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My anecdotal evidence of one reason why healthcare is so fricking high..., and rising!

Posted on 6/15/18 at 11:20 am
Posted by Bass Tiger
Member since Oct 2014
53597 posts
Posted on 6/15/18 at 11:20 am
I can't complain about my family's healthcare coverage, it's pretty good but it may be part of the problem. Here's some examples of what I'm talking about from my family's visit to the doctors office.

How many of y'all have some sinus issues? Mine has gotten worse as I've gotten older. Probably 1-2 times a year I'll have a bout of sinusitis. Use to be I would run to the doctor, now I'll use the nasal wash take some Extra Strength Tylenol and eventually it will subside until the next the bout. Why did I stop going to the doctor for my sinuses ? Here's why!

This personal story can be told with the same details half dozen or more times, here's how the visit goes.

Doctor says what am I seeing you for today, I tell him I'm having severe sinus pressure, so he looks in my ears, down my throat and up my nose. He then says how long have you been having these symptoms? I tell him off and on for years and then I tell him what was done to treat my sinus troubles in the past. I tell him that on my last visit y'all had X-rays done, said I had a sinus infection, was prescribed an antibiotic and it cleared up for a few months and now it's back. So he promptly orders X-rays of sinuses, says yep you have a sinus infection and prescribed an antibiotic......, again.

What's the money maker on these repeated trips to the doc for sinus trouble...., bingo, the X-rays. Quick and easy cha-ching for around $140 dollars and for the most part the X-rays are unnecessary considering my medical record documenting numerous visits for the same issue.

Now for the wife's latest visit to the doctor. The wife is in the yard taking the dog out to do its business, dog sees something, jerks the leash and spins the wife around and she twists her knee. It bothers her for a few weeks and she finally goes to the doctor. Before she goes on the appointment I tell her pretty much what they're going to do. I tell her they'll ask her how you did it, feel the knee joint and order X-rays and then I add the X-rays are unnecessary because you have soft tissue damage not bone damage in your knee. Ok the visit goes just like I said it would and the only thing that surprised me was no prescription for pain or swelling. She was also given some exercises to perform and was told she has arthritis. LOL!

2 weeks later she's still all fricked up and I told her to ask for a referral to an orthopedic and have them perform an MRI to see what's been damaged. She goes back tells them it's not any better and she comes home with 3 prescriptions, an anti inflammatory, a muscle relaxer because her knee is causing back spasms and Tylenol 3 with codeine.

I'm like frick me! She finally got a referral from BCBS last week to get an MRI...., torn meniscus.

How much unnecessary billing/BS was incurred in those two stories? My belief is between unnecessary X-rays and repeat office visits thousands of dollars of questionable medical expenses were billed. We both have good medical coverage so we weren't out of pocket for very much money but the insurance companies sure took the hit.

The system is setup to bill the insurance companies for some things I see as unnecessary such as X-rays and repeat office visits before finally referring you to a specialist which is where you should have gone after the 1st visit to your primary care doctor.
This post was edited on 6/15/18 at 11:22 am
Posted by Wtodd
Tampa, FL
Member since Oct 2013
68460 posts
Posted on 6/15/18 at 11:24 am to
quote:

why healthcare is so fricking high...,

Gubmit involvement
Posted by WildTchoupitoulas
Member since Jan 2010
44071 posts
Posted on 6/15/18 at 11:26 am to
When you run healthcare like a business, expect the business to maximize profits.
Posted by Ingloriousbastard
Member since May 2015
917 posts
Posted on 6/15/18 at 11:26 am to
My personal belief is that it’s an inefficient market that benefits from lack of transparency, billing practices, government laws, and lack of real competition.

Personally, I believe the fix is to have free public hospitals that only deal with easy fixes and generics and to let private insurance pick up the rest or for people that only want to go to private hospitals instead.
Posted by brian_wilson
Member since Oct 2016
3581 posts
Posted on 6/15/18 at 11:26 am to
This might not be relevant. But I used to get sinus infections 2-3x per year. I started allergy shots and they have almost completely disappeared. Maybe 2 sinus infections in the last 4 years.

eta: I do have to get shots every month. 4 injections / once a month. Its better than sinus infections though!
This post was edited on 6/15/18 at 11:27 am
Posted by Bass Tiger
Member since Oct 2014
53597 posts
Posted on 6/15/18 at 11:27 am to
quote:

My anecdotal evidence of one reason why healthcare is so fricking high..., and rising! quote: why healthcare is so fricking high..., Gubmit involvement


Definitely playing a major part of rising costs.
Posted by HailHailtoMichigan!
Mission Viejo, CA
Member since Mar 2012
73037 posts
Posted on 6/15/18 at 11:30 am to
quote:

When you run healthcare like a business, expect the business to maximize profits.
Ummmmm, you do realize what you are saying is extraordinary correct?

You are saying that the profit motive INCREASES costs.

That is an INCREDIBLE philosophical statement that is a shot not only at our healthcare system but at our ECONOMIC SYSTEM as a whole.

Do you realize you are speaking marxist thoughts?
Posted by Bass Tiger
Member since Oct 2014
53597 posts
Posted on 6/15/18 at 11:30 am to
quote:

This might not be relevant. But I used to get sinus infections 2-3x per year. I started allergy shots and they have almost completely disappeared. Maybe 2 sinus infections in the last 4 years. eta: I do have to get shots every month. 4 injections / once a month. Its better than sinus infections though!


I finally got a referral to a ENT and he had a battery of allergy tests performed and I was pretty much negative on any allergies. Also had a CAT of my sinuses and he said everything looked fine. He was the one that recommended the nasal washing and Extra Strength Tylenol.
Posted by joeyb147
Member since Jun 2009
16019 posts
Posted on 6/15/18 at 11:33 am to
quote:

When you run healthcare like a business, expect the business to maximize profits.

oh, you're one of those people who think doctors and nurses should work for free
Posted by Tiger on the Rag
Cattle Gap Egypt
Member since Jan 2018
7630 posts
Posted on 6/15/18 at 11:38 am to
another reason for the increases is people go to the emergency room for minor stuff because they can't get into see their doctor. I see it all the time. And most of their illness can be cured with over the counter stuff but medicare is not paying for that so they gang up at the emergency room. A disgrace
Posted by narddogg81
Vancouver
Member since Jan 2012
21846 posts
Posted on 6/15/18 at 11:39 am to
quote:

When you run healthcare like a business, expect the business to maximize profits.
when you run healthcare like a government agency, expect massive waste, fraud, delays, poor quality, and rationing. I'm definitely want my health handled DMV style
Posted by MSMHater
Houston
Member since Oct 2008
23144 posts
Posted on 6/15/18 at 11:39 am to
quote:

What's the money maker on these repeated trips to the doc for sinus trouble...., bingo, the X-rays. Quick and easy cha-ching for around $140 dollars and for the most part the X-rays are unnecessary considering my medical record documenting numerous visits for the same issue.


Would you willingly sign a waiver relieving the physician of all responsibility for any diagnosis missed due to the lack of x-ray? Even if you would, it doesn't matter. That would be illegal, if not entirely pointless (legally). So you're getting the x-ray.

quote:

The system is setup to bill the insurance companies for some things I see as unnecessary such as X-rays and repeat office visits before finally referring you to a specialist which is where you should have gone after the 1st visit to your primary care doctor.


The insurance companies disagree, and they have no desire to pay more. Your 2nd story is a lesson in cost containment from private payers. They feel that the hoops your wife jumped through will prevent overutilization and unnecessary charges.

You're not wrong in that the x-ray machine, after 2-3 years, is a profit center for the PCP/urgent care. But without record of the negative x-ray, BCBS likely wouldn't have approved the MRI at all.
This post was edited on 6/15/18 at 11:42 am
Posted by HailHailtoMichigan!
Mission Viejo, CA
Member since Mar 2012
73037 posts
Posted on 6/15/18 at 11:41 am to
quote:

oh, you're one of those people who think doctors and nurses should work for free
He is also one of those morons who ignores actual data that shows health insurance companies aren't making extreme profit margins

quote:


between them the five biggest health insurers—UnitedHealthCare, Wellpoint, Aetna, Humana, and Cigna—which cover 105 million members, last year had profits between them of $11.8 billion. This is not a small number; these are very profitable companies. But total U.S. health care costs last year were in the area of $2.3 trillion.

So, with a membership that included a little more than half of the Americans covered by private insurance, these five insurers' profits came to 0.5 percent of total health care costs.
Posted by WildTchoupitoulas
Member since Jan 2010
44071 posts
Posted on 6/15/18 at 11:44 am to
quote:

Do you realize you are speaking marxist thoughts?

Expecting businesses to maximize profits isn't Marxist.

Why do you hate American companies?
Posted by WildTchoupitoulas
Member since Jan 2010
44071 posts
Posted on 6/15/18 at 11:45 am to
quote:

oh, you're one of those people who think doctors and nurses should work for free

Why don't you think businesses should maximize profits? Do you have a problem with profit?

Are you some kind of commie?
Posted by brian_wilson
Member since Oct 2016
3581 posts
Posted on 6/15/18 at 11:45 am to
quote:

I finally got a referral to a ENT and he had a battery of allergy tests performed and I was pretty much negative on any allergies. Also had a CAT of my sinuses and he said everything looked fine. He was the one that recommended the nasal washing and Extra Strength Tylenol.


The nasal washing helped. But I was nasal washing 2x per day and still got 2-3 a year. It was really fricking unpleasant.
Posted by BamaAtl
South of North
Member since Dec 2009
22253 posts
Posted on 6/15/18 at 11:46 am to
quote:

You are saying that the profit motive INCREASES costs.


This is 100% true, and the fact that you think it's extraordinary illustrates your lack of comprehension on basic concepts.
Posted by WildTchoupitoulas
Member since Jan 2010
44071 posts
Posted on 6/15/18 at 11:48 am to
quote:

when you run healthcare like a government agency, expect massive waste, fraud, delays, poor quality, and rationing. I'm definitely want my health handled DMV style

Yep, long live corporate profits!

Why shouldn't demand help determine cost? I mean, my health should be worth everything I've got, right? (I actually had a doctor imply as much when I asked him how much a procedure would cost, he turned to me and said, "Does it matter? We're talking about your health here." The fact is that the doctor who was recommending the procedure had NO IDEA what the cost for the procedure would be.)
Posted by BigAppleBucky
New York
Member since Jan 2014
1807 posts
Posted on 6/15/18 at 11:49 am to
For profit healthcare combined with inelastic demand causes the price of healthcare to soar in the USA. It's that simple.
Posted by joeyb147
Member since Jun 2009
16019 posts
Posted on 6/15/18 at 11:49 am to
quote:

Why don't you think businesses should maximize profits? Do you have a problem with profit?

Are you some kind of commie?
Why do you think doctors and nurses should be slaves to you?

Are you some kind of democrat from the 1860s?
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