Health Insurance?

[XXX-er]

In loonies? That’s not much. Entry level wage in USA.

Don’t mistake my concise view of the marketplace with lack of compassion. Shoulda, woulda, and coulda is a fools errand.

I believe in a two tiered system like Hong Kong. A private and a public option.

225k is just the average for a GP, a specialist can make way more $, they all seem to live pretty good can afford to buy the tweed jackets with elbow patches and DPS skis but I could see how it wouldn't be enough if you live in America and have to pay for HC insurance eh?

I think they should let any MD who wants to setup a private clinic and bill the medical system do so to get rid of backlogs

edit: don't forget those MDs could easily hop the border write the boards and practise in America where they could make the buckets of money if they chose to OR ... just send in them bills to the Canadian gov

[4matic]

My medical costs and insurance could be cut in half if I moved an hour towards denver. But who the fuck wants to do that. That sounds like misery to me. If you've never been to the vail valley surgery center, well that's the gold standard. I'd rather walk into what looks like a hotel for some work than some industrial looking surgery center.

St Anthony's Summit in Frisco is the bomb too.

[TheSilverSurfer]

Hey after you have been bitching about how it is going to break, and doesn't work, you gotta make sure it breaks so everyone can see how right you are. The shameful part of it is, the ACA was basically the republican plan for years, and then it finally got implemented by a democrat, so now it is the devil. They never had a better plan, they were the dog that never thought it would catch the car, well now they did, and they have NO plan to improve care for people whatsoever. They have to break it to keep their year after year after year promises, and when their voters see their bad healthcare get even worse, Fox news will spin it so the dumb people never know what happened. Down is up. I get so pissed off thinking about this stuff.

Even with the fucking tax cut, eliminate the mandate, drive up healthcare costs that will eat up everyone's tax cut, meanwhile the rich carry the money bags away and put it on the fucking credit card. GRRRRRRR!

Exactly. It boils my fucking blood to think about it.

Austin is exactly the kind of voter they love. Getting shit on by the system and blames it on the safety net and the people doing worse off than he is, rather than on the thieves that he helped put in office.

[Viva]

Capitalism has victims. Necessity.

No; corruption has victims.

Sent from my XT1650 using TGR Forums mobile app

[ghosthop]

No; corruption has victims.

no, capitalism. It is inherent to the system. We only label it corruption when we assume a profiteer's motivations are antithetical to our own values. But to deny that capitalism fundamentally exploits worker's economic capital is to see things through rose-colored glasses.

[huckbucket]

no, capitalism. It is inherent to the system. We only label it corruption when we assume a profiteer's motivations are antithetical to our own values. But to deny that capitalism fundamentally exploits worker's economic capital is to see things through rose-colored glasses.

I get your point, but the things that most often make blood boil are the dubious legal aspects of capitalism that are bought and paid for by huge amounts of money.

[4matic]

Unfettered capitalism is like the world series of poker. Eventually there is one winner take all.

[TheSilverSurfer]

And right now that winter is Jeff bezos. Unfortunately I can't kick my Amazon habit.

[huckbucket]

And right now that winter is Jeff bezos. Unfortunately I can't kick my Amazon habit.

Hundred Bil. Whatcha gonna do with that kinda cash?

[jono]

2 things: are insurance companies actually mandated to pay out a percentage of their gross income as claims specifically, or are they just obligated not to have more than 15% left over as profit after paying claims and other costs to all service providers? Because I see a major loophole that is being exploited (increasingly as ACA implementation has matured): the insurance company has a parent company and a sister company (both wholly owned subsidiaries of the parent). The insurance company contracts with the sister to, say, write up claim denials for a fee. The sister employs "doctors" and "nurses" for this purpose. People who got their degrees but maybe aren't allowed a license since their pill factory got shut down. The sister is very profitable, because they are very efficient: they use form letters that get robosigned and crank out the denials at top speed. The parent company is very profitable because the sister kicks up all profits. The insurance company charges more each year because they just can't seem to get their costs under control, what with that sister charging half the premium costs every year.

The first year that profits were capped we got a refund at year end. That was when premiums were 1/8th of now. Never seen another refund since, but I have had the privilege of speaking with the pit bull my insurer's sister co. hires to make sure no one speaks with the claim deniers, which was nice: at least she confirmed the financial arrangement: "we're all Asuris."

Also. Capitalism is the worship of capital. It's right there in the name. The big lie is that capitalism is somehow tied to the free market which is the longstanding American approach. Free markets require competition. The greatest goal of the capitalist is monopoly. The only thing these two have in common is that profit is the goal of all participants, but there's profits and there's profits. Economic profits through barriers to entry are net negative and it may not be corruption in the private sector but it sure depends on some corruption in the public sector.

[Cono Este]

I’m afraid capitalism is less than ideal in healthcare. There are many forces at work to ensure insurance company executives, doctors, hospital execs, big pharmaceutical and even medical schools reap as much profit from us as they can.

It is a huge subject that can not be resolved easily. Personally one of the biggest problems I find in my job is the lack of physicians.

A couple weeks ago I called on behalf of a couple who have been seeing their doctor for 40 yrs in a small town. he doesn’t accept medicare or any medicare plan. He will submit the claim, the money gets sent to you, and then you send it to him with the additional amount he charges. Then you also have to submit the claim separately to your supplemental carrier. How fucking back logged do you have to be to be such a greedy asshole?

I can’t wait to call them back jan 3rd to tell them their wonderful town doctor does not give a shit about their poor asses and they have to find a new one.

“We helped start his practice” they said.

[XXX-er]

I’m afraid capitalism is less than ideal in healthcare. There are many forces at work to ensure insurance company executives, doctors, hospital execs, big pharmaceutical and even medical schools reap as much profit from us as they can.

It is a huge subject that can not be resolved easily. Personally one of the biggest problems I find in my job is the lack of physicians.

A couple weeks ago I called on behalf of a couple who have been seeing their doctor for 40 yrs in a small town. he doesn’t accept medicare or any medicare plan. He will submit the claim, the money gets sent to you, and then you send it to him with the additional amount he charges. Then you also have to submit the claim separately to your supplemental carrier. How fucking back logged do you have to be to be such a greedy asshole?

I can’t wait to call them back jan 3rd to tell them their wonderful town doctor does not give a shit about their poor asses and they have to find a new one.

“We helped start his practice” they said.

I've been told its easily 2 hrs out of an American MD's day trying to get stuff thru the insurance system so maybe Doc ^^ doesnt wana deal with insurance companies and who can blame him?

up here we are also running out of MDs, the old style MD would work 50-60-70 hrs whatever it took but they are getting pretty old & retiring so the new MD's don't wana work those stupid hrs, also med school grads are 50% female so they wana have a couple of kids work 1/2 time at least to start

In my town if it were'nt for the south africans I don't know where we would be

[Cono Este]

First, I’m talking about medicare, probably the easiest to bill and get things approved. That’s why I chose that example. But I also stated the doctor WILL bill medicare, but that in order extract more $ he officially does not accept what we call medicare assignment I.e the approved rate. So to be able to bill a higher rate, he does it that way. But even if it were Obamacare, the point remains the same. Nothing we do will help with a shortage of doctors and the good one flipping everyone the bird.

Second, when you are in a business where you can eliminate paperwork, or other non productive tasks, and pass it along to your customers, and those customers are told to live with it, or take a hike, AND you can bill more, then I’d say you’ve got the world by the balls.

And that’s fine, but don’t walk around like some kind high priest, or ask people to address you as Dr Douche, and act like we owe something because your just another greedy capitalist now.

[XXX-er]

I forget why but ALL the PT's up here opted out of anything to do with the gov ... pay up front and submit it your self

If a guy is so busy cuz there are no doctors he can fuck with paper for an extra 2 hrs OR he can spend the time practicing medicine and let the customer do the paper work what do you think he is gona do ?


but in any case ... why do you hate america?

[Dantheman]

+1 to Danno. The idea that you can live high on the hog on government handouts in this country is pure right wing propaganda.

Another +1 to basinbeater. Nailed it.

Regarding capitalism and free markets, the idea that "market solutions" can fix healthcare is absurd. Functioning free markets require three things; something resembling perfect competition, transparent pricing with easy substitution between competing goods/services, and consumers making rational decisions based on said transparent pricing. None of those conditions remotely exist in health care or health insurance.

Regarding universal health care and "fat fucks", I've read that the unhealthy actually save the system money. The guy who eats like shit, smokes, never exercises and drops dead at 60 has far lower lifetime HC costs than a healthy person who lives to 95.

[Cono Este]

Exactly. So when people complain about Obamacare failing, let’s not forget the doctors and hospitals that dropped it. In St. Louis, the entire mercy network dropped it 2 yrs ago. Because they can.

I hate doctors probably the most because I was married to a spoilt daughter of one. Best comment ever was when we moved back to my hometown of San Mateo Ca, from Chicago, her parents complained of the fuel stop they had to make in their twin baron. Fucking classic, but not as good as them complaining about their cardiologist who had a pressurized king air and could beat them to the caymans.

[huckbucket]

Regarding universal health care and "fat fucks", I've read that the unhealthy actually save the system money. The guy who eats like shit, smokes, never exercises and drops dead at 60 has far lower lifetime HC costs than a healthy person who lives to 95.

Misconception ... see the linked below. Summary on slide 24

https://www.brookings.edu/wp-content...tion-v6-RM.pdf

Then again, this might be leftist #fakenews, Brookings Institute and all.

[mecc69]

In the last 5 years I've been on a PPO provided by the Feds (multiple plan options), Medicaid expansion and now an employer provided HDHP coupled with an HRA.

Medicare was by far the easiest to deal with as a user. Not pre-approved? Not covered without hoop jumping. Fed provided PPO was excellent coverage with low out of pocket costs. Current HDHP/HRA arrangement is a pain in ass. I'd frankly rather be on Medicaid expansion.

Edit: Healthcare being fucked along with the apparent inability to invest in the future of this county for the benefit of all (ie - the "general welfare") rank in the top 3 reasons to consider moving to a 1st world country with better social mobility, equality, etc. if you have the skills and means.

Austin - No one on this board would trade places with someone living on government assistance. If you have a kid, a little reading around will dissuade you even more RE: social mobility.

[Cono Este]

Regarding capitalism and free markets, the idea that "market solutions" can fix healthcare is absurd. Functioning free markets require three things; something resembling perfect competition, transparent pricing with easy substitution between competing goods/services, and consumers making rational decisions based on said transparent pricing. None of those conditions remotely exist in health care or health insurance. 95.

100%

[jono]

Cono, don't conflate greed with capitalism; both exist independently. Thanks for mentioning your bias, your posts make more sense now. Without that it's hard to imagine XXXer having to explain basic efficiencies so many times. Surely you know how you get paid for calling on behalf of the patients you quoted, right?

DTM, I agree that we don't have the right conditions for a purely competitive market to exist in health care. On the other hand, given the dysfunction in health care, that is not so much an indictment of competitive markets as an indictment of health care as an example of what goes wrong when those conditions aren't present (whether the market is otherwise "free" or not). Rational decision making would always be a challenge in health care and the asymmetric nature of transactions seems pretty unavoidable, so I'm certainly not trying to advocate for some unregulated market or the like. I was simply stating that the broad part of those who think they support capitalism as a "system" have been duped into thinking the worship of capital is somehow fundamental to free markets when in fact the presence of capitalism is a disqualifier since pure competition requires equal access to capital (or at least no advantage to be gained by differences in access). Capitalism is anathema to a free market. 4matic's statements and a number of the other indictments of capitalism in this thread are accurate and ugly, but Americans are still defending capitalism because they're confused about what it means.

[liv2ski]

Regarding capitalism and free markets, the idea that "market solutions" can fix healthcare is absurd. Functioning free markets require three things; something resembling perfect competition, transparent pricing with easy substitution between competing goods/services, and consumers making rational decisions based on said transparent pricing. None of those conditions remotely exist in health care or health insurance.

Totally agree with the entire post but the above hits it on the head. This country, because of the people that bang on the Capitalistic drum, has evolved into a monopolistic shit hole enabled by the Oligarchy running this country.

Think about the services you need. How many of the providers meet the above three conditions for a fair and transparent market? Services like Health Care, can not be part of the Capitalistic business model, as that model is set up to fuck the majority.

Companies have bought off representatives to represent their best interests, not yours for the last 60+ years. As those companies have made progress in deregulation and merging into the strongest players in the industry, the American people have lost out.

IMO, there is no coming back from the path we have gone down, so now it is every man for himself. Lots of people are going to feel lots of pain going forward, hence the justification of 4Matics Capitalism comment.

[Dantheman]

Misconception ... see the linked below. Summary on slide 24

https://www.brookings.edu/wp-content...tion-v6-RM.pdf

Then again, this might be leftist #fakenews, Brookings Institute and all.

Cool, thanks. Looks like that came out a few years after the study I read. Still though, the BMI >40 category had much higher HC costs than BMIs under 40 and it's the smallest cohort by a lot. Most of their costs are also societal costs related to reduced work productivity. In terms of pure HC costs, the data they present seems to show that being moderately obese doesn't cost that much.

[Cono Este]

Cono, don't conflate greed with capitalism; both exist independently. Thanks for mentioning your bias, your posts make more sense now. Without that it's hard to imagine XXXer having to explain basic efficiencies so many times. Surely you know how you get paid for calling on behalf of the patients you quoted, right?

DTM, I agree that we don't have the right conditions for a purely competitive market to exist in health care. On the other hand, given the dysfunction in health care, that is not so much an indictment of competitive markets as an indictment of health care as an example of what goes wrong when those conditions aren't present (whether the market is otherwise "free" or not). Rational decision making would always be a challenge in health care and the asymmetric nature of transactions seems pretty unavoidable, so I'm certainly not trying to advocate for some unregulated market or the like. I was simply stating that the broad part of those who think they support capitalism as a "system" have been duped into thinking the worship of capital is somehow fundamental to free markets when in fact the presence of capitalism is a disqualifier since pure competition requires equal access to capital (or at least no advantage to be gained by differences in access). Capitalism is anathema to a free market. 4matic's statements and a number of the other indictments of capitalism in this thread are accurate and ugly, but Americans are still defending capitalism because they're confused about what it means.

No man, I don’t always get paid, and there is no guarantee I will find them a plan. I will recommend they don’t put up with that bullshit and find a new doctor.

Yesterday I got a call from a clients sister who has cancer, lives off 700 a month in Ferguson and I will go see her next week and get her everything for free. I will get her extra help from the state and federal govt and I don’t get paid doing that. I also need a fucking Glock when I into those neighborhoods to help people for nothing.

You guys talk about freeing the doctors up from paperwork to allow them to see more patients but you don’t talk about what it costs.

If you want transparency, try having no insurance and paying cash, if you have it.

[zion zig zag]

Regarding universal health care and "fat fucks", I've read that the unhealthy actually save the system money. The guy who eats like shit, smokes, never exercises and drops dead at 60 has far lower lifetime HC costs than a healthy person who lives to 95.

Yeah, we bitch about the unhealthy and the resources they take, but my "healthy" lifestyle has led to 6 ortho surgeries and all of the associated care. That wasn't cheap.

[Cono Este]

Yeah, we bitch about the unhealthy and the resources they take, but my "healthy" lifestyle has led to 6 ortho surgeries and all of the associated care. That wasn't cheap.

Yes, stop skiing. There are two Americas, everyone be glad if you have some group plan and just fork over a plastic card at the time of appt and never have to see the bill.