Coming home after screaming all day is great for lovers. You can come home and take it out on your wife then hate fck your gf
CEO of United Healthcare gunned down in midtown Manhattan
- Thread starter Thyrsis
- Start date
There are issues in rural healthcare especially. There is a huge feature to buying a million dollar scanner and have it running patients through as fast as possible. That doesn't happen in very rural areas. I don't know a great solution.
My everyday as a lawyer - argue with opposing counsel, argue with clients, and argue with my partners. Every damn day. It was exhausting and miserable. Escaping private practice was akin to Andy crawling out that shit tunnel.
Last edited:
People are going to have to travel for advanced/specialty services. There's just no way around it.
Rural healthcare facilities is going to have to provide baseline and emergency care only. And I'm guessing most will only be staffed by APPs.
I can’t figure out why you have baby mama drama.
Every day both of them message me. Often multiple times a day. It’s shocking how awful it is. I look at my phone, what was once a constant source of horniness, and my pecker literally retreats into my body
Internet access in rural areas is a concern for telemedicine, though it is becoming more and more a viable option. Mobile care units aren't the be all, end all for healthcare, but they are helping people get access to SOME healthcare in deep, rural areas.
The advent of Starlink will be a major blessing for Internet access in many, many parts of the globe.
I've found that it also comes in very handy at tailgating. There's no way you're getting quality service over terrestrial cell with that kind of concentration of people.
The problem with most of these that I have seen is in network vs out. I have personally seen cases I could get something cheaper, but it is out of network. So if I do it, it doesn't go against my OOP maximum. So there is a further analysis needed. Why we can't just say, "We will pay X no matter where you get it", then I get the choice of going somewhere cheaper (or better and pay OOP the overage).
Clearly not enough to gain enough market power to move prices.
What percentage of all dollars transacted in healthcare today are OOP (including those from an HSA)? I bet it's very low.
1789 14 July Bastille Day
Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures
In an unprecedented move, Anthem Blue Cross Blue Shield plans representing Connecticut, New York and Missouri have unilaterally declared it will no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes...www.asahq.org
Not saying what happened is right, but I think we are nipping at the edges of the guillotine phase of the French Revolution.
50% of private sector employees are using them according to this. I've had one for probably a decade. Think majority of the ACA exchange plans are HDHP as well.
51 percent of private industry workers participated in high deductible health plans in 2023 : The Economics Daily: U.S. Bureau of Labor Statistics
Among all private industry workers participating in medical care plans, 51 percent were participating in high deductible health plans in 2023. Across occupational groups, 49 percent of management, professional, and related workers and 58 percent of natural resources, construction, and...
www.bls.gov
Those with chronic conditions, I'm sure avoid these plans
50% of private sector employees are using them according to this. I've had one for probably a decade. Think majority of the ACA exchange plans are HDHP as well.
51 percent of private industry workers participated in high deductible health plans in 2023 : The Economics Daily: U.S. Bureau of Labor Statistics
Among all private industry workers participating in medical care plans, 51 percent were participating in high deductible health plans in 2023. Across occupational groups, 49 percent of management, professional, and related workers and 58 percent of natural resources, construction, and...
Those with chronic conditions, I'm sure avoid these plans
It’s the dollars that really matter. That’s where pricing power is going to come from.
According to CMS, OOP only accounted for 12.7% of all healthcare expenditures in 2019. Honestly, that’s more than I thought it would be. Interestingly, that’s down from 2009.
Nudged talked about OOP and skin in the game. In Medicare's prescription plan there is a dollar amount that once people reach it, OOP really shoots up. Then a few thousand later it goes away. Studies tracking expenses show that when that point is reached a lot of people stop getting prescriptions. I suspect if people stop taking prescriptions to save they may stop other procedures. So OOP may help in some areas, hurt in others.It’s the dollars that really matter. That’s where pricing power is going to come from.
According to CMS, OOP only accounted for 12.7% of all healthcare expenditures in 2019. Honestly, that’s more than I thought it would be. Interestingly, that’s down from 2009.
I think of a buddy who had a really cheap plan back before they were outlawed. It worked with one hospital in Indy. His wife, an RN, became convinced he was having a heart attack and called 911, he argued with her but it was done. The paramedics took him and said they were going to Methodist because it was close. He began arguing with them he had to go to this other hospital. The argument was settled when he coded. The doc at Methodist said he wouldn't have survived a longer trip.
Sometimes people don't make rational decisions. Maybe they lack information or whatever, but I suspect it happens fairly often in spending decisions and medical decisions. OOP may help costs but I am not sure it would be totally transformative. Especially since my plan gives me no incentive to shop. I might find a cheaper procedure in Indy but it is out of network which reduces my benefit to using it. Real life example on a cataract procedure.
My minion had a small clavicle fracture this past summer. I took him to his pediatrician. His pediatrician did an exam and said it’s probably worthwhile to get an X-ray. They don’t do X-rays in his office. We set up an appointment at Wash u. I took him to get the x-ray. We waited. They said they can’t read it for us. They have to send it to the pediatrician and we can find out from him. So the next day we went to see the pediatrician. There was a slight fracture. He said we should see a pediatric orthopedic and gave us a referral back at Wash u. Took hours and they finally called back and said they are out of network and may not accept my insurance. I called my insurance company. They said Slu is in network. I made an appointment with the orthopedic pediatricians there. They told me to bring the X-ray on a disc. They can’t take it by email. Wash u said they don’t provide scans on discs. So I called the pediatrician. He said sure they do. He’ll call. He called me back and said I can go to wash u now and get the disc. Drove to wash u and got the disc. Then drove to Slu to see the ortho. Their system was down so it took 4 hours for the ortho to review it. Finally it came back online and the ortho confirmed there was a small fracture. She also instructed that there’s nothing they do for it other than provide a sling if we want it. We did. He lost it at school the next day.
Urgent care down the street probably would have taken an hour
Your experience reminded me of one we had a couple of years ago. Daughter broke her foot down in Cabo over the holidays. Couldn't get in to see a doctor anywhere but the emergency room and the last time I was there in Cabo on a Saturday night let's just say it was a bad scene, so we had a nurse from a resort drive over for $50 and she confirmed that she was pretty sure it was broken without having an x-ray done.
Had befriended a native local and gave him $100 to find her a small walking boot somewhere on the southern Baja peninsula as the nurse and everyone we talked with thought something like that would have to be shipped in (he got to keep whatever was left past acquiring the walking boot.) She had one 12 hours later.
It was a massive help because she was too young to figure out crutches and I didn't have to carry her everywhere the last day and through the airport and onto the plane to get her back to L.A.
Came back to L.A. and went to an urgent care to avoid the emergency room again. They did an x-ray and two days later the doc called to confirm it was a small fracture. He suggested we keep her in a walking boot for two weeks and then slowly start weening her off of it as pain tolerance allowed. We got the CD with the x-ray and a bill for $200 for what our insurance wouldn't cover.
After your story, I feel lucky we didn't have to run all over town to get that CD and deliver it to someone else. 🤷♂️
Sever years ago my stoker broke her pelvis skiing. Minor fall she was mid 70’s. Ski patrol hauled her off the mountain and took her to the Copper Mountain clinic. Took an X-ray there, and a doctor in Denver read it on line. He saw a break but said to go to the hospital 15 miles away for a better image. Loaded her into an ambulance and off she went my buddy and I drove to the hospital and they said she was stable w/o surgery. I bot a walker at Walmart and back to the condo with a bottle of pain killers. I skied the rest of the week. She was pissed. Used that walker for about 3 months.
Care was slick as a whistle. All images were in line and read by doctors 70 miles away.
Those are big numbers yea, but the business are not very profitable. They consolidate and the more patient lives they add - the larger they get. But they’re not profit machines. UNH floats somewhere between 9 and 10% EBITDA margin.
They also employ a ton of people and do a lot of good. Having all of the data for patients and treatments and outcomes should lead to better outcomes. But they have flaws and regulations should prevent those from causing too much damage.
But my point is to not get too fixated on a revenue number - that’s just correlated to their consolidations and acquisition history. The healthcare systems is expensive and government makes it more expensive.
A wise man once said “there are no solutions - there are only trade-offs.” Those who think the NHS in UK or the Canadian system is a utopia should actually talk about those systems with their users and get a dose of reality pretty quickly.
I get that. But I also know a lot of vps at these companies. And I’m shocked at how much they make. My dipshit friends. Not brainiacs. Directional undergrads. A few with online or “professional” MBAs. And as I said some make more than our major hospital employed md buddy
So true. One of our competitors is the US subsidiary of a Canadian firm. The guy who runs it is from Toronto. You don’t want to get him going about Canada’s Medicare.
Tradeoffs, indeed. That is one of my favorite Sowell quotes. A lot of wisdom packed in such a simple sentiment.
Here’s a great example of (a) somebody either not getting the concept of tradeoffs…or else demagoguing the fact others don’t get it, and (b) a microcosmic representation of our quandary.
I don’t know all the ins and outs of the underlying issue regarding anesthesia. And they don’t even matter all that much.
The point is that costs have to be weighed against benefits and decisions will always have to be made about how best to tailor the balance.
But, to demagogues who wish to portray these as false choices being made in the name of high profits and salaries, there is no such weighing. They simultaneously demand both coverage of pretty much anything and everything…and low costs to have the coverage.
And any failure to deliver this is the fault not of economic reality, but greed - by providers, insurers, middlemen, drug companies, etc. To them, if the rich people involved in the healthcare industry could accept just being a little less rich, all the rest of us would have affordable access to the high quality healthcare we need.
The "man on the street" Canadians I know all love to bitch about their health care system... but when it comes down to reality they love that it's there and are grateful for it and think our system is madness.
Or it's where things trend when both sides of the political aisle insist on justifying ends over means, no matter how cold-blooded, murderous, and obscene the means. I fear that's the deeper lesson to learn here and the media coverage supports this.
Ugly stuff.
NYPD releases new photos of UnitedHealthcare CEO Brian Thompson’s alleged assassin sitting in taxi after NYC murder
The suspect is shown looking directly into a camera as he apparently peers through a divider window to talk to the driver in one photo.
nypost.com
And if they get bad cancer or a rare disease they’ll come here as fast as they can to get treated.
This link is absolute garbage and you diminish yourself by posting it.
Some good stuff here. The problem is that the complaints he discusses have been around for years. Obama so called greatest domestic achievement was health care reform, which supposedly was to address these issues, it didn’t. Obamacare was a huge head fake that really not only didn’t do much, but it increased costs with mandatory coverage requirements and expanded the fee for service model of delivery of all care. .
Last edited:
Why is that? Bonnie and Clyde became heroes to many Americans because they were sticking it to banks, very much a Robin Hood populism. I don't doubt some of the online vitriol has been bot activity, but it seems clear a lot of it is real. People really sympathize with this modern-day Bonnie and Clyde.
I made no endorsement for or against the article, but I have seen posts of sympathy for the killer and posts of no sympathy for the victim. Also a lot of rage at insurance companies and US healthcare in general. You seem to take personal offense to the article. Why?
I linked these for people to read or view and come to their own conclusions about them. These came from the Smerconish newsletter which I get every day.
Strange reaction by you. I was actually telling my wife the response to this murder is like nothing I've seen. Even on FB where folks have to show their face so to speak, many people were venting their frustration with healthcare in this county. And this guy was the lightning rod.
No one on here is condoning murder. But it is evident this country is at a breaking point on healthcare costs and overall lack of control on procedures/process.
Pablo Escobar, too, was a hero to many in Columbia.
