A Glimpse Into The DUmmy Subculture

[GOBUCKS]

Horse with no Name  (1000+ posts)        Wed May-20-09 12:56 AM
Original message
I just went through $27k of hospital bills. Insurance is NOTHING but organized crime
I pay between $7-8k a year for insurance.
I pay $20 co-pay for PCP, $30 for specialists.

In going through these bills....this is the breakdown.

Billed amount: $27,483.47
Eligible charges: $4924.63

So, right off the bat...the insurance company gets to WRITE OFF $22,558.84 for contractual obligation.

So, that $4924.63 that is "eligible", I paid out of pocket $1730.48 and the insurance company paid a whopping $3194.
Now...the REAL fun comes if you DON'T have insurance. There is nobody to bargain these prices for you and you end up getting ****ed and paying full price.

This is ridiculous.

 
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x5687782

This post was the usual DUmmy drivel about health insurance, this time from a DUmmy slyly bragging about being in the tiny minority of Skimmer's zoo who have it. She details her co-pays, etc., etc., and a few DUmmies weigh in with their normal bellyaching. Then the one that caught my eye:

smalll (1000+ posts)      Wed May-20-09 01:04 AM
Response to Original message
4. Um, you get PCP through your health plan? 
 Edited on Wed May-20-09 01:05 AM by smalll
Not a good idea. There's a thread in LBN right now about some guy on PCP out in California who chewed out one of his 4-year-old son's eyes. 

I think this DUmmy is serious. In their miserable lives, "PCP" is assumed to be angel dust, not primary care physician.

[Chris]

$27k is too cheap for a brain transplant.  Must have been something else.

[Vagabond]

I think she's looking at this wrong.  Her insurance is probably written so that she pays a percentage per year up to a certain amount, which seems to be $5K.  After that her insurance covers 100%.  That would explain the eligible charges and the bill.  She's nuts if she thinks the hospital received anything less than it charged the insurance company.

Of course, now we would have to explain the concept of shared risk to her, as well as the notion that most people will not use $5K of healthcare in any given year.....

[RobJohnson]

$27k is too cheap for a brain transplant.  Must have been something else.

HA! 

The $22,558.84 was the food he ate while in the hospital, it was not covered.

[franksolich]

$27k is too cheap for a brain transplant.  Must have been something else.

This might involve the hysteriarectomy Ms. Ed had, but it seems to me that was a while back, about a year.

[franksolich]

So, right off the bat...the insurance company gets to WRITE OFF $22,558.84 for contractual obligation.

Oh my.

Ms. Ed, the unappellated eohippus, should read her medical insurance policy.

A company can't "write off" a contractual obligation.

If it wrote it off, it wasn't a contractual obligation to begin with.

I suspect the middle-aged Ms. Ed go to Wal-Mart and pick up one of those cheap Chinese-made reading-eyeglasses, so she can read her policy.

[thundley4]

Oh my.

Ms. Ed, the unappellated eohippus, should read her medical insurance policy.

A company can't "write off" a contractual obligation.

If it wrote it off, it wasn't a contractual obligation to begin with.

I suspect the middle-aged Ms. Ed go to Wal-Mart and pick up one of those cheap Chinese-made reading-eyeglasses, so she can read her policy.

I suspect that the DUmmie may have had some sort of elective surgery which wasn't covered.  That or she is just out right lying.

[DumbAss Tanker]

$27k is too cheap for a brain transplant.  Must have been something else.

It depends on the complexity of the brains involved, so maybe not. 

[ReaganForRushmore]

The 27K was the RVS (relative value schedule) that all medical providers use (even Medicare). It is nothing more than maximum average of charges for medical services in a local area. The 4K was the amount that the evil insurance company negotiated on behalf of their insureds in order to avoid overcharges on medical procedures. A rough estimate looks like the benefit plan paid 75% of the remaining cost and the insured paid 25%. To me, it looks like a win-win-win,

1. The primitive received the quality medical care necessary for their condition,
2. The evil insurance carrier paid for no more than the negotiated terms on the procedure, and
3. The hospital actually made some money to offset the indigent care they don't get paid on.

Sounds fair to me.

[djones520]

What the hell is wrong with these DUmmies?  I swear everyone of them has some who be me tale about how they've wracked up tens of thousands of dollars in medical bills.

In the last 8 years I've been to the hospital in actual need of attention ONCE.  Maybe these people need to learn what a frickin treadmill is.

[franksolich]

Sounds fair to me.

Aha.

Thank you, sir.

This being Ms. Ed, the most accomplished liar on Skins's island, I figured there was a lie here, but couldn't put my finger on it.

So $4,900 would seem reasonable for hospital charges (remember, that's what Ms. Ed alleges these are) for a hysteriarectomy, and not the $27,000 as stated?

[thundley4]

In the last 8 years I've been to the hospital in actual need of attention ONCE.  Maybe these people need to learn what a frickin treadmill is.

So what were all the OTHER trips to the hospital for, Fun? j/k

[djones520]

So what were all the OTHER trips to the hospital for, Fun? j/k

Air Force requires I get a check up, and blood work done once a year.

[Ralph Wiggum]

Billed amount: $27,483.47
Eligible charges: $4924.63

So, right off the bat...the insurance company gets to WRITE OFF $22,558.84 for contractual obligation.

My goodness, HorseWithNoBrain is stupid.

Write-off?  WTF?

[ReaganForRushmore]

Aha.

Thank you, sir.

This being Ms. Ed, the most accomplished liar on Skins's island, I figured there was a lie here, but couldn't put my finger on it.

So $4,900 would seem reasonable for hospital charges (remember, that's what Ms. Ed alleges these are) for a hysteriarectomy, and not the $27,000 as stated?

Yep.........the 27K is retail....the insurance company paid wholesale (Think Earl Schieb .........I can do that procedure for $4,995!). The extremely dirty secret is that the hospital gets to have a nice writeoff on unpaid indigent care to their bottom line. The true losers are the ones with health insurance who subsidize high insurance costs by having indigent care cost shifted to those that already pay..that is why you see charges for 27K and the insurance company pay only $4,900.

[franksolich]

Yep.........the 27K is retail....the insurance company paid wholesale (Think Earl Schieb .........I can do that procedure for $4,995!). The extremely dirty secret is that the hospital gets to have a nice writeoff on unpaid indigent care to their bottom line. The true losers are the ones with health insurance who subsidize high insurance costs by having indigent care cost shifted to those that already pay..that is why you see charges for 27K and the insurance company pay only $4,900.

Well then, a charge of $4,900--hospital charges only--for two, three, days in the hospital after having a hysteriarectomy, in a hospital near, but not in, the Dallas-Fort Worth area, would be reasonable, right?

I tell you, Ms. Ed is such a professional liar that it boggles the mind.

[ReaganForRushmore]

Well then, a charge of $4,900--hospital charges only--for two, three, days in the hospital after having a hysteriarectomy, in a hospital near, but not in, the Dallas-Fort Worth area, would be reasonable, right?

I tell you, Ms. Ed is such a professional liar that it boggles the mind.

You are correct sir.

[blitzkrieg_17]

Air Force requires I get a check up, and blood work done once a year.

Ouch.

[happy1ga]

7-8 thou a yr for insurance? I would kill for that. My hubby and I both have health problems, and he had a mild heart attack in 92. Our insurance, with the only company that will insure us, is a whopping THIRTY-TWO THOUSAND A YEAR. And guess what DUmmies? I don't bitch about it much cause it is great care, and I wouldn't cover me, either. I like being seen by whomever I need to see whenever. I never wait, I get to see any kind of specialist I want, whenever, so life's like that. I currently see four different doctors, my hubby three, so they can bite me over there on the island. I don't want socialize-care. I'd rather pay out the rear for the rest of my days.

[RobJohnson]

DUmmies are dumb, insurance companies are already able to provide more for less money then the feds.....look at this example of a medicare advantage plan offered in NV:

Humana can provide this coverage for a $0 plan premium because the federal government pays us to provide your Medicare benefits. We are able to add extra benefits because our plans are structured to keep health care affordable.


Oh yeah, that includes part D drug coverage as well.........at no added cost!

[BlueStateSaint]

It depends on the complexity of the brains involved, so maybe not. 

Even though I just saw this on the second page, I've got to agree with DAT here.  Transplanting two brain cells, waving goodbye to each other, should cost about $11.99 after everything is factored in.