Saturday, March 17, 2018

Good advice on reducing major medical expenses


A writer styling himself "hedgeless_horseman" offers a detailed article on how to negotiate with medical service providers, to reduce their bills by as much as 80% or more, if you're lucky.  It's very long, but packed full of useful advice, and is worth reading - particularly if, like me, you're older, and can expect your medical expenses to increase.  Here's a brief excerpt.

Primarily, this talk is to educate those of you that are, now, or may be, in the future, responsible for paying for your own healthcare.  It is not directed at the nearly half of America that is now on Medicare, Medicaid, VA, Tricare, government employee insurance, etc., those whose healthcare expenses are the responsibility of the taxpayer, and who are essentially wards of The State.  However, the conversation we are going to have should still be interesting for them, too, and God only knows how long that government gravy train will last, so all of you should really pay attention.

Like all the speakers at this first ZeroHedge Symposium, I am talking about how to, in many instances, remove the middleman, in this case the health insurance company, and how to negotiate directly with healthcare providers, specifically physicians, hospitals, diagnostic facilities, and pharmacies.  This is a discussion about how to negotiate to pay less for healthcare, and not a discussion about how to not pay for healthcare.

. . .

You are going to need five things, which I am going to give to you, today, free of charge!

  1. Some absolutely critical industry vocabulary
  2. A clear understanding of how healthcare is priced in the USA
  3. Insight into to actual pricing
  4. A proven negotiation strategy, including:
    • The point of contact
    • Foreknowledge of what prices medical providers will usually agree to
    • A sample offer and agreement
  5. The confidence to successfully negotiate

There's much more at the link. Informative and recommended reading.

Peter

14 comments:

Old NFO said...

Good advice, and well timed! We ALL need to pay attention!

Bob M said...

" those whose healthcare expenses are the responsibility of the taxpayer, and who are essentially wards of The State."

To hell with that. I paid into medicare for years and years, just like I dud taxes.

I am not a ward of the state.

The government made a deal with me - a couple of deals actually - I would pay into social security and medicare all my working years and they - in return - would help me out in my old age.

this gut can take his "ward of the state" and stuff it.

deb harvey said...

agree with bob m.
we get medicare but husband is still working full time, cannot retire because soc. sec. very small.
we paid into it in dollars worth much more than today's dollar and it is ours.
then think of all who paid in and died young. their money is in there, too.
should be used for those who live longer than usual.
it is few of us who live that long but those elders are characterized by the manipulators in government as 'useless eaters'. shame!

Anonymous said...

Bob M writes: To hell with that. I paid into medicare for years and years, just like I dud taxes.

All of you expect to spend $250K on healthcare in the last year of your life, and not sell your house to fund it. You expect to get out several times more than you put in. You have no moral or legal case.

The government made a deal with me - a couple of deals actually - I would pay into social security and medicare all my working years and they - in return - would help me out in my old age.

Your deal wasn't going to work because of demographics, you've known that for almost 60 years, and you've been voting to steal from your children all along.

https://www.lewrockwell.com/2002/12/gary-north/it-usually-begins-with-ayn-rand/

In the spring of 1959, [Gary North's high school teacher Roy] explained the economics of Social Security. He told us that it was actuarially unsound and that it would go bankrupt before most of us died. He primed us on questions to ask the local Social Security PR flak who came to every school in the district every year to promote the program. In the man’s retirement year, he told Roy that his were the only classes where students ever asked him tough questions.

I am not a ward of the state.

That's correct, the state is not going to support you for much longer. The purchasing power of your welfare is going down by 10%/year and will forever.

Anonymous said...

To add to the previous Anonymous (who was not me).

So sad. Americans still (wish to) believe that SS and Medicare is not straight welfare. Honest Americans still believe that they were 'promised' something. That they are 'owed' something.

Honest decent people refuse to believe they've been hornswoggled that completely. It's all been a lie, guys. And 'Anonymous' before me is right: our children to the third and fourth generation will be paying the interest and debt on what we take out now.

Here's the truth: you were never 'owed' a dime. It was just revenue and votes to them, all along. They can make your SS and Medicare benefits go up or down, or go away, just by voting.

SS and Medicare is mandatory. You MUST pay in. But congratulations! They're not 'mandatory' in the sense that you have the freedom to receive nothing. (As yet) they won't force you to take anything out.

And here's the best part: Medicare is a poison pill; it's a 'mandatory benefit'. Retirees cannot disenroll from Medicare Part A (much less Parts B or D) without also losing their Social Security benefits, and refunding all the SS money already paid to them. (see Hall v. Sebelius)

You're on welfare, guys. And there's no way out. So wake up -- please????

Anonymous said...

I'm the previous Anonymous. Karl Denninger predicts the cost growth of Medicare or Medicade, I forget which, will take a sufficiently big bite out of the federal budget that the current arrangement of federal employees can't continue. He predicts this will occur before Trump's first term ends. This shortage will be dropped on the states, who unlike the federal government can't evade payment by currency inflation (official counterfeiting). The state budgets will fail, too.

The math doesn't say your savings and salary will be wiped out by dollar hyperinflation, although historically that happens. The math doesn't say the military won't suffer a face-losing defeat in an imperial adventure, although historically that happens. In 2002 the US Navy decided a carrier group could be defeated by the Iranian coastal fishing fleet armed with Russian silkworm missiles.

https://en.wikipedia.org/wiki/Millennium_Challenge_2002

On the good side, the collapse of government means the collapse of socialism enforcement. The national debt will be repudiated, not repaid by your children. Jubilee! We can go back to having affordable honest major medical insurance pay doctors instead of paper-pushers. All of you retirees will have to get a job.

Bob M said...

"All of you expect to spend $250K on healthcare in the last year of your life"

Really? You have no clue as to what I expect on anything. Do not presume to speak for me.

"SS and Medicare is mandatory. You MUST pay in."

Really? not so. Anyone can opt out of SS at any time. You just need to how. Obviously you don't.

And yes, honest Americans were promised something, and expecting the government to honor its commitments is not unreasonable. More to the point, honoring its commitments to CITIZENS, and not every border jumping illegal swarming into our nation. It is insane that illegals in this country are demanding the same rights as citizens. Kick the parasites and leeches out.

"Karl Denninger predicts the cost growth of Medicare or Medicade". You need to broaden your sources rather than rely solely on the likes of Denninger. his opinions - and that's all they are - have plenty of holes in them.

At any rate, quit providing for every damned illegal sucking on our national teat. There's millions of them. That would go a long way to stop the out-of-control growth.

Quit sending billions overseas to nations that spit in our faces. The system could function for us if the bastards in Washington would actually honor their oaths of office.

If there is a solution, it's exactly as Trump says... AMERICA FIRST. Let everybody else provide for themselves. it's not our responsibility.

One other thing.... if you haven't the guts to sign your names, hit the road. Your opinions and statements are worthless.

Anonymous said...

I’m dubious about his scheme. I want to hear from a few people who’ve tried it. Hospitals accept Medicaid patients only because the government forces them to. I find it difficult to believe they’d accept the equivalent of a Medicaid payment from someone who can clearly be forced to pay them more, e.g. has money in the bank or a house that can be sold. Also, I’m not too impressed by his whining about the evil government when his scheme depends on the existence of Medicaid, which is run by...the evil government!

I agree with Karl Denninger—we should demand that the evil government pass laws forcing hospitals to post their prices.

Anonymous said...

Honest decent people refuse to believe they've been hornswoggled that completely.

What did the voters know, and when did they know it? The culpability of the voters depends on what options they had available to them at the time. One thing the libertarians truly achieved was to scream at everyone who went to college, backed up by footnotes. The complete removal of all the excuses from voters.

Do not presume to speak for me.

Voters not only presume to speak for me, they hire men with guns to enforce their will on me.

At any rate, quit providing for every damned illegal sucking on our national teat. There's millions of them. That would go a long way to stop the out-of-control growth.

https://www.npr.org/2011/08/06/139027615/a-national-debt-of-14-trillion-try-211-trillion

Economics professor Laurence J. Kotlikoff, who served as a senior economist on President Reagan's Council of Economic Advisers, did the math. He said to keep the federal welfare political promises would require $200 trillion. That's something like three times total world human productivity. Illegal aliens are numerically not the problem.

Quit sending billions overseas to nations that spit in our faces. The system could function for us if the bastards in Washington would actually honor their oaths of office.

The only reason those candidate are in office is because voters voted for them,
obey their employees, and send them money. Voters are just as guilty as candidates. A criminal conspiracy to commit organized crime doesn't become non-criminal just because there are 200 million people conspiring.

if you haven't the guts to sign your names, hit the road. Your opinions and statements are worthless

I decline to make it easier to prosecute me for my dissent.

Anonymous said...

An acquaintance of mine has a bit of a system he uses for medical bills his Medicare or private insurance won't pay for but it's not entirely ethical. If the hospital won't accept a 10 dollar a month payment, he just waits until they send it to collections. The collections agency may pay 5 cents on the dollar for bad debt, so he tells collections company he's a poor retiree with limited income (true) but has received a one-time windfall that just so happens to be an amount 10 to 15 cents on the dollar of the debt. According to him they usually jump on the offer especially if it's been in collections for a while or has been sold/transferred to another company. Yes, his credit is terrible but he doesn't borrow money and lives a cash lifestyle so he really doesn't give a hoot in Hades about his FICO score. Again, not exactly ethical but it's what he does and it seems to work for him.

Anonymous said...

we paid into it in dollars worth much more than today's dollar and it is ours. then think of all who paid in and died young. their money is in there, too.

These government intergenerational wealth transfer programs are Ponzi schemes. The dollars you paid in 1970 with greater purchasing power than today, were paid out to recipients in 1970. There never was any investment, or investment return. There never was any savings. There is a lockbox containing IOUs made from one department of government to another. Since the treasury can't print hip replacement surgeries, these are worthless. When there were more workers than retirees, it appeared to work. Now that there are more retirees than workers, it is revealed to be fraud from the very beginning.

https://en.wikipedia.org/wiki/Ponzi_scheme

Anonymous said...

To expand on the previous point, when Social Security started, 6 people were paying for 1. Currently, it's aprox 4 people paying for 1, and when I reach retirement, due to demographics, 2 people will need to pay for 1. It doesn't matter if the lockbox is full of IOUs, when the government goes to the taxpayers to fund the IOU, the money won't be there. The government will then be in default and we'll have "interesting times".

There have already been a number of trial balloons floated to "fix" this by confiscating people's 401k's (or other savings) and giving them an annuity, "backed by the full faith and credit of the U.S. Government". That somehow sounds very much like another government program I've heard of. I'll note this has already been done by FDR & gold

Further, the cynicism regarding the Social Security scam was stated quite well by FDR, "Once the dollars start flying about, they will never be able to repeal it and it'll always exist". And every time someone has tried to fix it as opposed to kicking the can down the road, they have been killed in the press & election.

BobF said...

I had trouble concentrating on the rest of the article when I was told I was on a "gravy train" because I have TRICARE. (I couldn't care less what an anonymous/gutless poster thinks about it.)

I spent the majority of my adult life doing what I was ordered to do and going where I was ordered to go. For part of that time I had the additional duty of reenlistment counselor and handed out literature that said spend a career and the employer (Uncle Sam) will give you medical care afterward. Some took the deal.

Later, when the politicians turned their backs on the military, SCOTUS decided if it was a pamphlet and mot a regulation it wasn't real, never mind the bucks to print them and the hours invested in briefing them. So the deal I was told to offer was a lie all along, including the one supposedly for me and my family.

Makes no difference to the majority of the American public, however, evidence the state of the VA over decades. Want to know what the majority of this country REALLY thinks of the military? Look at the history of the VA the citizens have allowed. Friend or relative in the military? Probable supporter, which makes one in a very small group of the whole. The rest couldn't care less.

But I know what we were were promised, what *I* was instructed to promise, as part of a deal and I know what happened, so I don't need snide references to my being on a gravy train, and frankly, I'm somewhat surprised that Peter did not comment on it.

Anonymous said...

I wonder what the neighborhood street will be like when the entire elder demographic is declining in pain and poverty and no healthcare, as carefully planned and imposed at gunpoint by their earlier selves. They won't even get as much pain relief as they need for the hip replacement they won't get, since they voted for a drug war. I don't expect them to admit fault in the slightest.