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Lawrence and Douglas County

Lawrence and Douglas county

Unpaid bills put strain on hospitals

Patients increasingly unable to pay for care

March 8, 2007

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Another year means another increase in money that local hospitals lose in providing health care to people who are unable to pay their bills.

Costs for uncompensated care - defined as either bills that emergency room patients are unable to pay or bills sent to patients who are expected to pay but haven't - puts a growing financial strain on at least two area hospitals.

For the hospitals, the growth in uncompensated care costs means they could lose money available to pay for building improvements and equipment. For patients, either insured or uninsured, the spike in uncompensated care becomes one factor in why the patient's financial responsibility for a hospital bill continues to grow.

Kansas University Hospital had nearly $81 million in uncompensated care for the fiscal year 2006. KU officials project it will spend $97 million in medical costs by the end of the 2007.

"It's about a 14 percent increase over what we had budgeted," said Bill Marting, vice president of financial operations for the hospital.

Meanwhile, Lawrence Memorial Hospital paid nearly $17 million in uncompensated care in 2006, a 22 percent increase from 2005.

Simon Scholtz, LMH chief financial officer, hasn't made a projection on uncompensated care for 2007. "We sure don't expect it to level off," he said.

"When we do have a positive bottom line, we use that to fund future capital," Marting said. "As your bottom line becomes less and less, you have less ability to do that."

In 2006, revenues exceeded the amount the hospital lost to uncompensated care as the hospital recovered a net income of $72 million.

Driving force

At LMH, the majority of uncompensated care comes from bad debt - patients who don't pay their bill.

Scholtz said even for insured patients, the portion of the hospital bill they're responsible for becomes difficult to pay, contributing to bad debt.

It's also becoming less affordable for employers to provide health insurance as a benefit to employees.

In 2000, 69 percent of employers in Kansas offered health insurance to workers. That has since dropped to 61 percent, according to Rep. Jeff Colyer, R-Overland Park.

Colyer, chairman of the Kansas House Republican Task Force on Health Care, said the burden of uncompensated care costs that hospitals have to shoulder makes commercial health insurance pricier, which is why businesses find it harder to offer benefits to employees.

Health Care Access nurse practitioner Lori Winfrey, left, gives some advice to a patient, far right, before attending to patient Keeta Berger, Lawrence, center, accompanied by granddaughter Laney Wallace, 5. At Health Care Access, physicians contribute services to uninsured visitors at little or no cost. But costs of uncompensated care are soaring at local hospitals, with Lawrence Memorial Hospital chalking up $17 million in unpaid bills in 2006.

Health Care Access nurse practitioner Lori Winfrey, left, gives some advice to a patient, far right, before attending to patient Keeta Berger, Lawrence, center, accompanied by granddaughter Laney Wallace, 5. At Health Care Access, physicians contribute services to uninsured visitors at little or no cost. But costs of uncompensated care are soaring at local hospitals, with Lawrence Memorial Hospital chalking up $17 million in unpaid bills in 2006.

"It makes the commercial side more expensive, which means businesses drop out, which means more people get on Medicaid," Colyer said. "We're going in exactly the wrong direction and have been for the last five years, and one of the stressors is what we've seen in the hospitals."

Government reimbursement to hospitals for uncompensated care through Medicare and Medicaid doesn't come close to covering the costs, according to hospital officials.

"It's nowhere near the full cost," Marting said. "There's still a large amount that is totally unreimbursed."

What's being done?

Health care has become one of the major issues in Kansas Legislature this session. Gov. Kathleen Sebelius made a plea in her State of the State address to lawmakers to work toward universal health coverage.

The Legislature appears headed in another direction.

The Kansas House Republican Task Force on Health Care hatched a four-part health care plan Monday that would try to drive down the number of uninsured patients by increasing private sector health insurance plans and programs, rather than increasing reliance on government programs.

But even Colyer concedes solutions won't be quick or easy.

Hospitals have found some help in local safety net clinics that can provide some services to completely uninsured patients in need of medical care.

In Douglas County, where an estimated 12 percent of residents have no health insurance, one example is the Health Care Access clinic. There, physicians contribute services to uninsured visitors.

"The physicians are donating sometimes the entire procedure," said Nikki King, executive director of Lawrence's HCA. "Sometimes they will work out a very modest payment."

But the clinic, which gets most of its funding from in-kind services, reaches about one-tenth of the number of Douglas County residents who don't have private health insurance and don't qualify for government assistance.

A similar program emerged in Wyandotte and Johnson counties near the KU Hospital.

The WyJo Care program provides some specialty care services for uninsured patients with the hope that it will reduce the number of emergency room visits to hospitals, and perhaps help blunt escalating uncompensated care expenses.

WyJo Care relies on physicians who pledge to provide a certain number of visits and procedures with uninsured patients.

"For the hospital, (uncompensated care) is a big expense," said Mary Redmon, an assistant clinical professor in family medicine for KU School of Medicine. "If we can spend a little money up front as a donation, it's going to save a lot of money in emergency rooms in all our community hospitals."

Nevertheless, local hospitals continue to see not only uncompensated care costs rise but also the price of providing care increase overall.

Scholtz, LMH's CFO, said the hospital has tried expanding the number of services it provides to patients in general as a way to increase streams of revenue.

LMH has also found other ways to make money. For example, the Lawrence City Commission last year approved hospital revenue bonds for LMH - 30-year fixed-rate bonds sold based on the hospital's credit rating - to help pay for a $40 million expansion, along with a fundraising campaign.

But the hospital can't refuse emergency care to patients who can't pay for their health care, meaning the burden of uncompensated care will remain.

"The only other option," Scholtz said, "is to try to manage our expenses more tightly."

Comments

Richard Heckler 7 years, 5 months ago

"Eliminates overhead? You're kidding, right? The government has no overhead?"

This is what was stated: Presently, up to a third of the health premiums we pay to insurance corporations go not to health care but to their profits, marketing campaigns, CEO pay packages, posh headquarters, lobbying firms, and -- most damning -- massive bureaucracies whose sole purpose is to try to deny coverage for our medical treatments. With SPS, all of these costs are eliminated -- Medicare, for example, spends only 2 percent of its revenues on administrative costs.

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busymom 7 years, 5 months ago

So, delegatezero, what your saying is money is more important than people?

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Richard Heckler 7 years, 5 months ago

Less well-known, however, is the costly burden on millions more who supposedly are "covered" but may suddenly find themselves on the hook for thousands of dollars if they get seriously sick. Here's how it can happen: A 20 percent co-pay can quickly become a problem for middle-class workers who, for example, need cancer medicines running $12,000 per month. A trip to the hospital can leave you with a sickening side effect: having to pay $10,000 or more for treatments that were quietly excluded in your policy's fine print. * Of the 29 million Americans now in medical debt, 70 percent were insured when their medical bills put them in this situation. Medical bills help drive about a million people into bankruptcy each year -- 68 percent of them had health insurance when they filed.

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Richard Heckler 7 years, 5 months ago

National Health Insurance is an answer and why not? Big three auto makers would jump up and down with joy. Toyota would consider more jobs for USA auto workers. College students would be very happy. Unions would be happy. It would provide a stiff boost to economic growth as NEW industry would find this as an asset.

The AFL-CIO and millions of it's members have endorsed the National Health Insurance Concept. Is Washington D.C. listening or reading?

Cost of care would drop about 25% off the top due to less paper work thus less administrative duties. Cost of prescription drugs would drop due to massive purchases from one entity.

A single-payer system is the answer. An unusually strong editorial in March by the St. Louis Post Dispatch expressed the benefits succinctly: "Employers would no longer be saddled with health care. Workers would no longer worry about health care for themselves or their children. And we could toss the disgraceful private health insurance industry, with its wasteful bureaucracy and inscrutable coverage rules, into the dumpster." There's no legitimate excuse for this mess. A program to provide medicines for every single senior could and should be simpler and far less expensive than Bush's $1.2 trillion scam. Medicare, with its extremely low overhead and an efficient payment system already in place, is the logical conduit for such a program. It could negotiate with drug makers on behalf of every senior to get low prices on all medicines, then pay pharmacists directly for the total cost of prescriptions they fill.

It's well-known that our system coldly leaves more than 46 million of us without any health coverage. That's one in every six Americans, including 8.3 million children.

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Richard Heckler 7 years, 5 months ago

IT'S SOCIALIZED MEDICINE.Wrong. Like Medicare, government doesn't deliver the health care under a single-payer system (SPS) -- you still go to your choice of doctors and hospitals. SPS, as the name suggests, is merely a government-run payment system. Instead of you and me paying inflated premiums to profit-seeking insurance giants which then pay our medical bills, SPS eliminates the rip-off overhead of the middleman and pays all of our bills directly to the providers.

PRIVATE IS ALWAYS BETTER THAN PUBLIC. Not at performing truly public functions, such as assuring health care for all. Presently, up to a third of the health premiums we pay to insurance corporations go not to health care but to their profits, marketing campaigns, CEO pay packages, posh headquarters, lobbying firms, and -- most damning -- massive bureaucracies whose sole purpose is to try to deny coverage for our medical treatments. With SPS, all of these costs are eliminated -- Medicare, for example, spends only 2 percent of its revenues on administrative costs.

WE CAN'T AFFORD TO COVER EVERYONE. We can't afford NOT to have universal care. When today's uninsured millions get sick, they end up at the ER -- the most expensive care there is. Also, they get no preventative care, which is far cheaper than paying for the serious illnesses that they later develop. A decade ago, Taiwan switched from a U.S.-style corporatized system to a Canadian-style SPS. It quickly went from 60 percent of its people covered to practically all -- with virtually zero increase in overall health spending.

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Richard Heckler 7 years, 5 months ago

So I was informed insurance companies decide how much they will pay for certain coverages and/or procedures, and thus controls what coverages and procedures are available.

Most Support U.S. Guarantee of Health Care By ROBIN TONER and JANET ELDER Published: March 2, 2007 A majority of Americans say the federal government should guarantee health insurance to every American, especially children, and are willing to pay higher taxes to do it, according to the latest New York Times/CBS News poll.

http://www.nytimes.com/2007/03/02/washington/02poll.html?ex=1173589200&en=46444db95848ddd2&ei=5070&emc=eta1

=================================== Our Mission: Single-Payer National Health Insurance

Greg Silver, MD (Fl.) The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 46 million without health coverage and millions more inadequately covered.

This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment though a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.

http://www.pnhp.org/

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just_another_bozo_on_this_bus 7 years, 5 months ago

"We'll have to pay MORE than we're actually paying since there is a large number of people that can't 'technically' afford it... so YOU will pay for them as well."

You're a fool if you think you are paying for the uninsured now.

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bd 7 years, 5 months ago

I wonder how much of the unpaid amounts are due to Illegals? I am sure the millions of them are also pushing for a national heath care program!

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just_another_bozo_on_this_bus 7 years, 5 months ago

Correction:

You're a fool if you think you AREN'T paying for the uninsured now.

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jonas 7 years, 5 months ago

bd: Anecdotally, when I worked for the collection bureau that handled a hospitals overdue accounts, the amount of illegal immigrants-- if assumed by inability to speak english, spanish name-- was less than 1 in 50. The rest of those were good old American poor folk or irresponsable people.

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yankeelady 7 years, 5 months ago

I agree completely with merrill, although it's kind of scary to say so. Look at the insurance companies public financial information. the amount of their profits is staggering--not quite up there with Big Oil but close. They have a huge infrastructure of people (gatekeepers) whose sole function is to save the "companies money" Eliminating all that could save a huge amount of money. And the cost for universal health care wouldn't be that much more than we are paying now for insurance through our employers, those of us that have that. Make the premiums tax free. And with a huge pool of insured the premiums could be kept down, and suited to your needs--no obstetrical care for seniors, etc. It would need to be set up by folks who wouldn't be profiting from it. And certainly not by the current insurance executives.

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just_another_bozo_on_this_bus 7 years, 5 months ago

"And the cost for universal health care wouldn't be that much more than we are paying now for insurance through our employers, those of us that have that."

Actually, if the experience of every other country who has it (and pretty much every one of the industrialized democracies does) is that it would cut overall costs by 10% or more.

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be_cunning 7 years, 5 months ago

I don't have any sympathy for the hospital's finacial plight. I work (a lot), and I was underinsured although I had been paying monthly payments on my insurance. At my current ability to pay the hospital off, it'll be another year - at least - making monthly payments.

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Kat Christian 7 years, 5 months ago

I've been paying on an emergency room visit for the past 4 years. $5-10 a month but I'm getting it paid off - have just a couple more to go. There is no more tightening of my budget anymore than I already do - I could stop buying food I guess and just eat soup or eat at the LINK. I work everyday and hard. What needs to be done is the miniumum wage raised so I can get more in my paycheck. Then I could pay a high monthly fee to pay off my Doctor and hospital bills.

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ed 7 years, 5 months ago

Who would pay for a socialized medicine program?

Option 1: Tax the rich and small business owners New Jersey and California have adopted "tax the rich" philosophies. After they enacted a millionaire tax, many millionaires left the state. Now they want to have a high tax rate on anyone that makes over $200k. If that doesn't work...

http://njrereport.com/index.php/2006/03/30/even-higher-taxes-for-new-jersey/

Option 2: Tax everybody evenly I can't afford the additional taxes to pay for health insurance. I can barely afford to pay the high gasoline rates. If my taxes went up to pay for socialized medicine, I wouldn't be able to afford my other payments (house, car, kids, etc).

Option 3: Tax everybody a little, and settle for inferior healthcare. This is what has happened in countries that have socialized medicine. Hong Kong, Canada, etc. And when those people want the best healthcare, where do the go? The USA.

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BigDog 7 years, 5 months ago

Posted by Dambudzo

Will a new health care program replace Medicaid and Medicare?

Those are two programs that are really run well.


I hope you are being sarcastic. Both of those systems suck.

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jafs 7 years, 5 months ago

A single-payer federal health insurance system is different from a socialized health care system.

The single-payer insurance would still allow for choice of doctors, etc. and competition among private businesses - the benefits of non-socialized systems.

With health insurance premiums rising, I wonder if currently insured people would in fact wind up paying more, or if a similar amount would just wind up as taxes instead.

If employers don't have to pay insurance premiums, they could raise wages and/or lower prices for their goods/services, either of which would help offset any extra expense, if it exists.

Emergency room visits are quite expensive, and paying for them (through higher premiums) is very cost-and-health ineffective. I'd rather be paying for routine preventive care, especially for children.

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Linda Endicott 7 years, 5 months ago

Sometimes, the hospitals shoot themselves in the foot...

I have a friend who had to have tests done at the hospital here in Ottawa. When time came to pay, of course he couldn't afford the whole amount all at once. He offered to pay them $20 a month, until it was all paid off. That was all he could afford.

He was told that they required him to pay at least $80 a month, or nothing. He didn't think they would refuse the smaller payments. He sent them $20 that month. They refused it, and sent back his check, uncashed. He tried this three times. Each time, they refused the payment.

So, they required at least $80 a month, or nothing...they got nothing.

They could have accepted his payments, even though they were smaller, and eventually have had the bill totally paid off. The hospital chose to refuse this, and thus cheated themselves.

What kind of idiot plan is this for a hospital to have??

Isn't there a law in Kansas that if you send payments and they refuse to accept them, that after awhile you no longer owe the money?

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BigDog 7 years, 5 months ago

BigDog

Unless you're a doctor or have hit the RX "doughnut hole," what exactly is it that sucks about Medicare and Medicaid??


Talk to those who are on or have worked with either of the programs. Most doctors and dentists will not accept Medicaid because Kansas reimbursement rates are about 25% of the cost of providing the service. The paperwork for providers is quite burdensome and reimbursement for services provided is slow.

Basic Medicare does not cover a lot of services including dental so seniors have to purchase high premium supplemental policies if they want those services.

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Confrontation 7 years, 5 months ago

Those who are lucky enough to have health insurance are often the same people who don't want National Health Insurance. What if their employer drops their health benefits, or what if HealthWave stops supporting their lazy butts? Note, not all those on HealthWave are lazy.

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werekoala 7 years, 5 months ago

"IT MAKES ONE WONDER HOW A NATION CAN BECOME GREAT WITHOUT BASIC HEALTHCARE."

By insisting that our children have better opportunities in life than we do.

We also became great without electricity -- should we turn out all the lights?

It's called progress, and your ilk has fought agains it tooth and nail every time we've inched up the standard of living or extended political or social equality.

So I'm not surprised that you're against it. Sad that you're so glad to cut off your nose to spite your face. But more sad that I'm not surprised at the reaction to common-sense solutions to plain-as-day problems.

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gr 7 years, 5 months ago

"Government reimbursement to hospitals for uncompensated care through Medicare and Medicaid doesn't come close to covering the costs, according to hospital officials."

Why? I see the government setting an acceptable standard. Why should others, especially those who don't have insurance, have to pay higher than what the government gives as an acceptable cost? If anyone wants to speak about unfairness, charging different people different amounts for the same care seems unfair.

So, they raise the costs to cover the others, and then there's more who don't have insurance.

Let's raise the turnpike toll to pay for health care!

I think the insurance companies would be for national healthcare. The patient pays the governemnt, the government keeps some and subcontracts out to the insurance companies to manage it, the insurance keeps some, then gives some to the hospital. The patient pays more, the hospital gets less, the insurance company is smiling all the way to the bank with mandated revenue!

And, it's right, if people are getting by without seeing a provider, but if they are being forced to pay, they'd better take advantage of their mandated "benefits". Like I hear elsewhere, there will be long lines. Higher costs, less service.

I don't see how if people can't afford care now, forcing everyone to pay is going to make it more affordable. What will happen is some will get it free (as they are now), but others will be forced to pay more.

Another thing that's unfair is, why should I pay for the heart drugs of the fat slob who has to ask someone to hand him the next donut because he's too lazy to get up?

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BigDog 7 years, 5 months ago

Well there are those like my former sister-in-law too who help drive up private insurance costs. She never wants to use any of her sick time even though she is a state employee and can get off for other things easily. Instead she waits until the evening when doctor's office was closed to deal with the kids' illnesses. Then she just goes to the emergency room. They had Goodyear insurance and she knew most of it would be covered.

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gr 7 years, 5 months ago

Good point which won't change for national care. Long lines through normal means - go to the emergency room for no (lesser) wait times.

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budwhysir 7 years, 5 months ago

outrageous costs puts strain on bill payers,,,???

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BigDog 7 years, 5 months ago

BigDog

"Most doctors and dentists will not accept Medicaid because Kansas reimbursement rates are about 25% of the cost of providing the service."

If that is true, and I'm not certain you're not exagerating the percentage, it is a direct result of G.W. Bush intentionally slashing the Medicaid money to the states and cutting the Medicare plan reimbursemnt rates for doctors - purely and simply to slowly destroy Medicare and shrink Medicaid to a size "where you can drown it in the bathtub."

Bush's view of life - "we're all in this together alone"


kubacker -

I'll disagree with you there ..... there were not cuts to Medicaid funding to the states under Bush, if I would like to see that information. They were proposed by Bush but were not passed by Congress. The reimbursement rates paid to doctors and dentists who accept Medicaid is set by the state. Kansas has set their rates at one of the lowest levels in the nation.

The rates under Medicare is set by the feds. Medicare rates were proposed to be cut also last year but Congress also overrode those reductions. The major reductions in Medicare rates were actually done in the early 90's under either first President Bush or Clinton.

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MyName 7 years, 5 months ago

There are lots of reasons why a single universal healthcare system would be beneficial for this country.

Healthcare costs, a large portion of which are caused by administrative costs will go down substantially. I mean think about how much it costs doctors to file paperwork for all of the different insurance companies in order to get part of the bill paid? Compare that to a system where they only have to deal with one insurance company. Also, think about all of the advertising, lobbying, executive salaries and other costs that are all factored into your insurance premium. Those would be gone or significantly reduced. Think about all of the wasteful overlap that comes about from having all of the different insurance companies and their agents covering the same area? This is the kind of costs that get eliminated as well.

There would also be benefits to American businesses who currently have to compete with companies in Europe and Asia that already have this system. GM, for example, pays as much per car in healthcare as they do in steel, while Toyota doesn't have those costs, or at least they don't have to pay as much. Finally, think about how much more healthier we could be as a society if we all have the same access to preventative treatment, rather than having to rely on Emergency medicine? Healthier people leads to a better economy and a better society.

Of course, there are two problems, one, insurance companies don't want such a system and they are lobbying hard and spreading disinformation in order to keep it from happening. And secondly, we haven't found a good way to pay for this system that everyone can agree on. Still, it's better than what we've got now, which worked okay for 50+ years, but is starting to fail in terms of coverage and quality.

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BigDog 7 years, 5 months ago

Part of the problem with the current health system is also the people. We have become a society that believes our health insurance should pay for everything. A former national medical from Canada spoke at the Capitol last year about how we buy insurance for our home and cars but we don't expect insurance companies to pay for routine maintenance. But Americans expect health insurance to pay to even routine checkups.

Also a lot of individuals go to the doctor's office for every sniffle they have and expect medication.

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melott 7 years, 5 months ago

So, aside from the question of national health insurance, we have the scandal that insurance companies get about a 50% discount on hospital bills. That's right , if someone goes in without insurance they get billed double what their insurance company would if they had one. This is flat wrong. It should be outlawed, and it could be, at the state level, if enough pressure were put on our state representatives and senators.

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MyName 7 years, 5 months ago

Dambudzo

Just have the government issue everyone, illegals included medical credit cards for 3 months and see how expensive it will be.

I think that kind of falls under the problem of payment. We need to make sure that there is some sort of reasonable co-pay to prevent people from using the system frivalously. This co-pay could be deducted at the end of the year from income taxes, or credited towards taxes, depending upon income, but, again, this is something that could be fixed if we set the system up correctly. Of course, most of the people in favor of such a system are still too busy fighting insurance company lobbyists to nail down all of these details, which is unfortunate.

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TongieMom 7 years, 5 months ago

Melott - you nailed it!

I am fortunate to have excellent health insurance, but have been without insurance for a number of years in the past (but always paid my bills...$25-$50 month...slowly but surely it was paid).

When my husband had knee surgery to the tune of $17K OUTPATIENT, the insurance company only paid $2500...15%! Keep in mind, I had ZERO member responsibility or deductible. IF we hadn't had insurance they would expect us to pay the full price (or give a meager discount). It's disgusting!

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camper 7 years, 5 months ago

I'm willing to roll the dice with a national health system. Public health is not better served by private industry in my opinion. I admire the hospitals and health care professionals though.
Some of us will develop or have conditions which require costly treatments (for which we have a right to be treated for), but for the vast majority....good health care is not "rocket science". It should not be as costly and inflationary as it is. Meanwhile private industry seems more interested in profiting from other conditions such as......well you've probably seen the commercials.

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madcow 7 years, 5 months ago

Maybe if they didnt gouge thier prices so much people would be able to afford the bills.

When she went to LMH it was $235... for a simple blood test.

The same blood test costs $30 at any other lab in town.

If they want people to pay thier bills, charge them something reasonable.

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madcow 7 years, 5 months ago

oops, i need to learn to proof read.

My wife went in to get the blood test for some meds...

$235 for one vial of blood is retarded.

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Confrontation 7 years, 5 months ago

I don't have any health insurance, so I don't run to the doctor every time I have a minor concern. I know many other people who have health insurance and they do overuse the system. Even when I had decent insurance, I barely saw the doctor. Now, it costs me $100 (with a 20% "discount" for paying immediately) just to see the doctor for two minutes. This $100 doesn't even include lab tests. If you ask me, I believe that the doctors' nurses should be getting the money, considering they spend more time with you.

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redwaggoner 7 years, 5 months ago

Say what you want about Medicare & the Medicare drug programs). If it weren't for theses programs, I would more than likely be a vegetable. I do not have private medical insurance nor can I afford it. Before becoming eligible for Medicare, I went to the VA for health coverage. That was a nightmare! Care was provided by student "Dr's" that usually didn't know where to wipe themselves. Most spoke broken English at best so you could not communicate with them to tell them what was wrong. IF you went to the VA with a serious ailment that you could not wait six weeks to see your assigned Dr. you went to the Triage center to see a nurse who usually take your blood pressure and your temperature and if you wewe not bleeding, paat y9ou on the head & send you home. Six years ago I had a horrendous cough and I hacked for three months and could not get the VA (in Wichita) to do anymoore than say it was a bad cold and send me home. I went to the "Dr's" at this hospoital and tried for the best part of five years to convince them that I had a torn rotator cuff muscle in my shoulder. After this time I finally got a Phys assistant to listen to me and was scheduled for a diagnostic x-ray at a downtown hospital. Sure enough, I was right! I knew these symptoms as I had gone thru it once before about ten yrs earlier in another city.
Today our health care costs wouldn't be near what they are, if all the Dr's & Hospitals weren't so impressed with all their fancy machines & knowledge that they have to charge more and more to cover these costs. What happened to the old "Family Doctor" of years gone by? This physician could diagnose and treat everything without MRI's etc. and we were just as healthy then as now...perhaps more so. We have become a hypocondriacal society when we go to the Doctor and ask for the latest medicne we saw advertised on TV, whether this medication is truly right for us. Why not let the MD decide the right path of treatment for you and not listen to all the hype put out by the ivy leaguers on Madison Avenue to sell a product for the Pharmaceutical companies. Why can't one hospital "share" their radiologic equipment with all other hospitals in the area? Why does every hospital have to have their own? Why do hospitals have to advertise on TV & radio trying for all the medical patients? It's strange to me that this is a common practice. Another reason our health costs are high is due to the "shortage" of qualified nurses (RN's). An article appearing in theSalina Journal (Sallina, Ks.) recently cited that the local hospital is importing RN's from as far away as California and paying them in the $70 - $80 per hour bracket. Why? Aren't there enough nurses willing to work in this state, that nurses need to be imported from other states to cover the shortfall of qualified staff available here in this state?

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Crispian Paul 7 years, 5 months ago

Posted by Confrontation (anonymous) on March 8, 2007 at 10:27 a.m. (Suggest removal)

Those who are lucky enough to have health insurance are often the same people who don't want National Health Insurance. What if their employer drops their health benefits, or what if HealthWave stops supporting their lazy butts? Note, not all those on HealthWave are lazy.

Confrontation, I am a social worker. My agency is a child welfare contractor for SRS. Our clients generally have Healthwave. Your statements about Healthwave are innaccurate (in terms of its consumers being "lazy").

Healthwave is for uninsured lower income families to ensure that their children and those who are pregnant recieve medical care. It is not the same as Medicaid, although it is administered through the same program. So unless you think these children and pregnant women (many of whom already work) should be getting off their "butts" and getting health insurance, this is really a moot point.

In addition, there are two types of HealthWave...Healthwave 21 and Healthwave 19. The Healthwave 21 requires a monthly premium be paid in order to maintain coverage. This is offered to those who are above the maximum income for Healthwave 19. These are the so-called working poor.

Finally, if these "lazy" children do not heave healthcare, the social costs are exhorbitant. WE know that kids who lack regular, preventive medical care and dental care do less well in school, suffer from more school absenteeism, suffer from chronic pain due to preventable or easily treatable conditions (e.g. abcessed teeth, chronic ear infections), and many other school problems. These school problems then can also lead to potential for criminal acting out, long term homelessness, substance abuse, etc.

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OnlyTheOne 7 years, 5 months ago

Melott Quoting "That's right , if someone goes in without insurance they get billed double what their insurance company would if they had one. "

Actually it's usually the other way around. Those with insurance will be charged more because the insurance is going to pay most, if not all, of the charges. BSBC, of course, tells the provider what they'll pay. Those without any insurance get a lower rate under the impression they will be more able to pay it than the full charge.

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camper 7 years, 5 months ago

One last thought. Though I think national health care would be a better system.....it would be nice to see some evidence before-hand that the government is capable. Katrina relief and Walter Reed serve as reminders that beurocracies have their own set of faults.

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TongieMom 7 years, 5 months ago

I disagree with OnlyTheOne...

I've gone from not having health insurance to having insurance with the same doctor. What they accept as payment from insurance is less than what I paid without it. Granted, for a doctor visit the difference is not necessarily a large sum...but when you have to possibly go the pharmacy after that visit...every dollar counts.

In my experiences, the hospital will charge whatever they want ($17K knee surgery) and the insurance companies will pay a small % of it (15% in the last instance...although I'm sure it's often more) because they have negotiated that discount. I can guarantee that if I didn't have insurance, they would not accept 15% of the total billed amount as payment in full...it would be deemed 'unpaid'.

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Dayna Lee 7 years, 5 months ago

it costs $81 for an office visit without insurance and $57 if you have insurance due to "adjustments" at my doctor's office.

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MyName 7 years, 5 months ago

I think that's a very good point camper, which is why what is most likely to happen in this country is that any national system we end up having will be built from the state level up. We'll probably end up with taking a plan (or combining the best of several plans) from a state level and applying it to the country as a whole.

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concernedparent 7 years, 5 months ago

madcow, just a few questions? Why did your wife go to LMH instead of any other labs in Lawrence? And most of the offices in Lawrence send their blood to LMH after drawing it in the office. And then LMH bills out for it. So I'm just curious what other labs you are talking about

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melott 7 years, 5 months ago

Quote: "

Posted by OnlyTheOne (anonymous) on March 8, 2007 at 3:23 p.m. (Suggest removal)

Melott Quoting "That's right , if someone goes in without insurance they get billed double what their insurance company would if they had one. "

Actually it's usually the other way around. Those with insurance will be charged more because the insurance is going to pay most, if not all, of the charges. BSBC, of course, tells the provider what they'll pay. Those without any insurance get a lower rate under the impression they will be more able to pay it than the full charge."

You might think so, but no. They have a standard billing rate, then they have an "adjustment" which is usually about half. That's what they bill the insurance company. Then they pay, and the customer pays what is left.

Over many years, the adjustment is about half at many different kinds of places for a BCBS group plan I have been in.

I know others who experience the same.

The law should forbid this practice.

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Confrontation 7 years, 5 months ago

Crispian: Sorry your social work degree program didn't require that you know how to read. "Note, not all those on HealthWave are lazy." I guess you missed that part.

I know several women on Healthwave who got pregnant because they knew they'd get free coverage. Their friends had babies, and they all wanted to trap their men, so they got knocked up and ran for the free services. Instead of getting off their butts and getting a job/paying for their own insurance, they sucked every penny from the taxpayers. I also have an aunt who has never worked a day in her life and her husband doesn't make enough to afford healthcare. Healthwave is covering their two children, because my aunt is lazy.

I love how you jump to the conclusion that I was calling the kids "lazy." Get off your social work "high horse." I personally know who you are, and I know that you are most likely "high" on something else.

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werekoala 7 years, 5 months ago

What's funny about this whole stupid ongoing debate is that the outcome is inevitable. It really is -- health care costs are growing 6-10 times faster than incomes. And being a democracy, at a certain tipping point, there will be enough people going broke that there's going to be a general demand for change. It's already happening, there is FAR more support for this sort of initiative than there was when the Clintons first proposed it back in the early 90s.

The damnable misery of it, though, is that this sort of groundswell is only going to come after enough familes have been saddled with debt, and driven into bankruptcy, and lives already shattered by major medical issues have been further complicated in pursuit of profit. The only real question left is: how many? How many more people are we going to drive into bankruptcy before we admit that the private solution is a failure? Already, major medical complications are the leading cause of bankruptcy - 60-70% of them.

The private market does a great job at giving us longer, harder erections, and sleep aids, and curing restless leg syndrome, and hyperactivity. But at providing unprofitably cost-effective service to the average citizen, it fails horribly. That's why every single other developed country in the world has some form of guaranteed coverage for their workers. In the long run, it's cheaper per capita, and much more equitable.

Hell, at this point, every one has health insurance except the ones paying for it -- how fair is that? Taxes provide health insurance for children, the elderly, and the chronically infirm through healthwave, medicare, medicaid, and workers comp. The only people not getting this free ride are those paying for it -- the working americans, the private contractors, the day laborers, and everyone else who contributes to our economy without the benefit of health insurance.

I'm not a big fan of government interventionalism, but at a certain point, that's all we are left with. The only question we need to be asking each other is: when? When have we reached that point? When have we made enough families suffer? When have we driven enough people into debt? When have enough hard-working independent contractors lost their jobs, and tools, and livelihoods because they or their spouses have come down with cancer?

When?

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Linda Endicott 7 years, 5 months ago

I have health insurance through work, and I still rarely go to the doctor. The co-pays and the deductibles are outrageous. And before you go to the doctor for ANYTHING, you'd better call the insurance company first, because not only are all things NOT covered, but even some things that ARE covered require "prior approval".

Bad time to discover that your health insurance doesn't cover a procedure is after you've already had it done. And I've tried reading through that little insurance policy. It's so full of legalese (and BS), that I can't tell what is covered and what is not without a lawyer present.

What I don't like about insurance companies and their "prior approval" policy is that, if my doctor thinks a procedure or treatment is necessary, what business does the insurance company have telling me that "it's not medically necessary"? Are they all doctors? No.

The real reason a lot of people with little or no health insurance coverage go to the ER for little things? By federal law, no hospital can refuse to treat you.

A doctor's office CAN refuse to treat you, and frequently does.

I was in the waiting room at my doctor's for an appointment, and heard them talking to a pregnant woman who had just moved to the area. Both she and her husband were employed, but didn't have health insurance. The doctors have preset fees for prenatal care and delivery. The doctor's office refused her as a patient and said, "I'm sorry, we can't help you", because they couldn't afford to pay the whole amount in one lump sum. They offered to pay part of it, and then make payments on the rest. They were still turned down.

So pregnant women are now required to pay for prenatal care and delivery ahead of time. And if you don't have that enormous amount hanging loose in your pocket, you're just SOL.

I still can't believe they turned away a pregnant woman and refused to give her prenatal care. The doctors are always touting how important that is.

Want to bet this is one woman who had no other choice, and had to go to the ER for medical care?

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Linda Endicott 7 years, 5 months ago

The regular fees for an office visit at my doctor's are less for those with health insurance than for those without insurance.

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gr 7 years, 5 months ago

I once was going to a dentist office which offered small discounts for paying cash. Suddenly they no longer did that. When asked why, the insurance companies were complaining about the discount for prompt payment. They weren't eligible for the discount because it took too long for them to process the paper work. Doesn't matter that they pay less to start with, but they thought the discount wasn't "fair" and they had the clout so the cash people lost out.

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toefungus 7 years, 5 months ago

The lack of universal basic healthcare for the citizens of this great nation is without reservation, our greatest shame. The end consumer is each and every one of us. We are exploiting ourselves. What a strange thing to do. It is kind of funny that long ago, as a nation, we decided to work together to build roads. We tax ourselves for the best transportation system in the world. And yet, we won't tax ourselves for health care. I guess we should privatize all roads and pay tolls wherever we go to whoever has the best road for our needs.

One day, this cruel system of measuring out healthcare to only those that can pay the most, will be talked about with the same disgust we now talk about segregation.

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jafs 7 years, 5 months ago

I believe that reading by candle light was bad for one's eyes.

The distinction between national health insurance and health care seems to be lost on some people - if we're going to debate the issue, let's at least get it right.

Of course insurance companies will be against this - if the government becomes the insurance carrier, private insurance companies will lose lots of money.

Why should health care be a for-profit business?

Here's a thought - we could require that all organizations involved in health care be run as non-profit entities.

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hawklet21 7 years, 5 months ago

oh, i'm sorry, i won't eat for a month so that i can pay off LMH and they can keep going. i'm sure they need it that bad.

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concernedparent 7 years, 5 months ago

LMH accepts payments as low as $10 a month. They don't care what you pay as long as you're paying.

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