Health Care Discussion

[Jay Bee]

Most health insurance policies pay up to "usual and customary" charges.  as reimbursements drop, charges go up and "usual and customary" increases to make up the short fall.  It's a vicious circle.

Say what? How much were your silicones? Well worth it, I say. I thought you looked plenty feminine before the rack, but with those you are pure estrogen!

If you're a private pay (i.e., don't have the gubbment paying for you or the procedure isn't covered through an insurer for which there is a contractual allowance), I'd spend some time shoppin.. now that I think of it.. those of us with high deductible plans who won't max out in a year should consider shopping around a little more.

The best plan for health care is that once past a certain weight or age you go to prison. Prisoners get privileges for caring for the obese and elderly. They do the best they can. Also, weed is completely legal in these prisons to ease pain.

[Marqevans]

Most health insurance policies pay up to "usual and customary" charges.  as reimbursements drop, charges go up and "usual and customary" increases to make up the short fall.  It's a vicious circle.

Most policies pay the negotiated rate in network and pay usual and customary out of network.  Usual and customary has become the Medicare reimbursement rate in many policies making it very low.  This has greatly increased the risk of using a provider out of network, because the patient is responsible for 100 percent of the amount above usual and customary.

[77ncaachamps]

My wife is a PT at a relatively affluent hospital in the Milwaukee area and sees this all the time with the government funded patients.  Gets a patient that is told therapy should be able to treat the issue but surgery might as well and the government backed patient ALWAYS chooses surgery over PT.  PT would be infinitely less expensive and the outcome just as good, but because the patient doesn't care about cost they go for the quick fix.

Sounds like a patient who is given the option to lose weight, eat healthier, and exercise but elects to undergo a quadruple bypass.

We have the most advanced medicine in the world as is what about single payer system is going to change our life expectancy?  What is it about single payer that will vault us past those other systems?

I think the US health care is so advanced and some our choices as a society are so poor that we are lucky to be 37th in the world.  Yes our current system sucks but single payer isn't the answer that will make things worse.  Change the lifestyle

But that will make the many of the health care companies suffer IF WE TAKE CARE OF OURSELVES.

What a novel idea!

[77ncaachamps]

Others here have stated:  "Federal intervention is widely understood to be a source of cost control in this area."

On a very simplistic level, this is correct.  If a provider wants to charge $100 for a service like an x-ray, Medicare will usually say that only $80 is covered, and the provider only gets $80.  Cost containment, right?  If you don't look too closely, the answer looks like yes.  But here's the problem:  Medicare keeps paying the provider $80 every time it performs (and re-performs) that service.  So if the provider performs the service once, it gets paid $80; if it performs the service ten times, it gets $800, and so on.  Increased utilization leads to increased overall payment.  In theory, Medicare may deny some after a while...but these controls have proven not to work.

Now recall that the patient - who ultimately makes the decision whether to go back in and ask for another service - often bears little to no financial responsibility for that service.  He can keep asking for more and more, the provider will often keep performing it more and more, and Medicare will keep paying for it again and again.  Sometimes this is because the provider really believes it may help.  Other times it's because the provider is afraid of being sued for malpractice.  And yet other times, it may be due to a truly malicious provider (that's called fraud).  In any event, in this world where the purchasing decision is de-coupled from the payment responsibility, Medicare's superficial "cost containment" strategy will fail.

And the doctors and health care that continually accepts them says, "Thank you very much, come again!"

But we don't fault them, right, because the government is the stupid one for continually paying?



If I look at Education and where it's heading, health care will follow (is following?) suit: minimally paid workers who push papers, deal with patients like clockwork in small increments of time, heavily tech driven, less person-to-person interaction, quality suffers...all the while people complain and businesses who profit it from it tout the positives and never the negatives.

In the education realm, teachers will be needed less. Interactive software, apps, and programs that can instantly discern student weaknesses and target them are replacing teachers. Voice recognition software will improve to the point that you just need to talk to a screen; handwriting scanners will detect writing mista....ah forget it, who will write anything by hand anymore in the future!

In the future, little nanobots that circulate our bodies will do the recording and transmitting of our bodily functions to a dispensary where we can pick up bottles of pills that will correct whatever ails us.

We will be less reliant on doctors and more reliant on the engineers who innovate, program, and maintain the machines

[77ncaachamps]

nvm

[ChicosBailBonds]

Not that we didn't say this back in 2008.  Absolute TRAIN. WRECK.

http://washingtonexaminer.com/insurers-predict-100-400-obamacare-rate-explosion/article/2529523

[77ncaachamps]

Not that we didn't say this back in 2008.  Absolute TRAIN. WRECK.

http://washingtonexaminer.com/insurers-predict-100-400-obamacare-rate-explosion/article/2529523

I thought the Health Care sector was in on the formation of this....wwaaaaiiiitttt a minute!

[ChicosBailBonds]

I thought the Health Care sector was in on the formation of this....wwaaaaiiiitttt a minute!

LOL.  You mean strong armed into it.  Play ball or else....sort of like the IRS B.S. going on right now.  The intimidation tactics are Nixonian at this point.  Amazing.

[keefe]

LOL.  You mean strong armed into it.  Play ball or else....sort of like the IRS B.S. going on right now.  The intimidation tactics are Nixonian at this point.  Amazing.

I am astounded as Benghazi, the IRS witch hunt, and AP Gate are all significant issues. If this was another man there would be righteous indignation and challenges to competency.  What confounds me , though, is how a CinC can be asleep at the wheel on an international terror attack on sovereign American soil yet unleash the dogs of fascist rule against honest citizens. I mean, at least the Big Time fascists of the 1940's were consistent.

[Hards Alumni]

I am astounded as Benghazi, the IRS witch hunt, and AP Gate are all significant issues. If this was another man there would be righteous indignation and challenges to competency.  What confounds me , though, is how a CinC can be asleep at the wheel on an international terror attack on sovereign American soil yet unleash the dogs of fascist rule against honest citizens. I mean, at least the Big Time fascists of the 1940's were consistent.

I think it is hilarious that people think that Benghazi is the first US embassy to have been attacked.  The uninformed majority buying into the talking points thrown at them every day.  Truly classic.  I thought you were smarter than this.  I mean, there were only 12 separate attacks on US embassies under GWB, yet not a work is uttered regarding those catastrophes.  

[MU Fan in Connecticut]

Or the fact the Republican party voted to cut funding for embassy security.  Just sayin'.