Is the Medical Industry taking us for a ride?

[TALUS]

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.

I really think you over generalising now. Yes you had a gross experience and without knowing any facts, we accept your assesment of the specific case, but I can state 100% that money is not the motivating factor for most Dr's. Also NOBODY will daily practise as a Dr if they really don't care. Remind yourself that most Dr have the capacity to change careers and do something else if they really are fed-up with what they are doing.

[TALUS]

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?

Many provisos regarding this - but roughly yes.

[Sepia]

Seriously, if that is the whole Bill pay it smiling! Looks darn cheap to me. Your injury was terrible.

(My bill adds up to R60 000.00 for a "broken leg")

Edited July 11, 2014 by Sepia

[Skylark]

And how does pmb relate to medical emergencies?

I have been told if I go into an ER but I am not subsequently admitted to hospital then all costs are out of my own pocket.

[TALUS]

PMB is based on the underlying condition (and thus coding). Most trauma is PMB. Non-trauma depends on the condition.

[Grebel]

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.

 

A bit like that PDI when you buy a car from a dealer......

[Vangar]

 

A bit like that PDI when you buy a car from a dealer......

 

Or the on the road fees.

[NotSoBigBen]

I know one shouldn't generalise but damn I often feel that at least GP's and some specialists are no different really to bike mechanics and IT techs ....... If this doesn't work try that and if that doesn't work ..... difference being that often Bike mechas and IT techs will try fix it at no charge, once a doc is paid and you've forked out for the meds it's a done thing!

[Lynnie_the_Snail]

I had an op a year and a half ago… came in just under R200 000 for the whole thing… hospital fees, physio etc…

 

I did not have gap cover then… hence why I'm still riding my hand me down…

 

But on the bright side!! I'm a 150 percent health wise now!!

[Vangar]

I know one shouldn't generalise but damn I often feel that at least GP's and some specialists are no different really to bike mechanics and IT techs ....... If this doesn't work try that and if that doesn't work ..... difference being that often Bike mechas and IT techs will try fix it at no charge, once a doc is paid and you've forked out for the meds it's a done thing!

 

Being an IT Tech....there is some truth to that. I also have been prescribed Penicillin 3 times by a backup doctor when my regular one is busy. The FIRST thing on my file.....severe Penicillin allergy. I could understand once or twice. But 3 times is plain rediculous. Never going back there.

[Peach.]

And how does pmb relate to medical emergencies?

I have been told if I go into an ER but I am not subsequently admitted to hospital then all costs are out of my own pocket.

 

That is correct, if you are on a hospital plan you HAVE TO be admitted of medical aid wont pay a cent.

 

There is a rate, then there are rates.......and then there are RATES (.......the new secretary and ML Merc looks beeeatiefiiil).

 

Just a question.......private or state medical services?

 

Private.

 

My total bill was 27k, only 2.5k not covered by MA but I have GAP cover so they should cover that.

Surgeon was pretty much all covered by MA, Anaesth was pretty much 200% of MA rate.

So really not too bad, but they just charge for random stuff.

 

But at the end of the day they did a really good job and its the first time I haven't chucked my first meal after going under, So i'm just happy it will all be covered at the end of the day.

I would and probably will land up going back to them.

 

Can MA refuse to cover you if you keep on breaking yourself?

[PhilipV]

Funnily enough my anaesthetist must obviously not love money, as I had to actually phone and ask for a statement before the accounts lady sent it. "Oh, don't worry sir, you'll get it in the post." Ya, but I am moving in two weeks, and I still need to submit the bill to my med aid and to my gap cover. So the anaest will probably only get paid in about two weeks. Flip, if I work for someone they get an invoice the next day. and not by snail mail.

Oh and on, my life was in the hands of the surgeon and the Anaesthetist, so I don't bemoan them their cost.

my little ACL knee injury is running close to R60k before fysio and rehab. Luckily between my med aid and gap cover it wont cost me a cent (except for my premiums on both.)

Med aid and gap cover might be the devil industry, but I am really glad to have them both. And to have a really good broker.

[Konaman]

From my experience being part of the Health care industry i can only say 1 thing -

negotiate , negotiate and negotiate prices and charges.

 

If you don't then expect to pay maximum.

 

The healthcare professionals wait weeks and months to get paid by most medical aids, meanwhile the merc and holiday home needs to be paid for. Private and medical aid patients get charged levies or extra fees to keep the cash flow going.

 

If you have to have an operation, ask whether the anesthetist or surgeon or x-ray department or laboratory or even the hospital, is contracted in or out to medical aid fees BEFORE ANY SERVICE IS RENDERED.

 

If the anesthetist is contracted out, ask the surgeon to use another person or negotiate directly with the anesthetist before the procedure, to not have to pay above the medical aid rates.

 

If you are scared to speak to the doctor, then pay up and keep quiet. a Doctor is a person

like you and me and they will negotiate with you, if you state your reasons or financial situation to them,as it is.

 

Business is business today!!

[Delgado_073]

Ive also been to the "butchery " and my lower back operation cost over R310 000 and I'm still in pain somedays. Plus now have limited movement in one leg. I say these "knobs" PRACTICE medicine. So they haven't got it right , they still practicing .

 

Next Doctor or surgeon to see me will only charge me to certify me dead!

[igknot]

They are not taking us for a ride.

 

We are taking them for a ride. A ride in a luxury mobile of their choice to a luxury house..

[blondeonabike]

I had an op a year and a half ago… came in just under R200 000 for the whole thing… hospital fees, physio etc…

 

I did not have gap cover then… hence why I'm still riding my hand me down…

 

But on the bright side!! I'm a 150 percent health wise now!!

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