The $23,000 bug bite

[DragonLady]

Quote:

Not one person with this retarded stance has ever been able to explain in anything resempling REALITY why having some form of UHC is communist. Why is spending on roads, police, fire, parks not communist?

I don't understand that, either.

We'll provide a patch of grass under a shade tree for a man to die under. We'll provide an ambulance to haul him to the hospital AFTER the fact. We'll provide a burial, if we absolutely must (although first we'll hammer the family 'till they're bleeding), and then we'll provide police to prevent the grave being desecrated.

But...we won't provide care to treat the illness that killed him.

[AvalonXQ]

Originally Posted by DragonLady

We'll provide a patch of grass under a shade tree for a man to die under.

You will?

Last I checked, I was going to have to pay thousands of dollars for mine.

[DragonLady]

Originally Posted by AvalonXQ

You will?

Last I checked, I was going to have to pay thousands of dollars for mine.

I was talking about public parks. When I lived in SLC someone told me they were finding a homeless person dead in the park every single day in the winter.

There's a new reason to provide health care: so our fragile children -who can't see a breast in public or a penis anywhere- can be spared the horrific realities of a man turning black and covered with flies.

[AvalonXQ]

Originally Posted by DragonLady

There's a new reason to provide health care: so our fragile children -who can't see a breast in public or a penis anywhere- can be spared the horrific realities of a man turning black and covered with flies.

There's no need. All kids today have plenty of TV so they never have to visit public parks. See? All nice and protected.

[WildCat]

Originally Posted by DragonLady

I was talking about public parks. When I lived in SLC someone told me they were finding a homeless person dead in the park every single day in the winter.

There's a new reason to provide health care: so our fragile children -who can't see a breast in public or a penis anywhere- can be spared the horrific realities of a man turning black and covered with flies.

You have homeless drug addicts dying in the streets in countries with UHC too.

[TheRedWorm]

Originally Posted by WildCat

You have homeless drug addicts dying in the streets in countries with UHC too.

Point?

[AvalonXQ]

Originally Posted by TheRedWorm

Point?

How about, if X and not-X both correlate with Y, it does not make sense to attribute Y to not-X?

[TheRedWorm]

not necessarily, especially when, in one case, all that was offered is assertion. Also, correlation does not imply causation, so there's that.

[TragicMonkey]

Well, I've noticed that even in countries with fully-implemented UHC, people are still mortal and subject to eventual death. This demonstrates to my satisfaction that UHC isn't worth the effort and we should accept whatever we've got instead.

[AvalonXQ]

Originally Posted by TheRedWorm

Also, correlation does not imply causation, so there's that.

Yes, but lack of correlation means there's nothing there to explain in the first place.

Science, it works!

[TheRedWorm]

Originally Posted by TragicMonkey

Well, I've noticed that even in countries with fully-implemented UHC, people are still mortal and subject to eventual death. This demonstrates to my satisfaction that UHC isn't worth the effort and we should accept whatever we've got instead.

I think that's what Avalon and WildCat were advocating.

[WildCat]

Originally Posted by wollery

Except that a lot of these cases wouldn't exist under UHC because such operators wouldn't be able to bill the state in the way they can under Medicare.

Why not?

Originally Posted by wollery

You seem to be operating under the false assumption that UHC systems work the same way Medicare and Medicaid. They don't.

There's no way that the US government is going to purchase every single hospital, clinic, pharmaceutical company, medical equipment manufacturer, etc etc under any UHC system we end up with.

Originally Posted by wollery

Medicare and Medicaid are essentially government funded insurance, and pay out in the same way. UHC operates in a different way, and although fraud is possible, fraud of the type and scale shown in those stories is next to impossible under a proper UHC system.

Right, that's why it's next to impossible to bilk the government in military contracts. Unheard of!

[xjx388]

Originally Posted by TragicMonkey

Well, you're unlikely to find "paracetamol" listed in a US fee schedule. But you won't find such a list easily- they are confidentual business. A provider doesn't want one insurer to know another insurer is paying less, and vice versa. Amy Hospital and Bob Insurance agree that a Kidney Gruzzling costs $500. Bob will pay Amy $300 for each one, Amy can bill the patient for another $100, and the other hundred is sacrificed- which Amy is okay with, because Bob's sending her lots of patients, and Kidney Gruzzlings aren't very common.

But Amy has a deal with Charles Insurance as well. Charles is smaller, will send Amy less business, and Amy knows this when she negotiates the contract. So for Charles, a Kidney Gruzzling will be charged at $600. Charles will pay $400, Amy will bill the patient for $150, and the other $50 is written off.

Amy doesn't want Bob and Charles to know what the other one is paying, or they'll team up. Bob and Charles don't want Amy to know what they're paying Debbie Hospital, or Amy will realize she's a chump and getting less than half what they're paying Debbie for Kidney Gruzzling. Amy doesn't want Debbie to know what Amy's deals with Bob and Charles are because then Debbie could undercut Amy's prices and steal her business. And Bob and Charles have the same issue with each other, that each could undercut the others prices and get Amy's business.

Fee schedules are secret because neither provider nor insurer wants any other providers or insurers to know what they're charging and paying.

If only it were that easy to negotiate insurance contracts (as a doctor . . .). Doctors have no say in how much government entities will pay them for services; you get what they give you. Insurances say they will negotiate, but solo/small group docs really have no leverage. Large groups and hospitals have more, but even then, reimbursement is largely the same across docs and hospitals. Bob Insurance will only pay so much for a Kidney Gruzzling after all. So docs make sure to charge enough so that the charge is more than the highest paying insurance will pay. Of course, they charge their self-pay patients on a different fee schedule entirely. We are only too happy to share our self-pay prices with anyone who asks.

Of course, this is all moot for us because in a month, my wife will be transferring to a nice cushy hospital job and leaving behind the crazy private practice world.

[WildCat]

Originally Posted by xjx388

We are only too happy to share our self-pay prices with anyone who asks.

No one should have to ask, it should be required by law to publish them for all to see, preferably on the internet.

And no tiered pricing, everyone pays the same.

A little market pressure isn't a bad thing.

[wollery]

Originally Posted by DragonLady

I don't understand that, either.

We'll provide a patch of grass under a shade tree for a man to die under. We'll provide an ambulance to haul him to the hospital AFTER the fact. We'll provide a burial, if we absolutely must (although first we'll hammer the family 'till they're bleeding), and then we'll provide police to prevent the grave being desecrated.

But...we won't provide care to treat the illness that killed him.

Originally Posted by DragonLady

I was talking about public parks. When I lived in SLC someone told me they were finding a homeless person dead in the park every single day in the winter.

There's a new reason to provide health care: so our fragile children -who can't see a breast in public or a penis anywhere- can be spared the horrific realities of a man turning black and covered with flies.

Originally Posted by WildCat

You have homeless drug addicts dying in the streets in countries with UHC too.

Well, you totally missed DL's point there.

[AvalonXQ]

Originally Posted by TheRedWorm

I think that's what Avalon and WildCat were advocating.

If someone was attacking US health care with the fact that Americans are mortal, it would certainly be relevant that Canadians and Brits are still mortal as well.

[TragicMonkey]

Originally Posted by xjx388

If only it were that easy to negotiate insurance contracts (as a doctor . . .). Doctors have no say in how much government entities will pay them for services; you get what they give you. Insurances say they will negotiate, but solo/small group docs really have no leverage. Large groups and hospitals have more, but even then, reimbursement is largely the same across docs and hospitals. Bob Insurance will only pay so much for a Kidney Gruzzling after all. So docs make sure to charge enough so that the charge is more than the highest paying insurance will pay. Of course, they charge their self-pay patients on a different fee schedule entirely. We are only too happy to share our self-pay prices with anyone who asks.

My current employer is glad to trade the potential increased profit margins from individual negotiations for the security of a steady supply of patients whose bills will definitely be paid. In fact, on the strength of the current legislation, they gave us all raises!

[TragicMonkey]

Originally Posted by AvalonXQ

If someone was attacking US health care with the fact that Americans are mortal, it would certainly be relevant that Canadians and Brits are still mortal as well.

Canadians aren't. When a Canadian dies, it wakes up aboard a resurrection ship, in a vat of maple syrup, with all its memories downloaded to an identical body.

[AvalonXQ]

Originally Posted by TragicMonkey

When a Canadian dies, it wakes up aboard a resurrection ship, in a vat of maple syrup, with all its memories downloaded to an identical body.

^ Answer.

Question:
"Explain the continued existence of William Shatner in one sentence."

[xjx388]

Originally Posted by WildCat

No one should have to ask, it should be required by law to publish them for all to see, preferably on the internet.

And no tiered pricing, everyone pays the same.

A little market pressure isn't a bad thing.

Why should docs be required to publish their prices on the internet? I see little benefit to such a law. If people would simply shop around for a doc or hospital like they do for anything else, they would find prices are not as hidden as widely believed.

[xjx388]

Originally Posted by TragicMonkey

In fact, on the strength of the current legislation, they gave us all raises!

How so? I don't see that part of the legislation. . .

[DragonLady]

Quote:

Why should docs be required to publish their prices on the internet?

Why not? Every retail establishment in the country must mark items with prices, and honor those prices.

[TragicMonkey]

Originally Posted by xjx388

How so? I don't see that part of the legislation. . .

It's related to the other sentences in that post. My employer is confident that the legislation will increase its financial security, and therefore decided it was able to give all the employees raises. Only small ones, but still, pretty sweet.

[WildCat]

Originally Posted by wollery

Well, you totally missed DL's point there.

I could have sworn the point was: "There's a new reason to provide health care: so our fragile children -who can't see a breast in public or a penis anywhere- can be spared the horrific realities of a man turning black and covered with flies."

Children in UHC cuntries see the same thing. Plenty of homeless junkies dying in the streets and parks of UHC countries.

[WildCat]

Originally Posted by xjx388

Why should docs be required to publish their prices on the internet?

So people copuld look them up for themselves without having to travel or listening to a sales pitch.

Originally Posted by xjx388

I see little benefit to such a law. If people would simply shop around for a doc or hospital like they do for anything else, they would find prices are not as hidden as widely believed.

They can shop much more efficiently online, especially if they're immobile. Who wants to travel from hospital to hospital?

Health care costs are out of control, it couldn't hurt to introduce some market forces.

[DragonLady]

Well...that is what my post says. But most of the homeless I was referring to froze to death for lack of shelters. Frostbite, hypothermia and other medical problems were untreated unless they were life threatening. And by that time it was too late for them.

I have no idea how many were drug addicts.

[Skeptic Ginger]

Originally Posted by AvalonXQ

You will?

Last I checked, I was going to have to pay thousands of dollars for mine.

You can lie down and die in a park for free.

[AvalonXQ]

Originally Posted by Skeptic Ginger

You can lie down and die in a park for free.

Are you sure Obama hasn't taxed that yet?

[TheRedWorm]

Originally Posted by AvalonXQ

Are you sure Obama hasn't taxed that yet?

Well, I heard Romney's trying to set up toll booths, so...

[PhantomWolf]

Originally Posted by WildCat

Why not?

I'll explain in a moment.

Quote:

There's no way that the US government is going to purchase every single hospital, clinic, pharmaceutical company, medical equipment manufacturer, etc etc under any UHC system we end up with.

They don't need to. It helps if they have some control, but it's actually not needed.

Quote:

Right, that's why it's next to impossible to bilk the government in military contracts. Unheard of!

The trouble is that you don't understand the way to do it.

Okay, so the how.

Medical issues are not really random. That is, if you have a population, while random to the individuals of that population, you can get a pretty good estimate of how many injuries, how many heart operations, how many hip surgeries, how many cancers, etc, a specific hospital or clinic will see each year based on their population base. In wealthier areas the rate will be a little lower, in poorer areas it will be higher, but the same game applies.

So, instead of the hospital billing the Government, the Government pre-buys the services of the hospital. For instance, say you know that a particular area has approximately 0.3% Heart disease a year and a population of 200,000 people, then you know that you should have about 600 people needing treatment in a year. It's not that hard to correlate the estimate to the data to make sure of that. Let's assume they do match (if they don't you investigate and redo the estimate on what you find until they do). You then go to the Hospitals in the area that cover heart operations, and you buy 625 operations from them. They now have funding to pay for doing 625 heart ops in that year, 25 more than you expected. At the end of the year they show how many they actually did. If the figure is within a certain percentage of the original estimate (600) all is good and you carry on. If it's low then they have to explain why, may have to pay money back, and it might effect furture funding. If they are over the number, again it gets investigated as to why, and if legite, the funding is increased to cover those operations, and future funding could be increased.

Guess what, you have now eliminated fraud by over billing because any claims of higher numbers of services required than the population of the area predicts will be investigated prior to funding being given.

Best of all, hospitals and clinics can get on with the job of treating people instead of chasing payment for their services, because they have already been paid to do the job. The only way they can commit fraud is to get paid and then treat no one, and they'd get caught very quickly doing that.

[KDLarsen]

I never did get an answer to my question, inquiring as to which exercise regimen is recommended to restore the hair cells in my cochlea

[The Man]

Originally Posted by KDLarsen

I never did get an answer to my question, inquiring as to which exercise regimen is recommended to restore the hair cells in my cochlea

An answer I'd lend at least one ear to hearing, KDLarsen.