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Another healthcare cost thread

Started by PopeyesPappy, December 14, 2018, 11:35:23 PM

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PopeyesPappy

Dad passed away September 27 after spending about 4 weeks in the hospital. Most of that time was in intensive care. He was in surgery twice. Mom got the final statement from the hospital today. No doctors, of which there were several, are included. Basically, we are talking room and board, nursing care and drugs. The hospital bill was $850,000. Medicare paid about $90,000. Tricare (retired military insurance) paid another $22,000. Mom's share was $0.00. For someone with Medicare alone they would have been looking at paying the Tricare share out of pocket.

A couple of takeaways from this.

1. Healthcare costs in the US are out of control. Dad's healthcare for his final month cost the equivalent of his and mom's total income for the last 12 - 14 years. They had a better income than most. For many that would have been 30 - 40 years of income. for some it would be more than they made in a lifetime.

2. Hospitals are going broke because the government doesn't pay enough. Altogether the hospital got about 13% of what they billed for dad's care. Yes $850,000 was probably more than actual cost, but what the hospital settled for was more than likely less than actual cost. Either someone makes up the difference or the hospital goes out of business. Seven Alabama hospitals rural counties have closed in the last eight years leaving all seven of those counties without a hospital.
Save a life. Adopt a Greyhound.

Minimalist

First off, my sympathy for your loss, Pap.  It's never easy.

Second, as even the Orange Shitgibbon figured out, health care is complicated.  And your commentary about Alabama is well-attested.

https://www.healthline.com/health-news/rural-hospitals-closing#1

QuoteRural America tends to be sicker, older, and poorer than the rest of the country.

“This group suffers many health disparities. That includes higher rates of diabetes, higher rates of child mortality, fewer years of life, and loss of years of productive life,” Michael Topchik, the national leader for the Chartis Center for Rural Health, told Healthline.

Health insurance coverage is an important tool for helping people stay well and manage their chronic conditions.

The expansion of the Medicaid program under the Affordable Care Act provided coverage to millions of previously uninsured people from low-income households, including those in rural areas.

The law also enabled people with lower incomes â€" but above the poverty line â€" to buy coverage through the states’ health insurance marketplaces.

I don't know what the answer is but somehow every other civilized nation manages to do it.  Perhaps we are not civilized?
The Christian church, in its attitude toward science, shows the mind of a more or less enlightened man of the Thirteenth Century. It no longer believes that the earth is flat, but it is still convinced that prayer can cure after medicine fails.

-- H. L. Mencken

Baruch

#2
Quote from: PopeyesPappy on December 14, 2018, 11:35:23 PM
Dad passed away September 27 after spending about 4 weeks in the hospital. Most of that time was in intensive care. He was in surgery twice. Mom got the final statement from the hospital today. No doctors, of which there were several, are included. Basically, we are talking room and board, nursing care and drugs. The hospital bill was $850,000. Medicare paid about $90,000. Tricare (retired military insurance) paid another $22,000. Mom's share was $0.00. For someone with Medicare alone they would have been looking at paying the Tricare share out of pocket.

A couple of takeaways from this.

1. Healthcare costs in the US are out of control. Dad's healthcare for his final month cost the equivalent of his and mom's total income for the last 12 - 14 years. They had a better income than most. For many that would have been 30 - 40 years of income. for some it would be more than they made in a lifetime.

2. Hospitals are going broke because the government doesn't pay enough. Altogether the hospital got about 13% of what they billed for dad's care. Yes $850,000 was probably more than actual cost, but what the hospital settled for was more than likely less than actual cost. Either someone makes up the difference or the hospital goes out of business. Seven Alabama hospitals rural counties have closed in the last eight years leaving all seven of those counties without a hospital.

Correct on both.  A thing that expands by 10% a year .. is not sustainable.  If y'all think it is, then y'all flunked math.  All Americans flunk math.  Hospitals and other such situations (general contractors) ... know in advance how much their bill will be discounted, so they just double the bill to begin with.  Small rural hospitals are marginal, because you make money on giant size ... in the end, there will be just one giant hospital, in one giant city (cities do this too).  And in that giant hospital in the giant city there will be one super-doctor (gene modified) who is nephilim.

My family has been on both government and private medical coverage, in small town and big city.  Generally medical works out best in the big city, just as does everything else.  It isn't just medical costs that are out of control, that is just the most obvious bit.  The whole economy is out of control (see Nixon taking the US off the international gold standard ... because we hate France).  Russia and China are going back on the gold standard, and Switzerland never left it, though the EU borg are trying to eliminate them permanently (since 1815).

Minimalist ... yes, the US is not civilized.  Like Sweden?  Move there.  I knew an American, Vietnam War vet, who moved there long ago.  He loved it.  People in America say ... if you get sick or injured, just bugger off you worthless sod.  Do not however attempt to move to Russia or China, they don't want you either.  And they are civilized.  Europe is going down the toilette (see, French pronunciation).  So my acquaintance got there while things were good.  Sweden isn't so good now, unless you are a Muslim fighter from Syria.
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Baruch

#3
Different but related healthcare anecdote.  Nursing home.  Costs about $6000 per month.  If you can get Medicare/Medicaid pay for it, good for you.  Incidental costs (like cigarettes) the family needs to provide.  Also Depends, they love for you to donate lots of Depends for your incontinent parent.  Don't know why the home can't take care of that too.  This doesn't count medical emergencies ... such as the parent developing pneumonia and needing to go to the hospital.  That costs extra.

Cost breakdown:
Residency = $100 per day.  Same as a modest hotel, but it isn't Best Western
Nursing - $100 per day.  Cheap compared to a hospital.
so $200 per day x 30 days = $6000.

Not counting intensive care, nursing at a hospital is about $500 per day, but the nursing is much better, and you are there for a compelling reason.  They try to keep you there for as short a time as possible, for various terrible reasons.  If your parent is still really sick, but transitioning from hospital to nursing home, you need to move it, move it ... or they will put your parent out on the curb, because the hospital already knows you are broke.  If you take your parent home, while they are still really sick, or are beyond their own or your own ability to provide constant nursing care ... you will be found guilty of a felony abuse or negligent murder of your parent.

What do you mean, you took your parent home with you, but you aren't a licensed RN who can afford to provide 24x7 care?  You criminal!

Minimalist ... America isn't civilized, it is a shit hole.  That is true wherever monkeys live.

Reasons why health care is the most inflationary thing since the early Big Bang ..

1. We all want the best and most advanced care.  Cost wise, this is bleeding edge, direct from your pocketbook.
2. We all want to stay longer to recuperate in the hospital, which is the most expensive option if you can do otherwise.
3. Drugs are a huge money maker, that is basically unregulated in the US, when they are legal prescriptions.
4. Your doctor mostly acts as a gateway drug to the other drugs, he basically decides which drugs you need to be on, the more the better.  Drug companies reward doctors for this behavior.
5. Medicine is for profit, and the most successful private medical systems are profitable (not all are).
6. Americans are incredibly self destructive of their own health.  And hypochondriac.
7. Most medical costs are toward the elderly, who are inevitably the most sick, terminal in fact.  You might be healthy all your life, but rack up big profits for the medical industry (it is an industry, same as a casino) in the last 6 months of your life.  The undertaker gets the leftovers.
8.  We don't want to be injured or sick, and we want to be healed or cured ASAP naturally.
9.  We don't want to die ... though we all have an obligation to die, to make room for younger people, rather than star as extras in a zombie movie.
10.  Why do Europeans get free medical car, free Mercedes, free Berlin penthouse, free Bavarian brew ... because they are the master race!
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Minimalist

And let's not forget the insurance companies.... the real criminals in the matter.

https://www.dailykos.com/stories/2018/12/14/1819015/-The-nonprofit-whose-top-exec-earns-more-than-Apple-s-CEO?detail=emaildkre

QuoteThe nonprofit whose top exec earns more than Apple’s CEO

QuoteYou’ve probably heard of, and may even have, Delta Dental insurance. But did you know that the main entity behind it, Delta Dental of California, which operates plans using the Delta name in 16 states, is a tax-exempt nonprofit? Because of the public good it supposedly does, you subsidize it.

That, however, hasn’t stopped it from paying its CEO as if he ran a for-profit company 20 or 40 times as big. The $14.3 million it paid him in 2016 is more than the CEO compensation paid by 30 of the 100 largest companies in America, including Apple and Anthem, the giant health insurer.

The Christian church, in its attitude toward science, shows the mind of a more or less enlightened man of the Thirteenth Century. It no longer believes that the earth is flat, but it is still convinced that prayer can cure after medicine fails.

-- H. L. Mencken

Baruch

Insurance in general is a scam, and health insurance in particular.  Life insurance is more or less reliable, given that you can only claim it one time (sorry cats), and baring war or natural disaster, the actuary tables are good.  None of that applies to health insurance, it is a mathematical black hole, it can never be made into a viable business, unless you restrict access or cap totals.  Otherwise there is no way to predict, statistically how much expenditure the insurance company will make in any given year.
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Minimalist

Someone is making a metric fuckton of money off it!

https://www.fiercehealthcare.com/payer/ceo-pay-2017-342-million-unitedhealth-molina-cigna-aetna

QuoteNearly every health insurance CEO got a pay raise in 2017â€"in most cases, bringing home more than 300 times the amount their average employee earned.

All together, CEOs at the nation’s largest insurance companies earned $342.6 million in 2017, with the highest-paid executive bringing home $83.2 million, more than 1,400 times what the average employee brought home.

The top eight insurance companies paid out twice as much money to their top executives as they did the previous year thanks to notable churn in C-suites across the industry, according to an analysis of SEC filings by FierceHealthcare. The review included Aetna, Cigna, Molina, WellCare, Centene, UnitedHealth Group, Humana and Anthem.

And recall, this is just the handful of top dogs.  There are plenty of others sucking on the teat.
The Christian church, in its attitude toward science, shows the mind of a more or less enlightened man of the Thirteenth Century. It no longer believes that the earth is flat, but it is still convinced that prayer can cure after medicine fails.

-- H. L. Mencken

Baruch

Quote from: Minimalist on December 16, 2018, 03:10:43 PM
Someone is making a metric fuckton of money off it!

https://www.fiercehealthcare.com/payer/ceo-pay-2017-342-million-unitedhealth-molina-cigna-aetna

And recall, this is just the handful of top dogs.  There are plenty of others sucking on the teat.

Remember Bain Capital?  Yes, these mergers, adding vast corporate debt, breakup of a company to sell off the assets ... are vampire capitalism  This one affects me, since I am with Aetna, but thru my employer.  Presumably that gives me some buffering compared to an individual policy holder.
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Minimalist

Absolutely.

Its why I refer to the US as a plutokleptocracy.  Rule by rich thieves.
The Christian church, in its attitude toward science, shows the mind of a more or less enlightened man of the Thirteenth Century. It no longer believes that the earth is flat, but it is still convinced that prayer can cure after medicine fails.

-- H. L. Mencken

Baruch

Quote from: Minimalist on December 16, 2018, 06:49:49 PM
Absolutely.

Its why I refer to the US as a plutokleptocracy.  Rule by rich thieves.

And you object ... because like most of us, you are a loser?  At least that is why I think most people object to society and politics.  If you had your beach babe on your private Caribbean island like that guy, that Bill Clinton and Donald Trump were familiar with ... would you still object?  Or are you some kind of Old Testament moralizing prophet?

Or maybe you are a Marianne wannabe, those girls with nude breasts, painted silver and wearing red hooded robes?  What would Robespierre think!!
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Minimalist

Actually, according to one of these Wealth Generator sites:

Quote

You’re in the top
0.31%
richest people in the world.

That makes you the
13,943,571st
richest person on earth.

But neither do I have delusions of grandeur about it.  It is the top 0.001% of scumbags who call the shots and own worthless turds like Trump.
The Christian church, in its attitude toward science, shows the mind of a more or less enlightened man of the Thirteenth Century. It no longer believes that the earth is flat, but it is still convinced that prayer can cure after medicine fails.

-- H. L. Mencken

Baruch

Quote from: Minimalist on December 17, 2018, 01:17:34 PM
Actually, according to one of these Wealth Generator sites:

But neither do I have delusions of grandeur about it.  It is the top 0.001% of scumbags who call the shots and own worthless turds like Trump.

Comparing dick sizes?  But is your "head" mushroom shaped?  Its quality that rules, not quantity.
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.