I've always argued that big medical organization would really benefit from having a VP of common sense on the payroll (god knows they have enough useless VP's running around) who would sit in his office, surf the net, order out for lunch and be tasked with answering a question every three months or so like "Hey hobbes, we were thinking it would be a good idea to refuse to bill insurers and stick patient with insane bills, so we end up on TV looking like a bunch of moneygrubbing *******s. What do you think?"

"No, I wouldn't do that - it's a bad idea"

Be worth at least mid-six figures a year, I would think. I'd take the job.

MM MD

Any reason the government doesn't manufacture insulin and distribute it at cost?

People dying because they can't afford a generic drug is peak America.

Probably for the same reason we can't let Medicare negotiate drug prices like every other payer does. $$$$$$$$$ and lobbyists.

MM MD

There are over six *thousand* active gofundme campaigns for insulin.

https://twitter.com/onesarahjones/st...57415934668800

This ****ing country

WHY AREN'T MILLENNIALS HAVING KIDS?

To be clear, the charge is for a nurse/midwife to closely observe the mother/child after the newly delivered child is placed on the mother's chest shortly after birth to insure that the child doesn't experience SUPC (sudden unexpected postnatal collapse) - a (very) rare but often lethal complication. Also, kids delivered thru C-section are much more prone to hypothermia after delivery, which is also dangerous. So those kids need to be eyed more cautiously than your usual NSVD kid.

You can argue whether it's reasonable to allow an extra charge for this stuff, but medical billing is arcane, to say the least. I'd argue it isn't, and violates bundling regulations (kind of like if I sew up a laceration, I don't get to bill for numbing up the wound, irrigating it, suturing it and dressing it as four separate items - it's all supposed to be part of the general code for laceration repair)

MM MD

Hobbes should start a "Review my medical bill" thread.

People get upset about the completly wrong stuff.

The 40 bucks for 30-60 minutes of a medical professionals time to closely observe you and baby is fine. The complete absurdity is that they make up arbitrarily high baseline prices then in this case have the 5.5K “contractural adjustment” after insurance.

The whole bill is a disgrace. Having a kid should be free, period.

There is no other explanation at this point other than corruption. And you would think that advocates for fiscal responsibility and making everything more efficient and cost effective would argue for UHC and yet they deliberately don't. Busy "not understanding" things because their salaries depend on it. You could even argue a robust UHC system can lead to cuts in the welfare state because the individual becomes healthier and more productive w UHC. Especially the poor and middle class who struggle with cost the most.

America's healthcare system is FUBAR.

It is absolutely absurd and outrageous what is going on right now and for decades. A travesty.

Put the Oregon vax idiot parents in jail. That’s child abuse.

I'd rather be stabbed in the eye with a jamshdi needle. (trust me, it's bad)

MM MD

The 40 bucks for 30-60 minutes of a medical professionals time to closely observe you and baby is fine. The complete absurdity is that they make up arbitrarily high baseline prices then in this case have the 5.5K “contractural adjustment” after insurance.

Yep. My wife just had cataract surgeries done. The total "bill" was about 11K. I am out of pocket about 10% of that after insurance, which seems OK for two surgical (minor) procedures that result in her sight being pretty much back to normal.

Optho docs have it pretty good - I mean, who is gonna hate on the guy who keeps you from going blind....

MM MD

Depends if he's robbing you blind at the same time.

Reno doc will be by shortly to whine endlessly about everything including his $400k salary while opposing all reform options.

Nit: Neglect not abuse

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I don't have any problem with a medical professional being paid 40 bucks for 30 minutes of time observing mother and baby.

Where I do have a problem is billing the mother for that.

Just to be clear, that wasn't me. That was the OP.

MM MD

I can confidently state that he won't whine about that.

MM MD

lol at renodoc making only 400K. Unless he went part-time or something like that.

Are you suggesting the medical professional should work for free?

Im going to go with the obvious choice and say telemedicine shouldn't be used for a terminal diagnosis. It works great when I have a kid who's got a cold though.

https://www.nytimes.com/2019/03/09/s...imes&smtyp=cur

Like most of this stuff, it's complicated.

Telemedicine is going to be a LOT more common for a bunch of reasons - the biggest being that there just aren't enough docs coming into the workforce, especially in some specialties that for whatever reason aren't that popular with people starting residencies. Or esoteric specialties (say pediatric neurology) where the only realistic way to assure access may be telemedicine unless you're living in a major metropolitan area.

Another problem with this stuff is Marcus Welbey ain't around any more. I frequently have to do what the guy on the video screen did, and I dunno if having some big hairy guy in a set of scrubs that you've never met before give you the bad news is any better than some doc on a video screen doing it. I'd guess (but don't know) that to some degree it's a generational thing - people in their 70's/80's have a much more "Marcus Welby" expectation for medicine than people even in their 60's, I think. Back in the day, your family doc was there to hand out the bad news and be sympathetic - now you're being managed by a hospitalist who you first met two days ago. For a lot of reasons the hospitalist may be better in terms of actually delivering medical care, but there is no doubt little or no personal connection - and at the end of life when there is nothing to do, it's a big loss IMHO. Kaiser needs to work on this - so do most hospital systems, I'd guess.

MM MD