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The $23,000 bug bite

What is the cost of a paracetamol tablet in the US private system? Is such a figure even available?
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I have no idea about paracetamol, but the last time I got an itemized bill after a trip to the hospital, my insurance company was charge $48.00 for a "temperature control device". It was a latex glove filled with ice.
 
DragonLady said:
What is the cost of a paracetamol tablet in the US private system? Is such a figure even available?
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I have no idea about paracetamol, but the last time I got an itemized bill after a trip to the hospital, my insurance company was charge $48.00 for a "temperature control device". It was a latex glove filled with ice.
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No, the figure is not available, because it is not one figure. The price varies depending on provider and insurance. I might be paying two cents, you might be paying forty dollars.
 
wollery said:
A 1% profit on a $100billion turnover is $1billion. That's a lot of money from a small profit margin.
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The sum total of all private health insurance premiums in the US is ~$500 billion. Their profit margins average about 3%, so about $15 billion in insurance company profits.

By contrast, the health care industry in the US is over $2,000 billion.

You don't save much by eliminating insurance company profits. The problem is much, much more than insurance company profits.
 
Darat said:
Your argument seems to based on some form of USA "exceptionalism", as many of us have related in threads like this before we are sure we can match the USA in stupid politicians, pointless bureaucracy and screw-ups. What makes the USA so different?
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After the ACA, are you still sure of this argument? ;)
 
WildCat said:
The sum total of all private health insurance premiums in the US is ~$500 billion. Their profit margins average about 3%, so about $15 billion in insurance company profits.

By contrast, the health care industry in the US is over $2,000 billion.

You don't save much by eliminating insurance company profits. The problem is much, much more than insurance company profits.
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The cost savings of UHC is not just the profits of the insurance companies, but their costs as well. By eliminating medical insurance entirely, you save all the money it takes to run them, not just the money they make in excess of their costs.

You also save on the provider side, as a good deal of expense is dealing with insurance companies. Staffing costs, all the paperwork, contract negotiators, legal expenses, authorizations...it will vary, practice to practice, but at the ones I've worked for, dealing with insurance was about forty percent of the work, as opposed to actually doing medicine.
 
TragicMonkey said:
The cost savings of UHC is not just the profits of the insurance companies, but their costs as well. By eliminating medical insurance entirely, you save all the money it takes to run them, not just the money they make in excess of their costs.

You also save on the provider side, as a good deal of expense is dealing with insurance companies. Staffing costs, all the paperwork, contract negotiators, legal expenses, authorizations...it will vary, practice to practice, but at the ones I've worked for, dealing with insurance was about forty percent of the work, as opposed to actually doing medicine.
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How much of the work was dealing with Medicare?
 
TragicMonkey said:
The cost savings of UHC is not just the profits of the insurance companies, but their costs as well. By eliminating medical insurance entirely, you save all the money it takes to run them, not just the money they make in excess of their costs.

You also save on the provider side, as a good deal of expense is dealing with insurance companies. Staffing costs, all the paperwork, contract negotiators, legal expenses, authorizations...it will vary, practice to practice, but at the ones I've worked for, dealing with insurance was about forty percent of the work, as opposed to actually doing medicine.
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Mind you in the UK people are still free to pay into and use health insurance schemes, and employers offer them as part of an overall employment package, it's just they're more-or-less separated from the state run schemes.

Long may it stay that way, though given the cabinet reshuffle today I'm expecting some idiocy on that score.
 
WildCat said:
The sum total of all private health insurance premiums in the US is ~$500 billion. Their profit margins average about 3%, so about $15 billion in insurance company profits.

By contrast, the health care industry in the US is over $2,000 billion.

You don't save much by eliminating insurance company profits. The problem is much, much more than insurance company profits.
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Well, actually, by moving to a UHC system you eliminate almost all insurance company premiums, which according to your figures would be 20% to 25% (depending on whether or not it's counted in the $2,000 billion) of the industry costs. Sounds like a pretty big saving to me, and about half way to the cost reduction target.

Thanks for those figures.
 
WildCat said:
How much of the work was dealing with Medicare?
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I'd say roughly half. Primarily because our patient demographics skewed to senior citizens (it was an oncology practice). However, I will point out that UHC is not the same thing as Medicare- with UHC we wouldn't have the same paperwork- eligibility, authorizations, etc. From a billing standpoint, the only difference between Medicare and commercial insurance is that Medicare pays its bills on time. Proper UHC is not simply sticking everyone in Medicare.
 
WildCat said:
Who was being dishonest about the way the system, such as it is, works?
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I was just bugged by the suggestion that the cost of the hospital visit would have to have been paid in a lump sum, "college savings to pay the hospital bill," and the suggestion that he would have paid the same amount as the insurance company. Yes, the insurance companies negotiate a rate, but self pays get a discount. I was married to a job jumper. My kids and I went on and off insurance policies quite a few times in the 12 years I was with him. I've had to negotiate many emergency room visit, payments. I know the ropes. Not to mention, if this guy was a family, living on a limited income, he can also apply for hardship, which is even cheaper than the self pay discounts.
 
wollery said:
Please explain how a family with crappy income that doesn't provide health insurance, living in rented housing because they can't afford to buy, running a beat up car because they can't afford a new one, finds $25,000 to pay a medical bill, and how it doesn't bankrupt them.

Please, I'd love to hear this.
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$25,000 in and of itself isn't bankruptcy. I mean, if you want to create a cirumstance where it is, and then ignore that circumstance, then sure it's terrible, but at that point bankruptcy isn't necessarily a bad thing.
 
PhantomWolf said:
You don't even need to go that far. I'm earning a little over $50k a year, I have a nice car, but it's 17 years old now (a 1995 Toyota Corolla) so isn't worth more than a few thousand if I am lucky. I am renting, though I probably could afford to be paying a Mortgauge, though even if I was, I might not have the equity in it to afford to get a further loan of $25k. A bill of $25,000 would bankrupt me easy.
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If you can afford a mortgage you can afford payments on $25,000 on a payment plan with the hospital, you don't even need a loan and you wouldn't be paying interest on it either.

You'd lose some disposable income, but it wouldn't ruin you. That's all I'm saying.
 
Blue Mountain said:
Are you ignoring Travis' post where he had to declare bankruptcy over a $5,000 bill?
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No, but I wasn't ignoring the part where he said it was the straw that broke the camel's back either. Guy had a lot of other problems long before that bill and I think it's dishonest to ignore that and blame all his problems on a medical bill.
 
TragicMonkey said:
I'd say roughly half. Primarily because our patient demographics skewed to senior citizens (it was an oncology practice). However, I will point out that UHC is not the same thing as Medicare- with UHC we wouldn't have the same paperwork- eligibility, authorizations, etc. From a billing standpoint, the only difference between Medicare and commercial insurance is that Medicare pays its bills on time. Proper UHC is not simply sticking everyone in Medicare.
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I disagree, even a UHC system has to have detailed information about treatment etc if they are to prevent fraud, which already costs Medicare IIRC $60-80 billion/year. They'll need evidence the treatment is necessary, that it was actually performed, etc etc.
 
WildCat said:
I disagree, even a UHC system has to have detailed information about treatment etc if they are to prevent fraud, which already costs Medicare IIRC $60-80 billion/year. They'll need evidence the treatment is necessary, that it was actually performed, etc etc.
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Which is far less than the current paperwork. Eligibility, authorizations, and coordination of benefits because there are multiple insurers, these are the big paperwork-generators in Medicare. Universal healthcare would not have these tasks because everyone would be eligible, and there would be no secondary insurance. Evidence of treatment and necessity are easy stuff. In fact, under a universal healthcare system, they would be greatly simplified as a common software system could be developed. Fraud would be far more easily detected in a single universal system as well, if that is a huge concern.
 
Blue Mountain said:
Bug bites ten year old boy; total bill is $23,800

Short version: After a bug bite got infected, the kid ended up with MRSA. It was treated, but the bill is $23,800. The blogger's insurance, still covered by COBRA after his company relocated from California to Texas, is paying about 95% of the bill. He's left to pay "less than 6%"; at 5.5% his portion is $1,300. This after footing the entire health insurance bill himself for probably the last year.



In my opinion, the guy was lucky, since he's managed to find the funds to continue his health insurance through COBRA, at least for a while. How many other Americans aren't so lucky?

If this had happened in Canada, I dare say he would be paying zero dollars out-of-pocket for this incident, and he wouldn't have had to pay a huge amount for his health insurance just because his company decided to relocate from Ontario to Alberta. Unfortunately, if the doctor prescribes antibiotics for a few weeks after the boy leaves hospital, he'd likely have to pay for those himself. (I don't know of any provinces that have full prescription coverage. That and dental coverage are sorely lacking from the Canadian system.)
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Substitute Australian for Canadian and the result will be the same.

I had a similar thing once, a severe allergic reaction to a mosquito bite put me in hospital for a weekend when I was 6. As far as I know that part cost nothing. The kicker is that it also got infected, and they put me on Penicillin when I got out. We soon discovered I'm also allergic to Penicillin, since it nearly put me back in the hospital. It made me look like I had chicken pox and made me feel worse than when I did have chicken pox.
 
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