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Santorini 
Group: Members
Posts: 2015
Joined: Nov. 2007
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Posted on: Feb. 15 2013,9:54 am |
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Its been facinating watching the live feed of the MN house Health & Human Services Finance Committee. The parties are as polar as they come and it is so incredibly, blatantly obvious its actually funny! In discussing how the new healthcare bill (Insurance Marketplace Established) and costs will affect families a Republican addressed his concerns about how the credits on this bill hurt married couples (using a family of 4 making 60K a year). That if they divorced and filed separately they benefits were greater. His concern is the financial components of the bill having the harshest impact on the middle class and those who are penalized for getting ahead and making more money (80K was the example). How this bill actually undermined marriage and family instead of supporting it by the hefty tax penalties and presented data in support of his claim. Each Dem. who chimed in were not at all concerned about their fiscal responsibility to their districts and stated if (the Rep.) wanted to waste their time let them know because they have better things to do and they would be back for the vote.
After watching this for 2 days now it it no wonder why really nothing gets done statewide or nationallyl. Some of these dems are a very poor example of any kind of leadership or representation. Parts of this bill are obviously not up for discussion no matter how much its going to cost minnestoa families!
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"Things turn out best for those who make the best
of the way things turned out." Jack Buck
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Santorini
Group: Members
Posts: 2015
Joined: Nov. 2007
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Posted on: Feb. 15 2013,11:50 am |
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Had an actuarial expert go over slides of the projected numbers by 2016.
Individual premiums will increase 15-29%. It will be a 29% increase for those individuals who do not participate in the exchange. For those enrolled in the exchange it is estimated that after the application of individual tax credits there could be a decrease of up to 30% for minimal coverage. The increases will be calculated using an income scale. They say this is a broad reform of our system while still keeping private insurance in the mix and will include alot of flucuation while people try to navigate a new system. Those individuals that are at 400% of the poverty level have more choices which will ultimately increase premiums. Some will see a $490-1700 savings depending upon income level and if they are part of the exchange. Another factor that will influence premiums is that if people dont pay their premium insurance companies still have to pay for one month which can result in a substancial loss. But again there is a marriage penalty which in essence discriminates against marriage!
So far its all guess work!
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"Things turn out best for those who make the best
of the way things turned out." Jack Buck
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| Post Number: 3
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grassman
Group: Members
Posts: 3858
Joined: Mar. 2006
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Posted on: Feb. 21 2013,2:58 pm |
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Healthcare in it's entirety is in need of a do over. Here is an article I just read. It is long but it brings to light a huge part of the over all problem.
Bitter Pill: Why Medical Bills Are Killing Us
By Steven BrillFeb. 20, 2013
When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.
Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean.
Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children.
About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent. His condition had worsened rapidly since he had arrived in Houston. He was “sweating and shaking with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was … growing. He was panicked.”
Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card. The hospital says there was nothing unusual about how Sean was kept waiting. According to MD Anderson communications manager Julie Penne, “Asking for advance payment for services is a common, if unfortunate, situation that confronts hospitals all over the United States.”
The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900.
Why?
The first of the 344 lines printed out across eight pages of his hospital bill — filled with indecipherable numerical codes and acronyms — seemed innocuous. But it set the tone for all that followed. It read, “1 ACETAMINOPHE TABS 325 MG.” The charge was only $1.50, but it was for a generic version of a Tylenol pill. You can buy 100 of them on Amazon for $1.49 even without a hospital’s purchasing power.
Dozens of midpriced items were embedded with similarly aggressive markups, like $283.00 for a “CHEST, PA AND LAT 71020.” That’s a simple chest X-ray, for which MD Anderson is routinely paid $20.44 when it treats a patient on Medicare, the government health care program for the elderly.
Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE” charge of $36.00 appeared, accompanied by charges of $23 to $78 for each of a dozen or more lab analyses performed on the blood sample. In all, the charges for blood and other lab tests done on Recchi amounted to more than $15,000. Had Recchi been old enough for Medicare, MD Anderson would have been paid a few hundred dollars for all those tests. By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.
On the second page of the bill, the markups got bolder. Recchi was charged $13,702 for “1 RITUXIMAB INJ 660 MG.” That’s an injection of 660 mg of a cancer wonder drug called Rituxan. The average price paid by all hospitals for this dose is about $4,000, but MD Anderson probably gets a volume discount that would make its cost $3,000 to $3,500. That means the nonprofit cancer center’s paid-in-advance markup on Recchi’s lifesaving shot would be about 400%.
When I asked MD Anderson to comment on the charges on Recchi’s bill, the cancer center released a written statement that said in part, “The issues related to health care finance are complex for patients, health care providers, payers and government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”
The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That’s a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.1
The president of MD Anderson is paid like someone running a prosperous business. Ronald DePinho’s total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified “financial ties with his three principal pharmaceutical companies.”
DePinho’s salary is nearly triple the $674,350 paid to William Powers Jr., the president of the entire University of Texas system, of which MD Anderson is a part. This pay structure is emblematic of American medical economics and is reflected on campuses across the U.S., where the president of a hospital or hospital system associated with a university — whether it’s Texas, Stanford, Duke or Yale — is invariably paid much more than the person in charge of the university.
I got the idea for this article when I was visiting Rice University last year. As I was leaving the campus, which is just outside the central business district of Houston, I noticed a group of glass skyscrapers about a mile away lighting up the evening sky. The scene looked like Dubai. I was looking at the Texas Medical Center, a nearly 1,300-acre, 280-building complex of hospitals and related medical facilities, of which MD Anderson is the lead brand name. Medicine had obviously become a huge business. In fact, of Houston’s top 10 employers, five are hospitals, including MD Anderson with 19,000 employees; three, led by ExxonMobil with 14,000 employees, are energy companies. How did that happen, I wondered. Where’s all that money coming from? And where is it going? I have spent the past seven months trying to find out by analyzing a variety of bills from hospitals like MD Anderson, doctors, drug companies and every other player in the American health care ecosystem.
When you look behind the bills that Sean Recchi and other patients receive, you see nothing rational — no rhyme or reason — about the costs they faced in a marketplace they enter through no choice of their own. The only constant is the sticker shock for the patients who are asked to pay.
Yet those who work in the health care industry and those who argue over health care policy seem inured to the shock. When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high?
What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? Why should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college? What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down?
Recchi’s bill and six others examined line by line for this article offer a closeup window into what happens when powerless buyers — whether they are people like Recchi or big health-insurance companies — meet sellers in what is the ultimate seller’s market.
The result is a uniquely American gold rush for those who provide everything from wonder drugs to canes to high-tech implants to CT scans to hospital bill-coding and collection services. In hundreds of small and midsize cities across the country — from Stamford, Conn., to Marlton, N.J., to Oklahoma City — the American health care market has transformed tax-exempt “nonprofit” hospitals into the towns’ most profitable businesses and largest employers, often presided over by the regions’ most richly compensated executives. And in our largest cities, the system offers lavish paychecks even to midlevel hospital managers, like the 14 administrators at New York City’s Memorial Sloan-Kettering Cancer Center who are paid over $500,000 a year, including six who make over $1 million.
Taken as a whole, these powerful institutions and the bills they churn out dominate the nation’s economy and put demands on taxpayers to a degree unequaled anywhere else on earth. In the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.
According to one of a series of exhaustive studies done by the McKinsey & Co. consulting firm, we spend more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. We may be shocked at the $60 billion price tag for cleaning up after Hurricane Sandy. We spent almost that much last week on health care. We spend more every year on artificial knees and hips than what Hollywood collects at the box office. We spend two or three times that much on durable medical devices like canes and wheelchairs, in part because a heavily lobbied Congress forces Medicare to pay 25% to 75% more for this equipment than it would cost at Walmart.
The health care industry seems to have the will and the means to keep it that way. According to the Center for Responsive Politics, the pharmaceutical and health-care-product industries, combined with organizations representing doctors, hospitals, nursing homes, health services and HMOs, have spent $5.36 billion since 1998 on lobbying in Washington. That dwarfs the $1.53 billion spent by the defense and aerospace industries and the $1.3 billion spent by oil and gas interests over the same period. That’s right: the health-care-industrial complex spends more than three times what the military-industrial complex spends in Washington.
When you crunch data compiled by McKinsey and other researchers, the big picture looks like this: We’re likely to spend $2.8 trillion this year on health care. That $2.8 trillion is likely to be $750 billion, or 27%, more than we would spend if we spent the same per capita as other developed countries, even after adjusting for the relatively high per capita income in the U.S. vs. those other countries. Of the total $2.8 trillion that will be spent on health care, about $800 billion will be paid by the federal government through the Medicare insurance program for the disabled and those 65 and older and the Medicaid program, which provides care for the poor. That $800 billion, which keeps rising far faster than inflation and the gross domestic product, is what’s driving the federal deficit. The other $2 trillion will be paid mostly by private health-insurance companies and individuals who have no insurance or who will pay some portion of the bills covered by their insurance. This is what’s increasingly burdening businesses that pay for their employees’ health insurance and forcing individuals to pay so much in out-of-pocket expenses.
Her is a link to the whole article: http://healthland.time.com/2013...t=hp_c1
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git er done!
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Botto 82
Group: Members
Posts: 6293
Joined: Jan. 2005
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Posted on: Feb. 21 2013,4:07 pm |
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QUOTE Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance.
Utterly ridiculous.
And don't start with me about how these institutions need the money. Hell, Mayo has done massive expansions, and that's just in Albert Lea and Austin. It's that, or pay taxes on all that profit.
People say, "Well, if the healthcare in country X, Y or Z is so much better, why don't you go live there?" Believe me, if I could, I would.
Greatest country in the world, my a$$... 
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Dear future generations: Please accept our apologies. We were rolling drunk on petroleum.
- Kurt Vonnegut
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grassman
Group: Members
Posts: 3858
Joined: Mar. 2006
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Posted on: Feb. 22 2013,6:35 am |
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The more I read of this Bitter pill to swallow article the angrier I get. It is 11 pages. I seen they had an article on cnn last night about this article.
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git er done!
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Common Citizen
Group: Members
Posts: 4818
Joined: Jul. 2006
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Posted on: Feb. 22 2013,8:33 am |
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And you were all duped into supporting Obamacare because of the high costs of insurance.
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Common Citizen
Group: Members
Posts: 4818
Joined: Jul. 2006
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Posted on: Feb. 22 2013,8:40 am |
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(Botto 82 @ Feb. 21 2013,4:07 pm)
QUOTE QUOTE Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Utterly ridiculous. And don't start with me about how these institutions need the money. Hell, Mayo has done massive expansions, and that's just in Albert Lea and Austin. It's that, or pay taxes on all that profit. People say, "Well, if the healthcare in country X, Y or Z is so much better, why don't you go live there?" Believe me, if I could, I would. Greatest country in the world, my a$$...
Reminds me of all the money our government spends on higher education...or education period. Our state colleges constantly have high dollar construction projects going on...during QUOTE the worst recession since the depression. Pres. Obama
Have you seen how high and how fast tuition has risen? How come we never hear about that? It makes the health care industry look like Snookie standing next to Shaq.
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grassman
Group: Members
Posts: 3858
Joined: Mar. 2006
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Posted on: Feb. 22 2013,9:58 am |
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C.C. Let's not fog the issue at hand. We are talking about health care. It is right there in black and white how we are being ripped off by health care providers. Have you read the article? Health care is something EVERYONE eventually needs. It has been turned into a boom. A good example is right in your backyard. Mayo. Have you heard how much they want the taxpayer to cough up for expansion? I know a guy who lives in Arizona, he is a retired Mayo Research and Development guy. He has been all over the world courtesy of Mayo. He told me the facilities in Arizona are better than the ones here. It is all non-profit. Really.
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git er done!
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Rosalind_Swenson
Group: Members
Posts: 1527
Joined: May 2011
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Posted on: Feb. 22 2013,10:34 am |
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So, the medical equipment industry marks up their prices and makes crazy profit on the equipment they make and sell, the hospitals jack up the price even more and make crazy profit from sending their clients insanely high bills. Pharmaceutical companies charging insane prices for medicines. Insurance companies making deals with hospitals on what they will actually pay(but still agreeing to pay insanely high prices), so that hospitals can charge ( and punish) people who do not have insurance or have "cheap" insurance.
Meanwhile, all four industries are reaping record profits, record CEO pay, slaps on the wrist when problems arise which end up with people dead, small fines with the ability to "neither admit nor deny" any wrong doing, litigation caps being put in place for medical malpractice suits. And the media too busy telling us about Snooky having a baby instead of informing us of anything important.
So what if pharmaceutical and medical equipment companies make deals with some doctors and hospitals to use their pills/equipment instead of cheaper alternatives.
At least hospitals, insurance companies, pharmaceutical companies and everything else having to do with the medical field (plus their investors) are scoring big.
So what if some families have to use all their life savings on medical treatment.
So what if some people can't afford to live.
It's making ALOT of money for some.
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And the light shines in the darkness, and the darkness did not comprehend it.
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grassman
Group: Members
Posts: 3858
Joined: Mar. 2006
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Posted on: Feb. 22 2013,10:43 am |
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 Ros!
My mother in law was just told she needed a medication for $600. Family stepped in and asked if there was an alternative. You better believe it. $19.
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git er done!
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