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An audiophile and petrolhead's journal: Buckle up! - Page 348

post #5206 of 7475
Quote:
Originally Posted by Magick Man View Post

I like Jackie Stewart, but Polanski... not so much.

Good film maker, rotten human being. That also describes a large percentage of Hollywood.
post #5207 of 7475
Why doesn't Medicare pay for something like that? It p!sses me off that every working person in the USA pays 1.45% of our wages to Medicare AND every employer also pays a matching amount for each of their employees (so 2.9% total), yet little old ladies *still* can't get pain medications. It's ridiculous!

The more I learn about the Medicare system (because of my job), the more I think it is even worse than I ever imagined. The insurance companies that are contracted to be the primary interface between patients and care providers and do most of the administration of the Medicare system are simply horrible. The rules for submitting claims are arcane and hopelessly convoluted to the point that Medicare billing experts can still expect 20% of their claims to be rejected - yet 80% of those rejected claims are accepted when resubmitted - without changing them AT ALL! There are literally BILLIONS of dollars being wasted while patients struggle to get basic care.
Edited by billybob_jcv - 12/14/13 at 2:04pm
post #5208 of 7475
Didn't know the States had Medicare, thought it was just an Australian thing.
post #5209 of 7475
Might not be the same thing. US Medicare is for age 65+ or people with certain disabilities. It doesn't cover all medical costs, and most people (who can afford it) also have supplemental insurance to cover more of the costs. This is different than Medicaid, which is a program for low-income people.
post #5210 of 7475

Oz Medicare is universal healthcare.

 

Seniors get discounted drugs though the Pharmaceutical Benefits Scheme (PBS) which places a cap of $35 or so on filling a slip

 

and it even extends to residents of countries that have reciprocal agreements with Australia such as UK, Finland,Sweden,Norway

 

and a few more.

 

The Govt negotiates a price with the supplier and encourages generic drugs unless specified by the prescription.

 

Even I have a Medicare card despite private Insurance, which was pretty cheap since you never know when bad luck strikes:rolleyes: 

post #5211 of 7475
I thought so - that's a completely different animal. The US has no such program. If you are not poor, not elderly and not disabled - then you either pay cash or pay for private medical insurance or try not to get sick.

I have often wondered whether the entire medical industry is simply run incorrectly. What would happen if it was a pure free market system - no concept of "insurance" of any kind - either private or public - simply all cash. Would it be better or worse? Would the removal of all the nonsense overhead and the introduction of price competition create a better system? I honestly don't know.
post #5212 of 7475

"I have often wondered whether the entire medical industry is simply run incorrectly. What would happen if it was a pure free market system - no concept of "insurance" of any kind - either private or public - simply all cash. Would it be better or worse? Would the removal of all the nonsense overhead and the introduction of price competition create a better system? I honestly don't know"

 

The medical/pharmaceuticals companies have to compete for the Govt,s business and because of the bulk buying power of the Govt you get better rates.

 

You compete on your product/price/service and nothing else to get the Govt business.

 

You can also buy private insurance which is $700 in my case which includes glasses and limited dental but I get a refund in my tax return. No pre-existing conditions or any other

 

rubbish, just a market where Insurance companies compete for my business or else I tell them to get lost and get Govt Medicare and pay a penalty in my tax return.

 

 

If you,re really poor, the Govt looks after your medical expenses and discounts heavily since it is part of Social Security.

 

I consider it as my share of the Social Contract to them, they deserve life and happiness as much as any other Australian or else there wouldn't be any difference

 

between us and a 3rd world country.

 

 

The PBS/Social Security discounts I mentioned in my previous post applies to all whether you,re a millionaire or on the $1800 per/month pension.

 

The system's not perfect with a $1.3 billion waste last year but its the best we have. Combustion engines have a 60% efficiency yet we still drive cars so....


Edited by gikigill - 12/14/13 at 8:07pm
post #5213 of 7475
Thread Starter 
I simply hate bullies, I was bullied and harassed as a kid because I was physically and socially awkward (gangly and shy), which makes me very sensitive to it. When some self-important lump of lard starts going off on a crippled old lady... well, that's a good way for them to end up with my boot in their a**. That's no way to behave towards any human being, but especially not someone who suffers every minute of the day. Grrr. mad.gif That doesn't mean the pharmacist should have simply given her the medicine, or even commiserated with the woman over her situation, but publicly accusing and shaming her was entirely out of line. I'm not sure what will happen to Cruella, but I hope she learns from this and moves on to work somewhere else... far away from here. wink.gif


Medicare is specifically for the elderly, children in poverty, and those who are disabled and can't get traditional insurance. I'm not specifically against a single-payer system, in theory, but there are several problems with implementing such a program in the USA. Chiefly, the main issue is, we're broke.

1. We have so many other entitlement and grant programs, there's simply no money left.
2. We play world police and spend too much on defense. It's time we stop doing that.
3. We throw around too much money at other countries.

So if we could find the money, Medicare expansion could be okay, but right now we can't do it. There's also the issue that the US government is one of the least trustworthy in the "civilized world" too, I have trouble trusting them with something as simple as filling potholes, much less an important issue like our healthcare, so there's that as well. rolleyes.gif
post #5214 of 7475
The problem I have with the gov't run programs is the massive overhead associated with the administration of the program. All of that administration provides zero value to the actual medical care of the patients. The amount of useless paperwork and manpower that goes into granting those gov't contracts to the providers is ridiculous, as is the ongoing authorizations, reviews and other non-value add activity.

Here's just one example: When a doctor orders a medical device for a patient, they are required to provide a prescription, a certificate of medical necessity (CMN) and all the doctors notes pertaining to the patient. The doctor's notes MUST conform to the standards set by Medicare. This includes NOT being allowed to change or correct anything - to make any changes a new note must be created, dated and signed. Specific words and phrases must be used. All of this documentation must be kept by the doctor and the medical device provider, and also sent to Medicare. If even the most minor of issues is found (like if a doctor writes in the margin of the notes) the entire submission is rejected back to the provider. The provider must then contact the doctor's office, get a new set of notes and resubmit. It can take months for a provider to actually begin to receive payment from Medicare - and because Medicare will only pay to rent, not purchase the device, the provider actually receives a payment of ~$150/month. The provider must bill Medicare each month for the rental fee. All of that paperwork requires a team of people at the doctor's office and the provider's office - and lord knows how many working for Medicare and it's contractors. All of this is for a device that sells for cash for ~$2000.

BTW, in the US, I really doubt it would *really* be a "single payor system" - it would look like a single payor (the feds) to the outside world, but I can pretty much guarantee it would really be made up of subcontractors running regional processing systems - just as it is with Medicare (or worse, by state as it is with Medicaid). With Medicare, even though it is in-theory a Federal program, there are actually 4 regional processors that are contracted by the Feds - and each of those is significantly different. That's not such a big deal for a local provider, but for a national provider, it's a PITA. There are also state-based rules in the Medicare system, and you have to be certified by each state in order to be a provider in that state.
Edited by billybob_jcv - 12/14/13 at 9:06pm
post #5215 of 7475
Quote:
Originally Posted by Magick Man View Post



2. We play world police and spend too much on defense. It's time we stop doing that.
3. We throw around too much money at other countries.

 
 

 

So true.

post #5216 of 7475
Thread Starter 
Quote:
Originally Posted by Magick Man View Post

What my fund is jumping into, and you should too. We're backing ~40% of the Cointerra infrastructure for the next 5 years, with an option for 10 more years, at a conservative estimated RoR of 650%, year over year. Did you just do a spit take? I sure did, when I was told nearly 6 months ago. blink.gif Now that it's public I can talk about it, and this really and sincerely IS the "Next Big Thing".

http://www.anandtech.com/show/7246/the-rush-to-bitcoin-asics-ravi-iyengar-launches-cointerra

Is Bitcoin the future? No. But it's the predecessor of the future currency, and it will be rolled into it. Those on the ground floor are the next Tech Boom leaders.

Remember when I posted this? That was back when BCs were trading for $85, and now they're trading at 10x that. Heh. biggrin.gif
post #5217 of 7475
Holy crap Billybob, that simply shows the incompetence of the Insurance companies. Maybe there's profit in all that maze besides while I still have a little bit of faith in the USA, you really need to cut down the Military industrial complex. Spend it on fixing people's health, no more employer paid insurance as it ensures people are stuck with their job. The biggest problem seems to be that instead of prevention, the US spends more on curing. As an example, I like my job very much but I can simply leave with a months notice and not worry about mine or my family's health.
If people don't have to worry about health care, they have more social mobility as they can choose better jobs besides Insurers will be forced to compete whether they like it or not.
post #5218 of 7475
Quote:
Originally Posted by gikigill View Post
 

Oz Medicare is universal healthcare.

 

Seniors get discounted drugs though the Pharmaceutical Benefits Scheme (PBS) which places a cap of $35 or so on filling a slip

 

and it even extends to residents of countries that have reciprocal agreements with Australia such as UK, Finland,Sweden,Norway

 

and a few more.

 

The Govt negotiates a price with the supplier and encourages generic drugs unless specified by the prescription.

 

Even I have a Medicare card despite private Insurance, which was pretty cheap since you never know when bad luck strikes:rolleyes: 

Everyone gets a medicare card no matter what right? I have no idea, Im too sheltered XD

post #5219 of 7475
After going through the whole process again, I would say you have a greed problem instead of a money problem billybob.
Too many middlemen in a process that involves my health is the last thing I would want, whether public or private sector.
post #5220 of 7475
Quote:
Originally Posted by veyrongatti View Post

Everyone gets a medicare card no matter what right? I have no idea, Im too sheltered XD

Yup, as long as you are an Aussie permanent resident or a citizen. No matter who or what you are.
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