Can someone explain why democrats think

[Obamanation]

...and you dems can (and do) put money in the Caymans too...

You want to put your savings overseas? Go right ahead...

I would suggest that everyone that can profit by the Republican tax tactics legally do so. Laws passed to help the rich should be used by all that can use them, but most Americans realize they are not written for the riff-raff but for the Romneys. They are the rewards for those substantial campaign super-pac contributions.

What law was passed to help the rich? Don't you put your money in a tax shelter for retirement? Now that is a law that was passed! ...ironically, to help the common man.

No law was passed to help the rich... again, anyone can put their savings in any bank that will take their money... there is nothing wrong with that. dems do it republicans do it. rich do it, middle class does it, and the poor would too if they had any savings to do it with.

There is NOTHING WRONG WITH IT! lefty hate is the issue here...

 

[Bfgrn]

...and you dems can (and do) put money in the Caymans too...

You want to put your savings overseas? Go right ahead...

I would suggest that everyone that can profit by the Republican tax tactics legally do so. Laws passed to help the rich should be used by all that can use them, but most Americans realize they are not written for the riff-raff but for the Romneys. They are the rewards for those substantial campaign super-pac contributions.

What law was passed to help the rich? Don't you put your money in a tax shelter for retirement? Now that is a law that was passed! ...ironically, to help the common man.

No law was passed to help the rich... again, anyone can put their savings in any bank that will take their money... there is nothing wrong with that. dems do it republicans do it. rich do it, middle class does it, and the poor would too if they had any savings to do it with.

There is NOTHING WRONG WITH IT! lefty hate is the issue here...

Retirement plans are "tax-deferred". Some tax shelters are questionable or even illegal. They are a way of avoiding paying taxes.

 

[Obamanation]

I would suggest that everyone that can profit by the Republican tax tactics legally do so. Laws passed to help the rich should be used by all that can use them, but most Americans realize they are not written for the riff-raff but for the Romneys. They are the rewards for those substantial campaign super-pac contributions.

What law was passed to help the rich? Don't you put your money in a tax shelter for retirement? Now that is a law that was passed! ...ironically, to help the common man.

No law was passed to help the rich... again, anyone can put their savings in any bank that will take their money... there is nothing wrong with that. dems do it republicans do it. rich do it, middle class does it, and the poor would too if they had any savings to do it with.

There is NOTHING WRONG WITH IT! lefty hate is the issue here...

Retirement plans are "tax-deferred". Some tax shelters are questionable or even illegal. They are a way of avoiding paying taxes.

Everyone should do everything they can to legally keep as much money of theirs as possible. NOBODY ever looks for ways to give the backaszward gov't more of their money that would be retarded!!

This is why all libs are hypocrites --- they don't give the gov't more of their money than they have to either....

Taxation should be kept to a minimum. That way we all have more our our money in our own pockets!! We can make our own choices on how we wish to spend it. We don;t need the gov't to spend our money for us! They do a horrible job of spending our money and we should strive to control their spending at every turn!

 

[Bfgrn]

What law was passed to help the rich? Don't you put your money in a tax shelter for retirement? Now that is a law that was passed! ...ironically, to help the common man.

No law was passed to help the rich... again, anyone can put their savings in any bank that will take their money... there is nothing wrong with that. dems do it republicans do it. rich do it, middle class does it, and the poor would too if they had any savings to do it with.

There is NOTHING WRONG WITH IT! lefty hate is the issue here...

Retirement plans are "tax-deferred". Some tax shelters are questionable or even illegal. They are a way of avoiding paying taxes.

Everyone should do everything they can to legally keep as much money of theirs as possible. NOBODY ever looks for ways to give the backaszward gov't more of their money that would be retarded!!

This is why all libs are hypocrites --- they don't give the gov't more of their money than they have to either....

Taxation should be kept to a minimum. That way we all have more our our money in our own pockets!! We can make our own choices on how we wish to spend it. We don;t need the gov't to spend our money for us! They do a horrible job of spending our money and we should strive to control their spending at every turn!

Taxes should be kept at a minimum, BUT, not at the expense of vital social programs like Medicare. And government runs Medicare MORE efficiently and MORE cost effectively than private insurance corporations run health insurance.

 

[Obamanation]

Retirement plans are "tax-deferred". Some tax shelters are questionable or even illegal. They are a way of avoiding paying taxes.

Everyone should do everything they can to legally keep as much money of theirs as possible. NOBODY ever looks for ways to give the backaszward gov't more of their money that would be retarded!!

This is why all libs are hypocrites --- they don't give the gov't more of their money than they have to either....

Taxation should be kept to a minimum. That way we all have more our our money in our own pockets!! We can make our own choices on how we wish to spend it. We don;t need the gov't to spend our money for us! They do a horrible job of spending our money and we should strive to control their spending at every turn!

Taxes should be kept at a minimum, BUT, not at the expense of vital social programs like Medicare. And government runs Medicare MORE efficiently and MORE cost effectively than private insurance corporations run health insurance.

That is because medicare only serves a small percentage of the population. Decreased reimbursements in medicare have caused physicians to being to NOT ACCEPT medicare whenever plausable. Doctors, when balancing reimbursement and overhead, have found that they can not make enough money to justify seeing medicare patients.

We are already seeing the effect in rural areas where communities can't keep enough doctors around because there isn't enough money. When you exacerbate the broblem with more gov't control over healthcare the problem will grow exponentially. There are already fewer people seeking medical degree's and the best physicians in the field are retiring or leaving traditional private practice in search of ways to replace the money they can't make because of gov't involvement.

In 20 years we will have a doctor shoratage that can only be filled by subsituting PAs, and nurse practitioners --- thereby diluting the quality of care.

 

[Bfgrn]

Everyone should do everything they can to legally keep as much money of theirs as possible. NOBODY ever looks for ways to give the backaszward gov't more of their money that would be retarded!!

This is why all libs are hypocrites --- they don't give the gov't more of their money than they have to either....

Taxation should be kept to a minimum. That way we all have more our our money in our own pockets!! We can make our own choices on how we wish to spend it. We don;t need the gov't to spend our money for us! They do a horrible job of spending our money and we should strive to control their spending at every turn!

Taxes should be kept at a minimum, BUT, not at the expense of vital social programs like Medicare. And government runs Medicare MORE efficiently and MORE cost effectively than private insurance corporations run health insurance.

That is because medicare only serves a small percentage of the population. Decreased reimbursements in medicare have caused physicians to being to NOT ACCEPT medicare whenever plausable. Doctors, when balancing reimbursement and overhead, have found that they can not make enough money to justify seeing medicare patients.

We are already seeing the effect in rural areas where communities can't keep enough doctors around because there isn't enough money. When you exacerbate the broblem with more gov't control over healthcare the problem will grow exponentially. There are already fewer people seeking medical degree's and the best physicians in the field are retiring or leaving traditional private practice in search of ways to replace the money they can't make because of gov't involvement.

In 20 years we will have a doctor shoratage that can only be filled by subsituting PAs, and nurse practitioners --- thereby diluting the quality of care.

Bullshit. The insurance cartels pay doctors at about the same reimbursement scale as Medicare. But the government won't send out phoney bills that soak the patient above and beyond what the real COST of the treatment, test, procedure is.

You clearly don't have a clue what the real world is all about. You must believe in fairies. I don't have the time or energy to educate you. So...

Start your education here> Health Insurance: More Tricks of the Trade By David Belk M.D.

 

[Obamanation]

Taxes should be kept at a minimum, BUT, not at the expense of vital social programs like Medicare. And government runs Medicare MORE efficiently and MORE cost effectively than private insurance corporations run health insurance.

That is because medicare only serves a small percentage of the population. Decreased reimbursements in medicare have caused physicians to being to NOT ACCEPT medicare whenever plausable. Doctors, when balancing reimbursement and overhead, have found that they can not make enough money to justify seeing medicare patients.

We are already seeing the effect in rural areas where communities can't keep enough doctors around because there isn't enough money. When you exacerbate the broblem with more gov't control over healthcare the problem will grow exponentially. There are already fewer people seeking medical degree's and the best physicians in the field are retiring or leaving traditional private practice in search of ways to replace the money they can't make because of gov't involvement.

In 20 years we will have a doctor shoratage that can only be filled by subsituting PAs, and nurse practitioners --- thereby diluting the quality of care.

Bullshit. The insurance cartels pay doctors at about the same reimbursement scale as Medicare. But the government won't send out phoney bills that soak the patient above and beyond what the real COST of the treatment, test, procedure is.

You clearly don't have a clue what the real world is all about. You must believe in fairies. I don't have the time or energy to educate you. So...

Start your education here> Health Insurance: More Tricks of the Trade By David Belk M.D.

Actually, I have had this conversation with more than 20 doctors... Pretty sure you are the one in the dark here.

Tell me why then, so many doctors are not accepting medicare anymore!

Tell me why enrollment for medical school is down!

Tell me why I hear docs tell me that they are urging their children away from the medical field!

tell me why your only response to reason and truth is denial!!!!

 

[LoneLaugher]

That is because medicare only serves a small percentage of the population. Decreased reimbursements in medicare have caused physicians to being to NOT ACCEPT medicare whenever plausable. Doctors, when balancing reimbursement and overhead, have found that they can not make enough money to justify seeing medicare patients.

We are already seeing the effect in rural areas where communities can't keep enough doctors around because there isn't enough money. When you exacerbate the broblem with more gov't control over healthcare the problem will grow exponentially. There are already fewer people seeking medical degree's and the best physicians in the field are retiring or leaving traditional private practice in search of ways to replace the money they can't make because of gov't involvement.

In 20 years we will have a doctor shoratage that can only be filled by subsituting PAs, and nurse practitioners --- thereby diluting the quality of care.

Bullshit. The insurance cartels pay doctors at about the same reimbursement scale as Medicare. But the government won't send out phoney bills that soak the patient above and beyond what the real COST of the treatment, test, procedure is.

You clearly don't have a clue what the real world is all about. You must believe in fairies. I don't have the time or energy to educate you. So...

Start your education here> Health Insurance: More Tricks of the Trade By David Belk M.D.

Actually, I have had this conversation with more than 20 doctors... Pretty sure you are the one in the dark here.

Tell me why then, so many doctors are not accepting medicare anymore!

Tell me why enrollment for medical school is down!

Tell me why I hear docs tell me that they are urging their children away from the medical field!

tell me why your only response to reason and truth is denial!!!!

When are you going to stop lying?

 

[Obamanation]

Bullshit. The insurance cartels pay doctors at about the same reimbursement scale as Medicare. But the government won't send out phoney bills that soak the patient above and beyond what the real COST of the treatment, test, procedure is.

You clearly don't have a clue what the real world is all about. You must believe in fairies. I don't have the time or energy to educate you. So...

Start your education here> Health Insurance: More Tricks of the Trade By David Belk M.D.

Actually, I have had this conversation with more than 20 doctors... Pretty sure you are the one in the dark here.

Tell me why then, so many doctors are not accepting medicare anymore!

Tell me why enrollment for medical school is down!

Tell me why I hear docs tell me that they are urging their children away from the medical field!

tell me why your only response to reason and truth is denial!!!!

When are you going to stop lying?

...and what am I lying about?

 

[Ravi]

That is because medicare only serves a small percentage of the population. Decreased reimbursements in medicare have caused physicians to being to NOT ACCEPT medicare whenever plausable. Doctors, when balancing reimbursement and overhead, have found that they can not make enough money to justify seeing medicare patients.

We are already seeing the effect in rural areas where communities can't keep enough doctors around because there isn't enough money. When you exacerbate the broblem with more gov't control over healthcare the problem will grow exponentially. There are already fewer people seeking medical degree's and the best physicians in the field are retiring or leaving traditional private practice in search of ways to replace the money they can't make because of gov't involvement.

In 20 years we will have a doctor shoratage that can only be filled by subsituting PAs, and nurse practitioners --- thereby diluting the quality of care.

Bullshit. The insurance cartels pay doctors at about the same reimbursement scale as Medicare. But the government won't send out phoney bills that soak the patient above and beyond what the real COST of the treatment, test, procedure is.

You clearly don't have a clue what the real world is all about. You must believe in fairies. I don't have the time or energy to educate you. So...

Start your education here> Health Insurance: More Tricks of the Trade By David Belk M.D.

Actually, I have had this conversation with more than 20 doctors... Pretty sure you are the one in the dark here.

Tell me why then, so many doctors are not accepting medicare anymore!

Tell me why enrollment for medical school is down!

Tell me why I hear docs tell me that they are urging their children away from the medical field!

tell me why your only response to reason and truth is denial!!!!

Tell me why, in all your posts on this board, you have never posted an idea of your own but have merely posted rightwing talking points.

 

[Bfgrn]

That is because medicare only serves a small percentage of the population. Decreased reimbursements in medicare have caused physicians to being to NOT ACCEPT medicare whenever plausable. Doctors, when balancing reimbursement and overhead, have found that they can not make enough money to justify seeing medicare patients.

We are already seeing the effect in rural areas where communities can't keep enough doctors around because there isn't enough money. When you exacerbate the broblem with more gov't control over healthcare the problem will grow exponentially. There are already fewer people seeking medical degree's and the best physicians in the field are retiring or leaving traditional private practice in search of ways to replace the money they can't make because of gov't involvement.

In 20 years we will have a doctor shoratage that can only be filled by subsituting PAs, and nurse practitioners --- thereby diluting the quality of care.

Bullshit. The insurance cartels pay doctors at about the same reimbursement scale as Medicare. But the government won't send out phoney bills that soak the patient above and beyond what the real COST of the treatment, test, procedure is.

You clearly don't have a clue what the real world is all about. You must believe in fairies. I don't have the time or energy to educate you. So...

Start your education here> Health Insurance: More Tricks of the Trade By David Belk M.D.

Actually, I have had this conversation with more than 20 doctors... Pretty sure you are the one in the dark here.

Tell me why then, so many doctors are not accepting medicare anymore!

Tell me why enrollment for medical school is down!

Tell me why I hear docs tell me that they are urging their children away from the medical field!

tell me why your only response to reason and truth is denial!!!!

1) Ask your '20 doctors' if they know who sets the reimbursement rates for Medicare?

What Every Physician Should Know About the RUC

2) I already answered this question.

3) You are full of SHIT.

Medicine Remains Attractive Career as Enrollment Reach All-Time High
AAMC Reporter: November 2011


Reimbursement rates

Blood tests:

Comprehensive metabolic panel: A blood test that assesses liver and kidney function as well as electrolytes

Hospital charge: $179 Private insurance: $15 Medicare: $15

Lipid Panel: A blood test that checks total cholesterol and breaks it down to good and bad components.

Hospital charge: $68 Private insurance: $19 Medicare: $19

Complete Blood Count: A blood test that checks your hemoglobin, hematocrit, white blood counts.

Hospital charge: $51 Private insurance: $11 Medicare: $11

Urine Analysis: Looks for blood, signs of infection or protein in your urine.

Hospital charge: $92 Private insurance: $5 Medicare: $4

Hemoglobin A1C: A single blood test that checks your average blood sugar for the last 3 months.

Hospital charge: $61 Private insurance: $14 Medicare: $13

Thyroid Stimulating Hormone: A blood test that evaluates your thyroid function.

Hospital charge: $108 Private insurance: $24 Medicare: $23

Prothrombin Time: A blood test to check Coumadin level and your blood’s ability to clot

Hospital charge: $36 Private insurance: $6 Medicare: $6

PSA: A blood test that helps to check for prostate cancer.

Hospital charge: $117 Private insurance: $26 Medicare: $22

HIV: Tests for HIV (obviously).

Hospital charge: $92 Private insurance: $20 Medicare: $19

Cardiology:

EKG: A screening test for abnormal heart rhythms and other signs of heart disease.

Hospital charge: $367 Private insurance: $26 Medicare: $26

Echocardiogram: An ultrasound of the heart to look at valves and assess function.

Hospital charge: $4,361 Private insurance: $317 Medicare: $291

Exercise Stress Test: This test is good for evaluating chest pain to see if your heart is the cause.

Hospital charge: $1,182 Private insurance: $123 Medicare: $123

Radiology: (Price includes fee for Radiologist)

Chest X-Ray: To check for lung disease and some forms of heart disease.

Hospital charge: $375 Private insurance: $42 Medicare: $41

Mammogram: Screening test for breast cancer

Hospital charge: $336 Private insurance: $191 Medicare: $146

Ultrasound of the Abdomen: Can assess Kidneys, Liver, Gall Bladder and other organs.

Hospital charge: $1,440 Private insurance: $184 Medicare: $181

Ultrasound of the Pelvis: Images the Uterus and Ovaries

Hospital charge: $1,106 Private insurance: $170 Medicare: $169

CT of Head: Often used to look for lesions in the Brain.

Hospital charge: $2,621 Private insurance: $344 Medicare: $269

CT of Chest with IV Contrast: Can accurately evaluate lung disease and other problem in the chest.

Hospital charge: $5,295 Private insurance: $431 Medicare: $426

CT of Abdomen with IV Contrast: Accurately images the abdomen for tumors or other disease

Hospital charge: $5,680 Private insurance: $463 Medicare: $458

CT of Pelvis with IV Contrast: Often done at the same time as the abdominal CT.

Hospital charge: $5,030 Private insurance: $408 Medicare: $403

MRI of the Brain: A more accurate way to image the brain than a CT scan but it’s more expensive and can’t be done as quickly or easily.

Hospital charge: $3,422 Private insurance: $578 Medicare: $654

MRI of the Cervical Spine: Accurately images the neck

Hospital charge: $3,041 Private insurance: $584 Medicare: $587

MRI of the Thoracic Spine: Accurately images the upper back

Hospital charge: $3,422 Private insurance: $584 Medicare: $596

MRI of the Lumbar Spine: Accurately images the lower back.

Hospital charge: $3,535 Private insurance: $577 Medicare: $588

Procedures: (Usually these procedures are done in an office not a hospital. The amount billed varies substantially for different medical groups but it usually ranges from $1,000 to $8,000 for each).

Colonoscopy, Diagnostic: A screening test for colon cancer where the entire colon is examined through a fiber optic tube.

Private insurance: $504 Medicare: $464

Colonoscopy with Biopsy: If a lesion is found on screening colonoscopy a biopsy is needed.

Private insurance: $603 Medicare: $555

Upper endoscopy with Biopsy: Evaluates problems in the esophagus and stomach, again through a fiber optic tube.

Private insurance: $447 Medicare: $410

 

[regent]

Are the difference in prices due partly to the fact that hospitals treat so many that do not pay, and the higher prices are to compensate for those nonpayers?

 

[Bfgrn]

Are the difference in prices due partly to the fact that hospitals treat so many that do not pay, and the higher prices are to compensate for those nonpayers?

Health Insurance: More Tricks of the Trade

By David Belk M.D.

I recently saw a patient who I thought needed a CT scan of his head. In the last section (see diagnostic tests) I showed that head CTs go for $300-$350 if you’re an insurance company. This patient has insurance so it shouldn’t have been a problem. My receptionist called his insurance to get the proper authorization and I even spoke with them myself to make sure it went through; it did. The next day, the patient called my office to say that he couldn’t get the test because he couldn’t afford it. The radiology department wanted $500 up front and then said that they would bill him for the remaining $700. That’s $1,200! He has insurance, they approved the procedure, and still, he has to pay $1,200.


So what’s going on?

They have insurance. The bills are going through the insurance companies. Why do these tests cost them so much more than an insurance company would usually pay? Insurance companies don’t negotiate—at least not with groups as small as the lab at this hospital. They set a reimbursement rate, which is usually pretty close to what Medicare pays, and we (or the hospital) smiles and says “thank you.” After all, if we’re doing it for Medicare for $75, we’ll probably do it for United Health Care (or any other insurance company) for $80. Why would anyone say “no”?

Maybe United Health Care and Blue Shield are just being generous. But probably not—United Health Care is consistently one of my lowest payers. For example, they pay me $65 and Blue Shield (the insurance provider in the first example) pays me $73 for an office visit. For the same visit, Medicare pays me $79 (that’s right, most private insurers pay me less than Medicare). So why are they being so nice to hospitals?

I can think of at least two reasons an insurance company might price services so outrageously high on certain policies. First, that would punish anyone who buys inexpensive insurance with a high deductible (both of these patients did). Second, they keep you from finding out how much (little) medical service really cost. Patients with high deductibles pay for most of their own medical care. The insurance companies make sure that these patients see a much higher price than the “real” price that they could pay. Just as with generic prescription drugs, insurance companies, not providers determine the price of everything. They can hide their real costs, and punish you for not buying a more expensive plan.

And it doesn’t just change the way patients behave. If an occasional patient has a policy that pays at or near the maximum price charged by the hospital, the hospital is motivated to keep their outrageously high prices. This helps to keep medical care unaffordable to private payers. If these inflated reimbursement rates are only on policies that have very high deductibles, the insurance company will rarely get stuck with the bill. Even at these outrageous prices, most people with private insurance will never need more than $1,500 of medical care in a year. On occasion, someone with one of these policies will have a serious illness and the insurance will have to pay big, but the insurance companies more than make up for these loses with the increase in premiums they get by maintaining their smokescreen.

What this means is that insurance companies have enormous control over the medical industry. They set all rates of reimbursement for all medical services no matter how trivial. These rates vary greatly from policy to policy even for the same service from the same provider. You’ve seen many ways they can use this power to control (and profit from) the entire industry.

Where else do they use this control? Here are some more examples:

A healthcare provider—hospital, lab, physician, whoever—provides a medical service and informs the patient’s insurance company. If all goes well, the insurance company responds (agrees that we did actually provide that service). The response is called an “explanation of benefits (EOB).” The EOB explains what service we are paid for, how much we will be paid, who pays (the patient or the insurance) and what was denied or not allowed. Maybe there’ll also be a check, but not only will the amount be less what was billed (remember the amount billed is almost always inflated), it will usually be less than what the insurance allows.

Sometimes a fee is “not covered.” This might mean that the patient is on the hook for the entire amount (without even the discount). Sometimes a fee is “not allowed.” This might mean that provider won’t get anything and can’t even bill the patient. I can only assume that the first denial is to punish patients who ask for the wrong service and the second is to punish providers who offer the wrong service. Also, services that are not covered or not allowed vary not just for different insurance companies but for different policies from the same company.

Usually, though, the EOB is a complex explanation of the rules of the game we will have to play to get the money the insurance company has agreed we are owed. Here’s where we start to get into the strange language of insurance. If there is a “deductible,” that means the patient hasn’t had enough medical costs this year to start getting insurance, and I need to go the patient for the full amount (after the discount or “adjustment,” of course).

For example, if you have a $2000 deductible on your policy, the first $2000 of medical cost is on you each year. Some policies have exceptions on their deductibles in that they offer full coverage for physical exams and other preventive services even before the deductible is met. I should also explain here that the amount you pay for any medical service before you meet your deductible, in theory, should be the same as what the insurance company would pay for that service after you meet it (in other words, you get their discount for buying their policy).

If the EOB for this patient for this service for this insurance policy says they’ve already met their deductible, then we can get into copays and co-insurance: A copayment is a fixed amount (determined, of course by your policy) that you pay up front before you receive a service. This amount will often vary from service to service. For example, an office visit to your primary physician might have a ten dollar copay but a specialist might cost you fifteen dollars and an ER visit fifty dollars. These amounts are usually on your insurance card.

 

[thereisnospoon]

Let us stipulate that the system we have while far from perfect is far better than any government run taxpayer funded boondoggle.
End of story.