08:51 – The morning paper says that Blue Cross/Blue Shield has requested a rate increase of up to 26.7% for North Carolina. The fundamental problem, which no one ever talks about, is that insurers are being forced to cover people who shouldn’t qualify for any coverage at all, let alone subsidized coverage. Let’s hope that by some miracle SCOTUS actually rules according to the law rather than from political expediency and puts a stake through the heart of Obamacare. People are entitled to the best medical care they can afford without subsidies, and no more. If they can afford nothing, nothing is what they should get. And they most certainly should not have access to emergency room care.
Barbara is displeased with Colin because he’s being pretty blatant about being my dog. Last night, he refused to go out with her on his final walk of the day while I was in the kitchen cleaning up the evening’s dishes. So I took him and he went for his normal walk. I think the issue is that there’s been thunder around pretty constantly, and he can hear it even when we can’t. He’s terrified of thunder, and when he’s frightened he comes to me for protection. I told Barbara not to let it hurt her feelings. He goes to me for protection for the same reason he runs when I sneeze but ignores Barbara sneezing. He considers me the big, ferocious alpha male. It’s just a dog thing, but Barbara thinks he doesn’t trust her. Actually, he doesn’t fully trust anyone. He’s been timid ever since we first met him at 6 weeks old.
My parents brought home our first Border Collie in 1958, when I was 5 years old. We’ve had them ever since, often two or three at a time, and Colin is the first one who’s been “my” dog. The earlier ones were all my mom’s dogs, and Duncan and Malcolm were Barbara’s dogs. Oh, Colin likes Barbara well enough. He cuddles up next to her on the sofa and curls up next to her when she goes back to bed in the evening. The only thing that makes him “my” dog is that he comes to me for protection when he’s frightened. And Border Collies all have very strange personalities anyway.
More kit stuff today. My shipment of 96-well plates arrived yesterday, so I can finally finish building a bunch of kits.
12:16 – I’ve not been having much luck with UPS and FedEx lately. First, UPS bashed up a box of 1,500 bottles so badly that 413 of them were lost. They just ran a strip of packing tape over a small part of the main seam and delivered the box anyway. My bottle supplier has shipped replacements. Then I put in an order with walmart.com for 17 assorted 28-ounce cans of Bush’s Best Baked Beans, a bag of Krustez pancake mix, and a test bottle of Bertolli’s Mushroom Alfredo Sauce. The first time Walmart shipped that, FedEx damaged the box so badly that they didn’t bother to deliver it here, which is saying something. They just sent the remnants back to Walmart, which reshipped the order. That arrived today, with the 17 cans of Bush’s Best Baked Beans (12 of them with minor dents) and the bag of Krusteaz pancake mix. No bottle of Mushroom Alfredo sauce. So I just emailed Walmart to let them know. Presumably they’ll fix the problem, but the real problem is their shipping department. This shipment came in a large box with all of the items floating around loose. They’d put in some crumpled craft paper, but only about 2 sheets of newspaper worth. It needed 10 or 20 times that much to keep the canned goods secure. What they really should do is use packing popcorn or foam fill, but I guess they think all the hassles with returns cost them less than the few cents it’d cost to use the popcorn.
12:51 – Oops. The bottle of Bertolli’s Mushroom Alfredo Sauce was indeed in the box. It was wrapped very thoroughly with craft paper. Even at that, I’m surprised the glass jar survived the trip surrounded with heavy cans that were bouncing around. I found the jar as I was tearing down the box to put in recycling cart. I sent walmart an email to apologize for the false alarm and tell them they didn’t need to ship a replacement jar.
Ah Obamacare, how do I love thee? Not an F’n bit.
Since moving to a compliant plan, we pay higher premiums, for less coverage, with a higher deductible. And I get to pay for OTHER peoples’ crap coverage too.
Even with little kids, we haven’t used our deductible in 2 years. That means I’m paying 100% of my care, paying for insurance I haven’t used, and paying for my neighbor’s insurance that THEY are likely not using either. All that money going into the system, to be absorbed by overhead, and a few (relatively) really sick people.
The only reform that could work is to get the people consuming the services to pay for them, with 100% price transparency and a true free market for goods and services.
nick
That BCBS rate increase is nationwide, more or less depending on area but the average is 26% and is common for all the insurance carriers who are involved with ObolaCare, which means your rates are going up no matter if you have an ObolaCare policy or not, your Carrier is now using ObolaCare to base all premiums.
Medicare rates are also going up, no Part B is not free. The Medicare Advantage (replaces Medicare and you do not want) and Supplemental/MediGap (secondary to Medicare, what you want) Plans are also going up. Since I turn 65 in September I have from now to December to sign up. No matter the insurance company, Medicare Advantage and Supplemental Plans will not provide a firm price quote until I sign up, they are very up-front saying that prices are increasing every month and even once I sign-up my premium will change on January 1, 2016. There used to be 6 companies that wrote Medicare Advantage and Medicare Supplement plans in my area, now it is down to 3.
It gets more and more complicated but I have an advantage since my Daughter is a Certified Medical Coder. She knows what works and what doesn’t so she is watching out for good ol’ Dad.
Finally, don’t dismiss the policies available through AARP for political reasons. So far they have provided the best information and the best price quotes.
And remember, YMMV.
That means I’m paying 100% of my care
Well, not quite. You do get the benefit of having to ONLY pay the contracted amount to the facility rather than the full amount the doctor would bill. I too am in pretty much the same situation with the exception of two years (wife had a kidney stone one year, hip replaced another year).
As an example on my yearly physical the doctor sends blood to the lab. The lab bills the insurance company $548, insurance says nope, you will only get paid $52. The lab adjusts their fee and sends me the bill for $52. Without insurance I would have been required to pay the $548. If the company can make money at $52 then charging people without insurance $540+ is price gouging.
More likely at $52 they’re running at a huge loss, which they have to make up somewhere.
The only solution I see other than just letting poor people die without medical care–which would be my preference but many people have their delicate sensibilities offended by this idea–is to establish clinics in poor peoples’ areas and make them the only source of medical care for them. Run them as cheaply as possible. No taxpayer funding at all. Let the churches and other do-gooders pay for them. They don’t need doctors. A nurse-practioner would be fine as the primary medical person, with volunteers or at most minimum-wage drones filling nearly all the positions. No expensive equipment or drugs. No access to the emergency room. No right to sue. Of course, this would also require reversing decades of moving the scum into middle-class areas and re-establishing poor ghettos where these people could be contained. Better yet, camps away from the cities. Voluntary admission and exit. No one has to go there and anyone is free to leave any time. But absolutely no welfare services or subsidies outside the camps. Gruel for food. Absolutely no government spending on anything more than the absolute minimum needed to sustain life. Easy access to do-it-yourself suicide. That’s my idea of workable welfare reform.
I just realized that I pretty much summed up the lot of poor Greeks.
The amounts charged and amounts paid out are not even close. The surgery I had last June came out to about $100K. Payout by insurance was maybe $60K and about $3K out of pocket.
The hospital was over $70K (OR, seven days, six nights) but they received about $33K. No complaints about the care, maybe too much actually.
Wife had an angiogram last week, will be curious to see the bill on that. Six hours at hospital with about 20 min in the cath lab. (found nothing).
Medical costs are out of hand but we can thank government and lawyers for that.
The problem comes when the peasants are revolting.
It used to be “millions for defense; not one cent for tribute.” Now it’s “trillions for tribute; not one cent for defense (against the poor).”
I don’t want to pay taxes at all, let alone to support these worthless scum, let alone to support them at what in most other countries is a middle-class lifestyle. I begrudge them even gruel and basic shelter, let alone free meat, air conditioning, TVs, and automobiles. Free cell phones! Crap. They deserve nothing. No one “deserves” anything, other than to be left alone by the government.
If OFD is right and we see a complete collapse, I’ll do my best to help other middle-class people around me and do nothing whatsoever to help the scum. If that means piles of dead scum bodies, with a good percentage of politicians and bureaucrats, so be it. I’ve had enough. I had enough decades ago, but it’s really become intolerable.
I’ve mentioned this before in other comments here, but the State of Washington’s highly publicized “working” healthcare exchange is mostly Medicaid in disguise. The kind of clinics you describe above might actually happen in the WA urban areas since the state lacks income tax authority to restore the ~50% cuts in Medicaid physician reimbursement that happened once the government subsidies expired last year.
Court-imposed income tax to fund Obamacare and education is still a possibility in WA State, but I’m guessing that would come at a cost of Microsoft and Amazon departing for Canada and Texas, respectively.
Almost nobody pays the $548. They’re charging that much so that they can sell it to a collection agency for 10% and still keep the doors open. Or so that they’ll have a fighting chance of getting their $52 when the patient files bankruptcy, or the patient’s estate is settled.
“Let’s hope that by some miracle SCOTUS actually rules according to the law rather than from political expediency and puts a stake through the heart of Obamacare.”
I thought SCOTUS had already ruled favourably on Obolacare. If so it’sd unlikely they’d reverse themselves.
No. SCOTUS ruled (very wrongly, with no basis in law and from political expediency) that it was Constitutional to force people to have and pay for health insurance.
What they’re due to rule on now is whether or not subsidies are available for people in both states that have their own exchanges and and those that use the federal exchange. The law as written is very clear, and SCOTUS should have no option but to eliminate subsidies.
http://www.washingtonpost.com/politics/courts_law/obamacare-back-before-high-court-today/2015/03/03/6dff31a4-c1ec-11e4-9271-610273846239_story.html
“They’d put in some crumpled craft paper, but only about 2 sheets of newspaper worth. It needed 10 or 20 times that much to keep the canned goods secure. What they really should do is use packing popcorn or foam fill, but I guess they think all the hassles with returns cost them less than the few cents it’d cost to use the popcorn.”
For a while when I ordered books from Amazon it was well packed. The books were shrink wrapped onto a thick piece of cardboard that fitted the box perfectly, the remaining space was filled with pillows. The books arrived in pristine condition.
Now they seem to just toss books in a box with little or no pillows/peanuts and no shrink wrap on to a substrate. The books sometimes arrive dog eared and with pages folded. Not happy.
They did that because of complaints from the Greenies about too much packing material. Now they have their “no-hassle” packing, which is great other than that it doesn’t do nearly as good a job of protecting the items.
“I had enough decades ago, but it’s really become intolerable.”
Hey, not to worry, big guy! All we gotta do is elect Rand Paul or Rick Perry or Rubio, oh wait—they’re still piling outta that little cah—holy crap!
Once Rand gets in, we can cue up “Happy Days are Here Again!” and roll out the barrels and have us a swell ol’ time!
Nope. Let’s get Field Marshal Rodham and her Bolshevik minions in there to finish the job Dear Leader has been doing; eight more years oughta do it. Get it over with. We really NEED another civil war now. I don’t see any other way anymore.
Sure, it feeds right into the game plan the globalist elites have in store, but what else can we do? Hang on, hope to muddle through, and hope also that they don’t shut off our stuff and station APCs on each block, etc., etc.?
It’s gonna be a matter of timing; can we survive the strife and warfare long enough for the Empire to implode and collapse? And then build anew? With what? A few doddering old farts who can remember what Western civilization was and zillions of kids who don’t know and couldn’t possibly care less?
Ah, it’s overcast again today and despair is a sin.
I don’t have time for this shit. I’d leave, if any other country were any better. The US still has the best fundamentals out there, unfortunately. We’re just stuck watching the inevitable bread-and-circuses stage. I fear what will happen as that winds down, but I’m not going to let it get to me. I’ll just, as they say, pick up my guitar and play.
We’re just stuck watching the inevitable bread-and-circuses stage.
And watch Nero play the fiddle while Rome burns…. Alas, despair is a sin.
“Pick up my guitar and play
Just like yesterday
Then I’ll get on my knees and pray
We don’t get fooled again”
Hey don’t cherry-pick them lyrics, mister; gotta git on yer knees, boy….
…trouble is, when I do that, it’s deuced hard to git back up again…
“I’d leave, if any other country were any better. The US still has the best fundamentals out there, unfortunately.”
How true it is. And how sad. We’re pissing it all away just as fast as we can. An ahistorical and illiterate bunch of rubes, drones, derps and Mundanes, waiting to die. A small vanguard/cohort is out here, though, and just like the REAL tea party guys and the Bolshies in ’17, there’s a chance.
So we must needs go beyond both despair AND hope and git to doin’ what’s right.
People are entitled to the best medical care they can afford without subsidies, and no more. If they can afford nothing, nothing is what they should get. And they most certainly should not have access to emergency room care.
The USA medical system is the best in the world, bar none. If you go in for treatment, they will either fix you or kill you (either is a good option to me). My dad has had cancer 7 times now, four Lymphoma (stage 4 once in the brain) and three bladder (dont get radiated in your groin for lymphoma in the hip bone). He is still walking this earth in his middle 70s. My lower 70s mother just turned up with stage 3 endometrial cancer. I am fairly sure that they will cure her also, if she can stand the chemo.
The problem is that paying for our medical system reminds me of the accounting trolls in the basement in Dilbert. We are definitely medieval in medical system payments and regressing to caveman.
http://dilbert.com/strip/2001-10-22
If you are 65 or over, then your payment confusion is lessened, a little. If you are 54 like me, God help you because no one else will. For example, the wife took me to the ER four years ago with heart problems. My tachycardia would not stop (heart rate 150 to 200 bpm). First thing they do, mind you, I can barely stand up since I am so tired, is ask if I had insurance. I hand over my wallet and tell the guy where it is since I am shaking so bad. Then the moron asks how I am going to pay my $100 deductible. I told him to extract a credit card. After that five minutes, they started treating me. Took them three more hours to to get stable (lopressor is your friend!).
It is time to move to Single Payer for everyone in the USA. I say that as an individual and a taxpayer, and an employer who buys $7,000 of insurance for me and my employees each month. We need to reboot the entire medical payment system.
Yes, I know that I will pay more but my goodness, the randomness of everything is driving me crazy. There is no way to make sense of the medical payment systems.
No matter what we do, we can rest assured that the med/insurance industry will fleece us blind for as much as possible and as long as possible, in collusion with the Almighty State. We’re already at the stage where medical insurance premiums are equal to, or greater than, our mortgages. For lousier treatment and absolutely rotten customer service; the web-based monstrosity here in Vermont STILL doesn’t work right and it’s already cost us millions that we will never see again. Where did it go? No one knows or cares to know.
If I wasn’t a Christian or a person of decent morals, I’d have been smart to go into one of these fields decades ago, the med/insurance hucksters, financial carny barkers or as a gummint “consultant.” I could have retired in splendor many years ago, and not worried a whit over how many people and families I screwed over. Evidently there are plenty of brigands who don’t.
In a decent country we’d have them stood against a wall and shot.
As for the chronically poor, I’m a slightly softer touch than RBT; I’d give them a one-shot chance to get their shit together; after that, fuck ’em.
What? I think of myself as a very soft touch.
It’s just that I’d as soon shoot losers as have to look at them, let alone support them.
‘Almost nobody pays this” – true. They set the rates artificially high KNOWING that Medicare only pays 42% of billed (or whatever the rate is.) They know going into it that they are going to take a huge negotiated or mandated reduction, so they raise the price.
Of course it f#cks those of us paying for it ourselves as it establishes a high starting point. I went more than 15 years with no insurance, paying cash for service. EVERYTHING is negotiable if you are paying cash. My buddy pre-negotiated his children’s births with the hospital. They will not tell you what the insurance negotiated rate is, nor will they give you pricing in advance. You just keep hammering them until they accept your offer. In fairness, they probably don’t actually know those things. The payments and charges all come from a different department, and it may all be outsourced. Paying cash or cash equivalent gives you some leverage as they will get the money immediately, instead of MAYBE 6 months later. This works better with smaller providers.
Inflated and arbitrary pricing is why I would insist on transparent pricing. Posted in public, no group discounts or secondary schedules. No one with approval authority to set prices. No subsidies. No third party payers. Let the market set pricing. You can choose a provider like you choose where to shop. Walmart, Target, or Nordstroms, up to you. Oddly enough, this is pretty much how dentistry works. Very few people have dental insurance, most dentists have set prices, many advertise those prices, and in poor areas there are cheap providers. Many signs here for “extraciones simple’ ” at $49. It beats using pliers and a heated nail to kill the nerve….
Rural LOCAL governments might choose to provide some level of care, but it has to be funded locally so SOMEONE has an eye on pricing and spending who has skin in the game. [edit- also subject to the NO NEGOTIATED DISCOUNTS rule.]
nick
[edit- has the advantage of no Constitutional issues too.]
Lynn wrote:
“First thing they do, mind you, I can barely stand up since I am so tired, is ask if I had insurance. I hand over my wallet and tell the guy where it is since I am shaking so bad. Then the moron asks how I am going to pay my $100 deductible. I told him to extract a credit card. After that five minutes, they started treating me. Took them three more hours to to get stable (lopressor is your friend!).”
I’ve heard of women in the US giving birth in cars outside hospitals because they can’t afford admission. Crazy.
The USA medical system is the best in the world, bar none.
Mr. Chuck? You out there somewhere? You gonna let this go unchallenged?
Boy, y’all whining about the medical system in the US, and I don’t blame you. The care is great, the cost (unless a savvy user negotiates it) is insane. Come down here to Oz. I was in hospital for a week last year (would have been longer but I signed myself out) and had little complaint. (Well, I spent several days in a four person ward. I never want to hear “Mr Smith, have you opened your bowels today?” ever again.) The care was excellent and it was “free”. The only costs were for parking when I went there for outpatient visits. (Yes, I’ve been paying, and continue to pay, through the tax system for 35 years.)
Dave, you especially should come down here. You could train up and practice and not go to hell for greed.
Mr Atoz, I’ll accept that the care, if money is no object, is probably at or near world’s best. It’s the *system* that’s buggered.
Chuck’s probably forever riding the subway in Berlin, checking out the “tiny titties”.
I miss Mr. Chuck.
Go California! I’m moving there stat! Oh, wait, I’m not illegal. I think. I am WHITE! though so I’m RAACIST!!!!!
Once I have to leave Tricare for Medicare, I wonder if it will be a cheap. $465/year for the family.
An Australian friend is currently living in San Jose, Calif. She says when she retires they’ll move to somewhere in Arizona. She’s a real estate agent and says the home prices in the Bay Area are completely insane, and Az is much more affordable.
Of course, I’m trying to convince them to return to Australia.
Hey @atoz, you may be an illegal soon! “Teachers complain, chaos reigns as St. Paul schools spend millions on ‘white privilege’ training”:
http://eagnews.org/teachers-complain-chaos-reigns-as-st-paul-schools-spend-millions-on-white-privilege-training/
Aren’t all of these school systems complaining that they do not have enough money to teach the kids? Of course, if they would get rid of the extraneous crap then they would have to teach the kids.
I think the quality of US healthcare is indisputable. Everything I’ve seen about other countries having equal or better simply manipulates the data. In truth, there’s no other country that comes even close, just as there’s no other country that even comes close to the US militarily. And for the same reason. The last time I checked military spending, the US spent more than the next 10 or so countries combined. A great deal of our healthcare spending is wasted in the sense that, like so many other things, the feds have turned it into a make-work program
Still, there’s a reason why foreign billionaires flock to the US for medical care.
The last thing public school administrators want is to have children learn.
Oh, they want kidz to learn alright; stuff like self-esteem, Diversity is Wonderful, white people suck, men and boyz suck, white men and boyz REALLY suck, the U.S.A. is one long unmitigated history of evil write large, Hitler was bad (zero mention of Stalin, Mao, or the Castro brothers), and in the history books they’ll have 50 pages on MLK and zero on General Lee or Paul Revere.
Also, how to spy on your parents and turn their fascist asses in for stuff, global climate warming/change is Holy Writ, and have you considered becoming homosexual and/or transgendered? It’s loads of fun and handsome superstar celebrities are doing it, too! Try it on your dawg first: so Colin becomes Caitlyn. Put him, whoops, her, on the cover of Dog Fancy. Take her to the Westminster show.
We received a letter from the IRS yesterday stating:
Notice of intent to seize (“levy”) your property or rights to property.
The IRS said we failed to pay our 2014 1120 Corporate Income Tax. If not paid immediately they would come and kill us all (I made that part up, but probably not far off since I’m WHITE!)
I pay the Form 1120 taxes via EFTPS and logged in to check. Yup, paid in April of 2015 against 2014, so they were full of shit. After 90 minutes on hold (for a fucking business issue) they resolved it after saying “Whoops, we applied it against 2015”. I pointed out the EFTPS log says against 2014. Too, bad, your time is wasted, the IRS is not at fault and it will take six weeks to receive a letter “clearing the levy”. I was also expecting a “fuck you” since I could tell from the Ebonics, the IRS rep was Afrikan-Murkan.
Wut a Kuntry!
Welcome to our world, MrAtoz.
It’s where you and I can do everything right and by the book with these bastards and they screw up, screw us over, and then we eat chit and there is zero recourse.
A word of warning: they say the bit about the six weeks to get a letter blowing away the levy but don’t be shocked if the levy takes place anyway. The left hand notoriously does not know what the right hand is doing or has done with them.
And by the way, yes, it is somehow your fault. Don’t doubt it for a minute. They certainly don’t.
Go California! I’m moving there stat! Oh, wait, I’m not illegal.
I thought that Kalifornia was broke? So citizens have to pay for healthcare but illegals are free? Makes no sense whatsoever.
C’mon now, Mr. Lynn; where’s your humanity?
““We are talking about our friends. We are talking about our neighbors and our families who are denied basic healthcare in the richest state of this union,” Lara told his colleagues.”
See, it’s not broke; it’s the richest state in the country. Senor Lara habla. Comprende, hombre? Least we can do is take care of these wonderful people; so rich folks like you and MrAtoz and that guy down in Australia should foot the bill.
Heads up, for our friends down in Oz:
http://www.telegraph.co.uk/news/worldnews/australiaandthepacific/australia/11646009/Aggressive-walking-fish-is-heading-south-towards-Australia-scientists-warn.html
Yikes! Ain’t y’all got enough weird and dangerous critters there already???
I’m fairly sure I’ve posted this before, but it’s still a good example of the broken-ness of the health insurance system (not the health care system, as too many idiot politicians insist).
My older sister died in July of 2013. I took her to the ER on a Tuesday morning, and she died Thursday evening. About a month later, I (personal representative of the estate) got the final bill, with a grand total of $82,112.00 . The next line item was ‘Contractual Discount’ in the amount of $72,308.62, leaving a balance due of $9,803.38 . Of that total, BC/BS of Florida paid all but $1,000.00 .
I have no doubt that if my sister hadn’t had insurance, the hospital would have come after the estate for the full $82 grand, subject to my ability to negotiate with them. And of course if they had settled for some reduced figure, they’d crow about how generous their write offs were.
I also understand that Blue Cross is able to negotiate much better prices because of their volume purchases, just like our host gets better prices for batches of 100,000 vials rather than buying them 10 at a time. But it sure seems to me that if you’re willing to discount 7/8s of the original bill, it was bogus on its face, if not simply fraudulent.
As other have said, one helpful step would be upfront and honest pricing. There’s no way that an EKG actually costs $553, and yes I made an A in Cost Accounting so I have some grasp of how such figures evolve. So why not call it $215, for equipment, disposables, nurse’s time and be done with it? And I know that CAT scan machines are a hefty capital expense, but $7,942 for a scan is simply fiction.
The other flaw is in how health insurance is paid for. Unless & until employer paid insurance is done away with, the system will be skewed, and far too many people won’t have any actual idea of what it costs them. Until January of 2014, BC/BS of FL simply refused to sell me a health insurance policy, because I would pay for it myself. If, for example, I worked for the State of Florida, they’d be happy to let the State pay for my insurance. So either the actuaries think that working for Aunt Florida would make me healthier (asymptotic to zero, anyone?) or the finance people don’t want the public to know what it really costs.
Good points, all, Mr. pcb_duffer.
Merely one more illustration of how almost every transaction we now have with banks, insurance companies, the medical establishments, retailers, and last, but not least, the governments, is rife with fraud, deceit, and humbuggery. With very little if any recourse most of the time. When we see their lips moving or their siggies on pieces of paper, we know they’re lying again.
Yet if we engaged in the same sort of fraud, the forces of law and order would hammer us flat in record time.
For your viewing pleasure I present to you a recent photo shoot with a young lady from Norway.
http://www.raymondthompsonphotography.com/Celina
Do we really spend a third of health care dollars on billing and bureaucracy?
Study* finds that “after exclusions, administration accounted for 31.0 percent of health care expenditures in the United States.”
http://www.nejm.org/doi/full/10.1056/NEJMsa022033
*The New England Journal of Medicine – “Costs of Health Care Administration in the United States and Canada” by Steffie Woolhandler, Terry Campbell and David Himmelstein. (Campbell comes from the Canadian Institute for Health Information; Woolhandler and Himmelstein from the Cambridge Hospital and Harvard Medical School.)
The average medical loss ratio in the United States is about 80 percent. But the reason this study tacks on another 11 percent is that the medical loss ratio “does not take into account the cost of physicians to collect from insurance companies.” Physicians and hospitals have to spend all that extra money because of the complexity of the U.S. insurance system. Medical care providers incur considerable costs in their administrative dealings with insurance companies.
The medical loss ratio describes the percent of every dollar that an insurance company takes in that goes to medical costs. So, for instance, if a company has a 70 percent medical loss ratio, that means that 70 cents of every dollar goes to health care while 30 cents goes to other areas — administration, advertising and profit, for example. (Under the new federal healthcare law, the ratio must be 80 percent or insurance companies have to rebate the overage.)
Medicare’s overhead, meanwhile, is usually put somewhere around 2 or 3 percent.
Ever notice when you are in a big city, how the big fancy buildings are usually either banks or insurance companies?
They set the rates artificially high KNOWING that Medicare only pays 42% of billed (or whatever the rate is.)
Not really. The system works like this. For Medicare, the government sets rates based on a relative value guide and the local cost of living. They then publish a fee schedule for the entire US, along with the geographic adjustments. There is some back and forth, a few alterations. Presto. The Fees for all medical services for Medicare are set. Medicaid rates are state-dependent, but are generally a fraction of the Medicare ones.
“Ever notice when you are in a big city, how the big fancy buildings are usually either banks or insurance companies?”
I avoid big cities. In the small towns the biggest and fanciest buildings are the town halls and sometimes the libraries. A bank, if it was built early in the last century or before that. Otherwise the banks are these little branch offices now.
@ech, thanks for the clarification. Please substitute the phrase ‘the insurance companies’ for medicaid, which should fix it 🙂
So what was the recent news kurfuffle about medicaid reducing physician compensation, by IIRC, allowing an extension to the current rates expire?
And what do they base the ‘relative value guide’ on? Providers [artificially high] normal billing rates? Or do they start from 0 and go up, as in ‘each suture costs 3 minutes of a PAs time, and a piece of string is .5c and there are 7 of each so we’ll pay $28 for an ER suture.”
If the first, providers have every incentive to jack their price, knowing it will be cut. If the second, WTF do they actually know about running a medical practice? The complete unwillingness of local Drs to take patients on MC or MA would suggest that however the number is determined, it is too low.
nick
Also, it just occurred to me that under Ocare, I was FORCED to provide my SSN if I wanted a policy. Until then, the only agencies I was REQUIRED to provide a SSN to were the SSA and the IRS. It could not be required as an ID by anyone else, and they were all required to provide me with an alternate identifying number if I asked. Ocare changed that according to BC/BS.
I say again, one word:
RACKET
These people are racketeers, brigands, pirates, and criminal scum. They range throughout the banking, insurance, financial speculation and government organizations in one giant network. At our Mundane level we pretty much only come into contact with the drone bureaucracy, and the actual criminal activity takes place at much higher strata.
I say again: we live in a corporate fascist oligarchy. No need to sugarcoat it, and it’s why voting and elections and campaigns are like unto the various entertainments at carnivals and the circus.
They’ll be in charge until they’re not anymore. Probably within our lifetimes, too. The house of cards cannot be sustained much longer.
And no canned dried eggs to be had anywhere.
Scarcer than hen’s teeth, or .22LR
We eat a LOT of eggs here, and I’ve neglected freezedrieds.
Plenty of time to regret that if they keep killing birds.
I think I’ll check out some of the restaurant wholesalers this week.
nick
http://www.bobsredmill.com/vegetarian-egg-replacer.html
So what was the recent news kurfuffle about medicaid reducing physician compensation, by IIRC, allowing an extension to the current rates expire?
Eighteen years ago, the Medicare law was amended to put in some automatic reimbursement cuts for physicians if there was “too much” growth in the use of Medicare. All but a couple of years early in the program, there was “too much” and to avoid a payment cut, Congress would pass the “Doc fix”, pushing the cut a year. The payment cut increased each year and got to be about 21% of the reimbursements and would be across the board. This April, they passed a permanent fix that transitions doctors to a “Merit-Based Incentive Payment System” over the next few years. Since Medicaid reimbursements in most states are based on Medicare, it would have hosed Medicaid doctors even more. (Note that hospitals and other providers wouldn’t be affected by this.)
Physicians get about 13% of Medicare money, btw.
Man, I am getting old. The number one son and I went over to Sams Club tonight and I bought two Heavy-Duty 4-Shelf Welded Steel Treadplate Rack with Wire Shelves. I liked them because the end pieces are one piece of steel instead of two pieces. They are now up in the corner of my garage and are beautiful. Except, they are anodized black instead of chrome steel.
http://www.samsclub.com/sams/welded-rack-4-level/prod13130202.ip
Then we took a lot of stuff out of the garage over to the little office building like my pinball machine, etc. I had forgotten how heavy that sucker is. It is a 1981 Bally Harlem Globetrotters pinball that weighs about 250 lbs. Fully functional with a fairly new motherboard in it (the old one had a battery leak acid all over it). Three 6502 cpus!
Now I have to decide what to stack on the new shelves. That can wait a day or two as I have a feeling that I am going to be very sore in the morning based on the back and shoulder pain now.
BTW, my son said that my estimate of two 35 half liter bottle cases of water per person per week is way under. His experience is Iraq was that each person used a 24 half liter bottle case of Nestle’s water PER DAY. Drinking, cooking, cleaning, brushing teeth, etc for 1,500 Marines and Sailors.
That was when he was up in Hit, Iraq with no infrastructure whatsoever for seven months. The Euphrates river had turds floating in it from Syria (no water treatment) so they did not even touch that water. They ran out of water about five months in and drove their seven tons over to a army base (20,000+ army guys). They drove in a back gate empty and drove out with enough water for two months for 1,500 guys. All it cost them was the Sgt. Major’s cigars.
Well, NOAA thinks that the Brazos River has peaked at 49.9 ft. If so, that will be second highest level of the river in 100+ years. All I know is that it sure is a lot of muddy water and I wish that we had some way of storing it for the next drought.
http://water.weather.gov/ahps2/hydrograph.php?wfo=HGX&gage=RMOT2
“For your viewing pleasure I present to you a recent photo shoot with a young lady from Norway.”
Coincidence… Last Friday my elder nephew married a lady from Norway, in Norway. Another blonde (surprise surprise) and quite a dish. She speaks fluent English, and my nephew is learning Norwegian. They’re comming back here to live, and I’ve asked my nephew to bring at least one Norwegian, Swedish, Danish or Icelandic tart back for me… 🙂
Water requirements are highly dependent on the person (weight, age), environment (temperature, humidity), and activity level. The gallon/day is marginally sufficient for most people in most environments at average to high activity levels, but only for drinking water requirements and limited cooking. I recommend three gallons (12 L) per person per day if at all possible, or about 100 gallons per person-month.
In college, I worked summers on a road crew, often with hot mix (asphalt) in the sun all day long. Our foreman had a 5-gallon water container on the back of his pickup, which he often filled several times a day for our crew, which was typically four to six guys. We probably averaged three gallons per day each.
Just saw this on CNN.
Shares in insurance giant Humana (HUM) are moving up as investors expect it will increase its premiums on some Texas health plans by as much as 30%. Other insurers are proposing similar plans.
Yep, that Obamacare was really a success. Promises that premiums would not rise and many would drop, keep the same doctors (my doctor would have dropped me had I gone on the program), etc. That did not work out so well. That cretin in the oval office is a lying, dimwitted asshole. Typical politician.
I’ve chimed in before on the 1gal/per/day. Not enough for adults during a disaster. During live outdoor events I would assume a case of water (smaller bottles) /per/day. Often bottles are abandon partially full, and some people don’t drink enough no matter what you tell them. I have personally saved at least 2 and probably 4 people from serious, life threatening dehydration issues during events (it’s been a few years, and there was a LOT of drinking in between, so my memory is hazy on some stuff).
Working construction in Phoenix it wasn’t unusual to drink 2 or more gallons in a day per person. Of course, it was hot enough that getting in a 108 deg hot tub felt cool.
I stock paper plates, plastic utensils, and solo cups to minimize my wash water usage, but you need a surprising amount to stay clean and to keep food prep areas clean. Bleach solution is your friend here. Got dish soap? Got scrubby pads? Got wash basins?
nick
Ray wrote:
“That cretin in the oval office is a lying, dimwitted asshole.”
Careful Ray, many of the people on this board effectively voted for that dimwitted arsehole by staying at home on election day… 🙂
nick wrote:
“I stock paper plates, plastic utensils, and solo cups to minimize my wash water usage…”
That’s a really good idea I’d never thought of. Thanks.
I don’t worry too much about washing up. I use a quart/liter plastic mug all day long for Coke, tea, lemonade, etc. and wash it once every year or two whether it needs it or not. As far as plates, bowls, utensils, etc., I let Colin lick them clean after I finish eating. He does a pretty good job of cleaning them.
Needless to say, since I eat and drink like a medieval peasant, I have a very robust immune system.
“Careful Ray, many of the people on this board effectively voted for that dimwitted arsehole by staying at home on election day…”
Nope, that’s not how it works here.
But we’ve explained it many times before.
@ miles, glad it helps. That is why I like places like this. Cross pollination is a good thing, and sharing helps increase the knowledge pie for everyone. (hmmmm, pie for everyone….)
I am still constantly running across new ideas, even though I’ve been (officially) prepping since y2K. There is a fantastic thing happening in the prepping world as so many different subcultures come together and exchange bits and pieces. The traditional survivalists, back to the land folks, urban homesteaders, modern homesteaders, gunnies, ham radio operators, emergency mgmt pros, hobby farmers, church of LDS, and others; all come to this journey from different directions, with different backgrounds, different approaches to problem solving, different expectations, and tricks-of-the-trade.
What the business world calls “adopting best practices” most people call “stealing the good ideas” and the best part is that stealing them INCREASES their value, rather than diminishing it. I’m sure there’s a network effect there too. The value of being a prepper is increased as the number of preppers increases. Heck, it is now possible to make a living from the prepping culture.
BTW, there is also a cautionary tale in this too. Prepping is becoming commonplace, even if it isn’t openly called that by some practitioners. This indicates to me that the world’s problems are becoming widespread and obvious enough to concern a whole lot of folks. Believing that ‘bad times are coming’ is no longer a fringe thing, but part of the ‘conventional wisdom.’ There are real world statistics to back up this new prudence too, showing people paying down debt, saving vs. spending, increased precious metal sales.
That is in contrast to the overall lower employment, decreased wages, increases in credit use (car loans and ‘non-bank’ loans) and increasing income disparity, and high levels of welfare use.
We have two groups rapidly coalescing– those who see bad times coming and are getting ready, and those who are exploiting the current situation without regard for the future.
I have some other thoughts about this, but need to get them together first.
nick
@nick
+1
Careful Ray, many of the people on this board effectively voted for that dimwitted arsehole by staying at home on election day… 🙂
+1
Also, it just occurred to me that under Ocare, I was FORCED to provide my SSN if I wanted a policy. Until then, the only agencies I was REQUIRED to provide a SSN to were the SSA and the IRS.
Yep. Because the IRS needs to be able to cross check your income and the plan to verify any subsidies you claim. And to be sure you have health insurance when you file your taxes.
BTW, there is also a cautionary tale in this too. Prepping is becoming commonplace, even if it isn’t openly called that by some practitioners. This indicates to me that the world’s problems are becoming widespread and obvious enough to concern a whole lot of folks. Believing that ‘bad times are coming’ is no longer a fringe thing, but part of the ‘conventional wisdom.’ There are real world statistics to back up this new prudence too, showing people paying down debt, saving vs. spending, increased precious metal sales.
My potty chair got delivered yesterday. The wife went sky high. I explained that in case of major hurricane with the subsequent failure of the water and sewer systems, we may need to bag our refuse for a month. She calmed down a little bit after that but was still snappy when some #10 canned Auguson farms arrived.
http://www.amazon.com/Medline-MDS89664H-4-in-1-Steel-Commode/dp/B000BJEZ88/
Sigh.
Your wife is tougher than most, but I’d guess that more preppers than not get at least some flak from their spouses.
I’m just relentless, but with frequent breaks. That is, I’ll buy a lot of stuff, take a breather, and then buy more. Fortunately, Barbara is a lot better than average at putting up with these things. When you start seeing steam coming out of their ears, it’s time to let them depressurize a bit before you jump back into it.
“When you start seeing steam coming out of their ears, it’s time to let them depressurize a bit before you jump back into it.”
+1
But on the necessity of voting and then by not voting, effectively electing Obola?
-1
Dave, you’re like someone who has time but refuses to step out of the path of a bullet, “on principle”.
I’ve got a couple of these ‘toilet seat riser’ things.
http://www.amazon.com/AquaSense-Portable-Raised-Toilet-Inches/dp/B005IV0DDA/ref=sr_1_1?ie=UTF8&qid=1433365189&sr=8-1&keywords=toilet+seat+riser
They were a buck or two at yard sales. They have a raised lip on the bottom that fits perfectly in a five gallon bucket. They don’t quite fit completely IN the bucket, which would have been cool for storage. I have the bucket with a couple of trash can liners, and about 2 quarts of clumping kitty litter in a jar and the seat, ready for the car when we go somewhere with the kids (like to watch fireworks in a mall parking lot.) It’s probably a lot more comfortable than squatting over a coffee can, and better for the environment. Especially when that environment is acres of paved parking lot 🙂
Haven’t seen the need to buy the actual chair yet, but I see them all the time at estate sales and thrift stores. I’m actually a little surprised how cheap that one was.
nick
“Dave, you’re like someone who has time but refuses to step out of the path of a bullet, “on principle”.”
Greg, you’re like someone who has time but refuses to see, as in ‘there are none so blind.’
We live here. We’ve lived here all our lives. We’ve voted in the past, and we’ve watched what’s been going on all this time, in the case of myself and others, over sixty years. If someone as smart as RBT won’t vote, and someone like me with the lineage going back to the War of Independence and service in three U.S. wars won’t vote, what does that tell you? If anything…
I’ve also exhaustively studied our Federalist Papers, Anti-Federalist Papers, Bill of Rights, letters written by Adams, Jefferson, Washington, et. al., and a real eye-opener, “The Secret Proceedings and Debates of the Constitutional Convention, 1787” written by guys who were there.
Whatever you were taught back there in your education in Australia has little to no bearing on current reality here. But don’t feel bad or left out; we have lotsa peeps here who still apparently believe in the balderdash they were fed all through school, reinforced daily, if not hourly, by our captive media. They’ll dutifully and hopefully continue to exhort us to vote and they’ll go vote themselves, and then, if by some miracle, somebody or other who tickles their fancy actually gets into office, they’ll be cruelly disappointed all over again. In four years they’ll do it again.
There’s a reason the late Gore Vidal called this the United States of Amnesia.
Dave, all the above bluster doesn’t change the fact that you and the other right-wingers and libertarians who stayed home in 2008 and 2012 share responsibility for the mess you’re in now. If you think McCain would have been a worse president than Obummer then I just don’t agree.
Calling my post “bluster” doesn’t advance your own argument, either. McCain would have had us all in World War IV; he’s a maniacal loose cannon and most of my fellow combat vets agree.
So in short, we would now be in a far worse mess.
McCain would have had us all in World War IV; he’s a maniacal loose cannon and most of my fellow combat vets agree.
McCain does seem to be a little off the edge at times. Certainly less than 12 hours per day.
My uncle served as an aviator under McCain during Vietnam. He refused to vote for him also due to his arrogance. But my uncle’s wingman and McCain spent quite a few years together in the Hanoi Hilton.
miles_teg has repeatedly said that Hillary
BitchButch Clinton is a hottie. This is sufficient proof that he is either a troll, hopelessly insane, or dumber than a bag of weevils. In any case, we can disregard anything he says about voting in any nation.Well, to be fair, he’s also said that Sandra Bullock is a hottie; I frankly don’t see them as belonging to the same species.
Has anyone ever seen a bag of weevils? Our thing over here in Nova Anglia was always to describe someone as “dumber than a bag of hammers.” I wonder how these phrases originate and get around. Brewer’s Dictionary of Phrase and Fable used to do a good job, but there’s been newer stuff out and I should check if there’s an updated edition or someone else has done it differently. And we also have heard “uglier than a bag of pickled assholes,” which describes Field Marshal Rodham, and indeed most libturd and prog females. Why is that, I wonder? And I’m not the first to wonder by any means. How come us right-wingers have all the hotties on our side?
Dumber than a bag of Bidens.
Biden was first elected in, IIRC, 1972. I *cannot* believe he is still around.
OFD approves of the lovely Sandra? Looks like the feminists haven’t completely neutered him.
“Biden was first elected in, IIRC, 1972. I *cannot* believe he is still around.”
I won’t say anything bad about him today as he just lost his son, but suffice to note that his life behind the VP role is very troubled.
“OFD approves of the lovely Sandra?”
She’s OK; I only said they’re of two different species, not that Sandra is my cup of tea. It will be a cold day in Hell when the fembots neuter me; I’ve dealt with the worst of them over years of grad skool bullshit and the corporate world. Let’s see them piss up a rope.
how about “gayer than a bag of dicks” ?
Saw that one online and couldn’t stop laughing.
nick
Sandra Bullock? Sure, girl next door looks, seems sweet. Spent some time married to Jesse James though, so the crazy IS there.
“how about “gayer than a bag of dicks” ?”
I only heard that one recently myself and also busted out laughing. Gee, we must be homophobic bigots. I’ll turn myself in now. Suggest you do the same. Re-education camp for us.
“…so the crazy IS there.”
Riddle me this, Grasshopper: with womyn and grrlz, when is it NOT??
” I only said they’re of two different species, not that Sandra is my cup of tea.”
Okay, so the fembots didn’t do it. Who did? The VC? A jealous boyfriend/husband? In industrial accident? A crim you tried to arrest down in Maffachusetts? Missing plumbing is the only excuse a guy has for not being in love with the lovely Sandra.
Jessie James…
What sort of fleabrain would be unfaithful to a beautiful and rich lady like Sandra?
A bit of wisdom I’ve heard: for every beautiful woman, there’s a man who’s sick of her shit.
As for a bag of weevils, no, I’ve never seen one. I might, however, have seen bags of other crawlies gathered for retributive purposes, back when I was younger and less easy-going.