Wednesday, February 25, 2015

it's what's inside

Just got a near exact duplicate of my leg hardware.  My insurance company was billed just over $9,000 for what they hammered into my leg bone.  This titanium tibial nail arrived (sealed in a sterile package)...cost me $50 on Ebay.  46,62,34,0,B


Unknown said...

Here's a thought, would the hospital actually use the $50.00 tibial nail if you had been able to have a say in the matter? Hum?

Rev.jimmyleebob said...

yeah, know the ebay one isn't encrusted with cubic zirconia.

rondeb said...

Your insurance is paying for all the uninsured and those on no premium insurances provided by the Government. The insurance will only be paid the real $50. on those policies, but they can get $9,000 out of yours. Plain and simple

Larry G said...

ebay doesn't have to pay for charity care - you do!

when you go to the hospital and you have insurance, you help pay for the folks that don't!

sad but true!

Steve said...

If we had a single-payer healthcare system, there wouldn't be such a thing as $9,000 pins like that.

As Canadians are fond of saying, "Canada has a healthcare system – the US has a healthcare industry."

rpm said...

That's right John. If the insurance companies didn't charge $9000.00 for a $50 piece of metal, how could they possibly afford all the illegals having their babies here in the US.

I mean, it's just common sense.

Margery Billd said...

Yes rpm, I remember those years when I had no insurance (luckily I was well) and the people from Mexico had the best of care and babies at the San Antonio hospital when I visited. Shocking but true. Good summation Steve. I just saw the movie American Sniper. I thought that was a good movie?

Dale said...

My first reaction is what in the world were you thinking but what the heck deserts seem to draw or create eccentrics.

Smackmama said...

I want to know why you bought one from Ebay. What are you planning on doing with it? Next time donate that money to a charity.

Anonymous said...

MsBelinda said...

May I ask why?

Unknown said...

My daughter, 10 years old hit by a car. broke her femur. snapped it right in half. They have 2 long rods, in the x-ray they look like straightened out clothes hangers. No cast needed, shes up and hobbling around and the bone is healing nicely. This happened in late December. With everything we're looking at 40k. Without insurance I don't know what we would have done. Now her rods get removed, but before they do that as we're in the new year we have to pay the 1500 deduct upfront, else they wont remove the rods. I'm happy my kids alive, at the same time it makes me furious at the costs. I'm just a person, a normal guy. I can take care of the deduct but if we didn't have insurance. they would have done what to my kid. Maybe a simple cast, which would of had her laid up 6 months.. I saw a movie trailer where the dad holds the doctor hostage at gunpoint. Its not a fair world we live in, on the same note at least we don't have people being burned in cages.. I don't know what the answer is but somethings need to change.

Larry G said...

the thing about health insurance is that if you do not have employer-provided or Medicare -you are not entitled to it - at any price if the company thinks you are a bad risk.

people take employer-provided for granted but it's the govt that requires employer-provided to not deny people nor charge them more than others because of their health.

employer provided - also allows tax-free money for the insurance No Federal or state taxes, nor FICA - and that amounts to about a third of the cost which if folks had to pay taxes on it (like those who buy on the open market) it would be a significant tax bite.

Most folks on Medicare would never have insurance if they had to buy it on the open market - they're all bad risks - even the ones that are healthy because of their age.

so the folks who don't have employer-provided, or Medicare or in a state that has not expanded MedicAid - they have few options and they can be dropped and denied at any time.

so -yes we need to do something - we are the only advanced economy in the world where some people live at the edge of financial disaster.

If folks really want the govt out of health care then we should get rid of the govt-sanctioned employer-provided rules and let those folks get insurance on the open market like those without employer-provided have to do ..and get rid of Medicare.

sometimes I think we're so conflicted but in different ways that we cannot - as a society reach some level of agreement of what we want to do.

one more thing - we DO have Universal Health Care because we do not turn anyone away that needs care - we just transfer that cost to others and this is far more expensive than if people actually had insurance - even minimal insurance - like the MedicAid expansion which would provide managed Primary care to folks on a means-tested basis.

Harry Flashman said...

Rondeb is exactly right. You are getting soaked to pay for free medical care received by others.

PAL said...

I read a post this morning from a fellow in Canada who has been waiting a year for a hernia operation. I also recall hearing a woman talk on radio - about age 70 (do not remember exact age) who came to U.S. for joint replacements in her hands, wasn't allowed in Canada due to her age. I am not sure what the answer is but having the government in charge (single payer) in the U.S. is already becoming a disaster, as is anything the government handles IMHO.

Larry G said...

it's true - you do hear about these waits which are typical and routine in any country that has universal health care.

but it's also true in a country where someone does not have access to insurance... they have wait times also.

and it's true of even those that have insurance or even Medicare - they decide what your access and wait time is.

the only folks not subject to this are those who are independently wealthy and can get whatever medical care they want when they want it.

If you are not independently wealthy - no matter what country you live in - including the US - you can get put on a wait list.

remember the "death panels"?

edlfrey said...

In 2013 there were 2,596,993 deaths in the United States. The vast majority of those people had insurance coverage.

When is there going to be something done about people dying that are covered by insurance? Why has the government allowed this to happen? When are they going to stop it?

Larry G said...

one of the interesting things about insurance - is whether or not they pay off or not -

we take this for granted in this country but in other countries - developing and 3rd world countries - you're on your own.

there is no government that actually regulates insurance.. anyone can set up shop and claim to insure you and you have no idea if they have the financial resources to pay off or not.

In countries without govt regulation - insurance is a pig-in-the-poke.

If John were in Uganda - and had bought helicopter or health insurance, there would be no guarantee that they'd pay off..

In the US - we depend on govt to make sure the insurance companies are legitimate, are financially able to deliver benefits - and not be scams.

in short - we depend on govt in this country - even the folks who say they don't! They just take for granted how lucky we are to live in a country where the govt DOES protect our rights by regulating insurance companies!

Rev.jimmyleebob said...

Get a tasteful frame and hang it on the wall. My neighbor down the street has a kidney stone hanging on his wall.It's not much to look at from a distance but when you get up on it you can appreciate the effort it took to get it from point A to point B.

rondeb said...

My husband and I both are on Medicare and we pay around a total of $450. each for the medicare premiums to the Government and our supplement policies. We paid for our future Medicare insurance out of our paychecks for years before we could collect. Even those on Medicare are paying a fairly healthy premium each month for this benefit. Medicare is not free by any means and what they will pay for is getting less and less every year. The prescription formulary is becoming a joke.

Larry G said...

you paid out of FICA over the years for Medicare Part A (hospital). You never paid for Medicare Part B which you do when you retire.

what you pay for Medicare is cheap compared to most younger folks with employer-provided .

the think you have to remember also - that you are entitled, guaranteed insurance because of the government. It's the provider that does not deny coverage - takes everyone - and charges everyone the same price on a means-tested basis.

People who earn up to 85K a year in income pay only about 105.00 a month for basic Part B (doctors/providers).

If you have advantage it costs more but Advantage is heavily subsidized.

the govt pays 3/4 of the premium costs and that adds up to about 250 billion a year in the budget. The advantage program costs the govt about as much as basic Medicare Part B does but the impact on the budge is smaller (so far) because only about a third of people on Medicare also have advantage.

but as I said - the thing to know - is that you are entitled to Medicare Part B and Advantage BECAUSE of govt. Otherwise most over 65 would never have insurance at all.

Part A - you DID PREPAY. Par B you did not.

one of the big problems today with the health care controversy is that many people simple do not know the basic facts.. and believe that the insurance they have - like Medicare and like EMployer-provided has nothing to do with govt - whereas the truth is neither one would exist without the govt. that's just the simple fact.

pw said...

I am so loving ALL these comments! Very insightful and interesting to see some of the thinking that keeps us in a mess.

Larry G said...

there are two parts:

1. what you think or want to think

2. - the reality

make sure they're the same regardless of your politics.

and the reality is that employer-provided exists ONLY because of the govt

this will help one get started on understanding that part:

skip down to:

Health benefit plans

ERISA does not require that an employer provide health insurance to its employees or retirees, but it regulates the operation of a health benefit plan if an employer chooses to establish one.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits a health benefit plan from refusing to cover an employee's pre-existing medical conditions in some circumstances. It also bars health benefit plans from certain types of discrimination on the basis of health status, genetic information, or disability.

quite a few more links available.. to demonstrate that most folks benefit from the govt when it comes to insurance.

pamit said...

It is certainly a hard thing to put aside our "personal data points" and try to consider the situation objectively. But the situation is pretty clear regarding the astronomical prices of medical devices, like John's leg hardware. There are virtually no controls, transparency, or competition involved in the sale of medical devices to hospitals and providers. This results in device costs (and profits) in this country being higher than any other developed country. The Affordable Care Act places a 2.3% excise tax on such devices (part of keeping the ACA deficit-neutral) which manufacturers and the GOP are trying mightily to repeal. The industry can well afford such a tax, and with a higher percentage of the population insured, device makers will undoubtedly sell more pacemakers, hip joints, etc. so could afford such a tax even more easily. It's very telling how and why some parties are working hard to get it repealed.

I'm sure John is not implying that "it's the government's fault" that his device costs $9K. Larry G's last post is spot-on.

BigBuc said...

kickbacks. no pun intended.

cynlee said...

Oh my... 😳🤔