Guests - If You want access to member only forums on HSO. You will gain access only when you sign-in or Sign-Up on HotSpotOutdoors.

It's easy - LOOK UPPER right menu.

Sign in to follow this  
Followers 0
harvey lee

Insurance costs

33 posts in this topic

Why does insurance cost what it does? Here is a great example. I have had issues with my back for years and the insurance company has spent tens of thousands in bills for therapy and MRI's and cat scans. I have been going to a pain and back clinic since this spring to try and avoid surgery on my back. The doctor told me that I could now go to a fitness center like Snap Fitness and use two of their machines to achieve a possible reduction in my pain level instead of always coming to their office.

Today, I called my insurance company to see if they would rather pay the membership fee to use those machines rather than pay the Pain & back clinic I go to two to three times a week to the tune of approx. $800.00 a week. The cost for the same machines at the fitness center is $45.00 per month. They stated that they were not interested in doing this as they don't do it. I explained that they could save approx $9,000.00 annually in medical bills and they said no.

Now one knows why the costs for medical coverage costs what it does.

Isn't that just crazy and wrong.

Share this post


Link to post
Share on other sites

I feel your pain sir, I had a back problem a while back and they sent me to a Chiro and did x-rays and various treatments, with no results. It cost a lot with no improvement. Went to a second specialist and he said within 10 minutes, you are wasting your time with all that. You need surgery to correct. I said OK as I lived with the discomfort for to long. B-4 surgery I was a hunch back, barely could walk. 24 hours after surgery I was standing up straight to where my wife walked past me and did not even notice me. The surgery was 20 minutes long and cost less than the treatments b-4.

I don't get it either. I will tell you that the surgery did work wonders and that was 15 years ago, or so. It does not slow me down a bit. The best part of it was I was off work for 6 weeks and after 2 weeks I talked the doc into letting me do some fishing, so I had 4 weeks of pure fishing. It was great.

Good Luck

G.C.

Share this post


Link to post
Share on other sites

What if you got a membership per your doctor's orders? They do that from time to time I believe. With a doctor's order to use the gym, it seems it should be covered as part of the therapy.

Bob

Share this post


Link to post
Share on other sites

Well Harvey, what did the doctor say about surgery correcting the problem. I know they say that should be the last action to take, but how long do you need to suffer. Every case is different, but it sure worked for me. I can still remember the pain I went through.

G.C.

Share this post


Link to post
Share on other sites

I have been dealing with this for 17 years and the total solution is a rod in the back as my lumbar area of my spine is shot. I have been trying to not have the surgery as I would rather not but it looks like that may be the next avenue.

Share this post


Link to post
Share on other sites

I hear you on this Harvey and I fight insurance with my issues all the time. It makes no sense at all. Surgery is a last resort in my book. I had been to 5 doctors and specialists, physical theropy and nothing worked. I have chostochondritus which feels like you are having a heart attack all the time. I finally got to a good Chiro and it's getting better.

Share this post


Link to post
Share on other sites

I just had 2 mri's done last month, one on each shoulder, same day, took about 2 hours. The bill for the Mri's was $7800! Thats crazy!

Share this post


Link to post
Share on other sites

I agree Scott. My usual MRI for my back runs $2,000.00 for approx 20 minutes.

And we wonder why the insurance is so high.

Share this post


Link to post
Share on other sites

Though the cost of an MRI is quite high, working at a hospital I know these machines are outragously expensive. Then you need very well educated staff to run them. There are a lot of costs associated with everything that gets done. I work in IT, we don't generate any profit for the hospital but still have to be paid. So everything you pay trickles down to IT, janitors, new equipment, everything.

I do think some of these prices are over priced, but there's a lot that goes into it.

Share this post


Link to post
Share on other sites

Those freaking MRI machines cost something like $1 million a copy. No wonder an MRI costs so much. There's just something VERY wrong with the whole health care/insurance system.

Here's something else interesting. I take four medications each month (two for Type II diabetes, one for cholesterol/triglycerides, one for high blood pressure).

I am uninsured. When I was downsized from my last job in 2003 and rehired by another much smaller newspaper, I could not afford health insurance at the rates quoted by the newspaper's carrier, so I've been uninsured since then. Now that I'm working for myself, under the current crooked insurance system I'll likely never be able to afford health insurance, and will likely remain uninsured until Medicare kicks in.

But that's not the interesting part. This is: When my insurance lapsed and I went in to pick up my next month's meds, the total bill was about $260. I pointed out that I was no longer insured and couldn't afford that kind of money. They checked, and realized they'd made a mistake. Had I still been insured, that's what the total bill would have been, and what it had been up to that point. The insurance company was paying $215 of it and I co-paid $45. When they learned I was no longer insured, they quoted me an uninsured cash price of about $120, and that's what I've been paying each month for those meds ever since.

Things that make you go hmmmm.

Share this post


Link to post
Share on other sites

Those freaking MRI machines cost something like $1 million a copy. No wonder an MRI costs so much. There's just something VERY wrong with the whole health care/insurance system.

Here's something else interesting. I take four medications each month (two for Type II diabetes, one for cholesterol/triglycerides, one for high blood pressure).

I am uninsured. When I was downsized from my last job in 2003 and rehired by another much smaller newspaper, I could not afford health insurance at the rates quoted by the newspaper's carrier, so I've been uninsured since then. Now that I'm working for myself, under the current crooked insurance system I'll likely never be able to afford health insurance, and will likely remain uninsured until Medicare kicks in.

But that's not the interesting part. This is: When my insurance lapsed and I went in to pick up my next month's meds, the total bill was about $260. I pointed out that I was no longer insured and couldn't afford that kind of money. They checked, and realized they'd made a mistake. Had I still been insured, that's what the total bill would have been, and what it had been up to that point. The insurance company was paying $215 of it and I co-paid $45. When they learned I was no longer insured, they quoted me an uninsured cash price of about $120, and that's what I've been paying each month for those meds ever since.

Things that make you go hmmmm.

Note from admin, please read forum policy before posting, thank you.

Share this post


Link to post
Share on other sites

Originally Posted By: stfcatfish
Those freaking MRI machines cost something like $1 million a copy. No wonder an MRI costs so much. There's just something VERY wrong with the whole health care/insurance system.

Here's something else interesting. I take four medications each month (two for Type II diabetes, one for cholesterol/triglycerides, one for high blood pressure).

I am uninsured. When I was downsized from my last job in 2003 and rehired by another much smaller newspaper, I could not afford health insurance at the rates quoted by the newspaper's carrier, so I've been uninsured since then. Now that I'm working for myself, under the current crooked insurance system I'll likely never be able to afford health insurance, and will likely remain uninsured until Medicare kicks in.

But that's not the interesting part. This is: When my insurance lapsed and I went in to pick up my next month's meds, the total bill was about $260. I pointed out that I was no longer insured and couldn't afford that kind of money. They checked, and realized they'd made a mistake. Had I still been insured, that's what the total bill would have been, and what it had been up to that point. The insurance company was paying $215 of it and I co-paid $45. When they learned I was no longer insured, they quoted me an uninsured cash price of about $120, and that's what I've been paying each month for those meds ever since.

Things that make you go hmmmm.

Note from admin, please read forum policy before posting, thank you.

smilesmile

Share this post


Link to post
Share on other sites

If you think the MRI itself is expensive, consider the install is probably half again as much as the MRI itself. What you need to do to prepare to install one is ridicules and CT machines are not much better. But when people insist on top of the line care, expect it to not be cheap.

Share this post


Link to post
Share on other sites

I guess what most are trying to state is that the medical field is out of control with the costs. Now, I can find a way to save the insurance company thousands of dollars but they say no.

I guess the reason is, it doesn't matter what it costs as they just pass it on to the sick.

If one wants great care and then thats how they will decide how to charge, so be it. I'll skip a few steps if needed.

Share this post


Link to post
Share on other sites

In fact, they mostly try to find ways to deny covering those already sick. I have looked into insurance plans, Tom, and few would cover me because of the pre-existing condition. The few that would are demanding exorbitant premiums for poor coverage options.

That's one of the things that's gotten my attention with Obama. He's going to try to reform the health care/insurance system enough that I might be able to afford health insurance. Aside from the pre-existing condition, I'm generally healthy as an ox and pretty much never get sick, but as I get older that will change.

I don't know if Obama can do it. Reforming the health insurance industry is about as big a challenge as there is. Selfishly, I'd like to see him get a chance to try.

Share this post


Link to post
Share on other sites

Here is something else that drives up the cost of healthcare is the Dr.s order all those tests like MRI, CT, PET and others. And they do it to make sure they cover all the bases and their own butts, just in case it is called into question as to whether they did everything they could and by the book. You can blame lawyers and lawsuits for that.

The cost of medical care itself is not rising that high, it the medical industry implementing all the new technologies that come out that is driving up the prices. The money has to come from somewhere.

Share this post


Link to post
Share on other sites

Here is something else that drives up the cost of healthcare is the Dr.s order all those tests like MRI, CT, PET and others. And they do it to make sure they cover all the bases and their own butts, just in case it is called into question as to whether they did everything they could and by the book. You can blame lawyers and lawsuits for that.

The cost of medical care itself is not rising that high, it the medical industry implementing all the new technologies that come out that is driving up the prices. The money has to come from somewhere.

I agree with almost all that, upnorth.

I do believe, however, that instead of blaming lawyers and lawsuits we should blame ourselves. Too many medical malpractice lawsuits are filed because we the public think we can cash in by suing. It's the insurance companies who pay those settlements, and that drives costs up across the board.

I'm not advocating we "protect" insurance companies from such lawsuits, simply saying it's regular folks like us who should be able to back it off and not listen to some of the huckster lawyers out there telling us we can make some bucks.

Share this post


Link to post
Share on other sites

Quote:

I'm not advocating we "protect" insurance companies from such lawsuits, simply saying it's regular folks like us who should be able to back it off and not listen to some of the huckster lawyers out there telling us we can make some bucks.

Frivolous lawsuits comes to mind. And yes you are right many people are sue happy and I was probably at least somewhat off base blaming it all on Lawyers.

Share this post


Link to post
Share on other sites

The last Orthopedic doctor I saw was 4 months ago. I asked if he needed my MRI the other orthopedic surgeon had me take and he stated that no, it would only show what he already knew. He told me he never orders a MRI for any of his patients.

Funny how some want it and some don't.

Share this post


Link to post
Share on other sites

I am seeing an ENT for a re-occurring inner ear infection issue I have going on and she ordered a CT for my head, and yes there is something in there wink But it seems some Dr.s rely on/utilize the technology more than others. Basically what it winds up to be is the same thing my family Dr. said was going on, that I have some issues with my Eustachian tubes plugging up and they need to put tubes in my ears. I think some use these tools to verify their suspicions.

Share this post


Link to post
Share on other sites

Why does insurance cost what it does? Here is a great example. I have had issues with my back for years and the insurance company has spent tens of thousands in bills for therapy and MRI's and cat scans. I have been going to a pain and back clinic since this spring to try and avoid surgery on my back. The doctor told me that I could now go to a fitness center like Snap Fitness and use two of their machines to achieve a possible reduction in my pain level instead of always coming to their office.

Today, I called my insurance company to see if they would rather pay the membership fee to use those machines rather than pay the Pain & back clinic I go to two to three times a week to the tune of approx. $800.00 a week. The cost for the same machines at the fitness center is $45.00 per month. They stated that they were not interested in doing this as they don't do it. I explained that they could save approx $9,000.00 annually in medical bills and they said no.

Now one knows why the costs for medical coverage costs what it does.

Isn't that just crazy and wrong.

The insurance company has spent a ton of money on your back problem. I just wonder why you do not just pay the 45$/month for the membership and possibly less pain. It is a serious question. It is your back pain. I just don't understand why you would suffer if 45$ /month out of your own pocket would make you feel better. Health care costs can be driven up in many ways. You chose to avoid surgery. You should be able too. At some point the Doctors and ins. company should be able to say you are on your own. The person you talked to at the ins. company does not make the rules. I read your post and had a very different perspective of what drives health care cost up than you do. I did have back surgery 12+ years ago and am glad I did.

Share this post


Link to post
Share on other sites

Originally Posted By: harvey lee
Why does insurance cost what it does? Here is a great example. I have had issues with my back for years and the insurance company has spent tens of thousands in bills for therapy and MRI's and cat scans. I have been going to a pain and back clinic since this spring to try and avoid surgery on my back. The doctor told me that I could now go to a fitness center like Snap Fitness and use two of their machines to achieve a possible reduction in my pain level instead of always coming to their office.

Today, I called my insurance company to see if they would rather pay the membership fee to use those machines rather than pay the Pain & back clinic I go to two to three times a week to the tune of approx. $800.00 a week. The cost for the same machines at the fitness center is $45.00 per month. They stated that they were not interested in doing this as they don't do it. I explained that they could save approx $9,000.00 annually in medical bills and they said no.

Now one knows why the costs for medical coverage costs what it does.

Isn't that just crazy and wrong.

The insurance company has spent a ton of money on your back problem. I just wonder why you do not just pay the 45$/month for the membership and possibly less pain. It is a serious question. It is your back pain. I just don't understand why you would suffer if 45$ /month out of your own pocket would make you feel better. Health care costs can be driven up in many ways. You chose to avoid surgery. You should be able too. At some point the Doctors and ins. company should be able to say you are on your own. The person you talked to at the ins. company does not make the rules. I read your post and had a very different perspective of what drives health care cost up than you do. I did have back surgery 12+ years ago and am glad I did.

Hey ddsbyday, does your handle indicate you are a Doctor of Dental Surgery? If so, I think you've got a perspective on health care/insurance costs we haven't seen much here before.

Most (not all, but most) of the perspectives on these types of threads are from the consumer of health care, not a provider. I for one would have great interest in and take seriously any comments a DDS would have to make on the current system.

Now, I could be making an incorrect assumption about your career, or you may not want to engage yourself in this further. But if you are a DDS and feel like elaborating, I think you'd have an interested audience.

And it bloody well better be a respectful audience, I might add. smilesmile

Share this post


Link to post
Share on other sites

Yes, I am paying the $45.00 out of my own pocket at this time. It's not right that I pay the bill and save the insurance company the money but, thats what Im doing. I could continue the more expensive route as it seems that the insurance doesn't really mind at all. They have no interest in reducing any costs nor do many doctors.

Yes to date I have choose to avoid the back sugery as I have heard of to many bad stories of botched up back sugerys. I am in no hurry to go under the knife and have a rod placed in my back until I have exausted every avenue to see if it can be helped another way.

That would be another sugery and I have had 7 major surgerys already.

Share this post


Link to post
Share on other sites

I am in fact a dentist. Have been for 22 years. As a provider I have to deal with ins. companies daily. You just have to remember that they are buisnesses. Their goal is to charge premiums and not pay out. That is how it works. Your best interest is not on their balence sheet. I accept very few insurance plans at my office for a couple of reasons-reduced fees, (25-35%)with 70-75% overhead it isn't worth it. They usually will only cover the least favorable (cheepest) treatment. I don't diagnose by what coverage you have. You really have to look at insurance as a benifit not free health care. If you are unhappy with your coverage you need to talk to your employer. They are usually trying to purchase good plans for their. workers.

Share this post


Link to post
Share on other sites
Guest
This topic is now closed to further replies.
Sign in to follow this  
Followers 0