Is the Medical Industry taking us for a ride?

[Guest Sam Blake]

I'd hate to be negotiating rates with somebody just when I'm about to put my life in his/her hands.

 

"I'm afraid that rate is the best we can offer, sir."

"Come on, you're killing me, doc"

"Not yet…"

[Shebeen]

I'd hate to be negotiating rates with somebody just when I'm about to put my life in his/her hands.

We had an emergency caesar, anaesthetist gave us his 'I hope you have gap cover' speech, during his assessment time. Charged us for his travel time, sitting time, ball scratching time alles. Left a real bad taste in the mouth on what was an otherwise professional process.

[TALUS]

You are paying for many things that connot be quantified. I will gladly go into them if anyone is interested. Fact is your medical aid is ripping you of. This is a PMB condition and they are by law compelled to pay the whole account. Your Dr has no contract with the medical aid and by law cannot collude on prices. If they did not discuss pricing with you pre-op you have some leeway in negotiating prices. Funny how money only becomes important after you have been fixed. Before surgery it is always " just do the best you can" and "only the best please".

[blondeonabike]

We had an emergency caesar, anaesthetist gave us his 'I hope you have gap cover' speech, during his assessment time. Charged us for his travel time, sitting time, ball scratching time alles. Left a real bad taste in the mouth on what was an otherwise professional process.

I had a version(turn baby because it was breech)specialist saw me in his lunch time because I was nearly due...only charged me R260.00 bucks. Special rate, I think he felt sorry for me. The difference between an NUD ( no pain meds nogal and one night in hospital) and ceasar is at least ten grand. So when I sumitted my bill for R260.00 to med aid (which has saved them big bucks) they replied saying they would only pay R60.00. ????? (Nine yrs ago) Edited July 11, 2014 by blondeonabike

[Wyatt Earp]

I just spent 2 and a bit days in hospital.

The doctor in E.R. on Monday evening wanted to book me for a sonar scan go the stomach, the wife and I decided no as we would have had to pay for it out of our own pockets.

I am glad we did this, when the ward doctor eventually saw me she was very surprised that I was booked for a sonar scan of the stomach, so luckily lack of funds and not having money to pay for it, saved me from wasting R 3 k.

I am dreading to see the whole bill.

[Shebeen]

I just spent 2 and a bit days in hospital.

The doctor in E.R. on Monday evening wanted to book me for a sonar scan go the stomach, the wife and I decided no as we would have had to pay for it out of our own pockets.

I am glad we did this, when the ward doctor eventually saw me she was very surprised that I was booked for a sonar scan of the stomach, so luckily lack of funds and not having money to pay for it, saved me from wasting R 3 k.

I am dreading to see the whole bill.

get better dude...at least you timed it during the tour!

[Wyatt Earp]

get better dude...at least you timed it during the tour!

 

Thank you

One problem is I can't watch the telly for more than a half an hour

[TALUS]

Often ER Dr's are relatively inexperienced and work under lots of pressure.

The legal proffesion and public force them to practise defensive medicine. This leads to many unneaded tests to exclude all possible problems. The specialist is better equiped to deal with these problems. If somebody underdiagnose they get sued and end up paying. If they "overtest" you and your fund pay. This is the reality of a system where lawayers advertise they will sue for free (on a outcome basis).

[Wyatt Earp]

Often ER Dr's are relatively inexperienced and work under lots of pressure.

The legal proffesion and public force them to practise defensive medicine. This leads to many unneaded tests to exclude all possible problems. The specialist is better equiped to deal with these problems. If somebody underdiagnose they get sued and end up paying. If they "overtest" you and your fund pay. This is the reality of a system where lawayers advertise they will sue for free (on a outcome basis).

 

Yeah, that is the what I expected.

My stomach was heavily bloated, but I think it was from shock, my wife and myself did a rough diagnosis of the stomach and felt it was not necessary (in hindsight if I had deep pockets, I would have done the scan, most likely)

They were on hand very quickly with adrenaline and Nexium, I will say they saved me at the ER

[Greybeard]

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.

Anaesthetists feel they are sucking the hind tit behind the specialists and theatre time so they have all upped their rates. As for the pre op assessment this is the biggest rip off of all.

[flymango]

Of course, the soon-to-be-introduced National Health Insurance in SA is going to make all these problems go away. And then we all have to be happy. My guess is if you think you're being ripped off now or short-changed, just wait for NHI ...

[Spoke101]

My 2c

 

Last year collar bone had to be done and both the surgeon and anesthetist both charged me 300% of medical aid rates and that was after asking for a discount prior to the opp and it wasn't an emergency. This probably has to do with only being on hospital plan,

But hey there also have to make a living some how.

 

Got gap cover now and it covers up to 500% of medical aid rates.

 

As for expensive hospital visits just had a friend come out after surgery to remove cancer and then it got infected and so on and so forth, but the ICU bill alone came to 1.5 Million and that's without the 8 surgeries and everything associated with them.

[nonky]

An orthopaedic surgeon I know well is a trauma surgery specialist - his view is that the MOST IMPORTANT oke in the room during surgery is the anaesthetist...

[Scott2luvit]

ja had my fair share of medical bills this year, another industry that's taking us for a ride though, is the cycling industry

[Vangar]

Often ER Dr's are relatively inexperienced and work under lots of pressure.

The legal proffesion and public force them to practise defensive medicine. This leads to many unneaded tests to exclude all possible problems. The specialist is better equiped to deal with these problems. If somebody underdiagnose they get sued and end up paying. If they "overtest" you and your fund pay. This is the reality of a system where lawayers advertise they will sue for free (on a outcome basis).

 

A fair point perhaps, but ever since a doctors negligence and lack of interest contributed to my fathers death, I have very little sympathy for doctors. The reality is as well that a lot of doctors either don't care or are just terrible at their job, or are just out to make the most profit possible. I realise that there are still great doctors around who really do care and that I may be grossly generalizing, but their numbers seem to be dwindling.

[Skylark]

If it was an emergency or what qualifies as a PMB condition your medical aid has to cover the full amount by law. If it's an elective surgery IE you had the chance to "shop around" they're unlikely to cover more than prescribed rates. Fedhealth wanted to pay around 30 of the 130k bill when I destroyed my ankle but I got the whole amount paid out in the end. Talk to the surgeon re how to go about it.

 

This is news to me and I would imagine many, so if you are in a car accident the attending duty surgeon charges 500% medical aid rates and your plan only covers up to 300% they have to cover the full 500% rate because it's an emergency?

Wonder how many med aids try pull a fast one when billing time comes round in that situation?