New MEDICAL BILLING concept: PAY the Patient for processing time !

[RJSV]

   Time to rethink the whole aspect of a passive patient,  often navigating endlessly (stupid) systems.
   After all,  the HMO and Medicare crowd has 'thought up' scheme after scheme,  many making cash money,  hand over fist.
They PAY a patient,  now,  to 'Be Well', ...even calling that a 'wellness' transaction.

   I realized the advantage,  for the patient already spending hours and hours,  (if they have the competence to do the proper paperwork).  BUT,  ironically,  THAT word;  'Advantage' is taken,  as trademark for...well,  a 'wellness advantage.

   Now,  my current situation is only given for example,  (not asking for medical sympathy.)
Quit the current medical 'insurance' and replaced that with another...that was 5 months ago,  June 1,  but nobody seems to have taken notice.   Between the 3 or 4 various case 'managers' I'm never sure who needs to approve things,  who gets my monthly due, etc.

   I suppose there are NINE offices that would, technically,  'need to know' (that they've been dropped, or switched to the other insurance).
I guess,  technically,  it's myself that has to,  trudge over to each separate office,  and copy them my NEW CARD.

   But especially vexing,  is the ones I DID tell...they are just as clueless.

How could this be ?  I'm thinking,  in such a serious field,  having such chaotic management.   I've started hitting down the hours,  two hours easy,  but that was just with one letter / bill ($10).
THAT one went straight to collections, lol.

   So I'm thinking,  in corruption so thick you could slice it with your plastic, medical plan card,  why not PAY a patient for managing their own,  confusing pile of bills and notices.

  Because,  you see,  I'm also a
'attempting' to recover a couple of bills,  retroactively,  paid before the notice came.
Good luck there,  I'm thinking,  as I will need to get the old guys,  to reverse their billing,  and bill by way of the the 'new guys',...a completely separate private,  for profit org.


"No problem,  our office handles everything". The office worker had said...(I think that was July).


- - - Rick B.

[tom66]

Or -- this sounds a bit crazy so hold on...

We have some kind of national health system.  Or service.  All taxpayers contribute, and if you get ill, the doctors, nurses and other professionals that are paid by that system will look after you.

That means if someone falls on hard times, loses their job because of their illness, they'll still be looked after the best we can.

Probably won't ever happen so we'll have to deal with the corporate hell of healthcare insurance, I guess.

[krish2487]

Or -- this sounds a bit crazy so hold on...

We have some kind of national health system.  Or service.  All taxpayers contribute, and if you get ill, the doctors, nurses and other professionals that are paid by that system will look after you.

That means if someone falls on hard times, loses their job because of their illness, they'll still be looked after the best we can.

Probably won't ever happen so we'll have to deal with the corporate hell of healthcare insurance, I guess.

But... but... why should my taxes and insurance pay for someone elses medical care
/sarcasm in case it wasnt obvious...

[Analog Kid]

Well, you Yurpeens can joke all you want. Just be glad you don't live in the "land of the free and home of the brave", where we have to put up with the goddamndest stupidest Frankensteinian excuse of a "health care system" where you're free to starve to death and live out on the street if you have the misfortune of running up sky-high hospital bills not covered by insurance ...

Cuba would literally be a better place in that regard.

[wraper]

^The fun part is that US government still spends money on this "free market" healthcare system. Actually more money per capita than (wealthy) EU countries with free healthcare.

[Analog Kid]

^Yep. "Obamacare" was custom-designed by the insurance and pharmaceutical industries.

U-S-A!

[SiliconWizard]

Apparently, some people have jumped on a few keywords, but I for one am not sure I got Rick's point. It's confusing.

[jpanhalt]

Does Rick have a point?  Is this just trolling?

Medical reimbursement/insurance/billing in the US is a mess that began with LBJ's approval of Medicare on June 30, 1965.  I dealt with it first hand until 2006.   It was supposed to make medical care "more affordable."  What it really did was the opposite.  It turned America's first class medical care into a commodity.

Anyone who wants to self-pay ends up paying 3 to 4 times what is reasonable.  Your copays are a significant portion of what the caregivers actually get.  Insurance companies became rich.  Government bureaucrats extended the "insurance" to individuals who paid almost nothing in to buy votes.  Office expenses for billing exploded.  Now, a small physician group of 2 or 3 needs three people just to handle billing that used to be done by a part-time person.

Most important to me, diagnostic innovations are inhibited because reimbursements for new methods are de minimis.  Big diagnostics companies are in control.  Our regulations favor older and antiquated methods by controlling reimbursements based on method used rather than utility of results.

I don't see the point of this non-technical thread.  It's not unlike the currently popular thread on a humanoid robot.  Yes, I reported it, but seeing no action, I decide to respond.

[Stray Electron]

Well, you Yurpeens can joke all you want. Just be glad you don't live in the "land of the free and home of the brave", where we have to put up with the goddamndest stupidest Frankensteinian excuse of a "health care system" where you're free to starve to death and live out on the street if you have the misfortune of running up sky-high hospital bills not covered by insurance ...

Cuba would literally be a better place in that regard.

  Feel free to move to Cuba.

[Analog Kid]

Well, you Yurpeens can joke all you want. Just be glad you don't live in the "land of the free and home of the brave", where we have to put up with the goddamndest stupidest Frankensteinian excuse of a "health care system" where you're free to starve to death and live out on the street if you have the misfortune of running up sky-high hospital bills not covered by insurance ...

Cuba would literally be a better place in that regard.

  Feel free to move to Cuba.

Their medical system is actually superior to the US's in significant ways.
Even better when you factor in their extreme disadvantages due to continuing absurd sanctions.

Watch Michael Moore's Sicko for more details.

[EEVblog]

Or -- this sounds a bit crazy so hold on...
We have some kind of national health system.  Or service.  All taxpayers contribute, and if you get ill, the doctors, nurses and other professionals that are paid by that system will look after you.
That means if someone falls on hard times, loses their job because of their illness, they'll still be looked after the best we can.

That system sounds rather familiar to non-US people...

[Stray Electron]

Well, you Yurpeens can joke all you want. Just be glad you don't live in the "land of the free and home of the brave", where we have to put up with the goddamndest stupidest Frankensteinian excuse of a "health care system" where you're free to starve to death and live out on the street if you have the misfortune of running up sky-high hospital bills not covered by insurance ...

Cuba would literally be a better place in that regard.

  Feel free to move to Cuba.

Their medical system is actually superior to the US's in significant ways.
Even better when you factor in their extreme disadvantages due to continuing absurd sanctions.

Watch Michael Moore's Sicko for more details.

    You must be a complete idiot to believe anything that Michael Moore is pedaling!

   If the medical system is your only concern then you should be very happy in Cuba, but I've lived in four different countries including one with socialized medicine and I'll be staying the U.S. even with the absurd medical costs. 

  Bon voyage and let us know when your banana boat to the People's Paradise is due to set sail.

[Analog Kid]

You must be a complete idiot to believe anything that Michael Moore is pedaling!

What? I thought he was too fat to ride a bicycle.

[SiliconWizard]

I think to objectively judge a health system, one should use objective figures, like the global health of people in a given country, life expectancy, and so on. Not necessarily an easy task, because we can be tempted to compare oranges and apples.

But it's very often judged based on purely subjective points, or by taking a few examples here and there and making them a generalization. We tend to think of the US system as pretty bad, but I haven't seen blatant evidence that the global heath of americans was much worse than in other countries that are thought much "better" in this area (and I'm not talking about health issues due to bad eating habits, which is a real problem, not just in the US, but in particular there, and that has little to do with its health system per se). It's often thought that if you're poor in the US, you must have horrific health because it's just too expensive - but probably people should look at other countries where it's thought to be better and see if poor people there are better off. It's not completely obvious, objectively. It's just different approaches, that don't necessarily lead to a hugely different result. What's true though, as wraper mentioned, is that the US actually spends a lot more money for health than almost any country in the world, for a questionable benefit. That doesn't make it hugely worse than others though. Things are getting pretty bad progressively in Europe as well, so soon enough, I'm not sure we'll be able to give lessons to the US in that area.

As to Rick's musings, I still don't know for sure. I sense that he's kind of annoyed with the bureaucracy of it all, mostly, but again, still confused.

[wraper]

^For example, US is the worst in people rationing insulin by a huge margin (which is very dangerous, some die doing so) https://pmc.ncbi.nlm.nih.gov/articles/PMC11070566/#:~:text=Insulin%20rationing%20was%20reported%20by,and%20Canada%20(Figure%203B).
Also I don't know any other country where people are afraid of calling ER or go broke after doing so.

Insulin rationing was reported by 21.2% of participants across the US, Panama, India, and Canada, and by no participants in Sweden, the UK, or Germany (Figure 3B). The US had the highest percentage of participants rationing insulin at some point over the previous year, followed by Panama, India, and Canada (Figure 3B). The frequency of insulin rationing varied across the four countries. No participants from Canada rationed more often than yearly and no participants from Panama rationed more often than monthly, while participants in the US and India rationed weekly or more (Figure 3B; Supplementary Data 2, Supplementary Table 4A).

[Halcyon]

I don't see the point of this non-technical thread.  It's not unlike the currently popular thread on a humanoid robot.  Yes, I reported it, but seeing no action, I decide to respond.

I did see your report. I'm in two minds about locking/removing it.

I think robust discussion is important, even if it is off-topic. The thread might also arguably comply with the "occasional off-topic allowed" rule. Not sure what the other mods think?

[Zero999]

Whilst I generally think pubically funded healthcare is a good idea, our failing NHS isn't much good either. The main excuse provided by the mainstream media is lack of funding, but its budget keeps increasing. I doubt the amount of money wasted on pointless training courses, health tourism, providing interpreters for those who don't speak English, unproven treatments, corruption etc. is accurately reported.

[tom66]

Whilst I generally think pubically funded healthcare is a good idea, our failing NHS isn't much good either. The main excuse provided by the mainstream media is lack of funding, but its budget keeps increasing. I doubt the amount of money wasted on pointless training courses, health tourism, providing interpreters for those who don't speak English, unproven treatments, corruption etc. is accurately reported.

The problem with the NHS is the same problem every healthcare system will face.  As the population grows older and more complex diseases occur, and complex treatments for these become available, it costs a lot more to manage those.  Alzheimers for instance usually causes repeated hospitalisations because of falls and seizures.  30 years ago, someone in that condition would live a shorter life for many reasons and so the impact they could have on the health system was minimal. We also have the impact of obesity which has peaked somewhere around 2022 (lots of hope that GLP-1 antagonists may reduce this, but early days.)  Obesity causes a lot of problems like arthritis and heart disease before it kills someone.

All of this talk about DEI managers and health tourism and all that is missing the point that the medical staff budget of the NHS has increased ahead of inflation as the population is getting sicker faster than the economy grows.  There's definitely mismanagement but it's a small part of the problem compared to the population.

[themadhippy]

The biggest waste of money in the nhs is the multiple layers of management. 4 electricians don't need 6 charghands  and managers

[jpanhalt]

^For example, US is the worst in people rationing insulin by a huge margin (which is very dangerous, some die doing so) https://pmc.ncbi.nlm.nih.gov/articles/PMC11070566/#:~:text=Insulin%20rationing%20was%20reported%20by,and%20Canada%20(Figure%203B).

That report equates paying for something (out of pocket expenses) with rationing.  That means gasoline, food, and everything else a consumer buys is "rationed."  Personal responsibility doesn't quite have the same zing  as "rationing." 

How about looking at how long it take to get cataract surgery?  Spain is 6.2 months  (ca. 188 days )(https://pmc.ncbi.nlm.nih.gov/articles/PMC1857690/ ).  The US is about 14.4 weeks (101 days).  NB: The effects of COVID were different  depending on country   In England, some areas reported waits of 18 months; in the US, waits may actually have decreased in some areas.  Those  numbers given above presumably were not affected by COVID.

[Zero999]

Whilst I generally think pubically funded healthcare is a good idea, our failing NHS isn't much good either. The main excuse provided by the mainstream media is lack of funding, but its budget keeps increasing. I doubt the amount of money wasted on pointless training courses, health tourism, providing interpreters for those who don't speak English, unproven treatments, corruption etc. is accurately reported.

The problem with the NHS is the same problem every healthcare system will face.  As the population grows older and more complex diseases occur, and complex treatments for these become available, it costs a lot more to manage those.  Alzheimers for instance usually causes repeated hospitalisations because of falls and seizures.  30 years ago, someone in that condition would live a shorter life for many reasons and so the impact they could have on the health system was minimal. We also have the impact of obesity which has peaked somewhere around 2022 (lots of hope that GLP-1 antagonists may reduce this, but early days.)  Obesity causes a lot of problems like arthritis and heart disease before it kills someone.

All of this talk about DEI managers and health tourism and all that is missing the point that the medical staff budget of the NHS has increased ahead of inflation as the population is getting sicker faster than the economy grows.  There's definitely mismanagement but it's a small part of the problem compared to the population.

Lifespan also hasn't increased that much since the industrial revolution, once reduced infant mortality has been taken into account.  The main reason for our ageing population is a reduction in birth rate. I don't buy into the ageing population argument. Japan's health system is far superior and they have a much older population.

You have a point regarding obesity, but are way off the mark about pharmaceutical products being the solution. We didn't have that problem 50 years ago. It's a lifestyle problem.

DEI and health tourism are only part of the problem. Massive amounts has been wasted on unproven treatments and corruption (our regulatory bodies are very much in bed with big pharma) but we'll never know how much.

[wraper]

How about looking at how long it take to get cataract surgery?  Spain is 6.2 months  (ca. 188 days )(https://pmc.ncbi.nlm.nih.gov/articles/PMC1857690/ ).  The US is about 14.4 weeks (101 days).  NB: The effects of COVID were different  depending on country   In England, some areas reported waits of 18 months; in the US, waits may actually have decreased in some areas.  Those  numbers given above presumably were not affected by COVID.

If you're willing to pay out of pocket, you can get it in a week, most likely for less than a co-pay of US health insurance.

That report equates paying for something (out of pocket expenses) with rationing.  That means gasoline, food, and everything else a consumer buys is "rationed."  Personal responsibility doesn't quite have the same zing  as "rationing."

Dunno how you came up with it , quote please. Did you just read nothing more than the title and figure out so? Literally in the first sentence:

Continue investigating Out-of-Pocket Expenses (OoPEs) and rationing of insulin and diabetes supplies.

[jpanhalt]

My father was a generalist physician.  He was drafted at the beginning  of WWII and spent the duration.  After his discharge in 1945, he started his practice from scratch.  It was part of our family, so I can't avoid comparing 1950's medicine to the current situation in the US.

Here's what Google AI said:

In the 1950s, the average American spent a much smaller percentage of their family income on medical care than in 2020:
1950s
In 1955, the average American spent 4.1% of their disposable personal income on medical care. The average American spent less than $100 per year on medical care, which is about $500 in today's dollars.
2020
In 2020, the average employee's total out-of-pocket medical costs (premium and deductible) were 11.6% of the median household income.
Healthcare costs have been increasing over the past few decades, relative to the size of the economy. In 1962, healthcare costs were 5% of GDP, and by 2022 they had increased to 17%. The COVID-19 pandemic made the trend of rising healthcare costs worse.

What changed?  As mentioned previously, in 1965 America embarked on nationalization of medicine.  Today, individual self-pay is non-existent, and one must navigate  a web of bureaucracy and regulations even with private insurance.  Reimbursement is set de facto by the government and is  unrelated to actual charges.  The cost of bureaucracy is heavy and is not unique to America's broken system.  Even "single-payer" systems like the NHS have burdensome bureaucracy.

Worst of all, access to care has diminished.  How many physicians still make house calls?  My dad did almost every night, including weekends.  Wait times were minimal.  Today, one's more likely to see physicians work in shifts and pass patients off to others when "their shift is over."  There is supposed to be communication when that happens, but that step is often broken.  Of course, we can't go back to the good old times, but I simply can't blame the dedicate providers for the mess.   Creating more bureaucracy is not a solution.

[asmi]

(and I'm not talking about health issues due to bad eating habits, which is a real problem, not just in the US, but in particular there, and that has little to do with its health system per se).

Actually it kind of does - when government gets to pick up the tab, it has a vested interest in making sure the population is healthy, and so it's much more willing to invest money into various programs to improve it - from propaganda of healthy lifestyle to ensuring there is required infrastructure in place for maintaining that lifestyle (parks, gyms, emission controls, etc.), and limiting or even outright banning the most dangerous GMO garbage that for some reason is called "food" in US and is sold as such, when the most natural part of it is the paper it's wrapped in as opposed to whatever is inside.

[Analog Kid]

The problem with the NHS is the same problem every healthcare system will face.  As the population grows older and more complex diseases occur, and complex treatments for these become available, it costs a lot more to manage those.

Yes. Blame the inverted population pyramid (a global problem, BTW).