johno wrote:From personal experience: There is a high % of people taking ambulance rides to the ER (costing thousands of $$$) who don't need that level of care.
90% of EMS rides, nailed it.
I had a classic one last shift: 63 year old man with a persistent erection.
Me: You need an ambulance ride for this?
His friend: Yes, so he doesn't have to wait so long to be seen in the ER.
Me: No, the wait time is the same and the ambulance bill will be thousands. Drive him to the hospital.
(Many of our younger EMT's don't know how to un-sell an ambulance ride. Or are afraid to.)
Note - The social service providers who teach immigrants how to get along in the US advise their clients to call 911 for just about any medical event.
The best lack all conviction, while the worst
Are full of passionate intensity.
We received the letter in the mail a couple months ago. The good people at Regence Bluecross Blueshield were pleased to inform us that due to Obamacare our current low-monthly premium, comically-high deductible medical policy would no longer exist come January 1, 2014. Pleased, because a new and better plan would be offered in its place. Old monthly premium: $578 for a family of four (non-smoking, helmet-wearing, and paternally snipped). New premium: $1,123. A 94% increase.
Once the sound of boiling blood dissipated, in my head I heard my Republican friends chuckling at the sight of a liberal Democrat hoisted ten stories high on his own petard.
But wait, there's more...
I went to a friend and colleague—let’s call him Peter—for advice. He also had his individual medical policy cancelled because of Obamacare. “I’m stuck on the same question—income,” he told me. Peter does a little writing, a little farming, a little this and that to keep the ship afloat. “I got through to the exchange, and the woman there told me to just estimate what my income would be this year.” In other words: Make it up. If he overestimated, he’d be screwing himself out of a subsidy, Peter said. If he underestimated, he’d be hit with a big fat bill. He wasn’t sure he wouldn’t also be accused of fraud. So he called his accountant, who’s also a lawyer.
That only got him so far. At a certain point in the conversation, the accountant/lawyer had to get off the phone. “I have to stop answering your questions,” he told Peter. “I can’t ethically advise you, because honestly I don’t know the right thing to do. Nobody does. There are no answers. Right now it’s a complete clusterfuck.”
We received the letter in the mail a couple months ago. The good people at Regence Bluecross Blueshield were pleased to inform us that due to Obamacare our current low-monthly premium, comically-high deductible medical policy would no longer exist come January 1, 2014. Pleased, because a new and better plan would be offered in its place. Old monthly premium: $578 for a family of four (non-smoking, helmet-wearing, and paternally snipped). New premium: $1,123. A 94% increase.
Once the sound of boiling blood dissipated, in my head I heard my Republican friends chuckling at the sight of a liberal Democrat hoisted ten stories high on his own petard.
But wait, there's more...
I went to a friend and colleague—let’s call him Peter—for advice. He also had his individual medical policy cancelled because of Obamacare. “I’m stuck on the same question—income,” he told me. Peter does a little writing, a little farming, a little this and that to keep the ship afloat. “I got through to the exchange, and the woman there told me to just estimate what my income would be this year.” In other words: Make it up. If he overestimated, he’d be screwing himself out of a subsidy, Peter said. If he underestimated, he’d be hit with a big fat bill. He wasn’t sure he wouldn’t also be accused of fraud. So he called his accountant, who’s also a lawyer.
That only got him so far. At a certain point in the conversation, the accountant/lawyer had to get off the phone. “I have to stop answering your questions,” he told Peter. “I can’t ethically advise you, because honestly I don’t know the right thing to do. Nobody does. There are no answers. Right now it’s a complete clusterfuck.”
You voted for it. Pay the fuck up! Don't know what income you're going to make? Fuck you! Pay the fuck up! What's that? You missreported your income? I hope to God the IRS audits your hipster ass and fines the mother loving shit out of you.
whinny little cunt!
Arms are the only true badge of liberty. The possession of arms is the distinction of the free man from the slave.
Herv100 wrote:Medical prices have skyrocketed ever since people stopped paying cash and started using govt programs or insurance to pay. Doctors/Hospitals started charging the most they possibly could because they KNOW they're getting paid most of the time. Same reason it pays to own housing projects- the govt is paying, so you know you'll get your money
I saw an interview with Milton Friedman at least ten years ago, one of the questions they asked him was what he would do about health care. His answer was to first look at the root cause: World War II. During WWII, the government instituted wage fixing and labor was in demand. To attract workers, fringe benefits were invented. Before this time, if someone had medical insurance they paid for it out of their own pocket, they felt it, and they knew what it cost. With the invention of benefits, the consumer was insulated from the price, and hilarity ensued.
But when I stand in front of the mirror and really look, I wonder: What the fuck happened here? Jesus Christ. What a beating!
ccrow wrote:
I saw an interview with Milton Friedman at least ten years ago, one of the questions they asked him was what he would do about health care. His answer was to first look at the root cause: World War II. During WWII, the government instituted wage fixing and labor was in demand. To attract workers, fringe benefits were invented. Before this time, if someone had medical insurance they paid for it out of their own pocket, they felt it, and they knew what it cost. With the invention of benefits, the consumer was insulated from the price, and hilarity ensued.
It hasn't helped that there is so much more to buy now. Heart transplants, hip replacements, expensive drug treatment regimens, etc.
Herv100 wrote:Medical prices have skyrocketed ever since people stopped paying cash and started using govt programs or insurance to pay. Doctors/Hospitals started charging the most they possibly could because they KNOW they're getting paid most of the time. Same reason it pays to own housing projects- the govt is paying, so you know you'll get your money
I saw an interview with Milton Friedman at least ten years ago, one of the questions they asked him was what he would do about health care. His answer was to first look at the root cause: World War II. During WWII, the government instituted wage fixing and labor was in demand. To attract workers, fringe benefits were invented. Before this time, if someone had medical insurance they paid for it out of their own pocket, they felt it, and they knew what it cost. With the invention of benefits, the consumer was insulated from the price, and hilarity ensued.
It's not exactly true that they "invented" fringe benefits because of the wage controls. They simply increased the use of them. That would have been fine, except firms then lobbied Congress to make some of those benefits tax deductible.
"The biggest problems that we’re facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all."
ccrow wrote:
I saw an interview with Milton Friedman at least ten years ago, one of the questions they asked him was what he would do about health care. His answer was to first look at the root cause: World War II. During WWII, the government instituted wage fixing and labor was in demand. To attract workers, fringe benefits were invented. Before this time, if someone had medical insurance they paid for it out of their own pocket, they felt it, and they knew what it cost. With the invention of benefits, the consumer was insulated from the price, and hilarity ensued.
It hasn't helped that there is so much more to buy now. Heart transplants, hip replacements, expensive drug treatment regimens, etc.
The mechanism that national health insurance programs use to keep costs under control is aggressive, data-driven, cost control-- Obamacare can piggyback on European lessons. They aren't. The only lesson they've learned is accounting tricks (which only work for a while).
This mess is far worse than we think it is.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
So, if I follow correctly, the smartest president ever is not smart enough to ensure that his website works; he’s not smart enough to inquire of others as to whether his website works; he’s not smart enough to check that his website works before he goes out and tells people what a great website experience they’re in for. But he is smart enough to know that he’s not stupid enough to go around bragging about how well it works if he’d already been informed that it doesn’t work. So he’s smart enough to know that if he’d known what he didn’t know he’d know enough not to let it be known that he knew nothing. The country’s in the very best of hands.
Arms are the only true badge of liberty. The possession of arms is the distinction of the free man from the slave.
The ACA really screwed the fucking pooch. Going to be interesting for the next 6-18 months. I still hear celebrities say how awesome Obama is, recently Sara Silverman on Stearn. Yet none of them will discuss these ramifications.
It's a shame Obama's people didn't keep him in the loop. As he said, he was clueless about the website, about how to buy private insurance, about Benghazi, about the IRS coercing conservative groups, about the NSA spying on folks, about the misleading unemployment numbers, etc etc
An official with the nonprofit Obamacare enrollment group Enroll America conspired to give people’s personal information to what he thought was a political action committee, according to James O’Keefe’s latest video, provided to The Daily Caller.
You'll notice, not one single dingleberry leftist has even dared to come into this thread and present a counter arguement that Obama and the Democrat party lied to get Obamacare passed or that their plan an unmitigated disaster.
The closest they'll come to a counter argument is trying to muddy the waters with one the following two excuses or combination of these two excuses.
1) Don't tell them "I told you so". Because eventhough we are 100% correct, they don't like beng reminded they were told this would happen.
2) "Gee, we really really ment well" and in their everyone gets a trophy world; that's all that matters.
Arms are the only true badge of liberty. The possession of arms is the distinction of the free man from the slave.
Batboy2/75 wrote:You'll notice, not one single dingleberry leftist has even dared to come into this thread and present a counter arguement that Obama and the Democrat party lied to get Obamacare passed or that their plan an unmitigated disaster.
That's because you're the only one here wanting to simplify things down to a "left vs right" issue.
WildGorillaMan wrote:Enthusiasm combined with no skill whatsoever can sometimes carry the day.
Batboy2/75 wrote:You'll notice, not one single dingleberry leftist has even dared to come into this thread and present a counter arguement that Obama and the Democrat party lied to get Obamacare passed or that their plan an unmitigated disaster.
That's because you're the only one here wanting to simplify things down to a "left vs right" issue.
It is simple: The resident lefitist are missing in action. They and they alone own this mess. They didn't say maybe this would work. They didn't say, hey let's rolll the dice on this cool, idea. They promised nothing but unicorns, rainbows and never ending goodness. The result? Choas; and exactly the opposite of what was promised.
They don't get to stand along with the rest of America and say "Gee Willikers guys! What happened? Who did this?" as if they don't own this mess lock stock and barrel.
Arms are the only true badge of liberty. The possession of arms is the distinction of the free man from the slave.
Batboy2/75 wrote:You'll notice, not one single dingleberry leftist has even dared to come into this thread and present a counter arguement that Obama and the Democrat party lied to get Obamacare passed or that their plan an unmitigated disaster.
That's because you're the only one here wanting to simplify things down to a "left vs right" issue.
It is simple: The resident lefitist are missing in action. They and they alone own this mess. They didn't say maybe this would work. They didn't say, hey let's rolll the dice on this cool, idea. They promised nothing but unicorns, rainbows and never ending goodness. The result? Choas; and exactly the opposite of what was promised.
They don't get to stand along with the rest of America and say "Gee Willikers guys! What happened? Who did this?" as if they don't own this mess lock stock and barrel.
Do the voices in your head ever tell you to hurt yourself?
WildGorillaMan wrote:Enthusiasm combined with no skill whatsoever can sometimes carry the day.
Batboy2/75 wrote:You'll notice, not one single dingleberry leftist has even dared to come into this thread and present a counter arguement that Obama and the Democrat party lied to get Obamacare passed or that their plan an unmitigated disaster.
That's because you're the only one here wanting to simplify things down to a "left vs right" issue.
It is simple: The resident lefitist are missing in action. They and they alone own this mess. They didn't say maybe this would work. They didn't say, hey let's rolll the dice on this cool, idea. They promised nothing but unicorns, rainbows and never ending goodness. The result? Choas; and exactly the opposite of what was promised.
They don't get to stand along with the rest of America and say "Gee Willikers guys! What happened? Who did this?" as if they don't own this mess lock stock and barrel.
Do the voices in your head ever tell you to hurt yourself?
Move along cunt. As usual, you have nothing to contibute; even in rebuttal.
Arms are the only true badge of liberty. The possession of arms is the distinction of the free man from the slave.
Batboy2/75 wrote:You'll notice, not one single dingleberry leftist has even dared to come into this thread and present a counter arguement that Obama and the Democrat party lied to get Obamacare passed or that their plan an unmitigated disaster.
That's because you're the only one here wanting to simplify things down to a "left vs right" issue.
It is simple: The resident lefitist are missing in action. They and they alone own this mess. They didn't say maybe this would work. They didn't say, hey let's rolll the dice on this cool, idea. They promised nothing but unicorns, rainbows and never ending goodness. The result? Choas; and exactly the opposite of what was promised.
They don't get to stand along with the rest of America and say "Gee Willikers guys! What happened? Who did this?" as if they don't own this mess lock stock and barrel.
Do the voices in your head ever tell you to hurt yourself?
Move along cunt. As usual, you have nothing to contibute; even in rebuttal.
Because, if they do, you should listen to them.
The far left isn't the problem.
The far right isn't the problem.
The problem is uneducated, misinformed hillbillies like yourself who believe that it's a baseball game, er, sorry, NASCAR race, where all you need to do is spew drunken vitriol towards the other team while humping an American flag to be a productive member of society.
WildGorillaMan wrote:Enthusiasm combined with no skill whatsoever can sometimes carry the day.
As long as we are on the topic of doctors. You can't blame a guy for making a buck, but why do they make so much? It isn't because they are THAT special, although they generally really think they are THAT special. I see two intertwined reasons: artificial demand, and labor in management.
The artificial demand is this. They only churn out a fairly small number of doctors a year despite college kids beating down the doors. Very tough to get in med school, but once you get in med school, the attrition is very low - what does that tell you? So you have a system set up for short supply. Then on the other end, doctors are required to provide or prescribe and supervise almost all care. Due to pressure from managed care, new jobs like physician's assistants and nurse practitioners are starting to erode this but it's still enormous demand.
They can maintain the demand because our system breaks a fundamental rule of business: you have to separate the labor and the management. The airlines got into some trouble with this, letting the pilots make management decisions, but their tangle is tiny compared to what we have in health care. If you let the labor be the management, don't be surprised if your paying some high wages, Einstein. Doctors have NO qualification for the management role they play, no more than a pilot's license qualifies you to read a balance sheet. The only reason they can demand this role? See artificial demand above.
There is also the AMA et al of course, pretty powerful, but as special interests have gone Godzilla in the US over the last few decades, their relative influence is eroding.
I heard a good piece on NPR about how doctors roles have changed in Germany with their successful health care reforms. This was a few years ago, maybe even pre-Obama, and you know to take anything from them with a grain of salt. The GP they interviewed made something that came to about $150k/yr after reform, but was making nearly double that before reform.
There will be no relief until costs are controlled, no matter who pays for it and what the government role is. No matter how you slice it, if you follow the money, a huge amount of the health care costs go to doctors. If I was a doctor, I'd make sure I could scrape by on $150k/yr or so in the future.
But when I stand in front of the mirror and really look, I wonder: What the fuck happened here? Jesus Christ. What a beating!