Greed by Medical Practitioners & Arbitrary Bureaucracy in Healthcare

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Permalink Reply by Steve Stuck on August 18, 2009 at 9:30am

Blaming high medical costs on "greed" is like blaming plane crashes on gravity. Sure the plane comes down due to gravity, but what causes the accident? You should look into why costs are high for medical procedures.

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Permalink Reply by Michael R. on August 18, 2009 at 5:30pm

The doctors aren't the problem in the grand scheme of things. My father, who was an OBGYN for over 25 years had to hang up his practice because his malpractice premiums were obliterating his salary. To act like doctors are making money hand over fist is simply a matter of being uninformed.

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Permalink Reply by Pete Manzelli on August 19, 2009 at 6:32pm

Could not agree more.....Regardless of what medical practitioners charge, they will most likely write-off more than 50% due to declining reimbursement from insurance companies. At the same time, the costs of providing these services continues to rise....MD's & other health care providers are not making nearly as much $ as people think.

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Permalink Reply by Ben McCann on August 20, 2009 at 12:50am

@ Michael, that is one of the reasons we need TORT reform, the crazy frivolous law suits and sick pay outs don't help anyone, except the ONE PERSON who wins that case and the Malpractice Insurance Companies who rake in the profit.

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Permalink Reply by Ben McCann on August 20, 2009 at 1:26am

Response to questions:
1.) Greed is in every area of business in every industry, it is often discussed. Many providers try to UNBUNDLE services and then bill each item seperately to get more money thus raising the costs for everyone. ( i.e. instead of billing for HIP REPLACEMENT CODE, they bill line items for everything that goes into a hip replacement ) The insurance companies and TPA's have wised up and have UNBUNDLING programs that identify the codes that add up to a HIP replacement and pay for the hip replacement and tell the provider "nice try" thus keeping the costs down for everyone. This practice is rare and few providers actually get away with it, many times they are dropped from networks like Sagamore, Anthem, PHCS, etc... if they keep it up. This question & ensuing statement are emotionally based and not factual because GREED and people trying to cheat the system is discussed at length at almost every level of the healthcare industry, those who work in this industry know this... words like "ever discussed" show ignorance of the industry, the question is followed with a statement that is clearly vague... care to expound?... before you do, here are a few things to consider:
1. If a doctor is going to provide or recommend a treatment or service that is not covered by your insurance, then he or she has to notify you in writing and you have to sign off on it. you have the right to refuse to sign off, read the forms you fill out at the office, ask questions and don't be afraid to "not sign". or find another provider. All providers have a PATIENTS BILL of RIGHTS like THIS ONE
2. If he bills you for something that wasn't covered and you didn't sign off on it.. you are not liable for paying it. When you know the rules, you can tell them to shove if you get billed... the doctor doesn't usually even know what the billing is going to be, let alone what the cost is. So blaming providers for Greed is like pointing out about .0001% of the problem, which is probably why it doesn't get talked about as much as the other stuff, you know, the important stuff like the 85% of total costs are claims and over 50% of those costs are avoidable by lifestyle and behavior choices.
3. MEDICARE ( our nations lovely social insurance program ) is the primary determining factor of APPROVED and ALLOWED CHARGES and all other private insurance mainly follows suit. Since our Government Controlled messed up MEDICARE system had 25 years of non closely held cost containment mechanisms in place, coupled with the fact that it was literally designed part B over night as part of an "unexpected ways and means committee" meeting, with NO ACUTARIAL STUDY or DUE DILIGENCE DONE: ( see PAGEs 2(interview)16(actual) & 3(interview) 17(actual) in THIS DOCUMENT : REFLECTIONS ON MEDICARE, written by the NATIONAL ACADEMY of SOCIAL INSURANCE interviewing the 2 guys that CREATED the MEDICARE SYSTEM "Robert Ball & Arthur Hess" as they reflect back on how badly they screwed it up and how it was just slopped together. ) So, because of lack of diligence, stewardship, proper planning and hasty politics, a Social Insurance program was instituted and overnight the entire health care system and its delivery of services and payment were irreversibly changed, ultimately leading to the crisis we face today... thanks government... way to go, now you want to finish the job and screw it up all the way.. no thanks.

2.) I am sorry to hear that your friend is facing such a difficult obstacle in life, the blessing of being able to walk is taken for granted by so many people. I am sure your friend cherishes every step she is able to take. Without actually knowing the details of your friends situation, it is impossible to answer your question with any certainty, but I can certainly say that it is impossible to avoid bureaucracy in any sector, public or private. You need a good adviser, a good attorney, and a good planner who understands the laws and implications of them. Our Social Insurance system is really to blame for the bureaucracy... prior to their involvement in 1965, the cost for healthcare and insurance was significantly less in proportion to median income. Every person's situation is different and addressing private personal issues in a public forum like this may not be the best venue, you are free to contact me for a private personal FREE consultation regarding your friends issue, If I can't help them, I probably know who can.

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