Text 1537, 71 rader
Skriven 2006-06-27 07:03:46 av Bob Ackley (1:2905/3)
   Kommentar till text 1481 av BOB KLAHN (1:123/140)
Ärende: prescription problems
=============================
Replying to a message of BOB KLAHN to DAN CEPPA:

 BK>>> BTW, I blame the insurance companies, not the doctors. My doctor
 BK>>> is fine, but he is limited by the insurance companies rules. My
 BK>>> dentist even more so.

 DC>> Overall, I do too.  

 DC>> What's interesting is the prices for a procedure when billed
 DC>> through an insurance company as compared with "ala carte" 
 DC>> rates for others.  

 BK>  i've been through that. I would say about 250%.

 BK>  I have met one of the local areas premier immunologists.
 BK>  Nationally recognized. I have also met one of her patients who
 BK>  has a hereditary immune disorder, that requires monthly
 BK>  treatment. She has several with this disorder. About 2 years ago  I
 BK> helped him get a summer job, as he was in college. Back then I 
 BK> learned his treatments cost about $2000 each. Just last night I 
 BK> learned they are now about $23,000 each. I can't believe it, and 
 BK> suspect there may be an error in the reports he gets from the 
 BK> program. But, if it's true, I'll bet insurance companies have a  deal
 BK> where they pay a lot less.

You win.  On March 1, 2004, I had an emergency angioplasty with insertion
of a stent.  The hospital bill for my 3 day stay plus the procedure was $49,000
and change, of which my co-pay was a whopping $33.00; the insurance company
wrote the hospital a check for $9,000 and change and the hospital wrote off the
rest (adding it into other people's bills as overhead).  The insurance company
in 
effect wrote itself an 80% discount.  I have a major problem with that sort of
thing
(Medicare is a major offender in this regard and in fact many if not most
hospitals
actually lose money on Medicare patients - but they'd lose more if the bed was
empty),
but I don't happen to have 40 grand lying around loose to donate to the
hospital.

A little known financial factoid is the fact that if - using hospitals as an
example
but the principle is widely applicable - if a patient is able to pay all of the
variable
costs associated with his/her admission and can contribute at least a little
toward
the fixed costs, the hospital loses less money when the bed is occupied than it
would
if the bed were empty.  It'll still eventually go broke, though.  35 years ago
most
hospitals were running around 90% occupancy (there were a few occasions in
Omaha
where there literally NO unoccupied hospital beds in the city).  Ten years ago
hospitals
budgeted for 60% occupancy, today they're generally less than half full. 
Hospitals
in small cities/towns are generally *considerably* less than half full, some
years ago
the (49 bed) hospital in Hamburg, Iowa, had more staff working the night shift
than
they had patients in-house.

In 1984 I researched admissions/census of one of the Omaha hospitals for a term
paper
(at the time I was working on my BS in Health Care Administration); there was a
long-term slow decline in the average daily census, and I noted a noticeable
drop in the graph on the first of one month - that was the day an increase in
the room rates became effective.

--- FleetStreet 1.19+
 * Origin: Bob's Boneyard, Emerson, Iowa (1:2905/3)