eits
Lifer
it's what they do best... unifying to support the dumbest shit in the name of opposition. they're even unified in wanting obama to prove he's an american citizen. fuck yourselves.
Easy the doc is not going to charge you, what they charge the insurance office as they know your pockers are not anywhere as deep as the insurance companies pockets. When I stopped carrying dental insurance, the dentists office I went was in fact giving me better rates what he was billing insurance.
So next exercise is too the docs office and find out what an office visit costs, since next you will be paying upfront without insurance. My guess it is going to be less than the $150 per visit he billed insurance. The fundamental problem is that for so long, consumers have not cared what it costs as they had their $20 copay. Ths is something that has to stop, but it will not stop until consumers are forced to pay for the affordable out of pocket, rather than getting a 3rd party involved to pay the affordable.
And nothing wrong with that, so long as employees are adequalely compensated to do so? Is it a problem that you employee does not pay for you auto or house insurance?
Originally posted by: Engineer
i.e. HSA. Putting your own money in to pay your own bills. Not everyone with an HSA will have catastrophic insurance nor is it always "free" with an employer HSA. Not to mention (as I've stated), not all employers contribute to an HSA. But I've beat this horse into the ground and am going to spend the last of my forced 25 days off enjoying them (instead of arguing about stupid shit that I have no control over anyway)!
Everyone with an HSA has a high deductable plan, you cant get an HSA without one.
They are not the same. With an HSA you get to keep the money at the end of the year, with an FSA you dont.
sactoking
Diamond Member
- Sep 24, 2007
- 7,644
- 2,920
- 136
"...functions exactly like the HSA" was the wrong thing to say, semantically. It fills in the gap of expense not covered by insurance by allowing the owner to set aside tax-advantaged money. So, I guess "But you can get an FSA without one, and that uses the same mechanism and accomplishes the same thing as the FSA" would have been better, if you want to nitpick.
Engineer
Elite Member
- Oct 9, 1999
- 39,230
- 701
- 126
That's a straw man as my employer has NEVER paid for those items. However, if I'm moved to fund my own insurance and pay 100% of my own care, that is taking a step backwards in pay and benefits, period. So yes, it's an issue as I'm tired of getting less at this point. Tired enough that for the first time in a very long time, I'm looking for a new job. The old benefits and flexibility are starting to not be enough.
Comparing the New York Stock Exchange to the newly proposed Federal Health Insurance Exchange is pure amateur hour -- beyond the word "exchange" in their titles, they would have absolutely nothing in common.
I mean, really?
Stay in school kids.
It appears the Blue Dogs are pissed as hell and feel lied to by the leadership.
It will be an interesting week next week. If the leadership goes through with their threat to skip the proper procedure and process its going to get nasty amongst the Dems. Blue Dogs hold a majority of the dem seats on key committees overseeing this. If they get bypassed, the Dem leadership and Obama are going to lose control of the Democratic Caucus. Pelosi is playing with fire. The Blue Dogs arent going to back down on this.
Moderates and Blue Dogs appear to be sacraficial lambs in the eyes of the Democratic Leadership.
If they force a vote next week. It will likely fail. If it fails, its not likely to pass this year.
Congress needs to take the time to get this right before the vote on anything. They should look at the UHC systems put in place in other countries to see what works and what doesn't, especially Taiwan's system. Taiwan looked at almost every country's system and tried to take the best ideas from each one. They only spend 6% of their GNP on health care, but cover everybody.
It is not a strawman. They do pay for all those things, they just dont do it directly. IF they did not pay enough for you house or car insurance, you would be workign somewhere. Just like you no thinking of working somewhere else because you think you are not getting enough. IT does not matter how you get your benefits, as long as you paid enough to get them.
Engineer
Elite Member
- Oct 9, 1999
- 39,230
- 701
- 126
and like I said earlier. All HSA's are not created equal. My company's idea is to shift the burden of all healthcare to me, the employee. That is a benefit reduction, i.e. a decrease in pay. And as for the strawman comment, I thought you were referring to paying directly for those items. However, my auto and homeowner's insurance = 1/10'th the cost of the health insurance (my part and company's part). Losing health coverage = far bigger loss than the other two.
I dont disagree you are taking pay/benefit cut. I dont disagree some HSA are better funded than others. But my point is, it does not matter if you employees pay you more salary or pays for benefits directly the end result is the same. Having an employer pay for your benefits, means they are paying you less in salary to cover those benefit costs.
Engineer
Elite Member
- Oct 9, 1999
- 39,230
- 701
- 126
I understand that but that's not what has been happening in the US and my company, as I've said, is not the only one. If they move to the HSA only option, which has been discussed, there will be no pay increases to offset the loss of coverage. If they were to contribute some money to the HSA on a yearly basis (maybe some up front to get started), then it might be better. Still becoming a self payment issue.
By the way, how many doctors/clinics/etc. will 100% give you a reduced price with no insurance? I have not found one yet (I've asked 3).
Don't have time to debate more. Time to go on my nightly walk (about 1.5 to 2 hours). Doing my part to stay healthy and keep costs down!
IndyColtsFan
Lifer
- Sep 22, 2007
- 33,655
- 688
- 126
I am confused, so perhaps you can help me out. Does Obama support the current plan proposed by the Democrats?
Well the employment data says that rising medical costs has been eating up wage growth. Health bennies have become an important benefit, I do not see them going away on a large scale. Just because you have a poorly funded hsa, does not mean that poorly funded is an industry standard.
[/quote]
By the way, how many doctors/clinics/etc. will 100% give you a reduced price with no insurance? I have not found one yet (I've asked 3).
[/quote]
Apparently I have had better luck when asking, but that was several years ago. I got strange looks from the ones I did ask.
[/quote]
Don't have time to debate more. Time to go on my nightly walk (about 1.5 to 2 hours). Doing my part to stay healthy and keep costs down!
[/quote]kick up the pace, it wont take as long. I am going to do 5 or 6 miles in the morning when it is somewhat cooler around here.
Originally posted by: senseamp
Originally posted by: FerrelGeek
Oh yes, let's rush to pass a poorly conceived piece of garbage just to make you stop pouting and stomping your little size 6 foot. You've done nothing in this thread but hold yourself up as the poster boy that people like Rush like to lampoon. Way ta go!
Anything worth doing is worth doing well. If we're realy going to reform healthcare, let's do it in a way that won't screw up the 80%+ of Americans that have it. But all you care about is checking the box.
I don't think it's poorly conceived. Looks like it has a public option in place. If you think providing care to the uninsured is screwing everyone else, well, we already screw everyone at the ER then.
/Facepalm - I give up. You're beyond hope.
Ahhh... there's the right wing FUD. We already have a "Federal Health Insurance Exchange".... its essentially what the Federal Employees use and every single plan on there is private.
I'll post these replies here since the other thread "died"
I'm not going to request your CV showing me your experience in surveying health systems.
The number commonly touted around in the medical community is that 95% of all health care dollars are spent at the end of life. If you want to simply knock down the % utilization of GDP (reflected in pure dollar costs for care provided and not factoring lost wages and the like) simply disconnect grandpa from the vent.
I don't know how many times thhis year I spent trying to get people who were brain-dead off the vent by talking to families. While it may sound evil the fact is 3 days in the ICU geting constant brain perfusion scans and EEGs and basically sucking up an ICU nurse really runs up the bill. I haven't seen a single maggot (yeah that's what they amount to) in Congress address this issue. Why!?! They're not PAs, RNs, MDs or DOs. They don't know anything about medicine other than the numbers some secretarial aid crunched up.
There are lot of reforms that need to be made - like having a nation push for organ donation and ethics committees to decide to legally accelerate situations like brain-death. I almost tore my last bits of hair out trying to get a 92 woman to make her husband DNR after he was basically in a coma with 6 stage 4 ulcers. How that man survived for 10 months I don't know (I got stuck with him for 2 months). He easily cost Medicare over 5 million dollars. Even the chaplin could convince the woman for DNR and he said she was the toughest person he ever dealt with.
The solutions being offered by the "minds" in DC are pathetic. Most 3rd year medical students and LVNs could put together a better health care reform package and actually cut costs while improving on core quality. When Obama blatantly poo-poos anything the AMA says about tort reform (and I hate the AMA like I hate the AARP) then you know it's hopeless.
Funny they let baseball players testify about steriods on the hill for 3 days but can't find time to have open forum for medical professionals for 1 week. If the people reading this thread haven't written their reps they're part of the problem too. I for one have 13 letters written to Feinstein (1 was actually replied to).
You do know there is more than one medical lobby - although per media the second is dwarfed by the first. I'm referring to DOs and the AOA. I myself am a DO (mainly because I was unwilling to leave SoCal and not because of any philosophy). The number of DO schools more than doubled in the last 10 years and since most are private they put out large number of physicians.
DOs historically do primary care but in my class most people went into specialty which is where the money is. I myself matched for anesthesia (a somewhat difficult residency but financially overcompensated) but decided I would better serve people in primary care and made the stupid mistake of doing FP/IM (I could be blissfully ignoring paperwork and enjoying a GT3 right now instead of driving a Odyssey).
That brings me to my point about ethics. Sure I could have done the WS thing and given how driven I was in my 20s and how good I was at pulling 48 hour shifts w/p caffeine I could have probably been set for life by now. Don't think WS is holding $ back, the banks seem to still be on track for doling out the pork. If everybody who wanted to run to WS to make $ runs to Medicine to make $ - well you're going to be having a lot more shady physicians than we already have.
I chose medicine because I wanted the respect (yeah I'll admit it) and I wanted to genuinely help people. I'm a good listener, very patient and can solve problems quickly - none of those skill seem to be helping me today. Sure I read my CME articles and stay up to date - but I spend over 1/3 of my time filling forms and returning pages from something non-medical related.
As I said above I hate the AMA but if Obama refuses to listen to their pandering (he openly said it in a video clip) then I wonder who he'll (by he I mean Obama/Reid/Pelosi/Steele/et al) listen to.
Again I would like C-Span to show me 1 week where docs/nurses/PAs/therapist are up the hill testifying like every other group gets to do. Until I see that happen I'll laugh at the notion the government is compentently trying to fix anything.
BTW, the reason the AMA and AOA are so weak is because physicians are too lazy to get involved. They're so involved w/ running their practice and to some extent bogged with paperwork they don't choose to write the representative. A random poll done by myself showed that not one of 37 docs I saw in the doc lounge last year had written their congressional rep/senator. That's apathy. Guess Obama's HOPE didn't get to the docs.
TruePaige - above you made a good point that UHC can't cost 10x as much since it's 14% of the GDP. But what if in say 10 years the costs do continue to go up at a stable 7% per anum (we do have the boomers hitting the wall afterall). I fear the government's only option would be to print more $.
Ultimately there is a finite amount of $. The $ represents slavery in essence. I enslave myself to get those $s - they are precious to me :laugh:. If Obama is sincere in meaning deficit neutral - he means the net amount of work for caring for people should be the same. It would be pointless to keep the work the same and not improve outcomes - so I can only assume he wants better quality. I shell out close to $300 a month for Kaiser per year and have been doing so since age 22 or so (my dad paid for me when I was in med school). If you add 50 million people to the rolls they should be expected to utilize primary care. If they followed the docs advice (hell even I don't follow my own advice sometimes) and get healthy I would gladly shell out 10% more of my income. I don't see that happening any time soon.
If everbody is more or less covered evenly with UHC (kind of like Medicare is now) then everbody will have great primary care and horrible catastrophics/emergent care and the top levels of care will become unaccessable to all but the Rockafellers. Everybody would get their statin, their diabetes meds, their hypertensive meds, their pain control, flu shots, etc - but coronary stenting and the like simply won't be covered. I DON'T WANT ANYBODY OUTSIDE OF MEDICINE TO EVEN ARGUE AGAINST THAT - IT'S CLEARLY BEEN THE TRACK RECORD FOR NEUROLOGIC AND CORONARY CARE (look at reimbursements).
The other option would be to cover people only for inpatient needs and force a co-pay for outpatient visits. This could be fiscally sustainable since it's basically what we have now - but it doesn't really improve the health of those currently uninsured (unless they choose to pay for outpatient visits).
Look - no name calling. If people can avoid using name calling and stupid titles like Repub/Democrat/Neo-Con/Liberal then feel free to respond to this.
I'm not going to request your CV showing me your experience in surveying health systems.
The number commonly touted around in the medical community is that 95% of all health care dollars are spent at the end of life. If you want to simply knock down the % utilization of GDP (reflected in pure dollar costs for care provided and not factoring lost wages and the like) simply disconnect grandpa from the vent.
I don't know how many times thhis year I spent trying to get people who were brain-dead off the vent by talking to families. While it may sound evil the fact is 3 days in the ICU geting constant brain perfusion scans and EEGs and basically sucking up an ICU nurse really runs up the bill. I haven't seen a single maggot (yeah that's what they amount to) in Congress address this issue. Why!?! They're not PAs, RNs, MDs or DOs. They don't know anything about medicine other than the numbers some secretarial aid crunched up.
There are lot of reforms that need to be made - like having a nation push for organ donation and ethics committees to decide to legally accelerate situations like brain-death. I almost tore my last bits of hair out trying to get a 92 woman to make her husband DNR after he was basically in a coma with 6 stage 4 ulcers. How that man survived for 10 months I don't know (I got stuck with him for 2 months). He easily cost Medicare over 5 million dollars. Even the chaplin could convince the woman for DNR and he said she was the toughest person he ever dealt with.
The solutions being offered by the "minds" in DC are pathetic. Most 3rd year medical students and LVNs could put together a better health care reform package and actually cut costs while improving on core quality. When Obama blatantly poo-poos anything the AMA says about tort reform (and I hate the AMA like I hate the AARP) then you know it's hopeless.
Funny they let baseball players testify about steriods on the hill for 3 days but can't find time to have open forum for medical professionals for 1 week. If the people reading this thread haven't written their reps they're part of the problem too. I for one have 13 letters written to Feinstein (1 was actually replied to).
You do know there is more than one medical lobby - although per media the second is dwarfed by the first. I'm referring to DOs and the AOA. I myself am a DO (mainly because I was unwilling to leave SoCal and not because of any philosophy). The number of DO schools more than doubled in the last 10 years and since most are private they put out large number of physicians.
DOs historically do primary care but in my class most people went into specialty which is where the money is. I myself matched for anesthesia (a somewhat difficult residency but financially overcompensated) but decided I would better serve people in primary care and made the stupid mistake of doing FP/IM (I could be blissfully ignoring paperwork and enjoying a GT3 right now instead of driving a Odyssey).
That brings me to my point about ethics. Sure I could have done the WS thing and given how driven I was in my 20s and how good I was at pulling 48 hour shifts w/p caffeine I could have probably been set for life by now. Don't think WS is holding $ back, the banks seem to still be on track for doling out the pork. If everybody who wanted to run to WS to make $ runs to Medicine to make $ - well you're going to be having a lot more shady physicians than we already have.
I chose medicine because I wanted the respect (yeah I'll admit it) and I wanted to genuinely help people. I'm a good listener, very patient and can solve problems quickly - none of those skill seem to be helping me today. Sure I read my CME articles and stay up to date - but I spend over 1/3 of my time filling forms and returning pages from something non-medical related.
As I said above I hate the AMA but if Obama refuses to listen to their pandering (he openly said it in a video clip) then I wonder who he'll (by he I mean Obama/Reid/Pelosi/Steele/et al) listen to.
Again I would like C-Span to show me 1 week where docs/nurses/PAs/therapist are up the hill testifying like every other group gets to do. Until I see that happen I'll laugh at the notion the government is compentently trying to fix anything.
BTW, the reason the AMA and AOA are so weak is because physicians are too lazy to get involved. They're so involved w/ running their practice and to some extent bogged with paperwork they don't choose to write the representative. A random poll done by myself showed that not one of 37 docs I saw in the doc lounge last year had written their congressional rep/senator. That's apathy. Guess Obama's HOPE didn't get to the docs.
TruePaige - above you made a good point that UHC can't cost 10x as much since it's 14% of the GDP. But what if in say 10 years the costs do continue to go up at a stable 7% per anum (we do have the boomers hitting the wall afterall). I fear the government's only option would be to print more $.
Ultimately there is a finite amount of $. The $ represents slavery in essence. I enslave myself to get those $s - they are precious to me :laugh:. If Obama is sincere in meaning deficit neutral - he means the net amount of work for caring for people should be the same. It would be pointless to keep the work the same and not improve outcomes - so I can only assume he wants better quality. I shell out close to $300 a month for Kaiser per year and have been doing so since age 22 or so (my dad paid for me when I was in med school). If you add 50 million people to the rolls they should be expected to utilize primary care. If they followed the docs advice (hell even I don't follow my own advice sometimes) and get healthy I would gladly shell out 10% more of my income. I don't see that happening any time soon.
If everbody is more or less covered evenly with UHC (kind of like Medicare is now) then everbody will have great primary care and horrible catastrophics/emergent care and the top levels of care will become unaccessable to all but the Rockafellers. Everybody would get their statin, their diabetes meds, their hypertensive meds, their pain control, flu shots, etc - but coronary stenting and the like simply won't be covered. I DON'T WANT ANYBODY OUTSIDE OF MEDICINE TO EVEN ARGUE AGAINST THAT - IT'S CLEARLY BEEN THE TRACK RECORD FOR NEUROLOGIC AND CORONARY CARE (look at reimbursements).
The other option would be to cover people only for inpatient needs and force a co-pay for outpatient visits. This could be fiscally sustainable since it's basically what we have now - but it doesn't really improve the health of those currently uninsured (unless they choose to pay for outpatient visits).
Look - no name calling. If people can avoid using name calling and stupid titles like Repub/Democrat/Neo-Con/Liberal then feel free to respond to this.
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