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Thread: The health care debate thread.

  1. #571
    California wants to put a 125% of medicare price cap on services. If that happens a lot of unintended consequences (good and bad) will happen.
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  2. #572
    I know nothing about this stuff.
    What does that mean?
    Will I notice a change? (non-Californian, non-medicare user).

  3. #573
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Brian View Post
    I know nothing about this stuff.
    What does that mean?
    Will I notice a change? (non-Californian, non-medicare user).
    It means the California state legislature would control health care prices.

    It wouldn't affect non-Californians directly. It may indirectly help people in Oregon, Washington, and Arizona as health care providers flee to those states, creating more supply.

    Purposefully left out: Nevada. Nobody flees to Nevada except people in the Federal Witness Protection Program.

  4. #574
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by U-Ute View Post
    It means the California state legislature would control health care prices.

    It wouldn't affect non-Californians directly. It may indirectly help people in Oregon, Washington, and Arizona as health care providers flee to those states, creating more supply.

    Purposefully left out: Nevada. Nobody flees to Nevada except people in the Federal Witness Protection Program.
    There are some increasingly influential voices here who want healthcare to be considered a public utility.


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    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  5. #575
    Unfreaking believable what some GOP rep is trying to do with Medicaid in Michigan.

    https://www.huffingtonpost.com/entry...b10bf8c60c?fv2

  6. #576
    Quote Originally Posted by UTEopia View Post
    Unfreaking believable what some GOP rep is trying to do with Medicaid in Michigan.

    https://www.huffingtonpost.com/entry...b10bf8c60c?fv2
    that's a little sensational. the provision is based on the county unemployment rate not race like the Article makes it seem. I do think the provision is stupid though.
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  7. #577
    Quote Originally Posted by Mormon Red Death View Post
    that's a little sensational. the provision is based on the county unemployment rate not race like the Article makes it seem. I do think the provision is stupid though.
    The bill specifically segregates out the employment rates of large cities (mostly black) from the counties where they are located. The example in the article is Wayne County, where Detroit is located. Overall, Wayne County is below the threshold so the unemployed who live outside the county (mostly white) would be absolved of the work requirement, but those in the city of Detroit (mostly black, also in Wayne County) would not be absolved because the unemployment rate in Detroit proper is not below the threshold.

  8. #578
    Administrator U-Ute's Avatar
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    I've heard of "balance billing" but not "surprise billing", which sounds like a scam anyway.

    A Jolt To The Jugular! You’re Insured But Still Owe $109K For Your Heart Attack

    https://khn.org/news/a-jolt-to-the-j...-heart-attack/

  9. #579
    Quote Originally Posted by U-Ute View Post
    I've heard of "balance billing" but not "surprise billing", which sounds like a scam anyway.

    A Jolt To The Jugular! You’re Insured But Still Owe $109K For Your Heart Attack

    https://khn.org/news/a-jolt-to-the-j...-heart-attack/
    Crazy situation. Even more crazy is that the guy refused the final offer of paying $782.29, instead of $108,951 based on the principle of the matter.
    Dyslexics of the world, untie!

  10. #580
    Quote Originally Posted by U-Ute View Post
    I've heard of "balance billing" but not "surprise billing", which sounds like a scam anyway.

    A Jolt To The Jugular! You’re Insured But Still Owe $109K For Your Heart Attack

    https://khn.org/news/a-jolt-to-the-j...-heart-attack/

    This sort of crap drives me crazy, and frankly I sympathize with the insurer over the hospital. We've had this happen a number of times with providers, with my wife asking the question, "Do you accept our insurance plan" and then telling them whatever we've got. The provider always says yes, because it isn't an issue of a provider accepting the insurer, it is a case of the insurer having a provider on their network. So the short answer for any provider is, "Yes, we'll accept any insurance that will pay us our rates... but you will owe the difference." They don't say that though. Insurers decide what providers and facilities they cover, not the other way around.

    And so if you ever find yourself in this situation, don't ask the doc or the hospital, ask your insurer if the doc or facility is covered on your specific plan and in your specific network.

  11. #581
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Rocker Ute View Post
    And so if you ever find yourself in this situation, don't ask the doc or the hospital, ask your insurer if the doc or facility is covered on your specific plan and in your specific network.
    Absolutely right. Also, if you really want to keep them honest ask them if there is any out-of-network reduction in the reimbursement for the care. Sometimes hospitals will say “Yes, we are contracted with that plan,” but they won’t tell you that there is a lower out-of-network reimbursement rate. I guarantee you that all these and hospitals have people who know this stuff like the back of their hand. They know exactly what your reimbursement will be for specific procedures, and what your co-pay will be.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  12. #582
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    Quote Originally Posted by Rocker Ute View Post
    This sort of crap drives me crazy, and frankly I sympathize with the insurer over the hospital. We've had this happen a number of times with providers, with my wife asking the question, "Do you accept our insurance plan" and then telling them whatever we've got. The provider always says yes, because it isn't an issue of a provider accepting the insurer, it is a case of the insurer having a provider on their network. So the short answer for any provider is, "Yes, we'll accept any insurance that will pay us our rates... but you will owe the difference." They don't say that though. Insurers decide what providers and facilities they cover, not the other way around.

    And so if you ever find yourself in this situation, don't ask the doc or the hospital, ask your insurer if the doc or facility is covered on your specific plan and in your specific network.
    Hard to do if you're getting defibrillated in the back of an ambulance.

  13. #583
    Quote Originally Posted by U-Ute View Post
    Hard to do if you're getting defibrillated in the back of an ambulance.

    Yup, and the hospital should and does know better. Like LA said, there are people there who know this like the back of their hand.

    One of my favorites was when my son had to get stitches a while back... we had to do an ER visit and so the copay was $100. The total cost of the stitches was $700, the insurance payed $600, I get a bill for $160 not the $100 (I'm rounding numbers here). I call the hospital, obvious clerical error. After 20 minutes on the phone with them I am repeating this same math equation:
    "Okay, so the total bill was $700?"
    "Yes."
    "And the insurance paid and you received $600?"
    "Correct."
    "And $700 minus $600 is?..."
    "$100"
    "So how much do I owe you?"
    "$160"
    "And why is this."
    "Because that is what is left of what the insurance didn't cover."
    "And there is nothing on the bill that I'm not seeing?"
    "No, you are seeing all charged care."
    "And total cost of care is $700."
    "Yes."
    "And you already got $600 of that from the insurance?"
    "Yes."
    "And aside from this, you still believe $700 minus $600 is $100?"
    "Yes."
    "So why do I owe $160 instead of $100?"
    "Because that is what the bill says."
    "Let's start over..."

  14. #584
    Quote Originally Posted by Rocker Ute View Post
    Yup, and the hospital should and does know better. Like LA said, there are people there who know this like the back of their hand.

    One of my favorites was when my son had to get stitches a while back... we had to do an ER visit and so the copay was $100. The total cost of the stitches was $700, the insurance payed $600, I get a bill for $160 not the $100 (I'm rounding numbers here). I call the hospital, obvious clerical error. After 20 minutes on the phone with them I am repeating this same math equation:
    "Okay, so the total bill was $700?"
    "Yes."
    "And the insurance paid and you received $600?"
    "Correct."
    "And $700 minus $600 is?..."
    "$100"
    "So how much do I owe you?"
    "$160"
    "And why is this."
    "Because that is what is left of what the insurance didn't cover."
    "And there is nothing on the bill that I'm not seeing?"
    "No, you are seeing all charged care."
    "And total cost of care is $700."
    "Yes."
    "And you already got $600 of that from the insurance?"
    "Yes."
    "And aside from this, you still believe $700 minus $600 is $100?"
    "Yes."
    "So why do I owe $160 instead of $100?"
    "Because that is what the bill says."
    "Let's start over..."
    Last time I had to take my two sons to the ER was for two broken legs in the same week. The older one broke his playing football the younger one broke his on the trampoline two days later. There was no bill for either of them, it was free. Though we did have to buy two walking boots ... well, not really, that was covered by my supplemental insurance.
    Last edited by tooblue; 08-28-2018 at 07:05 PM.

  15. #585
    Quote Originally Posted by tooblue View Post
    Last time I had to take my two sons to the ER was for two broken legs in the same week. The older one broke his playing football the younger one broke his on the trampoline two days later. There was no bill for either of them, it was free. Though we did have to buy two walking boots ... well, not really, that was covered by my supplemental insurance.
    Was this after two weeks of waiting? I'm surprised that they weren't just put to death by one of the death panels.

  16. #586
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Rocker Ute View Post
    Was this after two weeks of waiting? I'm surprised that they weren't just put to death by one of the death panels.
    I'm more surprised that they weren't immediately healed using a potion that includes a strand of Trudeau's hair.

    Socialized medicine fails again.

  17. #587
    Quote Originally Posted by Rocker Ute View Post
    Was this after two weeks of waiting? I'm surprised that they weren't just put to death by one of the death panels.
    Those death panels are a tricky thing. Fortunately, they let my kids live ... this time.

    Quote Originally Posted by U-Ute View Post
    I'm more surprised that they weren't immediately healed using a potion that includes a strand of Trudeau's hair.

    Socialized medicine fails again.
    Actually, all Trudeau needs to do is wink at you. Unfortunately, he was busy that week protecting the Canadian dairy and soft wood cartels from US exporters.
    Last edited by tooblue; 08-31-2018 at 02:12 PM.

  18. #588
    Quote Originally Posted by Rocker Ute View Post
    Yup, and the hospital should and does know better. Like LA said, there are people there who know this like the back of their hand.

    One of my favorites was when my son had to get stitches a while back... we had to do an ER visit and so the copay was $100. The total cost of the stitches was $700, the insurance payed $600, I get a bill for $160 not the $100 (I'm rounding numbers here). I call the hospital, obvious clerical error. After 20 minutes on the phone with them I am repeating this same math equation:
    "Okay, so the total bill was $700?"
    "Yes."
    "And the insurance paid and you received $600?"
    "Correct."
    "And $700 minus $600 is?..."
    "$100"
    "So how much do I owe you?"
    "$160"
    "And why is this."
    "Because that is what is left of what the insurance didn't cover."
    "And there is nothing on the bill that I'm not seeing?"
    "No, you are seeing all charged care."
    "And total cost of care is $700."
    "Yes."
    "And you already got $600 of that from the insurance?"
    "Yes."
    "And aside from this, you still believe $700 minus $600 is $100?"
    "Yes."
    "So why do I owe $160 instead of $100?"
    "Because that is what the bill says."
    "Let's start over..."
    Rocker, why should car dealers be able to slip in bogus charges here & there when healthcare can't?

    My son got a new job, with a horrifically weak health insurance benefit, a preview of the kind of plans Trump, the GOP and health insurance con artists want to make more widespread.

    With even funerals of national heroes now controversial, there will be no movement on the issue nationally, which means more & more folks will resort to home remedies or even black market providers for things like stiches, as people just can't afford to be ripped off by the healthcare system.

  19. #589
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Ma'ake View Post
    Rocker, why should car dealers be able to slip in bogus charges here & there when healthcare can't?

    My son got a new job, with a horrifically weak health insurance benefit, a preview of the kind of plans Trump, the GOP and health insurance con artists want to make more widespread.

    With even funerals of national heroes now controversial, there will be no movement on the issue nationally, which means more & more folks will resort to home remedies or even black market providers for things like stiches, as people just can't afford to be ripped off by the healthcare system.
    I really don't mind that the GOP stands on the ground that socialized medicine isn't the solution. What I can't stand is the fact that they don't say what the solution is. They seem to simply want to go back to what we had before, which was horribly broken. It continues to be broken in many ways, and yet all they can worry about is the idea that we're moving to socialized medicine. If they offered a real solution to the problem, I suspect most Americans would jump on it.

  20. #590
    Quote Originally Posted by U-Ute View Post
    I really don't mind that the GOP stands on the ground that socialized medicine isn't the solution. What I can't stand is the fact that they don't say what the solution is. They seem to simply want to go back to what we had before, which was horribly broken. It continues to be broken in many ways, and yet all they can worry about is the idea that we're moving to socialized medicine. If they offered a real solution to the problem, I suspect most Americans would jump on it.
    I'm with you on this that I think there needs to be solutions and I've said here my frustrations with how woefully short Obamacare falls and how bad it has been for me as a self-employed person.

    One factor that doesn't get talked about much or is portrayed as politician being on the take with big medical and insurance corporations is the macro economic impact that would happen if we went to a single-payer system.

    A single payer system would eliminate a ton of jobs in Utah (and the nation) and I agree that very well may be a good and great thing, but would be devastating and difficult to absorb for pretty much everywhere.

    Sometimes you just have to take your medicine (pun unintended) but along with answers from the right on this, I also want answers from the left on how we are going to address the mass unemployment as a result in the near term.

    I actually think that is one of the reasons why Obamacare was an ill-conceived bill from the get go is because they understood what would happen if they went single payer and so they had to play in a world where much of the health system continued to be propped up by what we have.

    If we were going to have socialized medicine I think we probably should have done it 40-50 years ago, otherwise we'll have to anticipate pretty devastating short term economic impact.


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  21. #591
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Rocker Ute View Post
    A single payer system would eliminate a ton of jobs in Utah (and the nation) and I agree that very well may be a good and great thing, but would be devastating and difficult to absorb for pretty much everywhere.
    I think most would just end up working for the government administering the system.

    Either way, I'm not hung up on the job impact. Industries wax and wane. If you want to worry about that, I'd be much more concerned about what will happen to the 3.5 million truck driving jobs when self driving trucks become a thing.

  22. #592
    Clemson University researchers dug through 10,000 tweets from the treasure trove of Twitter data to reveal Russian trolls worked to undermine ACA: https://www.wsj.com/articles/nearly-...law-1536744638

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