I've been in the healthcare business for nearly 20 years. The company I currently work for works with hospitals to collect money from patients upfront before service or at time of service or enroll the patient in an extended payment plan that we administer. Almost all hospitals have something similar. If the patient's credit is decent, many financial companies will upfront the money to the hospital and let the patient make payments with interest. This is after the patient has been screened for the hospital's charity program. When I hear of a patient who is not being treated without upfront payment, it makes me wonder if the patient has previous bad debt at that facility and hasn't made an attempt to resolve it. My point is stories like this often do not provide all the details. They are written with an agenda in mind. Most hospitals carry way too much bad debt and it is the paying customers that pay the price.  

As a doctor, I find this author's attitude infuriating.

If I were to walk into a store and pick up a gallon of milk and walk out with it, without paying, I would be arrested.  Yet people think that they can take the risk of not having health insurance, because they "have other expenses" - skiing, 4 wheelers, as mentioned above...
Then, if something happens to them, it is the doctors' responsibility to take care of them.  Sure, just have the doctors and hospitals pay for it...

Medical care costs money.  Physicians like myself have rent, nurses and staff, equipment, malpractice insurance, and hundreds of thousands in debt, procedures, laboratory tests, and radiographic studies that we are responsible for.  That doesn't even start to include the money that you are supposed to be paying me for my medical expertise, expertise that I spent years to obtain, at the sacrifice of family, friends, and other aspects of my personal life.  Hospitals have many more expenses.  But according to the above article, and very common attitudes, I should be treating you for free.

Something about that doesn't make sense.  

I believe that people need to know that insurance is usually ONLY buyable while you are healthy.  The gal who doesn't buy it because she is healthy could find herself in an awful mess if anything happens while she is uninsured.  Once she has a problem, Insurers are going to decline her, rate her up, or waiver coverage of any condition presen when she applies.  I realize health insurance is becoming outrageously expensive, but even the poor could take a really high deductible and coinsurance.  If you were running up a $100,000 bill and owed Deductible and Coinsurance of $5000, chances are the hospital and physicians would work with you because they are going to get the other $95,000 from your Insurer.  Your rate will be low because of the large Deductible.  Everyone should be serious about having catastrophic insurance.  If your Employer doesn't offer insurance, then get out there and buy your own private plan   Hospitals and physicians DON'T work for nothing, DO YOU ?????

I agree with the article and I agree with some of the responses - BUT WHAT WE REEEALLLLLY NEED IS TO STOP GIVING FREE-BEES TO ILLEGAL IMMIGRANTS!!!!!!! HELLO!

Lack of insurance is often not the fault of the individual. I'm 41 years old, haven't been to the hospital in 20 years, don't smoke, have no medical condition, and take care of myself. In spite of this the least expensive full coverage health insurance I've found is over $400 per month! My business loan and my house payment are the only expenses that I have that cost more than that. Even when I tried to shop for high deductible major medical insurance it was a maze of weird requirements, exlusions, screenings, and one company even tried to make me pay for my own physical! They wanted me to pay for their screening process!
I have accident and disability insurance and they were easy to get. No problems. I've even filed a couple of claims on the accident insurance and it was no big deal. Even insurance with a $5,000 deductible had an endless number of hoops to jump through and was going to cost me more than my car note is every month, forever, even if I never used it.
Insurance companies are making record profits right now, not record sales, record PROFITS and while I'm all in favor of businesses  making a profit, I'm not in favor of this happening at the expense of everyday people who do without necessities in order to allow some executive the ability to make another yacht payment.

The responders are absolutely correct.  Let the poor die and there will be more for the rest of us.

You know what...I LIKE the idea of paying up front.  Most of the time, when you go in to a hospital, you are implicitly telling them: "here, fix me up, then send me a bill for whatever you want".  Basically, hospitals never tell you up front how much something might cost.

To the outraged Dr. Perrien...  I see your points, but let me extend your analogy a bit further...When you go to a store to get a gallon of milk, the price is clearly labelled BEFORE you but it, and BEFORE you walk out the door.  So the consumer has enough information to intelligently decide if they can afford this purchase.

Hospitals, on the other hand, hand the milk to you, then tell you to take it home and wait for the bill to arrive.  A few months later, after you already drank the milk, you get a notice saying that the milk actually costs $550/gallon.  Does that seem like a resonable or fair way to conduct business?

Don't get me started on everything that is wrong with our healthcare system!  I am even more disappointed in the comments by the Dr.  It begins with the FDA, goes right through the AMA and the drug companies are as crooked as they come.  Finally, because the health insurance carriers are squeezing the hospitals now they want to squeeze us.  Let them just try to turn away an illegal whose haveing a baby - the ACLU and the lawyers would be all over that one.  Of course, we can treat our own like dirt and no one cares.  We had an employee who was in the hospital recently.  He has health insurance but when it came to his coinsurance which equaled only about $3600.00 , the hospital refused to work with him on payment and told him if he couldn't pay the amount they wanted, then he could just wait for it to go to collections and they could work with him there.  
Why is it I can go to a dentist and if someone needs alot of work , they offer you a plan, much like a line of credit or a credit card so you can set up a payment plan right away.  (By the way Doc, cars and houses work the same way - very few of us pay for those things in cash and in full before we move in or drive them off the lot)  It is a sad sad day in our country.

If you follow the link in the aricle to the original video, there is a VERY telling comment at the end.  

As it turns out, the patient described in the article DOES does have the money.  She could pay her bill in full if she liquidates her retirement fund.  But she doesn't want to do that.

So there you go....She made her own choice.  She values her retirement fund more than her health.

Look...the healthcare system is definitely messed up, as I expressed in an earlier post, but this particular woman decided that she DID NOT WANT to pay, even though she could.  Basically, she decided that she didn't need to buy health insurance, and she would instead set aside money in her retirement plan instead.

I find it very frustrating that Eve (the author) did not address the fact that this woman DID have the money, but simply did not want to spend it.  Eve, did you think that little nugget didn't matter???

One Business Owner's Thoughts:

My wife and I do not pay for "sponsored" health insurance.  By sponsored, I mean a pool of money to which we have limited access, and only for health care.  The author says my wife and I are "living on the edge".

No, we've made what's called a "financial decision".  For the most part, we only purchase insurance that is either
- required by law (e.g. the minimum levels of car insurance required by Virginia), or
- required by contract (e.g., liability insurance required by a project I commit my engineering company to).

I pay for a sponsored health insurance policy for my employee and his family.  But I do this because we were able to settle on the policy he wants and I get a tax break, as opposed to just paying him the extra money so he could purchase it.  My employee understands he is really the one paying for his insurance in the form of a reduced wage.  This is the fundamental reality of sponsored health insurance which is glossed over or ignored by those pushing for mandates and/or tax incentives.  Reaching their goal requires a moral crusade to overcome most citizens' sense of liberty and personal responsibility.  And no crusade is complete without a bad guy.  Labor groups point to corporate ownership or management.  This article points to health care providers.  (And it seems virtually everyone ridicules folks like my wife and I, who are so naive, reckless or socially irresponsible as to actually decide not to buy even that level of sponsored insurance we can fit in our budget.  And let's face it, almost everyone can fit some level of insurance in their budget.  The trick for those pushing mandates for sponsored programs is keeping the perception of the "minimally-required" amount of insurance above what most folks can easily acquire.)

I suspect most insurance professionals would consider my wife and I to be vastly underinsured, particularly as a business owning family who can afford some level of sponsored insurance.  But we happen to view most sponsored insurance as a bet on failure.  Government should treat our judgement on this matter in a neutral fashion.  Should my wife or I become seriously ill, we have some money in the bank and various investments.  Should that money run out, we would take out a mortgage on our home or attempt other means to secure a loan.  Should that not suffice, we will swallow our pride and beg our family, friends, church or neighbors.  If that doesn't raise the money, or the ailment can not be cured no matter how much treasure is expended, I hope we will face reality with faith in God and Jesus Christ.  In other words, I hope we'll do what believers have done for centuries when calamity strikes.

What I hope we won't do is try to get a hospital or anyone else to provide a service for free or at reduced cost.  Hospitals are businesses, even those that are non-profit.  Expecting any business to provide free service is akin to expecting their employees, suppliers or subcontractors to do so.  And labeling a hospital's requirement for upfront payment as a "draconian" action abuses the concepts of trust and charity.

This article looks like so much of the so-called "news" in this age:  Simple facts of life are presented in such a way as to amplify the sense of crisis over some aspect of our temporal existence on Earth.  A spiritual battle has been raging in this world since Adam's time.  I submit this article only plays into the hands of the bad guys.  I'm not accusing the author of being in league with Satan, but I suspect he'd approve the intellectual tactic she employs.  The more we're frightened of the realities of our physical existence, the more energy we'll focus on protecting that existence.  This means less time and resources for, and ultimately less reliance upon, God.  Instead, we'll hand over more responsibility, time and resources to another manmade system.  I believe this is how past generations were talked into Social Security and the other welfare/entitlement programs we struggle with today.

In my opinion, America is a blessed, successful and charitable nation.  I whole-heartedly include our health care industry in that assessment, including our hospitals.  I just happen to believe we've received these blessings in spite of "progressive" government programs, mandates and enticements, not because of them.

Eve Tahmincioglu has an agenda.  Stories like these have been appearing ever since NFIB changed to support of nationalized health care. I read the Wall Street Journal article she writes about here. I came away with a very different opinion.  There is no doubt that the price of healthcare and health insurance is painfully high for the small business.  I still think cost shifting for government underpayment, state mandates for what employers have to include in coverage (overutilization anyone?) and free healthcare to uninsured is driving fees and premiums through the roof.  It is always somebody else who should be responsible for the bill.  

I have a perspective I haven't seen expressed.  I have virtually always been uninsured or under insured.  This is not all bad.  It motivated me to take a much greater interest in maintaining my good health by acquiring as much knowledge as I could about the human body and how it functions.

I am 67, take no prescriptions for anything, haven't had a cold or influenza since 1984, and since 1990 have been teaching others how to be similarly free of respiratory viral disease.  Had I been well enough insured that it would not have posed a hardship to be attended by a physician, I might never have developed a prophylactic procedure to prevent clinical respiratory disease.

Prior to the visit to the optometrist and ophthalmologist last year, who confirmed my assessment  that I had cataracts, I hadn't seen a physician for more than two decades.  Not in 1992, when I had a rapidly growing neoplasm, and not for the stroke I had almost three years ago.

I'll be talking more about cataracts soon on my blog and a few other sites, so I need not elaborate about my activities to extend the time before cataract surgery is required.  Currently, the intra ocular lenses which would work out best in my situation require an out-of-pocket expenditure of $2000+ PER EYE.  As patents get closer to expiring, that will change, or Medicare may eventually  elect to pay some additional portion of that cost.  The problem is, there is no way of predicting when.

I have some perspectives which differ from some of the posters above, but if I am to argue a point, I like to do so in a venue which does not shy away from a certain vigor in expression.

So I am going back to my blog, which I have been neglecting for a while.  Those with cataracts, especially, should find my posts thought-provoking.  And for those who wish not to get colds and flu, hunt around the archives a bit.  The information is there.  Or Google Anthropositor.



My point is, most of us can become much more self-reliant with regard to our health and well-being than we are.

 

I couldn't believe some of the comments on here, particularly from the MD's themselves. Has the medical system changed so much that Doctors take an oath to ensure profits, in front of a photo of Ayn Rand?

I mean, yes---docs--we certainly do expect you all to make money. However, you are now working with a smaller pool of people who can afford treatment. There is a much smaller piece of the pie for you all to share.

I suggest a reality check; our medical system has turned into quite the little elitist establishment. How embarrassing for this country.

The bottom line is that we wouldn't be having this discussion if we lived in the European Union or Canada or Australia or New Zealand... or even Costa Rica.

People in other western nations all have health care- and almost all of them score higher on leading public health indicators than the United States, despite spending substantially less money than we do.

And their citizens don't end up going bankrupt, losing their homes and retirement income when a family member is injured or has to be hospitalized for an illness (which happens all too often even though one has paid many years for insurance).

America really is exceptional in that regard.

So, if you don't have the money, you should just die?!  My, we aren't far out of the caves are we?  Doctors should beware. This type of treatment will get us to single-payer health care than any lobbying or hybrid plan.  It's coming, but it's coming slowly. Doctors in most other countries do not make the kind of money you do.  Keep pushing and you will get a drastic pay cut as we start to truly manage our health care.

I work for a small business that does not provide health insurance.  I went online to find help with the cost of my meds.  At www.rxdrugcard.com I found a prescription discount card that costs me only $4.50 a month.  They have their drug prices posted to check before you enroll.  Anyone can have this card.  They don’t ask about age or income or pre-existing conditions.   All the major drugstore chains accept RxDrugCard.   Wouldn’t it be great if small business owners bought this plan for their employees?

The health insurance problem is an epidemic and is spreading rapidly.  As an Insurance broker we often stuggle to get the necessary group enrollment even with the employer offer to pay 80 even 100% of the employees health insurance premium.   The reason... "well with the health insurance we would have a deductible.  I can just give a fake name and social security number and not have to pay anything."

I am dead serious about this reponse.  We hear it more often then not and in many cases it keeps companies from getting group coverage as it can't meet participation levels.

This attitude will continue to keep health insurance costs skyrocketing.  It is time to start holding eveyone accountable.  Not just the few who struggle to pay their bills and be resposible.

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