Oklahoma Doctors vs. Obamacare. Very interdasting.

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[ARCHIVED THREAD] - Oklahoma Doctors vs. Obamacare. Very interdasting.

Posted: 11/18/2012 7:15:31 PM EDT

http://reason.com/archives/2012/11/15/the-obamacare-revolt-oklahoma-doctors-fi/singlepage

"One reason our prices are so low," says Smith, "is that we don't have administrators running around in their four or five thousand dollar suits."

Posted: 11/18/2012 7:21:36 PM EDT

[#1]

Good read.

Posted: 11/18/2012 7:26:19 PM EDT

[#2]

Tagged

Posted: 11/18/2012 7:38:23 PM EDT

[#3]

Free enterprise will kick Congress' ass any day of the week.

When they try to shut down free enterprise completely then we will need more trauma centers.

Posted: 11/18/2012 7:46:28 PM EDT

[#4]

This used to be a very good customer of mine before I retired! It was obvious they were growing by leaps and bounds!

Posted: 11/18/2012 8:18:42 PM EDT

[#5]

love this, straight to face book

Posted: 11/19/2012 3:56:25 AM EDT

[#6]

Price list

Posted: 11/19/2012 3:58:45 AM EDT

[#7]

Taggage.

Posted: 11/19/2012 4:04:15 AM EDT

[#8]

Great read!!

Posted: 11/19/2012 4:10:45 AM EDT

[#9]

Hey, you mean to tell me that this place operates in the exact opposite manner as the government does,
but it actually works , and costs less?

Bullshit! That's impossible!

Posted: 11/19/2012 4:12:33 AM EDT

[#10]

Quoted:
Price list

Was just looking at that.

Prices seem pretty good. I figured a lot would cost more - like an ACL repair for $7K, knee Arthroscopy $3740

Posted: 11/19/2012 4:37:54 AM EDT

[#11]

Tag

Posted: 11/19/2012 5:24:12 AM EDT

[#12]

I've been saying for a long time - even before Obamacare was on the radar - that the best way to fix the healthcare system was with a big dose of capitalism.

Not only should hospitals post their price lists, they should also post there infection and error rates. You can get that information if you know where to look, but ALL of that info should be posted somewhere obvious and easy to get to.

Let the patients/consumers decide if they want to go to Hospital A, which is cheaper, but has a higher infection rate vs. the more expensive Hospital B, which has the lower infection rate. IMHO, this sort of competition would ultimately drive down prices, infection rates, and error rates at most hospitals as they improved operations in an attempt to attract more customers (patients). Lower infection and error rates should also help to reduce the number of lawsuits around those issues.

Posted: 11/19/2012 5:26:40 AM EDT

[#13]

Too bad OK has a Pro Sports team now...

Posted: 11/19/2012 5:37:42 AM EDT

[#14]

The part they leave out of the story is how the hospitals are forced by law to take the medicaid/uninsured/indigent/FSA types while the surgery center guys don't have to and thus their bottom line looks much better.

Posted: 11/19/2012 5:44:16 AM EDT

[#15]

I throught i read somewhere that plastic surgery is fairly cheap because it isn't covered by insurance and they need to be competitive with other PS facilities?

So i guess it would make sense that any medical procedure would fall in line.

my only question that would stem from this is what about 'uncommon" procedures? heart surgeries, organ transplants, etc...

Posted: 11/19/2012 5:58:22 AM EDT

[#16]

Quoted:
I've been saying for a long time - even before Obamacare was on the radar - that the best way to fix the healthcare system was with a big dose of capitalism.

Not only should hospitals post their price lists, they should also post there infection and error rates. You can get that information if you know where to look, but ALL of that info should be posted somewhere obvious and easy to get to.

Let the patients/consumers decide if they want to go to Hospital A, which is cheaper, but has a higher infection rate vs. the more expensive Hospital B, which has the lower infection rate. IMHO, this sort of competition would ultimately drive down prices, infection rates, and error rates at most hospitals as they improved operations in an attempt to attract more customers (patients). Lower infection and error rates should also help to reduce the number of lawsuits around those issues.

Perhaps it would also reduce the size of the mega-hospitals which concentrate services regionally, removing quality service from outlying communities.

Posted: 11/19/2012 6:00:46 AM EDT

[#17]

What horse shit...

A surgery center isn't a hospital. When 350lb patients roll in on medicare with legs that are rotting off from gangrene (had that this week) and you are expected to treat them until they are better, then come back to me. While I have no doubt that a surgery center could treat a wound, clean it, and patch it up I do not think that it would come anywhere close to the care required to be dispensed by a real hospital.

While I agree with the centers policy on billing, it would have no real world use within a hospital. Within a hospital a patient is billed based on the diagnosis the patient is admitted with. So if your patient comes in with pneumonia you get reimbursed for the 3 days it would take to treat a pneumonia. But if that patient had pneumonia on top of obesity, heart disease, and emphysema then your hospital is going to lose out because that patient is going to take significantly longer to finish treatment. And god forbid the patient had a pneumonia and a pressure ulcer or something else. If the ulcer was missed on initial screen, you eat the cost of treatment even if it didn't come from you. Which is why those patients are now screened for EVERYTHING you can think of: MRSA, VRE, flu, skin checks, etc.

Posted: 11/19/2012 6:21:37 AM EDT

[#18]

Quoted:
The part they leave out of the story is how the hospitals are forced by law to take the medicaid/uninsured/indigent/FSA types while the surgery center guys don't have to and thus their bottom line looks much better.

Love the story but this is a great point. While there's no doubt that hospitals can run more efficiently, the uninsured and nonpaying patients are a serious cost problem. Now you'll pay for them three ways:

Surtax on your insurance premiums
Surtax on medicare and possible income tax outlays
Inflated markups on your hospital bill

Soon it won't make any sense for healthy young people under 30 to pay $1,000+ per month for insurance they'll hardly use. They'll end up going with high-deductible or HSA plans, which is probably why Obamacare tried to neutered those plans.

Republicans need to roll with the Democrats with this shit. Raise income taxes as they wish, raise all taxes as they wish. If the Republicans fight them they'll get the blame when the whole fucking thing turns into a clusterfuck. The only hope we have is people rightfully see that Marxism fails... again. Then we roll the whole thing back.

Posted: 11/19/2012 6:45:51 AM EDT

[#19]

Quoted:

Too bad OK has a Pro Sports team now...

Funny thing is, The OKC Thunder practice facility sits directly behind this facility.

Posted: 11/19/2012 7:02:23 AM EDT

[#20]

Quoted:
What horse shit...

A surgery center isn't a hospital. When 350lb patients roll in on medicare with legs that are rotting off from gangrene (had that this week) and you are expected to treat them until they are better, then come back to me. While I have no doubt that a surgery center could treat a wound, clean it, and patch it up I do not think that it would come anywhere close to the care required to be dispensed by a real hospital.

While I agree with the centers policy on billing, it would have no real world use within a hospital. Within a hospital a patient is billed based on the diagnosis the patient is admitted with. So if your patient comes in with pneumonia you get reimbursed for the 3 days it would take to treat a pneumonia. But if that patient had pneumonia on top of obesity, heart disease, and emphysema then your hospital is going to lose out because that patient is going to take significantly longer to finish treatment. And god forbid the patient had a pneumonia and a pressure ulcer or something else. If the ulcer was missed on initial screen, you eat the cost of treatment even if it didn't come from you. Which is why those patients are now screened for EVERYTHING you can think of: MRSA, VRE, flu, skin checks, etc.

It would have a real-world use within a hospital.

In Oklahoma the facility cost for a colonoscopy has gone from $1,480 to $3,740 in less than 6 months. The OU Medical center used to bill $1,478 for a colonoscopy (not including the physician charge). The last bill I got for a patient they billed $3,780. The only difference in the two, was that Mercy (the other large hospital with a GI group) has raised their fees after purchasing the two free-standing facilities near their location, and bring those physician groups in-house. Their fees went from $1800 or so, to $4,000+.

I've worked in the medical finance field for almost 20 years. I worked for 9 years on the managed care side (for NY Life and an HMO of theirs), and for another 10+ years on the research side dealing with patient costs, research costs, facility, lab, etc.. There is no justification for the percentage increases we are seeing. They're outrageous. Drug costs alone are fucking ridiculous. And I guarantee you that those costs haven't increased to the point that you need to charge $200 for a fentanyl patch. That's highway robbery.

I know that traditional hospitals have to take the under/uninsured. That's a losing proposition. However, looking at the bottom line for most hospitals, they still manage to do better than break even. And that's after purchasing new equipment, and paying for facility expansions. Hell, look at OU Medical center's campus. Have you seen all the new shit going up there? They're the main hospital in the state treating the indigent, and they're expanding like a sumbitch. It's insane. But, they're losing tons of money, right? Hell no they're not. The insured people of this state (and every other state has the same type system) are the ones paying the bills. If enough people started doing what Dr. Smith did, I guarantee that the indigent would have some serious health care problems. The local hospitals wouldn't be able to afford to treat them

Posted: 11/19/2012 7:43:23 AM EDT

[#21]

My 4 day stay in a local hospital was billed at $131,000and that didn't include cost for any of the doctors. I was in the "operating" room for about an hour and they charged $13,000.

Posted: 11/19/2012 7:47:18 AM EDT

[#22]

I recently had a Carpal Tunnel Release surgery.
Total bill in an outpatient surgery center was $19K+. (paid by Insurance)

Same procedure at center in the OP is >$3K

Posted: 11/19/2012 1:25:48 PM EDT

[#23]

tag

Posted: 11/19/2012 2:34:59 PM EDT

[#24]

Long as you folks realize that is more a boutique surgery center and not a hospital
Then I am AOK with their plan

Posted: 11/19/2012 2:41:04 PM EDT

[#25]

So in 2014 hospitals will be able to turn away the indigent now that everyone is forced to buy health insurance right?

Posted: 11/19/2012 2:48:03 PM EDT

[#26]

Quoted:
Long as you folks realize that is more a boutique surgery center and not a hospital
Then I am AOK with their plan

Yep. The problem is the way the current laws are written,if you didn't have a facility before the laws went into effect, you're SOL. And I guarantee you, you arent going to get a certificate of need anywhere within the OKC/Edmond/Moore/Norman city limits. Too many hospitals and non-profits entities have too much to lose.

The law is written to drive consumers to use their local hospital. That way, the reimbursement costs (most by contract around here)are tied to medicare reimbursement rates, which are dropping like a rock. The hospitals charge a fortune, get reimbursed a percentage by an insurance company, and a patient with a job and money picks up the deductible, co-pay and coinsurance. The "indigent" with no discernable job, pays nothing. It's pathetic.

Posted: 11/19/2012 2:49:47 PM EDT

[#27]

There are companies that actually pay for an employees medical treatment?

Posted: 11/19/2012 2:59:46 PM EDT

[#28]

Quoted:
The part they leave out of the story is how the hospitals are forced by law to take the medicaid/uninsured/indigent/FSA types while the surgery center guys don't have to and thus their bottom line looks much better.

"Integris Health declined to make a spokesperson available to be interviewed for this story. But in a statement, the company defended its outrageous bills on the grounds that it needs a way to cover losses on services offered free. Whatever the merits of that argument, Integris must also cover overhead costs and bureaucratic inefficiencies that the Surgery Center has managed to abolish."

Not phrased very complimentary, but it is in there.

Posted: 11/19/2012 3:04:17 PM EDT

[#29]

Quoted:
The part they leave out of the story is how the hospitals are forced by law to take the medicaid/uninsured/indigent/FSA types while the surgery center guys don't have to and thus their bottom line looks much better.

Not all hospitals

Posted: 11/19/2012 3:04:38 PM EDT

[#30]

The major cause of exploding U.S. heath care costs is the third-party payer system, a text-book concept in which A buys goods or services from B that are paid for by C. Because private insurance companies or the government generally pick up most of the tab for medical services, patients don’t have the normal incentive to seek out value.

This

Posted: 11/19/2012 3:12:27 PM EDT

[#31]

Quoted:

There are companies that actually pay for an employees medical treatment?

If a company (or any organization) is large enough, it pays to self insure. My ex-brother-in-law runs a company called Magnacare in NYC, similar to The Kempton Group mentioned in the article, that manages self-insurance plans for companies. Magnacare basically manages all the paperwork and negotiates rates, coverages, etc with doctors and hospitals, but the company pays the bills instead of Magnacare paying the bill like a traditional insurance company would.

Posted: 11/19/2012 3:21:11 PM EDT

[#32]

I think we'll see more of this. The ObamaCare regulation only blocks new hospitals, not new private practice.

I use a combination of cash/health insurance for care. I have insurance but still see a doctor who doesn't take ANY insurance. Insurance covers tests and meds but can't question her diagnosis or practices. She doesn't have to justify prescriptions to my insurer. If the meds are covered under the plan, they pay.

I had to get a PICC line. It was inserted at a site that has set prices. Their cash price is about 1/4 what they charged my insurance company (it was posted on the "Explanation of Benefits" from my insurer).

Price list

Posted: 11/19/2012 3:30:12 PM EDT

[#33]

Quoted:

There are companies that actually pay for an employees medical treatment?

If a company (or any organization) is large enough, it pays to self insure. My ex-brother-in-law runs a company called Magnacare in NYC, similar to The Kempton Group mentioned in the article, that manages self-insurance plans for companies. Magnacare basically manages all the paperwork and negotiates rates, coverages, etc with doctors and hospitals, but the company pays the bills instead of Magnacare paying the bill like a traditional insurance company would.

I'd never heard of this until last month.

We got an email at work stating that because we'd grown (from 180 employees to over 1100) the company could now "self-insure" to keep costs down. Unfortunately our rates are still going up now that we can negotiate better rates.........

Posted: 11/19/2012 3:42:42 PM EDT

[#34]

Quoted:

Quoted:
Price list

Was just looking at that.

Prices seem pretty good. I figured a lot would cost more - like an ACL repair for $7K, knee Arthroscopy $3740

Yeah Im pretty sure my ACL repair 10 years ago approached 20k.

Posted: 11/19/2012 3:49:43 PM EDT

[#35]

That fever needs to spread.

Posted: 11/19/2012 5:06:29 PM EDT

[#36]

Quoted:
The part they leave out of the story is how the hospitals are forced by law to take the medicaid/uninsured/indigent/FSA types while the surgery center guys don't have to and thus their bottom line looks much better.

no they did not leave that out

Posted: 11/19/2012 5:08:50 PM EDT

[#37]

Quoted:

Quoted:
What horse shit...

A surgery center isn't a hospital. When 350lb patients roll in on medicare with legs that are rotting off from gangrene (had that this week) and you are expected to treat them until they are better, then come back to me. While I have no doubt that a surgery center could treat a wound, clean it, and patch it up I do not think that it would come anywhere close to the care required to be dispensed by a real hospital.

While I agree with the centers policy on billing, it would have no real world use within a hospital. Within a hospital a patient is billed based on the diagnosis the patient is admitted with. So if your patient comes in with pneumonia you get reimbursed for the 3 days it would take to treat a pneumonia. But if that patient had pneumonia on top of obesity, heart disease, and emphysema then your hospital is going to lose out because that patient is going to take significantly longer to finish treatment. And god forbid the patient had a pneumonia and a pressure ulcer or something else. If the ulcer was missed on initial screen, you eat the cost of treatment even if it didn't come from you. Which is why those patients are now screened for EVERYTHING you can think of: MRSA, VRE, flu, skin checks, etc.

It would have a real-world use within a hospital.

In Oklahoma the facility cost for a colonoscopy has gone from $1,480 to $3,740 in less than 6 months. The OU Medical center used to bill $1,478 for a colonoscopy (not including the physician charge). The last bill I got for a patient they billed $3,780. The only difference in the two, was that Mercy (the other large hospital with a GI group) has raised their fees after purchasing the two free-standing facilities near their location, and bring those physician groups in-house. Their fees went from $1800 or so, to $4,000+.

I've worked in the medical finance field for almost 20 years. I worked for 9 years on the managed care side (for NY Life and an HMO of theirs), and for another 10+ years on the research side dealing with patient costs, research costs, facility, lab, etc.. There is no justification for the percentage increases we are seeing. They're outrageous. Drug costs alone are fucking ridiculous. And I guarantee you that those costs haven't increased to the point that you need to charge $200 for a fentanyl patch. That's highway robbery.

I know that traditional hospitals have to take the under/uninsured. That's a losing proposition. However, looking at the bottom line for most hospitals, they still manage to do better than break even. And that's after purchasing new equipment, and paying for facility expansions. Hell, look at OU Medical center's campus. Have you seen all the new shit going up there? They're the main hospital in the state treating the indigent, and they're expanding like a sumbitch. It's insane. But, they're losing tons of money, right? Hell no they're not. The insured people of this state (and every other state has the same type system) are the ones paying the bills. If enough people started doing what Dr. Smith did, I guarantee that the indigent would have some serious health care problems. The local hospitals wouldn't be able to afford to treat them

Healthcare isnt just one side, Surgery is only one side. This is a great way to deal with part of it but not a final answer. You still have to be able to pay for the people that dont pay their bill. The hospital has to stay open and make a profit and it can not turn people away.

Posted: 11/19/2012 5:37:03 PM EDT

[#38]

Quoted:

Quoted:
What horse shit...

A surgery center isn't a hospital. When 350lb patients roll in on medicare with legs that are rotting off from gangrene (had that this week) and you are expected to treat them until they are better, then come back to me. While I have no doubt that a surgery center could treat a wound, clean it, and patch it up I do not think that it would come anywhere close to the care required to be dispensed by a real hospital.

While I agree with the centers policy on billing, it would have no real world use within a hospital. Within a hospital a patient is billed based on the diagnosis the patient is admitted with. So if your patient comes in with pneumonia you get reimbursed for the 3 days it would take to treat a pneumonia. But if that patient had pneumonia on top of obesity, heart disease, and emphysema then your hospital is going to lose out because that patient is going to take significantly longer to finish treatment. And god forbid the patient had a pneumonia and a pressure ulcer or something else. If the ulcer was missed on initial screen, you eat the cost of treatment even if it didn't come from you. Which is why those patients are now screened for EVERYTHING you can think of: MRSA, VRE, flu, skin checks, etc.

It would have a real-world use within a hospital.

In Oklahoma the facility cost for a colonoscopy has gone from $1,480 to $3,740 in less than 6 months. The OU Medical center used to bill $1,478 for a colonoscopy (not including the physician charge). The last bill I got for a patient they billed $3,780. The only difference in the two, was that Mercy (the other large hospital with a GI group) has raised their fees after purchasing the two free-standing facilities near their location, and bring those physician groups in-house. Their fees went from $1800 or so, to $4,000+.

I've worked in the medical finance field for almost 20 years. I worked for 9 years on the managed care side (for NY Life and an HMO of theirs), and for another 10+ years on the research side dealing with patient costs, research costs, facility, lab, etc.. There is no justification for the percentage increases we are seeing. They're outrageous. Drug costs alone are fucking ridiculous. And I guarantee you that those costs haven't increased to the point that you need to charge $200 for a fentanyl patch. That's highway robbery.

I know that traditional hospitals have to take the under/uninsured. That's a losing proposition. However, looking at the bottom line for most hospitals, they still manage to do better than break even. And that's after purchasing new equipment, and paying for facility expansions. Hell, look at OU Medical center's campus. Have you seen all the new shit going up there? They're the main hospital in the state treating the indigent, and they're expanding like a sumbitch. It's insane. But, they're losing tons of money, right? Hell no they're not. The insured people of this state (and every other state has the same type system) are the ones paying the bills. If enough people started doing what Dr. Smith did, I guarantee that the indigent would have some serious health care problems. The local hospitals wouldn't be able to afford to treat them

Healthcare isnt just one side, Surgery is only one side. This is a great way to deal with part of it but not a final answer. You still have to be able to pay for the people that dont pay their bill. The hospital has to stay open and make a profit and it can not turn people away.

What people are saying is, if more people that could pay their own bill used these types of centers then the hospitals would lose major revenue and would be unable to cover the cost of those that have no way of paying. These centers are a major threat to hospitals and for good reason.

This one looks to be a surgery center but whos to say that other doctors couldn't open up urgent care centers, overnight care centers, the list goes on and on. If this happens, then hospitals are in major trouble.

The hospitals would also lose doctors because they would go start their own center. Then all the centers could be competitive to each other and we would all benefit from it, its like a free market in the medical field.

Posted: 11/19/2012 6:50:04 PM EDT

[#39]

Wait... the free market solution is better AND cheaper??

Well. NO SHIT.

Posted: 11/19/2012 7:52:12 PM EDT

[#40]

Quoted:

Quoted:
What horse shit...

A surgery center isn't a hospital. When 350lb patients roll in on medicare with legs that are rotting off from gangrene (had that this week) and you are expected to treat them until they are better, then come back to me. While I have no doubt that a surgery center could treat a wound, clean it, and patch it up I do not think that it would come anywhere close to the care required to be dispensed by a real hospital.

While I agree with the centers policy on billing, it would have no real world use within a hospital. Within a hospital a patient is billed based on the diagnosis the patient is admitted with. So if your patient comes in with pneumonia you get reimbursed for the 3 days it would take to treat a pneumonia. But if that patient had pneumonia on top of obesity, heart disease, and emphysema then your hospital is going to lose out because that patient is going to take significantly longer to finish treatment. And god forbid the patient had a pneumonia and a pressure ulcer or something else. If the ulcer was missed on initial screen, you eat the cost of treatment even if it didn't come from you. Which is why those patients are now screened for EVERYTHING you can think of: MRSA, VRE, flu, skin checks, etc.

It would have a real-world use within a hospital.

In Oklahoma the facility cost for a colonoscopy has gone from $1,480 to $3,740 in less than 6 months. The OU Medical center used to bill $1,478 for a colonoscopy (not including the physician charge). The last bill I got for a patient they billed $3,780. The only difference in the two, was that Mercy (the other large hospital with a GI group) has raised their fees after purchasing the two free-standing facilities near their location, and bring those physician groups in-house. Their fees went from $1800 or so, to $4,000+.

I've worked in the medical finance field for almost 20 years. I worked for 9 years on the managed care side (for NY Life and an HMO of theirs), and for another 10+ years on the research side dealing with patient costs, research costs, facility, lab, etc.. There is no justification for the percentage increases we are seeing. They're outrageous. Drug costs alone are fucking ridiculous. And I guarantee you that those costs haven't increased to the point that you need to charge $200 for a fentanyl patch. That's highway robbery.

I know that traditional hospitals have to take the under/uninsured. That's a losing proposition. However, looking at the bottom line for most hospitals, they still manage to do better than break even. And that's after purchasing new equipment, and paying for facility expansions. Hell, look at OU Medical center's campus. Have you seen all the new shit going up there? They're the main hospital in the state treating the indigent, and they're expanding like a sumbitch. It's insane. But, they're losing tons of money, right? Hell no they're not. The insured people of this state (and every other state has the same type system) are the ones paying the bills. If enough people started doing what Dr. Smith did, I guarantee that the indigent would have some serious health care problems. The local hospitals wouldn't be able to afford to treat them

Healthcare isnt just one side, Surgery is only one side. This is a great way to deal with part of it but not a final answer. You still have to be able to pay for the people that dont pay their bill. The hospital has to stay open and make a profit and it can not turn people away.

Sure they can turn people away.

Don't accept Medicare or Medicaid. Then EMTALA does not apply. Hospitals have become welfare clients, dependent on Uncle Sam's payments.

Posted: 11/19/2012 8:50:33 PM EDT

[#41]

Quoted:
Sure they can turn people away.

Don't accept Medicare or Medicaid. Then EMTALA does not apply. Hospitals have become welfare clients, dependent on Uncle Sam's payments.

Posted: 11/19/2012 9:00:36 PM EDT

[#42]

No shit. I looked at a recent medical bill. 85 fucking dollars for a pair of forceps. How in god's name could you possibly make a pair of forceps that could cost $85 dollars?!?

Posted: 11/19/2012 9:07:01 PM EDT

[#43]

Awesome thread!

Posted: 11/19/2012 9:09:35 PM EDT

[#44]

Who is taking bet on how long it is before that guys operation is made illegal or otherwise regulated or legislated out of business.

Posted: 11/19/2012 9:15:28 PM EDT

[#45]

Penile Prosthesis $15,425

Posted: 11/19/2012 9:36:37 PM EDT

[#46]

Comrades. I see some dissidents who do not believe in glorious Obamacare system. What will Dear Leader think to see all of you cheering capitalist running dogs? Surely we must work to re-educate poor misguided souls before counter-revolutionary forces take hold.

[ARCHIVED THREAD] - Oklahoma Doctors vs. Obamacare. Very interdasting.

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