Pocahontas getting all DOGEy and sht?

vraiblonde

Board Mommy
PREMO Member
Patron
To DOGE or not to DOGE....that is the question.....

IMO it's too late for the Democrat Party. They've allowed it to be taken over by crazies like an abandoned house filled with crack heads. They'll never get back what they lost; I know I personally will never trust them again and will always assign an ulterior motive to anything they do that I might normally agree with.

🤷‍♀️
 

SamSpade

Well-Known Member
PREMO Member
I won't disagree about waste in the healthcare industry. I know that doctors order tests to be done that routinely deliver nothing. My son's doctor very often will send him for tests, and I think - it's been years. It NEVER finds anything. My wife thinks he does it to bring money into the practice while insurance covers most, and I pay 5-10 bucks for it.

I've spent DAYS in hospitals with family members - and I've seen stuff get done that obviously doesn't need to be done - but some regulation requires it - it is not done at the medical discretion of the staff. I've seen fees and stuff tacked on bills that are absurd. And I am currently fighting a charge for a IN NETWORK consult with a physician just prior to surgery.

Just the other day, we had to pay a 25 dollar fee to fill out a required form - and it was THEIR form. And most of it was irrelevant. I pondered so where does the FEE go? To pay the person demanding the FEE?

I don't know how other countries manage it - but we're awash in litigious inspired legislation that massively drives up the cost of healthcare.

On another note - I think I mentioned elsewhere I had read that our new Sec of Education - soon to be out of her job, Linda McMahon - said that only 47 cents out of every dollar spent actually goes towards educating students. The rest is swallowed by FEES - and administration.
 

Sneakers

Just sneakin' around....
PREMO Member
I won't disagree about waste in the healthcare industry. I know that doctors order tests to be done that routinely deliver nothing.
I had an interesting experience in the ER a few weeks ago. After being seen by at least 6 different people and having invasive procedures, I was expecting huge bills. So far, of the bills I have received, it's been less than $400 total, my portion was maybe $125. The cost of the individual tests and procedures was much lower than I expected. Probably take another month or two for everything to come in.

Was it related to DOGE or the new admin? Doubtful, not sure any actions would have made it to the end user level so quickly.
 

vraiblonde

Board Mommy
PREMO Member
Patron
My wife thinks he does it to bring money into the practice while insurance covers most, and I pay 5-10 bucks for it.

She's a smart woman, that Mrs. Spade.

That's why I never go to the doctor. For one thing, the niggling things I have "wrong" with me can be attributed to age and I'm okay with that being my new normal; but the kicker is that if I go to the doctor for my mild age symptoms, they'll blow it up and try to put me on some medication I won't take or try to set me up with long term care that is unnecessary.

Doctors are a business. They don't give a crap about people, they care ONLY about getting paid.
 

SamSpade

Well-Known Member
PREMO Member
I had an interesting experience in the ER a few weeks ago. After being seen by at least 6 different people and having invasive procedures, I was expecting huge bills. So far, of the bills I have received, it's been less than $400 total, my portion was maybe $125. The cost of the individual tests and procedures was much lower than I expected. Probably take another month or two for everything to come in.

Was it related to DOGE or the new admin? Doubtful, not sure any actions would have made it to the end user level so quickly.
Whenever I look at the ACTUAL COSTS billed to insurance on my Explanation of Benefits form I get in the mail (just about the only mail I get, anymore) - I always say out loud "I'm in the wrong business". I will see a test I know took five minutes, and it's close to a thousand.

I am convinced hower, that medicial staff bill whatever they want to insurance. MUCH of the time, there's a printed CAP on allowable charges - as in, sorry doc, you don't get to charge a thousand bucks for a procedure and still stay in our plan. We cap it at 400 - take it or leave it.

And that typically leads to higher and higher medical bills. It's why I favor plans similar to Australia and France, where government, medical personnel and insurance craft standard fees across the board for thousands of procedures.
 

SamSpade

Well-Known Member
PREMO Member
That's what surprised me. The actuals billed to the insurance company were far lower than I expected for the procedures.
I would love to be surprised like that. So many times, the costs SHOCK THE CRAP out of me, especially when it's surgery.

Sometimes, the costs of prescriptions shock me too. Like when Wegovy no longer was covered by insurance and the pills were no longer about 30 bucks, but more like 800. (I had to stop taking it).
 

Monello

Smarter than the average bear
PREMO Member
They should put in the next contract that a certain percentage of the meds have to come from non express script linked pharmacies.

Another solution is cap payments for drugs at the average of the 3 highest pharmacy's price.

3rd thing I would do is see whos' political campaign the board members of express scripts are donating to.
 
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Hijinx

Well-Known Member
Why is Fauxcahontas bring this up now and where has she been for the last 4 years?

What's going on ?
 
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Ramp Guy

Well-Known Member
I won't disagree about waste in the healthcare industry. I know that doctors order tests to be done that routinely deliver nothing. My son's doctor very often will send him for tests, and I think - it's been years. It NEVER finds anything. My wife thinks he does it to bring money into the practice while insurance covers most, and I pay 5-10 bucks for it.

I've spent DAYS in hospitals with family members - and I've seen stuff get done that obviously doesn't need to be done - but some regulation requires it - it is not done at the medical discretion of the staff. I've seen fees and stuff tacked on bills that are absurd.
Know the feeling. I have been receiving care for stage 4 mesenteric (stomach) cancer since Dec 2022. Have undergone 3 different operations and then placed on Chemo in Jan 2024 (last Thursday the Doctors said to expect 3 more years of chemo maintenance treatments) . I attend every other Tuesday for 4 hours at the hospital, then I'm attached to a portable pump for the next 46 hours at home. I return to the cancer center on a Thursday for "Disconnect". I see my Doctor on each disconnect day and we review my health progress. Once a month a smiling Doctor arrives with her little clip board on disconnect day checking on my eating habits. She asks the same questions as my oncologist did an hour ago- weight gain-weight lost-bowel issues etc. Next month a charge of 637.00 appears on my Medicare EOB's....crazy, Why doesn't she just read the Doctor's chart. I can't complain about how Medicare and my supplement Health insurance have handled the payments... I'm guessing since 2022 my out of pocket costs add up to under a $1000.00. Heck I had a 8 1/2 hour surgery this past June and between Doctors and Hospital it was about $235,000.00, and I haven't received a bill from any of them for charges not covered by my insurance... I've been real lucky with that. The Medical billing world is crazy....
 

Sneakers

Just sneakin' around....
PREMO Member
Know the feeling. I have been receiving care for stage 4 mesenteric (stomach) cancer since Dec 2022. Have undergone 3 different operations and then placed on Chemo in Jan 2024 (last Thursday the Doctors said to expect 3 more years of chemo maintenance treatments) . I attend every other Tuesday for 4 hours at the hospital, then I'm attached to a portable pump for the next 46 hours at home. I return to the cancer center on a Thursday for "Disconnect". I see my Doctor on each disconnect day and we review my health progress. Once a month a smiling Doctor arrives with her little clip board on disconnect day checking on my eating habits. She asks the same questions as my oncologist did an hour ago- weight gain-weight lost-bowel issues etc. Next month a charge of 637.00 appears on my Medicare EOB's....crazy, Why doesn't she just read the Doctor's chart. I can't complain about how Medicare and my supplement Health insurance have handled the payments... I'm guessing since 2022 my out of pocket costs add up to under a $1000.00. Heck I had a 8 1/2 hour surgery this past June and between Doctors and Hospital it was about $235,000.00, and I haven't received a bill from any of them for charges not covered by my insurance... I've been real lucky with that. The Medical billing world is crazy....
What a PITA for you. So sorry. Wishing you a good outcome.
 

Hijinx

Well-Known Member
Know the feeling. I have been receiving care for stage 4 mesenteric (stomach) cancer since Dec 2022. Have undergone 3 different operations and then placed on Chemo in Jan 2024 (last Thursday the Doctors said to expect 3 more years of chemo maintenance treatments) . I attend every other Tuesday for 4 hours at the hospital, then I'm attached to a portable pump for the next 46 hours at home. I return to the cancer center on a Thursday for "Disconnect". I see my Doctor on each disconnect day and we review my health progress. Once a month a smiling Doctor arrives with her little clip board on disconnect day checking on my eating habits. She asks the same questions as my oncologist did an hour ago- weight gain-weight lost-bowel issues etc. Next month a charge of 637.00 appears on my Medicare EOB's....crazy, Why doesn't she just read the Doctor's chart. I can't complain about how Medicare and my supplement Health insurance have handled the payments... I'm guessing since 2022 my out of pocket costs add up to under a $1000.00. Heck I had a 8 1/2 hour surgery this past June and between Doctors and Hospital it was about $235,000.00, and I haven't received a bill from any of them for charges not covered by my insurance... I've been real lucky with that. The Medical billing world is crazy....
I feel for you pardner. You have my best wishes and hopes for your future health.
 

Hijinx

Well-Known Member
Democrats always bring up defense spending. Savings there and taxing the rich are all they got for saving money.
Cover Your Ass medicine is expensive as hell.
I was going for an operation , but first had to see a coronary Doctor.
I had a Nuclear stress test a year ago and everything was fine. I had a Electro cardiogram the week before and I went to Coronary Doctor after leaving the cancer surgeon for a pre-op thinking he would sign off for me.
Nope.
He insisted on another Nuclear stress test, I had that and then he insisted on an angiogram at WHC.
The Doctor at WHC said I was clean no problems. so then he signed off on the operation.
Now my shoulder is hurting and will probably require surgery, I have an appointment Tuesday with the Shoulder Doctor. My hip Doctor doesn't do shoulders. Specialists LOL . Anyway i will probably have the same problem with my Cardiologist Covering his ass again.

I suppose they all need house and car payments and shuffle you from one to the other. One thing is certain, if you go to the Shah's you will meet them all before it is over.,
 
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glhs837

Power with Control
Normally I'm the one driving medical stuff for myself. Loved Dr Brown. He would listen and either agree and we would move out or explain why I was wrong. :)

I only have two examples of insane billing. When I did an ER visit at St Mary's quite a ways back and got a 600 dollar bill just for the contracted ER doctor. Insurance didn't want to cover him. The company he worked for wasnt a provider under that insurance. During the visit none of that about him being a different company was explained.

The day after my lumbar fusion up at GW, I had two gents come in from Physical Therapy. Said they need to check my mobility to see if I could go home. Got me up. Had me walk about 200 feet down the hallway. Asked if I felt up to stairs. Went up and back down a flight. They said awesome, far outside expectations. Have a great day. That was billed at $2800 for the entire 12 minutes it took.
 
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PeoplesElbow

Well-Known Member
To DOGE or not to DOGE....that is the question.....

IMO it's too late for the Democrat Party. They've allowed it to be taken over by crazies like an abandoned house filled with crack heads. They'll never get back what they lost; I know I personally will never trust them again and will always assign an ulterior motive to anything they do that I might normally agree with.

🤷‍♀️
I think a smart enough person could come in and "steal" it right from under those people. Not sure anyone wants to deal with all that goes with that though, definitely wouldn't be any current national level Ds.
 

SamSpade

Well-Known Member
PREMO Member
Cover Your Ass medicine is expensive as hell.
I was going for an operation , but first had to see a coronary Doctor.
I had a Nuclear stress test a year ago and everything was fine. I had a Electro cardiogram the week before and I went to Coronary Doctor after leaving the cancer surgeon for a pre-op thinking he would sign off for me.
Nope.
He insisted on another Nuclear stress test, I had that and then he insisted on an angiogram at WHC.
The Doctor at WHC said I was clean no problems. so then he signed off on the operation.
Now my shoulder is hurting and will probably require surgery, I have an appointment Tuesday with the Shoulder Doctor. My hip Doctor doesn't do shoulders. Specialists LOL . Anyway i will probably have the same problem with my Cardiologist Covering his ass again.

I suppose they all need house and car payments and shuffle you from one to the other. One thing is certain, if you go to the Shah's you will meet them all before it is over.,
I was at a LabCorp the other day, and it dawned on me ---

How MANY medical testing companies ARE there? Maybe part of the reason they cost so much isn't because of regulations and laws - but just a lack of competition. Maybe what we need is a Musk to come in, create a competing company with better more advanced tech that doesn't charge a fortune to use for five minutes.
 
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