Trump as tragicomedy

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Desert
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Re: Trump as tragicomedy

Post by Desert » Thu Aug 02, 2018 8:12 am

D1984 wrote:
Wed Aug 01, 2018 6:16 pm
[I think it was back when he talked about having an elbow re-set for around $300 instead of circa $3000.

I would like to add a couple of points, though:

One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.

Two, the plural of anecdote is not data; just because Xan got a good price as a cash-paying patient does not mean most people will; in fact, as per the chargemaster example noted above, the uninsured usually get hit with the WORST prices. The local hospital system in my city has essentially a monopoly and their charges to uninsured patients are as follows: If you make the poverty level or less, free or nominal; if you make from 100% of the FPl to 200% of FPL, prices are based on a sliding scale from almost nothing to roughly what BCBS of Georgia would pay; if you make one cent above that you pay the FULL chargemaster rate, no ifs, ands, or buts (with the singular exception that certain imaging services get 10% or 15% off the chargemaster price). oh, and even if the hospital does discount its prices due to your being poor enough, the doctors who work on you can (and generally do) still charge the full amount.

Three, every other country that has health care prices lower than ours (which is pretty much....all of them) has the government directly or indirectly negotiate prices; this is true whether the system in single provider (UK, Spain, New Zealand, plus Hong Kong as far as hospital care is concerned); single-payer (Canada, Taiwan, South Korea), or some form of private or nonprofit universal coverage (Germany, Netherlands, Japan, Israel, Switzerland, etc) or a hybrid of single-payer and private non-profit (France). Strangely enough, none of them rely on patients acting as cost-control kamikazes and trying to negotiate rates with providers themselves. They all have lower prices (see the IFHP reports if you don't believe me) as a result. Funny how that works.
Great post. I don't see why we can't make a universal coverage system work in the U.S., other than the lack of political will. And that lack of political will appears largely driven my misinformation put out by the parties that profit the most from the current system.
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Re: Trump as tragicomedy

Post by ochotona » Thu Aug 02, 2018 9:14 am

Desert, bingo for you
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Re: Trump as tragicomedy

Post by moda0306 » Thu Aug 02, 2018 3:41 pm

Xan wrote:
Wed Aug 01, 2018 9:45 pm
D1984 wrote:
Wed Aug 01, 2018 6:16 pm
One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.
This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
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Re: Trump as tragicomedy

Post by moda0306 » Thu Aug 02, 2018 3:44 pm

Maddy wrote:
Wed Aug 01, 2018 6:22 pm
moda0306 wrote:
Wed Aug 01, 2018 5:57 pm
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?
I regularly get 40 percent off the sticker price from an orthopedist for paying cash on the barrelhead. He says that's about the same discount the insurance companies are getting. My one other experience with discounts comes from my participation in a health care sharing ministry. They are associated with a company (the Karis Group) that negotiates bills on behalf of member-patients--mostly major stuff. From what I've heard, they routinely get much larger discounts than that.
Is it really a discount if everyone gets it? Who doesn't get the discount?

I'm not accusing anyone of being shady... it's just that it seems like everyone wants to have this healthcare discussion as if somehow we're all getting screwed, and (insert THE ONE THING here) is the cause of it... until you look two layers deep and realize that not only are there (LOTS OF THINGS), but (THE ONE THING) isn't even really one of them...

That said, I've heard horror stories of people paying huge amounts for pills and pads at the hospital... why do I get the feeling that the insurance companies are in-fact NOT paying these rates!? Maybe because they're not negotiating in a moment of weakness with an IV & a bed pan as their legal counsel.
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Re: Trump as tragicomedy

Post by Xan » Thu Aug 02, 2018 3:58 pm

moda0306 wrote:
Thu Aug 02, 2018 3:41 pm
Xan wrote:
Wed Aug 01, 2018 9:45 pm
D1984 wrote:
Wed Aug 01, 2018 6:16 pm
One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.
This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
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Re: Trump as tragicomedy

Post by moda0306 » Thu Aug 02, 2018 4:18 pm

Xan wrote:
Thu Aug 02, 2018 3:58 pm
moda0306 wrote:
Thu Aug 02, 2018 3:41 pm
Xan wrote:
Wed Aug 01, 2018 9:45 pm


This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
You didn't say "giant cartel," but the person you responded to an answer did, and you seemed to agree with them. You also seemed to be agreeing with their claim, but I'm reading between the lines a bit to try to establish an assertion pattern.

What $$ amount would you consider catastrophic?

And how is catastrophic insurance outlawed?
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Re: Trump as tragicomedy

Post by Xan » Thu Aug 02, 2018 4:39 pm

moda0306 wrote:
Thu Aug 02, 2018 4:18 pm
Xan wrote:
Thu Aug 02, 2018 3:58 pm
moda0306 wrote:
Thu Aug 02, 2018 3:41 pm


That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
You didn't say "giant cartel," but the person you responded to an answer did, and you seemed to agree with them. You also seemed to be agreeing with their claim, but I'm reading between the lines a bit to try to establish an assertion pattern.

What $$ amount would you consider catastrophic?

And how is catastrophic insurance outlawed?
I believe the traditional definition is a $10,000 deductible. It was outlawed in that I used to have it, and then the price quintupled because, I was told, I had "bad insurance that nobody should be allowed to have", and my plan was now required to cover well-visits, maternity, and a thousand other things in addition to being just plain insurance against a catastrophe.
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Re: Trump as tragicomedy

Post by moda0306 » Fri Aug 03, 2018 9:32 am

Xan wrote:
Thu Aug 02, 2018 4:39 pm
moda0306 wrote:
Thu Aug 02, 2018 4:18 pm
Xan wrote:
Thu Aug 02, 2018 3:58 pm


I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
You didn't say "giant cartel," but the person you responded to an answer did, and you seemed to agree with them. You also seemed to be agreeing with their claim, but I'm reading between the lines a bit to try to establish an assertion pattern.

What $$ amount would you consider catastrophic?

And how is catastrophic insurance outlawed?
I believe the traditional definition is a $10,000 deductible. It was outlawed in that I used to have it, and then the price quintupled because, I was told, I had "bad insurance that nobody should be allowed to have", and my plan was now required to cover well-visits, maternity, and a thousand other things in addition to being just plain insurance against a catastrophe.
While I generally agree with you about how to use insurance vs retaining risk & saving on an individual level, I wouldn't blame someone for thinking that if the government IS going to get involved in creating a floor of human suffering one shouldn't fall below, that $10k in annual medical expenses is way too much to expect the average citizen to maintain. Especially since if you're tossing out $10k in medical expenses per year every year, you're probably limited in your ability to work and tend to your family and home.

I think this comes down less to exactly how you view retaining vs transferring risk and more about what kind of floor the government should create for folks and how... obviously they get sort of intertwined so it's tough to detangle the conversations.
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Re: Trump as tragicomedy

Post by Maddy » Fri Aug 03, 2018 9:59 am

moda0306 wrote:
Thu Aug 02, 2018 3:41 pm
Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I'm not sure that's true. I travel two hours to be seen by the orthopedic group that gives me a 40% cash discount because the best deal I can get locally is 10 percent off a sticker price that's many times what my guy is charging.

Case in point: I recently had a minor surgical procedure performed on my hand, and the doc was kind enough to agree to do it in the office. Total cost: Less than $300. Just out of curiosity (and motivated by my desire to avoid a two-hour drive), I had checked beforehand with some other groups in the immediate vicinity, none of which were willing to do the procedure in the office. Total quoted price: Over $7,000 after their cash-pay discount. Had I not been an established patient who this doc knew wouldn't be a pain in the ass (and who's brought him grass-fed beef at every appointment), I would have had no choice but to pay the larger amount. I'm sure the majority of uninsured folks do.
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Re: Trump as tragicomedy

Post by clacy » Fri Aug 03, 2018 3:08 pm

Manufacturing jobs growing at fastest pace in 23 years despite Obama telling us that they were "never coming back" and "Trump doesn't have a magic wand"...

(or does he?)

https://www.marketwatch.com/story/heres ... =bigcharts
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Re: Trump as tragicomedy

Post by Desert » Fri Aug 03, 2018 3:53 pm

clacy wrote:
Fri Aug 03, 2018 3:08 pm
Manufacturing jobs growing at fastest pace in 23 years despite Obama telling us that they were "never coming back" and "Trump doesn't have a magic wand"...

(or does he?)

https://www.marketwatch.com/story/heres ... =bigcharts
Did you read the article? The risks to this expansion are primarily Trump's policies.
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Re: Trump as tragicomedy

Post by clacy » Fri Aug 03, 2018 9:12 pm

Lol saving the middle class by bringing back jobs isn’t a risk.

It’s gotta be getting hard to be anti Trump by now isn’t it?
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