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Today I spent 3 hours and about 15 phone calls to determine how much an MRI will cost me. They thought I was from another planet because I was trying to figure out the cost ahead of time. What other industry in the world expects people to just mosey in and have an expensive procedure and treats you like you're from another planet and you're inconveniencing them by wanting to know the price? The whole thing is a joke.

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Received a gofundme donation request this past weekend.  The campaign is for acquaintances who are about 50.  They both had serious health problems in the past year.  The wife is regularly traveling cross-state to the Cleveland Clinic and the husband has had a heart attack, back surgery, and needs another back surgery.  He just lost his job since the employer didn't want to keep paying a guy who is barely at work, and now Cobra is running out. 

 

They were both big anti-Obama, pro-Trump people.  Like I said, they're 50, and there's some chance they won't ever work again.  It's 15 long years until they qualify for Medicare, so who knows what happens.  They and others like them will lose their homes and perhaps have to declare personal bankruptcy. 

 

But Obama was a Communist, so they won. 

 

I had a very similar experience with relatives.  The irony is completely lost on them as well.


"Someone is sitting in the shade today because someone planted a tree a long time ago." - Warren Buffett 

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People are truly brainwashed. They are so convinced America always has it the best that they allow themselves to get blatantly screwed.

 

Americans brainwash themselves in some kind of weird cultural echo-chamber rather than getting brainwashed from the top down. But the effect is the same.

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Today I spent 3 hours and about 15 phone calls to determine how much an MRI will cost me. They thought I was from another planet because I was trying to figure out the cost ahead of time. What other industry in the world expects people to just mosey in and have an expensive procedure and treats you like you're from another planet and you're inconveniencing them by wanting to know the price? The whole thing is a joke.

 

Yeah I had that exact same experience with MRI's and other tests.  Nobody seemed to even know who knew how much things cost.  They assured me that my insurance would cover things without even asking who my insurer was or if I was on a high-deductible plan. 

 

 

 

 

I had a very similar experience with relatives.  The irony is completely lost on them as well.

 

I know someone who just suffered a food poisoning episode while vacationing outside the United States.  They came back and complained endlessly about how the ER didn't help them right away because they have a "ranking" system for who they help first.  Yeah, so do our ER's.  I saw a woman get bitten by a German Shepard a few years ago in Eden Park and drove her to Christ Hospital.  They took her right away, ahead of everyone else in the waiting room. 

 

 

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^^Or my Fox News family members will tell me that socialist countries wait 6 months to see a specialist, so they travel to the USA to get things done.  Have they ever tried to get an appointment with a specialist at the Cleveland Clinic?  It's a 6 month wait in most departments at a minimum....

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Kentucky being Kentucky -- then again, Ohio has been a gubernatorial breath away from letting its bubba legislature do the same thing here....

 

Bevin cuts dental, vision benefits to nearly 500K Medicaid recipients

https://www.courier-journal.com/story/news/2018/07/02/dempcrats-blast-matt-bevin-cuts-medicaid-rash/749974002/


"Life is 10% what happens to you and 90% how you respond." -- Coach Lou Holtz

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A friend wrote this....

The problem with for profit health insurance is self evident. You insure your car, your home, your business in a compact with the insurance provider that you will behave responsibly and not wreck your car, burn down your house or serve somebody a bad fish taco. There is a reasonable expectation that you may never need the insurance you’ve purchased and if you do the cost will be offset by the premiums that you and others pay and the insurance company can make money and remain profitable even while paying out claims. Health insurance can’t work like that because no matter who you are you are going to get old, you are going to get sick and you are going to die. The only way it makes sense as a sustainable business model is to cut people off when they start to cost money to insure. Universal care is a moral imperative in a modern civilized society. We share the costs of the roads, police and fire and many other services because that’s what people do when they want to live together in a healthy community with other people.

 


"Life is 10% what happens to you and 90% how you respond." -- Coach Lou Holtz

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The only way it makes sense as a sustainable business model is to cut people off when they start to cost money to insure.

 

 

 

...and no private company provided insurance to older people, which is why Medicare was created.  I hear old people complain about Medicare because it doesn't pay for absolutely everything.  They complain about a copay going up from $10 to $15.  Well guess what, if this program didn't exist, you'd just be drooling in a wheelchair out in the hallway if you hadn't already died. 

 

We have color slides of my great-uncle recovering from Polio in the 1950s.  You see the nurses in those old-fashioned outfits instead of scrubs but then you notice that they just didn't have much equipment.  There's a whirlpool, an iron lung, and that's about it.  They had virtually nothing to aid people in their recovery from situations that we resolve routinely today.  But those routine recoveries are often very, very expensive -- more expensive than a college education, more expensive than a house.  Sure, the labor is expensive, but a bunch of that expense is profit for the drug makers and medical device manufacturers.  And then the insurers and the huge cost of advertising, billing, and new buildings with highway visibility that advertise a medical system's brand to 70,000 passing cars each day. 

 

 

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^ think about how huge of a subsidy Medicare is to insurance companies.  The government insures the most expensive people leaving younger healthier people for the vultures, I mean, medical industrial complex

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^ think about how huge of a subsidy Medicare is to insurance companies.  The government insures the most expensive people leaving younger healthier people for the vultures, I mean, medical industrial complex

 

And look at the stock performance of the major insurers since the Affordable Care Act came into effect.  Some of them have more than doubled.  United Health has increased 5x from $50 to $250.  Mysteriously, Cardinal Health is back to 2014 levels. 

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People will never realize that the Affordable Healthcare Act was a giant stunt by both parties, but the Republicans came out way ahead.  The Republicans convinced their base that it was socialism when in fact it was cold-blooded capitalism (it was, of course, Romneycare, which was in itself a way in which Romney tricked the Democrats in the Mass gen assembly before they could push their own plan).  The Democrats convinced their base that it was socialism when in fact is was Romneycare, and therefore cold-blooded capitalism.

 

aetna_zps7au2mbdi.jpg

 

unitedhealth_zpsoujid0wg.jpg

 

anthem_zps75fbgvz8.jpg

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People will never realize that the Affordable Healthcare Act was a giant stunt by both parties, but the Republicans came out way ahead.  The Republicans convinced their base that it was socialism when in fact it was cold-blooded capitalism (it was, of course, Romneycare, which was in itself a way in which Romney tricked the Democrats in the Mass gen assembly before they could push their own plan).  The Democrats convinced their base that it was socialism when in fact is was Romneycare, and therefore cold-blooded capitalism.

 

Ding ding ding ding!  We have a winner! 

 

Now how to we convince the rank and file American's that they are all being duped by both parties in the name of profits? 

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Today I spent 3 hours and about 15 phone calls to determine how much an MRI will cost me. They thought I was from another planet because I was trying to figure out the cost ahead of time. What other industry in the world expects people to just mosey in and have an expensive procedure and treats you like you're from another planet and you're inconveniencing them by wanting to know the price? The whole thing is a joke.

 

I lived a number of years in a developing country in South America. I didn't have insurance and didn't need to because medical care was so cheap there. (They have free universal healthcare but you can choose to use a private hospital if you want to pay for better/faster service.)

 

You show up to the hospital and request to see a doctor or specialist of choose. You then prepay a flat consult fee ($15 US at the time) and wait outside the doctors office.

 

He calls you in and examines you, explains what your problem is in plain terms, and his recommended course of action. He tells you to go to the front to get a quote. It's like ordering healthcare from a fast food menu. It's brilliant and there's no surprises.

 

You get your quote and if you choose to move forward, you prepay with cash or a debit card or whatever, and go back to the doctor with the receipt. He does the procedure, gives you a prescription, xray, whatever it is he ordered. Once you are done, you go back to the front for a final invoice. They give you an itemized list of every service, pill, item, that you used and a total cost. You are given this to review. If they went over the estimate, you may owe a few more dollars. If they are under budget, they refund the balance.

 

And you go on your merry way.

 

Amazing an "underdeveloped" country can figure this out.

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Amazing an "underdeveloped" country can figure this out.

 

I have already had a few adventures with billing.  Part of the problem is that the bill (or second bill for the same visit) arrives more than a month after you were there, and if you went to multiple doctors and had multiple tests, it is hard to remember what actually happened on a particular day.  You often get a bill from your insurance company AND the office for the exact same visit/test.  So you can easily double pay for the same thing. 

 

Blood testing seems to be pretty organized, from what I can tell.  It's also fast and pretty cheap.  Makes you wonder what the hell Theranos was trying to achieve, other than defrauding investors. 

 

 

 

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The Best Health Care System in the World

 

@GlobeMCramer

Awful scene on the orange line. A woman’s leg got stuck in the gap between the train and the platform. It was twisted and bloody. Skin came off. She’s in agony and weeping. Just as upsetting she begged no one call an ambulance. “It’s $3000,” she wailed. “I can’t afford that.”

 


"Life is 10% what happens to you and 90% how you respond." -- Coach Lou Holtz

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All those Xtreme sports guys know the game, at least the more Xperienced ones ones. Unless they've got a ton of money like Pastrana or something, it's no ambulance unless completely necessary. They ask what everything costs ahead of time.

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Amazing an "underdeveloped" country can figure this out.

 

I have already had a few adventures with billing.

 

 

The wife had Humana, and went into a hospital here in Ohio for some tests that her doctor ordered. She presented her Humana card, they entered it in the system, and everything was hunky dory. These tests were "covered" by her insurance.

 

Fast forward 3 or 4 months, and we get an invoice for 5K+ from this hospital. Their explanation? They don't "work" with that insurance company anymore, as they have had problems with them in the past.

 

They were all too happy to accept the card in advance of the procedures, and yet refuse to accept it retroactively???

 

It's all a massive scam.

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I've had that happen too-- select a provider from the insurance company's own list, call and make an appointment, give my policy info, everything's cool, then I show up for the appointment and he practically spits on my insurance card.  "I'm not taking that, they don't pay me." 

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A recent @HUDgov study found that although 87% of HUD-assisted children had insurance coverage through public health insurance programs, they appear to have worse health status than the general population of children https://t.co/92M5EKw6kB


"Life is 10% what happens to you and 90% how you respond." -- Coach Lou Holtz

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https://thinkprogress.org/mercatis-medicare-for-all-study-0a8681353316/

 

A single-payer Medicare for All system would reduce the amount the U.S. spends on health care by more than $2 trillion, a Koch brothers-funded study released Monday found.

 

Study: https://www.mercatus.org/system/files/blahous-costs-medicare-mercatus-working-paper-v1_1.pdf


Very Stable Genius

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https://thinkprogress.org/mercatis-medicare-for-all-study-0a8681353316/

 

A single-payer Medicare for All system would reduce the amount the U.S. spends on health care by more than $2 trillion, a Koch brothers-funded study released Monday found.

 

Study: https://www.mercatus.org/system/files/blahous-costs-medicare-mercatus-working-paper-v1_1.pdf

 

It also goes to say that this assumes doctors and hospitals get on board with current medicare reimbursements which account for only 1/3 to 40% of billings. Private insurance bills out at 40% higher for hospitals and offices which is why most limit Medicare patients. If the docs and hospitals don't want to play ball it will cost a lot more.

 

In addition, it also says the cost for many people will be significantly more in taxes than actually buying health insurance.

 

It begs the question on whether people will really support this once the actual tax bill to fund it comes due.  Considering places like California cant even pass this for funding reasons, I would not be optimistic that a democratic congress will get it done either.

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What is the Republican solution to the health insurance / healthcare problem in the US?  Medicare for all may be expensive and force large tax increases, but at least I understand it and I can see it leading to cost reductions across the board due to efficiencies that are gained through the system as well as the massive bargaining power they would have.

 

When you look at this issue at a macro level it's glaringly obvious that we are way off the mark.  It's not even close.  So what are we going to do about it?  My opinion is that it will take some fairly drastic government action to start bending the cost curve downward.  Medicare for all is fairly drastic.

 

https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-start

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We might have something resembling MFA (or at least a public option) if Joe Lieberman wasn't beholden to the insurance companies and/or Democrats would have just pushed it through reconciliation and bypassed the filibuster in 2009/2010.


Very Stable Genius

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What is the Republican solution to the health insurance / healthcare problem in the US?  Medicare for all may be expensive and force large tax increases, but at least I understand it and I can see it leading to cost reductions across the board due to efficiencies that are gained through the system as well as the massive bargaining power they would have.

 

When you look at this issue at a macro level it's glaringly obvious that we are way off the mark.  It's not even close.  So what are we going to do about it?  My opinion is that it will take some fairly drastic government action to start bending the cost curve downward.  Medicare for all is fairly drastic.

 

https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-start

 

It is the same as the annoying line used by liberals that "the rich need to pay their fair share" yet nobody dares define what "fair share" really means.

 

WHen you see the price tag, most Americans who may have been sympathetic to Medicare for all realize it is not worth the cost to them. They may hate the current system but it is better in their eyes than Crazy Bernie's idea.

 

Heck, if you cant get this done in California or Vermont with overwhelming democratic majorities, do you think  you can get this done nationally.  Obamacare was at least signed into law by a GOP governor so it has some moderate points to it on the state level.

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^ not exactly.

 

What is said was that to pay for it, and the government administration that would be required it would be over $3 trillion in additional spending which is more than is spent by the US military.

 

It said that while the average citizen would not have to pay premiums for health care anymore, the average tax increase would be more than what their premium would have been for most people.

 

It also said that the presumed cost savings (which are not realistic) will be achieved by paying providers the same rates as Medicare and Medicaid which are 40% less than private insurance reimburses those providers. This is why hospitals and practices limit the amount of Medicaid patients they take. It would cause a lot of practices and hospitals to close as they would not be able to operate profitably anymore and would require physicians to take large pay cuts. This would exacerbate the doctor shortage as many physicians may opt for other career lines outside of the government healthcare plan.

 

However, what is also likely is some sort of compromise between docs and CMS where instead of reimbursement at Medicare/Medicaid rates, the reimbursement is somewhere in between that and private insurance. WHile it would keep the system stable, the cost savings projected in the plan would vanish and from a cost standpoint, we would not be better off (and maybe even more expensive).

 

This was all per the report.

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^ Doctors leaving practice doesn't seem realistic.  The number of doctors per capita in the UK, US, and Canada is effectively the same.  There are more doctors per capita in the EU.  If single payer led to fewer doctors, we would see different numbers.

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I spoke with a hospital CEO and also a former CEO of a large insurance company a couple years back. While the number of doctors may be similar to Europe, the needs are vastly different. The EU has a large number of primary care providers whereas in the US there is an extreme shortage of primary care physicians especially in rural or tertiary markets. In addition, the US physicians are far more specialized than their European counterparts. It is part of the reason why if you want the top medical treatment in the world, you come to the US.

 

The CEO pointed out an example that there are more Orthopedic Specialists in Brooklyn New York than there are in the entire country of France.

 

The reason for this is that the average physician in the EU earns about 2.5 times the salary of the average worker whereas in the US is it 4.5 times. Specialties in Europe do not compensate at the same level as the US does which is why physicians do not have the need to continue their training in a specialty field since the compensation does not justify the needs. They stop after residency there.

 

In the US, docs are avoiding the primary care fields because they can earn so much more as a specialist. When you have 200-400k in student loans on average, it makes sense to go the specialty route. Plus the patient volume at many primary care clinics is often excessive considering the low reimbursement rates.

 

When you get rid of the incentive to be a specialist, quality of medicine will suffer and fewer people will become doctors.

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R's always try to bring it back to how much doctors make. The waste isn't in paying doctors, it's in paying all these people to shuffle paperwork, make cold calls, create and sell advertising, type and constantly expand the numbers of people doing that stuff and the space for them.

 

We could easily pay doctors the same if we are able to fire all those salesmen.

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I spoke with a hospital CEO and also a former CEO of a large insurance company a couple years back. While the number of doctors may be similar to Europe, the needs are vastly different. The EU has a large number of primary care providers whereas in the US there is an extreme shortage of primary care physicians especially in rural or tertiary markets. In addition, the US physicians are far more specialized than their European counterparts. It is part of the reason why if you want the top medical treatment in the world, you come to the US.

 

The CEO pointed out an example that there are more Orthopedic Specialists in Brooklyn New York than there are in the entire country of France.

 

The reason for this is that the average physician in the EU earns about 2.5 times the salary of the average worker whereas in the US is it 4.5 times. Specialties in Europe do not compensate at the same level as the US does which is why physicians do not have the need to continue their training in a specialty field since the compensation does not justify the needs. They stop after residency there.

 

In the US, docs are avoiding the primary care fields because they can earn so much more as a specialist. When you have 200-400k in student loans on average, it makes sense to go the specialty route. Plus the patient volume at many primary care clinics is often excessive considering the low reimbursement rates.

 

When you get rid of the incentive to be a specialist, quality of medicine will suffer and fewer people will become doctors.

 

 

You seem to making a very good case for the EU model tbh.  The US can't even get PMP's in rural areas but the EU seems to do a better job.  If people have better access to PMPs there is less need for specialists.  This is why our life expectancy is less than the EU. 

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