I’ve lived in Germany for a year and a half now. I’m on a corporate assignment so I have private insurance which means I get billed directly for all doctor visits and medicine pay myself and then submit for reimbursement to my employer’s insurance company. The only thing that was direct paid was delivering our son.
The full, private insurance prices (which are higher than the government insurance prices) are comparable to my co pays in the US. A 15 minute checkup at the family doctor costs like 25-30 euros. A 90 day supply of a generic statin is like 18 euros. An ambulance ride was 300 euros.
Being private insurance I get a little better service, like my doctor will often give me the first appointment of the day so I can make it into work by 9:00, and prices are still seemingly less than 10% of equivalent prices in the US. Quality of care has been great too.
FDA Inspecting 1% of imported drugs seems fine actually. If a company is actually putting shit onto the market it would be found pretty quickly with a 1% quality check. The question is how much less than 1% is it? .5%? .01%?
I remember the faux handwringing of the Dubya administration over the “safety” of important drugs back when people were trying to get cheaper drug imports. The striking thing to me is that, simultaneously, it’s both a real concern (if this story is to be believed) and complete bullshit (since we were already importing a ton of generics when the handwringing was happening).
Yeah really. I mean drug traffickers only take a fraction of a percent of product to check if it’s legit before pushing it to its destination and all its customers come back for more.
Without looking I’m gonna guess the cancer pills are from some sweatshop in India or China as opposed to, like, cheap Canadian imports I always hear Boomers squawking about?
About a year ago, the formulary for my dad’s omeprazole changed from a bullshit Indian generic to a bullshit Chinese generic (or vice versa, not that it matters). Didn’t take too long before he was having serious chest pain and was taken to the ER (ED for you non-romantic types) for what eventually ends up costing him a grand or two with all of the testing and a bed for two nights. Everything was normal, unremarkable for cardiac problems.
After release he didn’t seem to be improving much, so that’s when they notified me of the change and asked if [cheap Chinese bullshit] might be the problem. What a softball question. We switched out the [cheap Chinese bullshit] with another PPI and his symptoms resolved immediately.
His GP still tried to send for heart cath and was angry when he refused. Later he obliged and took the consult, but the cardiologist said it was pointless and refused. I told him to tell his GP he got switched onto [cheap Chinese bullshit] and that that was the cause. His doctor was incredulous and said that couldn’t possibly be it <buzzer.wav> <sad_trombone.wav>. It doesn’t always help to have medical expertise. Sometimes you need scammer and grifter expertise.
I switch back and forth between two different generic types of ritalin. One is much stronger and gives me anxiety at work. But it’s great for hiking and getting shit done on a Saturday. The other is mellower.
It’s crazy how different they are for something that’s supposed to be identical.
Methylphenidate has four stereoisomers, of which the drug Ritalin contains only two. But of those two, one of them (commonly called dexmethylphenidate and sold as a drug in its own right called Focalin) is something like 10 times as potent as the other one. I’m not sure there are any standards on what percentage of Ritalin has to be the dexmethylphenidate diastereomer, so if different synthesis pathways were used, the potency of it could vary.
Edit: I mean that’s on top of the possibility of outright scamming. Like as far as I can tell it would be legal to sell “Ritalin” that was like 50% through 200% of the strength of Ritalin with 50% dexmethylphenidate.
I get significant intrabatch variability with generic amphetamine salts. Like some days are just total duds. I guess it could be a biological cause but I’d bet against it.
Is that from your healthcare provider or from your insurance company?
If it’s from your insurance company, they’re telling you that you have no responsibility but the healthcare provider is almost certainly going to try to get you to pay them the $840.
If it’s from the healthcare provider you should back away as slowly and quietly as possible, and try not to startle anybody on your way out of Dodge.
The doctor I see at the company who arranged the colonoscopy/endoscopy said they were going to appeal for me with new information. But the girl I talked to on the phone a week later knew literally nothing about anything. So who knows.
They want me to do another endoscopy and I told them I’d like this cleared up ahead of time next time instead of making decisions on the gurney with my hospital gown on. So that’s my leverage to get them to do something.
Disclaimer: I am not a lawyer nor an expert on medical care, health insurance, etc…
My guess on this is that you are not liable for what your health insurance does not cover, but it’s not illegal for the hospital to attempt to trick you into paying it, hence they will send you bills that have due dates and make it look like you have to pay it, but they wouldn’t actually be able to collect it.
Before acting on that theory, I’d contact your health insurance company, the billing department at the hospital, and possibly an attorney or advocacy group who handles this kind of stuff.
Man, this conversation is making me feel kind of patriotic about our healthcare system. USA #1 am I right?
Depends (I think) from state to state - but this sounds like balance billing - from a handy website…
Balance billing is illegal if the provider has a contract with your insurance that requires them to accept the negotiated rate for covered services as payment in full. So, if you receive a balance bill for any costs above your plan’s in-network rate, contact your doctor and insurer and ask about the contract to see if it’s an error.
If you have Medicare or Medicaid, the contract between your insurance and the provider is known as “accepting Medicare/Medicaid assignment.” If your provider “accepts assignment,” then it can not legally bill you for costs higher than what your insurance agreed to pay for covered services.
Before choosing a provider or before utilizing medical services, you can ask whether they accept assignment. If they say yes, you will know that any balance bill you receive is a mistake. Contact them immediately to appeal the charge.
Remember, if you are inappropriately charged more than your insurer will pay through balance billing, you are still responsible for your regular cost-sharing portion (copay/co-insurance). Providers just can’t bill you for costs beyond that.
This pissed people off, and I understand why but it’s more complicated than “Evil doctors and hospitals wanting more money” My group balance billed on BC/BS patients for several months because they refused to negotiate in any way - we were supposed to pay for the privilege of seeing their patients, I suppose.
First place to go is to see if the place that did the procedure has a contract with your insurer - if they do, you should be in the clear.
Do they do this thing in all the other countries tied for last where you have to physically pick up a written Rx for a C-II? This is the 4th (out of 5 possible) times this year my doctor’s office has fucked this up and I’ll be starting a really important week on Monday with no meds.
Had a discussion with my sister and two brothers in law last night about politics because my sister asked if I had watched the debate the previous night. she ended up making a comment that she felt whoever was pushing for m4a was basically hurting their chances.
I obviously disagreed, had to explain to all 3 what exactly single payer is etc. My sister and her husband both work in healthcare, my sister used to do billing I believe and her husband is in some sort of consulting business for companies relating to healthcare.
The main point I wanted to post was that my brother in law was adamant that he had been all over the country and places like Detroit and that poor people with our insurance had ways of getting care because he had seen it.
I brought up insulin and go fund me for insulin and he said he thinks that’s an education problem because you can definitely get it paid for you just have to know what to apply for and it takes some work.
I said I’m pretty sure there wouldn’t be go fund me for insulin if there was a solution but he disagreed…
Also his wife my sister brought up that they would be screwed if they hit a major illness and also that their insurance plan was largely garbage with high deductible but somehow not important enough to go Medicare for all.
Also the other person in the conversation is my corporate lawyer brother in law who said he was already paying a lot in taxes. I said something like yea and you make a lot of money. He said “I guess that’s bad on me?” and kinda shrugged like I said something stupid. It was really hard for me to not say yea it is motherfucker. I did say something later about how yes rich people would pay more than they might be now, cry me a river. Dude just bought a 600k house in one of the nicest areas in Alabama and then spent I’m sure at least another 50-100 renovating it. Wouldn’t want him to have to pay a bit more taxes right?
You need to add provincial and state taxes to this for the comparison to be meaningful. Especially in the context of health care, where the Fed/Prov relationship in Canada is a critical part of the dynamic.
You have to remember that if they both work in the administrative/business side of the healthcare economy, single payer would put them both out of work.
