Health Care Costs Destroying Small Businesses

[Diego in Seattle]

I wonder what happens when the rich folks disappear? You know, like in Maryland where the number of millionaire taxpayers fell significantly from last year after imposing higher taxes??

Last year it rained in Maryland, too.

Perhaps we should try to reduce rainfall since it caused a decrease in millionaires in Maryland, too.

Dumbfuck.

[titlover]

I wonder what happens when the rich folks disappear? You know, like in Maryland where the number of millionaire taxpayers fell significantly from last year after imposing higher taxes??

Last year it rained in Maryland, too.

Perhaps we should try to reduce rainfall since it caused a decrease in millionaires in Maryland, too.

Dumbfuck.

same thing is happening in NY state, dumbfuck.

[Left Seater]

I wonder what happens when the rich folks disappear? You know, like in Maryland where the number of millionaire taxpayers fell significantly from last year after imposing higher taxes??

Last year it rained in Maryland, too.



Dumbfuck.

Uhhh, seems you are the dumbfuck here. Learn how to cut and paste.

[Van]

You gotta wonder why anybody in their right mind would want to take up OB/GYN

Really?? You do??

Let me help you out with this one, Wolfie...



(I would've provided you with a more detailed and vivid explanation as to why I could see someone wanting to be an OB/GYN doc, but this wasn't my thread and I can't just go and add the necessary (!) to the thread title. So, even though I know it's been literally forever for you, search your memory and try and recall what she's hiding there beneath those panties. It's really very pretty, and kinda yummy too.)

[Van]

mvscal, I am not re-posting that nightmare, but suffice it to say that that's why they created Fridays, and letting some other doctor sub for you while you go off and play golf.

[Wolfman]

As you might expect--"VAN" has no clue about anything that deals with reality. Med students are avoiding certain specialties like the plague because of all the liability costs. He (or is it a she ?) thinks that someone would go into that part of medicine because it is a fun job to look up lady's twats all day. "Cunning linguist" tells it all. Fixation on sexual body parts much ??
Guess you never heard any of those lawyer TV ads about "untimely C-sections" et al.

[Van]

Wolfie, you are fast becoming quite beyond ponderous. Jesus, you're one humorless toad.

[smackaholic]

Do you suppose it's possible to be discretionary in the OB/GYN bidness? You know, just cherry pick your customers? I mean hot 24 year old dental hygenists need the occasional check up as well?

I'm guessing the AMA or whatever body it is that oversees the cooter doc profession, might frown on doing so.

BTW, just what the fukk is that, uhhh, think hanging down there in that pic? I'm guessing either left thigh or the mother of all fupas. Can we get a [G] in this thread's title, please?

[JMak]

Jmak has an interesting idea, though not expressed. What if the federales passed a law that prohibited employers from offering health insurance as a benefit incident to employment? Then everyone would have to get into a private insurance plan or risk financial ruin. The problem with employer paid plans is that someone else is, again, paying for it (i.e., the employer). If you make the users pay their own way, then they have an interest in the cost.

I've made this argument for years...the reason we cannot get cost containment in health care is precisely because the vast majority of those carrying health insurance do not pay the full cost of the health care services they consume nor the cost of the insurance that subsidizes what they consume. There's no financial incentive for an end-user to question the doctor's prescrition choice when they have to pay $5, $25, or even $40 of a $150 script. There's no incentive for doctors to not order more and more tests when they look at the patient and say that the insurance company will pick up the cost. There's no incentive for an individual exhibiting minor flu or cold symptoms not to go to the doctor and not blindly accept a z-pak script.

It makes me laugh every time I hear some dumb bastard complain because his company is making him pay $60 a month for health insurance when it used to be $30, and he just got a 100% increase. If people really knew what they were paying for health insurance, a lot of this shit would stop immediately.

Word.

[JMak]

ANd jmak makes a very good point that having something as critical as health insurance be paid for and controlled by an employer is pretty fukking dumb.

Thanks.

If my employer gave me the option of a couple thousand dollar deductible plan and paid me the difference, I'd be all over it.

Some employers are dumping employees into these high deductible plans and then turning around and reimbursing employees for some amount up to the deductible just to get the lower premium triggered by the high deductible. For example: $3000 annual deductible. The employer makes the employee pay the first $500 and then the employee gets reimbursed for expenses between $500 and $3000. Pretty smart.

Last year it rained in Maryland, too.

Perhaps we should try to reduce rainfall since it caused a decrease in millionaires in Maryland, too.

Dumbfuck.

Yeah, 'cuz, you know...when you raise taxes, taxpayers make no effort to reduce the amount of their income subject to taxes, right? My god you're dumb.

[JMak]

Guess you never heard any of those lawyer TV ads about "untimely C-sections" et al.

These are new commercials here in Metro Detroit. Our local PI lawyer, Geoffrey Feiger is now targeting OBs by suing them for infant brain defects. Blew me away the first time I saw his commercial.

[Mikey]

If my employer gave me the option of a couple thousand dollar deductible plan and paid me the difference, I'd be all over it.

Some employers are dumping employees into these high deductible plans and then turning around and reimbursing employees for some amount up to the deductible just to get the lower premium triggered by the high deductible. For example: $3000 annual deductible. The employer makes the employee pay the first $500 and then the employee gets reimbursed for expenses between $500 and $3000. Pretty smart.

Works for me, only we get our HSA funded with the full amount of the deductible. If we don't use the whole thing it carries over to the next year.

Thank you very much.

[smackaholic]

Don't sound very fair to me, mikey. Shouldn't that windfall you received because you were lucky enough to not have a heart attack go to subsidize the delivery of Consuela's 10th baby?

[JMak]

Don't sound very fair to me, mikey. Shouldn't that windfall you received because you were lucky enough to not have a heart attack go to subsidize the delivery of Consuela's 10th baby?

I'm sure Mikey is all for Obama's plan to tax his health care benefits. That's how Consuela's 10th kid, Mary's 6th kid, and Shaniqua's 8th illegitmate kid gets paid for.

[Mikey]

Don't sound very fair to me, mikey. Shouldn't that windfall you received because you were lucky enough to not have a heart attack go to subsidize the delivery of Consuela's 10th baby?

You're the father. You pay for it.

[Mikey]

Don't sound very fair to me, mikey. Shouldn't that windfall you received because you were lucky enough to not have a heart attack go to subsidize the delivery of Consuela's 10th baby?

I'm sure Mikey is all for Obama's plan to tax his health care benefits. That's how Consuela's 10th kid, Mary's 6th kid, and Shaniqua's 8th illegitmate kid gets paid for.

We end up paying for it anyway.

Whether it's by taxing health care bennies (not a good idea, IMO), or insured customers paying higher hospitalization prices to cover the indigent care that they are required to provide, or whatever other scheme they come up with, it comes out of the paying and/or insured customers' pockets in the end.

The best solution would be to harvest them while they're still young and tender, and turn them into gub'mint cheese. That way we could create an at least partly self-sustaining underclass.

[smackaholic]

The best solution would be to harvest them while they're still young and tender, and turn them into gub'mint cheese. That way we could create an at least partly self-sustaining underclass.

Wow, you really are turning into a republican.

Good to have you aboard.

[socal]

The best solution would be to harvest them while they're still young and tender, and turn them into gub'mint cheese. That way we could create an at least partly self-sustaining underclass.

Wow, you really are turning into a republican.

Good to have you aboard.

WW, you may want to turn away from your monitor.
.
.
.
.
.
.
.

[Dr_Phibes]

I've made this argument for years...the reason we cannot get cost containment in health care is precisely because the vast majority of those carrying health insurance do not pay the full cost of the health care services they consume nor the cost of the insurance that subsidizes what they consume. There's no financial incentive for an end-user to question the doctor's prescrition choice when they have to pay $5, $25, or even $40 of a $150 script. There's no incentive for doctors to not order more and more tests when they look at the patient and say that the insurance company will pick up the cost. There's no incentive for an individual exhibiting minor flu or cold symptoms not to go to the doctor and not blindly accept a z-pak script.

So you've been pissing up a rope for years.

The principle of insurance being successful is spreading the risk into as broad a pool as possible and you've got the impression that it should be pay as you go for your individual consumption? All the more reason to eliminate insurance companies from duplicating the same task.

You seem confused, you are making an arguement for no insurance at all.

And whinging about abuse is pointless, it averages 2% among all countries with socialised systems, I don't know what the US stats are, but I'll guess they wouldn't vary much. That's a shitty talk radio borefest.

[Terry in Crapchester]

If health insurance really worked like insurance there wouldn't be such a problem.

If you own an auto or a home you can get insurance, if you're willing to pay for it and don't have multiple DUI's.

In my example above, take away the assumption that the guy owns his home. The fact that health insurance is so expensive that it would require one to mortgage one's home to obtain it is another issue. If a person can't get COBRA - doesn't have a home to mortgage or misses out on the 30 day window to activate it - then they have to find individual coverage.

I don't know what the situation is where you live, but for most people here individual coverage is not just expensive, but impossible to find. Any existing condition, slight hypertension, whatever, will be cause for rejection. Almost anybody over the age of 40 will have something in their medical history that the insurance companies will use as a reason.

When I was self-employed I applied to Blue Cross. They said, "sure we'll cover your wife and kids but you can take a hike. We won't cover you at any price."

Thanks a lot. As far as I'm concerned the health insurance industry is a blot on our society. Socialism or not, I think they should all be run out of business.

Mikey, you're kinda ignoring a central point...no one is entitled to health care insurance. An insurer has no obligation to insure anyone who applies. As well, insurance works on the basis of risk. It's foolish for an insurer to offer insurance to an individual it knows, based on a health examination, will take out more in claims that he will pay in premiums. Insurance works on insuring against the risk of a claim. The examples you cited have high risk factors. Having your application for insurance approved, rejected, or charged a higher premium is precisely how the insurance industry should work.

The problem with that is that just about anything qualifies as a "pre-existing condition," from what I've been told.

A few years back I had a kidney stone. Not exactly the sort of thing that puts me in JSC territory as far as a health risk goes, but enough to put me in the "pre-existing condition" category.

I'm self-employed, so as it turns out, the cheapest way for us to carry health insurance is through my wife's employment. We pay about $450/month for a family plan, which I'm told is quite reasonable. Problem is, because of the pre-existing conditions that exist, my wife is stuck in a job that pays next to nothing and offers relatively little opportunity for advancement. And if my marriage were to go south, I might find myself stuck in it nonetheless if I want to continue to have health insurance.

[smackaholic]

I'm self-employed, so as it turns out, the cheapest way for us to carry health insurance is through my wife's employment. We pay about $450/month for a family plan, which I'm told is quite reasonable. Problem is, because of the pre-existing conditions that exist, my wife is stuck in a job that pays next to nothing and offers relatively little opportunity for advancement. And if my marriage were to go south, I might find myself stuck in it nonetheless if I want to continue to have health insurance.

Bull fukking shit!!!!

Your wife is not stuck in a shit job. Well, she might be stuck there, but, not for healthcare reasons. Remember that insurance portability thing bubba and the evil republicans got passed awhile back? It says your OL can go from one yob to another and the insurance has to take you. If she leaves a yob and goes uninsured for a spell, well, that's a different story, but, I can't imagine that something as minor as a kidney stone is gonna get you locked out of most policies.

[Terry in Crapchester]

I'm self-employed, so as it turns out, the cheapest way for us to carry health insurance is through my wife's employment. We pay about $450/month for a family plan, which I'm told is quite reasonable. Problem is, because of the pre-existing conditions that exist, my wife is stuck in a job that pays next to nothing and offers relatively little opportunity for advancement. And if my marriage were to go south, I might find myself stuck in it nonetheless if I want to continue to have health insurance.

Bull fukking shit!!!!

Your wife is not stuck in a shit job. Well, she might be stuck there, but, not for healthcare reasons. Remember that insurance portability thing bubba and the evil republicans got passed awhile back? It says your OL can go from one yob to another and the insurance has to take you. If she leaves a yob and goes uninsured for a spell, well, that's a different story, but, I can't imagine that something as minor as a kidney stone is gonna get you locked out of most policies.

Actually, upon further review, we're both wrong.

HIPAA does allow a lookback period for a pre-existing condition, but it's only six months. http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html Fortunately, that wouldn't lock me out on the basis of a kidney stone. I do have high cholesterol, so that would fall within the lookback period, but might be too minor to lock me out as a pre-existing condition.

I've heard that a kidney stone can qualify as a pre-existing condition, but don't know for certain whether that's true.

Still wondering why the pre-existing condition locks Mikey out of health insurance coverage, if that's the case, unless he's still receiving treatment for it.

[JMak]

So you've been pissing up a rope for years.

Well, yeah...not many people want to give up the subsidization of their health care costs whether by their employer or the government.

The principle of insurance being successful is spreading the risk into as broad a pool as possible and you've got the impression that it should be pay as you go for your individual consumption? All the more reason to eliminate insurance companies from duplicating the same task.

Pay as you go to a certain extent and then we'd have some rational consumption of health care services as opposed to what we have now. An appropriate analogy I saw long ago in the Detroit News...if we were to treat our car insurance like health care insurance, then AAA, Progressive, et al would be paying on claims for new brakes, new tires and wheels, and transmission repairs.

Yes, we should pay for health care as we go. Patients would use their brains more. Doctors would be more thorough in their diagnoses. We would not have Medicare and Medicaid corrupting the provision of health care services. Win, win, win. Insurance would be for catastrohic claims.

The current health care insurance business is as big a racket as auto sales, credit cards, and the former housing bubble...it's a vicious circle of passing the buck until someone has to pay up.

You seem confused, you are making an arguement for no insurance at all.

No, I'm making a case for rational consumption of health care services. Individually we treat health care as an infinite resource despite the fact that there's a finite amount of such resources. The fact that very few of us actually pays full freight for their health care only exacerbates this problem of over-consumption.

And whinging about abuse is pointless, it averages 2% among all countries with socialised systems, I don't know what the US stats are, but I'll guess they wouldn't vary much. That's a shitty talk radio borefest.

I'm certainly not complaining about abuse.

[JMak]

The problem with that is that just about anything qualifies as a "pre-existing condition," from what I've been told.

I don't see a problem there. Pre-existing conditions nearly guarantee future claims. An insurance company is obviously assuming a greater risk covering such conditions, hence, they should be able to charge greater insurance premiums to hedge that greater risk of a claim. Where's the problem?

I'm self-employed, so as it turns out, the cheapest way for us to carry health insurance is through my wife's employment. We pay about $450/month for a family plan, which I'm told is quite reasonable. Problem is, because of the pre-existing conditions that exist, my wife is stuck in a job that pays next to nothing and offers relatively little opportunity for advancement. And if my marriage were to go south, I might find myself stuck in it nonetheless if I want to continue to have health insurance.

$450 is quite reasonable. My employer pays more than $700/month for two-person coverage.

You're in a tough spot and I sympathize. So you're saying that you'd have to pay far more for coverage on your own, right? The problem for you is obvious...more out-of-pocket costs, but I don't see the problem, generally.

Sure, insurance is intended to spread the risk broadly, but that doesn't mean that the insurer has to so broadly spread that risk that it makes no money or cannot generate enough revenue to cover actual claims not to mention disadvantaging those insured who have no pre-existing condition and forcing them to pay even more to subsidize your claim(s).

[Terry in Crapchester]

I'm self-employed, so as it turns out, the cheapest way for us to carry health insurance is through my wife's employment. We pay about $450/month for a family plan, which I'm told is quite reasonable. Problem is, because of the pre-existing conditions that exist, my wife is stuck in a job that pays next to nothing and offers relatively little opportunity for advancement. And if my marriage were to go south, I might find myself stuck in it nonetheless if I want to continue to have health insurance.

$450 is quite reasonable. My employer pays more than $700/month for two-person coverage.

Maybe I wasn't quite clear. $450/month is our cost, deducted from my wife's paycheck. I don't know what her employer pays, I suspect about 1/2.

[Diogenes]

So since you personally have a problem with vow pre-existing conditions are defined by your carrier, the obvious solition is...

Have the Federal government take over the entire industry.

Perfect demonstration of how the Left defines 'reform'.

[JMak]

Maybe I wasn't quite clear. $450/month is our cost, deducted from my wife's paycheck. I don't know what her employer pays, I suspect about 1/2.

You're right, I didn't understand your prior comment. Thanks for the clarification.

[smackaholic]

I do have high cholesterol, so that would fall within the lookback period, but might be too minor to lock me out as a pre-existing condition.

Tell the OL to start cooking white folk's food. Or maybe chinese. No more fried chicken for you!!!

[socal]

vow solition

I think you'd better vow to switch to caffeine.

[Diogenes]

vow solition

I think you'd better vow to switch to caffeine.

Typo 'smack'?

Then again, I've seen your 'takes'. Acknowledge your limitations and stick with this.

[JMak]

Government-run health care - Canada-style: http://www.windsorstar.com/goes+Buffalo ... story.html

A 30-year-old man was diagnosed with stage IV melanoma: skin cancer that has migrated inside and invaded his chest and bowel. Although the skin cancer was diagnosed years ago, the stage IV was diagnosed late. Now, that may be because of the government monopoly's lack of access to specialists, but it may also be idiosyncratic. Even with the best access to health care, doctors can't catch everything.

In this case, what happened after the diagnosis is what's truly appalling. Because his home province of Ontario does not have the capacity to treat this advanced cancer, the Ontario Health Insurance Plan (OHIP), which has absolute control over every Ontarian's insured health care, must contract with U.S. providers. Scheduled for treatment in Detroit, OHIP screwed up the paper-work and he could not go.

By the time things were sorted out, OHIP had cancelled its contract with the hospital in Detroit (right across the river, as mentioned above), so he has to go to Buffalo, NY — four hours away.

Tragically, he hasn't been able to work, and his wife has just had a baby. The family relies on the charity of neighbors for the baby's clothes and other needs.

And this system is the darling of the Left's health care success stories?

More? http://www.canada.com/Health+wait+times ... story.html

In this year's report, the WTA evaluated wait times in the priority areas and beyond and found that a majority of patients had wait times that exceeded the 18-week target used by the WTA.

"The study showed that for many of the medical specialities in Canada examined, we don't even come close to meeting that target," said Bellan. "There remains a great deal of unfinished business when it comes to addressing wait times in Canada."

So, when we have Canada-style health care here in the US, where will I be able to go to receive basic treatment, let alone more critical treatments like chemo, dialysis, etc.?

[smackaholic]

I don't know what's worse, getting stage 4 melanoma or being told you have to go to detoilet.

[JMak]

I don't know what's worse, getting stage 4 melanoma or being told you have to go to detoilet.

One thing Detroit has is some very good hospitals and treatment centers. Henry Ford, St. Johns, and the Detroit Medical Centeral along with the Karmanos Cancer Institute are among the best in the nation in all sorts of specialities. That guy would have been very lucky to get treatemnt here. Not sure how it would compare to Buffalo, though, probably very favorably if not substantially better.

[Mikey]

Still wondering why the pre-existing condition locks Mikey out of health insurance coverage, if that's the case, unless he's still receiving treatment for it.

It locked me out when I went from an employer's plan to applying as an individual.

Blue Shield simply refused to cover me with an individual policy, and my wife wasn't working so there was no company plan to cover me there. When I went back to full time employment I got put on the company's policy and have no problem now. The OL is working now too (at the same place that I work at) so if I went back to freelancing I'd still have coverage.

The problem remains, though, that as an individual it's difficult if not impossible to find coverage unless you're 25 years old and never been sick.

[ucantdoitdoggieSTyle2]

Actually, upon further review, we're both wrong.

HIPAA does allow a lookback period for a pre-existing condition, but it's only six months. http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html Fortunately, that wouldn't lock me out on the basis of a kidney stone. I do have high cholesterol, so that would fall within the lookback period, but might be too minor to lock me out as a pre-existing condition.

The 6 month rule is not set in stone. As an example, you could have a heart condition that goes back to a "birth defect" and still be covered if it was never diagnosed. There's other provisions contained therein that detail late enrollment issues and lapses in coverage that may also have an effect on the exclusion period.

[Terry in Crapchester]

I do have high cholesterol, so that would fall within the lookback period, but might be too minor to lock me out as a pre-existing condition.

Tell the OL to start cooking white folk's food. Or maybe chinese. No more fried chicken for you!!!

No fried chicken for me. I won't claim to be the healthiest eater in the world, but I never really got into fried food of any sort (except French fries). Amazing, since I lived in the South for 3 1/2 years.

Even more amazing, I don't even do chicken wings, even though I'm from the home of the chicken wing. That's a story for another thread.

I will eat grilled, boneless, skinless chicken, however. And not even because I'm trying to eat healthy, I actually prefer the taste. My weaknesses, fwiw, are pizza and Mexican food.

[smackaholic]

I absolutely love pretty much anything deep fried. Fortunately for me though, I know enough to stay away from it most of the time. And how the fukk can you not be a wings far seeing as it's the one and only food group you fukks have bode on.

[Dr_Phibes]

Imagine what automobile insurers would charge if the policy required them to pay for gasoline, tune-ups, car washes, tires, brakes, tolls, etc. in addition to catastrophic losses incurred in accidents.

Again, you have no clue what you are advocating.

But you and Jmak keep returning to the same themes

- correct the asymmetry of knowledge between doctor and patient and a more responsible attitude from the doctor will constitute adequate reform. Keep Miguel, the runny nosed Mexican away from the hospital.

- Insurance is only for catastrophic events, not general practice.

Those fears are not borne out by socialist models. For example, the Canadian system covers every little pointless thing.. oil changes, tune ups, air fresheners, dashboard lighters - to major disasters.. transmission.
There are a few exceptions:

headlights/optometry
dental/grill
tattoo removal/touchup paint

And there is no explosion in cost, you're fear mongering. At this point in time, the United States government spends more per capita on health care than the Canadian government. Yes, the US GOVERNMENT. The amount of America's paycheque that funds the American health non-system dwarfs the proportion of Canada's paycheque that funds the Canadian system. It is a fact, and you only cover (half?) the population.

You exist in a state of denial that the problem is bureaucratic and administrative.

The only way you can argue this is like Jmak.. with the only weapons remaining in the repertoire of the anti-socialised insurance crowd - bizzare anecdotal evidence and confusing wait times between elective and emergency surgery.
I'll admit that quality of care in the US is slightly better, but it's so marginal that it doesn't even effect life expectancy or morbitity rates.
I'll leave Michael Moore to die of a heart attack in US, thank you very much - there are no perverse incentives to keep yourself fit in socialism, no fucking hippies telling you what you can and can't eat or you won't get treatment.

And what does advances in treatment have to do with a payment system? The pharmaceutical and medical industries are related but separate. You don't need to socialise drug production to socialise medicine (or medical insurance).

[Diogenes]

Typo 'smack'?

Then again, I've seen your 'takes'. Acknowledge your limitations and stick with this.

I would call it ignorant fucktard smack. Seriously, you're barely even literate.

Coming from a insipid moronic douche like you, that's quite underwhelming.

[Diego in Seattle]

I don't know what's worse, getting stage 4 melanoma or being told you have to go to detoilet.

One thing Detroit has is some very good hospitals and treatment centers. Henry Ford, St. Johns, and the Detroit Medical Centeral along with the Karmanos Cancer Institute are among the best in the nation in all sorts of specialities. That guy would have been very lucky to get treatemnt here.

I bet they're reall good at treating gsw's, with all that experience they have.