I got the bill today from ECMC for my heart procedure(Ablasion)
Haven't gotten the Doctor bill yet.
My cost to ECMC after my Insurance payment?
Having good health insurance, priceless.
The other day I got a copy of the invoice my health insurance company paid for a hose for a breathing machine I use when I sleep (another story altogether). The cost for this 4 ft. long piece of hose: $49.95! The health industry in this country is nuts. Physicians pay extremely high premiums for liability insurance, for example, because juries are prone to awarding very high payments to litigants, knowing there is virtually no support system for them.
I worked briefly in medical billing at a hospital. EVERYTHING you get is billed.
That Tylenol they give you? It's $14 for each pill that the nurse has to bring you. That's no joke, it's on the itemized statement, which patients don't see (the insurance company does).
Man seriously, if our country just spent a bit more on healthy eating and education from the beginning (for example not having pizza, meat and fried foods as school lunches for the first 18 years of a kid's life... they would literally save BILLIONS on health care! So ridiculous (and sad) that it doesn't happen. Haha we just need more Jamie Oliver's in this world! I also read an article on http://www.healthinsurancequotes.org that talked about what our country would be like with a few minor changes to the health care system... so freakin inspiring!
I am from Canada and I want to clear a few things up for the Americans.
First off in Canada a patient does not wait for emergency surgery. If you break your femur, need and appendectomy, require heart surgery, have cancer, etc..., you get treated right away. What we do wait for are elective procedures like a menisectomy (simple arthroscopy), gallbladder removal (if not an emergency) etc... Many Americans seem to think that if you need a procedure right away you have to wait...NOT TRUE. Our system is far from perfect but it is decent. We also have quality of life assessments for things like knee and hip replacements. So, people who need it most to continue with daily activities get them first. I had to wait about 3 months for each of my ACL recons (have had 4) which is not bad. ACL's are not life threatening so I have no problem waiting a bit. There are also possible solutions to avoiding surgery in the first place like losing weight or changing your diet. If people choose not to change their lifestyle then they have to wait (except for something like cancer). Also, some Canadians choose to go to the US if they can afford to pay out of pocket to get services faster or if they want to receive experimental treatment that is not approved in Canada. Because the government pays for Canadian healthcare, it cannot afford to fund treatments that are experimental in nature or not proven to be effective. For that you have to go to another country. The cost of prescription drugs in our country is also much lower than in the US. So please don't make assumptions about our healthcare without knowing the facts first. I have always been treated in a timely and respectable manner and am more than pleased with the healthcare I receive. I will admit that for those Americans that have good insurance, healthcare is amazing. I broke my arm really bad skiing in Veil a few years back and when the hospital found out that I had out of country health insurance they shuffled me to the front of the line and treated me like gold. I had no complaints, however, I did feel bad for the people that got pushed aside so I could be treated. I hope this clears things up a little.
I am also Canadian, but live in the States. BadGalSkier is right, emergency cases are done right away. Elective surgery usually takes much longer. Also indications for elective surgery are different. Over 45 and tore your ACL? You'll have a much tougher time finding a surgeon to fix it. Total joint replacement? Average wait time is at least 6 months and that's not counting the amount of time (usually years) that your primary care doc has been nursing you along until they refer you to an orthopod.
Have a headache? It took me two months to see someone. Need a MRI? Average wait time is 2 months.
I'm not saying that Canada has a bad healthcare system, but it's not perfect. It's all about allocation of funds and what people are willing to accept. There is a lot of waste in the current system, but there are an awful lot of questions that need to be answered before you can proceed. Are we willing to wait, ration healthcare, tort reform, and in some cases be denied care deemed experimental or extraordinary?
BTW BadGal, I doubt that you were whisked away to the front of the line because of your insurance. It's all about triage. Your injury was probably thought to be more severe and thus you got bumped up. Believe me, the people working in the hospital could care less what insurance you had. On a side note, my friend broke his wrist in Whistler and couldn't get treatment until he ponied up his Visa card!
For sure. I wrecked my car on black ice last winter...went to the hospital in an ambulance, had an x-ray and a CAT scan (all fine, face just a bit banged up and I got knocked out). Looked at my account on the website of my health insurance later...something like $12,000. Paid for. Thank heaven. (and thank heaven for the car insurance too, which also helped out and helped pay for my new glasses) I can't imagine if I hadn't had insurance (and that is why I scoff at people who say, "I'm young and healthy. I don't need insurance." I'm young and healthy too. But accidents happen. And everybody is healthy...until they're not.
Major illness is scary enough WITH insurance, considering deductibles and co-pays (mine is about 10% for most things, but even 10% of, say, $50,000 or $100,000 is really, really scary). It's terrible that there are people who go without.
It's scary when you consider the times, too, that I've battled with hospitals and insurance companies, usually over incorrect billing. I had one test that my insurance rejected because the coding sucked. After calling everybody under the sun and getting the run-around, having to get my doctor's office to send proof of why I had it (even though it was on the doctor's original order), it sat for months. It was not resolved several months later when I had the same test again. Which had the same coding error again. More runaround, more going after proof. Finally I got to deal with someone in that department who actually had a brain and wanted to do her job, and she's been working on it for me. It's been a year since the first test, and it finally got re-billed to my insurance company maybe in November? Unfortunately they paid it, even though they technically have a rule that if something isn't resubmitted within 6 months of the rejection, they don't pay. I wish they hadn't. I understand a service was rendered and should be paid for, but I feel like that department should've had to eat it and maybe next time they'd be more careful about their coding AND wouldn't let it sit for months and months on end without getting anything done to resolve it. Still waiting on resolution for the second test, which I had done in June. Had another issue with said car accident above...got a bill from the office of one of the doctors who saw me (no idea who he was. I was pretty out of it when I first got there and if he introduced himself, I'm clueless). This one was rejected because the date of service was wrong (I think someone typed in the billing date rather than the actual date I was there). Trying to fix it, I call the doctor's office. Their billing is done by an outside service so they're clueless. Call the doctor's office, nope, billing for work this doctor does in the ER is different than for work he does in his office. Call the hospital. They have no clue because thje bill didn't come from the hospital, it came from the doctor's office. Nobody will talk to me because they all say it's not their billing...do they want their money or not?? Silly.
I've had mostly really good experiences with my health coverage, but that's because I've been able to buy into pools.
I had cancer in 1992 and went through all of the procedures (surgery, radiation) and didn't pay anything out of pocket. I had an ablation, and later open heart surgery in 2004 to the tune of about $150,000 (though they never told me exactly how much) but didn't pay a dime out of my own pocket for any of it. On a follow up procedure I went in for they found a complication and had to put me under suddenly, I stayed in the hospital an entire week when I was supposed to be there for 3 hours. After I got home I got a bill from the HMO for $1400 for the anesthesiologist. I was shocked and called the company. The woman I first spoke with asked me about two or three questions, looked at her computer, and told me to throw away the bill. THEY had screwed up. The company is Group Health Cooperative, who gets all kinds of crap from locals who don't have it ("Group Death"), but in fact has been the best insurer I've ever had. Every time I've had another insurer it's been run around time over and over. At Group Health they just take care of you.
Not all insurers are bad. That being said, I think most of them are pretty despicable.
Tell me again when i had a lump in my breast that that I would get seen right away? I waited 3 months to get in to the cancer specialist and then decide what we wanted to do about it, let alone the time to then wait to get a biopsy. My father has waited 8 months with a swollen knee at 69 this year to get an MRI in Canada, my husband got one in 2 days in the states.. My mother in law died last year, after waiting 8 month's to find out why she vomitted everything she ate and finally getting in to see the specialist in Toronoto after being nursed along in her rural hospital, in and out to be told oh there's a blockage we can go around easy enough but she has a massive internal infection caused from how weak she had gotten and died 5 days after being put on antibiotics to try and clear it (they new she was probably too weak). My son was in a house fire in 2004 and had 16% of his body covered with 3rd degree burns. That same hospital took 8 hours to find somewhere with an open burn unit bed to send him too. There was none in Barrie, none in Toronto and he was sent by ambulance (no air ambulance) 5 hours away from his family to get one. When he wanted to come home he was told he had to go off morphine first, so he was very fast to get off morphine and then discovered he codln't be sent home as there was no one in our area could do the burn dressings. We found a home care, prior army trained nurse that agreed to do the dressings and was capable though not qualified and he came home. We were supposed to drive him 5 hours twice a week to have the dressings done though. In 2008 I dropped my son at the Kitchener hospital with a broken thumb and he sat there for 13 hours (j10pm to 11am next day) until a nurse read his Xray and put a splint on him and said she was so sorry no one had time to look at it yet, maybe he could go to a walk in clinic as he had no doctor as he had been on a waiting list for a year. I begged his old doctor in Guelph on a phone call to take him back and after much hemming and hawing he agreed to. The standard wait time advertised at the US hospital I use is a 30 minute ER. I am no exaggerating any of this. If you do not live in a metro area you will be on a waiting list for years just to get a doctor. I spent 6 years on a waiting list in Midland ON and was told my Health Care to just go to the hospital when i needed an annual physical. We all know how fast they'd see me when a broken rib takes 16 hours to be Xrayed and would , ofcourse, be a higher priority.
That you have been fortunate in a system may indicate you are in a major metro area, but as a Canadian resident that has coverage in the US also I can tell you, I regularily pay the fees, copays and percents needed and the premiums to get my health care in the states. The Canadian public would not believe the difference between the two systems and I understand why the 85% of the US that has coverage won't vote to let it go to Gov't ( what does gov't typically run well?), I do believe the US has one of the best care systems in the world but it does imo, need regulations to assist those that need to change jobs, you know,, laws that don't allow insurers to deny coverage or change it or raise it more then said amounts etc... things to keep profits in check (if you want to insure in our country you must offer this), and I do believe they could make it the best in the world and not copy an ailing system from another country. The US if far from perfect also, but if i was to put the 25% of my income I'd pay less in the states to tax to my health care premium I could get really good health care!
People in the States have no idea on the waiting times. My friends in Canada often abuse the emergency room, because they figure that waiting 12 hrs in the ER is better than waiting months for an appointment to see the doc.
I always hate to use anecdotal evidence, but I think that this story serves to point out some of the deficiencies of the Canadian system. My friend was skiing with his family, when his son went off a jump and took a spill and was knocked out. They took the kid to a hospital in Kelowna and on the way down the hill, the kid had a seizure. My friend is an anesthesiologist and wanted his son to get a CT scan to rule out a bleed. He was told that the only CT scanner in Kelowna was broken and that he would have to drive 2 hrs to Kamloops to get the scan. Instead, he drove the 5 hrs back to Seattle.
Granted, Kelowna is not a huge city (150 thousand), but it's twice the size of Bellingham, WA and I bet Bellingham has more than 10 scanners operating. On the other hand, why so many scanners in Bellingham?
It's a complicated issue. We have one of the best healthcare systems in the world and I hate to see it taken completely apart. Don't believe all the statistics showing us on par with 3rd world nations. For instance, the numbers looking at infant mortality rate do not take into account that in the US (and some other countries), they take into account any risk infant regardless of gestational age. Also, it is a well known fact that African American women (iregardless of socio-economic status) have a higher infant mortality rate. Also, why do people live longer in other countries? Probably has to do with genetics and overall health (we are a nation of obese people).
A change is going to come, but I'm weary to let the government do all of it. The AMA, insurance companies, lawyers, drug companies, etc all have big lobbyists. Also keep in mind that Canada's population is less than California's population. So, if there are problems there, think of what problems we would have here.
People in the U.S. abuse the emergency room too, because the ER can't turn you away for lack of insurance, so once a person's cold has turned into death-bed pneumonia because they couldn't afford a doctor, they hit the ER for treatment...
Most of the emergency room abuse here in WNY is by Medicare recipients who don't have regular family doctors or pay for health insurance. They always seem to be able to afford 2 packs of cigarettes which cost $8 a pack and a 6 pack of beer everyday. Add to that the fact most are overly obese from their eating habits and lifestyle and it's no wonder why we have health insurance concerns.
Did you know there is no waiting time in NY to get on welfare and free health insurance? That's why it cost me $850 a month for mine.
BTW, the County I live in has the 6th highest property tax rate in the entire US.
Single women and their babies move here everyday so they can get all the welfare freebies. A mother and 4 kids will get you the average salary of a person making $18 an hour. Why work?
Our new Governor has promised to fix this. Ya sure!