October 8, 2009

The Six Figure Miracle


That appears to be the butcher's bill for Key's aortic aneurysm, all in. Thankfully virtually everyone involved was within the network, so her maximum out-of-pocket on this thaumaturgy of American health care will be a thousand dollars. Incredible. I would have to say that, at least in our instance, private health insurance works.

Some interesting items, though: the miracle surgery? The doctor charged $18,152. That seems like a bargain, when you consider the hospital charged $24,621 for "supplies". That's a lot of fucking gauze. Another thing: the vascular surgeon in Gainesville who merely pumped her with painkillers and blood pressure medicine while he wrung his hands and mopped his sweaty upper lip in desperation while I insisted she be removed to St. Joseph's or Emory charged $6,681. For essentially doing nothing until he finally got a consulting cardiologist on the phone who said Get her to Emory, you limp dick.

Certainly, some of the charges are a wee bit suspect, but the point is the wheels went into motion immediately, by and large. The system worked. I don't doubt in our instance the insurance company will ever recoup that $97 thousand in premiums, but it's a numbers game, and they hold the actuarial cards, not us. Plus, I've paid health insurance premiums for 30 years, with no claims other than the occasional annual check up or back pain visit. If I'd put my premiums in a nice growth fund I'd have considerably more than the $97 thousand to offset Key's expenses. That's how the game works.

Here's the thing: how can we permit public servants to ram third world health care down our throats while they simultaneously innoculate themselves with a premium health care plan? That is my greatest bitch. I don't give a damn fuck all about term limits. We have the remedy for incumbency at the ballot box. What we do not have is a mandate that our public servants abide by the same laws they force the rest of us to abide by. And there isn't a single member of Congress who would vote for such a law, much less sponsor it.

They fancy themselves the elite, the Shit Don't Stinkers. Well, fuck that. The only constitutional amendment I want to see is the one that feeds congressmen into the same maw of social engineering that the rest of us are fed into. From public education to medical treatment to retirement plans to tax laws, these criminals should be subject to the same laws they foist upon the hoi polloi.

Better yet, let's put Congress on Medicaid, so they can wait in the emergency rooms and clinics with the cholerics, dyphtherioids, consumptives, pellagratives, measlers/mumpers/rubellics, pertussulites, Ebolaslags, and bacon double Marburgers. Or subject them to a reverse Tuskegee experiment, wherein instead of taking syphilitics and studying them while doing nothing for the symptoms, we actually infect them with syphilis, and perform experimental treatments gleaned from the annals of the rejected grant applications from the NEA. Got yer Piss Christ enema right here, Senator.

Now, I think, we're getting somewhere.

Posted by Velociman at October 8, 2009 4:52 PM | TrackBack

Fuck yeah.

But I do still like the idea of term limits. In a nation of 300,000,000, we can't find a replacement every 2, 4 or 6 years?

Like hell we can't.

Posted by: Randy Rager at October 8, 2009 6:31 PM

I like my congressman. Should I vote him out for a liberal? Or just give him syphilis? I'm torn, really.

Posted by: Velociman at October 8, 2009 6:33 PM

(a smarter man than I said...) 2 things:

- Term limits
- Remove "automatic withholding" of income tax.

Wait 4 years.

Posted by: Mike Wilson at October 8, 2009 7:10 PM

If people had to pay those bills instead of one thousand dollars of them, it woud be different. That doc who charged $ 6,000 for painkillers bp medicine and a misdiagnosis would never collect if he were being paid by the person getting the services.

Its impossible to talk price to a dr, sick or well under our current insurance regime.

Posted by: Doug_S at October 8, 2009 8:07 PM

Mike and Doug are both right. Separating the bill from he who receives the services drives costs up all round. That $6k charge is a perfect example.

Posted by: rob sama at October 8, 2009 8:31 PM

A few days ago I talked with a Canadian friend who had a spinal restriction and was unable to walk without crutches. He was told by a Doctor in Saskatoon that the most they could do for him was help with the pain. He went to Arizona, Scottsdale, I think he said and had day surgery and walked out on his own feet. He paid $30K and said it was worth every penny. Now, why would anyone sign on to Obama's vet clinic?

Posted by: Hermit at October 8, 2009 9:40 PM

Good plan, I like it.

When does it start?

Posted by: doubletrouble at October 8, 2009 10:28 PM

We pay 15K a year for health insurance for my family. We can't spike it out by person, it is what it is. That means in just over 6 years the insurance co would recoup their costs. It happens quicker than you would think...

Posted by: Bou at October 8, 2009 10:55 PM

We laymen cannot (will not) put a price on life and the precious Key is a damned good bargain at only $98k.

I, however, may recently have tested the limits of my worth when my surgery alone came in at over $110k. And, even still, anyone who walked through (or past) the hospital while I was there has filed a claim for something. I haven't added it all up, but it's likely in the $120k range when totaled and, personally, I think it was worth every damned cent. No questions, no bullshit. Aetna doesn't screw around.

Sarah Palin, I fear, might not have been too far off when she spoke of those "death panels". We'll end up submitting our resumes for review when seeking medical attention.

If there's anything else the lovely Key would like to tweak, she should do it now while the iron is hot!

Posted by: jmflynny at October 8, 2009 11:30 PM

My good man, the medical providers overbill and the insurance companies underpay. The longer they have done this the wider the spread has become. That's the game; it's somewhere between retail jewelry and an estate liquidation auction. Have someone in that business find out for you what they actually paid.

Posted by: james wilson at October 9, 2009 12:36 AM

An expensive medical journey, to be sure. Gratefully, the ends have hopefully justified the means. Love life and live long. We'll pay for it all when we're gone.

Posted by: bustoff at October 9, 2009 1:30 AM

I just got the EOB from the insurance company for my recent hospital visit. The $30,000 gallbladder is not looking so bad after reading this. :)

Posted by: PeggyU at October 9, 2009 3:44 AM

Have no fear, the insurance company will not need to make up $97K in premiums. Contractual adjustments with the provider probably knocked down their actual payment to around $50K and then there are other benefits to the provider only an accountant could explain for listing the full $97K in line itemed charges.

Another reason to doubt any number you hear regarding the cost of healthcare in the US.

Posted by: Dishonorable Schoolboy at October 9, 2009 9:01 AM

Better than the alternative...give KeyBaby my best...hope to see y'all soon.

Posted by: Sam at October 9, 2009 9:17 AM

What is billed and what is paid are never the same. Exmample with my heart adventure was a one day stay worth 48k, insurance offered up 16k. Bill paid. Me, not a dime.

Posted by: james old guy at October 9, 2009 12:41 PM

The only part of this equation that even remotely matters is that you get to keep the love of your life, not to mention your sanity.

Posted by: dick at October 9, 2009 1:37 PM

Glad to hear your love Key came through and is on the mend!

Posted by: Mockingbird at October 9, 2009 4:50 PM

This may be one of your best posts ever, containing as it does the simplest solution to Congressional malfeasance: The sauce that is good for us geese should be good for the Congressional ganders. And if they don't like it, tough shit.

I will not hold my breath waiting for this to happen.

Meanwhile, you have your sweetie. Lenny Bruce once said that doctors could really make a killing by demanding cash in advance: "You want that appendix out? That'll be $20,000. In cash. Small bills, please. Aw, I know it hurts..." Thank Gawd it doesn't work that way, at least for productive citizens who can hold down a job with benefits...

Best $97k y'all ever spent, am I right? I mean, ya coulda had a Benz. Priorities.

Posted by: Elisson at October 9, 2009 6:17 PM

I probably should have mentioned that I understand there will be negotiated fees. The ultimate bill to the insurance company will likely be half the $97k. It's like buying a car: the providers know they'll get negotiated down, so they start high. Unfortunately those without insurance pay sticker price, or, most likely, walk away from the bills, and that cost is reflected in the premiums.

Still, I don't want "free" or "cheap" health care. Like any other product, you gets what you pay for.

Posted by: Velociman at October 9, 2009 6:31 PM

Let's talk about that "supplies" item. In these parts, hospitals are forbidden to charge for nursing care. I don't give a damn how good your doctor might be, he ain't worth a crap without an equally good team of nurses behind him. However, good RNs cost money, so the hospital has to recoup the expense somewhere. Ergo, $100.00 tylenol.

I'm glad Key's feeling better. Sometimes, I feel like giving a doctor a good swift kick in the nuts, but I'll give nurses due regard and respect every time.

Posted by: PawPaw at October 10, 2009 9:08 AM

Retail is plain scary, Velociman, and yet almost nobody winds up paying it, and nobody should. People like me who pay in cash understand the system better than many doctor's office personel, but it is all an unnecessary and counterproductive way of doing business.
Were I in private practice, I would post in my waiting room a typical $100 billing and break down the portion that is devoted to malpractice insurance, staff to process insurance billing, student loans, overhead, regulation, state and federal taxes, and the remainder for the doctor. That would put resentment where it belongs, and to a more productive use.

Posted by: james wilson at October 10, 2009 2:17 PM

Yes, James! I am looking at a hospital bill that has one item which says "medical service". WTF is that? Could be anything! Transparency in itemization would be a step toward curbing costs. And another big one would be allowing emergency rooms to turn away people who are not in dire need and refer them to a walk-in clinic or to a general practitioner.

Posted by: PeggyU at October 10, 2009 3:57 PM

Brilliant analysis, V-dude, as always. Sauce for those geese would go a long way towards equity. But thank all the gods that it all worked well for Key!!

Posted by: Marianne at October 11, 2009 5:12 AM

"Butcher Bill" is a little inaccurate don't you think? It's a given that anyone with access to a keyboard and information after the fact is perfectly suited to render criticism. We all know that no matter what one does, nearly anyone else could have done it better, faster, and cheaper, if we'd only had the wisdom to ask them. It's a given.

The system worked. Your partner gets death deferred. The more suckers buy into the premise that there is a "health care crisis," or an "insurance crisis," the more likely it is that Government will screw up something that works. There is no crisis. The system works.

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I think the answer to all is.....request a "HOUSE" call every monday night. That is a sure cure.....

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