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Old 01 Aug 2011, 04:03 PM   #243911 / #1
cnorman18
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Default Uninsured Medical Care, US: a case study

Today I contacted the local county hospital here in Fort Worth -- that would be John Peter Smith hospital in Tarrant County, Texas -- about getting a colonoscopy. They are mailing me a packet of forms to fill out in order to qualify for their discount program.

I have investigated prices for the procedure at various private and public clinics; it ranges between $1,700 and $1,950, but that is exclusive of anaesthesiologist's fees and facility fees. Total costs appear to be in the neighborhood of $3,000-$3,500, though it's hard to find out these numbers in advance; hospitals and doctors here prefer to have you agree to their fees blindly in advance, and then hand you the bill afterward. Just for perspective, $3,500 amounts to about two month's wages for me.

Also for perspective; this is a preventive procedure, which could result in savings in six figures by making treatment for colon cancer unnecessary if it's found early -- or, more realistically, since no one's going to pay for that in my case, my slow and painful death.

Further perspective: decent health insurance is, technically and theoretically, available to me -- through the state high-risk pool at a cost of $1,000 to $1,200 per month in premiums. When I am married next month, I could be added to my fiancee's excellent, low-cost group plan -- at exactly the same premium.

I'll keep everyone posted as the process continues and I jump through local, state and federal hoops, try to qualify for financial assistance, and try to negotiate a payment plan.

Anecdotes aren't evidence, but since we've been discussing healthcare, let's see just how it works over here -- from the perspective of one who wants insurance, but for whom it is not, practically speaking, available.
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Old 01 Aug 2011, 04:11 PM   #243915 / #2
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Could "medical tourism" be an option? ie travelling to, say, India or maybe better where you are Mexico to get it done - where the cost of travel and the procedure combined would be cheaper
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Old 01 Aug 2011, 04:20 PM   #243920 / #3
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Good luck mate. Keep us posted.
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Old 01 Aug 2011, 04:38 PM   #243929 / #4
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Could "medical tourism" be an option? ie travelling to, say, India or maybe better where you are Mexico to get it done - where the cost of travel and the procedure combined would be cheaper
No. Thanks for the suggestion, but India is out of the question -- and travel to Mexico at the moment is statistically more hazardous than travel to, say, Afghanistan or Iraq. There is no effective law enforcement, and much of the country near the border is under the control of the narcotraficantes. More than 18,000 murders so far this year, and kidnapping of ordinary (non-wealthy) Americans for ransom is epidemic. The current term for "tourist going to Mexico" here is "moron." I'll take the cancer, thanks.

More to the point; I have $50.03 in my savings at the moment. Whatever price I negotiate, I'll be paying off by the month at a likely annual interest rate of about 20%.
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Old 01 Aug 2011, 05:14 PM   #243949 / #5
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Some observations:

Have you looked at the federal insurance program? I'm on it and I'm paying under $300/mo for it.

As for the total cost--there's no way you can get an exact value up front because not all of the charges are fixed. Anesthesia, for example, is billed based on the time you were under. Going in the doctor has no way of knowing exactly how long it will take and thus what the anesthesia bill will be.

Likewise, it's an exploratory procedure--he has no way of knowing what he will find that warrants a snip. If he finds something the sample goes to pathology and you get a bill from them.
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Old 01 Aug 2011, 05:22 PM   #243955 / #6
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Quote:
Originally Posted by Loren Pechtel View Post
Some observations:

Have you looked at the federal insurance program? I'm on it and I'm paying under $300/mo for it.
60, pre-existing conditions, etc. -- like I said, $1,000-$1,200/mo for me.
Quote:
As for the total cost--there's no way you can get an exact value up front because not all of the charges are fixed. Anesthesia, for example, is billed based on the time you were under. Going in the doctor has no way of knowing exactly how long it will take and thus what the anesthesia bill will be.
True, of course; but it's hard to get even an estimate.
Quote:
Likewise, it's an exploratory procedure--he has no way of knowing what he will find that warrants a snip. If he finds something the sample goes to pathology and you get a bill from them.
Also true. I'm proceeding on a best-case scenario and hoping they find nothing.

As I say, I'll keep everyone posted.
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Old 01 Aug 2011, 06:01 PM   #243964 / #7
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Cuba for medical treatment?
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Old 01 Aug 2011, 06:09 PM   #243967 / #8
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Cuba for medical treatment?
Can you find me a visa, a plane ticket, a hotel room, and a hospital that will do it, all for a total of $50?

Thanks for all the suggestions. Let's just see how it goes.
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Old 01 Aug 2011, 06:43 PM   #243975 / #9
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Can't you wait until next month, get married, get on your spouse's insurance, and THEN have it done?
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Old 01 Aug 2011, 06:45 PM   #243977 / #10
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Dreadful situation to have to be in. I've had (endured) two colonoscopies in the last 5 years as I have a fairly high risk and have had some worrying symptoms (so far negative luckily) but that was on the NHS and free. To be put in a position where you have to pay several times your monthly wage (if you can afford it at all) or live in fear for your life is just inhuman. And this for what is essentially just a check up - add to that any treatment if it is needed. Crazy situation.
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Old 01 Aug 2011, 06:51 PM   #243980 / #11
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That's our insurance business for you. Pretty much anyone WITH insurance can get one without paying anything beyond the normal monthly premiums. WITHOUT insurance, it's prohibitively expensive.

My husband's having a cardiac catheterization in a few days. Because of insurance, the procedure and any accompanying hospitalization won't cost me anything. Without insurance, we're looking at costs of nearly $10,000 if he stays in the hospital.
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Old 01 Aug 2011, 06:58 PM   #243981 / #12
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Can't you wait until next month, get married, get on your spouse's insurance, and THEN have it done?
He said those premiums would also be in the 1K/month range. No savings there.
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Old 01 Aug 2011, 07:14 PM   #243983 / #13
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I sometimes wonder whether the USA deserves to be called a civilised country.
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Old 01 Aug 2011, 07:36 PM   #243992 / #14
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Quote:
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Cuba for medical treatment?
It's illegal for Americans to even travel to Cuba.
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Old 01 Aug 2011, 10:08 PM   #244032 / #15
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Quote:
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Quote:
Originally Posted by Clivedurdle View Post
Cuba for medical treatment?
It's illegal for Americans to even travel to Cuba.
Quote:
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I sometimes wonder whether the USA deserves to be called a civilised country.
Land of the free
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Old 01 Aug 2011, 10:44 PM   #244047 / #16
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Well, remember the Golden Rule;

"Whoever has the gold, makes the rules."
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Old 01 Aug 2011, 11:01 PM   #244052 / #17
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This is why the mandate to buy health insurance is going to fail. I looked into insurance for my husband and myself so that I wouldn't have to be reliant on an employer. In my business, many employers don't offer medical insurance and it really restricts my job opportunities.

Affordable insurance? Ha! Right! Just based on our ages, the estimates were coming back at $1200 per month. We didn't even get to the part about pre-existing conditions, which we both have.
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Old 01 Aug 2011, 11:13 PM   #244054 / #18
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This is why the mandate to buy health insurance is going to fail. I looked into insurance for my husband and myself so that I wouldn't have to be reliant on an employer. In my business, many employers don't offer medical insurance and it really restricts my job opportunities.

Affordable insurance? Ha! Right! Just based on our ages, the estimates were coming back at $1200 per month. We didn't even get to the part about pre-existing conditions, which we both have.
It's my understanding that under the Obama plan, those who can't afford insurance (like us) will receive a subsidy that will make it affordable, on a par with employer-paid group plans.

I'm ready.
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Old 01 Aug 2011, 11:14 PM   #244055 / #19
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I feel bad for all of you chaps in that situation and I know there are a lot of you; I just find it shocking that there is opposition to 'socialised health care' in your country - the thing that gets me the most is when I see poorer [to average] people supporting GOP, I wish someone would shake them all by the shoulders whilst screaming "what the fuck are you thinking?!?!"
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Old 01 Aug 2011, 11:17 PM   #244058 / #20
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Quote:
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Quote:
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This is why the mandate to buy health insurance is going to fail. I looked into insurance for my husband and myself so that I wouldn't have to be reliant on an employer. In my business, many employers don't offer medical insurance and it really restricts my job opportunities.

Affordable insurance? Ha! Right! Just based on our ages, the estimates were coming back at $1200 per month. We didn't even get to the part about pre-existing conditions, which we both have.
It's my understanding that under the Obama plan, those who can't afford insurance (like us) will receive a subsidy that will make it affordable, on a par with employer-paid group plans.

I'm ready.
My income is high enough that I probably won't qualify for a subsidy but low enough that I can't afford what monthly insurance premiums will likely cost. I am well and truly screwed if I lose insurance through an employer.
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Old 01 Aug 2011, 11:29 PM   #244067 / #21
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Quote:
Originally Posted by Loren Pechtel View Post
Anesthesia, for example, is billed based on the time you were under.
Why?
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Old 01 Aug 2011, 11:31 PM   #244070 / #22
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Quote:
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Anesthesia, for example, is billed based on the time you were under.
Why?
'cause they have to pay someone to watch you all of the time that you are under?
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Old 01 Aug 2011, 11:46 PM   #244079 / #23
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Quote:
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Cuba for medical treatment?
It's illegal for Americans to even travel to Cuba.
Ironically, all the Gitmo inmates get free healthcare.

So the moral of the story - get caught on a battle field dressed in tribal rig, get extraordinarily renditioned, and then get your arse slung in the Gimto Hilton.

Everyone's a winner.
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Old 02 Aug 2011, 12:03 AM   #244087 / #24
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Quote:
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Quote:
Originally Posted by Garnet View Post
This is why the mandate to buy health insurance is going to fail. I looked into insurance for my husband and myself so that I wouldn't have to be reliant on an employer. In my business, many employers don't offer medical insurance and it really restricts my job opportunities.

Affordable insurance? Ha! Right! Just based on our ages, the estimates were coming back at $1200 per month. We didn't even get to the part about pre-existing conditions, which we both have.
It's my understanding that under the Obama plan, those who can't afford insurance (like us) will receive a subsidy that will make it affordable, on a par with employer-paid group plans.

I'm ready.
That's the boat I'm in. I'm poor enough that when the new Medicaid rules kick in in 2014 I'll be qualified for it and finally have some kind of medical coverage.

Now to just not get badly ill for the next 3 years.
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Old 02 Aug 2011, 12:53 PM   #244222 / #25
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You probably don't want to travel to Georgia but we have a group here that claims they will do a colonoscopy for 1500 dollars if you don't have insurance. I'm pretty sure that includes everything since they use their own nurse anesthetists, and they own the building where all the procedures are done. I've used their services and they are excellent, very high quality. I say that as a former QA nurse. They even post all their prices online and claim to be the lowest in the area. Just in case you are interested, the name is Atlanta Gastroenterology Associates.

You might look in your area to see if there are any similar large groups. I'm also confused. Are you saying that getting on your wife to be's policy will cost you 1K per month? That does seem high for group coverage. We pay about 300 per month for me to be on my husband's policy.


And YES. Our entire medical industrial complex is a big fucked up mess!

Edit to add. Have you looked at anything in San Antonio? San Antone has an abundance of hospitals and medical offerings.
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