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Medical Costs Bankrupt Patients; It's the Computer's Fault
nbauman writes "Don't get cancer until 2015. The Obama health reform is supposed to limit out-of-pocket costs to $12,700. But the Obama Administration has delayed its implementation until 2015. The insurance companies told them that their computers weren't able to add up all their customers' out-of-pocket costs to see whether they had reached the limit. For some common diseases, such as cancer or heart failure, treatment can cost over $100,000, and patients will be responsible for the balance. Tell me, Slashdot, how difficult would it be to rewrite an insurance billing system to aggregate a policyholder's out-of-pocket costs? 'A senior administration official, speaking on condition of anonymity to discuss internal deliberations, said: "We knew this was an important issue. We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person's out-of-pocket costs. They asked for more time to comply."'"
The rollout is being delayed until after the 2014 congressional elections. The problem is political, not technical.
quiquid id est, timeo puellas et oscula dantes.
We knew this was an important issue. We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person's out-of-pocket costs.
So what's on the other side of this "balanced" solution?
My current plan already does this and I'm certain it's a basic tenet of all medical insurance plans. After all, most people choose a plan by balancing the up front premium costs with the out of pocket costs on the backend. Der, someone is fibbing. X-/
Well damn, better go tell Microsoft to stop making Excel... *facedesk*
How the heck does this happen?
Who said you had to use a computer?
Place nail here >+
It's the age old problem of disparate computer systems and subsequent integration problem.
And I'm surprised that no one knows about MML - which is surprising since the insurance companies pretty much wrote the ACA.
So instead of just doing the paperwork on paper(or excel) theyre going to let the patients die if they cant cough up the cash, because the insurance company doesnt want(or cant) do 6th grade math.
Today your government is brought to you by PepsiCo and Corrections Corporations of America, Low on regulation and high on regulatory capture.
It's just another example of bought and paid for politicians sucking the dick of corporations. The famous words "of the people, by the people, for the people" are such a sick joke if you look at the USA government. Coming from a country that covers 100% of such common procedures, I just can't imagine how people can live like that. And Americans still think they have the most superior country in the world. America! Fuck Yeah! Please stop spreading your ideas of freedom to the world and try spreading those ideas at home instead.
Get ye head out of your ass and implement universal health care already.
Tell me, Slashdot, how difficult would it be to rewrite an insurance billing system to aggregate a policyholder's out-of-pocket costs?
That depends entirely on whether the insurance company wants to remain in business or not. Next question.
#fuckbeta #iamslashdot #dicemustdie
As long as the payers for service and consumers of it are different entities, this sort of nonsense will keep happening.
Does your scheme include room for the risk-pooling functions that people tend to like in situations with low-probability very-high-cost possibilities?
I'm not sure that there is a worse implementation of insurance than our present one; but a medical payment system without some provision for risk-pooling is DOA.
Huh, they sure seem to be able to add up stuff to tell me I haven't reached my deductible yet...
Which is what Obama has wanted since day one.
1) Pass a bunch of rules with an unreasonable compliance schedule that no insurance company on Earth could hope to meet
2) Blame insurance companies when the new "free healthcare for all" law fails miserably
3) Use it as an excuse to ram single-payer down everyones' throats
4) Government now has the power to decide who lives and dies, based on political ideology, which is what leftist despots like Obama want.
By what legal authority did Obama delay this implementation?
Do you have ESP?
So what is the opposition party alternative? Repeal.
That will limit the out of pocket costs when? Never.
Plus it will eliminate the various positive effects that the ACA is already having.
Basically the people that are screwing up here are the beneficiaries of the higher out of pocket costs, our Medical Insurance Overlords.
I'd make one very simple addition to all insurance building systems:
while(true) {
DontBeBastards();
RememberYoureDealingWithHumanBeings();
}
Easy answer on this one from someone who has worked in the insurance industry for a few years... the systems suck.
I am not defining 'suck' from the standpoint of performing because they do what they need to... however they become so bloated with complexities that even minor changes seem daunting. No person or team in my organization knows how the systems work from end-to-end and even the vendors need to use reverse engineering to resolve issues because of the complexities.
Not unusual for an insurance company to build a new system to support new plans because integration of the benefit rules into an existing system is not worth the pain. In the end the company ends up with several systems and IT silos built up around them.
The system at my current work will not be able to handle tracking co-payments over any period of time. The jobs that run overnight to price claims and track this sort of thing are already running at capacity.
On top of all this the executive management in this industry tend to be incredibly conservative and avoid risks like the plague.
As if these soul-sucking, perverse leeches on humanity (that health and sickness should be a source of capitalist profit is 100% my definition of perversity) don't have the ability to track every. single. penny. that passes through their disgusting hands. Another lovely chapter in the american long-con.
Businesses exist to maximise profits, all profits, even those derived from delaying compliance activities. It becomes a simple cost benefit case. Is it cheaper to pay some politician's wage and go moan about how hard it is for your one programmer to re-write the software within a timeframe, or is it cheaper to simply hire the right number of people to do the job properly and quickly.
The answer is nearly universally the former. Major companies (not just healthcare) will rather moan about how hard done they are by the government than actually step up to comply with the new regulations. If a large fine is linked with non-compliance they'd have the software modified by the end of the month.
I've seen similar cases in industry too. Companies will replace truly horrendous parts of their plant like-for-like because installing what they want is tied with meeting the new standards of the day rather than the easier standards of when the equipment was originally designed, and thus we have a plant basically half replaced as new with no gear that meets any modern emission standards.
There's simply no motivation to go down the more expensive route.
An old programmer once told me that insurance companies run on OpenEdge (aka Progress), and old versions at that.
Gigabytes of proprietary spaghetti code <<shudder>>
I'm not putting my hand up to fix that.
Step 2 is an immediate response, step 4 is handled in batch processing nightly. So far so good. Except that the Affordable Care Act makes it *illegal* to make a patient pay more than the annual limit. The authorizer and/or the pharmacy can be charged for forcing the patient to pay above the annual limit. This means that the authorizer must be aware of limit of each patient and be able to respond in real-time so that neither they nor the pharmacy will be sued. The insurance company doesn't have that information available real-time, nor do they make it available to the authorizer.
It is a computer issue, but as simple as everyone thinks. Putting individual insurance files on-line so that the out of pocket expenses can be tracked real-time isn't trivial. Now, maybe the Insurance companies were hoping the law wouldn't be implemented so they didn't do the hard work necessary to get set up, or maybe the rules were only written as to how to handle the annual limit must be handled.
Just remember, the last time companies put together a real-time on-line credit/debit system, the government decided that they charged too much to support the infrastructure, and started regulating it. That was the Durbin amendment to Dodd-Frank, which put a fixed limit on per swipe fees - regardless of what the infrastructure and support costs actually are.
jerry
"Software is the difference between hardware and reality"
Tell me, Slashdot, how difficult would it be to rewrite an insurance billing system to aggregate a policyholder's out-of-pocket costs?
It's somewhat more difficult when you waste three years assuming the Republicans are going to win big in 2012 and repeal the whole ACA. You gamble, you lose.
Snark aside, the real answer seems to be in the article:
The health law, signed more than three years ago by Mr. Obama, clearly established a single overall limit on out-of-pocket costs for each individual or family. But federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs. In many cases, the companies have separate computer systems that cannot communicate with one another.
So insurance companies outsourced different parts of their work to different companies that don't talk to each other. It's not "the computer's fault", it's an administrative problem within the insurance company itself. That text was right above the paragraph quoted in the summary, but curiously the submitter felt the need to ask a rhetorical question instead of including the most important piece of explanation in the entire article.
(Also, have you ever heard a story about a giant years-old financial/billing system that was clean, well-implemented, and easy to maintain and modify? I sure haven't. Not sure why we'd expect anything to be a trivial change in one of those...)
Visit the
The implementation has been illegally delayed. If you find yourself owing more than 12,700$ in one year for one incident, and the insurer claims you owe more, sue. The law states you do not. It doesn't matter what the administration says. They don't have the actual authority to delay this law, which states implementation dates.
If they really want health care to be more affordable they need to do one two things:
1) Force providers to charge consistent rates (i.e. no negotiating with insurance companies)
2) Force providers to provide cost information to the public so people can compare.
This can of course be started at the state level, because fuck congress.
The solution is simple. Make them responsible for all of those costs until their software can handle it. Watch how fast that update happens.
The USA health care system has some of the worst possible perverse economic disincentives. At literally no point is there a clear economic incentive for you to be healthy and taken care of.
1) Consumers have no interest in keeping costs down. They pay the same deductible no matter what happens. Unfortunately, this is only up to a point (see #4 below) but that's not going to enter casual consideration.
2) Hospitals have no interest in keeping costs down. They blatantly inflate their costs knowing that the insurance companies will only pay a fraction anyway. They also have no incentive to keep supplies costs down since they are paid "cost +" by insurance companies. They'll tend to buy whatever sponge or soap dispenser is in "the catalog".
3) Providers of supplies to hospitals have no interest in keeping their costs down. Hospitals get paid on a "cost +" basis by the insurance companies so charging $35 for that "medical grade" sponge that cost them $0.35 wholesale has 99% profit margins as its incentive.
4) Insurance companies have some incentive to keep costs down, which they generally do by axing their most expensive customers with any of the myriad of technicalities written into their eye-gouging 10 page contracts full of inverted double negatives and exceptions. A good example is somebody with a job who gets cancer. Sure, he/she may have excellent health insurance, but what about when he/she loses his/her job because they didn't show for four months while undergoing chemo therapy? Even so, the myriad of regulations in place (and a legal department that ensures that one plan can't be compared to another) provides an opaque enough service offering that customers are unable to distinguish which plan is actually "cheaper".
5) Doctors had to just about kill their mother to get through medical school, and are saddled with enough debt to make anybody contract stress-related symptoms. Since they get paid for the work they actually perform, they have every incentive to declare a medical emergency and take you under the knife, regardless of whether or not it's necessary or even beneficial. I'm not saying every doctor will give you heart surgery when you come in with a rash, but I'm not alleging something that doesn't happen. Citation 2.
The majority of bankruptcies in the United States are for medical reasons, and the majority of *those* are by people who had health insurance at the time they got sick. Anybody who says this ridiculous would-be-laughable-if-it-wasn't-true system is lying or misinformed.
I have no problem with your religion until you decide it's reason to deprive others of the truth.
Taxes are theft!
Collected by men with guns!
Which are then used to pay for two wolves and a sheep deciding what to have for dinner!
My insurance company (Aetna) already has an out-of-pocket limit on my policy. They're able to track what I've paid (at least as far as costs that're coverable under the insurance go) and determine when I've hit that limit. Every other insurance plan from every other company offered at every employer I've worked for has had the same sort of limit. The only ones that don't are the fake "insurance" policies you see offered on the low end that (if you read the fine print) aren't actually insurance, they're just a discount plan (and they don't actually pay the doctors, they pay you and you're 100% responsible for paying the bill). So if the insurance companies can keep track of out-of-pocket already, I fail to see why they'd have any difficulty doing so in the future.
"Tell me, Slashdot, how difficult would it be to rewrite an insurance billing system to aggregate a policyholder's out-of-pocket costs?"
you forget the part about needing to run on a PDP-11 and interface with an existing billing system written in the early 1970s
"They asked for more time to comply."
And this is why we should have gone to a Single Payer Health System a long time ago.
--
BMO
If your software are able to handle the law just do it manually.
(Those of you here who are too young to know about "Mister Rogers Neighborhood" need to move along.)
I can imagine Mister Rogers saying in response to the claim of the insurance companies. "This is bullshit. This is what it looks like. Can you say 'bullshit', children? Good. I knew you could."
It's really quite a simple choice: Life, Death, or Los Angeles.
Comment removed based on user account deletion
Competition not regulation? Let's do away with the middle men, the only way true competition could work if the consumer deal directly with the provider. No insurance company! The insurance company acts as an arbiter that artificially raises the prices to the consumer, their negotiated prices are usually much, much lower than what we as the consumer can get the services.
Why couldn't they use those other kind of computers?
You know, the ones they use to compute their profits..??
I also wonder why we have our heads shoved up our proverbial @ss's in the country. We seem to have the group think that if it's made in America then it's a POS idea. Switzerland had a system like ours before they went to basically the system we have because it was cheaper and allowed more people to run a business and work without fear of dealing with huge medical bills. The last time I checked they are the number one country to start and run a business in the world. Shouldn't we be able to look at other countries and leverage what they did to become successful?
What? Too simple for you? I guaran-fucking-tee you that if you put this mechanism in place, the insurance companies would suddenly discover that they can, in fact, figure out how much you've been billed over the time period in question. "Oooh! THAT billing info! We just need to look in this computer for THAT!"
I'm trying to teach myself to set people on fire with my mind... Is it hot in here?
Obama wants to delay the effect of his healthcare bill until after the election so that voters don't get angry and punish the democrats for it.
That is all it is... nothing more or less.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
Give me two days and I can write one in Python.
-AC
HR 676, Medicare for All would be simpler and cheaper.
What scheme?
You appear to have replied entirely on auto-pilot. Grandparent poster proposed no scheme.
They implied there exists some scheme where the payers were the consumers. There's a limited number of such schemes, and they are closely related, so I would think that it is a reasonable leap to assume a generic one from the limited pool to choose from.
You appear to be just stringing words together which sound medical. Risk pooling is about handling people whose insurance costs exceed their standard bracket rates.
Explain how you can pool risk and have the person paying for the service be the recipient. Risk pooling isn't about high costs, but having 100 people (of some arbitrary risk pool), share cost for 100 people. The idea being that any one person could get an unusual event that's high cost, and the other 99 would pay for it, and next time, it'll likely be someone else from the pool with the high cost event. That requires that the payer not be the recipient, and is not about insurance rates being high.
Learn to love Alaska
I used to work for a company that wrote applications that process medical billing. If someone figures out who it was, I don't have anything against them, but this is just how the industry is. I lost more brain cells than I can count (have since grown them back) trying to understand the medical billing process, and EDI made me want to kill babies. Trying to understand medical billing itself, along with all the conditions? Hell no. Having read some of the comments here, the situation is even more egregious than I thought possible.
Every other first-world nation has a single payer system. Why doesn't the US?
(It seems you can do that with a lot of things. "Every other first-world nation has X. Why doesn't the US?")
Why would this be a technical problem when my current medical plan has a maximum out of pocket limit?
In database design, it's a best practice for a schema to support zero, one, or unlimited amount of something. Perhaps the schema is architected to support only one limit, that of your current medical plan, not a second limit, that of the Affordable Care Act.
Insurance companies have some incentive to keep costs down,
Is that true? I know for a fact that State Farm Auto insurance in Texas, they make more profit the more claims they have (and the higher the cost of the claims). I do not know if the rules on health insurance are the same.
Since they get paid for the work they actually perform, they have every incentive to declare a medical emergency and take you under the knife, regardless of whether or not it's necessary or even beneficial. I'm not saying every doctor will give you heart surgery when you come in with a rash,
That, and the contrast to single apyer systems is that most single-payer systems require you to go through a GP for anything non-emergency. Tore and ACL? Talk to a GP, get a referral. Then get to an arthroscopic surgeon. In the US, I walked into a surgeon's office and demanded surgery. Insurance paid their bit, and I got treatment. Did I "need" it? Well, I limped in to a surgeon's office and asked him for surgery, what's he gonna say? That one was clear cut, and based on the operation video, nobody would have ever rejected it (a clean ACL break in an otherwise perfect knee, expected high success rate), but the point stands. People in the US demand the expensive treatment, and don't want any "solution" that keeps down cost. "Save her/him/me, no matter what the cost" is the standard mantra.
I moved out of the US for crap like that. Ended up in a universal health care country, and it served me well for my issues since. Cheaper and better care than I'd have gotten in the USA.
Learn to love Alaska
Sadly, everything you posted is true. Everybody who is a part of the health system, from patients to doctors to hospitals to insurance companies to suppliers are all guilty of creating an amazing modern healthcare system that nobody can afford.
My computer isn't set up to pay the bills. It isn't set up to pay the penalties for not paying the bills either. I was too busy programming an interface to my asset protection plan. It's beautiful. You should see it. Rounded corners and everything, and the interest on my overseas accounts is lined up in formatted columns and everything. It doesn't do medical billing outlays though. So sorry. I'm sure you'll understand.
For all intensive purposes, "whom" is no longer a word. That begs the question, "who cares"?
If you fixed the health care system and cut 50% each of the defense and intelligence budgets, our GDP would not longer be #1 in the world. We might be #2 or maybe even #3.
The way AC talked about 'risk pooling' (in a sense so utterly unlike the common use of the term) makes me wonder if 'risk pooling' is some byzantine term of art in the context of legislative haggling or something. I'd certainly never heard it used except as a description of what insurance is supposed to do (and, in the case of medicine, with its potential for unpredictable, enormous, and life-critical expenses, a more or less necessary function), so being flamed about it makes me wonder if it means something else in our specific legislative context.
Seriously. The human body needs maintenance, and we have the technology to give it that maintenance. Why do we need a middle man? When There's something we all need to live why wouldn't we just pool our resources. We do it for water and electricity and it works great. Hell, the few times we've 'privatized' basic utilities all we've accomplished is socializing the loses and privatizing the profits.
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Wouldn't that be a different plan?
For one thing, for existing insureds with an out-of-pocket limit higher than permissible under the Affordable Care Act, the insurance company would have to cancel the remainder of the old policy and enroll the insured in a new policy with the lower limit as of the effective date of the Affordable Care Act. Recording this cancellation and enrollment would take some coding. For another, what a policy defines as an out-of-pocket cost and what the Affordable Care Act defines as an out-of-pocket cost may differ. An insurer may have to count costs that are deemed out-of-pocket under the Affordable Care Act separately from costs that are deemed out-of-pocket under the current policy, and it may be complaining that it lacks infrastructure to separately count these costs.
I wish the administration would focus on the cost breakdown of medical procedures. I have read articles that basically seem to show hospital costs are pulled out of thin air and that the costs have no basis in care provided, or in any kind of reality. I mean $400 for an aspirin type stuff. Why does 1 night in a hospital cost $10,000? Hospitals are supposed to be non-profit after all. Why is a short ambulance ride $1000? It seems completely nonsensical to me. Until this is well understood, there is no hope. I basically assume the reason for these costs are either 1) They make up for people getting treated for free or 2) fraud. If the case is 1), I want to see this makeup cost as an explicit line item. It is also odd that surgeons get a small part of the total bill, and that hospitals are broke. Where does the money really go?
just do away with insurance companies and switch to single payer. We all need health care to live and stuff. What we don't need is a middle man that adds no value between us and our doctors.
Face it, health 'insurance' made since when the only thing a doctor could do was a) amputate and b) give out aspirin. It didn't matter that they only did a few big things that were mostly comfort before you died. Now we want to _use_ insurance. Insurance can't be profitable if we're all going to use it. The entire _point_ of insurance is that most of us aren't going to use it.
It's like hurricane insurance in Florida. Good luck buying it.
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would not be in the pocket of big money, the story would go in that manner:
What? Not ready by 01/01/2014 - it's going to cost you a million a day per case penalty and all the systems would be able to add up the numbers at deadline just fine.
This is laughable
An yes, the whole Obamascare show is political: http://www.dailykos.com/story/2013/08/11/1230529/-The-real-reason-for-the-GOP-s-all-out-war-on-Obamacare?detail=email
So it can't be that difficult (it's one of the Blue Cross Blue Shield companies).
They even have the statements automatically totaling my out of pocket history since I started my current job, (even though I've switched plans within the job) and my OOP from the job I had that I had a completely different plan with them like 10 years ago that I can access online. They're big on online.
I don't have any of them but there are some 'lifetime out of pocket' riders available, mostly dealing with Big Chronic things like MS and Cancer. You can even request the rider after diagnosis, and while they won't let you have it immediately, if you are under treatment for some period (2 years? 5 years? I don't know) the rider then takes effect and also counts the backdated OOP from when you applied.
I sure can't wait for the next George Bush administration to decided what medical procedures I'm allowed to get.
Paying taxes to buy civilization is like paying a hooker to buy love.
I wish they would give a detailed explanation of what they want to do; the reward for any person or group that actually does it; and the condition that their code is opensource.
Over and over you hear of these medical computer systems going into the billions (yes billions) and still not really working. Some parts of the system do involve some long drudge work such as entering the zillion codes for every ailment (mud in your eye) but I can't see the bulk of it being that terribly hard. As an open source project I could see groups of people just joining in for some altruistic fun.
But alas the large computer consultancies seem to have this locked up. They somehow convince the various governments to build systems that are so complicated that the documentation alone would fill tractor-trailers.
A great example of this would be the Canadian gun registry. It ran to around 2 billion dollars, never registered that many guns, and was an all around failure. My friends and I did some math and found that you could literally do the entire system in blocks of stone cheaper. That is you could carve all the records into blocks of stone and store them for access by people who would walk up and down the aisles with cell phones when someone called in a data request; and do this all much cheaper than 2 billion dollars.
But back to the opensource crowd sourced project. Why not give it a try? Worst case scenario it is a failure plus that failure wouldn't cost an arm and leg.
This is another example of how private health care doesn't work! Coming from Canada and having a few rare / serious medical conditions I just can't understand how anyone can support private healthcare.
I'd heard of "insurance" called "risk pooling" many times. That's the purpose of insurance. If we banned for-profit insurance, we'd have the "value" of insurance being exactly equal to its cost, with the benefit being risk pooling. Instead, all insurance is a poor financial decision, because you will statistically make more by not having it. But people buy it anyway because we are more risk averse than we are gain oriented.
Learn to love Alaska
What do you mean switch? We already have Medicare/Medicaid, and 1/3 of the uninsured go into those programs under Obamacare.
W..w..W - Willy Waterloo washes Warren Wiggins who is washing Waldo Woo.
Healthcare billing is seriously F####d
For example, we had the bureaucrats put in place the NPI or National Provider Identification number. Great. Now for every tax id number I have, I will have one provider number instead of 40, 50, 500, etc.
Except, the bureaucrats don't know that the Medicare/Medicaid/etc systems are still run with 50 year old COBOL code and they can't do that.
So, we are forced to "sub-part". Now for every legacy provider number we had, we now have a brand new NPI number.
The healthcare software billing systems in GOVT are seriously fubar'd.
NC has new medicaid system that "I S##T you knot" is written partially in cobol.
CSC NCTRACKS if you want to google.
Seriously - it may be a software problem that enables them to fix (temporarily) a political problem.
A good example is somebody with a job who gets cancer. Sure, he/she may have excellent health insurance, but what about when he/she loses his/her job because they didn't show for four months while undergoing chemo therapy?"
Three answers: short term disability, long term disability, and COBRA (which allows you to continue your health insurance even if you lose your job). Yeah, COBRA is a bit expensive, but it's a heck of a lot less expensive than paying for cancer treatments yourself.
"... to fleece everyone before you partially close the gravy taps!"
Don't just stand there, get that other dog!
The insurance companies do this already and already have out of pocket maximum calculated each year for many policies. It's clearly an empty excuse. They've known the law was coming for years. Obama knows this too. He just rolled over and did their bidding.
they don't get to decide. Doctors do. It's single PAYER, not single INSURER. It doesn't work the way you're thinking in Europe, Canada, Germany or any of the other single payer systems where people are entitled (whoops used a bad word) to health care. The only purpose of the gov't is to pay doctors. And they can be well paid and still provide great service.
:).
But far be it from me to let a little thing like facts and the failures of the US healthcare system get in thy way of irrational fear mongering perpetuated by a multi-billion dollar insurance industry. Viva la death panels (well, the private ones anyway)
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One way to reduce the cost of Cancer may be to support
alternatives to "Cut, Burn & Poison" = another docu-
mentary, eg:
1. Burzynski's Antineoplaston treatments, which seem
to be capable of resolving brain cancer in children, etc.
Documentary: "Burzynski - Cancer is Serious Business"
reports some successful cases, showing before & after
-scans- for tumors / tumor growth / resolution, from
well-known, large medical centers & traditional cancer
treatment facilities. (Patents for his antineoplastons are
cited with patent numbers.)
An adviser to Pres Obama is cited as one who has
said that a reason Burzynski's treatments aren't
recognized or getting any public funding is: They
could cause collapse of -exsiting- Cancer research &
treatment enterprises, including pharmaceutical co's.
(Parts 1 & 2 are out, with Part 3 on the way.
See: www.BurzynskiMovie.com for details.)
[Movie may also be found & viewed on YouTube.com]
Controversy: FDA has repeatedly investigated the
inventor / doctor (Burzynski) with at least four (4)
Grand Juries -declining- to find reason for charge.
(US FDA appears to be "the bad guy" in this story.)
Burzynski might do well to consider CrowdSourcing
the $$$'s needed to complete remaining clinical trials
of his treatments - past & future.
2. TED.com as at least one short talk on using Electric
Fields to stop cancer tumor growth.
Add your fav alternative cancer treatment in replies
- IFF the source(s) you cite -include- scans showing
before & after scans, etc.
Obamacare is really an attempt to create the sort of socialism that Americans can stomach. I got a good buddy with some serious health problems who relies on gov't health care (got several actually, because if you have a health problem it isn't long until you die or need help from the gov't unless you're an Heir/heiress).
Anyway, I started asking him what he was gonna do. How would he use private insurance. Wouldn't they insurer just keep raising his rates. He said that would be wrong, and so somebody should do something 'bout that. I asked who, and how and he said there should be a law that the insurance companies could only charge so much.
Basically he, like most Americans, deep down want single payer health care. But we're been taught from cradle to grave that socialism is bad. We're indoctrinated. It's called cognitive dissonance. He knows he needs socialism to live. He knows he needs help, and he knows it's his right (as a human) to live. Not just to have some blind dumb chance at good luck, but to actually have a life. But he's been taught, over and over, lied to and lied to. So he breaks down.
Obama recognized that there's lots of people like that. So he's giving them what they need (socialized health care) but doing it in the only way he can. He's letting the devil have it's due, and he's going to give billions and billions to parasitic insurance companies who's only purpose is to make us feel better about getting something that's a basic human right.
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lots of states will not opt those people in. Lots more will use lies and subterfuge to keep people off the roles. Arizona does everything it can to disqualify people. I've got friends with kids on the local medicaid program that have to report birthday money from granddad as 'income'...
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It is just Medicare, but it would cover everyone. HR 676 would save taxpayers $350 billion a year.
Don't blame patients. In the real world, as confirmed by A/B studies, people don't use healthcare like a typical product, they use healthcare because they need it, and the price isn't relevant. In reality, the cost of healthcare being lower doesn't increase the consumption of healthcare. In fact, it's worse than that - it's the reverse. It turns out that high co-payments cause people to avoid preventative and early care, which "saves money" but it really means that problems grow into major, and much more expensive care which costs far more. The extreme case is people with no insurance, who put everything off until they end up in the ER, costing an order of magnitude more than a regular doctor.
In economic terms, the best way to lower the cost of healthcare is to eliminate the co-payments, so people go to the doctor more often, and are in better health which has lower total cost. As a rather nice side-effect, people are also healthier and live longer, which I hope nobody's opposed to.
The only argument for pushing the cost of healthcare onto patients is that it makes the insurance company's profit margins higher. Since they're making record profits, while delivering low-quality services extremely inefficiently, I wouldn't mind seeing their profits drop.
Enable 3D printed prosthetics!
out_of_pocket = client.payments.current_year.inject(0){|sum, payment| sum += payment}
They pay less where there is any kind of error so it will hurt them to fix it fast.
I don't even need to see a business card to tell you who this is and what they're doing. It's not even an insurance company. It's a borderline investment company. They group people into groups, usually 50, and if someone has a significant claim that exceeds the premiums of the entire group added together, every single claim from anyone else in it is automatically denied regardless of ANY circumstances. Then you have to threaten to sue and get a 3rd party auditor up their ass to get them to cover it. The same thing happened to me. They were on the hook for $8 after my copay from a one time injury and they claimed it was a per-existing condition. Yes, loading out a band at a concert on stage crew and hurting my back was a per-existing condition. Mmhmm. This is why everyone should stick to larger, more reputable companies. I'm dropping those assholes at the end of this month.
You do realize that you're using the Internet, don't you?
Enable 3D printed prosthetics!
As a Canadian I have yet to see the very interference of the government into my health. I have never had any government official stop me getting an x-ray, stomp on my doctor when he ordered an ECG, or any of the other numerous tests and prescriptions he has ordered for me.
It's true that there are flaws, but when my wife was diagnoses with a life threatening cancer, no time wastes in diagnostics and in the two surgeries that followed. Better still, I was unemployed by the second surgery and we didn't have to bankrupt ourselves to save her life.
The world's burning. Moped Jesus spotted on I50. Details at 11.
Because I know the insurance industry upgraded systems every few years. So as a result they're constantly making changes to software.
Brings to mind a prosecution against a doctor I was involved with a decade ago. The Billing company TRIED to assert that they didn't keep more than three months of data online. But we got the data we wanted. Years later their I.T. guy who came with them to the meeting, he and I are working in the same I.T. unit. He said I was right - they had YEARS of data online. They just didn't want to seem complicit in knowing the doctor was upcoding his medicare patient visits. Oops.
As the insurance company is the ultimate person who pays, they do have an incentive to keep costs down, as it fattens their profit margins.
I know for a fact that is 100% false for car insurance in Texas. I've not seen anything that states that to be true for any other insurance. Profits are higher when costs are higher, for regulated auto insurance in Texas.
Learn to love Alaska
Tell me, Slashdot, how difficult would it be to rewrite an insurance billing system to aggregate a policyholder's out-of-pocket costs?
Tell me, Slashdot, how much would insurance companies have to charge all their even remotely healthy people to cover the hundreds of thousands of dollars thrown away in a futile attempt to save every life using every possible means regardless of cost?
Do you really want to know why the delay was put in place? Basic mathematics. The insurance companies have actuarial tables which tell them down to 1-3% mark just how much it'll cost them to cover all their millions of customers. The new legislation skewed the numbers by forcing insurance companies to add tons and tons of very sick people who'll never pay into the pool what the pool will pay out on their behalf. As such, they have to adjust their rates to match, but that big a change wasn't politically feasible; the backlash would have sunk the politicians and the insurance companies. So the extra time was built in to ensure a feasible boiling frog effect.
Boil, froggy. Boil and believe the lie that at least we've all got our own pot of water now.
-- "Government is the great fiction through which everybody endeavors to live at the expense of everybody else."
And what if the consumer has no money or assets to negotiate with?
The world's burning. Moped Jesus spotted on I50. Details at 11.
Yeah, ever so much better to let a vastly overpaid CEO make that decision.
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On the contrary, health insurance only "made sense" because during World War 2 businesses were prohibited from increasing wages to attract workers (because it would increase costs of material for the war effort), so they started offering employer-sponsored health insurance instead. Once the war ended, the idea stopped making sense again (but stuck around anyway).
"[Regarding the 'cloud,'] ownership was what made America different than Russia." -- Woz
If I screw up, such as being late with a payment, I get charged a fee. The insurance executives had almost four years to solve the problem, but have no incentive to fix it. They get more money with the status quo. Meanwhile, people go without medical care or go bankrupt from medical costs. It is time to penalize the executives, so limit their pay to a maximum of $400,000 until they solve the problem. Also, for any family that has to pay more than $12,700, each company involved should pay $500 fee for each incident, and three times the amount over $12,700. I bet they solve the problem really fast.
Actually, we (the United States) should just get rid of the insurance companies and implement a single-payer system. Everybody would be covered. Nobody would die for lack of health care. Patients would have more freedom and could choose any doctor they want. Copayments and deductibles could be eliminated, and there would be no medical bankruptcies. The country would save $592 billion in 2014 if we went to a single-payer system.
Have you ever been out of the United States?
No it's because the results of an unlikely occurrence are still far more catastrophic then the gain any single individual can obtain by not holding insurance.
The main thing for-profit insurance does is increase costs for consumers. It was pretty quickly recognized early on that the best possible insurance scheme for a country is single-payer, where everyone is part of the same risk pool since that's the greatest possible dilution of risk (it also means the government is strongly incentivised to keep its citizens healthy - companies dumping toxic waste into the local environment is no longer "not my problem").
Instead, all insurance is a poor financial decision, because you will statistically make more by not having it. But people buy it anyway because we are more risk averse than we are gain oriented.
It's not being "more risk averse" if the potential downside is so great... $10k for a broken leg, if you aren't prepared to pay it can often bankrupt folks. That insurance companies find ways to dump you in certain circumstances doesn't discount the insane hospital/medical supply pricing that makes *not having insurance* a budget breaker.
Make sure everyone's vote counts: Verified Voting
I have no reason to suspect that patients are particularly good at choosing the best option to suit their problem; but I've always found the 'But I learned about demand curves in EC101, and demand always increases when price decreases!' school rather delusional. Outside of Münchausen's cases (who do need treatment, just not the kind they seek), who goes to the doctor, much less undergoes any serious procedures, for fun? When everything is working properly, you go because the cure is less ghastly than the disease; but that's a pretty low standard for recreation...
But at least they wouldn't have anyone with whom to collude.
Which is worse: a monopoly, or multiple vendors constantly trying to make sure there service is the most expensive, because it's not like we can actually shop around here.
This signature is false.
It's not being "more risk averse" if the potential downside is so great...
Your inability to define "risk" doesn't make it not risk.
Learn to love Alaska
Insurance can be quite profitable even if the ensured want to use it. But the problem isn't that people want to use it - it's that everyone wants it to endlessly pay out dollars while paying in only pennies. And that's the insidious part of Obamacare... the notion that dollars can be printed from pennies is now enshrined in law. (Without actually fixing any of the real problems in our healthcare system.)
Within a decade of Obamacare taking full effect, you're going to see a wave of bankruptcies ripple through the insurance industry. The knock-on effects will make 2008 look like a child's tea party.
The expected value of insurance is less than the money it costs. That makes it a bad financial investment. The only reason people buy insurance is that people are risk averse. We'd rather have a guaranteed small loss than an small probability of a larger loss.
For-profit insurance is worse in that it drives demand against economic rules, and does so for a smaller gain.
Learn to love Alaska
Could someone define "out of pocket expenses" for non-US readers. For me out of pocket expenses is buying a coffee in the Costa at the hospital reception, plus the pay and display parking ticket for the hospital car park. From the article it makes it sound like "out of pocket expenses" is the full treatment cost!
Insurance is by definition risk-pooling.
You forgot to include "government" in your list there.
Obamacare is a compromise forced by unions and large corporations that want to maintain their tax deductible "cushy" medical plans whilst the rest of the populous get forced into a command-economy style health care industry.
If Obamacare was actually single payer, or socialist, the cushy medical plans couldn't really exist (because the infrastructure that would have supported them meaning the insurance companies and the pay-for-service medical providers would have evaporated) and there would have been no support for it. Regardless if the that is what Obama wanted, his support base wanted to be able to keep their plans, so this is what came out of the backroom deal.
If you want some evidence of this, I suggest you start with the sad fact that congress needed to hastily pass a law to allow their staffers to get a federal subsidy to help pay for getting their insurance through Obamacare since they feared "brain-drain" of people fleeing public service to get better health coverage from the private sector. No, the people in charge of Obamacare don't want the same coverage for everyone, they just want to change the way healthcare is funded for the masses, not the elite.
Tiered coverage often doesn't work with single payer very well, because of economies of scale limit the availability of competition for supplemental insurance resulting in a very have and have-not price points. As an example of this, you can start by looking into the fact that in the US medicare supplemental insurance needs to be subsidized by the government to keep providers in the market. If that seems like an inherently unfair use of government resources to give health benefits to some people over other people, well, you are probably looking at a preview of Obamacare in a few years if they want to keep private insurers in the market as costs rise, but premiums are capped due to political pressure.
On the other hand, if you are a cynic, you probably think that this design was an intentional long-term policy to drive out all insurers so that the system has to convert to single payer. If you want to see some evidence of this, look at what Obamacare is doing to Medicare Advantage programs (alternate Medicare-like insurance provided by private insurers).
As a Canadian living in the US, I HAVE seen the interference of health insurance companies into my family's health. My wife has a chronic migraine issue and insurance refused to allow an EKG prescribed by a neurologist to help in a proper diagnosis.
They also regularly either restrict the quantities or refuse to allow certain expensive prescription drugs to relieve the symptoms.
Computer says 'No'.
- Mad, ingenous - they've both left you puzzled -
Well, depends on how good your COBOL skills are.
My wife was in a very serious motorcycle accident on June 14th of this year. It took 30 min for ambulance to get to her to transport her to a local hospital where she never even left the parking lot but was loaded onto a helicopter and flown to a level 1 trauma center. I've avoided the avalanche of bills that have come in until she as finally home this past weekend, but out of all of them the bill for the helicopter ride was the most outrageous. The MINIMUM fee for life flight to take off from the pad is TEN THOUSAND DOLLARS. I sat in my wifes' hospital room for almost 3 weeks overlooking the helipad and it was as busy as a municipal airport. The cost per mile was 75 dollars btw. Our bill was $13,000. As grateful as I was for it's existence in no way is it possible that the cost to keep this service running 10,000/flight, especially not when there had to be a dozen flights a day on average. I am aware that the flight crew are specialists, not only pilots but nurses, but even if they were flying the surgeons to the accident it couldn't possibly cost this much. I am thinking very seriously about pressing the issue in some way to try and limit this egregious and larcenous practice. I read recently where some municipalities were going to try and force all ambulance rides to be my helicopter. I can't imagine why....
If I sound stupid, it's not me talking....
The computer says No.
So when the insurance company can cancel their cover over a technicality... and you have cancer. What provider do you switch to? Yea, free market at work, you showed that insurance company who's boss. Your talking your illness elsewhere.
If information wants to be free, why does my internet connection cost so much?
As a developer in the health care industry (pharmacy point of sale), I can tell you that it is fraught with many non-technical issues. When do you make these changes? With health care being a political football, you don't want to get started early because Uncle Sam may change his mind. How do you deal with privacy? In this case every payer would need access to a patients total related out of pocket expenditures. In today's world everybody is scared to death assuming more responsibility for personal health information than is absolutely necessary and sharing what you have gathered with everybody else who needs it is scary too. HIPPA HiTech and security certifications potentially with independent audits are expensive and time consuming. What exactly are the changes that need to be implemented? As a developer, do you really want your requirements document to be the total text of the Affordable Health Care Act? These systems are large, complex, and in many cases old. You cannot just edit a few lines of code and slam it into production. Changeing anything at all is a big deal. Unfortunately its a shitty situation and the problems are deceptively hard to solve. Tweaking this existing monstrosity of a system is a bitch. From a technical perspective, starting from scratch would make more sense.
Greed is the root of all evil.
Sick people don't make health insurance companies money. Healthy people do.
If information wants to be free, why does my internet connection cost so much?
"out of pocket" is calculated BY the insurance company however they want based on any point in time they chose. If they decide that a CATscan should cost $1000 based on the tables they use from 1987 then that's what the 'out of pocket' is calculated as. $12,700 is based on what THEY feel the costs SHOULD be not what they are. So if your CATscan costs $5700 and they reimburse 80% that out of what's left, a $1000 goes towards your out of pocket.
Somebody would have to type a SELECT.. WHERE line, you can't expect that.
back in 1995 I was working for a larGe TElco when my director called me into her office and instructed me to go down to Hartsfield (ATL airport) & pay the walk-up fare to get on the next flight to Raleigh b/c they couldn't process commissions & the SE sales reps were revolting ("you ain't kiddin' - they stink on ice" - sorry, couldn't resist). I immediately knew what problem was (well, 99+%) but felt conflicted so called (then) girlfriend (now wife) and said: "${DIRECTOR} just told me to get on next flight to Raleigh to fix commission processing but I'm 90% sure someone just didn't check ASCII->EBCIDIC when they uploaded the file" (which was prepared in 1-2-3) "I could probably walk them through it over phone in 5 min but it's effectively a free vacation day & I can probably get upgraded" (since I was medallion at time). she told me I should do the right thing & unfortunately I was born with the ethics gene (I probably be worth a lot more w/o it) & just called the desktop support guy in Raleigh who confirmed/fixed in 30 sec.
I just always thought that was funny - they were dead seriously telling me to pay probably $1K & waste a whole day to check an "x" in a dialog (& sadly I was too honest to take them up on it).
Hey, quit injecting your facts and experience into their wild speculation.
It's one of the reasons our healthcare costs are out of control in the first place.
In SOVIET RUSSIA... erm...NSA AMERICA, the Internet logs onto YOU!
Any halfway intelligent person can solve this problem in any number of ways, but we have powerful people that have a vested interest in the current system. These people, making a killing off the current US healthcare system, either are denying that the US healthcare system will collapse or they are frantically trying to make a much "big money" they can before the collapse.
Solutions exist but they are useless without the will to implement one of them.
My insurance has a max out-of-pocket and they do keep track of it. I see it on stuff they mail and I see it when I log in to their awful site. I don't get it.
simple, fast homepage with your links: http://www.ngumbi.com/
While in Jakarta, I took my daughter to the 24-hour emergency room after she had injured her arm and was unable to move it on her own. Two hours later, I was relieved to find out it was only a pulled muscle.
Next came the bill.. and I could hardly contain my laughter as I looked it over:
Proris (painkiller) - 5,706 IDR
Outpatient Doctor Consultation - 150,000 IDR
Radiology Services (7 x-rays) - 220,000 IDR
Total cost: $36.48 USD!
When there is only one payer, they control absolutely what things they will choose to pay for.
And you honestly don't think this happens today? Seriously?
Make no mistake: There are death panels in existence right now, this very moment. They work for the private insurance companies, doing their damned best to figure out how to kick people off of insurance rolls and rescind coverage for whatever reason will legally scrape by. Or even illegally, if they think that it would be cheaper to fight the battle until you die than to pay out your claim. The big difference is that today, you frequently don't find out what's not covered until after you're sick and need the coverage.
You don't trust government, I get it, I really do. And to some extent, neither do I. But you know what I trust even less than government? For-profit companies with a perverse incentive to deny you coverage you're paying for using whatever underhanded tactic they can and an historical willingness to do so, especially when the people being denied coverage don't have time or the money for a protracted legal battle and are at a physical or mental disadvantage that directly impacts their ability to fight such battles.
So yeah, I'd take a single-payer system over the crappy system we have today any time. Ultimately, that is the solution to our health care system, not private insurance, not employer-paid insurance, not even Obamacare, although it's a hell of a lot better than what we had. Maybe one of these days if you have the gut-wrenching experience of watching your mother fighting her insurance company for payment of cancer treatments while suffering from the "downtime" effects of chemotherapy, you'll prefer the general incompetence of government over the outright malice of for-profit insurance companies. Personally, I'm nice enough to rather you use common sense to arrive at the conclusion that having for-profit insurance companies responsible for funding your health care is and always has been a dumb idea.
On the other hand (here in the UK) my Dad was rushed to hospital when he had a blood clot in his lung and received first class treatment. My wife was admitted straight away for a gall bladder infection (after a visit to the GP), and our baby was born in a brand new birth centre with fantastic facilities and great midwives.
Generally speaking, the NHS is fantastic when anything life-threatening happens, but after care can be crap (for example, my Dad having to queue up to get his medication outside the clinic every week, even in snowy weather).
How's about until they upgrade their computer system, they just stop charging for out-of-pocket expenses altogether. Problem solved - entirely compliant.
More seriously, they could have (1) enforced the out-of-pocket limit per policy (so no policy individually charges more than the limit), and (2) let anyone whose totals are over the limit apply for a refund by submitting the bills from any other policies manually.
So instead, apparently while the limit for major medical expenses will be in place, there's (1) no limits on out-of-pocket expenses for prescription drug plans, and (2) no mechanism for refunding costs over the limits. ;-(
Am I the only one worried by the fact that there are going to be so many out of pocket costs that the software can't handle it? Am I gonna have to pay $400 for an asprin?
While our military spending is rather excessive I get the impression that Europe rather enjoys our spending on our military as it means they get to spend less on their militaries and enjoy the influx of US dollars into their countries. As a side bonus they get to divert those funds they would have to spend on their own defense elsewhere and can point out how much less they spend on defense than the US. Personally I would love to see us bring all of our troops home starting with Europe, the middle east, and South America as those are the easiest to unwind. There are a few instance that will take a bit more to unwind like active ares (Afghanistan, South Korea, Africa) but I would love to see us out of every country that isn't the US or its territories within the next 4 years. The only other issue I see is with keeping shipping lanes open and free of piracy which the US Navy puts a lot of effort into doing which seems to be a valid function but other countries should be stepping up to the plate more with this as well.
Time to offend someone
Yes, I'm sure. But you have to have a good insurance plan.
I'm sorry, health care ain't perfect up here, but when I see what saw of my acquaintances south of the border have to put up with, I wouldn't wish the US "system" on my worst enemy.
The world's burning. Moped Jesus spotted on I50. Details at 11.
Writing the computer code is relatively simple. The hard part is getting all the graft and kickbakcs sorted out. Getting all those back room negotiations sorted out takes time. When all that is done, the public will be screwed properly.
Generally speaking, the NHS is fantastic when anything life-threatening happens, but after care can be crap
That's pretty much the situation in the private healthcare market in the USA as well. Doctors are good at immediate needs, but not so good at managing longer-term health issues. They typically just put you on medications for anything long term.
Software sucks. Open Source sucks less.
The problem with the phrase "of the people, by the people, for the people" is that at least the way SCOTUS sees it corporations are persons. The actual people of the US (The liittle folk NOT corporatios) will have to kick those politions that believe this crap out of office! When that happens, maybe such crap will not happen.
(Don't hold your breath.)
RIGHT NOW, every medical insurance company knows if you've gone over your out-of-pocket limit. Proof: for those of you with a) medical coverage and b) any deductable at all.
There is zero excuse for this, other than their political power used to keep profits up.
mark
Citation needed.
If this were really true, why stop at insurance industry? Why not leverage the awesome economy of scale by getting rid of the petty competition between Coca-Cola and Pepsi? Ford and GM? This was, actually, attempted already — to miserable results.
It only works, if the people in charge of that monopoly you wish created are not only benevolent, but also omniscient and all knowing... Given that there are no such people in existence (present company excluded, of course), the second best choice is competition...
You are right in that size does matter for insurance companies. But only to a point. A company with 200 mln customers is not appreciably more efficient, than one with 100 mln. Having such companies compete with each other is much better for all the 300 mln, than to force them all into a single 300 mln-customer monopoly — governed charlie rangels and nansy pelosies to boot.
In Soviet Washington the swamp drains you.
My wife is Canadian and believes strongly in both government intervention and government/single payer/universal health care.
But the more she is exposed to American politics and American politicians, the more she is willing to agree that it might not be a good idea to let them be the ones in charge of an American single payer system.
If I felt I could trust my national government in any way shape or form to pursue my best interests, I might feel differently. Right now I believe it probable that, should the US deploy a national health system, lobbyists in DC will have more say in my healthcare than my doctor or my family.
I agree with your sentiment. I am just saying that the insurance companies have made everything worse, pushed prices outrageously. I am not hearing the good arguments from people breaking it down to black and white.
Do you allow people to suffer and die if they can't pay?
Right now we have socialized medicine by default, if your sick, in theory the hospitals have to treat you, but then the costs get dumped on everyone else. If your poor and can't pay, you just get the bill and throw it in the trash, can't pay it.
That may well be true, and the only way to fight the problem is by increasing competition — among insurers, doctors, medical schools, and hospitals. But the noisiest proponents of "change" are dead-set on the exact opposite course. Not only aren't foreign insurers allowed to sell policies to Americans, for example, even American companies aren't allowed to compete across state lines.
Removing the tax-incentive for employers to pay for the employees' "health-plans" is another much-needed step — it would make insurance companies sell directly to consumers of care, rather than to their employers. McCain was proposing just that in 2008, but was ridiculed and mocked for his efforts. And thus the peculiar tie-in between employment and health-insurance remains.
It is as if making things worse is useful for somebody... Given the drive towards "single-payer" — which would give our humble rulers even more control over our lives (to an extent, NSA can't even dream about) — I think, I know, who wants to make things so bad, the disastrous "single-payer" monopoly will begin to look appealing to the sufficiently large number of voters...
In Soviet Washington the swamp drains you.
Yes, of course. If the users of the health-insurance were the same entities, that pay for it, one of the layer between the consumers of health-care and payers for it would've been eliminated... It is a peculiarly US phenomenon, that our health insurance is tied to our employers — because the government gives them tax-breaks for buying the plans for us. McCain proposed abolishing these tax-breaks, which would've made insurance companies create and market plans to individuals and families, but he was mocked by the "Change" crowd, which continues to stall any attempts to introduce competition into the health-insurance market.
In Soviet Washington the swamp drains you.
I sure can't wait for the next George Bush administration to decided what medical procedures I'm allowed to get.
Why do people always say this? Is it any better that some for-profit corporation decides what medical procedures you're "allowed to get"?
That's how it is now, and nobody likes it!
At least if the government is making the decisions, you know who to blame and have a right to at least some tiny chance of doing something about it. Like maybe electing a Congressman who isn't a complete idiot. When it's Big Private Insurer calling the shots, you're completely SOL.
(one other thing, it's never "what medical procedures I'm allowed to get"... that's FUD. It's what medical procedures will get paid for by someone other than you.)
Take it easy, Charlie, I've got an Angle...
it should be done by now. Slashdotters have probably posted it somewhere. Can't scroll through the comments to find it tho. (Too lazy!)
Sadly, a Libertarian cannot force his views on another, and freedom cannot spread as does the cancer known as religion.
You can be angry at them, but the anger is (largely) misplaced. For example, auto-insurance has not pushed the prices of auto-repairs through the roof — because plenty of people still pay for repairs out of pocket.
The problem with the health-insurance situation was created — and is maintained — by the government's tax-incentives given to employers to buy insurance for the employees. This eliminates (or severely impedes) the consumer's choice of health plans — or to whether even carry a health insurance vs. just paying the doctors as most Americans used to until only a few decades ago.
Very few health-plans today are created for an marketed directly to consumers — the actual users of them. This distorts the competition as the people demand "the best" while being insulated from the costs of it. And the competition is further compounded, by the government's efforts to prohibit sales of insurance plans across state-lines...
In Soviet Washington the swamp drains you.
That is absolutely false. In Canada there are medical expenses the individual still pays for. It is just the majority of the costs are covered. Drugs, optometry, dentistry, othodontics are not covered except for certain cases, most people still have medical insurance to cover those costs. The point is that when I am dieing in a car accident. The question of how much it costs to save my life should not come up. And people complain about wait times, but the onlytime I have heeard of people being refused immidiate treatment while they are dieing is in the States.
The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family.
It makes no sense to set the same limit for everyone. To Bill Gates, $12,700 is nothing, and to others, it's completely unaffordable. Also, not everyone has the same tolerance for risk.
When it comes to other types of insurance, we are still free to choose how large our deductible is. How long until that freedom is also taken away from us?
That that is is that that that that is not is not.
The sponge margin is actually 10000%. I know it doesn't matter, but it bugs me when people confuse how to calculate percentages. The military has a lot of these issues too and its on a single payer system. I thought it was an interesting realization. And with number 5 knife jockeys are always knife jockeys. Its like that everywhere.
Look, computers are great as entertainment devices, and with some contortions they can even perform some light mathematical calculations. But they were never designed to add up numbers in the HUNDREDS OF THOUSANDS. It's unreasonable to expect to solve a task of this complexity using computers. The only hope seems to be some unknown future technology, and that's unlikely to happen be 2014.
If someone claims an out-of-pocket expense, you have to evaluate that it's not fradulent, while respecting al lthe privacy laws, and regulations, and working across dozens of systems which is actually pretty hard. If you could take people's word for it and just reimburse for whatever they claimed then it's pretty easy, but I'm pretty sure nobody could stay in business doing that.
I haven't been able to find this mentioned here, but these systems are already in place. There are insurance companies that offer high deductible plans, often linked with HSA accounts. These plans are supposed to be cheaper because you kick in more of the cost of health care and its supposed to make you "price shop" for services. These plans send monthly statements that not only list how much you have spent out of pocket to date, but itemize that list. So you can see what was spent, where and when how much of a "discount" you got from the MSRP. This whole "Our computers can't handle this type of detail" baloney is just because they want to delay spending the money to upgrade their systems, the software and tech are already available. Everyone would do well if they kept in mind that there are only two types of statements that come out of insurance companies: Lies and Damn Lies.
you don't have to chip in _anything_. The insurance companies profits would pay for your healthcare. You buy wholesale if you can, right? Then why do you have an insurance company between you and life saving medicine?
Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/
COBOL? MUMPS? CADOL?
I used to be
Really? So there's opportunity for patients to demand higher care than the system can support?
"I went on WebMD and think I might have PROBLEM X, I demand a CAT scan!"
And if healthcare is free, nobody ever has to pay the price for the obesity?
With no economic incentive to keep their individual costs down, Americans have proven they will overuse any system provided to them.
It's unproven treatments that don't get covered. There are lots of Cancer treatments like that. It might extend your life, it might not (and have bad side effects).
/. :).
The super rich will still get the best of the best. You're not going to change that. What single payer does is make sure you get good basic care and usually a bit more.
If you think you'll do better on you're own you're being silly. If you were one of the super rich you'd have better things to do than post on
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Hmm, somebody with a proven track record or someone that is just good at convincing others to vote for him...
Paying taxes to buy civilization is like paying a hooker to buy love.
Someone who can be gone in under 4 years or someone you have no influence over at all and could be there for ife.
They've had four years to get ready for this. As for integrating different systems, bitch please. Massive enterprises constantly make use of middleman software to pass requests from Database A to Database C and back again, every second of every day.
This is about profit, not capability.
Usually you see this excuse with lawsuits, or raising the minimum wage, but it's all the same crap.
All companies maximize revenue all the time.
If company can make more money by raising prices or firing workers, they'll go right ahead and do so.
As a Canadian I have yet to see the very interference of the government into my health.
Ok, so you don't see the interference. I'm not sure why that is relevant.
I have never had any government official stop me getting an x-ray, stomp on my doctor when he ordered an ECG, or any of the other numerous tests and prescriptions he has ordered for me.
And what of the stuff that your doctor might have ordered for you, but didn't? Opportunity cost is invisible.
Then that's a problem I have with my doctor. I have yet to see any test he ordered be turned down. This is a bizarre bit of logic you're applying here.
The world's burning. Moped Jesus spotted on I50. Details at 11.
Citation needed.
Well no, I explained why - it dilutes the risk pool. But take a glance over the history of insurance article on wikipedia and notice that the trend at every conceivable juncture was to expand the risk pool (but to try and drop bad risks). Architects of social welfare schemes obviously realized that when you are still responsible for a bad risk, the best answer is to include everyone.
If this were really true, why stop at insurance industry? Why not leverage the awesome economy of scale by getting rid of the petty competition between Coca-Cola and Pepsi? Ford and GM? This was, actually, attempted already — to miserable results.
The numbers speak for themselves: the overhead of Medicare is about 6%. The overhead of a private health insurance company is closer to 20%. The insurance industry - particularly medical insurance - does not work like any other product. It's non-optional for the users, they have no negotiating power at the time they need it, and everyone will need it. Which means you can't simply boot people off of it consequence free since doing so usually kills them.
You are right in that size does matter for insurance companies. But only to a point. A company with 200 mln customers is not appreciably more efficient, than one with 100 mln. Having such companies compete with each other is much better for all the 300 mln, than to force them all into a single 300 mln-customer monopoly — governed charlie rangels and nansy pelosies to boot.
Competition requires innovation, innovation has to operate within the constraints of physical reality. Insurance is not a technological enterprise by and large, there's no new inventions which mean someone can gain a competitive advantage - you can't sink money into R&D and come up with a cheaper, better product. The only things you can do are figure out new ways to drop people from insurance - ideally after they need it. Which is exactly what US health insurance companies have been innovating on.
And I explained, that this becomes irrelevant after the pool reaches a certain size. Certainly insurers want to keep growing — like all corporations — but a company with 200 mln policy-holders is not more efficient (per holder), than one with 100 mln.
First of all, we only know about Medicare's amazing figure from the Medicare themselves. It is in the bureaucrats' best interests to bump-up their efficiency figures, and they aren't particularly motivated to fight fraud — it is not their money being stolen, while reporting too much fraud will raise the questions about their efficiency. And second, Medicare is able to squeeze care-providers into money-losing rates. The providers then recoup the losses on commercially-insured (and uninsured) patients. Those of them, who don't cut off Medicare-covered patients at all, try hard to limit their numbers.
This is completely false. I'm startled, you'd make such statement in earnest — it competes with the infamous ones of the past like "Everything that can be invented has been invented" or "Nobody could possibly need more than 640Kb of memory".
There is ample innovation in the insurance industry. Less-regulated auto-insurance companies offer very different policies. Freed from overly-invasive regulation, health-insurers could've offered lower rates to healthier people for one: non-smokers should be paying less than smokers. Those with healthier BMI — less than the fatsos or anorexics. Or those living in healthier areas. Higher deductibles (and co-pays) could lower the monthly premiums dramatically (I know, I had a policy with a $10K annual deductible — spending about $500 a year out of pocket on minor things, while still insured against a truly catastrophic illness. When Massachusetts mandated the maximum of $5K, my premiums nearly doubled). Excluding coverage for elective nonsense like gender-changes is another way to lower prices for all the others.
But we wouldn't even know — because our governments try very hard to keep the competition to the minimum. As if they want us to suffer — to make the privacy-destroying "single-payer" appear palatable. The approach has certainly succeeded with you already...
In Soviet Washington the swamp drains you.
someone you individually have no choice but to accept or someone whom you can take your business elsewhere.
Paying taxes to buy civilization is like paying a hooker to buy love.
Yes, you can go to one of his golf buddies instead, but it's the same deal there plus, your fatal condition will then be 'pre-existing'. That and recission had to be outlawed at the federal level to make them go away after decades of a 'free market' failed..
Huh?
Paying taxes to buy civilization is like paying a hooker to buy love.