sherman and Clayton AntiTrust Acts?

Just do a simple Google search and you will see what i say is fact!

Go BS someone else Dic8Headless.......

Thu, 09/04/2014 - 18:55 | 5182275 Imagery
Imagery's picture

AND for those saying "someone else paying the bill" you need to think that thru for just a second.  I have assets and pay the extortion fees or they attach to my assets.

Secondly, my parents had no insurance and had 4 kids.  Yours too prolly.  They paid cash for every procedure ever performed on them or we kids.  They could do it because there was no "gimmickery" involved in cost-shifting the acutal costs protected by legislature.  Sure there are some indigents who go to ER and hospital eats those costs but they do so only becuase they get to charge the uninsured 15x rates, the legislature allows them to charge $16,000 for one vial of snake antivenom that one can drive across the border and obtain for $200; except that they have prevented you from doing that, or any other "cost effective measure taht clearly exposes their frauds" by lobbying our legislature to throw your ass in jail if you do it!  The insurers are ok becuase they agree to get theirs on teh monthly premiums which combined with HUGELY inflated Chargemaster for services (which only the patient pays - NOT teh Insurer) when patient is within deductible liimits.  Why? To protect their turf!

If you did away with all this BS one would not need to have insurance and could once again go pay cash for any procedure.

Go read Karl Denninger at The Market Ticker.  He has also done a lot to expose this HUGE fraud.

Fri, 09/05/2014 - 10:02 | 5184235 hardmedicine
hardmedicine's picture

I WORK for the medical insurance companies adjusting claims and I can assure you there is NO LAW that says that the doctor/hospital/whatever entity must charge the same fee to those insured as uninsured.  This is just patently false

 

Fri, 09/05/2014 - 11:29 | 5184628 hedgeless_horseman
hedgeless_horseman's picture

 

 

I WORK for the medical insurance companies adjusting claims and I can
assure you there is NO LAW that says that the doctor/hospital/whatever
entity must charge the same fee to those insured as uninsured.  This is
just patently false

Typically, insurance companies adjustors just follow their manager's training, and do not research the laws that dictate how medical providers must operate.  However, if you are so inclined, I believe that these are two of the more pertinent citations:

http://www.law.cornell.edu/uscode/text/42/1320a-7a

(2) knowingly presents or causes to be presented to any person a request for payment which is in violation of the terms of
(A) an assignment under section 1395u (b)(3)(B)(ii) of this title, or
(B) an agreement with a State agency (or other requirement of a State plan under subchapter XIX of this chapter) not to charge a person for an item or service in excess of the amount permitted to be charged, or
(C) an agreement to be a participating physician or supplier under section 1395u (h)(1) of this title, or
(D) an agreement pursuant to section 1395cc (a)(1)(G) of this title;

 

http://www.law.cornell.edu/uscode/text/42/1395u

(3) The Secretary—
(A) shall take such action as may be necessary to assure that, where payment under this part for a service is on a cost basis, the cost is reasonable cost (as determined under section 1395x (v) of this title);

(B) shall take such action as may be necessary to assure that, where payment under this part for a service is on a charge basis, such charge will be reasonable and not higher than the charge applicable, for a comparable service and under comparable circumstances, to the policyholders and subscribers of the medicare administrative contractor, and such payment will (except as otherwise provided in section 1395gg (f) of this title) be made—

 

See.  It is so simple!

lol

If a provider participates in Medicare, then he, she, or it, must, legally and practically, have only one usual and customary fee for each CPT code listed on the charge master and entered on a claim.

 

This CMS FAQ may help you to better understand.

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpati...

Fri, 09/05/2014 - 13:30 | 5185407 Dr. G
Dr. G's picture

It's more complicated than this.  A doctor's "usual and customary fee" is like list price for an automobile, except that it is now multiples of what insurance companies actually pay for a service.  So in a sense, every patient with insurance gets a very deeply discounted fee.  Some physician practices and hospitals unfortunately try to stick uninsured patients with the higher bill in the hopes that some will pay.  When I was in private practice myself, I regularly negotiated with a patient who was paying cash for an amount that was usually close to what insurance would pay since it was still what the "market" was paying and I didn't have the expense of billing an insurance company.

 

Fri, 09/05/2014 - 10:07 | 5184264 overmedicatedun...
overmedicatedundersexed's picture

hard, wtf? medicare you bill normal and customary cost or else..that sets the table for the rest of ins world, or do I not understand you?

Fri, 09/05/2014 - 08:03 | 5183648 drdolittle
drdolittle's picture

And, how does the doctor profit when the hospital sells the antivenom? Doctors are now mainly employees. Subject to repurcussions from their employers for practicing good medicine (taking a thorough history and physical to diagnose instead of ordering tests which hospitals make money off of). And, not admitting enough patients, last hospital I worked at wanted 25% of the patients in the ed admitted, that was their goal. And, you have to keep your healthcare consumers (not referred to as patients anymore) happy, especially if it means you order high value tests instead of telling them they don't need tests. People with insurance are usually reasonable if you explain yourself well, they understand they're gonna pay their share of the costs. People with medicaid thing you're trying to gip them if you don't order a chest x ray every time they bring their kid in with a cold. You do get to share in the high cost of entitlement medicine and I can tell you from experience those patients are brisk healthcare consumers. After all, there's no cost to them so why shouldn't they get "what's their's"

Thu, 09/04/2014 - 23:30 | 5183166 robnume
robnume's picture

You're right. I read Denninger, too, and he has many examples of patients being charged exorbitant amounts for a medicine or procedure, only to find out later that patient did some fact checking and found that, for cash, he could have paid a nominal fee for the same medical incident. He also states that diet and exercise - lifestyle choices - have everything to do with being sick.

Thu, 09/04/2014 - 20:16 | 5182519 hedgeless_horseman
hedgeless_horseman's picture

 

 

 

Go BS someone else Dic8Headless.......

Apparently, you still cannot understand the difference between usual and customary billed charges and contracted allowable amounts that are actually paid. Like the creation of money with fractional reserve banking, our healthcare system's design having separate charge masters for fees and fee schedules for reimbursement is, I believe, intentionally confusing. It clearly has confused you.

Thu, 09/04/2014 - 22:14 | 5183012 Greenskeeper_Carl
Greenskeeper_Carl's picture

+1 for being a class act and responding in that manner after he needlessly resorted to name calling. This place could use more of that. I enjoy your appears about this subject. If what you are saying is true, and I have no reason to think otherwise, it's pretty telling that the so-called opponents of this law never mentioning any of this stuff when speaking against it, or the blatant fascism of it all. Different wings of the same bird, and in the same people's' pocket.

Fri, 09/05/2014 - 07:18 | 5183587 disabledvet
disabledvet's picture

Senator Ted Cruz. He spoke out against it. Where were the rest of the Republicans? Oh, yeah..."exempting themselves."

The fact of the matter is the plan never involved hiring and training more doctors...the few that are left are now leaving the country to in fact practice.

The only "healthcare" that works now is called "healthcare tourism." The market and care...have been destroyed.

Fri, 09/05/2014 - 07:22 | 5183592 overmedicatedun...
overmedicatedundersexed's picture

hey my plan is peachy, extra high deductables means the ins co pays nada..open an ins co and become rich.

Thu, 09/04/2014 - 19:53 | 5182498 the grateful un...
the grateful unemployed's picture

mds are insurance claims adjusters, when someone comes in with insurance they go easy on the unnecessary procedures, when the perp comes with nothing, meaning medicaid, then the shopping list gets filled. people without insurance actually get better health coverage (or more tests anyway). i have known (deceased) people with good health plans whose doctors didnt catch the problem until it was too late. you really have to be your own advocate, its similar to the SOP in patient emergency room care, if you want fast service tell them you have chest pains. if you want good service tell them youre broke, you can show them your health card later, oh yeah i musta hit my head. i do not seriously advocate these things, but it does seem to be the way things work.

Thu, 09/04/2014 - 18:39 | 5182201 FeralSerf
FeralSerf's picture

Effectively not true. Not even close. I was uninsured and got charged much more than I was charged for the same procedure when I had insurance. The bill is heavily discounted for insured patients. It's the bottom line that counts.

Have you seen what Medicare does to medical bills on their payment advice?

Thu, 09/04/2014 - 20:07 | 5182553 hedgeless_horseman
hedgeless_horseman's picture

 

 

Have you seen what Medicare does to medical bills on their payment advice?

Yes, it is called an adjustment to the providers usual and customary fee, and is based on the contracted allowable the provider agreed to in order to be able to treat Medicare patients.

Thu, 09/04/2014 - 17:45 | 5181979 hedgeless_horseman
hedgeless_horseman's picture

 

 

You are also paying for all those that don't pay. Next time, go to an urgent care, not an ER that is required to treat indigents.

Thu, 09/04/2014 - 22:05 | 5182986 Greenskeeper_Carl
Greenskeeper_Carl's picture

HH is right. There is one not far from my house and it has a price list on the wall for cash payments for common procedures like stitches, even shoulder dislocations,etc. Exactly how it should be, and would be if there weren't layers of middlemen providing nothing but always taking their cut.

Fri, 09/05/2014 - 07:53 | 5183633 drdolittle
drdolittle's picture

Can't imagine an urgent care that can do shoulder dislocations. Usually need a great deal of sedation to get those in.

As far as your 2k stitches visit goes, a UC could've done that. I took my kid to ER for a hand xray and stitches. One of the line items I noticed was $700 for the room. For less than an hour. $500 for the xray. Docs charge was like 150.

And, yes, you should know the price up front. It's non economic. You pay for insurance and get services without any idea what the charge would be. What else do you buy that way? More and more docs will be going cash only and it will be a good thing. I feel for anybody that has to pay their share of a routine appendectomy. I'd bet the charge for that is 20k now.

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