No Clarity In This Process
Share this article
ADVERTISEMENT
(comments below)
Comments
Comments
13 responses to “No Clarity In This Process”
-
If you now qualify for cataract surgery I encourage you to get it done! The surgery is outpatient, quick, the recovery time is short, and your vision will be greatly improved. My night driving vision is profoundly better.
My wife chose to get her last cataract done without sedation and was amazed at how quick it was, about 5 minutes for the procedure. Some aspects of our medical morass have progressed to wonderful.
-
I’ve had folks wait until vision was really bad. Then they got it done and glory be how great it was.
-
Sort of the way it often seems to work with firing bad employees.
-
-
-
The problem is Medicare and employer provided insurance.
So insurers set the rules, including for surgeries, and huge costs are added, meanwhile overriding docs and what the doc thinks is the best course of treatment.
When Blue Cross de-mutualized 30 (?) years ago, the customers who received shares likely sold as soon as they got them. They have probably appreciated near 100X…
We need real market competition and price transparency and some way to encourage the “consumer” to act like he is spending his own money.-
The “cost” structure is enraging. I had a procedure several years ago. The bill was about $160k. Negotiated net was a little over $20k with Medicare picking up most of it. With a supplemental policy my copay balance was about $250. Without insurance they’d have come after my house for the whole $160k. It is criminal.
In looking over my statements there are many things that the negotiated charges I could pay for much less expensively than my combined Medicare and supplemental policy premiums, but the initial billings are insane.
With realistic charges for medical services like those now negotiated by insurers I’d be pleased to insure against catastrophe with high deductibles like I do with homeowners and auto policies then pay routine costs out of pocket. But I can’t because of the criminal fantasy of billing rates that as an individual I cannot negotiate.
-
-
Wonder what people in Denmark do while waiting for free eye exams? Probably something important like wonder why their laptop and their phone requires two different wires to fit the same power pack.
-
Dick thanks for posting. Pity we can’t have some sort of something that when we find stupid things like this out, they can be challenged. This spends more money than it saves.
-
I’m going to preface this by saying I know absolutely nothing about insurance–
But I wouldn’t be so quick as to absolve VEI of all responsibility over your issues. I went to them for a few years because one of the doctors was recommended to me (he was one of the first to do some kind of surgery I was looking at). But I left because their business side of things was confusing, expensive, and unhelpful. In terms of operations, it seemed like the right hand never knew what the left hand was doing. I always suspected it was to get more money out of each patient, but it might have just been bad business.
I started going to a smaller place five years ago and couldn’t be happier. There seems to be more cohesion and helpfulness with insurance on the front end. My only complaint is that my specialty contacts increased in price, so I did some price shopping. They have to be ordered through a doctor’s office, so I called VEI just to see what it would cost me through them. After awhile they advised me that a new contact specialist would be starting “sometime this summer” and to try calling back then.
-
That’s good. Because medical insurance isn’t insurance. It’s a payment plan for purchasing something that is greatly overpriced.
-
-
The same thing occurs with private insurance. Many retired federal employees, such as my wife, don’t subscribe to Medicare Part B because it’s a better deal financially to stay with the same health insurance they had while working. Taking both would make virtually every procedure free but the added premiums would be quite costly. One would need a very large out of pocket annual payment to break even.
When I lived in McLean, I saw a separate ophthalmologist and optometrist. Medical insurance paid for the former and vision insurance for the latter. In NC, I see a single ophthalmologist for monitoring my cataract and for contact lenses. I have to sign a paper acknowledging for which service I’m visiting the doctor. It works well for me.
-
I made a big mistake when gettting cataract surgery. Because I abhored wearingglasses for tennis and driving I opted for 2020 distance. Now nearing 95 I’m much more into reading and laptop use.
I Should have had one eye for reading and the other distance or both for reading.
-
We really would be better off if we stopped calling it insurance. Medical PrePay would be a better term. It’s a Christmas Club. You make 61 payments and they give you back 52. It’s a one-year credit card on which you make a minimum payment and they charge a 20% administrative fee; raising the minimum payment based solely on the deficit from last year.
It’s an incredibly simple model.
Label 10
You obtain the medical services you need. They take 100% of the charges for those services, increased by inflationary pressures, divided by 12, divided by the number of customers, and remove 20% to pay their salaries, shareholder dividends, and huge ULM bonuses.
This leaves a 20% legally allowed shortfall.
Their job is then to develop creative ways to force you to cover that shortfall at the time of service using inventive techniques, such as copayments, deductibles, coverage denial, excluded services, etc., etc., and to reduce the post-service payment by arm-twisting the service provider into accepting a discounted reimbursement.
Goto Label 10
-
Dick, thanks for posting this. Two comments. First, ask VEI if your cataracts are now at the stage where Medicare will cover it. And, I agree with the later comment that it is relatively easy and quick. I have had both of mine done.
Second, insurance companies deserve a lot of blame for medical complexity but in this case Medicare could be the culprit. Most insurance companies will provide the coverage that the insurer is willing to pay for. So, the refraction issue might be Medicare’s fault.
Leave a Reply
You must be logged in to post a comment.