New Taxes / Fees on orders.....

[MnFish1]

I think I am kind of confusing the two. Yes the treatments and care have been fair, but the prices were pretty outrageous while uninsured. The amount I had to pay left a real sour taste in my mouth making me think less about the actual treatment and care I received. To your point, I haven't had a problem with receiving treatment and paying for care after I grew up and got health insurance lol.

Well part of the problem with the 'system' is that each hospital, pharmaceutical company, physicians office, etc etc etc. negotiates the price for a given product / service with each individual insurance company. For example For service X that the hostpical charges uninsured patients $Y, One insurance company may pay the hospital 50% of Y. Another insurance may have negotiated to pay 30% of Y. Thus the cost to the insurance company is less than that for uninsured patients. Its interesting that some insurance companies may pay Y PLUS some percent - so that leads the hospital to set the bill higher than all of the insurance companies have agreed to pay - so they send out one bill to every company for Y - but may get paid hundreds of different amounts depending on what they negotiated with the different companies. The end result is that the uninsured person gets billed more - and often the hospital will cut the bill if asked.

 

[Opus]

Well part of the problem with the 'system' is that each hospital, pharmaceutical company, physicians office, etc etc etc. negotiates the price for a given product / service with each individual insurance company. For example For service X that the hostpical charges uninsured patients $Y, One insurance company may pay the hospital 50% of Y. Another insurance may have negotiated to pay 30% of Y. Thus the cost to the insurance company is less than that for uninsured patients. Its interesting that some insurance companies may pay Y PLUS some percent - so that leads the hospital to set the bill higher than all of the insurance companies have agreed to pay - so they send out one bill to every company for Y - but may get paid hundreds of different amounts depending on what they negotiated with the different companies. The end result is that the uninsured person gets billed more - and often the hospital will cut the bill if asked.

Here is a good article on how the insurance company isn't on your side as many think they are.

https://www.cnbc.com/2018/05/30/why-your-health-insurer-doesnt-care-about-your-big-bills.html

 

[Potatohead]

Cheaper / free shipping in US as preferred reefer, compared to international shipping. As well when I transport it across the border there is no brokerage fees, as I am the one bringing it over.
If you ship stuff you pay duty/tax and brokerage. Most times border guards ask what I am bringing and value, as I said always up front with receipt in hand. More often than not, they wave me thru.
BRS has great pricing and service, but as you know this hobby ain’t cheap. If I can save a buck here and there I will.

Not to mention most of the time cheaper prices for the actual goods. I find some big ticket items are pretty close but for example, Hanna alk checker reagents are $16 locally. BRS is $8 (under $11 CAD) shipped, so I usually buy four or five at a time.

I do absolutely agree however paying an extra 10% is going to kill a large amount of BRS purchases for me.

 

[Potatohead]

Also as stated earlier, while our health care system is far from perfect, if you have a legit problem that could manifest itself into something much worse, you are taken care of, pronto.

Two years ago I noticed a freckle on my wife's temple was darkening. About ten days later she went to a dermatologist who cut out a piece for a biopsy. A few days later, melanoma confirmed. Then within a few days she was with a plastic surgeon getting it cut out. Then another biopsy to confirm they got it all. Prescription drugs involved after for a while. Since then she has gone to a dermatologist three times a year (so six or seven times now) and will continue to go every six months for another two or so years, and once a year after that assuming no more problems. Cost for all of this outside of normal taxes, absolutely nothing.

 

[MnFish1]

Here is a good article on how the insurance company isn't on your side as many think they are.

https://www.cnbc.com/2018/05/30/why-your-health-insurer-doesnt-care-about-your-big-bills.html

The key to that article - is that the guy is complaining that his surgery cost 3 times 'medicare rates' or the rate the hospital paid to Medicare. Im sure thats true. Some things that are billed are reimbursed 10 x what is allowed by Medicare. Part of that money goes to profit for the insurance company but a great part of it goes to maintaining the quality of care (private rooms, etc) that people in the US are accustomed to - etc. This is the fallacy of 'medicare for all' - at least in part. If hospitals and physicians were only paid at medicare rates, either there would be a much lower standard of care, rationing, or other unintended consequences such as those seen in countries with 'socialized' healthcare (and in which people with the money buy PRIVATE insurance).

Im sorry - I see very little difference between the end result in the US and other countries, except that overall for most people the care is prompt, as good or better and easily accessible. Healthcare in Europe, for example is 'expensive' due to taxes. Healthcare in the US is expensive due to insurance (and profits).

Here is an interesting thought. At least in the US - if you buy insurance and dont use it - (or your employer offers it as a benefit) and you aren't sick - you dont pay any more for your healthcare. In Canada and Europe - everyone pays high taxes - whether they are sick or not. Certainly - its good for society to provide for 'everyone' - but really its the same here - the people that dont use their insurance are subsidizing those that do. And everyone with Private insurance is subsidizing Medicare - because the overall quality in our hospitals is higher due to the amounts reimbursed by private insurance.

As to America spending more than other countries per capita - with the same quality outcomes (depending on what those outcomes are) - it depends on the study. If they were looking at the outcomes of people with Stage 4 lung cancer, Im sure the US would spend more per person - because the US allows people access to expensive drugs - that may or may not be available due to 'rationing' elsewhere. Likewise - sicker patients tend to be treated more aggressively in the US as compared to other countries - leading to higher costs/person.

Here is another interesting article. I don't know the political leanings of the authors - but most of it seems to be sourced from ABC.
https://www.economist.com/democracy-in-america/2010/03/05/are-health-insurers-making-huge-profits

 

[Opus]

Sorry, didn't want to take up a lot of room with quoting you MnFish1. I personally don't really know how I lean. I go back and forth on the issue. I just know our current way is very inefficient and it is making a lot of insurance people rich. I can see the guys issues. My daughter had a hole in her eardrum when she was younger. ENT wanted to do surgery to plug the hole so he setup the surgery at the hospital next to his practice and they were in our network. Before the hospital would even let the surgery begin we had to pay our percentage we would owe for the surgery. The surgery took around an hour and she was in recovery for 2 hours. They pilled insurance $30k for the recovery room and based on our percentages we were due a refund of a couple of hundred dollars from the initial payment they had required. I called them and they said they would send us a refund. After several weeks and no refund I called them back. They said they "found" some more charges and had billed insurance and they paid it so we would not be getting a refund. Fast forward a year or so and my daughter still had a hole in her ear. Our ENT sent us to a specialist who set us up surgery at a different hospital. This time she was there for around 8 hours and that hospital only charged $10k for the entire day. If we had been at the previous hospital they would have charged around $80k. Also, as the article pointed out, the insurance company really isn't out anything when you get your insurance thru your employer and they are self insured. Your company is actually paying the medical costs and the insurance is just billing them an admin fee. That is why another middle man has popped up to try and make sure the insurance company is not over billing. So now there are 2 middle men between you and the medical provider.

 

[jduong916]

Well part of the problem with the 'system' is that each hospital, pharmaceutical company, physicians office, etc etc etc. negotiates the price for a given product / service with each individual insurance company. For example For service X that the hostpical charges uninsured patients $Y, One insurance company may pay the hospital 50% of Y. Another insurance may have negotiated to pay 30% of Y. Thus the cost to the insurance company is less than that for uninsured patients. Its interesting that some insurance companies may pay Y PLUS some percent - so that leads the hospital to set the bill higher than all of the insurance companies have agreed to pay - so they send out one bill to every company for Y - but may get paid hundreds of different amounts depending on what they negotiated with the different companies. The end result is that the uninsured person gets billed more - and often the hospital will cut the bill if asked.

I wish I would have known to call and complain, ahh you live and learn.

 

[Opus]

Many years ago I used to be on the external audit team that did a large local hospital system. If I remember correctly, they wrote off around 40% of their receivables each year as bad debt. For some reason they would get out so state women come there for premature pregnancy deliveries and they wouldn't have any insurance. Their babies would stay in NICU for a month or two and have bills for several hundred thousand that the hospital would then have to write off. They have to get that money from somewhere so billing the insured patients more is the only way.

 

[Opus]

We sure got this thread off topic!

Has anyone noticed anyone charging online sales tax that didn't before the court ruling? Most of the places I order from already had a presence in my state so I was getting charged sales tax before this all came down. I guess Newegg is the only place I've ordered from recently and I didn't get charged sales tax.

 

[MnFish1]

We sure got this thread off topic!

Has anyone noticed anyone charging online sales tax that didn't before the court ruling? Most of the places I order from already had a presence in my state so I was getting charged sales tax before this all came down. I guess Newegg is the only place I've ordered from recently and I didn't get charged sales tax.

They only charge if the state you live in mandates that they do. Like Washington. At least I think

 

[Bulk Reef Supply]

Not to mention most of the time cheaper prices for the actual goods. I find some big ticket items are pretty close but for example, Hanna alk checker reagents are $16 locally. BRS is $8 (under $11 CAD) shipped, so I usually buy four or five at a time.

I do absolutely agree however paying an extra 10% is going to kill a large amount of BRS purchases for me.

Honest question: If all online sellers have to comply with sales tax, and you have to pay sales tax are your local store, where will you purchase your supplies?

 

[Potatohead]

Honest question: If all online sellers have to comply with sales tax, and you have to pay sales tax are your local store, where will you purchase your supplies?

Most likely just stick with local in that case. It takes me about 60-75 mins round trip to go pick stuff up at the freight place in Blaine, WA. If I'm not saving at least about $50 it's not really worth it. If I have to pay WA tax (10%) and then also tax coming back home (12%) the value goes away real fast.

Also not everyone is charging the WA tax as of now but I realize they probably will be soon.

 

[Bulk Reef Supply]

Most likely just stick with local in that case. It takes me about 60-75 mins round trip to go pick stuff up at the freight place in Blaine, WA. If I'm not saving at least about $50 it's not really worth it. If I have to pay WA tax (10%) and then also tax coming back home (12%) the value goes away real fast.

Also not everyone is charging the WA tax as of now but I realize they probably will be soon.

Yes, I believe many stores are working on solutions and that will be the world we live in. It is unfortunate.

 

[Potatohead]

Yes, I believe many stores are working on solutions and that will be the world we live in. It is unfortunate.

As an example, I just purchased some 24" ATI Blue Plus from you because my local store has had them on backorder for a while for some reason and I was ordering the previously mentioned Hanna alk reagents from you anyway.

$19.95, plus 10% WA tax is $21.95, then x 1.32 USD to CAD conversion = $28.97, then local tax is another 12% making it $32.45. Also each package at the freight place is $4. Now granted depending on the value of goods I bring across I only get charged the local tax maybe 1/3 of the time. Locally that same bulb is $25.95 + 12% which is $29.06.

Now this is obviously liquid depending on exchange rate and this is all totally out of your control. There are also some things as someone stated earlier we just cannot get up here without great difficulty.

 

[davejep]

Honest question: If all online sellers have to comply with sales tax, and you have to pay sales tax are your local store, where will you purchase your supplies?

Honest answer.
#1 - Where I can get the best price.
Like above savings has to be worth the trip
#2 - Who is the easiest to deal with in regards to returns or warranty.

 

[Rispa]

I purchase a lot of my stuff locally because it's convenient. The tricky part for me is where will I purchase livestock from.

As for Medicare something that hasn't been mentioned is that the government sets the prices, but the market. What this means is that it is possible for a doctor or hospital to lose money paying those prices.

 

[alton]

Honest question: If all online sellers have to comply with sales tax, and you have to pay sales tax are your local store, where will you purchase your supplies?

For specialty items over a certain dollar amount I will still use BRS. But in saying that, two of my three LFS carry your products so most times it is easier just to stop by and pick them up to avoid paying shipping.

 

[squampton]

I purchase almost everything locally, as they are also one of the main internet based sellers in Canada as well, their prices tend to be very competitive, so may as well buy local whenever possible.

I have never taken sales tax into consideration when ordering online.

 

[KJa]

I try to purchase locally but where I live it's hard to find a lot of supplies so mail order tends to be a better option...even with sales tax.

 

[Xclusive Reef]

this sales tax really sucks. I now have to look for other options.. BRS should increase the points then to compensate for the taxes.