Patients on health care costs: we don't care and screw the insurance company

[Pharmacology]

Back when I was with the multistate healthcare organization, I did most of the risk management for their hospice service lines.  After seeing hospice up close and personal, when the time comes, I am going that route if I can. I would much prefer that than the ICU.  The most common diagnoses of people on hospice are cancer, dementia, respiratory disease and heart disease.  By federal law, if you have a terminal condition and are expected to live six months or less, you are eligible for hospice.  Medicare pays for it.  Only about 30% of the patients who are eligible for hospice avail themselves of it.

A lot of the patients and families I spoke to saw it as "giving up."
Objectively,  palliative care is far superior to the suffering I saw people experience as a result of stubbornly being a full code patient.

But... I don't know if I could bring myself to accept that fact if it were me.

[erictank]

A lot of the patients and families I spoke to saw it as "giving up."
Objectively,  palliative care is far superior to the suffering I saw people experience as a result of stubbornly being a full code patient.

But... I don't know if I could bring myself to accept that fact if it were me.

Oh, I would, in a heartbeat. I'd far rather die comfortably and with dignity, able to say goodbye to my family, than have every last scrap of biological function agonizingly dragged out of a terminally-failed body (housing a mind driven insane by pain) by a host of incredibly-expensive machines. Got no problem with CPR, with legitimate supportive measures aimed at an expected return to at least some reasonable semblance of a real life, but "heroic measures" aimed at preserving a life not worth living? No.

[mtnbkr]

As for checking prices prior to getting care, that's been practically impossible for us.  We'll call the hospital, they say it depends on what the insurance covers and which billing code the doc uses.  Call the insurance company and they can't answer until they're billed by the doc and/or hospital.  Call the doc and they can't tell exactly how it'll be billed.  Round and round we go, where we stop.....  is when the bill finally comes in, after the procedure.

That's the same sort of thing I ran into.  My favorite is when a procedure costs $0 when billed as "preventative", but $X when billed as "diagnostic". Same procedure, no difference at all. 

Chris

[Tallpine]

The medical profession is the only one I know of that can't possibly tell you how much something will cost beforehand, and then if they screw up you have to pay for their mistake. 

And they wonder why malpractice insurance costs so much 

[Scout26]

Scout, you can buy your own health insurance, but it's going to be staggeringly expensive. 

Employer provided/funded health insurance was a benefit to offset lower wages decades ago. 

Chris

BINGO !!!  That came about during WWII to prevent wage inflation as the pool of able-bodied males was shrinking due to the draft.  To keep people from job-hopping and forcing wages higher the .gov "made" companies offer health insurance to their employees to "chain" them to the current jobs and not interrupt war production.   It worked.  Still does.  People are chained to their jobs.

The second failing was when Insurance companies offer "preventative care coverage".  Yes, the goal was to save money by paying for minor, routine procedures to prevent major claims.  However, that defeated the original purpose of insurance, which was to transfer the risk of major expenses from the patient to the insurer.   Insurance then became "healthcare".  Whereas before, if you went to the doctor with the sniffles/cold/etc.  You paid the $25 or $50 (I don't know how much I just remember Mom writing a check when we went to the Doctor.)  Got your prescription filled, went home and took the meds per doctor's orders.   Having to pay out of pocket was a huge dis-incentive to not go to the Doctor unless you were really sick.   You were expected to be healthy and take care of yourself.

And once again, once .gov got involved the cost/price spiral began.  Just like education, transportation, and every other area the .gov has stuck it's nose into.
 

[Tallpine]

BINGO !!!  That came about during WWII to prevent wage inflation as the pool of able-bodied males was shrinking due to the draft.  To keep people from job-hopping and forcing wages higher the .gov "made" companies offer health insurance to their employees to "chain" them to the current jobs and not interrupt war production.   It worked.  Still does.  People are chained to their jobs.

...

Well, that and premiums deducted for employer "provided" health insurance is tax free.

[lee n. field]

My boss will kick in $125/mo towards whatever insurance we can buy.   

"Maybe I'll just go off somewhere and die."

[Scout26]

Well, that and premiums deducted for employer "provided" health insurance is tax free.

That was the deal the .gov struck with major manufacturer's.  No pay increases (driving the contract costs), employer's got to deduct the cost and employees got medical insurance (that's what it was originally, for going to the hospital for accidents/surgeries.)   Everyone won.  However just like the Spanish-American War Telephone Excise Tax, it didn't end when the war did.