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Old 10-08-2015, 07:31 PM
 
698 posts, read 983,155 times
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Quote:
Originally Posted by NLVgal View Post
Kaiser has nothing at all to do with medical care in Las Vegas. Nothing. You want to talk Las Vegas ? Talk Sierra/ HPN/ United Healthcare.

They touch more than 50 percent of the valley's healthcare either directly or indirectly.

You looked at your provider manual recently? Notice a similarity?
I'm familiar with The difference between Kiaser (had them when I lived in CA) and Sierra who I have now it was a survey of what average insurance premiums were pre ACA. Use LVOC's survey if you want, find your own, my point is in 2012 pre ACA few premiums were $30,000.
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Old 10-08-2015, 07:31 PM
 
13,586 posts, read 13,077,256 times
Reputation: 17786
Quote:
Originally Posted by lvoc View Post
Different Kaisers. One is a CA medical purveyor. The other a non-profit that does data gathering.
Gotcha. Thanks.

I've seen too many people from California comparing the valley to the Kaiser HMO system there.
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Old 10-08-2015, 07:40 PM
 
13,586 posts, read 13,077,256 times
Reputation: 17786
Quote:
Originally Posted by qingguy View Post
I'm familiar with The difference between Kiaser (had them when I lived in CA) and Sierra who I have now it was a survey of what average insurance premiums were pre ACA. Use LVOC's survey if you want, find your own, my point is in 2012 pre ACA few premiums were $30,000.
Read my posts. Am I a proponent of the ACA as it stands here in Las Vegas?
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Old 10-08-2015, 08:52 PM
 
698 posts, read 983,155 times
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Quote:
Originally Posted by ScoopLV View Post
And I'm tired of listening to them complain. Unrivet that wallet and pay up like the rest of us. Don't like it? Move to Panama or have surgery in Mexico with the rest of the medical tourists.

See? "Don't like it? Move!" works in the other direction, too!
Ha! I could care less if you tell me to move. That said, out of respect for your situation I won't comment any further here.

I have no issues with unriveting my wallet, just tell it to me straight, don't deceive me, lie to me and make every year an exercise in hoop jumping. Guarantee if the American public knew the lies that were being told to sell this thing it wouldn't have been passed. It's a tax, frame it as a tax and be done with it.

Was/is reform needed, yes, would I mind paying for it, not at all. Just call it what it is, tax me to pay for it, let me carry what I want to carry, see the Drs. I want to see as a financially responsible member of society and lets move on.
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Old 10-08-2015, 09:09 PM
 
Location: Sunrise
10,865 posts, read 16,960,118 times
Reputation: 9084
Quote:
Originally Posted by qingguy View Post
Ha! I could care less if you tell me to move. That said, out of respect for your situation I won't comment any further here.
You don't need to have any respect for my situation. *I* don't have any respect for my situation.

But the point remains -- you are splitting hairs. Anyone could see our population, and our percentage of fully insured and see that the status quo wasn't realistic.



Healthcare costs a lot of money. Europe decided to go the single-payer route. America decided to go the clown-car route.

This is a partisan issue masquerading as indignance.
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Old 10-08-2015, 09:43 PM
 
2,420 posts, read 4,359,469 times
Reputation: 3528
Quote:
Originally Posted by lvoc View Post
I personally take a financial beating on Medicare. I had a life time Cadillac plan with my long term employer as did my wife. Basically paid nothing. If not for Medicare I would have kept that plan. I now end up paying just short of a grand a month for Plan F and drugs. Wife's plan is a little cheaper and she does not have the big drug bill. Altogether $16,000 or so.
Ivoc, I said most insurance plans. Obviously if you had a Cadillac plan previously with your employer that paid everything, this is not most insurance plans. Also if you are paying any substantial amount with a F Medicare supplemental plan, you must have chosen the cheaper one with deductibles. I did not. Mine covers everything with no deductibles, but of course costs more.

Now prescription drugs are a different story. If you have health issues that require "specialty drugs" or drugs in the upper tiers, you can have some hefty costs. Pharmaceutic companies have been raising costs of even their old drugs by as much as 700%. They are also buying up companies who manufacture generics and raising prices ten fold on them as well. Hedge Fund companies have been purchasing the rights to life saving drugs and pricing them at unimaginable costs. Have you looked at the balance sheets on these pharmaceutical companies. Many are beyond extraordinary.

Please don't say they need the money for research and development. That is a line straight from their PR firms. Do you know what they are spending on advertising as opposed to research and development? How long can you watch TV without seeing at least three drug commercials or open a magazine where 3/4 of the adds are for drugs alone (sometime two or three pages for one drug.) Do you know that such advertising for drugs is illegal in most countries?

This is particularly true in the last few years, where pharmaceutical companies have gone hog wild on pricing drugs to treat more serious illnesses. This is one of the most recent escalation in costs out there right now. And making a deal with the drug companies not to negotiate drugs for seniors when Bush signed Part D into law was a very big mistake. You know it's really hard for a person who needs a drug to stay alive to do a very good job of negotiating for that pill on their own.

Even Hillary Clinton has made this a campaign promise to go after drug companies about this problem if she is elected. I won't hold my breath waiting though.
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Old 10-09-2015, 07:47 AM
 
698 posts, read 983,155 times
Reputation: 574
Quote:
Originally Posted by ScoopLV View Post
But the point remains -- you are splitting hairs. Anyone could see our population, and our percentage of fully insured and see that the status quo wasn't realistic.
Which is exactly why I wrote something needed to be done. I'll agree to disagree with you on the splitting of hairs.
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Old 10-09-2015, 10:29 AM
 
Location: Paranoid State
13,044 posts, read 13,826,471 times
Reputation: 15839
Comprehensive health insurance is such an ingrained element of our thinking, we forget that its rise to dominance is relatively recent. Modern group health insurance was introduced in 1929, and employer-based insurance began to blossom during World War II, when wage freezes prompted employers to expand other benefits as a way of attracting workers. Still, as late as 1954, only a minority of Americans had health insurance. That’s when Congress passed a law making employer contributions to employee health plans tax-deductible without making the resulting benefits taxable to employees. This seemingly minor tax benefit not only encouraged the spread of catastrophic insurance, but had the accidental effect of making employer-funded health insurance the most affordable option (after taxes) for financing pretty much any type of health care. There was nothing natural or inevitable about the way our system developed: employer-based, comprehensive insurance crowded out alternative methods of paying for health-care expenses only because of a poorly considered tax benefit passed half a century ago.

In designing Medicare and Medicaid in 1965, the government essentially adopted this comprehensive-insurance model for its own spending, and by the next year had enrolled nearly 12 percent of the population. And it is no coincidence that the great inflation in health-care costs began soon after. We all believe we need comprehensive health insurance because the cost of care—even routine care—appears too high to bear on our own. But the use of insurance to fund virtually all care is itself a major cause of health care’s high expense.

Insurance is probably the most complex, costly, and distortional method of financing any activity; that’s why it is otherwise used to fund only rare, unexpected, and large costs. Imagine sending your weekly grocery bill to an insurance clerk for review, and having the grocer reimbursed by the insurer to whom you’ve paid your share. An expensive and wasteful absurdity, no?

Is this really a big problem for our health-care system? Well, for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves.

The above quoted from How American Health Care Killed My Father - The Atlantic, written by a life-long progressive, btw.
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Old 10-09-2015, 02:09 PM
 
2,420 posts, read 4,359,469 times
Reputation: 3528
Quote:
Originally Posted by SportyandMisty View Post
Comprehensive health insurance is such an ingrained element of our thinking, we forget that its rise to dominance is relatively recent. Modern group health insurance was introduced in 1929, and employer-based insurance began to blossom during World War II, when wage freezes prompted employers to expand other benefits as a way of attracting workers. Still, as late as 1954, only a minority of Americans had health insurance. That’s when Congress passed a law making employer contributions to employee health plans tax-deductible without making the resulting benefits taxable to employees. This seemingly minor tax benefit not only encouraged the spread of catastrophic insurance, but had the accidental effect of making employer-funded health insurance the most affordable option (after taxes) for financing pretty much any type of health care. There was nothing natural or inevitable about the way our system developed: employer-based, comprehensive insurance crowded out alternative methods of paying for health-care expenses only because of a poorly considered tax benefit passed half a century ago.

In designing Medicare and Medicaid in 1965, the government essentially adopted this comprehensive-insurance model for its own spending, and by the next year had enrolled nearly 12 percent of the population. And it is no coincidence that the great inflation in health-care costs began soon after. We all believe we need comprehensive health insurance because the cost of care—even routine care—appears too high to bear on our own. But the use of insurance to fund virtually all care is itself a major cause of health care’s high expense.

Insurance is probably the most complex, costly, and distortional method of financing any activity; that’s why it is otherwise used to fund only rare, unexpected, and large costs. Imagine sending your weekly grocery bill to an insurance clerk for review, and having the grocer reimbursed by the insurer to whom you’ve paid your share. An expensive and wasteful absurdity, no?

Is this really a big problem for our health-care system? Well, for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves.

The above quoted from How American Health Care Killed My Father - The Atlantic, written by a life-long progressive, btw.
I read the book by Atul Gawande, "The Checklist Manifesto", as well as many many books on our health insurance/care industry. It is a passion with me, though I am not a doctor or connected in any way to the medical community. Just a very concerned citizen. Many of the things in the article mentioned, I believe have merit, but many I also do not agree with.

Health care is a very complex subject matter. It is also unique as it probably one service industry that can't and should not be profit driven. But that is counter intuitive in running a business. And unfortunately it is a business for the most part. As the article pointed out, there are billions and billions of dollars spent yearly in public advertising pushing pills and procedures not likely needed. And the medical industry is very money driven. That is why most other countries do not allow the medical community to push their drugs, procedures, etc. on the public. And the preferred method of paying doctors should be via well paid salaries compensatory to their education level and years of schooling, with advancement based on achievement in patient centered care.

Consolidation by large powerful hospitals is also a widespread problem. As are the pharmaceutical companies, large hospitals are either preventing competition through local government or buying them up as soon as they rear their ugly heads. One of the books I read recently wrote specifically about this.

I remember reading about two hospitals in New Jersey. I think it was Bayonne, but don't quote me on the city. They had two competing hospitals. One was a smaller hospital that performed cardiac procedures for half of what the larger one did, and so the larger hospital was losing business to the smaller hospital, that was favored by insurance companies. So, in the end, the big hospital made the little hospital an offer they couldn't refuse, and then there were no further cost discrepancies between the two hospitals and the cost of the procedures.

Supporting health insurance companies and the complex web of administration they weave is also costing us billions of unnecessary dollars. I could go on forever about this subject, but alas, no one is probably interested.

You state above "Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves." Here I can agree with you up to a point. A regular doctor visit could be borne by most people, but requiring continued monitoring from a specialist might be a problem for some. Lab work, without insurance negotiating prices can be off the charts for simple blood tests.

My son recently had to go the emergency room due to excruciating pain in the middle of the night in his abdomen. We did not know what it was. It turned out he was passing a kidney stone. They basically did nothing while there except scan him to see the cause of the pain, and he laid in a cubicle until he was finally able to pass it himself. That little three hour stint cost over $14,000. His only communication was with a doctor who poked his head inside the curtain and asked how he was doing, and told him to "hang in there". That doctor billed the insurance company $1,423 for that "consultation".

So what you say may have been true twenty years ago, it no longer is today I'm afraid.

Last edited by modhatter; 10-09-2015 at 02:29 PM..
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Old 10-10-2015, 12:05 PM
 
Location: Paranoid State
13,044 posts, read 13,826,471 times
Reputation: 15839
Quote:
Originally Posted by modhatter View Post
Consolidation by large powerful hospitals is also a widespread problem. As are the pharmaceutical companies, large hospitals are either preventing competition through local government or buying them up as soon as they rear their ugly heads.
Yeah, that's a major problem. There are so many, many things at which the government is incompetent - but this isn't one of them. One thing government at all levels is expert at is stifling competition. Governments love to carve out protected monopolies and auction them to the highest campaign contributor. This is an interesting twist on the phrase "privatize profits but socialize costs." The "profit" in this case is to the elected official in the form of legalized bribery called campaign contributions. The costs are borne by the public in the form of higher prices -- anyone with cable TV knows this very well. In fact, research into this area of economics is one of the things that earned George Stigler the Nobel Prize in Economics in 1982 (and I admit I'm a bit biased, as I took classes from him in the area of the economics of regulation when I was in grad school). Stigler wrote extensively that governmental regulation is an "economic good" in the same sense as wheat or corn in that it has a supply curve and a demand curve, and indeed much governmental regulation occurs as a result of demand from the industry being regulated -- to protect incumbent companies from competition. It is a big problem, and a difficult one to solve - the people in governmental entities tend to start out serving the public good but end up serving others instead.


Quote:
Originally Posted by modhatter View Post
You state above "Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves." Here I can agree with you up to a point. A regular doctor visit could be borne by most people, but requiring continued monitoring from a specialist might be a problem for some. Lab work, without insurance negotiating prices can be off the charts for simple blood tests.
The right questions is "why do labs charge prices off-the-charts for simple blood tests absent insurance negotiating prices"? Could it be that labs list off-the-charts retail prices because insurance companies negotiate X% off retail? Why do two people get charged vastly different prices? It is because of insurance companies being the "customer" instead of patients being the customer.

Imagine we all paid for gasoline via some system. You drive up to the pump & pay, say, $3.29 for a gallon of regular while I pay $2.09 for that same gallon - simply because we use different gasoline insurance companies who negotiate differently. Clearly, that's nuts. Why do we allow this for simple blood tests? It is BECAUSE of the existence of the vast network of insurance companies that the lab work's retail price is off the charts -- and few pay retail.

One of my personal pet peeves is airline pricing. I certainly understand why, but it pisses me off that I sit in a seat on a 737 and pay $400 while the passenger next to me pays $200. It pisses me off that the web price at 9:00 am 5 weeks before the flight is different from the price at 2:00 pm that same day, which in turn is different from the price at 9:00 am 2 days later -- but the price 3 days after that is back to the original. Thank goodness paying for health care isn't like that.




Quote:
Originally Posted by modhatter View Post
My son recently had to go the emergency room due to excruciating pain in the middle of the night in his abdomen. We did not know what it was. It turned out he was passing a kidney stone. They basically did nothing while there except scan him to see the cause of the pain, and he laid in a cubicle until he was finally able to pass it himself. That little three hour stint cost over $14,000.
Let's be clear: that "little three hour stint" did NOT cost over $14K. The PRICE was $14K but he COST to the hospital was trivial, as I'm sure you would agree - at most a few bucks. So -- why does the hospital CHARGE $14K for care that costs at most a hundred bucks?

In this case, many pundits agree it is about hospitals purposefully switching fixed cost allocations to the ER just so they can then report back to the community at large "we provided $X Millions of free ER services."

In the real world, they did no such thing. Those $X Millions represent bogus charges just so they can issue press releases.

This points out one of the oft-reported untruths - repeated so much that it has become "true" even though it is false. "ER visits are the most expensive way to treat many things that should be treated in urgent care or in a doctor's offices instead," goes the mantra.

That is just not true. It does not COST anymore to treat someone who comes to the ER with, say, flu symptoms in an ER than it does to treat that person in an urgent care clinic or in a doctor's office. The ER CHARGES more for it, but the COST is the same: a few minutes of a nurse, a few minutes of a doctor, and an admonition to go home & get bed rest & drink plenty of fluids. Those costs are the same.

One of the most misguided proposals I've seen is to set up urgent care clinics inside the ER, and people mostly go the the urgent care clinic while the true emergencies go the the ER. The person proposing this again mistakes prices for costs.
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