Is the "Patient Protection and Affordable Care Act" Constitutional?

425 posts / 0 new

Comments

Quote Art:

What is your argument for this? I don't see any reason to believe that this is true. Can you offer some examples?

Changes to medicare require acts of congress, Private insurance is under no such restriction.

Since it is late and I would like to keep my answers short, Read: On Innovation, Medicare Follows Rather Than Leads (last section)

So, we are supposed to base our National Health Care on concerns that some people are complainers?

Aren't we already... All they do is whine.

And the Private Insurance carriers don't dictate the terms of healthcare? Private insurers don't eliminate customer base and use the law to do it? Everybody in America get the same level of healthcare with today's Insurance Industry management?

Feel free to post anything that claims a doctor or Hospital has lost money charging Private insurance. I seem to recall Mayo Clinic had to charge thier private carries more to offset the losses of Gov Care. Since Mayo clinic is still operating, I'll assume it was successfull.

No, you get what you pay for. as it should be.

Do you have any kind of reasoning to support this opinion?

Turn on the news. NHS (UK) system is crashing bad...... the story from the UK should scare the shit out of you. France borderline bankrupcy, Sweden is privatizing certain aspects of thier healthcare system because it cheaper and more efficent. Lots of reasoning, lots of Support.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote Dr. Econ:

I was speaking more generally. If we, as a nation, believe that the welfare state is constitutional, then so should Obamacare.

Faith is a very poor substitue for reality. Believing something doesn't make you true.

But in this case, most do not "believe" the mandate is constitutional

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote Dr. Econ:

Sorry, that should be John Adams. Otherwise, yes, the system is basically a single payer system put in place by a blessed 'founder' and many other founders in congress. It was temporary in the sense they were covered while they were seamen, but otherwise there were no time limits and no other limitations of care specified in the law. The 'temporary' aspect refered to 'temporary relief' in addition to their health care (or 'maintenance '). Perhaps they were thinking of some assistence beyond their health care in the form of food or shelter. And, the law also covered disabled persons - which implies that some people who were simply disabled and not in need of health care would get assistence. The exact quote is

Quote John Adams: to provide for the temporary relief and maintenance of sick, or disabled seamen, in the hospitals or other proper institutions now established in the several ports of the United State

Does that 1798 Act Make Obamacare Constitutional?

As I said, Wrong on many levels. There were only 5 "Framers" in congress in 1798. Also will point out Adams was a founder, but not a Framer, He was in Europe during the Constitution.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

Back to the issue, I still haven't seen anyone argue that any one person can be certain to never require medical care, and if that person is without health insurance the tax payers and all health care purchasers are footing the bill of shirker.

And, even Justice Scalia has recently ruled that the commerce clause with the necessary and proper clause allows the federal government the power to enact any law or enforce any federal law over a state's laws. In California, the marijuana dispensaries are under attack for breaking federal laws, and Scalia said the feds have the power to execute the federal laws including any they deem necessary to carry out other laws, even if the marijuama never crosses a state or federal border.

Lastly, John Adams wrote the Massachusettes Constitution, before he went Paris. That included 3 branches of government, vetos, overides, and an independent judicial branch. And a bicammeral legislature. All firsts in the world. And they were all ideas adopted into the national constitution. Adams essentially wrote it first, and then it was copied for the feds except while Adams made slavery illegal in Massachusettes, at the national level the Southerners were able to block that.

Phaedrus76's picture
Phaedrus76
Joined:
Sep. 14, 2010 8:21 pm

Sorry but I gotta agree with Capital on that one. I don't much to add because I've been drinking. Peace.

Bush_Wacker's picture
Bush_Wacker
Joined:
Jun. 25, 2011 7:53 am

Actually, I don't think that Obamacare is 'reforming the healthcare system'--as I've tried to indicate with my previous posts, I think that Obamacare is extending what we have now into levels of inefficiency that will not--and cannot--be financially solvent--but which corporations will be--and are--able to capitalize on such an arrangement in the short run (in fact, I think that Obamacare was proposed by the health care industry for that very purpose). The main problem--and the main issue that needs to be addressed and answered--with the American health care system is whether this is to be a service universally available and applied as if a right to everyone--or a privileged product that is only available to those who pay for it.

As it stands right now, the mixing of its application as if legally a universal right (EMTALA laws, for instance--but, also, every medical malpractice case where those that pay nothing can sue for as much as those who pay all their costs personally up front--which does endorse the concept that everyone legally has the right to the same medical care) that alternately, and contradictorily, changes its financial impetus and payment structure for such an application as if if were to be sold as a privileged product creates all the earmarks possible for it to be abused--and is abused--by all involved. No one is following the bottom line--if everyone is to have medical care as has been legally promoted, how is that to be responsibly financed to cover all such costs? And, if it cannot be responsibly financed in any way, why is it legally promoted like everyone has the right to the same medical care? Decide it one way or the other--is medicine a legal right--or a financial privilege? And, act accordingly. But, until that fundamental issue to this industry is asked and answered, the abuse potential in its applicaiton and financing will continue--and, as a forced payment system into a private for-profit industry, Obamacare will just make matters worse. If this is going to be a universally applied system that it legally has claimed all along, somebody (or something) needs to follow the bottom line to the real costs of its application--or it can never be financially solvent with the way that it can be charged in an 'open ended' manner as if an industry in the so-called 'free market' constantly expanding its market potentials....as if it is 'competing' for the special privileges to be paid separately....

Barack Obama nailed this problem in his book, The Audacity of Hope, when he pointed out that 20% of the population takes up 80% of the health care budget. And, of that 20% that take up 80% of the health care budget, government already pays for 70 to 80% of that. Leaving the other 80% that take up 20% of the health care budget to have insurance companies be able to capitalize on for profit. A defacto corporate-government collusion. And, the problem with that is that the same person pays for both entities, the taxpaying consumer--as the taxpayer paying for the government subsidies and as the consumer paying apart from that for health care insurance. Why Obama, or anyone, has not pointed this out in any national debate or discussion about the difference between the application and financing of the health care system in America, I do not know. I suspect it is because it is too direct to decide on and maintain the personal wealth offered in the political advantages of colluding government with corporations. Also, it would then hold those making such decisions--in industry and government--responsible for their positions. If we are to finally say that health care is a privilege only to those who can pay, then address what some may have a problem with when the non-payers are turned away and die or are disabled. If we are to finally say that health care is a universal right, then colluding private industry with government subsidies is NOT a 'universal solution'--especially if no one is following the bottom line in the real costs of such an application.

We've avoided responsibly determining this issue for too long--and Obamacare is not making it any clearer or resolving the discrepancies possible when its comes to the private industry's implications of acquiring particularly private profits over the basic universal costs if health care is to be applied to everyone in America.

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm

So, with regards to my previous post, I do see Capital dancing around this issue of 'universal right' vs. 'privileged product in the market'--but I don't see Capital responsibly answering that contention.

For instance, Capital's answer to my question here in post #170...

And, when it comes to 'artificially limiting markets', don't insurance companies say what they will and will not pay for with respect to Healthcare? Is that an 'open market'?

was this in post #183:

McCarran–Ferguson Act was passed by Congress in 1945. Created 50 fiefdoms and severed portability between states. There are now 50 different insurance plans with their own level of mandates. That is not an "open Market" and it "artificially limits markets to a state level"

See the side-step there? Art noticed it. Did Capital address at all anything about how insurance companies deciding what and what not to pay for represented an 'open market' in the application of health care? No. All Capital implied was that government restricting insurance companies access to the 'national market' wasn't 'open'. And, if insurance companies were to be opened to the 'national market', what does that actually do to their deterimination on what they do and do not pay for? And, how does that determination represent an 'open market'--vs. something being 'artificially limited' by the insurance companies themselves? Which gets back to my original point: What is an 'open market' when it comes to the application of health care--especially if it is to maintain any semblance to its present legal application as if a right (with EMTALA laws and medical malpractice lawsuits)? Capital seems to say that EMTALA ought to be covered by Medicaid--another government subsidizing of what Capital is trying to represent as a privileged financial product. Is it a privileged financial product--or not?

Capital goes on to claim that the Mayo clinic has lost 800 million dollars from Medicare and Medicaid--and that doctors are refusing to see Medicare and Medicaid patients. While some doctors in private practice are starting to restrict seeing Medicare and Medicaid patients in their offices, it is because of the recent reimbursement changes in Medicare and Medicaid with respect to office visits. I suspect that is right in line with government 'saving' all that money spent out on private practitioners in order to 'spend' it more in line with the corporatization of medical practice--which, in the long run, will cost more money (but most lobbyists pay legislators in the interest of the industry--not in the interest of private practitioners). And, as far as the Mayo clinic losing 800 million dollars, if medical care is to be offered to everyone as it has been legally applied for decades, what would the loss be to the Mayo Clinic if no payment were offered but they were still required to give the care as has been the premise of medical applicaitons all along? In fact, if the Mayo Clinic is refusing to see Medicare and Medicaid patients, how does it get around the EMTALA laws to do so? Or, is this just another scam? Remember, at one point in this discussion, Obama was holding up the Mayo Clinic as being one that efficiently manages appropriate health care to its population--pointing out that, on a per capita basis, the Mayo Clinic is one of the least expensive places for Medicare patients to get health care (one of the most expensive was in the Texas-Mexican border of McAllen)--and, perhaps, the Mayo Clinic system (which has salaried physicians) could serve as a model for efficient and effective care for the nation. I suspect that the '800 million dollars' that the Mayo Clinic has lost is in comparing what it has recouped from Medicare on a per capita basis vs. McAllen--where the application of medical care costs Medicare almost twice as much. So much for 'efficiency'.....can't have that interfere with 'free market competition' and its 'profitability', now, can we?

Interesting aside that has recently been going on in the health care industry with hospitals is how such hospitals now approach those patients that have neither health insurance nor government subsidies. When it comes to those that have been 'caught in the middle' that are too rich (or not in the right category) for government subsidies but too poor to afford (especially personal private--not corporate employee endorsed) health insurance, hospitals having been billing them differently than they do either insurance companies or government. My brother's wife got lung cancer and had no insurance or government support because of that very issue (personal private health insurance not bound to a corporate employee job is still quite expensive--and, even with Obamacare, will still be so and whose price will still be adjusted according to pre-existing conditions--only corporate employee insurance is offered without adjusting to pre-existing condition increases in costs to the one it is for--now and with Obamacare--I guess to afford health care, you either need to be government subsidized or have a corporate job). At any rate, as my brother found out, hospitals now will adjust the bill if you are without government subsidies or health insurance benefits to your care--substantially downward (and can cut it by 2/3rds to 3/4ths or more with respect to what they bill Medicare and insurance companies). I know in my practice experience that if a privately practicing physician were to bill someone differently than they did Medicare or insurance companies in such a manner that would have been deemed as Medicare and insurance fraud--and that physician risk loss of license and possible imprisonment or fines. But, apparently not so when it comes to corporations......So, are the corporations billing the truly private pay patients less than their costs--or are they billing Medicare and insurance companies substantially more than their costs? 'Enquiring minds would like to know'.....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm
Quote Capital:
Quote Dr. Econ:

Sorry, that should be John Adams. Otherwise, yes, the system is basically a single payer system put in place by a blessed 'founder' and many other founders in congress. It was temporary in the sense they were covered while they were seamen, but otherwise there were no time limits and no other limitations of care specified in the law. The 'temporary' aspect refered to 'temporary relief' in addition to their health care (or 'maintenance '). Perhaps they were thinking of some assistence beyond their health care in the form of food or shelter. And, the law also covered disabled persons - which implies that some people who were simply disabled and not in need of health care would get assistence. The exact quote is

Quote John Adams: to provide for the temporary relief and maintenance of sick, or disabled seamen, in the hospitals or other proper institutions now established in the several ports of the United State

Does that 1798 Act Make Obamacare Constitutional?

As I said, Wrong on many levels. There were only 5 "Framers" in congress in 1798. Also will point out Adams was a founder, but not a Framer, He was in Europe during the Constitution.

You mean it is wrong to say John Adams was not a founder? This doesn't even past the laugh test!

And, really the Ludwig von Mises Institute? Really?

Dr. Econ's picture
Dr. Econ
Joined:
Jul. 31, 2007 4:01 pm

And, going back to this 'cost coverage' question with health insurance corporations, government, and hospitals, and Capital's claim that Mayo Clinic has lost 800 million dollars, if the costs of medical care aren't covered, how do the corporate chief executive officers make so much money to the order of millions--to hundreds of millions--of dollars? Is that too many questions, Capital?

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm
Quote Kerry:

So, with regards to my previous post, I do see Capital dancing around this issue of 'universal right' vs. 'privileged product in the market'--but I don't see Capital responsibly answering that contention.

How Clear do I need to be for you? IT IS NOT A UNIVERSIAL RIGHT.

If you misconstrue it again, I'll assume you are doing it on purpose.

See the side-step there? Art noticed it. Did Capital address at all anything about how insurance companies deciding what and what not to pay for represented an 'open market' in the application of health care? No.

It called spinning, As you are doing now. Address the limiting the Market to State Levels. Then you can ask about Insurance companies Contractual obligations. Which will be easy, because it's a Contract. Their picking and choosing is limited to what is written in the terms of the contract.

Capital seems to say that EMTALA ought to be covered by Medicaid

I am Saying they should fund the mandate they bestowed upon the market, Do you disagree?

In fact, if the Mayo Clinic is refusing to see Medicare and Medicaid patients, how does it get around the EMTALA laws to do so? Or, is this just another scam?

You already know how, for one I already told you. If you no longer accept Medicare payments you are no longer bound by EMTALA provisions..

I suspect that the '800 million dollars' that the Mayo Clinic has lost is in comparing what it has recouped from Medicare on a per capita basis vs. McAllen--where the application of medical care costs Medicare almost twice as much.

I can't even imagine the convoluted thinking needed by you to derive such crap.

The quote reads "Last year, Mayo lost $840 million on $1.7 billion in Medicare work. It compensated by charging private insurers a premium for the Mayo name, but (health plans are) starting to balk."

Why don't you deal with the whole host of issues I brought up before heading off on some tangent.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

Capital, under the authority vested in him by Mammon, declares that healthcare is subject to the ability to pay for it and is not a universal human right or part of the "general welfare" under the Constitution. I, under the authority declared by Kerry for telling him to go to hell, as arbiter of salvation, declare that healthcare is a universal human right. So there you go, Capital.

Actually, the Constitution leaves a lot of open-ended questions open and presumes that the ennumerated Rights do not exhaust all of the inalienable rights of human beings. The legalists have tried to use the Commerce Clause to do a lot of stuff by extension. You can have various opinions about these interpretations of texts and law. But, at some point we have to come up against a moral issue that is bigger than its letters or rules.

I do not believe the Founders establlished Commerce as the equivalent to democracy or saw "property rights" as the currency of human freedom. But, even had they believed this, they did not make us subject to a Commercialized vision of democracy and universal human rights.

If you want to argue tradition, religion and culture, you would have to invoke the rights of the sojourner in our land to be treated like the rest of us. If you see America having to do with a modern recognition of the dignity and worth of every person, it would also follow that basic human needs are to be met as part of being human.

But, if you just want to work from existential reality and what it takes to have an effective and functioning society, I think you will get to the same place. Freedom is still for all, or none. Being our brother's keeper is still the practical way to avoid unbearable results. We feed the hungry and care for the sick because it is essential to our own humanity. We are brought down by homelessness and poverty is costly. To have a "good country," we need to include rather than exclude our human brothers and sisters.

The economics of a good society are totally affordable and reasonable. Free people are not burdened with debt in the necessity of living. If freedom is not free, as our militarists constantly want to remind us, why are the costs of war more important than the costs of peace? I think it is really the reverse with war needing to justify itself, but in far more than loot.

I have accused Capital of being a sophist, and I think he does spin webs of trivia to distract us from the fundamental realities of human life on earth. FDR's "Four Freedoms" ring a lot more true to me as rising from the spirit of the Constitution and their vision of America than the pitiful perspective of "economic man" and the price of everything-value of nothing result.

Secular humanism and atheism may reject any appeal to divine authority, so the fact that the Bible is on my side and Mammon is the god Capital invokes may be irrelevant. Still, if "humanism" has any content and if we have to make our moral stands here in this real world, I still think we feed the hungry and care for the sick for our own security and humanity. I believe this is what a human right is all about.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm
Quote Kerry:

And, going back to this 'cost coverage' question with health insurance corporations, government, and hospitals, and Capital's claim that Mayo Clinic has lost 800 million dollars, if the costs of medical care aren't covered, how do the corporate chief executive officers make so much money to the order of millions--to hundreds of millions--of dollars? Is that too many questions, Capital?

If I made a drinking game from your use of "?" I'd would have had alcohol poisening by now.

Question is unrelated to the Point that Government care is short changing the Health industry and causing cost shifting and Higher Rates. Deal with the facts at hand

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote DRC:

Capital, under the authority vested in him by Mammon, declares that healthcare is subject to the ability to pay for it and is not a universal human right or part of the "general welfare" under the Constitution. I, under the authority declared by Kerry for telling him to go to hell, as arbiter of salvation, declare that healthcare is a universal human right. So there you go, Capital.

Somehow I just don't think that makes it so. But if you are Emperor of that world in your head, Let it be so.

FDR's "Four Freedoms" ring a lot more true to me as rising from the spirit of the Constitution and their vision of America than the pitiful perspective of "economic man" and the price of everything-value of nothing result.

Which one are you putting Healthcare under, Speech, God, Fear or Want. Can't be fear... since that was regarding War.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote Capital:

How Clear do I need to be for you? IT IS NOT A UNIVERSIAL RIGHT.

If you misconstrue it again, I'll assume you are doing it on purpose.

Then, can you explain in detail how you propose we handle those with life or limb threatening illnesses without such financial resources that present to the ER? And, please, don't say 'if everybody bought insurance policies, that would do it' because then you would be disregarding every point that I made with what this has really become between 'insurance industry profit' and 'government subsidizing of the most expensive patients'. Or, are you going to get rid of the government subsidies to some in an effort to remove all government input into this 'free market'? If so, then, explain how insurance companies, in their manner of deciding what to pay for and what not to pay for, will cover these patients profitably? Or, is government subsidizing the most expensive patients the 'one exception' that you allow government to intervene in this so-called 'free market'?

Too many questions, Capital? Let's see....

Quote Capital:

It called spinning, As you are doing now. Address the limiting the Market to State Levels. Then you can ask about Insurance companies Contractual obligations. Which will be easy, because it's a Contract. Their picking and choosing is limited to what is written in the terms of the contract.

I thought that my answer implied my point. I don't think that 'choices of insurance companies'--even in a 'national market'--especially considering the very option that you say 'contractual obligations' offer (and that being deciding what to pay for and what not to pay for)--is, in any way, a 'free and open market'. And, considering how you claim that health care is not a right--and how you haven't explained yet what to do with those who present to the ER with life or limb threatening illnesses without the ability (or even have their 'insurance policies') to pay for a certain intervention, I'm wondering how you can keep a straight face and claim that, in any way, 'government medicine creates Death Squads'. If you turn down a patient with a life threatening illness--or their insurance policy has limited their options for coverage not to include interventions that may save their life--then, by the very point that I am making with insurance companies deciding what to pay for and what not to pay for, you have 'created Death Squads' when you turn down the patient--or don't offer in that intervention in the 'contractual obligation' of an insurance policy to the patient--in need of a life-saving intervention...

Quote Capital:
Quote Kerry:

Capital seems to say that EMTALA ought to be covered by Medicaid

I am Saying they should fund the mandate they bestowed upon the market, Do you disagree?

I have said that this issue of medicine--through such laws as EMTALA and such civil actions as medical malpractice (with the patient that pays nothing being able to sue in exactly the same way as a patient that paid everything up front)--has legally offered medicine as if a universal right while, at the same time, paying for it as if a privileged financial product all along. Do you understand that statement? Now, if you are now saying that health care is NOT a right--and imply that it never should have been--can you walk me through how you propose to dismantle the political and legal entities that have claimed it as such all along?

By the way, EMTALA is a federal law. Medicaid is a state run program. If you are going to have EMTALA funded by government, it should be Medicare that does so--that's the federal program. But, then, that sounds too much like Hartmann's 'Medicare for everyone', doesn't it? Can't 'spin' too much if there are issues that people from both sides agree upon, can we, Capital? But, then, again, what does any government intervention have to do with your claim on the 'free market' and how this should be run like that? That would be more like get rid of EMTALA, wouldn't it? But, then, what about the issue that 'government intervention creates Death Squads' when, if you are turning people down with no financial support--or the 'wrong insurance policy support'--with life or limb threatening illnesses, how does that NOT create defacto 'Death Squads'? Despite how your 'spinning' tries to have its cake and eat it, too....

Quote Capital:

You already know how, for one I already told you. If you no longer accept Medicare payments you are no longer bound by EMTALA provisions

Problem with that neat little claim, Capital, if you have an emergency room based in a hospital open to the public, you cannot do that....first time that you get a complaint, or the first time that someone actually does show up that you turn down that, now, dies or is disfigured because of it (whether they could pay or not), you will be in for the very steep fines of violation of EMTALA and perhaps even stiff payments for any civil lawsuits that come from that. Nope, if that hospital has an ER open to the public, it cannot violate EMTALA. So, now what? As a carry over from the other thread, are you going to 'vote the buggers out' that put EMTALA in place--or even claim its 'unconstitutionality' in court? While government does not directly pay for EMTALA, of the most expensive patients that present to the ER, government is already more likely to pay for most of them. Do you want to get rid of that with EMTALA, Capital? Nah, it's too much in the interest of insurance companies making a profit on the rest....cliaming 'free market incentives' to do so--but relying on government subsidies to improve those profits and give the little people even a semblance that 'medicine is offered to all'....Do you disagree with that, Capital?

Quote Capital:

The quote reads "Last year, Mayo lost $840 million on $1.7 billion in Medicare work. It compensated by charging private insurers a premium for the Mayo name, but (health plans are) starting to balk."

You ignored the rest of my statement on that, didn't you, Capital? My memory is not quite that short. I do remember that when this issue of Obamacare was even being considered, the Mayo Clinic was being held up as being a model for others to follow as offering efficient medical care to its population--with the very point being that the application of care through Mayo Clinic were able to be done at about half the costs per capita than the most expensive per capita place for Medicare patients--and that being McAllen, Texas. You ought to be asking how McAllen was able to get twice as much per capita from Medicare than the Mayo Clinic was--but, that's not part of your argument--or, your spin, is it? But, instead of the Mayo Clinic basking in such compliments from government and explaining in detail how its costs could be covered at half the per capita costs to Medicare vs. McAllen, Texas, now, 'the spin' is that the Mayo Clinic 'lost money' on such care. And, you put out those numbers as if they confirm the costs--how so? Where's that confirmation? Which goes right in line with the last question that I asked you, Capital--which you conveniently ignored as many here in thomland with an agenda--or political twist--one way or the other do:

And, going back to this 'cost coverage' question with health insurance corporations, government, and hospitals, and Capital's claim that Mayo Clinic has lost 800 million dollars, if the costs of medical care aren't covered, how do the corporate chief executive officers make so much money to the order of millions--to hundreds of millions--of dollars? Is that too many questions, Capital?

Do you see that point, Capital? I do....despite what numbers you put out--or 'spins' you attempt to make....oh, I see that you did quote it in post #213, but you didn't answer it, did you? Claiming something on the order that 'It's not pertinent to the point'. Bullshit, Capital. The quesiton is quite straightforward and very pertinent to the point of 'financial solvency' (even with any real business in the 'free market', isn't it?)--If an entity is not having its costs covered, how is it able to afford to pay its executive officers so much money--and continue to operate as a financially viable business? Very much to this point, Capital...because it gets to the point despite any numbers you create to 'spin it'....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm

I really need to remember not to invoke humor with Capital. My simple point is that his "market" approach makes the "affordability" of healthcare the moral issue where I think the moral issue is the humanity. How we pay for and fund the provision of healthcare for all is, for me, secondary to insuring that all get it. The social reality is that we cannot afford not to care for all. Our current conflict is that public policy requires that all get care, but public financing pretends that individuals and purchased insurance should pay for it. I would change how the latter is done rather than leaving people out.

Economically, I see a healthy and educated, well-housed and well-fed fellow citizenry as a good investment. People who are treated as full human beings and whose "personhood" includes being free from being left out of the human family will have good reason to care about collective security and prosperity. To belong is to participate, and to participate is to gain an investment in the common project and program. Being free of the insecurity of alienation, dog eat dog loses its rationale. It was always suicidal and "lose/lose," but fear and desperation do not inspire our best creative imagination. Real freedom feels good because personhood and individuality is supported by a shared participation in interdependent reality. It is not escape, withdrawal or autonomy. It is the free person in mutuality and connection with other equally free persons. Interdependence.

Ironically, "market economics" celebrates personal choice and desire in consumers, and "risk" in venture and endeavor in work and business. This because its nature is of a social system rather than an individualized cosmos of encounters; the unfortunate product of reducing being human to technique and function instead of participation. Nothing about our individuality and unique personhood is lost or diminished at all by social participation. Far from it, social participation is where we are ourselves in clearest contrast as well as in community.

How do we invest in obtaining this human context? What price should it have? What obligations do we assume as participants? What benefits? What is the alternative?

Dog eat dog is a bad buy at any price. In my book, human beings are worth more in the symbiosis of community than in isolation, if only because it is symbiosis where we are more than the sum of our parts. Were we just blended and homogenized in a collective "goo" we would be less than our sum. And that's not what "market economics" implies when we don't get lost in the magic interaction of autonomous individuals. That "magic" only factors out the humanity from the game. It takes away the pain but offers little pleasure. If we "buy into" hard reality and learn how to cook and serve our fellow "dogs," will we forget our disappointment?

The price of love cannot be set. That does not diminish its value or centrality to our being. But it seems lost to the bottom lines that are supposed to express our truest human nature and reason for being. In that lean and mean place it becomes "the devil take the hindmost." "We" are the winners, the survivors and conquerors. See how we shine! Ignore the carnage all around us.

Where does the money come from? It comes from satisfied participants, from free people participating together in human society. If love is beyond price, freedom is also not free. It takes an investment, not just in war and the protection of property but also in ourselves and our world. The money is a symbol of value in real products and services, not the substance of that value. More people healthy and educated with skills and motivation working and playing together--or working out conflicts and misunderstandings--adds up to a good investment.

Finally, there is the inescapable need to care for the sick. Fixing what we know to be wrong or where people are suffering healing and restoring health is easier to diagnose and remedy than building perfect societies or economies. Society is the predicate of any economy and is where the latter proves itself. Measures of economic growth, wealth and employment matter, but no good economy produces a bad society. When that happens, the road to hell has been paved with unforgiven debt. Justice has been sold out. Humanity has been stripped of value.

What the Four Rights are about is real value. Freedom as participation in power is also beyond coercion or desperation. The economics of healthcare are that it is essential and has to include rather than exclude. Treating healthcare as a purchasable commodity cannot include all or allow refusal of care. Somebody always pays. It is cheaper and more effective to pay for our healthcare collectively and to have the delivery of healthcare find its value and efficiencies. The moral facts have an economic reflection, but they can be misperceived as their reverse there. How can we pay for it becomes more important than do we have to do it. Very costly "economies" follow.

Rights are inalienable and inherent. Only their recognition is debatable. I recognize the human beings and their rights. I don't think the economic reflection does them justice.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm

Quote Kerry:

Too many questions, Capital? Let's see....

Your Socratic questioning is beyond ridiculous. I am starting to believe it is a defense mechanism.

Well, I already covered my plan in detail and you chose to ignore it and head off on a EMTALA tangent. Had you been paying attention. You would have noted that the market would have provided very cost effective and reasonable catastrophic medical care insurance that nearly everyone could afford. And I provided that EMTALA be a funded Federal Mandate as part of the Safety Net. There rendering your entire first paragraph meaningless.

I'm wondering how you can keep a straight face and claim that, in any way, 'government medicine creates Death Squads'.

Strange, I don’t recall every making such a claim. Since the favored mantra is that Private insurance denies care and kills people. Does Gov Care deny care that results in death? We all know they do. If you would like to run around with your hair on fire….. be my guest. But to claim Gov extends life where Private insurance shortens life is beyond ridiculously stupid.

By the way, EMTALA is a federal law. Medicaid is a state run program. If you are going to have EMTALA funded by government, it should be Medicare that does so--that's the federal program. But, then, that sounds too much like Hartmann's 'Medicare for everyone', doesn't it?

Except I am only offering to those who NEED it, Not WANT it. A vastly smaller group of people to ever claim “everyone” . Because as my plan vastly lowers the price of health insurance, more will be able to afford it and less will rely on EMTALA.

Problem with that neat little claim, Capital, if you have an emergency room based in a hospital open to the public, you cannot do that....first time that you get a complaint, or the first time that someone actually does show up that you turn down that, now, dies or is disfigured because of it (whether they could pay or not), you will be in for the very steep fines of violation of EMTALA and perhaps even stiff payments for any civil lawsuits that come from that. Nope, if that hospital has an ER open to the public, it cannot violate EMTALA. So, now what?

It is both Neat and Accurate claim. For it is the rules of EMTALA. Feel free to read them sometime. As I said, if you do not accept Medicare payments, You do not have treat EMTALA patients.

You ignored the rest of my statement on that, didn't you, Capital?

You mean like you ignoring the first part. And completely making out a fictitious scenario that somehow magically spins off the loss. You ridiculous McAllen comparison does nothing to refute Mayo Clinic problems. Because nothing you are saying says anything to the effect of McAllen’s Cost shifting or Medicare reimbursements as stated by Mayo… If you wish to do some research on that, knock yourself out.

Do you see that point, Capital? I do....despite what numbers you put out--or 'spins' you attempt to make....oh, I see that you did quote it in post #213, but you didn't answer it, did you? Claiming something on the order that 'It's not pertinent to the point'. Bullshit, Capital. The quesiton is quite straightforward and very pertinent to the point of 'financial solvency' is (even with any real business in the 'free market', isn't it?)--If an entity is not having its costs covered, how is it able to afford to pay its executive officers so much money--and continue to operate as a financially viable business? Very much to this point, Capital...because it gets to the point despite any numbers you create to 'spin it'....

You can call it anything you want, It nothing but corporatist boogyman bullshit. You distraction is inconsequential against the Institutional cost shifting. Mayo is one hospital, You couldn’t total up every Chief Executive pay in the country to even offset the losses occurred by Mayo clinic. Now extrapolate the loses of every hospital and doctor in the entire country. You complain about millions, I complain about Hundreds of Billions. My problem with government Care completely overshadow your tiny insignificant whining of CEO Pay. I do not let myself get distracted by rodents when hunting Bears.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

Reasonable salaries for management would be a start. The money citizens do not have to send to the medical insurers, profiteering pharms and profit margins for private investors would add considerably to the sound public investment. Were the old structure of tax incentives in place, there would be no reward in investor profiteering and inflated salaries. The business income would have to be reinvested better medicine for more people. Otherwise it would be taxed. Either way, it all adds up to real money.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm

So, how many of our HMO's operate in multiple states?
How many hospital chains do to?

And to what degree is the general welfare advanced by the PPACA?

How much does this encourage commerce?

Phaedrus76's picture
Phaedrus76
Joined:
Sep. 14, 2010 8:21 pm
Quote Phaedrus76:So, how many of our HMO's operate in multiple states? How many hospital chains do to?

While the parent company might have multiple branches that operate in Different states. They operate independently. Oregon healthcare doesn't work in Washington they are all regulated by the State Insurance Boards.

And to what degree is the general welfare advanced by the PPACA?

If you were to ask me I would put the degrees in the Negitive form. It does nothing for the "general" welfare, but does a lot for the specific target groups welfare. The general Public is adversly affected by PPACA. The country is adversely affected. Does it statisfy the General Wefare, Not by a long shot.

How much does this encourage commerce?

Do you care if the Commerce is real or placed on a credit card for your children to deal with?

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

I would like the government to "play favorites" for the sick who need care as well as to insure that the caregivers have the facilities, resources, professional support and pay commensurate with our value of them. I think we should be in favor of good medicine for all.

I would like the government to "play favorites" for those whom the wealthy wittingly or not price out of participation in large areas of public life. But I think it is absolutely essential in healthcare. Rather than try to create utopia, I think we can address actual suffering and unmet needs in existential reality. If we want it, we can pay for it. It works.

I want government to be for more than enforcing contracts, war and supporting Big Money. I still like that "of, by and for the people." The alternative sure doesn't work even when it is running on pure power. "Two halves against the middle" presumes a balance to begin with. I want government seeing that there is a balance or even a cooperation. When the State is enforcing an imbalance, it is establishing the winners. When it is restoring balance, it is supporting those on the short end. That is its job.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm
Quote Capital:

Your Socratic questioning is beyond ridiculous. I am starting to believe it is a defense mechanism.

Is that just another of your twisted ways of saying you don't want to address them, Capital? I realize that the best defense is a good offense--no matter how offensive you can make that sound....

Quote Capital:

You would have noted that the market would have provided very cost effective and reasonable catastrophic medical care insurance that nearly everyone could afford.

Could Mayo Clinic recoup that 800 million dollars you say it lost on such 'efficient management' you think that this industry is all about? And, what is an insurance policy that you think 'everyone could afford'? Especially if it isn't associated with a corporate job. $1000/month? $500/month? How much do you think that private insurance benefits cost now not associated with corporations? Someone here says that they pay $1500/month. I have a nephew that has a disabled child that has to pay $1000/month. And, this is talking about what insurance companies charge when they don't pay for the most expensive patients in medicine--the 20% that take up 80% of the national health care budget now that government does pay for most of it. Are you saying that insurance could take all those expensive patients in and cover for their health care and charge less for the insurance premiums than they do now--especially to private insurers not associated with jobs that have corporate policies? Have you figured out how that's going to be done, have the Mayo Clinic recoup the 800 million that you say government underpaid them, and lower premium costs, and keep the chief executive officers in salaries and benefits that amount to millions--to hundreds of millions--of dollars? Have you really shown those figures, Capital? If so, where?

Quote Capital:

And I provided that EMTALA be a funded Federal Mandate as part of the Safety Net. There rendering your entire first paragraph meaningless

Oh, so you are having government stay in it, are you? Is that to cover for the most expensive patients like they do now so insurance companies can make more profits--and the Mayo Clinic can claim an 800 million dollar loss? How does that represent this precious 'free market without government intervention' that you initially proposed? You actually are allowing government to intervene just like it does now--so the little people can think that 'medicine is offered to all'--but, still not a 'right' to all--and, if that is now what you are proposing, how you distinguish this collusion of government and insurance as being seen as being 'offered to all' but NOT being seen as a 'right', I'd like to hear how you spin--I mean explain--that......at any rate, how does government staying in it at all represent what you say is a 'free market' to begin with since, beforehand, you claimed that government's intervention in these markets is what has caused the problem? Is this another spin--I mean 'explanation'--where you are trying to have your cake and eat it, too, Capital?

Quote Capital:

Strange, I don’t recall every making such a claim (of government creating 'Death Squads' if government 'takes over medical care')....

So, are you saying that you don't agree with the claim of government creating Death Squads if it does take over medical care? Or, are you saying that insurance companies by limiting what they will and will not pay for are not creating Death Squads? Or, are you claiming that you don't care if Death Squads exist just as long as it is insurance companies and not government creating them?

At any rate, the excuse for government not to take over medical care has been that they will create Death Squads. Are you saying that you have never heard of that? And, in what way will insurance companies that, through their 'contractual obligations', get to decide what they will and will not pay for in the case of any treatment offered NOT be as much of a Death Squad as anything government could do if it, by any such determination, limits life or limb threatening treatments to anyone that needs it? Are you saying that you don't understand that point, Capital? Or, are you just ignoring it......despite the knowledge.....

Quote Capital:

But to claim Gov extends life where Private insurance shortens life is beyond ridiculously stupid.

I thought we were talking about limiting access to any life or limb threatening treatment regardless of who does it. Are you saying that is appropriate whether government or insurance companies do it? Or, only if insurance companies do it under their 'contractual obligations'? Should have read the fine print, little people, right? Or, have a whole bank of lawyers interpret it for you like a whole bank of lawyers wrote it for the insurance companies (and, maybe even the government), right?

Quote Capital:
Quote Kerry:

By the way, EMTALA is a federal law. Medicaid is a state run program. If you are going to have EMTALA funded by government, it should be Medicare that does so--that's the federal program. But, then, that sounds too much like Hartmann's 'Medicare for everyone', doesn't it?

Except I am only offering to those who NEED it, Not WANT it.....

Who gets to define 'those who NEED it'? And, whoever that is, how do they distinguish that from those 'who (just) WANT it'? Would, say, a working poor man that is too rich to afford government subsidies now but too poor to afford an insurance policy (especially if a private policy not offered through a corporate job) that could go bankrupt over many life or limb threatening ailments and their treatments be ones that 'NEED it'--or ones that 'WANT it'--if faced with such bankrupting options?

Quote Capital:

.....Because as my plan vastly lowers the price of health insurance, more will be able to afford it and less will rely on EMTALA.

Again, and that be paying off the 800 million dollar loss that you say the Mayo Clinic suffered AND keep those chief executive officer benefits into the millions--even hundreds of millions--of dollars? Have you really actually shown on paper how that's going to be done? With, now, as you claim, insurance companies taking over the costs of the most expensive patients that government now already covers most of the costs for (those 20% that take up 80% of the national health care budget now)--and still paying off the Mayo Clinic's 800 million dollar loss AND keeping executive pay high? Bullshit, Capital. Unless--and until--you show the numbers. Bit by bit.

Oh, yeah, you did leave government in there with EMTALA regulations, didn't you? Is that your way of getting insurance companies off the hook in paying for the most expensive patients? But, that is why the Mayo Clinic lost 800 million dollars, isn't it? I thought you were going to take that over in the 'free market' of 'the competition of insurance companies'......are you--or are you not? KInd of like the fundamental question that you spin around--is this a privileged financial product--or not? Privileged to those forced to buy insurance policies--a right to those that can get government to pay for it without them.....and the taxpaying consumer responsible for paying for both, once again. You haven't gotten rid of that set-up have you? The very set-up that allows all those CEO's to make millions, Mayo Clinic to claim 800 million dollar losses, and still let the little people think that 'medicine is offered to all'.....without once admitting that the one paying 'for it all' is the same person--the taxpaying consumer....

Quote Capital:

It is both Neat and Accurate claim. For it is the rules of EMTALA. Feel free to read them sometime. As I said, if you do not accept Medicare payments, You do not have treat EMTALA patients.

Uh, dipshit, I looked up the Mayo Clinic hospital in Arizona policy and I found this:

http://www.mayoclinic.org/billing-sct/

http://www.mayoclinic.org/billing-sct/medicare.html

Which states this (my emphases):

Although Mayo Clinic provides medical services to Medicare patients, Mayo Clinic doesn't accept assignment from Medicare for professional and physician services. In other words, Mayo Clinic doesn't accept the Medicare-approved payment amount as full payment. Mayo Clinic follows an established fee schedule based on the federal guidelines for Medicare patients, which allows health care organizations to charge up to 15 percent above the Medicare allowable fee. You're financially responsible for the portion above the Medicare allowable amount.

That hospital in Arizona does take in Medicare payments--which means it does follow EMTALA. I don't know of any ER in any hospital in America that doesn't. I know that breaks your little privateering heart to think that the great Mayo Clinic has not dropped all Medicare patients and Medicare payments--but, sorry to tell you but you would be flat wrong if you thought that they did. As this site notes, the Mayo Clinic in Arizona no longer takes Medicare as the only payment for its services to Medicare patients--that doesn't mean it doesn't also take what Medicare pays for its Medicare patients. For it to get around any and all EMTALA regulations, it couldn't take any Medicare benefits in part or full from its Medicare patients. In fact, as one way of handling major EMTALA violations from hospitals, Medicare excludes them from all Medicare benefits. No hospital that I know of could survive that kind of restriction because, as I've said all along, government already pays for most of the most expensive patients--and that, by far, includes the patients covered by Medicare. Got that, dipshit?

Insurance company profits couldn't handle those kind of coverages and pay this supposed 800 million dollar loss of the Mayo Clinic for those kind of patients (of the 20% of the population that takes up 80% of the national health care budget of which government already pays for most of that...) AND keep their CEO's with their multi-million dollars in salaries and benefits. That's why you aren't seeing the insurance industry make the kind of claims that Capital is spinning with, now....there is no plan to get rid of the corporate-government collusion that is double-charging the taxpaying consumer....especially not even Obamacare....

Quote Capital:

It nothing but corporatist boogyman bullshit.

Oh, like your boogyman claim that 'government is ruining the insurance industry in health care'--as you even offer government to stay in under this EMTALA law as part of 'your solution'? You're missing my point. It's the CORPORATE-GOVERNMENT COLLUDED boogyman that is ruining the financial solvency of applying medical care in America. And, it is allowed to exist because it gains the impression that 'medicine is offered to all' but it pays it in a piecemeal fashion that has it appear to be a right to some--but a privileged financial product to others--with the same entity paying both the government and the insurance industry--the taxpaying consumer.....

Quote Capital:

Now extrapolate the loses of every hospital and doctor in the entire country. You complain about millions, I complain about Hundreds of Billions. My problem with government Care completely overshadow your tiny insignificant whining of CEO Pay. I do not let myself get distracted by rodents when hunting Bears.

First off, read the Mayo Clinic in Arizona's website. It is NOT 'abandoning Medicare'--it's making it a policy not to have Medicare payments as 'payment in full' for its patients. If this entire system falls on its face as I think it might--maybe even should--maybe then we will see how we 'pick up the pieces' to offer this ONLY as a privileged financial product or as a right to ALL. As my mother used to say, 'pitting the two halves against the middle'--and, in doing that, allowing government to play favorites--always opens up the opportunity for abuse--financially and professionally....every time it comes to someone with a life or limb threatening illness knocking at the door.....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm

Well, sorry that I edited the post from under DRC--but in comes DRC claiming that government should play favorites. Well, the whole point of the concept of rights to its citizens is that government should NOT play favorites--that's why I would like this addressed once and for all--it is a right to all or not? Because, if government is handling it as a right to any one--under the very 'equal application of the law' clause that we even try to base just and fair applications of government with, government should handle it as a right to all. When it comes to rights, government should not be playing favorites. When government does, those in position to do so (such as insurance companies in the health care industry) will (and do) take advantage of that....

Giving all the rights to the poor and the sick and placing an undue burden for the same service on the backs of the working poor that could be bankrupted by the same service if they were to use them that, otherwise, is offered for free to some to use at will is neither fair nor just....and I am not sure how DRC can claim to be for a government that does that as it does so now in America....by playing favorites....but, then, DRC seems to be able to claim this in some other way than rationally (ie. 'comparatively').....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm

I find your argument empty and even silly. We are talking about protecting the weak and vulnerable from predation or domination. I should have said playing the unfavorites to get equity instead of "favorites" if this concept just causes you pain. Why are you being so obtuse about this? Do you just ignore the injustice and prattle about the post-injustice world of natural balances so the two halves can do their independent thing without the tyrannical interference of government?

I am opposed to having government play favorites with the banksters while leaving poor schmucks foreclosed upon. I think war profiteering crony capitalism is a stacked deck. There ought to be a law against it that gets enforced, but that takes a government that plays favorites for the people rather than the looters. How do we defend ourselves against the warlords and landlords? How do we avoid being "the losers" against those with no conscience who turn victory into triumph?

What magic pill do you prescribe? I obviously do not favor the favorites the government of, by and for Corporate America has favored. I really don't see what point you are trying to make or how no government advocacy addresses the imbalances of power and privilege.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm

Quote Kerry:

Is that just another of your twisted ways of saying you don't want to address them, Capital? I realize that the best defense is a good offense--no matter how offensive you can make that sound....

It my way of saying, If I did address every question you asked, I'd die of Old age.

Could Mayo Clinic recoup that 800 million dollars you say it lost on such 'efficient management' you think that this industry is all about? And, what is an insurance policy that you think 'everyone could afford'? Especially if it isn't associated with a corporate job. $1000/month? $500/month? How much do you think that private insurance benefits cost now not associated with corporations? Someone here says that they pay $1500/month. I have a nephew that has a disabled child that has to pay $1000/month. And, this is talking about what insurance companies charge when they don't pay for the most expensive patients in medicine--the 20% that take up 80% of the national health care budget now that government does pay for most of it. Are you saying that insurance could take all those expensive patients in and cover for their health care and charge less for the insurance premiums than they do now--especially to private insurers not associated with jobs that have corporate policies? Have you figured out how that's going to be done, have the Mayo Clinic recoup the 800 million that you say government underpaid them, and lower premium costs, and keep the chief executive officers in salaries and benefits that amount to millions--to hundreds of millions--of dollars? Have you really shown those figures, Capital? If so, where?

How is it you are completely incapable of addressing Medicare reimbursements and it’s effects upon the Industry. Instead you spend an incredible amount of wasted time and word count weaving this bullshit equivocation.

Read the Article http://www.time.com/time/magazine/article/0,9171,1905520-3,00.html That you you can stop playing around.

Oh, so you are having government stay in it, are you?

How bout this…. You go back a couple of Pages and read what I wrote regarding “If I were King” That way, stupid comments like this will not irritate me. If by chance you ever catch me saying that Free Market Can’t be Regulated by Congress, than maybe you might have a case against me, Until then I suggest you get informed.

So, are you saying that you don't agree with the claim of government creating Death Squads if it does take over medical care?

Funny you should mention that. That rhetoric was used against Earl Blumenauer regarding a passage he wrote. Being that I am in Politics now, In Earl’s District. Do you know he still uses that a rally call to campaign. I blame Earl for how that played out. Because he decided to take the easy Victimhood partisan hack route instead of intelligently and calmly explaining his proposal for Living wills. Which (IF I were King) Everyone on Medicare would be required to have a living will upon enrollment.

But do I think that once Government becomes the provider for Healthcare and there no longer is a Safety net to fall back on or Private insurance to Cost shift to, That (Like the UK NHS) government could very easily cease to treat elderly and Very Sick as part of cost saving management.

Who gets to define 'those who NEED it'? And, whoever that is, how do they distinguish that from those 'who (just) WANT it'? Would, say, a working poor man that is too rich to afford government subsidies now but too poor to afford an insurance policy (especially if a private policy not offered through a corporate job) that could go bankrupt over many life or limb threatening ailments and their treatments be ones that 'NEED it'--or ones that 'WANT it'--if faced with such bankrupting options?

If I am King. ME.

If policies w ere more affordable… As they would be under my plan. The Working poor man would be able to afford the policy. If not, than he would be picked up by the safety net. And if he is still too stupid to take one of those option… Then the State can bankrupt his ass for all I care. I do not deal with the stupidity of the individual person. Mine is only to build the biggest most affordable and encompassing system possible for everyone.. But as an American, Freedom to choose is still an option as long as I live. Unlike DRC who wishes to to take away freedoms in order to gain something for the illusion of free.

Again, and that be paying off the 800 million dollar loss that you say the Mayo Clinic suffered AND keep those chief executive officer benefits into the millions--even hundreds of millions--of dollars?

It really is too bad you don’t have a clue what you’re talking about. Mayo Clinic CEO Denis A. Cortese only made $750K.

Bullshit, Capital. Unless--and until--you show the numbers. Bit by bit.

Hey.. here’s an idea… Stop worrying about your rhetorical word count and pointless Socratic questioning and post something of substance.. Clearly you know nothing of the details and have completely ignored the Big picture.

If you have read my Ideas and supporting arguments and still disagree with them, Then we would have something to talk about. But this is ridiculous. You might have some substance in the rest of the Post that bears considering, But I have neither the time nor the energy to sift through the vacuous crap to find it.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

Quote DRC:I find your argument empty and even silly.

I know it rude to ignore you. But quite frankly I find no value in your posts. It's just an exercise in Hot air. So.... your opinion of my posting is equally vacuous. So just to keep you informed, When I do not respond to your posts, it because I found nothing of substance to respond to. My plan does Far more for the Weak and vulnerable there yours ever would, Mine is sustainable and provides Economy wide benefits. Yours is a race to the bottom of the barrel where we all will share the misery.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote DRC:

I find your argument empty and even silly.

They're real, DRC. Some who have the government paying for all of it can come in by ambulance with a stumped toe and demand service without, at any point, having any personal responsibility to contend with that care (made worse by corporations making them 'customers' instead of 'patients'). Others have to hesitate at the door with a potentially life-threatening illness for fear it may bankrupt them. If you think that that set-up represents 'caring'--which is made possible by how you condone 'government playing favorites'--you are as hypocritical and self-righteously callous as you claim that argument to be 'empty and silly'....

Quote DRC:

We are talking about protecting the weak and vulnerable from predation or domination.

Yeah, by adding to the burden of those who try to maintain their own integrity and responsibility against your impositions to that--that you, then, hypocritically and self-righteously call 'love'. That doesn't 'remove domination', that just makes the hypocrites 'dominating'....

Quote DRC:

Why are you being so obtuse about this?

Obtuse, DRC? How much clearer can I be? If the government offers a right to one, it should offer that right to all. Government should not be playing favorites. In fact, once again, playing favorites by government is a form of hierarchic domination....even if done for the 'most loving' of hypocritical posturing....'the best of reasons'....

Quote DRC:

Do you just ignore the injustice and prattle about the post-injustice world of natural balances so the two halves can do their independent thing without the tyrannical interference of government?

From government politically? Emphasizing and endorsing a right makes a right. Doing it for everyone makes it equal, fair, and just. Two wrongs don't make a right....

Quote DRC:

I am opposed to having government play favorites with the banksters while leaving poor schmucks foreclosed upon.

I am too--and that has nothing to do with race or gender. I see economics as a 'game with rules'--and those that 'win that game' oftentimes 'make the rules'. And, just like its analogy to the real gambling industry, those that 'make the house rules' never lose money--they just change the pay-outs offered. And, to claim that represents a 'free market' in any way that I can see it as 'free' is just more of the same lying bullshit. Government can introject for the people in a manner that has nothing to do with race or gender. It may be 'class'--but, then, if government doesn't do this, by the very 'rule-making' capacity of 'the winners', there will be 'class'.....that can be countered somewhat by 'equal opportunity'--it would best be met by 'equal respect' (as in 'mutual respect')--but, government cannot mandate that as if it were a positive 'written' law--it can bank on it if it allows 'natural interpretive law'--but, then, that would only be confirmed by those who take their rights and their personal responsibility earnestly (not hypocritically), also.....something that our founders realized from the beginning of the American experiment in democracy....

Quote DRC:

How do we avoid being "the losers" against those with no conscience who turn victory into triumph?

Make them personally accountable to the words they say and the actions they take--'by their words they will be acquitted and by their words they will be condemned'...

Quote DRC:

I really don't see what point you are trying to make or how no government advocacy addresses the imbalances of power and privilege.

Read above. I like Jefferson's idea on 'rational Christianity'--especially in its political context. I don't know why you don't....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm
Quote Capital:

I know it rude to ignore you.

Uh, Capital, I do think that DRC was talking to me. I actually don't ignore DRC because, in the final analysis, I think that DRC means well. You, on the other hand, are a different story.....still claiming that 'medical costs aren't covered' as the CEO's continue to rake in millions--sometimes hundreds of millions--of dollars for themselves...

I noticed you missed that whole point about what the Mayo Clinic in Arizona does now with Medicare patients--and it's NOT not take Medicare patients or Medicare payments for those patients. So, EMTALA still applies even in the Mayo Clinic in Arizona. Did you miss that?

Of course, you're entire claim on how insurance companies in a 'freer market' would do better is absolutely baseless (since you have no real answer on how insurance companies deciding what to pay for and what not to pay for 'limits' that very market that you claim government has 'limited for insurance companies')--even in your description of what you would do with government and insurance companies undermines your claim on 'free markets unfettered with government' (a market that I am sure the health insurance industry DOES NOT want). You go ahead and add government with EMTALA to your 'free market' scenario, anyway. And, you fail to recognize that insurance companies now make so much profit in the industry because they don't have to pay for most of the 20% of patients that take up 80% of the medical budget--government already does that--and Obamacare won't change that, either (and the insurance industry doesn't want that change, either). And, as I've said, corporations are gearing up to take advantage of that--in a way that I have never experienced in the 30 years that I have been in medicine--and 20 years that I have been doing ER.....I can only equate it with the medical industry's equivalent of the financial industry's debacle with the home mortgage crisis--with 'government making them do it'--and industry 'writing the government policy to do it with'....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm

Oh, and let me make one other point about 'insurance policies for the elderly' with regards to this Mayo Clinic in Arizona 'not taking Medicare' claim from Capital. I've said this before in thomland but it deserves to be repeated--and, if you follow those connections I offer on the payment structure of the Mayo Clinic, you will see that point (I even mention it in what I posted here from that site). Insurance policies for the elderly are designed to be based on what Medicare allows to be charged depending upon a given diagnosis. Medicare pays 80% of what it allows to be charged--and all insurance policies for the elderly are designed only to pay (minus any deductible) for the 20% of the Medicare allowable charge that Medicare doesn't pay for. It does NOT say, 'In the case of the Mayo Clinic, if they don't take any payments from Medicare, we'll pay for the whole thing'. Bullshit. Capital is twisting and spining to try to get this to look like something that it is not.

And many insurance policies not for Medicare patients are following that 'allowable charge' format. For you to get an insurance policy that would pay anything that the hospital could charge, you will be paying out the ass....again, something that not too many people could afford (and certainly not if it's not tied to a corporate job).

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm

OK Cap, I hear you about your desire to manage the best society possible, to make health care "affordable" and the safety net work. I don't know what your approach to management is, I can only guess.

I am also wondering about "freedom to choose" and great inequalities of wealth. How much do markets constrain the "freedom to choose" by ability to pay and how do you sort out the deserving from the undeserving at a cost/effective budget? My answer is, rather poorly from the top down. The better way is to build from the bottom-up and to work with local owners of the results. It takes a management that presumes and respects the authority of those who do the work. One that supports their authority and function, not one trying to be "boss" or worried about professional or executive "turf."

Creating the kind of teams that share the burdens and challenges and share their skills and interests doing something of value is essential to my vision of good managing. The authority of competence goes to the manager who gets the loyalty of the team by being there for them. It does not go to the bully or "superior." The "owner" is "the man," but "working for the man" is an indictment.

I have not seen much smart management taught in Biz Schools, but there have been some lessons from organizing volunteers that have worked for me. The problem is that "the techniques" have to be genuine instead of "management." It really is about caring for the people and the community, not just getting that old fiduciary straightened. As a big fan of bottom-up power, I see managing as working with that authority and trusting it rather than "bossing" it.

Groups need moderators to process meetings and allow business to get done. Addressing the personal rather than repressing, ignoring and punishing it for showing up at work or at the meeting is the smarter choice. Refer for therapy as needed, but we work and play together with people who are more human to us rather than less. The organizer who serves the needs of the organization and its people gets the respect of the workers and can deliver connection to the real authority to those "in charge." The person "in charge" who listens and works with those getting the work done is doing the right thing.

So, when does this managing scare you with Saul Alinsky 'radicalism?' When does broad participation in power activism become tyranny? If all you have in mind is providing what you prescribe as good value and "responsible choices" for as many as possible paying Americans, with recognition of a "safety net," how organized can the consumers and providers be? How do the limits square with "freedom of choice?"

Maximum partipation in power is the measure of meaningful "freedom" metrics. Philosophically, it is about freedom being for all, an elemental universal. When freedom is subdivided and individualized, it becomes that illusion you blame me for. When it is managed from above, it is even worse. That management style has to neutralize and command the power of the subordinates rather than to encourage and respect it. Preventing the abuses of power from below is the excuse given by those who should know about the temptations of power and how they get you. The losers must be stopped from doing the crime which the winners treat as second nature.

I would wish you luck and success in your hopes to manage a good society, but I fear for your encounter with the real world. You lack respect for your human fellows, or at least for a persistent and visible minority who fail to support themselves. At a certain point, they just get cut off the public treasury. What meager crumbs do they find to live? Do they just go "away?" Even were you in command and control, you would have to use techniques that make the privileged cooperate with the common good when they do not see why they should.

The bottom can have the preponderance of power. The top can serve it rather than run it. The workers need effective support from "above," and they will reward it with loyalty and productivity. Don't "fight the power" when you can align yourself with it. Stand firmly on the ground of authority.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm

Quote Kerry: Uh, Capital, I do think that DRC was talking to me.

He's been rambling on for some time now. If he was, just tells you how much time I put into read his posts,

noticed you missed that whole point about what the Mayo Clinic in Arizona does now with Medicare patients--and it's NOT not take Medicare patients or Medicare payments for those patients. So, EMTALA still applies even in the Mayo Clinic in Arizona. Did you miss that?

No I caught... Was was researching it. I already knew it was a trial program. But your summery is a bit off from thiers

Some recent media reports have inaccurately stated that Mayo Clinic in Arizona is no longer seeing any Medicare patients. This is not true.

Rather, a five-physician Mayo Clinic Arizona family practice clinic in Glendale, Ariz., has opted out of Medicare as part of a Mayo Clinic time-limited trial that will be reviewed at its conclusion. This means that Medicare will no longer reimburse Mayo Clinic for primary care services at this specific primary care facility, not at Mayo Clinic in Arizona overall. This affects only primary care office visits for the five Mayo family practice physicians at this site. Specialty care, laboratory services, imaging studies and ancillary services at Mayo Clinic are still covered by Medicare. Current Medicare patients may continue receiving primary care at the Glendale clinic but will be required to pay out-of-pocket for office visits.

As it is a Test case to see if the Mayo Clinic can run without taking Medicare. Because Why?

Of course, you're entire claim on how insurance companies in a 'freer market' is absolutely baseless--even in your description of what you would do. You add government with EMTALA. And, you fail to recognize that insurance companies now make so much profit in the industry because they don't have to pay for most of the 20% of patients that take up 80% of the medical budget--government already does that--and Obamacare won't change that, either. And, as I've said, corporations are gearing up to take advantage of that--in a way that I have never experienced in the 30 years that I have been in medicine--and 20 years that I have been doing ER.....I can only equate it with the medical industry's equivalent of the financial industry's debacle with the home mortgage crisis--with 'government making them do it'--and industry 'writing the government policy to do it with'....

At some point I assume you will get around to explaining what the hell you’re talking about instead of spouting meaningless numbers. I assume you are referring to dialysis treatments for End stage Renal Failure. Or you are actually talking about the end of life statistics regarding Medicare expenditures.

That is alright, I’m a patient man…. I can wait till you finally develop a coherent point. Because if it is the Latter… Already answered that.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote Kerry:

Oh, and let me make one other point about 'insurance policies for the elderly' with regards to this Mayo Clinic in Arizona 'not taking Medicare' claim from Capital. I've said this before in thomland but it deserves to be repeated--and, if you follow those connections I offer on the payment structure of the Mayo Clinic, you will see that point (I even mention it in what I posted here from that site). Insurance policies for the elderly are designed to be based on what Medicare allows to be charged depending upon a given diagnosis. Medicare pays 80% of what it allows to be charged--and all insurance policies for the elderly are designed only to pay (minus any deductible) for the 20% of the Medicare allowable charge that Medicare doesn't pay for. It does NOT say, 'In the case of the Mayo Clinic, if they don't take any payments from Medicare, we'll pay for the whole thing'. Bullshit. Capital is twisting and spining to try to get this to look like something that it is not.

And many insurance policies not for Medicare patients are following that 'allowable charge' format. For you to get an insurance policy that would pay anything that the hospital could charge, you will be paying out the ass....again, something that not too many people could afford (and certainly not if it's not tied to a corporate job).

How is your Math skills Kerry?

The sentence says: "Last year, Mayo lost $840 million on $1.7 billion in Medicare work." What is the Medicare Reimbursement Rate? Does it even look like in the 80% range. Are you Planning on Calling the Mayo clinic Liars. If so, do so now. If not, Deal with what was said by the Mayo Clinic in a Time Magizine Article and stop guessing.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

I know you only read what confirms your opinions, Cap. Biz School was like that, a lot more like that than seminary.

Kerry, the stuff on management was about Cap's "good intentions" as a social manager. But he knows how to be a boss without my advice, it seems. Would rather debate the Mayo Clinic statistics with you. I will try not to feel snubbed. How it became the topic eludes me, but I am trying not to let molehills become mountains.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm
How is your Math skills Kerry?
How is your grammar skills Capital?

Art's picture
Art
Joined:
Jul. 31, 2007 4:01 pm

Don't know exactly how much of a mountain or a molehill this is that Capital is creating. Now, we go from the Mayo Clinic in Arizona not accepting Medicare (and not following EMTALA) because it 'lost 800 million dollars' down to 'five family practitioners in their (Mayo Clinic sponsored) clinic being in an experiment the Mayo Clinic is doing by not accepting any Medicare payments'. Did those 5 family practitioners lose Mayo Clinic's 800 million dollars from Medicare? Do those 5 family practitioners even do hospital work? If they do, as their website points out, I bet they do accept Medicare as a partial payment--and I bet their diagnoses do not get paid beyond what 'Medicare allows', either.

I suspect that those 5 family practitioners that 'don't accept Medicare payments' still offer the paper work to their Medicare patients to have those patients recoup what they can from their office bills. I did that when I practiced private practice over 20 years ago. But, I didn't do that as an 'experiment to see what happened' with my income, I did it because I was a small office and didn't hire enough workers to have to bill Medicare for my services for every patient--I charged a flat fee for my office visits and, then, gave the patients the paper work to file for reimbursement from Medicare for that visit. My fee was 15 to 20 dollars a visit. I remember one man that I had taken a seborrheic keratosis off his face (a simple procedure that might take me 5 minutes). After he dealt with Medicare, he came back to me quite pissed and claimed that I screwed him. 'How so?' I asked. He said that the Medicare office told him that he would have received a much bigger reimbursement had I used a different code in the billing. 'Oh?' I asked not having any idea about such 'different coding', 'How much different?' He spouted out, 'They said that they would have paid me $80 if you had used the right code.' Thinking to myself that I only charged him no more than $20, I wondered how 'I' screwed him in that deal. But, I restrained myself and claimed that I would try to do better next time. 'You better,' he piped in.

Now, I took that information and made a little change in my office practice. When an elderly person came into my office displaying one of those age spots on their face, I would alter my situation with them and say, 'Do you want me to take that spot off your face? I'll even do it and bill Medicare myself. You won't have to pay a thing.' That day, I figured out that the 'coding schedule' that was being used was basically irrational. A procedure that might take me 5 minutes from start to finish paid me more than having to deal with a complicated diabetic intervention that had heart disease and hypertension to have to manage and juggle that can take me 30 minutes to complete. But, what the hell, I thought to myself. I can't make the rules--so, I might as well take advantage of them.....and, so it goes in 'the medical industry' with 'third party payments'.

Now, multiply that little scenario to thousands and thousands of dollar interventions and you might get a more realistic idea as to how the 'medical industry' really works. Capital's Mayo Clinic 'losing' 800 million dollars? I am sure it all depends upon how you define costs--and who (or what) gets to define it.

But, as Capital seems to admit now, that little diddy about how the Mayo Clinic in Arizona has 'dropped Medicare payments' was highly overstated--intentionally designed to mischaracterize and misrepresent the real facts at hand.

And, when I looked at that Mayo Clinic in Arizona site, I noticed that it was built in a rather well-to-do Phoenix suburb. Perhaps where most people had insurance that covered clinic charges--or had people wealthy enough to pay for it, themselves. But, when it comes to hospital charges, it takes a very wealthy person to afford those charges 'on their own' without taking a substantial hit on their budget.....thus, the impetus for all 'third party payers' in American medicine today.....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm

On this Medicare/ Mayo issue,

1- is the $800 mil loss a loss, ie the amount of money the Mayo can charge for services minus the cost of providing those services equal -800mil

Or

2- The cost of care for the services provided is $800 mil less than what they can charge HMO's for those same services?

If it is #1, then certainly the Mayo should quit accepting Medicare today.

But, if as I assume, it is #2, then what advantage does private insurance give people? The private market does not do a very good job at controlling costs, or negotiating. The private market fails to get the consumer the best deal. So, how can that be? Oh wait, the blood sucking leeches at the HMO need to charge as much as possible for their own services, and "bake" that number into the cake. The consumer at that point accepts that price because they have no way to shop across HMO's at that moment, and lack the knowledge to do so.

The Mayo Clinic signed a contract with Medicare, for that pricing structure. If the provider wants a different deal, then go back to the negotiating table. Or, leave that market. 5 providers have.

Phaedrus76's picture
Phaedrus76
Joined:
Sep. 14, 2010 8:21 pm

I don't even want bankers who are in it for the money. I want them interested in good banking services and business integrity. The corrupt effects of money are powerful because money is important; but nothing is more corrupting than making money the focus and ultimate reward. Are you shocked that a Medicare administrator might think "everyone" was trying to max their claims? You are not the one here who makes money the point of everything.

This is why I agree with doctors and nurses who want to practice medicine and not a subset of commerce and finance. I am very provider friendly, wanting them freed from bureaucracy and freed to do medicine with the support of the "managers." Providers know that the patients are critical to the cure, so there is an incentive in cooperation and communication to involve them as participants instead of subjects in the hands of experts. Profits incentivize the expert and celebrity images instead of collaboration. Individuals do not make decisions that include the social benefits and good by making personal self-interest decisions. Not well enough nor often enough.

Or, you could say that individuals with a social conscience and are comfortable with their personhood and self in the midst of interdependence and "we" can find economies of scale too. Working together like a team, with intuition and connection is good. The game plan of individualism does not win. Music must be made with...others and/or the silence being disturbed. We are not alone. Aren't you glad?

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm

It seems Capital that you are really invested in this issue. Let me ask you this: if healthcare is a privilege and not a right then what things do you think humans ought to be entitled to as a right? Because quite frankly I would prefer having guaranteed health care over a whole bunch of shit that our government does for me. And I don't want to hear any argument about whether government or the private sector can administer it better because that is not what's at issue in my question.

mdhess's picture
mdhess
Joined:
Apr. 9, 2010 11:43 pm
Quote mdhess:It seems Capital that you are really invested in this issue.

Just an issue I've been discussing on and off for 5 years and have fairly strong opinion on.

Let me ask you this: if healthcare is a privilege and not a right then what things do you think humans ought to be entitled to as a right?

You have the right to Free speech. Government does not provide you with words, A voice, a forum or the thoughts. (yet) Your right to free speech only extends to that government cannot take it away

You have the right to assemble. Government does not provide you transportation, people to hang with, reasons to gather or places to gather in. Your right to assemble only extends to that Government cannot take it away.

The disingenuous argument that Healthcare is a right. Is that they are demanding that Government provide the money, the facilities and the workforce to provide Healthcare. In order to do that, Government must Take away in order to provide. Healthcare can NEVER be a Right.

To claim “entitlement” means you are dependent upon someone else to provide it for you.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

Quote Kerry:

Don't know exactly how much of a mountain or a molehill this is that Capital is creating.

How bout we just nip this in the bud, one simple question. Do you think Medicare/Medicaid reimbursements cover the cost of the provided care?

If you do, Mayo $800 million loss is accounting trickery, If you don't, then Mayo $800 million loss in symptomatic of a larger problem.

I’m not answering another question until we start discussing from the same page.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

Your opinion, but not a persuasive one. Just your way of pretending that we do not have a shared, collective interest in healthcare for all and that doing it together is cheaper and better for all, if you care about "country first." If you just want to be a privileged elitist, you will insist that you have no obligation to be part of the universal risk pool or to fund good public health with your taxes as "general welfare."

How is this so different from the way to fund roads and highways?

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm
Quote Phaedrus76:

But, if as I assume,

Are you basing this assumption on anything of substance or just off the cuff spitballing?

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote DRC:

How is this so different from the way to fund roads and highways?

Roads are in the Constitution, Fits the defintion of General Welfare spending in that everyone regardless of geography, socioeconomic, class, sex, disability, race, etc etc... can use that road. Road and Highways are funded by USAGE tax (gas tax)

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

So, we fund a healthcare system open to all and direct taxes to its support as well. The gas taxes tend to subsidize commerce. We don't have toll roads as the better way. As I am sure you are aware, the nature of medical care has changed a bit since the Constitution was written. I am glad we are not having to debate language about the "right to leech." Healthcare still rings the gong as "general welfare" and "common good."

Single Payer is coming.

DRC's picture
DRC
Joined:
Jul. 31, 2007 4:01 pm
Quote DRC:

. As I am sure you are aware, the nature of medical care has changed a bit since the Constitution was written.

I'm pretty sure people still died.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote Capital:

How bout we just nip this in the bud, one simple question. Do you think Medicare/Medicaid reimbursements cover the cost of the provided care?

If I coded it right, they did for me in my office, Capital.

Does it cover all the costs and expenses in hospitals? Depends upon who gets to define that. It's an open secret that, when it comes to nursing salaries, hospital administrations constantly claim that they are 'losing money and can't afford to increase their salaries or bonuses'. However, and this can even be within the same economic cycle, that same hospital administration can claim in the local paper to be 'succeeding beyond all projections' and starting 'to expand for the community their facilities and their services'. Which one is the truth there, Capital?

When Mayo Clinic claims it is losing money, are you implying that that is a peculiar problem just for Mayo Clinic--or a systemic problem for every facility? And, if it is a systemic problem, once again, why are the CEO's being able to rake in millions--to hundreds of millions--of dollars for themselves if this system is faltering so much with Medicare and Medicaid? Why isn't the health care industry demanding that it covers all those 20% of the population that takes up 80% of the national health care budget that government already pays most of the price for? Why doesn't someone say openly that medicine is a privileged financial product only to be offered to those who pay the set price than it be the piecemealed set-up we have now where government covers the most expensive patients so that insurance companies can profit off the rest of them (and it appear, in any way, to be applied as if 'medicine for all')--again, at the financial cost of the same person in our society being responsible for it--the taxpaying consumer?

Is there anything else set up quite like this in any other part of the economy that you say is covered by the 'free market' that supposedly runs best when 'government is left out of it'? Where is 'government left out of it' here? And, that's not even going back over how you say an insurance policy that determines what and what not to pay for, itself, is 'limiting the market' as much as you claim 'government intervention' does so....

Would insurance policies that follow the exact same format that Medicare does (some even tied to Medicare) of setting prices according to diagnoses 'cover all the costs' of any medical program any better than Medicare or Medicaid? Capital claims they would--but, has Capital really proven it? How can a universal application of a product like medicine 'increase' its 'market share'? And, if it doesn't apply it universally--but only to those that 'can pay'--how is it able to 'increase' its 'market share' (since it won't be able to do so to those that can't pay)? It can't--other than by increasing its price (and claiming insurance will cover that--and how is insurance going to be able to do that 'efficiently' and maintain its profit margins?). Again, Capital seems to want to have the cake and eat it, too....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm
Quote Kerry:

If I coded it right, they did for me in my office, Capital.

Interesting, So the entire "Doc Fix" legislation that has been going on since 1997 is nothing more than a Dog and pony show. Everyone who has ever claimed that Medicare reimbursement are so substandard they can no longer take new Medicare patient at the risk of financial ruin are liars or incompetent with their coding.

Which one is the truth there, Capital?

You tell me, you created this fantasy. If you have a specific example, please post it.

When Mayo Clinic claims it is losing money, are you implying that that is a peculiar problem just for Mayo Clinic--or a systemic problem for every facility?

Clearly I have said the Problem is Systematic.. If you like I can post you 100 articles regarding Hospitals struggling with low Medicare Reimbursements… If you can find me 1 that claims Hospitals are doing just fine with Medicare reimbursements.

Why isn't the health care industry demanding that it covers all those 20% of the population that takes up 80% of the national health care budget that government already pays most of the price for?

If I have to wait any longer for you to explain this statement, I’m going to assume it’s just an empty dogmatic statement.

Would insurance policies that follow the exact same format that Medicare does (some even tied to Medicare) of setting prices according to diagnoses 'cover all the costs' of any medical program any better than Medicare or Medicaid? Capital claims they would--but, has Capital really proven it?

You of course from the Lack of Complaining from Hospitals Unless you can provide articles that have hospitals complaining about Private insurance reimbursements as part of a systematic problem instead of them claiming they are shifting their loses onto Private insurance. (which of course I can Prove) I’m going assume you are making shit again as you keep trying to dodge and equivocate the problems I and discussing.

Let me know when you are ready to put on your big boy pants.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm
Quote Capital:

You tell me, you created this fantasy. If you have a specific example, please post it.

I told you my example, Capital. It's happening right now in my local community. The hospital corporation is planning on a multi-million dollar office building expansion with 17 new physicians (all salaried by the corporation--a brand new entity for this area of primarily private practitioners and government-backed physicians--and the hospital has stated it wants to replace the present physician staff with their physicians). All within the next 5 five years and to the tune of millions and millions of dollars--and this is along the Texas-Mexican border where I am sure that, if the hospital bills get paid at all, more are paid by Medicare and Medicaid than insurance carriers or, certainly, private pay. Does that mean that this hospital corporation is 'losing money on Medicare and Medicaid' like your Mayo Clinic example--or is the Mayo Clinic really losing that much money? If so, is that unique just to the Mayo Clinic--or systemic? And, if it is systemic, how are hospital corporations funding the expansions being planned now? How are CEO's raking in millions--sometimes hundreds of millions--of dollars for themselves if 'all the industry is losing money on Medicare and Medicaid'? Especially since government already pays for most of the 20% that take up 80% of the national health care budget....

Quote Capital:

If you like I can post you 100 articles regarding Hospitals struggling with low Medicare Reimbursements… If you can find me 1 that claims Hospitals are doing just fine with Medicare reimbursements.

I'm not judging it by what they say(obviously, since neither you nor I have any independent source to determine that, they can lie--even say one thing in the context of paying nursing staff and another in expanding facilities without, at any point, resolving those discrepancies), I'm judging it by what they do, Capital. And, there are still those CEO's in this industry that rake in millions--if not hundreds of millions--of dollars for themselves. How are they able to do that, Capital? Do you really have any idea?

Quote Capital:

If I have to wait any longer for you to explain this statement, I’m going to assume it’s just an empty dogmatic statement.

Have you been following this conversation? It's a statement that Obama makes in his book, The Audacity of Hope, that 20% of the population takes up 80% of the national health care budget and no one that I have pointed that statement out in medicine doubts it. Medical care is not (and never has been) 'evenly divided' among the population--a small section of the population needs it a whole lot more than the rest of us. The elderly, the disabled, the pregnant, the burned, the traumatized, the chronically ill, the extremely poor and malnurished, the extremely young, etc. In fact, whether it is government or insurance companies as the 'third party carriers', the whole point about their situation is a lot of relatively healthy people are going to be supplementing for a smaller amount of relatively unhealthy people--which can fairly be arranged only if they have the guarantee that if they are in such a need, such a service will be available. But, not if the system collapses under its own financial insolvency as the predators that make the millions--and hundreds of millions--of dollars from this set-up are even able to suck more out with Obamacare....

Quote Capital:

You of course from the Lack of Complaining from Hospitals Unless you can provide articles that have hospitals complaining about Private insurance reimbursements as part of a systematic problem instead of them claiming they are shifting their loses onto Private insurance. (which of course I can Prove)

I will come up with that explanation when you show me a private insurance policy that claims it will pay everything that any hospital charges--and tell me the price of that policy as it stands now. So, if you can prove it, prove it--but, start it by proving that you can even get a private insurance policy that pays whatever a hospital charges. Alternatively, you can even come up with a private insurance policy that compares how it will pay for certain diagnoses directly with what Medicare claims--and what is its average cost per person--since most private insurance policies do NOT pay what the hospital charges, they pay a set amount depending up the diagnosis just like Medicare.

And, insurance policies for the elderly? They are designed only to pay for the 20% (minus deductibles) of the acceptable charge allowed by Medicare that Medicare pays the other 80% of. Can you show me an insurance policy for an elderly person that doesn't do that? In fact, where's that policy that says it pays for the 20% of the Medicare allowable charges that Medicare doesn't pay for 'except in the event of those charges coming from the Mayo Clinic in Arizona, of which it will pay anything charged'......

Quote Capital:

Let me know when you are ready to put on your big boy pants.

Get after it, dipshit. You've already been caught in the lie that the Mayo Clinic in Arizona doesn't follow EMTALA--and doesn't accept Medicare--because it's 'lost so much money'-- but even the Mayo Clinic in Arizona site refutes that. Now, you've adjusted it to mean '5 family practitioners in a clinic as an experiment that Mayo Clinic in Arizona is doing'. Are you going to be adult about it and admit you lied and intentionally misrepresented the facts in this issue? And, you wonder why people, as real responsible adults, should judge this more by their actions--and not their words (or even their numbers). Claiming to lose money when it comes to nursing salaries and benefits but making money when it comes to expanding the facilities and services offered....and does so all the time....

And, judging by actions instead of words or numbers, tell me again how the CEO's in this industry can make millions--even hundreds of millions--of dollars if this industry is 'losing money systemically'?

Didn't lawyers ever advise you that, as a 'witness', once you have been caught in one lie, everything else you say is suspect?

Now, are you really playing with the big boys--or just acting like their shill?

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm
Quote Kerry:

I told you my example, Capital. It's happening right now in my local community.

You told me nothing. Give me an article or a Hospital Name so I can research your claims. I have no interest in play Hypothetical pin the tail on the Donkey.

I'm not judging it by what they say(obviously, since neither you nor I have any independent source to determine that, they can lie--even say one thing in the context of paying nursing staff and another in expanding facilities without, at any point, resolving those discrepancies), I'm judging it by what they do, Capital. And, there are still those CEO's in this industry that rake in millions--if not hundreds of millions--of dollars for themselves. How are they able to do that, Capital? Do you really have any idea?

You keep hounding that ridiculous mantra like a religious zealot. Then I guess the Medicare is doing wonderful and is the best solution to the Healthcare problem, Because there are a few people out there in the world that make too much money for you comfort level. FanFuckingTastic reasoning you have there Kerry. Impressive as always.

Have you been following this conversation? It's a statement that Obama makes in his book, The Audacity of Hope, that 20% of the population takes up 80% of the national health care budget and no one that I have pointed that statement out in medicine doubts it.

ROTFLMAO…. You are quoting Obama. Priceless. And you have the mitigated gull to call me a shill. Should I dare Ask, do you actually know what Obama means by that, or is his mere words proof enough Like God to Moses. .

I’m not doubting the number, I know what the number is and where it comes from. I’m doubting you understand what the number is. Since you use the number like a weapon.. I’m curious if you know how to use it.

I will come up with that explanation when you show me a private insurance policy that claims it will pay everything that any hospital charges--and tell me the price of that policy as it stands now. So, if you can prove it, prove it--

The old negative proof fallacy. Shall I assume that Mayo claim to shift cost to private insurers, the countless cost shifting studies that show percentage of premiums rise due to cost shifting probably wouldn’t cut it. You’re asking for the text section of an Insurance policy that makes a ridiculous claim. I don’t have to prove they pay EVERYTHING. I just have to prove they pay more than they do.

How many studies would you like me to post that proves they pay more and that is primarily due to Cost shifting? Goggle “Medicare cost shifting studies” results in 7,300,000 hits. Should come up with a couple

Get after it, dipshit. You've already been caught in the lie that the Mayo Clinic in Arizona doesn't follow EMTALA--and doesn't accept Medicare--because it's 'lost so much money'-- but even the Mayo Clinic in Arizona site refutes that. Now, you've adjusted it to mean '5 family practitioners in a clinic as an experiment that Mayo Clinic in Arizona is doing'.

If it makes you feel better, I will retract the statement since I can’t find the article I remember reading it in regarding the rise of freestanding emergency rooms as a way around EMTALA. Until I find it anyway.

I have adjusted it to say they are testing a NO Medicare clinic because of Medicare losses occurred. You can equivocate that anyway you want. It would never have happened if there wasn’t a Huge unfunded problem with EMTALA.

And, you wonder why people, as real responsible adults, should judge this more by their actions--and not their words (or even their numbers). Claiming to lose money when it comes to nursing salaries and benefits but making money when it comes to expanding the facilities and services offered....and does so all the time....

Clearly you do not understand business.

And, judging by actions instead of words or numbers, tell me again how the CEO's in this industry can make millions--even hundreds of millions--of dollars if this industry is 'losing money systemically'?

Because the Board of directors use Salary and benefits to attract highly qualified executive they feel will do the company more benefit then the cost. Perhaps Doctors are overpaid and we should cut their salaries as well. A surgeon in India Makes $2000/ year. Sound like a Plan?

Should I start Highlighting your post as examples?

Amazing how much you derail a topic just so you can avoid talking about the real problems. Let spend 3 more pages talking CEO pay… as if that has anything to do with the structural problem of Healthcare

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

The questions that you are conveniently ignoring are quite straightforward, Capital.

And, despite your claim on how I'm a shill for everything that Obama is for like you are a shill for those who want to claim that insurance companies in the medical industry represent a 'free market', I will remind you that I am NOT a proponent of Obamacare--it is neither a responsible form of 'universal coverage' nor a true 'free market' initiative (as nothing in this 'industry' is a true 'free market' initiative). Did that escape your attention? Or, do you constantly twist the conversation in order to avoid addressing the main points?

So, like Obama's book states, if you understand that 20% of the population take up 80% of the national health care budget, do you, also, understand that government already covers for most of that? And, if you understand that government covers for most of that, can you explain in the detail that you claim to know 'in business' how that is to be addressed by insurance companies if government does get totally out of funding any of the health care market? And, when, and if, you do explain that, can you explain how the insurance industry will do that AND make up for the Mayo Clinic's 800 million dollar loss AND keep the industry's CEO's making millions--to hundreds of millions--of dollars for themselves? Or, could the insurance industry even cover for these 20% that take up 80% of the health care budget and even make the profits that they do now AND efficiently cover all those most expensive patient care costs which it has never had to do before? And, if you think that it can do that, as the 'business expert' you claim to be, can you describe how that is to be done in enough detail to indicate that you even know what you are talking about?

Of course not because you really aren't here to do that, are you? Now, who's the shill, Capital?

Quote Capital:

Let spend 3 more pages talking CEO pay… as if that has anything to do with the structural problem of Healthcare

Well, is the CEO salaries not part of the structure of Health care or not? I say they are. So, in that light, how can the CEO salaries maintain their millions--to hundreds of millions--of dollars in salaries and benefits AND the structural problems of Health care include 'losing millions and millions of dollars' as you say that the Mayo Clinic in Arizona has done? Not a fair question, you say? I say it is....

You did have to retract your misstatement on how the Mayo Clinic has handled such an 800 million dollar loss, didn't you? Because, frankly, you either knew you were lying and wanted to misrepresent it as the truth or, if you were talking like you thought that was the truth, you're not as knowledgeable as you claim you are about this issue. So, now, maybe you can see my incentive to go by their actions--and not by their statements--when it comes to determining what is really happening in 'the industry' of Health care. And, one action is that their CEO's continue to make milllions--if not hundreds of millions--of dollars in this industry. And, if they are able to do that and incur the losses that you say exist, as the expert business person that you claim to be, where are they offsetting those losses? And, how is that offsetting 'supporting the industry' in a way that wouldn't result in, say, a Mayo Clinic losing hundreds of millions of dollars? Having the other employees work for nothing, otherwise? NOT offering as 'extensive a service' as you claim it could--'covering more people for less' (when it's not even having to cover for the most expensive patients now)? What, Capital?

Now, are you really an 'expert business person' so knowledgeable about the interworkings of this industry--or just a shill for that very industry despite any real knowledge of its interworkings? 'Enquiring minds would like to know'....

Kerry's picture
Kerry
Joined:
Jul. 31, 2007 4:01 pm
Quote Kerry:

The questions that you are conveniently ignoring are quite straightforward, Capital.

You realize just in this post you use 18 question marks. So yes, I am ignoring a lot of them. If you feel there is 1 or 2 you would like an answer too, Post them separately and not hidden a pile of rhetorical crap.

if you understand that 20% of the population take up 80% of the national health care budget, do you, also, understand that government already covers for most of that?

You didn't even bother to look it up.

The High Concentration of U.S. Health Care Expenditures

And, if you understand that government covers for most of that, can you explain in the detail that you claim to know 'in business' how that is to be addressed by insurance companies if government does get totally out of funding any of the health care market?

What makes you think they cover most of it? Even is you assume everyone over 65 is exclusively medicare, only 43%.

And, when, and if, you do explain that, can you explain how the insurance industry will do that AND make up for the Mayo Clinic's 800 million dollar loss AND keep the industry's CEO's making millions--to hundreds of millions--of dollars for themselves?

I don't need to, becuase your old tired dogma does not apply to Mayo, whose CEO on make $700K. Not even the most convoluted thinking can bridge Mayo losses with CIGNA's CEO salary. Since Mayo Losses were the direct result of Medicare Rreimbursements and have nothing to do with CIGNA CEO pay. Unless of course you arguing that Mayo Should Cost shift even more to Private insurance to make up for Government shortcomings.

Or, could the insurance industry even cover for these 20% that take up 80% of the health care budget and even make the profits that they do now AND efficiently cover all those most expensive patient care costs which it has never had to do before?

Of course they could.

And, if you think that it can do that, as the 'business expert' you claim to be, can you describe how that is to be done in enough detail to indicate that you even know what you are talking about?

R.A.I.S.E. P.R.E.M.I.U.M.S.

Takes real rocket science, doesn't it.

Of course not because you really aren't here to do that, are you?

Ackward isn't it that I answer all your questions...... In the first paragraph anyway.

Capital's picture
Capital
Joined:
Sep. 30, 2011 3:51 pm

Currently Chatting

A Rising Tide Only Lifts All Boats When Everyone Has a Boat.

President John F. Kennedy once said about economic development that “a rising tide lifts all boats.” Kennedy was, of course, right, but he missed something really, really important: A rising tide lifts only lifts all boats when everyone has a boat.

Powered by Pressflow, an open source content management system