pirana

Well sure, matching the world dollar for dollar, more with the wars, is the real problem here, not HC funding. We need reform so that doctors making 200k out of med school and RN's making 100k is reduced, this causes the massive costs. I mean, let the hospitals pay docs and RN's that much, but not at the cost of over-inflated HC which causes millions to be out of coverage. Most definitely; we need providers to actually compete - it is utterly ridiculous that they for the most part do not have to even pretend to be competing for patients. The AMA and it's lobbyists have come down extremely hard on anything that even hints at medical professionals having to compete for business. Costs (as well as outcomes) vary significantly amongst providers; and the best outcomes do not always correlate to the expensive providers. There are providers that perform 50% more C-sections than average. There are providers that utilize MRI/CAT at double the average rate. There are scads of dirty little facts providers never tell you; and they fight tooth and nail to curtail any publication of such info. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Depends on how finely we define principles. To me principles are broadly defined attributes such as integrity, honesty, understanding, sanctity of life, etc. "Brother, can you spare another 10% of your income so we can implement our preferreed version of HC reform?" is not a priciple centered question and the answer does not necessarily lead to a definition of someone's principles. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Or else stop posting. BTW, mine are toeless. How sexy is that? " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Hogwash. They made a concious decision not to insure themselves, just the kids. They had to have applied with a health history to get coverage for just the kids, so I would not buy any story in which they claim they did not know that. They obviously saved a boatload of money with that strategy; but now that it has bit them in the ass, the insurance company is evil. What a crock. This is a good arguement for guarantee issue, though mandatory coverage of some sort must be a part of guarantee issue - or you get anti-selection situations like this in which people opt out when they don't want ot or percieve they don't need it - then complain when that strategy backfires. Glad the kid got the emergency care he needed (the cost of which will be passed on to others) and hope the parents can finance ongoing care. Wonder how the parents feel about their strategy now? " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Not only is it fattening, but double cheeseburgers for Passover is just about as non-kosher as you can get.

In that respect forecasting the economy is much like forecasting the weather; everybody has the same source information, but somehow they often come up with different interpretations. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

It's limited, but I don't consider 25 to 50% as feeble. That's like saying 50 mpg is feeble because you demand a car that gets 200 mpg. Is everything in your world that has limits considered feeble if those limits don't meet your expectations. How about this: What level of discount should they extract in order for it to not be feeble to you? Should docs work for free? 100% discount would be nice heh? For an academic, you either have very poor logic, or can't remove your emotion from the debate. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Fraud! Doesn't look like a Kaiser to me. Looks more like sliced toast; with Swiss cheese, and some of that fake butter product. Isn't a Kaiser a nice robust bun? Like this: " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Headache removal medicine: Alice In Quantumland by Robert Gilmore. Best layman's read I've found on the topic. Also, Where Does The Weirdness Go? by David Lindley. Either book breaks it down for us non-physicists; and provides a certain comfort by way of explaining why there is no danger our cats may be dead when we are not looking. Extrapolation to the scale of things like cats, cars, the family jewels, etc makes for fun thought experiments; but the number of possible states for things that large are so smoothed out on our scale that they can be ignored. p.s. - The subtitle of Lindley's book, Why Quantum Mechanics Is Strange, But Not As Strange As You Think; says a lot. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Did the specific injury occur, or did you previously suffer the same injury prior to the purchase of the insurance? Some states mandate previously held continuous coverage as meeting requirements to satidfy a pre-x clause. Basically, as long as you have had coverage for a set number of months (typically 18, but self-insured companies often exploit a loophole that allows them to make it whatever they want) and you maintain continuous coverage, there is no pre-x. Continuous coverage is a must in order to waive pre-x or we end up with people that forego coverage until they need services; then run out and buy insurance. It's called anti- or negative selection. States that allow insurers to not recognize previous continuous coverage are in the wrong - ethically IMO. Though they are probably in the minority, that is one of the things I understand is addressed in ObamaCare. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

If there is anybody here who has ever sat on the other side of the table (negotiating reimbursement rates on behalf of a provider system), please chime in so Mr Kallend doesn't think I'm making this all up. Is your experience that the insurers pay whatever the provider requests, and that they have no incentive to bargain? Tell us why it is, if our insurers are SO effective in bargaining down costs, that we have the world's most expensive so-called "system". Fabulous logic; reminds me of the Truthers. We have the most expensive HC system in the world, therefore, insurers must not be bargaining. Well, at least that is one step back from your BS claim that insurers do not bargain and simply pay what the providers bill. Examine a sample of claims resolution documents (typically called EOB's) and compare billed amounts to allowed amounts. That difference represents the amount the insurer was able to bargain for, and is typically 25 to 50% of the charged amount. Without the reductions insurers bargain for, the bill would be that much more. If you do not have insurance, that is what they will collect. Uninsured patients who know this and are saavy can often negotiate their bill down to the amount the provider accepts from insurance; but if you do not ask for it, they won't tell. How ethical is that? " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Yes. Doesn't need to be precise; just give us something more than vague whiny hyperbole (like you just did again). Maybe the amounts of the bonuses as a percent of the revenue stream. Percent of claims denied would be good, and a breakdown for the reasons for denial. Are you aware that when the hyperbolic numbers for denied claims are thrown about by the uninformed (such as yourself), never mentioned is that the number 1 reason for claims denials is for duplicate filings? Or that the number 2 reason is for insufficient information, like forgetting to name the patient. Are you aware of the results of independent audits of claims processing (accuracy as measured against contracted benefits)? Are you aware of claims processing timeliness (% in X number of days)? Are you aware at all, or are you just another uninformed ranting hyperbolic internet lunatic spewing forth based on the emotional flames someone is fanning? (See this is why I was not more successful when I was in the biz - I got fed up and could not deal diplomatically with uninformed idiots). " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

I an nutshell: Cost are high because there is already huge government invovlement and regulation (such as required to treat illegals and can't turn them in). The fix for to much government is not more government. Healthcare can be provided for cheap and quick if it was a truely free market system. There is nothing wrong with people having to live with the consequences of thier own actions. Its not "fair" to punish me (a hard worker who plans ahead) because of the consequences of others actions/inactions or irresponsibility. By rewarding people and protecting people from the consequences of thier action you provide no incentive for people to work hard and make the right decisions. Still a little long but much shorter than in was. In principle, I pretty much agree with your statements. The slightly liberal lean I have though says a civilized society takes certain care of it's members. Because a basic availability to maintain good health does rely in part on access to professionals, and because we have already established ourselves as a society that does those things for the basic needs in life, then a certain level of care ought to be guaranteed for all. My opinions on the mechanics of making that happen is the only difference between me and ObamaCare. I say thoughtful sensible, but comprehensive regulation that fosters healthy business competition is the way to go. ObamaCare just extends the current system for now - special favors, loopholes, outdated BS, sacred cows all included - watch it struggle even more under the burden - then when it fails, transition to the world's largest bureacracy ever seen, and collect whatever it takes in taxes to keep it running. Perfect. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

The AMA, in cohorts with the medical colleges, control the bottleneck on the supply of doctors - not the scummy caste you refer to. Also, without that scummy caste, health care grinds to a near (relatively) halt. You have no idea what access to health care was like when the only way to get it was to pay out of pocket, do you? Well run health care financing companies (insurance) retain about 10% of rates for admin. That is for EVERYTHING - salaries, infrastructure, mowing the lawn - EVERYTHING. The other 90% is paid out as reimbursement for claims. The average is somewhere in the low to mid 80's; which is why the target set in the legislation of 85% is hardly earthshaking. I think a company that returns 90% of revenues in the form of goods and services is representative of a well run machine. Do you think they should work for free? Rather than rant with stereotype and hyperbole, why don't you specify exactly what it is that the scummy caste are doing that is running the system into the ground? Use numbers if at all possible, with clear explanations about the specific activities. BTW, you hit on a point that is definitely on the right track. Increasing the number of doctors would probably get the biggest bang for the buck in reducing the cost and improving the quality of health care (and thefefore insurance). If there were enough doctors that they had to actually compete for patients, everything about health care delivery and financing would change drastically. Our governments reluctance to deal with the AMA has more to do with the anticipated emotional response (flames the AMA would fan as best they could) than with any financial reality; insurance-wise, cost-of-care-wise, tax-wise, or any other wise. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Ion, I may agree with you, I may not; but I'll never know because your posts are sometimes so long. Any chance you could shorten it up a tad? " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

I directly participated in several negotiations over the years with major health care systems in the Twin Cities. In every single one the provider group was asking for at least double the cost indicated by pricing and utilization trends, and at least 4 times the cost of CPI. The only thing that kept them in check was the bargaining power of the large insurance companies via the cash flow they provided in the form of direct payments. If those large systems had to rely on direct payment from patients - they'd all be bankrupt. Reminds me of when Wellstone/Clinton said they wanted more competition, but also wanted a single payer. 3 companies were not enough, but 1 was just right? BTW, the primary reason given for the excessive increases being necessary, without exception, was to compensate for the low level of reimbursement from government programs patients. Not patients without insurance, not bad debts - but because of government patients. I'll bet the docs can't wait until all patients are reimbursed at government rates. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

If there is anybody here who has ever sat on the other side of the table (negotiating reimbursement rates on behalf of a provider system), please chime in so Mr Kallend doesn't think I'm making this all up. Is your experience that the insurers pay whatever the provider requests, and that they have no incentive to bargain? " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

And that is because the insurance companies have no incentive to bargain costs down because they just pass them along, and the healthcare consumer is insulated from the cost. A single payer system is the way to fix that problem. Why does a hospital charge $10 for an aspirin tablet? Because it can. You know not what you speak of. That comment just showed me you are sorely lacking for information in this debate. Insurance companies bargain like a MF with providers. And multiple companies bargaining with multiple providers is THE single biggest source of downward price pressure. I guess that's why pharmaceuticals are so much cheaper here than in Canada. Oh, wait... Different issue, different factors. Nice try at diverting though. You made a blanket statement that insurance companies have no incentive to bargain prices downward. That is absolutely false and shows you have limited to no knowledge on the topic of provider/financer negotiations. Let me spell it out for you. They are very incented to bargain down prices because their reimbursement rates are in competition with every other insurance companies reimbursement rates; directly impacting the rates at which they sell their contracts. Go to single-payer and remove that single most effective pressure on price and the only option remaining is price-fixing. The providers can not compete directly - or more accurately do not need to - because the AMA makes certain the supply remains below demand. Something that may come to an end if the government has to resort to fixed pricing (which effectively places salary caps on physicians). " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

And that is because the insurance companies have no incentive to bargain costs down because they just pass them along, and the healthcare consumer is insulated from the cost. A single payer system is the way to fix that problem. Why does a hospital charge $10 for an aspirin tablet? Because it can. You know not what you speak of. That comment just showed me you are sorely lacking for information in this debate. Insurance companies bargain like a MF with providers. And multiple companies bargaining with multiple providers is THE single biggest source of downward price pressure. I directly participated in several negotiations over the years with major health care systems in the Twin Cities. In every single one the provider group was asking for at least double the cost indicated by pricing and utilization trends, and at least 4 times the cost of CPI. The only thing that kept them in check was the bargaining power of the large insurance companies via the cash flow they provided in the form of direct payments. If those large systems had to rely on direct payment from patients - they'd all be bankrupt. Reminds me of when Wellstone/Clinton said they wanted more competition, but also wanted a single payer. 3 companies were not enough, but 1 was just right? " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Bingo. I spent less than 24 hrs in the system for a relatively routine surgery. The bill was $44K. When I see the doc at the office, I'm in the system for maybe 10 minutes, and the bill is anywhere from $100 to $500. Nothing in this addresses that (at least none of the stuff I've read so far). I think the docs are going to get a rude awakening once it becomes apparent that rationing and price fixing will be the only way under a government run plan to bring costs down. Can you imagine ther response if we end up with a mandate that all docs accept reimbursements rates along the lines of Medicare - or even less? " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

It may not be the most efficient, but there is no proof it is the most expensive. It depends on the changes in consumer behavior (utilization) as a result of the changes. I know it grates on people who's arguments are grounded in emotions, but there is a price threshold at which improved health becomes too expensive. Similarly, we could turn the majority of kids in the world into highly educated, smart as a whip, knock your socks off professionals - but would we be willing to foot the bill for a 1:2 teacher to student ratio? Everything has it's price, and that price should be known before commiting to a plan. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

The tricky part is providing access to the care that will save money (or break even) without opening the floodgates to overutilization. It is proven that opening channels to increased care (especially when it is perceived as "free" by many at point of care) increases utilization across the board - to fraud, unnecessary care, needed care - everything. There is no definitive data available to determine whether the savings from improved preventive care and increased utilization will balance out. It will almost certainly lead to at least a slightly healthier population, but at what price. Overutilization was a big problem back in the days of 100% coverage with no patient costs at point of care. Kind of like crime prevention. We could quadruple our police forces and probably dramatically reduce crime, but at what price. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

I do listen occasionally. And each time I've had my views of him confirmed. He's an arrogant, loud mouthed, hypocritical ideologue (based on a failed ideology) who has learned that he can charge "confiscatory" advertising rates to advertisers by appealing to the political gamesmanship fetishes of an audience of head-nodding, table pounding dittoheads. It's a form of brain draining entertainment that's quite lucrative for him but bad for the country. "Radio crack" if you will Ditto. Used to tune him in once in a while, more out of morbid curiosity and to see what all the fuss was about. He's so extemely party aligned that I can't figure out why anyone of reasonable intelligence gives him any credibility. He's great at entertaining his target market. He's a lousy source for anything resembling balanced insight. But, THAT'S ENTERTAINMENT! " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

glad you struck that. Frosted mini-wheats would be the Cadillac cereal and be subject to an additional tax. They can take my Cap'n Crunch when they pry the box out of my cold, dead hand. Captain Crunch will soon be either illegal or very heavily taxed. It is unhealthy, and you are burdening society by eating it. There could be a bright side to this form of governance. They could make being fat illegal. Actually to be more in line with the trend, I suppose making it mandatory to buy and consume low fat foods is where we are headed. Getting a little paunchy - you get a tattoo on your forehead and it becomes illegal for you to purchase: Any food that derives more than 10% of it's calories from fat. Any milk other than soy. Cheese. Alcohol. Bacon. Tight-fitting clothes; other than a choke-collar so people can give you a firm yank when you walk past McD's. Any motorized form of transportation. Fat people will be required to walk - everywhere. Hey, it's for the good of society. Obesity is costing the country too much money. " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

Agreed. Take it to the ballot box. VOTE (Vote Out The Incumbents) " . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley