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"Death Panels"? Really? There's no such thing as "Death Panels" - you get to decide right now, before you're ever sick - your own future fate, and how much you want covered. If you want to make sure that your hospital coverage takes care of 3.5 million dollars in terminal care before it stops covering any more, then you are free to do that by your very own self - you are the sole person who gets a vote in that based on how much you are willing to pay for your medical insurance today. Are you only willing to pay for 100k worth of terminal care tomorrow because today you didn't see that you were going to get hit by a train and put into a coma in the morning? That's fine, but if your medical bills are going to be 150k for the hospitalization and treatment for your recovery, then either you have to come up with the other 50k somehow - or you'd better be quick at convincing a financial institution that you can repay a loan for that amount of unsecured debt. Are your outstanding bills $1m and you only make 35k/year? Good luck - and don't try to call the lender a "death panel" either. They exist merely to loan you unsecured debt that they need to have a reasonable expectation that you will repay.
Asbestos style? Where no one knew there was an issue until many years later? The employer and employee are equally responsible. They both chose by their own free will to participate in that line of work. In this case, it's good to have a "perpetual care" rider on your insurance which states that "once a condition is identified as beginning while the insured carried this insurance, that condition will be permanently covered by this insurance company regardless of future insurance status"
Also, this is a case where you're again determining that the value of a human life is so great as to have large societal consequences if it is lost. This is inaccurate. If a worker or class of workers dies in the future because a modern-day line of work was incorrectly considered safe, and those workers were uninsured, the company went bankrupt, and they could not afford the medical treatment, it would not be a significant loss to society - if alternatively we paid $100k/year per injured worker for a class of workers based on a cause that we deem in the future to be deadly or chronic, then that will indeed be the significant cost to society which we must avoid in the first place.
Yes. Covered correctly, the health insurance will pay for all covered medical bills and then seek recoupment of costs incurred if so deemed necessary.
This shows a partial understanding of the true societal value of a human life. We must also understand that this sort of event can be as true for a 7 year old as it is for a 100 year old. Other major costs (not an all-inclusive list) are those related to compliance and those related to "medical malpractice" - both also being direct descendants of "the value of a human life". There are plenty of places where we can cut costs of providing medical care simply by making it legal to be less focused on bullshit and more focused on "providing medical care".
Yes you are, Yes it is.
Citation Needed.
I'll provide one to the contrary:
In insurance, an insuring company determines your individual risk and assigns you a premium based only on the factors of your individual risk. For "group insurance policies", an insurance provider determines a risk profile for the whole group based upon - for instance - their employment - which actually used to be a useful tool when most people's primary health risks (and not-coincidentally their covered injuries) were based on the work they were doing. While the "group policy" does redistribute payment from the healthy to pay for premiums of the sick, the group is still literally paying today's premiums to cover tomorrows unanticipated accidents.
If instead, everyone had exactly the same health insurance premiums across the entire country, then we could say that "Insurance is everyone pooling their resources together to take care of the sick." In real life, nobody actually cares about "the sick" unless they personally know them, and all motives are self-serving, including those which on the surface appear to be selfless.
Fully true. Also compare to the active ingredients found in: You pay for insurance because you think it's better to pay a little bit every month now instead of paying out the *** in the unexpected event that something bad actually occurs in the future.
Young people have been like '**** this' for decades, because they realize that the cost of insurance has been astronomical compared to the relative cost of care ever since "government" had mandated that "those with the highest insurance premiums are only allowed to pay 6x what those with the lowest insurance premiums pay". The ACA had nothing to do with that.
The insurance "death spiral" is a condition where people with lower medical costs are forced to pay for people with higher medical costs (thus, the healthy subsidizing the ill). In every such scenario where the healthy are asked to pay higher premiums so that health insurance for the ill is more affordable, the healthy immediately flee the market. The reason that the ACA had issues was because it took freedom of choice away from the healthy, and they were then *required* to pay for the sick - moreso, the ACA, with premiums so structured, was never really even a case of "the healthy subsidizing the sick" - but rather it was always a case of "the rich subsidizing the sick"; it would have been politically unpopular to force "the healthy to pay for the sick." (As you mentioned below)
end point: If everyone knew what their lifetime medical expenses would be, there would be no need for medical insurance - we would simply start saving for medical expenses from day 1 so that our "devastating car accident at age 36" would be paid for just in the nick of time. Unfortunately, that is unrealistic since most of us never actually experience a devastating car accident in our lifetimes. Insurance, then, exists solely to cover the unexpected. Every other thing that insurance "covers" (like routine checkups or female reproductive care) is government mandated hogwash.
1) Death panel comment was tongue in cheek.
2) Asbestos style: Many years later. So you're basically faulting a person for not mitigating risk that they didn't know existed or that they weren't told existed. This is why OSHA has to exist... Your next comment is kind of bizarre. So you're not going to treat someone now because they're get reimbursed at some point? It's more expensive to treat many things the further on they go... So you're basically insisting on higher health costs here.
3) Re: Partial understanding of societal value of human life.
Actually my information is based on self reported quality of life and outcome data. Patients that go through the end of their life via palliative care report less pain and depression than those that don't (and often end up having the kind of dramatic care I described).
It's not the same for a 7 year old because most things that would cause large interventions on children (thinking leukemia/other cancers) have far better long term treatment success rates in kids than in adults. So, I'm not making any value judgement on life or cost. I'm merely talking about outcomes. The cost is happenstance, but it supports this. We're also pretty shitty as a society about death. It didn't used to be that way. We basically think that western medicine is going to make us live forever and refuse to admit that there is such a thing as too much intervention late in life. Many hospitals are starting to ask patients about DNR's and living wills etc when they come in for regular visits now. It's a step in the right directin.
4) Your link says nothing about how the money is used. Insurance isn't a flex account. You don't put into a system to take the money out later. The insurance company mitigates their own risk by insuring people that are lower risk as well (i.e. those that will cost less) this is why there isn't insurance for sick people only. It doesn't make sense... Your citation doesn't disprove anything I said. It just says that they use actuarial data, which is news to nobody. Actuarial data isn't used in isolation of other factors, it's based on a pooled value of risk and cost to make the company money in the end. Actuarial data within companies is based on those they insure.
5) It might not be pooling resource ala single payer, but you don't have an individual account with insurance. Your lifetime limit is likely going to be a number you'll never reach with insurance payments. It's based on the probability of the risk spread around all the insured by a policy/company. That's risk stratification and is as I said, i.e. pooling resources. Just because it's happening for a different reason doesn't mean I'm incorrect....
6) See above. The healthy have always subsidized the sick.
7) End point: See above again. Insurance covers the unexpected for you and assumes that it's going to happen for someone else. Your policy doesn't exist in a vacuum.
Woah, just look at how much we spend on administration and 'other'.
There's also insane use of technology here at a level that isn't warranted. I think this is a byproduct of CYA medicine... (Aka cover your ***).
That gets expensive fast!
And then, our primary care setup kinda sucks, so folks that have treatable illnesses aren't really caught and treated till it's too late and our entire society is pretty unhealthy as a whole (obesity/T2DM etc.).
Americans are a pretty expensive group to care for because they expect medicine to fix them without putting in the effort themselves...I've worked with colleagues that are european doctors and they don't see the same level of entitlement to amount/volume of care in their home countries nor do they see patients that expect to not live with the consequences of their actions/lifestyle or work to fix it.
I honestly think that the best solution is to burn it all down to the ground and start over, but that's political suicide here so it's never going to happen.
QUOTE: I honestly think that the best solution is to burn it all down to the ground and start over, but that's political suicide here so it's never going to happen.
This, of course, coincided with massive increases in malpractice insurance premiums (as well as the near-universal adoption of malpractice insurance by healthcare providers in general), and also greatly increased administrative costs, as hospitals and pharmaceutical companies greatly expanded their legal, compliance, and related departments. At the same time, physicians became incentivized to vastly increase the number of laboratory / imaging / diagnostic tests which they ordered. Nobody wants to be on the witness stand at their own trial and be asked by the counsel for the plaintiff "So, Doctor, why didn't you order [ludicrously expensive procedure] in order to rule out the possibility of [extremely rare condition] when Mrs. Jones first saw you, complaining about [totally unrelated symptom]?"
2: HIPAA (and regulations like it.)
This one should be pretty obvious. Every new regulation imposed on the healthcare system creates additional cost. Part of this is administrative paperwork, part of it is increased costs in clinical trials, part of it is technology and related maintenance expenses for systems not actually related to treating the patient.
3: Health Insurance.
50 years ago, people used health insurance as, well... insurance. Something to cover catastrophic events (being hit by a bus, catching the plague, etc.) Today, we are accustomed to using health insurance for literally every single transaction related to healthcare. Heck, when I get a flu shot, they ask for my insurance card. Same for routine examinations, teeth-cleaning, etc. Excessively involving insurance companies in every-day affairs has three effects:
It adds an additional layer of cost-burden to the transaction, as insurance companies are for-profit corporations.
It increases administrative overhead on the healthcare provider, as they now have to employ people solely to process the myriad of the transactions related to verifying and submitting insurance claims, and complying with the myriad of different procedures and regulations for all of the different insurers, and
It creates what engineers refer to as a layer of abstraction, separating the consumer of healthcare from the payer. This, in turn, makes patients less aware of, and less sensitive to, the costs involved.
Last edited by Joe Perez; 03-12-2017 at 04:16 PM.
Reason: Fixed bullet-point indentation.
When I was a young lad, our family Doctor used to come to the house. He would first check out the person that was under the weather and supply whatever medications they required. He would then check the rest of us and would accept dinner as payment for his services. My parents were not of fantastic means, but they would force him to accept some cash also.
Later in life, I started going to a Doctor who was starting his practice in the late 80's. He was a very good young Doctor that had seen service in the military and was very patient oriented. His wife was helping in the office to get him started, but he needed to take on an additional person because of insurance claims. After not seeing him for a year or so, I called him to arrange for a physical. He told me that he had closed the office and had taken a position in a local hospital as an internist where he was able to be a Doctor instead of an administrator.
Being in private practice yourself is extremely expensive. The system makes it extremely hard for a small business owner to succeed.
More and more organizations are buying up those offices as satellite clinics for a bigger group.
Your first doctor also probably had little to no debt coming out of medical school and could make those exceptions. Now the docs that do that kind of home care don't even take insurance and service wealthy clients.
Being in private practice yourself is extremely expensive. The system makes it extremely hard for a small business owner to succeed.
More and more organizations are buying up those offices as satellite clinics for a bigger group.
It's also true that many of the best physicians are not especially good business-owners, and that's exactly what a doctor's office is.
Many choose to become hospitalists. Some are employees of the hospital, other are, on paper, independent, but utilize the services of the hospital for nearly all of their administrative requirements.
My own father was a general practitioner who opened his own office in Florida in the early 80s, after having partnered with a small group practice run by some friends of his for a few years. By all accounts, he was a very good doctor, but we were not rich by any stretch of the imagination. My recollection (and it's been many years) was that he employed two nurses and three administrative staff to handle insurance, billing, recordkeeping, etc.
Those physicians who do get rich in private practice (apart from surgeons or other advanced specialists) are not necessarily the best doctors. Most open boutique-type practices, specializing in things like weight-loss or pain-management. Others operate membership-based practices.
To the latter point, large corporations are increasingly purchasing the practices of independent physicians and then hiring them as employees. My mother is the VP of being the Corporate Overlord for one such group. Having seen the operation from an inside perspective, there is a great economy of scale realized by centrally consolidating functions not directly related to treating the patient, and this actually allows doctors to focus on being a doctor rather than a business-owner.
Anyway, this is the political random pictures thread, not the healthcare thread, so here's President Trump pulling flags out of his nose:
Does pointing out black peoples inaccuracies automatically make a white person a racist?
From what I've been told, if you're white, then being alive makes you a racist.
Technically, I'm a "white Hispanic" (see: Florida v. Zimmerman, 1712FO4573, Florida Circuit Court, 18th Judicial Circuit, Seminole County, 2012.)
I'm not sure if that makes me a racist or a victim. I don't feel like either...
Anyway, people are always finding new and ever-more-creative ways to be offended. Apologies for citing an ostensibly pro-conservative news source. There wasn't much reporting on this outside of Fox News, which I refuse to cite as a source except in the most extreme of circumstances.
Students Denounced As Racist For Wearing US Flag Colors
Rob Shimshock, Education Reporter 7:20 PM 03/12/2017
Students from one Iowan high school recently apologized to the principal of another Iowan high school when people found their choice of red, white and blue attire offensive.
Supporters of the Des Moines North High School basketball team, many of whose players are from refugee families, were offended when fans of Valley High School’s basketball team wore red, white and blue last week, The College Fix reports.
“This is an example of BLATANT racism,” said Ty Leggett, a Valley High School alum, on the Valley High School – WDMCS Facebook page. “ALL participating should have been pulled and banned from ALL VHS extracurricular events for the remainder of the year! As a parent, I’d be mortified that my son or daughter thought this way, acted in this fashion and refrained from taking a stand against this 21st century inexcusable behavior!”
Erin Ness Carter, a mother living in the Iowan district, remarked that “for the supporters of one team from a primarily white part of town to paint themselves as the ‘team of the USA’ it strongly implies that the other team, the less white team, is less American.”
Some individuals defended the Valley High students.
“Now we can’t wear USA stuff without making someone upset?” asked Melissa Fraas-Bader, another Valley High alum. “Oh please….”
“This country is the United States of America and our country colors are red, white, and blue no matter what color of skin you have or what race you are,” said Mallorie Paige Sander, a current Valley High student. “The intentions to offend anyone by wearing USA themed clothing was no where in the thoughts of any of our student body, why would it be? We all live in America.”
The assistant coach of Valley’s opponent, Des Moines North, had different thoughts.
“Any normal person, any educated person can look at that and think what the hell are these kids thinking,” said Morgan Wheat, assistant coach of the Des Moines North basketball team, according to WHO-TV.com. “Kids are kids, I get it, but I do have questions. I want to know why.”
Morgan Wheat, assistant coach at Des Moines North
Des Moines North coach Chad Ryan also reflected on the incident to The Des Moines Register.
“I don’t want to judge those young people not knowing their motives,” said Ryan. “What I will say is we’re proud of our diversity at North High School — not only on our basketball team, but our population.”
“It’s been good for us, as a school. They learn from each other about people with different cultures and backgrounds — and we try to use it as an educational piece.”
One Valley High School student, Dayna Dunnwald, noted that the school’s students had dressed with a USA-theme instead of their black and orange school colors “many times in the past.”
“A lot of people were very upset about it,” explained DeNasja Spencer, a sophomore at Des Moines North, to KCCI. “Even if that was their theme for the game, I feel like they should have switched that because everyone knows North is a more diverse school.”
Valley High School student leaders drafted and delivered a letter to the principal of Des Moines North.
“We are deeply sorry if we have offended anyone in any way,” reads the statement, in part. “We have traditionally dressed in such a fashion for great games such as the one last night. Everyone here at Valley has immense respect not only for your team and players but for your community as a whole. Please know that our intent was in no way to offend or demean—just to support our own team in a way we have done before.”
Some Facebook users commented on Valley High School – WDMCS, noting that they had heard the chant “deport him” or “deport them,” but others denied these claims. Valley High responded to the accusations, stating that “administrators and teachers did not hear nor have evidence during the game of this occurring. If we had been aware of it, we would have taken immediate action to stop it. Now having received reports, we are investigating and disciplinary action will be taken for evidence found.”
The Valley High School Tigers defeated the Des Moines North Polar Bears 57-55 in the basketball game.
Does pointing out black peoples inaccuracies automatically make a white person a racist?
I'm not sure what the goal is "taking things back". Are we about to see a reemergence of the Back-to-Africa movement?
Also, are the numbers given @12:50 really that high?
So, not sure what her tweet has to do with a charade about anything. She has a WALL of tweets talking about the CBO estimates and the one you posted was just one of them.
When posting that meme, can we please use one of the pony versions, either the one where Rainbow Dash is leaving the rainbow behind, or the one where Pinkie Pie is riding the star?
When posting that meme, can we please use one of the pony versions, either the one where Rainbow Dash is leaving the rainbow behind, or the one where Pinkie Pie is riding the star?
03-10-2017, 02:17 PM
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