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rickman

Jan 1, 1970
0
Our screwed up tort law.

There's not much to that I can comment on. What isn't screwed up? But
the tort law works. You may not like some of the consequences, but it
is a lot better than no laws at all.

Was there something in particular you wanted to comment on? Or do you
just prefer to complain while expressing no particular point?

That's why I say: Open the chargemaster to the public. Just like the
auto parts store shows its prices to the public before they buy (it's
the law), not after they have installed the parts and can't return them.
Because hospitals do the latter, you get treated and _then_ they tell
you what it costs.

I don't know what a "chargemaster" is. If you mean the price books,
then I think they should open all columns. The parts store doesn't do
that. They have the retail prices shown. Commercial customers get much
better pricing.

No, I happen to work in the medical device space and know this stuff. Do
you?

Oh, you have to resort to playing that card eh? I thought that was John
Larkin's favorite card.
Who do you think ends up paying the $100k plus malpractice premium for a
cardiologist? Why do you think a doc who does simple diagnoses that
could be done with a $25k ultrasound system buys the $120k system? He
told me: "If I get dragged into court I can tell that I use the best
system on the patient that money can buy".

What's wrong with having liability insurance. Don't you have it too?
It costs a lot because the liability of being a doctor is very high.
When they screw up it is a big deal to their patients.

As to why doctors make the decisions they do isn't a function of tort
law. It is a result of the huge stakes of their making a mistake.

The real problem is not tort law, it is medical practice. Why can the
doctor charge whatever he wants for an ultrasound? Once the system
covers everyone under medical insurance, the reimbursements will be
fixed by the insurance companies. Doctors won't be able to run labs,
clinics and hospitals as profit centers for their own personal benefit.
They will have to compete in the market or go out of business. Why do
you think medical school enrollment is so limited? Because there just
isn't a way to train more doctors? No, to prevent an over supply of
doctors from lowering the prices. Doctors run nearly all aspects of
medicine including who gets to be a doctor and when they are no longer
allowed to be a doctor. What other occupation is self regulated like
that? In this case it is an entire industry with not enough overview.

But by then it's too late. Perfectly good health plans like ours will
have death-spiraled, and so on. Then we'll get a single payer socialixed
system because there won't be any other way out of the mess. And maybe
that's the real purpose behind all this?

What health plan is that? Why will Obamacare affect your plan and make
it implode?

I, for one, will be very happy with socialized medicine. I think it is
very overdue. Why are you afraid of it? I guess it is just the fact
that you think you are well taken care of by the current system. Have
you looked into the lifetime cap on your policy? Most of them have it.
That is the part that puts you into bankruptcy when you get cancer or
a hospital infection. No one ever went bankrupt with socialize
medicine, but people don't realize this until it happens. Kinda like a
roulette wheel. Is it time for your number to come up?
 
J

Joerg

Jan 1, 1970
0
rickman said:
There's not much to that I can comment on. What isn't screwed up? But
the tort law works. You may not like some of the consequences, but it
is a lot better than no laws at all.

Was there something in particular you wanted to comment on? Or do you
just prefer to complain while expressing no particular point?

As I mentioned before, if cardiologists have to pay north of $100k/year
in premiums tort law clearly does not work.
I don't know what a "chargemaster" is. If you mean the price books,
then I think they should open all columns. The parts store doesn't do
that. They have the retail prices shown. Commercial customers get much
better pricing.

The chargemaster is in essence the electronic price book. Guarded like a
huge secret. Even the staff doesn't have proper access. We were once
quoted $20 for a shot and then billed $90. A complaint to the state
board was simply brushed off, as expected.
Oh, you have to resort to playing that card eh? I thought that was John
Larkin's favorite card.

You wrote I go off without facts. That was a rude comment. So I merely
said that I work in that field and happen to know the facts. Then asked
if you work in that field as well (because you profess to know that my
facts are off). What's wrong with that?

What's wrong with having liability insurance. Don't you have it too? It
costs a lot because the liability of being a doctor is very high. When
they screw up it is a big deal to their patients.

No, I do not have it. Why? Because every single carrier for EEs has
bowed out, for the reasosn I mentioned and that you don't want to
believe. The millisecond you check the box "Do you design medical
devices?" in conjuntion with the US -> out, you become a pariah and get
what the insurances folks call a "decline to quote" notice. Ask Marsh,
ask Lloyds, ask anyone. I've had phone conferences with them about it so
I know.

As to why doctors make the decisions they do isn't a function of tort
law. It is a result of the huge stakes of their making a mistake.

The real problem is not tort law, it is medical practice. ...


No, I disagree with you there. Talk to a practicing cardiologist about
it, that'll be an eye opener for you.

... Why can the
doctor charge whatever he wants for an ultrasound? Once the system
covers everyone under medical insurance, the reimbursements will be
fixed by the insurance companies. ...


They already are.

... Doctors won't be able to run labs,
clinics and hospitals as profit centers for their own personal benefit.
They will have to compete in the market or go out of business. ...
^^^^^^^^^^^^^^^^^^^

If you haven't noticed, that has already started happening. Good luck
finding a doc who will still take Medicare patients in some areas.

... Why do
you think medical school enrollment is so limited? Because there just
isn't a way to train more doctors? No, to prevent an over supply of
doctors from lowering the prices. Doctors run nearly all aspects of
medicine including who gets to be a doctor and when they are no longer
allowed to be a doctor. What other occupation is self regulated like
that? In this case it is an entire industry with not enough overview.

Do yourself a favor before making such statements: Talk to some actual
doctors.

What health plan is that? Why will Obamacare affect your plan and make
it implode?

It is a Kaiser high-deductible plan. Since Obamacare the premiums have
started to skyrocket and when questioned about a death-spiral I got
somewhat evasive answers. That is a rather bad sign.

I, for one, will be very happy with socialized medicine. I think it is
very overdue. Why are you afraid of it? ...


I am not, because I am fairly healthy. Once health fades, all you have
to do is take a look at Canada. Even one of their own judges made the
bold statement "Access to a waiting list is not access to health care".
Also, they often send the more difficult cases to the US because they
can't get that together.

... I guess it is just the fact
that you think you are well taken care of by the current system. Have
you looked into the lifetime cap on your policy? Most of them have it.
That is the part that puts you into bankruptcy when you get cancer or a
hospital infection. No one ever went bankrupt with socialize medicine,


No, but people have died. On waiting lists.

but people don't realize this until it happens. Kinda like a roulette
wheel. Is it time for your number to come up?

With socialized medicine one will know when one is on a waiting list or
sees that rubber stamp "Denied" on a cancer treatment application.
 
S

Spehro Pefhany

Jan 1, 1970
0
As I mentioned before, if cardiologists have to pay north of $100k/year
in premiums tort law clearly does not work.

Good cardiologists, anyway. ;-)

If they're actively killing one out of ten or twenty patients, that
might be about right.


Best regards,
Spehro Pefhany
 
J

Joerg

Jan 1, 1970
0
Spehro said:
Good cardiologists, anyway. ;-)

If they're actively killing one out of ten or twenty patients, that
might be about right.

Not quite. I talked to one from Florida, had a good clean record. He
paid $160k per year just in malpractise insurance premiums. Same for his
colleagues. That is sick.
 
Good cardiologists, anyway. ;-)
Good ones probably have a higher death rate than average. They're the
ones getting referred the more tricky problems.
If they're actively killing one out of ten or twenty patients, that
might be about right.

Well, they're all going to die. The problem is that tort law doesn't
recognize that fact.
 
J

josephkk

Jan 1, 1970
0
Our screwed up tort law.




That's why I say: Open the chargemaster to the public. Just like the
auto parts store shows its prices to the public before they buy (it's
the law), not after they have installed the parts and can't return them.
Because hospitals do the latter, you get treated and _then_ they tell
you what it costs.



No, I happen to work in the medical device space and know this stuff. Do
you?

Who do you think ends up paying the $100k plus malpractice premium for a
cardiologist? Why do you think a doc who does simple diagnoses that
could be done with a $25k ultrasound system buys the $120k system? He
told me: "If I get dragged into court I can tell that I use the best
system on the patient that money can buy".


But by then it's too late. Perfectly good health plans like ours will
have death-spiraled, and so on. Then we'll get a single payer socialixed
system because there won't be any other way out of the mess. And maybe
that's the real purpose behind all this?

Yep, that is Pelosi and Obummer's rat. Knew i wouldn't be the only one to
smell it.

?-)
 
R

rickman

Jan 1, 1970
0
Good cardiologists, anyway. ;-)

If they're actively killing one out of ten or twenty patients, that
might be about right.

Ok, let's put a value on the human life. The state of Maryland says it
is worth $0.25M max. Of course they say the same if you only lose a
finger or a toe, but let's not digress. If your insurance premiums are
only $0.1M then you can only kill one patient every 2.5 years to break
even. Since the insurance company has to make a profit and have
overhead, let's say they shave 37.5% of the premiums which stretches
your rate to one dead patient every 4 years. If you are worse than that
you are costing the insurance company money and you will likely be
canceled.

So how many patients get their $0.25 without dying I wonder?
 
R

rickman

Jan 1, 1970
0
Not quite. I talked to one from Florida, had a good clean record. He
paid $160k per year just in malpractise insurance premiums. Same for his
colleagues. That is sick.

I bet he couldn't afford to put premium gas in his Lexus. Or did he
drive a Mercedes?
 
R

rickman

Jan 1, 1970
0
Good ones probably have a higher death rate than average. They're the
ones getting referred the more tricky problems.


Well, they're all going to die. The problem is that tort law doesn't
recognize that fact.

Some not soon enough. lol
 
C

Charlie E.

Jan 1, 1970
0
What reason? Liability?

Prices in hospitals are like prices in the auto parts store. They have
different columns for different customers. If you have no insurance,
you pay top dollar. That should be criminal! Don't rant at me about
liability causing it because there is no substantiation to that claim.
For a fairly rational person you seem to go off without facts over some
issues.
Exactly - differernt prices for different customers, many different
prices for many different customers. Is the customer with InsurerA?
Or B? Or Z? Each one has a different rate on that procedure, which is
not the same as the Medicare or Medicaid rate. Also, many are based as
a DISCOUNT on the cash price, meaning that any one that elects to pay
directly ( a much more efficient and easier option) pays the highest
price.
 
Exactly - differernt prices for different customers, many different
prices for many different customers. Is the customer with InsurerA?
Or B? Or Z? Each one has a different rate on that procedure, which is
not the same as the Medicare or Medicaid rate. Also, many are based as
a DISCOUNT on the cash price, meaning that any one that elects to pay
directly ( a much more efficient and easier option) pays the highest
price.

Contract pricing isn't exactly unknown in other industries. The prices
I see as "cash" prices on components are shocking too.
 
J

Joerg

Jan 1, 1970
0
rickman said:
I bet he couldn't afford to put premium gas in his Lexus. Or did he
drive a Mercedes?

You seem to bet a lot of things lately :)

AFAIR some kind of Nissan, Altima series or comparable. Not very new
either. I don't think that qualifies as extravagant.
 
Ok, let's put a value on the human life. The state of Maryland says it
is worth $0.25M max. Of course they say the same if you only lose a
finger or a toe, but let's not digress. If your insurance premiums are
only $0.1M then you can only kill one patient every 2.5 years to break
even. Since the insurance company has to make a profit and have
overhead, let's say they shave 37.5% of the premiums which stretches
your rate to one dead patient every 4 years. If you are worse than that
you are costing the insurance company money and you will likely be
canceled.

So how many patients get their $0.25 without dying I wonder?

First, some aren't worth two bits. Secondly, if they got the money,
they didn't die.
 
R

rickman

Jan 1, 1970
0
You seem to bet a lot of things lately :)

AFAIR some kind of Nissan, Altima series or comparable. Not very new
either. I don't think that qualifies as extravagant.

I have trouble feeling sorry for most doctors, at least not financially.
The greatest single cause of bankruptcy is medical bills and you want
to blame that on Tort law! Absurd.

How many doctors go bankrupt each year? No, doctors go to Europe.
 
R

rickman

Jan 1, 1970
0

What is in this story to say doctors are going bankrupt? I don't even
see the word "bankruptcy" mentioned.

I did see that much of the info was provided by "Tom Blue, executive
director of the American Academy of Private Physicians". I can't
imagine that he was putting any spin on the story.

They didn't mention *one* failure of a physician practice, did they?
You would think if doctors were going under they would have found at
least ONE failed doctor to interview, don't you?
 
J

Joerg

Jan 1, 1970
0
rickman said:
What is in this story to say doctors are going bankrupt? I don't even
see the word "bankruptcy" mentioned.

I did see that much of the info was provided by "Tom Blue, executive
director of the American Academy of Private Physicians". I can't
imagine that he was putting any spin on the story.

They didn't mention *one* failure of a physician practice, did they? You
would think if doctors were going under they would have found at least
ONE failed doctor to interview, don't you?

Quote "Government-backed loans to doctors have surged more than 10-fold
in the past decade, a trend industry insiders say is a red flag that
doctors in America are in financial distress".

Now why would any doc in his right mind take up such a loan? Why the
steep increase? Also, SBA numbers cannot be spun, they are real numbers
that can be verified. These guys quote CNN which can hardly qualify as a
"right-wing" media outlet:

http://www.naturalnews.com/034615_physicians_bankruptcy_health_care.html

I also do not doubt the numbers in writings like this, because someone
put their full name and reputation behind it:

http://medinnovationblog.blogspot.com/2012/01/pinning-physician-bankruptcies-on-tail.html

Do you honestly believe that people like Dr.Pentz can pay his staff out
of their personal savings forever? Think about it, if they did, what
does that usually lead to?

Then:

http://www.healthcarefinancenews.com/news/survey-over-26-percent-solo-docs-may-close-their-practices

My prediction is this: We will see a rising number of patients, first
from Medicare and then from Obamacare, who will face increasing
difficulty finding a doctor that will take them. I personally know
Medicare patients who have already experienced that trend. Then, longer
term, this whole new "health system" will implode.
 
H

huang lin

Jan 1, 1970
0
在 2013å¹´2月16日星期六UTC+8上åˆ10æ—¶19分27秒,rickman写é“:
 
R

rickman

Jan 1, 1970
0
Quote "Government-backed loans to doctors have surged more than 10-fold
in the past decade, a trend industry insiders say is a red flag that
doctors in America are in financial distress".

Now why would any doc in his right mind take up such a loan? Why the
steep increase? Also, SBA numbers cannot be spun, they are real numbers
that can be verified. These guys quote CNN which can hardly qualify as a
"right-wing" media outlet:

Hell! I'll take a loan backed by the government! You make it sound
like these loans are bad things. They are GREAT things for doctors.
Why do you think they take them rather than going to the banks
themselves!!!???

http://www.naturalnews.com/034615_physicians_bankruptcy_health_care.html

I also do not doubt the numbers in writings like this, because someone
put their full name and reputation behind it:

http://medinnovationblog.blogspot.com/2012/01/pinning-physician-bankruptcies-on-tail.html

Do you honestly believe that people like Dr.Pentz can pay his staff out
of their personal savings forever? Think about it, if they did, what
does that usually lead to?

Did you actually *read* this page? The closest they come to talking
about bankruptcy is "starting to see serious financial issues." That is
not very damning evidence.


You seem to be very sensitive to "the sky is falling" as long as it is
the sky you want to see fall... From this article,

'"I was trained as a physician and not a businessman and not an
insurance coder," one family physician from North Carolina said.'

There you go. His problem is that he isn't a businessman, he is a
doctor and should not be running a business. That's not a condemnation
of the medical system, it just shows his ignorance in opening a practice
he doesn't know how to run.


'Another physician found the "cost of rent, medical supplies,
malpractice [insurance], employees" to be "prohibitive" and was forced
to close as well'

Notice the top of the list was "rent". That said it all to me, another
non-businessman who should have never opened a private practice in the
first place. He should be working on a hospital staff where he can do
what he knows and let private practices be run by those who know how to
run businesses.

My prediction is this: We will see a rising number of patients, first
from Medicare and then from Obamacare, who will face increasing
difficulty finding a doctor that will take them. I personally know
Medicare patients who have already experienced that trend. Then, longer
term, this whole new "health system" will implode.

What you don't get is that doctors who don't take Medicare and Obamacare
patients will find they don't have many patients. Why do you think they
take Medicare patients now? They don't like sitting around waiting for
people to come in the door.

My prediction is this: first we will see a lot of complaining from
doctors who find there are a lot more people who will have insurance to
get care, but the reimbursements are lower. Then the costs of insurance
will rise as the ever higher costs are passed on until the insurance
starts to become unaffordable. Then everyone can see the problem isn't
insurance, it is the inflated cost of medical care. Ultimately the
prices will be managed by the government in some way.

In Japan they regulate the price of medical care and physicians get
about the same wage as engineers or maybe a little less... yet, they
still get quality care. In England they have nationalized health care
and no one goes bankrupt from medical costs... and yet they still get
quality care.

In the US medical care is broken, but only for the ones who can't afford
it, which includes ones who are too poor to pay at all as well as those
with insurance but a major illness exceeds the cap on their coverage and
wipes out their finances. This is largely because medical care in this
country is a big, big business and run for the profit of doctors, not
the care of patients. Eventually this will change. I just hope to live
long enough to see it.
 
C

Charlie E.

Jan 1, 1970
0
What is in this story to say doctors are going bankrupt? I don't even
see the word "bankruptcy" mentioned.

I did see that much of the info was provided by "Tom Blue, executive
director of the American Academy of Private Physicians". I can't
imagine that he was putting any spin on the story.

They didn't mention *one* failure of a physician practice, did they?
You would think if doctors were going under they would have found at
least ONE failed doctor to interview, don't you?
They don't usually go 'bankrupt', what happens instead is that they
become uninsurable, or unable to afford insurance, so they just
quietly go out of business. Usually, when hit with the higher
insurance and regulatory compliance costs, they just up their fees and
go on, sticking it to the users and insurance companies just like any
other business.
 
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