Go Back   iRV2 Forums > iRV2.com COMMUNITY FORUMS > Just Conversation
Click Here to Login
Join iRV2 Today

Mission Statement: Supporting thoughtful exchange of knowledge, values and experience among RV enthusiasts.
Reply
  This discussion is proudly sponsored by:
Please support our sponsors and let them know you heard about their products on iRV2
 
Thread Tools Search this Thread Display Modes
 
Old 06-17-2012, 02:13 PM   #43
Registered User
 
Vintage RV Owners Club
Gulf Streamers Club
Join Date: Oct 2010
Location: Indiana
Posts: 4,954
Quote:
Originally Posted by WheelingIt View Post
From what I've seen VA & Medicare may be exceptions. They are some of the lowest payout insurances, and for that very reason (as I said above) some places are dropping them. The most notable example is Mayo Clinic dropping Medicare (my link above) for the very reason that negotiated prices were not working out for them.

Those of us without Medicare or VA pay higher pricing whether through insurance or cash. For these cases my experience (and the links I've linked to above) show cash pricing is significantly cheaper in every instance. I'm not saying this is a good option...in fact for someone in my position it's really the only option. Individual health insurance is simply too expensive! This is where price transparency would make a huge improvement for everyone.
Agreed..
__________________

__________________
Midniteoyl is offline   Reply With Quote
Join the #1 RV Forum Today - It's Totally Free!

iRV2.com RV Community - Are you about to start a new improvement on your RV or need some help with some maintenance? Do you need advice on what products to buy? Or maybe you can give others some advice? No matter where you fit in you'll find that iRV2 is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with other RV owners, see fewer ads, upload photographs, create an RV blog, send private messages and so much, much more!

Old 06-17-2012, 02:15 PM   #44
Senior Member
 
Join Date: Feb 2011
Location: Port Orange, Florida
Posts: 251
Quote:
Originally Posted by WheelingIt View Post
Totally agree. I feel lack of price transparancy and understanding is HUGE issue in today's US health care. Hospitals can charge & collect different prices (depending on the insurer). The exact same procedure can cost VASTLY different amounts in different places and no-one knows (or cares?) what $$ are actually going through the system. I truly believe it would help to have price transparency (and the market competition that comes with it). These past 3 years of fulltime RVing and shopping around for out-of-pocket healthcare has really opened my eyes to the HUGE variations out there and how difficult it is to actually figure out pricing.
I like your thinking WheelingIt. Transparancy would help pricing and market competition. But how can we get this to happen? Do you really believe we can get these big health care business's to go along with this? or do we have to make them?

I had free to 20% payment for my insurance for 31 years. As soon as I retired it went to $1,200 per month/2 people with NO pre existing conditions, so we went on our own and found BCBS for $480 with a high deductible. In 18 months it has gone up 28% and as stated by someone earlier it is going up every year as we get older. I can afford this increase but so many can't. This latest increase is going to make some people lose their health insurance. This is what upsets me more. Then they will go to emergency rooms and we will end paying for it with more taxes.

Is it a NO win situation?
__________________

__________________
mga60tw is offline   Reply With Quote
Old 06-17-2012, 02:20 PM   #45
Registered User
 
Vintage RV Owners Club
Gulf Streamers Club
Join Date: Oct 2010
Location: Indiana
Posts: 4,954
Quote:
Originally Posted by WheelingIt View Post
Here's some more specific examples. I happened to shop around this particular issue over this winter for various reasons (not for me)

Vaginal Delivery
---------------

"Blue Book" value - this is the fair and agreed value that most insurance companies will pay out. You can find the blue book here:
Admission for Vaginal Delivery Pricing by Healthcare Blue Book
The bluebook value in this case, just for hospital delivery is ~$4,500
This is for San Diego area.

Shopping around the area hospitals there is a vast array of "cash" prices. Some come close to the blue book, but some are significantly cheaper
Scripps -> $,4700 paid up-front
Sharp Birch Medical Center -> $2,250 paid up-front
Both prices incl. 24 hour stay

Again, outside of VA and Medicare this has been my typical experience. I'd love for you to tell me I'm wrong since it might change how I handle medical bills in the future.
That link says over $6100 just for the Doc, Hospital and Anesthesia.. However, I dont believe it as my Niece just got her bill and the insurance only paid $3450 total (2 night stay - births have no co-pay). So, using that, your 'cash' price seems a little high..
__________________
Midniteoyl is offline   Reply With Quote
Old 06-17-2012, 02:26 PM   #46
Senior Member
 
WheelingIt's Avatar
 
Monaco Owners Club
Join Date: Oct 2010
Location: On Wheels
Posts: 1,983
Quote:
Originally Posted by mga60tw View Post
I like your thinking WheelingIt. Transparancy would help pricing and market competition. But how can we get this to happen? Do you really believe we can get these big health care business's to go along with this? or do we have to make them?
Gosh, the million dollar question. This is what I can't answer, but I know that if I were campaigning for government this would be my platform. Price and service transparency everywhere!

We had this in Hong Kong (where I lived for most of my teenage years, and again for 5 years as an adult) and it was truly a joy to live the health care system there -> clear pricing on every procedure (printed directly on their website, or you could go get a brochure from the hospital) and options (Public Hospitals -> good ones too) for those who couldn't afford private care. Since everything was public knowledge competition between hospitals was strong. I used both systems (private and public) when we lived there. My sister-in-law gave birth at the public hospital and recieved excellent care. I don't know if such a system would work in a bigger and more complex economy such as the US, but I sure miss the simplicity of it.

Sadly I cannot even vote here in the US (I'm one of those green-card holders) so I'm out of the loop on everything.
__________________
12 paws, 40 feet and the open road
WheelingIt is offline   Reply With Quote
Old 06-17-2012, 02:27 PM   #47
Senior Member
 
Join Date: Jun 2011
Posts: 359
Quote:
Originally Posted by RVluvin View Post
For those of us still in the workforce, why does the employer choose the medical insurance company?
In my particular case, because I am a participant in my companies' plan and because I'm footing the bill, I want the best deal out there. I can use my group's clout to shop for the most affordable plan with the best benefits for all of us, and I also evaluate competitive quotes to verify I'm getting the most bang for my buck.
On that line, it's humbling the way the premiums are assessed, by far the most expensive employees are young families of child-bearing age.
The actuaries figure we old folks are going to die off much sooner or transition to Medicare. So I have a price on my head, it just takes a little while for it to soak in.
__________________
2007 K-Z 35 Toyhauler, 2006 Chev 2500HD Duramax, 2005 H-D Road King Classic, 2007 Mini-Schnauzer "Scooter"
menoble is offline   Reply With Quote
Old 06-17-2012, 02:28 PM   #48
Senior Member
 
Romeo's Avatar
 
Newmar Owners Club
Join Date: Dec 2008
Location: Spokane, Washington
Posts: 1,161
Quote:
Originally Posted by hamguy View Post
I would be banned from this board if I posted what I think about you. Nuf said!
What the heck do you mean; that sounded nasty...
__________________
Ron... WB7DJV
2000 38' Dutch Star | 2006 Grand Cherokee | SilverLeaf VmsPc Engine Monitor | TST TPMS
FMCA, NKK
Romeo is offline   Reply With Quote
Old 06-17-2012, 02:33 PM   #49
Registered User
 
Vintage RV Owners Club
Gulf Streamers Club
Join Date: Oct 2010
Location: Indiana
Posts: 4,954
Quote:
Originally Posted by WheelingIt View Post
It's true that insurances don't pay "wholesale" costs, but they still pay waaay more than cash prices. In my research over the past year (of alot of medical stuff) I've found there are 4 main prices for healthcare...in decreasing order:

1/ "wholesale" price (my terminology) - what hospitals would have you believe is the regular price..often grossly inflated, but this is the basis for many insurance negotiations and anything government-related (e.g. statistics)
2/ "insurance" price - what hospitals actually charge insurance companies and what the insurance companies payout. Payout depends alot on the insurance company. Medicare is one of the worst payers and some hospitals (e.g. Mayo Clinic) have started dropping them for that reason.
3/ "cash" price - what you'd pay in cash if you paid direct. Often >50% less than #2
4/ "pre-pay cash" price - a discount on #3

This is not just personal experience (I've been calling alot of hospitals this year), but it's documented by others too...for example:

Many hospitals, doctors offer cash discount for medical bills - latimes.com

Healthcare - Home


Nina
Your own link to Health Care Blue Book says differently..
Quote:
The uninsured are charged higher prices. In many cases, the uninsured pay higher prices for hospital care, prescription drugs, doctor visits and other healthcare services than those with insurance. A study, From ‘Soak The Rich’ To ‘Soak The Poor’, published in Health Affairs found that charges are often more than 2.5 times more than what most health insurers actually paid.
Healthcarebluebook.com is dedicated to helping people better manage their healthcare by providing them with the knowledge and tools they need to shop for and receive a fair price for their healthcare services. by Healthcare Blue Book
__________________
Midniteoyl is offline   Reply With Quote
Old 06-17-2012, 02:34 PM   #50
Senior Member
 
WheelingIt's Avatar
 
Monaco Owners Club
Join Date: Oct 2010
Location: On Wheels
Posts: 1,983
Quote:
Originally Posted by Midniteoyl View Post
That link says over $6100 just for the Doc, Hospital and Anesthesia.. However, I dont believe it as my Niece just got her bill and the insurance only paid $3450 total (2 night stay - births have no co-pay). So, using that, your 'cash' price seems a little high..
I was quoting the hospital services only (just as a simple comparison). I did not include Anesthesia or physician service but I did get a quote for these too when I was shopping around (for example anasthesia at Birch was $700, and they include pediatrician newborn screening, but you pay for physician...and that price depends on the physician). I just wanted to compare apples to apples (the quote for hospital services only) so you got the general picture.

Did you neice give birth in San Diego? Pricing is significantly different in different parts of the country. I had the link set for area code for 92101. Look up the blue-book value for the zip code where she gave birth and let me know.
__________________
12 paws, 40 feet and the open road
WheelingIt is offline   Reply With Quote
Old 06-17-2012, 02:38 PM   #51
Registered User
 
Vintage RV Owners Club
Gulf Streamers Club
Join Date: Oct 2010
Location: Indiana
Posts: 4,954
I did.. it was only $100 or so less.. Still over $6000 as shown.

BTW: Do we really know who owns CareOperative, LLC? I've been trying to look, but keep running into the same old press releases..
__________________
Midniteoyl is offline   Reply With Quote
Old 06-17-2012, 02:42 PM   #52
Senior Member
 
WheelingIt's Avatar
 
Monaco Owners Club
Join Date: Oct 2010
Location: On Wheels
Posts: 1,983
OK, now we're getting into an even trickier area of health care costs which I should have listed as cost #5 in my original list. This is the price you pay if you have no insurance and do not ask or negotiate for a cash discount. It is the same as the "wholesale" price for #1. If you go into a hospital for care without insurance and do not negotiate a cash price, you will pay out the wazoooo. This is true.

Again I have personal experience in this. For my winter operation I paid everything up-front. My "hospital services" charge was $800. Two months later I get a bill for hospital services that has $4,450 on it...WTF?? I call the hospital and ask what's up. "oh that's the non-insured price, but I see you paid up-front so just ignore it".

So really there are 5 different potential hospital costs for the same procedure
- a wholesale price
- a non-insured price (if you don't ask for a discount)
- an insurance price
- a cash price
- an up-front cash price

Gotta love lack of price transparency.
__________________
12 paws, 40 feet and the open road
WheelingIt is offline   Reply With Quote
Old 06-17-2012, 02:46 PM   #53
Registered User
 
Vintage RV Owners Club
Gulf Streamers Club
Join Date: Oct 2010
Location: Indiana
Posts: 4,954
Quote:
Originally Posted by WheelingIt View Post
OK, now we're getting into an even trickier area of health care costs which I should have listed as cost #5 in my original list. This is the price you pay if you have no insurance and do not ask or negotiate for a cash discount. It is the same as the "wholesale" price for #1. If you go into a hospital for care without insurance and do not negotiate a cash price, you will pay out the wazoooo. This is true.

Again I have personal experience in this. For my winter operation I paid everything up-front. My "hospital services" charge was $800. Two months later I get a bill for hospital services that has $4,450 on it...WTF?? I call the hospital and ask what's up. "oh that's the non-insured price, but I see you paid up-front so just ignore it".

So really there are 5 different potential hospital costs for the same procedure
- a wholesale price
- a non-insured price (if you don't ask for a discount)
- an insurance price
- a cash price
- an up-front cash price

Gotta love lack of price transparency.
Agreed.. IF you are uninsured, ALWAYS negotiate a price up front and be prepared to move on if the price isnt right.

Not disputing you on this, just that being, and paying for, insurance is usually a better option.. Especially as we get older..
__________________
Midniteoyl is offline   Reply With Quote
Old 06-17-2012, 02:47 PM   #54
Senior Member
 
WheelingIt's Avatar
 
Monaco Owners Club
Join Date: Oct 2010
Location: On Wheels
Posts: 1,983
Quote:
Originally Posted by Midniteoyl View Post
I did.. it was only $100 or so less.. Still over $6000 as shown.

BTW: Do we really know who owns CareOperative, LLC? I've been trying to look, but keep running into the same old press releases..

Interesting. So your niece's $3500 price or so included hospital services, anastesia and physician? And your neice is not under VA insurance, I'm guessing? The reason I ask is I'd actually love to call that hospital and ask them for a cash price just to see what they say. Like I said if you prove me wrong I would love to be able to find a cheaper way to handle my bills. So far everything I've worked on has proved working through insurance is more expensive than negotiating cash up-front, but perhaps I'm wrong? If you'd like to PM me the hospital info I'd be happy to call them and report back on the forum with the results.
__________________
12 paws, 40 feet and the open road
WheelingIt is offline   Reply With Quote
Old 06-17-2012, 02:53 PM   #55
Senior Member
 
WheelingIt's Avatar
 
Monaco Owners Club
Join Date: Oct 2010
Location: On Wheels
Posts: 1,983
Quote:
Originally Posted by Midniteoyl View Post
Agreed.. IF you are uninsured, ALWAYS negotiate a price up front and be prepared to move on if the price isnt right.

Not disputing you on this, just that being, and paying for, insurance is usually a better option.. Especially as we get older..
Oh agreed....and I should add I'm not advocating anyone should forgo insurance. I have a high-deductable insurance ("catastrohpic" if you will), which means I pay a significant amount of my bills out of pocket before insurance kicks in, and I generally prefer not to involve the insurance at all unless I can avoid it (simply to avoid insurance premium hits). SO out of pocket costs and insurance versus non-insurance prices are a big deal to me. Despite the $$ I pay for services it is still cheaper for me to go that route (pay out of pocket cash pricing and have a high-deductable insurance as back-up) rather than pay for a low-deductable insurance (i.e. one that covers more services). Cost differences are enormous over time.
__________________
12 paws, 40 feet and the open road
WheelingIt is offline   Reply With Quote
Old 06-17-2012, 03:01 PM   #56
Registered User
 
Vintage RV Owners Club
Gulf Streamers Club
Join Date: Oct 2010
Location: Indiana
Posts: 4,954
Quote:
Originally Posted by WheelingIt View Post
Interesting. So your niece's $3500 price or so included hospital services, anastesia and physician? And your neice is not under VA insurance, I'm guessing? The reason I ask is I'd actually love to call that hospital and ask them for a cash price just to see what they say. Like I said if you prove me wrong I would love to be able to find a cheaper way to handle my bills. So far everything I've worked on has proved working through insurance is more expensive than negotiating cash up-front, but perhaps I'm wrong? If you'd like to PM me the hospital info I'd be happy to call them and report back on the forum with the results.
No problem.. St. Joseph Hosp in Plymouth, In.

Yes, total bill.. and no, she's on her own plan through work..
__________________

__________________
Midniteoyl is offline   Reply With Quote
Reply



Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


» Virginia Campgrounds

Reviews provided by


Copyright 2002- Social Knowledge, LLC All Rights Reserved.

All times are GMT -6. The time now is 01:45 PM.


Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.