WASHINGTON--President Barack Obama said lawmakers shouldn't move forward on health-care legislation until Massachusetts's new Republican senator takes office.
Great political minds think alike
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Bill Glasheen
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Bill, I don't meant hat you shouldn't have a say in how your coverage works when you need it, but I don't see how spending your aftertax bucks is any guarantee that you will. Should you become czar, I highly encourage you to align incentives in health care and take what works in high quality, low cost systems and force it on everyone else. Unless you want to watch Jefferson's country slide into bankruptcy.
--Ian
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Bill Glasheen
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- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
You take much for granted, my friend.IJ wrote:
I don't see how spending your aftertax bucks is any guarantee that you will.
You have health insurance as a benefit, right? Cool. Did you know that the money they take out of your paycheck for that insurance is before-tax dollars? That is the nature of an employer-based health insurance system. Furthermore if they cover some of your health insurance as an additional benefit, they get to do that with their own pre-tax dollars.
Meanwhile...
In an effort to control costs after the imposition of universal health care in Massachusetts, my employer shed many of its "employees" and re-hired them as subcontractors. From that point forward, they neither offered the pre-tax cover for health insurance for me, nor are they now paying any portion of my health insurance with their own pre-tax dollars. Instead they give me a pay check for my services, I put money aside for my taxes based on that total amount, and THEN I use what money is left to purchase health insurance.
In other words, I just got screwed big time. It amounts to thousands of dollars per year in additional taxes that I have to pay.
Am I making any sense? It sure makes sense to me, as Uncle Sam is giving YOU a break that *I* don't get. What's fair about that?
The whole reason for this artifact has to do with days in the past where the government had imposed wage freezes (to get a handle on inflation). In order to allow companies to get around those caps to attract employees, government allowed said employers to "pay" additional wages in the form of benefits - all of which were paid for with pre-tax dollars.
- Bill
We understand that situation Bill, I believe what Ian is questioning is this statement you made earlier:
As Ian is getting at, how does paying for your own insurance with after-tax dollars guarantee that you will have more say in what health-care you get then do we paying for insurance with before-tax dollars? Your whole argument in the past has been that the insurance companies get to make those decisions regardless.I pay (dearly) in advance for my health care, so nobody's going to tell me what I can or can't get when the sheet hits the fan
Glenn
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Bill Glasheen
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- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Straw man argument alert!!!Glenn wrote:
how does paying for your own insurance with after-tax dollars guarantee that you will have more say in what health-care you get then do we paying for insurance with before-tax dollars? Your whole argument in the past has been that the insurance companies get to make those decisions regardless.
FIRST
If I'm paying for insurance - either as employer-based because I EARNED it through my hard labor or as individual insurance out of my pocket - then I am entitled to health care services when there is a medical necessity. That's the law.
SECOND
Let's get over this bullschit big bad insurance language of the flaming liberals and Obamamaniacs.
- An individual chooses their insurance policy either by default of the company they choose to work for or individually on the open market.
- In many companies (including ones I have worked for), individuals have a choice off of a menu of several available policies. Having done the research, I happen to know that individuals will (on average) make rational choices in such a scenario. Bottom line - total cost for paid services is higher than if there was only one policy because individuals will choose a policy which is in their best interest - at the expense of the insurer trying to hold cost down via benefit design.
- An insurance policy is a contract between the insurer and the insured. Anyone who does any amount of research on this knows that a whole array of individuals (from the insurance company to the doctors to the hospitals) will be contractually obligated to perform services as specified by the policy. Failure to do so will get them in trouble with the courts and/or the bureau of insurance. That being the case, smart companies often negotiate customized contracts that are to the benefit of their employees. For example state workers often have very rich benefits because the state is an 800-pound-gorilla customer and benefits make up for an otherwise schitty salary.
I've had continuous coverage for 35 years. No pre-existing conditions crapola for me since I've always done the right thing. I have little sympathy for people who choose not to get insurance until they need it, or who allow coverage to lapse while having chronic conditions.
FOURTH
As an individual who has no (zero, zilch, nada) subsidies for his insurance either from Uncle Sam or from his employer, I'm not going to take a lot of schit from folks whose care is otherwise subsidized. Why should I when I handle the entire bill and get no hand-outs? I pay for 100% of the management of my risk, and I expect delivery per my insurance contract. Nobody has the moral high ground on me.
It's also worth mentioning that - as an individual - I get no break on the "risk" side. Large employers have more predictable risk so can get ASO policies (administrative services only). In other words, THEY go at risk and pay the insurance companies for their networks, their network contracts, and for paying claims. That's much cheaper. Small companies and individuals must buy "fully insured" policies because they can't take advantage of the risk pooling. That makes their insurance higher, since the insurer is entitled to be paid for accepting that risk.
- Bill
No strawman Bill, you still haven't answered the question about how you will get more say over what you "can and can't get when the sheet hits the fan" when it still has to go through insurance. Saving a life is a medical necessity, but we know insurance does not pay for all life-saving treatments. Insurance companies all the time tell people what they can and can't have. As you have said, they are paying the bill so they make it their call, yet your statement implied that you would get more say because you are paying a greater percentage of the cost of insurance yourself.Bill Glasheen wrote: Straw man argument alert!!!
FIRST
If I'm paying for insurance - either as employer-based because I EARNED it through my hard labor or as individual insurance out of my pocket - then I am entitled to health care services when there is a medical necessity. That's the law.
That's an idealistic way of looking at it. I've asked around people I know and have yet to find anyone who had a real choice in their insurance, particularly when there is not a lot of job choices that would allow them to choose a job based on its insurance benefits.An individual chooses their insurance policy either by default of the company they choose to work for or individually on the open market.
Sure, at the places we've worked we've been able to choose if we want medical, prescription, dental, and/or vision coverage. The choice is always "yes" or "no" though, not which medical plan do you want. I have heard of places offering a choice between an insurance company policy and a HMO policy, but of course an HMO is not an adequate option for most, and those who have chosen it for the lower cost end up regretting that decision later when they need health care.In many companies (including ones I have worked for), individuals have a choice off of a menu of several available policies.
Glad that has worked for you, same here for 22 years. However you are well aware that pre-existing conditions can arise even in those who do the "right thing" (a concept that changes by the week). Many people are born with pre-existing conditions, you and I are fortunate that we were not. But chronic conditions eventually arise in all who live long enough.I've had continuous coverage for 35 years. No pre-existing conditions crapola for me since I've always done the right thing.
People with chronic conditions who are laid off and thus have lost their benefits have their former employers to thank for their coverage lapsing, and there has been a lot of that over the past 18 months. As soon as they try to get coverage on their own or through a new job, that BS of not covering pre-existing conditions kicks in. Sure there is COBRA when laid off, but it is unaffordable to the unemployed and thus not a real option. Whether you are sympathic or not, there are real people going through real hardships that are affecting their ability to get medical care. People get insurance to pay for needed medical care, period. Pre-existing condition exemptions do not provide what many people need. You can talk about risk calculations all you want, but that is insurance-industry speak and not what the person needing treatment considers or cares about, they simply want insurance companies to live up to their ads promising coverage for the care they need. The martial arts advocate knowing yourself and your opponent; stop for a moment and think about insurance like the general public does, and how much your views are influenced by being an insurance-industry PhD-level analyst-modeller insider.I have little sympathy for people who choose not to get insurance until they need it, or who allow coverage to lapse while having chronic conditions.
With regard for being healthier for doing the "right thing", that sure was easier back when insurance companies covered preventative care such as physicals and vaccinations. Since the industry changed to requiring the consumers to foot the bill for preventative care, while they only cover health problems after they arise, fewer people can afford to get preventative care. Fortunately the industry seems to be swinging back again to covering at least some preventative care.
Nor has anybody said that they do. You are the one who keeps bringing in the distracting preaches about how bad the public is and how good the insurance industry is. I realize you work in that industry, but try to be a little less overprotective about it!As an individual who has no (zero, zilch, nada) subsidies for his insurance either from Uncle Sam or from his employer, I'm not going to take a lot of schit from folks whose care is otherwise subsidized. Why should I when I handle the entire bill and get no hand-outs? I pay for 100% of the management of my risk, and I expect delivery per my insurance contract. Nobody has the moral high ground on me.
All I am trying to figure out is how you'll get more say over your insurance company in your health care because you pay a greater percentage of the cost of your insurance. If that is true then it sounds like you have the better deal!Glenn
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
I still don't own your straw man, Glenn. I can't figure out how you attribute all that you are saying to me.
Here are some facts, Glenn.
1) People who learn about their insurance policies get the most from them. How do I know this? My statistical studies pick this up. The more months of continuous enrollment on a policy, the higher the utilization (and therefore the higher the amount that the insurance company pays). Moral of the story? Learn your benefits. IT'S A CONTRACT!!! There are obligations on the part of both parties. The insurance company may not arbitrarily decide not to cover something if the contract says they do. IF they do, you can appeal any number of ways - depending on state law.
2) The "say" you get is all about the benefit design you sign up for *beforehand*. Particularly when I'm on my own and I have complete freedom to pay a good chunk of my salary for any insurance sold in my state, I have LOTS of say about my benefit design. If someone is getting this paid for partly by their employer and partly by Uncle Sam and they don't like their lack of choice, puuleeeeze!!! Stop your pity party. I'll trade places any day and save LOTS of money.
3) HMO is not an adequate option for most? The data do not support your assertion, Glenn. If you are a member of a typical family, it is THE best policy to have. Why? Because these plans are monitored by the independent and nonprofit NCQA. Accreditation by that organization is highly sought after, as most companies will not buy an HMO plan without it. HEDIS (process quality) results are collected and published for all to see. It is one of the rare places in U.S. medicine where quality is monitored, reported, and rewarded.
What don't people like about HMOs? Mostly it's the access issue. They force you into a smaller hospital and physician network. And many must choose a "gatekeeper" and see that doctor first before seeing specialists (unless it is an emergency).
The problem most people have with HMOs is that they don't read the rules and they do something which is a violation of their benefit design (like go straight to an ER for primary care). When they do so, they get stuck with the bill. (They also pizz ER docs off, but that's another story...) These rules are there for a good reason. HMOs are one of the first attempts by U.S. medicine to ration care. Given the problems with health-care inflation, that's very important. HMOs fell out of favor around 1999 during low unemployment. But something like them will be making a comeback.
HMOs may also put severe restrictions on certain kinds of very expensive care. It is what it is. These kinds of policies tend to work like a quartz clock for the vast majority of people who are not severely ill - providing the member jumps through all the hoops.
HMOs are very good when it comes to babymaking and childhood care. They're also very good for the treatment of common chronic conditions (asthma, diabetes, etc.). There is a LOT of money associated with these events. Back in the day, all this came out of your pocket. Now people take it for granted that it's covered. How spoiled we have become. My dad paid for the delivery of all 8 kids in my family - out of pocket. He also paid for all our doctor visits. And he had to pay hospital and doctor charges rather than payment amounts pre-negotiated by a large entity delivering consistent volume to the hospitals and physicians.
4) I've been laid off 3 times. I've survived these layoffs because I save for rainy days and get employed again ASAP. I also work it out with my partner so that SOMEBODY can get employer-based coverage. But I've also had to pay out of pocket for insurance at times. The bottom line is that I haven't lost continuous coverage because I've lived a careful life and I work hard.
I am very well aware of people (in my small social network) who are the reason for SOME health care reform. On more than a few occasions I've brought such people to doctor's offices and paid for their care. I've also shown them how to work with the drug companies to get massive discounts for medication they need for their chronic conditions. And I've informed one person how to work with Medicaid and public hospitals to get coverage for things like having a baby out of wedlock while experiencing a VERY high risk pregnancy (over 100 ultrasounds, bed rest, lots of transfusions, month in a hospital, etc.). Why do you think so many Mexicans come north of the border to have their babies? (Other than getting citizenship)
5) Having worked for insurance companies either directly or with their data, I'm familiar with the "choice" issue for benefit designs. Frankly the insurance companies hate it when they go at risk, because it always costs them more. (Again, people on average make rational choices, and that usually means they get more value for their benefits.) I can't speak to your anecdotal experiences.
And finally...
6) If you have insurance coverage at birth and you never have coverage dropped, you can't EVER have a pre-existing condition.
And if you choose to get flood insurance one week before a hurricane hits, do you think the insurance company will pay for your home floating down the Mississippi? Heeellll no. Same with buying renters insurance AFTER you have been robbed. Fair is fair.
- Bill
Here are some facts, Glenn.
1) People who learn about their insurance policies get the most from them. How do I know this? My statistical studies pick this up. The more months of continuous enrollment on a policy, the higher the utilization (and therefore the higher the amount that the insurance company pays). Moral of the story? Learn your benefits. IT'S A CONTRACT!!! There are obligations on the part of both parties. The insurance company may not arbitrarily decide not to cover something if the contract says they do. IF they do, you can appeal any number of ways - depending on state law.
2) The "say" you get is all about the benefit design you sign up for *beforehand*. Particularly when I'm on my own and I have complete freedom to pay a good chunk of my salary for any insurance sold in my state, I have LOTS of say about my benefit design. If someone is getting this paid for partly by their employer and partly by Uncle Sam and they don't like their lack of choice, puuleeeeze!!! Stop your pity party. I'll trade places any day and save LOTS of money.
3) HMO is not an adequate option for most? The data do not support your assertion, Glenn. If you are a member of a typical family, it is THE best policy to have. Why? Because these plans are monitored by the independent and nonprofit NCQA. Accreditation by that organization is highly sought after, as most companies will not buy an HMO plan without it. HEDIS (process quality) results are collected and published for all to see. It is one of the rare places in U.S. medicine where quality is monitored, reported, and rewarded.
What don't people like about HMOs? Mostly it's the access issue. They force you into a smaller hospital and physician network. And many must choose a "gatekeeper" and see that doctor first before seeing specialists (unless it is an emergency).
The problem most people have with HMOs is that they don't read the rules and they do something which is a violation of their benefit design (like go straight to an ER for primary care). When they do so, they get stuck with the bill. (They also pizz ER docs off, but that's another story...) These rules are there for a good reason. HMOs are one of the first attempts by U.S. medicine to ration care. Given the problems with health-care inflation, that's very important. HMOs fell out of favor around 1999 during low unemployment. But something like them will be making a comeback.
HMOs may also put severe restrictions on certain kinds of very expensive care. It is what it is. These kinds of policies tend to work like a quartz clock for the vast majority of people who are not severely ill - providing the member jumps through all the hoops.
HMOs are very good when it comes to babymaking and childhood care. They're also very good for the treatment of common chronic conditions (asthma, diabetes, etc.). There is a LOT of money associated with these events. Back in the day, all this came out of your pocket. Now people take it for granted that it's covered. How spoiled we have become. My dad paid for the delivery of all 8 kids in my family - out of pocket. He also paid for all our doctor visits. And he had to pay hospital and doctor charges rather than payment amounts pre-negotiated by a large entity delivering consistent volume to the hospitals and physicians.
4) I've been laid off 3 times. I've survived these layoffs because I save for rainy days and get employed again ASAP. I also work it out with my partner so that SOMEBODY can get employer-based coverage. But I've also had to pay out of pocket for insurance at times. The bottom line is that I haven't lost continuous coverage because I've lived a careful life and I work hard.
I am very well aware of people (in my small social network) who are the reason for SOME health care reform. On more than a few occasions I've brought such people to doctor's offices and paid for their care. I've also shown them how to work with the drug companies to get massive discounts for medication they need for their chronic conditions. And I've informed one person how to work with Medicaid and public hospitals to get coverage for things like having a baby out of wedlock while experiencing a VERY high risk pregnancy (over 100 ultrasounds, bed rest, lots of transfusions, month in a hospital, etc.). Why do you think so many Mexicans come north of the border to have their babies? (Other than getting citizenship)
5) Having worked for insurance companies either directly or with their data, I'm familiar with the "choice" issue for benefit designs. Frankly the insurance companies hate it when they go at risk, because it always costs them more. (Again, people on average make rational choices, and that usually means they get more value for their benefits.) I can't speak to your anecdotal experiences.
And finally...
6) If you have insurance coverage at birth and you never have coverage dropped, you can't EVER have a pre-existing condition.
And if you choose to get flood insurance one week before a hurricane hits, do you think the insurance company will pay for your home floating down the Mississippi? Heeellll no. Same with buying renters insurance AFTER you have been robbed. Fair is fair.
- Bill
And I have no clue what you're seeing as a strawman about you, so we're even!Bill Glasheen wrote:I still don't own your straw man, Glenn. I can't figure out how you attribute all that you are saying to me.
This is the answer I was asking about, thanks.The "say" you get is all about the benefit design you sign up for *beforehand*. Particularly when I'm on my own and I have complete freedom to pay a good chunk of my salary for any insurance sold in my state, I have LOTS of say about my benefit design.
Glenn
Sure, you have legal recourse if the insurance company stiffs you. But then when you sue it will take years to get that money. In the mean time your bills are all still due. Then you get to tack on lawyers bills, and unless you can prove malfeasance then you don't get that back. If you can get a contingency arrangement, and you can afford for a lawyer to take half of a settlement, then you can do it. But if you can't afford to face a massive legal stonewall, then you're up the creek. This applies to a lot of industries, not just insurance.
Also Bill, you know you're a lot smarter and more well informed than most people. There are lots of people who can't sift through the contract language and even figure out what's really being offered. You work in the field, you're a smart guy with a lot of education. To you, it's no big deal and maybe it seems everybody should be able to make smart, informed decisions on highly complex issues rife with pitfalls. Unfortunately not everybody can. As you said, you've walked from companies that wouldn't pay. But you have a lot better understanding of what your legal rights are and when it can be worth it to sue than most people. And because you have all the advantages you do, having a company stiff you a moderate amount isn't a disaster, because you can afford it, even if you don't want to. There are a lot of people who get stiffed and can't afford it. For whom a $5000 medical bill turns into a credit card debt they can't get out from under, and who can't afford a lawyer and years of waiting on a settlement or award from the case.
Also Bill, you know you're a lot smarter and more well informed than most people. There are lots of people who can't sift through the contract language and even figure out what's really being offered. You work in the field, you're a smart guy with a lot of education. To you, it's no big deal and maybe it seems everybody should be able to make smart, informed decisions on highly complex issues rife with pitfalls. Unfortunately not everybody can. As you said, you've walked from companies that wouldn't pay. But you have a lot better understanding of what your legal rights are and when it can be worth it to sue than most people. And because you have all the advantages you do, having a company stiff you a moderate amount isn't a disaster, because you can afford it, even if you don't want to. There are a lot of people who get stiffed and can't afford it. For whom a $5000 medical bill turns into a credit card debt they can't get out from under, and who can't afford a lawyer and years of waiting on a settlement or award from the case.
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Bill Glasheen
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- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Flattery sometimes works...
Much of what you say is true. And it does dovetail in nicely with what I said. In other words, most people eventually figure their benefits out, and start using them pretty well.
On the flip side, some people will always screw their lives up, no matter how hard you try to make life easy for them.
I remember a fellow fraternity brother (Stuart Large) who was a reasonably smart guy. No PhD in his future, but he did manage to become president of our frat (on his well-liked personality) and eventually made it to medical school after his third try. He eventually went into a new specialty on the treatment of pain.
At the time (somewhere in-between the discovery of the wheel and the space shuttle launch) there was yet another public debate about what to do with U.S. health-care. Socialized medicine (a.k.a. a single payer, government-run system) was being actively advanced as a possible paradigm for U.S. health-care to evolve into. These debates actually made it into the interviews of the many students trying to get into medical school.
Stuart had an interesting take on this. With a perfectly serious demeanor, Stuart acknowledged that folks very well could end up bankrupt while facing the battle against either a chronic or a life-threatening illness. And then he brought up the classic problem with single-payer, government run system - long waits, particularly for elective procedures. He finished the representation of his position with "I'd rather be bankrupt and cured than financially secure and dead."
And you know what? Stuart has a point. In this whole health-care debate, there is no free lunch. We have our GDP, we have resources used to treat illness and/or maintain wellness, and we have population morbidity. There are only so many ways you can distribute the resources. And at the end of the day, somebody's going to be left unhappy.
So the solution is largely a product of the kind of society people wish to live in.
- Bill
Much of what you say is true. And it does dovetail in nicely with what I said. In other words, most people eventually figure their benefits out, and start using them pretty well.
On the flip side, some people will always screw their lives up, no matter how hard you try to make life easy for them.
I remember a fellow fraternity brother (Stuart Large) who was a reasonably smart guy. No PhD in his future, but he did manage to become president of our frat (on his well-liked personality) and eventually made it to medical school after his third try. He eventually went into a new specialty on the treatment of pain.
At the time (somewhere in-between the discovery of the wheel and the space shuttle launch) there was yet another public debate about what to do with U.S. health-care. Socialized medicine (a.k.a. a single payer, government-run system) was being actively advanced as a possible paradigm for U.S. health-care to evolve into. These debates actually made it into the interviews of the many students trying to get into medical school.
Stuart had an interesting take on this. With a perfectly serious demeanor, Stuart acknowledged that folks very well could end up bankrupt while facing the battle against either a chronic or a life-threatening illness. And then he brought up the classic problem with single-payer, government run system - long waits, particularly for elective procedures. He finished the representation of his position with "I'd rather be bankrupt and cured than financially secure and dead."
And you know what? Stuart has a point. In this whole health-care debate, there is no free lunch. We have our GDP, we have resources used to treat illness and/or maintain wellness, and we have population morbidity. There are only so many ways you can distribute the resources. And at the end of the day, somebody's going to be left unhappy.
So the solution is largely a product of the kind of society people wish to live in.
- Bill
Wow, WTF was that all about? 
As you might guess, Bill, this associate professor of clinical medicine and practicing doctor and insured, bigtime taxpayer knows the basics of how insurance works, and I wasn't talking about economic theories or rights or tax policy. I just meant to suggest that insurance companies aren't models of customer service all the time.
Interesting issues were raised however. I think it's worth pointing out that it is very easy to block care from going to a policy holder. For example, let's say you have a guy with severe anemia that expensive epogen prescribed by his hematologist is barely keeping out of the hospital for transfusions. When it isn't enough, I become his doctor overnight and somehow my CONTINUING his epogen becomes an act, or I assume responsibility for it; they deny it, demanding I demonstrate he's failed all alternatives (such as? bueller? bueller?) and I spend 90 minutes on the phone explaining to moron after moron (Bill, I know you're sensitive to this issue having explained how you dropped a phone company for connecting you to Mumbai for service, but English speakers are only a bit better if they don't know what words mean or how their company works) trying to convince them there is no alternative agent nor should there be a repeat trial of being off epo merely because even it isn't sufficient for his condition. They connect me pingpong style to so many people I assumed they were hoping I would drop it and the patient would just die, and it all eventually stopped when I told someone "Listen, if you don't want to pay hundreds for epo, then I'll have to keep him hospitalized for blood for thousands more, and I will explain to him, your manager, and the news why that became necessary." All that to reinvent a wheel that never stopped rolling; his epo had nothing to do with his brief and uneventful admission to our hospital. Of course all along, they were just exercising their well justified plan for prior authorization for specialized prscriptions, right?
When my census drops perhaps I'll have time to review all that other stuff. Briefly, I do think we should tax health insurance benefits so people understand it's real money and start caring about it. Maybe they'd understand why their wages stagnated. As far as rational choices and healthcare, there's some relationship, but choices are soooo far removed from consequences I think it is a remote one. And if we get too far into the choice, rational market thing then someone will point out that you have a choice to get another job with better benefits. However, that sounds way too Republican for me.
As you might guess, Bill, this associate professor of clinical medicine and practicing doctor and insured, bigtime taxpayer knows the basics of how insurance works, and I wasn't talking about economic theories or rights or tax policy. I just meant to suggest that insurance companies aren't models of customer service all the time. Interesting issues were raised however. I think it's worth pointing out that it is very easy to block care from going to a policy holder. For example, let's say you have a guy with severe anemia that expensive epogen prescribed by his hematologist is barely keeping out of the hospital for transfusions. When it isn't enough, I become his doctor overnight and somehow my CONTINUING his epogen becomes an act, or I assume responsibility for it; they deny it, demanding I demonstrate he's failed all alternatives (such as? bueller? bueller?) and I spend 90 minutes on the phone explaining to moron after moron (Bill, I know you're sensitive to this issue having explained how you dropped a phone company for connecting you to Mumbai for service, but English speakers are only a bit better if they don't know what words mean or how their company works) trying to convince them there is no alternative agent nor should there be a repeat trial of being off epo merely because even it isn't sufficient for his condition. They connect me pingpong style to so many people I assumed they were hoping I would drop it and the patient would just die, and it all eventually stopped when I told someone "Listen, if you don't want to pay hundreds for epo, then I'll have to keep him hospitalized for blood for thousands more, and I will explain to him, your manager, and the news why that became necessary." All that to reinvent a wheel that never stopped rolling; his epo had nothing to do with his brief and uneventful admission to our hospital. Of course all along, they were just exercising their well justified plan for prior authorization for specialized prscriptions, right?
When my census drops perhaps I'll have time to review all that other stuff. Briefly, I do think we should tax health insurance benefits so people understand it's real money and start caring about it. Maybe they'd understand why their wages stagnated. As far as rational choices and healthcare, there's some relationship, but choices are soooo far removed from consequences I think it is a remote one. And if we get too far into the choice, rational market thing then someone will point out that you have a choice to get another job with better benefits. However, that sounds way too Republican for me.
--Ian
Addendum:
"And then he brought up the classic problem with single-payer, government run system - long waits, particularly for elective procedures."
Why does this always come up when we talk about single payor? It happens in Canada, but not in all other systems. I mean, gross slabs of bacon covered with maple syrup could result from single payor too, I guess, but they don't, eh? Not always.
"And then he brought up the classic problem with single-payer, government run system - long waits, particularly for elective procedures."
Why does this always come up when we talk about single payor? It happens in Canada, but not in all other systems. I mean, gross slabs of bacon covered with maple syrup could result from single payor too, I guess, but they don't, eh? Not always.
--Ian
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
It IS a problem with most single payer systems. Sorry... not my idea. So I'm not going to defend their incompetence.IJ wrote:
"And then he brought up the classic problem with single-payer, government run system - long waits, particularly for elective procedures."
Why does this always come up when we talk about single payor? It happens in Canada, but not in all other systems. I mean, gross slabs of bacon covered with maple syrup could result from single payor too, I guess, but they don't, eh? Not always.
For your perusal...
The Myths of Single-Payer Health Care
- Bill
