An interesting article about how we talk about the healthcare debate.

92CelicaHalfTrac wrote:

MrJoshua wrote:

Otto Maddox wrote: In reply to 92CelicaHalfTrac: I was going to say that, going to point out how he already gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses, etc. But I give up. Some people join a discussion to learn, some just to argue.

How is it that "gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses"? Is he delinquent on his bills or is he just paying cash? (please forgive me if I missed a post where he is settling a delinquent debt for reduced rates)

He's stated before in these discussions that he gets 80-90% off services. At a write off that big, it's impacting other people. Even if it's really only a ~50% reduction and he's exaggerating, he's still taking advantage of the negotiations that the insured have paid for through their premiums.

Please quote me saying that. I bet you can't. I also direct you to the other post where I explain simple business. There is no need to be dishonest and make E36 M3 up.

ThePhranc wrote:

92CelicaHalfTrac wrote:

MrJoshua wrote:

Otto Maddox wrote: In reply to 92CelicaHalfTrac: I was going to say that, going to point out how he already gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses, etc. But I give up. Some people join a discussion to learn, some just to argue.

How is it that "gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses"? Is he delinquent on his bills or is he just paying cash? (please forgive me if I missed a post where he is settling a delinquent debt for reduced rates)

He's stated before in these discussions that he gets 80-90% off services. At a write off that big, it's impacting other people. Even if it's really only a ~50% reduction and he's exaggerating, he's still taking advantage of the negotiations that the insured have paid for through their premiums.

Please quote me saying that. I bet you can't. I also direct you to the other post where I explain simple business. There is no need to be dishonest and make E36 M3 up.

Ok well if i'm wrong, then i apologize. Someone said it, and with you being the main crusader of "berkeley insurance, i pay cash!" it stuck in my head as you. Big difference between "dishonest" and "simple mistake." Calm yourself.

Either way. Your cash discounts are there because of insurance.

You're welcome.

93EXCivic wrote:

Duke wrote:

Knurled wrote: It's a total racket. There's no other business that can financially destroy not just a person but an entire family, without their consent.

Correct me if I'm wrong, but did they make getting treatment MANDATORY? You pretty much have to consent to anything they do to you. You may not like the alternative, but you DO have to agree to accept the treatment.

If you are unconscious, consent is assumed.

Exactly.

That's kinda the way it should be, but on the flip side, the goverment is making you buy things whether you want to or not. OH WAIT

ThePhranc wrote:

Otto Maddox wrote: In reply to 92CelicaHalfTrac: I was going to say that, going to point out how he already gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses, etc. But I give up. Some people join a discussion to learn, some just to argue.

Actually you don't subsidize me. I pay the cost for the service provided. You pay more then I do. If you paid cash you too would pay less. Clearly the doctor knows what something costs and is still making money off of me at the lower rate. Its ok if you don't understand how business works.

Wrong, and no need to talk down to anyone. That is not welcomed here. It might be ok over on MX6.com or Probetalk, but check yourself.

It's obviously not so simple as "how business works" when insurance gets involved. When you have people paying into a system that lowers the cost for them vs. people who don't.

What's happening here that yes, the Doctor knows what something costs and yes, he's still making money off of you.

What he CANNOT do according to his contract (if he has one. If he doesn't, then this discussion is completely irrelevant.) is charge you LESS than the rate that he negotiated for with the big bad insurance company. That rate is where it is BECAUSE of the insurance company.

What he CAN legally do is charge you the original billed charge that he started negotiations with with the insurance company. However, he knows most people won't pay it, so he figures that "some" is better than "none."

And here we get into a "Chicken or the Egg?" scenario. Your rate is lower because of people who pay for insurance. You could make an argument that the original billed charge is so high because of lowballing by insurance companies.

But it's besides the point. It is what it is, and that's why you get the reduction. It's not because you pay cash necessarily... anyone who asks about it would likely get it.

And either way, if you end up with services that you CAN'T afford, we would absolutely be subsidizing it. It might not have happened previously, and it might never happen. But just because you think it will never happen, doesn't mean it won't.

ThePhranc wrote: Its an intellectually dishonest approach...

Didn't see that coming.

ThePhranc wrote: See you have to create a false argument because you can't actually refutiate mine.

No he didn't. He used hyperbole as a rhetorical device to make his point.

TheTroll wrote: Thanks for playing,

It's okay if you don't understand logic and rhetoric.

Another thread degenerated into personal attacks and nonsense being presented as fact.

Have fun with it Phranc one. You win the internet.

ThePhranc wrote:

92CelicaHalfTrac wrote:

MrJoshua wrote:

Otto Maddox wrote: In reply to 92CelicaHalfTrac: I was going to say that, going to point out how he already gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses, etc. But I give up. Some people join a discussion to learn, some just to argue.

How is it that "gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses"? Is he delinquent on his bills or is he just paying cash? (please forgive me if I missed a post where he is settling a delinquent debt for reduced rates)

He's stated before in these discussions that he gets 80-90% off services. At a write off that big, it's impacting other people. Even if it's really only a ~50% reduction and he's exaggerating, he's still taking advantage of the negotiations that the insured have paid for through their premiums.

Please quote me saying that. I bet you can't. I also direct you to the other post where I explain simple business. There is no need to be dishonest and make E36 M3 up.

$1500 MRI? I just had one and it was only $200.

ThePhranc wrote:

oldtin wrote:

ThePhranc wrote: Funny you would pick that place as somewhere with more liberty and freedom.

Why funny? People say they want less government - how about none? - effectively no rules or regulations, you don't have to pay for other people's kids to go to school, no taxes, no service - you can do what you want - the ultimate in laissez-faire - every man for himself. Somalis are unburdened by a government. They have however much liberty and freedom they can enforce.

Argument adsurdum. Its an intellectually dishonest approach used when some one can't actually justify their argument and instead come up with an argument so absurd to discredit the other person. Too bad they only discredit them self. See you have to create a false argument because you can't actually refute mine. Thanks for playing,

You asked why you have to pay for public education, healthcare.... perhaps it's a smartass answer - intellectually honest and accurate -it is because you were born in America and in our society we have established some baseline rights and yes, privileges, including some level of healthcare that the people who have the means fund for the people who don't. Some places have a different baseline and they may pay more than us - other places like Somalia don't give a E36 M3 about the public so no baseline. All the political discussion is about negotiating where the baseline is and perhaps where it's going.

So what I get is that you don't value healthcare as a human right - it is a privilege you pay for if you can afford it. That's fine. In my personal experience, most people I've run across with that view have limited experience with healthcare (hopefully because you've had good health and no real need). Working in a hospital, I see thousands of people suffering, I see their families being bankrupted in getting services that they hope will give them a normal life back. As the most affluent society on the planet I think we should have some high standards. So we diverge on where each thinks the base should be. I don't particularly like the reform bill - it's a crappy compromise. I like the opposition plan less.

As far as saying if you couldn't afford it, you wouldn't get the service - as others have pointed out, you may not have a choice if you can't speak for yourself and secondly, it sounds good hypothetically, it's different when you're actually facing it up close and personal. Perhaps that's the point where society steps in and says no one should have to suffer because they can't afford relief.

ThePhranc wrote: Its ok if you don't understand how business works.

ThePhranc wrote: Argument adsurdum. Its an intellectually dishonest approach used when some one can't actually justify their argument and instead come up with an argument so absurd to discredit the other person. Too bad they only discredit them self. See you have to create a false argument because you can't actually refute mine. Thanks for playing,

ThePhranc wrote: Please quote me saying that. I bet you can't. I also direct you to the other post where I explain simple business. There is no need to be dishonest and make E36 M3 up.

Phranc, You need to calm yourself here. Stop being combative and antagonistic. If you want to talk please feel free. If you're too angry to be polite and considerate of other posters who you disagree with, feel free to go.

The GRM staff has asked us to be more polite and less troll-y around here. I'm asking you to respect that request.

Otto Maddox wrote:

ThePhranc wrote:

92CelicaHalfTrac wrote:

MrJoshua wrote:

Otto Maddox wrote: In reply to 92CelicaHalfTrac: I was going to say that, going to point out how he already gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses, etc. But I give up. Some people join a discussion to learn, some just to argue.

How is it that "gets his bills discounted to the point where the rest of us already pay some of his healthcare expenses"? Is he delinquent on his bills or is he just paying cash? (please forgive me if I missed a post where he is settling a delinquent debt for reduced rates)

He's stated before in these discussions that he gets 80-90% off services. At a write off that big, it's impacting other people. Even if it's really only a ~50% reduction and he's exaggerating, he's still taking advantage of the negotiations that the insured have paid for through their premiums.

Please quote me saying that. I bet you can't. I also direct you to the other post where I explain simple business. There is no need to be dishonest and make E36 M3 up.

$1500 MRI? I just had one and it was only $200.

Ah! So that's the spark for 80-90%. MRI's are advertised by private businesses for less than $300. I am guessing thats what he had.

I argue that insurance drives up rates in many ways. They may allow you to afford the occasional big catastrophe, but adding a GIANT middleman between you and your health care cannot reduce costs.

I think of insurance as somewhat neutral regarding healthcare rates. They mostly need to be able to predict costs accurately and pass the expense on the whoever pays the premium. If they can negotiate lower costs, it might give a competitive advantage in selling plans, but it's short lived, and if overhead/admin/profit is calculated as a percentage of premium (outside of investment profit) - there is a counter pressure to let rates rise over the marketing incentive to hold them down.

We also tend to have higher performance/higher resolution MRI/MRA equipment & techs than most 1st world countries with socialised medicine.

In reply to oldtin:

insurance can't be neutral because of the nature of the monster now.

health insurance isn't insurance, they don't cover the cost of sudden medical needs alone.

in the us, health insurance is for some reason expected to cover preventative medical maintenance care too.

for this to work, they MUST somehow put a markup on the cost of those maintenance services because those are redeemed not as an unexpected expense, but on a condition of being a client.

Generally, they do this by spreading the costs to ALL their insureds so you don't notice it as much as an individual. that is untill....

What he CANNOT do according to his contract (if he has one. If he doesn't, then this discussion is completely irrelevant.) is charge you LESS than the rate that he negotiated for with the big bad insurance company. That rate is where it is BECAUSE of the insurance company.

....until you run into a cash only doctor that accepts NO insurance. This doctor can undercut pretty much the best offers made to/by insurance companies because their practice doesn't have the restrictions and trappings of the insurance industry anymore.

Thats the clearest lense on the true costs of health care we have.

madmallard wrote:

What he CANNOT do according to his contract (if he has one. If he doesn't, then this discussion is completely irrelevant.) is charge you LESS than the rate that he negotiated for with the big bad insurance company. That rate is where it is BECAUSE of the insurance company.

....until you run into a cash only doctor that accepts NO insurance. This doctor can undercut pretty much the best offers made to/by insurance companies because their practice doesn't have the restrictions and trappings of the insurance industry anymore. Thats the clearest lense on the true costs of health care we have.

Right. Which... he would have no contract.

But, there's not really hospitals that are like that, and you still run into the same thing. If you have a big issue, you're on the hook, you go bankrupt, and then the insured pick up the slack.

I'm not really one to go around spouting "For the greater good!" (The greater good) but this is one of those instances where it makes sense. But again... the rest of the bill can DIAF.

madmallard wrote: We also tend to have higher performance/higher resolution MRI/MRA equipment & techs than most 1st world countries with socialised medicine.

Just to be clear- we do not have socialized medicine.

Private insurance companies paying private practice doctors is not socialized. We didn’t get socialized medicine, single payer insurance, or even a public option. The entire thing is being done 100% within the confines of private industry. I know it's become the standard to call the health care act "socialized" or "government run", but it is an intentional effort by divisive politicians and pundits to confuse the issue. Continuing to repeat their propaganda makes it more difficult to have a productive conversation about the plan we actually enacted.

In reply to fast_eddie_72:

my statement wasn't characterising the USA medical system one way or the other, it was a remark about MRI quality in socialised medicine. ~_~

in reply to Beef Supreme:

I know of no ER/trauma equipped hospital like that, true. But there are HUGE segments of private practitioners & clinics that have done this in multiple states successfully.

madmallard wrote: In reply to fast_eddie_72: my statement wasn't characterising the USA medical system one way or the other, it was a remark about MRI quality in socialised medicine. ~_~

I was just pointing it out. I thought it likely you made the statement in some way to contribute to this conversation. But if it was a non-sequester aside, so be it. There does seem to be a maniacal obsession with inserting the word "socialized" into the US health care debate.

I try not to be cynical, so I'm sure this isn't the case. When you make a comment about the quality of a medical procedure in countries with socialized medicine, when you know we don't have and are not getting socialized medicine - a cynical person might think you're being

wait for it

Intellectually dishonest!

But as I say- I'm not cynical like that.

In reply to fast_eddie_72:

well not excatly non-sequitor...

the reason i brought it up is because where the government forcibly dictates what will be paid for a given procedure, a comprimise of quality or timliness WILL be made without exception.

In the case of MRI, most of these prices people are throwing out on the low spectrum are private firms taking non-insurance referrals, at least down in the south.

In the case of socialised medicine where the government tells the medical system what a given service will be paid, in this case an MRI, the quality of the image elements is usually far lower.

I'm referring to the MRI in this case because I remember learning about a study on such things after watching a PBS special on social medicine that referred to it as an example of the 'comprimises' such limitations make.

so the point in me bringing it up is 2-fold.

1: in cases where socialised medicine forces a cost that is below the real cost of the product, that product will decline in quality and availability without fail.

2: in cases where socialised medicine is inefficient or flawed in management, then costs will baloon to fill the inefficiency wherever possible. there are multiple examples of insurance and the government plans (medicare) offering TOO much coverage for many things in their negotiated prices, and so the out of pocket expense will bloat until it takes up all that slack.

in the us, where a private firm can turn over a quality MRI for $300 without the insurance industry, another private firm must follow the same mandatory laws governing whatever insurance company their patient belongs to and compliance costs reflect that in $1200 for the same service.

madmallard wrote: In the case of socialised medicine where the government tells the medical system what a given service will be paid, in this case an MRI, the quality of the image elements is usually far lower.

So you're talking about Medicaid/Medicare? In our health care system, private isurance companies will tell the medical system what they will pay, just ad they do now.

fast_eddie_72 wrote: when you know we don't have and are not getting socialized medicine

1) You KNOW that socialized healthcare is the real goal, right? So let's not Bob Costasfoot around with semantics. This "not socialized" fiasco of a system is designed to crash and burn, so those with the agenda can then step in and use the resulting debacle to lever the real program through.

2) Follow me here: I don't buy insurance, even though I could afford it. I get assessed the "not a penalty". Note that the "not a penalty" is based on a percentage of my income, NOT upon the cost of an insurance premium. That money is put into a pot to pay for insurance for those who make below a certain amount (which is less than I make) who are deemed unable to afford the required insurance on their own. Yet I don't get the "free" coverage they do; I'm still on the hook for my own care, because I make more than the maximum allowable amount. How is this NOT socialized medicine? Do you really want to try and sell that line? If it quacks like a duck, looks like a duck, and E36 M3s in the pond like a duck, it's close enough to being a duck for argument's sake.

In reply to Duke:

Obamacare isn't socialized medicine. It was a republican plan intended to be a better alternative to both our current system and socialized medicine. Of course, the republicans instantly hated their plan once the democrats co-opted it.

We shall see. I am not convinced it is the best alternative.

In reply to fast_eddie_72:

I mentioned medicare by name later than that quote, so yeah. but medicare's current problem is the opposite of the MRI example, and thats bloating costs.

Socialized anything gets a bad rap. But jeez, without some level of socialization, we wouldn't really be a country. We'd have no military, for starters.

madmallard wrote: In reply to fast_eddie_72: I mentioned medicare by name later than that quote, so yeah. but medicare's current problem is the opposite of the MRI example, and thats bloating costs.

For my own selfish reasons, I wish medicare was footloose and fancy-free with the money. They squeeze the hell out of everyone in the healthcare industry.