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Town HaLL Meetings

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Re: Town HaLL Meetings

Unread postby rangerone314 » Mon 17 Aug 2009, 09:13:48

$this->bbcode_second_pass_quote('Arsenal', '')$this->bbcode_second_pass_quote('HumbleScribe', 'I')t's no wonder you rednecks are worried about riots on the streets...


Ahhh. Such an intelligent and thoughtful response from across the pond.


Yeah, but he DOES have a point. 17% is pathetic, when Europe pays like 10% and Japan about 7%?
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Re: Town HaLL Meetings

Unread postby rangerone314 » Mon 17 Aug 2009, 09:18:29

Here's a dumb question... if a doctor pays $200,000 in malpractice insurance, and there is something like a 50-1 doctor to patient ratio or such in the US, wouldn't that mean that the average patient is footing $4,000 in malpractice insurance in terms of medical costs.

Here's an idea, since parasite lawyers are getting a massive chunk of that $4,000, why not have tort reform to limit malpractice lawsuits?

Oh, gee, a stupid suggestion by RangerOne... THAT might actually bring medical costs down.

Or we could do universal fee schedules like they do in Japan, where each medical procedure has a price pre-determined to limit costs.

Instead of trying to reform the health system, we should reform the political system first, so everyone with a buck to make doesn't get to shape the health system.
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Re: Town HaLL Meetings

Unread postby rangerone314 » Mon 17 Aug 2009, 09:22:58

$this->bbcode_second_pass_quote('AlexdeLarge', '[')img]http://www.ibdeditorials.com/IMAGES/cartoons/toon081709.gif[/img]


Idea of government healthcare is scary but so is health insurance company policies of canceling people's insurance or denying valid claims even when it is illegal (simply because criminal penalties are considered a cost of doing business by the industry and cost them less money than paying claims)

Lawyers #*%$ everything up... health insurance, malpractice insurance, the criminal justice system, the legisislature...
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Re: Town HaLL Meetings

Unread postby rangerone314 » Mon 17 Aug 2009, 09:25:28

$this->bbcode_second_pass_quote('Voice_du_More', 'I') actually had the thought the other day that the shouters might be democratic plants, brown-shirts in plaid if you will. So Obama gets these guys to disrupt his own meetings and then rides in on the proverbial white horse.

All I know is I read some of the bill and if it gets past it is the end of America as we know it. It is not simply a government option it is a government takeover of the entire medical establishment in time. What would be really sad is if they think it will catually lower costs. It can't there is not money to cover the 45 trillion dollars it will cost for the baby boomers to retire en mass. The ride is over, please pick up your wrist watches at the door.


That is so weird though... I had the same thought that they might be democratic plants put there to make republicans look stupid. Until I realized two things: the democrats are not that smart and with people like Bush and Palin the republicans don't need help looking stupid.
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Re: Town HaLL Meetings

Unread postby socrates1fan » Mon 31 Aug 2009, 19:01:17

$this->bbcode_second_pass_quote('AlexdeLarge', '[')img]http://www.ibdeditorials.com/IMAGES/cartoons/toon072409.gif[/img]

How ridiculous.
I know people who are uninsured and those idiotic stereotypes don’t describe any of them.
Most of them are offered an insurance policy (like at Wal-Mart) that does basically nothing for them so it isn’t worth it, and many people simply cannot afford insurance, but put their children on government healthcare.
This is quiet stupid really; there are a lot of uninsured or under insured who simply cannot afford it.
:-x
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Re: Town HaLL Meetings

Unread postby Serial_Worrier » Tue 01 Sep 2009, 18:47:02

$this->bbcode_second_pass_quote('socrates1fan', '')$this->bbcode_second_pass_quote('AlexdeLarge', '[')img]http://www.ibdeditorials.com/IMAGES/cartoons/toon072409.gif[/img]

How ridiculous.
I know people who are uninsured and those idiotic stereotypes don’t describe any of them.
Most of them are offered an insurance policy (like at Wal-Mart) that does basically nothing for them so it isn’t worth it, and many people simply cannot afford insurance, but put their children on government healthcare.
This is quiet stupid really; there are a lot of uninsured or under insured who simply cannot afford it.
:-x


Your anecdotal evidence means nothing. Stats prove that there are not 47 million uninsured because they can't all afford it.
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Re: Town HaLL Meetings

Unread postby socrates1fan » Wed 02 Sep 2009, 10:23:13

$this->bbcode_second_pass_quote('Serial_Worrier', '')$this->bbcode_second_pass_quote('socrates1fan', '')$this->bbcode_second_pass_quote('AlexdeLarge', '[')img]http://www.ibdeditorials.com/IMAGES/cartoons/toon072409.gif[/img]

How ridiculous.
I know people who are uninsured and those idiotic stereotypes don’t describe any of them.
Most of them are offered an insurance policy (like at Wal-Mart) that does basically nothing for them so it isn’t worth it, and many people simply cannot afford insurance, but put their children on government healthcare.
This is quiet stupid really; there are a lot of uninsured or under insured who simply cannot afford it.
:-x


Your anecdotal evidence means nothing. Stats prove that there are not 47 million uninsured because they can't all afford it.


I didn’t say everyone who wasn’t insured, was so because they couldn’t afford it.
However, there are MANY people who don’t have insurance because they simply cannot afford it.
I think a much bigger issue is the underinsured, because you can have crappy insurance (like Wal-Mart insurance) but still be ‘insured’.
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Re: Town HaLL Meetings

Unread postby smallpoxgirl » Wed 02 Sep 2009, 11:11:36

$this->bbcode_second_pass_quote('socrates1fan', 'I') think a much bigger issue is the underinsured, because you can have crappy insurance (like Wal-Mart insurance) but still be ‘insured’.


IMHO, the much bigger issue is overinsurance. If you're using "insurance" every time you go to the doctor, you don't have insurance. At that point, you have a medical payment plan. It's an extremely wasteful and expensive way of paying your medical expenses. Insurance is supposed to cover you in the event of an unexpected and catastrophic event. If it's an expected and predictable expense, you are far better off having savings to cover it and not involving a third party payer. The biggest problem with overinsurance is that it encourages people to wastefully overuse the medical system because they're not paying for it. That then drives up the cost of insurance. IMHO, no one should have insurance with less than a $2000 deductible.

One really simple change that would help out a lot IMHO is to allow everyone access to Health Savings Accounts. For those who aren't familiar, HSA is currently only available to people who aren't eligible for any employer subsidized health plans. You also have to purchase high deductible insurance to qualify. You're allowed then to put $3000 per year into your HSA untaxed. Unlike the employer based health care flex spending accounts, HSA funds can roll over from year to year. It's a great option for a young person who's unlikely to incur medical expenses in any given year, but can save them up for a rainy day. It also doesn't have all the hassles of the flex spending account in terms of having to pay the expense and then submit it to your employer for reimbursement. With the HSA, you get a checkbook and a debit card. When the doctor's bill comes, you just pay it. The accounts are even interest bearing.
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Re: Town HaLL Meetings

Unread postby vision-master » Wed 02 Sep 2009, 11:28:49

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('socrates1fan', 'I') think a much bigger issue is the underinsured, because you can have crappy insurance (like Wal-Mart insurance) but still be ‘insured’.


IMHO, the much bigger issue is overinsurance. If you're using "insurance" every time you go to the doctor, you don't have insurance. At that point, you have a medical payment plan. It's an extremely wasteful and expensive way of paying your medical expenses. Insurance is supposed to cover you in the event of an unexpected and catastrophic event. If it's an expected and predictable expense, you are far better off having savings to cover it and not involving a third party payer. The biggest problem with overinsurance is that it encourages people to wastefully overuse the medical system because they're not paying for it. That then drives up the cost of insurance. IMHO, no one should have insurance with less than a $2000 deductible.


I'm really starting to dislike you. :badgrin:

How on Earth a Doctor with private practice can spend all day posting on web forums is beyond me. How much do you charge for a 20 min office call, $250?
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Re: Town HaLL Meetings

Unread postby smallpoxgirl » Wed 02 Sep 2009, 11:40:19

$this->bbcode_second_pass_quote('vision-master', 'H')ow much do you charge for a 20 min office call?


Thanks to Medicare and their creation, RBRVS, it's not an answerable question. Doctors don't charge based on time. They charge based on CPT codes.

Not that it's any of your business, but I don't have to work today. If I did have to work today, it's only 8:30 PST. The clinic doesn't open until 9:00.
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Re: Town HaLL Meetings

Unread postby vision-master » Wed 02 Sep 2009, 11:43:12

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('vision-master', 'H')ow much do you charge for a 20 min office call?


Thanks to Medicare and their creation, RBRVS, it's not an answerable question. Doctors don't charge based on time. They charge based on CPT codes.

Not that it's any of your business, but I don't have to work today. If I did have to work today, it's only 8:30 PST. The clinic doesn't open until 9:00.


Exactly, Doctors don't post their rates and many have to pay up-front. What a fricken racket. :badgrin:
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Re: Town HaLL Meetings

Unread postby smallpoxgirl » Wed 02 Sep 2009, 11:57:27

$this->bbcode_second_pass_quote('vision-master', 'E')xactly, Doctors don't post their rates and many have to pay up-front. What a fricken racket. :badgrin:


I think it would be a phenomenal thing if doctors were paid by the hour just like a lawyer or an accountant. Blame medicare, not me. In most cases it's impossible to post rates up front because I never know in advance what services I'm going to be performing for any given patient, the list of possible CPT codes is the size of a smallish phone book, and every insurance plan has different adjustments to the fees I end up charging anyway. As a ball park guess, I'd say a 20 minute visit for an established patient that doesn't need any procedures or lab testing is probably going to cost somewhere between $40 and $60 depending on what insurance the patient has. Make that 20 minute visit a colposcopy with 3 biopsies, and it's going to bill out around $1000 and maybe pay anywhere from $500 to $900 depending. That's why I keep talking about how screwed up RBRVS is. It WAY over compensates any sort of invasive procedure. Talking to patients and thinking doesn't pay very much.
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Re: Town HaLL Meetings

Unread postby vision-master » Wed 02 Sep 2009, 17:30:00

Another thing, those HMO's play games with you on drug coverage. The Doc always say, "I don't know if this is covered under your insurance or not'.

Well Doc, find the fook out while I'm still setting here then! :evil:

Otherwise, I gotta make another *^^()% trip down here after it's straighted out. :badgrin:
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Re: Town HaLL Meetings

Unread postby smallpoxgirl » Wed 02 Sep 2009, 19:16:58

$this->bbcode_second_pass_quote('vision-master', 'W')ell Doc, find the fook out while I'm still setting here then! :evil:

Otherwise, I gotta make another *^^()% trip down here after it's straighted out. :badgrin:


Sounds great. No real way to do it. The pharmacist has to send it in for approval and see if they reject it. If it's a formulary issue, the pharmacist should get a response to the rejection that includes a list of covered alternatives. They fax it back to us, and we can approve an alternative.

I'll point out, by the way, that this is another advantage of high deductible health plans. You don't have to worry about whether your script is covered. It's not. Instead of paying a ton of money to the insurance company to give you the run around, you have the money in your HSA to spend at will. In that case, you can ask the doctor a couple of questions that they actually are able to answer "How expensive is this and is there a cheaper alternative?"
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Re: Town HaLL Meetings

Unread postby vision-master » Wed 02 Sep 2009, 20:01:46

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('vision-master', 'W')ell Doc, find the fook out while I'm still setting here then! :evil:

Otherwise, I gotta make another *^^()% trip down here after it's straighted out. :badgrin:


Sounds great. No real way to do it. The pharmacist has to send it in for approval and see if they reject it. If it's a formulary issue, the pharmacist should get a response to the rejection that includes a list of covered alternatives. They fax it back to us, and we can approve an alternative.

I'll point out, by the way, that this is another advantage of high deductible health plans. You don't have to worry about whether your script is covered. It's not. Instead of paying a ton of money to the insurance company to give you the run around, you have the money in your HSA to spend at will. In that case, you can ask the doctor a couple of questions that they actually are able to answer "How expensive is this and is there a cheaper alternative?"


Well, I get nicked on co-pays anyhoo. :badgrin:

I hate those HMO's :)
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Re: Town HaLL Meetings

Unread postby smallpoxgirl » Wed 02 Sep 2009, 23:31:53

$this->bbcode_second_pass_quote('vision-master', 'I') hate those HMO's :)


I love my health insurance. Hasn't paid for anything and that's fine. It costs me $90 per month and has a $5000 deductible and a $6500 per year out-of-pocket cap. If and when I get really sick, it'll be there for me. In the meantime, I pay my doctor bills out of my HSA, and it works great. It would have cost me $450 per month to get a standard, low-deductible, 80/20 co-pay plan. It wouldn't have been nearly as good a protection if I got really sick and I'd be tearing my hair out about co-pays and rejected claims and such.
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Re: Town HaLL Meetings

Unread postby centralstump » Thu 03 Sep 2009, 00:40:50

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('socrates1fan', 'I') think a much bigger issue is the underinsured, because you can have crappy insurance (like Wal-Mart insurance) but still be ‘insured’.


IMHO, the much bigger issue is overinsurance. If you're using "insurance" every time you go to the doctor, you don't have insurance. At that point, you have a medical payment plan. It's an extremely wasteful and expensive way of paying your medical expenses. Insurance is supposed to cover you in the event of an unexpected and catastrophic event. If it's an expected and predictable expense, you are far better off having savings to cover it and not involving a third party payer. The biggest problem with overinsurance is that it encourages people to wastefully overuse the medical system because they're not paying for it. That then drives up the cost of insurance. IMHO, no one should have insurance with less than a $2000 deductible.

One really simple change that would help out a lot IMHO is to allow everyone access to Health Savings Accounts. For those who aren't familiar, HSA is currently only available to people who aren't eligible for any employer subsidized health plans. You also have to purchase high deductible insurance to qualify. You're allowed then to put $3000 per year into your HSA untaxed. Unlike the employer based health care flex spending accounts, HSA funds can roll over from year to year. It's a great option for a young person who's unlikely to incur medical expenses in any given year, but can save them up for a rainy day. It also doesn't have all the hassles of the flex spending account in terms of having to pay the expense and then submit it to your employer for reimbursement. With the HSA, you get a checkbook and a debit card. When the doctor's bill comes, you just pay it. The accounts are even interest bearing.


I've said this for years, but it is comepletly alien to people, including my wife.



They just don't understand the meaning of the word insurance. This has effectively pushed the consumer from the doctor.

Since we treat health insurance like some sort of peicemail cost spreading tool, (i.e. universal health care) why is everyone so scared of the actual thing?

Oh ya. Because we are told by talk radio to be afraid of it.
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Re: Town HaLL Meetings

Unread postby smallpoxgirl » Thu 03 Sep 2009, 01:10:25

$this->bbcode_second_pass_quote('centralstump', 'T')hey just don't understand the meaning of the word insurance.


That's a whole separate rant, but I completely agree. American's WAY over consume insurance. One of the car insurance companies now has this thing where you tell them what you can afford to pay for car insurance and they make a policy to match. If you think about it for a second, that has got to be the stupidest idea ever. The more that you can afford car insurance, the less you need it. If you've got money, you should have savings, which means you can tolerate higher deductibles and save yourself a lot of money. Extended warranties are another great example. The big box electronics stores make almost their entire profit margin off selling extended warranties - basically broken goods insurance. Nobody ever uses the things, so they make a killing off it.

Likewise health insurance. Americans average $6000 per person per year in health care costs, but a $2000 deductible is considered high. So if your health cost are 66% below average for the year, that's an unexpected catastrophe that you need an insurance company to indemnify you for? Really?
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Re: Town HaLL Meetings

Unread postby Pretorian » Thu 03 Sep 2009, 02:04:54

$this->bbcode_second_pass_quote('smallpoxgirl', ' ')Americans average $6000 per person per year in health care costs, but a $2000 deductible is considered high. So if your health cost are 66% below average for the year, that's an unexpected catastrophe that you need an insurance company to indemnify you for? Really?


This expence, $6000 per year its not " average" expence, it includes mega-millon expences of the last days/month/years of life of the Army of Undead who dont pay their bills anyway. Average American doesnt buy an insurance he gets it as a perk from his employer, so big deductible is a big deal. What kind of "health" insurance is it if its usefull only if you are about to die? A young or a middle-aged person without health issues does not need any health insurance at all. He/she has one-- its called immunity system, it works selflessly for a few calories a day and it works better than any Star-Treck style modern hospital with a 1000 MDs in it. As for a catastrophic event-- what does he/she got to lose? an Ipod? Most Americans below 40 do not have a rusty penny to their name.
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Re: Town HaLL Meetings

Unread postby vision-master » Thu 03 Sep 2009, 09:17:01

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('centralstump', 'T')hey just don't understand the meaning of the word insurance.


That's a whole separate rant, but I completely agree. American's WAY over consume insurance. One of the car insurance companies now has this thing where you tell them what you can afford to pay for car insurance and they make a policy to match. If you think about it for a second, that has got to be the stupidest idea ever. The more that you can afford car insurance, the less you need it. If you've got money, you should have savings, which means you can tolerate higher deductibles and save yourself a lot of money. Extended warranties are another great example. The big box electronics stores make almost their entire profit margin off selling extended warranties - basically broken goods insurance. Nobody ever uses the things, so they make a killing off it.

Likewise health insurance. Americans average $6000 per person per year in health care costs, but a $2000 deductible is considered high. So if your health cost are 66% below average for the year, that's an unexpected catastrophe that you need an insurance company to indemnify you for? Really?


I know someone who retired early from a public school system. Under the "school's" plan this person is paying $20,000 year for family insurance now. 8O
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