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03/13/2014 04:55:59 PM · #176
Originally posted by DrAchoo:

Hey Spork and I agree. But don't listen to me. It's not like my livelihood isn't dependent on knowing these facts and what my insurance contracts say...

Instead you should listen to Wendy Craig-Payne of Dallas who, according to LinkedIn, is an owner of a Jazzercise franchise. :D


Fair enough not a good source. How about this one.
03/13/2014 05:01:39 PM · #177
Originally posted by coronamv:

Originally posted by DrAchoo:

Hey Spork and I agree. But don't listen to me. It's not like my livelihood isn't dependent on knowing these facts and what my insurance contracts say...

Instead you should listen to Wendy Craig-Payne of Dallas who, according to LinkedIn, is an owner of a Jazzercise franchise. :D


Fair enough not a good source. How about this one.


Dude. Are you really one of those people who thinks that by cruising Google you are more knowledgable than someone who is in the field? Here's a quote from your source. It says exactly what I said above...

Federal law prohibits doctors from billing Medicare and Medicaid “substantially in excess” of their usual charge, so offering discounts to cash-paying patients could potentially affect the provider’s definition of their customary charge for equivalent procedures, and it is unlikely that a physician or other provider will offer for sale a medical service below what they receive from Medicare for an equivalent “billable service”. If the provider accepts a cash offer from such a patient, it remains confidential, and is not the same as a published offer for sale.

Originally posted by DrAchoo:

...thought the "cash discounts" skirt this issue...


Message edited by author 2014-03-13 17:01:54.
03/13/2014 05:02:53 PM · #178
Just one persons experience similar to one I had while not insured.
03/13/2014 05:05:53 PM · #179
Originally posted by DrAchoo:

Originally posted by coronamv:

Originally posted by DrAchoo:

Hey Spork and I agree. But don't listen to me. It's not like my livelihood isn't dependent on knowing these facts and what my insurance contracts say...

Instead you should listen to Wendy Craig-Payne of Dallas who, according to LinkedIn, is an owner of a Jazzercise franchise. :D


Fair enough not a good source. How about this one.


Dude. Are you really one of those people who thinks that by cruising Google you are more knowledgable than someone who is in the field? Here's a quote from your source. It says exactly what I said above...

Federal law prohibits doctors from billing Medicare and Medicaid “substantially in excess” of their usual charge, so offering discounts to cash-paying patients could potentially affect the provider’s definition of their customary charge for equivalent procedures, and it is unlikely that a physician or other provider will offer for sale a medical service below what they receive from Medicare for an equivalent “billable service”. If the provider accepts a cash offer from such a patient, it remains confidential, and is not the same as a published offer for sale.

Originally posted by DrAchoo:

...thought the "cash discounts" skirt this issue...


I hear what you are saying about Medicare and Medicaid, but I am talking about insurance in general or the lack of insurance and what Doctors and Hospitals do. So my question is simple and since you are in the profession you should be able to answer this. Why do you bill the insurance company say $1000 for a procedure and except say $100 from them? But don't give the same break to the uninsured?
03/13/2014 05:08:08 PM · #180
I would almost bet you will take the $900 loss and use it as a tax deduction.
03/13/2014 05:13:27 PM · #181
Originally posted by coronamv:

Just one persons experience similar to one I had while not insured.


I think that's decent advice, though it won't always get you where you want to be. I sorta chuckle that the mere ant bite (as the gal kept referring to it) seemed to somehow be serious enough that they sought medical care and someone else's medical expertise in the first place. What did it cost me, as an Allergist, to become the expert at treating that ant bite life-threatening anaphylactic reaction? Thirteen years of my life at $185,000 of debt. Some people have no concept of things.

And for the last time, you can't take these write-offs as tax deductions! Why would any doctor ever pay tax if that was the case? Hey, friend, I'm going to charge you $10,000,000 for this check-up, but you only have to pay $150. I just need to now write off almost ten million dollars as a "loss" which means I have no tax liability. LOL.

Message edited by author 2014-03-13 17:15:21.
03/13/2014 05:14:49 PM · #182
Originally posted by coronamv:

I hear what you are saying about Medicare and Medicaid, but I am talking about insurance in general or the lack of insurance and what Doctors and Hospitals do. So my question is simple and since you are in the profession you should be able to answer this. Why do you bill the insurance company say $1000 for a procedure and except say $100 from them? But don't give the same break to the uninsured?


Last response. You don't think regular insurance companies don't include the exact same language in their own contracts as Medicare and Medicaid? Duh.
03/13/2014 05:19:19 PM · #183
Originally posted by DrAchoo:

Originally posted by coronamv:

Just one persons experience similar to one I had while not insured.


I think that's decent advice, though it won't always get you where you want to be. I sorta chuckle that the mere ant bite (as the gal kept referring to it) seemed to somehow be serious enough that they sought medical care and someone else's medical expertise in the first place. What did it cost me, as an Allergist, to become the expert at treating that ant bite life-threatening anaphylactic reaction? Thirteen years of my life at $185,000 of debt. Some people have no concept of things.

And for the last time, you can't take these write-offs as tax deductions? Why would any doctor ever pay tax if that was the case? Hey, friend, I'm going to charge you $10,000,000 for this check-up, but you only have to pay $150. I just need to now write off almost ten million dollars as a "loss" which means I have no tax liability. LOL.

I have to agree with the tax part. I have seen "coming from a CPA firm" some creative accounting done in the medical field. Many loop holes. For you commuters here is a tax loop hole for you. If you drive more than 51 miles round trip to work you can have your wages adjusted where $10 P/H is per diem. It will save you thousands lol
03/13/2014 10:30:46 PM · #184
Originally posted by DrAchoo:

Hey Spork and I agree.


Let it be carved into the stone tablets of DPC history!

as well as commemorated with cake…and maybe pie.
03/13/2014 10:37:22 PM · #185
Originally posted by Spork99:

Originally posted by DrAchoo:

Hey Spork and I agree.


Let it be carved into the stone tablets of DPC history!

as well as commemorated with cake…and maybe pie.


I like pie...
03/13/2014 10:58:33 PM · #186
What's that old saying....An apple a day...Hehehe
04/01/2014 05:05:38 PM · #187
I noticed the White House is happy that 7 million people have signed up for the ACA which was the original CBO estimate. If we take Judith's previous quote that 50 million people didn't have insurance before, some unknown amount of people had their existing policies cancelled, and 7 million joined the ranks (not sure of the fraction of the seven million who are "young and healthy"). Do we see covering at most 14% of the uninsured population as success?

I want to see health care become sustainable in this country, obviously. My career depends on it. But in as unbiased a fashion as possible, I think the ACA has, so far, been a dud overall. That doesn't mean it cannot become a success, but there is no guarantee that it will. I predict the Republicans will make gains in the fall because of the status quo (for better or worse, probably to an indifferent result).

We still search for a solution.
04/01/2014 05:16:15 PM · #188
• At least 6 million people have signed up for health coverage on the new marketplaces, about one-third of whom were previously uninsured.
• A February survey by consulting firm McKinsey & Co. found 27% of new enrollees were previously uninsured, but newer survey data from the nonprofit Rand Corp. and reports from marketplace officials in several states suggest that share increased in March.
• At least 4.5 million previously uninsured adults have signed up for state Medicaid programs, according to Rand’s unpublished survey data, which were shared with The Times. That tracks with estimates from Avalere Health, a consulting firm that is closely following the law’s implementation.
• An additional 3 million young adults have gained coverage in recent years through a provision of the law that enables dependent children to remain on their parents’ health plans until they turn 26, according to national health insurance surveys from the federal Centers for Disease Control and Prevention.
• About 9 million people have bought health plans directly from insurers, instead of using the marketplaces, Rand found. The vast majority of these people were previously insured.
• Fewer than a million people who had health plans in 2013 are now uninsured because their plans were canceled for not meeting new standards set by the law, the Rand survey indicates.

//www.politicususa.com/2014/03/31/due-obamacare-10-million-previously-uninsured-americans-coverage.html
04/01/2014 05:19:48 PM · #189
Originally posted by DrAchoo:

...We still search for a solution.


I am ever so glad to hear that Doc, but from way out here in the frozen tundra, one gets the impression that the Republicans are not so inclined to help and don't (yet?) seem to have a counter proposal.

I do hope you fine folks find a solution... cause you ain't there yet.

Ray
04/01/2014 05:22:01 PM · #190
My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.
04/01/2014 05:25:44 PM · #191
Originally posted by DrAchoo:

I noticed the White House is happy that 7 million people have signed up for the ACA which was the original CBO estimate. If we take Judith's previous quote that 50 million people didn't have insurance before, some unknown amount of people had their existing policies cancelled, and 7 million joined the ranks (not sure of the fraction of the seven million who are "young and healthy"). Do we see covering at most 14% of the uninsured population as success?

I want to see health care become sustainable in this country, obviously. My career depends on it. But in as unbiased a fashion as possible, I think the ACA has, so far, been a dud overall. That doesn't mean it cannot become a success, but there is no guarantee that it will. I predict the Republicans will make gains in the fall because of the status quo (for better or worse, probably to an indifferent result).

We still search for a solution.


I've generally quit voting, and if I do vote, I generally vote independant or green - but I'm thinking about voting blanket Republican just for revenge in the fall.
04/01/2014 05:27:20 PM · #192
Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Yeah... Awesome isn't it. She should probably send a thank you letter to all the hard working folks who are paying 8x that per month so that she doesn't have to.

I don't mean to be offensive here, but stories like that are only serving to further upset me.
04/01/2014 05:30:05 PM · #193
Originally posted by Cory:

Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Yeah... Awesome isn't it. She should probably send a thank you letter to all the hard working folks who are paying 8x that per month so that she doesn't have to.

I don't mean to be offensive here, but stories like that are only serving to further upset me.


Why? Her husband had a stroke. He's now disabled and on medicare. She worked when she was young, before she had kids then was a stay at home mother after that. They've lost everything. Their savings, their home. Why would you begrudge her coverage?
04/01/2014 05:33:21 PM · #194
Originally posted by Cory:


I've generally quit voting, and if I do vote, I generally vote independant or green - but I'm thinking about voting blanket Republican just for revenge in the fall.


... and exactly what will that solve? Just curious.

Ray
04/01/2014 05:35:55 PM · #195
Originally posted by RayEthier:

Originally posted by Cory:


I've generally quit voting, and if I do vote, I generally vote independant or green - but I'm thinking about voting blanket Republican just for revenge in the fall.


... and exactly what will that solve? Just curious.

Ray


Well, first, I don't think voting really makes any real direct difference (too small of a cog in too large of a machine).. However, with that being said, I do think it's about the best "Fuck you" I can possibly send to the dimwits who've created and supported this horrible idea.
04/01/2014 05:43:42 PM · #196
Originally posted by Kelli:


Why? Her husband had a stroke. He's now disabled and on medicare. She worked when she was young, before she had kids then was a stay at home mother after that. They've lost everything. Their savings, their home. Why would you begrudge her coverage?


Look, I feel for her, but in the end life's kinda like that - you can't always win... But when you try to make sure everyone wins the only realistic outcome is that everyone loses.

The fact is that we're lessening the impact of bad choices, while devaluing the benefit of making good choices.. Frankly I have an ex who has three kids with three different men, all of whom are in jail or unemployed, and she's doing at least as well as I am while earning minimum wage and working 30 hours a week.... Is that supposed to be perceived as fair? It certainly doesn't strike me as being so, and this is just another small tentacle of the same issue.

So don't think it's something personal towards your aunt, it's simply the observation that our system is actively rewarding irresponsible decision making while punishing responsible decision making.
04/01/2014 05:45:33 PM · #197
Originally posted by Cory:

Originally posted by RayEthier:

Originally posted by Cory:


I've generally quit voting, and if I do vote, I generally vote independant or green - but I'm thinking about voting blanket Republican just for revenge in the fall.


... and exactly what will that solve? Just curious.

Ray


Well, first, I don't think voting really makes any real direct difference (too small of a cog in too large of a machine).. However, with that being said, I do think it's about the best "Fuck you" I can possibly send to the dimwits who've created and supported this horrible idea.


I am intrigued by the last portion of your comment. That horrible idea seems to be working in other countries... why would it not in the USA. It may not be perfect, but surely it would provide some protection to the more vulnerable of your society....like old folks like me. :O)

Ray
04/01/2014 05:48:49 PM · #198
Originally posted by Cory:

Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Yeah... Awesome isn't it. She should probably send a thank you letter to all the hard working folks who are paying 8x that per month so that she doesn't have to.

I don't mean to be offensive here, but stories like that are only serving to further upset me.


You nailed it with the 8x, Cory. I'm 59, work my ass off at 2 to 3 jobs (which definitely do NOT leave me rich), have been without coverage for the past eight years, and the best deal I could find was about $475/ month with a $6000 deductible. Seriously? That sucks.

Kelli, I'm sorry for your aunt's situation and I don't begrudge her coverage, but I sure as shit don't think that paying a $5700 premium then $6000 out of pocket each year before coverage kicks is in any stretch of the imagination "affordable".
04/01/2014 05:55:06 PM · #199
Originally posted by cgino:

Originally posted by Cory:

Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Yeah... Awesome isn't it. She should probably send a thank you letter to all the hard working folks who are paying 8x that per month so that she doesn't have to.

I don't mean to be offensive here, but stories like that are only serving to further upset me.


You nailed it with the 8x, Cory. I'm 59, work my ass off at 2 to 3 jobs (which definitely do NOT leave me rich), have been without coverage for the past eight years, and the best deal I could find was about $475/ month with a $6000 deductible. Seriously? That sucks.

Kelli, I'm sorry for your aunt's situation and I don't begrudge her coverage, but I sure as shit don't think that paying a $5700 premium then $6000 out of pocket each year before coverage kicks is in any stretch of the imagination "affordable".


When I was working I paid $800/month for my coverage through my employer. According to them, that was half. When my job got offshored, they offered me cobra @$2k a month (which was more than my unemployment). Seriously, this was 7 years ago. So, I really don't think your premiums are unaffordable if you're working 2 or 3 jobs.
04/01/2014 06:11:31 PM · #200
Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Looking at specific stories is generally not a great way to decide what is the best course of action for society. I am happy for her. You are aware that her premium is so low because other people are paying part of the premium for her, right? We haven't magically made health care cost $58/month, it's just that your aunt only pays $58 of the price.

Thanks for those bullet points in your other post. They were helpful. I didn't think about people who signed up outside the exchanges. They would be added to the number of newly insured.

EDIT: Argh. I went to your link and was immediately turned off by the byline "real liberal politics". That doesn't make the statements untrue, but one does now worry about selective reporting and/or bias. Even then, the headline seems to bump the number up from only 7 million to "nearly 10 million". Not a large increase and, I assume, that's the best case scenario.

Message edited by author 2014-04-01 18:14:43.
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