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drreb
Advanced Member
USA
902 Posts |
 Posted - 07/11/2012 : 08:48:21 AM
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| Nobody knows exactly what is in this new law, and won`t until it comes to full force in 2014, but here are some facts.....Medicaid is a 20% loser for physicians, Medicare is about a "break even", and private ins is about a 20% profit. Now, add 20 million new medicaids to that absolutely true situation and see what kind of numbers you get. Any businessman will tell you what is about to happen to smaller medical practices all over the country, and BTW the hospital ER will become a raging liability that goes from a money loser to a huge money loser. Hospitals look at one thing.....bottom line, and they see it coming. Me? I just plan to retire next yr and fish all I can. |
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Lookidat
Senior Member
USA
599 Posts |
Posted - 07/11/2012 : 10:45:06 AM
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Ya know Doc, when my daughter told me years ago that she wanted to be a Vet, I tried to convince her to be a "people doctor". Her response to me was; "I like animals more than I like most people"! She is now in practice as a brand new vet, and I believe she made the smart choice, unless of course, Obama decides that he knows what is best for our animals as well!
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marco
Average Member
USA
303 Posts |
Posted - 07/11/2012 : 9:57:01 PM
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@drreb, what facts do you have to backup the margins for all practices? Private practices are just that and don't disclose their financials like public companies do.
@Lookidat, you are good at comparing apples and oranges. Keep it up.
How about we take the Republican approach to the high cost of health care in the United States? Want a taste of your own medicine? Yes, pun intended.
Instead of raising the reimbursement rate for medical providers, lets outsource health care, as much as possible, to cheaper countries and then we increase H1B1 visas to foreign medical professionals so they can practice here in the USA for a fraction of what US medical providers charge.
PROBLEM SOLVED!!!
Don't you just love the Republican ideology? |
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Lookidat
Senior Member
USA
599 Posts |
Posted - 07/12/2012 : 2:06:01 PM
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marco, I'm not sure what you mean about the apples and oranges. Can you be more specific so I can respond appropriately?
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zzydeco
Senior Member
USA
522 Posts |
Posted - 07/13/2012 : 07:19:20 AM
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d*** Cheney announced yesterday that Willard Romney is the best qualified to lead if we have another 9/11! That endorsement alone should tell you that Romney is the wrong person for the job.
I don't have a bucket list but my f-ucket list is a mile long. |
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Lookidat
Senior Member
USA
599 Posts |
Posted - 07/13/2012 : 11:33:52 AM
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Actually zzydeco, I am not a big fan of Cheney. I have nothing specifically against him, but I never really liked him either, so his opinion doesn't mean much to me. To be honest, I look at that the same way I look at Obama "getting Bin Laden". he just happened to be the one in the hot seat when it went down, just like Bush just happened to be in it when 911 went down. Neither decision was really a challenge. Should we kill Bin Laden? OF COURSE! Even Pelosi could have figured that one out! Let's see, terrorists just killed 3000 Americans, and declared war on us? Looks like my options are; 1-Fire a couple of cruise missiles into the middle of the desert (Clinton)2-Ignore it and hope it goes away (Clinton again) or 3-Retaliate with extreme violence. Some decisions are easy as long as the eprson making them has a backbone, and should another major attack strike the US, I have no doubt that even Obama would fire back. Afetr all nothing increases a president's popularity like a shooting war.
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marco
Average Member
USA
303 Posts |
Posted - 07/15/2012 : 11:26:03 PM
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Lookidat, I meant the comparison between medical doctors and veterinarians.
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Lookidat
Senior Member
USA
599 Posts |
Posted - 07/16/2012 : 07:23:12 AM
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marco, I wasn't really comparing them, I meant that at least as a Vet, she doesn't have to worry about Obamacare, although...... when the economy is depressed, one of the things people cut back on is medical care for animals, so as long as he is president, I guess he COULD negatively impact her business.......Sorry, I couldn't resist!
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drreb
Advanced Member
USA
902 Posts |
Posted - 07/16/2012 : 12:30:03 PM
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| Marco, June issue of "Medical Economics". A national survey of physician`s offices. Believe it or don`t believe it, but that`s about right for my office at the present time. If this thing goes on through to become effective law in 2014, the healthcare you get in the US will be drastically different, and not in a good way. |
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marco
Average Member
USA
303 Posts |
Posted - 07/16/2012 : 4:50:03 PM
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ddreb, I am sure that is a Doom and Gloom picture some people have prematurely. I guess what you and other with similiar pre-conceived notions fail to understand is that the health care system in its present form is unsustainable. The costs for it was gradually consuming more and more of the country's GDP. Insurance companies were insuring less and denying coverage for pre-existing conditions which could easily result from a change in employment for somebody who decided to move up to a better position with another company.
Because insurance companies are covering less for patients and medical providers, some people who had major medical issues in their lives would go financially bankrupt.
The banking crisis made things even worse by putting many people out of work and causing them to loose their work provided health insurance.
We both know this country cannot continue on this downward spiral.
As I've said many times over, there are some good policies in the ACA and there are some that are not. There are simply too many variables in the equation to get everything right the first time. Lets wait and see what turns out to be useful for citizens and what doesn't and fix the broken parts. Even those aspects of the ACA that both Dems and Repubs think are good ones may in actuality crash and burn even though it initially looked good on paper. If we fail, lets fail together and not divided. Our biggest enemy isn't Russia, North Korea, the Taliban, or even Iran. It is our own narrowing view of political ideology that is consuming us from inside.
I think this country could go back to greatness if each political party dropped their extreme political ideology on governance for this nation. |
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Lookidat
Senior Member
USA
599 Posts |
Posted - 07/17/2012 : 08:27:54 AM
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marco, there you go again, being all rational and all! You sure know how to ruin a good fight!
I agree that our health care system was in trouble, but the reason the ACA was rammed down our throats was not to fix the problem, it was to buy votes and to immortalize Obama and Pelosi. They admit that they did not read it, nor did they know what the details were, but by God they were going to make it happen. Yes there are a few good ideas, but as you said, our previous system wasn't working for a percentage of society, yet we now have a system that is un-affordable, and won't work for a larger portion of society. Simple mathematics tell us that you cannot expect to cover more people with the same amount of money.
If there is any good to this, I think it will be that BOTH parties will have to get serious about fixing the problem. I hope that after Obama is defeated in October, we scrap this system, take the good ideas that are in it, and refine them, and come up with something that is workable and sustainable. AND before you point it out to me, I know that Romney has not offered any concrete plan to replace Obamacare, and that may be his downfall. I believe that if he came out with a realistic plan to change it, he would do a lot better with independents. As I have said before, I ain't a big fan of Romney, but he still looks better than the idiot we have now.
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marco
Average Member
USA
303 Posts |
Posted - 07/18/2012 : 2:25:11 PM
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Oh no.... I can't believe you called me rational. What is this world coming to? Next, we'll be going fishing and guzzling down beer together....lol.
The ACA wasn't rammed down our throats. It was a Republican idea to start with and when the Dems were pushing it through Congress the Republicans responded in the same way Romney is doing today which is not offering a different plan. They simply cannot offer another plan because this was their original plan to begin with from back in the Bush Sr administration days. The Republicans responded with "NO". Therefore, the legislation went through on mostly Democratic votes.
The Republicans instead of offering an alternative plan spent a lot of time (and money) trying to undermine it through the federal courts and up to the Supreme Court. All of that failed too. They also spent more time (and money) passing more meaningless "repeal" bills when that time (and money) could have been better spent coming up with a new plan or offering changes to the currrent ACA law.
"Simple mathematics tell us that you cannot expect to cover more people with the same amount of money."
This is not true. The problem with our health care system is abuse and waste. Abuse and waste by people who are not insured, abuse by insurers cherry picking patients, and abuse by medical providers who gauge the government and the insured. If you get more people insured and drastically reduce abuse, then the same money currently in hand will be able to cover more. We as country spend more per capita on health care than most other countries and get less results. I work for a bank where we are constantly looking at our operating expenses compared to other similiarly sized banks and if it costs us a lot more to operate than the other guy then we are not doing it right. You can bet there will more efficiencies squeezed out of our operations.
Remember, every mathematical equation consists of variables and not fixed numbers. Therefore, simply throwing more money at the problem is not the solution.
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drreb
Advanced Member
USA
902 Posts |
Posted - 07/23/2012 : 12:43:56 PM
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| Marco, Do you really think the government is really concerned about your healthcare? Anyone`s healthcare? They are too busy getting all they can for themselves to be concerned about your health. You are a banker, so let me ask you....did Barney Franks and Chris Dodd have the best interests of the US banking system in mind when they crashed it? No, they were simply trying to guarentee that everybody who wanted one, could own a home! Did it ever enter their mind that thousands upon thousands of totally wothless loan papers would eventually crash the banking system? Why no, it had never happened before so why should it happen now. If you think Franks and Dodd are honest men, then we have other problems, but I suspect you know exactly what they are. Now....do you suppose that there just might be a few others in D.C. that wish to garner votes by promising free heathcare to all? Please tell me which one of these is the best bet.....!. Free healthcare to all, with no limits 2. A $1,000,000.00 home loan to a family with a $40,000.00 yearly income, with essentially no questions asked. Healthcare for all is a good idea, but now how will we pay for it? Cleaning up fraud will not come within several trillion dollars of the total bill and once it is in place, it will be very hard to change and you know it. Please name one enterprise run by the government that is not a disaster, so it will be with healthcare. Change it after it is in place? Well, first let`s go change rules at the post office and see if we can save money. Wanna take a shot at cleaning up fraud and abuse at Amtrack? Energy dept? EPA? SS? Yep that goverment of ours really knows how to handle money. |
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marco
Average Member
USA
303 Posts |
Posted - 07/24/2012 : 08:51:23 AM
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@drreb,
I never said that I wanted the government to take care of me. There is no such thing as free healthcare or a free lunch. I wanted ACA because it will implement certain policies that the insurance companies were abusing.
- Eliminate caps on coverage
- Stop insurance companies from denying coverage for pre-existing conditions
- Setup of exchanges so that people can buy insurance coverage on a more open and competitive market
The banking crisis was mainly caused by banks and not the government. Banks are the ones that set credit criteria and gave out loans to people who couldn't afford them.
Government is not a business and never has been 100% efficient. However, free enterprise isn't that much better either. As we all know, large companies usually start as a small business. The failure rate for small businesses starting up is almost 80%-90%. Capitalism itself never gets it right the first or second or even the third time. I can't tell you many times I see small businesses starting up in my local area and then shutdown a year later. Does that mean we should stop starting small businesses because of the high failure rate? Does that mean free enterprise is a failure? If anything the government of the USA has outlasted most companies in this country. To me, the USA is about opportunity and not welfare/tax breaks for ghetto mammas, corporate america, and the rich.
I never said reducing fraud/abuse in health care was the silver bullet. It is one factor. You have to make the system more efficient through automation, less paper based, simple rules, less bureaucracy, and accountability. You also get everybody to contribute to the system. Again, it is not going to be perfect.
ACA was never a promise for free health care as it is the same individual accountability legislation Republicans wanted to pass not once but twice. How can ACA be about free healthcare when I will stay in my current employer sponsored plan that I have to pay into and those that don't get coverage on their own will be penalized, oops taxed (according to SCOTUS), by the government?
I am all for cleaning up the government entities you mentioned using the same criteria I mentioned for ACA. However, it is difficult to do with when you have corporate america corrupting our elected officials to give them sweet contract deals, pass tax laws with loopholes, and buying legislation that favors their industry or company to the detriment of US citizens.
Do you think Barney Franks and Chris Dodd wanted everybody to have a home or were they really being paid off by the banks (corporate america) to tell everyone that?
As the saying goes, we have the best democracy money can buy.
Money=Greed=Corruption |
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Lookidat
Senior Member
USA
599 Posts |
Posted - 07/24/2012 : 3:59:45 PM
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marco, you are correct that many small businesses fail, but when they fail, they take the money of the owner, or VOLUNTARY INVESTORS. Obama has "invested" MY MONEY in several business that I had no say in, and when they went t!t$ up, you and I were left holding the bag! All for the sake of buying votes.
The government played a large part in the banking failure, as they were using their clout to force banks to make loans to people who were terribly unqualified for the home loans they were getting, And why? because those people who were horrible credit risks were potential democratic votes. So once again, the government used my money to buy more votes.
As far as you staying in your current insurance plan, I wouldn't count on it buddy. Depending on the size of your company and it's workforce, it may be cheaper for the company to NOT provide insurance, and just pay the penalty. Go ahead and research it. If the bean counters figure out that they can save 20% by doing so, don't think for one minute that you won't find yourself without insurance. Of course, then you will have to get your own, Reckon that won't cause a slight increase in the cost of insurance, and a big decrease in the quality of said insurance?
I don't want to wish bad luck on anyone, but I am actually hoping that this scenario plays itself out with a lot of people like yourself who believe so strongly in the ACA. Then what is your opinion going to be? Keep in mind, that if it happens, you are just "taking one for the team" for the greater good!
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drreb
Advanced Member
USA
902 Posts |
Posted - 07/26/2012 : 12:47:12 PM
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Well marco, we agree on some things after all. This ACA is interesting isn`t it? Seems fair, balanced, all pay into it and those who need care but can`t afford it can have it free of charge. Sounds like a well thought out compasion filled law.....but wait...why is congress not signing up to use it? Walmart? Many, many companies have already applied for and gotten exemptions. I just can`t figure out why. All the government employees continue with their own plans, wonder why? Your company has ins on you now, but I`ll bet that changes within 2 yrs. Some numbers for you.....private ins costs about $1000.00 monthly for you and your family but the fine(tax) for not having it is $750.00. You work in a bank so the outcome here is probably clear.
Franks and Dodd threatened banks in order to get these worthless loans out, took bribes from Greentree etc, and now just can`t understand what the fuss is about. What`s the big deal? They didn`t lose any personal money, just government money. Had they knowingly pulled this in the private sector, they would be in jail now.
We both hate large insurance companies and for good cause, but to exchange them for government controlled healthcare is a mistake. BCBS at least understands economics and business....a clerk in HHS has no clue about anything in the private sector, doen`t want to know, and you are simply "pestering" him to call and ask questions.
Caps on coverage? Already being done, but done by economic means. You want a triple bypass? Thry don`t pay enough to get any good CV sugeons to do one. Even the foreign medical graduates are no longer willing to work for what they will pay, so they are heading back home.
We are in a mess and the ACA is NOT part of the solution. |
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KurtS
Average Member
136 Posts |
Posted - 07/26/2012 : 4:37:42 PM
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drreb - you make so much sense that it's scary!
keep up the good work
Franks & Dodd- now there's 2 examples of why government is worse than useless |
Edited by - KurtS on 07/26/2012 4:39:12 PM |
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marco
Average Member
USA
303 Posts |
Posted - 07/28/2012 : 8:45:01 PM
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@Lookidat, the government didn't loan out the money. The banks did. They did it because many, like mine, were originators and sold it as grade "A" mortgage investments to investors and other banks. Those banks that did buy and serviced the loans took out Credit Default Swaps (CDS) against them to make money on both sides of the equation. These credit default swaps, aka insurance bets, were issued by insurance companies such as AIG and investment firms such as Lehman Bros. When the bad mortgage loans began to default and insurance companies such AIG, investment firms such as Lehman Bros had to cover those credit default swaps, they went bankrupt. Banks that only originated the loans had NOTHING TO LOSE so they didn't care about credit quality of the borrower or how accurate those property appraisals were for the collateralized loans. The banking and investment industry got greedy. Plain and simple. The bank, insurance, and investment executives didn't loose personal money either. If anything, these guys got bonuses. And it is not the first time. This is no different than the Savings and Loan scandal of 1980s where almost half of the savings and loan institutions failed because of deregulation.
You cannot self-police greed.
Regarding health insurance in corporate america, this is a voluntary benefit provided to employees. Employers can drop it anything and don't need ACA as an excuse so your argument about companies opting for the cheaper ACA penalty is moot.
@drreb, your argument about government employees staying on their sweet insurance benefit and not going to ACA as a sign of failure is also moot. While they will most likely not drop it for ACA, on the same token, they haven't dropped it for the current capitalist and profit driven health care system either.
The Insurance exchange is a marketplace for insurance providers to compete and not for government to take over insurance companies. I don't know where you got that misconception.
Yes, we are in a mess and remember that we are in that mess because we have been in a capitalist and profit driven health care system that does serve the needs of America. Instead, it is failing and taking our country with it.
Remember, ACA was a Republican idea about individuals getting insurance as a mandate. So, you Republicans have shot yourself in not one but both feet.
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marco
Average Member
USA
303 Posts |
Posted - 07/28/2012 : 8:47:51 PM
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quote:
Originally posted by marco
@Lookidat, the government didn't loan out the money. The banks did. They did it because many, like mine, were originators and sold it as grade "A" mortgage investments to investors and other banks. Those banks that did buy and serviced the loans took out Credit Default Swaps (CDS) against them to make money on both sides of the equation. These credit default swaps, aka insurance bets, were issued by insurance companies such as AIG and investment firms such as Lehman Bros. When the bad mortgage loans began to default and insurance companies such AIG, investment firms such as Lehman Bros had to cover those credit default swaps, they went bankrupt. Banks that only originated the loans had NOTHING TO LOSE so they didn't care about credit quality of the borrower or how accurate those property appraisals were for the collateralized loans. The banking and investment industry got greedy. Plain and simple. The bank, insurance, and investment executives didn't loose personal money either. If anything, these guys got bonuses. And it is not the first time. This is no different than the Savings and Loan scandal of 1980s where almost half of the savings and loan institutions failed because of deregulation.
You cannot self-police greed.
Regarding health insurance in corporate america, this is a voluntary benefit provided to employees. Employers can drop it anything and don't need ACA as an excuse so your argument about companies opting for the cheaper ACA penalty is moot.
@drreb, your argument about government employees staying on their sweet insurance benefit and not going to ACA as a sign of failure is also moot. While they will most likely not drop it for ACA, on the same token, they haven't dropped it for the current capitalist and profit driven health care system either.
The Insurance exchange is a marketplace for insurance providers to compete and not for government to take over insurance companies. I don't know where you got that misconception.
Yes, we are in a mess and remember that we are in that mess because we have been in a capitalist and profit driven health care system that does serve the needs of America. Instead, it is failing and taking our country with it.
Remember, ACA was a Republican idea about individuals getting insurance as a mandate. So, you Republicans have shot yourself in not one but both feet.
Yes, we are in a mess and remember that we are in that mess because we have been in a capitalist and profit driven health care system that does not serve the needs of America. |
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drreb
Advanced Member
USA
902 Posts |
Posted - 07/29/2012 : 12:03:43 AM
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marco, capitalism is not a bad system. Is making a profit evil? If I go to school for 23-24 years to prepare for a job, run up a load of debt paying for it, then spend more money setting up an office, do you not think I deserve to make a profit? Maybe not "desreve" but at least allow me the profit margin to repay the debt and feed my family? I do work for free every day and always have, but I just don`t see the bank that I use doing banking for free, so who is the dirty capitalist now? If US medicine will not allow physicians to make a profit for their work, how long will anyone train so they can work for free? If your employer told you tomorrow that they were going to cut your pay by !/2, would you stay? How about they cut your pay by 2/3, wanna stay now? Well, you might, but now you are asked to put in 16-18 hr days to keep your same pay. This is not a moot point. You might go look for another bank to hire you but in a single payor system(government) there simply is nowhere to go for a physician. When this happens, and I`ll bet it does(the law passes), you can kiss most all the medical specialties goodbye. It will be simply too much time spent to work a money losing profession.
What does it mean to me personally? Not much, because if it passes I will retire before it goes into effect, as will many, many physicians across the US. Some facts for you....physicians can`t unionize, can`t set our own fee schedules, can`t discuss their charges with another physician, live under so many government guidlines, mandates, and CMS oversight, that medicine is already so encumbered as to be slow and frustating to physicians and patients alike. |
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marco
Average Member
USA
303 Posts |
Posted - 07/29/2012 : 6:34:15 PM
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There is absolutely nothing wrong with earning a profit from a business when everyone competes on a even playing field. The problem is when companies game the system, engage in unethical practices, and bribe and corrupt our government for their own gain at the expense of other citizens that do follow the rules. I've repeated the first hand experience I had with a roofing company that replaced my roof using illegal immigrants to undercut companies that do play by the rules.
I'll be the first to tell you that banking is one of the most greedy and many times unethical industries out there. Please don't tell me that the medical industry isn't? If you do, I may have to go see a doctor. :)
ACA, which again is a Republican concept, is not a single government payor system. Maybe you should provide a link that states that as fact.
Complaining about regulation and mandates? Well, wake up and look around because your industry is not the only heavily regulated line of business. Ask the nuclear or petroleum energy sectors, aviation, banking, insurance, investments, manufacturing, military industrial complex, etc..
As people, we need regulation in some form or fashion because we cannot be trusted to be civilized on our own. Therefore, we need a common set of laws. Otherwise, God would have never given us The Bible or the Ten Commandments.
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drreb
Advanced Member
USA
902 Posts |
Posted - 07/31/2012 : 12:43:12 PM
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| marco, I have a good time bantering all this stuff about with people who have differing views than mine, but here`s my problem with all these changes that effect our lives....I don`t trust any elected officials who are in Washington now. Dems, Repubs, Independents, or any of them. That just makes me sick. I can`t think of even one official up there that I would allow to carry out my garbage. When people want to repeal the second law of thermodynamics because it constrains their energy policy, you just know the inmates are running the asylum. They ALL need to be voted out of office, today. |
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Lookidat
Senior Member
USA
599 Posts |
Posted - 07/31/2012 : 3:01:08 PM
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HERE HERE! You throwin ur hat in the ring Doc? You got my vote!
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drreb
Advanced Member
USA
902 Posts |
Posted - 08/23/2012 : 12:46:47 PM
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I listened to some of the talking heads last night(totally ran out of something else to do) and was astounded! The Dems say that if Romney is elected, he will stop all the screening tests one can get on medicare today. Uh, medicare doesn`t pay for screening tests, and hasn`t in 15-20 years. The quickest way to get a payment denial from them is to code out any test or service as "screening". I`m not certain how Romney will stop them from doing something that they are already NOT doing!
Marco, I didn`t say that the ACA was a sigle payor system, but did say that it will LEAD to one. And yes, I do think that congress shouldn`t force this great ACA down our throats with fines, taxes, and bullying....then they don`t have to use it? If they pass it, they should have to abide by it. They don`t really care what the average Joe has as healthcare coverage, as long as they can buy, uh, get his vote by telling him how great things will be. If this ACA is that great, congress needs to belly up to the bar and get the same treatment. |
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Lookidat
Senior Member
USA
599 Posts |
Posted - 08/27/2012 : 10:42:00 AM
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Doc, you know the diberal limocrats have never let a little thing like truth get in the way of their self-ritious claims! (Or Republicans either for that matter)
I saw where a judge in Texas got into trouble for saying that if Obama won, there would be civil insurrection. I disagree with him. I believe that if Obama LOSES there will be widespread rioting and insurrection. I amuse myself during the day by reading CNN news, and the associated blogs, and it is obvious that a large number of Obama supporters are very radical, and the idea of Romney defeating him is intolerable. Mark my words, if Obama loses, and I am convinced that it is a long shot, there will be Democrats raising up, looting, and swearing that the Republicans somehow "stole" the election. If Obama wins, we just get to watch him spend 4 more years destroying this country. INVESTMENT TIP: buy heavily in gold and lead.
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It's Official; We now have a Dictatorship
