pirana

Not enough Pirates? It is a wild guess; but Pirates just sem to be a hot topic these days. Kind of like when you are playing Trivial Pursuit and you get the Literature category and you are no good at it unless it is a comic book question. When in doubt, the answer to give is Shakespeare. Works about half the time. So, . . . is it Pirates? " . . . 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 you brought up homicides, what's you point? That there's always an excuse by the right wingers for poor performance by the USA, whether it be homicides or healthcare. Man, you're the liberal personification of the Chatty Cathy Doll - just pull your string and you repeat the same old shit, over, and over, over again I thought the dolls name was Chatty Patty. " . . . 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 lower 40% don't pay taxes. Should they be excluded from the "free" healthcare? No. They get a safety net plan, with sliding scale premiums and are REQUIRED to have their annual checkup. " . . . 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

More heresey bullshit. You think a person with a Doctoral is processing claims. How fucking naive can you be? There are MD's at insurance companies. They are usually Medical Director's overseeing areas that establish policy - - they don't process claims. They do set policy (not unilaterally) such as what is categorized as experimental, investigative, cosmetic and/or elective, medical necessity, and so on and so forth. I guarantee that docs are not sitting around examining claims line by line to see how much they can deny. Taking Mr. Moore's BS as the gospel on health care financing is the equivalent of getting skydiving info from a whuffo. Wake up people. You are being grossly misinformed and having your emotions toyed with by people with a highly politicized agenda and just about zero facts on their side. I'll bet there are more than a few people on this board that just assume the BS claims of 40 to 50 million uninsured Americans is true, simply because it has been parroted over and over again by Moore and his followers. " . . . 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

Nothing speaks like results. Don't see a lot of Kings and Pesidents and Shieks and other various rich-people types heading to Laos to get that prostrate cancer treated do we? They go to Mayo, and other notable US clinics because it is the best care in the world, period. Affordability, that is different. Access, also a problem. The long term solution is universal care. The thorny part is that so many people think that means everybody gets free access to whatever they desire. No, we are not perfect at affordability or access; but we have a very decent system. Most have access, and there are safety nets that provide at least a certain minimal level of care for those who can not afford care. Lots of room to improve, but it ain't goinna happen until we solve the bottom line cost of medical care issue. " . . . 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

There's always an excuse for poor performance by the USA, whether it be homicides or healthcare. WTF is that supposed to mean? I take it you haven't noticed our morbidly obese population in this country? McDonald's kills far more people with their food than those scary "Assault Weapons" you're always bitching about. Why don't you organize a ban on fast food? That would save far more people from certain death than any gun ban in history. Is someone proposing a gun ban? Or is this yet ANOTHER strawman? I think we combine efforts. Ban assault rifles for any purpose other than picking off obese people slogging their way thru their 4th value meal of the day. " . . . 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 depends a lot on where you are. Plus, one of the reasons that solo and small group practices are disappearing is because of the need to share overhead when retaining big support staffs. Regardless, it's a bona fide fact that a very large percentage of doctors in the USA today are unhappy in their work, and would change professions if they could. My wife (who is a doctor) looked at that article, kind of shrugged, and said "that's news?" One of the reasons that GP's are less happy is probably pay. All the "overpaid" doctors you hear about are specialists (mostly surgeons), and even then I'd argue that they are often not really overpaid. GP's are often making salaries in the low 100's or less, but having to service huge debts from years of medical school. If you average out lifetime earnings for a typical pediatrician, and assume a modest savings rate, they'll typically make less than someone in a skilled trade (carpenters or plumbers, for example) over their lifetime. It's not just the support staff; it's the scale of everything. A one or 2 doc office is simply not a viable business to be in. Gone the way of the neighborhood grocer and small automaker. This country at one time had over 150 automakers, and that was only 60 or 70 years ago. Aside from the issue that we may soon have none, it simply proved to be a business that could not operate below a certain scale. Hard to believe that any doc would try to operate solo these days. Like the house call, it's something they could do; but the premium for such a luxury service is something the patient needs to bear personally. Same thing can be expected to happen to hospitals in the near future. Capacity is ridiculously high. The economics of having six hospitals with full MRI capacity in a metro area that could get by with 2 MRI machines will eventually force contraction. Many areas are already seeing the mobile units instead of every clinic spending millions for the prestige of owning one. " . . . 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

They are either using an archaic system (wasting their's and the insurance companies resources) or they have their boss snowed. No way 2 chiros can treat enough people in a day to keep a person submitting claims busy full-time. Submitting for 5 docs, and not using electronic, that might be full time. But like I said, using electronic submissions, anything more than a minute is dillydallying. It's basically data entry, drop down menus, and plenty of pre-populated fields. Most of the review and reject activity is for stupid human error, not because of abuse or intent to defraud. Simple stuff like name, ID, etc. And with electronic submission it is difficult to even make those errors because the claim cannot be submitted without valid field entries. I am somewhat passionate about health care financing, but far more objective and critical than passionate. I did check a couple of the other links; very biased and bogus. The stuff about claims submission posted on the autism site - a load of BS that would might impress people unfamiliar with the business. It would be the equivalent of sensationalizing the horrors of finding the right oil filter for a car: 1 - Determine the year, make, model, and engine in the vehicle - VERY CONFUSING. 2 - Look up the part number in the book - OH THE HORROR. 3 - Go to the shelf and get one - THIS IS ASKING TOO MUCH. Their claims about the difficulty of coding are BS. The proper ICD-9 for a patient's given diagnosis does not vary based on insurance company or benefit plan. Their claiming so makes me think they are manipulating the system by using codes they think will generate the most payment. Just use the correct codes instead of trying to game the system. And yes, when they are trying to game the system, it will be detected and those claims will kick out for manual review at a much higher rate than average. It's claims submission, it's their job. Get good at it or find something easier to do. It only becomes challenging when they try to manipulate things instead of just putting the correct information in the right boxes. 75% electronic is a pretty low number. MN is over 90%, but then we are out front on this stuff. Anybody still using paper is part of the problem. One of the smartest initiatives the new administration could take up is getting the holdouts up to snuff electronic-wise. Maybe a handling fee for the paper holdouts; making them pick up part of the additional expense they are adding to the system. I don't cite references because I am the source. Don't mean that to express conceit; but my information is from direct experience and actual hands on access. I've consulted in damn near every facet of this business - service operations; IVR/VFR; claims, membership & billing; provider contracting; web design; on-line applications; marketing & sales. . . you name it. (I've never done underwriting, but am very familiar with the process). BTW - At the chiro I used to go to, claims submission (electrinic of course) was something the receptionist did in between greeting patients, collecting copays, and scheduling appointments for the 2 or 3 chiros on site at any one time. It really is that easy for the right person with the right tools. Apologies for the longwindedness - but people that aren't interested won't read anyway. " . . . 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

What? No late afternoon massage with hand job? Sounds like time to go on strike. " . . . 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

We Americans are giving other countries money (in the form of interest on T-bills) because we're too stupid to balance our budget. In fiscal year 2008 we paid $451 BILLION dollars in inerest on the national debt.. 25% of our debt is in the hands of foreign countries meaning that we're already paying foreign countries over $100 BILLION a year for being stupid. Paying the Japanese a small sum like $50B to take over the American car companies would be less than the annual expenditures we already send over seas for being stupid. Yes, and in the grand scheme of today's global market; it is far more important that things are run effectively than worrying about who runs them. The kind of nationalism that breeds fear over foriegn ownership is bordering on propoganda. It's just not that relevant anymore. " . . . 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

MANAGEMENT is responsible for managing its workforce along with all other aspects of the corporation. Is it difficult - sure, that's why CEOs are paid $(tens of) millions in salaries, perks and bonuses. Blaming the unions is a standard cop-out. Hogwash. The unions knew they had the automakers by the short hairs because the short-term costs of relocating would have killed them. It's a heavy industry that is hardly transportable. So they squeezed for all they could get - ridiculous wage and benefit packages for lots of no- and low-skilled labor. The automakers caved in the name of survival, but all it did was delay the outcome. The total labor burden (wages, benefits, pensions) paid in this country put the industry on the road to doom long ago. They created labor costs that had all the manufacturers teetering on the brink of survival for years; waiting for any kind of climate shift in the economy to drive them to extinction. Along comes an economic slowdown; which, last time I looked was still not an outright contraction, and they are suddenly an unviable industry. That did not happen overnight; it took years of being bled by the UAW. So IMO, the leadership and the workforce get equal blame for their no longer having a say about the business they are in. Can't wait to see what the real wages are if they get bought out and the business goes non-union. Guaranteed they will not be paying $60 or $70 an hour for what amounts to assembly work. " . . . 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

That she is; and one that is relevant to the topic at hand - which would be your health. " . . . 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

What about the people who come to this country, get fucked up then bail on the bill? Hell this is a post from one of our own. http://www.dropzone.com/cgi-bin/forum/gforum.cgi?post=3387993;search_string=lax%20customs;#3387993 Is that where you get your opinions from? Michael Moore? Oh come on. Try this one then: www.reuters.com/article/vcCandidateFeed2/idUSN12299426 That's not a study, it's a survey. Way too much room for interpretation. I'll bet they even had questions asking them how certain things made them "feel." " . . . 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 money is supposed to go for research and development for fuel efficient cars... like the competition has been doing for 10 years. Let Toyota and Honda buy GM and Ford. They can immediately scrap all the worst 10 useless models that no one is buying. There are car manufacturers, building cars in the US, who are making business decisions based on common sense. The market has already made its decision with their wallets. Why give them more taxpayers money to continue on in their mistakes? Welcome to capitalism. Agree. The morons who ran that business, and the unions that helped fuck it all up, deserve what they get. Why should we pore billions of public money in? Let Toyota buy it for what it is still worth. They'll turn it around faster than giving the same old same old fucktards more money to do their same old same old shit. Isn't that how business is supposed to work? Enough of the handouts to those that have proven they can not be trusted to run a business. Let them go down. It will be painful for a bit, but the recovery will be speedier and we'll end up with a better outcome. " . . . 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

Strange slant in that article. It seems to be coming from the perspective of a private practice doc, or a very small operation. That is a very rare thing these days, at least in this part of the country. Most medical care today is provided in clinics that are of the scale that lends itself to professional support staff who take the paperwork out of the docs hands. My doc writes notes in my chart. That is the extent of his paperwork. (And even that will soon be electronic). Interesting too that the shortage is mostly in GP. Since that is the area of practice least likely to have their claims scrutinized for irregularities; pointing at the insurance companies sounds to me like a lazy excuse. Apparently the paperwork is not scaring away specialists; whose offices are guaranteed to see more paperwork than that of a GP. " . . . 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

IMO, those things mostly suck. True, they are now taken for granted; in other words, they have all become entitlements. They all need overhauling. But, you make some good points on where we go from here. Trying to mimic or transplant a system that works elsewhere, in a place that is very different than the US, is a bad idea. Freedom of choice is big here. So is a healthy distrust of wholsale turnover of our health care system to the government. What would work well here is guaranteed coverage, choice of products based on what people want to spend, a sliding scale of premiums for low income families, and incentives for healthy behavior. It is a good mix of safety net and accountability. Linking to my previous post though, none of it means anything until we get a handle on cost of care. " . . . 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

Now you have hit on a salient point; the supply of doctors. Guess who controls that? Give you a hint - it's not the insurance companies. As with most issues, follow the money to find the answers. Who beneifits financially by putting a false ceiling on the number of doctors allowed to practice medicine? Who benefits by restricting the number of candidates allowed to enter medical school? In neither case is it the insurance companies. The benefactors of such restrictions are doctors and the people teaching them. Oh, what a surprise, the teachers are also doctors. At some point the public needs to be woken up to the real cost of health care. An employer sponsored system was a great way to get things started back in the 40's and 50's; but it is a seriously out-of-date model. It hides the real cost of care. Many docs and legislators and uninformed people have jumped on the bash-the-insurance-company bandwagon. All that shows is their ignorance of the topic. Truth is, in the not-for-profit segment of the business; admin costs are about 10 to 12%. So eliminate the insurance companies and depending on utilizattion trends for that year you might not see a rate increase that year. (That is of course if you can find someone to do all the administrrative work for free). Then of course there is the year after, and the year after, and so on and so forth. Bottom line is that the cost of care, the actual costs incurred per patient per year has been going up on average double digit percentages per year while insurance admin costs have been going down. Some of it is utilization trend, some of it is cost per encounter, some of it is institutional overcapacity, some of it is new drugs and technologies, some of it is malpractice liability, some of it is an aging population, and so on. Contrary to falsely held beliefs, it would be far worse without the insurance companies. The automation of administrative systems and the reimbursement agreements between providers and insurance companies are actually putting downward pressure on costs. An anecdote for an ending here. I had a surgery 2 summers ago. I was in the system for 24 hours. About 2 hours under the intensive care of 4 people, a couple more hours under 1 on 1 not-so-intensive care, and about 20 hours of someone stopping in to say hello every couple hours. The billed charges came to $44K. The insurance company cut the bill just about in half based on their contractual agreements for reimbursement. I paid my $2K annual out-of-pocket, and the insurance paid $20K. But for someone paying cash, the bill would have been $44K. That is fucking ridiculous. The real culprit folks is the cost of care, and someday our insurance companies and legislators are going to have to face that, take off the gloves, and go after the actual providers of care to change the supply side of the equation - despite how politically dangerous it will be to do so. The alternative is a cost of care that is rising so fast it is going to price the average person right out of routine health care in our lifetime. " . . . 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

Well, the insurance companies have computers that deny deny deny claims all day long. So the insurance people don't have to work as hard denying claims. Typically, a small office practice with two or three doctors have at least one person on staff full time to code the insurance claims. They are extensive, and if one little code on page 3 is not right, then insurance company will send it back to you, then you have to repeat the entire process, and between all the mailings, you've lost a week in the process. Source: http://www.talkaboutcuringautism.org/health-insurance/health_ins_reimbursement_tips.htm So yes, insurance companies spend a great deal of time and money rejecting claims. That is absolute bullshit! 90%? Absolute crap! Insurance companies have computers that pay pay pay far more claims than they deny. Don't even know where to start on the gross exxageration about small medical practices. For starters, there are a relatively very few around. Secondly, tell me the name of the 2 or 3 doc clinic that has a person submitting claims full-time. If someone told you this, it is an outright lie or they are the slowest worker bee on the planet. With today's systems it takes seconds to submit a claim, and almost all are submitted electronically. The patient info is all on file, and it takes only seconds to enter codes for procedure, diagnosis, place of service, etc. Get a code wrong, and damn straight it will come back at them. You should see some of the bullshit that gets submitted. And if they are using mail to submit claims, they are part of the problem in admnin costs. Extremely archaic. Initial submission and subsequent adjustments (roughly 5% of claims get adjusted - and that includes all the stupid errors like forgetting the patient name, ID, DOB, procedure, etc) can all be handled electronically. Your total lack of knowledge is showing badly. Even if an electronic claim has to be printed, scanned, or whatever and becomes a piece of paper - it is 1 page long. So the page 3 comment is totally bogus. Get to know the topic before you blast away from the hip with outrageous bullshit claims. " . . . 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

A good reason for health care providers and health care financing to be in the realm of not-for-profit. Some states have that as a regulatory mandate. Health care decisions are far more likely to focus on patient outcomes when the decision makers do not have to answer to stockholders (much less hold stock themselves). I'm sure there are a few bad apples out there, but if Michael Moore's claim is that people that process claims are in general paid more if they deny more - - he's full of shit. It's like assuming the few fraudulent medical practices out there represent the norm. There is some abuse, and there are processes in place to catch it and punish it. Does it continue? Yes. Is it rampant? No. But just to be clear; the company for whom I do the bulk of my work handles over 2 million claims per month, has a little over 100 claims processors (80% of claims are never touched by humans), and nobody has any incentive whatsoever to pay less than or more than the contracted benefit. The audits that are performed are to ensure payments exactly reflect the benefits as stated in the contract - not a penny more or a penny less. There are some incentives in place but they are all geared towards accuracy as measured against benefit purchased - not dollars paid out. There also is no payout if there is an operating loss (running administratively in the red), not to be confused with claims loss due to utilization trend or underwriting loss. " . . . 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

Is the system run on that 700/mo, or is it also funded by income taxes? Please learn the purpose of paragraphs. Your lengthy posting was mostly wasted time because it's an ordeal to read. Don't know the details beyond what was provided; but I doubt very much that the system is funded solely by that rate of contribution. " . . . 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

Seems a contradiction to me. You say the astronaut is not aware of gravity, but that they can "feel" it. How can a person feel it but not be aware of it? It would be true if there is no acceleration taking place (which would require being in a closed system and not acceleerating relative to any of it's other constituent parts). If there is any acceleration (and an astronaut in orbit is accelerating), regardless of whether or not there was any air, it can be detected (within the limits of human perception of course - itsy bitsy amounts of acceleration might not be detected human senses alone). Also, wouldn't the terminal velocity of a fluid in a closed container be the same as the container itself? It is moving the same speed as the container, so it's speed relative to the container is zero. It's speed relative to say, the planet towards which the container is falling would be the same as the container. Either way, it would not be infinite; 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

He'd better make sure he knows what he is getting in to. Definitely not for everybody. See the world translates into forget about ever being able to count on being home. Family, much less kids - -family; forget about it. I have one friend who is a MM. Works the Great Lakes boats. Has been living out of a trunk his entire adult life. Very crusty person. Good man, very self reliant. No social life or family outside of the MM though. They are like the OTR truckers of the seas. " . . . 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 you like them done. " . . . 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

No, you probably misunderstood me :) I meant when the drogue is already released. The guy is standing on the tandem, the drogue is released and he is holding to it, it looks really awesome. Here's a rough sketch of what I meant Your sketch literally made me laugh out loud. Haha no idea why. Maybe because it is a silly drawing of a really stupid thing to do. " . . . 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

Don't know you or him, so don't mean to offend; but, is he psychotic? Violent? Be careful with an ultimatum that could push a desperate and whacked out person over the edge. Yes, he's your dad; but still. Plenty of examples of people doing the unthinkable. Don't become tommorows sensational headline. " . . . 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