Coronavirus

militaryhorn said:
I don't understand the argument presented in the link. It was trying to argue that each patient is different based on insurance coverage and what will be needed for treatment. While I understand that point of view, what is the case for the individual who wants to pay cash for treatment with no insurance involved?

My personal opinion is that if medical facilities were forced to post prices on procedures then the market would force competition. Which would eventually lower prices and then ultimately bring insurance costs down, making it affordable for most people like car insurance.

While I am spouting my opinion, why do most people feel that taking little Johnny to the doctor's office for a routine sick call should be covered with insurance?

I would think that a 15 to 20 minute appointment would cost $100 to $200 to see a doctor. I don't know for sure but if insurance was used for big medical cost only, i.e. minor surgeries, physical therapy, etc., then cost could be reasonable for all. I would be in favor of the government covering catastrophic/preexisting conditions that require deep pockets.

Look at car insurance, it doesn't cover getting an oil change or really anything other than accidents, theft, or minor damage. Why does medical have to cover everything?
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Ditto Mr. Deez. Also, the companies prefer that insurers go to the doc before a minor problem becomes a huge expense. Unfortunately, people will ignore that tiny lump on that left testicle rather than pay $100 to their GP to get it checked. They go when the lump gets to golf ball size, and a $20,000 course of treatment for early stage cancer has become $150,000 for advanced. People are foolish. The insurance companies know this.
 
towersniper said:
Ditto Mr. Deez. Also, the companies prefer that insurers go to the doc before a minor problem becomes a huge expense. Unfortunately, people will ignore that tiny lump on that left testicle rather than pay $100 to their GP to get it checked. They go when the lump gets to golf ball size, and a $20,000 course of treatment for early stage cancer has become $150,000 for advanced. People are foolish. The insurance companies know this.
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The costs for hospitals are known. Medicare pays at cost. Most insurance companies now pay at Medicare + negotiated %. Hospital based infections and re-admissions leave a financial mark. Hospitals are motivated to get patients in, get them out and keep them out.

hospitals that have no uninsured can charge a lower rate as they have no unfunded care to offset. In Tulsa the cheapest options are also the best for most things. Their two physician owned hospitals cater to patients with insurance and don’t have ER’s to attract patients. They can offer better care cheaper.
 
OUBubba said:
We were told by the pathologist that test sent to the lab overnight is 99+%. The POC tests are supposedly 97% accurate. I’d like to know the truth.
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One issue is the correct taking of sample with a swab to the very back of your sinus cavity
 
Bubba,

Medicare "makes the market" and sets the rate. Thanks to Pete Stark there are fewer healthcare facilities owned by physicians and fewer types of business opportunities for physicians. They are all reimbursed the same. Bill $900 for a CT, accept $165. Stark Law left doctors a few things like surgery centers, LTACHs, certain hospitals with proper structuring. Then there is the insurance opportunities - not reimbursement.

Unless you are a level I trauma center, there's no reason to have an ER.

Why are there so few ventilators for this epidemic? Because of the Medicare reimbursement. Hospital makes a lot of money the first few months, then is stuck with the patient.In fact, a decade ago, hospitals in Denver, Dallas, Amarillo, OKC, KC were sending patients & cash to nursing homes in smaller Texas towns to get rid of them.
 
Monahorns said:
Our medical system is broke
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You have no idea how bad it really is. I visited DC in the late 90s when my Congressman Bill Archer was head of the Ways & Means. I showed Archer how moving 7-8% of Medicare funding would save Medicare 40-45% of its budget. It was not radical and required very little effort or cost, but Big Pharma and whores like MD Anderson shot it down.

Get into the bowels of MD Anderson. You'll be so busy throwing up you won't have time for HornFans. They do a lot of good for a lot of people, but there is a dark under belly.

WestMall comment - Archer was my congressman; 28 years in DC and never introduced a single piece of legislation. He never failed to ask for donations or cash the checks.
 
That means that if Medicare didn't exist that Big Pharma and MD Anderson couldn't dictate things. They would have to compete with innovators.
 
Not even close. They exist and dictate around Medicare. That's why certain providers don't take Medicare - they don't want to deal with the federal government, there special ******** accounting among other things.

Medicare sets the reimbursement rates for managed care.
 
SabreHorn said:
Bubba,

Medicare "makes the market" and sets the rate. Thanks to Pete Stark there are fewer healthcare facilities owned by physicians and fewer types of business opportunities for physicians. They are all reimbursed the same. Bill $900 for a CT, accept $165. Stark Law left doctors a few things like surgery centers, LTACHs, certain hospitals with proper structuring. Then there is the insurance opportunities - not reimbursement.

Unless you are a level I trauma center, there's no reason to have an ER.

Why are there so few ventilators for this epidemic? Because of the Medicare reimbursement. Hospital makes a lot of money the first few months, then is stuck with the patient.In fact, a decade ago, hospitals in Denver, Dallas, Amarillo, OKC, KC were sending patients & cash to nursing homes in smaller Texas towns to get rid of them.
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Medicare rate is cost based reimbursement. Your rate is estimated. At the end of the year the auditors compare your costs retroactively and then CMS either gives you a check and then adjusts your rate up a smidge or they adjust your rate down. Hospitals are motivated to be efficient and frugal to keep their Medicare rate quasi low to be competitive in the market place for the Blue Cross/Blue Shields of the world. But, not too low. They want to be in a sweet spot.
 
Not even close. They exist and dictate around Medicare. That's why certain providers don't take Medicare - they don't want to deal with the federal government, there special ******** accounting among other things.
Medicare sets the reimbursement rates for managed care.
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So "they" dictate and Medicare sets rates? That is a contradiction. Dictating around Medicare just sounds like negotiation and not sometimes not agreeing. But ignores how the medical industry uses Medicare and other government regulation to keep competitors out.
 
Bubba,

I understand cost reports all too well. They are used for certain things. At one time they were used or home health, but are now just a shield. Medicare has fixed rates for things like imaging, surgical procedures, drugs.

Medicare is so damned worried that someone might make a profit off them that they have created a cottage industry in cost reports. You file, you and Medicare agree to reimbursement, you build a business model, and half way through the year they lower your rate and bankrupt your company.
 
TheWalkingHorn said:
PE teacher here. How are your kids doing with distance learning? I'm curious how parents are feeling.
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My kindergartner attends a US Department of Defense Dependents School in Germany. I think his teacher is doing a great job. We get daily assignments and instructions (which I think are written by curriculum specialists, not his teachers), and I sit down with him and make sure he reads everything correctly and does the work.

It can be pretty tedious at times, because I have to direct him the whole time. However, his teacher is very responsive when we need help and does two virtual meetings with him each week. Under the circumstances, it's not bad.
 
Monahorns said:
At this point, the CDC says that asymptomatic people are contagious. So all the horror stories are over blown. The disease can be tracked much easier. The problem is really a public thing but who you are coming into direct contact with. Still not good, but a little rationality to think through.

This is an unfortunate point for Longest Horn's narrative and derision of Trump. But don't worry. He will ignore it!
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:popcorn:
 
Well, every crisis seems to highlight the same thing. The Federal government is completely incompetent and it's foolish to expect otherwise.
 
I have a business partner whose wife’s family is from and lives in Spain. His MIL is 83 and got Covid. Was in the ICU in Madrid for three days. Her doctor told the family she would likely pass soon. Apparently, her husband was allowed to buy an experimental drug and authorized the doctor to give it. Within two hours, his wife recovered.
 
2020 is not even half done yet
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horninchicago said:
The guy who did mine has certainly studied that image.
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I had sinus surgery in the 80’s, back before it was just day surgery. In those days, you had packing up your sinuses for 3 days after the surgery. The end of the packing almost stuck out the end of your nostrils. It was gross.

when it came time to remove the packing, you had to go back to the doctor’s office. He gave me a metal bowl to hold under my chin. He then took some forceps, grabbed the packing, and pulled it out the end of my nose. It felt like he was pulling my brain out through my nose. Then a bunch of blood and other stuff came rushing out my nose into the bowl. My wife, who was in the room with me, said she almost threw up. It was one of the most painful things I’ve ever experienced. And, you still had the other nostril to go!
 
theiioftx said:
I have a business partner whose wife’s family is from and lives in Spain. His MIL is 83 and got Covid. Was in the ICU in Madrid for three days. Her doctor told the family she would likely pass soon. Apparently, her husband was allowed to buy an experimental drug and authorized the doctor to give it. Within two hours, his wife recovered.
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Cold medicine? No one believes you.
 
Clean said:
I had sinus surgery in the 80’s, back before it was just day surgery. In those days, you had packing up your sinuses for 3 days after the surgery. The end of the packing almost stuck out the end of your nostrils. It was gross.

when it came time to remove the packing, you had to go back to the doctor’s office. He gave me a metal bowl to hold under my chin. He then took some forceps, grabbed the packing, and pulled it out the end of my nose. It felt like he was pulling my brain out through my nose. Then a bunch of blood and other stuff came rushing out my nose into the bowl. My wife, who was in the room with me, said she almost threw up. It was one of the most painful things I’ve ever experienced. And, you still had the other nostril to go!
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That’s a wrap. Shut down thread.
 
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