Sure you can have health insurance (not sure how you will pay for it).

[phixer]

Quote:
Originally Posted by AggieAlum http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/160#post_3539689
Quote:
Originally Posted by Phixer http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/160#post_3539639
The double jeopardy clause, so if OJ were to admit it now he could not be tried for it again? Thats the way I understand it?

I used to live in Sydney and Perth in the 90s for a few years, visited Hobart Tasmania once, you must be referring to the outback right? Antarctica is also not very populated but the polar bears seem to do OK

. Should we be encroaching into these areas? and if so when do we stop consuming and expanding ?

My family grew up as farmers before govt subsidies , this is one reason why I believe in personal independence so much. Some of our friends came from the old USSR and left after the communist govt took over their family shop and home, kicked them out on the street and left them destitute. Once they got to the US they started over and did well because they were esssentially free of govt control. Before my great Grandmother passed away, she was deeply troubled because she saw the same thing unfolding here with the expansion of govt that she witnessed in the old country. It has measurably increased in gradual increments but many that have lived here their entire lives dont notice this because they have nothing to compair it too. Most kids have never heard of an 8 track cassette either.

It would be nice not to have to wait in line everywhere you go and fewer traffic lights, less pollution, crime, trash, graffiti and we wouldn't have to continually expand everywhere encroaching into wilderness, less people begging on each corner because the cost of goods would be within reach due to less competition for resources as it was 30 yrs ago in the US.

Yeah, Im serious about the death thing. I dont fear it, it's a part of life for me. I mean, no one escapes it. Im not sure whats on the other side but I know what overpopulation has done to the earth and what kind of society it has created. It became easier for me to accept once I realized life on earth consists of pain and suffering with very small periods of joy (not enough to make a difference for me). Dying isnt hard , it's living thats hard (Josey Wales).
If your ancestors had the same mentality as you, you wouldn't be here. Your great Grandmother can't compare her childhood and younger years to how this country exists today. When she was growing up, she probably didn't have inside plumbing, and her only form of entertainment was making comforters by hand while sitting near to the tube radio listening to the Adventures of Howdy Doody. Her friends and relatives didn't live past 55 because someone could get something as simple as a common cold, contract pneumonia, and they were dead because penicillin or antibiotics weren't invented yet. Stepping on a rusty nail killed who knows how many. Then there was the Typhoid outbreak, Polio, and the dreaded Small Pox. Government has had to expand to keep up with the technological and other advances that have occurred to this country over the last 200 years. That's how progress works. If you want to go back to those days, knock yourself out. The Australian Outback is waiting for you.
"The Matrix is a system, That system is our enemy. But when you're inside, you look around, what do you see? Businessmen, teachers, lawyers, carpenters. The very minds of the people we are trying to save. But until we do, these people are still a part of that system and that makes them our enemy. You have to understand, most of these people are not ready to be unplugged. And many of them are so inert, so hopelessly dependent on the system that they will fight to protect it."


But what if Im not able? will you pay my way and "throw me a bone"?

or must I agree to your terms before your generosity includes me? Isnt that how communism works?

What would have happened without medicine? Crazy to imagine. Would we be stronger or weaker? Fewer people but much stronger people, how is that a bad thing?
I dont know how my Grandmother lived to be 104 without hand sanitizer.

What you describe isnt progress it's socialism. Govt does not have to expand to keep pace, private enterprise does. Govt expansion enslaves people by removing freedom via more rules, regulations and laws, and creates zombies within it, ever been to the DMV? Outside of defense and infrastructure govt is not needed. Private enterprise via capitalism is what moves societies forward because it does so based on supply and demand. Govt exists even when you dont want or need it (i.e Al Franken). When govt expands it never stops growing (like Barney Franks collection of leather chaps) and you end trading personal freedoms for security (the NSA). Anyone who would sacrifice individual freedom for more govt should move to North Korea.

Like a splinter in your mind. Some are just not ready to be unplugged.

 

[phixer]

Quote:
Originally Posted by Bang Guy http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/160#post_3539690
I admit my opinion on this is biased because if it were "survival of the fittest" I would have died when I was 9 when my appendix burst.

I understand the need for ditch diggers and how strong and fit they are and how much they benefit society but I don't see us all as being better off if they ruled.
At 9 life is pretty much the responsibility of ones parents, yours at the time were strong enough (i.e. resources) to ensure you survived? Once people become adults that's when it's time to get off the teet. In other words, time for them to get a life. So if ones appendix burst at 39yrs of age, who's responsibility would it be then? IMHO the individual, so if the individual cant fix it whos responsibility does it become? ...The worms, it becomes the worms responsibiltiy to turn them into compost.

The cream always rises to the top, that's why I dont fear the legion of unified ditch-diggers conquering the universe anytime soon.

 

[darthtang aw]

Why does a broken record come to mind?
You didn't listen.  Of course it doesn't curb medical costs.  The lobbyists for that group would never allow it.  There hasn't been an administration since the inception of healthcare that's ever attempted to curb costs.  The sole intent of ACA is to provide anyone who wants to obtain some form of affordable insurance the capability to do so.  Yes, it's just another Band-Aid to the problem, but until someone in Congress has the balls to put their foot down and say "We're mad a Hell, and we're not taking it anymore" and stand up to the medical industry in regards to costs, then you just remain status quo and do what you can to insure the average American doesn't go bankrupt getting simple medical treatments.
Because they aren't getting the push from the citizens. The majority are sheep and feel once they cast their vote they are done. The guys in washington can handle it. I have had many discussions with my congressmen and woman face to face. I see them monthly. It isnt that the lobby groups push against it so much. It is the focus has always been on insurance costs with the public. Hell the insurance lobby's pushed against this bill and all the others before. They even pushed against Medicaid and medicare at its inception. This has been same conversation since 1910. Health insurance. Why? Because the end consumer doesn't actually see the true bill. The typical consumer just looks at the portion they owe. Never caring about the rest. Because of insurance the "free market" aspect of this private enterprise is unable to work.
I still dont understand why an 800 bed hospital needs 1300 administrative clerks for processing payment and such.
Whe your car is damaged, the insurance company cuts you a check and it is your responsibilty to find someone to fix it, or they direct you to a place they have worked a deal with for repairs. Usually through a bidding process.
Wait a minute, first you tell me that drug companies are justified in charging the costs they do for certain medications because of the research and patents they have on those drugs.  Now it's the government setting those prices?
I said the EUROPEAN GOVERNMENTS purchase them from the drug companies and set the price. Which isnt entirely a bad idea, except it would put a friend of mine out of work. Part of your prescription is included in the sales team. Which has to work very hard to convince Doctors and Pharmacies to bring in their new drug. The average parmaceutical salesman makes minimum 75,000 a year, gets a company car...and a company expense card. They do spend a lot of time away from home, which is the trade out. However if the government was doing the primary purchasing then setting the price and selling to hospitals you can cut out this cost immediately for the drugs manufacturing.
People go to the hospital for the common cold because they can't afford to go to a regular doctor to get the same services they can get for free.  Setting allowed limits for a procedure is a good idea, but the flaw with your logic is continuing to allow the doctors the ability to set their own rates for similar services rendered.  So your knee goes out, and you need a replacement.  You're willing to go to Cut-Rate Dr. Joe Bob that hasn't had the best track record when it comes to getting people back on their feet after his knee surgeries because he's the only one you can afford, or do you take a second mortgage out on your house so you can go to one of the leading knee surgeons to insure you'll never have another problem with that knee.  Better yet, you willing to put your life on the line when needing heart surgery simply because you can't afford the best heart surgeon available?
It isn't making it cut rate. You more than anyone complain about how much money people amass and keep. Doctors are no different, Many charge far more for their services than standard rates should be. Because they can. This might allow a few "cut rate" doctors to scate by for a while, but eventually the other doctors will either want to get paid or stick to dealing only with the rich. My ex wife got a breast augmentation while we were married. This is not covered by any insurance so would be paid out of pocket. Their were several in the Minneapolis area...go figure this was almost 15 years ago. She ended up going with the second best surgeon in the area. The best Charged 20,000. He charged 4500. The average going rate was 6500. Why was he second best? He performed 4 of these surgeries a day due in part to his rates. He was more familiar with the procedure than anyone in the area. Even went over options we hadnt heard of. The guy charging 20,000 averaged 3 a week. Now I understand it isn't needed medical care....but it does show an example of how when people actually know the pricing, how they make a "smarter" decision and actually care. Medicaid is ballooning...Because the people on it never see a bill.

Insurance companies do know the costs for certain procedures prior to the patient having those procedures.  Look at your health insurance policy some time.  It states that when it comes to major surgeries or certain medical procedures, you have to contact your provider prior to the services being rendered.  I guarantee you that you couldn't get a heart transplant performed without prior consent from your insurance provider, unless you're willing to accept the financial responsibility for any services the insurance company deem are not standard coverage's.

receiving prior consent did not mean there was a set charge for the surgery itself negotiated or compared. It means the individual had enough money left on their insurance plan to cover the cost. It has nothing to do with what is charged and everything to do with "how much is covered and how much you have available." If a consent is denied, their is never a response saying,"they charge to much, you need to find the surgery for X amount as this is market norm.". They Deny or approve based on the allotted account...and if it is in the "system" of doctors covered.

 

[darthtang aw]

I am also still waiting for a valid argument against allowing Insurance companies to sell across state lines. Other than it is a republican Idea.

 

[aggiealum]

Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539708
Why does a broken record come to mind?
Because they aren't getting the push from the citizens. The majority are sheep and feel once they cast their vote they are done. The guys in washington can handle it. I have had many discussions with my congressmen and woman face to face. I see them monthly. It isnt that the lobby groups push against it so much. It is the focus has always been on insurance costs with the public. Hell the insurance lobby's pushed against this bill and all the others before. They even pushed against Medicaid and medicare at its inception. This has been same conversation since 1910. Health insurance. Why? Because the end consumer doesn't actually see the true bill. The typical consumer just looks at the portion they owe. Never caring about the rest. Because of insurance the "free market" aspect of this private enterprise is unable to work.
You are one of the fortunate one's. I haven't seen a politician in Texas that cares a tinker's damn about the "normal citizen". When they do bother to come to the state from Washington and have "face to face" time with their constituents, they surround themselves with their "own kind". I have a friend who is a hard-core Liberal who tried to attend a function Crazy Ted Cruz was hosting so he could counter some of his many misinformed claims he's made while playing Mr. Smith Goes To Washington. His first amusement was the majority of those who attended we over the age of 55, and primarily White. He listened to Cruz as he spoke to the group, and when it came to Q&A time, he started asking what he called the "hard questions". After it became quite apparent that he wasn't one of Cruz's ardent supporters, he was summarily shut down, then quietly asked to leave. Welcome to The House Of Cards.
So when you go to a restaurant and get the bill, do you question the owner where he got the ingredients to make your meal, or do you simply just "pay the bill" and walk away? Most people who just "pay what they owe" when it comes to medical treatment do so because they don't have a medical degree which is required to comprehend the majority of the services provided. You have insurance on your car. When you purchased that insurance, I imagine all you cared about was what the 6-month premium would be, and what your deductibles were for collision and non-collision repairs. If you get into an accident and it's not your fault, do you question the cost of all the repairs being done to your car, or do you just pick it up when it's ready because the cost isn't your problem? If the accident is your fault, do you go over each line item as to what is being repaired, and do you know exactly what it costs to replace or repair that dented fender, and the cost of materials and labor to paint that fender when it's fixed, or do you pay your $500 deductible when the car is ready and drive away?

I still dont understand why an 800 bed hospital needs 1300 administrative clerks for processing payment and such.
Whe your car is damaged, the insurance company cuts you a check and it is your responsibilty to find someone to fix it, or they direct you to a place they have worked a deal with for repairs. Usually through a bidding process.
When's the last time you had a car accident? My daughter got into one not to long ago, and my insurance provider, Geico, gave me two or three places to go that are "Geico approved". If I took it anywhere else, I wouldn't get a lifetime warranty on any repairs performed. Just as I stated, I have a $500 deductible for any collision repair needing done to my vehicles if the fault is mine, or in my daughter's case, some person backed into the front of her car in a parking lot, ripped the corner of her bumper off, and drove away. I could play the game of this "bidding process" to get it repaired, but what would be the point? I knew the damage was going to cost well over my $500 deductible, so I relied on Geico to determine where I should go because it was essentially on their nickel, not mine.
I said the EUROPEAN GOVERNMENTS purchase them from the drug companies and set the price. Which isnt entirely a bad idea, except it would put a friend of mine out of work. Part of your prescription is included in the sales team. Which has to work very hard to convince Doctors and Pharmacies to bring in their new drug. The average parmaceutical salesman makes minimum 75,000 a year, gets a company car...and a company expense card. They do spend a lot of time away from home, which is the trade out. However if the government was doing the primary purchasing then setting the price and selling to hospitals you can cut out this cost immediately for the drugs manufacturing.
It isn't making it cut rate. You more than anyone complain about how much money people amass and keep. Doctors are no different, Many charge far more for their services than standard rates should be. Because they can. This might allow a few "cut rate" doctors to scate by for a while, but eventually the other doctors will either want to get paid or stick to dealing only with the rich. My ex wife got a breast augmentation while we were married. This is not covered by any insurance so would be paid out of pocket. Their were several in the Minneapolis area...go figure this was almost 15 years ago. She ended up going with the second best surgeon in the area. The best Charged 20,000. He charged 4500. The average going rate was 6500. Why was he second best? He performed 4 of these surgeries a day due in part to his rates. He was more familiar with the procedure than anyone in the area. Even went over options we hadnt heard of. The guy charging 20,000 averaged 3 a week. Now I understand it isn't needed medical care....but it does show an example of how when people actually know the pricing, how they make a "smarter" decision and actually care. Medicaid is ballooning...Because the people on it never see a bill.
receiving prior consent did not mean there was a set charge for the surgery itself negotiated or compared. It means the individual had enough money left on their insurance plan to cover the cost. It has nothing to do with what is charged and everything to do with "how much is covered and how much you have available." If a consent is denied, their is never a response saying,"they charge to much, you need to find the surgery for X amount as this is market norm.". They Deny or approve based on the allotted account...and if it is in the "system" of doctors covered.
Your wife was fortunate. My wife could provide you with numerous horror stories where patients in your exact same situation went the cheap route and ended up having multiple operations to fix the damages done by Mr. Second Best.
Think you may want to look at those prior consent rules again. My sister-in-law needed a specific procedure performed that she "assumed" was covered under her policy, and there were no set limits as to cost. When it came time to getting the procedure performed, there were certain portions of the procedure that the insurance deemed "not covered", and they wouldn't be covered by them. If she still wanted the procedure, she would be responsible for those costs. You're talking about "In Network" and "Out Of Network" when it comes to doctors or medical facilities. Deductibles and covered percentages are different between the two.

 

[aggiealum]

Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539710
I am also still waiting for a valid argument against allowing Insurance companies to sell across state lines. Other than it is a republican Idea.
I explained that. You may get some competition in your metropolis areas where there are more hospitals, doctors, and medical facilities, but those in the rural areas would see no benefit at all due to lack of competition. Insurance companies would set rates based on what their costs would be, not the consumer. You can see that with the wide range of plan costs in ACA, based on which state you live in. You could move to Texas and save 30% or more on your insurance rates than you have in New Mexico if you moved to Houston, Dallas, San Antonio, or any other major city. Head out to West Texas, and the rates are completely different because there's less competition and fewer hospitals to keep costs down. They're seeing this in Colorado up in the mountain resort areas like Vail and Aspen, as opposed to living in Denver or Colorado Springs. You just made an entire argument as to the "evils" of health insurance in general, but you someone think selling that same insurance across state lines is going to improve healthcare costs?

 

[darthtang aw]

I explained that.  You may get some competition in your metropolis areas where there are more hospitals, doctors, and medical facilities, but those in the rural areas would see no benefit at all due to lack of competition.  Insurance companies would set rates based on what their costs would be, not the consumer.  You can see that with the wide range of plan costs in ACA, based on which state you live in.  You could move to Texas and save 30% or more on your insurance rates than you have in New Mexico if you moved to Houston, Dallas, San Antonio, or any other major city.  Head out to West Texas, and the rates are completely different because there's less competition and fewer hospitals to keep costs down.  They're seeing this in Colorado up in the mountain resort areas like Vail and Aspen, as opposed to living in Denver or Colorado Springs.  You just made an entire argument as to the "evils" of health insurance in general, but you someone think selling that same insurance across state lines is going to improve healthcare costs?
So how does passing this law hurt?

 

[darthtang aw]

You are one of the fortunate one's. I haven't seen a politician in Texas that cares a tinker's damn about the "normal citizen". When they do bother to come to the state from Washington and have "face to face" time with their constituents, they surround themselves with their "own kind". I have a friend who is a hard-core Liberal who tried to attend a function Crazy Ted Cruz was hosting so he could counter some of his many misinformed claims he's made while playing Mr. Smith Goes To Washington. His first amusement was the majority of those who attended we over the age of 55, and primarily White. He listened to Cruz as he spoke to the group, and when it came to Q&A time, he started asking what he called the "hard questions". After it became quite apparent that he wasn't one of Cruz's ardent supporters, he was summarily shut down, then quietly asked to leave. Welcome to The House Of Cards.
Has nothing to do with the discussion so anecdotal.

So when you go to a restaurant and get the bill, do you question the owner where he got the ingredients to make your meal, or do you simply just "pay the bill" and walk away? Most people who just "pay what they owe" when it comes to medical treatment do so because they don't have a medical degree which is required to comprehend the majority of the services provided. You have insurance on your car. When you purchased that insurance, I imagine all you cared about was what the 6-month premium would be, and what your deductibles were for collision and non-collision repairs. If you get into an accident and it's not your fault, do you question the cost of all the repairs being done to your car, or do you just pick it up when it's ready because the cost isn't your problem? If the accident is your fault, do you go over each line item as to what is being repaired, and do you know exactly what it costs to replace or repair that dented fender, and the cost of materials and labor to paint that fender when it's fixed, or do you pay your $500 deductible when the car is ready and drive away?

.
For the first half of this. I see menu prices before I order. I can ask questions as to preparation and the types of ingredients as well as how it is prepared. I can check to make sure certain ingredients aren't used due to allergies
Your wife was fortunate. My wife could provide you with numerous horror stories where patients in your exact same situation went the cheap route and ended up having multiple operations to fix the damages done by Mr. Second Best.

I didn't say it was the cheap route, but whatever. Are you saying all surgeries need to be performed by only the best surgeon in the area?
Read this link.
http://www.tulsasurgicalarts.com/
Then read this link
http://radaronline.com/exclusives/2013/06/plastic-surgeon-chopped-off-nose-sued/
I guess you are lucky even when you get the best.
So what was your point?
Are you comparing heath insurance to how car insurance is done and that they are similar? I am missing your point here.
When's the last time you had a car accident? My daughter got into one not to long ago, and my insurance provider, Geico, gave me two or three places to go that are "Geico approved". If I took it anywhere else, I wouldn't get a lifetime warranty on any repairs performed. Just as I stated, I have a $500 deductible for any collision repair needing done to my vehicles if the fault is mine, or in my daughter's case, some person backed into the front of her car in a parking lot, ripped the corner of her bumper off, and drove away. I could play the game of this "bidding process" to get it repaired, but what would be the point? I knew the damage was going to cost well over my $500 deductible, so I relied on Geico to determine where I should go because it was essentially on their nickel, not mine.
had a fender bender a few months back. The insurance company sent a claims adjuster to my house to inspect and estimate damage. we both looked at everything. discussed things. The adjuster cut me a check minus my deductible. leaving me to choose where to take the car and if more expensive I cover the difference, if cheaper, I keep the money, If I dont get it fixed at all...that is on me. Insurance is washed of the incident.

Think you may want to look at those prior consent rules again. My sister-in-law needed a specific procedure performed that she "assumed" was covered under her policy, and there were no set limits as to cost. When it came time to getting the procedure performed, there were certain portions of the procedure that the insurance deemed "not covered", and they wouldn't be covered by them. If she still wanted the procedure, she would be responsible for those costs. You're talking about "In Network" and "Out Of Network" when it comes to doctors or medical facilities. Deductibles and covered percentages are different between the two.

Insurances each operate differently. some people near their maximum limit. which is also why prior approval is needed.
My whole point is to be approved for a dollar figure and find out costs before the procedure (when possible of course. Obviously there are situations when this is not possible). Insurance gives you the money and you find the doctor for the cost of the surgery.

 

[aggiealum]

Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539790
Has nothing to do with the discussion so anecdotal.
.
For the first half of this. I see menu prices before I order. I can ask questions as to preparation and the types of ingredients as well as how it is prepared. I can check to make sure certain ingredients aren't used due to allergies
I didn't say it was the cheap route, but whatever. Are you saying all surgeries need to be performed by only the best surgeon in the area?
Read this link.
http://www.tulsasurgicalarts.com/
Then read this link
http://radaronline.com/exclusives/2013/06/plastic-surgeon-chopped-off-nose-sued/
I guess you are lucky even when you get the best.
So what was your point?
Are you comparing heath insurance to how car insurance is done and that they are similar? I am missing your point here.
had a fender bender a few months back. The insurance company sent a claims adjuster to my house to inspect and estimate damage. we both looked at everything. discussed things. The adjuster cut me a check minus my deductible. leaving me to choose where to take the car and if more expensive I cover the difference, if cheaper, I keep the money, If I dont get it fixed at all...that is on me. Insurance is washed of the incident.
Insurances each operate differently. some people near their maximum limit. which is also why prior approval is needed.
My whole point is to be approved for a dollar figure and find out costs before the procedure (when possible of course. Obviously there are situations when this is not possible). Insurance gives you the money and you find the doctor for the cost of the surgery.
Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539790
Has nothing to do with the discussion so anecdotal.
.
For the first half of this. I see menu prices before I order. I can ask questions as to preparation and the types of ingredients as well as how it is prepared. I can check to make sure certain ingredients aren't used due to allergies
I didn't say it was the cheap route, but whatever. Are you saying all surgeries need to be performed by only the best surgeon in the area?
Read this link.
http://www.tulsasurgicalarts.com/
Then read this link
http://radaronline.com/exclusives/2013/06/plastic-surgeon-chopped-off-nose-sued/
I guess you are lucky even when you get the best.
So what was your point?
Are you comparing heath insurance to how car insurance is done and that they are similar? I am missing your point here.
had a fender bender a few months back. The insurance company sent a claims adjuster to my house to inspect and estimate damage. we both looked at everything. discussed things. The adjuster cut me a check minus my deductible. leaving me to choose where to take the car and if more expensive I cover the difference, if cheaper, I keep the money, If I dont get it fixed at all...that is on me. Insurance is washed of the incident.
Insurances each operate differently. some people near their maximum limit. which is also why prior approval is needed.
My whole point is to be approved for a dollar figure and find out costs before the procedure (when possible of course. Obviously there are situations when this is not possible). Insurance gives you the money and you find the doctor for the cost of the surgery.
Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539790
Has nothing to do with the discussion so anecdotal.
.
For the first half of this. I see menu prices before I order. I can ask questions as to preparation and the types of ingredients as well as how it is prepared. I can check to make sure certain ingredients aren't used due to allergies
I didn't say it was the cheap route, but whatever. Are you saying all surgeries need to be performed by only the best surgeon in the area?
Read this link.
http://www.tulsasurgicalarts.com/
Then read this link
http://radaronline.com/exclusives/2013/06/plastic-surgeon-chopped-off-nose-sued/
I guess you are lucky even when you get the best.
So what was your point?
Are you comparing heath insurance to how car insurance is done and that they are similar? I am missing your point here.
had a fender bender a few months back. The insurance company sent a claims adjuster to my house to inspect and estimate damage. we both looked at everything. discussed things. The adjuster cut me a check minus my deductible. leaving me to choose where to take the car and if more expensive I cover the difference, if cheaper, I keep the money, If I dont get it fixed at all...that is on me. Insurance is washed of the incident.
Insurances each operate differently. some people near their maximum limit. which is also why prior approval is needed.
My whole point is to be approved for a dollar figure and find out costs before the procedure (when possible of course. Obviously there are situations when this is not possible). Insurance gives you the money and you find the doctor for the cost of the surgery.
Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539790
Has nothing to do with the discussion so anecdotal.
.
For the first half of this. I see menu prices before I order. I can ask questions as to preparation and the types of ingredients as well as how it is prepared. I can check to make sure certain ingredients aren't used due to allergies
I didn't say it was the cheap route, but whatever. Are you saying all surgeries need to be performed by only the best surgeon in the area?
Read this link.
http://www.tulsasurgicalarts.com/
Then read this link
http://radaronline.com/exclusives/2013/06/plastic-surgeon-chopped-off-nose-sued/
I guess you are lucky even when you get the best.
So what was your point?
Are you comparing heath insurance to how car insurance is done and that they are similar? I am missing your point here.
had a fender bender a few months back. The insurance company sent a claims adjuster to my house to inspect and estimate damage. we both looked at everything. discussed things. The adjuster cut me a check minus my deductible. leaving me to choose where to take the car and if more expensive I cover the difference, if cheaper, I keep the money, If I dont get it fixed at all...that is on me. Insurance is washed of the incident.
Insurances each operate differently. some people near their maximum limit. which is also why prior approval is needed.
My whole point is to be approved for a dollar figure and find out costs before the procedure (when possible of course. Obviously there are situations when this is not possible). Insurance gives you the money and you find the doctor for the cost of the surgery.

Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539790
Has nothing to do with the discussion so anecdotal.
.
For the first half of this. I see menu prices before I order. I can ask questions as to preparation and the types of ingredients as well as how it is prepared. I can check to make sure certain ingredients aren't used due to allergies
I didn't say it was the cheap route, but whatever. Are you saying all surgeries need to be performed by only the best surgeon in the area?
You should do the same when having any medical procedure performed. My wife insists her patients get a second opinion before she even considers performing a major surgery procedure on them. You'd be stupid not to.
Of course not. My father was a patient of Dr. Denton Cooley when he had his 5-way bypass back in the 80's. If our family had the chance to do it all over again, we would've selected a different surgeon. The best surgeon in the business isn't always the wisest choice. However, if you go by statistics alone, and their percentages of successes as opposed to failures, money is irrelevant. It's your life you're dealing with, not some dent in your fender.
Read this link.
http://www.tulsasurgicalarts.com/
Then read this link
http://radaronline.com/exclusives/2013/06/plastic-surgeon-chopped-off-nose-sued/
I guess you are lucky even when you get the best.
So what was your point?
Are you comparing heath insurance to how car insurance is done and that they are similar? I am missing your point here.
had a fender bender a few months back. The insurance company sent a claims adjuster to my house to inspect and estimate damage. we both looked at everything. discussed things. The adjuster cut me a check minus my deductible. leaving me to choose where to take the car and if more expensive I cover the difference, if cheaper, I keep the money, If I dont get it fixed at all...that is on me. Insurance is washed of the incident.
Insurances each operate differently. some people near their maximum limit. which is also why prior approval is needed.
You sound like some of those trolls who buy clunkers, get required insurance with full coverage, wreck the car on purpose, and take the cash and walk away. Now go purchase a $30,000 car on credit, wreck it, and see if you can do the same as you did with your paid off model. The two scenarios are completely different.
All insurances are essentially the same. You are covering yourself or your property in the event something gets damaged beyond your control. You're trying to compare you're privately purchased insurance with insurance provided by corporations like the insurance I have. If I'm not mistaken, my "lifetime limit" for treatments being paid by my insurance is around $5 million. For some terminal diseases, there is no limit. The approval only comes into play if it's something that's not covered. For instance, experimental drugs aren't covered. Those are on my pocketbook.
My whole point is to be approved for a dollar figure and find out costs before the procedure (when possible of course. Obviously there are situations when this is not possible). Insurance gives you the money and you find the doctor for the cost of the surgery.
That's not realistic in the medical industry because as you pointed out, there's a massive swing in the costs of the same procedure based on where the procedure is being performed, and who is performing it. You honestly think some insurance company is going to cut you a check for $300K to get a lung transplant, and let you go "shopping" for the most cost effective facility and doctor to perform it, or just let you pocket the cash and go do your Bucket List before you die instead? You're sitting on life support in a coma. Pray tell, how will you go "find a doctor" to perform a surgery if it could possibly get you out of your coma and back on your feet? Or do we only do this for elective surgeries that aren't life threatening? You seem to be under the impression that there would be no situations in your lifetime where you would need emergency care. Sorry, but the human body doesn't work that way.

 

[2quills]

I explained that.  You may get some competition in your metropolis areas where there are more hospitals, doctors, and medical facilities, but those in the rural areas would see no benefit at all due to lack of competition.  Insurance companies would set rates based on what their costs would be, not the consumer.  You can see that with the wide range of plan costs in ACA, based on which state you live in.  You could move to Texas and save 30% or more on your insurance rates than you have in New Mexico if you moved to Houston, Dallas, San Antonio, or any other major city.  Head out to West Texas, and the rates are completely different because there's less competition and fewer hospitals to keep costs down.  They're seeing this in Colorado up in the mountain resort areas like Vail and Aspen, as opposed to living in Denver or Colorado Springs.  You just made an entire argument as to the "evils" of health insurance in general, but you someone think selling that same insurance across state lines is going to improve healthcare costs?
Why move to another state to find cheaper insurance? That seems rather senseless. You just made an argument that rates in rural areas are high due to a lack of competition. And you're arguing that allowing outside competition in would be bad?

 

[darthtang aw]

That's not realistic in the medical industry because as you pointed out, there's a massive swing in the costs of the same procedure based on where the procedure is being performed, and who is performing it. You honestly think some insurance company is going to cut you a check for $300K to get a lung transplant, and let you go "shopping" for the most cost effective facility and doctor to perform it, or just let you pocket the cash and go do your Bucket List before you die instead? You're sitting on life support in a coma. Pray tell, how will you go "find a doctor" to perform a surgery if it could possibly get you out of your coma and back on your feet? Or do we only do this for elective surgeries that aren't life threatening? You seem to be under the impression that there would be no situations in your lifetime where you would need emergency care. Sorry, but the human body doesn't work that way.
They dont have to cut you a check. But they can gie you a spending allowance based on the average in your area. I also stated clearly this would be done when possible. Obviously it isnt always possible.
Since you fail to give a solid reason for allowing Insurance to sell over state lines that would do harm, I can assume you are unable to do so and only against it since it came from republicans still. Just say that, it is ok. If you notice, a lot of my thoughts on this are borderline socialism and definitely Democrat based ideas. Some are Conservative ideas. But since I stated them, you automatically discount them since I lean conservative. Your bias is obvious. Government purchase of prescriptions is done in all single payer health care systems. The set rates for procedures and operations, are all done in single payer healthcare systems. In fact every proposal except one I have brought forward are done in single payer heathcare systems. A socialist/democrat idea. The difference is I presented it differently. It is clear that if the idea is proposed by someone you percieve as a "right wing wacko": the idea must be bad. Thank you for proving that.
The other thing that can be deduced is, you want your cake and eat it too.
You sound like some of those trolls who buy clunkers, get required insurance with full coverage, wreck the car on purpose, and take the cash and walk away. Now go purchase a $30,000 car on credit, wreck it, and see if you can do the same as you did with your paid off model.

There goes that intolerance again. I never referenced doing anything of the like. You just cant avoid trying to belittle or insult those you attempt to debate with. If it truly matters, I got my mini cooper fixed. I would have preferred the rear end my H2 then I wouldnt have had to make an insurance claim and just replace my ball hitch. My mini was bought with cash...paid 30,000 for it. Clunkers must be expensive in Houston.
Since you can't continue with out throwing insults or attempting to paint an individual as a thief or less than scrupulous individual, I am done with this discussion. All you show is your inability to address the topic at hand intelligently without clouding the discusion with anecdotes and insults.

 

[aggiealum]

Quote:
Originally Posted by 2Quills http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539800
Why move to another state to find cheaper insurance? That seems rather senseless. You just made an argument that rates in rural areas are high due to a lack of competition. And you're arguing that allowing outside competition in would be bad?
Outside competition would make no difference in those areas. As long as the costs to obtain those medical services remain the same, no health insurance provider will undercut another knowing they will lose money in the long run.

That's the mantra of the Conservative mindset. If you don't like where you live because you disagree with laws and how they dictate your life, simply pack up and move somewhere more to your liking. The initial intention of ACA was to have affordable rates no matter where you lived. But when Red States like Texas refused to join in on the game, that's changed everything. I do find it ironic that ACA rates in Texas are lower than rates in some Conservative states depending on what part of the state you live in.

 

[aggiealum]

Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539806
They dont have to cut you a check. But they can gie you a spending allowance based on the average in your area. I also stated clearly this would be done when possible. Obviously it isnt always possible.
Since you fail to give a solid reason for allowing Insurance to sell over state lines that would do harm, I can assume you are unable to do so and only against it since it came from republicans still. Just say that, it is ok. If you notice, a lot of my thoughts on this are borderline socialism and definitely Democrat based ideas. Some are Conservative ideas. But since I stated them, you automatically discount them since I lean conservative. Your bias is obvious. Government purchase of prescriptions is done in all single payer health care systems. The set rates for procedures and operations, are all done in single payer healthcare systems. In fact every proposal except one I have brought forward are done in single payer heathcare systems. A socialist/democrat idea. The difference is I presented it differently. It is clear that if the idea is proposed by someone you percieve as a "right wing wacko": the idea must be bad. Thank you for proving that.
The other thing that can be deduced is, you want your cake and eat it too.
There goes that intolerance again. I never referenced doing anything of the like. You just cant avoid trying to belittle or insult those you attempt to debate with. If it truly matters, I got my mini cooper fixed. I would have preferred the rear end my H2 then I wouldnt have had to make an insurance claim and just replace my ball hitch. My mini was bought with cash...paid 30,000 for it. Clunkers must be expensive in Houston.
Since you can't continue with out throwing insults or attempting to paint an individual as a thief or less than scrupulous individual, I am done with this discussion. All you show is your inability to address the topic at hand intelligently without clouding the discusion with anecdotes and insults.
Nice out when you're losing the argument. I've given you several reasons as to why selling health insurance across state lines would not make any difference in the overall cost of medical care, and you simply choose to ignore them. Why would I have bias towards the healthcare industry when my wife has been working in that industry for over 25 years? Your solutions to reducing costs make absolutely no sense. First you trot out some 180-whatever Republican solution to healthcare costs, when all that does is redirect the costs over to the taxpayers through tax deductions instead of subsidies to pay premiums for individuals who can't afford them. You have this vision that if we allowed health insurance providers to sell their plans across state lines, it would somehow magically reduce overall medical costs, but then you go on this rant about how there's no regulation in what medical providers can charge WHICH IS THE MAIN REASON INSURANCE PREMIUMS ARE SO HIGH IN THE FIRST PLACE. Then you want to make health insurance like some a-la-carte 5-course dinner where you can go talk to Flo at Progressive and pick and choose what you want to pay for medical services. You keep bouncing back and forth between the two that it's impossible to keep up.

I made the statement about the way you handled you car because my brother and father did auto body work and repairs for over 40 years. They had people come to them all the time trying to get inflated estimates so they could collect bigger checks from their insurance company, then never fix their rat-trap cars. You never said the value of the car you had an accident in. Why anyone would pay $30K in cash for a car, then even have an afterthought of not fixing it is beyond me. So I'm supposed to be impressed you spent another $30K - $40K on some gas guzzling status symbol that has no practical use in a urban setting? Do you go 4-wheeling in that overblown Jeep, or are you afraid you might scratch the paint and make it look too ghetto? Why anyone would spend $30K on one of those "clown cars" is beyond me. I can get a car that has more ******** space for half the price that gets the same gas mileage, if not better than a Mini Cooper. See what that $30K "investment" will get you in another 5 years when you try to trade it in for another car that's the latest craze. If you'd have waited just a year, you could have gotten the exact same car with about 12,000 miles on it for $10K less.

 

[2quills]

Outside competition would make no difference in those areas.  As long as the costs to obtain those medical services remain the same, no health insurance provider will undercut another knowing they will lose money in the long run.
That's the mantra of the Conservative mindset.  If you don't like where you live because you disagree with laws and how they dictate your life, simply pack up and move somewhere more to your liking.  The initial intention of ACA was to have affordable rates no matter where you lived.  But when Red States like Texas refused to join in on the game, that's changed everything.  I do find it ironic that ACA rates in Texas are lower than rates in some Conservative states depending on what part of the state you live in.
So allowing outside competition would make no difference huh? Didn't you just argue that different doctors charge different prices for services? Have you ever been to a rural doctor? I have and their prices are not even close to what you find in the bigger cities. Auto mechanics aren't fixing cars for cheaper rates so how are these companies that sell insurance online able to offer cheaper rates?
Jumping states to get away from some bs laws or over taxation is one thing. Up rooting your family and business to find cheaper insurance is another.

 

[darthtang aw]

Nice out when you're losing the argument.  I've given you several reasons as to why selling health insurance across state lines would not make any difference in the overall cost of medical care, and you simply choose to ignore them.[/QUOTE] Yet none of those statements answered the question I REPEATEDLY ASKED, So let me try it a different way.
What harm would be caused by allowing insurance companies to sell across state lines?

Why would I have bias towards the healthcare industry when my wife has been working in that industry for over 25 years? 
I didn't say you had a bias towards the healthcare industry. Go reread.

Your solutions to reducing costs make absolutely no sense.  First you trot out some 180-whatever Republican solution to healthcare costs, when all that does is redirect the costs over to the taxpayers through tax deductions instead of subsidies to pay premiums for individuals who can't afford them. 
I never said I supported the bill. Your claim was the only republican proposal you have ever heard is selling insurance across state lines. I brought the link to show there are other ideas as well. Nothing more, nothing less.

You have this vision that if we allowed health insurance providers to sell their plans across state lines, it would somehow magically reduce overall medical costs, but then you go on this rant about how there's no regulation in what medical providers can charge WHICH IS THE MAIN REASON INSURANCE PREMIUMS ARE SO HIGH IN THE FIRST PLACE.  Then you want to make health insurance like some a-la-carte 5-course dinner where you can go talk to Flo at Progressive and pick and choose what you want to pay for medical services.  You keep bouncing back and forth between the two that it's impossible to keep up.
There is no bouncing back between the two. Lets see if I can simplify it for you since the complicated aspects seem to be confusing you. Insurance sold across state lines increases competition. Might reduce price might not, depends on the area. I am not saying ala carte insurance. I am saying Insurance sets pricing for procedures based off of Market average. By doing this heathcare costs will have to adjust as most people would stay within their given insurance budget and go where the claim can be covered. The way it is now, negotiations occur after the procedure has taken place or the treatment has happenned. This places the negotiation befvore the service is rendered...just like every other industry.
I made the statement about the way you handled you car because my brother and father did auto body work and repairs for over 40 years.  They had people come to them all the time trying to get inflated estimates so they could collect bigger checks from their insurance company, then never fix their rat-trap cars. 

Which part of "they sent an insurance adjuster out" do you not get. I didn't get quotes from mechanics before hand...The insurance company sent their agent to do the estimate....do you even read anything anyone types or do you just skim and make shit up to respond to?
You never said the value of the car you had an accident in. 

It wasn't pertinent to the discussion.
Why anyone would pay $30K in cash for a car, then even have an afterthought of not fixing it is beyond me. 

Did I say I didn't fix it?
So I'm supposed to be impressed you spent another $30K - $40K on some gas guzzling status symbol that has no practical use in a urban setting?  Do you go 4-wheeling in that overblown Jeep, or are you afraid you might scratch the paint and make it look too ghetto? 
Yes I go off roading. I could go into all the reasons I purchased one but that would be pointless. I spent less on the H2 than the mini.

Why anyone would spend $30K on one of those "clown cars" is beyond me.  I can get a car that has more ******** space for half the price that gets the same gas mileage, if not better than a Mini Cooper.  See what that $30K "investment" will get you in another 5 years when you try to trade it in for another car that's the latest craze.  If you'd have waited just a year, you could have gotten the exact same car with about 12,000 miles on it for $10K less.

That is nice. I suppose I could have bought my wife's engagement ring from a pawn shop as well.
Cars aren't an investment. Wife wanted a new mini at the time. We got a new Mini. See, I love my wife very much and she works her ass off within our businesses, so when she does want something I don't begrudge her. If we can get it we do.

 

[aggiealum]

Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539848
Yet none of those statements answered the question I REPEATEDLY ASKED, So let me try it a different way.
What harm would be caused by allowing insurance companies to sell across state lines?
None. It would just be another red-tape boondoggle that wouldn't change anything regarding cutting healthcare costs.
I didn't say you had a bias towards the healthcare industry. Go reread.
I never said I supported the bill. Your claim was the only republican proposal you have ever heard is selling insurance across state lines. I brought the link to show there are other ideas as well. Nothing more, nothing less.
There is no bouncing back between the two. Lets see if I can simplify it for you since the complicated aspects seem to be confusing you. Insurance sold across state lines increases competition. Might reduce price might not, depends on the area. I am not saying ala carte insurance. I am saying Insurance sets pricing for procedures based off of Market average. By doing this heathcare costs will have to adjust as most people would stay within their given insurance budget and go where the claim can be covered. The way it is now, negotiations occur after the procedure has taken place or the treatment has happenned. This places the negotiation befvore the service is rendered...just like every other industry.
Which part of "they sent an insurance adjuster out" do you not get. I didn't get quotes from mechanics before hand...The insurance company sent their agent to do the estimate....do you even read anything anyone types or do you just skim and make shit up to respond to?
It wasn't pertinent to the discussion.
The point you're missing is the competition is already there. Want an example of what happens when you allow certain markets to compete across state lines? It's called monopolies. Look how AT&T sucked up every Baby Bell back in the 80's and 90's. See Comcast sucking up Time Warner. Look at the airline industry. You may see healthy competition at first, but eventually the Big Boys suck up all the little guys, and your stuck with fewer options than you had before the mergers began.
There is no Market Average to base medical costs on. Certain procedures have ridiculous swings related to costs, that you couldn't come up with a viable average. You have to factor in what is involved with performing those thousands of different procedures - manpower (surgeon, doctor, nurses, anesthesiologist, lab techs, etc.), facility costs (hospital, surgical rooms, labs, MRI's, CAT Scanners, X-Ray machines, surgical tables, surgical instruments, etc.), then there's the drugs used for a procedure, saline drips, Band-Aids, tape, the list goes on.... Hospitals and their staff have to recoup those costs somehow, or you end up with sub-standard services. When it comes to trauma's and emergency services, you can't sit around negotiating what things will cost because most doctors in that field have no clue what it will take to keep their patient alive at the time services are being rendered.
Most negotiated rates set after a procedure is performed are industry-standard charges when it comes to major services. My doctor gets paid the same rate for an office visit regardless of which insurance provider he's billing. Every patient pays the same rate in regards to specific lab work they receive. The same goes with the charges my wife submits for her work performed on a patient.



Did I say I didn't fix it?
Yes you did. But you also said you had the option of simply pocketing the money and leaving the car damaged. That's not the intent of car insurance. You purchase that insurance to protect your vehicle in the event of an accident, and it pays to repair that vehicle to it's original manufacturer condition, if possible. It's not intended to be someone's revenue generator if they decide it's OK to drive around in a wrecked car if that's what they choose to do.
Yes I go off roading. I could go into all the reasons I purchased one but that would be pointless. I spent less on the H2 than the mini.
That is nice. I suppose I could have bought my wife's engagement ring from a pawn shop as well.
Yes you could if you felt it was a good deal, and the quality is what you'd expect it to be. That's a poor analogy. Most diamonds are a good investment and rarely lose their value over time. You spent less on the H2 because their depreciation value is probably 60%, if you bought the thing used.
Cars aren't an investment. Wife wanted a new mini at the time. We got a new Mini. See, I love my wife very much and she works her ass off within our businesses, so when she does want something I don't begrudge her. If we can get it we do.
Again, good for you. I'm sure your wife appreciates everything you do for her.

 

[darthtang aw]

None. It would just be another red-tape boondoggle that wouldn't change anything regarding cutting healthcare costs.
Finally! Elaborate the red tape boondoggle, please.
When it comes to trauma's and emergency services, you can't sit around negotiating what things will cost because most doctors in that field have no clue what it will take to keep their patient alive at the time services are being rendered.

pretty sure I excluded these instances from my thought process when discussing prepricing.
I am also pretty sure the cost for items has an average price. There is nothing in the surgical process that would make the actual pins increase in price during surgery during ankle surgery. Or the pacemaker increase in price. saline drips, anesthetic can vary. even sometimes the actual time in surgery. but the actual cost of goods does not vary. some hospitals charge more for those goods,

 

[darthtang aw]

The point you're missing is the competition is already there. Want an example of what happens when you allow certain markets to compete across state lines? It's called monopolies. Look how AT&T sucked up every Baby Bell back in the 80's and 90's. See Comcast sucking up Time Warner. Look at the airline industry. You may see healthy competition at first, but eventually the Big Boys suck up all the little guys, and your stuck with fewer options than you had before the mergers began.

Comcast sucking up time warner is a bad analogy. Time warner pretty much had a monopoly on cable in those areas. Comcast was not in those areas. By comcast acquiring time warner all it did was remove time warner and replace it with comcast. Meaning comcast just expanded their metroplitan reach. In fact cable television is a monopoly. each municipality or area is only serviced by one provider. If I live 15 miles over I cant have comcast. I have to have cable one.
Go read the history of AT&T and the baby bells. I believe you have that wrong as well.

 

[aggiealum]

Quote:
Originally Posted by Darthtang AW http:///t/397098/sure-you-can-have-health-insurance-not-sure-how-you-will-pay-for-it/180#post_3539914
Comcast sucking up time warner is a bad analogy. Time warner pretty much had a monopoly on cable in those areas. Comcast was not in those areas. By comcast acquiring time warner all it did was remove time warner and replace it with comcast. Meaning comcast just expanded their metroplitan reach. In fact cable television is a monopoly. each municipality or area is only serviced by one provider. If I live 15 miles over I cant have comcast. I have to have cable one.
Go read the history of AT&T and the baby bells. I believe you have that wrong as well.
Say what? What do you think a monopoly is? Yea, they sucked up Time Warner and "expanded their reach". But now, you have one huge company that can set prices and what options a customer has in not only one area, but an entire sector of this country. You may have some areas that have smaller alternative providers, or you could go to satellite providers like Dish or DirectTV, but sooner or later Comcast can pull a WalMart and cut prices to kill the rest of their competition. Once that's gone, they have the control to set any price they want.

The reason you'd have to have Cable One instead of Comcast if you moved 15 miles over isn't due to one cable company being a monopoly over another. It has to do where their service areas can reach at the time. Comcast probably just doesn't have a Central Office or their fiber installed in that area. Cable and fiber can reach just so far. If they don't have a Repeater Station in that area, they can't get their signal there. A buddy has had Time Warner since he moved in his house, and ATT Uverse recently started providing service in his neighborhood. Two of his neighbors a few houses down ordered Uverse, and they told him how better the service was, and it also cost less due to their new introductory prices. He contacted AT&T, they check his address, and tell him they can't provide him service at this time because he's essentially 1500 ft out of the range of their fiber connectivity.

What do you think BCBS, United Healthcare, and Aetna are? Large corporations that are monopolies in the areas they do provide service.

Is there a provision in the ACA law that states health providers can't provide rates in any state they want that has these Federal exchanges in place? If not, amend the law that will allow them to do so. Instead of repealing the entire law and trying to start all over again (in the case of the Conservatives, just keep it the way it was so my pockets can continue being lined with the money from these insurance providers.), simply open up these new exchanges to allow any insurance provider to sell their services. That will test your theory as to whether selling across state lines will reduce overall costs or not.

 

[darthtang aw]

Do you understand the difference between a natural monopoly and a true monopoly?