Healthcare Industry Post CoVid Prediction

C2tuck

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Bahahahahahahahaha!!!!!!!!!

I am guessing you are the type that wants his healthcare for free.

I bet you bitch and moan about believing your time is worth more than you are paid.

But hey, why not go get your nursing or MD degree and treat yourself so you don’t have to worry about “extortion”.



So you have uninsured, insured in network, insured out of network, then Medicare/Medicaid.

Of the uninsured you have those that will pay and those that will not.

Different insurance companies negotiate different prices with providers and facilities.

I worked at two university medical centers and one private, nonprofit facility. Each year at each facility we would write off millions in unpaid services.

Last university I worked for we got reimbursed $0.25 per dollar charged to Medicare/Medicaid.

There have been payment plans and even incentives which lowered bills for uninsured at all three hospitals I worked at.

A lot of the cost associated with care is due to the layering and waste that government and credentialing agencies have created. Joint Commission is a ****ing mob. Perfect example, study upon study has shown zero bacterial growth in IVs at more than 96 hours. Yet when I left patient care an IV set needed to be started on a patient within 4 hours or we had to toss it due to JC. Propofol, comes in multi-use vials yet they can only be used on one patient due to JC. The list goes on.

I truly believe JC is made up of hacks that passed the school work but failed practicals and now want to make their mark on the history of healthcare. No sane person that has worked any actual time in the field would make the rules they do. Their policies and regulations lack scientific basis.

Again, cost comes down to a government problem and insurance problem more than hospital problem. Most hospitals make very little in profit.




I’m collecting dildos for broke ass hoes. I call it, “Toys for THOTs”

Another example that doesn’t make sense...

Crash carts.

For those who don’t know, picture the lower box on a 42” tool chest, with a numbered plastic lock on it. These are filled with multiple rounds of first line cardiac drugs, arrhythmia meds, and many, many other drugs/shit that we never used. Ever.

Part I never understood was, once that tab was broken, that patient had to pay for whatever was in the entire cart...somewhere around $100k. It wasn’t like the pharmacy was going to throw away all the unused items, it was straight up robbery.

These were used mainly for coding a patient and despite what Grey’s Anatomy or ER would lead you to believe CPR only works about 0.02% of the time.

We would regularly tell the family of the newly departed NOT to pay the bill.

I vividly remember a lady in her late 30’s saying “but he (her dad) had perfect credit, we can’t not pay it” to which I replied “I’m pretty sure they don’t take credit where he is now...”
 

Double"O"

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Another example that doesn’t make sense...

Crash carts.

For those who don’t know, picture the lower box on a 42” tool chest, with a numbered plastic lock on it. These are filled with multiple rounds of first line cardiac drugs, arrhythmia meds, and many, many other drugs/shit that we never used. Ever.

Part I never understood was, once that tab was broken, that patient had to pay for whatever was in the entire cart...somewhere around $100k. It wasn’t like the pharmacy was going to throw away all the unused items, it was straight up robbery.

These were used mainly for coding a patient and despite what Grey’s Anatomy or ER would lead you to believe CPR only works about 0.02% of the time.

We would regularly tell the family of the newly departed NOT to pay the bill.

I vividly remember a lady in her late 30’s saying “but he (her dad) had perfect credit, we can’t not pay it” to which I replied “I’m pretty sure they don’t take credit where he is now...”

Usually it is just the med drawers that get 100% replaced even if unused...i dont understand that...but i cracked my fair share of em
 

7998

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I cannot fathom or comprehend how or why our HI went from the following in 2008.
Premium $9600
Copay $20
Emergency copay $100
26 chiropractic visits.
$0 deductible

To what it is now in 2020
Premium $23,000
Copay $35
Specialist copay (Anything other than normal Dr) $50
ER copay $500
0 chiropractor visits
$8,000 deductible

I know its not going to make my Dr rich.
EMT's (The guys who come and try to save your life when you call the ambulance) make about as much as a Wal-mart cashier, so it ain't going there.
So why is it so much more?
 
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Deceptive

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I cannot fathom or comprehend how or why our HI went from the following in 2008.
Premium $9600
Copay $20
Emergency copay $100
26 chiropractic visits.
$0 deductible

To what it is now in 2020
Premium $23,000
Copay $35
Specialist copay (Anything other than normal Dr) $50
ER copay $500
0 chiropractor visits
$8,000 deductible

I know it going to make my Dr rich.
EMT's (The guys who come and try to save your life when you call the ambulance) make about as much as a Wal-mart cashier, so it ain't going there.
So why is it so much more?

Two things:

1. How is your doctor getting rich?

Unless he negotiated a higher cut with the insurance company that copay will just be deducted from what he receives from the insurance company.

2. Because the insurance companies spend the second most in lobbying. They spend more than hospitals/doctors do. Medical equipment manufacturers/pharmaceutical companies are number one and I think of the two pharmaceuticals makes up for the bulk of the spending.


I’m collecting dildos for broke ass hoes. I call it, “Toys for THOTs”
 
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MG0h3

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I cannot fathom or comprehend how or why our HI went from the following in 2008.
Premium $9600
Copay $20
Emergency copay $100
26 chiropractic visits.
$0 deductible

To what it is now in 2020
Premium $23,000
Copay $35
Specialist copay (Anything other than normal Dr) $50
ER copay $500
0 chiropractor visits
$8,000 deductible

I know it going to make my Dr rich.
EMT's (The guys who come and try to save your life when you call the ambulance) make about as much as a Wal-mart cashier, so it ain't going there.
So why is it so much more?

If I recall, premiums went up immediately and heavily once Obamacare went into effect. All to “insure” like 13 million people or something.
Kicker is, if Obamacare totally went away, the premiums would stay where they are. I promise
 

IronSnake

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I have no predictions about health care in the future. I think regardless of who's in office, it was headed in the wrong direction. There's such a thing as inflation, and then there's another thing called health care costs. Both are not equal.

After witnessing the costs of my sons birth and the absolute mind blowing totals that were then turned into a copay + deductible charge to us, I figured out pretty quickly it's all a shit show. I have zero hope that health insurance will get better, while simultaneously knowing that our ability as a species to treat our health issues + prevent them is rising.
 

598

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Bahahahahahahahaha!!!!!!!!!

I am guessing you are the type that wants his healthcare for free.

I bet you bitch and moan about believing your time is worth more than you are paid.

But hey, why not go get your nursing or MD degree and treat yourself so you don’t have to worry about “extortion”.



So you have uninsured, insured in network, insured out of network, then Medicare/Medicaid.

Of the uninsured you have those that will pay and those that will not.

Different insurance companies negotiate different prices with providers and facilities.

I worked at two university medical centers and one private, nonprofit facility. Each year at each facility we would write off millions in unpaid services.

Last university I worked for we got reimbursed $0.25 per dollar charged to Medicare/Medicaid.

There have been payment plans and even incentives which lowered bills for uninsured at all three hospitals I worked at.

A lot of the cost associated with care is due to the layering and waste that government and credentialing agencies have created. Joint Commission is a ****ing mob. Perfect example, study upon study has shown zero bacterial growth in IVs at more than 96 hours. Yet when I left patient care an IV set needed to be started on a patient within 4 hours or we had to toss it due to JC. Propofol, comes in multi-use vials yet they can only be used on one patient due to JC. The list goes on.

I truly believe JC is made up of hacks that passed the school work but failed practicals and now want to make their mark on the history of healthcare. No sane person that has worked any actual time in the field would make the rules they do. Their policies and regulations lack scientific basis.

Again, cost comes down to a government problem and insurance problem more than hospital problem. Most hospitals make very little in profit.




I’m collecting dildos for broke ass hoes. I call it, “Toys for THOTs”

LOL at me wanting my health care for free. I've been self employed for a long time, writing my own check for all my premiums and deductibles. Obama care jumped me from sub 20K a year for a Cadillac policy to north of 30K all in just to have a policy. If I don't pay the insurance company to be my middleman to the medical provider, I'm bankrupt the first time I want or need service. Because of false billing, I literally cant self insure. That's extortion. I'm self employed so I set the rate that I get paid for what I do. I don't bitch about what I'm paid and then still get up the next morning and do it again anyway, I make changes to improve my situation. I have nurses very close to me so I know in-depth some of the BS they have to endure, but being a Dr. or nurse wouldn't stop me from being forced into the corrupt system of payments. You asked what would change post covid, and I answered that nothing positive unless we addressed the goofy billing system. As long the gross bill is 50-100K but the expected real and negotiated behind closed doors is closer to 10K, nothing positive will happen. Just today, Buffett, Gates, and Bezos announced that they were going to mothball their attempt to fix healthcare. It took them 3 years I guess to figure out if they put in motion the things necessary to fix American healthcare, they would destroy the corrupt system that allowed them to jointly fleece the American population of around 400 billion net.
 

MG0h3

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LOL at me wanting my health care for free. I've been self employed for a long time, writing my own check for all my premiums and deductibles. Obama care jumped me from sub 20K a year for a Cadillac policy to north of 30K all in just to have a policy. If I don't pay the insurance company to be my middleman to the medical provider, I'm bankrupt the first time I want or need service. Because of false billing, I literally cant self insure. That's extortion. I'm self employed so I set the rate that I get paid for what I do. I don't bitch about what I'm paid and then still get up the next morning and do it again anyway, I make changes to improve my situation. I have nurses very close to me so I know in-depth some of the BS they have to endure, but being a Dr. or nurse wouldn't stop me from being forced into the corrupt system of payments. You asked what would change post covid, and I answered that nothing positive unless we addressed the goofy billing system. As long the gross bill is 50-100K but the expected real and negotiated behind closed doors is closer to 10K, nothing positive will happen. Just today, Buffett, Gates, and Bezos announced that they were going to mothball their attempt to fix healthcare. It took them 3 years I guess to figure out if they put in motion the things necessary to fix American healthcare, they would destroy the corrupt system that allowed them to jointly fleece the American population of around 400 billion net.

Didnt Trump nix the penalty for not having insurance? I mean if you’re spending 30k a year; that might be worth pocketing if you’re otherwise healthy. If something does happen just speak a foreign language and shrug your shoulders when they ask for your name and SSN.
 

7998

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Two things:

1. How is your doctor getting rich?

I fixed it. He's not getting rich is what I meant


If something does happen just speak a foreign language and shrug your shoulders when they ask for your name and SSN.

I often wondered this. Why not just play dumb and give a false name and address.
Meanwhile like 598 alluded to I could bank my premium and defer it to a HSA and self insure. My dad had a heart valve replaced at U.Penn Presbyterian in philly and it was like $60k. Shit thats a little over 2 years premium for me.
 

Double"O"

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If I recall, premiums went up immediately and heavily once Obamacare went into effect. All to “insure” like 13 million people or something.
Kicker is, if Obamacare totally went away, the premiums would stay where they are. I promise
Absolutely they wont drop a cent
 
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Morgan

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LOL at me wanting my health care for free. I've been self employed for a long time, writing my own check for all my premiums and deductibles. Obama care jumped me from sub 20K a year for a Cadillac policy to north of 30K all in just to have a policy. If I don't pay the insurance company to be my middleman to the medical provider, I'm bankrupt the first time I want or need service. Because of false billing, I literally cant self insure. That's extortion. I'm self employed so I set the rate that I get paid for what I do. I don't bitch about what I'm paid and then still get up the next morning and do it again anyway, I make changes to improve my situation. I have nurses very close to me so I know in-depth some of the BS they have to endure, but being a Dr. or nurse wouldn't stop me from being forced into the corrupt system of payments. You asked what would change post covid, and I answered that nothing positive unless we addressed the goofy billing system. As long the gross bill is 50-100K but the expected real and negotiated behind closed doors is closer to 10K, nothing positive will happen. Just today, Buffett, Gates, and Bezos announced that they were going to mothball their attempt to fix healthcare. It took them 3 years I guess to figure out if they put in motion the things necessary to fix American healthcare, they would destroy the corrupt system that allowed them to jointly fleece the American population of around 400 billion net.

My premiums doubled after the AHA took effect and totaled over $25k. I found a cheaper alternative BUT the coverage and service were horrible.

Have you looked at joining a "group" through a Membership Organization that diversifies risk across a larger population to reduce premiums?
How to Get Group Health Insurance Without an Employer Plan

Concierge Medicine might be another option. It's like having a private doc on call for a monthly fee. They typically work on a cash basis and essentially negate your need for the more expensive insurance plans.
 

q6543

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Where is all the money going?
Insert random insurance company stock chart... UNH
Screenshot_20210104-171007.jpg
 

IA Shelby

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I don’t have the time to debate all of the opinions that have been presented as fact but I will comment on a few.....

1) premiums would remain the same if Obamacare went away..... First you need to understand what type of policy you are describing as Obamacare had very different levels of impact on different market segments. Large group fully insured policy - very little impact. Individual market - huge impact.

so let’s take the individual market. The reason why premiums skyrocketed was primarily due to the fact that the individual market went from being underwritten to a community rated, guaranteed issue product. Prior to Obamacare the bad risk could be denied and on;y good and average risk could get insurance. This kept rates lower. The ability to differentiate age band was a 5 to 1 ratio allowing you to rate older people at 5 times the lowest age rating. Obamacare changed that to 3 to 1.

if these changes went away you would be absolutely premium rates drop like a rock in the individual market.

also know that insurance companies rates need to be actuarial justified and approved by state insurance regulators.


2) in regards to UHC and their stock price...understand what is the primary driver of the profits for United Health Group. It is not health insurance. It is their Optum division which is not health insurance. Understand what they are telling wall st now. They are deemphasizing commercial health insurance and placing their bet on Medicaid and Medicare Advanatge programs and Optum.

3) providers and fee schedules....understand that unit cost (negotiated rates) is 1 leg of a 3 legged stool. The other two are utilization and intensity. And yes there have been significant increases in intensity which results in higher payments to providers.

One also needs to understand the amount of malpractice insurance that is required which requires higher payments to providers. What it also encourages is over use of tests and other medical services because providers do not want to be held liable for not running those extra three tests that could have potentially prevented a complication or death.

I don’t deny this is a massively complex industry. It has several challenges. If you recall Amazon, Berkshire and JP Morgan and their celebrity CEO’s three years ago formed a company called Haven that was going to fix this issue. Today they announced that the company is folding and will not exist in a month.


 

gimmie11s

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Kevins89notch

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I often wondered this. Why not just play dumb and give a false name and address.

I legit know a doctor who's wife wasn't born in this country, and he's joked that when her parent visit, that if they need anything, he will just send them to the ER and they will play the "I don't speak English" game.
 

Deceptive

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My family and I did one for about a year while i was self-employed and $1M worth of coverage cost me about $550 a month. It worked well and would go back in a heartbeat if need be.

Did that have any copay or deductible or $550/mo covers all? That is not bad at all even if you have copay a and deductibles, depending on what those are.


This signature has been removed due to it violating your sensitive anus.
 

gimmie11s

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Did that have any copay or deductible or $550/mo covers all? That is not bad at all even if you have copay a and deductibles, depending on what those are.


This signature has been removed due to it violating your sensitive anus.

Yes, had a $1500 deductible that you were responsible for. Any HC costs over that $1500 was covered cost. My bad, i should have mentioned that.
 

Deceptive

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Yes, had a $1500 deductible that you were responsible for. Any HC costs over that $1500 was covered cost. My bad, i should have mentioned that.

That is damn good!


This signature has been removed due to it violating your sensitive anus.
 

Rb0891

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The for profit medical industrial pharmaceutical complex is the problem.

Profit needs to be removed from medicine. If that kills innovation so be it. I don't believe that it will though.
Lmao. Should profit be removed from anything medically related that affects cost? Say, buildings, gas, computer tech...

Son, if you went to school you need to either get your money back or go back and try harder.

Now if you want to talk about some type of caps vs. patent lengths or something along those lines, I am all ears. I suspect though this is over your head.
 

me32

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Again, cost comes down to a government problem and insurance problem more than hospital problem. Most hospitals make very little in profit.

I’m collecting dildos for broke ass hoes. I call it, “Toys for THOTs”

Whats your opinion of HMO? Kaiser? Non profit hospitals?

I can't speak for other states but in Ca hospitals make a killing in profit, and non profits just bonus out upper level management to keep from showing no profit.
 
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