Who appointed this guy Chief A$$HoLe?
But be careful what you wish for: what we may get could be worse than what we have.
Gold futures saw a massive $1.5 billion liquidation in one minute yesterday which had all the hallmarks of a "non profit" liquidation - a large seller trying to manipulate gold futures lower rather than maximise profits.
Presented with no comment...
Source: Goldman Sachs
That costs extra
Frontal lobotomies are free in DC and Ca.
They don't have Alaska on there, which has some of THE HIGHEST health care costs in the US.
Recently, my wife and I had typical annual physical bloodwork done. We are both late 30s, very healthy, active, good diet, etc. Nothing unusual at all, just routine.
NINE HUNDRED DOLLARS EACH!
We are now planning to do annual health care, including some dental work she needs done, during a vacation in anther country. By the time one looks at deductibles, costs, etc ... we can get it done cheaper while on vacation!
I now resume my blissful KHYI afternoon at work ...
All appendectomies are emergent, so that hospital is not an option.
WTF do you expect when the feds, state, and local governments pay the health care industry $1.1 trillion a year and insurance companies charge 12 cents on the dollar for services?
I would rercommend Asia, but avoid Singapore which is now virtually US prices. Thailand is excellent with modern facilities and specialisists who are ALL US trained. I have US friends who have enjoyed a vacation in Thailand and had medical work done all, including Business Class airfares, for less than the cost of the medical work in the US.
As for Obamacare...."I'm from the Government and I'm here to help"?
Thailand IMO has great health care. Like night and day compared to the homeland.
Thai people are famously kind and caring. Just pay as you go, if you need to go, because it's affordable. No need for no stinkin 'health insurance', but they'll help with the docs if you do have insurance to help you get reimbursed. The clients at these places are from all over the world.
I'm approaching 60, so I went in for a complete check-up a few years ago at St. Louis Hospital. When I hit sprint speed on the treadmill, the Dr. and nurse had to talk me down. They said I was breaking the equipment and not to worry as I will never get a heart problem.
What does an appendectomy cost?
An arm and a leg.
No disrespect intended TD .. it is Sunday morning and I am in a prayerful mood .. but.., er maybe butt.. err .. even butter or any lube of your best discretion,,heh.. heh maybe more important ..the thing to know would be the relative costs of a colonoscopy..Particularly in Bloommie Fingerman New York City , or Rahm it up your butt Chicago.
Need a root canal? Go to Mexico or Eastern Europe, pay the BEST dentists that house state of art equipment, enjoy a 'vacation' and still have money left over while enjoying better service than you would get at a great dentist in USA... all while paying prices that are <1/10th of a cheap/lousy US dentist.
OK,, close... but I humbly submit that the best place to go for expertise, economy and a real great visit is Singapore.
Boris is find out "Professional Dentist" is use Tungsten, not Gold (like NYC Gold Dealer), so Boris is now go to cousin Yuri who is teach Home Dentistry. Not is so bad, pain is toleration if drink vodka first.
Boris, my friend.. I speak good mangle English too...
But maybe not so much tungntsen..but way more Vodka .. maybe some Pb in teeth or other places too.. eh?
oh.. and does entreprenurial cousin have sister (or mother) that has disposition for comforting?
are your women any good?
Its free in Chna.
But then again, they take all your other organs too.
The government has removed consumers with vested interests from equation.
It's like the government telling every grocery store in the country to give us whatever they want the bill is on them and wodnering why rib eye steaks cost $250lb.
Our health care system provides the best health care in the world but there is no constraint on costs. The same thing happened to government employee pensions and benefits. Why the fuck would government bureaucrats not give us everything we wanted when they have unliimited money to spend? Their power depends on it.
Don't want to rain on Tyler's parade but there are different ways to skin the healthcare debacle.
I had insurance for a long time while I was in the employ of a major aerospace company. When I left to enter the world of entrepreneurhip, I had to go without insurance. I have raised 4 kids, had 4 surgeries and paid cash for everything.
What I found out is there is 2 prices at the doctor or hospital. If you have insurance it costs XXXXX.XX, if you pay cash you get an 80% discount...
In April of last year I had an obstructed bowel and had surgery to correct. The bill was ~$52K, after negotiating a cash payment the bill was settled for ~$13K.
Just my .02 on taking my healthcare into my own hands and out of the hands of a 3rd party.
Not completely accurate. For a long time hospitals have been charging the uninsured more, yes more. The rules of Obamacare are supposed to make this illegal.
The more likely explanation for why your bill was reduced was because you called & negotiated/complained. Works damn there every time.
The hospitals are so used to getting $0 from the uninsured that they were pleased as punch to get $13k.
It's been "completely" accurate for me! Every doctor I've had in the past 15yrs has always given me a discouont for cash.
Their response has been that they would much prefer to discount for cash and get an immediate payment then bill and wait only to have the payment discounted by the insurer.
My duaghter had a leg injury during her High School cross country career, the hospital discounted 55% if I paid cash for her x-ray.
Obamacare is a disaster in the making and if you think it is any kind of equalizer for the poor, you've been hoodwinked!
It will only "create" more poor just like every other .gov program sold to the masses as a remedy.
Obamacare is no remedy. It's a complete disaster.
I'll be retiring early as will a large number of MD''s in high demand areas of medicine. Some of us will work part-time in free clinics, but mark my words, there's going to be a huge shortage of doctors in the coming years. The plan of replacing MD's with nurse practitioners is going drop the level of care much greater than buearocrats could have ever conceived. It's not going to be a pretty site.
I don't so much see having nurse practitioners as primary care providers as such a bad thing, particularly if they have experience in terms of clinical hours and know when to refer patients to specialists. This is particularly true for patients at the low end of the food chain, where access and continuity of care problems make visits to the ER and being exposed to unneccesary tests their only choice. Here is the way one emergency medical practitioner sees it:
Also, maybe we can import more doctors when entrepreneurs such as yourself choose to leave, since we can't seem to get around that artificial restriction on training more of our own.
You are a fucking idiot who knows nothing
The UK health service has stolen doctors from every 3rd world shithole and imported plenty of euro trash
But I used to spend 20% of my time sorting out their stuff ups
Have you seen the death rates in the UK?
Much from foreign docs who couldn't care less
Be careful what u wish for
Yeah, I've seen statistics for outcomes of the UK compared to the Us, but YOU obviously haven't. For all the extra money the US spends on health care per capita, the only rich country with a higher death rate is Denmark. Go study up on FACTS.
Wow. ONLY 13,000 died needlessly in a 5 year stretch in the UK? Try 180,000 deaths PER YEAR from hospital errors in the US. Chicago hospitals have the worst record. Get a clue.
"entrepreneurs such as yourself choose to leave"
I guess your definition of entrepreneur would be consistent with one volunteering in a free clinic after they retire. That's not my definition. So go fuck yourself.
The reasons MD's will be quitting in regards to Obamacare has nothing to do with income. Foreign trained MD's are a good solution. Frankly, many of the best MD's I've known are foreign born. As long as someone can pass the various certification tests then it does not matter where they received their training. Going into medicine in this country is a daunting endeavor. First, it is very costly with median education debt around $170k with some being $300k+.
In addition to the debt incurred, there as a big opportunity cost with a minimum of 7 years post-graduate work (4 years med school & 3+ years residency).
I also would not say that there is an "artificial restriction" on training MD's in the U.S. It's not only expensive for the individual going through the process, it's expensive for society because it's a shared cost, but particularly so in the U.S. because anytime the government funds anything they do it in a very inefficient manner.
NP's have their place, but I've already seen them in positions where they are in way over their heads. Give it time. This is only the beginning. The number of NP's is going to go up exponentially.
No downie from me, but I see one rub with the "foreign doctor" solution. When the Administration sees that there is a shortage of doctors, and not enough coming in from other countries, there will be pressure to lower the standards to get enough.
Eventually, we will be producing 100,000 new doctors per month, comrade, and nobody will admit to waiting in line to see the doctor!
And the "artificial restriction" that he's talking about is certification by the AMA, who wishes to keep the number of doctors low enough to ensure high demand for those already in the guild.
The solution is much simpler than that. Fill out you Obamacare form and reveal all of your bad habits.
Having heart problems? Tough shit. You didn't eat the Obama diet and exceeded the Obama calorie intake amounts. In other words you are fat. No Care For You!
Have a lovely purple and black mole on your shoulder that's getting bigger buy the day? Well you didn't wear the prescribed sunscreen. No Care For You!
It's all so simple really. The Gov will have all of your purchase histories can refer to all of you conversatins, Facepage posts, emails etc and determine that you lived a poor life not deserving of very valuable health care that proper citizens should be receiving.
Doctor shortage? What doctor shortage?
Allowing more NPs to practice under the direction of experienced NPs and MDs is a much better way of addressing the shortage of primary care physicians than allowing the current system, as described by the emergency care practitioner in the link I supplied, than anything else we have at this point.
The majority of NPs have years of experience as registered nurses to draw on before starting their graduate education, are able to focus on the population they will be treating and don't need to rotate through specialties after graduation, which is overlooked when comparing them to MDs. In addition, MDs spend years of training on specialties that are not necessary for primary care. A study by Emanuel and Fuchs published in JAMA, "Shortening Medical Training by 30%" calls for compression of medical school to 3 years (or expansion of 5-6 year combined college/med school programs), reduction in general internal medicine residency and surgical residency by one year, and an elimination of mandatory research years for all fellows: ”It is wasteful to add years of training for all physicians to ensure the small minority destined to be researchers has the opportunity to engage their interest in research.”
The average NP has 9.3 years of experience, and yet doesn't get to graduate out of supervision, which doesn't seem right. What needs to happen is for standards to be developed for NP residency, but there are many seasoned NPs who are just as capable as MDs of being primary care providers right now.
Kudos! I have a nurse practitioner as my primary, and I have nothing bad to say about her. She is great for the flu, gyn exams, and other shit that is routine. If I ever needed a physician, she would be the first one to let me know. I say leave the surgeries to the doctors.
She diagnosed me as having two vitamin deficiencies after I'd been to three physcians for unexplained fatigue. She's tops in my book! :)
Glad to see some doctors reading ZH, and i agree that "give it time" will prove you right. The champions of obama care will find that they have selected their own euthanasia only it will be called cost control. You would be wasting your time responding to your critics. Just give them a down arrow and move on. The price of ignorance is often death.
this is funny
A real doctor would have known how to spell bureaucrat.
I call bullshit.
Why do you think drs have such messy handwriting, so that you can't see their spelling mistakes. =)
Yeah -- equalizer for the poor...not!
If it truly was an equalizer there would be ONE plan for everyone. None of this "Metal" based BS, exemptions for the connected, and custom plans for Congress.
If you're well off, you can afforded the higher end options and a 90/10 outlay. However, lower middle class folk get screwed and will be bankrupted by the 60/40 deductible that they will be unable to afford. Their first medical emergency puts them into financial trouble. I'm surprised that they didn't write into the bill that medical cost are non-dischargable during bankruptcies. The lower middle class are going to get squeezed into poverty, which seems to be the goal of ACA.
Imagine what would happen to the cost of healthcare if you could not only do without health insurance but ALSO have the government's involvement completely eliminated. Those are the two real drivers of healthcare's explosive cost.
Imagine if individuals actually boght the insurance for themselves and shopped rather than being entitled by being employed or having it supplied for free by the government.
The reason health insurance sucks is bacause nobody has an interest in the costs of their insurance except for a very few of us who buy our own. But for us the choices are so fiucked up and the government regs so insane that it doesn't matter any longer. Why the fuck do employers have to give health benefits again? Why doesn't everyone simply buy their own?
It's because the fucking "progressive" government wants to completely control health care. It's 'the keystone in the arch of communism'.
When people paid outright overall costs were a lot less.
My experience was that the doctor was willing to give a discount for cash, but the hostpital charged more than what insurance would pay, and refused to negotiate.
Whoever junked you is a moron. You are absoluetely correct. Secondly, how many peple are even bright enough to ask or negotiate? Pricing is completely opaque for the most part and a joke. $50 band-aids and $80 aspirin are not unusual on a hopital bill only to be marked down for managed care networks. Cash prices at your local pharmacy are called "Ususal & Customary" aka high retail++ (unless you play the stupid discount card game if you have them). I was in this fiasco for 25+ years and know what's up. So, I ask again, how many Joe six-packs negotiate with their doctor of pharmacist? NONE and that's the way most of them want it.
Hospitals have negotiated price agreements with health insurers which lets them plan for that profit stream.
Charging the uninsured more is part of a strategy to inflate the eventual bad debt writeoff to offset profit and lower total taxes.
If you are uninsured and intend to pay, they will work with you and retroactively produce a more reasonable bill.
There are many uninsured patients who enter a hospital with no intention of paying anything. Many use hospitals to avoid paying for asprin and other over-the-counter items - they often wait for hours for common, low-priced items. Their usefulness for hospitals is to provide the largest possible tax deduction.
The sad part is, some people go bankrupt or worse trying to pay an outrageous bill, not knowing it is almost always negotiable.
>The sad part is, some people go bankrupt or worse trying to pay an outrageous bill, not knowing it is almost always negotiable.
The sadder part is, from the graphic at least, that Medicare is one of those people
ALL healthcare is negotiable. I haven't paid a full bill EVER.
Once you get past the deductible, doctors and hospitals will negotiate prices. But you have to get past the deductible.
If you pay cash, you ALWAYS get a discount, but you have to work it out ahead of time. If you don't ask any questions, that's what they count on.
BTW, services in Europe understate prices. It's not a valid comparison. Since there is no market, and prices are not set based on the variety of factors employed here in the US, it's apples and oranges.
when I was living in VT half the year I'd go see this country doc who charged $85 for a 30 minute visit - and $64 if I paid cash, which I always did. One day he gave me a pretty complete physical and froze a basal cell carcinoma off my nose - all for $65. I asked him how he could do it - he said something quite rare - "I like helping people."
Then I think of that drunk Goldman fuck who hasseled the black couple and deservedly got his lights punched out. A tale of two cities.
a tale of
My Vermont doctor was the same. I had no health insurance, he knew I was just making ends meet. If I had to go see him for anything he didn't charge me much. If it was more than I could afford all at once, we worked out a payment plan of $20 a month until I paid him off. God bless Dr. Keith Michl, great doc and fine human being.
damn, I miss Vermont (6 months out of the year anyway lol)
What we need is a government run free health care system like Europe and Canada because Capitalism has failed.
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