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The guys Dr. who is a wife disagrees with you (msu2x). Also I have two Dr. in my family and I work in a hospital. I think I have a good idea of what's going on.
Yea sometimes the head of the hospital is a doctor but not always. Also you seem to dismiss administrations role on a whim. If you believe they have little to do with the cost of health care then you have no cimpreshension either.
Actually look up Columbia St. Marys in Milwaukee. They laid off 400 workers and the CEO who approved the stupid addition to the hospital skipped town before it fell apart.
You're right on both accounts.
Hospitals in many cases ARE big government (public hospitals?), and the myriad of govt & insurance regulations essentially require a 'bloated' administration to deal with. Otherwise they would just be large operations that compete for customers like any other business, yet those other businesses all have executives that run the show, as you say, 'sucking off the makers'
I believe the original point of this thread was the increase of rules and regs from OUTSIDE the hospital that are making working in the hospital more onerous.
"This board would be great if it weren't for all the posters. ." -- AA Spartan 12/16/11
So why do you think single payer would be so bad?
You realize costs will go down right?
How exactly do hospitals compete for your business?
When you need surgery do you make multiple doctor and hospital visits to pick one? Do they show you all of the costs prior to the surgery so you can "shop" for the best deal? Do you do the same thing for something as simple as having an infection that requires antibiotics? I have yet to find a hospital or doctor's office that openly publishes the billed amounts for it's procedures.
No, you do what everyone else does. You go to a doctor and if you don't like them or find the bills too expensive you move on and hope to find a better one.
And what rules and regs make it more onerous for the doctors?
This post was edited by MSULordyoda 13 months ago
Private hospitals run just like the public ones. I dont work in one but my wife does. I hear constantly about endless meetings with the admins trying to track this and that while essentially wasting the doc's time. Everyone has to justify their job/salary so they create a lot of waste drumming up little projects and what not. This happens in the private sector as well but on a smaller scale. Like the guy in office space that walks back and forth between engineering and customer service.
Don't kid yourself, unless their is only 1 provider in town, they are competing. In our market we have at least 3 relatively large systems and they want to be top of mind for anyone in the area. Ever notice satellite medical offices located in different parts of town?,billboards? radio spots? Those are there to draw patients in to the hospital system.
Granted, the competition is primarily about volume, our system makes it very difficult to compete or shop based on price, as many of those costs are predetermined, usually set by Medicare and/or Insurance co's.
You're right, privates are very similar to public, other than the politicians trying to score points by meddling (more) in publics.
Like Office Space, the time wasting endless meetings are common to many large organizations. Bad management is not limited to hospitals.
This all day long. Heck I sit in these mind numbing meetings. These people are always trying to justify a salary, while direct service to patients suffer.
IB I don't not mean to say that healtcare is all on the administration. However to dismiss them as not being part of the problem is silly.
Again, Do you visit each hospital and ask about costs prior to any procedure or check up? NO!
And you couldn't be more wrong on where the charges come from. They come from the hospitals themselves. The Insurance companies have to negotiate with each hospital (or system) individually based on the charges set by the hospitals. So no, there isn't some magical rate for every procedure. If hospital A decides to charge $4000 for an MRI, the insurance company has to negotiate based on that. It's independent of the fact that hospital B might only charge $3000 for the same thing. And if Hospital A doesn't like that the insurance company is only willing to pay $2500, they can simply refuse to accept that insurance. So what ends up happening is a company like Blue Cross will end up paying Hospital A $3300 for that MRI and pay hospital B $2500 for the exact same thing.
And that doesn't even take into account that United Health may pay hospital A $3500 and hospital B $2800. That's how the whole damn thing works.
I wonder how much of the average person's bill is due to lobbying costs, advertizing and other related expenses?
Don't bother posting facts to the likes of ib and fishmsu. Neither is capable of understanding anything close to the truth.
You hit that nail on the head, hospital billing is worse than the IRS tax code, with different amounts charged depending on who's paying. I have been led to believe that Medicare sets a baseline for many procedures/charges. Insurance companies negotiate with each hospital like you say, but that baseline, though arbitrary, enters into the equation. Are you in the industry?
And since most patients don't know, or usually care, what a particular provider charges, their selection criteria is not related to cost, but other factors that providers use to differentiate themselves, whether it is a particular doctors reputation or the sign they saw in left field at the ballgame.
This is what happens when you completely remove the marketplace from pricing. Who knows what a colonosocpy would cost if you bought one like you buy anything else in your life. Likely would be less.
The only medical procedures that have an actual marketplace are cosmetic surgery and corrective vision procedures. Prices on both have fallen.
No I'm not in the industry, but Steven Brill had a massive article on it in Time Magazine and had a long conversation with John Stewart on the Daily Show about the article. He walked through the whole process. I would like to get a hold of the article to read more details than what he was able to provide in a 15 minute interview though.
His big point was that each hospital has what is called a "charge master" who sets the billing rates for everything. One example in the interview was a hospital billing you $200 for a $6 surgical gown and your insurance negotiated rate was $100. All you're going to see is that you "saved" $100...yet the hospital pocketed big bucks. That stuff is rampant all over the industry. (I'm sure we've all heard the stories of or experienced first hand being charged $10 for an Advil or Tylenol. Another example were two hospitals in neighboring towns in Connecticut. One charge master set the rate for an MRI at $6000 while the other set it at $2000.
And while I'm sure Medicare has a baseline, we all know the insurance you and I have aren't going to get anywhere close to that. And even then, Medicare still has to negotiate against the charge master's rates at any particular hospital. There isn't a Medicare standard nationwide for a procedure. Medicare is just the biggest player and is able to demand the best rates.
This has been one of my points all along. How am I supposed to make "informed health care cost choices" if I have no idea what a doctor or hospital charges? I mean if I'm having a heart attack, it's not like I'm going to call a few ambulance services to find the cheapest one to drive me there. Same with which hospital I go to.
While you're a "consumer" of health care, it's not like you have complete control over what you consume in a majority of the cases.
You can't the way it works now.
I was impressed by Dr. Ben Carson's suggestion that everyone has a health savings account from birth and you pay for your own healthcare expenses. People will care real quick what they are being charged and the industry will have to make it easy to compare prices-like laser vision correction now. Insurance should only be for the really big stuff.
Actually, insurance should pay for ALL the costs. That's the purpose of having insurance.
You're not real clear on how the system works, are you?
I think he is purposely avoiding you. I would be mad if I were you.
The most hypocritical aspect of the mess that was passed is that the staffers, the people who wrote the bill, (remember tight ass nancy said "we won't know what's in it until we pass it") exempted themselves from the bill and they don't have to apply to the exchanges like everyone else, including members of congress. Now if it's so great, why did the authors of the bill exempt themselves?
This post was edited by rob 12 months ago
"I think the world is run by C students"
I'm just waiting for a return on our investment. Have seen little that justifies leaving the system as its been the last decade.
The stats dont lie, for the amount we pay,
beers, blowjobs, and t-bone steaks should be complimentary at every doctor visit.
Health should not be a for profit buisness. Period.
But if americans are going to enjoy a national healthcare system, which i am all for,
they need to have accountability for not taking care of themselves
Just cuz ur to fat and u trip over your kankles getting out of your chair, dont mean uncle sam needs to buy you a hover round for example
oh, and fuk michigan
This post was edited by chooba mingy 12 months ago
What?? Are these bitter Repubs still trying to debate ObamaCare???
Sorry fellas, but that debate ended with the SCOTUS' decision. End of debate. And just to refresh your memory, Bill Frist, former PHYSICIAN and Republican Senate Majority Leader, says ObamaCare is necessary. A Republican who was once a doctors himself....Think he might know a bit more than you clowns about what's right and wrong with the old system??? http://www.politico.com/news/stories/0912/81275.html
Frist: "As a doctor, I strongly believe that people without health insurance die sooner,” Frist wrote. People can go to the emergency room, but they delay treatment of health concerns, skip preventive care and when they finally seek treatment, their condition is worse and more costly, he continued. “State exchanges are the solution. They represent the federalist ideal of states as ‘laboratories for democracy.’”
As far as the OP's point, I know a few doctors pretty well. In fact, I have some in my family. 100% OF THEM PLAN TO RETIRE EARLY!! So your 60% number is low, but it has nothing to do with ObamaCare. 100% of them plan to retire early because they'll make shit-loads of money between the ages of 35 and 55. More money than they need to retire on. So why the fuck would they work any longer than they have to???
My own sister-in-law is pulling in close to half a mill per year, and she's a fucking a DENTIST (oh, and she only works 4 days a week). If a dentist is pulling in that kind of money at the age of 40, why couldn't a doctor retire early?? Sure they can, and good for them.
Dumb thread OP.
This post has been edited 3 times, most recently by VladtImpaler205 12 months ago
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