Is the Medical Industry taking us for a ride?

[Captain Fastbastard Mayhem]

I think we also need to be aware that currently medical aid rates do not exist. The legislation that governed this was set aside in 2010 with the hospersa judgement in 2010. So the rates we use are 10 years old and are not cost based. It's simple economics if you charge less than the cost of sales you will liquidate your business. Also consider the statutory cost of your practice. Income tax at 38%,vat 14%, paye, wcc, mal practice, hpcsa registration, the costs of cpd points to maintain registration. That's just the beginning. Consider the cost of your degree and not working for 10 plus years that you didn't work while attaining your degree. Post graduate qualifications. The list goes on and on. I always say nobody forces any one to use private health care. When you need to go to hospital you do. have a choice you can go to a public health care facility to. Like anything in life you want the best it's never cheap. You cannot get Ferrari care for mini money. Again my two cents what it's worth. Also remember the less medical professionals there are the more scarce the skills more we will pay. It has become a commodity unfortunately world wide. Lastly, consider that a gynecologist may have to pay up to 500k in professional indemnity insurance per annum before he makes a cent. Huge costs!

All true, med aids have their owb induvidual rates which are loosely based on the old NHRPL list, and are adjusted for inflation and medical advancement each year. Still not anywhere near what they should be, but then if they were then the med aid policies would be far more costly. Especially if they maintain the existing structure and can't rare according to health.

 

Just didn't realise that the PI cover was that expensive for some of the disciplines. Are you sure!?

[LeftBhind]

So I got my outstanding bills from my most recent break after medical aid had paid their share.

What are we really paying for?

 

The Surgeon wasn't bad, only slightly over medical aid rates.

 

But the Anaesthetist, WTF

 

Consultation and assessment charges are for the 5 min he talks to you before theater.

On top of paying for his time at R34.67 per minute I then have to pay him for the operation and for the skeletal modifier which he has nothing to do with.

 

When I called to query all we got was "this is what the medical board has approved as standard billing"

 

Good thing I took out GAP cover.

Seeing as your anaesthesiologist was unable to explain your bill let me try.

 

First thing: there are no "medical aid rates" any longer. Every practitioner and medical aid must determine their own rate (Competition commission ruling 2004). Your medical aid pays you out at the rate they determine according to the plan you take with them. Save money on a cheaper plan and you get paid out at a lower rate. (Like car Insurance).

You have actually been charged at a medical aid rate the Discovery Classic rate which is their middle rate (which is 213% of the 2006 medical aid tarrif adjusted for inflation).

In addition every bill now has to charge VAT as the government decided that healthcare is a value added item and they added 14% to each acccount.

 

Your account:

An anaesthetic account is made up of 4 parts:

1. The preoperative preparation (called assessment in this account) which is a basic consultaion of less than 10 minutes and the preparation of the anaesthetic part of the theatre (Mixing drugs, checking equipment and monitors. (You don't want a Michael Jackson scenario here). This can take the anaesthestist up to 30 minutes and the fee covers this time.

 

2. The complexity of the operation. In your case a fracture of the radius and ulnar which is given a value but also recieves a skeletal modifier for difficulty. This is a modifier for additional complexity. I am sure you appreciate that the complexity of a fractured radius is less than that of a fractured hip or open heart surgery and is charged as such.

 

3. Anaesthetic time. You are charged for every minute that you are under the care of the anaesthetist. This is because your anaesthetist is monitoring you continuously throughout the procedure.

 

4. Other modifiers: Additional procedures, or risks are then added depending on the patients health status or type of operation.

In your case as this procedure was done on a Sunday you have been charged a set of emergency modifiers for taking the anaesthetist away from their family or their ride.

Other modifiers are charged for things like obesity, ICU admission, pain control procedures, strange operating positions and controlling blood pressure.

 

Anaesthesiologists are specialist medical doctors having done a full medical degree and then specialised for at least 4 years (just like surgeons) allowing them to anaesthetise you for any operation you may need and as a result charge fees commensurate with highly qualified specialists.

Just because you do not see the work they do does not mean they do not contribute significantly to your well-being during an operation. If you doubt this you should try having your next operation without one.

[footdoc]

 

All true, med aids have their owb induvidual rates which are loosely based on the old NHRPL list, and are adjusted for inflation and medical advancement each year. Still not anywhere near what they should be, but then if they were then the med aid policies would be far more costly. Especially if they maintain the existing structure and can't rare according to health.

 

Just didn't realise that the PI cover was that expensive for some of the disciplines. Are you sure!?

Most definitely, just have a look how many ob/gyn are not doing obstetrics anymore! The most litigated profession in the world.

[footdoc]

 

Seeing as your anaesthesiologist was unable to explain your bill let me try.

 

First thing: there are no "medical aid rates" any longer. Every practitioner and medical aid must determine their own rate (Competition commission ruling 2004). Your medical aid pays you out at the rate they determine according to the plan you take with them. Save money on a cheaper plan and you get paid out at a lower rate. (Like car Insurance).

You have actually been charged at a medical aid rate the Discovery Classic rate which is their middle rate (which is 213% of the 2006 medical aid tarrif adjusted for inflation).

In addition every bill now has to charge VAT as the government decided that healthcare is a value added item and they added 14% to each acccount.

 

Your account:

An anaesthetic account is made up of 4 parts:

1. The preoperative preparation (called assessment in this account) which is a basic consultaion of less than 10 minutes and the preparation of the anaesthetic part of the theatre (Mixing drugs, checking equipment and monitors. (You don't want a Michael Jackson scenario here). This can take the anaesthestist up to 30 minutes and the fee covers this time.

 

2. The complexity of the operation. In your case a fracture of the radius and ulnar which is given a value but also recieves a skeletal modifier for difficulty. This is a modifier for additional complexity. I am sure you appreciate that the complexity of a fractured radius is less than that of a fractured hip or open heart surgery and is charged as such.

 

3. Anaesthetic time. You are charged for every minute that you are under the care of the anaesthetist. This is because your anaesthetist is monitoring you continuously throughout the procedure.

 

4. Other modifiers: Additional procedures, or risks are then added depending on the patients health status or type of operation.

In your case as this procedure was done on a Sunday you have been charged a set of emergency modifiers for taking the anaesthetist away from their family or their ride.

Other modifiers are charged for things like obesity, ICU admission, pain control procedures, strange operating positions and controlling blood pressure.

 

Anaesthesiologists are specialist medical doctors having done a full medical degree and then specialised for at least 4 years (just like surgeons) allowing them to anaesthetise you for any operation you may need and as a result charge fees commensurate with highly qualified specialists.

Just because you do not see the work they do does not mean they do not contribute significantly to your well-being during an operation. If you doubt this you should try having your next operation without one.

Perfect reply, anesthetics 99% boredom and 1% pure terror. You don't pay to be put to sleep you pay so the doc can wake you up again!

[Sharkie 2]

I had a knee op two weeks ago. just the hospital bill was R44 000.

I chatted to a family friend who is a surgeon about it. Just the theater time costs R230 per minute.

 

On the flipside, my little boet is a 6th year med student. He is still working for pocket money in his holidays. He is 24. when i was 24 i was already living it up.

You may say that but as soon as he starts his first community service year he will in all likely hood take home more than what most hubbers much older than him earns

[footdoc]

 

You may say that but as soon as he starts his first community service year he will in all likely hood take home more than what most hubbers much older than him earns

Fair comment but most hubbers are not working 24h a day 7 days a week in crap public hospitals

[eddy]

 

Fair comment but most hubbers are not working 24h a day 7 days a week in crap public hospitals

 

With 6 years of post matric studies behind them......

[Riaanvt]

 

All true, med aids have their owb induvidual rates which are loosely based on the old NHRPL list, and are adjusted for inflation and medical advancement each year. Still not anywhere near what they should be, but then if they were then the med aid policies would be far more costly. Especially if they maintain the existing structure and can't rare according to health.

 

Just didn't realise that the PI cover was that expensive for some of the disciplines. Are you sure!?

 

R330 000 for obstetrics. Highest risk category,

 

http://www.medicalprotection.org/adx/aspx/adxGetMedia.aspx?DocID=49f05d50-63ab-4dd3-8ac5-f3cd4a8341ad

[Captain Fastbastard Mayhem]

 

R330 000 for obstetrics. Highest risk category,

 

http://www.medicalprotection.org/adx/aspx/adxGetMedia.aspx?DocID=49f05d50-63ab-4dd3-8ac5-f3cd4a8341ad

Eek. Mine pales in comparison

[Sharkie 2]

 

Fair comment but most hubbers are not working 24h a day 7 days a week in crap public hospitals

Very true but I am of the opinion that people who preach and say doctors are always well off, drive fancy cars, have huge houses are this and that etc. are the biggest idiots of them all. I have friends who are doctors, one busy with his community years the other one a specialist. Let me tell you they deserve every cent they earn, I have never chatted to a medical student ever who has told me he is studying 6 years or 7...for the money one day.

 

The responsibilities doctors take are huge! The hours they work are horrendous at most times and it is not because of the money it is because of the oath the took to provide the best care to people like me and you on The Hub and everyone one else. Do they have weekends? No most doctors don't they have to do ward rounds and attend to emergencies that occur. Think about it when you are sitting having a beer with a friend and the family having lunch or a braai, doctors do not often have this luxury.

 

Many professions are overcharging and one can debate this to the tee but doctors deserve every cent they earn and it is a calling to them. Also for those so speculative of the costs the doctors charge they have a business, it is called a practise. Monthly fees like salaries, room charges, maintenance costs etc.

[footdoc]

 

Very true but I am of the opinion that people who preach and say doctors are always well off, drive fancy cars, have huge houses are this and that etc. are the biggest idiots of them all. I have friends who are doctors, one busy with his community years the other one a specialist. Let me tell you they deserve every cent they earn, I have never chatted to a medical student ever who has told me he is studying 6 years or 7...for the money one day.

 

The responsibilities doctors take are huge! The hours they work are horrendous at most times and it is not because of the money it is because of the oath the took to provide the best care to people like me and you on The Hub and everyone one else. Do they have weekends? No most doctors don't they have to do ward rounds and attend to emergencies that occur. Think about it when you are sitting having a beer with a friend and the family having lunch or a braai, doctors do not often have this luxury.

 

Many professions are overcharging and one can debate this to the tee but doctors deserve every cent they earn and it is a calling to them. Also for those so speculative of the costs the doctors charge they have a business, it is called a practise. Monthly fees like salaries, room charges, maintenance costs etc.

Agreed, well said.

[TALUS]

Problem is that most people don't like the real answers.

[marko35s]

Fair comment but most hubbers are not working 24h a day 7 days a week in crap public hospitals

Nor is he.

Please if you want to make a point don't exaggerate stupidly for effect.

[V12man]

Nor is he.

Please if you want to make a point don't exaggerate stupidly for effect.

 

DESPITE what you think, he is not far off - when I wss specialising, I worked an average of 110 hours a week on site and had to eat, sleep and study over and above that for 4 years - and finished up with a student loan of over 7 figures at the end of it all. 20 years later I still work when my family wants me home, and now, finally, make more money from non medical business than medicine.

 

now I just need someone else to pay my Insurances, registrations etc, so I can work for free, rather than paying in to work for free... which is what happens...

 

Dont feed the trolls chaps....

 

 

[footdoc]

Nor is he.

Please if you want to make a point don't exaggerate stupidly for effect.

With respect, sadly it's not far off.

[Skylark]

 

R330 000 for obstetrics. Highest risk category,

 

http://www.medicalprotection.org/adx/aspx/adxGetMedia.aspx?DocID=49f05d50-63ab-4dd3-8ac5-f3cd4a8341ad

 

HAUW!

So that basically is cover that will payout to patients if the doctor makes a stuff up?

Edited July 12, 2014 by Skylark