KaskadskyjKozak Posted June 1, 2007 Posted June 1, 2007 When people get things for free they don't work harder. Are you saying that students in private schools work harder than those in public schools? I don't know for a fact, but it is just as likely the other way around. On average, students at top-tier public schools tend to work harder than those at lower-tier public schools, and students with free-ride scholarships often work the least. That's been my experience. Quote
Peter_Puget Posted June 1, 2007 Posted June 1, 2007 I'm not exactly sure what you wrote there, PP, but I think you may have misread what I posted. The cost of collection is extremely low if the self-paying customer pays at the time of service -- and they offer these "pay at time of service" discounts in recognition of this fact. I have seen these discounts offered not only at every physical therapy / massage / etc. provider I have been to, but they offer the same thing at outpatient clinics including one run by your very own Swedish Hospital here in Ballard. These clinics are NOT serving rich people. Virtually every clinic, doctor or other provider you go to has a deal where if you are self-paying, you can get a hefty discount - 30% if you pay the date of service. This is their way of getting around the insurance company policies that say they cannot charge extra for insurance billing. The cost of waiting six months to be paid (no exaggeration) and filling out all the paperwork is HUGE. Huh? While I agree with the time value of money I also think that cases where healthcare providers/facilities collect 70% of charges (on average) is rare. What are the costs associated with collecting on self-pays? I would bet they can be HUGE. There is a great deal of competition for cash paying customers => see increase in the offering of bariatric services. These competitive services however tend to cater to the well to do. It is always the other guy who misunderstands.... I agree that prepays are cheaper than credit collections. I think I suggested as much. Cash upfront business is vere rare for most traditional services. It is not rare for either bariatric or comsetic services. Most cash payments are people w/o insurance or catastrophic insurance only. In either case third parties would not be involved. Earlier you clearly claimed (in bold) that the discount arose out of insurance restrictions. Now you claim that the discount is recognition of close to zero collection cost for pre-pays. Which is it? _________________________ Quote
cj001f Posted June 1, 2007 Posted June 1, 2007 It is always the other guy who misunderstands.... I agree that prepays are cheaper than credit collections. I think I suggested as much. Cash upfront business is vere rare for most traditional services. It is not rare for either bariatric or comsetic services. Most cash payments are people w/o insurance or catastrophic insurance only. In either case third parties would not be involved. Earlier you clearly claimed (in bold) that the discount arose out of insurance restrictions. Now you claim that the discount is recognition of close to zero collection cost for pre-pays. Which is it? _________________________ I was actually in agreeance with you earlier until you talked yourself into this box. 1) Make health insurance no longer deductible for businesses 2) Make medical records easily accessible to the consumer and other doctors, thereby making the consumers record transferable 3) Establish some sort of universal baseline individual catastrophic coverage to fund the mandated universal emergency room coverage Quote
mattp Posted June 1, 2007 Posted June 1, 2007 Earlier you clearly claimed (in bold) that the discount arose out of insurance restrictions. Now you claim that the discount is recognition of close to zero collection cost for pre-pays. Which is it? PP, it is pretty simple. The cost of providing services that will be reimbursed by insurance is much greater than that for those who will pay their own bills. The increased cost is due to all the forms, delay, and BS imposed by the insurance companies, which is clearly as much or more an effort to delay and reduce their payout as much as it may be aimed toward reducing fraudulent claims. The person who is actually going to pay their own bill doesn't much benefit from delaying payment (assuming they can afford the services they purchased), but the insurance company who invests the money entrusted in their care benefits HUGELY from delaying payment. This is why the insurance companies ALWAYS delay payment, while the person paying for their own treatment generally preferss to "pay as they go." The very real affect of allowing a discount for paying on the date of service (exclusively available to those who actually pay for their own services because an insurance company cannot and never does this) is to impost a surcharge on insurance billing. This isn't advanced math. The ideas that receipt of payment concurrent with treatment is better for the healthcare providers, and that delayed payment and extra red tape is bad for them and expensive are not mutually exclusive. Quote
JosephH Posted June 1, 2007 Posted June 1, 2007 1) Make health insurance no longer deductible for businesses 2) Make medical records easily accessible to the consumer and other doctors, thereby making the consumers record transferable 3) Establish some sort of universal baseline individual catastrophic coverage to fund the mandated universal emergency room coverage The U.S. will never stop the competitive slide with this approach. Again, an educated workforce is the only competitive edge we will have going forward and 'baseline catastrophic coverage' will never provide the necessary baseline of family health necessary. Quote
cj001f Posted June 1, 2007 Posted June 1, 2007 1) Make health insurance no longer deductible for businesses 2) Make medical records easily accessible to the consumer and other doctors, thereby making the consumers record transferable 3) Establish some sort of universal baseline individual catastrophic coverage to fund the mandated universal emergency room coverage The U.S. will never stop the competitive slide with this approach. Again, an educated workforce is the only competitive edge we will have going forward and 'baseline catastrophic coverage' will never provide the necessary baseline of family health necessary. Unfortunately the fat ass I'm going to sit my ass on the couch and eat doritos I need that pill the adds just pitched me American public would bankrupt a reasonable system. Plus the first Senator who was told they can't have the surgery at 2:45pm on a thursday, conveniently after they are done fucking their intern following the 4 martini 3 lomo lunch, but have to have at 12:45 missing their sirloin satisfaction would throw a fit. Quote
JosephH Posted June 1, 2007 Posted June 1, 2007 Unfortunately the fat ass I'm going to sit my ass on the couch and eat doritos I need that pill the adds just pitched me American public would bankrupt a reasonable system. Plus the first Senator who was told they can't have the surgery at 2:45pm on a thursday, conveniently after they are done fucking their intern following the 4 martini 3 lomo lunch, but have to have at 12:45 missing their sirloin satisfaction would throw a fit. You'll get no argument from me there - the self-feeding cycle of corruption and entitlement is killing us... Quote
Peter_Puget Posted June 1, 2007 Posted June 1, 2007 Matt if you had restricted your comments to massage therapists I would have said nothing but you wrote Virtually every clinic, doctor or other provider .... In other areas of healthcare self pay can be a different bird. I will simply leave it at that. Quote
JayB Posted June 1, 2007 Posted June 1, 2007 1) Make health insurance no longer deductible for businesses 2) Make medical records easily accessible to the consumer and other doctors, thereby making the consumers record transferable 3) Establish some sort of universal baseline individual catastrophic coverage to fund the mandated universal emergency room coverage The U.S. will never stop the competitive slide with this approach. Again, an educated workforce is the only competitive edge we will have going forward and 'baseline catastrophic coverage' will never provide the necessary baseline of family health necessary. 1). You seem to be either oblivious to or deliberately omitting an acknowledgment of the role that lifestyle choices have on one's health, and healthcare expenses. Take a look at obesity alone, here. There are scores of millions of fat people who have zero problem accessing an extravagance of preventive care, none of which has any impact whatsoever on their waistlines. Ditto for smoking, etc. 2). The notion that preventive care is a major, or even the sole determinant of workforce productivity and/or competitiveness is just bizarre. Education, taxation, infrastructure, labor-market regulation, trade policy, etc, etc, etc, all factor into the mix. I don't think that you'd be able to convince many folks that direct foreign investment in China or India is driven by the strength of their health care systems. Quote
JosephH Posted June 1, 2007 Posted June 1, 2007 1). You seem to be either oblivious to or deliberately omitting an acknowledgment of the role that lifestyle choices have on one's health, and healthcare expenses. Take a look at obesity alone, here. There are scores of millions of fat people who have zero problem accessing an extravagance of preventive care, none of which has any impact whatsoever on their waistlines. Ditto for smoking, etc. Not at all, it all goes hand in hand, and obesity rates are going up in industrialized countries around the globe. Preventative care is also all about education and training, and dealing with obesity will require a lot of both. 2). The notion that preventive care is a major, or even the sole determinant of workforce productivity and/or competitiveness is just bizarre. Education, taxation, infrastructure, labor-market regulation, trade policy, etc, etc, etc, all factor into the mix. I don't think that you'd be able to convince many folks that direct foreign investment in China or India is driven by the strength of their health care systems. I never said it was a sole component of competitiveness, but rather a foundational element no different than infrastructure. You have two options - either you have a healthy educated workforce or an expendable one. India and China are operating on an expendable model and working furiously towards a healthy educated one. They recognize it's all about education. At this point they can afford to pump education and not worry overly about overall health - they'll gleam the best as they go for some time. But no one, not even the Chinese, want to invest in educating people who then are not healthy enough to produce. It isn't rocket science. Quote
Dechristo Posted June 1, 2007 Posted June 1, 2007 Does this include all those really rich that have there money in other places? goddammit, Seahawks, tell me where! Go read Trumps book with Forbes. This will give you just a small idea. They have fucking people on there payrolls to do this shit. Get a clue buddy. Quote
Dechristo Posted June 1, 2007 Posted June 1, 2007 I just saw Lauer's interview of Carl Bernstein on the Today Show about his new biographical book on Hillary, A Woman In Charge. CB said, "there are over 25 front-page stories in this book" which covers Hillary's life from childhood to present. Some of the points I heard (and remember): Hillary did not pass her initial Bar Exam taken in DC, but then moved to Arkansas and passed it there. She always forgave Bill for his many infidelities, but ruthlessly condemned and excoriated the women of those affairs raising doubts of her personal convictions in women's rights. Hillary has "self-invented" many aspects of her life and passes off many falsehoods as fact about herself. Initially, the Clintons were very affable and helpful to Bernstein in his research for the book, providing names of childhood friends and personal acquaintances for interviews, but turned to adversarial posturing toward the completion of the book. To me, the interview with Lauer left little doubt why. Bernstein said, "she could be a powerful, effective leader and change the world, if only a little, but, only if she can become her genuine, authentic self. Quote
Seahawks Posted June 1, 2007 Posted June 1, 2007 (edited) Does this include all those really rich that have there money in other places? goddammit, Seahawks, tell me where! Go read Trumps book with Forbes. This will give you just a small idea. They have fucking people on there payrolls to do this shit. Get a clue buddy. Hope you got the point. Hey I heard there is a national spelling B going on right now. Are you in it? Edited June 1, 2007 by Seahawks Quote
Dechristo Posted June 1, 2007 Posted June 1, 2007 yeah, I won with the correct spelling of "their". I get your "point" every time you take your hat off of your head. Quote
KaskadskyjKozak Posted June 1, 2007 Posted June 1, 2007 Hillary would make a fine 21st century version of Josef Vissarionovich! Quote
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