Forum Replies Created
-
Posts
-
Search on YouTube for “America is a nation that can be defined in a single word….” and then tell me honestly if you feel safe with that guy having the nuclear codes.
I don’t take President Trumps rants and raves seriously- but I do find them entertaining. What I do take seriously are his actions which made the world a better place for every single person who wanted peace and was willing to work for a living.
Is the world a better place under Biden for those that want peace and work hard for a living? If so, please explain how.
I’m not surprised that he can’t come up with the money and here’s why.
According to Hillary Clinton in a debate with Donald Trump back in 2016 she claimed that he started his business with a $14,000,000 loan from his late father. He didn’t become a multi-billionaire (at a time when there were very few billionaires on the planet) by putting the money into as savings account and earning interest- he used his genius level IQ and real estate brilliance to hire the best people, build the best buildings and re-invest the profits into new ventures.
A healthy company looking to grow will have teams that predict future income, project future expenses and another team that lines up investments so that the future income and future expenses line up while coming up with methods to mitigate unfavorable outcomes. The closer these companies can come to aligning the cash flows, the less cash they need to keep on hand. Selling off those investments much earlier than anticipated usually results in massive losses.
Given the efficiency at how his company runs I’d be very shocked if he had that much cash just sitting around. In a typical environment, if a huge company run by a well known and proven leader needed that much cash other companies would be running to lend money for a bond but here, they’re afraid of the attorney general going after them as well.
I don’t plan on donating to his legal fees though, for two reasons:
1. This may sound selfish on my part but I think that if his buildings do get seized, he’d have a better chance and getting reelected, undoing some of the damage that Biden and Obama have done to the country and bringing peace back to the world while saving countless lives. (Hopefully some of the loony Libs will realize that Democrats are the threat to democracy and vote them out.)
2. When I bought my previous house in NY, I paid between $30,000 and $50,000 more than it was worth- I don’t want to do anything that will make her come after me next.
Please join me and all other Frum Yidden who love Hashem, the Torah and basic human morals more than the few Dollars the Democrats give you not to work and vote for President Donald Trump in November.
There were four posters who contacted me through the decrypted message, two I was able to validate (Squeak being one of them) and two refused to validate themselves (by posting a message I asked them to post in the screen name they claimed to be). I assumed that one (or possibly both) of the supposed screen names is (are) yours.
Squeak is pretty confident that you didn’t decrypt the messages. Letting me know the product of those three numbers would have proven me correct.
Contacting me at an email address you’ve contacted me at in the past proves nothing as I know that you have it already. I don’t plan to challenge you to a game of chess and I’m going to assume that Squeak doesn’t either. If it makes you happy I can ask him directly.
As far as the mess I created- don’t fret, I’m going to climb back under my rock. I may swing by a couple of times over the next few days to respond to any follow up questions but that’ll probably be it.
I can’t answer that. I just gave him a heads up that you’re going to be waiting for him and he said that he’s not going to be here. (And resigning from what- the Coffee Room or the game of chess?)
He’s also suspicious about you having the email address from the coded post. To prove that you cracked the code would you be able to provide the product of the first digit of the public key used to encrypt the message, the first digit of the private key used to decrypt the message and the number corresponding to the first letter of the email address in the message.
Given that I’ve retired from the Coffee Room again I will not be taking his place.
(I came back to let @ujm know not to waste his night waiting around for Squeak but I have no intention of hanging around.)
I gave Squeak a heads up that you’re going to be looking forward to continuing your game of chess but he said that he wasn’t planning on participating.
Sorry
55 years ago, the Democrats were a totally different party. The worked to get man on the moon, nowadays they worked to get man into the ladies locker-room (not sure whose line that is but it sums up how far off the deep end they fell). President Kennedy famously said “Ask not what your country can do for you but what you can do for your country”. If he was president nowadays, he’d be considered a Republican.
To me it’s no surprise that you want to abolish the Electoral College. When I first learned of it, I also thought it was unfair- until I learned why it was established. There have been a handful of times that the Republicans won the Electoral College but lost the popular vote. I don’t believe it ever happened in the other direction.
The Founding Fathers were brilliant in how they set up the Constitution. Without the Electoral College, candidates would only have to campaign in the largest cities and can ignore entire states like Wyoming. (Take the three largest cities in the US- New York, Los Angeles and Chicago- is the cumulative population larger than the amount that President Biden won the popular vote by?)
By having a vote in Wyoming carry a disproportionate amount of weight- candidates are forced to campaign in small states as well and not neglect them.
I’m still waiting for you to name a single, positive accomplishment from President Biden- one that helped a good number of hard working US Citizens, not one that benefited less than half of one percent of the country.
@CTLAWYER-
I’m not sure why you still don’t believe that after the ACA was enacted we were paying 400% of what we were previously paying. Seriously- where did you think the huge amounts of money would come from, if not the hard-working middle class?
I agree though, there have been many threads about the ACA and I did take this thread off topic- I was leading you up to this so that I can point out the following (about self-employment vs. working for a corporation) and ask a question that I’ve asked before (not necessarily to you) but haven’t gotten a response.
It’s your choice to be self-employed- you seem like a smart person with skills that many corporations could use. You chose to be self-employed because you probably make more money that way. Many corporations (even pre-ACA) had generous health insurance plans with no lifetime limits or preexisting conditions exclusions. Health insurance for those who paid for it themselves was very expensive and didn’t cover as much as corporate plans did (except possibly paying for the most expensive of plans).
So, here’s (a slightly different version of) my hypothetical question again. Let’s say you have two families, let’s call them A and B. The A family lives in a small size house and has a small amount of savings. Mr. A works in an entry level position for a corporation and has a generous health insurance coverage. The B family lives in a large house and has a respectable amount of savings. Mr. B is self-employed, brings in a nice income and has health insurance but it has a limit of $1,000,000.
Unfortunately, the B family has unexpected health expenses and it exceeds the cap. Should the government:
a. Expect Mr. B to get a job with a large corporation that has no preexisting conditions exclusions and no lifetime cap,
b. Expect the B Family to use their savings towards their expenses,
c. Expect the B Family to sell their house for a smaller one and put that money towards their expenses or
d. Raise the premiums and deductibles for the A Family which will wipe out their savings, make them unable to pay their mortgage and force Mr. A to sell the house, move the family out of the only neighborhood they ever lived in and find a new job?
I still fail to see where you explained why you thought the Democratic nominee will win but whatever.
Just because you saved lots of money under the ACA (or whatever you want to call it) doesn’t mean that no one paid for it and that it didn’t have catastrophic consequences for millions of hard working US Citizens, my family included.
We went from paying about $200 a month in premiums and a negligible $250 deductible to paying $400+ per month for a $7,500 deductible. Our annual health insurance expenses went from $200 x 12 + $250 = $2,650 to $400 x 12 + $7,500 = $12,300.
Do you still not agree that health insurance expenses jumped by 400% for some hard working families?
@Sam Klein
This is a very important issue that needs to be discussed.
May I respectfully ask that you start a new thread as to not hijack the OP’s thread (unless the OP feels that it ran its course).
OP’s post specifically asks “Who is going to win and why?”.
The “why” IS in the OP’s post and you left that out- that’s exactly what was mentioning in the first sentence of my last paragraph.
The rest of the last paragraph is a separate issue that I’ve noticed with Libs- they refer to President Trump’s time as president as a disaster but don’t bother to explain why and mention President Biden as the best person for the position given his 50 years in politics but fail to mention a single accomplishment.
I’m not familiar with the insulin cap that you mentioned and who’s ultimately going to pay for it (is it by any chance hard working citizens whose health insurance costs already jumped by more than 400% under President Obama?) but it helps less than 1% of the US population. While it may mean the world to those people it’s far from something to rave about given the damage that he’s done to the planet.
I barely ever agree with CTLAWYER but this is one of those rare times.
The OP asked who’s going to win and why. The intent was to laugh about how wrong everyone was so CTLAWYER replied with something that’ll hopefully be wrong so everyone can laugh at him.
The OP also asked why. Given that Libs can never list a single positive thing (for law abiding and tax paying citizens) President Biden has done as President (or in the 50 or so years he’s been in politics), CTLAWYER left out that part in his response.
@huju-
In short someone is in pain that she’s being judged harshly for something that she didn’t cause or ask for. While she feels that it made her into a better potential spouse she’s not being given the chance to prove it.
@ 4980112t
The shidduch process is really a filtering process if you think about it- you date someone to see if they’re for you or if you need to filter them out. While rejection (especially for something that you had no control over and made the best out of) is painful and frustrating- it does help you filter out those who you wouldn’t want to be related to anyway.
You seem to have taken a challenging situation and made yourself a better person (and potential wife) out of it. May הקב”ה help you find a husband (and mother-in-law) who appreciates your fine qualities.
הצלחה רבה and גמר חתימה טובה.
@FollowMesorah
I agree with CTLAWYER about 1% of the time (possibly even less) but this is one of those times.
If you can’t crack $250,000 then don’t live as if you are. It’s definitely possible for the average couple to make savvy financial decisions and live with much less.
When you purchase an insurance policy you’re paying the insurance company to expose themselves to the risk being insured instead of being exposed yourself.
If your policy requires you to add children regardless of whether they’re home most of the time or not and you decide not to then it’s stealing since you’re exposing them to a risk that you’re not paying for.
(If the kid NEVER drives then it still may be violating your agreement with them but a Rov might say that it’s not stealing. Similarly- if you’re willing to take the risk and cover all damages on your own, without filing a claim, then a Rov might say that it’s not stealing.)
You’re best off call them and being upfront with the living arrangements.
The company we use allows us to have children specifically excluded from the policy while they are away from home.
If the company expects them to be added and you don’t then they won’t cover an accident. If you somehow hide who the driver was and file a claim then you’re stealing.
Why are you so sure that we’re not in the same old age home? Maybe I almost missed the last food cart so I decided to make a joke about the wagon?
(Continuing the trip down memory lane- in the riddle about the monkeys (December of ‘08) he wrote that it was in a magazine in the ‘50’s, he didn’t write that he read it then (he also didn’t write that he didn’t).)
I deal with insurance but not on the casualty side. (I can share my experience with you but from a consumers’ point of view and not the insurers’.)
There are things that insurers check in your personal life / background that may not appear to have anything to do with your driving but show if you’re a responsible person or not. (For example they may give better rates to a teen that’s a good student and raise the rates if he/she doesn’t keep up the good grades.)
With that being said it may be worth giving them a call to see if they can shed some light. They may also be able to give you a more competitive rate or offer you a discount if you take a defensive driving course.
Our premiums started creeping up as well- I attributed it to the price of used vehicles shooting upwards. (They also look heavily at your ZIP code, is there an area in your ZIP code with a high rate of accidents?)
When we added a teen driver the premiums more than doubled. We called an agent and got a quote that (with our new teen driver) was less than we were paying with GEICO before we added the teen driver so we switched.
Hope this helps.
I’m not sure how many of you will appreciate this but recently I was shmoozing with squeak and I looked at my watch and said that I needed to catch the next wagon. (Referencing the post from October of 2010.) He did get a kick out of it.
I can only imagine remembering these posts in another 50 years.
I think his name was Avraham Grosser A”H and he was niftar in 1964. If I remember correctly he was about 17 at the time.
If there’s one standard used by all textbooks then I’d agree with you but from the different answers I see listed above it seems as if different textbooks teach the order of operations differently. (I can not recall seeing a textbook that gave an order of operation that would yield a number other than 1 but from Google searches it seems like there are.)
Well, I think everyone would agree that if it says 2+3=6 that it shouldn’t be followed but there are other situations that are more complicated. A college professor of mine told our class of a story where a builder followed the engineer’s directions while building an oil rig and it collapsed. After the investigation was completed it turned out that one (or more) of the formulas required an integral that couldn’t be solved in closed rectangular format and the software used a numerical approach which the builders used without changing the internal default tolerance. Anyway- there was a massive lawsuit with everyone blaming everyone else and the lawyers and expert witnesses making tons of money.
That’s hilarious. (Your post to all MAGA supporters.)
What’s not hilarious is that in the future (hopefully very distant future) you and all other lefty loony libs are going to stand before the Judge of all Judges, a Judge that will have no mercy on Democrats, a Judge that can’t be bribed by Soros and a Judge that will know the truth no matter how good of a liar you think you are.
There will be no DA to grant you cashless bail or a woke jury that will send you to Gan Eden if you claim you woke up feeling like a female. You’re not going to be able to ignore Hashem like you ignore the posts that call out your lies and you’re going to have to answer on your own behalf as there will be no lawyer to defend you. You’re also not going to get parole.
You’re going to have to explain to Hashem why so many Yidden in the generations above us had so little and were willing to give up the little that they had for the sake of perpetuating Yiddishkeit while we BH have so much yet you’re willing to vehemently defend the political party that is doing all in its power to destroy the Torah. Those who vote Democrat for entitlements that the government gives out in this world (for those who don’t want to take responsibility for themselves) will RL realize when it’s too late that it’s miniscule compared to what is in store for them in the next world.
And those who use these threads as a platform to RL spread their anti-Torah views will have to take responsibility not only for themselves but for all those who sin based on what they posted.
I keep davening that you and the other libs see the light before it’s too late and do Teshuva.
The Democrats may have some victories here and there and the Republicans may lose some battles here and there but ultimately Hashem is in control.
I agree that we all need to be on the same convention but who has the authority to make this convention and what happens if someone doesn’t follow it? (I.e. what are the consequences going to be? Can an architect be sued if the builder uses a different convention and the building collapses?)
(When documenting a process, I personally put in parentheses very generously to avoid any ambiguity.)
I’m currently auditing the calculation of a financial product and part of a formula in the documentation is given as a/b/c. Is it (a/b)/c or a/(b/c)?
20/10/5 = ?
(20/10)/5 = .4
20/(10/5) = 10@ubiquitin and @ Always_Ask_Questions
Do you remember the one about FLT from August of 2010?
It’s hard to follow since the conversation was taking place in two different threads so it’s not continuous.
It’s hard having a normal conversation with someone who’s either a blatant liar or is totally clueless. By stating that you don’t know if the charges are politically motivated, you’re putting yourself into one of those categories.
But you did ask me two quick questions and I’ll give you two quick answers.
“No” and “No” (At least not that I know of)
And here’s why-
Former President Trump called for Ms. Clinton to be locked up for storing classified material unlawfully on an insecure server (which is punishable by jail time regardless of whether she knew what she was doing was illegal). Look up the case of Kristian Saucier, he went to jail because his last name isn’t Clinton. Former President Trump wasn’t afraid to call for her to be locked up because he knew that the chant couldn’t be turned around at him.
Former President Trump is a brilliant businessman who used his genius to make himself into a multi-billionaire when there were literally only a handful of them on the planet. The last thing President Biden needs is for people to question where his money came from so he, or the puppeteers who control his life (e.g. The Easter Bunny), wouldn’t dare call for Former President Trump to be locked up based on his business practices.
Similarly, Former President Trump’s moral behavior is nothing to look up to, yet it would be pretty dumb for President Biden (who started living with Jill while she was married to someone else and has dozens upon dozens of videos on YouTube of him forcibly touching females in an unwanted manner) to publicly comment about that.
Quick question- all I’m asking for in the answer is either “yes” or “no”.
Would Bragg have acted the same way if it was President Biden?
What just happened?
@Avram in MD
Reb Avram-
Yes, I really would support that idea. I currently get health insurance through my employer and my employer is selfiinsured. Being able to get up every morning and report to work makes people a cheaper risk to insure. I don’t know the exact percentage for my employer but I’d say the vast majority of the employees here have a college education (or are working on it) which shows some amount of responsibility and again- a cheaper pool to insure. Additionally- given the background and criminal checks that financial institutions have to perform on prospective employees the irresponsible behavior gets filtered down even more. I can’t think of a way to get a less risky pool of insureds than to hypothetically remove every single irresponsible individual as @ubiquitin hypothesized. Obviously in a situation like that there would be no smokers for the pharmaceutical industry to medicate and by default everyone would be doing, at minimum, the amount of exercise necessary to stay healthy. It would also be unrealistic to ensure everyone does the correct amount of exercise…
Having a single payer system would have the government collect a premium from every person and pay the provider for the claims incurred. This would put me in a much more expensive risk pool and my expenses would shoot up- probably in the same range as by the ACA.
I agreed with the idea (as hypothetical as it may be) to show @ubiquitin that I’m not against the government being the single payer per se- I just don’t think they would know what they’re doing or that it’s possible for them to take over without my expenses going up significantly again.
@Avram in MD
Reb Avram-
Thanks for taking the time to read and comprehend my rant- If I would have known that I had an audience I would have posted it earlier.
It doesn’t favor large companies at the expense of smaller companies per se- it encourages the greedy companies to continue their behavior at the expense of the companies that are trying to do what’s morally correct.
Another issue I saw in the ACA that I haven’t seen mentioned too much is the CSR debacle.
CSR (Cost Share Reduction) would pay part of the premium for people who earned a living but not enough to pay their full premium (it was a function based on their income and the poverty level). So, what people would do is sign up for coverage, have the ACA pay for a percentage of their premiums (say 50% or so) and never pay a premium on their own. So, CMS would pay for 50% of their premiums which would get them through half the year, they’d cram in as many appointments and fill as many prescriptions as they could (and trust me, it’s not cheap for people who haven’t taken care of their health in years). When those premiums ran out the policies lapsed and then CMS would claim that those policies never should have been active as the insured never made a single payment and demanded back the premiums that they fronted. So, these companies had to return millions of Dollars in premiums to CMS, paid out millions of Dollars in claims to providers for people who were never even members (technically they could have demanded the funds back from the providers as they shouldn’t have been made in the first place- but good luck with that) and had to absorb the loss themselves. (Keep in mind that with 80% to 85% of premiums taken in being paid out to legitimate claims or the policy holder is issued a rebate, 20+% is going to Risk Adjustment payments- that’s already over 100% of all the premiums collected for the year- and that doesn’t include payments for real estate, employee compensation, millions in claims paid for people who aren’t members plus all the regulatory filings…)
(To be fully transparent though- some larger companies may have anticipated this and built a feature into the process that ensured the insured was making the required premium payments before paying claims.)
I respectfully disagree with you on your staircase example, humans are humans and humans have human nature which tries to get away with as much as possible- until stopped. So, until people are gently reminded not to stop and schmooze on the staircase it’s going to continue. Would you say that highways should have speed bumps every 100 feet to make sure no one speeds? Or would you say that there should be speed traps to gently remind people not to speed?
From your screen name (and the public-school incomes you provided for your state) it seems like you’re in Maryland. There was a story in the news a year or two ago where a Baltimore mother was shocked to hear that her son wasn’t going to graduate as his GPA was less than .15 or something (yet he still ranked around the 50th percentile in the grade). So while $58,000 may not sound like a high salary- they should only be paid the rate of a babysitter (if they insured that the kids were there and stayed out of trouble under their watch- which I don’t recall was the case).
In short- if they get paid $58,000 and have nothing to show for it- it’s a huge salary.
““THIS MAY NOT SOUND LIKE A BIG DEAL TO YOU”
Actually, it does.”I actually didn’t realize the future implications it could have until later on- when I switched doctors, I didn’t have my record transferred.
@Avram in MD
Reb Avram-
“We’re over a decade into the ACA, are we still on a trajectory to fail? What does the failure look like?”
Depends what you call failure. Based on what it was supposed to do and what it’s doing now I consider that a failure.
“Try us. I want to know what you saw, and can handle some complexity and ask follow-up questions if I don’t understand. I don’t find the appeal to authority argument to be convincing.”
I don’t have the time or capacity to discuss it in too much detail and for the back-and-forth questions that you and others will have but I’ll describe an additional disaster at the end of this post.
Risk Corridor was supposed to exist for three years I think (possibly 2014 – 2016 but don’t quote me on this). The fact that despite CMS promising to cover the payments at 100% and only funded the first year at 12.6% was catastrophic in that it put many smaller companies out of business and the larger ones have less competition. It may have been close to 10 years ago but the industry hasn’t recovered yet (and since then even more companies went under which means even less competition).
“Do you see Medicare as a big pile of waste?” I have nothing to do with Medicare but I’d be surprised if there weren’t billions of Dollars of waste going on. (E.g. doctors ordering unnecessary test, prescribing unnecessary medication, patients not following doctors directions…)
“What’s the going rate for a teacher?”
Depends on many factors (e.g. years of experience, training, certifications, location…). But if you take a public school teacher from a class where not a single student can pass a proficiency test – yet that teacher is making $100,000 and you take a teacher from a nearby Yeshiva with the same years of experience, training and certification who’s pulling in $50,000 a year- I’d say that the public school teacher is making a huge salary while the Yeshiva teacher is making a meager salary.
25% of all claims being preventable amounts to hundreds of billions of Dollars. That’s huge. I see that number sky rocketing if all health care becomes free- people will take more risks knowing that it won’t financially cost them anything. A study I saw somewhere claimed that the invention of airbags didn’t reduce the number of car accident related deaths as people figured they could take more risks while driving and assuming the airbag will save them.
Finally- as promised- here’s another feature of the ACA that helped cause its catastrophic failure.
Risk Adjustment
Risk Adjustment takes money from companies that have a healthier population and gives it to companies with a less healthy population.
The point of Risk Adjustment was to discourage companies from not providing coverage to those with chronic illnesses and encourage those companies to issue policies to them.
So, what went wrong?
First Issue – The formula for calculating payments was seriously flawed. At first CMS vehemently denied this but then admitted it and said that they would fix it but it would take some time (possibly a few years- I have nothing to do with it now so I have no idea what ended up happening and I have no interest in looking it up.)
Second of all- Take a small startup company that’s trying to build up its network of providers but still has a small network. Patients that have a chronic illness are not going to get insurance through that company and will go to a more established company with a larger network of providers.
At the end of the year the small company will have a healthier population, lower claims and will not be permitted to raise their rates too much for the next year while still having to make a large Risk Adjustment payment to the larger, more established company. (This may sound petty but it was rather significant. There were instances where after paying out the 80% to 85% percent of premiums towards claims as required by the MLR the company still had to pay an additional 20+% to a much larger company and put the smaller company out of business while the payment to the larger company was less than .1% of their total premium collected.)Third Issue – Take two identical patients with Stage 2 Diabetes for example. Patient A gets insurance from Company A while Patient B gets insurance from Company B.
Company A encourages Patient A to see his doctor on a regular basis by dropping all copayments associated with his illness and having a nurse on staff call him and ensure that he goes to his appointments and takes his medications. At the end of the year, after spending thousands and thousands of Dollars on Patient A he’s somewhat healthier and moved up to Stage 1. Company B refuses to waive the copayments, doesn’t do anything to ensure he goes to his appointments and at the end of the year, aside from medication (which isn’t part of the Risk Adjustment formula) spent nothing on the patient who is now suffering from Stage 3 Diabetes. After all that Company A spent to make Patient A healthier- they’re still going to have to make a substantial payment to Company B for having a healthier population.
Fourth Issue – This whole Risk Adjustment is in reality just a numbers game where companies are trying to game the flawed formula – companies spent millions of Dollars hiring claims specialists to review hundreds of thousands of claims to see if they could get a doctor to issue a more severe diagnosis than what was originally on the claim. These millions of Dollars could have been better spent trying to make their patients healthier.
Fifth Issue – (possibly part of the fourth) It encouraged doctors to put inaccurate diagnoses on patients claims. In my situation I went for my annual physical and before doing any bloodwork the doctor diagnosed me with an illness I never had and put it on my medical record, after he got the results of the bloodwork which showed that there was no sign that I had the illness (or that the illness was ever present) he wrote that there is no sign of the illness but didn’t remove it from my record. I asked him to remove it from my record but he refused. The same exact thing happened at my next two annual physicals and I switched doctors after that. This may not sound like a big deal to you but think about a situation where a patient is found unconscious and rushed to the hospital where the ER doctors see the false diagnosis on the patients charts. Also, it’s on my record and will probably affect my life insurance premium rates if I try getting another policy.
“We disagree on the last part, namely as to whether something can be done.”
I’m still not convinced that something can be done (which will work fairly for those that were already seriously burned by the ACA).
You’re correct when you say that I’m talking from my experience and it seems like the people that you’re talking on behalf of is a fraction of those that are still paying thousand more in health care costs than before the ACA.
I believe that my reasons were compelling enough but if you disagree – we’ll have to just disagree on that.
(Just curious though- I don’t know one way or another- does Medicare have a process by which they approve procedures and deny claims or is everything by default approved?)
Oh- and to your last point- I would love it if they would do that. There are many “if”s that need to be worked out but if there’s a way to work out all those kinks, I’m confident that it would lower the health care costs and encourage those who aren’t eligible to become eligible. Sounds like it may have some growing pains in the beginning but would be a win – win in the long term. I actually like that idea!
@ujm
I’m not sure if my previous post went through as I got an error message- so here it is again. Apologies if it’s a duplicate.I’m not either an expert but based on discussions I had with a former supervisor who lived in the outskirts or Queens or on Long Island I believe that it’s true.
He said that the district raised property taxes sky high (with the blessings of the residents) to keep the riff raff from moving in and used the extra money to create public schools that are on par with the most prestigious private schools.
Reb Avram-
1. So the US Government doesn’t run the ACA but they created a system that was mathematically guaranteed to fail and the states need to follow it. I got to see lots of this stuff first hand during the year that I worked in the ACA and it was pathetic to think that someone actually thought it would work. Most of the stuff is too complicated to discuss here and isn’t readily available online (you need to dig pretty deep in some of the endless files on the CMS website) but take a look at the Risk Corridor 2014 payments catastrophe to begin getting an idea. (In short, despite promising that it’ll be paid out at 100% it was paid out at only 12.6% and many companies were shut down because of that.) I’m not even judging them by the rollout disaster.
2. Public Schools (the ones that I’m referring to) are a huge disaster as they waste hundreds of billions of Dollars and have little to nothing to show for it. I believe that the same will be true if the healthcare system turns into a single payer system. In short- I was referring to the hundreds of billions of Dollars that will be wasted- regardless of who pays for it or how it’s paid.
3. I consider a huge salary to include those who work for unions and are getting paid much more than they would be getting if they were paid the going rate- especially the public-school teachers that have nothing to show for it. Many places publish the salaries of public employees online so you can take a look. I consider a meager salary to be the salary of those who get pretty low compensation when they have lots to show for their work (i.e. many Rabbeim…).
4. Regardless of who is at blame, who caused it, weather you believe it or not or the amount spent on each age group- the point is that hundreds of billions of Dollars is wasted every year on preventable claims. That number needs to come down before a single payer system can work.
Ok, you got me there. I wasn’t reading your posts carefully and I apologize. I believe I misunderstood a comment of yours that health insurance companies shouldn’t be run by high paid CEOs, I took that to mean that you felt that they should be run by low paid CEOs and not that you felt that they should be shut down altogether. I was fixated on that point and my posts reflect that.
I’d still like to continue our discussion if you don’t mind. And again, I apologize for any frustration I may have caused you.
א גוטין חודש
Avi
ATTN: MODS
“Can you break up the super long posts into shorter ones? Or send more coffee over to Mods HQ?”
I don’t use any foul language, Lashon Hora or viscous attacks in my post so you don’t need to moderate them before approving them.
“Medicare works”
Ok, here’s another important point of mine that you ignored. I mentioned earlier that Medicare is generally for people aged 65 and older. People that age grew up in a different era where they took more responsibility for their health. Once you start including the younger generations the costs will spiral out of control.
“here other countries manage. I see no reason why the US can’t manage soemthing similar.”
Again, it’s the culture ingrained nowadays in the US that life and health are practically worthless.
“The fact that something else was tried has nothing to do with this .”
To me it does- it proves that the US Government has no clue how to manage healthcare for those under 65.
“Sure
No premiums. taxes go up. Government pays for health costs.
Easy peasy
Same as medicare just for everybody”That’s easier said than done. It’s like saying you can fit five elephants in a Volkswagen by putting two in the front and three in the back.
“I am nto sure what there is to address. But I’ll repeat it again so encourage people to care about their health.”
That’s not my problem and I have no idea how to go about doing it- it’s a horrible culture that they’ve been brought up in- if you’re trying to get a single payer system to work you need to first figure out how get people to take responsibility for their own health. That’s the first step.
“for the 21st? Time they shouldn’t survive. that is my plan.
How on earth are you still not getting this?”You made it clear that you don’t like health insurance companies, you’ve made it clear that you don’t like it that CEOs make so much, you’ve made it clear that you don’t think companies need high paid CEOs to survive and you’ve made it clear that health insurance companies should be not-for profits with low paid CEOs- I don’t believe you’ve said that they should all be closed down.
“Take one day’s worth of the Ceo’s salary use it to pay my neighbor’s cancer treatment for 2 years (10,000 a month), the ceo will barely notice the missing money its not even a rounding wrror. And neighbor gets to live a few more years . I know I know “no sane person” would expect insurance company to shell out money just to gain few years (The rep practically told him that too) . and leshitascha I can’t blame them they have to make profit.”
The massive salaries that the CEOs make can not pay for all the claims that are denied (it’s not only your neighbor whose claims are getting denied). This is a problem with a for profit company (the health of the insureds should come first but the wallets of the shareholders have a higher priority) and I’d be all for a single payer system if there’s a chance that it’ll work.
“This is incorrect Medicare is very popular.
and by far the easiest company to deal with.”Of course it’s easy to get them to give out other people’s money- those weren’t the issues I was having with them. One issue I was having with them was when I needed a response from a certain person regarding a report I needed to submit that was already overdue. She (and her supervisors) ignored my repeated calls, voicemails and emails for over a month. When I learned that she was hosting a webinar I joined and during the Q & A at the end I asked my question. She gave me the wrong answer and when I pointed it out based on guidance published by CMS she said she would look into it and get back to me. Despite numerous attempts to contact her (and her supervisors) I never heard back from them.
“what ? Seriously, What?”
What part don’t you understand- that a CEOs salary is based on his / her performance determined by the board or my idea what you could do if it bothers you?
“Again?
Sure. so encourage people to take more responsibility. You got me. I’m in.”Yes, Again- until this issue is resolved a single payer system will not work.
“Sure.
firstly Medicare works so no reason to compare to ecucation which is less similar.”As mentioned previously, Medicare works because it’s for a more responsible part of the population. Education is less similar but similar enough in that it’s failing because the people that it serves don’t take responsibility for themselves or their kids.
When I used to take my kids to the doctor for an ear infection I would make sure to follow the doctors directions and pick up the medication right away- aside from not wanting my kids to be in pain I didn’t want to have to pay the copayments for follow up visits. For people who don’t care about their kids (i.e. the ones who send them to public school, have no idea that their kid is failing every single subject and barely ever shows up to class) and aren’t concerned with a copayment- what incentive is there to follow the doctors recommendations? This attitude is one of the things that is going to break the system.
“Second all the government will be doing is paying the bills.”
If they keep paying all the bills (with no cost to the patient) what’s going to discourage someone with a paper cut from going to the emergency room, taking up a bed, wasting precious resources and having the government pay hundreds or thousands of Dollars- instead of them just going to Duane Reade and spending a few Dollars to get a box of Band-Aids? Eventually they’re going to have to do some denial of claims and then it’s going to be the government that decides who’s going to live and who’s going to die? Does it make you happier that it’s the government deciding and not some rich, greedy CEO?
“And I’m not sure how you think private medical insurance makes sure their clients are listening to doctors any more than Medicare does.”
That’s what copayments and deductibles are for- to discourage unnecessary follow-ups and encouraging the patient to follow the doctors directions. Besides- when people pay for things with their own money (i.e. health insurance premiums and private education) they tend to value it more.
“I dont understand this.
I support one idea, why do I “have to” defend a different idea ?”As I’ve said before but you never adequately answered (a strong point that you ignored)- you’re advocating for the US Government, who failed miserably at the ACA, to be in charge of a single payer system. You need to explain why you think the same US Government could successfully run something of a much larger magnitude.
“I am advocating paying less for a higher quality system.”
That was former President Obama’s claim with the ACA- the typical family will save $2,500 per year in healthcare- and we all saw that it wasn’t the case. I understand that you’re advocating for that (and I wish it were possible) but you haven’t explained how we’re going to end up paying less (where the money is going to come from) or how the quality is going to go up.
Would you mind explaining how you think it’s going to work?
“By any Benchmark the US pays MORE for healthcare. By most benchmarks we have worse outcomes.”
I’ve said this point before and you haven’t addressed is so I’m going to repeat again- this is mostly due to the irresponsible culture here of people not caring about their health or taking responsibility for their wellbeing.
“Same for healthcare. “Hey it works for me who cares about those it doesnt work for, that is just a necessary evil” (almost a verbatim quote)”
Where’s this coming from? You can’t ask people who are struggling to make their own health care payments (already so overpriced due to the people who refuse to responsibly of their health) to care more about someone else’s health than they care about their own. (Again- I’m referring to those who are fully capable of taking care of themselves but refuse to, not people sick with illnesses that they didn’t bring upon themselves.)
“As I said (20 times?) I don’t think health insurance should be a for profit industry. So while you keep repeating this point over and over. It has absolutely nothing to do with the subject at hand .”
You’ve said that health insurance companies don’t need to be run by high paid CEOs- did you mean to say that for health insurance companies to work they need high paid CEOs but health insurance companies shouldn’t exist at all? You still haven’t explained how a company will survive with a low paid CEO.
“Ok so CEO wont be filthy rich. I’m fine with using that extra $$$ to approve more cancer treatments.”
Then the CEO will resign and become a high paid CEO elsewhere. I agree that they’re greedy but we need them to run our corporations which provide employment to millions of people making a modest salary and provide goods and services to hundreds of millions of people. Go ahead and replace them with well-meaning but low paid CEOs and watch how fast everything will fall apart and make things worse for everyone.
“You say there is no CEO of a healthcare company that gets a reasonable salary. Yes I know, THAT is the problem The problem IS that health insurance IS a for profit venture. Yes Its hard to find a reasonably paid CEO, that is EXACTLY the problem. Have I really not said this ????”
I didn’t write that there isn’t one (I’m not saying that there is, I have no idea one way or the other). I just asked if you could explain how it could work without one. Until a not-for profit system can be designed we need for profit companies which come along with high paid CEOs. I mentioned how practically every single COOP (not for profits that received Billions of Dollars and had low paid CEOs) failed.
“But if you insist as far as I can tell Chiquita Brooks-Lasure the head of CMS (center for medicare and medicaid services) makes $249,723.”
CMS isn’t a private company- it’s a government agency. From the ridiculous dealings I had with them (while working in the ACA) and the sheer incompetence of the people working there all I can say is that a typical company that acted like that would be out of business within a year. The president of the US also makes a mere fraction of what these CEOs make- but again- no company could survive with him at the helm.
“In contrast Cigna CEO David Cordani took home more than $91 million in 2021 thats more than 364 times as much!!! put another way, he made her salary every single day of the year minus his birthday.”
Obviously the shareholders and board which determines his compensation felt that that’s what he’s worth. If you feel that he’s overpaid start a mutual, not-for-profit company that’s owned by the policy holders, become the low paid CEO, pay all claims, charge lower premiums and if you can stay in business you can put them out of business- that’ll show them.
“As I said over a month ago (February 2, 2023 5:35 pm) that is a technicality. If you want to increase taxes on smoking /sugary drinks etc to encourage good behavior. sure I can get on board. You want some sort of mandatory exercise program, I’m a bit squeamish but ok if thats what it takes I’m in”
You may have said that over a month ago but it still doesn’t respond to my strong point that a single payer system CAN NOT work until people start taking more responsibility for their health. Can you please respond to that directly?
“My apologies I missed all of your “strong points”
Do you mind repeating them”Sure- here’s one of them.
I mentioned a few times that a single payer system will turn into a calamity the size of the public school disaster. Some school systems pay in the $30,000 range per student yet don’t have a single student that is proficient in math ot English. All this while the teachers (some of them who have no business being around children but are protected by the powerful unions) are bringing in huge salaries. After paying for all this in taxes, families that want their kids to get an education are forced to send their kids to private schools at an additional expense.
With a single payer free health care for all, you’re going to have people who don’t take care of their (or their kids’) health, don’t follow doctors directions and end up costing the system billions of Dollars in unnecessary expenses while clogging up doctors’ offices, hospitals and emergency rooms. What’s going to end up happening is that those of us who care about our health and currently have insurance are going to have to pay more in taxes for a single payer system while having to take out private insurance all over again if we want quality health care.
“There were no points in this last post that were strong nor that I didn’t previously reply to”
Uh- there was- the comparison to the public school that I just repeated again. Please explain why it’ll be different
Can you break up the super long posts into shorter ones? Or send more coffee over to Mods HQ?
“I’m not defending ACA because that is not my proposal. A single payer system was proposed but quickly shot down.”
You’re going to have to defend the ACA if you’re insisting that the government can come up with a single player system that’ll work after they failed miserably on something of a much smaller scale.
“That hasn’t been my experience.
Most people I talk to who have had a medical expense (Cancer treatment denied, procedure denied both in the past week) do not think this is working. They are sane people, but whereas you “sympathize with them and wish something can be done” I know that something can be done”There are exceptions- I agree, that’s why I used the word “probably”- to exclude people who, for extreme circumstances, would not be in that category. Please explain though why any sane person (not in an extreme situation) would want to pay more for a lower quality healthcare system?
“You remind me of the Onion article that runs after every mass shooting “”‘No Way to Prevent This’, Says Only Nation Where This Regularly Happens””
The reason why we’re the only nation where this regularly happens is because we’re the only nation where it’s ingrained in people’s culture that life (their own or others) has little to no value. Change that culture and the number of mass shootings will go down.
“I can hear it:
“No way to fix this says only country where medical bills is leading cause of bankruptcy” !
And “we have the best healthcare system in the world says the country with highest healthcare expenditure and lowest life expectancy of (almost) any western country””Sure there’s a way to fix this. Change the culture of people and teach them the value of life at a young age. Look at all the unhealthy lifestyles that people have- get them to make healthier choices from when they’re young and the healthcare expenditure will go down and the life expectancy will go up. Instead, we have people like you putting the blame in the wrong place. Once people start taking responsibility for themselves- then a single player system can be a viable option. Until then- it’s going to crash and we’re all going to be worse off.
At this point I’m getting pretty frustrated with this discussion. I respond to practically everything that you write (no matter how many times you repeat the same thing in different words) and you don’t respond to many of the strong points that I make. The points that you do respond to, you don’t bring up any claim to back it up.
I’m happy to continue this conversation if you can answer my questions straight to the point. If not, it was a pleasure discussing this with you but I’m done.
1. You mentioned that health insurance companies don’t need high paid CEOs to function. I brought you many examples of non-public companies run by low paid CEOs that failed miserably (the ACA COOPS). Can you show me (or explain how it’s possible) a health insurance company (public or private) that functions with a low paid CEO?
2. I opined that until people learn to take responsibility for themselves a single payer healthcare system will turn into a calamity the size of the public school system where those who want quality healthcare will have to pay for their own insurance above the extra taxes they are already paying to fund the single payer system. Can you please explain why you disagree with that?
“Medicare already exists, its popular it works
all we need to do is expand it. We can lower age to 55 then 45 etc etc”Once people made it to Medicare eligible age, I’d put most of them in the category of those who take responsibility for themselves. The bulk of them are retirees not doing stupid things like drugs, drunk driving… Once you start lowering Medicare to start including the age rage where people don’t take responsibility for themselves it’ll fail.
“I’m not defending the ACe, mentioned that earleir .”
Why aren’t you going to defend it? If the government failed catastrophically at the ACA, why do you think they’re going to succeed at something that’s going to be much larger?
“Other countries manage. We can do it! don;t give up so easily We are the best USA USA ! We put a man on the moon! We can do anything! Murica!!!”
What other country has citizens that are as unhealthy as US Citizens and has universal healthcare that works? In order for it to work the citizens need to start taking care of themselves and get themselves healthier. This will take a few decades but can be done. As of now we’re heading in the wrong direction full speed so I don’t see it becoming feasible within the next few generations.
“Do you disagree that high paid CEOs are needed for health insurance companies to function?
Yes”Can you explain how it would work (or show some examples) without high paid CEOs?
“It wont last. I ve said this several times. for profit healthcare system CANNOT work. By design to profit they HAVE to deny care. people have to needlessly die/suffer. You said this.”
What I meant was for you to go ahead and start a not-for-profit company that pays all claims and become its low paid CEO. Let’s see how long that lasts.
“now if you say the benmefit outweigh that. fien I hear. I disagree but Ihear.
But then you miz up your messages and tell me that healthcare companies need to make a profit.
YEs that is YOUR position not mine. I have said that a few times. I am not sure wh yyou keep repeating that.”I’m not sure what you’re trying to say here.
“No Not finally.
I said that from the begining when I pointed out that you hypothetical was illy.”I mentioned numerous times that my hypothetical situation was meant for @jackk just to get a starting point where we’d probably agree on something, unfortunately he (and @CTLAWYER) refused to acknowledge the post. It was NEVER meant to represent a situation that can ever come up in real life.
“Yes for a healthcare company to profit they have to deny healthcare. people need to suffer/die/go bankrupt. There is no other way.
(you said this to me a few times as if I didnt get taht, I get it that is EXACTLY the problem with outr current system. IT CANNOT work for everyone)”
Yes, I said this and I still stand behind this. It’s unfortunate and it doesn’t work for many people. I sympathize with them and wish something can be done. Unfortunately, the amount of people that the health care system won’t work for will sky rocket if the government takes over which is why the current system needs to stay in place for the time being. Like I keep saying, just because we have a system that doesn’t work 100% of the time for 100% of the people, doesn’t mean that you throw it out for a system that is guaranteed to fail.
“The only way to have it work for everyone is for the government to step in.”
This is 100% wrong. The system will not work for everyone if the government steps in and will eventually collapse- possibly taking all aspects of healthcare with it.
“There are 2 reasons I can think of why someone would oppsoe this
1) Dont think it would work
2) don;t think governemtn should be involved even if would work.”I’m in the first category (as well as probably every sane person in the country who currently has health insurance)- I have no problem with the government running it- as long as they have a realistic plan. The last time they tried this (i.e. the ACA), they failed miserably. The only people in the second category are probably sovereign citizens and those who wear tin-foil caps.
“1- I don’t fully get. so make it work. It works for Medicare it works in other countries. It works for dialysis patients expand it to cancer expand the age for medicare.”
So make it work? That’s easier said than done.
(I’m not familiar with kidney dialysis but does Mediare actually pay for all their expenses?)“I say denying healthcare is a non starter if thats the only way it can function,”
It’s too late for that- health insurance companies have already been started, are going strong and are here to stay.“then we need a different way. Period If that means Insurance will no longer be the lucrative field it is (one that MADE money during a pandemic!!!)”
Sounds good to me, go find another way- one that’ll work though. Just because something isn’t functioning 100% doesn’t mean that you get rid of it for something that has a 0% chance of succeeding.“and instead we a need a non-for profit system or Government run Ok so be it.”
The government tried that already with the COOPs (part of the ACA). Each state was supposed to have one, they were supposed to be not for profit and the CEOs (or any employee) couldn’t make too much money. The government pumped billions of Dollars into them and they practically all failed within a few years (causing the providers to lose hundreds of millions of Dollars in unpaid claims and causing the policy holders to lose thousands of Dollars each in high deductibles that had to be restarted mid-year).“But denying healthcare a patient and or doctor* deems neccesary is a non-starter for me”
Again, just because the system isn’t functioning 100% of the time for 100% of the people- doesn’t mean that you get rid of it for something that has no chance of working.“disagree completely”
It would help if you would let me know what part of my comment you’re disagreeing on.Do you disagree that CEOs make lots of money in their positions?
I’ve never researched this but I think the salaries of CEOs in publicly traded companies is available online.Do you disagree that high paid CEOs are needed for health insurance companies to function?
Again, take a look at the failure of the COOPs where CEOs weren’t allowed to make too much money.If you think it’s possible, go ahead and start a company that pays all claims- let’s see how long it lasts.
“Agree but while you view that as a feature. To me hat is a bug. In other words yes That is the way it has to be to function this way. My reply is: It cant be that way there fore it shouldnt function this way. we need a new system. Period.”
It’s an unfortunate feature- If companies just approve every claim they’re going to go out of business as premiums weren’t priced based on that. If they raise the premiums to be able to afford to pay all claims- the policy holders will just switch to a company that doesn’t pay all claims. You’re correct that it shouldn’t be that way but, again, just because there’s problems with a system doesn’t mean that you throw it out for a system that’s guaranteed to fail.“Yes becasue of what yyou addmitted was “as unfortunate as it may be” If it is unfortunate, change it! It doesnt HAVE to be this way. We chose this.”
Again- just because a system is unfortunately not working 100% doesn’t necessarily mean that there is a way to fix it or that changing the system will be better. It doesn’t necessarily even mean that it’s the design of the system that’s flawed- the system could also be harmed by people who aren’t even part of it but are still bringing it down.“YES! that is where we disagree. As I said from one of my first posts”
Finally! We agree on what we disagree on. As I mentioned in an earlier post- in order for a government run healthcare to work in this country the inhabitants need to start taking more responsibility for themselves- and we’re decades away from this and heading full speed in the wrong direction. Were the government to take over it would turn into an epic disaster probably the same size as the public-school calamity. Taxes will go up; the system will barely work for anyone and those who are serious about their healthcare are going to have to buy their own insurance (above what they’re already paying in their increased taxes).I strongly feel that a system that’s working, but not for 100% of the people, shouldn’t be thrown out for a system that is guaranteed to fail catastrophically. Apparently, you disagree.
Thanks for taking the time to break down the issues and discuss them one at a time- we can now see where we agree and where we disagree.
We seem to agree that CEOs make lots of money in their positions and that high paid CEOs are needed for the health insurance companies to function. We also agree that (as unfortunate as it may be) CEOs (and companies) need to either be aggressive in denying claims (lawfully or unlawfully) to keep premiums down or they’ll either go bankrupt or put out of business by the competition. (It’s wrong, I know, but that’s the only way it can function.) We finally seem to agree that a physician should be doing everything for the best interest of a patient and setting aside how his / her decision will affect the bottom line of the company.
What we seem to disagree on is who should be running the healthcare in this country.
Despite all the problems going on with corporations running healthcare as a business I still think it’s the lesser of the two evils. Just because there are decisions that are being made that are morally wrong doesn’t mean the alternative is better.
A government probably could run an efficient healthcare system but the United States is decades away from that happening. The catastrophic implosion of the ACA proves that the government is nowhere near ready to take over the entire system. Even if the Government knew what they were doing, for such a system to work the culture of citizens needs to change- they need to take more responsibility for their health and actions and realize that just because they’re not paying for something doesn’t mean that it’s free (i.e. not costing anyone anything).
If the US Government would suddenly take over all aspects of healthcare it would turn into a crisis like the public school systems in many cities and states. Tuition is free, many schools have entire grades where not a single student is proficient in English or Math, truancy is rampant, teachers couldn’t care less about what goes on but use the unions to inflate their salaries and parents blame the teachers and schools when their kids fail (while they didn’t know or care that their kids weren’t even going to school). Everyone (who pays taxes) pays for the public school systems with their taxes and if someone wants a quality education for their kids they need to pay for a private school on top of that.
Imagine the same with public healthcare run by the government- doctors’ offices, hospitals and emergency rooms would be full of people expecting the system to take care of them while they refuse to follow the directions given to them, show up for follow-ups or do anything to improve their health. Taxes would shoot up to pay for this and anyone who seriously wants to take care of their health would need to pay out of pocket (above what they’re already paying in extra taxes) to go to a doctor that’s not part of the system.
So down the road it may be possible but it doesn’t look promising as the country is headed full throttle in the wrong direction.
“Percentage alone isnt everything”
That’s definitely correct, there are many, many more metrics that can be used to quantify data. However, given that CMS uses a percentage it’s the most appropriate metric to quantify this data.“The Ceo’s and Presidents of insurance companies get paid multiple millions of dollars”
That’s correct again. There aren’t too many people on the planet that can accomplish what CEOs of large companies accomplish and those that can do it and are willing to give up their personal lives can command whatever salary they want. If you don’t like it start your own company and pay the CEO $150,000, let’s see what kind of CEO you get and how long the company remains afloat.“At one Point Mark Bertoloni received almost 28 million dollars in one year. while running a company that denies claims that could have saved lives.”
This is morally wrong but he’s a businessman and makes business decisions. Had he approved all of the claims that were denied the company would either have gone out of business or had to raise premiums much higher than the competition and then gone out of business the next year. It’s wrong, I agree- but that’s how it needs to be in order for it to work.“What I was most outraged about whas the physician who just rubber stamps what nurse had previously denied. what is the poitn of having a physician reviewer if he isnt actually reviewing it?”
That was totally appalling- physicians shouldn’t be businessmen, they should forget about money and do what it takes to make the patient as healthy as possible.“It is their business model . Yes they have t pay 85% that still leaves millions and million and millions for their top executives .”
The 15% doesn’t only go to executives, it goes to all employees, marketing, real estate, IT, employee benefits and many other expenses. The top executives do get millions but the company wouldn’t function without them.
“I question your statement that the bill of healthcare expenses could be avoided if people took care of themselves from a young age.”
I’m going to assume that you meant to write “bulk”, but anyway- I got that from a presentation made by actuaries and they had the ratio at around 85% avoidable to 15% unavoidable. Luckily, I hopped off the gravy train I was riding at the time at the last stop before its catastrophic crash. Unfortunately, though, as I’m no longer in the health care industry, I don’t have access to that presentation and I can’t find the slides I thought I saved.
@jackk mentioned pregnancies in a previous thread and I was looking for the study to see its sources and see if they counted pregnancies as avoidable or unavoidable but as I mentioned I couldn’t track it down.So Bli Nader until I can find the presentation and investigate the sources, I’ll try not to write that the “bulk of medical costs are avoidable” but rather “hundreds of billions of Dollars in medical costs are avoidable”.
You mentioned that you’re a supporter of the ACA- in your personal opinion, how do you justify the catastrophic consequences it had on millions of families whose medical expenses went up by around $10,000 annually? If they’re hard-working families and already had generous coverage- is it fair to make them pay so much more?
I read the article (it’s long) and I was shaking and fuming. I’ll get to that later on.
“The only point I said wasn’t true was this”
Can we hit the reset button on this? I was having a pleasant discussion with you where, although we didn’t agree on everything, we discussed things peacefully and respectfully. What I meant to say what that there possibly could have been a better choice of words. You probably didn’t mean any harm but comments like that can potentially be perceived as a personal attack and disturb the flow of the conversation.
Most of the complaints against healthcare were, in my opinion, unfairly pointed at insurance companies. As I mentioned earlier, they cannot raise premiums at their whim and 80% or 85% of premiums must go to providers, any additional premiums collected are returned.
As far as the government providing free health care and dental care- I think theoretically a government should but given the culture of the citizens here we’re way too far away from that becoming a reality. (The money has to come from somewhere and people need to take more responsibility for their health. Until that happens any attempt will implode pretty fast.)
I feel bad for you for the trouble you’re going through with health insurers- I normally don’t have those kinds of stories. The issues I’ve had normally begin with a claim being denied due to a provider putting an incorrect diagnosis code or procedure code (they’re extremely confusing) and then the insurance company not paying until the error is corrected. I then get the run around from the provider who wants to get paid (their billing department says that they can’t change what the doctor wrote) and the doctor who doesn’t have time to call back or review / correct the records. These could take months to resolve and even get sent to collection agencies (I know it’s frustrating) but ultimately, it’s not the insurer at fault.
As far as the story you mentioned is concerned- I hope that’s the exception and not the norm. I found it sickening that they were willing to save money by taking a business risk at the expense of a different human’s quality of life. Equally as sickening was the immature giggling you can hear in their phone conversation when they came up with the excuse to discontinue his drug coverage. (Even if they had a valid reason to deny the claim- any human that can laugh at saving money at the expense of another human has no business being making any health decision for anyone else.)
If this unfortunately does go on on a regular basis then I take back what I wrote earlier and agree that health insurers share a larger percentage of blame in this mess than I earlier attributed to them.
Have a Gut Shabbos
“Sure! in one of my first comments to you
here it is:”I posted a point that I was trying to make which was 100% true and you said that it wasn’t true. I asked if you could respectfully mention that you had a different point in mind instead of accusing me of lying. You left out the second half of my sentence in your response. (And no, an earlier post of yours cannot constitute a response to a later post of mine.)
Anyway- from my point of view this thread has run its course- I answered a number of questions other posters had but they still want to point the blame in the wrong place. I don’t think there’s anything else I can add.
I explained why actuarially it’s not possible to have reasonable premiums and coverage for dental care but people still think that insurance companies are selfish capitalists.
I mentioned that the ACA mathematically had a 0% chance of working as designed (it’s more complicated than dental care but I was willing to discuss it if anyone had any questions) but posters still consider health insurers to be greedy corporations.
The issues that you brought up, having to find new doctors every time your employer switches insurers, is more of a problem with your employer not keeping the same plan and your providers not being in consistent networks than with health insurers trying to be stingy. Sure, it’s annoying and I sympathize with you but you need to put the blame where it belongs.
I didn’t read the story you mentioned but I’ll agree with you that there can be some bad apples out there just like there is in any industry, that doesn’t mean that the insurance industry is rotten to the core.
As far as insurance companies raising rates whenever they want to make the greedy executives even richer- that’s a lie. As I mentioned before- insurers have to file a rate increase with the state before they can raise the rates and the state usually doesn’t allow the full increase applied for. This is on the CMS website.
Also, on the CMS website you can read about the MLR- Medical Loss Ratio. Depending on the plan 80% to 85% of premiums have to go to medical claims, the other 15% to 20% can go to marketing, salaries, benefits, real estate, bonuses… If the claims ratio doesn’t reach the threshold the insurer needs to return the excess to the policy holders- they cannot pocket it.
So, in short- NO, insurers cannot raise premiums on their whim to enrich themselves.
“no, I’m mising YOUR point. yo uare trying to make this about Obamacare and your specific circumstance (not that I blame you)
reread my comments, I am not discussing Obamacare.”My point was specifically regarding the catastrophic consequences on hard working families caused by the ACA and I explicitly mentioned that.
If you were referring to a different point can I respectfully suggest that you mention that instead of saying that something I wrote wasn’t true? It disturbs the peaceful flow of this discussion.
“I did but they don’t care. and there is not much I cna do about it other than quit. and a system where you have to quit to keep your doctor is even crzier than finding a new doctor in my opinion.”
I feel bad for you, it’s definitely not a good situation, but it seems like this issue is caused by your employer and providers, not the insurance companies. When my employer switched insurers the providers were in both networks so I’m wondering what’s going on as it seems like the premiums you and your employer are paying are much higher than the premiums paid by me and my employer (I.e. the networks should be around as good)? Do you work for a Frum place? Frum employers tend to have higher premiums.
The only doctors I recall switching from where two that weren’t honest (one billed me for a sick visit by my annual physical even though I felt great and one diagnosed me with a disease I didn’t have).
“Great We agree then!
Medicare for all!!! Huzzah”Whoa- not so fast. It’ll take generations to implement. First we need to get people to take responsibility for themselves. A major part of that is getting rid of the culture embedded into the youngest of our citizens that their health isn’t their problem. Keep in mind that there’s a major political party paying people to be takers and vote for them. Even if the makers are still a majority the takers are reproducing at a much faster rate.
As I’ve mentioned before and I’ll mention again- insurance companies are in the business of collecting premiums to assume risk. The higher the risk the more premiums they charge.
Insurance companies lost hundreds of millions of Dollars due to the ACA and many companies were put out of business causing providers and their insureds to lose additional hundreds of millions of Dollars.
Why do you consider insurance companies any more greedy than any other corporation that’s trying to make a profit (e.g. a car dealership, a cruise line, and an amusement park…)
“There is nothing stopping them from raising premiums and lowering coverage.”
That’s another one of your lies! Insurance companies have to file proposed rates hikes with the state, justify them and wait until they get approved. Check out the CMS website for more information.
“All this was happening before Obama.”
That’s true- he didn’t invent the freeloaders, he just came along and exasperated the problem exponentially.
“Individual Americans have no recourse.”
That’s another lie! Just because you don’t want to do something doesn’t mean that you can’t. Individual Americans can go ahead and vote Republican.
“This is not true
The increase in tax was $695 that is ti . And it ONLY applied if you dindnt have health insurance .”Again- you’re purposely totally missing the point. I specifically wrote that it wasn’t an “income tax or sales tax but it was a forced tax on the hard working makers to pay the premiums for the lazy takers”. My portion of the monthly premiums went up by around $200 and my employers portion went up by $200 as well. The annual deductable went from $250 to $7,500. Again- this was not a typical tax per se but an extra expense forced on me by the ACA through former President Obama.
“right , a complelty insane system. so if I change jobs I may need a new doctor. If my employer gets a better deal I and chanegs companies I may need a new doctor it is crazy.”
Complain to your employer if they keep switching insurers or complain to your doctor if he / she isn’t in enough networks. Insurers attempt to keep premiums down by agressively negotiating with providers who want to be in network. If your provider is too greedy to agree to the insurers terms you can’t blame the insurer.
“what on Earth does my insirance have to do with my employer”
As I explained earler- the fact that you can report to work makes you appear healthier than the general population and makes the premiums cheaper. If you’d rather pay more to have a consistent policy that doesn’t change from year to year go ahead a buy one on your own. The percentage that the premiums increase from year to year will be significantly higher.
“Yes youve said that the problem is it isnt the just the “lazy” who get cancer .”
I’m not sure what you meant to write over here. But again, too much of health care costs in the US are avoidable if people were to ask responsibly. Some costs are unavoidable and the government should be there if the patient was someone who for reasons beyond their control couldn’t get adequate coverage.
“and Again if it got you on board, Id support increased oversight on halthier diet/excerices increased regulations on smoking etc”
Yes, that would get me on board.
“Yes health insurance companies are greedy. I hate them too.”
Health insurance companies are there to make a profit just like any other company. Their business model is to take payments to assume a risk. Why do you consider them any more greedy that any other company that wants to make a profit?
“Not sure why you blame that on Obama.”
I don’t blame Former President Obama for insurance companies wanting to make a profit- I blame him for forcing me and tens of millions of other hardworking people to pick up the slack for those who choose not to work.
“If you dont mind my asking what was the change in benefits? Why dd it go up so much?”
Any changes in the benefits were negligible. The extra premium was to cover the premiums of those who aren’t going to be paying the premiums on their own. A deductible (and copayment) is to discourage people from calling an ambualnce to be rushed to the emergency room for a paper cut. The skyrocketing deductibles were to cover those who don’t have a deductible (or copayment) and will be calling an ambulance to be rushed to the emergency room for a paper cut. (As it’ll be cheaper for them than buying a Band-Aid from CVS.)