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Old 12-06-2011, 12:38 PM   #201
suzzer99
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Re: Who Will Be the 2012 Republican Presidential Nominee?

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Originally Posted by seattlelou View Post
And you thought I was unreasonable for calling taxation confiscation.
lol that's the point, it was in response to one of the tax=theft people who has no problem with people walking away from a huge medical bill.
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Old 12-06-2011, 12:45 PM   #202
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Re: The Great ObamaCare Debate, Part 231

I've had no dental insurance for twenty years. Yet I see the dentist every five months for a cleaning. I was happier with health care before insurance. I pay for what I use.
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Old 12-06-2011, 12:49 PM   #203
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Re: The Great ObamaCare Debate, Part 231

Dentist is a little different than catastrophic health coverage.
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Old 12-06-2011, 12:55 PM   #204
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Re: The Great ObamaCare Debate, Part 231

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Of course not. You need to explain how with that extra money you and everyone else is going to suddenly feel generous enough that you take care of all of those sick people that use to get treated by the Government.

And government run education has gone better than a completely free-market education system.
Well JJ why do the dems cry about taking care of the poor if they wouldn't be willing to do it if no one was forcing them to. Isn't that a cop-out to say they care about it but want someone to do it for them. I personally do care and would have no problem contributing to something like that, because I do feel it's our responsibility to take care of someone in need, our responsibility not the govs.

And come on now you're not really going to defend our schools right? I mean we're doing terribly compared to other countries, despite spending more than they are. Why?
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Old 12-06-2011, 12:58 PM   #205
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Re: The Great ObamaCare Debate, Part 231

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I've had no dental insurance for twenty years. Yet I see the dentist every five months for a cleaning. I was happier with health care before insurance. I pay for what I use.
Get cancer or heart disease and get back to us on that.


(Actually please don't get either, just look up the costs associated with both. Hell look up the cost of having your appendix removed.)
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Old 12-06-2011, 01:16 PM   #206
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Re: The Great ObamaCare Debate, Part 231

this is just more
"we need more insurance to cover the increase in costs doctor's charge because of insurance'
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Old 12-06-2011, 01:36 PM   #207
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Re: The Great ObamaCare Debate, Part 231

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Well JJ why do the dems cry about taking care of the poor if they wouldn't be willing to do it if no one was forcing them to. Isn't that a cop-out to say they care about it but want someone to do it for them. I personally do care and would have no problem contributing to something like that, because I do feel it's our responsibility to take care of someone in need, our responsibility not the govs.
Well that's great that you feel that way, but most people don't. A lot of people, in fact, say exactly what you do, but then when they get their tax rebate they spend the money on a flat screen TV. In the meantime people without insurance keep dying.

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And come on now you're not really going to defend our schools right? I mean we're doing terribly compared to other countries, despite spending more than they are. Why?
For a myriad of reasons, not the least of which is how the money is being spent. The private schools aren't faring much better, though. Studies show the test scores for US schools are trending down, for both public and private schools.
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Old 12-06-2011, 01:38 PM   #208
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Re: The Great ObamaCare Debate, Part 231

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Originally Posted by TheWorm967 View Post
Well JJ why do the dems cry about taking care of the poor if they wouldn't be willing to do it if no one was forcing them to. Isn't that a cop-out to say they care about it but want someone to do it for them. I personally do care and would have no problem contributing to something like that, because I do feel it's our responsibility to take care of someone in need, our responsibility not the govs.
This is great and all. But you were claiming that if we removed all this government "theft" people would still ensure that people were treated properly. Do you have any basis for this?

I don't understand why you want to invoke the name of the Dems when that has nothing to do with this. There are lots of people that will honestly tell you that if they were given more money they wouldn't spend it on charity.

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Originally Posted by TheWorm967;
How's government run education gone?

Quote:
Originally Posted by jjshabado;
And government run education has gone better than a completely free-market education system.
Quote:
And come on now you're not really going to defend our schools right? I mean we're doing terribly compared to other countries, despite spending more than they are. Why?
First off, define "terribly compared to other countries". I think you'll find that a bit of an exagerration.

Second, are you under the impression that those other countries don't have government intervention in their school systems? Or do you believe that it's only the American Government that mismanages things?

Edit: Adding context of our discussion so that maybe you'll actually stay on topic.
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Old 12-06-2011, 02:15 PM   #209
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Re: Who Will Be the 2012 Republican Presidential Nominee?

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lol that's the point, it was in response to one of the tax=theft people who has no problem with people walking away from a huge medical bill.
I know man i am with you on this.
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Old 12-06-2011, 02:28 PM   #210
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Re: The Great ObamaCare Debate, Part 231

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I've had no dental insurance for twenty years. Yet I see the dentist every five months for a cleaning. I was happier with health care before insurance. I pay for what I use.
I don't believe in dental insurance. If you have a bit of money saved up in case of a catastrophic event, then its easy to recognize that due to the cost of administration and the fact that insurance companies profit off of you makes it a -EV bet in both nominal and utility dollars.

Unfortunately however there's a problem that keeps me from simply dodging the issue of dental insurance. Insurance companies make deals with dental offices behind closed doors that dictate the amount the company and the patient will pay for certain procedures. The problem is that this combined amount is usually going to be less than what an office ideally wants to charge. The office is usually ok with this because it brings in a large group of new customers, but to make up for the fact that it doesn't get what it wants from insured customers it charges uninsured customers more.

So unfortunately it creates a situation in which the size and power of the insurance companies screws over the uninsured. This situation alone may turn insurance into a +EV bet for me, but obviously there are plenty of factors to consider.
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Old 12-06-2011, 02:31 PM   #211
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Re: The Great ObamaCare Debate, Part 231

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Nurse practitioners and physician's assistants do this too, bro.



No, it's systemic.

http://theincidentaleconomist.com/wo...-introduction/

The bracket is the excess spending in the US:



This is what comprises that bracket with the portions physicians are responsible for highlighted:





That story is told in Atul Gawande's Complications IIRC. Good read for those interested.



This series covers it pretty well: http://theincidentaleconomist.com/wo...-introduction/
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Well I'm not going to get into your last 2 posts very much but I really don't think they indicate all all that much about the US healthcare system needing to be reformed significantly. Of course significantly is a subjective term. Also I'm not claiming that US healthcare system doesn't need significant reform (I'm on the fence) but just saying that your posts don't make it all that clear that this is the case.

I've never understood the argument that the US spends too much on healthcare as evidenced by the percentage of GDP devoted to healthcare costs. First and foremost of all as societies advance of course they are going to devote more of their resources to health care IE improved outcomes for health care. Second of all where is the threshold at for spending too much? Personally I don't thing comparisons to other countries strictly on the basis of GDP says a whole lot. The quality of care issue has been discussed ad infinitum in the the threads on this forum.
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Old 12-06-2011, 02:54 PM   #212
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Re: The Great ObamaCare Debate, Part 231

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Old 12-06-2011, 03:00 PM   #213
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Re: The Great ObamaCare Debate, Part 231

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the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.
Quote:
Today, that bomb goes off.

Today, the Department of Health & Human Services issues the rules of what insurer expenditures will—and will not—qualify as a medical expense for purposes of meeting the requirement.

As it turns out, HHS isn’t screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.

Here’s an example: For months, health insurance brokers and salespeople have been lobbying to have the commissions they earn for selling an insurer’s program to consumers be included as a ‘medical expense’ for purposes of the rules. HHS has, today, given them the official thumbs down, as well they should have. Selling me a health insurance policy is simply not the same as providing me with the medical care I am entitled to under the policy. Sales is clearly an overhead cost in any business and had HHS included this as a medical cost, it would have signaled that they are not at all serious about enforcing the concept of the medical loss ratio.
http://www.forbes.com/sites/rickunga...day-halleluja/

ObamaCare provision kicking in today.
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Old 12-06-2011, 03:04 PM   #214
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Re: The Great ObamaCare Debate, Part 231

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I've never understood the argument that the US spends too much on healthcare as evidenced by the percentage of GDP devoted to healthcare costs.
Neither have I, but that argument comes from the right as an excuse to cut benefits or even eliminate "socialized" medicine. The argument here is that the cost of what we are paying for is too high, not that we are spending too much.
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Old 12-06-2011, 03:15 PM   #215
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Re: The Great ObamaCare Debate, Part 231

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the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit.
So now we'll know what the rake is.
20% lol

Truly shows you how much these companies were gouging you before.

Last edited by NMcNasty; 12-06-2011 at 03:36 PM. Reason: misquote
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Old 12-06-2011, 03:24 PM   #216
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Re: The Great ObamaCare Debate, Part 231

Meh, this is a good response to that article: http://www.forbes.com/sites/timworst...-in-obamacare/

It certainly rings much truer to me.
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Old 12-06-2011, 03:30 PM   #217
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Re: The Great ObamaCare Debate, Part 231

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Originally Posted by adios View Post
I've never understood the argument that the US spends too much on healthcare as evidenced by the percentage of GDP devoted to healthcare costs. First and foremost of all as societies advance of course they are going to devote more of their resources to health care IE improved outcomes for health care. Second of all where is the threshold at for spending too much? Personally I don't thing comparisons to other countries strictly on the basis of GDP says a whole lot. The quality of care issue has been discussed ad infinitum in the the threads on this forum.
WRT. the bolded, I agree, and that's included in the first graph I posted. That one didn't sort spending by % of GDP, but rather as expected exptenditure based on national wealth. It's from a McKinsey study which acknowledges that a country will spend more money on health care as it's per capita income increases. What it's pointing out is that the US expenditures are a vast departure from the regression curve, and it's that departure which is what they're considering excess spending.

The problem is that despite all that additional spending the outcomes are generally not improved.

I'm not sure what the optimal level of spending is, but I do tend to agree that devoting far more of your resources to a problem while achieving similar results as your peers who devote much less to that problem is generally not ideal.


My second post was more of an "interpret what you will" post, but it should be obvious that health care demand is generally inelastic regardless of the underlying economic conditions, and that the market does't really work efficiently when it comes to HC.
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Old 12-06-2011, 03:31 PM   #218
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Re: The Great ObamaCare Debate, Part 231

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What aspect of Obamacare is making you change your doctor?
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Old 12-06-2011, 03:48 PM   #219
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Re: The Great ObamaCare Debate, Part 231

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Sorry but I must be missing something. Why can't you keep your own doctor? If you already have health insurance, what is going to change for you after PPACA?
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Old 12-06-2011, 04:00 PM   #220
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Re: The Great ObamaCare Debate, Part 231

Shifting millions of Americans into medicaid or some other type of government supported plan rather than the employer provided insurance they now have?

This is still up for debate?
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Old 12-06-2011, 04:08 PM   #221
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Re: The Great ObamaCare Debate, Part 231

btw- since these threads are so fun.

I saw a 23 year old healthy female the other day who was referred to me for a "bullseye maculopathy." You can google if you want--this would probably fall into the 20% that the chimp/robot couldn't get right.

Anyway, I didn't find anything wrong with her. I had my partner look at her also and I called the referring doc to ask him what exactly he thought he saw. I did an OCT which was normal. I also took funds photos at no charge. I think she's got blue cross insurance. Here's a normal OCT (not hers):



So, new patient in my office for about 90 minutes. Gets some tests done and sees two doctors.

How much should I get paid for seeing this patient?

How much will I get paid for seeing this patient?
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Old 12-06-2011, 04:10 PM   #222
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Re: The Great ObamaCare Debate, Part 231

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Shifting millions of Americans into medicaid or some other type of government supported plan rather than the employer provided insurance they now have?

This is still up for debate?
Except that's not happening, the public option was rejected.

So yeah, I guess it is.
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Old 12-06-2011, 04:10 PM   #223
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Re: The Great ObamaCare Debate, Part 231

iirc from my mom, one visit, no procedures, ~50 bucks after average overhead on medicare


pay system is so effed.
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Old 12-06-2011, 04:11 PM   #224
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Re: The Great ObamaCare Debate, Part 231

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So, new patient in my office for about 90 minutes. Gets some tests done and sees two doctors.

How much should I get paid for seeing this patient?

How much will I get paid for seeing this patient?
Too much, probably.
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Old 12-06-2011, 04:34 PM   #225
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Re: The Great ObamaCare Debate, Part 231

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So, new patient in my office for about 90 minutes. Gets some tests done and sees two doctors.

How much should I get paid for seeing this patient?

How much will I get paid for seeing this patient?
Just off the top of my head since we're just having fun here -

1. Probably around $125, just thinking of a doctor's salary in hourly terms.

2. Immediately about $50. The benefits of carrying an insurance company is difficult to calculate though (I would be interested to see how you do it).
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