American health care costs

[kallend 2,151]

airdvr

*********Are you resenting the rich? He went to med school, made the grades, built his practice. I thought that being rich was within anyone's grasp if they just invested a little effort.


Wendy P.

Agreed. My step-daughter just finished her fellowship in hand surgery and is now practicing in Mountain View CA. She has been in school for 14 years. Little does she realize Obamacare will be taking her down a couple of notches soon. But she worked really hard. I don't know if I would have been able to do it. She deserves to make some bank now.

So do newly tenured associate professors of (History/English/Anthropology/Archeology/Music...) who also spend 14 years in school and work really hard to get tenure. Should they make as much as MDs? Or is you sympathy reserved for family members?

I know you'd like to believe understanding Shakespeare is a life or death situation...



Irrelevant to your previous point, which was about time spent in school and working hard. Not even a clever evasion.

...

The only sure way to survive a canopy collision is not to have one.

[DanG 1]

That just describes how their rates may vary between customers. It doesn't say that there is a cap on the rates themselves.

- Dan G

[airdvr 210]

DanG

That just describes how their rates may vary between customers. It doesn't say that there is a cap on the rates themselves.

Currently, federal law does not place any limits on the ways that insurers set their premium rates. However, beginning January 1, 2014, insurance companies must meet minimum premium rating rules for health plans for individuals and small businesses. Health plans will be allowed to adjust premiums based only on the following factors:

Individual vs. family enrollment (i.e., individual + spouse, individual + dependent(s), etc.)
Geographic area
Age (but cannot vary by more than three times among adults)
Tobacco use (the rate cannot vary by more than 1.5 to 1)
Other factors that insurers traditionally use to charge higher premiums, such as health status, use of health services and gender, will no longer be allowed under the ACA. The rating rules in the ACA set a floor, so states can retain or enact a tougher standard than federal law.

All of the things the insurance company used to do to rate a bad risk higher they are not able to do anymore. They are in effect telling the insurance companies how much they will allow them to make.

Please don't dent the planet.

Destinations by Roxanne

[maadmax 0]

wmw999

Are you resenting the rich? He went to med school, made the grades, built his practice. I thought that being rich was within anyone's grasp if they just invested a little effort.


Wendy P.

That is a load of propaganda. As a Veterinarian we go through the same training, perform the same services on as many as 7 different species for one tenth the income. The human health care system is grossly out of control and based on greed not compassion.


...

[GeorgiaDon 380]

Hey Max! Hope you're doing well.

Around campus, I've seen bumper stickers that say "Real doctors can treat more than just one species". I've got to find out where to get one of those.

One of the problems with medical costs is what is described in the video linked in the first post as "inelastic demand". If someone needs medical treatment, they usually REALLY need it. How much will you be willing to pay if the alternative is, you die? So people will sell their home, drain their retirement, whatever it takes. Veterinarians don't have that kind of leverage, people will pay only so much for their pet's health. It's even worse for large animal vets, as no farmer will pay more than an animal is worth at market for its care.

If someone is having a heart attack, or is diagnosed with a malignant tumor such that even a small delay in beginning treatment reduces the chances for a good outcome, can they really start calling around to see where they get the best value for their dollar?

Add to that the secrecy that clouds everything about what medical services actually cost, and meaningful negotiation is impossible. I had minor surgery for a trigger finger, and I got bills for months. I separate bills from the surgeon, the surgical clinic, the anesthesiologist, for the x-rays, for the consultation, it just went on and on. No veterinarian could retain any clients if they treated patients that way.

Medical costs are out of control because the system is engineered to exclude competition base on price, and because the alternative to paying whatever the system demands is disability or death.

By the way, I suspect you might have misunderstood the point of Wendy's post. Sarcasm is hard to get across online.

Don

_____________________________________
Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996)
“Education is not filling a bucket, but lighting a fire.” (Yeats)

[DrewEckhardt 0]

airdvr

They are in effect telling the insurance companies how much they will allow them to make.

No. They only placed a limit on _gross_ margins or markup depending on how you look at it. The health insurers can markup any goods and services delivered to their members by 25% (an 80% medical loss ratio for individual and small group plans means a 20% gross margin which is the same as a 25% markup) regardless of how much that is.

For example, before ACA insurance companies maximized profits by approving Prilosec which is available as a generic and less expensive in branded form due to the competition but not Nexium which is patented and more expensive although otherwise the same thing without the D-enantiomer which is not bioactive.

After they can "improve" care and maximize profits by allowing Nexium which performed better in clinical trials comparing 20mg of the S-enantiomer form to just 10mg of it in Prilosec and profit from the 25% markup on 8X the sales.

This has nothing to do with the upper limits on how much more they charge people with risk factors; although most of us don't suffer from those so a better way of looking at it is that the law mandates charging young people at least 1/3 of what they charge old people and non-smokers at least 2/3 what they charge smokers.

My son's insurance almost ($85 to $150 a month) doubled with the normalization for Obamacare.

[weekender 0]

maadmax

***Are you resenting the rich? He went to med school, made the grades, built his practice. I thought that being rich was within anyone's grasp if they just invested a little effort.


Wendy P.

That is a load of propaganda. As a Veterinarian we go through the same training, perform the same services on as many as 7 different species for one tenth the income. The human health care system is grossly out of control and based on greed not compassion.


...

People do not put the same value on livestock and pets as they do themselves and their families. They are willing to pay more to have their children healthy than their livestock or pets.

You run a business as does a regular physician. They can charge more than you because people value their services more than yours. this cannot be the first time you heard of this.

"The point is, I'm weird, but I never felt weird."
John Frusciante

[maadmax 0]

People do not put the same value on livestock and pets as they do themselves and their families. They are willing to pay more to have their children healthy than their livestock or pets.

You run a business as does a regular physician. They can charge more than you because people value their services more than yours. this cannot be the first time you heard of this.

___________________________
___________________________

If that is your criterion then farmers should charge accordingly. My point is that I know what medical costs really are. All of my training and supplies are the same as with human medicine. The actual costs are astronomically lower than what is charged. Everyone could have health care for a fraction of what we spend. Our legal system and heath care system are the biggest scams going. Makes the banking debacle pale in comparison.


...

[OHCHUTE 0]

wmw999

Are you resenting the rich? He went to med school, made the grades, built his practice. I thought that being rich was within anyone's grasp if they just invested a little effort.


Wendy P.

Yea, but complaining that he's not making the money he use to is a tad much. I told him to get out of medicine. He, had no answer.

[weekender 0]

maadmax

People do not put the same value on livestock and pets as they do themselves and their families. They are willing to pay more to have their children healthy than their livestock or pets.

You run a business as does a regular physician. They can charge more than you because people value their services more than yours. this cannot be the first time you heard of this.

___________________________
___________________________

If that is your criterion then farmers should charge accordingly. My point is that I know what medical costs really are. All of my training and supplies are the same as with human medicine. The actual costs are astronomically lower than what is charged. Everyone could have health care for a fraction of what we spend. Our legal system and heath care system are the biggest scams going. Makes the banking debacle pale in comparison.


...

Farmers charge what the market will bear and its not my criterion, this is the basics of a free market system. im not saying anything radical or remotely new. vets and family doctors do the same. Everyone does . The actual costs have nothing to do with it. You do not price your product based on your cost, you charge what you can get and if its more than expenses you are profitable.

People do not value your services as much as they do family dr's. so you can charge less and they can charge more. pretty simple stuff.

(edit to add. my father in law is a vet and my sister is a family dr. I'm am very close to both. he has actually been very helpful, giving her advice on running a practice. my point is i'm not so unaware of running either business as you might assume.)

"The point is, I'm weird, but I never felt weird."
John Frusciante

[devildog 0]

weekender

You do not price your product based on your cost, you charge what you can get and if its more than expenses you are profitable.

Yep. Look at the actual cost of say, a hamburger or coke from McDonald's and compare it with the price they charge.

You stop breathing for a few minutes and everyone jumps to conclusions.

[base698 20]

Horse cocky. Farmers are the farthest from free market you can get. The government pays subsidies for all kind a of things they shouldn't and even have protections and price controls. Not to mention the market manipulation by commodity traders...

My wife used to specialize in auditing medical practices. It's anecdotal, but they were all making $2 mil a year. I'd always here stories of them bitching about $200 fee making her job harder.

[weekender 0]

base698

Horse cocky. Farmers are the farthest from free market you can get. The government pays subsidies for all kind a of things they shouldn't and even have protections and price controls. Not to mention the market manipulation by commodity traders...

My wife used to specialize in auditing medical practices. It's anecdotal, but they were all making $2 mil a year. I'd always here stories of them bitching about $200 fee making her job harder.

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

"The point is, I'm weird, but I never felt weird."
John Frusciante

[lawrocket 3]

base698

Horse cocky. Farmers are the farthest from free market you can get. The government pays subsidies for all kind a of things they shouldn't and even have protections and price controls. Not to mention the market manipulation by commodity traders...

Depends on a crop. Depends on the farmer.

My wife used to specialize in auditing medical practices. It's anecdotal, but they were all making $2 mil a year. I'd always here stories of them bitching about $200 fee making her job harder.

Is that $2 million in gross receipts?

My wife is hotter than your wife.

[base698 20]

It wasn't gross receipts for the business, but it was the take home gross. I'm sure they took home $1.2 after taxes.

Quote

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Why don't you explain since you're close to the trade :) I just remembered some story about Goldman.

http://www.usnews.com/opinion/blogs/economic-intelligence/2013/07/24/how-goldman-sachs-and-wall-street-manipulate-alumnimum-and-other-commodities

[kallend 2,151]

weekender

***Horse cocky. Farmers are the farthest from free market you can get. The government pays subsidies for all kind a of things they shouldn't and even have protections and price controls. Not to mention the market manipulation by commodity traders...

My wife used to specialize in auditing medical practices. It's anecdotal, but they were all making $2 mil a year. I'd always here stories of them bitching about $200 fee making her job harder.

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Nice way to miss the point.

US farmers do not operate in a free market, there are countless government controls and price supports in place.

A good friend of mine owns a farm and he is paid handsomely by the government to grow NOTHING except for his own family's consumption.

And commodity traders don't manipulate prices? What universe are you living in?

...

The only sure way to survive a canopy collision is not to have one.

[weekender 0]

kallend

******Horse cocky. Farmers are the farthest from free market you can get. The government pays subsidies for all kind a of things they shouldn't and even have protections and price controls. Not to mention the market manipulation by commodity traders...

My wife used to specialize in auditing medical practices. It's anecdotal, but they were all making $2 mil a year. I'd always here stories of them bitching about $200 fee making her job harder.

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Nice way to miss the point.

US farmers do not operate in a free market, there are countless government controls and price supports in place.

A good friend of mine owns a farm and he is paid handsomely by the government to grow NOTHING except for his own family's consumption.

And commodity traders don't manipulate prices? What universe are you living in?

My father was a vegetable farmer. My family is still in farming. I am a professional trader with 20 years experience trading for major institutions. That is my universe.

Manipulation is illegal. If you and the other gentlemen know how people are manipulating the price of securities, then please explain it to me. keep in mind, this is a subject i am an expert on and not easily fooled.

as far as farm prices, i did not miss the point. I stated that farmers price to what the market will bear. they do not set prices based on cost. nothing you are the other gentlemen stated disproves that. my comments are about pricing and cost and are on point.

"The point is, I'm weird, but I never felt weird."
John Frusciante

[weekender 0]

base698

It wasn't gross receipts for the business, but it was the take home gross. I'm sure they took home $1.2 after taxes.

Quote

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Why don't you explain since you're close to the trade :) I just remembered some story about Goldman.

http://www.usnews.com/opinion/blogs/economic-intelligence/2013/07/24/how-goldman-sachs-and-wall-street-manipulate-alumnimum-and-other-commodities

that is an opinion piece and points out no actual manipulation. it is common sense that stockpiling anything can lead to market disruptions. i agree with the author, regulators should be hyper vigilant in assuring ETF's do not create disruptions. he raises a valid concern but that is not manipulation.

"The point is, I'm weird, but I never felt weird."
John Frusciante

[kallend 2,151]

weekender

***It wasn't gross receipts for the business, but it was the take home gross. I'm sure they took home $1.2 after taxes.

Quote

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Why don't you explain since you're close to the trade :) I just remembered some story about Goldman.

http://www.usnews.com/opinion/blogs/economic-intelligence/2013/07/24/how-goldman-sachs-and-wall-street-manipulate-alumnimum-and-other-commodities

that is an opinion piece and points out no actual manipulation. it is common sense that stockpiling anything can lead to market disruptions. i agree with the author, regulators should be hyper vigilant in assuring ETF's do not create disruptions. he raises a valid concern but that is not manipulation.

So you're claiming that the Hunts weren't manipulating the silver market? en.wikipedia.org/wiki/Nelson_Bunker_Hunt#Silver_manipulation

In 1989 in a settlement with the United States Commodity Futures Trading Commission, Nelson Bunker Hunt was fined US$10 million and banned from trading in the commodity markets as a result of civil charges of conspiring to manipulate the silver market

You're claiming that Enron didn't manipulate energy markets?

...

The only sure way to survive a canopy collision is not to have one.

[weekender 0]

kallend

******It wasn't gross receipts for the business, but it was the take home gross. I'm sure they took home $1.2 after taxes.

Quote

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Why don't you explain since you're close to the trade :) I just remembered some story about Goldman.

http://www.usnews.com/opinion/blogs/economic-intelligence/2013/07/24/how-goldman-sachs-and-wall-street-manipulate-alumnimum-and-other-commodities

that is an opinion piece and points out no actual manipulation. it is common sense that stockpiling anything can lead to market disruptions. i agree with the author, regulators should be hyper vigilant in assuring ETF's do not create disruptions. he raises a valid concern but that is not manipulation.

So you're claiming that the Hunts weren't manipulating the silver market? en.wikipedia.org/wiki/Nelson_Bunker_Hunt#Silver_manipulation

In 1989 in a settlement with the United States Commodity Futures Trading Commission, Nelson Bunker Hunt was fined US$10 million and banned from trading in the commodity markets as a result of civil charges of conspiring to manipulate the silver market

You're claiming that Enron didn't manipulate energy markets?

i'm claiming that it is a crime and you will be prosecuted for it. As you point out. The original poster and yourself are implying that farm commodity prices are manipulated regularly. I disagree and am asking you to explain to me how it is done.

Pointing out real time electric and metals cases does not disprove my comments on farm commodity manipulation. You actual prove my point that it is a punishable crime.

"The point is, I'm weird, but I never felt weird."
John Frusciante

[kallend 2,151]

weekender

*********It wasn't gross receipts for the business, but it was the take home gross. I'm sure they took home $1.2 after taxes.

Quote

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Why don't you explain since you're close to the trade :) I just remembered some story about Goldman.

http://www.usnews.com/opinion/blogs/economic-intelligence/2013/07/24/how-goldman-sachs-and-wall-street-manipulate-alumnimum-and-other-commodities

that is an opinion piece and points out no actual manipulation. it is common sense that stockpiling anything can lead to market disruptions. i agree with the author, regulators should be hyper vigilant in assuring ETF's do not create disruptions. he raises a valid concern but that is not manipulation.

So you're claiming that the Hunts weren't manipulating the silver market? en.wikipedia.org/wiki/Nelson_Bunker_Hunt#Silver_manipulation

In 1989 in a settlement with the United States Commodity Futures Trading Commission, Nelson Bunker Hunt was fined US$10 million and banned from trading in the commodity markets as a result of civil charges of conspiring to manipulate the silver market

You're claiming that Enron didn't manipulate energy markets?

i'm claiming that it is a crime and you will be prosecuted for it. As you point out. The original poster and yourself are implying that farm commodity prices are manipulated regularly. I disagree and am asking you to explain to me how it is done.

Pointing out real time electric and metals cases does not disprove my comments on farm commodity manipulation. You actual prove my point that it is a punishable crime.

Given the general toothlessness of the regulators, I'd wager that the prosecuted cases are just the tip of the iceberg.

...

The only sure way to survive a canopy collision is not to have one.

[weekender 0]

kallend

************It wasn't gross receipts for the business, but it was the take home gross. I'm sure they took home $1.2 after taxes.

Quote

Please explain to me how commodity traders manipulate prices.
I am an equity market maker and am very curious how my commodity trading peers are able to manipulate prices in a regulated market and get away with it. Since you seem to know, i would love for you to share that with me. Please be as specific as possible as i am not a laymen and have a very good understanding of the markets.

Why don't you explain since you're close to the trade :) I just remembered some story about Goldman.

http://www.usnews.com/opinion/blogs/economic-intelligence/2013/07/24/how-goldman-sachs-and-wall-street-manipulate-alumnimum-and-other-commodities

that is an opinion piece and points out no actual manipulation. it is common sense that stockpiling anything can lead to market disruptions. i agree with the author, regulators should be hyper vigilant in assuring ETF's do not create disruptions. he raises a valid concern but that is not manipulation.

So you're claiming that the Hunts weren't manipulating the silver market? en.wikipedia.org/wiki/Nelson_Bunker_Hunt#Silver_manipulation

In 1989 in a settlement with the United States Commodity Futures Trading Commission, Nelson Bunker Hunt was fined US$10 million and banned from trading in the commodity markets as a result of civil charges of conspiring to manipulate the silver market

You're claiming that Enron didn't manipulate energy markets?

i'm claiming that it is a crime and you will be prosecuted for it. As you point out. The original poster and yourself are implying that farm commodity prices are manipulated regularly. I disagree and am asking you to explain to me how it is done.

Pointing out real time electric and metals cases does not disprove my comments on farm commodity manipulation. You actual prove my point that it is a punishable crime.

Given the general toothlessness of the regulators, I'd wager that the prosecuted cases are just the tip of the iceberg.

i have no doubt that you assume the markets are manipulated. It is very common for lay people to feel so. The markets are complex and few schools even attempt to educate students on them.

There are billions of transactions a day and some are bound to be fraudulent. They are still a very small exception.

"The point is, I'm weird, but I never felt weird."
John Frusciante

[kallend 2,151]

Yep. Everything's always above board in the financial sector.

www.theinnoplex.com/news/newssub/milliseconds-insider-knowledge-of-feds-bond-announcement-suspected

...

The only sure way to survive a canopy collision is not to have one.

[weekender 0]

kallend

Yep. Everything's always above board in the financial sector.

www.theinnoplex.com/news/newssub/milliseconds-insider-knowledge-of-feds-bond-announcement-suspected

I do not believe that nor implied it. there are trillions of transactions a day and with that volume it is not hard to find a few bad apples.

Posting another unrelated link does nothing to disprove my comments that farmers set pricing based on market prices and not cost. Nor does it prove your comment that farm commodity prices are regularly manipulated.

"The point is, I'm weird, but I never felt weird."
John Frusciante