Medical Cost

[Snobdds]

Last week I caught Covid (my first time) Got to the doctor the same day to get Paxlovid. My wife whet to the pharmacy to pick it up. "List price" was $ 1777, and my cost with a part D drug plan was $ 695 ! The idiot running the FDA apparently decided that the subsidies were no longer needed. Given that most people needing Paxlovid are retired (highest risk group) and they should bear the burden of the high cost for a potentially devastating illness.

Paul

Why are boomers so entitled.

You paid 39% of something, on a drug plan that is probably $60 per month.

How much more assistance do you need?

 

[Snobdds]

I've never been a single-issue voter, but the medical costs in this country are becoming something I can no longer ignore and are beginning to move to the forefront of my voting considerations.

I'm a logical person, so when I see inflation running at a average of 3%, but medical costs keep increasing at a rate double that, there has to be a solution.

We need to break up the hospital groups. After obamacare, it incentivized all the hospitals to vertically integrate. Now we have hospital systems with college campus like amenities.

The medical tend prior to obamacare was 4-6% annually. Now we are 10-12%.

It doesn't take a rocket scientist to figure out what is going on...

 

[jyoutz]

We need to break up the hospital groups. After obamacare, it incentivized all the hospitals to vertically integrate. Now we have hospital systems with college campus like amenities.

The medical tend prior to obamacare was 4-6% annually. Now we are 10-12%.

It doesn't take a rocket scientist to figure out what is going on...

Medical costs have increased for people who don’t have Obamacare at rates that far exceed inflation. There is far more to the story than Obamacare.

 

[Snobdds]

Medical costs have increased for people who don’t have Obamacare at rates that far exceed inflation. There is far more to the story than Obamacare.

All benefits are mandated to be those of obamacare. So you may not have a subsidized policy, but your benefits on that policy are the exact same as obamacare policies.

 

[ultrarunner]

The business model is giant vs giant…

Even supply chain is like this where the big players have the most power.

Corp flat out demands 60 days to pay invoices and they get it…

All invoices must be electronically submitted… one error or box not checked means it sits there forever…

I’ve had great local providers say they will not do business with us… the local approved backflow guy charges $50 an inspection… he just want deal with corp.

My fire extinguisher guy comes once a year and if the previous invoice is 1 year and a day he needs to apply all over to be approved vendor…

Same with the best operating table repair father and son team.

My work around is I pay them and submit the invoice to be reimbursed within 14 days…

All corp credit cards have been cancelled except for that of each hospital administrator…

Get big enough and the take it or leave it model prevails.

 

[Eagle1]

All benefits are mandated to be those of obamacare. So you may not have a subsidized policy, but your benefits on that policy are the exact same as obamacare policies.

Since the ACA limits the medical loss ratio it has caused the industry to vertically integrate to increase the revenue and profit pool by billing themselves with the structure as separate subsidiaries. If you are limited to profit margin you can only raise costs to increase the total profit dollars. Higher costs = higher total in profit at the same %,
Just like higher home prices increase total property taxes, etc

 

[Snobdds]

Since the ACA limits the medical loss ratio it has caused the industry to vertically integrate to increase the revenue and profit pool by billing themselves with the structure as separate subsidiaries. If you are limited to profit margin you can only raise costs to increase the total profit dollars. Higher costs = higher total in profit at the same %,
Just like higher home prices increase total property taxes, etc

The vertical integration was more from the standpoint of patient reporting requirements. Small dr. offices did not want to endure the burden of all the requirements. So they teamed up with hospital systems to help with the reporting requirements. Hospital systems also barred doctors that were not in the "system" from using surgical centers to perform surgeries. Another form of making doctors being in the "system". No longer can a private doctor make it without being tied to a large hospital.

The road to hell is paved with good intentions.

 

[QRTRHRS]

Our primary and our cardiologist closed out their business's and went with hospital's. Our primary stayed in his building. The cardiologist went into an office with a few other doctor's. In his case, our wait times decreased a lot while the care improved. They also have inhouse bloodwork, stress tests, etc., etc.

 

[sixdogs]

Go to the emergency room? They have to treat you?
And then try getting blood from a turnip.
I have great insurance but thinking about my retirement in 4 years. Can you just carry Medicare Part A which is free and let the hospital eat the rest?

They will come after you for everything you own and since you signed a personal liability form for the unpaid portion, they will likely collect.

 

[Eagle1]

They will come after you for everything you own and since you signed a personal liability form for the unpaid portion, they will likely collect.

I decided to no longer own anything other than my 20+ old cars and a 30 year old tractor, sold everything else to my kids who allow me to live in their house on their land in exchange of caretaker and baby sitter. Still have a bit in an IRA but that won't go far.