Frank, did you not understand the rest of the post? Medicare causes both providers and hospitals to bill at FIVE (5) times what they would normally bill just to recover their costs. If you have insurance, look at what the insurance paid, not what was billed. You may still find it excessive, but overhead, liability insurance, etc. also add to the cost. Before Medicare, the surgeon's bill would have been around 2400 dollars an hour. Still high, but insurance and office overhead would be taken out of this. When I had my back surgery, the PA that assisted actually received 7 times as much as the surgeon who performed the surgery due to the fact that the PA was not subject to the Medicare billing rules. I am sure the surgeon received much of the money since the PA worked under the surgeon's supervision.
@Frank Sanoica to go a little deeper in the VA system, it can get quite complicated and those who use it need to do their homework. If you choose to only have part A of Medicare and qualify for VA coverage, you do not have to enroll in part B and just use the VA system. There are problems if you want to op into part B at a later date. In my case, I could have declined Part B when I turned 65 and had my health care done at a VA facility due to my disabilty rating and it being Service Connected. But I am also retired Military and have a plan called 'Tricare for Life' that covers all cost after Medicare pays their share. So, I have no deductables or out of pocket cost. This part gets kind of complicated. Any treatment I have that is 'Service Connected' I go to the VA. ( about 6 items in my case...) For anything else, I see my regular doctor. I am forunate, in the fact that someone is going to perform the treatment and I am fully covered. Now that I've totally confused everyone, including myself, I'll go back down in my hole...
Medical cost is just a rip off. Here in the D.R. hospitals are free clinics charge. My niece came down got dental work done the cost difference between Canada and here paid for her fight and two week holiday she took the bill back to Canada to get it covered. She made a good profit and free holiday. My medical expenses $0 my insurance $0 what a difference a few miles makes
@Don Alaska Guess you're right, I don't understand. "Free" costs me over a hundred bucks monthly, deducted before I get to even smell it, whether I like it or not. Free? Frank
@Don Alaska " Medicare causes both providers and hospitals to bill at FIVE (5) times what they would normally bill just to recover their costs. " Ditto again about not understanding, I guess. First, Medicare per se cannot force anyone involved to charge what they are told to. May CAUSE it, yes. What I don't seem to understand is whether these differences between amount billed and actually paid are the result of prior agreement between the parties involved or just another example of political hocus-pocus. Put another way, suppose I fail/refuse to pay some service provider, whatever the service, it is likely I will lose in the end: if a lot of dough is involved, I can lose my personal assets. In the medical netherworld it seems to be different. Therefore I conclude the provider and insuror have entered into collusion beforehand, to settle on pricing, and any litigation is prevented. Second, you keep referring to "Medicare" being involved in these decisions. How can that be at all possible when I have signed away my Medicare deduction to a private insuror, Humana? Use of that deduction then, I assume, is at the discretion of Humana, not Medicare. No? Frank
I don't know the exact number but that sounds reasonable. As the former owner of an ambulance company and director of another ambulance service, I know that we billed far more than we would have otherwise, if not for Medicare. Given that Medicare paid, at that time, 80% of the allowable costs, and the allowable costs were adjusted periodically according to the average billing for the same service or item within the region, we had to bill more than what they would allow or we would be contributing to bringing the allowable costs down for the entire region. As an example, we charged $25 for a low-dose aspirin, for which we had paid less than a dollar for the whole bottle. This was not some special EMS aspirin, but the typical low-dose aspirin that doctors often recommend for people with a potential for heart attacks. Through our cooperative, we paid less for that bottle of aspirin than you would have paid for it in the grocery store. For a while, we were offering discounts for quick payments, but we ran afoul of Medicare because someone from Medicare discovered that we were offering discounts for payments made within thirty days and considered the discounted price to be our actual price, and demanded that, despite the fact that they might take several months to pay. In order to accept direct payments from Medicare, we could not bill Medicare patients for the difference between their allowed rate and the rate that we charged, nor could we charge the patient for any services that were disallowed by Medicare. Consequently, in order to encourage increases in the allowed rate, we had to charge well above Medicare's allowed rate and, while we couldn't bill Medicare patients for this amount, we had to bill all other patients for that amount, and we couldn't offer discounts to anyone that we didn't offer to Medicare, and we couldn't require them to live up to the terms of the discount, such as a quick payment.
Only part A is free. You must also have part B. That covers (some) outpatient costs. That is what costs $100 plus per month and has co-pays. If you don't sign up for B when you reach 65, you have to have employer-provided healthcare to avoid a late enrollment penalty. It gets very complicated and changed dramatically in the 1980s because as originally set up, it was going to bankrupt the U.S.
@Don Alaska As I recall, Medicare must go back pretty far, as I believe my Dad was on it, retired in 1966. Although, I could be wrong. His last hospitalizations seemed to be covered pretty well, as I remember it. A tough, and trying time for my family. Frank
Original Medicare started under Johnson, I think. It may have been Kennedy's idea, but I believe it was implemented under LBJ. It was associated with SS, and I don't remember Part B then. I know Part B was in place and in trouble in the 1980s and made healthcare more expensive because of the way it was constructed, as I recall. It is a long story, which I won't bore people with here. If you really want what I can recall, I could send it in a conversation/PM.
So you made the assumption I want to stay with the VA because I want others to pay for my healthcare? That's a pretty insulting claim to make toward someone you don't know so you can go on a political rant. I like the care I receive at the VA better than private services. I looked up before going to the VA and found they had better outcome results on most areas of care than private providers. What I've found is they are quick, efficient, and provide evidenced based services. Plus most who work there are extremely warm, caring, and friendly for me. It just works for me better and I'm disappointed to lose it. My counselor today at the Vet Center told me veterans are less than 1% of the population. I wonder why then all veterans can't be served by the VA. I'd be happy if I could still obtain my care at the VA even if I had to pay the same costs as private providers. But Don, I served so opinionated people like you can openly express yourself and everyone can see how much people like you lack courtesy and sensitivity and decide for themselves if they want to jump on board with you or not.
Terry, I wasn't commenting on your VA status. I was commenting on your remarks about a single-payer system. That is all. As far as I know, your earned any VA benefits you have/had and deserved to have them in partial payment for your service. You are completely misreading what I am saying. The VA has nothing to do with Obamacare.
I'm pretty happy with my healthcare, can't complain. My total cost is $125 a month for Part B. So far Ive not been denied anything really. I got PT for my frozen shoulder...I'm getting a second mammogram in a year paid for because of my dense breasts and it was recommended....doing that on June 14th...ugh. My insurance actually approved paying for brand name Wellbutrin because I said generic doesn't agree with me. They paid Walgreens $1,500 dollars for 30 pills. My copay on that was $87. I took it for less than a month because I don't do well on antidepressants. They also paid for a genetic cheek swab test to see what meds I don't do well on...meaning I'd get the side effects. The results were that I don't do well on most. Of course I never had surgery or even gone to the ER so don't know how well my insurance coverage would be but I'm guessing good. So far Ive been extremely pleased. I also get $50 a month of free OTC meds and vitamins that I can order from a catalog but haven't used that yet, also haven't used my free Silver Sneakers gym membership but I plan on doing that soon. Although optometrists aren't covered I have high pressure in my eyes and that requires an opthamologist and that is covered. I take drops so I don't get glaucoma. I get a major field of vision exam every 3-6 months and so far my peripheral vision is perfect. Don't think I have dental coverage but with 4 dentists in my immediate family I don't need it. I also don't think it's about the money because even the very rich die of cancer etc. don't feel there is discrimination based on income that much. Yes, sometimes the price of meds is outrageous but usually there is some help if you can't afford it. For the most part, most generic meds are $5 copay. Even without insurance these generic drugs are cheap.
Depending on the kind of drug plan you have, if you require cataract surgery, be it laser or regular, you will be shocked at how much the eye drops cost that you use after surgery. We found out that there are three different eye drops used and each cost around $400 out-of-pocket. However, Medicare, my supplement and drug plan did take very good care of me for my left shoulder rotator cuff surgery. The surgery alone, without the rehab and meds, was around $35,000 and we only paid some $600. The rehab was completely covered and a little co-pay for the pain med I had to take after surgery. Heck, even the Ice Machine, that my shoulder was put on in Recovery and given to us, cost us nothing. From reading the Medicare benefits, only people with Diabetes can get their vision care for free.
I don't know but I think my cataract surgery will be covered...maybe not laser. My dr said so. He also,wants to do a drain in my eye when he does the cataracts so I don't have the high pressure. Not going for that...no thanks. My pressure is just fine and normal with the drops I use every day, they're prescription. Even the thought of the cataract surgery scares me...no drain for me. I don't think I'll have to pay for the $400 drops...remember I'm on widow's benefits..so limited income. I'm not diabetic either but ophthalmologist visits are covered. Before I had Medicare and was without ins I paid out of pocket for My ophthalmologist visit. $300 a visit!!