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  1.    #41  
    Quote Originally Posted by lazslo11 View Post
    This might have helped pay for something.

    http://www.ritholtz.com/blog/wp-cont...ndollarwar.jpg

    We're ranked 37th in the world for health-care.

    Our life expectancy is about the same as Cuba. They pay $20 a year,we pay $14,000 per year.

    Germany pays 9% of GDP for health-care and the USA pays about 16% of GDP.

    We pay the most for the least, thanks to the Corporations, At least we have the best politicians(R&D's) money can buy.
    Are you saying that you would RATHER go to those countries for healthcare? Fine....please go to Cuba, pay your $20 a year, and enjoy your better health care. I'd still rather stay here and pay for my $804 back brace. Good grief, really? Comparing our current system to Cuba? Perhaps one reason our health care is more expensive is because 1/3 of the population is over weight and generates more health care problems than you can shake a stick at? I wonder how many people in Cuba are over weight? Or maybe because you watch your TV and can see a ton of prescriptions that you can go get your doctor to prescribe for you. I wonder how many Rx ads run on Cuba TV? Seriously, Cuba? LOL
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  2. Micael's Avatar
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    #42  
    I heard someone once talking about using healthcare to pay for wellcare visits, etc. His comment was that we don't use autoinsurance to pay for oil changes, checkups, wiper replacements, minor body work, but we expect health insurance to pick up everything.

    I thought it was an interesting point. I'm for the freedom to choose whether or not to carry insurance, and if you do, opt for full featured plans if you want, and hospitalization and catastrophic illness coverage if you want.

    The young would go for the later, and the older might choose full featured plans, or something in between.

    And opening up the borders would drive competition and price wars.

    Just some random thoughts, don't mind me....
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  3.    #43  
    Quote Originally Posted by Micael View Post
    I heard someone once talking about using healthcare to pay for wellcare visits, etc. His comment was that we don't use autoinsurance to pay for oil changes, checkups, wiper replacements, minor body work, but we expect health insurance to pick up everything.

    I thought it was an interesting point. I'm for the freedom to choose whether or not to carry insurance, and if you do, opt for full featured plans if you want, and hospitalization and catastrophic illness coverage if you want.

    The young would go for the later, and the older might choose full featured plans, or something in between.

    And opening up the borders would drive competition and price wars.

    Just some random thoughts, don't mind me....
    I have given a similar example of home owners insurance. Imagine what are premiums would be IF when our toilet broke we paid a co-pay to get if fixed....or maybe a $500 co-pay for a new roof when it was leaking....or maybe a $25 co-pay for a new window. As the regulars in here know, I have an HSA plan that pays for major services and, I might add, the PCIP from obama care also uses HSA plans. You can protect people from major health issues with a lower premium.
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  4. Micael's Avatar
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    #44  
    What about a house? Shouldn't that be in there too? And how about food? Should that be in the bill or rights? I mean, we're wealthy right? Nobody should go hungry.

    Oh, and a car. We need to have transportation so we can get to work for the job that we deserve.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  5. #45  
    BTW, before someone pulls out their calculator about which country has the highest corporate taxes... It's a complicated topic and I'm not going to spend time on it when I'm supposed to me finding a job... But the statement about "the highest" can be used to mean many different things. And we know that figures don't lie, but liars figure...

    A quick google indicates that we had the 2nd highest corporate tax rates, behind Japan. I believe that is based on the statutory total of federal and state taxes. That doesn't mean that is what corporations actually pay that, any more than most of us pay personal income tax at the rate required for our gross earnings - deductions and tax breaks reduce the effective tax rates so that we are a bit lower, but still in the top 10 industrialized countries.

    So why don't we see such amazing passion wondering why it costs so much more to run our government and secure our borders than what it costs the cubans? We should all desire that our taxes be lower than most, just like we should desire that our healthcare costs are lower.

    As a & of GDP, we are near the top in what is actually paid. But that assumes we actually know what is actually paid in other countries, and we probably don't. We are also near the top in % of GDP paid in individual taxes. So in a general sense, we pay more and get less than most (if not all) the modern economies around the world.

    And states can't just print money like the federal govt can (another reason to let the states control what their govt does, and keep the role of the federal govt as small as possible)... Many states are starting to rase corporate taxes to deal with their huge revenue shortfalls, and the recent increases proposed or implemented by a bunch of states has put that combined federal/state tax rate above any other (or will shortly, because we were only 1/2% behind Japan already).

    So everyone here that is on Sprint because it's cheaper than VZW or AT&T... why are you trying to save money? Because nobody wants to pay more than we have to... but that part of the brain turns off when it comes to taxes and the cost of government.

    Let's all get as wound up at all the other things we pay too much for compared to other countries. Some of them are probably worth it... but as a general rule you'd think we should be able to keep costs below most countries because we are so creative and capable as a nation.

    Note to washington: A penny saved is a penny earned. Stop wasting money. Stop borrowing money. Stop pretending that the jobless rate isn't still going up. Just stop it. Didn't your mothers teach you anything about how to be responsible in how you handle money? Geesh. Just stop it.

    It's ok to pass laws preventing me from doing something, but forcing me to earn money so you can buy stuff for someone else. is to force me to take action against my will... The 13th amendment says you can't do that, and a very smart federal judge in Florida had the stones to say so.

    ...and as Danel Tosh likes to say. "for that, we thank you."
  6. #46  
    Quote Originally Posted by Cantaffordit View Post
    @davidra

    In terms of medicare, I'd I think that Medicare is unconstitutional, but I doubt it could be challenged after all those years. As my recently departed mother used to say, "two wrongs don't make a right", so basing the obamacare disaster on the idea that they are already doing something wrong is like Obama invading Iran because we are already conducting an immoral war in the neighborhood. Or keeping that evil GITMO prison camp open, and since it's already operating we might as well expand it and send more prisoners there...

    In terms of what voters intended when voting out so many obamacrats... let's pretend that you are right that voters showed up as "almost evenly divided" (even though it wasn't even close). Let's pretend that many of the voters that fired the democratic house majority really like obamacare... (even though they voted overwhelmingly for candidates that opposed it).

    After all that pretending, you can't deny that the voters clearly wanted the government to stop spending your great-grandchildren's money and destroying the economy. So if that overwhelming election result didn't really mean that obamacare was something they didn't want to repeal (even though the winners mostly included that in their platform), the voters absolutely sent the message to stop spending like drunken sailors and fund government operations without borrowing $billions.

    You are probably tired of hearing me say this... but I'm all for every citizen getting good healthcare. And clean air. etc. etc.

    But obamacare won't produce that result any more than welfare has reduced the level of poverty in this country. (IMHO). If I thought it would, I'd be much less passionate about opposing it.

    And my plan? I spent many days last spring outlining plans and numbers for you. You didn't like any of what I suggested. Kinda like the republicans, you were just against anything I said because it didn't revolve around government healthcare as the starting point.

    You might recall that I came up with numbers showing the amount of money that we wasted on the "stimulus" could have funded insurance for all uninsured citizens for more than 10 years and could have been implemented before the mid-term election...

    And the cool thing is you said you would only listen to people without insurance. Well, I am without insurance and without a job. So you have to listen! . And if the economy doesn't improve, I'm gonna have to send you a PM to see if we can come over and live with you for a while... (ok, I'm kidding about living with you...)

    ... that's all I have to say about that...
    -Forrest Gump
    What I remember about your posts is that they absolutely did NOT provide coverage for people that don't have insurance. Like Pointy, and I've been saying it for years, I consider health care to be very different than gasoline, or housing, or food.

    And for someone who claims to want everyone to have health insurance, you sure haven't come up with anything close to covering everyone that needs it. Just like the republican health care plan that covered an additional 3 million or so people and left 40 million without.

    You and Clemgrad have never proposed any clear-cut proposal that would "cut medical costs" which is, indeed, the problem. Cutting the overhead and profit made by insurance companies is a start, however....especially the overhead. That is what the 80% requirement is about. Since the overhead for private insurers is about twice that of Medicare, which would still be about half of 20%, that sounds immenently fair to me. Issues of selling across state lines and tort reform have been shown to contribute minimally to any improvement in costs. I'll be glad to change my mind about that when you show me some data instead of some talking points. The only data shows that tort reform in Texas did absolutely nothing to control costs.

    I have no problem whatsoever with controlling the amount of money paid to doctors and hospitals, as everyone knows. I've used the example many times that the simple use of DRG's has dramatically decreased expenditures to hospitals. I would have no problem with extending that reimbursement to physician payment as well. There is basic philosophy at work here, and it has nothing to do with power or control,and that is the right of any citizen of the United States to get the health care they need. You can rail about bailouts, or limiting someone's income (which has nothing whatsoever to do with this issue), or other expenditures, or whatever you want, it doesn't change that basic philosophy...which you claim to share, but refuse to acknowledge.

    And finally, I fully expect that if you or your family should unfortunately fall severely ill, you will refuse treatment because you don't want Clemgrad to pay for your care....correct? Would you please go ahead and make that promise, because if you don't, your hypocrisy is overwhelming.
  7. #47  
    Quote Originally Posted by davidra View Post
    What I remember about your posts is that they absolutely did NOT provide coverage for people that don't have insurance. Like Pointy, and I've been saying it for years, I consider health care to be very different than gasoline, or housing, or food.

    And for someone who claims to want everyone to have health insurance, you sure haven't come up with anything close to covering everyone that needs it. Just like the republican health care plan that covered an additional 3 million or so people and left 40 million without.

    You and Clemgrad have never proposed any clear-cut proposal that would "cut medical costs" which is, indeed, the problem. Cutting the overhead and profit made by insurance companies is a start, however....especially the overhead. That is what the 80% requirement is about. Since the overhead for private insurers is about twice that of Medicare, which would still be about half of 20%, that sounds immenently fair to me.

    I have no problem whatsoever with controlling the amount of money paid to doctors and hospitals, as everyone knows. I've used the example many times that the simple use of DRG's has dramatically decreased expenditures to hospitals. I would have no problem with extending that reimbursement to physician payment as well. There is basic philosophy at work here, and it has nothing to do with power or control,and that is the right of any citizen of the United States to get the health care they need. You can rail about bailouts, or limiting someone's income (which has nothing whatsoever to do with this issue), or other expenditures, or whatever you want, it doesn't change that basic philosophy...which you claim to share, but refuse to acknowledge.

    And finally, I fully expect that if you or your family should unfortunately fall severely ill, you will refuse treatment because you don't want Clemgrad to pay for your care....correct? Would you please go ahead and make that promise, because if you don't, your hypocrisy is overwhelming.
    Given that my ideas all had basic math behind them, you must once again allow me the opinion that I did provide viable answers, even though you don't think I'm qualified to have opinions about anything related to health care. One line of thinking was as simple as taking the average cost of health care per US citizen (that number came from a link you provided) and divided that in to the amount borrowed for the "economic stimulus"... You may not like it, but all that money could have bought insurance for everyone for a lot of years...

    The good news is that my opinion is that it's a function of three things:

    1. Legitimate role of the federal government
    2. Logic and history to determine what causes increase or decrease in costs or wages. Those principles can be applied to determine how to increase availability and lower costs (free market economics), or they can be used to work on the principle of scarcity that says we cant create anything, only re-arrange what already is (liberal/socialist economics).

    3) If we get in to trouble and need medical care, food, shelter, etc. We will look to government last, not first. We will use our resources, then look to family, then to friends, then our church, and then to local charity. I am hopeful that we wont need any of that. But you can see that I'm committed to taking care of my family, and for taking that responsibility rather than expecting you or Clemgrad to do it for us. I never said that a government safety net wasn't a good thing, or that no one should ever take assistance from taxpayer funded organizations.

    I did say that is more the responsibility of people. family, and state government. I don't see much justification for involvement from washington, and I don't believe that involvement by washington will be very helpful.

    If I have no where to turn after having exhausted every possible alternative... you might find that Clemgrad would be happy to help. I'll bet you would too. I don't think it will come to that, of course. But the best thing the federal govt can do to help me is to make sure that I can afford the essentials such as housing, healthcare, food, etc. The cheaper it gets, the easier it is for me to take a lower paying job, and the more resources I have to donate to the betterment of my fellow man. I[ll let you know when it's your turn to lend me a hand, and I'll even clean out your garage so there is room for us!!!

    Finally, I know you are fine with setting limits on what doctors earn. But you are assuming that you will agree with the limit and be able to trust the person that gets to decide those limits.

    So lets start with a personal challenge. Agree to limit your household income, to an arbitrary number that I set. You can do the same by setting a limit for people that are in my profession.

    You will agree to work harder, increase gross earnings, and be frugal in how you spend money. But you don't get a say in who makes the decision or what that limit is. In return for that, I promise that you will have healthcare, a roof over your head and 3 meals every day. OK? I've got a number written on this piece of paper, and I'm going to slide it across the table to you. Then you can turn it over after you send your number to me. OK? ANd I hope you didn't rack up a bunch of student loans based on what you thought you'd be able to earn while paying them back. Nope. You are ok with having others determine your maximum income.



    Seacrest out
    Last edited by Cantaffordit; 02/07/2011 at 06:09 PM.
  8. #48  
    Quote Originally Posted by Cantaffordit View Post
    Given that my ideas all had basic math behind them, you must once again allow me the opinion that I did provide viable answers, even though you don't think I'm qualified to have opinions about anything related to health care.

    The good news is that my opinion is that it's a function of three things:

    1. Legitimate role of the federal government
    2. Logic and history to determine what causes increase or decrease in costs or wages. Those principles can be applied to determine how to increase availability and lower costs, or they can be used to work on the principle of scarcity that says we cant create anything, only re-arrange what already is.

    3) If we get in to trouble and need medical care, food, shelter, etc. We will look to government last, not first. We will use our resources, then look to family, then to friends, then our church, and then to local charity. I am hopeful that we wont need any of that. But you can see that I'm committed to taking care of my family, and for taking that responsibility rather than expecting you or Clemgrad to do it for us. I never said that a government safety net wasn't a good thing, or that no one should ever take assistance from taxpayer funded organizations.

    I did say that is more the responsibility of people. family, and state government. I don't see much justification for involvement from washington, and I don't believe that involvement by washington will be very helpful.

    If I have no where to turn after having exhausted every possible alternative... you might find that Clemgrad would be happy to help. I'll bet you would too. I don't think it will come to that, of course. But the best thing the federal govt can do to help me is to make sure that I can afford the essentials such as housing, healthcare, food, etc. The cheaper it gets, the easier it is for me to take a lower paying job, and the more resources I have to donate to the betterment of my fellow man. I[ll let you know when it's your turn to lend me a hand, and I'll even clean out your garage so there is room for us!!!

    Seacrest out
    It's funny to think of a conservative being unreasonably idealistic, but that's the case. Do you realize that what you would pay for one emergency admission and hospitalization would probably feed and house you for a year? Putting food and shelter in the same category as a major illness is shortsighted. Fine, go to your church and neighbors for a million dollar bill. You actually and rationally believe that buying insurance would not be worth avoiding that situation? And with regard to a "safety net" for everyone, fine, that's a start. Now tell me how you would do that, because that would make a big financial difference for hospitals, increase jobs, and decrease the cost of care. Put your math to work on that one.
  9. #49  
    Quote Originally Posted by Micael View Post
    Ok

    No, that would be the entitlements crowd screaming that. The conservatives are the "lift yourself up by your own bootstraps and make your own way" crowd, remember?

    You're correct. The "right" hasn't put something out there, because the "right" are not trying to take over health insurance companies.
    Actually when the chips are down, even the conservatives are gonna be screaming.
    I would suggest, however humbly, that your insurance companies have taken over you health care. Perhaps Obamacare is just a way of taking it back... from the right.

    Based on an aging population, your going to need something, even your good ol boys are going to need it. The lift themselves up by their bootstrap types tend to get a little ****y when the boot strap breaks.
    Life is short, Play hard, and enjoy every moment as if it was your last.
  10. #50  
    ok i have a question,, just for easy numbers.. how much would a straight forward broken leg cost to be xrayed, set, and cast..?? assuming no insurance?
    Life is short, Play hard, and enjoy every moment as if it was your last.
  11. #51  
    Quote Originally Posted by xForsaken View Post
    ok i have a question,, just for easy numbers.. how much would a straight forward broken leg cost to be xrayed, set, and cast..?? assuming no insurance?
    $200??

    lol lol ltm ltm

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  12. #52  
    Quote Originally Posted by davidra View Post
    It's funny to think of a conservative being unreasonably idealistic, but that's the case. Do you realize that what you would pay for one emergency admission and hospitalization would probably feed and house you for a year? Putting food and shelter in the same category as a major illness is shortsighted. Fine, go to your church and neighbors for a million dollar bill. You actually and rationally believe that buying insurance would not be worth avoiding that situation? And with regard to a "safety net" for everyone, fine, that's a start. Now tell me how you would do that, because that would make a big financial difference for hospitals, increase jobs, and decrease the cost of care. Put your math to work on that one.
    I didn't say I didn't think it was worth it. But I certainly can't afford (or don't want to pay) the $1,600/month for Cobra just in case. And our wonderful govt forgot to include an option to allow me to remove features to reduce the cost. Nope, the govt says COBRA is take-it-or-leave-it... $1,600/ month for the three of us.

    So what I've done is taken out a temporary policy with REALLY high deductibles to protect myself from a catastrophe as you suggested. But there is no way I'll ever hit the deductibles for regular doctor visits or prescriptions unless it's all related to wrapping my car around a bridge support at 100 mph, or that thing on my back turns out to be cancer. Ok, I made that last part up. But since I'm telling you all about my personal finances, I have protected myself from a life changing catastrophe and I am betting that I will be money ahead by funding any minor stuff that happens between now and my next job... I've always done that with car & home insurance, and conserving cash is more important than being able make free doctor visits at the moment.

    If everyone did that with healthcare, the number of extraneous procedures and unnecessary medical bills that wouldn't happen would dramatically reduce the cost of healthcare...

    I hope you will sleep better now, knowing that I'm making wise choices.
  13. #53  
    Quote Originally Posted by xForsaken View Post
    ok i have a question,, just for easy numbers.. how much would a straight forward broken leg cost to be xrayed, set, and cast..?? assuming no insurance?
    A couple if years ago I cut my hand badly (that story is for another OT thread on another day). I had a trip to the emergency room (and yes, it really WAS an emergency), a couple of xrays, and dozen stiches, and a few follow-up visits to a surgeon...

    The whole thing about $6,000 and maybe a bit more. The interesting thing I learned is that they actually charge MORE if the patient doesn't have insurance. A whole lot more. You'd think it would be the opposite because in theory those without insurance can't afford it... But it turns out that is the only type of patient where they aren't restricted to a specific set of rates they can charge... so they really run up the price when there is no insurance company that previously negotiated a rate (what, an insurance company doing something to control costs?) or the government dictating medicare reimbursement rates. And by the way, I got to see that medicare stuff up close with my mom over the summer... and they were penny wise and pound foolish to the point that my mom was trying to save money more so than medicare was. If it circumstances had been different it would probably have been funny.

    Anyway, a decent trip to the emergency room can easily be $5,000 if you go there because you need to, and not just as a convenience... and I set up my temporary coverage so that the first trip to the emergency will be on me.... and the insurance company can get their wallet out if I have more than one or it is more serious than average.
  14. #54  
    Quote Originally Posted by Cantaffordit View Post
    I didn't say I didn't think it was worth it. But I certainly can't afford (or don't want to pay) the $1,600/month for Cobra just in case. And our wonderful govt forgot to include an option to allow me to remove features to reduce the cost. Nope, the govt says COBRA is take-it-or-leave-it... $1,600/ month for the three of us.

    So what I've done is taken out a temporary policy with REALLY high deductibles to protect myself from a catastrophe as you suggested. But there is no way I'll ever hit the deductibles for regular doctor visits or prescriptions unless it's all related to wrapping my car around a bridge support at 100 mph, or that thing on my back turns out to be cancer. Ok, I made that last part up. But since I'm telling you all about my personal finances, I have protected myself from a life changing catastrophe and I am betting that I will be money ahead by funding any minor stuff that happens between now and my next job... I've always done that with car & home insurance, and conserving cash is more important than being able make free doctor visits at the moment.

    If everyone did that with healthcare, the number of extraneous procedures and unnecessary medical bills that wouldn't happen would dramatically reduce the cost of healthcare...

    I hope you will sleep better now, knowing that I'm making wise choices.
    You are making "wise" choices based on the absurd system we currently have...and you are still "betting", to use your own words.
    Why should you have to bet on anything? Your kid gets appendicitis....congrats, that'll be $23,000. Your math won't help you. You really, deep down inside, think that you should have to worry about getting adequate health care, and you are willing to bet your financial future on the fact that nothing bad will happen to you or your family? And "free" doctor visits? You mean the ones that can detect early colon cancer, or manage your kid's asthma? And do you really think your share of the tax burden if Medicare was expanded would be an additional $20,000 a year in income tax (i.e. more expensive than your Cobra annual payments)? No matter what kind of public plan was available for those who wanted it, the costs would be less than that per person. And finally, please remember that the rest of the 50 million uninsured are just like you; 90% of them are working. The poor and the elderly are insured already. It is working people that are at risk, just like you, and many of them will get bankrupted because of it. If you like that kind of system, more power to you.
  15. #55  
    so you figure its about 5-say 8 grand.. wow.. for a simple break, xray and cast... wow.
    No wonder the insurance companies are fighting Obamacare so hard.
    Last edited by xForsaken; 02/08/2011 at 11:57 AM.
    Life is short, Play hard, and enjoy every moment as if it was your last.
  16.    #56  
    Quote Originally Posted by xForsaken View Post
    so you figure its about 5-say 8 grand.. wow.. for a simple break, xray and cast... wow.
    No wonder the insurance companies are fighting Obamacare so hard.
    That statement makes no sense....sorry X....please explain how the insurance companies BEING BILLED so much for services by the doctors/hospitals reflects on them? This is just crazy. You do realize the insurance companies don't keep the money they are billed, right? You realize if the greedy doctor charges $5000 for that "simple break, xray and cast" that the insurance company sends that money to the providers, right? It's these ridiculous costs (the $5000) that dictates the premiums the insurance company charges.

    Insurance companies actually try and "negotiate" lower rates with the providers. That is why when my doctor billed the insurance company $1500 for the back brace, they "only" sent a check to the physician for $804. They had negotiated that rate down. I was mad my insurance company paid that! So please, explain your comment as I just don't understand your thinking on that.
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  17.    #57  
    Quote Originally Posted by xForsaken View Post
    so you figure its about 5-say 8 grand.. wow.. for a simple break, xray and cast... wow.
    No wonder the insurance companies are fighting Obamacare so hard.
    And by the way.....I dispute that figure of $5-$8000. I live in a fairly expensive area for health care, and I just don't see anything that expensive for an x-ray and cast. I went into an "urgent" center for a cut on my heel that involved cleaning, 3 stitches, medication, and a shot for $602, that was reduced to $473. I didn't find that so outrageous. So $5,000 for a break and a cast...not buying that. I think davidra can agree that is way to high, unless that is a Medicare physician trying to fraud the government.
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  18. Micael's Avatar
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    #58  
    While many can point to anecdotal evidence supporting either cash or an insurance approach to managing health care costs, logic tells me that as more and more doctors and hospitals started competing for cash, cash prices would become competitive. It's the system we were once on not so long ago, with insurance coverage just for emergency and catastrophic situations. My dad paid for my birth as well as my sisters, and it didn't devastate his pocketbook. At the time he was young and had just barely worked his way up into the lower middle class wage area.

    But back to anecdotal evidence, cause that's interesting too:


    Quick care? Pay cash
    By PAUL HARASIM
    LAS VEGAS REVIEW-JOURNAL
    Posted: Mar. 28, 2010 | 12:00 a.m.
    Updated: Mar. 28, 2010 | 12:52 p.m.

    As Congress passed legislation last week ensuring that health insurance coverage is the right of every U.S. citizen, Las Vegas Dr. Kevin C. Petersen did what he has done for the past two years -- performed surgeries that range from gallbladder removal to hernia repair on a cash-only basis, largely on patients who don't have insurance.

    They come from across the country, the uninsured who have been enticed, say, by his $5,000 total charge for a hernia repair, about a third what they've been quoted by other medical professionals or facilities.

    Even when the new legislation takes full effect and everyone has insurance coverage in 2014, Petersen hopes to continue performing outpatient surgery for cash patients or those who pay by credit card.

    And he says it's not just because his $2,000 gross profit on a hernia case is about four times more than he would currently be paid by Medicare or an insurance company.

    "I started doing no-insurance surgery because I wanted freedom, independence, self-determination and to get back closer to why I originally became a physician," Petersen said Monday as he sat in his Summerlin office.

    "No one outside of the profession tells me now how I should be treating a patient," he said. "I don't want the red tape, to have to rush with my patients. I don't want to have to work 100 hours a week to make a decent living. Working this way, I'm able to make on average per case what I made 25 years ago."

    If Petersen is able to continue his style of practice, he knows his patient mix will undoubtedly change from those he generally sees now -- the uninsured often desperate to find an affordable way to correct a medical problem -- to the insured with the financial means to get their medical care done quickly outside a legislated system that will provide service much more slowly with 31 million new insured patients.

    What we have seen in countries where medical care is guaranteed, Petersen said, is that people judged by authorities to have less serious maladies have to wait their turn to be treated, often months for conditions that can be painful but not life threatening.

    "Americans aren't known for their patience," he said.

    On Monday, Norman Younghusband and his wife Kathy sat in Petersen's waiting room and recounted how they found the physician.

    "We were actually checking how much a hernia repair for Norman would cost in Mexico when Dr. Petersen's name popped up on the Internet," Kathy Younghusband said. "He was so much cheaper than everybody else had quoted in the states and he was only a few hours from our home" in Kingman, Ariz.

    When the 59-year-old Younghusband left his last construction job in 2006, he thought he would be able to buy insurance on the open market, but he was denied because of his pre-existing conditions of a hernia and high blood pressure.

    Finally, Younghusband said, after the first of the year the hernia became so uncomfortable that he knew he had to get it repaired.

    "We were a little nervous at first because Dr. Petersen's price for the uninsured was so much lower than anyone else," Kathy Younghusband said.

    But the couple researched the surgeon's background and had a free half-hour consultation with Petersen over the phone. The cost of treatment of the hernia repair included lab work, a pre-operation electrocardiogram, the fee of an anesthesiologist and the rental cost of a surgical center.

    So many hospitals want $15,000 to $20,000 for the same service for someone who is uninsured, Kathy Young*husband said.

    Petersen said he is able, on behalf of the uninsured, to negotiate fees for anesthesia and an operating facility just like plastic surgeons, who never receive insurance payments for cosmetic procedures. He does not reveal the names of the providers he negotiates with, arguing that such information is proprietary.

    Petersen said 25 years ago, before private insurance companies started basically using the Medicare rate as their reimbursement benchmark as well, he would receive about $2,000 for a hernia repair on a privately insured patient. Back then, Petersen said, Medicare already paid physicians what he said was far too little for the procedure, about $800.

    "Gradually along the way private insurance started reimbursing about the same as Medicare, which has made physicians increase their volume to just stay in the same (financial) place," he said. "That's why patients have felt so rushed and why physicians are even more worried today when they hear talk that the Medicare rate is going to be cut another 20 percent."

    Petersen said many doctors have talked about doing a cash-only business, but few carry it out.

    "Marketing can cost you $500 to $1,000 a day," Petersen said.

    An accomplished computer programmer, Petersen advertises heavily on the Internet to push people to his Web site at No Insurance Surgery.

    A lot of doctors may say they want to do the same thing, but they're afraid to spend the money on the marketing when they're unsure it will pay dividends.

    When Petersen analyzes his $5,000 fee for a hernia repair, he finds that his $2,000 profit comes after $3,000 in expenses that include anesthesia, facility and lab fees, financing fees for patients making monthly payments and marketing costs.

    Though he continues to see the insured patients that he had on the books before switching to an all cash practice two years ago, Petersen said he sees 10 new uninsured patients for every one insured. Any new patients who come to him with insurance must pay him just as though they are uninsured, though he says it is possible that their insurance companies may reimburse them for a procedure.

    His change to a cash-only business has allowed him to earn nearly $300,000 a year. According to Salary.com, the base salary for a general surgeon in the Summerlin area is about $318,000 a year.

    "I only have to do 30 or 40 cases a month instead of 70," Petersen said.

    There are other physicians across the country, generally in primary care, who are working much like Petersen. About 1,500 doctors across the country are in a group called SimpleCare, which steers patients to doctors who offer cash discounts.

    The No Insurance Club, which is headquartered in Arizona with participating physicians in 13 states, offers prepaid health care plans for an annual fee of $480 for singles and $680 for families. The service covers basic medical services that include a variety of tests, shots and physicals and nearly 20 office visits per year.

    Chad Harris, who runs the club, thinks entrepreneurs like Petersen will flourish under the new health care reform law.

    He said the Las Vegas surgeon's patients will be those who are too impatient to wait on services as well as individuals who decide to pay the penalty for not having insurance -- which will be nearly $700 by 2016 -- rather than paying much more for yearly insurance.

    "There are going to be many niche areas because of this plan," he said.

    One of the niche areas, Harris believes, will be nearby "medical tourism."

    Harris said he is part of a business venture that will bring a world-class surgical facility to Mexico and just be 30 minutes from Phoenix.

    "American surgeons will rotate coming there and they are excited about it," he said. "We saw that Canadians would come to the United States to get something done quickly, and I think Americans will do the same thing. It'll be like being at a resort and cost 70 percent of what it would in the United States."

    Harris said the only thing that could hurt entrepreneurs such as Petersen is if the American government decides that cash-only doctors somehow cripple the new system and regulate them out of existence.

    Richard E. Ralston, executive director of Americans for Free Choice in Medicine, wouldn't be surprised if cash-only doctors are regulated out of work in what he believes would be a misguided attempt to take away this option under the pretext of fairness.

    To Ralston, the future for people like Petersen "looks pretty grim." The government "may say it hurts those who can't afford to do that (go to a cash-only doctor)."

    To the Younghusbands, who were back in Kingman on Thursday after Norman Younghusband's successful surgery, their biggest hope is that health reform simplifies care.

    "I just wish that everything could be as simple as our dealing with Dr. Petersen," Kathy Younghusband said. "He quoted us a fee and we had the procedure done just like that. And he treated us great. That's the way it should be done."

    Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

    ###
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  19. #59  
    Quote Originally Posted by davidra View Post
    You are making "wise" choices based on the absurd system we currently have...and you are still "betting", to use your own words.
    Why should you have to bet on anything? Your kid gets appendicitis....congrats, that'll be $23,000. Your math won't help you. You really, deep down inside, think that you should have to worry about getting adequate health care, and you are willing to bet your financial future on the fact that nothing bad will happen to you or your family? And "free" doctor visits? You mean the ones that can detect early colon cancer, or manage your kid's asthma? And do you really think your share of the tax burden if Medicare was expanded would be an additional $20,000 a year in income tax (i.e. more expensive than your Cobra annual payments)? No matter what kind of public plan was available for those who wanted it, the costs would be less than that per person. And finally, please remember that the rest of the 50 million uninsured are just like you; 90% of them are working. The poor and the elderly are insured already. It is working people that are at risk, just like you, and many of them will get bankrupted because of it. If you like that kind of system, more power to you.

    "betting" is what the "pursuit of happiness" is all about. It's part of being a grown up and taking on the responsibilities of a family. And it isn't really betting so much... it just mean being responsible enough to save money so that when things happen, we don't become homeless... that's just grown up behavior.

    I have to save money in case the car needs a new transmission... or in case I need a new car. Why would it not be expected that people would save for those but not for medical stuff? I know, it's because people have been told they don't need to save for any of that, because there are government programs to handle it for them.

    No need to save, just borrow more than you can afford to buy a car that's nicer than you need to park in front of the house that has a second mortgage... Or save, pay cash when you can afford it. Live on less than you make...

    So if you think I shouldn't have to incur any "risk" related to healthcare because one of us might break a leg or have appendicitis... that's no different than retirement, cars, a place to live, etc. That's just how life is...

    Who would want to have all the challenge and risk removed. We'd all turn out like the Kardashians...
  20. #60  
    Quick care? Pay cash
    By PAUL HARASIM
    LAS VEGAS REVIEW-JOURNAL
    Posted: Mar. 28, 2010 | 12:00 a.m.
    Updated: Mar. 28, 2010 | 12:52 p.m.
    interesting....but of course very anecdotal. For instance, what happens if the patient has a complication and needs hospitalization? Hernia repairs are not very challenging, and I'd love to know what the hospital that owns the operating room makes on that rental, but nonetheless it's an interesting approach. Most doctors would love to avoid dealing with insurance companies. So would most patients. They are inefficient and much of that money taken in goes to overhead, in spite of Clemgrad's explanation that all the costs are based on what the patient is billed by their provider. If that was the case, insurance companies wouldn't have record profits either. I'm all for throwing insurance companies under the bus. The worst thing about the health care law is that it actually would likely be a financial boon for insurance companies. That's the only reason I would favor rewriting it. As I've said many times before, I see no reason that an insurance company should make any profit from the healthcare system since they provide no direct care. Do away with insurance overhead and profit, the need for extra personnel to deal with insurance companies, and then watch how much money is saved. But of course that approach will not be palatable to those who are in the insurance business, even if combined with controlling provider charges. Right?
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