I'm going to take my wife to the Dr. today and it started me thinking about our health care system, again.
I have a few examples and I'm curious if you all have others. I know this can get political, but I think there are plenty of problems to spread around without getting into the politics.
So here is example 1.
The wife has back problems that are easily controlled with epidurals. The insurance (medicare in this case) will pay for these 4 times a year. But here is the deal. She needs to go to the primary care guy for a referral, then to the guy that does the procedure for a check (about 3 minutes) then back to him for the procedure. Now I suppose they could do an MRI each time and say "yep, you still have arthritis" or they could just let her get the treatment until it stops working. The 2 visits cost us $5 each and Medicare about $30 and $45 while the actual treatment costs us $45 and Medicare about $250 I think. Anyway, it seems like a waste of time and money to me.
Example 2:
I have an advantage plan with an on line pharmacy. I take 2 drugs. One for a thyroid condition and another for arthritis. Neither are very expensive - I think one is $20 for 90 days the other about $15 (my cost). Medicare about $70 for both. The deal is that thru the online pharmacy they are both free to me. Does that imply that the pharmacy is making $35 (or more) to fill them?
Example 3:
My wife and my friend both had colonoscopies within 2 weeks of each other at the same hospital with the same doctor. Both had Michael Jackson anesthesia. He had very good insurance at the time with GM while she was on Medicare. The cost charged to the insurance and the amount paid by the insurance was different by almost an order of magnitude. With the good insurance paying the higher amount.
Anyone with similar experiences?
PS
Would be interesting to see how this works in other countries.
I have a few examples and I'm curious if you all have others. I know this can get political, but I think there are plenty of problems to spread around without getting into the politics.
So here is example 1.
The wife has back problems that are easily controlled with epidurals. The insurance (medicare in this case) will pay for these 4 times a year. But here is the deal. She needs to go to the primary care guy for a referral, then to the guy that does the procedure for a check (about 3 minutes) then back to him for the procedure. Now I suppose they could do an MRI each time and say "yep, you still have arthritis" or they could just let her get the treatment until it stops working. The 2 visits cost us $5 each and Medicare about $30 and $45 while the actual treatment costs us $45 and Medicare about $250 I think. Anyway, it seems like a waste of time and money to me.
Example 2:
I have an advantage plan with an on line pharmacy. I take 2 drugs. One for a thyroid condition and another for arthritis. Neither are very expensive - I think one is $20 for 90 days the other about $15 (my cost). Medicare about $70 for both. The deal is that thru the online pharmacy they are both free to me. Does that imply that the pharmacy is making $35 (or more) to fill them?
Example 3:
My wife and my friend both had colonoscopies within 2 weeks of each other at the same hospital with the same doctor. Both had Michael Jackson anesthesia. He had very good insurance at the time with GM while she was on Medicare. The cost charged to the insurance and the amount paid by the insurance was different by almost an order of magnitude. With the good insurance paying the higher amount.
Anyone with similar experiences?
PS
Would be interesting to see how this works in other countries.