quickies

[cellio]

Is my health-insurance provider the Wall-Mart of the medical world, or are conventional rates really that wacky? I got a statement from them today (from a recent doctor visit) that said things like "[some test], provider's fee $92.50, our allowance $17.47, you owe $0". While that line-item was the most extreme, for most items the "fee" was about

Comments

[ginamariewade]

Is my health-insurance provider the Wall-Mart of the medical world, or are conventional rates really that wacky? I got a statement from them today (from a recent doctor visit) that said things like "[some test], provider's fee %92.50, our allowance $17.47, you owe $0". While that line-item was the most extreme, for most items the "fee" was about three times the "allowance". Does this mean that the insurance company is gouging doctors so much that they end up stiffing the uninsured, because it's fiscally fatal to not accept insurance, or what?

I think there's some kind of formula where the insurance pays only a percentage of what the doctor charges, and so the doctor charges 3-4x what they actually think is the going rate so that they'll get full payment from the insurance company.
A lot of doctors will offer a cash discount to the uninsured, that if you pay up front, you only have to pay half or a third of the going rate.

It's a mess, and just further proof that we need a single-payer health insurance system NOW.

[geekosaur]

Quickly (actually I'm a few minutes late...) --- my understanding is that this is correct, the numbers quoted to the insurance companies are artificially high because the insurance companies will only pay some small fraction of it, so doctors have to overclaim to get anything. It's an absolute mess. (Although lefkowitzga will probably have the last word on it after Shabbat. :)

[ichur72]

I sympathize re: the pollen. It gets really bad in Atlanta in the spring, to the point where there are actually miniature drifts of yellow dust blowing all over the sidewalk. All I can say is thank G-d for Claritin!

On another front, my experience with Chabad services (and with many other Orthodox minyanim) is that the shaliach tzibbur will go through the preliminary stuff & psukei d'zimrah at a very zippy pace, so it doesn't surprise me to hear that they would get all the way to the Torah reading in just over an hour. My husband and I occasionally go to a minyan that starts at 9:30, and it usually finishes in just about 2 hours.

[cellio]

Pollen: thanks. My spring allergies are actually mild compared to the summer allergies, but spring produces that uniform layer of greenish-yellowish cruft on everything that makes it noteworthy. I try to hold off on taking the allergy drugs until I really need them, but I did pop an Allegra yesterday. (I'm limited in which allergy drugs I can take to begin with, and I've had others turn ineffective on me after long-term regular use, so I try to be careful.)

My husband and I occasionally go to a minyan that starts at 9:30, and it usually finishes in just about 2 hours.

Wow. The orthodox services I've been to (four congregations, so not a large sample) have all run closer to 3 hours. So that was my baseline expectation. I guess I need to get out more. :-)

[ichur72]

I guess I'm lucky -- I'm fine with Claritin, Allegra and Zyrtec all. My only limitation seems to be that I can't take the -D versions of these drugs for more than a few in a row -- after 3-4 days of Claritin-D, I begin to feel slightly unhinged. Gotta love that pseudoephedrine. :P

I wish I didn't have to take allergy drugs, but I'm much better off if I do. My spring allergies tend to take the form not of sneezing and such, but rather of feeling feverish and ill, and I do prefer to avoid that.