The exorbitant price of healthcare

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Specializes in pulm/cardiology pcu, surgical onc.

NOT looking for medical advice, just a rant.

So today I received my statement for 6 sessions of physical therapy that I recently completed. To make a long story short, many years of back breaking work will indeed wreck your back despite correct body mechanics, exercise, etc. So I go to PT for the umpteenth time to appease my FNP and was shocked to say the least when I saw what my health plan charges ITSELF. I'm employed for a non profit hospital system that sells it's own insurance plan to employees/public and SO requires plan members to use it's OWN PT services. On two of the visits the PT tried to get me to waste time on the treadmill...umm no my legs work just fine thank you, my problem is with my back I told her (that was a Kodak moment!). So besides just the years of wear and tear, with thick adhesions to back injury on top of back injury they do find sometimg wrong. They found a twist in the T-12 disk which was manipulated once but went right back when I slept that night. I had 6 sessions in the course of a month, my FNP approved for me to have 2 additional sessions BUT the PT d/c'd my tx plan because "I wasn't making adequate progress and she didn't see any room for improvement", "maybe I could try accupuncture". And for this the insurance was charged well over 1K for 6, 30 minute sessions. This just seems so wrong to me in so many different ways I could write a book, apologies for the long post.

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Specializes in home health, dialysis, others.

But how much will the insurance PAY? Charging and paying are 2 different things. And that amt seems normal for the sessions. Let us know what was paid!!

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Specializes in pulm/cardiology pcu, surgical onc.

Oh my copay is 20%. Which isn't too bad but I just feel ripped off, let down, and given up on. Here's a script for pain pills, go away kid you're bothering me, LOL. But in all seriousness, I did the calculations and it comes to >$5.50 per minute. It just seems a little excessive to me regardless of who's paying for it.

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Specializes in LTC.

just out of curiosity what is your premium via employer? I have cigna insurance....I signed up for the family plan (my hubby is changing jobs and his former one doesnt offer any benefits) for medical, dental family and vision for me and my toddler...total new premium for me will be 267.00 every 2 weeks. During our open enrollment we had options for regular cigna or a limited plan thru them called starbridge...so I originally signed up for the family starbridge which wouldve been 175/ 2 wks....then my HR person calls me up and says ...no..you cant buy down according to cigna..you have to keep the full cigna or nothing at all...ummm...what????????????? I asked her to explain to me why the insurance company can OFFER 2 different plans .....and when you need the cheaper because its more affordable...they yank it away....she said that the starbridge is for "new hires", not re enrollees. Thats a load of bull to me....I said if they dont want us to sign up for it then take it out of our enrollment packet as an option ....thats false and misleading to all of us. In 07 the family plan was 131 2/wks....then it went up to 213 and now its gone up to 235/2wks just for the medical part! An ER copay is 300.00 plus a 20% copay. Id hate to think about what a PT bill would be. Ive been looking nonstop for a prn job to do on the side since June just to offset the loss in my paychecks from just this insurance. I cancelled my short term disability insurance because it went up also and I couldnt afford to have all that taken out. I guess its better than not having no insurance at all though.

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6 * 30 min for PT. Cost of facility existence (building). Cost of electricity/heat/ac. Cost of equipment. Cost to clean afterwards. I don't see the $1K as unreasonable. My last ER visit when I had no insurance....$3K just to walk in the ER...then the costs add from there. Now, THAT is exhorbitant. I tried going to the nearest acute walk-in (Solantic), but they said they couldn't handle a separated shoulder. I had to go ER. Worse yet...after waiting more than 3 hrs, my DD, exhausted.....grabbed her own hand over her head, started pulling and ****SNAPPPPP!!!!*****....reset her own shoulder. When the nurse finally got her a bed, she asked what could they do for her....and I snappishly replied, "Nothing now. She set it herself." I then got called a liar. Yeah, tell that to the other 15 people in the secondary waiting room (the waiting room after the waiting room before the bed). They HEARD it. Quick Xray, a script and a sling.....Nice $5K total.

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Specializes in pulm/cardiology pcu, surgical onc.
6 * 30 min for PT. Cost of facility existence (building). Cost of electricity/heat/ac. Cost of equipment. Cost to clean afterwards. I don't see the $1K as unreasonable. My last ER visit when I had no insurance....$3K just to walk in the ER...then the costs add from there. Now, THAT is exhorbitant. I tried going to the nearest acute walk-in (Solantic), but they said they couldn't handle a separated shoulder. I had to go ER. Worse yet...after waiting more than 3 hrs, my DD, exhausted.....grabbed her own hand over her head, started pulling and ****SNAPPPPP!!!!*****....reset her own shoulder. When the nurse finally got her a bed, she asked what could they do for her....and I snappishly replied, "Nothing now. She set it herself." I then got called a liar. Yeah, tell that to the other 15 people in the secondary waiting room (the waiting room after the waiting room before the bed). They HEARD it. Quick Xray, a script and a sling.....Nice $5K total.

I'm not saying my situation is unique, I just think in general healthcare is so extremely overpriced for what you actually receive.

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Specializes in pulm/cardiology pcu, surgical onc.
just out of curiosity what is your premium via employer? I have cigna insurance....I signed up for the family plan (my hubby is changing jobs and his former one doesnt offer any benefits) for medical, dental family and vision for me and my toddler...total new premium for me will be 267.00 every 2 weeks. During our open enrollment we had options for regular cigna or a limited plan thru them called starbridge...so I originally signed up for the family starbridge which wouldve been 175/ 2 wks....then my HR person calls me up and says ...no..you cant buy down according to cigna..you have to keep the full cigna or nothing at all...ummm...what????????????? I asked her to explain to me why the insurance company can OFFER 2 different plans .....and when you need the cheaper because its more affordable...they yank it away....she said that the starbridge is for "new hires", not re enrollees. Thats a load of bull to me....I said if they dont want us to sign up for it then take it out of our enrollment packet as an option ....thats false and misleading to all of us. In 07 the family plan was 131 2/wks....then it went up to 213 and now its gone up to 235/2wks just for the medical part! An ER copay is 300.00 plus a 20% copay. Id hate to think about what a PT bill would be. Ive been looking nonstop for a prn job to do on the side since June just to offset the loss in my paychecks from just this insurance. I cancelled my short term disability insurance because it went up also and I couldnt afford to have all that taken out. I guess its better than not having no insurance at all though.

Well i have to say I have excellent benefits, I don't pay any premiums for my family as long as I work FT, that includes dental too. If I worked under 32 hrs a week I would pay around $50/2 wks. For being a non profit the company I work for has the highest profit even after they contribute to charity, in the city I live in. I really have no complaints with the amount I pay, i just think like I said in previous post how far fetched for what the patient actually receives.

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