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rdw4potus
rdw4potus
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October 23rd, 2012 at 7:00:43 PM permalink
Quote: SOOPOO

This will prove to be true..... Just the beginning part, a TINY part, of Obamacare, was the requirement that docs use Electronic Medical Records, to 'increase efficiency and thus cause the system savings'. Of course, the EMRs have allowed docs and hospitals to bill more efficiently, too, and thus now there is a greater cost to the feds who are sending threatening letters saying they are paying out much more so there must be increased fraud! I can't tell you how many extra boxes I have to check and initial to fulfill new federal 'SCIP" regulations, another minor part in the continuum that is Obamacare....



So, you used to accidentally fail to bill people. The new system helps you not miss billings. You have to fill out extra forms, but you also get extra money. Umm...boohoo?
"So as the clock ticked and the day passed, opportunity met preparation, and luck happened." - Maurice Clarett
AZDuffman
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October 23rd, 2012 at 7:07:52 PM permalink
Quote: SOOPOO

For many who have little competance at managing their own lives the more the government controls is good... I am just not in that group....



Glad to have you in the 53%. Who is John Galt?
All animals are equal, but some are more equal than others
rxwine
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October 23rd, 2012 at 8:17:17 PM permalink
Back in reality land.

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AZDuffman
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October 23rd, 2012 at 9:48:26 PM permalink
Quote: rxwine

Back in reality land.



So just buy less health insurance and healthcare for yourself if you think you are spending too much. People seem to value health in the USA at a higher level is all this shows.
All animals are equal, but some are more equal than others
rxwine
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October 23rd, 2012 at 10:15:58 PM permalink
Quote: AZDuffman

So just buy less health insurance and healthcare for yourself if you think you are spending too much.



That's brilliant.

It's like solving poverty and famine by telling people to spend and eat less.
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AZDuffman
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October 23rd, 2012 at 10:26:22 PM permalink
Quote: rxwine

That's brilliant.

It's like solving poverty and famine by telling people to spend and eat less.



Not sure where you get that. My point is almost all of us make our own healthcare decisions. If you think it costs too much, don't buy it, use a substitute. Go to a free clinic in the city instead of the private office in the suburbs for example. If enough people do this then the suburban doctor will have to lower his or her rates.

This is not how the lefties want costs lowered, however. They want a control of what the doctor charges. They want a "public option" because somehow the insurance company is not supposed to make a profit.

What is not understood is that profit is not the measure of a man, what matters is how he got it. If he produced it by creating value the it is a token of honor. If you demand his money or service at less than a market rate simply because "you need it" then you are nothing but a looter.

Those that want a "public option" are nothing but looters.
All animals are equal, but some are more equal than others
rxwine
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October 23rd, 2012 at 10:49:42 PM permalink
Quote: AZDuffman

Not sure where you get that. My point is almost all of us make our own healthcare decisions. If you think it costs too much, don't buy it, use a substitute. Go to a free clinic in the city instead of the private office in the suburbs for example. If enough people do this then the suburban doctor will have to lower his or her rates.



Oh sure...

Quote:

The researchers found that illness or medical bills contributed to nearly two thirds, or 62 percent, of all bankruptcies in 2007óbefore the major impact of the housing collapse and current economic downturn. Thatís a 50 percent increase over a similar survey in 2001 by the same researchers.

Most of the debtors are middle aged, middle class and have a college level education, and each of them has their own story.



http://news.consumerreports.org/health/2009/06/health-care-bankruptcy-on-rise-medical-debt-medical-bills-how-to-avoid-bankruptcy.html

Also, "Looters" is a term Romney should use for the 47%. Hope he makes an ad for that soon.
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SOOPOO
SOOPOO 
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October 24th, 2012 at 5:11:18 AM permalink
Quote: rdw4potus

So, you used to accidentally fail to bill people. The new system helps you not miss billings. You have to fill out extra forms, but you also get extra money. Umm...boohoo?



Not me or my group, as anesthesiologists do not get paid more from the government for taking care of sicker patients. But hospitals and internists do! So, yes, many 'secondary' diagnoses were missed when bills were submitted, but now the computer can search the entire record for one instance of the word 'diabetic', and that might result in a larger bill for the hospital.
The joke about the SCIP program's 'extra' money is this... You will get around a 1% bonus on your Medicare collections if you meet all of the requirements. My group of 12 might collect $120,000 from Medicare, so thats about $1200 to be split up. The paperwork required was 1/2 of a secretarial FTE, so pay around $25,000 to get $1,200...... I LOVE Obamacare.....
EvenBob
EvenBob
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November 1st, 2012 at 3:11:35 PM permalink
Here ya go, in Jan 2014 the IRS will be demanding
your healthcare info on your tax form. How about
'none of your F-ing business' for an answer.

http://www.atr.org/new-obamacare-tax-form-mandates-americans-a7285
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rdw4potus
rdw4potus
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November 1st, 2012 at 3:17:44 PM permalink
Quote: EvenBob

Here ya go, in Jan 2014 the IRS will be demanding
your healthcare info on your tax form. How about
'none of your F-ing business' for an answer.

http://www.atr.org/new-obamacare-tax-form-mandates-americans-a7285



Ummm...duh? Part (actually, all) of proving that you have health insurance is, you know...proving that you have health insurance. Did you just realize this now??
"So as the clock ticked and the day passed, opportunity met preparation, and luck happened." - Maurice Clarett
EvenBob
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November 1st, 2012 at 3:37:56 PM permalink
Quote: rdw4potus

Ummm...duh?..Did you just realize this now??



Yeah, duh, I knew the IRS was the StormTrooper
part of the gov't enforcing Obamacare. Its the
first time I've actually seen the form. Duh..
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EvenBob
EvenBob
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January 11th, 2013 at 1:58:14 PM permalink
The thing you never want to happen in your family
has happened. We found out our son in law needs
a kidney transplant. He's 38. It was a complete
surprise, he didn't even know he was sick. He was
getting migraines and he went to his doctor and thats
how they found his kidneys were functioning at 20%.

Now the rush is on to find a compatible donor in his
family. His doctor is scaring the crap out of him about
Obamacare if a family match can't be found. There
is a big revamping of how the donor program will work
under Obamacare. There will be Obamacare Death Panels
who decide who gets the kidneys and who doesn't.
Right now its whoever is next on the list. With the Death
Panels, its whoever some gov't official decides is next. Just like Obama
said with the elderly woman who needs treatment, remember
her? Just give her a pill and send her home to die, she's
old, screw her.

What a rosy future we have coming, and its almost here.
It does not suck to be me.
EvenBob
EvenBob
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February 1st, 2013 at 3:33:42 PM permalink
The IRS said today a family of 4 making $120K
a year combined income, will have to pay $20,000
a year for the lowest tier (crappiest) of Obamacare.

This is the IRS saying this, not FoxNews, not Rush
Limbaugh, not the RNC.

Are they fricking insane? My wife's youngest sister
has 3 kids at home and they make $125K combined
income. They now pay $6500 a year for insurance
thru their employer. So they will be paying 3 times
more under Obamacare? Thats 1/6 of their income
BEFORE TAXES! It will bankrupt them.

It just gets better and better.

http://cnsnews.com/news/article/irs-cheapest-obamacare-plan-will-be-20000-family
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rainman
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February 1st, 2013 at 3:44:51 PM permalink
I thought the prices were going to go down and the doctors weren't gonna make enough so they were all gonna retire or quit and body's were going to pile up in the streets.
EvenBob
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February 1st, 2013 at 3:51:11 PM permalink
I thought the average family was going to SAVE
$2500 a year on health insurance. What happened
to that?
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rxwine
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February 1st, 2013 at 3:56:08 PM permalink
Quote:

They now pay $6500 a year for insurance
thru their employer. So they will be paying 3 times
more under Obamacare?



Well, if they want to pay 3 times more voluntarily that would be stupid. Because they don't have to switch.
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ahiromu
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February 1st, 2013 at 3:57:54 PM permalink
Quote: EvenBob

They now pay $6500 a year for insurance
thru their employer. So they will be paying 3 times
more under Obamacare? Thats 1/6 of their income
BEFORE TAXES! It will bankrupt them.



Although I agree with your sentiment, I think you may be mistaken here. Most likely, THEY pay 6500 and then the employer takes up part of the cost. I was looking at my health plans and the most expensive family plans are on the order of 950/450 per month or about 17k per year, where the employee pays 5400 per year. These are federal benefits, so the employer payment is probably smaller for just about everyone else. Still expensive, very expensive, but not 200% more expensive.

The worst part about this is we're learning about all of this now, for something this monumental to be pushed through like it was is criminal.

Edit: I compared the cheapest Obamacare plan to the most expensive current private plan which wasn't correct. A cheaper plan is closer to 1000/month total.

Edit2: Found a plan at 10k/year, 6500 might not be out of reason for maybe a high deductible plan?
Its - Possessive; It's - "It is" / "It has"; There - Location; Their - Possessive; They're - "They are"
Face
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February 1st, 2013 at 3:58:14 PM permalink
Quote: rxwine

Well, if they want to pay 3 times more voluntarily that would be stupid. Because they don't have to switch.



Not trolling, I've an honest question - I thought that, as you said, if you don't want O-care, then you can opt out provided you have coverage. But if that is true, and someone doesn't have coverage because they can't afford it, how are they going to afford the 3x's more expensive option?
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EvenBob
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February 1st, 2013 at 4:04:29 PM permalink
Quote: rxwine

Well, if they want to pay 3 times more voluntarily that would be stupid. Because they don't have to switch.



Their employer has told them their insurance is going
bye bye as soon as Obamacare is available. There will be
some available but its so expensive nobody will want it.

Employers aren't stupid, they will save a mint by not
offering insurance.

"A report from the House Ways and Means Committee finds that 71% of companies would find it far more economical to drop their health care plans and simply pay the penalty for not complying with the Obamacare employer insurance mandate."
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Llew
Llew
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February 1st, 2013 at 4:57:51 PM permalink
Thus creating a crisis with the populist solution being single-payer (i.e., government) health insurance. As if this was not the plan all along: to make the health insurance system so bad that people want to scrap it entirely.
kenarman
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February 1st, 2013 at 7:41:27 PM permalink
Quote: rxwine

Well then, you get the short supply of a cancer drug before a 5 year old kid maybe. Donald Trump gets a heart, and some families 16 y/o kid dies waiting for one.

That's the party of mean, that I recognize.



What makes the kids jump to the front of the line any more fair than the rich getting to the front of the line. There is probably no fair way to ration valuable resources unless we can bring Solomon back to life. One thing you can probably bank on though is that government employees are probably not the right choice. Think going into any government office to get something done and how fair and impartial that experience allways seems to be.
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rxwine
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February 1st, 2013 at 8:16:56 PM permalink
Quote: kenarman

What makes the kids jump to the front of the line any more fair than the rich getting to the front of the line. .



Even Hitler would probably admit he lived a full life before sacrificing his young son if there was only saving himself or his son.

Okay, maybe not, because he's Hitler. But if one thinks like Hitler, than maybe you're closer to Hitler-like thinking.
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AcesAndEights
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February 1st, 2013 at 9:32:05 PM permalink
Quote: rxwine

Even Hitler would probably admit he lived a full life before sacrificing his young son if there was only saving himself or his son.

Okay, maybe not, because he's Hitler. But if one thinks like Hitler, than maybe you're closer to Hitler-like thinking.


I'm so confused, Hitler didn't have any kids!
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Llew
Llew
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February 1st, 2013 at 9:38:37 PM permalink
Quote: rxwine

Even Hitler would probably admit he lived a full life before sacrificing his young son if there was only saving himself or his son.

Okay, maybe not, because he's Hitler. But if one thinks like Hitler, than maybe you're closer to Hitler-like thinking.



If you can't make your argument without invoking Hitler, you shouldn't make it.

Now, the problem here is that you can't craft sensible policy on emotional/sentimental instincts. Sure, maybe it feels good to say that children get first dibs. But what if there's a renowned scientist who has made the lives of millions of people better, and who will continue to do so if he gets to live longer - should he get precedence over a child with multiple ailments who will likely die anyway, or who has brain damage and will be a burden on society? It depends on what you want to accomplish. If you want warm fuzzy feelings combined with negative consequences that don't affect you emotionally because you're unaware that they are, in fact, consequences of that policy, then sure, make those kinds of laws.

We typically allocate scarce resources using wealth, because someone who accumulates wealth is (in theory, in a free market capitalist system) providing something of value to society in exchange for that wealth. If you don't like what society values - for example, if you think that people providing entertainment such as movies, sports, TV shows, porn, gambling, etc. should not be wealthy - that should be your beef with out society and culture, not with the people who benefit from it.

Perhaps you think that we should have a system where, because government is large and powerful and controls various sectors of the economy, the most effective way to get what you want is not to earn wealth by providing society with what it wants, but to get government to provide you with special favors. In such a system, political connections are the new currency, and lobbying is the wisest investment.
Buzzard
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February 1st, 2013 at 9:58:35 PM permalink
Quote: AcesAndEights

I'm so confused, Hitler didn't have any kids!



Goebels had 6 young children and murdered them all.
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rxwine
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February 1st, 2013 at 10:07:57 PM permalink
Quote: Llew

If you can't make your argument without invoking Hitler, you shouldn't make it.
.



Next time it will be Himmler or Goebbels.
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EvenBob
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February 2nd, 2013 at 12:32:54 AM permalink
Look, the Brits are taking a page from our new
Socialism. Their medical records will be available,
for their own good of course, to the gov't. Glad
we could be of help.

http://www.dailymail.co.uk/news/article-2272166/Big-brother-log-drinking-habits-waist-size.html#axzz2JhXYhdJ3
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boymimbo
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February 2nd, 2013 at 6:12:03 AM permalink
I've thought about this, and I think the major question is "should the government know about your health?". A number of people's response is in the "no" column. Meanwhile, every western country in the world has gone with a form of government health care, and the result is that the per capita health cost of every citizen in those countries are much lesser than in the United States, and the quality of health of every citizen in these country is equal to or better than those in the United States. In these cases, the people have put the trust in their government to deliver health care to them. The argument that Americans generally are more unhealthy than anywhere else doesn't wash.

And yeah, as a result, outside of the United States, it is sometimes not fair. There are waiting lists. You can't jump to the "front of the line" based on your insurance company, and people are supposed to be treated equally. Of course there are problems, everywhere. It's government, for crying out loud.

But there's Bob's example. His family has to pay $5,800 in premiums even though his employer covers a portion of his health care costs. The fact is that health care costs have gone so much out of control in the US that it has become a major portion of the employer's costs and presents a major competitive disadvantage on the global market. US health care per capita costs are 45% higher than its closest competitor (the Netherlands). Bob gets mad about that. 10 years ago, most people who were employed full time paid NOTHING for health care because the employer could absorb the cost and still be competitive. Now, employers pass on the health care costs to its employees; health care becomes impossible to afford for those who are unemployed or underemployed, and it becomes a huge life-long financial burden, especially those with long term chronic illnesses (such as diabetes, cancer, mental disorders) who can't work because of their medical conditions. The current per capita cost of health care is $8,233. If Bob's family is paying $5,800 in premiums for a family of four, it is likely that his employer is kicking in an additional $15K for its one employee. That represents an $8/hour benefit that the corporation is absorbing in addition to a 35% corporate tax rate. In Canada, the payroll tax for health care is $0 and the corporate tax rate is 26%. Where would you rather be opening a business?

Driving down health care costs has got to be a priority and it has to come from the government, because the companies truly don't care about the welfare of their customers. Health insurance companies don't compete with each other. Instead, they are allowed to monopolize markets and when they do compete, they use unfair practices (not unlike the oil companies) to create an oligarchy. And because everyone is out for a profit, there are huge margins on their services. And because they make huge profits, they are inefficient as hell because they can afford to be.

Something has got to change in the United States to drive down the costs of health care. Obamacare isn't it. But the solution has got to come from government, because it isn't going to come from the corporations, and the end result (whether your company is paying for it or you are) is that companies can't compete, and you (as a payer) have to be stuck making compromises and gambles about how much insurance you are going to pay for based on how you think your health will be.

The solution sucks because the each member of congress and the senate is stuck between serving its shareholders (its corporate donators from every lobby) and its constituents. So every law that is passed by the Feds is a piece of crap because mixed in there is language to serve the interests of the shareholders. It's corruption at its worst in a democracy that was lost a long time ago.

You can vote all you want, but all you are going to get is the same crap. Its smell may be different depending on which color you vote for, but it's still shit. And you can be a libertarian all you want and state "pay as you go", which is all fine and dandy until you get the $100K bill from the hospital that you can't afford (and wasn't your fault).
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EvenBob
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February 2nd, 2013 at 6:25:28 AM permalink
Quote: boymimbo

and the quality of health of every citizen in these country is equal to or better than those in the United States.



So if medicine is so much better everywhere else,
why do those that can affod it choose to come
here for treatment? Let me ask, if you had a
serious heart problem, or needed a kidney
transplant, and you had money, what country
would you go to for the best treatment, if most
places are better than the US.
It does not suck to be me.
stoneynv
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February 2nd, 2013 at 6:31:11 AM permalink
when healthcare is considered a "right" this is what you get, an irrevocable mess. Read a piece about a guy pulling teeth and filling cavities in the Dallas area. It was a cash and carry operation. He was unlicensed maybe not a dentist. Although if he is pulling teeth and filling cavities I would considerer him a dentist. He was providing a great service for pennies on the dollar and now faces two to ten in our prolific prison system.
AZDuffman
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February 2nd, 2013 at 7:20:24 AM permalink
Quote: EvenBob

There will be Obamacare Death Panels
who decide who gets the kidneys and who doesn't.
Right now its whoever is next on the list. With the Death
Panels, its whoever some gov't official decides is next. Just like Obama
said with the elderly woman who needs treatment, remember
her? Just give her a pill and send her home to die, she's
old, screw her.

What a rosy future we have coming, and its almost here.



This is only the begining of it. Just give it a few years and we will see "affirmitive action" for who gets the kidney. If a qouta of the "wrong" racial makeup groups has had too many kidneys lately you can bet your skin color and gender will come into play.

Not to hijack so split if this takes off, but what would you peeps think about a Central American kidney-transplant clinic? Build a smallish hospital and staff it with a few top-line surgeons. And let people sell their kidneys if they wish. So imagine a poor person from who knows where could offer their kidney for what they consider a life-changing amount. Meanwhile the rich person could offer to buy. The donor would get the trip paid for and their stay all on top of the sum received for the kidney.

It could be done online-auction style. You would be type-matched. Then you would be told an estimisate for the demand for your kidney. A price would be put online for what you are offering. The recipiant would work the same way, just they would put a price offered. (See the website "Prosper" for how this works with loans.) When it got close there might be more negotiations.

Prices might be lower, though insurance will never pay for it. And we would have to safeguard for human trafficing. But what do you think assuming the criminal elemnent would be weeded out and it would be on the level?
All animals are equal, but some are more equal than others
boymimbo
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February 2nd, 2013 at 8:27:40 AM permalink
How could you ever assume that the human trafficking wouldn't be weeded out. Given the sex trade going on in third world countries that is unabated, what is stopping people from forcing others to sell bodily parts for an enormous profit?

Yikes.

The average US prices for transplants according to a study on milliman.com PDF here is $262,900 for a kidney transplant, and $997,700 for a heart transplant.

So, yeah, if you're a multi-millionaire and have $263,000 to spare, you can afford to travel to the United States and be at the front of the line and get the best care imaginable. Seriously, for that kind of money, I expect hourly blowjobs from the nurses, and they'd better be current porn stars who know what they're doing... the Viagara or Cialis better be free too! My point is that yep, if you have the money, you can jump the queue by going elsewhere. That's an option anywhere. And it happens all the time. And I don't mind as it pushes the people who can't afford it up the queue. Even in Canada, if your injury is work-related, you jump the queue because it's paid for by a different fund.

And if you are a US resident and require a kidney transplant and don't have health insurance, Medicare will pay for 80% of the cost and will pay for 80% of your medication for three years, leaving you on the hook for 50-60K of the total cost, which would bankrupt alot of people or at least delay the onset of care. Another huge part of the problem is that US kidney donors are often denied insurance after they donate because they're missing a kidney.

Do you wonder why people are leaving the United States and using medical tourism to get operations elsewhere for cheaper?
----- You want the truth! You can't handle the truth!
SOOPOO
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February 2nd, 2013 at 9:19:33 AM permalink
Quote: boymimbo



Health insurance companies don't compete with each other.



This is a ridiculous comment. In Buffalo there are three big players, and many smaller ones, all advertizing up the wazoo to try and steal a client from the other. I would label the competition as 'feverish'. It is classic free market competition.... Company A advertises free health club membership, Company B advertises free cooking classes, Company C advertises no copays on gyn visits.... You get to choose which one fits you better...
Buzzard
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February 2nd, 2013 at 9:27:07 AM permalink
Quote: SOOPOO

This is a ridiculous comment. In Buffalo there are three big players, and many smaller ones, all advertizing up the wazoo to try and steal a client from the other. I would label the competition as 'feverish'. It is classic free market competition.... Company A advertises free health club membership, Company B advertises free cooking classes, Company C advertises no copays on gyn visits.... You get to choose which one fits you better...



Corporations have 3 goals, to make money, to make money, and to make even more money. They can not do that without customers. DUH Of course they compete. Do they ever !
Shed not for her the bitter tear Nor give the heart to vain regret Tis but the casket that lies here, The gem that filled it Sparkles yet
rainman
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February 2nd, 2013 at 9:28:37 AM permalink
Can you compete from out of state?
SOOPOO
SOOPOO 
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February 2nd, 2013 at 9:32:26 AM permalink
Quote: boymimbo



And if you are a US resident and require a kidney transplant and don't have health insurance, Medicare will pay for 80% of the cost and will pay for 80% of your medication for three years, leaving you on the hook for 50-60K of the total cost, which would bankrupt alot of people or at least delay the onset of care. Another huge part of the problem is that US kidney donors are often denied insurance after they donate because they're missing a kidney.



Most kidney transplant recipients do not pay a dime. The poor ones who only have Medicare then qualify for Medicaid, which pays the other 20%. The ones who had jobs and 'regular' insurance generally have to pay copays that average less than $1000 for the entire operation. My 'regular' insurance requires a $5 copay for each drug per month, so if a kidney recipient needs 6 different drugs that is still less than $1000 per year.
And what kidney donor has no insurance now so that they are denied in the future?

And for every person who quotes some better health insurance in some foreign country, go there! Now I am not saying that this is good use of resources, but I know we operate on older and sicker patients here than overseas. And we'll put in an expensive defibrillator ($50,000) in someone with a life expectancy of just a few years. And the profoundly mentally retarded will have multiple opthalmological and dental operations throught their lives here. So, yeah, we spend a lot of money on health care. But if I ever needed an operation, or special care, there is no other country I'd be having it in....
boymimbo
boymimbo
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February 2nd, 2013 at 9:54:08 AM permalink
Quote: SOOPOO

This is a ridiculous comment. In Buffalo there are three big players, and many smaller ones, all advertizing up the wazoo to try and steal a client from the other. I would label the competition as 'feverish'. It is classic free market competition.... Company A advertises free health club membership, Company B advertises free cooking classes, Company C advertises no copays on gyn visits.... You get to choose which one fits you better...



Thanks for correcting me on the kidney stats. Why do people go bankrupt then for medical reasons if Medicare/Medicaid is paying for everything? I'm confused.

New York is one of the few states with a relatively open market. That said, free cooking classes, free health club membership, and no-copays are just gimmicks. I'm talking about competition by lowering what doctors and hospitals get for services.

Why don't you show me a chart showing how much you get from each insurance provider for a typical service and show me the difference in prices? You can blank out the insurance provider's name. I'll go down your alleyway, just for fun)

So, for example, for CPT code 64479 (Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level). On GE's site it shows $564.32. The medicare rate for Facility is $129.32, and non-Facility $235.47.

In Ontario, you bill OHIP at the rate of $15/unit with a minimum unit count of 7 (a unit is 15 minutes for the 1st hour, 7.5 minutes for the next 30 minutes and 5 minutes thereafter) and you get a premium based on time of day (50% between 5pm and midnight, 75% for overnight). Just out of curiousity, SooPoo, how would you do in Canada. Ontario OHIP rates for anesthesiology
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SOOPOO
SOOPOO 
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February 2nd, 2013 at 10:13:11 AM permalink
Quote: boymimbo

Thanks for correcting me on the kidney stats. Why do people go bankrupt then for medical reasons if Medicare/Medicaid is paying for everything? I'm confused.

New York is one of the few states with a relatively open market. That said, free cooking classes, free health club membership, and no-copays are just gimmicks. I'm talking about competition by lowering what doctors and hospitals get for services.

Why don't you show me a chart showing how much you get from each insurance provider for a typical service and show me the difference in prices? You can blank out the insurance provider's name. I'll go down your alleyway, just for fun)

So, for example, for CPT code 64479 (Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level). On GE's site it shows $564.32. The medicare rate for Facility is $129.32, and non-Facility $235.47.

In Ontario, you bill OHIP at the rate of $15/unit with a minimum unit count of 7 (a unit is 15 minutes for the 1st hour, 7.5 minutes for the next 30 minutes and 5 minutes thereafter) and you get a premium based on time of day (50% between 5pm and midnight, 75% for overnight). Just out of curiousity, SooPoo, how would you do in Canada. Ontario OHIP rates for anesthesiology



Super interesting! In NY, and specifically western NY, I'll give an example for a total knee replacement, and use a total of 3 hours of anesthesia time. We do units differently.. it is always 1 unit per 15 minutes... And I think a knee has a base of 8...

Canada as per your example... 34 units... x $15 = $510
Medicaid 20 x 10 = $200
Medicare 20 x 21 = $420
Workers Comp 20 x 22 = $440
Real insurance... 20 xxx = xxx

I left out the numbers, because I have to negaotiate separately with each insurance carrier, and am not allowed to collude with any other group.
But the ASA has stated that Medicare pays about a third of what real insurance pays, so that would come to $1260.

We do not get extra for cases after 5pm, or extra axtra after midnight from any government insurer.
For whatever it's worth, I am pretty sure we make more than your docs in canada, that's why many of them are trying to come here. In Buffalo we have LOTS of ex canadians, as the best will find jobs..... draining the brightest from your system...

So to finish my Obamacare rant, if the government decides to be the single payor, and chooses something it is used to, like the government payors listed, then there will be a mass exodus from my specialty, and no one will put in the 12 years post high school needed.... I am lucky that I am towards the end of my career...
boymimbo
boymimbo
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February 2nd, 2013 at 10:15:09 AM permalink
I hope so, because Canada could certainly use the doctors!
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RonC
RonC
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February 2nd, 2013 at 11:21:53 AM permalink
The doctors who will leave as Obamacare is implemented, along with those who will leave if and when we move to "single payer" most likely won't be moving elsewhere--they'll simply stop providing care and live off of their savings/investments. We'll lose many experienced professionals who just won't want to work any more under these new systems.

I know some of you will say that is okay and that they get too much money anyway but the truth is that they go through 12 or more additional years of schooling after high school without even an assurance they will be successful. They DESERVE to be among the best paid among us based on the expertise obtained through schooling and practice. They don't deserve the huge cuts in payments that will surely come as we move to socialize medicine. Their malpractice insurance will still be a fortune...will anyone care about that?

Oh...and some other bright ones we know get from other countries...well, they will just stay in their own countries and we'll lose another group of excellent physcians.

Can we do better? Sure. Obamacare is not "better"...it is a disaster at every turn.

We could do better with more mid-level providers (at lower rates than doctors but under close supervision), true health insurance competition, and other measures.

Obamacare will be the legacy of this administration...and I predict it won't be a good one!!
boymimbo
boymimbo
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February 2nd, 2013 at 11:34:44 AM permalink
Everyone will get paid less in the race to the bottom. Perhaps lawyers will be next...

The same people who advocate the destruction of unions also advocate for inflated doctor's salaries.

My daughter is likely to try medical school at McGill (at least that's what her plan is). There is absolutely no lack of demand here in Canada for people entering medical school, despite the "very low" salaries that are in Canada and everywhere else in the world.
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SanchoPanza
SanchoPanza
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February 2nd, 2013 at 4:07:29 PM permalink
Quote: AZDuffman

What would you peeps think about a Central American kidney-transplant clinic? Build a smallish hospital and staff it with a few top-line surgeons.


Johns Hopkins already has quite an impressive medical center for medico-tourism in Panama City.
EvenBob
EvenBob
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February 15th, 2013 at 5:20:50 PM permalink
The part of Obamacare for people with pre-existing medical problems
is already running out of money because its far
worse than they estimated. Talk about the tip of the iceberg, wait
till this abomination Obamacare is fully started. The cookie jar is already
empty, they'll be begging for more money every 90 days.

http://www.washingtonpost.com/national/health-science/2013/02/15/cb9d56ac-779c-11e2-8f84-3e4b513b1a13_print.html
It does not suck to be me.
AZDuffman
AZDuffman
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February 15th, 2013 at 6:25:08 PM permalink
Quote: boymimbo



The same people who advocate the destruction of unions also advocate for inflated doctor's salaries.



This is an invalid comparison. Doctors negotiate for their services as individuals offering a service. Unions force workers to join and hand over part of their earnings whether they want to or not to negotiate as a group.
All animals are equal, but some are more equal than others
boymimbo
boymimbo
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February 15th, 2013 at 6:46:29 PM permalink
Hey AZ, where have you been?

Well, 29% of doctors are in the AMA, which is a professional group and represent a powerful lobby in Washington. The number was 75% in the 50s. The fee is $420/year. The goal of the AMA was to limit doctors in order to keep its supply low and its wages high.

When you get an offer of employment, you know that you will be joining a union and will be subject to its fees and regulations. You have the choice to work in this environment. Some people do well in unions and others don't. In Hamilton, Ontario (where I was born), the city was basically a two company town: Stelco (unionized) and Dofasco (non-unionized). While local 1005 drove up wages and benefits for all workers in the city, its propensity for striking was crippling to the industry in the town.

The American middle class was born thanks to the union and high-paying manufacturing jobs. With globalization and the world-wide pressure to reduce prices everywhere, unions are quickly becoming the evil scourge on the way to the lowest common denominator. All that does is increase the burdens on everyone else.
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EvenBob
EvenBob
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February 15th, 2013 at 7:09:52 PM permalink
Quote: boymimbo



The American middle class was born thanks to the union and high-paying manufacturing jobs. .



The lower middle class. The actual middle class was
born after WWII with the GI Bill. Unprecedented
numbers of young men went to college to get better
jobs. Before WWII, people went to school to get a
rounded education. After the war, colleges became
businesses and the white collar middle class was born.
It does not suck to be me.
AZDuffman
AZDuffman
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February 15th, 2013 at 7:13:29 PM permalink
Quote: boymimbo

Hey AZ, where have you been?



Remodeling my house, trying for some comps on myvegas, and building a website of sorts.

Quote:

Well, 29% of doctors are in the AMA, which is a professional group and represent a powerful lobby in Washington. The number was 75% in the 50s. The fee is $420/year. The goal of the AMA was to limit doctors in order to keep its supply low and its wages high.



Lots of professionals are in associations. As a notary I am in one. Associations do not force payment of dues nor require membership as a condition of employment. If a doctor is in the AMA and they lobby for Obamacare he can leave. If an autoworker does not want his dues to go for lobbying for Obamacare he has to quit his job.


Quote:

The American middle class was born thanks to the union and high-paying manufacturing jobs. With globalization and the world-wide pressure to reduce prices everywhere, unions are quickly becoming the evil scourge on the way to the lowest common denominator. All that does is increase the burdens on everyone else.



This is only partially correct. Henry Ford doubled wages as a union-free shop. The problem is unions are no longer about trying to improve standards for their workers, they are about pushing a liberal agenda on the nation and they have become socialists. Way back unions knew their employer had to be competitive for them to thrive as well.

A union leader with common sense would never support Obamacare as it takes away a selling proposition of his union, namely the union will try to get you better medical insurance. Obamacare, as a route to a single-payer system, means why pay dues?

I worked under a union. All it meant was you had to "wait your turn" for a promotion and the lazy slob you worked with never got fired.
All animals are equal, but some are more equal than others
EvenBob
EvenBob
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February 15th, 2013 at 7:53:54 PM permalink
Quote: AZDuffman

they are about pushing a liberal agenda on the nation and they have become socialists. .



They haven't become socialists, they've been socialists
from the gitgo. The UNION of Soviet SOCIALIST Republics,
the old USSR, was all unions. US unions have always been
suspected of having commie ties, and still are. A union
movement is always a communist movement, to take away
a workers individuality and make part of the invisible whole.
It does not suck to be me.
DigitalTim
DigitalTim
Joined: Apr 20, 2010
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February 15th, 2013 at 8:07:16 PM permalink
Quote: EvenBob

So if medicine is so much better everywhere else,
why do those that can affod it choose to come
here for treatment? Let me ask, if you had a
serious heart problem, or needed a kidney
transplant, and you had money, what country
would you go to for the best treatment, if most
places are better than the US.



boymimbo, please excuse EvenBob. Your post was well thought out and thought provoking.
boymimbo
boymimbo
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February 15th, 2013 at 9:34:28 PM permalink
AZ, I think you're generalizing unions. However, the world climate is significantly different than it was 20-30 years. Many, many unions have given up major concessions in order to keep business afloat. Airlines come first to mind. For manufacturing, global markets do it cheaper and faster than the American counterparts. This gives manufacturers the ability to simply close up shop or to put major demands on unions to cut costs. And of course, working in groups in order to get the best deal for the collective is in the best interest of the employees.

I suppose manufacturers and governments can continue to crash unions and pay its employee whatever its market is. For oligarphies like airlines, governments, and segregated manufacturers, I guess they can set the market to oh, say $10/hr. All of a sudden you have a segment of society who instead of making $50K / year is now making $20K, and collecting food stamps to boot. They lose their home, and then people are complaining about why their neighbourhoods are going to shit.

Besides government who get COLA raises (if that), I'm trying to think of unions who have been receiving better beneifts and wages over the last 10 years and I can't find an example. Unions are giving up concessions all of the time for their employers, including bloated pensions. Sometimes, they strike and try to make a stand, to everyone's temporary detriment.

As for the union's activities of lobbying for Obamacare and all of the other activities that you might object to with your money, we deal with that every day. We pay taxes for things we don't want to. We give money to a church who we might agree with 80% of the time. I don't command the salary that I should because my executive is very greedy. We all make choices when we choose our career, including whether our employer is a union shop or not. People who go to work in a union shop know that some of their dues are supporting things that they may not agree with and the flipside of that is generally, the union will have your back. Oh well. Guess what -- we live in a society, and we are going to make choices and contributions for the greater good.

It's called giving people a living wage in order to give them a chance. There are people in society who just don't have the mindset to make $60 - 70 - 80K / year. They graduate high school and go right into manufacturing, because hey, they're the 50% of society who aren't smart enough for college, or they have demands on their life that prevent them from going to school. Or they go and serve their country in the military for a few years.

I worked for a few unions in my time too and didn't like it, because it stymied my career growth. But for the people who were 50+ years old and have been working in the same office for 20+ years, better to pay them $35 - $40K so that they can raise their kids, put some decent clothes on them and put them through college than to decertify, give the jobs to youngin's at $25K and throw the older workers on the street. There's a place for unions, and it ain't really for liberatarians.
----- You want the truth! You can't handle the truth!

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