Just Plain Ruff Posted October 26, 2010 Share Posted October 26, 2010 ok, I had some pretty significant lab tests done over the past couple of months. Just got the insurance notification of payment. Total cost of tests billed to the insurance company - about 4200.00 The lab company wrote off 3600.00 of the tests due to a provider contractual agreement My insurance then kicked in and paid 530.00 of the remaining bill leaving me with a total bill to the lab company of 70.00 and some change. The question I have is this, if the lab company writes off 3600.00 of the bill just how much does the test really cost? One test in particular was 1974.00 and they wrote off the entire 1974 dollars. Did the test really truly cost 1974 or is this just the markup on the test. What makes me so pissed off at things like this is that if I didn't have insurance, I would be responsible for the entire 4200.00 bill. I'm just venting on this as I was without insurance about 1 year ago and the bills from that period of time were high. I'm still paying for the tests run back then. No wonder why the US has the highest cost of health insurance around. Venting over. but seriously 1974.00 for a single lab test. And when our baby was stillborn we had a genetic test done on the baby and my wife and that bill came to around $27000.00 for a battery of about 35 tests. Insurance covered all of that by contractual write off's and provider discounts and our co-pay and our reaching our out of pocket maximum. I know you buy insurance to mitigate your risk but aren't you just spreading that risk and cost around to those less fortunate than you? Link to comment Share on other sites More sharing options...
HERBIE1 Posted October 26, 2010 Share Posted October 26, 2010 It's not about how much the test actually costs, it's about how much an insurance company will pay for it. As we know, that cost is quite different than what they would charge someone who pays cash. Hospitals, labs, and other providers have contracts with the insurance company, so the "cost" is a relative term. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted October 27, 2010 Author Share Posted October 27, 2010 It's not about how much the test actually costs, it's about how much an insurance company will pay for it. As we know, that cost is quite different than what they would charge someone who pays cash. Hospitals, labs, and other providers have contracts with the insurance company, so the "cost" is a relative term. That's true but I made a little investigation and I called said lab company. I asked them what the cash cost of the 1974.00 test would be to me if I paid cash on the day of the test. They told me 1200.00 and some change. So the cash discount for that particular test was not bad. It makes me wonder what we are to expect from this health insurance overhaul/takeover. The "cost" of the tests I'll bet won't change but I'll bet that there won't be much in negotiated costs changing. But I'll bet that those without insurance who choose to pay cash will be hit with the entire amount due not the cash price above of 1200.00 But seriously, the question I have is this. Does it really cost 1974.00 to do a lab test? Or does it truly cost 27000 to get genetic testing done? I'm sort of thinking that it doesn't cost that much. If the provider writes off a significant amount then you can bet it doesn't even cost what the remainder due is. Just my thoughts. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted October 27, 2010 Share Posted October 27, 2010 Yeah, like Herbie said, costs are relative, and I have mixed feelings on that. One of my favorite shows ever was West Wing. It was a political/White House show for those of you that didn't see it. A liberal and a republican were talking about the death rates in Africa due to HIV/AIDS I think. One one said, "It just pisses me off that that people are dying because they can't afford to pay $1000 for a pill that cost .30 to manufacture! (I don't remember the exact conversation, but you'll see the point.) The other said, "C'mon, you know it was the second pill that cost .30. the first one cost 500 million." Do we pay way to much for everything? Sure. But the vast majority of the tests that you required were developed in the private sector. For everything they attempt to 'discover' they have hundreds, or thousands of possibilities that fail, and none of that research is cheap. Do they make billions/year? Again, of course. But they aren't going to do any of that research as a hobby. They make the breakthroughs and produce the drugs so that they can get paid. That is their primary responsibility in a free enterprise system. I finally have good insurance, and praise the Gods for it. The system is broken, and about to get way, way more broken I believe, but unfortunately it is what it is so all we can really do is get rich, or consider the insurance options offered by potential employers as a deal breaking option instead of the 'nice to have' option it used to be. Dwayne Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted October 27, 2010 Author Share Posted October 27, 2010 Right on Dwayne, yes we don't see the original cost to the manufacturer of getting it right. Consider that to bring a new drug to market it may cost of upwards of 250-500 million dollars. They got to recoup their costs somehow and that cost goes to the consumer. I agree that healthcare is broke and going to get much worse over the next years unless something is done differently and I don't mean this healthcare bill. Here is some info I got from the provider of my HSA or flex spend account. Every over the counter medication such as cold remedies, tylenol, aspirin, and many other items that you used to be able to put on your HSA card or get reimbursed for will not be paid for without a prescription. So what the feds have done now is to force you to go to your doctor to get a prescription for an over the counter drug. So now you need to call or visit your doctor to get that bottle of tylenol to be covered under the HSA plans. In addition, they have now put an extra workload on the already overworked doctors and if your doctor is like mine he has precious few open appointment slots, I am going to have to wait to get that tylenol covered. What freaking idiot thought this one through. There are bound to be more of these types of Gotcha's in the coming months. My advice to anyone who has a HSA or flex account is to make an appointment with your doctor and have a list of medications (over the counter) that you think you might need. Then have your doctor write a script out for each of those medications. Keep those scripts in a safe place in your house and then when you go to buy one of the medications on your list, you will have the script for it. Make sure you get pleny of refills on the script or you will have to go back to your doctor to get another one thus clogging up his office for this Silly and stupid new requirement. How is universal health care going to reduce our costs when we have to jump through hoops like this? Link to comment Share on other sites More sharing options...
HERBIE1 Posted October 27, 2010 Share Posted October 27, 2010 I NEVER thought Obamacare was a good idea. The same people who were shouldering the burden before will still be required to do it after this law goes into effect. As for the nuts and bolts of the plan, many of the details are still emerging- who could have possibly read through all that language to see exactly what was in that bill? Even so, most people did not want this reform, yet here it is. You don't "fix" one problem by creating another one. Problem is, as was noted by Ruff and Dwayne, it still costs tens of millions to develop these treatments and medications. If a company will be penalized for making a profit- whether or not we think that profit is excessive- why on earth will they put out the money for R&D if they will not see a return on their investment? Sorry to our friends up north, but people are not flooding Canada to get the new, best, and most promising treatments for their diseases, they are coming HERE. If we move towards a Canadian style health care system, who will pay for the innovations we so desperately need? People who need top notch medical care come here from all over the world for a reason. What happens when that reason is gone? We will have a mediocre system like the rest of the world. This is about a cradle to grave entitlement and dependency that some think is a good idea. I fail to see any long term benefit in that. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted October 27, 2010 Author Share Posted October 27, 2010 Herbie, I'll tell you who will foot the bill for the new drugs and new treatment procedures that are so desperately needed. it will be the american people who will foot the bill. The government will restrict the R&D ROI (research and development Return on investment) by decreasing the amount paid for each procedure to the point where the returns do not justify the means no matter how many people it will affect. The the government can come in and say Roche or Bayer or Teva are too big to fail so they will pump in billions into their operations, require repayment or just absorption into the government and it will no longer be Roche but Government Roche pharmaceuticals. So now the tax payer will be saddeled with even more debt. Why is it that I can't get help with my mortgage but the mortgage company can get help with it's problems. They get bailed out yet I fall deeper in debt and farther behind. No wonder why it's such a vicious political campaign season this year. Link to comment Share on other sites More sharing options...
HERBIE1 Posted October 27, 2010 Share Posted October 27, 2010 Herbie, I'll tell you who will foot the bill for the new drugs and new treatment procedures that are so desperately needed. it will be the american people who will foot the bill. The government will restrict the R&D ROI (research and development Return on investment) by decreasing the amount paid for each procedure to the point where the returns do not justify the means no matter how many people it will affect. The the government can come in and say Roche or Bayer or Teva are too big to fail so they will pump in billions into their operations, require repayment or just absorption into the government and it will no longer be Roche but Government Roche pharmaceuticals. So now the tax payer will be saddeled with even more debt. Why is it that I can't get help with my mortgage but the mortgage company can get help with it's problems. They get bailed out yet I fall deeper in debt and farther behind. No wonder why it's such a vicious political campaign season this year. You are absolutely correct, Ruff, but specifically, it will be the middle class folks who are stuck with the bill. I'm all for providing a safety net for folks who need help, but the middle class simply cannot afford any more responsibility to carry this burden. What I fear is that so many people will be carried by the middle class that there will not be enough people paying into the system to allow it to survive. I think we are there now, and it's only going to get worse. If we will have a socialistic type medical system that's fine, but there will also be a heavy price to pay. We will no longer have the best health care in the world- that type of system is simply not sustainable. As for bailing out drug companies and insurance- under this administration, that will never happen- big pharm are the bad guys. The government wants more and more control over private sector businesses- think GM- and will "punish" any firm they feel is too big. They will impose restrictions to the point where no company can sustain itself and the feds will take over. Voila- government run, single payer, universal coverage. Count on it. Do things need to change- yep, but I submit that scrapping the whole system is NOT the answer. \\end rant.. LOL Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted October 27, 2010 Author Share Posted October 27, 2010 As for bailing out drug companies and insurance- under this administration, that will never happen- big pharm are the bad guys. The government wants more and more control over private sector businesses- think GM- and will "punish" any firm they feel is too big. They will impose restrictions to the point where no company can sustain itself and the feds will take over. Voila- government run, single payer, universal coverage. Count on it. Do things need to change- yep, but I submit that scrapping the whole system is NOT the answer. \\end rant.. LOL Herbie, this is where I think you might be wrong. Big pharm and big insurance are just the groups that I think will be targeted in the next phase. Big pharm is hated so what better than to take them over and put them under the government. Besides, government always makes things better not worse right? Insurance carriers - hated too because Obama made that abundantly clear. Who better to save us from big insurance than the government and once they get rid of big insurance the government becomes the defacto saviour of the country because they are now in the insurance business and surely that's better than the free market system and capitalism right? Once the takeover of insurance is complete (think the borg) we will be dependent upon the government for insurance just like I am now dependent on the government to get a student loan. Can't get a private student loan anymore - that's not possible unless you want to pay 8-13% interest or more through a private lender. Link to comment Share on other sites More sharing options...
HERBIE1 Posted October 27, 2010 Share Posted October 27, 2010 Herbie, this is where I think you might be wrong. Big pharm and big insurance are just the groups that I think will be targeted in the next phase. Big pharm is hated so what better than to take them over and put them under the government. Besides, government always makes things better not worse right? Insurance carriers - hated too because Obama made that abundantly clear. Who better to save us from big insurance than the government and once they get rid of big insurance the government becomes the defacto saviour of the country because they are now in the insurance business and surely that's better than the free market system and capitalism right? Once the takeover of insurance is complete (think the borg) we will be dependent upon the government for insurance just like I am now dependent on the government to get a student loan. Can't get a private student loan anymore - that's not possible unless you want to pay 8-13% interest or more through a private lender. I think we actually agree on this, but differ on semantics. I don't look at what the government wants to do with big pharm and insurance as a take over, but more like forcing them out of business, or at the very least, drastically changing how they operate. Unless they cede control to the government- ala GM- they will be forced to shut down. Even if we go to single payer, government run insurance(gawd help us), there will still be a couple private carriers around for those with big money. In the socialist type, government run systems, these private carriers do exist. Problem is, most of the carriers will never be able to compete with Obamacare, and will eventually fold. Link to comment Share on other sites More sharing options...
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