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      08-01-2019, 10:06 AM   #67
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Originally Posted by Joekerr View Post
Anyone know what a US doctor gets paid to take out a gallbladder?

An appendix?

Do a colonoscopy?


I'd be interested to know. I can tell you from a Canadian perspective:
A gallbladder the general surgeon gets to bill around $330.

An appendix is less - I believe (but can't remember) about $250.

A colonoscopy depends on whether they are removing polyps or not (as they get paid more if they are also removing polyps, but are capped at getting paid for maximum two polyps, even if they find and remove 10). But on average, they make about $400 for a base colonoscopy, and I think they can get up to $575 with two polyps.

So how do those prices compare? Myself, I can't believe you'd go to school for all those years to get paid $330 for a gallbladder.


But I will say this - cost of insurance is probably a lot lower up here for doctors than down there in lawsuit happy America. And that might be one of the things to work on. The chances of my wife getting successfully sued is low. Her medical insurance is about $9K per year (just looked it up).
NOTE: Keep in mind this is in a very low cost of living area of the country. Expect these numbers to be double this in major metro areas such as NYC or SFO.

Spoke to a surgeon friend of mine who is also a professor at the medical school. He said that these days, he is on salary at the hosptial, which also covers his malpractice insurance costs. He said this is common to nearly all surgeons these days, other than those with cosmetic practices.

His comments were as follows:

Wouldn't disclose his personal salary, but said a general surgeon at the hospital typically receives a salary of around $240,000 to $280,000. The hospital picks up the malpractice insurance premiums. Specialists receive substantially more.

Some examples of his actual portion of pay for a few surgeries he did in the past before being on salary:

- simple pinky finger amputation: $800
- minor cancer resection: $1,300
- laparoscopic cholecystectomy: $600
- uncomplicated appendectomy: $650
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      08-01-2019, 10:28 AM   #68
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Quote:
Originally Posted by Run Silent View Post
Quote:
Originally Posted by Joekerr View Post
Anyone know what a US doctor gets paid to take out a gallbladder?

An appendix?

Do a colonoscopy?


I'd be interested to know. I can tell you from a Canadian perspective:
A gallbladder the general surgeon gets to bill around $330.

An appendix is less - I believe (but can't remember) about $250.

A colonoscopy depends on whether they are removing polyps or not (as they get paid more if they are also removing polyps, but are capped at getting paid for maximum two polyps, even if they find and remove 10). But on average, they make about $400 for a base colonoscopy, and I think they can get up to $575 with two polyps.

So how do those prices compare? Myself, I can't believe you'd go to school for all those years to get paid $330 for a gallbladder.


But I will say this - cost of insurance is probably a lot lower up here for doctors than down there in lawsuit happy America. And that might be one of the things to work on. The chances of my wife getting successfully sued is low. Her medical insurance is about $9K per year (just looked it up).
NOTE: Keep in mind this is in a very low cost of living area of the country. Expect these numbers to be double this in major metro areas such as NYC or SFO.

Spoke to a surgeon friend of mine who is also a professor at the medical school. He said that these days, he is on salary at the hosptial, which also covers his malpractice insurance costs. He said this is common to nearly all surgeons these days, other than those with cosmetic practices.

His comments were as follows:

Wouldn't disclose his personal salary, but said a general surgeon at the hospital typically receives a salary of around $240,000 to $280,000. The hospital picks up the malpractice insurance premiums. Specialists receive substantially more.

Some examples of his actual portion of pay for a few surgeries he did in the past before being on salary:

- simple pinky finger amputation: $800
- minor cancer resection: $1,300
- laparoscopic cholecystectomy: $600
- uncomplicated appendectomy: $650
There are so many variables at play.

The biggest one is in-network vs out of network.

Every insurance company will pay a different amount for a procedure. For example NYSHIP (great payer) will pay $10,000 for a Cervical Spine Surgery while Medicare will pay $500. If that $500 is every PT the doors get closed. Period.

I have to go but I can get into this in more detail later.
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      08-01-2019, 02:58 PM   #69
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Originally Posted by Hawkeye View Post
When did I say that I didn't have insurance? I have enough saved away to pay insurance premiums and the out of pocket max for 10+ years... you know, the same option that is available to everyone else.

I guess maybe you guys understood "pay for it myself" as without insurance. I was talking without government assistance or bankruptcy, since that is really the point of this discussion. I haven't read anything in here complaining about paying the market price for medical insurance to cover yourself.
FWIW, most hospitals have different discounts if you dont go through insurance as well.

My wife had a bad accident a couple years back and has had a few in patient procedures after the initial emergency procedure. Every time i asked to see the insurance and non-insurance costs (the initial incident i thought we werent covered as we were on a new plan and wasnt fully aware of how they worked so I was working with the finance department everyday to figure it all out)

Non-insurance payment plans were ~50% of the insurance billed cost with a 10-15% downpayment and i think it was 5yr plan. The paid in full cash price was about 30% the cost of insurance. For the hospital, they know that the amount of people defaulting on medical bills is high, and they would rather get some money vs no money so they give you incentives if you can actually pay.
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      08-02-2019, 11:07 AM   #70
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Originally Posted by TheWatchGuy View Post
FWIW, most hospitals have different discounts if you dont go through insurance as well.

My wife had a bad accident a couple years back and has had a few in patient procedures after the initial emergency procedure. Every time i asked to see the insurance and non-insurance costs (the initial incident i thought we werent covered as we were on a new plan and wasnt fully aware of how they worked so I was working with the finance department everyday to figure it all out)

Non-insurance payment plans were ~50% of the insurance billed cost with a 10-15% downpayment and i think it was 5yr plan. The paid in full cash price was about 30% the cost of insurance. For the hospital, they know that the amount of people defaulting on medical bills is high, and they would rather get some money vs no money so they give you incentives if you can actually pay.
This is very true, and you can most definitely negotiate the price you pay as well. They always bill insurance companies a lot more because it increases what they will receive.

I don't personally forsee a time when health insurance is not available on the market. I use my HSA as a retirement vehicle since I already max my 401k and Roth. From what I understand, in retirement, HSA funds don't count against Medicare/medicaid so it actually has a decent extra benefit above the normal tax benefit. For this reason my HSA is pretty well funded.
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      08-02-2019, 11:30 AM   #71
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With govt bureaucrats falling in love with MMT like they did with Keynesian theory almost 100 yrs ago perhaps the printing press will really start running to pay for it?
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      08-02-2019, 11:38 AM   #72
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Blame us for your sh!tty healthcare

'Americans are essentially subsidizing the cost of drugs for the rest of the world'

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