Going without Healthcare

Health, Fitness, Insurance, ...
EdithKeeler
Posts: 1067
Joined: Sun Sep 01, 2013 7:55 pm

Re: Going without Healthcare

Post by EdithKeeler »

For prescriptions, shop online or call local pharmacies and ask what your drug costs for someone without insurance. You will frequently pay *less* than someone with insurance. (Insurance companies have contracts with pharmacies and benefit managers to jack up the price.)

You can do the same thing with doctors, lab tests, imaging tests, and specialists. If your doctor prescribes a test or procedure, ask him for the Billing Code. Then call around to ask for the self-pay price. (If you tell them you have insurance, they will not know the price. Because it depends on your plan's specific contract with each in-network
I’m just wondering if you’ve ever actually done this. Because that’s really common advice, but it’s also really hard to do.

I do it a lot in my job. I’ve also tried it for myself when we first went to our high deductible plan and it was touted as an “opportunity” to save money.

Here’s what i’ve run into:
—“X is the person you need to speak with—I’ll have him call you.” (He never does).
—“You would have to talk to our billing company XYZ” which is based in another state and pretty much wont talk to you without an account number.
—The honest answer: “we have no idea what it would cost because our billing department handles that and have different rates for every carrier, etc.”
—Another honest answer: “somewhere in the range of X and Y, depending on what they find/do. However, we can work with you on payments.”

It would be really nice if you could call and say “what do you charge for a colonoscopy” and they tell you a flat fee. But it’s not a restaurant menu.

I do recommend for prescriptions asking your doctor for samples. My mom takes Eliquis, which is very expensive, and when she hits the Medicare “donut hole” it cost about $275 a month. Her doctor know, and he’ll usually give her a month’s worth of samples when she comes in, which helps defray costs. Also, of course, ask your doc to prescribe generics where possible.

ThisDinosaur
Posts: 997
Joined: Fri Jul 17, 2015 9:31 am

Re: Going without Healthcare

Post by ThisDinosaur »

@Edith
Yes, I do this for prescription drugs and lab tests.

By contrast, I recently called to schedule a second-opinion appointment for my wife. I asked them what a single visit would cost, but I also told them I had insurance. They had no idea the cost and said I should call my insurance company. I did so and they didn't know either. I conferenced called the insurance rep and doctor's office. They exchanged billing codes while I listened in order for the insurance rep's computer system to spit out prices.

ThisDinosaur
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Joined: Fri Jul 17, 2015 9:31 am

Re: Going without Healthcare

Post by ThisDinosaur »


Mister Imperceptible
Posts: 1353
Joined: Fri Nov 10, 2017 4:18 pm

Re: Going without Healthcare

Post by Mister Imperceptible »

What about medical tourism? If I can hop on a plane to Costa Rica, and see a US-trained doctor who is offering private care that is unaffordable to most locals but is dirt cheap for me because of the exchange rate....well, why not? I haven’t done much research but with the individual mandate gone for 2019 I am strongly considering foregoing health insurance.

Who knows, the idealist Costa Rican doctor who returned home to take care of her tribe might have a rockin’ body and I can wake up to her calling me Calvin Klein.

Clarice
Posts: 267
Joined: Sat Dec 02, 2017 4:45 pm
Location: California

Re: Going without Healthcare

Post by Clarice »

ThisDinosaur wrote:
Tue Jul 17, 2018 9:40 am

I asked them what a single visit would cost, but I also told them I had insurance. They had no idea the cost and said I should call my insurance company. I did so and they didn't know either. I conferenced called the insurance rep and doctor's office. They exchanged billing codes while I listened in order for the insurance rep's computer system to spit out prices.
@ThisDinosaur:

That's the thing - the medical help is fractured and bureaucratized beyond all recognition (by a normal person). :roll: You think - I'll come and ask for advice. They think in terms of CPT codes. Every simple little thing becomes complex and over-sized by the way of CPT codes. Until your wife comes, presents a specific case, and they address it they normally don't want to lock themselves into a set amount in the hopes that something comes up and they can bill more. The system is opaque to keep the outsiders out and money in. :twisted:
Last edited by Clarice on Tue Jul 17, 2018 11:06 pm, edited 1 time in total.

EdithKeeler
Posts: 1067
Joined: Sun Sep 01, 2013 7:55 pm

Re: Going without Healthcare

Post by EdithKeeler »

Mister Imperceptible wrote:
Tue Jul 17, 2018 9:26 pm
What about medical tourism? If I can hop on a plane to Costa Rica, and see a US-trained doctor who is offering private care that is unaffordable to most locals but is dirt cheap for me because of the exchange rate....well, why not? I haven’t done much research but with the individual mandate gone for 2019 I am strongly considering foregoing health insurance.
That plan will work GREAT if you fall off a ladder and break your leg, or have a car accident and your face is smashed in.

I admit that because of stuff in my personal life right now, plus my work life, I'm a bit obsessed with medical stuff. I absolutely HATE how convoluted our system is, and hate the frustrations of dealing with health insurance.

But boy, I sure am glad I have a good plan and money in my health savings account.

Farm_or
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Re: Going without Healthcare

Post by Farm_or »

Years ago, my son had spent four days in a hospital. I had a literal 1 1/2 inch thick stack of numerous bills to work through. My mother was doing medical coding at the time and I asked for her help.

There were numerous "errors" that were hidden in the codes. They double charged and charged for completely unrelated services! When I finally got through to a talking head at my insurance company, they were nonchalant - uninterested.

They were paying the bulk of the errors. Why were they not interested in the "errors" that I and my mom worked hard to uncover? Something fishy there...

EdithKeeler
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Joined: Sun Sep 01, 2013 7:55 pm

Re: Going without Healthcare

Post by EdithKeeler »

They were paying the bulk of the errors. Why were they not interested in the "errors" that I and my mom worked hard to uncover? Something fishy there...
I can tell you why: the cost of correcting the errors is greater than the benefit. And/or the cost of the errors is ultimately factored into what the insurance company agrees to pay providers.

I work in property casualty insurance, and we do this in different ways, but on a smaller scale (we don’t have the kabillions of transactions that medical insurers have).

Michael_00005
Posts: 98
Joined: Thu May 04, 2017 12:26 pm
Location: East coast USA

Re: Going without Healthcare

Post by Michael_00005 »

I’m just wondering if you’ve ever actually done this. Because that’s really common advice, but it’s also really hard to do.
I did this a few years back for what I thought might have been a broken bone in my foot, and was considering an MRI. 1st off the doctor's office was surprised the question was even asked given there was health insurance. Lots of run-around for them to finally give a quote, 1 or 2 days later. Their quote was ~ $2,300 , so I called a few others places; one medical imaging lab priced it at ~ $400. After asking them why it was comparatively very cheap, they said they don't deal with insurance, just cash.

@ Mister Imperceptible
What about medical tourism?
This would be my plan as well, but it would require (very helpful) doing your homework ahead of time, also a good idea to visit the doctor or office before healthcare is needed. The one thing that would not be covered is emergency, but it's only a real problem for expensive procedures. Given the deductible and monthly savings the most common emergencies would not be a factor in the decision.

There are many things not to like about health insurance, one of the more offensive is that it almost feels like blackmail. If we continue to blindly accept the corrupt system, how will things ever change?

A lot of the freedom to choose comes from living a healthy lifestyle, otherwise I'd likely be in the camp of paying for health insurance. As things stand, a decision would only be made after looking at costs, and local healthcare options - post corporate.

ThisDinosaur
Posts: 997
Joined: Fri Jul 17, 2015 9:31 am

Re: Going without Healthcare

Post by ThisDinosaur »

https://www.vox.com/policy-and-politics ... na-lawsuit
The India-born surgeon decided he would open his own imaging center in Winston-Salem, North Carolina, and charge a lot less. Singh launched his business in August and decided to post his prices, as low as $500 for an MRI, on a banner outside the office building and on his website.

There was just one barrier to fully realizing his vision: a North Carolina law that he and his lawyers argue essentially gives hospitals a monopoly over MRI scans and other services.

mustafayacoob
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Re: Going without Healthcare

Post by mustafayacoob »

Health insurance is less about access to doctors. The rub is the Hippocratic oath means that people without coverage historically have used the emergency room as their PCP and they are not turned away. Healthy people catch diseases and suffer accidents.

ertyu
Posts: 1191
Joined: Sun Nov 13, 2016 2:31 am

Re: Going without Healthcare

Post by ertyu »

OP, ditching all traditional health care is throwing the baby out with the bathwater. Recent research e.g. Dr Valter Longo suggests fasting before chemo and doing chemo while keto-adapted (and keeping protein down!) vastly improves chemo outcomes. I'm with you, in general. I prefer to go with "natural" options if they are available.

shemp
Posts: 109
Joined: Wed Jun 12, 2019 11:17 am

Re: Going without Healthcare

Post by shemp »

I already discussed this in my journal or intro post, but I've been without health insurance since 1995 . Prior to that I had the usual gold-plated corporate health insurance but only used it twice: (a) Ear infection. nurse cleaned out a bunch of wax, doctor gave me prescription for antibiotic, which didn't work. Too much trouble to go back to the doctor, so I just waited and the infection went away in its own. (b) Pinworms. I didn't know what these were. Doctor told me to get a specimen from my stool, put it in a jar he provided, then he would write a prescription. Too much trouble. So I just used a salt cure: salt water enema followed by caking salt around my anus. Went to sleep chuckling at the idea of the worms writhing in torment from all that salt. Sure enough, they were gone the next day.

I've had several ear infections since, but they always go away after a week or so. Also numerous cases of food poisoning (splitting headache, diarrhea, cramps, etc) that go away after vomiting and defecating followed by a good night's sleep. Plus lots of colds and flus and minor cuts. Back around 2012, I had a kidney stone, which went away in its own after 4 days of agony. I also had a vasectomy when I turned 55 in 2016, but that was purely optional.

Unlike the OP, I think doctors do an excellent job with some medical problems: trauma (broken bones, severe cuts, swallowed objects, etc), basal carcinoma, wart and mole removal, appendicitis, problem pregnancy, parasites, etc. Things that involve cutting and rearranging bones and tissue, or else administering poison that hurts the pathogen more than it hurts us, followed by letting the body heal itself. Not so good with systemic problems where the body is no longer functioning properly: organ failure, weak immune system (cancer in this category), arthritis and other joint failure, etc. Basically, I believe modern medicine is only slightly better than medicine of the stone age, however might as well take advantage of the few things it does do well.

If I suffer some sort of trauma in the USA, I'll just pay out of pocket for initial care, then rely on medical tourism for followup. I currently spend 8 months each year in Europe, so if the trauma occurs there, then medical tourism by default.

I would expect a worst case trauma accident to cost $1 million in the USA and much less in Europe, and I'm prepared for that, though it would hurt. Much more likely would be under $100K, in which case I come out ahead, since I've already saved at least $5K/year for 25 years, or $125K, plus investment gains, by not buying health insurance.

If bill was $1 million, I would have the option of using my money instead to buy foreign residency in Europe, move all money to Europe so as to make myself judgement proof, then skipping out on the bill. I would have no moral qualms about being a deadbeat like this, since the USA heathcare system is thoroughly crooked IMO. Why behave honestly with thieves?

ToFI
Posts: 136
Joined: Thu Jun 16, 2011 1:22 am

Re: Going without Healthcare

Post by ToFI »

@Michael_00005

We have similar thought.. Our kind of thought will be attacked by many people. They will say things like: "of course we want people live a healthy life. They don't listen. " The fact is modern medical system is motivated by money majority of time.
I am in Canada so we have free healthcare but I am not big fan of it modern medicine.

After I witnessed how my father went through the medical system, I lost faith in the modern health care system. He got the anti-biotic resistant bacterial infections from the hospital and it never went away. He's in and out of hospital so many times because of infections. He rapidly losing the mobility and eventually become bed ridden at age of 75. For old people, hospital is a very dangerous place. The more they go, the fast their health goes down hill.
In the last few months of his life, he could barely talk and I had difficult communicate with him. No quality of life. Also at long term care home, it's NOT a good place to be. It's like hospital but with more old people on wheels chairs staring down the hallways like zombies. Hospice is worst when the terminally ills are giving little food/water and morphine to speed up death process. Lot of people are put into sleep with morphine and died from lack of water/food.

For dental, I have free dental coverage. But I stopped going to to dentist couple years ago. It's a money grab for them. The more work they perform, the more money they make. It's less not about making your teeth healthy. They don't tell you to avoid candies, soda drinks. One day, the dentist told me I had cavities and needed two fillings. In trusting professionals, I said OK. The dentist used machine to polish two crown teeth removing substantial amount of teeth materials and then filling it with artificial materials. Afterwards, those two teeth are super sensitive to hot/cold/sour food to a point of pain. Once a while, I noticed the teeth are less sensitive if i eat more nutritious food.

Another example, a young UK boy while in Canada noticed he had Phimosis and went to doctor to seek help. The doctor recommended circumcision. The boy trusted the doctor because he trusted professional. The fact is everyone can pull it a few times a day, over a few months, the foreskin will pull down normally. Later, the boy believed it's genital mutilation. Also because of the difference of how he felt and committed suicide. What's tragedy.

For this reason, I avoid to invest in bio stocks that make drugs directly. I saw a company growing rapidly which makes drugs for cystic fibrosis, a genetic disease. I checked out a drug called Trikafta, I'v read the review on YouTube. They are very happy about the drug. I was thinking about investing... then I saw the price for the drug is $0.3 million bucks a year! (Trikafta will cost $311,503 annually, or $23,896 per 28-day pack, according to the Securities and Exchange Commission.) and there are only 30,000 people with CF in US. I feel it's morally wrong to profit from a minority of 30,000 sick people. They should sell the drug for low cost.

I try my best to live a healthy life. I avoid obvious thing like meat, alcohol, tobacco, cannabis. I avoid over eating and eat same portion at the same time every day. and the result is I have same amount of poo at the same time every day! No constipation means less chance of bowel cancer and digestion system diseases. I remember I was constantly constipated when I was eating meat as a kid.

I can have a free family doctor but I don't even have one. Even my father realized they are useless. What can 15 minutes appoint do? Prescription more drugs. My mother is relatively healthy and they prescribed 5 or 6 drugs. Some are for diabetic. That's OK. But some are for blood pressure and heart. My mother's blood pressure depends on her mood. If she's in panic, no drug will lower the blood pressure. If she's calm, no drug is needed to have normal blood pressure.

If it's a small problem, we can manage. If it's big problem, modern health care can't help.. Hypothetically, just say I have cancer. I rather live naturally for the rest of life than subject myself to harmful therapy and eventually hospice. Hospice is like Hey this guy is suffering, let's shoot him down kinda thing. It's obvious very painful getting sick. It's not a justification for Euthanasia. They even have a hospice team in long term care home in Canada! I never want to get in long term care home. Its' a disgrace.

Yes, We still need emergency service like: viral/baterial infection, physical damage like if we get into an accident. surgery is very useful.

The Old Man
Posts: 442
Joined: Sat Jun 30, 2012 5:55 pm

Re: Going without Healthcare

Post by The Old Man »

ToFI wrote:
Fri Feb 14, 2020 8:07 am
The boy trusted the doctor because he trusted professional.
Yes, in the past I did as well. Now, I know otherwise.

I contracted a tropical illness when I was in Africa. Back in the USA I saw a doctor about my symptoms. Informed him of my African travels. The doctor incorrectly diagnosed me with cancer and conducted surgery. The surgery had complications and almost killed me. You have to think for yourself. At the time the Internet was in its infancy, but now I would be able to be far better informed and make a better diagnosis.

I just despise where I have to act as a doctor, just so I can make reasonable decisions for my medical care. If the Internet had been more developed at the time I would have been able to diagnose my difficulties and see an appropriate tropical disease doctor.

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