Hot and humid, not much chance of clouds. The next three days look the same. Yesterday was hot in Houston, and at the BOL.
Some work got done, some fun was had.
Today is nose to the grindstone. Again. This time for realz.
Because hard times are coming.
Stack it up.
n
Jesum. Christ on crutches. I know the US health system is sick, but…
Consider how long the procedure was, and how many people were involved. Give them a nice salary, then triple it to cover equipment, buildings, etc..
I had a colonoscopy in January, which took half-an-hour or so. Figure three people involved (one doc, two nurses), average salary $200/hour (probably under for the doc, definitely over for the nurses), so that’s $300. Triple for equipment, etc., that’s $900 (without pathology). Now give me a minute, to go look up the bill…and it’s Fr. 827.55, so I overshot by a bit.
How can the US not fix such an insane system???
@brad:
Why should they? It’s working perfectly. For them. Everyone else, not so much.
Seriously, though, I agree entirely.
G.
Nobody actually pays the amount on the bill. If you are sedated (common) add for that. Imagery might be better.
The insurance cost the Dr’s face for malpractice is insane, and has to be paid.
My knee surgery was $10’s of thousands, but the Dr on ly saw ~$600 per knee iirc after all the discounts, etc. It was so low I was embarrassed for him.
n
79F and 90%RH this morning. Sun is poking up. Sky is clear.
I don’t feel too bad, considering the kayaking…
n
How much do you pay in income taxes to support your health system? In Germany payroll taxes are about 50%. Mine is about 14%. Someone, somehow, some way, is paying for the cost.
You also failed to include the cost paid to manufacturers for each use of specialized equipment. The facility not only pays for the equipment but also for each test. MRI vendors are particularly greedy.
My knee replacement was billed at $35,000. I paid $22.00 for medication that was not covered. Taxpayers paid the rest which was about $14K after the discounts My wife’s heart attack was billed at $85K. Insurance (Medicare and private) paid $30K discounted. I paid $0.00.
Yes, the US system sucks. The Canadian system sucks. The German system sucks. All the systems have issues. Cost, getting access, quality of care. There is no perfect system.
What annoys me most in the US is getting the actual cost. The hospital will inform what they will charge. Getting that information from the surgeon is almost impossible. Getting that information from the insurance company is impossible. The same procedure in a different facility, by a different doctor, can vary by thousands. It is difficult to make informed choices.
@brad, who pays the sugi-center? Who pays the cleaning staff? Who buys the machine to clean the camera?
Don’t forget about all the overhead costs. I’ll admit that our billing system add a large percentage in non-productive labor wrt billing and collections, but there are always more costs than just 3 guys in a room.
n
@nick:
Agreed. But what about the negotiability of all these costs? And the fact that insurance claims appear to be padded to the max? Also rates vary dramatically depending on location.
Add to that the fact that I, personally, don’t believe that health should be a profit centre. If you have to charge, charge at cost, not cost plus<as much as we think we can get away with>.
I know which I prefer, although I grouse about the tax bite.
G.
What, then, pays for development of new devices and procedures and drugs?
I can answer that: to a first approximation, the entire world is freeloading on American innovation.
See also: anti-piracy patrols in international waters
@brad, @Geoff, there are lots of attempts to try to explain our medical costs, and I don’t believe any of them. It is a lucrative for-profit investment, and everyone who goes into any medical field does so for the money. I know several nurses, who freely discuss how much they are paid, starting at $80 an hour, plus additional for OT, travel bonuses, shift differentials etc. Doctors are trying to shift all their patient care onto paraprofessionals, and the doctor takes a cut of what is billed for those he supervises.
Like everything, there are some situations in which people don’t earn what they had expected to earn … we’ve seen some reports about that here… but those are not ordinary. I’ve known many doctors over the years socially and as friends. Most doctors live well and grow rich early. Some retire at 50, some keep working until they are 80, that just depends on the person.
We know some great doctors, who are rational in the fees they charge the patient, and who deliberately limit their practices to human scale, because they’ve made their money and now they can afford to enjoy their calling.
In our experience the faith-based traditional non-profit hospital systems have never overcharged us or our insurance. They still have all the funding they need for everything they want – personal as well as professional. A national single-payer system, as you folks in Europe have, could and would work as well here, I think, and I’d hoped one would be in place by now.
And remember that our current medical system, based mostly on employer provided insurance*, is the result of government meddling in wage control. Employers were forbidden to pay a wage high enough to attract workers out west, and so Kaiser invented the employer provided health insurance, as an additional compensation.
That and the change in the law that required hospitals to take all comers, regardless of ability to pay, while insisting at the same time that they get all the possible medical interventions, led to the opaque, screwed up system we have now.
n
*changing, shifting to .gov paid, but still structured that way. MOST people with insurance use as much as they can, because the costs are opaque, and not born by the consumer.
Clot-shot in a graphic:
Vax Effectiveness
Quick trip to Costco yesterday to order a pair of prescription sunglasses for my son. I picked up a few things while there, one being a couple pork tenderloins. My son said “wow, $3.99 for that? That’s a great price.” No son, that’s $3.99/lb. This pack is $15.00. I see I have more teaching to do…
Nothing I normally get was low, except for dog food. There was a sign up limiting purchases to 1 bag, and there were only 3 bags left – no different types, just 3 bags. Luckily our remaining dog can eat anything, so I grabbed one. The price wasn’t inflated. I’ll be the restock will also be more expensive.
Zero. Mandated private health insurance, i.e. everybody must have it. Poor folks do get a subsidy, so I suppose some portion of our taxes go to that.
Anyway, the private insurance runs about $500/month for the wife and I together, with an annual deductible of $2500. So I paid the colonoscopy myself, because it’s the first bill of the year.
That sounds like one step nearer to the problem: overhead an order of magnitude higher than the actual treatment cost. Insane, and if there’s any reason to march on Washington, that sounds like a good one.
I am friends with a doctor, spent a lot of time camping with his family. I asked him why insurance is billed $500.00 when insurance only pays $100.00. He stated they bill the maximum they can because they don’t know what insurance will pay. One insurance company may pay $200.00, another insurance company may pay $350.00. The billing system is so messed up even the doctors don’t know what they will get for a procedure. The only cost that is known is Medicare and VA which parallels Medicare rates.
My dentist was one of those people. But he died suddenly. A cleaning was $110.00 from him. I tried a new dentist when I had a real pain issue and my regular (now deceased) dentist was on vacation. The new chap billed $400.00 for the cleaning. The root canal was $1,200.00. He also has lots of new, shiny equipment, best of the best. I will not be returning as he also wanted to pull most of my teeth and replace with implants. A cool $10K cost. Uh, no thanks. My old, deceased, dentist told me my teeth will last another 20 years although a couple may have to be pulled.
I don’t go along with that assertion based on the doctors that I know. The ones that really make the money are the surgeons. General doctors do well, but so does my plumber and electrician. I cut my finger badly and went to my general practitioner to see what I should do. He saw me rather quickly without an appointment. I really did not want to pay ER fees. He stated he was happy to see me as he got to do something different, stitches. Took two stitches. No deadening as the injections would have been as painful as the stitching.
Applies to new drugs and medical machines. The development cost is supported by the users in the US, and paid for by users in the US.
I think otherwise. I think hospitals need to make a profit. They are generally part of a corporation and that corporation has shareholders. Those shareholders need to make something on their investment. The facility also needs to make a profit to expand, improve, or replace their facilities. As to the amount of profit, that is unknown and open to debate. Certainly not to the point of gouging the patient.
When my wife had a procedure there was a charge on the bill for $250.00 for video. I did not get the video. I asked for the video since I was charged for the video. I was told no, that video was to protect the hospital. I said I am not paying for their video and remove it from the bill. The hospital did.
Another time my wife needed a hip replaced. My share of the hospital cost was $6K. I had a high deductible account. That amount had to be paid in full before the hospital would allow the procedure to scheduled. I asked for a payment plan and was told no as I had insurance. That, in my opinion, was wrong. Not everyone can pony up that amount for a much-needed procedure.
Regardless of the system, someone, somewhere is paying. Universal healthcare is funded by taxes, heavy taxes, as much as 50% of income. Nothing is free.
The demand for free good is infinite. I knew a lady from years ago, on TNCare (state Medicaid). She went to the ER eight or ten times a month for her or her kids. No doctor would take her as a patient. Sniffles was an emergency trip to the ER. When the state considered limited ER visits, except for life threatening, to no more than six a month she went ballistic. The state was also going to limit prescriptions to no more than 20 a month. Another item for which she complained.
Her abuse of the system was not that uncommon for those leaches on the public dole. The slightest discomfort or symptom was an ER trip. The state was paying thousands of dollars a month for her medical issues that were generally minor. Sniffles that can be treated with OTC. Nope, not going to happen. Best to get to the ER for “free” medicine.
Both of her daughters got pregnant. The daughters had plans to get married but waiting until long after the baby was born. That allowed to the daughters to have the birth without paying anything as it was covered by state. The daughters did not work and were on welfare, same as their mother. Their abuse of the “free” system was rampant and they were not alone.
A universal “free” healthcare system would be crushed by the leaches.
Like most Americans, a lot of doctors live on debt if they don’t have family money.
I’ve given up on waiting for the medical license at our house to generate the kind of money that most people associate with physician income. I now have two rules: (1) I don’t subsidize the private practive of medicine with my income/savings like I did for most of the first 20 years my wife practiced even when I was unemployed and (2) the license must generate a take home check equal to 4x the house payment monthly as it did when we first qualified for our current mortgage.
Also, ABSOLUTELY NO DEBT beyond the mortgage. Student loans were paid off nearly a decade ago … but don’t tell my in-laws since they’ll start planning the date when they move in with us.
The Chinese relations on the West Coast are getting a taste of “Medicare for All” with one aunt needing a kidney and being on dialysis three times a week. The husband sold off his state retirement benefits a decade ago so they live Medicare without a supplement plan.
What I find interesting is their complaints now about the system being “unfair” despite personal wealth at all of the households in the seven figure range. They don’t like writing the checks for the dialysis, and God forbid they get asked for one for the transplant.
Unalloyed Medicare requires a five year wait for a kidney. That’s effectively a death sentence.
The leeches would be quickly crushed by a universal system. A *real* universal system. They definitely don’t want that.
Agreed. Prior to proliferation of the insurance racket, that was pretty much how things were.
My wife and I have decided that if either of use needs extraordinary care we will get divorced. Each will get half of our assets. The one in the extraordinary care will soon lose all their money and be placed on Medicaid. Getting divorced will protect the other person from becoming destitute. That was decided years ago and the rules may have changed since then where both people, even being divorced, will lose everything. I don’t know if that could apply to future income.
A guy I knew at church wife developed Muscular Dystrophy, really bad. 20 years ago when she got the disease. She went downhill quickly. He divorced her. I thought that was really shallow. After talking with him about his life since my opinion changed.
He stated he did not get remarried as he still loved his wife. But he could not afford her care and trying to do so would have bankrupted them into poverty. He divorced her to allow her to get on Medicaid and state medical. She got better care, a better support system (chair, home modifications, caretaker) than he could have ever afforded. Or the care she would have received with private insurance. If the insurance did not drop her coverage. The monthly cost is in the 10’s of thousands. Getting divorced was the only way to get her the proper care.
My husband has had only Medicare coverage for the past ~13 years. No supplement -we couldn’t afford that. He’s never had to wait for anything he has needed, and has always received top notch care. In most cases, we’ve felt that our portion after Medicare paid was appropriate. We feel very blessed.
One hospital “system” gouged medicare and us each time we’ve used them, so we don’t use them any more. But Hendrick, Providence, and the private surgical center have been fair and honest with their billing of Medicare AND us. He’s had a procedure every six months for the past 7 years in an out patient surgical center that is part-owned by his urologist. Our co-pay for the procedure, which requires general anesthesia, is all paid at once $240.00. That includes surgeon, radiology, anesthesiologist, etc.
Research the Medicaid clawback rules in your state before deciding to go that route. A lot of states have tightened in the last decade.
Florida is really brutal, up to 10 years IIRC. Florida even makes the beneficiaries of the estate criminally liable for any fraud the patient commits against the system, including concealing assets.
Dentists have long been a field where it pays to price check before making that first appointment. Root canals can be a real profit center, esp when they stretch them out over 4 or 5 visits. Some of them really have a racket going, and it starts with those unneeded ‘initial visits” where “his girls” chart the teeth etc etc for a couple hundred dollars, but won’t do any actual work. Our current dentist charges $40 for an office visit, $40 for an x-ray, etc. When Paul saw him a couple months ago to get his dentures relined, there was no charge for the initial soft lining… and there may be one more of those in the interim …. we’ll only have to pay when he does the final hard new lining.
You certainly have a way with words. 🙂 And, yes, good for both of you. I’ll bet you will enjoy that guitar almost as much as him.
That’s not where the bill will end up but top line, where things started.
The BCBS plan from the VA wasn’t involved until last week, and that will bring things down to Earth quickly.
My original co-pay was $1200, which I would have covered out of my HSA accumulations from the last two jobs. That would be about right to cover the hour of time of the people in the room and the overhead. My new employer has self funding coverage, and, as I noted before, does not let me fund an HSA so the bill was probably a roll of the dice to see what else could be squeezed out for cost shifting.
I’ve had this discussion with certain people in the US and they simply don’t believe me. (Remember I’m from the UK) They have no idea about the system in other countries, are 100% convinced by the cherry-picked data on TV, and don’t take in contrary facts.
Right back atcha, cupcake.
Well, waddayaknow… checked my ebay acct and the negative feedback was removed. No emails or other mention, just gone.
Since the buyer was a scammer I’m happy to have blocked her and to see the last of her.
n
I know. It used to be 3 years, now it is 5 years to look for assets. At one time assets that were split because of a divorce were not considered. That may have changed.
A lady where I used to work had her father go into a Medicaid paid nursing home. The state put a lein on the house and took all the funds her mother got from retirement and SS and left the mother with $400.00 a month. That amount is impossible on which to live.
When I put my aunt on Medicaid the state tried to go back five years. I had to inform the agent that the clawback was currently 3 years and the 5 years did not into effect until next month. Really did not matter, my aunt was out of money.
The state also tried to take her VA money of $90.00 a month. I had to get a letter from the VA telling the state they were not entitled to the money. The state knew, they were just hoping to get more based on lack of knowledge of myself. My aunt was left with $140.00 a month, $50 left from her retirement, and the VA money.
The state is ruthless.
– the fact he thinks it’s “outlandish” is pretty telling. None of those things sound like bad ideas to me. Why do we have troops in Africa again? And what do we want from African nations?
n
Agreed. President Trump, at the very beginning, also wanted to take us out of NATO altogether, and to put everyone in the USA on the same Medical Insurance coverage that Congress gets. He had full, detailed, long range impact plans for everything he wanted to do.
But the GOP aligned with the Democrats to stymie everything.
re: Medical costs in U.S.
Embrace the healing power of “and”. Democrat price and wage controls (Thanks, FDR!), insurance tied to work, federal regulation of insurance limiting it to individual states, excessive administrative costs due to the arcane billing/charging systems, scum-sucking lawyers, genuine malpractice, federal regulations requiring free treatment at ER for everyone, including illegal invaders, a subculture of resident citizen leeches, not-for-profit (but definitely not non-profit) organizations with the goal of building their organizations, standard-of-care that leads to things like denying transplants to people who are skeptical of the new useless “vaccine”…. The list goes on.
Houston Methodist Hospital has added a billion dollars in new capital improvements in the last 10 years. Let that sink in. The not-for-profit organization has generated enough revenue to pay their costs plus a billion more, at least.
No one is going to fix this system. It will have to collapse. One of the steps of that collapse is the widespread loss of trust in medicine we’ve experienced over the last couple years. I will go to my PCP appointment in June, just so I can get the scrip I need for Lisinopril and Allopurinol, to keep my blood pressure under control and keep gout at bay. Nothing else the man says is trustworthy. He’s simply a conduit from the CDC and Methodist to give me the party line (and statins, which he can shove where the sun does not shine.)
I suspect that when the U.S. system does collapse, the smug people in the rest of the world with their single-payer systems will a) be severely impacted and b) have no clue why. Americans will be similarly clueless.
People don’t like going to run-down and old hospitals. Improving facilities is expensive, very expensive. Run-down and facilities and equipment is left to the VA facilities. Those patients having little choice of facility.
I suspect that when the U.S. system does collapse, the smug people in the rest of the world with their single-payer systems will a) be severely impacted and b) have no clue why. Americans will be similarly clueless.
Yup.
I am amazed that I am still walking around with a missing right coronary artery at age 61. First, that my cardiologist was able to diagnose me without cracking my chest. Second, that a simple drug (Lopressor) invented in 1969 in Sweden is able to keep me from having more heart attacks.
https://en.wikipedia.org/wiki/Metoprolol
My extensive heart ablation surgery in 2018 was performed without cracking my chest. My electrocardiologist inserted his tools in my groin veins and ran them up into my heart. Worked like a champ, we should have done it earlier. Healing time was 24 hours plus a month or two for the heart interchamber hole.
Except I live in TX and I’ve experienced both.
Wow, ERCOT is going to hit 70,000 MW of demand today around 5pm. And even more wow is that the wind turbines are providing 20,000 MW of that demand. And the solar panels are providing 7,000 MW of that demand. ERCOT is running fat, dumb, and happy at the moment.
https://www.ercot.com/gridmktinfo/dashboards
ERCOT’s costs are definitely up due to the $8/mmbtu natural gas. That cost was $3/mmbtu two years ago. With the USA supplying almost 20 BCF/day (billion cubic feet) to the world as LNG, our natural gas costs here in the USA have more than doubled. But, the sellers have the right to seek the best markets for their products.
One of the independent thriller writers in the USA thinks that we are heading for a financial and social collapse caused by the medical system rising to more than 20% of the GDP and bankrupting the USA government. He may be correct.
https://www.amazon.com/Holding-Their-Own-Story-Survival/dp/1939473691?tag=ttgnet-20/
Whoa, I am still one of the front page reviewers of the book on Big River out of 475 reviews.
When Paul saw him a couple months ago to get his dentures relined, there was no charge for the initial soft lining… and there may be one more of those in the interim …. we’ll only have to pay when he does the final hard new lining.
Dear God, please let me keep some of my teeth until the day I die.
My paternal grandmother had all of her teeth pulled when she was 80 and replaced with dentures. She was in continual discomfort until her death at 86.
Wow, the stock market is a blood bath today. Amazon is down to $2,208.
https://finance.yahoo.com/
Obamacare was designed to collapse and have people demand something “better”.
I thought there was some resistance at $2300, but that number is history.
“Doctor Strange 2” didn’t help Disney’s price. Q2 must be bad.
“Drakas!” by S. M. Stirling
https://www.amazon.com/Drakas-S-M-Stirling/dp/0671319469?tag=ttgnet-20/
Book number five of a five book alternate history military science fiction series. I read the well printed and well bound MMPB published by Baen in 2000 that I bought used on Amazon since there are no more new copies. This book is collection of twelve short stories about S. M. Stirling’s Drakas by other authors with Stirling as the editor. I doubt that there will be any more books in the series.
After the American revolutionary war, the British loyalists in the colonies mostly escaped to Canada. But in an alternate timeline, those 90,000 British loyalists were exiled to the southern tip of Africa at the direction of George Washington from 1783 to 1786. They took over the Dutch colony of South Africa as other unwanted groups joined them and merged into their slave holding culture. They eventually called themselves the Domination of Draka. By 1998, the Domination of Draka has totally subjugated the Earth and the Solar System and are in the process of genetically modifying themselves to be more dominant and their serfs to be more subservient. Grim, very grim.
The prolific author has a website at:
https://smstirling.com/
The five books of the series are listed at:
https://en.wikipedia.org/wiki/The_Domination
My rating: 4 out of 5 stars
Amazon rating: 4.4 out of 5 stars (55 reviews)
Hot stuff coming thru….
98F in the sun here on the west side of Houston.
Humidity is only 57%RH but that feels like a wet blanket at 98 degrees.
n
“Amazon Removes Purchases From Kindle for Android”
https://www.pcmag.com/news/amazon-removes-purchases-from-kindle-for-android
I see a lawsuit coming to a federal judge soon.
@Greg
I feel dumb asking, but any tips on researching? Somehow I doubt the state calls it “clawback”, surely gov uses some innocuous confusing terminology instead.
@JimB
Yep -grin-
——
Gorgeous warm day today. High 40’s F, blue skies, light breeze. Winds were gusty last night, secured the loose items on the deck, didn’t lose anything. Daughter and friends have their audition tomorrow for the school talent show. I’m playing roadie in the morning. Breaking down, transporting, and setting up the drum set, the keyboard, getting one of the child’s guitar tuned and set up with the amp.
I have heard it called “look back”. Search for “Medicaid look back” should get some hits.
Medical costs in US.
There are so many variables. The billing is a train wreck in its complexity and the number of hands that touch it. The high tech equipment and advances come with a high cost. The pharmaceuticals and their non-sense also charging schemes.
My employer contributes nearly $1,000 a month to my health insurance. I have our family set up on the high deductible / health savings plan. That reduces the actual monthly charge for health insurance to a bit less than what my employer contributes, the excess goes into our HSA (health savings account). I fully find our HSA with the first few paychecks the year. Hard on the bank account in January / February but worth it. Helps reduce our overall income enough that we don’t tip into the next tax bracket. When I realized we always meet our maximum out of pocket, and the cost of my husbands prescription, I realized this gave us the best financial return when I factored in that federal tax savings.
Our local sisters of providence catholic hospital used to be humane and caring and affordable. That changed sometime in the last 5-7 years and now they’re horrid. In humane treatment of the families, dictator like insistence on treatments, takes a lawyer and deep pockets to get out if you have long term needs and decide you don’t like their treatment plan. They’ve been in the paper more than a few times over the last few years over refusal to transfer or release patients who didn’t want the treatments the hospital wanted to inflict. Families left bankrupt when loved ones needed to have the plug pulled because verdict was no hope of recovery, and hospital refused.
Horrible heart breaking stories.
Aside from the moral problems, running up tens of thousands of dollars in care daily on someone whose own doctor says is never going to wake up or recover? Big huge problem.
@nick
Dog training – Raising Canine is doing a webinar on building a good recall with your dog. I haven’t taken their recall class, but have done quite a few of their other webinars and like them. They generally have good instructors with good value for the time and dollars.
https://www.raisingcanine.com/course/recall-games/
@Ray, Greg
Thanks. Found it.
Alaska – Five years, with complexities to digest.
Horrible headline. Purchases are not removed. Ability to purchase within the app has been removed.
Didn’t this already get litigated by Apple and they, mostly, lost?
Social Security Administration.
Last week, I spent yet another 40 minutes on hold waiting for someone to tell me “Yes, we received your form. And even though we promise a decision within 60 days, no decision has been made yet. Oh, and the local offices are open if you want to come in and do business face-to-face.”
Hallelujah! No more waiting on hold. And I can probably take care of 2 issues at once, instead of needing to be on hold twice.
So I dropped by the local office today on Dillard Drive.
FML. There are 2 doors. It’s 96 degrees outside. There are about 50 people lined up at each door. Some brought folding chairs. Some of them were even wearing masks.
Fortunately, the wife and I got our goobermint-teat money retirement all via the website. I would dread having to work with the SSA in person at any office. My only frequenting before G-T money was looking at the yearly statement to make sure we weren’t getting screwed out of our quarters of work. The Army dropped the ball on a full year, but I had the statements to correct it. Back when everything was mail, phone, and in person. PITA!!!
I’m enough younger that I don’t expect to have to deal with the papershuffling morons in trying to collect my socialist security benefits. The system will have collapsed before I get there, though I have no doubt they’ll still be demanding a slice of my income to prepay the benefits I won’t get. Lucky me.
— the nook is still around?
n
yeah, google play should just be walked behind the barn and ended.
n
I think it’s called “look back” in Texas. Five years last time I looked. Not too worried, Mom was broke and on Medi-whatever and with Tri-care For Life. Scam. Almost everything went through Medi-whatever.
Oh, ya’ll want to look back and claw back? Go for it you puta pendejos. Her house is tax appraised at 60 grand now. It’s up from 45 grand since she died. Oh, and while y’all are clawing back, what happened to that 150 grand helicopter ride bill from Burnet to Seton in downtown Austin?
Yep. I’m pissed.
The nursing home, seemingly good folks all, locked down at the beginning of Kung Flu. NO visiting. They called and said she was getting extra crabby. They wanted to up her sedatives. Early June. I told them she has acted like this before, take her to the Doctor for a urinary track infection. Ok but No…. can’t do that because of what the fu*k and quarantine. So she died end of August and guess what was the first cause of death?
How nice. She didn’t like being there and was grumpy. But she was social. I’m good with that. Broccoli pureed and mixed into mashes potatoes is just evil. And stinks. Yeah, and from a taste half of the potatoes was cauliflower.
I’m not good with not being able to visit her for almost a year. And then getting a box of ashes. She wasn’t exactly a lot of fun to visit, but she was my Mom. Correction, my Mommy.
Ok. That’s off my chest. for now.
Meanwhile I have an ineffectual real estate guy fucking around with the house. Ok, $X for clearing the lot, it’s 60 by 300 feet and pretty grown up and MORE $X to clear out the house.. and then there’s noise that the house is “unusual” . No kidding? Your first clue was what? The house is round?
Hey, it’s built with cinder block and it has no drafts. Pretty much air tight. My Dad had it figured out.
I did my SS stuff on the web.
Lots of folks said I would have to go to an actual SS office to park my butt for a few hours and then deal with some diversity hire. <shrug>
I don’t know. Last time I had to renew my DL the letter said I need to have a birth certificate. Why? I had to have that when I got my license way back when. Yeah, didn’t take that. I have a passport, right. Anyway, the dude doing the renewal process said, “we have all of your info”.
Just weird. But I have the fancy star on my DL so I can get on an airplane.
Searching “clawback” seems to bring up the right information too.
“Clawback” is more intimidating. That’s the term I use with the West Coast relations to make it clear that something unpleasant will happen if they talk my mother-in-law into signing over her real estate and leave her with nothing but Florida Medicaid to cover any needed nursing home care.
Local SS office? Never been to one. My wife signed up on line about thirteen years ago. Back then, the nearest office was about 100 miles away. Rumor has it we now have a local office. Big whoop. No need to go there as we are spoilt (UK spelling, or close. :-))
You big city folk don’t have all the good stuff any more.
I handled my SS application online, mostly. They ended up making me call a special phone number because I triggered a fraud alert. Which is a good thing, really.
Unfortunately, my remaining 2 issues are with the IRMAA adjustment increasing (more than double) my Medicare Part B and Part D premiums because I made good money up until I got fired, and trying to become the responsible party for my brother’s SS, so I can change bank accounts for his direct deposit.
There’s a form for the IRMAA shirt (-r) but that’s the decision they’re sitting on. And I applied for my brother’s stuff months ago and have no idea where that stands.
@SteveF, there is actually a chance you will live to collect some SS. Even when it goes completely bankrupt, they can keep the current level of payroll tax and pay something like 60% to 75% of the benefit. There are a whole lot of assumptions built into that, not the least of which is bureaucrats exhibit a small amount of common sense and the US govt. continues to operate until then.
Yes, I’m aware SS is actually completely bankrupt right now, but I’ll honor the fiction that they are still draining the “trust fund” until 2036 or whatever.
Hmm, my credentials disappeared since my last post earlier today. Wait, two days ago on this computer. My phone was unaffected for several days.
There’s more. Ten minutes ago, my wife said her “Internet” was down. She could not make a call on her cell phone. OK, that would be her cellular network. I investigated. Since I am chained to this computer trying to get a few things done, I checked here and everything looked normal. Went upstairs from my dungeon and checked her computer first. It was showing no Wi-Fi in the status tray. Clicked that and it was indicating that there was no Internet on the hotspot. Disconnect-reconnect, and Bob is again a family member. Checked the cell phone; dialed the weather number, and it went through. Must have been a temporary glitch. Attempted to explain that these things happen; they are temporary, and often self-correcting. Please, try again before attempting to troubleshoot. Back to abnormal.
Why does Microsoft insist on making the first choice a troubleshooting option. Yes, this seems to work well, but to nontechnical people it can be confusing, and worse, lead them to change settings that should be left alone. She is right: I can’t tell her when it is OK to just wait, and when to initiate troubleshooting. And, don’t change some things. Which things? Darned if I know. Told her she should try Linux networking if she really wants a challenge – didn’t win me any points as she hates Linux. My only Linux box still on the network has a Samba password that I somehow misplaced, making it impossible to log on from Windows. Why does it have to have a separate network password? I can log from it to my Windows boxen by just giving my Windows account password, but then I can’t run batch files from Linux. Fun! If solving puzzles delays Alzheimer’s disease, I will be good for many years.
Yes, I’m aware SS is actually completely bankrupt right now, but I’ll honor the fiction that they are still draining the “trust fund” until 2036 or whatever.
SS is just fine as they are holding almost three trillion dollars in USA tbills and have a cash income of about $1.09 trillion per year. But the SS checks are running close to a $1.14 trillion per year and jumping.
https://www.ssa.gov/oact/progdata/assets.html
The problem is that the USA tbills are worthless. And the last of the baby boomers (me !) have yet to retire.
Medicare is the one that is scary. For 2022, the estimated cash income is $933 billion, the estimated expense is $936 billion, and they are holding only $278 billion in USA tbills.
https://www.cms.gov/files/document/2021-medicare-trustees-report.pdf
Worst part is that the troubleshooter wizards don’t tell you what they changed.
Yet, plugs is sending 10s of billions more to Ukraine. Our goobermint is run by crazed ijits.
A bunch of rabid crazed weasels running on hamster wheels would be more accurate, and the reality of such would be no worse than the people we have.
How many abortions has our President claimed to have had so far this week?
https://townhall.com/tipsheet/mattvespa/2022/05/09/bill-maher-trashes-liz-warrens-college-debt-plan-for-a-very-simple-reason-n2606938
If loan forgiveness doesn’t happen, a lot of people are going to look seriously at the other relief mechanisms in the Student Loan Act, specifically Borrower Defense, to get out from under the debt, and that would destroy the reputations of the institutions granting the “bulls**t” degrees.
Begala is the classic Good German. He proudly wore his political affiliation for all of the world to see … until it became unfashionable.
Maher too, but Begala’s fingerprints are all over the Clinton’s rise to power.
>> Why should they? It’s working perfectly. For them. Everyone else, not so much.
Just so it’s clear, “them” include the health insurance companies (only need one with single payor) and our ever money hungry Congress-critters (as I’ve said before: term limits).
>> If you are sedated (common) add for that.
Still waiting for the bills to start rolling in for my wife’s recent knee replacement. She was given spinal anesthesia for the actual procedure but in pre-op she was asked if she wanted to stay awake (just some Valium) or be sedated (Propofol). She chose sedation.
>> What annoys me most in the US is getting the actual cost. The hospital will inform what they will charge. Getting that information from the surgeon is almost impossible. Getting that information from the insurance company is impossible. The same procedure in a different facility, by a different doctor, can vary by thousands. It is difficult to make informed choices.
The CMS finally got around to finalizing the regulations for the Health Plan Price Transparency law which will (may??) help consumers. Of course, the resistance (lawsuits, data obfuscation, etc.) by the suppliers has already started.
https://www.cms.gov/healthplan-price-transparency/consumers
>> MOST people with insurance use as much as they can, because the costs are opaque, and not born by the consumer.
I’ve worked at large companies that self-fund their health insurance (the insurance company is hired only to process claims) and each year during open enrollment it was made clear where the money to cover increased costs came from.
>> The ones that really make the money are the surgeons.
Specifically plastic surgeons and also anesthesiologists.
>> Dentists have long been a field where it pays to price check before making that first appointment.
It’s also good to check how ‘narrow’ their scope of practice is. I find these days that many general dentists will do only the most routine of procedures and then farm you out (for a kickback??) to a specialist (e.g. to an oral surgeon for what is a routine extraction and back when would have been done by your family dentist).
Horrible headline. Purchases are not removed. Ability to purchase within the app has been removed.
Didn’t this already get litigated by Apple and they, mostly, lost?
Nope.
As the Kindle app on my iPad still says when I am browsing with it: “This app does not support purchasing of this content.”
>> If you are sedated (common) add for that.
Still waiting for the bills to start rolling in for my wife’s recent knee replacement. She was given spinal anesthesia for the actual procedure but in pre-op she was asked if she wanted to stay awake (just some Valium) or be sedated (Propofol). She chose sedation.
No freaking way ! I don’t know of anyone who wants to see a surgeon working on their bones with a hammer and a chisel. And then with a powered screwdriver.
Yeah it sucks. Apple wants a cut of everything. They’ve worked hard to stop “jail breaking” the iPhone.
Speaking of Kindle:
I’ve read Amazon is dropping mobi support for the “Send to Kindle” app. But adding support for epub. At last. Not on the device itself. It is converted to their proprietary format. Weird. I’m gonna try some epubs on my iPad mini using Apple’s “Books” app to compare.
According to my wife the apple ipad makes the best kindle.
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Weird that gold spot was down 1.6% too.
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Weird that gold spot was down 1.6% too.
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Headed into a depression at 100 mph.
I had a colonoscopy in January, which took half-an-hour or so. Figure three people involved (one doc, two nurses), average salary $200/hour (probably under for the doc, definitely over for the nurses), so that’s $300. Triple for equipment, etc., that’s $900 (without pathology). Now give me a minute, to go look up the bill…and it’s Fr. 827.55, so I overshot by a bit.
Overhead in the most efficient organizations runs 40%. Average orgranizations run 60 to 65% overhead.
Did you have an anesthesiologist ? My wife had one in her colonoscopy last month. He was running in and out of her recovery area trying to keep her comfortable for two hours.
Did you have a recovery nurse ? My wife had one in her colonoscopy last month. He spent two hours dedicated to her due to her complications.
Do you have an admitting nurse ?
Did the building have a security officer or did they let the public wander around the place ?
Was there a building or was the procedure conducted in an open field ?
Who created your bill ?
Did anyone contact you for preadmission to see if you had any allergies or complications ?
Someone manipulates GLD and the futures.
Physical delivery of a once ounce 2021 Eagle is over $2000 from dealers.
See what price the Mint sets for the 2022 coin next month. That’s an ounce of gold, delivered, in USD.
A failed fiction writer and accomplished extortionist with an advanced degreee in Obfuscation.
Jerry Pournelle once wrote about a neighbor – they lived near the Hollywood Hills – who did that; Darryl Dragon and Toni Tennille. He got sick of some degenerative disease, they divorced but continued to live together. His medical care was billed to the state, and she didn’t have to lose all of her assets taking care of him.
For me, the best decision I ever made was made on November 11, 1968, when I raised my hand and enlisted in the US Navy. After 21 years in the Canoe Club, Tricare and Medicare pay virtually all our medical bills. Granted, we haven’t had any major problems, but my wife’s heart medication would be a few grand a month if we had to pay for it. But it’s delivered to our door every 90 days.
In Fort Worth, a sign that leftist cultural dominance may have peaked
https://www.americanthinker.com/blog/2022/05/in_fort_worth_a_sign_that_leftist_cultural_dominance_may_have_peaked.html
It ain’t going to be that easy. The AFT and NEA are well-funded Democrat communist workers collectives that have been extremely successful in pulling the public teat for the benefit of their members while ensuring that the Democrat officeholders they elect rubber-stamp their demands and owe them other political favors.
They know that their natural rights include controlling the school boards. They will resist any oversight with every means at their disposal.
The school board itself needs to develop their own educational program. I’ve never seen it done. All the members run on their own experience, pulling their own little red wagons with their own agendas. Some may have common backing with other candidates (like Fort Worth) or run as parts of reform slates, but it’s rare for any of them to recognize that going in they may be ready to make decisions but might not have all the tools to make the best ones.
The Fort Worth School Board needs to hit the ground running and make sure that they do not present a sitting target. Pledge public accountability and public year-on-year academic performance metrics along with figures on state and local funding, costs per pupil, time in the classroom, and collective bargaining results. Make the lesson plans accessible to the public and have a mechanism for real public input. Publish photos of the classrooms and hallways. Put cameras in the classroom. Make it easy for parents to sit in and observe what goes on. Make it clear to the public that their concerns will be heard with mutual civility.
And start the whole revision process by throwing out the undoubtedly vacuous Mission Statement full of meaningless leftist weasel words and develop a new one with the help of the taxpayers and parents that have the real investment in the outcome. That should include delivering the best education for the top students, the middle students, and the ones that may not have the ability to go to college but must become productive citizens.
Set high standards and expectations for student athletes. Position athletics as a way for students to represent their school and community, not a device for the previous generation’s failures on the field to live vicariously, and not a front-end to feed the college athletics machine.
Publish the library card catalog and institute clear rules for age-appropriate content. Shitcan the leftist indoctrination carp. If Shakespeare and Huckleberry Finn are not on the shelves and being taught in high school literature, terminate the librarians and literature teachers if they cannot show that what is on the shelf and being taught is better.
Have clear language in all employment contracts that the job description is education, not advocacy, and that viewpoint discrimination is not tolerated.
Give the students clear requirements on dress code, conduct, and mutual respect. Make civics a requirement. Require that students concentrate on learning during the school day, not on social media. Make cell phone usage a privilege with a threshold age that can be revoked if it interferes with the classroom.
@Lynn: To answer your questions: No anesthesiologist, just the doc doing the exam and two nurses. All three were there for the entire procedure, from prep through waking up from the propofol. Presumably the nurse administering the propofol has appropriate training. Total elapsed time about 30 minutes. Waking up from propofol was really easy, but they had me sit in the waiting room for a few extra minutes; when I was clearly ok, they turned me over to my wife.
Sure, hospitals have overheads, as does any big organization. My rule of thumb for any complex organization is tripling the direct personnel costs to account for overhead and equipment. It usually gets you within spitting distance of the right answer.
Preadmission was handled by my GP, so I suppose I should count that appointment as well, but that was only another $100 or so. 15 minute appointment: fill out a questionnaire, tell me what to expect, get the prescription for that gross stuff you have to drink.
Billing was done by the hospital, directly to insurance, who then passed it on to us since it falls under my deductible.