Dumber than a box of rocks

Discussion in 'Politics' started by Swamp Donkey, Nov 6, 2018.

  1. Zambo

    Zambo Poo Flinger
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    I have a friend who needs biannual cancer checkups to make sure she is still in remission. The last time she went, she visited a hospital in Tecate Mexico instead of going to one in the states.

    The quality of care was outstanding and the bill was far cheaper than anything she would have paid in the states. She made a FB post about the experience and how wonderful it was compared to our system.

    Of course, friends like morningswede chimed in about how great their system was in Mexico and how stupid our system is here. But of course no one understood that the hospital she went to for her checkup is a PRIVATE hospital. It is pay as you go, here is the bill and if you can't pay it you don't get the care. Its not the "free" hospital that the cake-eaters go to so they can apply to have a surgery or get an aspirin for their broken foot. Yes my friends, it is simply amazing what kind of care you can get from a private hospital when they don't have crazy malpractice requirements, don't have to treat customers who can't pay their bills, and a long list of other burdensome requirements that US hospitals have to deal with. None of which will magically go away if we transitioned to a single payer system.

    I for one would love to be able to switch to a private hospital for routine health care and have an insurance policy which covers only catastrophic illness and injury.

    For those who think there is some magical way to give everyone top notch health care for no money, keep f'n dreaming. There isn't enough money on the planet (no matter which planet you live on Crazy eyes Cortez).
     
    • Durty South Swamp

      Durty South Swamp doodley doodley doo!
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      she has. the look. :eek3:
       
      • Swamp Donkey

        Swamp Donkey Ox is a Poor Man's JBoss
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        Lol. I guarantee you as a former counsel for several hospitals and physician groups, Ive forgotten more about the subject than you get from a lifetime of socialist facebook memes.
         
        • Durty South Swamp

          Durty South Swamp doodley doodley doo!
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          :burn2:
           
          • gator1946

            gator1946 Senior Member
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            If you don't see that the delivery system is badly broken and inefficient as hell, then you've been busy hovering above the system without getting your hands dirty. I've been involved in the nitti gritti for over 25 years. There are huge opportunities to improve the delivery efficiency and reduce cost..20% plus opportunities. Socialism has nothing to do with it. What we have is not a competitive system. It won't get better unless it receives a kick in the a.s.s. Ask some of the Docs around here about our new brilliant mandate for more granular ICD-10 codes. Or the overhead that's involved in getting paid. Or who gets to treat whom for a hangnail. Or what they pay for insurance. Or how often discharge instructions and meds are screwed up when a patient is transferred to another facility. Or overspecialization. Or or or or.
             
            • Durty South Swamp

              Durty South Swamp doodley doodley doo!
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              and govt is gonna solve all those problems huh? sorry bud, govt created most of those problems.
               
              • 5-Star Finger

                5-Star Finger Apex predator of the political forum biome
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                Before the ACA ruined HSAs I saw those as the wave of the future. A tax advantaged account that rewards me for saving money and then gives me access to a cash price for healthcare? Yes, please. My premium and "account fee" combined was $47 a month and I contributed $250 in pretax income for my wife and myself. If we did not use this money - it was still ours, it didn't vanish into a health insurers "earned premium." Because my employer also had a benefit in contributing they matched the first $200. The plan had a high deductible, but an out of pocket maximum was only about 12k so any accident, surgery, or cancer treatment would be mostly covered and my bill wouldn't be stupid. As it didn't involve a "network" I had the power to shop.

                When we had our son we picked a doctor and swiped a card. Done. Trip to the dentist? Swipe the card. We found a dentist we loved that didn't typically take clients with insurance, government or otherwise. Because he didn't have a whole staff of billers filling out forms and making phone calls to get paid he could offer services at prices in line with copays and in some cases cheaper - all without me having to pay anyone a monthly premium for dental "insurance."

                Because the insurance company would almost never have to pay out, the insurance was reasonable. It provided me with an incentive to save - provided my employer with an advantage to contribute and do so in a way that was much more transparent than a "company health plan." The problem is the idea of health insurance. Insurance works when the risks of a claim are balanced against the premium paid. If people were wearing blindfolds while driving, car insurance would be through the roof. With the terrible diets, lack of exercise and the high stress lives people are leading there are going to be health problems. You can't have a functional "insurance" program, government or otherwise for something that is definitely going to happen. That's why a HSA with a reasonable out of pocket maximum that will cover catastrophic, low probability events is the best solution for the vast majority of people, in my opinion - that is if we repeal the ACA that wrecked its model by requiring that it cover things that had to be exempted from the deductible, defeating the whole point of the plan in the first place.

                We can try and make a plan for the people that don't fit in that mold - but it should be tailored to that and not an attempted takeover of healthcare.
                 
              • Swamp Donkey

                Swamp Donkey Ox is a Poor Man's JBoss
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                Not competitive. Exactly. Lack of competition is THE primary issue.

                Most of the public aren't aware that archaic systems that have been in place since the 1930s, guaranteeing virtual monopolies ("certificates of need" system) keeping medical facilities from competing against each other and lowering prices.

                There's a fine line between socialism and crony capitalism anyway. The effects are similar.

                The entire medical systems still run on Rooseveltian theories of "efficient monopolies". What a joke. These theories have been thoroughly disproven seven decades ago.
                 
                #28 Swamp Donkey, Nov 7, 2018
                Last edited: Nov 7, 2018
                • gator1946

                  gator1946 Senior Member
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                  Where in the world did I say that? They may have to provide a kick in the ass however. Obama care was an attempt to fix the problem without even considering the core of the problem. I screamed from day one that that train was off the tracks.

                  See Donkey's response. I interpret that to mean there's a fine line between a kick and the ass and socialism. Special interests (I'm really beginning to hate that term) will stand in the way of every attempt to reform the system. I myself have an interest in seeing this ridiculous cumbersome over bloated mess stay the way it is. But for the good of us all I will keep screaming foul and get out of the way.

                  If you want things to stay the way they are, let congress diddle around talk talk talk and not do ****. Just sit back and watch prices rise till they bankrupt the country. Meanwhile pass on the opportunity to reduce cost by 20% or more. That would be equivalent to one hell of a tax cut wouldn't it.

                  Oh by the way there's no way in the world congress will do anything. It's a very complicated issue and we've diluted the average IQ of congress to the point that they don't know how to wipe their nose.
                   
                  #29 gator1946, Nov 7, 2018
                  Last edited: Nov 7, 2018
                  • 92gator

                    92gator Well-Known Member

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                    You contradict yourself sir.

                    Socialism has everything to do with it.

                    We just dont own the incremental socialism weve implemented, incrementally

                    By design, of course--since the wholesale of it, would be a non-sale, ab initio.

                    Theyve been chipping away at free market healthcare for decades.

                    The solution is less centralized care, not more--not doubling down on stupid.
                     
                    • 92gator

                      92gator Well-Known Member

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                      1. Not bc of the remaining vestigial free mkt aspects.....

                      2. Where are the lines of Americans going overseas for trestment?

                      3. Why do ppl. constantly seek to come here for treatment? Especially from places like Canada n UK where they have your utopian govmnt provided HC?

                      TBL--Reality doesnt seem to support your contention.
                       
                    • 92gator

                      92gator Well-Known Member

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                      Ok, so how would you propose to procure these '20% cost cuts', that are supposedly there for the taking?
                       
                    • gator1946

                      gator1946 Senior Member
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                      Well thanks for the Sir at least. I don't have time to peel back this onion again. Somewhere in our archives I've discussed point by point what should be done. Think Trump (and I'm not all that fond of him by the way). Blow it up start over. I'm exaggerating of course. But do you think the health care industry is going to decide to blow themselves up? No they will not. Am I advocating socialism. No I am not. I'm a conservative. At least I was until they went nuts.
                       
                    • gator1946

                      gator1946 Senior Member
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                      I'm busy. I wasted literally days posting this stuff back when Obama care was on the table. Go back and find it. I'm too busy making money from our bloated health care system. There is so much I want to say but can't.
                       
                      • gator1946

                        gator1946 Senior Member
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                        Ok, here you go with one example:


                        Doc writes a chart. It includes an impression, a condition code, procedure codes, and meds. Impressions, and conditions are assigned ICD-10 codes. A list of codes which in the government's infinite wisdome has been expanded exponentially. So much so that one Doc told me that’s why he just said screw it and quit. Procedures are assigned a code from an ungodly long list of snomed codes. Meds get rxnorm codes. Don’t screw any of this up in you program set up or you won’t get paid.

                        Next some, not all, entities review the chart they may assign other things like level of care.

                        Next the “completed” chart goes to a third party biller (most of the time…sometimes they bill in-house). The biller checks codes re-assigns a bunch of things and passes it on.

                        Next the insurance company gets it, and decides if everything is legit and if there’s a reason to deny the claim.

                        Next, if they find one reason to deny, back the chart goes to the provider who then has to scramble to fix whatever is wrong or just give up.

                        Next, with problem fixed (hopefully) the chart goes back to the biller.

                        Meanwhile it the right info is not entered correctly for the patient’s insurance, someone has to track that down. In emergency situations they may not even know the carrier. More time tracking that down.

                        Meanwhile pre-authorization is required for anything out of the ordinary. And too much is out of the ordinary. And tons of time is spent dealing with each situation. Provider vs Insurance company.

                        You're getting mighty close to 20 % right there. I know because I know what each of these functions cost.

                        Sound efficient to you? It aint.

                        Annnnnd that's just one of my top twenty inefficient things in the system.
                         
                      • -THE DUDE-

                        -THE DUDE- This is the year!!!

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                        I've had/about to have 2 procedures done on the past 2 years...luckily I haven't had many health issues and rarely have to use my insurance.

                        I had Lasik done 1 1/2 years ago which insurance doesn't cover but i can use my HSA on. I go in to get evaluated and based on how it goes and how bad my eyes are determines which machine and price. I go to have it done and pay my bill and it's done.

                        I am about to have surgery on my wrist in December to remove some cysts. I ask what this will cost...they can't tell me because i have insurance and they can only quote someone who is paying on their own and not through insurance. So i ask what if i pay out of pocket how much...and the response is you have insurance so we have to run it through insurance. Luckily i have a really good plan through my employer and it won't cost me much but still think it's freaking ridiculous. Granted my understanding of health insurance is limited but seems to me they are just going to charge the insurance company as much as possible and they will pay that increased price. I don't understand why there aren't clear prices for procedures. Seems pretty simple.

                        So what exactly is the solution?
                         
                      • Zambo

                        Zambo Poo Flinger
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                        Imagine if you will a world where hospitals have to be efficient and effective in order to compete with other hospitals or else they go out of business. Imagine if the hospitals that provided the best care at the best cost got lots of customers and the hospitals that did a bad job and charged too much money were forced to change or shut their doors. Just think how awful that would be.
                         
                        • gator1946

                          gator1946 Senior Member
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                          Yep. Also see Dude's post above. If we keep up with a laundry list this thread will win the award for longest in chatter history. They do this **** because they can.

                          This discussion is screwing up my like ratio. I quit.
                           
                          #38 gator1946, Nov 7, 2018
                          Last edited: Nov 7, 2018
                          • 5-Star Finger

                            5-Star Finger Apex predator of the political forum biome
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                            Sounds terrible. It would do nothing but harm any other system as well.

                            school 2.JPG
                            Charter.JPG
                             
                            • Gatormac2112

                              Gatormac2112 The Voice of Reason
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                              Conservatives went nuts?

                              :headslap:
                               

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