U.S. Politics: Hairpiece In the Middle East Part 2

[DMC]

11 minutes ago, Kalbear said:

That's a different question. Why things are so expensive in the US is a weird combination of factors. What we can do to lower costs is another weird answer, given that you have to appease not only the health lobby but also everyone who gets their insurance via employers, which is the bigger majority of people. That's a tough sell. I know at my company (Microsoft) there were a TON of people who were totally pissed off that their insurance was changing for the worse, even though it was still better than 95% of everyone out there. 

Get where you're coming from but it's not a different question.  The point is the problem is private insurance - and yes, I realize I'm making an entirely unrealistic argument, which is a switcheroo between us.

[Gareth]

1 minute ago, Cas Stark said:

It's a discount, I know what they charge for a regular office visit and I know they do not take ACA exchange insurance because he says they would lose money. And I know he hand writes the $$ on the form every time I go there.

See my edited comment above about how he may be committing kickback violations.  And if you are paying cash, there is actually a law about discounting cash payments.  

[Cas Stark]

4 minutes ago, Kalbear said:

It's actually worse; he forces the government and those with good insurance to pay for him. Cas Stark is basically living on the charity of others. 

Well, now that I'm signed up for the crap ACA insurance, I'm paying for all that "insurance" that I don't use, every month.  

 

[LongRider]

N'ah, MAGA Math don't work for us regular folks, I tried that shit in college and no magic on my test scores!  One has to be Orange and ethically challenged for the magic to work.

[Cas Stark]

1 minute ago, Gareth said:

See my edited comment above about how he may be committing kickback violations.  And if you are paying cash, there is actually a law about discounting cash payments.  

Oh brother.

[Kalbear]

Just now, Cas Stark said:

Well, now that I'm signed up for the crap ACA insurance, I'm paying for all that "insurance" that I don't use, every month.  

So dump it. No one is forcing you any more to pay for it. You can stop any time you like now. Alternately, find another doctor, one who isn't breaking the law by discounting cash payments and bilking his law-abiding patients. 

[Kalbear]

2 minutes ago, dmc515 said:

Get where you're coming from but it's not a different question.  The point is the problem is private insurance - and yes, I realize I'm making an entirely unrealistic argument, which is a switcheroo between us.

Right - the problem is private insurance, but that doesn't mean the solution is to make the insurance lobbyists happy. They're only one aspect of the issue, and arguably not even the hardest to appease. There's a good chance that simply throwing more people at them would make them pretty happy, especially given that almost every single insurance company will make a profit this year on the marketplace. 

[Cas Stark]

Just now, Kalbear said:

So dump it. No one is forcing you any more to pay for it. You can stop any time you like now. Alternately, find another doctor, one who isn't breaking the law by discounting cash payments and bilking his law-abiding patients. 

Um, it's mandatory...if I "dump" it the IRS will charge me a penalty for not having insurance.  

And my doctor is not breaking the law because I"m not paying in cash.  Jesus Christ.  He's giving me a discount on the standard charge of an office visit because I can't afford the full fee.  

Note to self:  you were right the first time when you stopped attempting to discuss anything political on this board, dissenting opinions are not tolerated.

[DMC]

1 minute ago, Kalbear said:

Right - the problem is private insurance, but that doesn't mean the solution is to make the insurance lobbyists happy. They're only one aspect of the issue, and arguably not even the hardest to appease. There's a good chance that simply throwing more people at them would make them pretty happy, especially given that almost every single insurance company will make a profit this year on the marketplace. 

Totally agree.  We're reaching some zen place at this point.

2 minutes ago, Cas Stark said:

Um, it's mandatory...if I "dump" it the IRS will charge me a penalty for not having insurance.  

No, that won't be enforced.

[OldGimletEye]

Just now, Nasty LongRider said:

N'ah, MAGA Math don't work for us regular folks, I tried that shit in college and no magic on my test scores!  One has to be Orange and ethically challenged for the magic to work.

MAGA math is what I did when I was too busy fucking off to study for a test. Just did MAGA math and pretended like I aced the test, even though I really bombed.

[Kalbear]

1 minute ago, Cas Stark said:

Um, it's mandatory...if I "dump" it the IRS will charge me a penalty for not having insurance.  

Didn't you hear? Trump stopped that. Told the IRS to stop worrying about it.

1 minute ago, Cas Stark said:

And my doctor is not breaking the law because I"m not paying in cash.  Jesus Christ.  He's giving me a discount on the standard charge of an office visit because I can't afford the full fee.  

Cash, check, doesn't really matter. He isn't supposed to do what he's doing precisely for the reason that he's doing it.

1 minute ago, Cas Stark said:

Note to self:  you were right the first time when you stopped attempting to discuss anything political on this board, dissenting opinions are not tolerated.

Dissenting opinions are perfectly tolerated. They're also argued. If you wanted to be unchallenged in your opinions and your thinking behind them, why would say them?

[Fragile Bird]

19 minutes ago, OldGimletEye said:

This sounds suspiciously like insurance.

Well, in Canada if you are a citizen or a landed immigrant you automatically get health coverage. Health coverage is paid out of our taxes, which is why I pay more in taxes than you guys do. But people tell me they pay 1 or 2 or more thousand dollars a month for health insurance, which rapidly becomes much more than I pay in taxes. And my health care has no dollar limit.

Now, the way health care developed in Canada was the government first agreed to cover the cost of hospital care, then it expanded to visits to your doctor as well. Unlike many European countries, we don't cover medications, unless you are in hospital. Outside of hospital you have to pay, for medications and assistive devices. And dental is not covered, nor glasses. Once I left my workplace to run my own business and no longer had dental care, my dentist offered me a discount too. For cash. No receipt, no tax deduction.  I wonder if Cas Stark's doctor gets cash from him that never makes the books, which is another form of subsidy in the end.

The province I live in has just announced that all prescription medicines will be paid for for children up to the age 25. People across the country are hoping this is the start of a developing prescription medication benefit that will eventually be expanded to other provinces and then to cover all age groups. Right now seniors over 65 get their meds paid for. I'm not sure if children had any coverage until now.

[Gareth]

3 minutes ago, Cas Stark said:

Well, now that I'm signed up for the crap ACA insurance, I'm paying for all that "insurance" that I don't use, every month.  

 

Being in healthcare, I have some familiarity with health insurances.  I researched much for my parents who got their health insurances from exchange in Texas.  If you want, I could look at your state exchange and break it down for you.   You may have purchased the wrong option (if there are multiple options).  Unfortunately, you can't switch now because open enrollment is over...unless a major life event occured. 

[Kalbear]

Man, I know Vox is left-wing and isn't precisely impartial, but boy do they have a way with words.

Quote

More to the point, it’s a sign that the Trump White House simply isn’t set up to govern the country at all. It’s normal for Congress to reject large aspects of a president’s budget proposal, but normally you would expect a same-party Congress to at least seriously consider what the president is requesting. But Trump isn’t even remotely in the neighborhood of a blueprint that Congress could use if they were so inclined. He’s taken the vast technical and analytical resources of the executive branch and effectively thrown them all in the trash can.

 

[Cas Stark]

10 minutes ago, Gareth said:

Being in healthcare, I have some familiarity with health insurances.  I researched much for my parents who got their health insurances from exchange in Texas.  If you want, I could look at your state exchange and break it down for you.   You may have purchased the wrong option (if there are multiple options).  Unfortunately, you can't switch now because open enrollment is over...unless a major life event occured. 

It's a long story, which I am not going into since people are accusing my doctor of committing criminal acts.

But, in case you missed it, his practice is very high end, e.g. they have a special section for concierge medicine, all above board, right there in your face:  here is where the rich people who don't bother w/insurance sit.  It is not illegal for a doctor to take patients who pay themselves, some specialists who literally only treat people who are paying out of pocket. 

[Gareth]

4 minutes ago, Cas Stark said:

And my doctor is not breaking the law because I"m not paying in cash.  Jesus Christ.  He's giving me a discount on the standard charge of an office visit because I can't afford the full fee. 

He may be breaking kickback laws if your discount is lower than what he offers to insurers.  Its kickback laws that were championed by insurers...go figure.  Thats why I mentioned above that it is probably the same discount that he offers to health insurance companies or Medicaid/medicare.  

Anytime you use your insurance for services, you should get in the mail, a EOB (explanation of benefit).  It's not a bill (and it will state that) but it explained how much the service was charged by your provider, plan discount/exclusions, benefit exclusions, amount paid by your insurance and amount you owe to provider.  Check out an EOB, and you will see that there is always a discount/exclusions.  

[DMC]

11 minutes ago, Kalbear said:

Man, I know Vox is left-wing and isn't precisely impartial, but boy do they have a way with words.

I won't say you buried the lede, but you neglected to include my favorite quote from that article:

Quote

 Larry Summers, the former Treasury secretary and National Economic Council director, calls it “a logical error of the kind that would justify failing a student in an introductory economics course.”

 

[Cas Stark]

8 minutes ago, Gareth said:

He may be breaking kickback laws if your discount is lower than what he offers to insurers.  Its kickback laws that were championed by insurers...go figure.  Thats why I mentioned above that it is probably the same discount that he offers to health insurance companies or Medicaid/medicare.  

Anytime you use your insurance for services, you should get in the mail, a EOB (explanation of benefit).  It's not a bill (and it will state that) but it explained how much the service was charged by your provider, plan discount/exclusions, benefit exclusions, amount paid by your insurance and amount you owe to provider.  Check out an EOB, and you will see that there is always a discount/exclusions.  

Concierge medicine is not illegal.  There are some doctors who don't even take patients with insurance, only those who are paying directly.  So, I don't see how me, a private pay patient, getting a price that is less than the standard fee is a 'kick back' or would be illegal.

https://www.wsj.com/articles/how-to-cut-your-health-care-bill-pay-cash-1455592277

As consumers get savvier about shopping for health care, some are finding a curious trend: More hospitals, imaging centers, outpatient surgery centers and pharmacy chains will give them deep discounts if they pay cash instead of using insurance.

 

[Gareth]

11 minutes ago, Cas Stark said:

But, in case you missed it, his practice is very high end, e.g. they have a special section for concierge medicine, all above board, right there in your face:  here is where the rich people who don't bother w/insurance sit.  It is not illegal for a doctor to take patients who pay themselves, some specialists who literally only treat people who are paying out of pocket. 

I didn't question the legality of a provider only accepting patients who pay out of pocket.  For example, lots of cosmetic plastic surgeons do this since the type of procedures they do are considered elective and not covered by third party insurance anyway.  And the laws are different from state to state.  Although many states have laws about discounting services for out-of-pockets or out of network if that provider accepts other insurances as part of their kickback law.

[OldGimletEye]

I have got say, this whole just pay your doctor with cash and it's no problem, sounds suspiciously to me like the "Chicken Healthcare Plan".

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