Angiography $145K ,,, Our government has fucked up our medical system
- Thread starter ArmyJerry
- Start date
AJ, hope you are OK. Assuming that you are alive and kicking, keep kicked ng.
So, some reality here. I,ve worked in the medtech field on the venture/company side for years.
Average angioplasty procedure for someone without insurance in the US is between $25-145k. Angiograph is within that procedure. If stents are emplaced, cost is larger by that device and associated charges. Average costs to insured, the negoiated rate is in the $20-35k rate. Having been in the cath lab, the procedure is about 8 minutes.
This has nothing to do with the government. CMS sets cost reimbursement for Medicare, government funded, patients. Angiography is in the $10-15k range. Take a look at these summary schedules froBoston Scientific, one of the leaders in medtech: https://bsci-prod2-origin.adobecqms.net/content/dam/bostonscientific/Reimbursement/PI/2018/2018 Procedural Payment Guide.pdf
The ACA, Obamacare, even sought to measure performance and monetarily penalize low performing and high cost centers. So the government did that.
A consequence a free market in American healthcare is that prices differ center to center and when you have an event you don’t really have time to shop around. A normal economic event is where the person who receives a good or service both chooses and pays for it. The economic equation in health is like nothing else: doctors choose care, insurance pays for it and patients receive it. Certainly, patients or people pay for the whole system indirectly through taxes (Medicare) and insurance. But, this brings in the next distortion in the economics and politics of healthcare- when you pay insurance we hate it, we are suspicious of services to others which drive cost and want it to be as cheap as possible. When we use insurance, have event, we want gold plated service without a consideration to pay for it.
Certainly, those are oversimplifications, but to address the OP, I’m not sure the government fucked this up for you and a truth you may not want to see us that the whole approach behind Obamacare was designed to smooth some of this out. I’m not saying it was a perfect system but it was a valid experiment in light of a free market which is not designed, by the incentives of the players, to solve this problem.
So, negotiate your bill.
So, some reality here. I,ve worked in the medtech field on the venture/company side for years.
Average angioplasty procedure for someone without insurance in the US is between $25-145k. Angiograph is within that procedure. If stents are emplaced, cost is larger by that device and associated charges. Average costs to insured, the negoiated rate is in the $20-35k rate. Having been in the cath lab, the procedure is about 8 minutes.
This has nothing to do with the government. CMS sets cost reimbursement for Medicare, government funded, patients. Angiography is in the $10-15k range. Take a look at these summary schedules froBoston Scientific, one of the leaders in medtech: https://bsci-prod2-origin.adobecqms.net/content/dam/bostonscientific/Reimbursement/PI/2018/2018 Procedural Payment Guide.pdf
The ACA, Obamacare, even sought to measure performance and monetarily penalize low performing and high cost centers. So the government did that.
A consequence a free market in American healthcare is that prices differ center to center and when you have an event you don’t really have time to shop around. A normal economic event is where the person who receives a good or service both chooses and pays for it. The economic equation in health is like nothing else: doctors choose care, insurance pays for it and patients receive it. Certainly, patients or people pay for the whole system indirectly through taxes (Medicare) and insurance. But, this brings in the next distortion in the economics and politics of healthcare- when you pay insurance we hate it, we are suspicious of services to others which drive cost and want it to be as cheap as possible. When we use insurance, have event, we want gold plated service without a consideration to pay for it.
Certainly, those are oversimplifications, but to address the OP, I’m not sure the government fucked this up for you and a truth you may not want to see us that the whole approach behind Obamacare was designed to smooth some of this out. I’m not saying it was a perfect system but it was a valid experiment in light of a free market which is not designed, by the incentives of the players, to solve this problem.
So, negotiate your bill.
Last edited:
I think your anger is misplaced. The insurance industry has really F'ed up medical prices in the US, way more so than the government. It's insane.
The government fucks up everything they touch! You may have to sell five percent of your ammo stash!
Last edited:
All I know is my insurance was more affordable before the " affordable " care act.
Hope you're OK AJ
Hope you're OK AJ
I don't know how anyone in the medical field can look someone in the eye and tell that they owe $145,000 for a 2 hour procedure. I just don't know how they sleep at night.
They sleep just fine on the best mattress money can buy.
Your not getting charged that. The insurance company is and they have negotiated rates of medicare. Your just seeing the overall bill which means nothing. If you don't have insurance and the hospital is telling you you owe it tell them fuck off and sue you. Hospitals get reimbursed by the Gov for uninsured care. The hospital will try to get something from you but offer them 5% of the bill or whatever you can afford to pay. They will take it and be done with it. The hospital has no way to compel you to pay it other than collection agency which is worthless, especially if you ignore them. They can sue you but usually don't because they don't want their ridiculous charges becoming public. Any Judge would throw it out. So they will hassle you for the few bucks you can afford.
i have insurance, its not the point,, the point is that the gov restricts the free market so prices get this crazy/.....it is the feds and state govs fault... they shake down the industry for a few thousand and make us waste trillions... I hope DC has its day of reckoning before I croak, its gonna end up a burning ring of fire if they keep this shit up.
the procedure was an abdominal artery blockage heading to my left leg, though it was my back acting up again,
Plenty of blame to go around...including patients. People want every skinned knee and sniffle covered so they run to the doc at the first sneeze.
If you would stay off those damn two-wheeled spine compactors.
Be wise Jerry. Pain that isnt just like before needs checked out.
Did the pukes investigate why you developed a clot? A warrior stud of 39 young years shouldnt be having a clot in his mesentary. Or anywhere really.
And yes the billing sustem is super super screwed up. Its part insurance companies (75%) and part the govt.
Hospitals are forced to play the game.
They tell insurance they need 18k for that procedure. Plus the doc bill usually.
Insurance offers $4800
They really do need 18k. So they bill 145k and get 17.5k after a bunch of negotiations.
Its stupid.
At my place of work, we bill individuals without coverage at same as Medicare and Medicaid reimbursements, the lowest out there. Its not super easy to qualify for medicaid, and we try to get those that need it on it to help.
Problem is, those on it work under the table to keep eligibility up and use a lot of drugs. But we cant test em and kick em out of the program for being dopers.
Lets kill all the lawyers (except @MosesTheTank) i think he is and he seems awesome, and a couple good Constitution guys I know.
Thats a darn good start.
Most polititians are lawyers, so that helps too.
Heal up @ArmyJerry. Please hit me up with any questions. I know a thing or two from watching ER and Grays anatomy....... ?
Did the pukes investigate why you developed a clot? A warrior stud of 39 young years shouldnt be having a clot in his mesentary. Or anywhere really.
And yes the billing sustem is super super screwed up. Its part insurance companies (75%) and part the govt.
Hospitals are forced to play the game.
They tell insurance they need 18k for that procedure. Plus the doc bill usually.
Insurance offers $4800
They really do need 18k. So they bill 145k and get 17.5k after a bunch of negotiations.
Its stupid.
At my place of work, we bill individuals without coverage at same as Medicare and Medicaid reimbursements, the lowest out there. Its not super easy to qualify for medicaid, and we try to get those that need it on it to help.
Problem is, those on it work under the table to keep eligibility up and use a lot of drugs. But we cant test em and kick em out of the program for being dopers.
Lets kill all the lawyers (except @MosesTheTank) i think he is and he seems awesome, and a couple good Constitution guys I know.
Thats a darn good start.
Most polititians are lawyers, so that helps too.
Heal up @ArmyJerry. Please hit me up with any questions. I know a thing or two from watching ER and Grays anatomy....... ?
AJ will be getting out of a dang wheelchair and onto a motorcycle.
And kicking some 25 yr old kids butt who is scared to go fast.
Probably carrying too many cases of ammo into the store room caused the clot......
Or he stopped his old man aspirin dose......
And kicking some 25 yr old kids butt who is scared to go fast.
Probably carrying too many cases of ammo into the store room caused the clot......
Or he stopped his old man aspirin dose......
Q
QuickNDirty
Guest
aj ain't 39, dude. He's at least 60.
Everyone has their finger in the medical pie.
Device manufacturers want ROI.
Lawyers want pay for patent protection/liability oversight
Universities wont future earnings from med students
Insurance/lawyers want future earnings from docs
Drug manufacturers want ROI
Govt applies regs with good intentions that increase costs to everyone
Insurance imposes costs on everything done pushing paper
Behind the doc are probably 6 or 7 people just pushing paper for each procedure
The cost is not the procedure its the giant money sucking apparatus behind it
Insulin is a pretty mature technology, been around since the 1920s. You would think it would be pretty much a generic item. Nope every 15 years the manufacturing process is tweaked, patents are issued and costs are maintained.
For a month of insulin you see a copay of $100. The phrarmacist tells you you have great insurance and shows you the insulin billed for was $700.
I think the actual cost of the insulin is covered by the $100 copay - including profit/cost to bring to retail - and all the other money is paper shuffling.
The result - $15/1 aspirin.
We have the best med technology because manufacturers make profit - that is good. Seems like med devices is the last remaining area where I see well made American goods. I find myself looking at these machines when in a Dr/Dentists office and most are made in USA. Optometrists seem to get a lot of German or Jap gear, American stuff often marked Corning NY.
Whats the fix?
Better Insurance competition across state lines?
Organization of health co-ops by association?
Get the sniffles and cough ailments out of the mainstream hospital treatment to ease pressure on limited resources?
Whatever the answer is I dont want the govt mandating or running shit.
The further control gets from the consumer the worse the cost controls.
Govt will use control over health care politically, either directly by screwing certain consumers or by giving legislation to players other than the direct consumer to get kickbacks for their party.
Some of the most messed up stuff out there is due to insurance lobbyists convincing pols it will be good for their wallet to screw over the constituency.
If you really need it and can pay for it you get better care now but if you dont need catastrophic care the old GP doc living and treating people out of his big Victorian house on the corner was a good provider. He would even come to your house and if you didnt have cash but knew plumbing he would trade care for a fix of his kitchen sink.
He cant exist today the way regulation mandates reams of paper.
There was also the local hospital. Same thing giant health conglomerates have bought them out and shut down in order create efficiencies with their other acquisitions.
Surprised they found a heart in their @ArmyJerry. Id of guessed a case of FGMM 175 kept you ticking.
Device manufacturers want ROI.
Lawyers want pay for patent protection/liability oversight
Universities wont future earnings from med students
Insurance/lawyers want future earnings from docs
Drug manufacturers want ROI
Govt applies regs with good intentions that increase costs to everyone
Insurance imposes costs on everything done pushing paper
Behind the doc are probably 6 or 7 people just pushing paper for each procedure
The cost is not the procedure its the giant money sucking apparatus behind it
Insulin is a pretty mature technology, been around since the 1920s. You would think it would be pretty much a generic item. Nope every 15 years the manufacturing process is tweaked, patents are issued and costs are maintained.
For a month of insulin you see a copay of $100. The phrarmacist tells you you have great insurance and shows you the insulin billed for was $700.
I think the actual cost of the insulin is covered by the $100 copay - including profit/cost to bring to retail - and all the other money is paper shuffling.
The result - $15/1 aspirin.
We have the best med technology because manufacturers make profit - that is good. Seems like med devices is the last remaining area where I see well made American goods. I find myself looking at these machines when in a Dr/Dentists office and most are made in USA. Optometrists seem to get a lot of German or Jap gear, American stuff often marked Corning NY.
Whats the fix?
Better Insurance competition across state lines?
Organization of health co-ops by association?
Get the sniffles and cough ailments out of the mainstream hospital treatment to ease pressure on limited resources?
Whatever the answer is I dont want the govt mandating or running shit.
The further control gets from the consumer the worse the cost controls.
Govt will use control over health care politically, either directly by screwing certain consumers or by giving legislation to players other than the direct consumer to get kickbacks for their party.
Some of the most messed up stuff out there is due to insurance lobbyists convincing pols it will be good for their wallet to screw over the constituency.
If you really need it and can pay for it you get better care now but if you dont need catastrophic care the old GP doc living and treating people out of his big Victorian house on the corner was a good provider. He would even come to your house and if you didnt have cash but knew plumbing he would trade care for a fix of his kitchen sink.
He cant exist today the way regulation mandates reams of paper.
There was also the local hospital. Same thing giant health conglomerates have bought them out and shut down in order create efficiencies with their other acquisitions.
Surprised they found a heart in their @ArmyJerry. Id of guessed a case of FGMM 175 kept you ticking.
don’t forget you have to pay your share to cover illegals that don’t pay a cent or those with no means
and we all forget...this is a expensive business.
30-40 years ago, youd be dead on the floor watching TV one night with out that procedure
now you can do wind sprints in 8-10 weeks
if we all want to go back to 1970 payments and procedures thats fine...but dont plan on being a great grandpa any time soon.
how many "old" uncles were always strong and tough and worked his whole life...he went to the hospital and dies..."hospitals kill you"
we have all heard that story a 1000 times
no dumb ass you had something wrong and it was caught it too late
no big profits...no new tech/procedures
no investment firm will back a new procedure or tech company if the ROI is 100 years
its the same with prescription drugs, we can mandate a sale price of new drugs (like england does) but if the ROI of that new drug will not bring investors to fund the research...no more new drugs.
which would be fine IF we dont mind not spreading the money they make off viagra (useless non life saving drug in reality) to spend on cancer research.
no expensive viagra...no cure for cancer research
society wants to roll the dice; if you get cancer you die..thats one thing
stop hospitals from performing procedures on a accident victim because his credit card cant cover the balance
these are the really hard questions that no one wants to deal with, which is why health care is the red herring
30-40 years ago, youd be dead on the floor watching TV one night with out that procedure
now you can do wind sprints in 8-10 weeks
if we all want to go back to 1970 payments and procedures thats fine...but dont plan on being a great grandpa any time soon.
how many "old" uncles were always strong and tough and worked his whole life...he went to the hospital and dies..."hospitals kill you"
we have all heard that story a 1000 times
no dumb ass you had something wrong and it was caught it too late
no big profits...no new tech/procedures
no investment firm will back a new procedure or tech company if the ROI is 100 years
its the same with prescription drugs, we can mandate a sale price of new drugs (like england does) but if the ROI of that new drug will not bring investors to fund the research...no more new drugs.
which would be fine IF we dont mind not spreading the money they make off viagra (useless non life saving drug in reality) to spend on cancer research.
no expensive viagra...no cure for cancer research
society wants to roll the dice; if you get cancer you die..thats one thing
stop hospitals from performing procedures on a accident victim because his credit card cant cover the balance
these are the really hard questions that no one wants to deal with, which is why health care is the red herring
A buck forty five for two hours? 
Makes me feel better about the $2500 for shoving a hose down my throat to look at my ulcer (endoscopy).
Some interesting explanations here, thanks. I do think Obummer tried to improve things but just fucked it up.
Sounds kind of like a state hiway job...3 white guys and 3 black guys standing around watching a Mexican dig a hole with a shovel.
$1500 dollar hammers for the army.
Buy more ammo.
Makes me feel better about the $2500 for shoving a hose down my throat to look at my ulcer (endoscopy).Some interesting explanations here, thanks. I do think Obummer tried to improve things but just fucked it up.
Sounds kind of like a state hiway job...3 white guys and 3 black guys standing around watching a Mexican dig a hole with a shovel.
$1500 dollar hammers for the army.
Buy more ammo.
Good points. When I got cataracts in both eyes I whined 'why me'. The surgery gave me 15/20 and 15/18 vision. Just 50 years ago Id have been blind and unable to drive.
Now I say "Im glad I live in a time its fixable."
Glass half full.
I am a civilian worker,, i pay my insurance so yes i do pay for it..there is no magic money unicorn in economics...
Same procedure in rope is 10k...
Same procedure in rope is 10k...
@QuickNDirty
Pretty sure @ArmyJerry is only 55 or 56. Just old enough to adopt me to “keep track” of all his ammo.
But he plays harder than most young guys so I gave him a few years.
Cant wait to see pics from the butt whuppin he gives you for saying he is at least 60. ?
Pretty sure @ArmyJerry is only 55 or 56. Just old enough to adopt me to “keep track” of all his ammo.
But he plays harder than most young guys so I gave him a few years.
Cant wait to see pics from the butt whuppin he gives you for saying he is at least 60. ?
In a totalitarian state, pretty much everything can be traced back to big brother.
In this case, it was Obama's fucking with the already fucked up system we have here and instead of getting a 1 payer system (which has it's good points and bad points) we ended up with a new system that espouses the bad points from both sides and none of the good.
I have to change my insurance every year. Haven't kept the same insurer for over six, seven years now. Ever since Obama touched it. It goes up every year, last year or the year before was one of the worst with something like a 40% increase and it's still going up with no signs of stopping.
This is what happens when your government tells the citizens "buy a product or else".
I used to feel proud when I'd see the flag, anymore I see it and feel sick to my stomach worrying about what's coming next.
In this case, it was Obama's fucking with the already fucked up system we have here and instead of getting a 1 payer system (which has it's good points and bad points) we ended up with a new system that espouses the bad points from both sides and none of the good.
I have to change my insurance every year. Haven't kept the same insurer for over six, seven years now. Ever since Obama touched it. It goes up every year, last year or the year before was one of the worst with something like a 40% increase and it's still going up with no signs of stopping.
This is what happens when your government tells the citizens "buy a product or else".
I used to feel proud when I'd see the flag, anymore I see it and feel sick to my stomach worrying about what's coming next.
its because the 4 gang bangers with gunshot wounds who came in before you didn't pay their bill, so when they see a white guy come in they quadruple his bill to make up for it.
Spent some time in the cath lab, worst part was staying still in recovery for several hours. The plumbing was OK, they didn't want any surprises during my procedure a few days later... While having a gallbladder attack the ER did an echo of my heart and found a tumor in my tricuspid valve.... Say hello to papillary fibro elastoma...... Dr. Said I was possible that this could have been a result of 9/11 and my time on duty downton in the months, years to follow... He said they are super super rare and most times found at autopsy.... They wrote a medical paper about me that's how rare it is..... Lucky to be here, wish you good health....... Yes I'm BMA as AJ says and going to reload some in the very near future.... Footsteps 
the story behind interocular lenses is interesting. An RAF doctor or engineer by the name of Raynor, if I remember correctly, observed that pilots who survived crashes and aerial catastrophes sometimes had fragments of the Perspex shields that covered cockpits of fighter planes in WW2 embedded in their eyes and would recover. He concluded that the eye tissue tolerated the foreign material and, noting the optical qualities of the material, hypothesized that lenses ground out of Perspex could be used to replace clouded lenses in cataract patients. Before that time, and going as far back as classical Egypt, doctors would hook and remove the included lenses which restored some sight.
Over the past 50 years the technology behind IOCs has blossomed to everyone’s benefit but only because there was a market that rewarded the innovation.
Similar threads
