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Author Topic:   How Does Republican Platform Help Middle Class?
crashfrog
Member (Idle past 1466 days)
Posts: 19762
From: Silver Spring, MD
Joined: 03-20-2003


Message 407 of 440 (613182)
04-22-2011 11:48 AM
Reply to: Message 406 by New Cat's Eye
04-22-2011 11:38 AM


Re: side-question
Most insurance companies follow the Medicare model and pay a predetermined amount for medical services; medical service providers have to submit a bill coded with the insurance company's proprietary billing codes for procedures. For instance, if a hospital bills for a laparoscopic surgery, there's an associated billing code for "laparoscopic surgery to the knee" or whatever, and associated codes for the materials used up in the surgery (dressings, bandages, anesthetic, etc.)
Basically the insurance company uses its monopsony power to say "we'll pay you exactly $8000 for billing code LPS-12 (a laparoscopic surgery to the knee), or you can fuck off and not accept patients on our insurance. Since that's about 30% of the people who live and work here in your county, that would be a pretty stupid thing to do." Medicare does the same thing. It's a powerful means of health care cost control, of course, doctors hate it. And, of course, when it's just you and your wallet, you have no bargaining power at all, so the doctor can charge you more to make up for insurance and Medicare paying him less.
And of course, since each insurer has it's own incompatible system of billing codes - one code for each possible medical procedure, medication, and consumable - so perhaps a hundred thousand codes per insurer, plus the Medicare billing code system, plus a Medicaid billing system (one per state.) Now you can see why billing is more than 50% of the administrative costs, on average, of any health care provider, and why moving to single-payer (and therefore a single unified billing system) stands to reap such an enormous increase in efficiency.

This message is a reply to:
 Message 406 by New Cat's Eye, posted 04-22-2011 11:38 AM New Cat's Eye has replied

Replies to this message:
 Message 408 by New Cat's Eye, posted 04-22-2011 12:15 PM crashfrog has replied

  
crashfrog
Member (Idle past 1466 days)
Posts: 19762
From: Silver Spring, MD
Joined: 03-20-2003


Message 410 of 440 (613207)
04-22-2011 5:30 PM
Reply to: Message 408 by New Cat's Eye
04-22-2011 12:15 PM


Re: side-question
I've seen those TV commercials for various types of educations to get jobs where one of them is "Medical Billing and Coding". In the back of my mind I always wondered just why that would require going to one of those schools....
Well, there you go! It's a growth industry, like the rest of the health care sector.
That's kinda shitty.
And it's why the "free market" doesn't end up controlling costs, but inflating them.
Think of it another way - heath care providers, like any manufacturing provider, give discounts if you buy in bulk. (Buy 50 knee laparos, get the 51st free!) If you buy one at a time, you pay full price. If you gather everybody who needs a laparo together and bill for it all at once, you can pass the savings on to them. It's like when an office all goes in together for sandwiches so that they can split the delivery charge.
In any marketplace, bulk purchasing is a way for buyers to get some leverage on sellers. In the market for health care, where people are usually quite motivated to pay whatever it costs regardless of whether it works or not - see "homeopathy" - bulk purchasing power is the most promising way to control the rise in health care costs. Of course, the larger your "bulk" the better, so the logical terminus of that is a single-payer system that covers all Americans, simplifies billing, and uses monopsony power ("bulk purchasing" power taken to the logical extreme of a single buyer in the entire market) to exert force against the increase in prices and the marketing of expensive but useless snake oils.
Thanks for the reply.
You're welcome. I don't know why it worked differently at your dentist's office; my suspicion is that it doesn't work that way anymore, that he simply can't pad the bills for most insurers since they pay set rates for set procedures, and that therefore he's charging the out-of-pocket patients a lot more these days. I know when I had four cavities filled and a crown installed a few years ago, I paid out of pocket and it was almost two grand. (And I got the cheap mercury fillings!)

This message is a reply to:
 Message 408 by New Cat's Eye, posted 04-22-2011 12:15 PM New Cat's Eye has not replied

  
crashfrog
Member (Idle past 1466 days)
Posts: 19762
From: Silver Spring, MD
Joined: 03-20-2003


Message 414 of 440 (613738)
04-27-2011 12:07 AM
Reply to: Message 412 by marc9000
04-26-2011 9:28 PM


Here, read about mission creep. You can claim that it doesn’t matter, that bureaucrats like Browner are caring people, but you can’t claim that actions like hers don’t take place.
I don't recall making any claims about who was, or wasn't, a "caring person"; to me it seems more like a function of personal incentive. Someone who makes money as a direct percentage of company profits - the owner and CEO, for instance - has a lot to gain, personally, by making the decision to violate the property rights of others and steal from them by polluting into their water, rather that paying for costly disposal of hazardous wastes. They might even write an article in Forbes redefining "property rights" as the right to violate other people's property rights to their air and water. A bureaucrat, on the other hand, gets paid the same regardless, basically, so what's their incentive to "mission creep" besides the legitimate need for regulation?
And what actions are you talking about, specifically? Restructuring the EPA with the approval of Congress? This would seem to be proof of my position - the function of any regulatory agency is circumscribed by the laws it has to follow.
And what are you here for?
To discuss with you. That's why I'm posing direct questions and answering yours. It'd be nice if you could return the same courtesy.
To be a member of a shout-down gang?
That's a tired canard, Marc. We have no power to "shout you down" - no matter how many times we post, it won't prevent you from saying whatever you want. You're under no obligation to respond to anybody you don't want to. You're free to invite any participants you like to a Great Debate thread, on any topic you choose, where others literally will not be able to post.
Of course, then you'd have no excuse to complain about being "shouted down."
You'd have to check with Jar on that Message 145 I'm an independent myself.
"Independent" is a voting affiliation, not an ideology. Ideologically, you're a conservative. Obviously.
And I've had my own issues with Jar; we're hardly monolithic.

This message is a reply to:
 Message 412 by marc9000, posted 04-26-2011 9:28 PM marc9000 has replied

Replies to this message:
 Message 421 by marc9000, posted 04-30-2011 9:30 PM crashfrog has replied

  
crashfrog
Member (Idle past 1466 days)
Posts: 19762
From: Silver Spring, MD
Joined: 03-20-2003


Message 424 of 440 (614031)
04-30-2011 9:54 PM
Reply to: Message 421 by marc9000
04-30-2011 9:30 PM


They also have a lot to LOSE personally, by making decisions that that show most any type of disregard for the general public, some of whom they depend on to buy their product or service.
Not really. There are plenty of clueless or apathetic folks - like yourself! - who are completely unaffected by the notion of saving a couple of bucks at the expense of an aquifer or two. I mean, you didn't stop buying electricity, right? Even though your power company contributed to the improper storage of a fly ash pond which resulted in tens of millions of gallons of groundwater being contaminated with heavy metals?
Did you even know about it? It probably wasn't your water, so why would you care?
So, no. I don't see much of a market incentive against pollution. Indeed, pollution is the economics-textbook example of an "externality", a "cost of doing business" that doesn't actually fall on those engaged in the transaction.
Paid the same, you seem to think that money is the only thing that controls human activity, but it often comes in second or third, when it comes to individual motivation.
Usually people don't pick their own pockets. I don't know if that makes money their "top priority" but clearly monetary incentives influence behavior. That's the fundamental truth underlying economics.
Carol Browner qualifies/qualified as a tyrant by most standards the U.S. founders used to describe one.
Again - her actions are restrained by laws. So, no, she's not a "tyrant", she's a public servant executing the duties of her office. She just happened to rub the writer of your article the wrong way - probably, she regulated his business or something - and you've taken a great deal of self-motivated grousing at face-value.
The U.S. president’s salary is currently $400,000 per year, plus benefits.
True. How much should it be? It's kind of a 24-7 deal, even on vacation he's not really ever on vacation.
How much should it be when your guy is president?
Enemies of the U.S. certainly agree, and gifts to Browner for using her position of power to shrink the U.S. economy a lot more likely than your claims of gifts and rewards to company CEO’s who enthusiastically poison the air and water to sicken and kill people who buy their products.
Here you go with the conspiracy theories again. What's your evidence that Browner was taking bribes? And why do you think that the people being poisoned by the hypothetical CEO are the ones who would buy his products? Why would it have to be? What if he poisons Kentucky streams and just sells the power to Tennessee?
Some environmentalists are blaming "climate change" for the recent tornadoes in Alabama.
Which is obviously and scientifically valid. Given the reality of climate change, the reality of its effects on weather and the creation of storm systems, it's not reasonable to suggest that climate change was not involved. What else is the explanation for almost five times the number of tornadoes so far in this storm season, and more than double the previous record? That's just a coincidence?
The possibility of eliminating tornadoes by addressing climate change (and shrinking the economy) seems to excite them very much.
Nobody's suggesting that it's possible to eliminate tornadoes, but it's worth addressing the factors that apparently created more than four times the usual frequency of such storms. Don't you think Alabama's economy just shrinked as a result of the destruction? How much money can 300 dead people (and rising) spend?
The ones that were described in that link.
You answered generally. I asked you which actions specifically.
Do you understand the difference between "general" and "specific"?

This message is a reply to:
 Message 421 by marc9000, posted 04-30-2011 9:30 PM marc9000 has replied

Replies to this message:
 Message 429 by marc9000, posted 04-30-2011 10:26 PM crashfrog has not replied

  
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