Talk of The Villages Florida

Talk of The Villages Florida (
-   The Villages, Florida, Political talk (

Guest 08-09-2007 12:02 PM

We need to institute a national health insurance system that allows all to benefit from it.

Case in point. I know a guy that does carpet, tile, wood flooring installs. I asked him to stretch a carpet this week. While he was doing it, he said he to go to the hospital for back and side spasams. He had no insurance, the hospital charged him $7500 for the emergency room and he has not gotten the bill for the cat-sacn, xrays, and blood work. HE HAS TO PAY THE FULL LOAD. If you have insurance, the negotiated payment from the insurance company is probably a thousand or two. My wife went to The Villages regional emergency room thinking she was having a heart attack. Billed amount $7000, amount accepted by the hospital from the insurance company $800.

SO why should he have to pay the full load?

We currently pay $900 a month down from $1450 before my wife went on Medicare. BUMMMER

Guest 08-09-2007 12:48 PM

You're right. Something must be done. But all the options are going to be costly for the lower middle class on up. Remember, those that are totally busted or low income pay nada via Medicaid state programs. Medicare/Medicaid now pays for 45% of all health care costs in the country. The slack is now getting picked up indirectly and direcly by the caregivers and private insurers. I did an internship at a 600 bed teaching hospital....St. Elizabeth's, Dayton, OH......the St. Elsewhere of the region....we used to call the ER the "Knife and Gun Club". In business for more than 125 years, they closed their doors and shut down for good in '96 I think. And it's still happening as hospitals try to stay in the blue ink.

Medicare reimburses hospital for inpatient care via a system of payment under DRG (diagnostic related groups). They get paid a set amount per patient discharge based on DRG and weighted by case mix and region. If a hospital treats a patient for less than the reimbursed amount, it makes a profit....if it costs more to treat than the reimbursed amount...the hospital must absorb the loss as the patient cannot be billed for the excess under the Medicaid/Medicare system (I think this answers a question raised under a previous topic). Complicating matters even further, there are RBRVs (Resource Based Relative Value Scales) which affect how physicians are reimbursed. And while Medicare Part A deals with inpatients, hospitals moved certain procedures to an outpatient setting....which are reimburse through yet another set of criteria under APCs (ambulatory payment categories). APCs are based on a combination of CCPCS and ICD-9-CM coding systems for outpatient or ER visits and within which hospitals must justify the medical necessities for treatments and/or tests or absorb the cost.

Bottom's a complicated administrative nightmare as it exists today and there isn't an easy way to fix it. Tearing the system down and starting anew is a thought.....perhaps a good thought....but we're all gonna pay one way or another. And, if the government gets more involved than it already vis is-a-vis Medicare/Medicaid......will we end up with a more simplified system? Think "tax code" dude....'nuff said.

Guest 08-29-2007 05:51 AM

I don't know about National Health Insurance.
I currently work at a Detroit area hospital and there is an influx of ill Canadians who are coming here for tests and treatments that they are waiting for in Canada.
From what I am hearing there is a long waiting list for MRI exams because of the lack of scanners in Ontario.
Everything is based on need, so if you suspect cancer and have no symptoms you might have to wait for your exam. "Emergencies" come first, so plenty of patients are coming across the border and paying $$ for scans to "stage suspected cancers". That sounds like a system that isn't working to me.


Guest 08-29-2007 07:36 AM

LG: I don't go for the National health Insurance. I know many many Canadians that wish they had our Health care. Remmember nothing in life is free , we end up paying one way or another

:dontknow: :dontknow:

Guest 10-02-2007 11:54 AM

"We need to institute a national health insurance system that allows all to benefit from it."

LG I agree with you.

Guest 10-05-2007 11:38 AM


Posted by Guest
Self-employed people should be buying their own insurance, not relying on the public or the government to pay their bill. Our 23 year old daughter, who just became a realtor, is paying for her own insurance, but that is probably because she has been taught to take responsibility for herself. Not only that, it was her choice to become self-employed, hence the drawbacks.

Well I'm not 23 but 62 and I am paying 900 a month.. BUT if they would allow organizations like the Nation Association of Realty to qualify for Group rates... it could bring down the cost significantly and allow more people to have insurance...

Guest 10-10-2007 10:52 AM

The point is we all make chooses in life and as such must be held responsible for those chooses. If you feel that health care should be Nationalized why stop there? There are many people who dont have a home, lets have the government buy homes for them. All Americans have a car correct? Not so, Uncle Sam could purchase a fleet of cars for the unfortunate. Currently only 60% of American households have internet access, surely the government should step in and provide the unfortunate 40% with free service. Cell phone? Surely you good hearted citizens willing to us other peoples money so freely would want every american (legal or illegal) to have the ability to stay in touch with family. When did we become a greedy, self serving welfare state? How is it your right to have the govt steal another mans money to pay for your needs. This is the problem with our country today, many have a sense of entitlement where none exists.Its nobodys job to fix the bad decisions you've made, education, career, marraige, children, housing, savings, health insurance,...these are personal responsibilitys and if your chooses turned out bad im sorry, but the rest of us should not have to pay for your mistakes.

Guest 10-13-2007 12:50 PM

sistagurl, you apparently don't live in the real world like the rest of us. Maybe you're too young to remember, or ignorant of history, when the Social Security Law was passed that some predicted we'd have socialism within 10 years. "The sky is falling. the sky is falling............." If you had a medical catastrophe, could you pay all your medical bills if you didn't have any medical insurance-----no Medicare, no private insurance (prior medical problem exclusion)? Now, many people go to the emergency room for things that could be treated in a Dr.'s office because they don't have money to pay the Dr., but the hospital must treat them. Do we have "socialzed medicine" now? Sure we do, but it's not universal-----medical care for the military and retirees, Medicare, Medicaid, etc. Believe you need to look beyond the buzz words and those who preach "The sky is falling" and educate yourself about the problem of health care in this country.

Guest 10-13-2007 02:22 PM

We visited cousins in Ireland and the UK this summer. Both families are very pleased with their health care. Our 70 year old cousin had bypass surgery and is getting along great. He has no complaints. We are pleased with our Medicare and Medicare Suppliment also, but my heart goes out to those who are not insured or under insured. In a country as great as ours, everyone needs to be covered.

Guest 10-13-2007 03:51 PM

Believe me I am quite educated about the issues, and I find it hard to believe that our generation and our childrens generation are turning this country into a nanny state. When did it become the job of government to provide all of your needs? I have private health insurance because I pay for it. I dont sit around and wait for the government to "take care of me". I'm sure your parents never thought it was someone elses job to raise you or take care of you. Stop feeling as if your entitled to have someone else pay for your needs. That is the "real" world, you work you eat!!! If there are people in need it has always been a community, church, family thing not Washingtons job. It makes me sick to think what some in this generation have turned into.

Guest 10-13-2007 08:24 PM

:agree: With sistagurl :agree:

I busted my butt to make a living and to provide for me and my family. To give it away free to everyone is ludicrous!! Where do you think that the money will come from to provide these "free" services?

When Social Security first started it was to assist those of old age. Now we have SSI to suppport those that can't afford to provide for themselves or don't want to. We have welfare programs for those that can't or do not want to provide for themselves. Where does it stop? Everytime someone sets up a worthwhile program for the underprivileged, there are people that take advantage of it.

And don't even start about the illegal aliens that are bleeding us dry.

Guest 10-13-2007 09:51 PM

:agree :agree: I totally agree with sistagirl and zcaveman. We all have to make choices is life; we choose whether to spend the money on vacation, house, etc or health insurance. If I choose not to insure my house and it burns to the ground, I don't expect the government (i.e., all the taxpayers) to bail me out. If I choose not to purchase health insurance, why should the taxpayers bail me out. If I truly cannot afford health insurance Medicaid is available. There are programs for the truly needy, and no one in this country is going without health care. I think I understand the situation also - I spent 9 years as chairman of our local hospital board and learned more than I ever really wanted to know about the situation. One thing I learned early - government is the problem, not the answer.

Guest 10-13-2007 10:39 PM

rdkent :agree: that government is the problem, however I also agree with LG in that when a Hospital or medical professional bills $7000. for services rendered, but will accept $800.00 as payment, then something is screwey. If we can do it for $800. then charge a fair price for the service rendered, then there would be more to go around for everyone, and perhaps those who did make bad decisions can recover. I would also like to point out that not everyone made the decisions that put them out there without insurance. More companies are now cutting back because health care is so expensive, so employees are finding fewer benefits. We are a generation that have enjoyed these benefits and have become used to having them. Generations behind us will not have fixed pensions and health care benefits as we know it. As I have said before when we were younger, we could afford insurance we did not need. Now that we are older we cannot afford the insurance that we so desperately need and deserve. I do not want the government to give me anything. I can and have earned my way. I just want a level field for all. Again $7000. vs $800.

Guest 10-14-2007 11:31 AM

bama - I agree with most of your post. :agree: However, on the pricing take a look at JohnZ's post on August 9. Hospital pricing is way too complicated to get into here. It would take a very long post and still wouldn't cover it all. Short version - everything is driven initially by Medicare and Medicaid. Government holds the big stick. For quite a while hospitals (and doctors) covered the shortfall from Medicare and Medicaid payments by charging insured patients more. Insurance companys finally said enough and started playing hardball. If you don't accept this we'll cut you out of our network. Providers negotiate best deal they can get, then accept that that is it. Their variable costs may get covered but not all of the fixed. They try to charge uninsured patients the full load, but most uninsured don't have the assets to cover the charges. Result, taxpayers (state, federal, and local) pick up the difference. Second result, many smaller hospitals (and quite a few large) are out of business. Also, the $7000 vs $800. The $7000 is what the full cost probable is. The federal govt or the insurance company will not pay full cost, so they end up taking what they can get. I guarantee you the $800 does not cover their real costs.

Guest 10-14-2007 02:20 PM

rd: Well said and thanks. And I agree with you in that $800 is nowhere near the true cost if the hospital bill was calculated to be $7,000.

All times are GMT -5. The time now is 11:43 AM.

Powered by vBulletin® Version 3.8.11
Copyright ©2000 - 2020, vBulletin Solutions Inc.
Search Engine Optimisation provided by DragonByte SEO v2.0.32 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.