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oh wait they'll (docs) make on average 60k per year instead of 170k per year.




That's just a grand idea....pay doctors less than nurses. Why would anyone go through 10 years of med school when they can make more with a 2 year nursing degree?

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The whole industry is so inflated right now... we should just mandate a 40% decrease in all cost (cost of equipment, care, drugs, salaries, insurance premiums, etc). They'd still be making money.





Are you serious? Especially in regard to salaries. Try and tell an emergency room, critical care or psychiatric staff to take a 40% pay cut. Do you realize what these people do?

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Take a look at the health care industry as a whole right now... open up you classified section. They actually are one of two segments hiring people. Yeah they're really hurting. They're (hospitals, docs, insurance co., drug co.) making money hand over fist.




Hospitals aren't making money hand over fist....I know, I work at one. We just laid off 71 people. Just because they're hiring doesn't mean they are raking in the dough. You have to fill positions to stay in business.

I'm not saying the industry doesn't need reforms, but the things you are bringing up are ludicrous.


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Congratulation on the most ignorant post of the year so far! That entire post is pathetically funny.

And....I wouldn't work for 60 grand a year, I certainly wouldn't expect a doctor to.

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Hospitals aren't making money hand over fist....I know, I work at one. We just laid off 71 people. Just because they're hiring doesn't mean they are raking in the dough. You have to fill positions to stay in business.




Also, don't hospitals have mandates for patient vs staff ratios they have to maintain?


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Yes, yes they do.


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Thank you... I'm glad I can contribute to your pile of rubbish.

The 40% wasn't really meant to be taken literally. As Jules pointed out, I'm just a blabbering ignorant fool that knows nothing about health care costs and profits. It just happened to be the number that popped in my head. But IMO they do make too much money. And if a nurse is making 60k with a 2 year degree then they're making too much too. Cops make 28k a year... Teachers make 30k a year... What's wrong with 100-130k for an ER doc? A good doctor isn't in it for the money anyway... they enjoy what they do as a service to the community. Sure they wouldn't be able to afford that big house, fancy car, etc until they retire like the rest of us bums... but they wouldn't be hurting by any stretch of the imagination.

Again... health care is one of two markets that has had a gain in numbers of employees. They aren't hurting and we'll never hurt. There are enough sick people to go around.

But thats beside the point... my point is the the industry as a whole (everyone... even patients) is not willing to take less. Only more...


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A good doctor isn't in it for the money anyway... they enjoy what they do as a service to the community.




ROFLMAO. Are you serious? That's insane. The things ER docs have to do (and most docs for that matter) are crazy stressful. Good judgement, high training and quick response by all Emergent Medical personnel is the difference between life and death a lot of times. Sure there are folks that use the ER as their neighborhood clinic (which they shouldn't but some have no other choice), but in a true emergency which in some bigger cities include full Trauma units, and seeing the hours they put in and the care they take, I'd almost say they don't get paid enough.


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No the question is are you serious... you think thats the only profession that is highly stressful?

An ER doc (I know a few) work 12 hr shifts 3 times a week. Most are payed hourly and can pick up shifts to earn more income. A 12 hr shift 3 times a week is not taxing in my book. Hell in a given work week I work 75-80 hrs a week for not even half their salary. Be it I am in IT and don't have the stress level of having someones life in my hand... just millions of dollars and 10 Bobs to answer to. But I'd argue a police officers job is more stressful than an ER doc. And they make 1/4 of what an ER doc does while working more hours and working side security jobs.

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A good doctor isn't in it for the money anyway... they enjoy what they do as a service to the community.


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ROFLMAO. Are you serious? That's insane.




Please don't ever become a doctor...


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The biggest reasons doctors NEED to make a lot of money is because they go into an insane amount of debt to become a doctor.


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Maybe that's all the ones you know work. But I know a lot that work much more than that. My wife is a ER nurse and has been in the industry for over 17 years. I've seen the inside of a trauma unit from a patients standpoint and a employee standpoint.

The number of hours can vary according to the hospital you are at, and your position within the ER. In the ER near where I live, the doctors are on 24 hours, off 36 hours. The Nurses work 12 hour shifts and have done 16 hour shifts. Try working in a busy ER in a major metropolitan city, the things they see and have to do to save a life is absolutely incredible. The sheer amount of training to be where they are commands the salary they get. That's not even counting the amount of ongoing, continuing education that must be done.

As far as your comparison that they shouldn't be paid as much as a peace officer, that's irrelevant to the conversation. But since you want to bring it in, I will respond. Police officers and Fire rescue are highly UNDER paid. It's not so much that a Doc is paid too much, but more of a arguement that those that put their lives in danger are paid too little. I've said that about our military men and women before and I'd say it again and again.

Whether a doctor wants to contribute to his or her community has nothing to do with if they are a good doctor. A good doctor has the skills to perform what is required.

There are many, many clinics where these wonderful doctors and nurses put in free volunteer time. There are many ways in which they contribute to their community.


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I guess then my question to you is... Why can other countries pay their doctors (I know I started it.. but I don't think doctors salaries are the reason we are where we are... it's more a symbol of why we are, where we are) far, far less and recieve the same health care and in some cases better health care? If you don't believe it (one source): web page

"The United States ranks 50th out of 224 nations in life expectancy, with an average life span of 78.1 years, according to 2009 estimates from the CIA World Factbook."

For example an avg ER doc in Japan makes 130k... Germany 70k... Another source with a list of nations with us at the top: web page


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1. Those other nations' doctors don't have to pay the insane and debilitating amounts that ours do for Malpractice Insurance.
I know of a few doctors that retired because they couldn't afford to stay in business (two of my Dad's doctors) because insurance premiums have gotten so out of control.

2. It is what the market bears. If there was a glut of doctors out of work that hospitals could hire cheaply, then the salary paid to them would come down. There isn't, so it doesn't.


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We have gone from having leaders in this country's earliest days like Captain John Smith who once said "He that will not work shall not eat." to a nation of people who say "It's OK if someone will not work, and we should take care of that person so as not to injure their psyche and/or hurt their feelings, and not only should they have the right to eat, but also the right to housing, transportation, and free medical care ....




It's OK, because those who do work can pay for it all ....... "


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Put simply? Malpractice insurance is a major cause of it. The other is like Purp said. It's what the free market will bare.

To give you an idea, here is a excerpt from the NY Times in 2005 (4 years ago, you know prices haven't declined significantly in that time).

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The most expensive place in the country is South Florida, where some obstetricians and general surgeons paid nearly $280,000 for coverage last year, according to The Monitor. Obstetricians in Illinois paid as much as $230,428, The Monitor said, while in Nebraska, the least expensive place in the country for malpractice insurance, obstetricians paid $16,194. Florida adopted a cap on awards of $500,000 to $1 million in 2003. Illinois has no cap and Nebraska has a cap of $500,000.




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1. Those other nations' doctors don't have to pay the insane and debilitating amounts that ours do for Malpractice Insurance.
I know of a few doctors that retired because they couldn't afford to stay in business (two of my Dad's doctors) because insurance premiums have gotten so out of control.





Agree.. tort reform is key to alleviate that and should bring down some needed salary. But do you think the salaries would go down if there were a cap or legislation put in place to stop these lawsuits? I doubt it... humans are too greedy. How much is insurance by the way... I googled a bit but couldn't really find anything. Is it a flexible cost or something stable you pay dependent upon your location?

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2. It is what the market bears. If there was a glut of doctors out of work that hospitals could hire cheaply, then the salary paid to them would come down. There isn't, so it doesn't.




Also another good point I have no argument for... except there will never be a glut of docs running around as not many people can/want to go to school for so long.


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xcept there will never be a glut of docs running around as not many people can/want to go to school for so long




and thus they will always earn a lot, and deserve to do so.


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$280,000 for coverage last year




What?!? I knew it was high... but not that high. How can someone who makes on avg 200k a year pay 280k... or are OBGYN's in Florida making 400k?


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I think that you are now starting to understand, Grasshoppa


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South Florida is among the priciest places to live in the United States. It would not surprise me if they did make $400k a year. Or more.

But like you said in a earlier post. There won't be a glut of folks running around because of all the required schooling and training and then on top of that additional fees like Malpractice insurance.

And that's not even looking at the continuing education or community service that they do.


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I'm not saying they shouldn't earn more than most... I'm just saying they should earn less than they do now. The doctors I know personally have even stated that to me...


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Are those doctors you personally know dropping the amount they charge insurance companies? Are they taking a voluntary decrease in salary? Somehow I doubt it.


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Well, let your doctor friends know that they are more than free to work for less, they just need to choose to do so.


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continuing education




Most docs I know don't pay a thing for this... they are payed for by drug companies or their place of employment.


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No they'd be stupid to do that... that's why I think someone else has to step in. We humans are a greedy bunch... and while the giving is good we take what we can.


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jc..


There's a comedian out there that tells a joke that goes something like this...

A Harley mechanic and a Doctor are sitting at a bar, and the mechanic says to the Doctor, "You know, I get paid 50k to fix motorcycles, you get paid 200k to fix people, we baiscally do the same thing. I can take a broken engine apart, repair it, and put it together and it runs for several more years. Same thing you do but with people".

The Doctor looks at the mechanic and says, "You are right, we both fix things and make them last longer, but you ought to fix it next time with the engine still running."


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I'm not saying they shouldn't earn more than most... I'm just saying they should earn less than they do now. The doctors I know personally have even stated that to me...






Bullcrap.

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Not sure what part your calling bullcrap about... if its that I'm CoachB'n you well I don't know what to say... Disclosure: All of these statements were made by docs who were at a party with me, drinking at the time, talking about this very topic:

Eye Surgeon - "I would do it for nothing... I love my freakin job."

Med Student - "Some of the doctors I've worked with are complete morons and shouldn't make 10/hr..."

ER Doc - "You say we make too much.. and I partially agree. But look at us vs. a pro athlete, or some of these CEO's."


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Eye Surgeon - "I would do it for nothing... I love my freakin job."





Easy to say that when you know you don't or won't have to.

Quote:


Med Student - "Some of the doctors I've worked with are complete morons and shouldn't make 10/hr..."




There are some of those in every profession, it's not reserved to the doctors.

Quote:


ER Doc - "You say we make too much.. and I partially agree. But look at us vs. a pro athlete, or some of these CEO's."




Doesn't sound like he was willing to get paid less, just expressed reality that he gets paid better than the average joe.

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June 21, 2009
We Don't Need Radical Health Care Reform
By George Will

WASHINGTON -- To dissect today's health care debate, the crux of which concerns a "public option," use the mind's equivalent of a surgeon's scalpel, Occam's razor, a principle of intellectual parsimony: In solving a puzzle, start with the simplest explanatory theory.

The puzzle is: Why does the president, who says that were America "starting from scratch" he would favor a "single-payer" -- government-run -- system, insist that health care reform include a government insurance plan that competes with private insurers? The simplest answer is that such a plan will lead to a single-payer system.

Conservatives say that a government program will have the intended consequence of crowding private insurers out of the market, encouraging employers to stop providing coverage and luring employees from private insurance to the cheaper government option.

The Lewin Group estimates that 70 percent of the 172 million persons privately covered might be drawn, or pushed, to the government plan. A significant portion of the children who have enrolled in the State Children's Health Insurance Program since eligibility requirements were relaxed in February had private insurance.

Assurances that the government plan would play by the rules that private insurers play by are implausible. Government is incapable of behaving like market-disciplined private insurers. Competition from the public option must be unfair because government does not need to make a profit and has enormous pricing and negotiating powers. Besides, unless the point of a government plan is to be cheaper, it is pointless: If the public option conforms to the imperatives that regulations and competition impose on private insurers, there is no reason for it.

The president characteristically denies that he is doing what he is doing -- putting the nation on a path to an outcome he considers desirable -- just as he denies any intention of running General Motors. Nevertheless, the unifying constant of his domestic policies -- their connecting thread -- is that they advance the Democrats' dependency agenda. The party of government aims to make Americans more equal by making them equally dependent on government for more and more things.

Arguments for the public option are too feeble to seem ingenuous. The president says competition from a government plan is necessary to keep private insurers "honest." Presumably, being "honest" means not colluding to set prices, and evidently he thinks that, absent competition from government, there will not be a competitive market for insurance. This ignores two facts:

There are 1,300 competing providers of health insurance. And Roll Call's Morton Kondracke notes that the 2003 Medicare prescription drug entitlement, relying on competition among private insurers, enjoys 87 percent approval partly because competition has made premiums less expensive than had been projected. The program's estimated cost from 2007 to 2016 has been reduced 43 percent.

Some advocates of a public option say health coverage is so complex that consumers will be befuddled by choices. But consumers of many complicated products, from auto insurance to computers, have navigated the competition among providers, who have increased quality while lowering prices.

Although 70 percent of insured Americans rate their health care arrangements good or excellent, radical reform of health care is supposedly necessary because there are 45.7 million uninsured. That number is, however, a "snapshot" of a nation in which more than 20 million working Americans change jobs every year. Many of them are briefly uninsured between jobs. If all the uninsured were assembled for a group photograph, and six months later the then-uninsured were assembled for another photograph, about half the people in the photos would be different.

Almost 39 percent of the uninsured are in five states -- Florida, Texas, New Mexico, Arizona and California, all of which are entry points for immigrants. About 21 percent -- 9.7 million -- of the uninsured are not citizens. Up to 14 million are eligible for existing government programs -- Medicare, Medicaid, SCHIP, veterans' benefits, etc. -- but have not enrolled. And 9.1 million have household incomes of at least $75,000 and could purchase insurance. Those last two cohorts are more than half of the 45.7 million.

Insuring the perhaps 20 million persons who are protractedly uninsured because they cannot afford insurance is conceptually simple: Give them money -- (refundable) tax credits or debit cards (which have replaced food stamps) loaded with a particular value. This would produce people who are more empowered than dependent. Unfortunately, advocates of a government option consider that a defect. Which is why the simple idea of the dependency agenda cuts like a razor through the complexities of this debate.



http://www.realclearpolitics.com/article...plan_97094.html

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We Don't Need Radical Health Care Reform





And that Mr Will, is the position that yielded an overwhelming Obama victory.

I'm opposed to just about everything Obama has done and that includes his health care plan, but; to claim that our current system doesn't urgently need to be corrected suggests that the writer is out of touch with the common man.

How many products do you buy that you have no idea how much it will cost you? Just one - health care. Even with variable usage purchases like electricity we have a base rate to work from.

Simple and routine medical services (like my daughter's broken arm -which was described by the orthopedist as routine and not serious) will involve a seemingly endless chain of bills by a vast variety of companies. The ER, the X-ray company, the X-ray interpreter, the Ortho, the facilities services, and the list goes on and on.

None of these fees are posted upfront. None of these seperate entities can explain anything past "you owe me". There's no single point of contact, no over-riding system that can give consolodated answers.

Worse yet is that after all these entities submit the billing to the insurance companies there are an array of unpaid charges that still can't be explained. Insurance companies intentionally deny valid claims to reduce costs. Providers double bill and over bill out of either incompetance or fraud.

Ridiculous exceptions show up - such as a 9 year old girl with a broken arm and cast up to her bicep doesn't qualify for a SLING. A item that was a simple and cheap little nylon sling that looked like it belonged in the Dollar Tree store in the end was paid for out of pocket to the tune of roughly $65.

It should be obvious that our healthcare system needs radical correction and the more the George Wills of the world profess that "Everything is fine" the more likely we are to wind up with an Obama plan.

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I agree with you that there is no "base" to work from when it comes to healthcare. Which I presume is based on the fact that usually we aren't in a situation where you can get quotes like you can for car repairs or something. It is often an immediate need.

Your kid with a broken arm, are you going to drive here to 4 different hospitals to find the best deal? Most likely not, although I wouldn't put it past some people .

There should be a pre-agreed upon list of services and their costs, even if it is just between the insurance company and the hospitals, but there should be a base. In such a case, you could choose to take your girl to ER-2 because you know they charge less than ER-1 and the extra 10 minute drive isn't life or death.


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Also the fact that your boss buys your insurance, not you. You are not the customer, they don't care about you. It is in their best interest to provide you the least possible services. As long as the bottom line for your boss looks good, their customer is happy.



I thank God every day that I don't work for somebody with that mentality. It may be rare, but I work for a company of about 260 employees, my healthcare is paid 100% and it's darn good insurance. They take a survey every year asking what they can do to improve benefits, if I would be willing to pay for even better coverage, etc... Life insurance, health insurance, short term disability, fitness reimbursement, 2 weeks sick time, 3 weeks vacation, 2 days of optional holiday..... There are still employers out there that realize to get and keep the best employees, you have to treat them right... and mine does.


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There are still employers out there that realize to get and keep the best employees, you have to treat them right... and mine does.




and they have not fired you yet


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Simple and routine medical services (like my daughter's broken arm -which was described by the orthopedist as routine and not serious) will involve a seemingly endless chain of bills by a vast variety of companies. The ER, the X-ray company, the X-ray interpreter, the Ortho, the facilities services, and the list goes on and on.

None of these fees are posted upfront.





Those things you listed are no different than any product you buy from a store. We see a priced good on the shelf, but we as the consumer are not privy to how that price is derived. How much the retailer wants to profit, how much of the price goes into over head, how much goes to packaging, how much goes to the individual companies that made parts for the good, the labor required to make that good, etc...

Same damn thing. The only difference is you can see the final price at the individual retail store.

BTW, if people take the time to look up info they can get an idea of what hosptials charge in their area for different procedures.

http://mhcc.maryland.gov/consumerinfo/hospitalguide/hospital_guide/cost_report.html Click on the PDF link from that site. After a few pages it shows the average prices for the entire state of Maryland, as well as the individual hospitals.

http://www.hospitalvictims.com/hv_state.asp?mode=letter&letter=d&state=oh#

That one doesn't give you amounts, but it gives you an idea of how hospitals rank according to cost to charge ratio for the State of Ohio.

http://www.fiercehealthcare.com/story/pa-bill-requires-healthcare-pricing-disclosure/2007-03-22

That link refers to a bill which mandates that pharmacies must submit prices for their top 150 drugs.

Now I didn't look very hard for this info. I simply typed in Hospital Pricing in the Yahoo search engine. I typed in OH Hospital pricing, and PA hospital pricing. I picked a link that was near the top of the list for those searches. The very little effort I put into it gave me some answers I would have never known. It helps when we/patients do our part to research hospitals in our area. If people used technology to their advantage and researched pricing, they very well could go to a hospital that is more to their financial liking.

I'm sure had I took the time to do a thorough search I could have come up with more links...perhaps some for every state. The government over the last several years (state by state) have been asking and demanding that hospitals submit information for public information purposes. Its up to us to find that info and use it to our advantage. We can't blame a hospital for something that we fail to look into.

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Those things you listed are no different than any product you buy from a store. We see a priced good on the shelf, but we as the consumer are not privy to how that price is derived. How much the retailer wants to profit, how much of the price goes into over head, how much goes to packaging, how much goes to the individual companies that made parts for the good, the labor required to make that good, etc...

Same damn thing. The only difference is you can see the final price at the individual retail store.




Not really a good analogy.

To use your analogy, you would go to a store to buy something that you require, not want, and never see the price. Then when you get home, you get a bill from that store, the distributing company, the shipping company, the clerk that put it on the shelf, the manufacturing company, and if you needed a ride then also the taxi company.


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Quote:

Those things you listed are no different than any product you buy from a store. We see a priced good on the shelf, but we as the consumer are not privy to how that price is derived. How much the retailer wants to profit, how much of the price goes into over head, how much goes to packaging, how much goes to the individual companies that made parts for the good, the labor required to make that good, etc...

Same damn thing. The only difference is you can see the final price at the individual retail store.




Not really a good analogy.

To use your analogy, you would go to a store to buy something that you require, not want, and never see the price. Then when you get home, you get a bill from that store, the distributing company, the shipping company, the clerk that put it on the shelf, the manufacturing company, and if you needed a ride then also the taxi company.




Chiefsfan, I'm going to go a step farther and tell you it's a terrible analogy . What keys said is on the money and that doesn't even address whether or not the billing is considered "in network" or "out of network".

Before you tell me to just look it up online take a deep breath and consider this.

I had to schedule her follow up visits with another orthopedist. I when to my insurance provider's website and ran a search to see who was close by and "in network". (out of network providers cost me about three or four times the in network).
I found one just a couple miles down the street - called - and tried to schedule an appointment. Lucky for me I spoke with a receptionist that cautioned me to avoid a pitfall.

The doctor was "in network" but the facility he works out of isn't! Any X-rays, casts, and so on would have cost me mega bucks.

It's a quagmire to deal with any of it. If my industry (telecommunications/IT?network facilities) pulled stuff like this Congress would pass an Act.

(actually my industry used to behave that way and Congress DID pass an Act - so that was an inside joke for anyone with the right background )

In the end, it seem we're stuck with two extreems - 1) everything is great -or 2) let's have the Govt run everything. From personal experience I can tell you what we have today is horrible and yet gov't run healthcare (go to a VA hospital and look around) is even worse.

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first off...when looking at charges for an "aspirin" or a "sling" or "cast" and then trying to compare it to pricing outside of the hospital it is important to remember one thing. 99% of the charge is NOT the item itself...but the ADMINISTRATION OF THAT ITEM. You are paying for the expertise and time of those who give that item to you or put that item on you. That item may go through many hands before it gets to you. Each person who has spent time and has to be paid. but even that is not very much. Each of those people have to ensure and guarantee that the medication is exactly what it is said to be. and it is given in the manner it is supposed to be. because even if a patient was prescribed aspirin and a mixup happened and he waqs given a placebo....a sugar pill...and less than 5 minutes later they found the error and gave the patient his aspirin. The hospital is looking at a Lawsuit that will cost them hundreds of thousands of dollars to possibly millions after settlements and legal fees are calculated. So you are also paying for that insurance premium to help protect the hospital and keep it in business.

People are always so quick to jump on the hospital over that $10-$15 price for an aspirin...and at first glance I don't blame them......But that isn't what they are paying for...the hospital wou LOVE to charge them a couple cents for the aspirin. But thanks to our greedy Sue happy society......I would not bet on seeing that happen....


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I think what Gift Horse and a couple others are saying (myself included).... is that we could care less that administratively it took 5.00 to give and aspirin.. or another 5.00 for their insurance premiums. We've already concluded that...

How about putting somethings in place to get these ludicrious costs down... instead of saying everything is fine. No way is a $15 aspirin fine...


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And the hospitals would be the first to admit that but their hands are tied...I mean you think they are just charging out the wazoo for no reason whatsoever...just to be greedy??? and 90% of the time it is not....There are hospitals closing all over this nation. Why do you think that is????Hospitals lose money on every single Medicare, Medicaid, govt. insured program...you name it...they lose money on it.....The sue happy society dictates the way in which they can conduct business. And when they conduct business in that manner, the insurance companies and the government then say well we are not going to pay for that kind of treatment.

The hospitals have been crying out for decades...but no one has been listening...even now when they bring the Big names like Toby Cosgrove(Cleveland Clinic's top guy) and others to Washington...they don't like what they hear and don't listen....

The hospitals are doing what they can...and they are listening to see if they can do more...But there is only so much that they can do....


I thought I was wrong once....but I was mistaken...

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And that's why I believe there should be caps on malpractice suits.

I'm sorry if a loved one died because a problem arose, or a mistake happened during surgery. Guess what, no one is perfect, not even doctors. It's not a big deal if I mistype some code in a script. It errors out, someone complains, I fix it. No big deal.

A doctor does it and it's a much more serious error, not because they made any different mistake than any of us do in our everyday lives. Just that the implications are more serious, and they take every precaution possible, but crap happens, life isn't fair. It sucks, but take the $200,000 they offer and move on. It's not like the doctors do crap on purpose to kill people. And that's what people need to realize.

People have 2 choices, go to the doctor and hope they can save you, or sit home and die. Choose option 2 if you can't stomach the fact that everything might not go perfectly.


We don't have to agree with each other, to respect each others opinion.
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