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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:19 am 
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Killer V wrote:
Boilermaker Rick wrote:
Cashman wrote:
Are we talking about what you get through work or through the exchange?
Either one is fine in this discussion. It's the idea that everyone, regardless of how well off they are, should have the EXACT same healthcare.


So shouldn't everyone also drive the same car?



Sounds like a lot of you are against healthcare as a human right.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:24 am 
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Boilermaker Rick wrote:
Killer V wrote:
Boilermaker Rick wrote:
Cashman wrote:
Are we talking about what you get through work or through the exchange?
Either one is fine in this discussion. It's the idea that everyone, regardless of how well off they are, should have the EXACT same healthcare.


So shouldn't everyone also drive the same car?
That would be another good example. I just want to point out that I'm not on the side of saying that every person should have the exact same healthcare.

Health care, like education and social services, are not products. They're not something you can make and sell as goods. If you think they are, you need a class in metaphor and epistemology. The relationships and variables that go into social services are practically and politically a thousand times more complex and fraught with implications affecting the lives of people than any manufactured product. No one, other than those who let their political beliefs get in the way of their thinking, believes that practices like education and health care are products.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:24 am 
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Joe Orr Road Rod wrote:
Killer V wrote:
Boilermaker Rick wrote:
Cashman wrote:
Are we talking about what you get through work or through the exchange?
Either one is fine in this discussion. It's the idea that everyone, regardless of how well off they are, should have the EXACT same healthcare.


So shouldn't everyone also drive the same car?



Sounds like a lot of you are against healthcare as a human right.




Michael Steele was on Bill Maher about a month or so ago with a good quote. Said something like, rights are in the constitution, but health care is something we should provide. I don't have the exact quote.


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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:35 am 
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My biggest issue is the misuse of the word "healthcare". The ACA and all the crap the GOP was slinging this year was on "Health Insurance". They're drastically different things. One is the problem and one is something people need.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:35 am 
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Cashman wrote:
Joe Orr Road Rod wrote:
Killer V wrote:
Boilermaker Rick wrote:
Cashman wrote:
Are we talking about what you get through work or through the exchange?
Either one is fine in this discussion. It's the idea that everyone, regardless of how well off they are, should have the EXACT same healthcare.


So shouldn't everyone also drive the same car?



Sounds like a lot of you are against healthcare as a human right.




Michael Steele was on Bill Maher about a month or so ago with a good quote. Said something like, rights are in the constitution, but health care is something we should provide. I don't have the exact quote.



I am sure some of you wordsmiths can do it better but one might think of it like this. The constitution gives you the right to life, liberty.... Healthcare is something that will help you have a better life or eve survive. It is an essential part of our civilized society but technically not a right per se.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:38 am 
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pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?
Because they would almost all go out of business? It's not a 10 minute oil change place.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:42 am 
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formerlyknownas wrote:
Health care, like education and social services, are not products. They're not something you can make and sell as goods. If you think they are, you need a class in metaphor and epistemology. The relationships and variables that go into social services are practically and politically a thousand times more complex and fraught with implications affecting the lives of people than any manufactured product. No one, other than those who let their political beliefs get in the way of their thinking, believes that practices like education and health care are products.
If you want to get literal, then they are services and not products.

It still doesn't change the ultimate point is that there are good reasons why every person shouldn't have the exact same healthcare as has been pointed out. Everyone should have a base level of healthcare though.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:43 am 
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pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?


Why don't the docs just tell the med schools they're only going to pay $75k for all of their schooling?

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:48 am 
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pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?

Because that would be a terrible idea.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:48 am 
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Boilermaker Rick wrote:
pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?
Because they would almost all go out of business? It's not a 10 minute oil change place.


Do you happen to know how much a PCP gets from insurance or medicaid for a office visit? You might want to guess the bold part or maybe less.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:50 am 
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Killer V wrote:
pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?


Why don't the docs just tell the med schools they're only going to pay $75k for all of their schooling?


I am sure eventually that would have to be part of the change would it not? Do you think if we get to single payer docs and medical schools will make as much?

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:53 am 
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pittmike wrote:
Do you happen to know how much a PCP gets from insurance or medicaid for a office visit?

I didn't know you liked to get wet, dog

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:54 am 
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pittmike wrote:
Boilermaker Rick wrote:
pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?
Because they would almost all go out of business? It's not a 10 minute oil change place.


Do you happen to know how much a PCP gets from insurance or medicaid for a office visit? You might want to guess the bold part or maybe less.

They bill based on what is wrong and what they have to do and how much time is spent with the patient. Setting a standard rate "no matter what is wrong" would certainly be tough for the doctor I go see with a broken arm. I can't imagine what $75 would get me for that.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 8:59 am 
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Boilermaker Rick wrote:
pittmike wrote:
Boilermaker Rick wrote:
pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?
Because they would almost all go out of business? It's not a 10 minute oil change place.


Do you happen to know how much a PCP gets from insurance or medicaid for a office visit? You might want to guess the bold part or maybe less.

They bill based on what is wrong and what they have to do and how much time is spent with the patient. Setting a standard rate "no matter what is wrong" would certainly be tough for the doctor I go see with a broken arm. I can't imagine what $75 would get me for that.



Wrong answer. An office visit is an office visit. When you begin testing or hospitalization is where the costs go up depending on your ailment. That is where I said turn the paying over to medicaid or similar.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:04 am 
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pittmike wrote:
Wrong answer. An office visit is an office visit. When you begin testing or hospitalization is where the costs go up depending on your ailment. That is where I said turn the paying over to medicaid or similar.
I'm confused. Are you talking about the patient simply walking into the room?

You said "they get $75 a visit no matter what is wrong". This is not how it works right now. If I get a checkup, and I go in for a broken arm, I assure you the price will be different.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:12 am 
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Boilermaker Rick wrote:
pittmike wrote:
Wrong answer. An office visit is an office visit. When you begin testing or hospitalization is where the costs go up depending on your ailment. That is where I said turn the paying over to medicaid or similar.
I'm confused. Are you talking about the patient simply walking into the room?

You said "they get $75 a visit no matter what is wrong". This is not how it works right now. If I get a checkup, and I go in for a broken arm, I assure you the price will be different.


If you have a broken arm I hope you are not dumb enough to make a PCP appointment and go there rather than the ER or urgent care. What I am saying is really what the PCP has become. They are gatekeepers to guide you if necessary to other resources. You go there you will pay a standard amount. They will check your vitals and talk with you about your issues. That all is the same costs. Based on that visit is when you go to tests, hospitalization, prescriptions, specialists etc where the true costs rise.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:19 am 
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pittmike wrote:
If you have a broken arm I hope you are not dumb enough to make a PCP appointment and go there rather than the ER or urgent care. What I am saying is really what the PCP has become. They are gatekeepers to guide you if necessary to other resources. You go there you will pay a standard amount. They will check your vitals and talk with you about your issues. That all is the same costs. Based on that visit is when you go to tests, hospitalization, prescriptions, specialists etc where the true costs rise.
Well, you are talking about a specific specialty now, but even those bill differently based on the type of visit. For instance, an initial visit will bill higher than a folllowup mostly having to do with the extra time required. That's not too much different than a first visit with a cardiologist though.

Your question of "Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?" seems to be quite far from the fact that a large majority of primary care physicians make one of a few standard billing codes for their patients.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:25 am 
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Douchebag wrote:
pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?

Because that would be a terrible idea.

Are there no doctors here? Doctors were moaning about this change 20 years ago. Health insurance companies drastically cut/changed what they would get paid for work performed.

And to RR's original point, correct sir. Don't fret over what you can't fix and work on making yourself better. A clearer picture will emerge, but that is not now. Unless you can somehow affect the outcome, focus more on you.


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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:29 am 
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Boilermaker Rick wrote:
pittmike wrote:
If you have a broken arm I hope you are not dumb enough to make a PCP appointment and go there rather than the ER or urgent care. What I am saying is really what the PCP has become. They are gatekeepers to guide you if necessary to other resources. You go there you will pay a standard amount. They will check your vitals and talk with you about your issues. That all is the same costs. Based on that visit is when you go to tests, hospitalization, prescriptions, specialists etc where the true costs rise.
Well, you are talking about a specific specialty now, but even those bill differently based on the type of visit. For instance, an initial visit will bill higher than a folllowup mostly having to do with the extra time required. That's not too much different than a first visit with a cardiologist though.

Your question of "Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?" seems to be quite far from the fact that a large majority of primary care physicians make one of a few standard billing codes for their patients.


There is no need to complicate this. My idea was based on future not now. You do not just look into the directory and make a cardiologist appointment now or in the future. You go see your PCP (gatekeeper) and get a referral. Regardless, the an initial visit is $75 in my new world system. Then you are into the ,again new system, to have medicaid or similar pay the rest.

The reason I pick some dollar amount an refer to them as gatekeepers is important. It is at this time where seriousness of your situation is decided as well as waste avoided. If it sounds very much like single payer that is because it is like that. You don't like the $75 they screw off and don't be a PCP or doc doing initial consultations. The system now runs this and everyone does it the same.

If you have your own money and don't like it go private.

Don't get me wrong I do not want this system. I a simply telling you in my opinion there is the pre 2008 system and single payer. All this shit with politicians, medical bureaucrats, pharma and lawyers in between the two will never be resolved to everyone's satisfaction. I would bet anyone that if we were still around six years from now we would have the same debate as today which is the same as 2008.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:31 am 
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beni hanna wrote:
Douchebag wrote:
pittmike wrote:
Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?

Because that would be a terrible idea.

Are there no doctors here? Doctors were moaning about this change 20 years ago. Health insurance companies drastically cut/changed what they would get paid for work performed.

And to RR's original point, correct sir. Don't fret over what you can't fix and work on making yourself better. A clearer picture will emerge, but that is not now. Unless you can somehow affect the outcome, focus more on you.



I am not sure what you are asking me? PCPs as you point out have been fucked for years. Many are going out of practice or have been consolidated into large groups that see as many patients per hour as possible to make their money. They are losers in the "doctor" scheme of things.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:32 am 
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pittmike wrote:
Boilermaker Rick wrote:
pittmike wrote:
If you have a broken arm I hope you are not dumb enough to make a PCP appointment and go there rather than the ER or urgent care. What I am saying is really what the PCP has become. They are gatekeepers to guide you if necessary to other resources. You go there you will pay a standard amount. They will check your vitals and talk with you about your issues. That all is the same costs. Based on that visit is when you go to tests, hospitalization, prescriptions, specialists etc where the true costs rise.
Well, you are talking about a specific specialty now, but even those bill differently based on the type of visit. For instance, an initial visit will bill higher than a folllowup mostly having to do with the extra time required. That's not too much different than a first visit with a cardiologist though.

Your question of "Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest?" seems to be quite far from the fact that a large majority of primary care physicians make one of a few standard billing codes for their patients.


There is no need to complicate this. My idea was based on future not now. You do not just look into the directory and make a cardiologist appointment now or in the future. You go see your PCP (gatekeeper) and get a referral. Regardless, the an initial visit is $75 in my new world system. Then you are into the ,again new system, to have medicaid or similar pay the rest.

The reason I pick some dollar amount an refer to them as gatekeepers is important. It is at this time where seriousness of your situation is decided as well as waste avoided. If it sounds very much like single payer that is because it is like that. You don't like the $75 they screw off and don't be a PCP or doc doing initial consultations. The system now runs this and everyone does it the same.

If you have your own money and don't like it go private.

Don't get me wrong I do not want this system. I a simply telling you in my opinion there is the pre 2008 system and single payer. All this shit with politicians, medical bureaucrats, pharma and lawyers in between the two will never be resolved to everyone's satisfaction. I would bet anyone that if we were still around six years from now we would have the same debate as today which is the same as 2008.
Ok, I see what you are saying now.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:35 am 
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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:47 am 
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Joe Orr Road Rod wrote:


Sounds like a lot of you are against healthcare as a human right.



Rights are things that can't be taken away from you, basically protections against an overbearing government. I don't believe the government owes us anything, meaning you should not have a right to food, an education, healthcare, etc. Now as a society we have rightly chosen to make sure there are safety nets and universal education. But it is a much different thing if you calls these things rights. Then you go down the road of people being owed (in a legal sense) unlimited amounts of stuff. Because that is where the courts would take it.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:49 am 
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denisdman wrote:
Joe Orr Road Rod wrote:


Sounds like a lot of you are against healthcare as a human right.



Rights are things that can't be taken away from you, basically protections against an overbearing government. I don't believe the government owes us anything, meaning you should not have a right to food, an education, healthcare, etc. Now as a society we have rightly chosen to make sure there are safety nets and universal education. But it is a much different thing if you calls these things rights. Then you go down the road of people being owed (in a legal sense) unlimited amounts of stuff. Because that is where the courts would take it.


Language matters.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:52 am 
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All health insurance providers need to be non-profit. The doctors have the talent/skills and they need to be paid accordingly. That's a full stop. What doesn't make sense is these insurance companies like BCBS making billions. They don't have the talent and offer nothing outside of being the "broker" of money between patient and provider.


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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:53 am 
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What if I want a Viagra every day?

I agree with what Mrs. BRick said ... 'why are you bringing that up?'

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:56 am 
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denisdman wrote:
Joe Orr Road Rod wrote:


Sounds like a lot of you are against healthcare as a human right.



Rights are things that can't be taken away from you, basically protections against an overbearing government. I don't believe the government owes us anything, meaning you should not have a right to food, an education, healthcare, etc. Now as a society we have rightly chosen to make sure there are safety nets and universal education. But it is a much different thing if you calls these things rights. Then you go down the road of people being owed (in a legal sense) unlimited amounts of stuff. Because that is where the courts would take it.



The view you're expressing above is informed by established institutions. Pretend we all just landed on earth. Are some people simply more entitled than others?

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:59 am 
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Joe Orr Road Rod wrote:
The view you're expressing above is informed by established institutions. Pretend we all just landed on earth. Are some people simply more entitled than others?
Not on day 1. On day 365, probably. On day 3650, certainly.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 9:59 am 
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pittmike wrote:
Why don't they ever upset the apple cart that is the insurance, medical, pharmaceutical and legal professions when they mess with this system?

Why not do away with health insurance altogether and use price fixing for "basic" healthcare needs? Why don't they just tell docs they get $75 a visit no matter what is wrong and medicaid for the rest? Why not stop the drug money train and severely change the lawsuit influence on the game? Why do we accept that us dopes here talking about the same old bad ideas for healthcare is the only way?

I think pittmike just broke on through to the other side.

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 Post subject: Re: Health insurance
PostPosted: Fri Jul 28, 2017 10:00 am 
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Boilermaker Rick wrote:
Joe Orr Road Rod wrote:
The view you're expressing above is informed by established institutions. Pretend we all just landed on earth. Are some people simply more entitled than others?
Not on day 1. On day 365, probably. On day 3650, certainly.


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