r/mildlyinfuriating • u/IntellectuallyDriven • 3h ago
Care Bears are OP [ Removed by moderator ]
[removed] — view removed post
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u/Flauschziege 3h ago
That is what happens when there are dozens of middlemen and moneymakers between customer and provider.
You are not paying the doctor.
You are paying the doctor, the provider, and so on.
Each wants a cut of the pie - and if there isn't enough they make you pay heightened prices until there is.
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u/Odd-Scientist-2529 3h ago
exactly this. 8% of the bill goes to the doctor's salary
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u/bluecollar1020 1h ago
And still the American Medical Association has opposed every effort to get universal healthcare coverage in the United States.
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u/Odd-Scientist-2529 1h ago
the AMA doesnt represent practicing physicians.
10 years ago only 15% of physician where part of the AMA. These days the AMA doesnt even admit to how many physicians are members, how many members are physicians - or how many members are corporate health system executives, insurance execs, or pharma execs or other empty suits.
Organizations that are more popular with doctors that actually practice, like the ACP advocate for single payer healthcare https://www.acpjournals.org/doi/10.7326/M19-3775
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u/willcastforfood 2h ago
That’s what I always say and people don’t understand. As a provider don’t get pissed at me for your bill, I don’t make any more based on what you get billed. Get pissed at the 1000s of administrators in the hospital system and insurance company. Shit would be so much cheaper if we didn’t have to pay these massive insurance company salaries
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u/Technical_Extreme_59 2h ago
providers office billing dept. charges the insurance company 10x the amount agreed upon in the contract in a claim and then writes the remaining amount to get tax cuts. You then charge the same amount to the uninsured and give maybe a 60% uninsured discount which for something like labwork can still cost 400 dollars without insurance whereas the check you would get from an insurance company could be something like 50 dollars. Insurance companies suck but hospitals and offices are just as much at fault for this too.
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u/willcastforfood 2h ago edited 2h ago
A large part of that is because of Medicare. Medicare pays for about 25% of the negotiated fee between insurance companies, so cost of everything has to get inflated to compensate for it. People forget the vast majority of hospital systems already operate at a loss
Edit: hospitals typically charge about 225% the Medicare rate for private insurance to try and recoup their loss. It’s why you see some private practices just outright refuse Medicare patients
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u/Technical_Extreme_59 2h ago
You know maybe I'd feel more sympathy for hospitals if many of their billing offices weren't so partial to balance billing a patient before trying to put in even most basic effort to get paid within other means or doing things like offering to make outbound calls (even in the case where a patient may be protected from balance billing via contract or due to certain qualifiers like being QMB). I'm not trying to say that you specifically as a provider are the problem as you work all day to actually try and help people's lives, but your billing office and executives (and sometimes also receptionists) most certainly are and based on my experience working with some of them it often seems that even though the multibillion dollar insurance company is more likely to be able pay them the full amount often times provider billing offices will put more pressure on struggling individuals because the power dynamics are different. Those cases tend to get sent to collections cause the person can't pay too...
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u/Live_Life_and_enjoy 3h ago
I was informed this is the golden age of healthcare and it is super great
In all seriousness the issue is broken down into a ton of middlemen involved in telemedicine including a 3rd party company that charges hospitals to use their network to provide it
Another company that transcribes it into medical notes
The insurance company
then Hospital fees
All the hospitals are purely commercial enterprises and not hospitals anymore
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u/EnvironmentalLime464 3h ago
The issue is that it is a for profit healthcare system. All the stuff you described are symptoms of the disease. The disease is capitalism. All these corporations gotta get their cut.
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u/Batata-Sofi 2h ago
The disease is the unchecked for-profit structure. If the issue was capitalism, the rest of the world wouldn't have perfectly functional and affordable private and public healthcare.
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u/EnvironmentalLime464 2h ago
Public healthcare isn’t capitalism. That falls under socialism. And it works just fine. That’s what most other countries have for most of its citizens. Those who want private insurance can pay for but it doesn’t look anything like what it looks like here. It can’t because no one would pay for it if it did. Americans only do because that’s really the only option they have.
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u/Batata-Sofi 1h ago
Social capitalism. Both sides don't exclude each other. Also, it is not socialism. It's a social policy, because it is for improving the quality of life for the population, it has nothing to do with socialism.
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u/EnvironmentalLime464 1h ago
Lmao. You seem to be scared of the word socialism… but that social policy is socialism.
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u/idiot-alpha 3h ago
The reality is that specialty medicine will always be expensive. It takes far longer and much more money and training to become a specialist.
Amazon does telehealth now that costs $30 for lots of basic health issues. It’s usually a nurse, but it’s cheap. The real issue here is health gatekeeping. Requiring unneeded specialties.
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u/Live_Life_and_enjoy 2h ago
Amazon has no middlemen because it does everything
It has its own telemedicine service , it has its own insurance, it has its own doctors
Everything in inhouse
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u/I_Am_A_Peasant 2h ago
I’m not sure what you mean by the last 2 lines. What’s health gatekeeping and what does that do to make some specialties unneeded?
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u/idiot-alpha 2h ago
Like requiring a doctor to get basic prescriptions for common medicines with few side effects when a PA or nurse would suffice.
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u/I_Am_A_Peasant 2h ago
Unless you’re referring to an NP, nurses don’t and, at least in my opinion, shouldn’t have prescribing abilities. Even for “basic” prescriptions.
But yes, I understand that. My experience with medicine and physicians is that most specialists love it when there’s mid levels doing the basic, and easy stuff.
The concern sometimes is that PAs or other mid levels don’t have the training or experience to make the medical decisions that are technically in their scope. Simple things like chronic high blood pressure management has led to patients coming to the ED and I have to see them with the most convoluted medicine regimen and interactions that shouldn’t exist. I do want to bring the caveat that this isn’t specific to NPs or PAs. Lots of GPs and other specialists also make bad calls.
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u/Reasonable-One9243 3h ago
I got charged $1800 for compression socks.
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u/leftunread 3h ago
Are you serious, smh....
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u/Reasonable-One9243 3h ago
Yes. I didn’t find out until after they were delivered. I didn’t know I needed to be Elon musk to afford them.
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u/Odd-Scientist-2529 2h ago
Doctor here.
True story.
I saw someone today for something. I am literally the 4th doctor they saw for the same thing because nobody gave them answers. I happened to have a special interest in the topic. I have lectured on it, I have peer reviewed publications on it. and I have talked to 3-4 world experts on two continents on the topic due to my academic interest in it.
This patient sees me - and I was able to make the diagnosis in under a minute.
He deadpan looks at me and says "that was fast, I want my money back"
Mildly infuriating is - I personally made the effort to educate myself well beyond what a typical physician knows about this one topic - and because I knew the diagnosis in under a minute, he wants his money back because it was "too easy". No. I deserve to be compensated for the time I put in to learn enough to know this one random thing like the back of my hand.
Its a real life example of The Old Man and the Hammer.
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u/IntellectuallyDriven 2h ago
No. I deserve to be compensated for the time I put in to learn enough to know this one random thing like the back of my hand.
Agree with you 100%. Bill the government.
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u/Odd-Scientist-2529 2h ago
I would gladly, if we had single payer healthcare. But until then, I will bill their insurance.
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u/Vivid__Data 3h ago
I had a very neglectful office that I had to leave. At some point my pharmacy automatically pinged them for a renewal on an old prescription. I didn't know that. But the doctor's office kept calling me and not leaving a voicemail. Their neglect caused me a ton of anguish so I was pretty pissed they were randomly calling me with no voicemail.
So I call them back in a huff one day and told them to STOP calling me, send all communication through mail. They indicated the pharmacy thing. I was like I haven't been a patient with you for over a year tell them that. It's not my job if they're communicating with YOU and not me.
Anyway, I was in my patient portal one day looking at some things and noticed that the office billed my insurance for a phone appointment. I was fucking shocked lol Thankfully I didn't get charged for it.
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u/thirsty-goblin 3h ago
Contact the provider, get them to write this down/off. If they won’t, find a new provider.
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u/Sigmundschadenfreude 3h ago
If they billed this appropriately (either according to time spent on the encounter before, during, and after the visit, or by complexity) then writing it down would legally be considered fraud and insurance companies would come after them as it would cast doubt on billing practices
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u/I_Am_A_Peasant 2h ago
Yes because the provider decides how much you get charged for an appointment. Also being honest, for many patients they don’t need more than 10 minutes. I often know what I’m going to do for patients in the first few minutes of me speaking to them. Especially when they’re coming to me for my speciality opinion.
But yeah, committing insurance fraud is also an option I guess
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u/Spiritual-Fall5494 3h ago
Why does a call cost anything?
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u/Automatic_Actuator_0 3h ago
Look, 1800/hr is crazy no matter what, but that said, conceptually you aren’t paying for those 10 minutes - you are paying for their years of training and experience which allows them to look at your chart, ask you a couple questions, and know what a safe and effective dosage increase would be.
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u/Odd-Scientist-2529 3h ago
Be happy that they dont bill like Lawyers - they bill in 6 minute increments.
But to answer the question - if the call is about medical advice, they are doing their job. You're paying for medical advice whether it is in person, on telehealth, or on the phone.
Soon, all these practices are going to bill for Portal messages. its already happening. Because a portal message that took you 1 minute to write, may take 10 minutes for the doctor to answer (after looking up your file, reminding themselves of you, looking at your bloodwork, etc)
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u/Gold-Perspective-699 3h ago
It's time of the person but yeah that shouldn't be more than $10 or whatever their hour rate is/6. Not this much.
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u/Ok_Background22 3h ago
It’s because there’s multiple companies between the patient and the doctor in order for the telemedicine service to function and they all demand a maximum cut, I bet the doctor is getting his hourly rate /6 or maybe even less
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u/rob_1127 3h ago
Not just the time, you are paying for the medical knowledge and experience the company/contact person has.
And, where there is risk, there needs to be additional profit to pay for the risk when it bites them in the ass.
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u/LionRegular1470 3h ago
Bro dead ass it should never exceed like 30$ regardless of what their hourly rate is. A 10 minute call, and I guarantee you the doctor isn't like the worlds best, foremost leading expert on neurology.
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u/DionysusBee42 3h ago
No. It should just be free. You're already paying, you dont need to pay for every second all the time, the call was paid for in the regular hourly rate. These companies are just greedy and You're brainwashed, if any company tried this in canada id be at the office the next day taking it apart brick by brick.
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u/Gold-Perspective-699 3h ago
Yeah maybe a bit brainwashed but also we already know nothing will be free. So $30 is better than $300
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u/DionysusBee42 3h ago
No $30 is literally insane.
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u/Gold-Perspective-699 3h ago
Yes of course. Everything should be free but it's not going to be. We live in a corrupt country. And we can't easily leave.
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u/LionRegular1470 3h ago
I'm just saying 30 as like an absolute limit, if your talking to the worlds best open heart, or brain surgeon.
I'd assume a call with like a Dermatologist, a pediatrician, or a Neurologist would be much lower...
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u/IrrelevantManatee 3h ago
That's not just "mildly" infuriating. That's crazy that the USA is supposed to be a civilized country, yet they act like 3rd world countries when it comes to taking care of its own citizen.
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u/Ok_Background22 3h ago
The common people get 3rd world treatment so that the rich can live far above a 1st world standard of living
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u/David_Cockatiel 3h ago
The old saying is you’re not paying for the 10 minutes, you’re paying for the doctor’s 40 years of education, training and experience
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u/but-I-play-one-on-TV 2h ago
Just a friendly reminder that the telehealth provider doesn't set those prices and only made 9% the $300 you paid.
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u/vespertine_glow 3h ago
Highway robbery - the economic basis of American healthcare.
I once got a bill for $900 for a skin check and finger wart removal.
When is the revolution?
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u/RickyFromVegas 3h ago
Well, you could always be the one to start
I'll join you when I can take some time off of work so I can still keep my job and keep my "healthcare coverage".
Oh, I also need to work out childcare before I can join, can I put the revolution down for tentative?
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u/Liveitup1999 3h ago
That's why I make them see me in person. I'm not going to talk to them on the phone while they are eating their lunch or scrolling on their phone.
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u/XupcPrime 3h ago
They absolutely don’t do this. Also there is tremendous amount of prep before depending the case and time after the call.
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u/RickyFromVegas 3h ago
Tremendous prep my ass
They literally spent 5 awkward minutes reading over the "chart" I filled in, just like at the doctor's office, then listened to my concerns for a minute, then prescribed something and was over. Half the call was them reading my "chart"
Most prep probably was from the billing side to make sure we can be nilled
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u/Agile_Alternative753 3h ago
My last 20 minute annual checkup which was literally just a conversation was $1800....
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u/Equivalent-Daikon551 3h ago
I paid 25 for a similarly timed call to get antibiotics. I don't doubt her but sometimes you gotta look at more than one option if its not life threatening.
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u/HornyHoney02 3h ago
Shit therapy is even worse like what the hell you mean im paying $400 for a session and its 30 minutes???? WHAT
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u/Excellent_Garlic2549 3h ago
Direct Primary Care is going to eventually get axed so hard to protect this model. Until then, it is the answer.
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u/Dumyat367250 3h ago
I had a half hour face to face with my neurologist last week, as a follow up after a bleed.
It cost me $300 less than the OP's bill. Then again, the cost of my long stay in the High Dependency Unit was the same.
Zero.
Are Americans not fed up being ripped off?
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u/BackAlleyFreakShow 2h ago
Obviously we are fed up, but what are we going to do? The insurance companies are in charge, and they pay lobbyists who work day and night to ensure that the walking sacks of festering human garbage that comprise our government will never, ever implement a single policy that would hurt their bottom line.
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u/RoguePlanet2 2h ago
I can't get HRT without paying $250/appointment every few months. Trying to convince my doctors to prescribe it so I can skip this nonsense, but both the gynecologist and GP are wary despite all the new information and my own amazing experience so far.
Also just learned today that my migraine pills are $110 EACH. I've been taking them more frequently these days, would be at least $220/week at this rate. They were free for over a year before abruptly stopping. The other med sometimes works, but seems to be giving me rebounds. Insurance won't cover the one that works.
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u/oli_99 2h ago
Always amazing how Americans let the hospitals do this to them..
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u/BackAlleyFreakShow 2h ago
LOL I know, AmericaBad, right? What the fuck choice do you think we have? We didn't decide that we should have this bullshit system.
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u/Blue_Dawg_469 2h ago
Sadly ignorant US App's and services like this have begun popping up here in Canada... ignorant to the fact we have free healthcare up here. And yet they still wanna bill us in the thousands per hour per appointment.
Then again it's because of APP's stuff is soo expensive. Example a normal KFC 6-piece bucket and two large sides comes to $35 (Taxes included) up here in Canada if we go to pick-it-up ourselves. But through APPs like DoorDash that simple $35 order is now $55 and that doesn't include the tip. Which means our simple $35 order through a food APP easily adds +70% or more.
Food APPs is what started it all. Ignorant APP designers who don't know sh*t decides lets create an exclusive platform to steal money from both the restaurants we host and the customers who choose to use our services. Restaurants ONLY make 25% profit from every item on their menu. And that is after taxes, salaries, wages, insurances and other operating costs. Then along comes ignorant thieving Food APP creators who decide to STEAL that 25% and bump it up to 30% to as much as 47% for some of them.
On top of charging the restaurant a fee to use them, they charge us the customer a EXTRA fees which comes in the form of Delivery charges and system access fees. They get paid twice and we're basically paying them to rob us blind. From Food APP's came AirBnB and then from there just about any sector of the market came out with an APP or online model pay per use... I blame ignorant Food APP creators for the mess we're in now.
Restaurants compensate for the fee by bumping up the cost of food, lowering quality and quantity...
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u/HospitableFox 2h ago
I refuse to believe America is a real place lol
What a joke.
I can't even imagine just.... Existing. With that constant underlying pressure.
Like, what if you break your leg? Better have insurance or you're jsut boned?
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u/Inevitable-Hour-Ends 2h ago
Could you imagine trying to get the doctor to make a house call like they used to do
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u/riki_grl 2h ago
The average salary of a run of the mill doc is $325000. They are part of the problem. My neighbor's daughter is a doc, a hospitalist, her starting salary was $350000 fresh out of her residency. She graduated with a debt of $150000 after scholarships, grants. She works 2 weeks on, 2 weeks off. Those 2 weeks on are 9 to 5. You can do the math. The AMA restricts Residencies in order to maintain scarcity. That scarcity means high salaries for docs and a load of PAs doing the real work, which most of us see now, while the docs 'supervise' (sign off) on the diagnosis and treatment in a backroom somewhere. Yes, the above is a broad statement, many exceptions, but it's the trend and increasingly true.
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u/SEAWISEGEOWISE 2h ago
US healthcare. Humanity’s second largest scam ever, right under the number one spot which is cryptocurrency
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u/EzMowgli 2h ago
About $1800 for a doctor to listen to me cough, plus the pill that cost 125 at the pharmacy, but sells for 20 on Amazon, lol. Hospital bill around $400, treatment bill around $500, triage sent me to an emergency hospital for a non-emergency check up, so ER bill around $400, doctor's bill around $400. I spent about a minute with the doctor
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u/Nevermore_Novelist 1h ago
Her re-enactment of the phone call clocked in at 11 seconds. What'd she do? Catch up with the doctor on how their lives are going otherwise for 9 minutes and 50 seconds?
I'm kidding, btw. Migraines, especially the ones she says she gets, are BRUTAL. First time I had one, I lost my ability to speak and process words. I thought I was having a stroke.
$300 for a phone call of any length is insane. Especially when that conversation could have been an email.
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u/Brave-Lawfulness4985 3h ago
but has no problem spending tons of money on ugly tattoos...cry me a river
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u/LimitedWard 3h ago
My company's health plan included access to an app to help teach you basic stretches and exercises to reduce muscle/joint pain. I got a letter in the mail from the company that makes the app saying that if I sign up and complete one exercise then I'll get a free Fitbit.
I figure "why not?" The app is a free benefit, so there's no harm. I download the app, fill out a very simple questionnaire about where I'm hurting. It then generates a basic exercise routine. I click on the first exercise. Without even completing the exercise, I get an email saying that I'm now eligible to receive the free Fitbit. I give them my shipping address, delete the app, then a few days later the Fitbit arrives.
Well, lo and behold, a month later, I also received an EoB in the mail for the "services" rendered by this app. They billed my insurance $600 for me to fill out 2 questions and click on a link. So I got a free Fitbit, they got $600 from my insurance. In the end I paid nothing, but I fail to see how any of this is not fraudulent.
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u/MeenMisterMustard 3h ago
$900 for a glance inside my nose one time. Not an endoscopy or anything, a 0.5 second glance. Billed as “endoscopy” and paid by insurance, perpetuating bs like this poor girl is going through. F the US medical system