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Gotta Love American Healthcare

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Gotta Love American Healthcare

Postby Madison » Sat Jun 28, 2008 9:02 am

I'm posting this for informational reasons for the millions of people out there without health insurance. For those that don't know, my appendix ruptured about 4 weeks ago and I had to have emergency surgery to remove it and clean out the damage it did. Once I returned home I spent a little time searching the net and had a hard time finding solid info about the costs involved and what to expect as far as the bills go. I've always been a generally healthy person so I was fairly clueless other than I knew it wouldn't be cheap. So for those wanting to know "What does an appendix surgery cost?", "How much is an appendix surgery?", or "How much does an appendix surgery cost?", well here you go.

Background:

Ruptured appendix in extremely bad shape.
911 call for an ambulance because I couldn't move or even stand up.
Done in Texas (prices vary by state but this info still could help someone).
3 days in the hospital.
3-prong approach rather than the one huge incision, so no stitches and only 3 small cuts (wasn't given an option, but happy they went this way).

I'm going to list 2 prices on everything. The original price, and then the "cash discount" or "no insurance discount" (EDIT: Note that for most of these, you have to ASK if they have a discount, most don't just "give" it to you, so make sure you ask!). Turns out everyone involved will give a discount if you'll pay it within 10 days of getting the bill. Personally, I had to take out a bank loan to pay this since I'm not rich and couldn't predict this coming. :-b Anyway, here's the damage:

Hospital --- $18,883.14 - discounted to - $13,183.20
Surgeon --- $1,238 ------ discounted to - $818
Ambulance - $993.33 ---- discounted to - $795.27
ER Doctor -- $424 -------- discounted to - $339.20
Pathologist - $352 -------- discounted to - $264
Radiologist - $375 -------- discounted to - $187.50
anastegeologist - $1210 -- discounted to - $787

Totals - $23,425.47 ------ discounted to -- $16,374.17

Ouch huh? !+) I can't really complain though. My only option for health insurance is through my wife's work, but they want over $600 per month for it (was $800 per month until this year). So if you factor in just $600 per month for the 10 years we've been married, that would be $72,000 and we haven't spent $2,000 on health related stuff in that time. So we're way, way ahead of the "insurance game" so to speak.

Anyway, now that some real info with exact numbers is out there, I hope it helps someone prepare for the bills that will be coming. ;-D
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Sick of those who are hypocrites.
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Yes doctor, there will be blood.....
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Re: Gotta Love American Healthcare

Postby Yoda » Sat Jun 28, 2008 9:53 am

I understand your point about how expensive insurance premiums are but what happens if something worse happened to you or your family and you don't have enough money saved to take care of it? As you get older, the chances of your health deteriorating and needing medical care rises exponentially. The problem with insurance is, you don't need it until you really need it.

Anyway, glad to hear that you are ok. I had my appendix taken out a year ago and it was not fun at all.
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Re: Gotta Love American Healthcare

Postby Mookie4ever » Sat Jun 28, 2008 10:21 am

That's rough. Glad to hear that you're OK Madison. ;-D

I love the "discount" price if you don't have insurance. :-b
My dentist does that for work that is not covered by my insurance plan.
The discount price is their real price but they overcharge insurance companies b/c they charge insurance whatever insurance will bear. Pretty much accepted insurance fraud. Doctors, dentists and hospitals bilk the system and it ends up getting paid by everyone that pays insurance. For some reason lawyers hired by insurance companies are subject to intense scrutiny, they must agree to hard caps on rates and fees and often must agree to do files for a flat fee. Most lawyers will not work for insurance companies because of this. Insurance companies get the best rates in legal service.
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Re: Gotta Love American Healthcare

Postby Madison » Sat Jun 28, 2008 10:37 am

Yoda wrote:I understand your point about how expensive insurance premiums are but what happens if something worse happened to you or your family and you don't have enough money saved to take care of it? As you get older, the chances of your health deteriorating and needing medical care rises exponentially. The problem with insurance is, you don't need it until you really need it.

Anyway, glad to hear that you are ok. I had my appendix taken out a year ago and it was not fun at all.


I'd be up a creek, just a little deeper one. :-b

The thing is simply that most uninsured people can't afford the premiums. I don't mean they don't "want" to pay it, I mean they cannot afford to pay it. Things like eating, clothes, rent, are a bit more important. ;-) If health insurance was affordable, most people would have it (including me).

True though about age, and I figure once I start getting close to that danger zone, then I'll explore the options a bit deeper. Maybe I'll win the lottery by then and will be able to afford it. Wait... I don't play the lotto. Maybe I need to start. :-b

Mookie4ever wrote:That's rough. Glad to hear that you're OK Madison. ;-D

I love the "discount" price if you don't have insurance. :-b
My dentist does that for work that is not covered by my insurance plan.
The discount price is their real price but they overcharge insurance companies b/c they charge insurance whatever insurance will bear. Pretty much accepted insurance fraud. Doctors, dentists and hospitals bilk the system and it ends up getting paid by everyone that pays insurance. For some reason lawyers hired by insurance companies are subject to intense scrutiny, they must agree to hard caps on rates and fees and often must agree to do files for a flat fee. Most lawyers will not work for insurance companies because of this. Insurance companies get the best rates in legal service.


Actually it's a bit different here, or at least here's a different perspective.

They all bill high for a couple of reasons. #1 is simply the amount of uninsured people that don't pay the bill. I could tell all of those people to "stick it" and what are they going to do? Put my appendix back? :-b They can crush my credit for 7 years, which prevents me from buying cars, a house, etc., but that's all they can do. So they bill high in order to recover some of the money that those who don't pay owe. #2 is because they claim that full amount as a "loss" when doing taxes for all unpaid accounts. The government kicks them back a percentage of that total "loss" and they get tax breaks for it. The health insurance companies here are quite aggressive and actually pay quite a bit less than the cash customers do.


And thanks for the warm wishes guys. ;-D
Yes doctor, I am sick.
Sick of those who are spineless.
Sick of those who feel self-entitled.
Sick of those who are hypocrites.
Yes doctor, an army is forming.
Yes doctor, there will be a war.
Yes doctor, there will be blood.....
Madison
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Re: Gotta Love American Healthcare

Postby bigh0rt » Sat Jun 28, 2008 10:50 am

Madison wrote:
Yoda wrote:I understand your point about how expensive insurance premiums are but what happens if something worse happened to you or your family and you don't have enough money saved to take care of it? As you get older, the chances of your health deteriorating and needing medical care rises exponentially. The problem with insurance is, you don't need it until you really need it.

Anyway, glad to hear that you are ok. I had my appendix taken out a year ago and it was not fun at all.


I'd be up a creek, just a little deeper one. :-b

The thing is simply that most uninsured people can't afford the premiums. I don't mean they don't "want" to pay it, I mean they cannot afford to pay it. Things like eating, clothes, rent, are a bit more important. ;-) If health insurance was affordable, most people would have it (including me).

True though about age, and I figure once I start getting close to that danger zone, then I'll explore the options a bit deeper. Maybe I'll win the lottery by then and will be able to afford it. Wait... I don't play the lotto. Maybe I need to start. :-b

Mookie4ever wrote:That's rough. Glad to hear that you're OK Madison. ;-D

I love the "discount" price if you don't have insurance. :-b
My dentist does that for work that is not covered by my insurance plan.
The discount price is their real price but they overcharge insurance companies b/c they charge insurance whatever insurance will bear. Pretty much accepted insurance fraud. Doctors, dentists and hospitals bilk the system and it ends up getting paid by everyone that pays insurance. For some reason lawyers hired by insurance companies are subject to intense scrutiny, they must agree to hard caps on rates and fees and often must agree to do files for a flat fee. Most lawyers will not work for insurance companies because of this. Insurance companies get the best rates in legal service.


Actually it's a bit different here, or at least here's a different perspective.

They all bill high for a couple of reasons. #1 is simply the amount of uninsured people that don't pay the bill. I could tell all of those people to "stick it" and what are they going to do? Put my appendix back? :-b They can crush my credit for 7 years, which prevents me from buying cars, a house, etc., but that's all they can do. So they bill high in order to recover some of the money that those who don't pay owe. #2 is because they claim that full amount as a "loss" when doing taxes for all unpaid accounts. The government kicks them back a percentage of that total "loss" and they get tax breaks for it. The health insurance companies here are quite aggressive and actually pay quite a bit less than the cash customers do.


And thanks for the warm wishes guys. ;-D

$600 seems awfully high per month. Did they give reason why? Is it because of your age? (No, I'm not calling you an old fogey, but when I was 22 I had no health insurance after I graduated college and could've gotten it for half that price; and still chose to go 18 months without, praying I didn't need to go to the hospital). Medical history or something?

My health care just went from $388 a year to $768 starting next school year and I'm miffed about that. Talk about seeing it from a different perspective... You need to get a Fantasy Cafe Union and start providing health care for all the Mods, Mad. :-D
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Re: Gotta Love American Healthcare

Postby Madison » Sat Jun 28, 2008 11:15 am

bigh0rt wrote:$600 seems awfully high per month. Did they give reason why? Is it because of your age? (No, I'm not calling you an old fogey, but when I was 22 I had no health insurance after I graduated college and could've gotten it for half that price; and still chose to go 18 months without, praying I didn't need to go to the hospital). Medical history or something?

My health care just went from $388 a year to $768 starting next school year and I'm miffed about that. Talk about seeing it from a different perspective... You need to get a Fantasy Cafe Union and start providing health care for all the Mods, Mad. :-D


Nope, no reason. Same rates for all of their employees and their families. Always sounded high to me since it's a trillion dollar global company that has offices and does business all over the world. We've got zero health issues here, like I said above, not even $2K spent in 10 years (with no insurance) and the large majority of that was when the kiddo wound up with a ganglion cyst. ER visit, X-rays, etc., since we thought he had broken his wrist. They just have their rate and that's that. Not even any questions. Probably part of why it's so high is because it's a flat rate across the board, so healthy people like us pay extra to help cover the costs of those who aren't as healthy. Stinks, but just the way it is.
Yes doctor, I am sick.
Sick of those who are spineless.
Sick of those who feel self-entitled.
Sick of those who are hypocrites.
Yes doctor, an army is forming.
Yes doctor, there will be a war.
Yes doctor, there will be blood.....
Madison
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Re: Gotta Love American Healthcare

Postby eastcoaster » Sat Jun 28, 2008 12:10 pm

Oh gosh, Madison, so sorry about all of that! Glad you're on the road to recovery; I've heard people can die from a ruptured appendix! :-o

American healthcare is in a horrific state IMO. I think about some of the European systems (Germany, for example), and find them to be a bit more acceptable. Sure, you still pay for it (like a tax, I think), but the care is decent, and there is not such a thing as a bill at the end. Whatever care you need, you get. It may not be your doctor or treatment of choice, but I've heard it's adequate.

I have to agree with some of the others that insurance IMO is a necessary evil. There are certain things that could happen to a person which would break them financially for the rest of their lives.

Again, very sorry this happened to you! Sounds like you caught it just in the nick of time :-o :-o
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Re: Gotta Love American Healthcare

Postby AcidRock23 » Sat Jun 28, 2008 12:27 pm

Glad to hear you are ok, that is some gnarly stuff to go through.

I work for an insurance company (property & casualty, rather than health insurance, but they like us to pay the bills as we don't push the 'reasonable and customary' bit all that much...) and I suspect that the reason that the 'discount' price is available is very likely because hospitals are aware of 'reasonable and customary' charges in the area and are aware that their initial bill would not stand up to the scrutiny of litigation (or negotiation with an insurance company...most health insurance providers, such as the one MrsAcidRock works for, negotiate fees for procedure codes up front and often get a similar discount), which is probably where quite a few accounts like this end up? So they hedge their bets and adjust their cost to 'reasonable' up front to look like the good guy. Still, $5K is $5K.

This whole thing is a bigger shenanigan than the Broncos RB situation and I hope that whoever wins in November takes some steps to streamline the process to make it less absurd.
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Re: Gotta Love American Healthcare

Postby menyak » Sat Jun 28, 2008 4:25 pm

eastcoaster wrote:American healthcare is in a horrific state IMO. I think about some of the European systems (Germany, for example), and find them to be a bit more acceptable. Sure, you still pay for it (like a tax, I think), but the care is decent, and there is not such a thing as a bill at the end. Whatever care you need, you get. It may not be your doctor or treatment of choice, but I've heard it's adequate.

In Austria you pay between 7.5% and 9.1% of your income for health insurance. The maximum amount ANYONE pays for it is 4,892 Euros per year. The price is the same no matter if you're single or have a spouse and a kid (or ten kids). The key is that insurance is mandatory, so everyone has to pay for it, even the filthy rich who prefer to pay cash to their private doctors. So yes, it's like a tax. :-)
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Re: Gotta Love American Healthcare

Postby knapplc » Sat Jun 28, 2008 6:06 pm

Mad, I'm sorry to hear about your medical troubles. I'm sure I'm not alone in having no idea this was going on. It's good to see that you've gotten through it, albeit a bit lighter in the wallet, unfortunately.

Health insurance is really only a good deal in the event of catastrophic health issues. When my wife went through breast cancer treatment a few years ago, the costs involved rose to over $500,000 the first year alone. All told, she's into insurance for well over a million dollars now, and out of pocket we've paid only about $30,000, if that. That covers three surgeries, half a year of chemo, about three months of radiation, blood cell growth inducers (which cost nearly $5,000 per syringe-full) and post-op meds that she'll be taking for years to come. We shell out about $200 in prescriptions per month, and that's after insurance covers their portion.

So while, overall, it may not be a good economic decision for you to have insurance at this moment, it's a really great idea to have ongoing coverage in the event of some kind of catastrophic health emergency, like advanced-stage cancer, so that when you need the coverage you have it. I can't imagine it would be an easy sell to get health coverage from some insurance company when their actuaries are telling them you'll pay in about $600 per month, but take out $10,000+ per month the second you walk in the door.

It's best not to have to worry about the $$$ at that point, you know?
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