doctors bills/medical aid

[murdock]

medical aid...or not...i have not had medical aid for about 10 years...but my wife insisted that i take out medical aid in case i have an accident at work or end up in hospital from a heart attack...so i got one...so i go to the dentist to have my teeth fix...no can do...the cost to repair my teeth is around R18000.00...so i cannot do it.

i go to hospital because i get hit in the face and need stitches...but i have to pay because the medical aid savings is finished...i am still battling to understand why i took out medical aid...before i would go to the doc tell him i was not on medical aid...pay half the price or go to macords hospital pay R14 including my medicine.

but this is what really blew my mind...i was working at one of the hospitals the other day and was watching the people waiting to go into theatre for operations...i was listening to one of the patients begging the annethatist to give him a better rate or should i say to do the work at medical aid rate...he made a comment which i didnt hear but what i did hear was the guy had to sell stuff to foot the balance of the bill which the medical aid would not cover...anyway i get home and tell my wife about it and she tells me it is normal and we will have to do the same thing when she goes in for the babies birth.

i am sure the last thing you want to do when waiting like cattle for the slaughter outside the theatre is negotiate the rate they will be charging you...can i sue for a refund from the anethatist because the last operation i had i woke up on the operating table...they had to inject me 3 times to try calm me and get me back on the operating table...luckily my arm was strapped on because they had cut open my elbow to remove pieces of bone...i can clearly remember seeing the skin pulled over my elbow and the bones exposed...the nurse was saying you cannot give him anymore you will kill him...as they battled to hold me down...when i woke up from that operation i was in so much pain i had to be injected for pain for 2 days before the pain stopped and i was told i would never have the use of my right arm again ever...where are our rights as patients.

[Dave A]

You've opened a mine of issues, Murdock.

First, I reckon medical aids are commercial enterprises which trade for profit. If you put the money away (invest it), you'll be well ahead of the game - even after all "tax advantages" of going the medical aid route. The problem is we don't put our money away as we should.

Next, the medical aids are raped silly in so many ways, rates on genuine claims being only one of them.

[murdock]

my daughter got ill at 3 months old and to cut a long story short...the doctor almost killed her...i was advised by a nurse in ICU after 19 days and being told she only had a few days left so i should prepare myself...i decided to get a second opinion and a new doctor took over she was out of ICU in 3 days and is now 17 years old...i was sued for R79000.00 in doctors fees forced to pay as i did not have the finacial backing to take the doctor to court.

the doctor would have killed my daughter and i wouldnt have known the wiser if i was not told by the nurse to get second opinion...and there would have been nothing i could do.

[Chatmaster]

I seriously believe the real problem here lies with the medical profession and greed. The hospitals and the doctors are largely to blame for the costs that are sky-rocketing. Seriously, paying a specialist more than R900 an appointment just doesn't make sense! Having to take your kids to the doctor 3 or 4 times for the same silly flu also doesn't make sense. Going to the dentist for 7 appointments to have 3 teeth fixed also doesn't make sense. The medical profession has become a major money spinner, a money factory that are being tapped to the bone. Hospitals are totally crazy with their prices not to mention the pharmaceutical companies! There is another problem, lack of "competition" caused by the doctors leaving the country. This creates a scenario that is easy to take advantage of.

I personally have a hospital plan that is it, to pay over 4k for a medical aid that is kaput by June is crazy enough, so I just make provision in my budget for the greedy doctors appointments each month and do not touch it throughout the year even if it is unused.

[daveob]

and the doctors are all still PRACTICING -- on you.

[IanF]

I personally have a hospital plan that is it, to pay over 4k for a medical aid that is kaput by June is crazy enough, so I just make provision in my budget for the greedy doctors appointments each month and do not touch it throughout the year even if it is unused.

Roelof
I agree with and also have a hospital plan. After dealing incompetent claims clerks it is easier and less frustrating that way, plus you have disaster insurance.

[murdock]

this is why we are called patients...we had an appointment to a scan and to see the doctor...at 11.30 we arrive at 11.20...in for the scan by 11.30...11.40 we finished the scan and i must say the lady who did the scan was very helpfull and seemed to know what she was talking about...11.45 in the doctors room...12.15 we told to go have coffee down stairs the doctor will be unavailable until after 13.00...13.00 back in the waiting room 14.00 get to see the doctor 14.10 finished with the doctor...and paid R300 cash before we leave...not medical rate and the savings is depleted so we have to pay cash for the visit...the fella looking for some type of investment in the other thread sudy to become a doctor...60 divided by 10 minutes...thats 6 patients an hour x 300 =R1800 p/hr x 8 hrs=R14400.00 per day x 5 days =R72000.00 per week x 4.33 = R311760.00 per month....Flip i could pay my house off in 2 months...and that not including surgery i would hate to know what a surgeon earns a month to top it all you sign an imdemnity to say if they kill you or make a mistake they are not liable...and the thing that piss*s me off is they bitch when i change them R350.00 an hour to drive to their house in my vehicle at my cost petrol...maintenace... risk of being on the road...hijackings...climb around in the roof which is around 50 degrees in summer sweat my butt off...and them wait 3 months for payment...i should have become a doctor.

[Dave A]

...and all this before we touch on costs without proper cause - like people buying sunglasses and make-up at the pharmacist and putting it on the medical aid.

[Morticia]

How about the "diagnose by numbers / my name is Earl (crossing of the list)" exercise I'm currently experiencing - have been in xtreme pain for last +-2 weeks - have now had every imaginable scan/scope/x-ray/blood/urine/whatever test under the sun performed and my doctor looks "pleasantly suprised" to say the least every time I return with yet another array of test results (negative I'll have you know!! so I suppose I need to be thankful for small mercies) but still the same complaint. A money-making gimmick or a not-so-clued-up doc????

[duncan drennan]

After dealing incompetent claims clerks it is easier and less frustrating that way, plus you have disaster insurance.

I have also gone this route and put my "medical savings" into my bond each month (and keep track of it).

The major problem that I have with medical aids is all the stuff that you would expect to be covered by your hospital plan, but isn't actually (depends on medical aid). For example, trips to the ER are not covered (with Discovery). If you don't get allocated a hospital bed then you have to pay everything out of your own pocket. Also, you often have to put down large deposits before they will even check you into hospital to cover all the extra expenses (above the medical aid rates).

I often wonder if all the money that gets ploughed into private health care would be better invested in our public system.

[Dave A]

How about the "diagnose by numbers / my name is Earl (crossing of the list)" exercise I'm currently experiencing

When it comes to dealing with anything that is less than clearly obvious, I prefer my doctors to be 50 years and older

[Christob]

Well let me open myself here for a lot of criticism here and try and give some clarity on the private healthcare industry in South Africa.
Medical aids are not for profit organizations but the companies managing them (administrators) are not. So they do make money out of the system.

Lets compare the SA system with the UK where healthcare is free. Waiting time to see a GP 3 weeks - here you make an appointment and see the doc the next day. Waiting time to see a specialist is 3 months and lets for instance say that your Gran needs a hip replacement then you wait 18 months - and no I am not talking rubbish this is the average waiting times in the UK. So lets compare access to healthcare with the UK!?!?!?!?

In America a Ceasar for the wife to deliver a baby will cost you $17000 US, Compare that to more or less the same cost in rands here and so you will understand the difference.

Private healthcare in South Africa is relatively cheap and reliable and no doctor can guarantee that he will fix the problem it is impossible!!! Nowhere in the world...

My suggestion is to stay on medical aid or a hospital plan - when you need it and its not there its too late...!!!

[Graeme]

Not always bad

What you guys have gone through sounds like a series of nightmares! I belong to Key Health and have had none of these problems - they have paid for two operations for my wife recently and they paid in full for hospital (Entabeni), surgeon, anaethetist, drugs etc without the slightest hassle, they pay for expensive medicine for cronic condidions in full, no hassle with dentistry if within pretty generous prescribed limits - the only time I have had to pay for myself is for recent visits to our GP for which they allow so much per annum. I think you chaps should look around and find yourselves decent medical schemes; there are plenty of them - ask to see their schedule of benefits before joining. The only negotiating I had to do was with the Anaethetist, who readily agreed to charge medical aid rates - but the time to do that is a day or two before the operation, not whilst waiting to go in to the theatre! Most medical schemes have a hospitals pre-admission routine; i.e. you warn them beforehand, even if this is on admission (if an emergency) - you ignore that rule at your peril.

[Alta Murray]

I have been through some tough medical bill calls lately, and I have always meant to read this thread:

Yes, I agree with Dave that if we start with our own savings we can end up ahead of the game, but it is such a huge risk Dave that I can feel my knees knocking. The same goes with normal insurance.

A bed in ICU on a ventilator costs you R 12 000.00 per day. That is not including the blood tests, dr's fees, medicine,x-rays etc. And after having been a frequenst visitor in the ICU with both my parents, I can tell you that age is not a defining factor, it can happen to any one of us any day. I got a bit nervous when the hospital bill got to R700 000.00 and there was still no improvement with my father, it puts you under tremendous pressure as you are faced with a loved one's suffering and the financial implications.

I had to pay off a lot of bills, and starting with my mother, who died after 6 weeks in the ICU, I couldn't believe the cost left over after the medical aid had paid their bit. I was upfront with all the service providers -- I would honour the debts and arranged for payment plans -- everyone one was so helpful, I got discounts and as I type I am still paying off on an a stent at the local private hospital in 12 manageable amounts.

Trick is you have to know your rights, I would have been left with a private fund minus 1/2 a mill, if I did not know what rights I were entitled to. The best thing I have ever done was to appoint a lawyer for my father, it was a cost and a life safer. She only ever advised me on what to do, and made one call to the hospital. Her fee compared to what she saved us, was a mere pittance. Check your rights on the Internet!

I have also found the advocate at the Health Department very helpful, he helped me so much, but I will still rather go to a private hospital. The State ICU's are top notch but the general wards are too scary for me.

Do have a medical aid, but compare the different options, I am on Discovery and I am very happy.

To take a doctor to court, oh please don't even bother, that is why my son hates the medical students and we are told there has always been bad blood between the two faculties. I had a ceaserian where the dr botched up bad, I could actually feel him cutting and opening the incision on one side, and he had his mistress, who didn't work at the hospital, with him, so the poor man was in a hurry. I felt every single thing on my left hand side, and I was the second patient this had happened to. The pos. outcome was that I was out of the hospital in a jiffy, recovery time speedy I was asked by the hospital if I would like to sue the dr, as they were going to take steps against him, but I wasn't interested at all.

But i also know a lot of dr's who are fantastic, and have stood by me as I dealt with my parents, so it isn't all bad. Check the rates out before you go see a specialist, many dr's opt for medical aid tarrifs, and there is no differentiation between the level of expertise you will receive.

[Alta Murray]

Oh, and if you are not happy with the first treatment, go for a second opinion. Medicine is not an exact science! I go to a GP who has a more holistic view of medicine, so even after being traumitized after both my parents, he told me to take some healthy exercise and stop feeling sorry for myself, he didn't put me on medicine, and his answer to flu and colds -- Viral Choice which works a charm.

Got sick in Scotland and was very impressed with their treatment, and it was for free!