1. Attachments are working again! Check out this thread for more details and to report any other bugs.

Healthcare Pricing

Discussion in 'Fred's House of Pancakes' started by Patrick Wong, Feb 3, 2010.

  1. Patrick Wong

    Patrick Wong DIY Enthusiast

    Joined:
    Mar 8, 2008
    18,200
    6,474
    0
    Location:
    Green Valley, AZ
    Vehicle:
    2015 Prius
    Model:
    Two
    I'm at the age where periodic colonoscopies are required. While living in southern CA over the past nine years, I was a Kaiser Permanente HMO member so the cost of these procedures was not apparent. I just paid the nominal copayment.

    Now, having moved to AZ last summer, I have Aetna Preferred Access healthcare coverage purchased via my employer. I recently had a colonoscopy and was amazed to see the difference between "retail" pricing and the price negotiated by Aetna.

    There were three different charges, for the facility, the gastroenterologist, and the anesthesiologist:

    Facility: $1,900 original bill, $455 Aetna agreed pricing
    Gastro: $650 original, $247 Aetna agreed pricing
    Anesthesia: $665 original, $422 Aetna agreed pricing

    So, if I didn't have healthcare coverage, I would have been billed $3,215? This is crazy, when you compare to the Aetna agreed pricing of $1,124.

    In general, people who don't have healthcare coverage have relatively low incomes. Yet, those individuals are asked to pay such a high price for medical care?
     
    #1 Patrick Wong, Feb 3, 2010
  2. a_gray_prius

    a_gray_prius Rare Non-Old-Blowhard Priuschat Member

    Joined:
    Jun 13, 2008
    2,927
    782
    0
    Location:
    IL
    Vehicle:
    2008 Prius
    Model:
    N/A
    What ends up happening is that those who are uninsured get medicaid, and often times the resulting price is negotiated down.
     
    #2 a_gray_prius, Feb 3, 2010
  3. efusco

    efusco Moderator Emeritus
    Staff Member

    Joined:
    Nov 26, 2003
    19,891
    1,192
    9
    Location:
    Nixa, MO
    Vehicle:
    2004 Prius
    Model:
    N/A
    Many 'experts' suggest negotiating with the hospital/clinic before hand for a better price than the one on the 'menu'. Having never tried that myself, I'm not sure how effective that really is. But the experts claim that something like 70-80% of people are successful in negotiating lower rates.
     
    #3 efusco, Feb 3, 2010
  4. Politburo

    Politburo Active Member

    Joined:
    Feb 15, 2009
    971
    208
    0
    Vehicle:
    2009 Prius
    The base prices are all a scam, I believe. Some articles that came out during the heat of the HC debate seemed to indicate that if you don't have insurance (ETA: and don't qualify for assistance), many doctors will negotiate directly with you for a more reasonable fee.
     
    #4 Politburo, Feb 3, 2010
  5. Patrick Wong

    Patrick Wong DIY Enthusiast

    Joined:
    Mar 8, 2008
    18,200
    6,474
    0
    Location:
    Green Valley, AZ
    Vehicle:
    2015 Prius
    Model:
    Two
    All good, but who would think the retail price is 3x the price that a large insurance provider can negotiate? How much can an individual negotiate off retail: 25%?
     
    #5 Patrick Wong, Feb 3, 2010
  6. SageBrush

    SageBrush Senior Member

    Joined:
    Jun 4, 2008
    11,627
    2,530
    8
    Location:
    Southwest Colorado
    Vehicle:
    2012 Prius v wagon
    Model:
    Two
    Patrick, the real egregious billing conduct is the 'facility' fees. Google stories from Seattle if you want details. Otherwise just avoid hospital based services if at all possible. Do realize that off-site clinics can still fall under the billing umbrella of the mother hospital facility, so a telephone call is in order.
     
    #6 SageBrush, Feb 3, 2010
  7. hyo silver

    hyo silver Awaaaaay

    Joined:
    Mar 2, 2005
    15,232
    1,563
    0
    Location:
    off into the sunset
    Vehicle:
    2004 Prius
    Model:
    N/A
    What?! You have to...no, never mind. No point hastening the move of this thread to the political forum.
     
    #7 hyo silver, Feb 3, 2010
  8. Darwood

    Darwood Senior Member

    Joined:
    Feb 21, 2005
    5,259
    268
    1
    Location:
    Minnesota
    Vehicle:
    2010 Prius
    Model:
    N/A
    /\
    Socialist!!!

    :D
     
    #8 Darwood, Feb 3, 2010
  9. qbee42

    qbee42 My other car is a boat

    Joined:
    Mar 2, 2006
    18,058
    3,074
    7
    Location:
    Northern Michigan
    Vehicle:
    2006 Prius
    /\
    Fascist!!!

    :D
     
    #9 qbee42, Feb 3, 2010
  10. galaxee

    galaxee mostly benevolent

    Joined:
    Mar 14, 2005
    9,810
    465
    0
    Location:
    MD
    Vehicle:
    2005 Prius
    we were able to negotiate in some but not all cases. it ranged from 25% to 50% depending on who it was, and we found hospitals are much harder to negotiate with. in a few cases we had to delay paying the bill until they were ready to send to collections- but they offered a pretty good % off if we paid in full, so i took the deal. other times at the end of the year they would make an effort to shore up all their accounts so they offered a % off. most of this involved being way behind on the medical bills, and i really do not miss those days.
     
    #10 galaxee, Feb 3, 2010
  11. Philosophe

    Philosophe 2010 Prius owner

    Joined:
    Jun 2, 2009
    437
    72
    1
    Location:
    Montréal, Québec (Canada)
    Vehicle:
    2010 Prius
    Model:
    N/A
    Hew..... :(

    Glad I live in a developed nation (universal health care system). Also, as a citizen, I wouldn't want to pay twice as much as I do now for a system that achieves such a poor general performance (in terms of infant mortality and life expectancy: same as Cuba) (Health care system - Wikipedia, the free encyclopedia).
     
    #11 Philosophe, Feb 3, 2010
  12. Darwood

    Darwood Senior Member

    Joined:
    Feb 21, 2005
    5,259
    268
    1
    Location:
    Minnesota
    Vehicle:
    2010 Prius
    Model:
    N/A
    Keep rubbing it in!



    (PLEASE...many Americans believe the lies that our system is better than yours)
     
    #12 Darwood, Feb 3, 2010
(You must log in or sign up to post here.)