Making Baby Jesus Cry

[Mmmm, Burger (C.J.)]

Originally posted by Tyrone Slothrop
We ration care now, using markets.

what markets? because the payor and the consumer aren't usually the same person. It's like a giant summer program for health care spending--yeah, i'll have an appetizer, surf n turf, and dessert. not my dime.

[Mmmm, Burger (C.J.)]

Originally posted by taxwonk
Rationing care on what basis? It's hard to seriously consider the idea in the abstract.

Age and desert.

[taxwonk]

Originally posted by Penske_Account
Overregulation of pricing by the government has introduced a host of inefficiencies which has contaminated the market. The government should get out but for the social safety net.

Health care is one of the more unregulated areas of commerce in the entire economy. The McCann Act keeps the federal government from regulating insurance. The insurance companies pay the state legislators generously to keep out of their cesspool. The only area where there is regulation is in Medicare and, to a lesser extent, Medicaid. These are both relatively small segments of the market.

[taxwonk]

Originally posted by Hank Chinaski

• Heat dashes Palestinian quest for longest sandwich
  
  
  Palestinians abandoned a quest to build the world's longest sandwich on Wednesday after health officials told them their 750-meter construction risked rotting in the West Bank summer sun.
  
  Hundreds of volunteers spread a 750-meter bun on tables along a dusty roadside in the West Bank city of Jenin, long a hotspot of Israeli-Palestinian violence.
  
  But the attempt was called off for health reasons before volunteers got a chance to add 180 kg of mortadella meat, 350 kg of tomatoes and 250 kg of green peppers.
  
  Organizers had planned to serve the sandwich to the poor, and said they were aiming to beat a record set in Portugal in 2004 for a 634-meter sandwich.
  
  "We were planning to add the mortadella and stuffing at the last minute to rule out any possibility of rotting," chef Ahmed Nazzal told Reuters. "There must be a conspiracy against us by other competitors."

Nice try, but mortadella is made from pork.

[taxwonk]

Originally posted by Mmmm, Burger (C.J.)
Age and desert.

So if you're over 70 and live in Moab or Death Valley, you're fucked?

[sgtclub]

Originally posted by Hank Chinaski

• Heat dashes Palestinian quest for longest sandwich
  
  
  Palestinians abandoned a quest to build the world's longest sandwich on Wednesday after health officials told them their 750-meter construction risked rotting in the West Bank summer sun.
  
  Hundreds of volunteers spread a 750-meter bun on tables along a dusty roadside in the West Bank city of Jenin, long a hotspot of Israeli-Palestinian violence.
  
  But the attempt was called off for health reasons before volunteers got a chance to add 180 kg of mortadella meat, 350 kg of tomatoes and 250 kg of green peppers.
  
  Organizers had planned to serve the sandwich to the poor, and said they were aiming to beat a record set in Portugal in 2004 for a 634-meter sandwich.
  
  "We were planning to add the mortadella and stuffing at the last minute to rule out any possibility of rotting," chef Ahmed Nazzal told Reuters. "There must be a conspiracy against us by other competitors."

Must have been the Jews fault.

[sgtclub]

Originally posted by taxwonk
Health care is one of the more unregulated areas of commerce in the entire economy. The McCann Act keeps the federal government from regulating insurance. The insurance companies pay the state legislators generously to keep out of their cesspool. The only area where there is regulation is in Medicare and, to a lesser extent, Medicaid. These are both relatively small segments of the market.

Are you kidding me? You honestly believe that 50 regulators, rather than 1, is less regulation?

Incidentally, this is one area where I'd be in favor a federal system, precisely for the inefficiencies that are inherent in serving 50 masters.

[Mmmm, Burger (C.J.)]

Originally posted by sgtclub
Are you kidding me? You honestly believe that 50 regulators, rather than 1, is less regulation?

Incidentally, this is one area where I'd be in favor a federal system, precisely for the inefficiencies that are inherent in serving 50 masters.

Chances are good you'll see that in the next couple of years. There's a lot of movement in Congress to revise McCarran-Ferguson (I think that's what wonk was talking about) to make regulation federal, rather than state. Probably the biggest objection will come from all the state insurance regulators who have been feeding at the trough lo these many years.

[Replaced_Texan]

Originally posted by taxwonk
Health care is one of the more unregulated areas of commerce in the entire economy.

I think I'm out of a job, then.

The only area where there is regulation is in Medicare and, to a lesser extent, Medicaid. These are both relatively small segments of the market.

You're kidding, right? Medicare is the largest purchaser of healthcare in the country. Almost every single insurance company bases its reimbursement rates off of RBRVS. Every single hospital in the country seeks JACHO accreditation because they'd lose their Medicare dollars if they didn't. The Medicare cost report is one of the single most important financing tools for hospitals in the country.

[ltl/fb]

Originally posted by Replaced_Texan
I think I'm out of a job, then.

And I'm back into willing to work in that area . . .

[taxwonk]

Originally posted by Mmmm, Burger (C.J.)
Chances are good you'll see that in the next couple of years. There's a lot of movement in Congress to revise McCarran-Ferguson (I think that's what wonk was talking about) to make regulation federal, rather than state. Probably the biggest objection will come from all the state insurance regulators who have been feeding at the trough lo these many years.

Yep, that's the act I was talking about.

And for Club, the "feeding at the trough" Burger's speaking of here is what has kept the 50 states from actually regulating the industry in any meaningful way.

[notcasesensitive]

Originally posted by Spanky
Instead of torturing us with your pithy comments why don't you just ask NCS out. All she can say is no. From my limited experience with here she seems very direct, confident, and therefore, won't lead you along. You will know right away exactly where you stand. What have you got to lose?

Whoa. It is like a lawtalkers dating service here. Thanks for the action, Spanky. Maybe I'll get some Nuts! out of this endeavor.

[ltl/fb]

Originally posted by taxwonk
Yep, that's the act I was talking about.

And for Club, the "feeding at the trough" Burger's speaking of here is what has kept the 50 states from actually regulating the industry in any meaningful way.

Just because they aren't regulating the industry in any meaningful way doesn't mean that there aren't a ton of regulatory hoops to jump through -- it just may be that the hoops are more to keep competition and oversight and liability away from the insurance companies.

Though, actually, I think we self-insure almost everything except maybe life and some supplemental stuff, so I'm not that concerned -- mostly have to deal with federal stuff. And, like, HIPAA. Which is a piece of cake, right? Easy as pie?

God I'm hungry.

[Replaced_Texan]

Originally posted by ltl/fb
Just because they aren't regulating the industry in any meaningful way doesn't mean that there aren't a ton of regulatory hoops to jump through -- it just may be that the hoops are more to keep competition and oversight and liability away from the insurance companies.

Though, actually, I think we self-insure almost everything except maybe life and some supplemental stuff, so I'm not that concerned -- mostly have to deal with federal stuff. And, like, HIPAA. Which is a piece of cake, right? Easy as pie?

God I'm hungry.

Right, and and the ERISA preemption prevents across the board regulation by the states for anyone who decides to self-insure.

[taxwonk]

Originally posted by Replaced_Texan
I think I'm out of a job, then.



You're kidding, right? Medicare is the largest purchaser of healthcare in the country. Almost every single insurance company bases its reimbursement rates off of RBRVS. Every single hospital in the country seeks JACHO accreditation because they'd lose their Medicare dollars if they didn't. The Medicare cost report is one of the single most important financing tools for hospitals in the country.

I wasn't kidding, so much a vastly oversimplifying. Medicare regulations are extensive, but they serve a relatively small segment of the population. For everyone else, there are no real price controls.

Insurance companies may base their rates off of Medicare, but providers are free to charge more, and individual consumers of healthcare have little bargaining power to change that.

Case in point, I just recently got a bill for $5000 from the ER physician relating to a June trip to the hospital. The basis for the bill was that the doc wasn't part of my insurance company's network, therefore, I was responsible for out-of-network charges.

Recourse for me? None. The insurance company denied my request for a review. The doc was unsympathetic to my arguments that I was unable to choose a network doc for ER care. In fact, his office manager told me that almost no ER docs in my part of the country belong to any insurance networks because they can charge more by not joining.

That's what I meant by no real regulation for the average person.