From HousingWire:
March job creation bodes well for housing inventory crisis
March job numbers brought welcome news as more jobs were added to the construction market, which bodes well for the current lack of inventory in the market.
Job creation increased by 215,000 in March, while the unemployment rate remained stagnant at 5%, the U.S. Bureau of Labor Statistics reported Friday.
…
“The mix illustrated the crosscurrents affecting economic growth in the past two quarters, with some improvement in construction showing up in 37,000 added jobs as a response to the short supply of homes for sale, and the recession-like weakness in manufacturing revealed in a decline of 29,000 jobs,” continued Duncan.The job report posted that construction employment rose by 37,000 in March, with job gains occurring among residential specialty trade contractors (+12,000) and in heavy and civil engineering construction (+11,000). Over the year, construction has added 301,000 jobs.
“New construction jobs provided a double boost to the economy in March. These jobs not only helped feed strong employment growth but also provided a lift to the housing market, where the dearth of homes for sale has stymied homebuyers for the past year. Much of the decline in new housing starts is attributable the lack of skilled construction workers, so the 12,000-worker increase in residential specialty trade contractors is welcome news in today’s report, especially when paired with the pickup in new single-family construction we saw in February,” said Redfin chief economist Nela Richardson.
In February’s homebuilder confidence report, National Association of Home Builders Chairman Ed Brady, said, “Though builders report the dip in confidence this month is partly attributable to the high cost and lack of availability of lots and labor, they are still positive about the housing market. Of note, they expressed optimism that sales will pick up in the coming months.”
Re Lib 144 – Not sure what the value of an “in-network” hospital is if all the providers don’t participate and no one advises you of that before they render services.
Grim – we may need to pick your brain on balance billing at some point.
I forget the numbers, but close to half a million down to $20k or so.
Most of this on appeal, secondary to that were billing issues, and lastly negotiation with 3 different providers. There were also hospital billing issues, we had to have the hospitals/doctors resubmit numerous bills. I suspect a big issue here is early billers – the insurance company doesn’t have the full picture, and these one-off bills that come in outside of the context of the broader stay/situation get flagged and rejected.
One that really irked me was a bill that insurance refused to pay because it had fell out of the window – it would have passed on appeal, but it had slipped through the cracks, then we’d gone back and forth with the appeal, and they pulled the plug. That one was like $2k – so start your appeals NOW.
We were able to play two insurance companies though, which I think what was what helped us the most. Maybe it was just a technicality, but childbirth and the immediate stay is initially covered by the mother’s insurance. My daughter was on my policy as well, so technically covered by two insurance companies. We were able to play the appeals game across both. There were absolutely instances where her insurance refused, but mine covered, and vice versa – there is zero consistency to any of this.
The absolute main factor to push in the appeal is that all services rendered in all hospitals was for an emergent need in a life or death situation. This is the wildcard against balance billing and out-of-network providers. You didn’t have a choice in the matter.
Not sure I remember, but I think we submitted about 50 appeals. After the first 10, it became more of a form-letter.
I’m really disgusted that the NJ legislature bent over and did nothing about this.
Asking who is in or out of network doesn’t work in the context of a hospital stay.
When the resident calls a consult in the middle of the night – you have no say in this. When the consult orders a test – you have no say in this.
At St. Joes in Paterson – all the in-house blood work was out-of-network.
Figure that one out. How is nearly the most routine test done in a hospital not able to be performed in-network?
This is why I believe this has nothing to do with insurance negotiation, and everything to do with being a huge f*cking scam.
Even if 97% of the people successfully appeal, I guarantee you that there is a sizable amount of incoming revenue that is paid outright by people that don’t know any better.
This reminds me of the gift-card scam nonsense when gift cards became popular. Companies loved them, because about 3-5% of the outstanding balance went unclaimed, or companies could erode balances through service charges.
It wasn’t the 97% that made them lucrative to companies, it was the 3% that they stole.
Worst part is, insurance companies don’t care either, because it’s less they have to pay.
I remember having a good conversation with the insurance appeals person – she basically said:
Look – you need to do exactly what I tell you. Don’t question it, just submit the appeal in exactly this manner.
She said what she could, because the call was probably recorded, but you could read between the lines easy enough to know she was really saying:
I’m not supposed to help you, and we’re not here to protect you. The whole f*cking system is rigged to have you not place this appeal, to get confused, to not do it in time, or to just make the payment outright not realizing. We are not your fiduciary, and we could care less if you can’t afford to pay these bills.
Oh oh oh, how could I forget – manually submit every balance billed claim directly – this is key. Some don’t submit at all. Also, insurance companies are stupid, we had them accept manual claims that were previous rejected.
This is before appeal. Only appeal on the denials.
Also, get out your insurance paperwork and start checking the appeals process. If they deny your appeal, you may have an option to request a third-party onbudsman or go to arbitration. Towards the end we threatened arbitration and magically the remaining amounts were paid.
Again, everything is emergency life or death – everything. Do not waver on this.
Don’t negotiate with anyone until it goes to collections.
We pushed a number of bills into collections specifically to negotiate under our terms – all I did out of principle – f*cking pricks.
Let them eat the 5 cents on the dollar. We settled all of these for high single digit amounts.
Not a single one reported to credit.
YMMV.
4
“The whole f*cking system is rigged to have you not place this appeal, to get confused, to not do it in time, or to just make the payment outright not realizing. ”
Clearly, the medical industry is the worst offender but I think this has become the default customer service strategy in most industries and in all large companies.
All those commercials, billboards, advertisements that make it seem like insurance companies are here to protect us, the customer, are a load of garbage. The whole construct is a load of bullshit foisted on all the while a stupid fucking jingle is playing in the background including lyrics like “we care, we’re here for you”.
The fact of the matter is that the insured is the enemy, they are not your fiduciary, they owe you nothing. They are our best buddies while collecting the premium, but once it comes time to pay out, you’ll see who is on your side.
This whole thing just drives me so f*cking insane.
Why is it such a stretch to provide consumers with one single, simple thing – if you go to a hospital – who is in-network – you should have an expectation that all services are provided in-network, no questions.
This is so basic, so simple.
If a provider will not play along, remove their privileges. Do not tell me that there are not a dozen other providers willing to take their position and accept the same set of insurance as the hospital. There will no longer be any anesthesiologists? Yeah, Ok. CALL THE F*CKING BLUFF.
The fact that this did not happen, and was fought tooth and nail not only by the hospitals and the doctors, but also the insurance companies, tells you all you need to know, the system is setup to F*CK the consumer over, period, no other reason.
Single payer system might be the only answer. A person can lose everything when they get sick
10 – Why didn’t the great Obamacare address balance billing? Which was specifically excluded? This is not a new issue, this was well known at the time.
In fact, some argue that ACA actually made balance billing more common, as it forced hospitals to start pushing services out to external companies, rather than risk having to cover those costs themselves.
Did you find that the Out of Pocket maximum was a valid cap or was that not applicable due to the out of network charges?
Balance billing is typically outside of non-network out-of-pocket maximums. Out of pocket maximum would be based on the reasonable and customary charge, not the actual charge.
So really, the line on your insurance form that says “maximum out of pocket” is a load of bullshit, that’s based on their math, their numbers, their calculations, not the real world bill you have to pay.
Sanders: Bread lines are a sign of economic health.
http://thelibertarianrepublic.com/video-surfaces-of-bernie-sanders-praising-breadlines-and-food-rationing/
Grim,
Why is it such a stretch to provide consumers with one single, simple thing – if you go to a hospital – who is in-network – you should have an expectation that all services are provided in-network, no questions.
There is, it’s called Medicare.
Something Romney and his henchmen are trying desperately to do away with.
You think you had it bad, try it next time with a voucher..
No one likes socialized medicine, except for Senior Citizens.
Why not for all??
I hear a lot of dead veterans are not terribly fond of it.
Raymond Reddington formerly Phoenix says: says:
April 4, 2016 at 9:21 am
No one likes socialized medicine, except for Senior Citizens.
Why not for all??
16 – So you saying Stu should have checked into the hospital as Guillermo Hernandez, Dreamer?
http://www.cnn.com/2015/09/02/politics/va-inspector-general-report/
307,000 veterans may have died awaiting Veterans Affairs health care, report says
Grim on a ripper this morning. 1 year old partially swallowed a pill late last year. One trip to ER then they pushed us out, by ambulance, to another hospital with infant ICU. They were both in same hosptial system…then you get the bills and realize the sham. All done for brand. We got so many double charges and bogus fees. Still fighing it. My son was fine by next morning but I counted 4 doctors (interns really) coming in to confirm diagnosis. It was nothing more than “do you agree, Dr?”. Yep, 4 more line items on my bill. Any system set up for excess and abuse will eventually fail. Obviously, it is fine if hundreds of thousand of families get wiped out in mean time.
A fair debate on health care but as my practice has expanded to include it, I find I have to stay out of it.
Nonetheless, these are good questions and points in a highly complex issue
Yeah, like the neonatologist that charged us $5,000 a visit. One “visit” a day. Charged every kid in NICU the same fee (at least a dozen kids).
We were in the NICU 24/7 – the guy was there for 5 minutes, max.
$5,000 a day as the attending? Assume his billing was $60,000 a day given the dozen kids there.
This is not egregious?
Not to be confused with the NICU charges, which were separate – this was only the physician fee.
Attending doctor in the NICU in St Josephs PEDIATRIC HOSPITAL is out of network.
Again, how does this make any f*cking sense?
He was one of the bills we did not pay, and let go to collections, where we settled the $15,000 bill for about $1,000.
N.J. to order property tax-changing revaluations in 3 municipalities
http://www.nj.com/politics/index.ssf/2016/04/nj_to_order_revaluations_in_3_municipalities.html#incart_river_home
State officials will take the action against Jersey City, Elizabeth and Dunellen, which they say have defied the state Constitution’s calls for fair and uniform assessments, according to a person familiar with the state’s investigations of those towns.
The municipalities will have until November 2017 to complete revaluations, according to the source, who is not authorized to speak publicly and requested anonymity.
Yeah, like the neonatologist that charged us $5,000 a visit. One “visit” a day. Charged every kid in NICU the same fee (at least a dozen kids).
My father was a neonatologist. Essentially, they are billing out that so they get a $50 payout from Medicare/Medicaid because it works off percentages of what you normally charge. The big joke about “rising healthcare costs” is if you are handed a bill for $15000, you tell the doctor, you have $300 cash and they’ll accept it as full payment in a heartbeat. Costs aren’t rising. Shadow games with billing make numbers go up.
#24
Yep, pop the popcorn. Fulop and his Hudson county backers won’t take this lying down.
I predict they escape they reval with some other sham equalization measure for appearance sake. Meanwhile Jersey City will continue receiving the same level of state “aid” despite the exploding growth that’s taken place.
Grim,
Last year, I had hospital try to charge me 3k for procedures done in 2013. Apparently Aetna did audit and pulled money back stating they should not have covered certain claims. Really? 2 years later? I thought about letting it go to collection but realized that I pay $7/month for Metlaw at work. Best deal ever. One letter from the lawyer and I have not heard boo. I have used them several times to fight the system before it gets to collection.
America will never realize that physicians are the most organized labor cartel on the face of the planet.
22
Comrade,
From what you just said you either can’t or won’t respond … and that’s fine, I understand. I am not trying to start an argument. But it is not as complex as some claim, not even close in my opinion.
To put this bluntly the medical industry has intentionally put forward a system by which it can screw you with impunity, obtaining exemptions from the laws that cover every other area of commerce, thereby effectively forcing you to buy overpriced services you do not want to purchase lest an unexpected life event literally wipe you out.
https://market-ticker.org/akcs-www?post=163733#
Wow, horror stories with healthcare this morning. Confirmed my suspicions that it’s a rigged game. Health industry is legalized robbery.
There is no honor in this economy anymore, just a house of cards trying to exploit the population. No one making an honest buck, just looking for a way to get over on the next guy. It’s sad. You have businesses raping their workers of their due raises so they can profit more. You have businesses selling products for a higher value than they are worth, ripping off the customer of the value they rightfully paid for.
This is why I mentioned the Manhattan Hospitals vs the NJ hospitals in one of my posts. I went in for shoulder surgery and had a choice between both. Total out of pocket cost for my $25,000 surgey at HSS was $250 plus parking tolls. In Jersey I could almost imagine the games. Same thing with Sloan for cancer. They have the whole process down pat even the billing. From scheduling, exams, follow up. Its worth the tolls and parking.
We got hit with my son’s tonsil removal.
Doc in network – Check!
Anesthesiologist in network – Check!
Raritan Bay One Hospital Plaza Old Bridge in network – Check!
Wing of Hospital where Surgery was actually performed – NOT IN NETWORK!
Same address but a different “wing” of the building, not in network? WTF
Here is a article I found on the expansion if Raritan Bay. It was pretty much was brand new and the paint was still drying when we went there for the Surgery in January.
http://www.nj.com/middlesex/index.ssf/2013/05/raritan_bay_medical_center_to.html
“Hospital officials said the new building, tentatively scheduled to open in 14 months, will connect to the main hospital on the second floor via a “sky bridge.”
“This new building will transform the Old Bridge facility by placing greater emphasis on surgical services such as orthopedic and bariatric surgery as provided by our Human Motion Institute and Institute for Weight Loss programs,” said Michael D’Agnes, president and chief executive officer of Raritan Bay Medical Center.
D’Agnes and other officials broke ground for the new building May 15.
The 95,000-square-foot medical building will include a new imaging center, a five-room operating suite, physician practice offices and a same-day surgery center, officials said.
The new building is a joint venture/partnership between the medical center and a group of more than 25 surgeons from the center’s medical staff.”
We aren’t paying. Got an extortion letter from some “Advocate” offering to settle the 11k for 3k.
Over my dead body on principle.
Ben really? I though tit would have been the teachers union.
America will never realize that physicians are the most organized labor cartel on the face of the planet.
Not health care but related and a topic we may yet see here in the future. This from my industry news feed this morning:
“Parents urge province to ban fees for daycare waiting lists;
Petition points out charges discriminate against lower-income families and lack transparency
Laurie Monsebraaten Toronto Star
Like most first-time Toronto parents, Nadine Blum knew she would have to put her name on numerous child-care wait lists if she hoped to get a spot for her son in time to return to work last December.
But she wasn’t expecting to pay for the privilege of getting in line behind scores of other parents desperate for daycare.
“I must have been on 20 to 30 lists, I lost track of the number,” said Blum, 38. “But what really surprised me were the fees to get on those lists.”
About one-third of the daycares Blum contacted in her east-Toronto neighbourhood charge non-refundable wait-list fees. While most asked for $20 or $30, one non-profit centre charged $120, she said.
When a private centre charged $150, she balked.
“I asked to speak to the manager because I thought the worker was trying to scam me,” she said in an interview.
In the end, Blum secured a space in a downtown centre that doesn’t charge wait list fees. But after she returned to work as an associate at Goldblatt Partners LLP – a labour law firm that often tackles broader social justice issues – she and fellow lawyer Kelly Doctor decided to do something about the centres that do charge.
Later this month, Blum’s local MPP, Arthur Potts, will present their petition to the legislature, calling on the government to ban non-refundable daycare wait list fees in Ontario.
The scarcity of daycare across the province – in Toronto there are spots for just 21 per cent of children younger than age 5 – means parents are forced to put their names on multiple wait lists. . . .”
As with health care, they can try to stop preferential pricing by legislation–Canada banned concierge medicine. But it will merely drive it underground or into semi-legal “broker” arrangements, much like the buyer’s groups in Canada that you can join in order to get preferred access. You see this with rent control too; government tells you what you can charge but those with means go to the head of the line the same way we used to go to the head of the line at the club–by slipping a Jackson to the bouncer. In Cambridge, MA decades ago, it was not uncommon to see people offer “finder’s fees” in the thousands for a rent-controlled apt. I can only imagine it is well into 5 figures now, and the landlords are getting some, if not all of it. So these fees will still happen, they will just be sub rosa.
What’s sad, these are smart individuals; proves greed wins out in the moral argument of doing what is right. You would think the doctors would stand up to this and end the blight on their industry, but greed prevails.
Ben says:
April 4, 2016 at 10:25 am
America will never realize that physicians are the most organized labor cartel on the face of the planet.
[29] joyce,
I now represent a lot of plans and plan sponsors, and while commenting isn’t barred by the NJ attorney ethics rules, it is safer to not court controversy.
But as I delve into this, I think I am safe in saying that this area is even more byzantine than tax, if that is possible. And the competing policy considerations are also deeper and more complex than you hear about on the news. So I disagree that it is a simple issue, either when looking at policy from 10K feet, or being down in the weeds negotiating PBM contracts or resolving appeals.
34
Banking is pretty bad.
37
Fair enough, agree to disagree.
24 Just wait until the inspector finds all the illegal rental units in Elizabeth
Ben really? I though tit would have been the teachers union.
The barrier to entry into the teaching profession is miniscule. Doctor’s have setup a national system in which supply is artificially constrained and it is illegal for anyone else to perform several basic services.
Imagine all of the work that’s been done without permits or inspections to avoid a higher property tax bill. Some people might have it reported..and have to go through inspections and apply for permits…while politically connected people have the inspectors look the other way…its sure to be a mess…if they actually do the reval, that is.
Mike says:
April 4, 2016 at 11:32 am
24 Just wait until the inspector finds all the illegal rental units in Elizabeth
Yup. I’m starting to look at laws as a means of taking advantage of individuals with good ethics/morals. People willing to cheat the system, always get ahead of people following the laws of the system. That’s why the top of the income pyramid is littered with the biggest crooks in our country, individuals with no morals or ethics.
D-FENS says:
April 4, 2016 at 12:20 pm
Imagine all of the work that’s been done without permits or inspections to avoid a higher property tax bill. Some people might have it reported..and have to go through inspections and apply for permits…while politically connected people have the inspectors look the other way…its sure to be a mess…if they actually do the reval, that is.
Mike says:
April 4, 2016 at 11:32 am
24 Just wait until the inspector finds all the illegal rental units in Elizabeth
Panama papers?
19 Grim,
Not Medicaid, Grim, but Medicare.
There is a difference. Also, don’t need a name like Guillermo Hernandez to need Medicaid like you suggested.
One job loss combined with an illness can bankrupt Joe Smith just the same.
Also, the things people complain about in the healthcare system are the same things you could say about many other businesses as well.
No one tells you that you have to buy health insurance. Feel free to pay cash if you like.
Use a credit card, take out a loan. Works for cars, homes, etc. You can even go to another country or state for your healthcare if you like.
Funny how those embrace capitalism when it comes to their own paycheck, but it’s not ok for someone else. Why not a fixed price for plumbers, lawyers, etc?
One of the reasons some doctors only take cash/credit cards now. Why fight with 50 insurance companies all trying to dicker with what they will or will not pay for? Just like grim fought over bills, the doctors and hospitals do the same over receiving payment, one little coding error by a clerk and the check bounces.
DFENS, I believe you are right in your statement. So which would you choose and why? Medicare or VA? Both are forms of socialized medicine. My preference, Medicare hands down. Absolutely amazing what it will pay for, which is one of the reasons Romney and his henchmen want it shut down. Ask any senior citizen if he/she wants Medicare or a “voucher” aka 20% off coupon.
People love capitalism. They like when they are smart and get a good deal. The times they walk into a car dealership and save 5k thru bartering and laugh at the poor sucker who paid full price. The dealer makes up on one from the other at the end of the day. No one embraced the ” Saturn” one price , no dicker, no bartering method except for the ” less informed, less confrontational” types. The others felt like they were ripped off. When it comes to medicine, no one feels like bartering. So choose the Saturn aka Medicare/Socialized or not.
There are crooks in every industry. Medicine has it’s share also. Especially those who lobby aka drug companies, lets not forget Martin Shkreli. It’s capitalism at it’s finest.
37. CND
You nailed it. When a lawyer who deals with these contracts on a daily basis finds them to be complex, just imagine a layperson.
The poor are insulated, they walk in, never pay. May or may not get good service, but get an awful lot for what they pay.
The seniors are mostly insulated, good coverage, good service, pay somewhat, but without a doubt a bargain for what they receive.
Those with good private healthcare plans get good service all around but pay plenty for the plan they have, loopholes increasing by the minute. This group is getting squeezed from all angles.
Great post. Thanks for taking the time to write it up.
Raymond Reddington formerly Phoenix says: says:
April 4, 2016 at 1:13 pm
19 Grim,
Not Medicaid, Grim, but Medicare.
There is a difference. Also, don’t need a name like Guillermo Hernandez to need Medicaid like you suggested.
One job loss combined with an illness can bankrupt Joe Smith just the same.
Also, the things people complain about in the healthcare system are the same things you could say about many other businesses as well.
No one tells you that you have to buy health insurance. Feel free to pay cash if you like.
Use a credit card, take out a loan. Works for cars, homes, etc. You can even go to another country or state for your healthcare if you like.
Funny how those embrace capitalism when it comes to their own paycheck, but it’s not ok for someone else. Why not a fixed price for plumbers, lawyers, etc?
One of the reasons some doctors only take cash/credit cards now. Why fight with 50 insurance companies all trying to dicker with what they will or will not pay for? Just like grim fought over bills, the doctors and hospitals do the same over receiving payment, one little coding error by a clerk and the check bounces.
DFENS, I believe you are right in your statement. So which would you choose and why? Medicare or VA? Both are forms of socialized medicine. My preference, Medicare hands down. Absolutely amazing what it will pay for, which is one of the reasons Romney and his henchmen want it shut down. Ask any senior citizen if he/she wants Medicare or a “voucher” aka 20% off coupon.
People love capitalism. They like when they are smart and get a good deal. The times they walk into a car dealership and save 5k thru bartering and laugh at the poor sucker who paid full price. The dealer makes up on one from the other at the end of the day. No one embraced the ” Saturn” one price , no dicker, no bartering method except for the ” less informed, less confrontational” types. The others felt like they were ripped off. When it comes to medicine, no one feels like bartering. So choose the Saturn aka Medicare/Socialized or not.
There are crooks in every industry. Medicine has it’s share also. Especially those who lobby aka drug companies, lets not forget Martin Shkreli. It’s capitalism at it’s finest.
Hypothetically,
Grandma is living in your house, she is sick and needs full time care. You love her more than anything in the whole world. Can’t feed herself or make it to the bathroom, complains about what you cook, miserable all day, bad legs, falls often. You have a career of your own. Do you give up your job to take care of her or do you pay someone? How much would you have to pay yourself to give up your job to consider taking care of her as a career? What is that job worth per hour in your mind? Would you be willing to pay someone else the same amount as you would pay yourself?
Yup……
I am a healthcare worker, and I work directly with patients. I shy away from any billing and insurance questions, leaving that to the admin staff. It’s tough for patients to ask questions about money, they want to be sure the doctors are on their side in the exam room. There is nothing that compares, consumer wise, to dealing with a health problem. There is no posting of our prices, anywhere in the office! It’s a strange thing, I don’t know how in the year 2016 you walk into our office and have absolutely no idea what your charge will be, especially if the doc orders special testing to be done in house. It’s really awkward for a patient to decline such testing, thinking the doc knows best, better just go along with what he/she orders for testing. Add to that all the time you have already spent just waiting in the office, you just give up and say, sure go ahead and do the testing. We almost never, ever have a patient decline a service the doc advises, and that includes surgeries.
Had my other computer completely lock up on me. Mouse cursor would not move. So I had to shut down by tabbing around the commands.
Reminded me of the story of the blonde who was locked out of her car. Someone came over to help and she said “I can’t get in my car, my remote doesn’t work. What will I do?” He said “let me see your key ring” and she handed it over. He flipped out the key and opened the door. For a moment or two, I felt like the blonde.
“”Obviously this is Trenton politics at work because of the documented and rocky relationship between Mayor Fulop and Governor Christie dating back to Bridgegate,” city spokeswoman Jennifer Morrill said.
City Council President Rolando Lavarro, a Fulop ally, also questioned the Christie administration’s motives.
“It isn’t hard to figure out that politics is at work here,” Lavarro told The Jersey Journal in an email.
Christie’s spokesman was not immediately available to comment. A spokesman for the state Treasury, which this morning announced that Jersey City must complete a citywide reval by Nov. 1, 2017, said the state would accept nothing less than full compliance with its order.
“The elected officials in these municipalities swore an oath to uphold the entire state constitution, not merely the sections that they like,” said spokesman Joseph Perone.”
http://www.nj.com/hudson/index.ssf/2016/04/fulop_order_forcing_jersey_city_reval_more_politic.html#incart_river_home
Also, the things people complain about in the healthcare system are the same things you could say about many other businesses as well.
No one tells you that you have to buy health insurance. Feel free to pay cash if you like.
Absolutely, let’s start by requiring medical providers to post prices and provide estimates before performing services. Or, if an estimate can not be reasonably provided, provide a cost of the service at a fixed cost bid.
This is the only business in the world where you are purchasing a service without the provider giving you any sense at all of the cost of it.
Seems they have enough time and wherewithall to make you sign a disclaimer when you walk in.
And you are obligated to pay, regardless of the outcome.
Let’s open it all up – lets have all the costs made public, by procedure, so we can chose the doctors that provide the best outcomes at the overall lowest prices.
Those who can’t, should go out of business, just like the other businesses you chastise above.
55. Best outcomes.
What a laugh. Want best outcomes, choose best patients. Those with support systems, financial ability, those with less issues. Don’t do joint replacements on diabetics, poor outcomes-who wants that on their records.
Are these patient’s compliant? Did they take their medications after they left- no? Check blood sugars? problem resurfaces and it’s your problem that they were non compliant, maybe they love their cigs and liquor too much.
Way to many variables to deal with.
re: #54 – “Let’s open it all up”
Bidding is already here.
https://www.medibid.com/search-browse-medical-procedures
Raymond,
There is a lot of truth in your posts, but also lot of falsehoods. Many govt constraints (mostly at the behest of industry lobbyists) in health care; so many it’s laughable to suggest there is a free market… save for maybe cosmetic surgery.
Without consumer protection legislation in some form, it would be very difficult to prevent providers and insurers to take advantage of someone in an emergency situation. That said, removing pre-existing state and federal laws would eliminate most of the other problems.
agree
The Great Pumpkin says:
April 4, 2016 at 1:31 pm
Great post. Thanks for taking the time to write it up.
Raymond Reddington formerly Phoenix says: says:
April 4, 2016 at 1:13 pm
19 Grim,
Not Medicaid, Grim, but Medicare.
There is a difference. Also, don’t need a name like Guillermo Hernandez to need Medicaid like you suggested.
One job loss combined with an illness can bankrupt Joe Smith just the same.
Also, the things people complain about in the healthcare system are the same things you could say about many other businesses as well.
No one tells you that you have to buy health insurance. Feel free to pay cash if you like.
Use a credit card, take out a loan. Works for cars, homes, etc. You can even go to another country or state for your healthcare if you like.
Funny how those embrace capitalism when it comes to their own paycheck, but it’s not ok for someone else. Why not a fixed price for plumbers, lawyers, etc?
One of the reasons some doctors only take cash/credit cards now. Why fight with 50 insurance companies all trying to dicker with what they will or will not pay for? Just like grim fought over bills, the doctors and hospitals do the same over receiving payment, one little coding error by a clerk and the check bounces.
DFENS, I believe you are right in your statement. So which would you choose and why? Medicare or VA? Both are forms of socialized medicine. My preference, Medicare hands down. Absolutely amazing what it will pay for, which is one of the reasons Romney and his henchmen want it shut down. Ask any senior citizen if he/she wants Medicare or a “voucher” aka 20% off coupon.
People love capitalism. They like when they are smart and get a good deal. The times they walk into a car dealership and save 5k thru bartering and laugh at the poor sucker who paid full price. The dealer makes up on one from the other at the end of the day. No one embraced the ” Saturn” one price , no dicker, no bartering method except for the ” less informed, less confrontational” types. The others felt like they were ripped off. When it comes to medicine, no one feels like bartering. So choose the Saturn aka Medicare/Socialized or not.
There are crooks in every industry. Medicine has it’s share also. Especially those who lobby aka drug companies, lets not forget Martin Shkreli. It’s capitalism at it’s finest.
@BernieSanders
My Medicare-for-all plan
will cost $6 trillion less than the current health care system over the next ten years.
I’m all for socialized medicine, let’s start the deployment with the public sector employees.
That includes politicians..
Why not right Grim? Every time we install a new technology at work, all the IT people are the first to be on it. We wouldn’t install a product we didn’t believe in.
http://www.nj.com/politics/index.ssf/2016/04/blue-collar_borough_braces_for_forced_property_rev.html#comments
Of the about 30 municipalities that haven’t held a revaluation or reassessment in at least 25 years, state officials have set their sights on nine: Jersey City, East Newark, and Harrison in Hudson County; Elizabeth, Roselle, Westfield and Winfield in Union County; and Dunellen and South River in Middlesex County.
First off Grim…appreciate the time you have spent addressing the billing issue we are facing. I plan on battling my insurance company like the D is battling his cancer.
“One job loss combined with an illness can bankrupt Joe Smith just the same.”
Forget the job loss. You could have an incredible job. Huge savings and it wouldn’t put a dent in what we are being billed. Based on what I’ve seen so far, I full well expect the billed amount of care for this malignant brain tumor removal, therapy, shunt, chemo and then most likely radiation to be in the multi millions. My max out of pocket for family is 10K. Outside of choosing CHOP, we have not been offered any decisions so far. Everything was vitally necessary. We were advised by our neurosurgeon (out of network though were never told as was the anesthesiologist) not to move our son as it was too dangerous. We did not opt for rehab, or chemo or radiation. If you want your kid to live, you have no choice. As for opting to stay bedside with your 3-year old or hire a bedside nurse so you can work to make enough money to pay one twentieth of the bill? What choice do you have? Your kid has a 1 in 4 chance of not being alive by Christmas. Are you really going to hire a bedside nurse to accompany him? Really. What good is insurance for us if all they are willing to pay on a $75,000 bill of which we already have 4 of them is $2,500 or so? So we get balanced billed…what should we reasonably pay? I’m surprised these bills don’t just have an infinity symbol on them. Might as well. What is the value of three hours of a brain surgeon’s time? At the rate he billed us, it’s exactly equal to what Cespedes gets paid to play in one 3 hour baseball game. But of course, our surgeon performs multiple procedures a day. I suppose he deserves to be the league MVP.
Once again, good luck Libturd. Stay strong.
Totally OT Alert
Gotta brag on one of my daughter’s besties who won this race series in her age bracket (11-12 girls). Again.
https://www.epicmix.com/Lindsey-Vonn-Results.aspx
That list undoubtedly has some future Olympians on it, and she consistently tops it.
So when she’s on the podium, I can think back “damn, it was only X years ago, she was in our condo, borrowing my daughter’s clothes.”
“What you don’t know about your doctor could hurt you”, article from Consumer Reports Magazine dated 3/29/16/ Fascinating, you can find more about how your toaster is rated than you can find out about your doctor, is one of the quotes. I followed the link for the NJ Health Care Profile of doctors. It’s pretty useless. If the malpractice suit against a doctor is more than 5 years old, they don’t even show that there was ANY history of a suit against the doctor.
Clinton/Trump gaff mashup: “The unborn person doesn’t have any constitutional rights but there needs to be some punishment.”
65 it is disgusting, it isn’t bad enough that you have to deal with the illness and everything else that you are worried about but then the medical industry with it’s byzantine process, you purchase insurance which probably costs 20k per year for a family with an expectation that you have a “out of pocket maximum”. I understand things are expensive but in reality what is done in the medical industry is usually grossly overpriced and there is more than enough room for adequate compensation for the skills and talents of the people needed. The issue is one largely of transparency, an extremely regulated industry where the regulations were drafted to help insurers and the medical industry itself rather than the patients. Insurance is just that, and therefore should by law be inclusive and provide you with some indication of just how much you are protected for, maybe they need to bound maximum out of network payment but it certainly should not be the way it is now. This is what kills me about Obamacare, it did nothing to fix the problem but insert another level of cruft onto a system that isn’t working.
So, has anyone ever sued a hospital for lying and for breaking consumer protection laws? “Yes we are in your network” but not all of their providers are. What a scam. A plumber couldn’t pull this crap so why can hospitals and physicians?
Humans need not apply.
Human labor is very close to being deemed useless. Video does a fabulous job of explaining why automation is about to take out every job. No one is safe. If a computer can be taught to beat a human at chess or jeopardy, it can beat a human at anything, even creativity. The conversation between the two horses is one of the best examples I have witnessed at explaining why human labor will be worthless. Crazy stuff. What kind of world will it be if human labor is no longer needed to survive. Pretty much, throw all economics out the door, there is no economic model that works without human labor. How will resources be divided in these type of conditions?
https://m.youtube.com/watch?feature=youtu.be&v=7Pq-S557XQU
It all comes back to what is wrong with our government. As long as politicians are owned, there will never be positive change. Never! Enjoy pulling the lever for that cheated, on coattail riding, lying criminal. I’m sure she’s going to make it much better. Morons!
65- Lib, excellent write up demonstrating the joke that our healthcare industry is. Prayers are with you and your family.
(Lib, this is not directed at you personally in any way)You might save your life, but at what cost? Become a slave debtor to the healthcare industry for the rest of your life? Parasitic industry claiming to save lives, when all they do is ruin them.
Great, you saved my life. Now the rest of my life is spent working as a slave to pay you back. Thanks. (Not trying to be inhumane, just making a point)
grim (11)-
Cause Bojangles had to put insurers on his team to get the piece of shit known as Bommacare passed. This is one of many kisses the insurance vultures got at the closing table.
“Why didn’t the great Obamacare address balance billing? Which was specifically excluded? This is not a new issue, this was well known at the time.”
Yep, Shrillary’s on the common man’s side.
Projectile vomit at your leisure.
Thinking of you & yours, Stu.
Let this serve as proof that when rictus-faced Nancy Pelosi tells you to read a document ‘later’, check your sphincter. Chances are good her c0ck is halfway in, and you haven’t felt it yet.
Cloward-Piven Strategy of Economic Terrorism.
Makes for some light summer reading.
Wow. We got off cheap. We had both our daughters at Brigham & Women’s Hospital in Boston. The first one, in 2002 – Free. Never got a single bill. I had a friend at work who just had a baby (and whose FIL was a cardiologist) and asked him ahead of time if there was any secret billing(s) that I could avoid. He told me to tell the admitting nurse that we had no pediatrician yet and we would accept the “on-staff” pediatrician. He said doing that would save us $500, so that’s what we did. He also told us that Children’s Hospital is just a suspended hallway away where they have the best pediatricians in the world, so why worry about paying some regular office pediatrician $500 to show up for five minutes? Good advice. I think our second in 2004 was $400 or less. Coincidentally, we had the same delivering doctor for both girls, and she wasn’t our regular OB/GYN either, but from the same practice. By passing on our pediatrician on the first one we just caught who was on staff. Turned out to be Dr. Gregory Young. He’s the best pediatrician in Boston. President and CEO, Pediatric Physicians’ Organization at Children’s. On subsequent checkups we would brush elbows with Red Sox players and their wives frequently. I guess it’s better to be lucky than smart.
Hey Clot. Still have any booze connections at Red Bull Arena. Our buddy just introduced Ironbound Cider from real Harrison Apples which would make a great fit, especially for the chicks. I’ll stick with my Boddington’s.
[79] Also, as luck would have it, the practice is right across the street from Children’s hospital. We’ve had a couple incidents where we called up the pediatrician, got an emergency appointment immediately, went to our pediatrician and they called us ahead to Children’s across the street where my wife could walk our kid across in 5 minutes without even moving the car. My youngest had, on two separate occasions, a complex break in her elbow, and a complex break in her pinky finger, both involved broken and *rotated* bone parts. Both required surgery and pins at Children’s. I can only imagine how that works out if you live in Kansas.
[80] Lib – I hope your little one is doing well at CHOP in Philly. My 12 year old nephew was there as his *third* hospital, within 3 days of being born 12 years ago. (Google ECMO) They are the best!
72- Like the author of the video pts out, this isn’t some dream technology, it’s already here. Shits about to get real. First people to lose their jobs will be the legions of drivers who drive for a living. Their jobs are already gone.
Pumpy – you are just so extremely prolific, maybe you should start your on site? Someplace we can go that’s just all Pumpkin, all the time?
dick
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