Supreme Court Ruling on Health Care

[seekerz]

A ballpark? Are you serious?

A doctor can see you in exchange for a chicken. It does not obligate him/her to further service. It really is that simple although Democrats wold attemt to convivne otherwise.

The problem with healthcare in America is the co-pay and unrestriced advice for MRI’s, CT’s etc…

Yes, I am serious. Are you serious, with your chicken-doctors?

This is the real world where real medical services cost real money, and resorting to name-calling in the face of the TRUTH says more about you than about fictional Democrats.

The problem with health care in America is the lack of knowledge (and sometimes overt denial) of how things work. Among those who stand most to gain from that lack of transparency, some would do anything to keep it that way.

 

[Bill_Freeman]

White House Statement on Obamacare Mandate Tax Contradicts Supreme Court Ruling

cnsnews.com/news/article/white-house-statement-obamacare-mandate-tax-contradicts-supreme-court-ruling

They are ignoring the Supreme Court’s own ruling. Shows the White House does not want to acknowledge it is a tax.

Roberts’s opinion says the mandate is not a tax for purposes of the Anti-Injunction Act (but is a tax under an analysis of Congress’s taxing power). It is equally consistent to say the mandate is not a tax as it is to say the mandate is a tax. The opinion says that the mandate is both a tax and not a tax. You own every member of the Obama administration an apology.

 

[seekerz]

I would dispute the first statement. I have read thousands of Medicaid recipients’ charts, and they are not only overutilizers of medical services, they go the ER far more than most people. Why wait to see the doctor on Monday when you can go to the ER on Saturday evening for the poison ivy you got on Saturday morning? Either way, it costs them nothing.
Expand the number of people who pay nothing or very little, and you’ll get more, not less, ER use.

I would dispute your second assertion as well. I have seen no persuasive evidence that this is so, because apples are never compared to apples. If you look at life expectancy, you find two things:

First, if you’re simply going by life expectancy at any time in life, the older a society is, the greater is the life expectancy. That’s just a statistical thing. An 80 year old has a higher life expectancy than a 10 year old because everybody, no matter how old, has a theoretical life expectancy beyond the day you look at it, whereas a young person is subject to all the hazards of life. Every developed country in the world has an older population than that of the U.S.

Second, if you look at life expectancy at birth, you have to realize that infant deaths are recorded differently in different countries. We count more “live births” in the U.S. than they do in most developed countries, because our definitions of “live birth” are different. We count as “live births” all births where the infant shows any signs of life at all. In other countries, if a child dies shortly after birth, or is significantly premature and dies within hours of birth, it’s counted as a “stillbirth”.

In addition, the U.S. admits to this country massively more people who come from primitive societies than do other developed countries. Japan, for example, admits virtually none. We admit them almost without limit. Such people often have primitive ideas about health, have experienced poor nutrition and often bring bad health conditions in with them. In addition, and particularly among Mexican immigrants, they can buy the most powerful medications imaginable over the counter in Mexico, and they bring them in all the time. Self-diagnosis and self-treatment are extremely common among them, often with very adverse results. It’s also interesting to read the commentaries on people from primitive societies in the Diagnostic and Statistical Manual of the APA. The beliefs about health and what to do about illness among immigrants can be not only bizarre, but widespread.

You really can’t use outcomes and life expectancies as yardsticks with which to compare the U.S. and the medical systems in other developed countries.

Seriously, I debunked most of your ‘points’ in a different thread.

Statistics, including the recording of live births, is standard in most developed countries, life expectancy at birth (the indicator most commonly used for comparison) does not depend on the age distribution in a population and, lastly, we are by far not the only developed country that accepts immigrants from all over the world - statistically, their contribution to these indicators is minimal.

 

[iamrefreshed]

Yes, I am serious. Are you serious, with your chicken-doctors?

This is the real world where real medical services cost real money, and resorting to name-calling in the face of the TRUTH says more about you than about fictional Democrats.

The problem with health care in America is the lack of knowledge (and sometimes overt denial) of how things work. Among those who stand most to gain from that lack of transparency, some would do anything to keep it that way.

You are eating everything Democrats feed you aren’t you?

In the “real world” services are rendered for the prevailing rate.

I’d suggest you contact several doctors offices to negotiate rates. I have and it has resulted in drastically reduced charges.

But you keep believing your shearers.

 

[seekerz]

You are eating everything Democrats feed you aren’t you?

In the “real world” services are rendered for the prevailing rate.

I’d suggest you contact several doctors offices to negotiate rates. I have and it has resulted in drastically reduced charges.

But you keep believing your shearers.

I’m sorry if for some reason you’re feeling upset today, but if you don’t mind your manners I will be reporting you.

You have done nothing to refute the facts I posted. Provide me a single quote that says I made up the existence of levels of medical service or how they work. You can’t. Instead you generalize and cast aspersions.

 

[iamrefreshed]

Yes, I am serious. Are you serious, with your chicken-doctors?

This is the real world where real medical services cost real money, and resorting to name-calling in the face of the TRUTH says more about you than about fictional Democrats.

The problem with health care in America is the lack of knowledge (and sometimes overt denial) of how things work. Among those who stand most to gain from that lack of transparency, some would do anything to keep it that way.

I’m continually amazed how many seemingly intelligent people refuse to use their brains.

A doctor, with an insurance covered patient, has nothing to lose by recommending further tests (and everything to lose without tort reform). Neither does the insurance covered patient.

I 've been there. My knee hurts…get an MRI is what you hear.

Well if that MRI costs $300 we might change our mind.

Wait til an MRI is paid by the wages earners of the country!

 

[iamrefreshed]

I’m sorry if for some reason you’re feeling upset today, but if you don’t mind your manners I will be reporting you.

You have done nothing to refute the facts I posted. Provide me a single quote that says I made up the existence of levels of medical service or how they work. You can’t. Instead you generalize and cast aspersions.

Report away. You’ve reported no facts unless you consider a Wikepida link a fact?

Sounds like a Democrat threat.

 

[Dawnia]

Good. Now do you know of the term ‘level of service’?

Source
(emphasis, mine)

So, unless your doctor is failing to follow insurance guidelines or has invented a magical way to determine complexity of the visit before he sees you, all that you can be offered beforehand is a ballpark figure.

I think the apt phrase is - He who pays the bill gets to determine the services.

 

[Mickey_Finn]

He’s stated as much, repeatedly.

I’m assuming the proof of his diabolical plot to foist a Romneycare program on the entire country will be forthcoming?

The burden of proof is on you to prove a false positive, sir.

“Repeal and replace” I hope if he manages this. His version is a little more to everyones liking.

ATB

 

[Dawnia]

“Repeal and replace” I hope if he manages this. His version is a little more to everyones liking.

ATB

It won’t be…there will always be some segment of the population that complains.

 

[seekerz]

Report away. You’ve reported no facts unless you consider a Wikepida link a fact?

Sounds like a Democrat threat.

Seriously, you want to argue medical billing principles with me? Basic established practice that thousands of people adhere to everyday? I’m simply scratching my head at this point…

 

[Mickey_Finn]

Well I don’t know about you in NY, but here in Ohio both my Congressman and Senators are very receptive to me. QUOTE]

You guys do have an interesting Political enviroment. I’ll give you that.

 

[Mickey_Finn]

It won’t be…there will always be some segment of the population that complains.

True. Lets let it be someone else.

ATB

 

[Dawnia]

True. Lets let it be someone else.

ATB

What a party pooper.

 

[seekerz]

I think the apt phrase is - He who pays the bill gets to determine the services.

The extent and complexity of the care rendered is determined by the doctor. The patient may consent or refuse to services (or decline to access them at all), but otherwise has no (name removed by moderator)ut in determining how much a visit costs.

I really do apologize if these facts fly in the face of anyone’s cherished opinions, but that’s reality for you.

 

[Ridgerunner]

One more comment about the “cost of healthcare” in other developed countries, then I need to leave and do other things.

You can’t compare them without totally dissecting and rearranging how various countries account for healthcare. U.S. costs are pretty easy to know, because of the way records are kept and concentrated at the point of service. But in France, for instance, government pays for medical school and it is not counted as part of the cost of healthcare. In the U.S. med students graduate with a lot of debt, typically, and that has to be recouped in medical costs, so it is counted.

Again in France, the government pays for the malpractice insurance of the doctors in the “public” system (about 2/3 of the whole system) That’s not counted as part of the cost of healthcare. But since doctors in the U.S. have to recoup that cost in fees, it’s counted.

And the cost of malpractice insurance is lower there, because all malpractice cases are tried before specially-trained judges, not juries, and the attorneys can only charge hourly fees, not fees based on awards. The cost of those judges, court clerks, etc, is not counted. Since the costs of litigation in the U.S. are paid by insurers who charge premiums based on them, which have to be recovered in medical fees, they are counted.

And of course, in some countries the government purchases the medication in enormous bulk, but also chooses which meds to buy at all. In many countries, the “top of the line” drugs and “orphan” drugs are not purchased at all and are not available in the public systems. So that skews the apparent cost as well.

And naturally, if the U.S. has, for example, vastly more MRIs per capita than other developed countries (which it does) and if I pull my shoulder and am in severe pain, the great likelihood is that I will have an MRI of my shoulder within minutes or within hours at most. Most of the time, the outcome will be benign, and I will recover by tincture of time. I could refuse it, but if I have insurance and it’s there to do, chances are I will do it. If I have something like a rotator cuff tear, likely it will be repaired surgically very quickly. If I have to wait months for an MRI, chances are that I will never have it at all because I will either simply get well or the condition (like an incomplete but full thickness rotator cuff tear) becomes irreparable in fairly short order. Eventually, my pain goes away, but my rotator cuff remains torn and vulnerable. My motion is limited, but I learn to live with that.

We do a lot of things they don’t do in other countries because the means of doing them are ready to hand, and because somebody else is almost always paying for it.

One last thing, and I’ll quit.

Nobody, in promoting Obamacare ever took into account one major reason why, at the time, insurance rates were so high. A significant part of that is because interest rates have been so low and because mortgage backed securities crashed. Insurance companies make a very large part of their income on investments, and the only place they can go to make up for low returns is in higher premiums.

One can blame Clinton for appointing Greenspan or Bush for re-appointing him, or Bush for appointing Bernanke, or Obama for re-appointing him. Or one can blame congress for the overspending that has forced the Fed to over-purchase government securities. Or one can blame Dodd, Frank, Schumer and Obama for not curbing the bad loan buying of FNMA and FHLMC. Or one can blame Bush for not defeating Dodd, Frank, Schumer and Obama politically when he tried to reform those entities and they opposed him.

Lots of blame to go around, but the insurance companies themselves are probably the least at fault of all. But they’re happy now to soak their biscuits in government gravy as long as they stay in the health insurance business, which might not be all that long. And almost nobody in all of this mess has really been looking at the right things…or perhaps cared to.

And again, I feel disappointed in Roberts in a way. I do. But if Roberts really was looking at what an incredibly stupid thing this country did in 2008 by electing candidates based on unreasonable expectations, emotions and ignorance and simply told us all that we made our beds and now have to lie in them until we learn not to have unreasonable expectations and romantic notions, then maybe he’s just the most reflective thinker in this whole country.

 

[iamrefreshed]

Seriously, you want to argue medical billing principles with me? Basic established practice that thousands of people adhere to everyday? I’m simply scratching my head at this point…

Scratch away. I have personally negotiated and paid for multiple surgical procedures.

I’ll take my personal experience over your Wikipedia everytime.

 

[seekerz]

I’m continually amazed how many seemingly intelligent people refuse to use their brains.

A doctor, with an insurance covered patient, has nothing to lose by recommending further tests (and everything to lose without tort reform). Neither does the insurance covered patient.

I 've been there. My knee hurts…get an MRI is what you hear.

Well if that MRI costs $300 we might change our mind.

Wait til an MRI is paid by the wages earners of the country!

You do know what a deductible is right; and a co-pay and co-insurance? Most good insurance plans have them. Insurance is not a carte blanche for a person to simply demand unnecessary services just because…indeed some low-wage earners with ‘bad insurance’ act like they’re uninsured and forgo doctor visits because even with insurance, they can’t afford to go.

I have to admit that some doctors do order unnecessary services, but that is not a judgment that can simply be made across the board without the benefit of medical training, because some types of knee pain DO merit an MRI to forestall complications and even disability down the road…

 

[seekerz]

Scratch away. I have personally negotiated and paid for multiple surgical procedures.

I’ll take my personal experience over your Wikipedia everytime.

We’re talking surgery now. I thought we were talking doctor’s visits, you know the part where you visit the doctor before he actually decides that you need surgery…

CPT Code/
Time in
minutes
1-History of Present Illness 2 - Exam 3 - Medical
Decision Making
99201 - 10
99241 - 15
Problem-Focused Problem-Focused Straight-Forward
99202 - 20
99242 - 30
Expanded Problem-Focused
Expanded ProblemFocused
Straight-forward
99203 - 30
99243 - 40
Detailed Detailed Low
99204 - 45
99244 - 60
Comprehensive Comprehensive Moderate
99205 - 60
99245 - 80
Comprehensive Comprehensive High

source

Each of the 5 digit numbers beginning with 9 carry a different charge and they are all determined by what happens DURING a doctor visit.

Hopefully you will find that non-Wikipedia source credible. If not, there are thousands more online.

 

[iamrefreshed]

You do know what a deductible is right; and a co-pay and co-insurance? Most good insurance plans have them. Insurance is not a carte blanche for a person to simply demand unnecessary services just because…indeed some low-wage earners with ‘bad insurance’ act like they’re uninsured and forgo doctor visits because even with insurance, they can’t afford to go.

I have to admit that some doctors do order unnecessary services, but that is not a judgment that can simply be made across the board without the benefit of medical training, because some types of knee pain DO merit an MRI to forestall complications and even disability down the road…

Belittling an alternate opinion is usually the sign of a weak argument.

Maybe you can school me on deductibles and co-pays because I’m just some dumb republican?! It’s not like I haven’t been paying them for 30 years!