Making Baby Jesus Cry

[taxwonk]

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.

I wasn't trying to minimize what you, or RT, or any of the healthcare or ERISA people on the boards do. I'm just saying that to the extent there is regulation for people not on Medicare, it's not there to help protect their ability to get affordable health care and it doesn't keep the health care industry from raping some people to make for what they get under regulated programs.

[Shape Shifter]

Originally posted by Buck
Feed me!

In consideration, here is historical tale that the deer of your wood have handed down from generation to generation. We think you will like and in return you will give us a salt lick or something.

TODAY'S HISTORY LESSON:

The two most important events in all of history were the invention of beer and the invention of the wheel. The wheel was invented to get man to the beer. These were the foundations of modem civilization and together were the catalyst for the splitting of humanity into two distinct subgroups: Liberals and Conservatives.

Once beer was discovered, it required grain, and that was the beginning of agriculture. Neither the glass bottle nor aluminum can were invented yet, so our early human ancestors just stayed close to the brewery .That's how villages were formed.

Some men spent their days tracking and killing animals to BBQ at night while they were drinking beer. This was the beginning of what is known as the "Conservative movement."

Other men who were weaker and less skilled at hunting learned to live off the conservatives by showing up for the nightly BBQ's and doing the sewing, weaving and hair dressing. This was the beginning of "the Liberal movement." Some of these liberal men eventually evolved into women. The rest became known as 'girleymen'.

Some noteworthy liberal achievements include the domestication of cats, the trade union, class action lawsuits, the invention of group therapy & group hugs and the concept of democratic voting to decide how to divide the meat and beer that conservatives provided.

Over the years conservatives came to be symbolized by the largest, most powerful land animal on earth, the elephant. Liberals are symbolized by the jackass.

Modern liberals like beer with lime added, but most prefer white wine or imported bottled water. They eat raw fish but like their beef well done. Sushi, tofu and French food are standard liberal fare. Another interesting evolutionary side note: most of their women had higher testosterone levels than their men. Most social workers, personal injury attorneys, journalists, hairdressers, dreamers in Hollywood and group therapists are liberals. Also, Liberals invented baseball's designated hitter rule because it wasn't "fair" to make the pitcher also bat.

Conservatives drink domestic beer and eat red meat & potatoes. Conservatives are big-game hunters, rodeo cowboys, lumberjacks, construction workers, medical doctors, police officers, corporate executives, soldiers, self-employed, athletes & generally anyone who works productively outside government. Conservatives who own companies hire other conservatives who want to work for a living.

Liberals produce little or nothing. They like to "govern" the producers and decide what to do with the production. They also like to take money away from successful people and give it to the failures. Liberals believe Europeans are more enlightened than Americans. That is why most of the liberals remained in Europe when conservatives were coming to America. They crept in after the Wild West was tame & created a business of trying to get MORE for nothing.

Thus ends today's lesson in world history.

This shouldn't be a politics sock.

[ltl/fb]

Originally posted by taxwonk
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.

You are on crack, nttawwt. All you are saying is no price regulation. How many industries have price regulation?

Good god, man. Was it a head injury? Was it really an emergency? Employer health insurance seems like it customarily doesn't place the same restrictions on actual emergency stuff b/c they know you have less of a choice (e.g., I am not sure you have to go to in-network hospitals etc.) -- but I'm not in IL and I don't know what kind of plan you have and I'm not sure you have a group policy.

Anyway. No price regulation does not equal no regulation.

[Hank Chinaski]

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.

you might know. Is there beef mortadella? Tofu-based? were these christian Palistinians?

[Hank Chinaski]

Originally posted by Shape Shifter
This shouldn't be a politics sock.

2. but I really thought there was no need for the "spanky based" socks at all. Spank board was built on straightforward and simple questions and answers, non-veiled observations. Why sock there?

[Replaced_Texan]

Originally posted by taxwonk

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

There are state and federal oversight agencies. There are state licensure agencies. There's EMTALA. There's HIPAA. There's JACHO. There are IRBs. There are ethics committees. There are requirements for peer review under the HCQA. There's the NPDB. There is Stark I. There is Stark II. There is the anti-remuneration statute. There are IRS rules regarding private inurement. There's the FTC and Justice Department enforcement of antitrust rules. There's the DHHS OIG. There's OHRP. There's the FDA and the DEA.

There is PLENTY of regulation for the average person.

[Hank Chinaski]

ERISA- yo fringey I need you now.

Aged auntie has supplemental medical though hubby's pension. Hubby dies and there is a 1 year window for her to switch to herself. she neglects to do so. She could have had supplemental through her employer but elected to just use hubby's. she has been retired for 15 years.

Can she get hubby's reinstated or can she get her's started. I know you have to "read the plan" but is there any real chance?

[Porkchop]

Originally posted by Hank Chinaski
2. but I really thought there was no need for the "spanky based" socks at all. Spank board was built on straightforward and simple questions and answers, non-veiled observations. Why sock there?

Sometimes I just can't help it.

[notcasesensitive]

Originally posted by Hank Chinaski
ERISA- yo fringey I need you now.

Aged auntie has supplemental medical though hubby's pension. Hubby dies and there is a 1 year window for her to switch to herself. she neglects to do so. She could have had supplemental through her employer but elected to just use hubby's. she has been retired for 15 years.

Can she get hubby's reinstated or can she get her's started. I know you have to "read the plan" but is there any real chance?

Shouldn't this query be on the ERISA board?

[Penske_Account]

Originally posted by Replaced_Texan


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 was going to say the same, but I STP'd. Healthcare could scarcely be more regulated. The economic basis as set by CMS is very anti-market. When essentially the providers of about 75% of the long term care beds in the country go into Chapter 11 based in large part on one legislative amendment, I'd say there is a regulatory issue.

[Penske_Account]

Originally posted by taxwonk
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.


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

You are wrong, almost all pricing in healthcare (except pricing which occurs on a private pay basis outside of third party insurance which is a very small portion of the market limited to upper income consumers) is based on CMS promulgated rates.

[Hank Chinaski]

Originally posted by notcasesensitive
Shouldn't this query be on the ERISA board?

I am merely trying to ensure movement away from the CAFTA posts. Normally I would not try and generate ERISA/Tax posts, but much like forest fire fighters may start a back fire to end a main fire, I felt it prudent.

[Penske_Account]

Originally posted by Shape Shifter
This shouldn't be a politics sock.

2. Next time I delete.

[Penske_Account]

Originally posted by ltl/fb
You are on crack, nttawwt. All you are saying is no price regulation. How many industries have price regulation?

Good god, man. Was it a head injury? Was it really an emergency? Employer health insurance seems like it customarily doesn't place the same restrictions on actual emergency stuff b/c they know you have less of a choice (e.g., I am not sure you have to go to in-network hospitals etc.) -- but I'm not in IL and I don't know what kind of plan you have and I'm not sure you have a group policy.

Anyway. No price regulation does not equal no regulation.

There is essentially price regulation. Otherwise I agree with you.

How irritating am I now?

[sgtclub]

Originally posted by ltl/fb
You are on crack, nttawwt. All you are saying is no price regulation. How many industries have price regulation?

2