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Incentives for Health Reform November 3, 2009

Posted by Admin in Health Insurance, Healthonymous.
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Just caught a TV program where Bill Gates, Jr. was answering questions from students. Being Bill, he was asked many questions, one of which was on health care. He spoke to the question of what behavior the system currently promotes. The example he used was the difference between preventing an asthma attack vs. having an expensive episode treated in the hospital. The latter is rewarded with money, i.e. the procedures are “covered” by insurance. The former is not always “incentivized”.

Another example was the original inclusion of discussing on a voluntary basis end-of-life care with your physician earlier this summer in one of the bills proposed by Congress. This conversation would have received insurance coverage, but due to misrepresentation and outright lies, the provision was dropped by Congress. Some types of conversations with one’s physician simply have no incentives in the current health care and insurance systems, so they don’t occur.

When you or I see a health care provider, there is usually coverage for an office visit, but tests and procedures are rewarded too.

What incentives should be built into our system? (more…)


It’s a “Procedure”-Until the Bill Arrives September 22, 2009

Posted by Admin in Cancer, Health Insurance.
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Then it’s surgery! Well, the colonoscopy paperwork arrived today. Total costs before adjustments: $2809 (no biopsies or polyps-that gets it to almost $9000). After provider adjustments $2243.46. My share $402.19. And I’ve already met my deductible, so if that wasn’t the case, make that $602.19.  I am most grateful that only one CPT code will apply to the surgery, I mean procedure.

I also noticed that the lovely, lovely injectable drug cost $70. My last dose of nitrous oxide at the dentist cost $100 and was not delivered through an IV. I would have thought that IV delivery would be more expensive. Especially for a person like me who needs drugs in order to receive drugs!

I’m not saying that it’s too expensive (how would I know?), or not worth it (this I do know), only that this is getting to be an expensive month for me. And I have insurance in a PPO plan where I receive 80% coverage. I know some plans are now 70/30 splits. Would I have been able to find to find a discount or lower cost provider? In theory, there is a “Colonoscopies R’ Us”, in practice would you want to go there?

Total today $402.19

Month to date:$650.68

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