One of my biggest frustrations is the fact that no one seems to be placing responsibility on individuals. Obesity, smoking, stressful lifestyles, women having 4-5 children on public assistance, etc. add a lot of cost to the system. When do we start taking personal responsibility for some of the excessive cost in the system?

“Americans know the price of almost everything they pay for, except for one of the most important things they pay for — their healthcare. With a point and click, they can find the price of anything from clothes to cars. Yet they don’t know what they are paying for healthcare and what sort of quality to expect in return. There’s no Carmax for healthcare.” By Secretary Mike Leavitt, US Dept of Health & Human Services. Posted: 05/10/06 12:00 AM — http://hill6.thehill.com/healthcare-may-2006/
transparency-in-healthcare-a-priority-2006-05-10.html

Secretary of HHS tried for over 2 years to make the healthcare cost transparent. He has gotten nowhere. Why? Healthcare companies spend $100 million every year for lobbying alone. Once it is transparent, they lose control; but they don’t care even if thousands of people die early because of this mess.

Therefore, I seek my pricing information from the insurance side. Afterall, I’m a paying customer. I pay the premium and therefore I want to know what my insurance company has agreed to pay for my care at facilities in my area. That’s not easy to obtain, but persistence, exerting one’s rights, and being out spoken does save money.

Also, more insurance companies are negotiating fee’s at or below the medicare fee schedule. Since this fee schedule is available to the public, it is a very good guide. Typically a medicare recepient is someone over 65. As a human being, I have observed that the older we get the more things seem to break down. So, if you are younger than 65 and in pretty good health, perhaps you may not want to pay more than the population that is a higher health risk than you.

Again, I think the key is to know the prices my insurance company has negotiated. Then considering price, I pick which facility or provider that best suits me. It would seem that if myself and my fellow employees would focus on selecting the low price provider, then perhaps our premiums wouldn’t keep rising. Currently, I am content to let the providers and insurance companies fight it out over the “cost” and “charges” of healthcare. I simply want to have the prices my insurance company has arranged(agreed to pay) for my care. If I don’t like them, then I will just change insurance companies(and probably keep my same provider).

JFR

As Mike commented, about half the healthcare cost is wasted in the form of administrative & ‘litigation related’. May be even more. The ‘litigation related’ components include ‘defensive medicine’ (where patients undergo unnecessary tests) and doctors’ malpractice insurance.

First, make the pricing absolutely transparent; force the hospitals publish their rates for every procedure. Then take care of wastage in administrative and ‘litigation related components’; it can be done only by simplifying the system. We don’t need millions of companies like health plans, brokers, agents, administrators, etc.

When a third party like health plan is involved, administrative & legal components of the healthcare cost take it to astronomical levels.

Looking forward to your “price list” JFR. Thanks in advance.

Mike

JFR

There is an elaborate process (already in place) which is updated very regularly by Centers for Medicare & Medicaid Services (US Dept of Health & Human Services). For more information, please visit http://www.cms.hhs.gov/PhysicianFeeSched/01_Overview.asp#TopOfPage

How many people know this info? My guess is, outside healthcare industry folks, over 90% of the general public do NOT know this. I think, at least half the healthcare related personal bankruptcies can be avoided when they have this information.

Yes, healthcare cost can be significantly reduced, if people are involved in the payment process. When people are made to pay for most of the services directly (at least a significant percentage as co-pays), then they will certainly ask the hospitals as to 1) how much the service/procedure costs? 2) are there any alternatives? This is enough to reduce the cost drastically.

Today, people are scared when you say they need to pay a significant percentage as copays because they are used to seeing exorbitant amounts in their hospital bills. If they get to know what Medicare pays (and hospitals accept), they will be very comfortable in making similar payments even fully (if they don’t have insurance).

But, how do you know what you are paying is reasonable or not. Here is some information to help you effectively deal with providers especially hospitals:
1) Before you avail any service, ask the providers for the procedure codes (CPT/Current Procedural Terminology codes) for the services you need. This is a 5 digit code; some codes may have an additional 2 character suffix.
2) Go to American Medical Association website, (https://catalog.ama-assn.org/Catalog/cpt/cpt_search.jsp) and select your state, location and the CPT code/s….boom, you will get what the Govt pays (for Medicare) for that service in your location. This is public information. Now you have the ammunition to deal with the provider; you don’t need to pay a penny more. You don’t even need to ask several providers to find the cheaper ones.

What you will notice will definitely surprise you. This will be a much smaller amount than what you would expect. You would feel that you don’t need insurance; the premium what you pay could be much more than what you would need to pay the doctors directly.

Please feel free to browse the American Medical Association website for checking how much Govt pays for different procedures in your area. Knowledge is power.

PJ

Health insurance can not be the solution; it is THE problem. Let the Govt provide Medicare-Part E (new) only for catastrophic/emergency services and let the people pay the doctors/hospitals directly for all other services.

We can either
– have a system just like what is in Canada or UK or France; if people are concerned about waiting time for elective procedures, then let them have private insurance on their own OR
– let the individuals pay the doctors or hospitals directly from their HSAs which can be funded at least partially by employers. And for catastrophic/emergency events, let the Govt provide Medicare like coverage and of course people would not mind paying a few hundred additional tax dollars for the purpose. When the individuals take control of the payment for majority of the procedures, the cost will be significantly less.

I personally think our health system should be more like that of Canada’s. Paid by the Government.

We would no longer have to worry about the cost ourselves, and the people with “success” in life would be able to get the health care then need.

Now, we would have to pay in the form of Taxes, but the Government would find someway to raise taxes on us anyway.

Whay not let them raise it a bit for health care and at least KNOW we’re paying for something worth the deduction.

Just a thought!

- Ray

Why do dogs eat their poop? One reason dogs eat their poop is because it just plain taste
good. Another reason is it could be a vitamin deficiency. One other reason for the poop
eating is that it is an instinctual behavior in the wild to eat the poop to keep other predators
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Some solutions for stopping poop eating are: You can put meat tenderizer on it.

What do you think?

By the way, I love that too!  Where did you get that at?  

Bye, bye - Wendy! 

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That was well said. Always appreciate your indepth views. Keep up the great work!

John