When THEY Run Everything.

[Steve]

Jim,

"a Washington-based liberal think tank" Right there you lost credibility. It's illegal to charge different fees to the uninsured vs the rest. It is absolutely illegal to charge the uninsured more. Physician fees are the same to all US citizens (you can charge a ferener whatever you want, sorry Hardy). In 14 years of practice, I've never been paid more than 50% of my charges by an uninsured patient and more than 2/3 of the time I collect less than 10%.

Insurers do "negotiate" lower contracted fees that are substantially less than our charges (here ya go doc, we don't care what you charge, this is what we'll give you this year, sorry it's less than last year.). This is bothersome in some respects as we have to, by law, charge the uninsured the full amount. In effect, this forces us to charge the indigent more than what we're reimbursed by patient who has insurance. Ironic. That being said, most physicians never attempt to collect the money from indigent patients (why bother, they don't have it?) so it really ends up being charity work anyway. Your premiums do not have any built-in additional "bonus" to cover uninsured patients. CAP has no data to support that. Period. If you really feel that's the case, why don't you ask your carrier for an 8% discount because you don't want to pay for your share of the indigent. You'll get silence and confusion on the other end of the phone.

Hospitals do receive some federal and state govt reimbursement for some of their costs (doctors do not). It doesn't cover all their costs.

 

[Jim Craik]

Account

Study: Average Family Pays $1G a Year to Cover the Uninsured

The average family with health insurance shells out an extra $1,000 a year in premiums to pay for health care for the uninsured, a new report finds.


Read more: Study: Average Family Pays $1G a Year to Cover the Uninsured | Fox News

So now I suppose you will say Fox News can't be believed!

 

[Doug S.]

Actually as I understand it, there is no levy on deposits under $100,000. The belief, anyway, is that the larger depositors are foreign, primarily Russian, and engaged in money laundering in the Cypriot banking system. So the levy is on the higher amounts....

Never having had a bank account with $100,000 in it, I guess that makes Pete right, then....they are taking from just the rich.

...not that that's a bad thing....particularly to someone who has NEVER been in the, what was it, 49% that doesn't pay taxes....I have always been sort of in that middle class group who gets to fund the majority of the governmental activities simply due to our numbers, so I have little sympathy for someone who has been able to accrue what seems to me to be a sizable fortune (but what would only be a good start on buying a Ferrari or Lambo or Aston Martin or Bugatti....or a GT40 :idea: ) and is being asked to give up a part of it to save the economy of the government that has been so good to them.

I know...I'll hear all about how hard work should be rewarded instead of punished by extra taxes....to which I say, feel fortunate that you lived in a country where that hard work could pay off for YOU, because it doesn't for everyone. Either we're all in this together, or we aren't. I would gladly give up the same percentage of my paltry bank account as the rich would have to give up if it were to help keep the country from financial ruin.

Can you say the same, I ask?

Cheers to Pete, who got it right.....and to Jeff who said so!

Doug

 

[Steve]

Account

Study: Average Family Pays $1G a Year to Cover the Uninsured

The average family with health insurance shells out an extra $1,000 a year in premiums to pay for health care for the uninsured, a new report finds.


Read more: Study: Average Family Pays $1G a Year to Cover the Uninsured | Fox News

So now I suppose you will say Fox News can't be believed!

That report is from Families USA, a liberal leaning consumer health advocacy group with little credibility. Fox merely reported it. I guess in this instance Fox is following through on it's mantra "we report, you decide":laugh:

The report states "That left about $43 billion unpaid, and that sum made its way into premiums charged by private insurance companies to businesses and individuals, the report said." It's not possible to pass these unpaid fees onto insurance companies. Why the hell would they pay for it? And, of course, they don't cite a single specific instance. In addition, providers (hospitals and MD's) don't simply raise their rates to the payors as the article asserts. The payors would tell them to f*** off if they did. The only way a provider can hold a gun to the payor's head is if they have a monopoly in an area and that would violate the antitrust laws.....

Gee Jim, didn't realize you perused Fox. Are you becoming more moderate or was it just a weak moment?:thumbsup:

​

 

[Jim Craik]

So the reports are all wrong, Fox is wrong, you know best!

I forgot, you are the only person in the history of business who does not factor in non-payment into your fees and business model.

 

[Steve]

Jim,

As I've stated many times, doctors have "fees" but we're virtually never paid the full fee. What we are paid is what the insurance companies feel like reimbursing. For example: I may charge $1200 for a carpal tunnel release. Medicare pays about $356. That's it. That includes the surgery and the first 90 days of postop care. The difference is a loss. It is illegal to collect the difference from the patient or they're supplemental if they have one. All other insurances function the same. We are totally beholden to the third party payor. The way we factor non-payment into our business model is to work harder, more efficiently, and work later. That's it. There is no other mechanism for physicians to recapture that lost payment. I've mentioned this all to you before but you seem to have forgotten.

Never said Fox was wrong (did you read my post?), just said they're reporting Family USA's claims.

 

[Jeff Young]

I'd post a chart but apparently that sends people into a tizzie....

Putting aside "liberal" and "conservative," the facts are these. Over the last few years, the health care cost curve has bent downward some, meaning that the increase in the cost of health has continued, but at a slower rate. People are not entirely sure why. It may be Obamacare, to an extent. It may be the slower economy. It may be that doctors and providers are getting better and providing services.

Insurance premiums are going up, primarily because (in my opinion and the opinions of others), insurers are overreacting to the new minimum coverage requirements the PPACA requires. Some of that is offset by the subsidy to low income purchasers of plans, but some is not. Last estimate I saw was that 59% of Americans would see their premiums go up, 41% would see a decline or a "hold steady."

 

[Steve]

I'd post a chart but apparently that sends people into a tizzie....

Putting aside "liberal" and "conservative," the facts are these. Over the last few years, the health care cost curve has bent downward some, meaning that the increase in the cost of health has continued, but at a slower rate. People are not entirely sure why. It may be Obamacare, to an extent. It may be the slower economy. It may be that doctors and providers are getting better and providing services.

Insurance premiums are going up, primarily because (in my opinion and the opinions of others), insurers are overreacting to the new minimum coverage requirements the PPACA requires. Some of that is offset by the subsidy to low income purchasers of plans, but some is not. Last estimate I saw was that 59% of Americans would see their premiums go up, 41% would see a decline or a "hold steady."

Jeff,

You're probably right in the first paragraph in that the slowing of the growth seems to be related to all of those factors. Every doc I know has noted patients putting off elective surgeries from 2008-2012 due to temporary loss of coverage, loss of a job, or concern about taking time off work. I'm not sure Obamacare has anything to do with the curbing of growth as, unfortunately, there's virtually nothing in the 2000+ pages of the legislation that truly curbs the growth of spending. Other mechanisms such as ACO's (accountable care organizations) and payors reimbursing for results rather than traditional fee for service might curb spending. These were underway before and are independent of Obamacare.

We'll see about the growth of premiums/spending in the next 2-3 years. It will be interesting. One thing is for sure, Obama campaigned heavily on "the average family of 4 will see up to a $2500 annual decrease in their premiums". That will not come to pass.

 

[Pat]

Never having had a bank account with $100,000 in it, I guess that makes Pete right, then....they are taking from just the rich.

...not that that's a bad thing....particularly to someone who has NEVER been in the, what was it, 49% that doesn't pay taxes....Can you say the same, I ask?

Doug

Congratulations on never being in the 49% that doesn't pay taxes (apologies for the double negative). Government research on the size of duck sex organs needs you. However, your support of punishing those miscreants with life savings over $100,000, the widow with the insurance proceeds from her deceased husband, the sale of her home or the small business owner that powers the economy is an admirable way to champion the interests of "the little people". Celebrate class warfare and the associated guilting strategies, they are so motivational to the voting patterns of the masses! "Confiscate the ill gotten gains of those like the rich murderer Mitt Romney!"
Jeff's brilliant treatise on the Cypriot financial system neglects one small thing. Banks make money by taking the deposits of one group, and lending that money to other groups for a fee that is higher than the interest they pay the depositors. This effectively multiplies the money in a positive way and creates jobs, funds expansion, innovation and drives economies. Deposits are the life's blood of banking. Trust in the banking system is the life's blood of deposits.
If the EU can now prey upon depositors at will, how might that affect the actions of current and future depositors? Who in their right mind would keep large sums in a Spanish, Italian or Irish bank? How might that affect those institutions future ability to lend to the businesses that fuel the economy? Given the spending patterns of governments around the world, the evil rich simply don't have enough money to pay all the freight and eventually the remaining 49%ers will have to pay - it still won't be enough. As governments print money, inflation, the "cruelest tax on the poor" cripples economic viability for everyone-especially those with less.
But it sure feels good to get even with those rich big-dollar bastards doesn’t it?

 

[Jeff Young]

Uh, the 49% DO pay taxes -- sales tax, state income tax, whatever, and more importantly the only reason they don't pay federal income tax is becuase they are able to use the standard deduction and personal exemption available to all. Eliminate those two items, and all of our taxes go up.

But I digress. What Pat is missing is that if a bank FAILS, then who loses? The biggest depositors/shareholders. These banks in Cypress were going to fail. The levy thus really changes nothing from what was going to happen in teh real world, other than to protect small depositors. Those who invested/deposited in these banks bear the cost of having done so.

Personal responsbility and all that.

Just like those who argued we should have let our banks failed in 2008.

 

[Pat]

Jeff, if a bank fails, large depositors predictability lose. If governments unpredictability seize deposits, they also lose. But the big difference is that one can look at a balance sheet and make a decision as to the viability of a bank. As was evidenced in Cyprus, one does not know what government bureaucrats will do. Banks have failed for centuries and this is a known risk. We have now crossed a like when governments seize assets at will. You are naive if you do not think this will affect deposit behavior and it's resultant effect on the economy.
Would you put your life savings in a Greek, Cypriot, Italian, Irish or Spanish bank?

By the way, there were 25 U.S. bank failures in 2008.

 

[Jeff Young]

You are mixing up cause and effect. There would be no levy but for the impending failure of these banks.

Net effect on large depositors of the levy: ZERO. They'd lose their money anyway.

 

[Pat]

Try to follow me here Jeff, think globally as to the impact of this government seizure. After all, never before in the history of the Eurozone financial crisis has a major banking system allowed depositors to lose money, no matter how reckless and stupid and greedy their bank managers have been. And only rarely have bank lenders--those who hold bank bonds--been asked to pony up.
Those who will be largely wiped out include uninsured depositors and bondholders, including senior creditors. 40% of large uninsured deposited funds is quite an attention getter and it has an undermining effect on the faith in the Eurozone banking system. The damning effect is not only on the failing banks but on all the other European banks that, having lost the faith of depositors (solvent or not), will no longer have those deposits and thus money to lend. What's next now that the “sudden seizure” line has been crossed? Will the EU "tax" wealthy depositors of sound banks to fund weak ones? Government seizure of bank deposits impacts every other institution that counts on deposits for the lowest cost of funds to lend to others. This is a massive impact compared to the losses in Cyprus and the kind of thing that causes a run on the bank's deposits. The whole reason they closed the banks in Cyprus was to stop a run on deposits, not just from the rich Russian gangsters but from everybody.
This may quite easily make unhealthy banks out of ones that are currently secure. In other words, what the EU has done to Cyprus depositors, gangsters or not, impacts the trust and deposit behavior in every other European bank.
Ironically, it may mean a windfall for the U.S. as the fleeing deposits come here. and it will likely cause many people to wonder and worry about where their money is.

When you refer to the 2008 "bailout" do you mean TARP?
Anybody who believes that TARP kept the financial system together simply doesn’t know the facts. The TARP program didn’t even do the things it is now hailed for having done – like keeping the credit markets from shutting down. Most of the things TARP is credited with were accomplished by the Fed or by summary guarantees announced by the Treasury, either before or immediately after the passage of TARP.
All TARP really "saved" was AIG and GM, both of which arguably would be better off with a structured bankruptcy and reconstitution.

To make my point, would you put your life savings in a Spanish, Italian, Irish or Cypriot bank? If it's there would you keep it there? What if they even pay great rates and give out toasters??

Hint: if you want to know if your local bank is about to fail, look for a huge and sudden increase in CD rates as they madly try to raise capital, it just might be an indicator.

 

[Danimal W]

And just an observation to add....

It's reported that now that Cyprus banks are open, Cyprus is restricting how much one can withdraw per day in cash (similar to most banks here). But in addition, one can not wire transfer funds to other institutions and they are limited to how much cash they can physically carry out of Cyprus.

So even the small depositor is hurt by this.

So a country is trying to control s currency that is not their own.

This leads to a lot of uncertainty in the local AND global economy.

 

[Mark]

Of course, it is totally and morally just for anyone, government or not, to walk on in, grab your cash and fook off out the door with it! No one see's a problem with that?

 

[Bob Fechter]

The little people always get off on someone with more than them getting screwed, Mark.

 

[Bob Fechter]

Prime Minister Thatcher had it right, "The trouble with socialism is that eventually you run out of other people's money."

 

[Pete McCluskey.]

Prime Minister Thatcher had it right, "The trouble with socialism is that eventually you run out of other people's money."

Indeed, she got that right! Love the proganda from the Cypriot government .
The large depositors are mostly Russian Mafia money launderers.
Yeah right!

 

[Tom P]

Wonder how the Kennedy's would feel if the government took some of their money made from early 1900's illegal booze. Is there such a thing as a good crook?

 

[Bob Fechter]

Wonder how the Kennedy's would feel if the government took some of their money made from early 1900's illegal booze. Is there such a thing as a good crook?

Sure, as long as they vote correctly, Robert Byrd falls readily to mind.