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hobbesmaster posted:Isn’t that as likely to be viral or fungal which would require either no other other treatment? It's interesting though that an American has to make this decision. Getting access to medicine that costs essentially nothing to create is apparently out of reach. The idea that the medicine has to be restricted due to overuse and bacteria resistant to treatment is almost laughable, because anyone here can share multiple anecdotes of a doctor prescribing them a steroid and antibiotic for just about whatever runny nose or sore throat they may have.
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Aug 30, 2018 00:25
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litany of gulps posted:The idea that the medicine has to be restricted due to overuse and bacteria resistant to treatment is almost laughable, because anyone here can share multiple anecdotes of a doctor prescribing them a steroid and antibiotic for just about whatever runny nose or sore throat they may have. 
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Aug 30, 2018 13:51
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Called the radiologist yesterday, my dead father apparently owes $38. The billing office told me it was for an x-ray done on the day he died. Medicare rejected covering it because the procedure was done after his death. Except, you know, it wasn't. The billing office confirmed that it was done at 630am, I confirmed from his death certificate he died at noon. So he advised me to call Medicare. I do that, Medicare says I need to request a packet, wait for that, fill it out, notate what the issue is, send it back in, and hope the appeal reverses the denial. Jesus, I'll just pay the $38 out of pocket. Thanks, America.
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Aug 30, 2018 20:01
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litany of gulps posted:It's interesting though that an American has to make this decision. Getting access to medicine that costs essentially nothing to create is apparently out of reach. "The gatekeepers let too much through, therefore we should have no gatekeepers" is not an argument I like on other regulatory topics so it's not one I like here.
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Aug 30, 2018 20:03
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Endymion FRS MK1 posted:Called the radiologist yesterday, my dead father apparently owes $38. The billing office told me it was for an x-ray done on the day he died. Medicare rejected covering it because the procedure was done after his death. Except, you know, it wasn't. The billing office confirmed that it was done at 630am, I confirmed from his death certificate he died at noon. So he advised me to call Medicare. I do that, Medicare says I need to request a packet, wait for that, fill it out, notate what the issue is, send it back in, and hope the appeal reverses the denial. I've had experience with this, with my parents death. First of all, I'm so sorry for your loss. Second of all, if Medicare doesn't want to pay it, you could just tell the radiologist to bill the Estate of your deceased father. You shouldn't have to pay off his bills after death. When the Estate is settled, if there's money to pay the bill, it gets paid from the Estate. If not, then they might have to take a loss on it.
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Aug 30, 2018 20:18
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Qu Appelle posted:I've had experience with this, with my parents death. Wouldn't I be the estate? I'm an only child and he was divorced so either way I'm paying it right?
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Aug 30, 2018 20:53
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Endymion FRS MK1 posted:Wouldn't I be the estate? I'm an only child and he was divorced so either way I'm paying it right? No, you don't automatically owe your parent's debts. The estate is a separate legal entity.
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Aug 30, 2018 21:37
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Hieronymous Alloy posted:No, you don't automatically owe your parent's debts. The estate is a separate legal entity. I am not a lawyer; this is not legal advice, but this is how it worked in the State of Wisconsin. Basically, his Estate is his assets and debts, which are completely separate from yours. (There are complications with if you cosigned onto accounts with him, but it doesn't sound like that's the case. If you did? OMG Lawyer Time.) His Estate is made up of all of his assets (bank accounts, property, stock, etc.). If he has a Will, the Executrix of that Will is usually the Executrix of the Estate. Which might be you, as you're an only child (solidarity, BTW - I am one as well.). Basically, you do this: Get all of his assets together, and all of his debts together. If there looks like to be complex issues (like a lot of property, etc., hiring an Estate Lawyer is the way to go. Same if he didn't have a will drawn up). However, if there are more assets than debts, pay off the debts FIRST, and then distribute the remainder of his assets to his legal heirs. If there are more debts than assets, then some debts are going to remain unpaid - and they cannot come after living relatives to get those debts paid off. Instead, the debts are written off. They will probably require proof, like a Death Certificate, and if they think that the Estate is being mismanaged, they can sue for that, but a Radiologist isn't going to do that for a $48.00 bill. I can understand if this is all overwhelming; it was to me, as well. A good Estate Lawyer can be of help, and they are also paid by the Estate. Practically speaking, you could be a billionaire and your parents could die destitute, and you don't have to pay one cent towards their debts. You are not liable. It's actually kind of fun to tell debtors that no, you will not be paying that bill out of pocket. Some will try to guilt trip you into paying; just remember: You are not liable. So - TL;DR - the magic words to the Radiologist is "I'm sorry; I am not liable for this bill. He is deceased; you will have to submit it to his Estate. The contact info is this: (blah)." It's even better if you have a lawyer; then you can throw around the "Lawyer" word, and they *hate* that. Qu Appelle fucked around with this message at 22:19 on Aug 30, 2018 |
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Aug 30, 2018 22:13
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Endymion FRS MK1 posted:Called the radiologist yesterday, my dead father apparently owes $38. The billing office told me it was for an x-ray done on the day he died. Medicare rejected covering it because the procedure was done after his death. Except, you know, it wasn't. The billing office confirmed that it was done at 630am, I confirmed from his death certificate he died at noon. So he advised me to call Medicare. I do that, Medicare says I need to request a packet, wait for that, fill it out, notate what the issue is, send it back in, and hope the appeal reverses the denial. honestly if it is a Medicare issue, call your Rep. or Senator.
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Sep 1, 2018 03:58
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GreyjoyBastard posted:"The gatekeepers let too much through, therefore we should have no gatekeepers" is not an argument I like on other regulatory topics so it's not one I like here. I mean, correct me if I'm wrong, but the vast majority of the world population has access to inexpensive, easily obtained antibiotics. A small segment of the global population making such drugs expensive and relatively difficult to acquire hardly qualifies as anything resembling a "gatekeeper" in any reasonable sense. It's not as if the antibiotic resistant illnesses that develop as a result of this situation respect political borders. Isn't pretending as though our system is actually protecting us some kind of medical security theater? Wouldn't acknowledging reality and taking other steps to counteract the effect of antibiotic resistant illnesses, like devoting funding to researching new forms of antibiotics, make a lot more sense than whatever it is we currently do? Or perhaps a focus on making home testing for bacterial illness more affordable? Why do I need to pay 200 bucks for some goober to swab my mouth and tell me there's nothing they can do for me? Why can't I do that myself? This situation is what drives people to take antibiotics without seeing a professional.
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Sep 1, 2018 05:33
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litany of gulps posted:I mean, correct me if I'm wrong, but the vast majority of the world population has access to inexpensive, easily obtained antibiotics. A small segment of the global population making such drugs expensive and relatively difficult to acquire hardly qualifies as anything resembling a "gatekeeper" in any reasonable sense. It's not as if the antibiotic resistant illnesses that develop as a result of this situation respect political borders. This may be true. I don't know--it depends how how good of a job American doctors do at preventing antibiotic overuse and how much America matters. This argument sounds a lot like Republican arguments regarding the futility of US environmental regulations designed to reduce global warming, given that China is the biggest polluter. You are going to get a tonne of pushback in this thread based on that, I think. litany of gulps posted:Isn't pretending as though our system is actually protecting us some kind of medical security theater? Wouldn't acknowledging reality and taking other steps to counteract the effect of antibiotic resistant illnesses, like devoting funding to researching new forms of antibiotics, make a lot more sense than whatever it is we currently do? Aren't retail health clinics supposed to offer these kinds of services at lower prices and at greater convenience?
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Sep 1, 2018 17:39
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litany of gulps posted:Or perhaps a focus on making home testing for bacterial illness more affordable? Why do I need to pay 200 bucks for some goober to swab my mouth and tell me there's nothing they can do for me? Why can't I do that myself? This situation is what drives people to take antibiotics without seeing a professional. Speaking as a former microbiologist, I’d have to say the idea of people culturing and identifying their own bacterial infections at home is....  Yeah, not happening, even if homes had sterile culture growth facilities standard. There is a lot more to identifying harmful bacteria and best antibiotic to use than just a swab, to put it mildly. You *might* come up with some sort of specific home test that IDs very specific organisms by DNA/protein markers, but for the effort that would cost you’d get better results working on improving antibiotics and keep the bacterial identification to the labs with the facilities to do the work. As for “security theatre” I wouldn’t say focus on reducing antibiotic use is POINTLESS by any means. It’s not sufficient on its own of course (if that’s all you mean then yeah, sure you’re right) but just because others don’t do the right thing doesn’t absolve us from at least trying. Besides, training in the US/other Western countries crosses borders too, so it’s worth teaching the right thing at least. Sitting on our butts and assuming that’s enough is indeed not wise though.
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Sep 1, 2018 19:22
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litany of gulps posted:Or perhaps a focus on making home testing for bacterial illness more affordable? Why do I need to pay 200 bucks for some goober to swab my mouth and tell me there's nothing they can do for me? Why can't I do that myself? This situation is what drives people to take antibiotics without seeing a professional.
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Sep 2, 2018 02:36
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cowtown posted:VistA has the honor of having by far the least intelligible source code I've ever seen in a shipping product. I know this is old, but why does this have 'horse', 'hay', 'needle' and 'nail' as variable names?
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Sep 2, 2018 05:14
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Stickman posted:Thanks! I didn't realize that was under the Medicare umbrella. Yeah, DSH (disproportionate share hospital) payments are a modifier on Medicare payments for a facility. But I want to say that PPACA used it as a payfor because it was supposed to reduce / eliminate bad debt from care, so it's either partially or fully phased/phasing out.
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Sep 2, 2018 13:10
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Insulin goes for eye-wateringly high prices. This is not news, I know. The thing I wonder is: Why the hell isn't there a generic available? If ever there was a case for breaking the patent, you'd think insulin would be it.
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Sep 7, 2018 03:06
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Spacewolf posted:Insulin goes for eye-wateringly high prices. Dude life-saving medications are constantly on shortage. SC DHEC had to extend expirations dates on epinephrine last year which is used for anything from anaphylactic reactions/asthmatic bronchospasm to cardiac arrest. Hypotension. Croup. It's an old drug. It's cheap. And for awhile, it was in total shortage from lack of manufacture. Prices skyrocketed. Normal Saline was in shortage a couple years back. Benzos and pain medications are frequently out of stock. No shortage of dick pills or PO painkillers though!
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Sep 7, 2018 03:11
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With insulin specifically one of the big problems is shipping and storage: it's fragile, it has to be refrigerated, and it has a relatively short shelf life. That means that the only reliable existing distribution methods are the exact same small group of drug manufacturers currently gouging the price, and, well....
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Sep 7, 2018 03:18
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It's so bad hospitals are trying to cut out the middle man entirely and make the drugs themselves https://twitter.com/npr/status/1037754803244290049?s=21 The magic of capitalism and the invisible hand in action baby
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Sep 7, 2018 04:39
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Rhesus Pieces posted:It's so bad hospitals are trying to cut out the middle man entirely and make the drugs themselves How long till the first lawsuit is filed to stop this? I give it two weeks.
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Sep 7, 2018 04:41
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Zil posted:How long till the first lawsuit is filed to stop this? Who would sue someone for making saline bags? It's literally just mixing salt and water. There's no patent on it.
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Sep 7, 2018 14:42
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Leon Trotsky 2012 posted:Who would sue someone for making saline bags? It's literally just mixing salt and water. Was in a bit of a pessimistic mood with my original post. Drug companies are not known for their fondness of sharing profits on anything. I figured some pharmaceutical company will want to stop this kind of thing early on, before the hospitals start trying to manufacture other things that are high cost/short supply. Though I would like to see this kind of thing take off and there be more drug manufacturers out there that are non-profit or at least not for profit in nature.
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Sep 7, 2018 15:36
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Zil posted:Was in a bit of a pessimistic mood with my original post. The "big drug companies" do not want to make these drugs. They should be be ecstatic that their entire lines can be devoted to on patent stuff that costs $500/month to treat a chronic condition.
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Sep 7, 2018 15:42
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Speaking of drug patents: https://twitter.com/christina_s_ho/status/1038071960591376386?s=21
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Sep 7, 2018 16:13
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Maybe profit incentive isn't an economic panacea.
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Sep 7, 2018 16:16
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My company is offering a HSA for the first time this year. Anyone have much experience with those types of accounts? From what I read, it seems more like a tax shelter rather than an alternative to a traditional health insurance plan.
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Sep 11, 2018 13:56
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HSAs are 100% just tax shelters for people who can afford it.
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Sep 11, 2018 14:03
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Big Mouth Billy Basshole posted:My company is offering a HSA for the first time this year. Anyone have much experience with those types of accounts? If you have very low fixed healthcare costs each year, then they are basically a tax shelter. I'd take it if you only go to the doctor once a year, are young, have no health issues, and already max out your IRA.
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Sep 11, 2018 15:32
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Big Mouth Billy Basshole posted:My company is offering a HSA for the first time this year. Anyone have much experience with those types of accounts? HSAs are not an alternative to insurance. They allow people with high deductible health plans to save pre-tax money to cover out of pocket expenses. "High Deductible" is defined as at least $1350 for individuals and $2700 for families (and the deductible can be as high as the out of pocket maximum for individual/families as defined by the HHS). Because of the increased deductible (and generally increased out of pocket maximums up to federal limits) HDHPs usually have cheaper premiums than their lower deductible counterparts. HDHP combined with an HSA can be a good option for many people. Those are usually going to be younger and healthier folks that don't rack up many health expenses period. I personally use a HDHP and HSA and I throw in the difference in premium between the HDHP my employer offers and the PPO into my HSA plus some additional money to reach the HSA max. For me it works out because my average annual health expenses are <$200. Even with the higher deductible it is possible for the HDHP to be a better deal even if you use your insurance a lot; you would have to run the numbers to see where the break-even points are. Edit: And it should be noted that contributions to your HSA are pre-payroll tax as well. 401k contributions and such usually only shelter you from income tax; the HSA will shelter your from all tax. And any HSA funds used for approved medical expenses (as defined by law) are tax-free. You can also withdraw from your HSA in retirement penalty-free and just owe taxes on the amount. It's a pretty awesome tax shelter if you don't have a lot of medical expenses.
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Sep 11, 2018 18:21
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HSAs are not much different from regular PPO insurance. If you do not have regular medical costs you will probably be better off in the long run picking the HSA and investing the difference in premiums in to the HSA until you have enough to meet your deductible. The one thing to remember is that the deductible on an HSA is a "true" deductible, which means you can not receive any benefits from your plan until it is met. This means any doctor visit or drug you get at the pharmacy can not have a copay until you meet your deductible, as the difference in allowed charges and your copay is a benefit you receive from the plan. If you don't have any maintenance prescriptions or see doctors regularly this won't impact you significantly.
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Sep 11, 2018 18:33
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Reik posted:HSAs are not much different from regular PPO insurance. If you do not have regular medical costs you will probably be better off in the long run picking the HSA and investing the difference in premiums in to the HSA until you have enough to meet your deductible. The only caveat here is that "preventative services" are covered right away, including prescriptions. Generally the formulary for preventative prescriptions is pretty thin and there are only a few preventative services covered under law (and many have gimmicks to gently caress you too; like colon cancer screening is covered, but if they end up biopsying a polyp then that isn't covered).
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Sep 11, 2018 23:50
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Raldikuk posted:The only caveat here is that "preventative services" are covered right away, including prescriptions. Generally the formulary for preventative prescriptions is pretty thin and there are only a few preventative services covered under law (and many have gimmicks to gently caress you too; like colon cancer screening is covered, but if they end up biopsying a polyp then that isn't covered). Same with "free" mammograms; that's pretty much true with all the preventive-vs.-diagnostic "free" stuff covered under the ACA. There are numerous anecdotes about people going to their "free" annual physicals, and then when the doc asks if they have any concerns and they deigned to bring them up, they were billed for the exam as diagnostic, rather than preventive. I remember one woman's story in particular; her friend cautioned her to not bring up anything on her own, but then she honestly answered her doc's query and mentioned something then bam! Billed out in full.
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Sep 12, 2018 02:05
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It almost seems like visits are only "preventative" and free if you're completely healthy and the whole visit was a useless waste of time. If that's the case then why bother at all? Doesn't this still discourage poor sick people from seeing the doctor and defeat the entire purpose of preventative medicine?
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Sep 12, 2018 02:26
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Rhesus Pieces posted:It almost seems like visits are only "preventative" and free if you're completely healthy and the whole visit was a useless waste of time. If that's the case then why bother at all? Doesn't this still discourage poor sick people from seeing the doctor and defeat the entire purpose of preventative medicine? It's also fine if the preventive testing shows an issue, as long as you don't actually mention any symptoms or hint that you may have any issues. Unless your doctor uses the wrong code of course, then you're hosed again.
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Sep 12, 2018 02:35
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baquerd posted:It's also fine if the preventive testing shows an issue, as long as you don't actually mention any symptoms or hint that you may have any issues. Unless your doctor uses the wrong code of course, then you're hosed again. Yeah I'm sure doctors love dealing with tight-lipped patients who refuse to mention any symptoms or answer questions honestly. That makes the diagnostic process so much easier!
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Sep 12, 2018 02:38
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Willa Rogers posted:Same with "free" mammograms; that's pretty much true with all the preventive-vs.-diagnostic "free" stuff covered under the ACA. Yeah, I've dealt with that with my doctor for my asthma. She asks what my concerns (none) are and does some volumetric flow tests and bam a huge bill for the pleasure. There are some good GPs out there who don't do that poo poo and overall go the extra mile. It can take a bit of hunting without a referral and good luck if they aren't in network.
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Sep 12, 2018 02:47
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LeeMajors posted:Normal Saline was in shortage a couple years back. Still is. Puerto Rico was the country's primary source of normal saline and then Hurricane Maria happened.
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Sep 12, 2018 03:02
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https://www.youtube.com/watch?v=ZK_UB8Thctg All perfectly normal and nothing to be angry about.
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Sep 12, 2018 19:29
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"What does this have to do with... oh. OH. Holy poo poo  "
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Sep 13, 2018 17:42
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I just wanted to point out that I have basically become a walking example of what is called a "perverse incentive." I was approved for Medicad as I now live in a state that expanded it. I have been unemployed now since 1 May, and it has convinced me to avoid seeking most jobs except for jobs with excellent guaranteed benefits (of which there are very, very few) or non-benefited part-time jobs with super low salaries in order to stay under the income cap. There is a very small patient contribution that starts at $1 per month (seriously) for people with no income and goes up to I believe $15 a month for people near the monthly income cap, which is less than $1200. I would be fine to pay a higher absolute cost/percentage of my salary to keep what I have, but if I pass the maximum earnings threshold I lose everything. Naturally, any job that pays a paltry $300 a month would not allow me to purchase anything close to decent coverage, so it's in my best interest to either avoid full-time labour entirely or hold out for a "serious" job. I just wanted to point out the absurdity of this.
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Sep 25, 2018 01:53
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