Quote Originally Posted by Lady's Human View Post
A conversation with my doc prior to minor surgery:

So, how much is this going to run?

We don't know.

Huh? It's a simple procedure, local, slice, a couple stitches, done.

Well, it all depends on your insurance co, the anesthesiologist who's used, the nurse who's used, we can't tell until it's all done how much it's going to cost.

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And therein, boys and girls, lies the problem.

A mechanic in NY state has to post their hourly rate prominently in their customer area, and has to tell you up front how many billable hours a repair is going to be.

The health care industry is under no such restrictions, even for simple exams and procedures.
There is a 'set' price list for healthcare procedures!

This is how it works.

There are two costing 'guides' that are used.

One is called the International Classification of Diseases and the other is called a Diagnosis Related Group.

The ICD is a coding guideline that is used to classify a disease/illness into a numeric format.

The DRG deals with the average cost/stay/care of a hospital stay.

Back in the late 70's an appendectomy/birth of a child was a minumum
3-4 day hospital stay. Now? I have seen appy's discharged after an overnight stay- some new moms have been sent home the same day-hours after delivering a baby.

In an HMO setting, some med centers actively discourage physicians/docs/surgeons from keeping patients past a certain time frame.

A DRG is the averaging of any hospital stay or illness.

The guvmint uses those averages to pay back the centers/facilities for services rendered.

If an appy surgery costs 10k and two days in the hospital and the patient stays in for 5 days because they had an unforseen illness/condition?

The provider has to justify the extra days/care in order to get the money from the guvmint.

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During the years I worked in the industry? I saw many cases where a patient suffered because of cost cutting measures, worries about being paid and the ineptness of staff.

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The next time anyone has a problem with billing, costs, care and other shiat in the HC industry?

Look no farther than the industry itself.

The system is set up to maximize the profits and needs a reform like no one's business. The Health Care Initiative is a joke and the prez of the US should be ashamed of passing that bowel movement and making us believe that it's for the common good.

The system needs to be dismantled, there has to be caps on malpractice insurance and jury awards .

There is a local commercial where a woman tells the story about her husband passing from mesothelioma. Her quote is "the asbestos fell from the sky, like snow..." She goes on to praise the law firm that got her a HUGE settlement.

Lady,
Your husband literally killed himself to give you a house and to feed you while he was alive.

Now you want to make MORE MONEY off his death.

She'll get a nice settlement, the lawyers get paid and the workers get their insurance pulled because the company can't afford to cover the workers.

Brilliant.