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4 hours ago, NMpackalum said:

You truly need to be educated about Medicaid and Medicare with regards to how much they control the healthcare system. Reimbursements/payments for procedures, diagnosis and visits etc are based on a relative value scale established by CMS and are used as a reference for every healthcare entity. Just to start. And it goes much deeper. It is difficult to comprehend unless you are in the industry so I'll give people who don't understand a pass but it's frustrating hearing completely inaccurate things expressed. It's as if I posted inaccurate things about accounting or oil and gas production.

Are you suggesting insurance companies don't set a relative value scale and issue payments and reimbursements in a similar fashion?  Hell, don't chargemasters of hospitals set fees for procedures, diagnosis and visits based on a relative value scale they establish?

 

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5 hours ago, UNLV2001 said:

Still doctors and hospitals are not government employees and government does not run health care..............as for fees, medicare might set some market rates via insurance companies negotiating reduced fees...........   but if that rankles medical people then don't accept medicare (if that can be done).

Something is wrong when I see medical bills that start out at $400 then show insurance adjust to $73 and paying $50 after the patient pays the $20 co-pay.

I don't know the accounting in medical offices but if they can charge $400 and only take in $73 does the $327 get written off or is it an amount that never happened.

All I can say is, if the ACA is immediately repealed & millions are thrown off insurance there will be mass bankruptcies and a bump in deaths - But hey, in a capitalist the poor & afflicted probably don't deserve to live, which is pretty much the American model for most of the countries history 

 

I just don't think you have sufficient experience or insight to the current insurance or medical system to give appropriate or correct commentary on the current state of our health care system.  The government is intimately involved in everything about healthcare.  

Do you think the ACA has been a net benefit to society?  It's caused the poor to continue getting insurance like before on the backs of the middle class with exponentially higher rates for people who had good plans before.  It is a complete disaster.  There were never as many people who were uninsured as the government claimed.

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5 hours ago, Boise fan said:

Are you suggesting insurance companies don't set a relative value scale and issue payments and reimbursements in a similar fashion?  Hell, don't chargemasters of hospitals set fees for procedures, diagnosis and visits based on a relative value scale they establish?

 

That is the way it is moron.

That is exactly what he is suggesting because that is what is mandated by our socialist government.

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14 hours ago, Boise fan said:

Are you suggesting insurance companies don't set a relative value scale and issue payments and reimbursements in a similar fashion?  Hell, don't chargemasters of hospitals set fees for procedures, diagnosis and visits based on a relative value scale they establish?

 

Again, they all have to use the RB RVS set by medicare. They pay based on a percentage or set their own system based on conversion factors added to RBRVS. CMS runs the healthcare system whether directly or indirectly. Prank your local hospital administrator by saying you want to schedule a CMS audit. Watch the panic start.

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13 hours ago, Jack Bauer said:

I just don't think you have sufficient experience or insight to the current insurance or medical system to give appropriate or correct commentary on the current state of our health care system.  The government is intimately involved in everything about healthcare.  

Do you think the ACA has been a net benefit to society?  It's caused the poor to continue getting insurance like before on the backs of the middle class with exponentially higher rates for people who had good plans before.  It is a complete disaster.  There were never as many people who were uninsured as the government claimed.

The poor probably never had insurance before and they were still on the back of the middle class because they get treatment at emergency rooms & tax payers foot the bill - bigger bills because they wouldn't seek care until the problem became a real issue 

UMC (University Medical Center) the county run hospital here in the LV area was bleeding $$$ for decades due to having to serve a mass of uninsured patients 

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Just now, UNLV2001 said:

The poor probably never had insurance before and they were still on the back of the middle class because they get treatment at emergency rooms & tax payers foot the bill - bigger bills because they wouldn't seek care until the problem became a real issue 

UMC (University Medical Center) the county run hospital here in the LV area was bleeding $$$ for decades due to having to serve a mass of uninsured patients 

The poor had/have plenty of options for health care, and always have, previous to this terrible law being passed.  Do you realize that around 1/3 of the people who were "without insurance" were actually eligible for current plans but were too lazy to sign up and enroll? Many of the poor are too stupid to realize that it's much cheaper to go to a clinic and pay a nominal fee (80-100 dollars) instead of showing up in droves to the ER (800-1200 dollars for a simple visit) and then avoiding bills for the next few years until it's finally written off.  The bottom line is that they don't think they should have to pay at all, that's why they show up at the ER because they don't make you pay for your care.  Maybe they're not so stupid after all. 

I'm a big advocate of having a triage physician at the ER who won't let you in unless it's an actual emergency, but they won't do that because the dirty little secret is that the ERs love people coming for colds and non emergent care because they use little to no hospital resources for their visit, but bill at a very high rate because it's care that took place in a hospital or ER setting. 

The middle class shouldn't have to foot the bill for everyone's pre-existing conditions and all the 20 something millenials that pay a paltry "fine" come tax time.  When people used to pay 2000 dollars in premiums are now paying 12k per year, there's something wrong with the "affordable" act you've passed.  The ACA was never meant to help people have more affordable health care.  It was designed to make people hate it so much that the government takeover of medicine would be complete once they got rid of the ACA. 

There's a great way to include private insurance plans with government care if people would look at it (Germany's system).  I just think politicians don't really want to solve this issue.  The D's get a lot of support from the poor for this stuff, and the R's get traction from their base for opposing this stuff.  Lost in the middle is the actual care and needs of the populace.

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11 minutes ago, UNLV2001 said:

The poor probably never had insurance before and they were still on the back of the middle class because they get treatment at emergency rooms & tax payers foot the bill - bigger bills because they wouldn't seek care until the problem became a real issue 

UMC (University Medical Center) the county run hospital here in the LV area was bleeding $$$ for decades due to having to serve a mass of uninsured patients 

Where do you think the newly minted medicaid insured people are going for their care? I don't know UMC visit totals year over year but I do know that our local hospital has had ED visit increases every year despite (or because) the ACA. With regard to the losses for unnecessary ED visits, our local hospital used to receive county indigent funds from the state which was removed after implementation of the ACA thinking that people would have medicaid/exchange plans. Of course no one signs up for it until they need it so the net 6 million dollar deficit resulted. Those not very well thought out (though predicted) consequences are the norm for the ACA.

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2 minutes ago, Jack Bauer said:

The poor had/have plenty of options for health care, and always have, previous to this terrible law being passed.  Do you realize that around 1/3 of the people who were "without insurance" were actually eligible for current plans but were too lazy to sign up and enroll? Many of the poor are too stupid to realize that it's much cheaper to go to a clinic and pay a nominal fee (80-100 dollars) instead of showing up in droves to the ER (800-1200 dollars for a simple visit) and then avoiding bills for the next few years until it's finally written off.  The bottom line is that they don't think they should have to pay at all, that's why they show up at the ER because they don't make you pay for your care.  Maybe they're not so stupid after all. 

I'm a big advocate of having a triage physician at the ER who won't let you in unless it's an actual emergency, but they won't do that because the dirty little secret is that the ERs love people coming for colds and non emergent care because they use little to no hospital resources for their visit, but bill at a very high rate because it's care that took place in a hospital or ER setting. 

The middle class shouldn't have to foot the bill for everyone's pre-existing conditions and all the 20 something millenials that pay a paltry "fine" come tax time.  When people used to pay 2000 dollars in premiums are now paying 12k per year, there's something wrong with the "affordable" act you've passed.  The ACA was never meant to help people have more affordable health care.  It was designed to make people hate it so much that the government takeover of medicine would be complete once they got rid of the ACA. 

There's a great way to include private insurance plans with government care if people would look at it (Germany's system).  I just think politicians don't really want to solve this issue.  The D's get a lot of support from the poor for this stuff, and the R's get traction from their base for opposing this stuff.  Lost in the middle is the actual care and needs of the populace.

Hospitals are doing just the opposite - they are advertising people to go to the emergency room - all around the LV area we have billboards with digital signed telling us the wait time at nearby emergency rooms - Hospitals want to maximize profits and emergency rooms are the route they are going.

There are flaws in the law, which was the idea conservatives to begin with, but the republicans refuse to consider any fixes so here we are - and the republicans have no idea on what to replace the ACA with or they would have trotted out that idea since 2010 and not just wasted 60+ failed votes to repeal it ............and unless Trump wins the White House, the law stays in place for at least another 4 to 8 years 

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3 minutes ago, NMpackalum said:

Where do you think the newly minted medicaid insured people are going for their care? I don't know UMC visit totals year over year but I do know that our local hospital has had ED visit increases every year despite (or because) the ACA. With regard to the losses for unnecessary ED visits, our local hospital used to receive county indigent funds from the state which was removed after implementation of the ACA thinking that people would have medicaid/exchange plans. Of course no one signs up for it until they need it so the net 6 million dollar deficit resulted. Those not very well thought out (though predicted) consequences are the norm for the ACA.

The law is written so people can get regular checkups to try to prevent the last minute dire situations - but you can't legislate people to do the smart thing like preventive checkups :(

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Just now, UNLV2001 said:

Hospitals are doing just the opposite - they are advertising people to go to the emergency room - all around the LV area we have billboards with digital signed telling us the wait time at nearby emergency rooms - Hospitals want to maximize profits and emergency rooms are the route they are going.

There are flaws in the law, which was the idea conservatives to begin with, but the republicans refuse to consider any fixes so here we are - and the republicans have no idea on what to replace the ACA with or they would have trotted out that idea since 2010 and not just wasted 60+ failed votes to repeal it ............and unless Trump wins the White House, the law stays in place for at least another 4 to 8 years 

Look, it's disingenuous to suggest the conservatives had much of anything to do with the law, as the liberal Congress who had a large majority ramrodded the law down our throats.  They weren't interested in any compromises to the law at that time. A law where people from both sides actually felt like they'd have some input would have gone a long way to helping people and politicians (who we all know are not people) feel better about things.

If I was Obama, I'd have said "Look, we can pass this law with or without you, but I think it would be beneficial for everyone to have input on this so we can present a law that's fair to the public and that people feel good about." and gone from there.  Instead he said "There's consequences of losing elections" and didn't really act like he was willing to reach across party lines to get a law that truly benefitted society.  What we're left with is this law, and there's been a lot of unintended consequences from it. 

There's things that are good about the law, like pre-existing conditions and stuff like that's, it's a start.  But, the penalty for not purchasing insurance needs to disincentivize people enough to actually purchase insurance.  The law won't work if everyone doesn't purchase insurance.  The manner in which the insurance companies are pulling out of the exchanges is also troubling, because that was supposed to be a selling point of this, that would cause the companies to compete.  Insurance companies don't really compete with each other, and they still don't, and that needs to be changed because I think we'll see better rates for things if they compete more.

 

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7 minutes ago, UNLV2001 said:

The law is written so people can get regular checkups to try to prevent the last minute dire situations - but you can't legislate people to do the smart thing like preventive checkups :(

That's what is supposed to happen, and that is another step in the right direction re: preventative care being covered, but you can't balance the equation for human ignorance and stupidity.  People ignore their health and only seek care when things get dire, as a rule.

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12 minutes ago, Jack Bauer said:

Look, it's disingenuous to suggest the conservatives had much of anything to do with the law, as the liberal Congress who had a large majority ramrodded the law down our throats.  They weren't interested in any compromises to the law at that time. A law where people from both sides actually felt like they'd have some input would have gone a long way to helping people and politicians (who we all know are not people) feel better about things.

If I was Obama, I'd have said "Look, we can pass this law with or without you, but I think it would be beneficial for everyone to have input on this so we can present a law that's fair to the public and that people feel good about." and gone from there.  Instead he said "There's consequences of losing elections" and didn't really act like he was willing to reach across party lines to get a law that truly benefitted society.  What we're left with is this law, and there's been a lot of unintended consequences from it. 

There's things that are good about the law, like pre-existing conditions and stuff like that's, it's a start.  But, the penalty for not purchasing insurance needs to disincentivize people enough to actually purchase insurance.  The law won't work if everyone doesn't purchase insurance.  The manner in which the insurance companies are pulling out of the exchanges is also troubling, because that was supposed to be a selling point of this, that would cause the companies to compete.  Insurance companies don't really compete with each other, and they still don't, and that needs to be changed because I think we'll see better rates for things if they compete more.

 

Fact is and it's been proven, the ACA is basically the 1990's Conservative think tank Heritage Foundations law and it's almost exactly the same law that conservative Mitt Romney put in place in Massachusetts - If anything the liberals wanted single payer but that wasn't going to fly with republicans so this ACA is the compromise and the GOP still refused to accept what is their own parties policy...........and the GOP opposed anything Obama tried - it's simple fact .............just like right now Obama has called for $$ to fight the Zika virus but guess who's refusing to take that up.................it's been 8 years of 100% opposition to anything Obama tired to pass,.....Obama can't even get s somewhat conservative SCOTUS judge a hearing.

Thinking Obama rammed the law through is a pure figment of conservative propaganda - and the proof there is the GOP won't lift a finger to try and fix the flaws in the law - been 6 years and the GOP has had their finger up their ass the entire time 

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28 minutes ago, UNLV2001 said:

The law is written so people can get regular checkups to try to prevent the last minute dire situations - but you can't legislate people to do the smart thing like preventive checkups :(

 

20 minutes ago, Jack Bauer said:

That's what is supposed to happen, and that is another step in the right direction re: preventative care being covered, but you can't balance the equation for human ignorance and stupidity.  People ignore their health and only seek care when things get dire, as a rule.

Wait, so despite their best efforts, you're telling me that the nanny state can't actually protect us from ourselves?

5 minutes ago, UNLV2001 said:

Fact is and it's been proven, the ACA is basically the 1990's Conservative think tank Heritage Foundations law and it's almost exactly the same law that conservative Mitt Romney put in place in Massachusetts - If anything the liberals wanted single payer but that wasn't going to fly with republicans so this ACA is the compromise and the GOP still refused to accept what is their own parties policy...........and the GOP opposed anything Obama tried - it's simple fact .............just like right now Obama has called for $$ to fight the Zika virus but guess who's refusing to take that up.................it's been 8 years of 100% opposition to anything Obama tired to pass,.....Obama can't even get s somewhat conservative SCOTUS judge a hearing.

Thinking Obama rammed the law through is a pure figment of conservative propaganda - and the proof there is the GOP won't lift a finger to try and fix the flaws in the law - been 6 years and the GOP has had their finger up their ass the entire time 

ani-wonder_deflection.gif

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1 minute ago, FSpoopypants said:

 

Wait, so despite their best efforts, you're telling me that the nanny state can't actually protect us from ourselves?

ani-wonder_deflection.gif

Some people care more about the innards of their car than their own body 

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7 minutes ago, UNLV2001 said:

Fact is and it's been proven, the ACA is basically the 1990's Conservative think tank Heritage Foundations law and it's almost exactly the same law that conservative Mitt Romney put in place in Massachusetts - If anything the liberals wanted single payer but that wasn't going to fly with republicans so this ACA is the compromise and the GOP still refused to accept what is their own parties policy...........and the GOP opposed anything Obama tried - it's simple fact .............just like right now Obama has called for $$ to fight the Zika virus but guess who's refusing to take that up.................it's been 8 years of 100% opposition to anything Obama tired to pass,.....Obama can't even get s somewhat conservative SCOTUS judge a hearing.

Thinking Obama rammed the law through is a pure figment of conservative propaganda - and the proof there is the GOP won't lift a finger to try and fix the flaws in the law - been 6 years and the GOP has had their finger up their ass the entire time 

Well back in 1990, the "experts" thought we were going to enter a new ice age too. Hormone replacement, mega doses of vitamins, margarine and sit ups were good. Red meat, eggs and nuclear power were bad. Your last comment about how Republicans have refused to fix it is solely propaganda or your inability to get past your vacuum. Paul Ryan among others has had a very sensible plan for many years including optional vouchers for medicare recipients to purchase commercial plans for those who could not find a provider willing to take Medicare.

Honestly, I don't give a crap about the ACA or exchange plans since they only account for 10-11 million people if you believe government statistics. That group except those with pre-existing diseases unable to get insurance will always go to the ED sometimes not of their choice because the ACA does nothing about patient access to care. My beef is what the ACA has done to private commercial insurance. Unless you are a business owner or purchase your own insurance, you really can't comprehend the radical changes to purchasing commercial insurance. Pre ACA, I bought monthly insurance for $500 for singles and $850 for families. For that I had $10 dollar copays and $10-$20 tiers for drugs with 80/20 coverage to a 1000 dollar max out of pocket. $100 for out patient surgeries and $500 for inpatient surgeries or hospitalizations. Forward to present, I pay $2200/month for family with $500 deductible with 80/20 coverage with max out of pocket of $6500, very limited formulary. I paid $7700 out of pocket for my son's recent foot surgery despite paying that kind of premium. I would say 30% of my surgeries cancel because they can't come up with that money despite paying their portion of insurance. The only people who don't worry about the costs are those on medicaid and they only show to their appointments half of the time. Doesn't seem fair to those employees that work hard to pay their premiums to subsidize others. Not to mention the $10-25,000 cost to employers per employee. All for what? More ER utilization? Decreased access for specialty care and needed surgeries. 

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7 hours ago, UNLV2001 said:

Fact is and it's been proven, the ACA is basically the 1990's Conservative think tank Heritage Foundations law and it's almost exactly the same law that conservative Mitt Romney put in place in Massachusetts - If anything the liberals wanted single payer but that wasn't going to fly with republicans so this ACA is the compromise and the GOP still refused to accept what is their own parties policy...........and the GOP opposed anything Obama tried - it's simple fact .............just like right now Obama has called for $$ to fight the Zika virus but guess who's refusing to take that up.................it's been 8 years of 100% opposition to anything Obama tired to pass,.....Obama can't even get s somewhat conservative SCOTUS judge a hearing.

Thinking Obama rammed the law through is a pure figment of conservative propaganda - and the proof there is the GOP won't lift a finger to try and fix the flaws in the law - been 6 years and the GOP has had their finger up their ass the entire time 

You're more in to "gotcha" posting and not addressing the issue and whining about Obama being opposed.  Obama is supposed to lead, and bring the sides together to compromise.  He hasn't done that.  Opinions change 20 years later, at this point it doesn't matter who's fault it is, it's been a net negative overall, in particular for middle class people who are drowning under this law.

As for money for Zika, as a medical professional, I can think of fifty things medically that are more pressing needs for our country.

People like me and @NMpackalum actually have to work and navigate the system under these laws, and I don't feel like either of us have an agenda when we're telling you it hasn't been good for the patients that we see in clinic.  

6 hours ago, NMpackalum said:

Well back in 1990, the "experts" thought we were going to enter a new ice age too. Hormone replacement, mega doses of vitamins, margarine and sit ups were good. Red meat, eggs and nuclear power were bad. Your last comment about how Republicans have refused to fix it is solely propaganda or your inability to get past your vacuum. Paul Ryan among others has had a very sensible plan for many years including optional vouchers for medicare recipients to purchase commercial plans for those who could not find a provider willing to take Medicare.

Honestly, I don't give a crap about the ACA or exchange plans since they only account for 10-11 million people if you believe government statistics. That group except those with pre-existing diseases unable to get insurance will always go to the ED sometimes not of their choice because the ACA does nothing about patient access to care. My beef is what the ACA has done to private commercial insurance. Unless you are a business owner or purchase your own insurance, you really can't comprehend the radical changes to purchasing commercial insurance. Pre ACA, I bought monthly insurance for $500 for singles and $850 for families. For that I had $10 dollar copays and $10-$20 tiers for drugs with 80/20 coverage to a 1000 dollar max out of pocket. $100 for out patient surgeries and $500 for inpatient surgeries or hospitalizations. Forward to present, I pay $2200/month for family with $500 deductible with 80/20 coverage with max out of pocket of $6500, very limited formulary. I paid $7700 out of pocket for my son's recent foot surgery despite paying that kind of premium. I would say 30% of my surgeries cancel because they can't come up with that money despite paying their portion of insurance. The only people who don't worry about the costs are those on medicaid and they only show to their appointments half of the time. Doesn't seem fair to those employees that work hard to pay their premiums to subsidize others. Not to mention the $10-25,000 cost to employers per employee. All for what? More ER utilization? Decreased access for specialty care and needed surgeries. 

This x 1000

Everyone needs to have some skin in the game.  If you don't, then you have no incentive to keep up your end of the bargain.

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3 hours ago, UNLV2001 said:

Fact is and it's been proven, the ACA is basically the 1990's Conservative think tank Heritage Foundations law and it's almost exactly the same law that conservative Mitt Romney put in place in Massachusetts - If anything the liberals wanted single payer but that wasn't going to fly with republicans so this ACA is the compromise and the GOP still refused to accept what is their own parties policy...........and the GOP opposed anything Obama tried - it's simple fact .............just like right now Obama has called for $$ to fight the Zika virus but guess who's refusing to take that up.................it's been 8 years of 100% opposition to anything Obama tired to pass,.....Obama can't even get s somewhat conservative SCOTUS judge a hearing.

Thinking Obama rammed the law through is a pure figment of conservative propaganda - and the proof there is the GOP won't lift a finger to try and fix the flaws in the law - been 6 years and the GOP has had their finger up their ass the entire time 

Your full of it.  Whatever idea a think tank had more than a decade before the law was passed has nothing to do with what ideas conservatives were advocating for when healthcare reform was an issue. Not even Romney wanted Romneycare at a national level.

And no, the liberals didn't want single payer.  They wanted Obamacare, because they voted for Obama, whose plan during the campaign is near identical to the ACA, sans the public option.  It was not a compromise with conservatives. If the liberals wanted single payer they could have voted for John Edwards, the one major candidate who was advocating for a back door single payer.  They didn't.  They voted for the candidate of Obamacare. Then they lied relentlessly to get the shitty law passed, without a single vote of support from the other side. The dems own this shitburger all on their own and have since 2008.

It was never the GOP party's policy.  So you can drop that line of shit forever.

We’re all sitting in the dugout. Thinking we should pitch. How you gonna throw a shutout when all you do is bitch.

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3 hours ago, UNLV2001 said:

Hospitals are doing just the opposite - they are advertising people to go to the emergency room - all around the LV area we have billboards with digital signed telling us the wait time at nearby emergency rooms - Hospitals want to maximize profits and emergency rooms are the route they are going.

There are flaws in the law, which was the idea conservatives to begin with, but the republicans refuse to consider any fixes so here we are - and the republicans have no idea on what to replace the ACA with or they would have trotted out that idea since 2010 and not just wasted 60+ failed votes to repeal it ............and unless Trump wins the White House, the law stays in place for at least another 4 to 8 years 

That is hilarious a law passed without a conservative vote, is now the fault of conservatives because it doesn't work.   Conservatives actually passed all kind of legislation that would have fixed Obamacare (repealed the stupid shit).

 

Commie2001 has a unique outlook.  HA! HA! HA! HA! HA! HA! HA! HA! HA!

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