Author Topic: Comparing treatment with health insurance vs without  (Read 14356 times)

Offline mr_freezer

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Comparing treatment with health insurance vs without
« on: February 16, 2015, 06:49:00 PM »
Greetings,

This is a comparison that isn't completely apples to apples but very close. 

BACKGROUND: We just dumped our health insurance, going with an alternative to health insurance which I posted about.  We also have discovered, through a friend that there is a family cash clinic that opened up about an hour away from our house.  This is a comparison of our experience as a regular insurance customer vs finding the free market alternatives that we didn't know existed until opened our eyes and looked for them.

About a month ago, before we dumped our health insurance, one of our kids had a nasty cough that turned into bronchitis.  We did what we normally would, we called and got an appointment with our family doctor and she was able to see him right away, regular hours.  We got the medicine, spent about $170 at the doctor and $30 for the medicine, just under $200 total.  We like that doctor and we appreciate everything she's done for us over the last 5 years.  That clinic is 15 minutes away, so it is pretty convenient. 

Fast forward to 3 days ago.  A second child got an ear infection so this isn't apples to apples but it is close.  I just love the crud that is going around.  Part of our quest for an insurance alternative turned up this family clinic that accepts no insurance or government program patients, and business is cash (credit/bank cards accepted) only.  We thought we'd try them out so we did and got an appointment that very morning, saw a doctor who offered to let me see the infection through the scope and compare it to the healthy ear ($39), got the medicine right there at the clinic ($10)... $49 total.  They have a list of services and prices right there at the front desk, all affordable.  Its all up front and honest and I feel great about it.

I asked and they explained how these guys are doctors who left the local hospitals because of the whole mess, government, hospitals, pharmaceuticals and insurance companies all conspiring for control, $$$ and all the while losing connection with the patient and why they are there in the first place.

I highly recommend anyone to look into these types of clinics.  Maybe there are those out there that don't pass muster but this one gives me hope.  America, the place where free markets can still find a way to exist, even in healthcare...  God bless them!

Offline r_w

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Re: Comparing treatment with health insurance vs without
« Reply #1 on: February 16, 2015, 07:26:27 PM »
Similar experience here.

My doctor went cash only concierge style a couple years ago.  $20 visits-not copay, TOTAL.  I had a chunk of skin cancer removed and stitched up, $48, including biopsy.  A yearly subscription that is not that expensive and includes your yearly physical or checkup.

My son broke his hand over thanksgiving, it was $1800 (reduced insurance negotiated prices) for the ER to take 3 xrays and set it in a splint.  It cost $80 for the cast and removal from my Dr.  Plus $49 for an xray from the radiology clinic downstairs from the Dr.

We have been going in exactly the wrong direction and the only way I see to fix it is to go Galt.

Offline Nate

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Re: Comparing treatment with health insurance vs without
« Reply #2 on: February 16, 2015, 08:38:02 PM »
How did you find something like this in your area?  Word of mouth?  Yellow pages or Google?  This has me intrigued.

Offline Marinesg1012

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Re: Comparing treatment with health insurance vs without
« Reply #3 on: February 16, 2015, 09:21:24 PM »
what about the added cost of being fined under the "affordable health care act"

Offline alan123

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Re: Comparing treatment with health insurance vs without
« Reply #4 on: February 16, 2015, 09:26:34 PM »
They are setting up Clinics in some Target stores in my area. Not as cheap as the above though- around $75. And no broken bones, just simple things http://www.target.com/pharmacy/clinic-services  run by Kaiser Permanente in the So California area.

Offline Carl

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Re: Comparing treatment with health insurance vs without
« Reply #5 on: February 17, 2015, 01:02:24 AM »
I buy a lot of drugs,and while I had insurance I was happy to pay a $20 copay and walk out with a $48 medicine.....
I lost the insurance when I was set free of work obligations by my ex-boss....I now buy the SAME DRUG FOR $4 cash!!!!
And it is the same store!!!

Offline David in MN

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Re: Comparing treatment with health insurance vs without
« Reply #6 on: February 17, 2015, 06:20:17 AM »
Take this as legend...

I've heard the Amish get crazy low medical rates because they pay cash and negotiate.

Offline r_w

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Re: Comparing treatment with health insurance vs without
« Reply #7 on: February 17, 2015, 06:57:57 AM »
Partial legend. 

They also get reduced rate as goodwill/charity from some doctors, although that is much rarer these days. 

Corporate pricing structure and .gov reporting requirements have limited what most hospitals can do.

I know this because we are friends with several Amish and have taken them to the hospital on multiple occasions. 

Offline CKMe

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Re: Comparing treatment with health insurance vs without
« Reply #8 on: February 17, 2015, 07:42:03 AM »
 :popcorn:

Offline Carl

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Re: Comparing treatment with health insurance vs without
« Reply #9 on: February 17, 2015, 07:45:10 AM »
Every Dr and surgeon I asked in the past gave a cash price about 60% upon payment of bills....now they just must take IOU as all of my money is gone... :'(

Offline Caveat

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Re: Comparing treatment with health insurance vs without
« Reply #10 on: February 17, 2015, 08:11:57 AM »
 :knitting:

Offline mountainmoma

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Re: Comparing treatment with health insurance vs without
« Reply #11 on: February 17, 2015, 01:59:12 PM »
Maybe things are getting better. I havent had regular insurance alot in my life and actually I always had to pay MORE than insurance companies did -- should be illegal. They would say that the price was xxx, but that the insurance companies had a negotiated price of xx that they paid. Those of us without insurance had to pay the full rate of xxx.


Offline Cedar

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Re: Comparing treatment with health insurance vs without
« Reply #12 on: February 17, 2015, 02:02:27 PM »
I am paying out of pocket for a mere dental exam for SP. I cannot find anyone who takes our insurance and the insurance company is impossible to get ahold of to find out who will take it, so it will cost me $315 out of pocket for a dental exam and cleaning.

Cedar

Offline mnotlyon

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Re: Comparing treatment with health insurance vs without
« Reply #13 on: February 17, 2015, 02:10:09 PM »
what about the added cost of being fined under the "affordable health care act"

As of January 1st, my family is enrolled in a health sharing plan that has been grandfathered. It's not really "insurance" but we don't have to pay the obamacare fine either.

Offline mr_freezer

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Re: Comparing treatment with health insurance vs without
« Reply #14 on: February 17, 2015, 02:19:44 PM »
I found out about this place by word of mouth.  They have done zero advertising and searching on the internet for Cash Clinic (city, state), turned up nothing.  I assumed there was nothing around.  After talking to some people, I found out that this place existed.  My advice is for those who know of these places, post it where you can so that people know that they exist. 

The question about being fined by the government for not having insurance; we are now exempt from Obamacare.  That's right, my family is exempt from being fined because we discovered that there are exemptions built into the law that we qualify for.  We are on a program that you'd probably consider insurance but it isn't.  Personally, I think its better in many ways including the human factor.  We are Christians who lead healthy lives and we are going to church...  That led us to a Christian Healthcare cost sharing program (See the post on Health Insurance alternatives that a number of us have been posting to on this forum).  A number of members have contributed info and experiences with these types of groups.  There may be other exemptions out there, you just need to do the digging.  If you find some, please, please, please post to that thread. 

My research showed, much like Carl said, that hospitals give insurance companies 40%-60% discounts...  Now, you as a paying customer with a high deductible might think that because you have an insurance company, you get their discount but it sure doesn't look like that to me.  Looks to me like we pay "open/full rate" on our deductible and the insurance company gets their contract rate on their portion.  Thanks Insurance company...  If I'm wrong, I'll retract that but I don't think I am.

- MountainMoma: The first thing we did when we were looking at going without insurance was to call the hospital that we normally went to and found out that they had an 8% cash discount...  Not good enough.  Our healthcare sharing program negotiates for us for the big things (which are covered in our program) and this cash clinic may also be able to help us find larger care items at a great discount, which helps the entire sharing group.  These are doctors who have spent years developing relationships that they are using to benefit other care providers and their cash customers who all want to avoid the overpriced system that we are all too familiar with.  This is seriously like stepping into another dimension for me.  I'm slack jawed and dying to share with whomever I can.

Our healthcare cost sharing program doesn't have regular dental/vision care in the plan but it does give you access to some dental savings though I haven't gone over that yet to see what it amounts to...  If I were you, I'd shop around and see what there is the old fashioned way if you know you need something done.  I have an uncle who takes his family on vacation to Mexico when they need dental work done.  He says it pays for the vacation if they need something significant done...

Is there a place that we can post names and contact info for cash clinics on this site?  Something to help members find something in their area? 

Thank you all for your contributions.  I never cease to be amazed at what we in America are capable of.  Affordable healthcare in spite of all the regulations and onerous laws, you just need to work to find it. 

Offline mountainmoma

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Re: Comparing treatment with health insurance vs without
« Reply #15 on: February 17, 2015, 02:38:38 PM »
I am paying out of pocket for a mere dental exam for SP. I cannot find anyone who takes our insurance and the insurance company is impossible to get ahold of to find out who will take it, so it will cost me $315 out of pocket for a dental exam and cleaning.

Cedar

yes, this is the case here, for sure. I theoretically have insurance, dual medicare/medicaide -- there is a local insurance name for the medicaide part, but I never have an opportunity to use it, except for filling prescriptions and standard blood lab work. I just  paid out of pocket for the dental work I had to have done last week also. And, no doctor will take new medicare patients in this county, as far as we have seen. there are a few clinic type places. I pay out of pocket for a boutique doctor who doesnt take insurance, but she is expensive. If California succeeds in the "pilot" programs of making a one place HMO type plan for dual government program covereds, like me, it will be interesting, as HMO type plans do not like to fill prescriptions and lab work orders from out of network doctors.

When my youngest and I relocated briefly 5 years ago to another county, I worked hard on finding these resources, and went to the local dentist clinic in that county that served the medicaide type population (Western Dental, Santa Rosa). My young daughter was there with me when I had my teeth cleaned. She told me when we left, mom, dont ever make me go to a place like this....and, the cleaning wasnt anywhere near as thorough as I have ever had from a regular dentist, instead they said that they would recommend a "deep cleaning" that was an extra service that the insurance didnt cover and would be xx amount more.....this would have been part of the cleaning at a regular dentist.

While I have had various times in my life I was literally uninsured, this type of coverage,since doctors and dentists cant afford to take patients on it, doesnt feel much different.

Offline mountainmoma

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Re: Comparing treatment with health insurance vs without
« Reply #16 on: February 17, 2015, 02:52:45 PM »
The greater SanFrancisco Bay area has a very expensive cost of land/housing/business office rentals, so generally wont have inexpensive clinics.

After what I now know about health, materials used in dental work, etc... I dont think I would ever have this type of work done at a cheap place or out of country, I have way too many allergies and sensitivities. I am allergic to alot of materials commonly used for crowns, so I personally now knowing this is more common than many realize, would never skimp on the dental work. Getting these metals out of my system 10 years ago made me ALOT healthier, realy, I used to be much worse. Makes sense, I can no longer wear earings, etc... for years now too, so nickel and various other metals, yes and mercury..... I developed an allergy to the plastic bandaging/covering on a PIC line even back then. So, yeah, the dentist that put my gold crown back on last week is the only one I will use. Likely what he charged me was a realy good price too, since it was his work, just still expensive for me of course. The initially work was horribly expensive, at that time I was still on my ex's insurance and he covered a bunch of the rest we had to pay

Offline alan123

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Re: Comparing treatment with health insurance vs without
« Reply #17 on: February 17, 2015, 10:38:28 PM »
I work with many dentists as a dental tech. Call up a dental lab and ask who they would go to. They know who is expensive, who does shoddy work, who is great and they would send their mother to. Western Dental no no no! These types of clinics, the lab I work for, can not afford to work for. Corners would have to cut hard.

Offline r_w

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Re: Comparing treatment with health insurance vs without
« Reply #18 on: February 18, 2015, 06:25:51 AM »
This is why my wife and I have taken to studying Weston A. Price, Kennedy, and several other holistic and natural dental people.  Dental costs are going to break people before medical as obamacare gets into full swing.


Offline mountainmoma

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Re: Comparing treatment with health insurance vs without
« Reply #19 on: February 18, 2015, 09:47:25 AM »
This is why my wife and I have taken to studying Weston A. Price, Kennedy, and several other holistic and natural dental people.  Dental costs are going to break people before medical as obamacare gets into full swing.

Taking care of yourself is fantastic to learn and do. Realy good idea to learn to take care of your dental/medical needs.

The Affordable Care Act is NOT going to save us all as it gets into full swing. The ACA coverage is a race to the bottom as far as coverage goes. Seems like people do not pay attention to details, when it was being proposed/debated, alot of enthusiastic people were trying to tell me it would of course help people like myself with substandard coverage. I was paying attention and Knew better, what it sounded like, and indeed IS as rolled out, is ensuring that everyone has coverage as lousy as mine. So, lets make sure everyone has coverage like medicaide..... where the medicines you need arent on the list and there are no doctors who can afford to take it, so  you cant get a doctor. You would need something with unaffordable premiums like Gold or Platinum coverage to approach what standard medical plans through employers used to be.

Where this is heading is to keep going until we have medical clinics with standards of care comprable to the Western Dental dental clinics --


Offline GreatWhiteDan

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Re: Comparing treatment with health insurance vs without
« Reply #20 on: March 02, 2015, 08:48:05 AM »
I am a Pre-Sales design engineer for Contact Centers, and in that make good money, and our company has good healthcare.  That being said, i hate health insurance.  It is a true cost sink for us.  It costs me $7800 a year to get insurance through the company, and there is a $2500 deductible.  In the 15 years I have been paying for insurance I have never gone over a deductible.   So a few years ago, we moved to an HSA High deductible insurance.  We paid for our doctor visits and most of the time, they gave us a 50% discount for cash.  Due to the ACA, we lost the HSA and struggled which way to go. 

Just like earlier mention, we are Christians, and thus joined a Christian Health share.  It is really great.  We help pay for the groups needs and overall it is working out well.  We still pay cash and love doing that, and are exempt from the ACA.  I would recommend anyone else in the same faith to research this.  We are a part of Samaritan's Ministries.  They have enough members to cover everyone and in the 25+ years they have been open, have never fallen short of helping a family in need.

Also, find a local doctor who cares about your family and the community.  Our current doctor will allow us to trade bulk wheat from our farm, and chickens if needed for payment.  Not that we do that now (we just give him wheat that we grow) but that could be handy if times get rough for my family for some reason.

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Re: Comparing treatment with health insurance vs without
« Reply #21 on: March 02, 2015, 09:26:14 AM »
I'm not a fan of the ACA by any means, but self insurance only goes so far with the big stuff.  Rattlesnake antivenin is $2,000 a vial and a bite may require anywhere from 3-25 vials depending on severity and your reaction to the venom.  My ex-wife's breast cancer treatment, start to finish was around $75,000.  I remember them hanging just a single IV bag during her chemo and it was $3,000 for that one treatment alone and she got one of those every three weeks for three months and then switched to a different set of drugs for the last three months that were nearly as expensive.  One pill of the anti-nausea meds that she had to take was $150 and she had to take one a day for three days after each treatment.

Just one of many risks that seems to demand at least a major medical level of coverage.

Offline Carl

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Re: Comparing treatment with health insurance vs without
« Reply #22 on: March 02, 2015, 09:34:07 AM »
I'm not a fan of the ACA by any means, but self insurance only goes so far with the big stuff.  Rattlesnake antivenin is $2,000 a vial and a bite may require anywhere from 3-25 vials depending on severity and your reaction to the venom.  My ex-wife's breast cancer treatment, start to finish was around $75,000.  I remember them hanging just a single IV bag during her chemo and it was $3,000 for that one treatment alone and she got one of those every three weeks for three months and then switched to a different set of drugs for the last three months that were nearly as expensive.  One pill of the anti-nausea meds that she had to take was $150 and she had to take one a day for three days after each treatment.

Just one of many risks that seems to demand at least a major medical level of coverage.

I do understand. :'(

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Re: Comparing treatment with health insurance vs without
« Reply #23 on: March 02, 2015, 10:04:18 AM »
I do understand. :'(
I remember there was a brief moment of excitement when she realized that she had hit her major-medical ceiling and wouldn't have to pay anything else out of pocket the rest of the year.  That was before realizing just how many more months of that crap she would have to deal with.  Chemo sucks.  I've had a mere glimpse of what you're going through, Carl, and I wish you the very best.  As for her, well, in about two weeks she'll/we'll be having her celebration for 11 years cancer-free. 

Offline Carl

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Re: Comparing treatment with health insurance vs without
« Reply #24 on: March 02, 2015, 10:21:07 AM »
I was lucky,my chemo(poison actually) was only $10K per month for the pills and the radiation(actually cooking you from the inside) plus the surgery ,removing a good bit of my plumbing...have me to a point where DRs are stepping back to let the smoke clear and see if they "did it"...they do not yet know...I wait to see if I can say "cancer free" as your wife now does...the cure is HELL. I am glad to hear you wife is clear for so many years now.

To get back on track...the odds you will need major cost type medical are pretty sure,prepare as you are able.

Offline Smurf Hunter

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Re: Comparing treatment with health insurance vs without
« Reply #25 on: March 02, 2015, 11:44:23 AM »
Quote
One pill of the anti-nausea meds that she had to take was $150

Sounds like Zofran.

Offline 11steve11

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Re: Comparing treatment with health insurance vs without
« Reply #26 on: March 02, 2015, 11:48:43 AM »
When my wife and I were 1st married, I got sick and had no insurance (and no money). We called around to some clinics and found one that could see me for cash. The Dr saw me, grabbed some antibiotics out of the sample cabinet and $50 bucks later I was out the door.  Over the next 25 years we only bought catastrophic insurance at around $50 a month, developed cash relationships with Dr's, learned how to make medicines & take care of ourselves.  When four of us go to the Dr. now, we find them HAPPY to give us cash (or silver) prices just like others have found in this post.  In fact, we are finding Dr's are cutting back on their lifestyle or moonlighting or expanding their services to somehow not go backwards as a result of ACA.  We are finding it easier to find Drs taking cash, but it is much harder to find afordable health insurance.

Fortunately we have not had any pharmaceutical or catastrophic needs in 25years, if we had my opinion might be different.

Offline Carl

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Re: Comparing treatment with health insurance vs without
« Reply #27 on: March 02, 2015, 12:07:54 PM »
You don't mess with the ZOHAN!

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Re: Comparing treatment with health insurance vs without
« Reply #28 on: March 02, 2015, 01:33:35 PM »
Sounds like Zofran.
I can't recall, but looking at the price for Zofran, maybe.  I had no clue zofran was so damn expensive.  We give it out on the ambulance like it was candy when people have upset tummies from narcotics.  That's another flaw in the medical system.  Nobody who practices medicine has a clue what anything costs.  If doctors (and paramedics) knew the cost of some of these drugs, they might hesitate on giving them, inform patients, or look at alternatives.

Offline Smurf Hunter

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Re: Comparing treatment with health insurance vs without
« Reply #29 on: March 02, 2015, 01:57:28 PM »
I can't recall, but looking at the price for Zofran, maybe.  I had no clue zofran was so damn expensive.  We give it out on the ambulance like it was candy when people have upset tummies from narcotics.  That's another flaw in the medical system.  Nobody who practices medicine has a clue what anything costs.  If doctors (and paramedics) knew the cost of some of these drugs, they might hesitate on giving them, inform patients, or look at alternatives.

Twice, per the advice of our pediatrician, we've taken our daughter to the E.R. when she wouldn't break a fever and couldn't keep down fluids after 12 hours.
In one case she required a zofran and an IV to rehydrate her (something I'm not setup to give her), but the other time they gave her a tylenol and a popsicle.

Each visit cost around $500 and change.   :o