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What did we learn from this election?
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Partner cracklover


Nov 7, 2012, 8:23 AM
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What did we learn from this election?
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And perhaps more importantly, is there anything that will come of it on the national level? Something so clearly spoken by the people that a consensus can be built around it?

I'll throw this one into the ring for discussion:

There *is* a political center in the country around one agenda, and it's big enough to potentially move forward: The federal government can tighten its belt, raise some taxes, and preserve many key social programs.

Let's hope those politicians on the extremes (and there are more than enough of them to derail any progress) will either have the decency to bow to the will of the people, or will be voted out of office in midterm elections in two years.

GO


veganclimber


Nov 7, 2012, 9:58 AM
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If I was a republican I would have learned that old white heterosexual christian males is just not enough of a base to win elections any more. I would have also learned that most people do not see rape as a blessing in disguise.


rmsusa


Nov 7, 2012, 12:07 PM
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In reply to:
There *is* a political center in the country around one agenda, and it's big enough to potentially move forward: The federal government can tighten its belt, raise some taxes, and preserve many key social programs.

The election was close enough that nobody's got enough political capital to push ahead with a unilateral agenda. Let's hope that it's a learning experience for both sides. The basic balance of power in congress hasn't changed.

As far as your agenda goes; it's easy to say, but the devil lies in the details. What does "key" mean and can you gather enough votes around your definition? Raise taxes or simplify, broaden and eliminate? Tighten? How much? It's going to be a really complicated political task. I hope the people in the executive branch can work with the people in the legislative branch.


Partner cracklover


Nov 7, 2012, 12:55 PM
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The devil is always in the details. But the details can always be ironed out - especially behind closed doors - if there is any will to do so.

The one fly in the ointment is that the Republicans have worked hard to drive out all the people in their own party who are really good at working out a consensus. And maybe someone else here knows, but I'm not sure I could point at anyone in the Democratic party (either House or Senate) with a proven track record on consensus building either. So even if both sides want to, it becomes hard to accomplish.

With that said, here's the thing: if the Republicans continue to be obstructionist, all the Bush Tax cuts go away, and there are massive cuts to the military. That's a mighty sword hanging over their head, and both of those events hurt Republicans more politically than they do the Democrats. Of course Republicans can continue to play chicken and hope the Dems blink first. It's worked in the past. But I think if that happens, there will be carnage on the Republican side if they miscalculate.

GO


gunkiemike


Nov 7, 2012, 1:23 PM
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cracklover wrote:
The devil is always in the details. But the details can always be ironed out - especially behind closed doors - if there is any will to do so.

Politics, it is said, is the science of compromise.

cracklover wrote:


With that said, here's the thing: if the Republicans continue to be obstructionist,

I have no doubt they will continue their "Let's make this President look bad every chance we get" practice. I truly believe they can't help but do this, as married to party-before-country as they are.

cracklover wrote:
all the Bush Tax cuts go away, and there are massive cuts to the military. That's a mighty sword hanging over their head, and both of those events hurt Republicans more politically than they do the Democrats.
GO

I don't know about that last point. The GOP is very, very good at blaming the other side. If bad things happen during Obama's second term - even if they are brought about by GOP obstructionism in Congress - they will use this as ammo in 4 years to show how bad the Dems have been for America. In fact, being able to say that next time virtually guarantees that they will let bad things happen. With apologies to whoever said "If you can't say something nice..." I'd call this the "If you can't do the good things you want to do, do bad things and blame the Democrats for it" theory of consensus-building.

M. (can you tell I'm sick of partisan politics?)


Partner cracklover


Nov 7, 2012, 1:58 PM
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gunkiemike wrote:
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With that said, here's the thing: if the Republicans continue to be obstructionist,

I have no doubt they will continue their "Let's make this President look bad every chance we get" practice. I truly believe they can't help but do this, as married to party-before-country as they are.

cracklover wrote:
all the Bush Tax cuts go away, and there are massive cuts to the military. That's a mighty sword hanging over their head, and both of those events hurt Republicans more politically than they do the Democrats.
GO

I don't know about that last point. The GOP is very, very good at blaming the other side. If bad things happen during Obama's second term - even if they are brought about by GOP obstructionism in Congress - they will use this as ammo in 4 years to show how bad the Dems have been for America. In fact, being able to say that next time virtually guarantees that they will let bad things happen. With apologies to whoever said "If you can't say something nice..." I'd call this the "If you can't do the good things you want to do, do bad things and blame the Democrats for it" theory of consensus-building.

M. (can you tell I'm sick of partisan politics?)

Sick of it or not, I think you're wrong. The strategy you're referring to was a reasonable (if despicable) one before November. See, it made political sense to drive Obama out of office and then get their agenda done. What you're missing is that that ship has sailed.

Instead, in two years there is an election in which Obama is safe, but many members of the House are not. And right now, they look bad. Really bad. They have an approval rating a few ticks lower than dirt. No matter how much they convince the public that Obama is responsible for the death of every kitten, the spoiling of milk, and the destruction of everything good and true, it won't matter one whit. When the populace is angry, it throws the bums out, right left and center. And they know that.

Besides, *everyone* has military jobs in their home constituency. If they get drastically cut, all congresspeople suffer, but... Democratic voters will be more forgiving of things like cuts to the military and tax hikes - you know that.

Besides, now that the housing market is recovering, the economy will pick up. So that makes the POTUS look good, as if his policies are working.*

GO

*Even though the depressed recovery hasn't been due to his policies, and the fact that it will now pick up also won't be due to his policies. It's a simple matter of economics: recoveries where real estate is stuck in the the toilet are very poor, because people don't spend $$ when they feel the value of their real estate is depressed, and the converse is also true.


(This post was edited by cracklover on Nov 7, 2012, 2:04 PM)


gunkiemike


Nov 7, 2012, 2:55 PM
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How many GOP House incumbents were ousted in this election? I honestly don't know, but I bet it wasn't very many. And I bet Dems were ousted in equal measure. I hope I'm wrong, but I think the US electorate is too stupid to hold the troublesome people accountable.


scrapedape


Nov 7, 2012, 4:32 PM
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gunkiemike wrote:
How many GOP House incumbents were ousted in this election? I honestly don't know, but I bet it wasn't very many. And I bet Dems were ousted in equal measure. I hope I'm wrong, but I think the US electorate is too stupid to hold the troublesome people accountable.

Well, we managed to turf out one of the last ~2 centrist Republican senators. Too bad he couldn't / wouldn't walk back his position on repealing Obamacare - he would have had my vote if he had.


scrapedape


Nov 7, 2012, 4:34 PM
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gunkiemike wrote:

Politics, it is said, is the science of compromise.

Bismarck called politics the "art of the possible," which I think is a more accurate characterization. It's more art than science, and it need not involve compromise.

In our specific current environment, mind you, compromise does seem to be necessary.


styndall


Nov 7, 2012, 6:16 PM
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gunkiemike wrote:
How many GOP House incumbents were ousted in this election? I honestly don't know, but I bet it wasn't very many. And I bet Dems were ousted in equal measure. I hope I'm wrong, but I think the US electorate is too stupid to hold the troublesome people accountable.

A fair number of the crazies lost.

Akin? Lost.
Mourdock? Lost.
Allen? Lost.
Walsh? Lost.
Hoekstra? Lost.
Hell, Bachman's seat seemed pretty safe, and she only won by a tiny margin to a dude practically nobody'd ever heard of. Those are just the national ones I could rattle off the top of my head.

Here in Michigan, the tea party crazy mayor of Troy got successfully recalled, we made up ground in the state houses, the 'require 2/3 majority for any tax increases' amendment failed with a resounding majority, and Maroun's anti-publically-owned bridge to Canada amendment crashed hard.

This election, if nothing else, shows the tea party that they had their two years, but we're tired of them. The extreme right doesn't sell, at least not like gay marriage does, which should tell them all they need to know about their chances of winning this culture war they're always on about.


Toast_in_the_Machine


Nov 7, 2012, 6:32 PM
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So longish rant, but hey, I started it this morning and here it is:

So the “most electable” of the Republicans who threw their hat into the ring for their party’s nomination lost. Before we go any further, does anyone think that Rick “that frothy foam” Santorum or Newt “family values” Gingrich would have done any better? I’m both surprised, and not surprised, that Mitt did as well as he did. I’m surprised because, and let us not forget, he didn’t release his taxes, he didn’t hold an open press conference, and he ran a campaign based on the solid plan of “I’m not Obama” and after the election everything will be OK.

Now, to beat Nate Silver at his own game – I did call the election months ahead of time. Based only on gas prices, my guess was that if crude stayed below $100 Obama would win. And if you look at the crude oil charts on the net, oil did flirt with $100 about mid-September. That, and the recent softening of the Dow determined that this would be a close election.

To go on with it, however, the Republicans need to seriously examine their party. Bluntly put, the demographic trends are not in their favor. If you look at their core (white, male, married, protestant) they are, as a percentage of the population going down. I would argue that the grand old party has fully flipped its historic script and is now the party of the southern secessionists. A scan of the map and which ones were red matches almost perfectly, not just with the Civil War, but also with modern economic malaise. Except for Texas, if you live in a red state (as I do) your state probably received more federal money than it paid it. Democrats aren’t living at the teat of the federal dole, they are the ones paying for the Republicans to suck at it.

Sure, even today, the day after the election you can hear some Tea Party people claim victory (no really: http://www.boston.com/...Ma2cxPtjJ/story.html). But make no mistake, that is a false profit. The demographics of the Tea Party are the demographics of the dying end of the GOP. To embrace the Tea Party is to embrace death of the party itself.

And words that I never thought I would type or say, “based on insight I got from Dan Quayle”, the GOP needs to expand its base, not restrict it. You can only use so many dog whistle words to excite your base. And while the holding the House may be some comfort, what great statesman can the republicans put up next election cycle? If Mitt and his magic underwear and masshole street cred can’t break out of the confederate electorate, who can?

Here are my 5 suggestions for the Republicans:
1) Tell Fox news to fuck off. Really. The fact that the political party has its own news network (and yes the “liberal bias” of the news article was on their website last night) is not a healthy thing. More republicans need to go on Fox (and also on other media outlets, including web based forums) and have their ideas challenged. The endless echo chamber that is B.S. Mountain creates a party that can only excite its base. You can’t reach out to others if you only repeat the old party line.
2) Tell Grover Norquist to fuck off. Accept some taxes. Hell, Mitt proposed “closing loopholes”. Back in the day, we called that raising taxes. The reason “cap and trade” was a great republican idea was that it had a free market combined with taxes. Accept it. You can’t be both the party of balanced budget and the party of “I’ll never, under any circumstance, ever, raise taxes”. Take some of that money you blew on trying to buy the election and pay some think tanks to come up with some “good” taxes.
3) Tell Karl Rove to fuck off. You don’t buy elections. Trying so only pisses people off. Sure one could argue that the underlying economics dictated the results and that all of the money spent was just wasted money, but damn that was a lot of money. Think of how better that could have been invested. Take that money, invest in some republican shithole (i.e. Mississippi), and next election we’ll be talking about the “Mississippi Miracle”. You know, that place where conservative values combined with smart business investments resulted in an economic powerhouse. Face it, if you can prove that republican fiscal ideals generate collective good, then the next election you’ll have some ideas sell. (If it works, that is.)
4) Tell Huckabee to fuck off. The vast majority of the US has settled on the opinion that “we don’t like abortion, but it is the most personal of decisions involving ones conscience and beliefs and intruding on that is wrong”. More and more people in America are OK with people being gay and think that removing their right to choose a live partner is wrong. If you want to be more moral, be moral. Do good. Quit trying to make other people do the same. There is a strong hint that the “New England” liberal actually lives a very conservative life, they just accept that others have different choices. Look to be more like that. Be a beacon of morality not a deacon.
5) Tell the racists in your party to fuck off. Look, I’m not stupid. The old racists in the south haven’t died. They are just the +65 year old voters for republicans. Are there people who voted for Mitt because he was white, just as there are people who voted for Obama because of his skin color? Sure. But really “Socialist Muslim” Obama is not. Obama’s “ideals” are those of a moderate republican and every honest republican should be upset that he was elected as a democrat. The demonization prevents the party from growing.

Lastly, for the love of pete, can you please next time pick a VP candidate who can walk and chew gum at the same time? The last two: Palin and Ryan frankly make the previous bad one, the aforementioned Quayle, look statesmanlike.


skiclimb


Nov 7, 2012, 8:13 PM
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Disciples of the 1930's propaganda tool the "BIG LIE" are not yet capable of prospering in the USA.


guangzhou


Nov 7, 2012, 10:22 PM
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I once again was reminded that not every vote counts. The winner can and is announced long before all the states are finished voting.

Got to be something wrong with that system.

Of course, I am not sure how to fix it yet.


(This post was edited by guangzhou on Nov 7, 2012, 10:22 PM)


sbaclimber


Nov 8, 2012, 2:34 AM
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guangzhou wrote:
I once again was reminded that not every vote counts. The winner can and is announced long before all the states are finished voting.

Got to be something wrong with that system.

Of course, I am not sure how to fix it yet.
Getting rid of the electoral college would be the best place to start!


Partner cracklover


Nov 8, 2012, 8:49 AM
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Toast: good rant.

Norm Ornstein is a "non partisan" at the American Enterprise Institute, a conservative think tank. He's recently been publishing articles and books saying much the same thing (and has been getting a lot of flak for it). He was interviewed yesterday on Fresh Air: http://www.npr.org/...mp;prgDate=11-7-2012

Here's a snippet from a recent article of his:
In reply to:
We have been studying Washington politics and Congress for more than 40 years, and never have we seen them this dysfunctional. In our past writings, we have criticized both parties when we believed it was warranted. Today, however, we have no choice but to acknowledge that the core of the problem lies with the Republican Party.

The GOP has become an insurgent outlier in American politics. It is ideologically extreme; scornful of compromise; unmoved by conventional understanding of facts, evidence and science; and dismissive of the legitimacy of its political opposition.

When one party moves this far from the mainstream, it makes it nearly impossible for the political system to deal constructively with the country’s challenges.

The whole article: http://www.washingtonpost.com/...IQAxCVUlT_story.html

Basically, he argues that the Republican party has moved from being conservative to being radical, and lost its problem-solving ability.

GO


petsfed


Nov 8, 2012, 9:57 AM
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sbaclimber wrote:
guangzhou wrote:
I once again was reminded that not every vote counts. The winner can and is announced long before all the states are finished voting.

Got to be something wrong with that system.

Of course, I am not sure how to fix it yet.
Getting rid of the electoral college would be the best place to start!

We just have to do so carefully, otherwise you end up disenfranchising another area entirely.

Every state has at least 3 electoral votes. 2 from senate districts, the rest from house districts. I think that the votes from house districts should be distributed based on the outcome in each district. The Senate votes, meanwhile, would go to the popular winner of that state. I readily admit that this may over-dilute the voting power of low population states, so it may be worthwhile to reverse which allocation, House or Senate, gets the district-by-district treatment in those states.

Also, I thought the networks made predictions, but because of the particular concern, the actual winner isn't announced by the government until all votes have been counted. So if you don't like that the networks (who are NOT agents of the state) make such announcements, stop watching, and get everyone you know to stop watching.


(This post was edited by petsfed on Nov 8, 2012, 9:57 AM)


curt


Nov 8, 2012, 2:56 PM
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The Republicans have a real problem and it was clearly exposed by this election cycle. To win the Republican party nomination today a candidate has to demonstrate extreme conservatism--basically in line with Tea Party values.

However, the Republican party is shrinking--basically all moderate Republicans have been labeled RINOs and have left the party to become independents or even Democrats.

So when the general election comes around, the Republican vote (as cohesive as it is) is insufficient to elect a Republican president--and their extreme positions are repelling to moderate crossover voters.

Curt


gunkiemike


Nov 8, 2012, 5:40 PM
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curt wrote:
The Republicans have a real problem and it was clearly exposed by this election cycle. To win the Republican party nomination today a candidate has to demonstrate extreme conservatism--basically in line with Tea Party values.

However, the Republican party is shrinking--basically all moderate Republicans have been labeled RINOs and have left the party to become independents or even Democrats.

So when the general election comes around, the Republican vote (as cohesive as it is) is insufficient to elect a Republican president--and their extreme positions are repelling to moderate crossover voters.

Curt

The faithful can still have their hopes:

http://www.theonion.com/...latest-setbac,30282/


guangzhou


Nov 8, 2012, 7:39 PM
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Petsfed,

I agree, it would need to be done carefully. For the bigger issue would be that candidates would then focus themselves on places like New York City, Los Angles, and other huge cities while not visiting and maybe even excluding the locations with smaller population.

I agree the government doesn't announce before all votes are in, but once those key states are in, the election is over, the rest is just a formality.

Again, I don't like that the election can be decided before all votes are in, but I don't have better way yet.


USnavy


Nov 9, 2012, 1:35 AM
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I learned to expect the 9% national unemployment rate to continue for the next four years. I also learned that apparently if I dont have a health insurance plan because I cannot afford $300 a month for something I probably wont even use, then I am going to get fined at the end of the year. Fortunately the military has a way of hooking its service members up.


Partner rrrADAM


Nov 9, 2012, 9:04 AM
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USnavy wrote:
I learned to expect the 9% national unemployment rate to continue for the next four years. I also learned that apparently if I dont have a health insurance plan because I cannot afford $300 a month for something I probably wont even use, then I am going to get fined at the end of the year. Fortunately the military has a way of hooking its service members up.

Do any research?

Even for a family, the newer High Deducatble plans are only around $60 a month... Then, after a $5,000 detuctable, for the entire family, it is 100% covered... And that includes prescription medication.

For single people, its even cheaper.


(This post was edited by rrrADAM on Nov 9, 2012, 9:06 AM)


USnavy


Nov 9, 2012, 10:16 PM
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rrrADAM wrote:
USnavy wrote:
I learned to expect the 9% national unemployment rate to continue for the next four years. I also learned that apparently if I dont have a health insurance plan because I cannot afford $300 a month for something I probably wont even use, then I am going to get fined at the end of the year. Fortunately the military has a way of hooking its service members up.

Do any research?

Even for a family, the newer High Deducatble plans are only around $60 a month... Then, after a $5,000 detuctable, for the entire family, it is 100% covered... And that includes prescription medication.

For single people, its even cheaper.
Well, I have looked into about 100 different health insurance plans, so yea, I did a little bit of research. I am aware of the $60 a month plans you are referencing (actually more like $85 a month) and they are complete utter shit. In Hawaii, $85 a month will get me a plan with a $10,000 deductible, maybe $5,000 if I am lucky. Then, it will include another $10,000 in copayments with only 30% coverage before I hit the copayment limit roof, and on top of that it will have coverage limitations (PPO, HPO, ect) which means if I have an emergency and there are not any in-network hospitals in my area, I get 0% coverage or even larger deductibles.

Furthermore, with a plan like that I have practically 0% coverage for any type of standard treatment outside of basic office visits. If I go into the doctor and need an xray, MRI, or something of the like, it will count towards my annual deductible which means I have no coverage. Basically, aside from medication, wellness office visits, STD testing, and other very basic amnesties, I have no coverage until I reach my deductible cap.

In Hawaii, a plan that has a $500 deductible and no copayments would cost me about $300-400 a month. For a $1,500 maximum out of pocket, it would cost me about $200 a month. Oh, and did I mention I am 25, a non-smoker,in perfect health and I have no dependents? Fortunately my affiliation with the military has made this all irrelevant as I have coverage through them. So, thank you but no thank you. If a serious trip to the ER is going to cost me $20,000, it mind as well cost $200,000, it is all the same; thus, there is no functional point for me to have a “health insurance” plan like that.

The military health insurance program, TriCare, should be the de facto standard on how health insurance should work. Do you know what happens when a service member needs medical care? It’s easy. I walk into a clinic and show my DoD ID card. I get the treatment I need: office visits, xray, lab testing, medication, whatever. Then I walk out the door and drive home. I don’t get any paperwork in the mail, no bills, no coverage limitations, no networks (for ER care), no questions, no bullshit, I get the coverage I need and that is the end of it.

Healthcare in America is disgraceful and we very much need the healthcare reform act. I just dont understand what the functional point of fining people without insurance is. Supposedly it is to help force people to buy insurance, but if the insurance costs too much, it costs too much, end of story. We need to focus on making insurance affordable, not fining those who cannot afford it or have realized that there is no functional point to having a plan with a out of pocket cap that is roughly equivalent to the cost of a brand new sedan.

The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.


(This post was edited by USnavy on Nov 9, 2012, 10:34 PM)


petsfed


Nov 10, 2012, 12:05 AM
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I recall (maybe it was struck down in committee) that you could show undue burden and therefore get out of the insurance requirement if you weren't sufficiently employed to get employer provided insurance. The main thing is to discourage people who can afford insurance but choose not to get it, but reason that they'll also choose not to need it.

The hope, I as I recall, was to counterbalance the part of the law that compelled companies to cover the elderly and folks with pre-existing conditions. There's no way to do that without either killing the insurance industry or requiring people who can afford it to carry insurance.

By the way, my $100 a month, specific to 25-year-old extreme sports enthusiasts plan had a pretty decent deductable (about $1000 or so) and good coverage, so maybe you were just looking in the wrong spots, or things have changed a lot more than I expected in the last 3 years.


Gmburns2000


Nov 10, 2012, 1:40 AM
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USnavy wrote:
The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.

This is only partly the truth. You're partly correct in that some costs to the recipient payor (govt or uninsured patient) are high because there are people who use the incredibly expensive emergency option because they can't afford insurance. When they do this, either the person picks up the tab or the govt. When it's the govt, they pay a set rate (often at or below the hospital's costs). When it's the person, well, if they couldn't afford insurance then they don't pay the emergency room bill and, of course, costs rise. This is actually THE impetus behind the health care system in Massachusetts. Of course, other things are included in the overall system, but that's why it was created in the beginning.

But that's not really why hospital prices are high to the uninsured. In almost every single contract between insurance companies and hospitals is a clause that states that insurance companies will pay the lesser of either the hospital's charge (their price) or the contracted rate. In other words, if the insurance company agrees to pay $1000 for an emergency visit, and the hospital's charge is $900, then the insurance company pays $900. This causes the hospitals to increase their charges so that all charges are higher than all contracted payments are (from ALL the insurance companies contracted with that hospital).

Almost all hospital charges are high almost exclusively from this contract language.


yanqui


Nov 10, 2012, 6:00 AM
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Re: [Gmburns2000] What did we learn from this election? [In reply to]
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Gmburns2000 wrote:
USnavy wrote:
The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.

This is only partly the truth. You're partly correct in that some costs to the recipient payor (govt or uninsured patient) are high because there are people who use the incredibly expensive emergency option because they can't afford insurance. When they do this, either the person picks up the tab or the govt. When it's the govt, they pay a set rate (often at or below the hospital's costs). When it's the person, well, if they couldn't afford insurance then they don't pay the emergency room bill and, of course, costs rise. This is actually THE impetus behind the health care system in Massachusetts. Of course, other things are included in the overall system, but that's why it was created in the beginning.

But that's not really why hospital prices are high to the uninsured. In almost every single contract between insurance companies and hospitals is a clause that states that insurance companies will pay the lesser of either the hospital's charge (their price) or the contracted rate. In other words, if the insurance company agrees to pay $1000 for an emergency visit, and the hospital's charge is $900, then the insurance company pays $900. This causes the hospitals to increase their charges so that all charges are higher than all contracted payments are (from ALL the insurance companies contracted with that hospital).

Almost all hospital charges are high almost exclusively from this contract language.

I have a real question about hospital fees and it sounds like you might know something about this, so I thought I'd ask. I had hip surgery in Belgium (with one of the world's top hip surgeons) and in general costs (Doctor's fees, assistant's fees, implant cost, materials etc.) are all roughly the same as the US except for one HUGE difference: the hospital fee. My hospital fee in Belgium was a few thousand Euros but in the US hospital fees for the same surgery run as high as 40,000 dollars. This is the main reason hip surgery in Europe costs from 20 to 30 thousand dollars less than it does in the US. The hospital cost is apparently independent of whether or not the patient has insurance or not. I know of one top hip surgeon in the US (Thomas Gross) who has at least made an effort to lower his hospital costs, but for the most part doctors (and patients) don't worry about this, because insurance covers the fee. The whole thing smacks of some kind of Mafia-like arrangement between hospitals and insurers. WTF is going on there?


(This post was edited by yanqui on Nov 10, 2012, 7:15 AM)


Gmburns2000


Nov 10, 2012, 8:49 AM
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Re: [yanqui] What did we learn from this election? [In reply to]
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yanqui wrote:
Gmburns2000 wrote:
USnavy wrote:
The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.

This is only partly the truth. You're partly correct in that some costs to the recipient payor (govt or uninsured patient) are high because there are people who use the incredibly expensive emergency option because they can't afford insurance. When they do this, either the person picks up the tab or the govt. When it's the govt, they pay a set rate (often at or below the hospital's costs). When it's the person, well, if they couldn't afford insurance then they don't pay the emergency room bill and, of course, costs rise. This is actually THE impetus behind the health care system in Massachusetts. Of course, other things are included in the overall system, but that's why it was created in the beginning.

But that's not really why hospital prices are high to the uninsured. In almost every single contract between insurance companies and hospitals is a clause that states that insurance companies will pay the lesser of either the hospital's charge (their price) or the contracted rate. In other words, if the insurance company agrees to pay $1000 for an emergency visit, and the hospital's charge is $900, then the insurance company pays $900. This causes the hospitals to increase their charges so that all charges are higher than all contracted payments are (from ALL the insurance companies contracted with that hospital).

Almost all hospital charges are high almost exclusively from this contract language.

I have a real question about hospital fees and it sounds like you might know something about this, so I thought I'd ask. I had hip surgery in Belgium (with one of the world's top hip surgeons) and in general costs (Doctor's fees, assistant's fees, implant cost, materials etc.) are all roughly the same as the US except for one HUGE difference: the hospital fee. My hospital fee in Belgium was a few thousand Euros but in the US hospital fees for the same surgery run as high as 40,000 dollars. This is the main reason hip surgery in Europe costs from 20 to 30 thousand dollars less than it does in the US. The hospital cost is apparently independent of whether or not the patient has insurance or not. I know of one top hip surgeon in the US (Thomas Gross) who has at least made an effort to lower his hospital costs, but for the most part doctors (and patients) don't worry about this, because insurance covers the fee. The whole thing smacks of some kind of Mafia-like arrangement between hospitals and insurers. WTF is going on there?

If hospital costs in Europe are generally as low as you say they are, then I'm not sure why that is. If I had to suspect a reason, it'd be that hospitals get some sort of funding from the govt.

Hospitals aren't cheap to operate. Costs and revenues are actually pretty difficult to forecast in relation to each other. And MRI machines, for example, aren't cheap. Someone in Europe is paying for that. It may not be the direct consumer or insurance company, but someone is. And it doesn't matter if a person has insurance or not, why is it that the hospital shouldn't be paid? After all, they have the greatest financial risk in the game.

Payors (insurance companies) and hospitals are definitely NOT in bed with each other. That would be illegal and constitute as price setting. The problem is that during negotiations you have this language I noted above and the hospital's inability to know, considering all contracts and shifts in population, where revenues will fall in relation to costs. Hospitals charge what they can to ensure they get the best deal possible. There is a strong belief that if providers had to deal directly (financially) with patients then prices would be different.

Having said that, there is a strong initiative amongst everyone (payors, doctors, hospitals) to lower costs overall these days. Govt involvement has essentially mandated this. Also, there are many, many hospitals in the US that are hurting financially in spite of the current climate.

Also, never trust a doctor who says he's trying to get his hospital's costs lowered. All that means is he's trying to get a bigger slice of the pie (i.e. - control of where the money goes). Are there some egalitarian doctors out there? Yes, but most are looking at the bottom line, too.

In short, someone is paying for that hospital. My bet is that in Europe, the govt is and you're not being charged because you're not european. In the US, you see the charge because the govt doesn't pick up that tab.


Partner rrrADAM


Nov 10, 2012, 2:11 PM
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Re: [USnavy] What did we learn from this election? [In reply to]
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USnavy wrote:
rrrADAM wrote:
USnavy wrote:
I learned to expect the 9% national unemployment rate to continue for the next four years. I also learned that apparently if I dont have a health insurance plan because I cannot afford $300 a month for something I probably wont even use, then I am going to get fined at the end of the year. Fortunately the military has a way of hooking its service members up.

Do any research?

Even for a family, the newer High Deducatble plans are only around $60 a month... Then, after a $5,000 detuctable, for the entire family, it is 100% covered... And that includes prescription medication.

For single people, its even cheaper.
Well, I have looked into about 100 different health insurance plans, so yea, I did a little bit of research. I am aware of the $60 a month plans you are referencing (actually more like $85 a month) and they are complete utter shit. In Hawaii, $85 a month will get me a plan with a $10,000 deductible, maybe $5,000 if I am lucky. Then, it will include another $10,000 in copayments with only 30% coverage before I hit the copayment limit roof, and on top of that it will have coverage limitations (PPO, HPO, ect) which means if I have an emergency and there are not any in-network hospitals in my area, I get 0% coverage or even larger deductibles.

Furthermore, with a plan like that I have practically 0% coverage for any type of standard treatment outside of basic office visits. If I go into the doctor and need an xray, MRI, or something of the like, it will count towards my annual deductible which means I have no coverage. Basically, aside from medication, wellness office visits, STD testing, and other very basic amnesties, I have no coverage until I reach my deductible cap.

In Hawaii, a plan that has a $500 deductible and no copayments would cost me about $300-400 a month. For a $1,500 maximum out of pocket, it would cost me about $200 a month. Oh, and did I mention I am 25, a non-smoker,in perfect health and I have no dependents? Fortunately my affiliation with the military has made this all irrelevant as I have coverage through them. So, thank you but no thank you. If a serious trip to the ER is going to cost me $20,000, it mind as well cost $200,000, it is all the same; thus, there is no functional point for me to have a “health insurance” plan like that.

The military health insurance program, TriCare, should be the de facto standard on how health insurance should work. Do you know what happens when a service member needs medical care? It’s easy. I walk into a clinic and show my DoD ID card. I get the treatment I need: office visits, xray, lab testing, medication, whatever. Then I walk out the door and drive home. I don’t get any paperwork in the mail, no bills, no coverage limitations, no networks (for ER care), no questions, no bullshit, I get the coverage I need and that is the end of it.

Healthcare in America is disgraceful and we very much need the healthcare reform act. I just dont understand what the functional point of fining people without insurance is. Supposedly it is to help force people to buy insurance, but if the insurance costs too much, it costs too much, end of story. We need to focus on making insurance affordable, not fining those who cannot afford it or have realized that there is no functional point to having a plan with a out of pocket cap that is roughly equivalent to the cost of a brand new sedan.

The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.


Short reply here... You had said you have to pay $300 a month for somehting you probably would never need or use, yet, you are complaining about what you get for just $85 a month... The two don't go together.

Also, I have never heard of such an ubsurd High Dectuctable plan... I would suggest looking into it a little more, as there certainly better HD plans out there, but the deductables are high, but then again, "you probable won;t need to use it", so it won't matter, right?


Partner rrrADAM


Nov 10, 2012, 2:18 PM
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Re: [yanqui] What did we learn from this election? [In reply to]
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yanqui wrote:
Gmburns2000 wrote:
USnavy wrote:
The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.

This is only partly the truth. You're partly correct in that some costs to the recipient payor (govt or uninsured patient) are high because there are people who use the incredibly expensive emergency option because they can't afford insurance. When they do this, either the person picks up the tab or the govt. When it's the govt, they pay a set rate (often at or below the hospital's costs). When it's the person, well, if they couldn't afford insurance then they don't pay the emergency room bill and, of course, costs rise. This is actually THE impetus behind the health care system in Massachusetts. Of course, other things are included in the overall system, but that's why it was created in the beginning.

But that's not really why hospital prices are high to the uninsured. In almost every single contract between insurance companies and hospitals is a clause that states that insurance companies will pay the lesser of either the hospital's charge (their price) or the contracted rate. In other words, if the insurance company agrees to pay $1000 for an emergency visit, and the hospital's charge is $900, then the insurance company pays $900. This causes the hospitals to increase their charges so that all charges are higher than all contracted payments are (from ALL the insurance companies contracted with that hospital).

Almost all hospital charges are high almost exclusively from this contract language.

I have a real question about hospital fees and it sounds like you might know something about this, so I thought I'd ask. I had hip surgery in Belgium (with one of the world's top hip surgeons) and in general costs (Doctor's fees, assistant's fees, implant cost, materials etc.) are all roughly the same as the US except for one HUGE difference: the hospital fee. My hospital fee in Belgium was a few thousand Euros but in the US hospital fees for the same surgery run as high as 40,000 dollars. This is the main reason hip surgery in Europe costs from 20 to 30 thousand dollars less than it does in the US. The hospital cost is apparently independent of whether or not the patient has insurance or not. I know of one top hip surgeon in the US (Thomas Gross) who has at least made an effort to lower his hospital costs, but for the most part doctors (and patients) don't worry about this, because insurance covers the fee. The whole thing smacks of some kind of Mafia-like arrangement between hospitals and insurers. WTF is going on there?

Not an expert, but I would guess that 'regulation', negotiation by insurers with providers, and everybody paying their part (insurers and people) brings the costs down.

Example: The merchandice we buy at stores includes the cost of money lost by the merchant through theft... It gets passed on to us... Along with 'what the market will bear. In a similar manner, if everybody paid their hospital bills (i.e., had insurance) the providers wouldn't have to charge extra to those that do pay to recoup costs of those that don't... AND, instead of providers charging "what the market will bear", some sort of regulation or negotiation (between insurers and providers) would bring the prices down to what is "fair", instead of just what people (or insurance companies) would pay... On that last not, what is paid to providers (by both me and my insurance combined) is less than what someone paying cash would pay , as what is paid is the "negotiated rate" if I use a provider in my "network", which is almost any provider... I see this on my bill sumaries (i.e., the amount billed, negotiated rate, and what is paid).


(This post was edited by rrrADAM on Nov 10, 2012, 2:25 PM)


Gmburns2000


Nov 10, 2012, 3:37 PM
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Re: [rrrADAM] What did we learn from this election? [In reply to]
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rrrADAM wrote:
yanqui wrote:
Gmburns2000 wrote:
USnavy wrote:
The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.

This is only partly the truth. You're partly correct in that some costs to the recipient payor (govt or uninsured patient) are high because there are people who use the incredibly expensive emergency option because they can't afford insurance. When they do this, either the person picks up the tab or the govt. When it's the govt, they pay a set rate (often at or below the hospital's costs). When it's the person, well, if they couldn't afford insurance then they don't pay the emergency room bill and, of course, costs rise. This is actually THE impetus behind the health care system in Massachusetts. Of course, other things are included in the overall system, but that's why it was created in the beginning.

But that's not really why hospital prices are high to the uninsured. In almost every single contract between insurance companies and hospitals is a clause that states that insurance companies will pay the lesser of either the hospital's charge (their price) or the contracted rate. In other words, if the insurance company agrees to pay $1000 for an emergency visit, and the hospital's charge is $900, then the insurance company pays $900. This causes the hospitals to increase their charges so that all charges are higher than all contracted payments are (from ALL the insurance companies contracted with that hospital).

Almost all hospital charges are high almost exclusively from this contract language.

I have a real question about hospital fees and it sounds like you might know something about this, so I thought I'd ask. I had hip surgery in Belgium (with one of the world's top hip surgeons) and in general costs (Doctor's fees, assistant's fees, implant cost, materials etc.) are all roughly the same as the US except for one HUGE difference: the hospital fee. My hospital fee in Belgium was a few thousand Euros but in the US hospital fees for the same surgery run as high as 40,000 dollars. This is the main reason hip surgery in Europe costs from 20 to 30 thousand dollars less than it does in the US. The hospital cost is apparently independent of whether or not the patient has insurance or not. I know of one top hip surgeon in the US (Thomas Gross) who has at least made an effort to lower his hospital costs, but for the most part doctors (and patients) don't worry about this, because insurance covers the fee. The whole thing smacks of some kind of Mafia-like arrangement between hospitals and insurers. WTF is going on there?

Not an expert, but I would guess that 'regulation', negotiation by insurers with providers, and everybody paying their part (insurers and people) brings the costs down.

Example: The merchandice we buy at stores includes the cost of money lost by the merchant through theft... It gets passed on to us... Along with 'what the market will bear. In a similar manner, if everybody paid their hospital bills (i.e., had insurance) the providers wouldn't have to charge extra to those that do pay to recoup costs of those that don't... AND, instead of providers charging "what the market will bear", some sort of regulation or negotiation (between insurers and providers) would bring the prices down to what is "fair", instead of just what people (or insurance companies) would pay... On that last not, what is paid to providers (by both me and my insurance combined) is less than what someone paying cash would pay , as what is paid is the "negotiated rate" if I use a provider in my "network", which is almost any provider... I see this on my bill sumaries (i.e., the amount billed, negotiated rate, and what is paid).

i.e. - patients in europe pay the govt via taxes and the govt subsidizes the hospitals. that's how they get around the "not paying" part, because everyone pays taxes.


yanqui


Nov 10, 2012, 4:08 PM
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Re: [Gmburns2000] What did we learn from this election? [In reply to]
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Gmburns2000 wrote:


If hospital costs in Europe are generally as low as you say they are, then I'm not sure why that is. If I had to suspect a reason, it'd be that hospitals get some sort of funding from the govt.

Hospitals aren't cheap to operate. Costs and revenues are actually pretty difficult to forecast in relation to each other. And MRI machines, for example, aren't cheap. Someone in Europe is paying for that. It may not be the direct consumer or insurance company, but someone is. And it doesn't matter if a person has insurance or not, why is it that the hospital shouldn't be paid? After all, they have the greatest financial risk in the game.

Payors (insurance companies) and hospitals are definitely NOT in bed with each other. That would be illegal and constitute as price setting. The problem is that during negotiations you have this language I noted above and the hospital's inability to know, considering all contracts and shifts in population, where revenues will fall in relation to costs. Hospitals charge what they can to ensure they get the best deal possible. There is a strong belief that if providers had to deal directly (financially) with patients then prices would be different.

Having said that, there is a strong initiative amongst everyone (payors, doctors, hospitals) to lower costs overall these days. Govt involvement has essentially mandated this. Also, there are many, many hospitals in the US that are hurting financially in spite of the current climate.

Also, never trust a doctor who says he's trying to get his hospital's costs lowered. All that means is he's trying to get a bigger slice of the pie (i.e. - control of where the money goes). Are there some egalitarian doctors out there? Yes, but most are looking at the bottom line, too.

In short, someone is paying for that hospital. My bet is that in Europe, the govt is and you're not being charged because you're not european. In the US, you see the charge because the govt doesn't pick up that tab.

I think this is an interesting point and I don't see it talked about much at all in the US, so I'm going to push this some. My information came from investigating costs for hip surgery, but I suspect it is generalized.

First off the hip surgery I was interested in costs about 12,500 Euros in Belgium or England and the main reason for the cheaper fee is that hospital costs are so much lower (less than 5000 Euros for this surgery). You suggest this has to do with government support, and perhaps some support could make a small difference in cost, but I don't see how it can account for the huge difference that exists. For example, in a hip surgery site I recently saw this:

"I should say at the outset - I am paying my yearly deductible of $8200 and then insurance pays 100% of the balance of the medical bills. I just received the bill from the hospital for my 48 hour stay. $81,046.86!!!"

Like I said, I paid less than 5,000 Euros for the same thing.

As another piece of evidence, Dr. Thomas Gross (a US surgeon I contacted) has actively managed to get the cost of his surgery down around $25,000 by aggressively going after hospital costs, but this is mainly because he is passionate about what he does (he is booked up many months in advance and almost all patients pay from insurance). Other doctors continue to charge $50,000 or more for the surgery when the extra money is all going to hospital costs. Who cares, right, if insurances covers the difference?

You might argue that use of hospital facilities and a two night stay over (in the US hospital fees often include the implant cost as well) is somehow really "worth", say 81,000 dollars, but I suspect if people had to pay for this surgery out of their pockets (as I did) that a reasonable lower cost alternative would have evolved. I find it very difficult to believe that European governments subsidize each hip surgery to the tune of 30,000 or 40,000 dollars and find it much easier to believe that insurance companies in the US have not looked after their clients interests in allowing this cost to balloon. Exactly why that lack of interest exists is an interesting question, but I am convinced it is one of the main reasons premiums are now so expensive


Gmburns2000


Nov 10, 2012, 4:28 PM
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Re: [yanqui] What did we learn from this election? [In reply to]
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yanqui wrote:
Gmburns2000 wrote:


If hospital costs in Europe are generally as low as you say they are, then I'm not sure why that is. If I had to suspect a reason, it'd be that hospitals get some sort of funding from the govt.

Hospitals aren't cheap to operate. Costs and revenues are actually pretty difficult to forecast in relation to each other. And MRI machines, for example, aren't cheap. Someone in Europe is paying for that. It may not be the direct consumer or insurance company, but someone is. And it doesn't matter if a person has insurance or not, why is it that the hospital shouldn't be paid? After all, they have the greatest financial risk in the game.

Payors (insurance companies) and hospitals are definitely NOT in bed with each other. That would be illegal and constitute as price setting. The problem is that during negotiations you have this language I noted above and the hospital's inability to know, considering all contracts and shifts in population, where revenues will fall in relation to costs. Hospitals charge what they can to ensure they get the best deal possible. There is a strong belief that if providers had to deal directly (financially) with patients then prices would be different.

Having said that, there is a strong initiative amongst everyone (payors, doctors, hospitals) to lower costs overall these days. Govt involvement has essentially mandated this. Also, there are many, many hospitals in the US that are hurting financially in spite of the current climate.

Also, never trust a doctor who says he's trying to get his hospital's costs lowered. All that means is he's trying to get a bigger slice of the pie (i.e. - control of where the money goes). Are there some egalitarian doctors out there? Yes, but most are looking at the bottom line, too.

In short, someone is paying for that hospital. My bet is that in Europe, the govt is and you're not being charged because you're not european. In the US, you see the charge because the govt doesn't pick up that tab.

I think this is an interesting point and I don't see it talked about much at all in the US, so I'm going to push this some. My information came from investigating costs for hip surgery, but I suspect it is generalized.

First off the hip surgery I was interested in costs about 12,500 Euros in Belgium or England and the main reason for the cheaper fee is that hospital costs are so much lower (less than 5000 Euros for this surgery). You suggest this has to do with government support, and perhaps some support could make a small difference in cost, but I don't see how it can account for the huge difference that exists. For example, in a hip surgery site I recently saw this:

"I should say at the outset - I am paying my yearly deductible of $8200 and then insurance pays 100% of the balance of the medical bills. I just received the bill from the hospital for my 48 hour stay. $81,046.86!!!"

Like I said, I paid less than 5,000 Euros for the same thing.

As another piece of evidence, Dr. Thomas Gross (a US surgeon I contacted) has actively managed to get the cost of his surgery down around $25,000 by aggressively going after hospital costs, but this is mainly because he is passionate about what he does (he is booked up many months in advance and almost all patients pay from insurance). Other doctors continue to charge $50,000 or more for the surgery when the extra money is all going to hospital costs. Who cares, right, if insurances covers the difference?

You might argue that use of hospital facilities and a two night stay over (in the US hospital fees often include the implant cost as well) is somehow really "worth", say 81,000 dollars, but I suspect if people had to pay for this surgery out of their pockets (as I did) that a reasonable lower cost alternative would have evolved. I find it very difficult to believe that European governments subsidize each hip surgery to the tune of 30,000 or 40,000 dollars and find it much easier to believe that insurance companies in the US have not looked after their clients interests in allowing this cost to balloon. Exactly why that lack of interest exists is an interesting question, but I am convinced it is one of the main reasons premiums are now so expensive

Yeah, insurers don't really care, that's true. Hospital charges are set almost exclusively off payor contracts (either with the govt or third-party payors). European hospitals don't have to deal with this quite as much.

There are certainly some market imbalances at play in the US, that's for sure, but when the govt is the biggest payor (and regulates, as Adam noted above), you get what you get.

Regarding doctors who ask hospitals to lower costs. It is my experience, not as a patient but working in revenue management for a hospital (prices, contracts, costs), that doctors who fight hospital costs very often don't reduce their own charges. We had several free-care funds that we offered to children who needed medical care and couldn't afford it. These weren't for asthma, but for more serious concerns that most hospitals couldn't handle either medically or financially (and we could do both). We had about $10M-15M in annual funds that the hospital would "donate to itself" (i.e. - the patient wouldn't be charged), but in order for doctors to take advantage of these funds then they had to drop their charges, too.

I'll give you a hint without even asking the question: the only fund that ever got emptied every year was the intl patients fund, and that had a budget of less than 15% of the total. And we had a monopoly position on our patient population.

Doctors want hospital charges to be lowered so they can attract more patients. When they attract more patients, that improves their negotiating position with the hospital. What really needs to happen is for EVERYONE to lower charges. Doctors don't like to talk about that part.


Partner macherry


Nov 10, 2012, 6:05 PM
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USnavy wrote:
rrrADAM wrote:
USnavy wrote:
I learned to expect the 9% national unemployment rate to continue for the next four years. I also learned that apparently if I dont have a health insurance plan because I cannot afford $300 a month for something I probably wont even use, then I am going to get fined at the end of the year. Fortunately the military has a way of hooking its service members up.

Do any research?

Even for a family, the newer High Deducatble plans are only around $60 a month... Then, after a $5,000 detuctable, for the entire family, it is 100% covered... And that includes prescription medication.

For single people, its even cheaper.
Well, I have looked into about 100 different health insurance plans, so yea, I did a little bit of research. I am aware of the $60 a month plans you are referencing (actually more like $85 a month) and they are complete utter shit. In Hawaii, $85 a month will get me a plan with a $10,000 deductible, maybe $5,000 if I am lucky. Then, it will include another $10,000 in copayments with only 30% coverage before I hit the copayment limit roof, and on top of that it will have coverage limitations (PPO, HPO, ect) which means if I have an emergency and there are not any in-network hospitals in my area, I get 0% coverage or even larger deductibles.

Furthermore, with a plan like that I have practically 0% coverage for any type of standard treatment outside of basic office visits. If I go into the doctor and need an xray, MRI, or something of the like, it will count towards my annual deductible which means I have no coverage. Basically, aside from medication, wellness office visits, STD testing, and other very basic amnesties, I have no coverage until I reach my deductible cap.

In Hawaii, a plan that has a $500 deductible and no copayments would cost me about $300-400 a month. For a $1,500 maximum out of pocket, it would cost me about $200 a month. Oh, and did I mention I am 25, a non-smoker,in perfect health and I have no dependents? Fortunately my affiliation with the military has made this all irrelevant as I have coverage through them. So, thank you but no thank you. If a serious trip to the ER is going to cost me $20,000, it mind as well cost $200,000, it is all the same; thus, there is no functional point for me to have a “health insurance” plan like that.

The military health insurance program, TriCare, should be the de facto standard on how health insurance should work. Do you know what happens when a service member needs medical care? It’s easy. I walk into a clinic and show my DoD ID card. I get the treatment I need: office visits, xray, lab testing, medication, whatever. Then I walk out the door and drive home. I don’t get any paperwork in the mail, no bills, no coverage limitations, no networks (for ER care), no questions, no bullshit, I get the coverage I need and that is the end of it.

Healthcare in America is disgraceful and we very much need the healthcare reform act. I just dont understand what the functional point of fining people without insurance is. Supposedly it is to help force people to buy insurance, but if the insurance costs too much, it costs too much, end of story. We need to focus on making insurance affordable, not fining those who cannot afford it or have realized that there is no functional point to having a plan with a out of pocket cap that is roughly equivalent to the cost of a brand new sedan.

The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.

it's sadly really that your healthcare reform was not real healthcare reform.


curt


Nov 10, 2012, 6:30 PM
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macherry wrote:
it's sadly really that your healthcare reform was not real healthcare reform.

Well, forward thinking people here consider our existing healthcare reform to be a decent first step--but not much more than that. The good thing is that a public option could easily be added (perhaps as a second step) and an eventual move to a real single-payer system could possibly emerge from that. We'll see, I guess.

Curt


USnavy


Nov 11, 2012, 10:39 PM
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Re: [Gmburns2000] What did we learn from this election? [In reply to]
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Gmburns2000 wrote:
yanqui wrote:
Gmburns2000 wrote:
USnavy wrote:
The American system is pretty hilarious actually. Part of the reason why insurance is so expensive in the first place is because no one can afford it. So because no one can afford it, they get hurt and dont pay their medical bills. Then the hospitals have to raise their prices which in turn forces the insurance companies to raise theirs. That leads to an even greater increase in uninsured people, an increase in non-paid treatments, and the cycle goes on and on.

This is only partly the truth. You're partly correct in that some costs to the recipient payor (govt or uninsured patient) are high because there are people who use the incredibly expensive emergency option because they can't afford insurance. When they do this, either the person picks up the tab or the govt. When it's the govt, they pay a set rate (often at or below the hospital's costs). When it's the person, well, if they couldn't afford insurance then they don't pay the emergency room bill and, of course, costs rise. This is actually THE impetus behind the health care system in Massachusetts. Of course, other things are included in the overall system, but that's why it was created in the beginning.

But that's not really why hospital prices are high to the uninsured. In almost every single contract between insurance companies and hospitals is a clause that states that insurance companies will pay the lesser of either the hospital's charge (their price) or the contracted rate. In other words, if the insurance company agrees to pay $1000 for an emergency visit, and the hospital's charge is $900, then the insurance company pays $900. This causes the hospitals to increase their charges so that all charges are higher than all contracted payments are (from ALL the insurance companies contracted with that hospital).

Almost all hospital charges are high almost exclusively from this contract language.

I have a real question about hospital fees and it sounds like you might know something about this, so I thought I'd ask. I had hip surgery in Belgium (with one of the world's top hip surgeons) and in general costs (Doctor's fees, assistant's fees, implant cost, materials etc.) are all roughly the same as the US except for one HUGE difference: the hospital fee. My hospital fee in Belgium was a few thousand Euros but in the US hospital fees for the same surgery run as high as 40,000 dollars. This is the main reason hip surgery in Europe costs from 20 to 30 thousand dollars less than it does in the US. The hospital cost is apparently independent of whether or not the patient has insurance or not. I know of one top hip surgeon in the US (Thomas Gross) who has at least made an effort to lower his hospital costs, but for the most part doctors (and patients) don't worry about this, because insurance covers the fee. The whole thing smacks of some kind of Mafia-like arrangement between hospitals and insurers. WTF is going on there?
Payors (insurance companies) and hospitals are definitely NOT in bed with each other. That would be illegal and constitute as price setting.
HAHAH, oh shit, I couldent stop laughing when I read that. It's illegal so that stops them hua? Since when has that stopped any corporation? Corporations are internationally renowned for shafing their customers and partners to make every last buck, regardless if their actions are legal or not. It is kind of hard to get into any serious trouble when you have an entire team of Harvard law grad attorneys at your side to guide your every step. I promise you, many corporations commit felonies on a daily basis, this is not new news. I dont know if insurance companies are in bed with hospitals or not, but I can assure you that insurance companies are as far from straight as possible, I dont think I need to tell anyone that. I would envision that every major insurance company in every industry has denied some legitimate claims in the past. Of course that would be a felony, but they know they can get away with it to some extent, so it does not stop them.

I can give you a perfect example. Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.


(This post was edited by USnavy on Nov 11, 2012, 10:52 PM)


guangzhou


Nov 11, 2012, 11:23 PM
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In reply to:
Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.

In this case, I have to agree with the insurance company. She should take better care of her stuff. If every-time someone had their unattended purse stolen, an insurance company had to pay for it, the insurance situation in America would be even worse.

Also, not sure how this is an example of insurance companies in bed with the hospitals.


USnavy


Nov 12, 2012, 1:04 AM
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guangzhou wrote:
In reply to:
Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.

In this case, I have to agree with the insurance company. She should take better care of her stuff. If every-time someone had their unattended purse stolen, an insurance company had to pay for it, the insurance situation in America would be even worse.

Also, not sure how this is an example of insurance companies in bed with the hospitals.
I never said they were in bed with the hospitals. I said many insurance companies conduct illegal activity, and just because something is illegal does not mean a company will not partake in it.

And she did take care of her stuff. What about if you park your car in the dark in New York City and it gets stolen. Should the insurance company refuse to replace it because you could have parked in a better more lighted neighborhood? What about if your car stereo gets stolen? Should the insurance company refuse to replace it because you should have removed the detachable face? What about if she put her purse inside her car, but while in the trunk someone reached in through the window and stole it? Would that make a difference?

See, that is why it is not supposed to be up to insurance companies if they pay out or not. The exact parameters outlining what will result in a claim denial are explicitly written in a legal contract between the insured and the insurer, it's call the policy. If an event is not specifically mentioned as prohibited in the policy, it's covered. Insurance companies cannot add verbally expressed clauses to the policy after the claim to shift judgement in their favor in an attempt to validate their judgement against the claimant, that's illegal. But they do it all the time. They deny your claim and then they give you a reason that is not really listed in the policy, or use a reason listed in the policy, but outside its written context. In my example, they used the abandonment clause to validate their claim denial. I dont think I need to explain to you what the word abandon means and how leaving a purse on your car 5' away with the intention of retrieving it 20 seconds later is not property abandonment.


Partner rrrADAM


Nov 12, 2012, 4:10 AM
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Curious... What is your rate in the NAVY? BM, perhaps? If I had to guess, I would say something BM1.

I was a DP3 before I got busted down and kicked out.


USnavy


Nov 12, 2012, 5:05 AM
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Partner rrrADAM


Nov 12, 2012, 5:10 AM
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USnavy wrote:
IS2. So what, DP used to be a cross between what is now IT and CT right?

Not sure what it is now... I was in in the 80's, and I was more of a coder and troubleshooter.

As to your post, before you edited it... It's not like I suggested you were a YN. Wink


USnavy


Nov 12, 2012, 5:12 AM
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Yea, I would guess it merged into IT or CT something. Anyway, I would rather be a YN than a BM. BMs sit on the deck all day and pretty up the mooring lines and scrub the deck and paint the haul. At least YNs get to sit at a desk.

You could rejoin as an ETN. Dont you do nuclear reactor work anyway? Perfect fit.


(This post was edited by USnavy on Nov 12, 2012, 5:14 AM)


Partner rrrADAM


Nov 12, 2012, 11:55 AM
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Kinda... I'm a QC/NDE Inspector at nukes. What a specialized HT would do, when inspecting welds, but I look at more than just welds now.


Gmburns2000


Nov 12, 2012, 12:13 PM
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INRT


curt


Nov 12, 2012, 12:19 PM
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USnavy wrote:
I can give you a perfect example. Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.

For $500 she could have sued in small claims court with zero attorney's fees.

Curt


notapplicable


Nov 12, 2012, 6:28 PM
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curt wrote:
USnavy wrote:
I can give you a perfect example. Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.

For $500 she could have sued in small claims court with zero attorney's fees.

Curt

Judge Joe Brown woulda hooked it up


USnavy


Nov 13, 2012, 2:09 AM
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curt wrote:
USnavy wrote:
I can give you a perfect example. Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.

For $500 she could have sued in small claims court with zero attorney's fees.

Curt
Sure, she could have. But the defendant would still have their Harvard grad lawyers by their side. Companies keep them on retainer specifically for stuff like this. So how exactly is a layman without an attorney supposed to win a suit against a defendant with a team of high price attorneys? I think if she were to win the suit, she would need help. Plus, many small claims courts now say that if the plaintiff looses, s/he has to pay for the defendant's attorney fees.


(This post was edited by USnavy on Nov 13, 2012, 2:11 AM)


Partner rrrADAM


Nov 13, 2012, 4:15 AM
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Re: [USnavy] What did we learn from this election? [In reply to]
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USnavy wrote:
curt wrote:
USnavy wrote:
I can give you a perfect example. Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.

For $500 she could have sued in small claims court with zero attorney's fees.

Curt
Sure, she could have. But the defendant would still have their Harvard grad lawyers by their side. Companies keep them on retainer specifically for stuff like this. So how exactly is a layman without an attorney supposed to win a suit against a defendant with a team of high price attorneys? I think if she were to win the suit, she would need help. Plus, many small claims courts now say that if the plaintiff looses, s/he has to pay for the defendant's attorney fees.


No... You are missing a very important point... The insurance companies are in the business of making $$$, and weigh cost vs payout. It would COST much more to defend against your friend with "Harvard Lawyers" and court costs than it would to pay out a relatively small claim... IF she had filed. (i.e., $100K paid to the lawyers to defend, or $1,000 to settle... Do the math)


(This post was edited by rrrADAM on Nov 13, 2012, 4:17 AM)


Toast_in_the_Machine


Nov 13, 2012, 5:58 AM
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Re: [cracklover] What did we learn from this election? [In reply to]
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cracklover wrote:
Basically, he argues that the Republican party has moved from being conservative to being radical, and lost its problem-solving ability.

GO

Here is a different take on it, with graphs!
http://grist.org/...he-rights-gone-nuts/


curt


Nov 13, 2012, 10:50 AM
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Re: [rrrADAM] What did we learn from this election? [In reply to]
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rrrADAM wrote:
USnavy wrote:
curt wrote:
USnavy wrote:
I can give you a perfect example. Once one of my friends set her purse on the top of her car in a parking lot while she was looking through her trunk. When she stuck her head back up, the purse was gone. She took her eyes off it for less than 20 seconds. She claimed it on her renters insurance policy but the claim was denied off the basis that the property was "abandon" because she left it unattended. Now both her and the insurance company knew the abandon property clause of her policy refereed to indefinitely leaving an item unattended on unspecified property with no intention of returning to reclaim it. Clearly the insurance company broke the law, but with a $500 claim, do you think she is going to sue? I tried to get her to, but she chose not as it was not worth the risk of loosing out on $10,000 in attorney fees.

For $500 she could have sued in small claims court with zero attorney's fees.

Curt
Sure, she could have. But the defendant would still have their Harvard grad lawyers by their side. Companies keep them on retainer specifically for stuff like this. So how exactly is a layman without an attorney supposed to win a suit against a defendant with a team of high price attorneys? I think if she were to win the suit, she would need help. Plus, many small claims courts now say that if the plaintiff looses, s/he has to pay for the defendant's attorney fees.


No... You are missing a very important point... The insurance companies are in the business of making $$$, and weigh cost vs payout. It would COST much more to defend against your friend with "Harvard Lawyers" and court costs than it would to pay out a relatively small claim... IF she had filed. (i.e., $100K paid to the lawyers to defend, or $1,000 to settle... Do the math)

In addition, many small claims courts do not allow you to bring an attorney.

Curt


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