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Tickerguy
Posts: 148437
Incept: 2007-06-26
A True American Patriot!
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Nick, don't step into the bear trap.

The bear trap is "Single Payer", otherwise known as Socialized Medicine.

That's NOT the same thing as a government safety net.

You're right on the facts but where you go into the weeds is by taking the bait in the first place. Down that road lies death and bankruptcy -- and most-probably both at the same time.

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Winding it down.
Nickdanger
Posts: 617
Incept: 2011-06-12

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I'm confused, Karl. Please help me understand where I stepped into the bear trap of "single payer". My post was regarding cannabis and the medical industry, and I'm totally on-board with your posts about the detriments of single payer.

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Grammar: the difference between knowing your **** and knowing you're ****.
Tickerguy
Posts: 148437
Incept: 2007-06-26
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It doesn't matter how you slice and dice it that guy was touting Single Payer and constraints on access if you did a "bad thing." Not constraints on Uncle Sugar picking up a tab if you have no money, BUT CONSTRAINTS ON ACCESS OF ANY SORT WHATSOEVER.

Those are NOT the same thing.

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Winding it down.
Jerrydenim
Posts: 2
Incept: 2017-03-31

SoCal - LA
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Thanks to everyone who responded to my post on why a single payer system is the answer instead of a whole bunch of incredibly complicated legislation and new regulations to straighten out what I believe is a irreparably flawed and criminal system.

I found it interesting that while many critized my post on a basis of all "shouty caps" communism (!) and specious arguments regardinh costs (Norway delivers superior healthcare outcomes for half the cost with their single-payer system and people like it) not one single person addressed the main thrust of my argument which was while Mr. Denninger's policy prescriptions are all very good indeed the implementation of such policy will require a large, very tough and very toothy new regulator with the political will and strength to declare war on a nearly 4 trillion dollar criminal enterprise. For a bunch of free-market, antigovernment right wingers you guys have a heck of a lot of faith in government! In a country where the Supreme Court has ruled unlimited money in politics is legal because money = free speech what exactly prevents a 3.8 trillion and growing criminal mafia from subverting the laws in a short amount of time and suborning the regulators? Anyone?

To everyone who attempted to straw man my argument with cost concerns and saying I dismissed Karl's cost constraining measures- allow me to clarify: I did not. I thought it went without saying a Nordic-like single payer system would of course contain all of the sane and necessary cost saving mechanisms like allowing the single payer - the US government - to negotiate favorable prescription drug prices just like the rest of the world. The Bush era brand name prescription drug benefit would be gone (generics are fine) and yes of course the PBMs would be gone. All of the parasitic, rentier, toll booth capitalists that drive up healthcare costs, provide zero service, and attempt to insert themselves between Americans and their doctors would be gone. And again, cost- go look it up yourself if you don't believe Karl or me. Norway delivers a superior product (healthcare not health insurance - huge difference) for half the cost with s single payer model. I believe it is the only solution due to the real world issues with implementing Karl's reform. With enough money and motivation I suppose any wrecked car can be fixed but sometimes it just makes way more sense to call it "totaled" and get a new car. The wreck is really bad, multiple attempts to salvage it have failed. There's not much else that makes sense at this point.
Aztrader
Posts: 7750
Incept: 2007-09-10

Scottsdale, AZ
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We saw what unlimited money going into the college system did and now crappy online schools are charging $500 an hour. If you socialize medicine without putting Karl's fixes into the system, we will see substantially higher costs and a lots more fraud.
I know of so many people that run to the doctor for everything and anything. Many are on Medicaid or the state run system. These people should be the first in line that should be monitored before they hand them this free lunch. I am betting that if the government actually put the numbers out there breaking down individual diseases by Medicaid recipients, we would find that a large amount of them simply need a lifestyle change. I heard recently that up to 3 million of the new Medicaid leeches were alcoholics and drug addicts. Just think what they are costing us. Ask yourself why these people have unlimited coverage while the folks buying their own insurance have none. They need to cap this system immediately to slow down it's growth until they get it fixed.
Due to too many people on the system that aren't contributing, there is no way that any socialized program could work.
In the past 8 years, they loosened what was considered a disability and the program exploded. When they handed out the extended unemployment, then that group exploded too. Easier to sit at home then to go to work. Human nature is what it is and the politicians know it. Most people are cheap *****s looking for the next opportunity to skin the game and most government programs simply hand it to them. The system needs major changing and this will be our only opportunity to do it. I hope the good guys are listening.
Lobo
Posts: 366
Incept: 2013-12-25

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How does a diamond of truth get recognized in a sea of bull****?
'Cause the bull**** is everywhere. For example: https://www.linkedin.com/pulse/american-....

This guy mentions costs and then runs screaming in another direction.
Of course, as a CEO I'm sure his salary and stock options absolutely depend on having a finely tuned bull**** distributor.

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Village Idiot
Tickerguy
Posts: 148437
Incept: 2007-06-26
A True American Patriot!
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Quote:
To everyone who attempted to straw man my argument with cost concerns and saying I dismissed Karl's cost constraining measures- allow me to clarify: I did not. I thought it went without saying a Nordic-like single payer system would of course contain all of the sane and necessary cost saving mechanisms like allowing the single payer - the US government - to negotiate favorable prescription drug prices just like the rest of the world.

Uh huh.

Let me point out that your famed Nordic nations still pay $50,000 for a $200 drug. Sure, it's better than $80,000, but will it matter at 8% acceleration? No. Not by more than a year or two.

Oh, and you believe the same US Government that has refused to enforce 100-year old law for the last 35 will magically start "negotiating" -- at least as well as the Nordics? Never mind their "negotiation", which is only half the shaft instead of the whole thing.

This sort of insanity is why we're in this mess. Go run it somewhere else.

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Winding it down.
Dennisglover
Posts: 586
Incept: 2012-12-05

Huntsville, AL
Online
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That kind of nonsense ignores completely the most basic root cause of the whole mess by imagining a "unicorns and skittles scenario" where some model might work better.

The problem with that wishful-thinking feel-good-ism is that it addresses the problem of human nature not at all!

The Sherman Act, the entire basis of Title 15 of the United States Code, will be 127 years old before January 1. It, along with Sherman, Robinson-Patman, and all the other laws comprising Title 15, have long been ignored, and mostly by we, the people first, and by government second. So long as that condition obtains, no proposed "solution" stands a chance, because human nature inevitably will pervert, misapply, and bring to no effect every such non-solution!

We do not have "better angels" to help us out in this kind of thing! What we have, if anything is to be improved, is (right now) the barest hope for punishment being doled to the offenders, either by government, or by a suddenly enraged, furious, and hungry populace who have watched the entire magnificent edifice melt into nothing, and that practically overnight.

Again I say, "Enforce the Law that exists! Appeal on the basis of common ground, of common need, by all means, most certainly, and hopefully make 'converts' that way. But always know that the ultimate end is restoring the primacy of Law as it must exist for there to be a civil and just society! Do not offer some socialist, 'single-payer' (where everyone pays) idea, when the only possible answer is enforcing the existing Law! Doing that will only increase my anger."

Does anyone even begin to imagine that a new Law will be obeyed, when our general, standard, and confirmed attitude and response to all Law is to ignore it?

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TANSTAAFL
Topgun
Posts: 60
Incept: 2016-09-10


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Quote:
I found it interesting that while many critized my post on a basis of all "shouty caps" communism (!)...
And instead of refuting my facts, you come back and get yourself banned.

[stands up claps hands]

Well done pal.


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When Revolution comes to America, I want to shoot these sumbitches with Black Powder so they know Im not blowing smoke up their backsides.
Aztrader
Posts: 7750
Incept: 2007-09-10

Scottsdale, AZ
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Lobo,
People like this live in a world that completely ignores what the ACA has done to people that actually have to pay for it. He is seeing people that don't contribute and are now eligible to get treatment for FREE because people like me are forced to pay $800 a month for no coverage. Sure millions of people now have access to healthcare, but what has it done to millions of others? It cost shifted their treatment onto our premiums. It has destroyed the free choice of getting insurance or care in a lot of states because this law destroys the ability for anyone to make money without charging extreme premiums in certain states. Arizona has had major cost increases and not a word about what Karl discusses in this blog. They are all in bed together and the media refuses to talk about it. If this could go viral and get people fired up about what is really happening, then maybe something could be done.
Trump is losing support right now because most of us simply want the ACA GONE!. No replacement, just gone. Get rid of all the rules, regulations and taxes that were implemented and start over.
Trinityalpsgal
Posts: 25
Incept: 2017-03-30

Weaverville, CA
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Good morning all.

The bottom line for me is this: Moving to a "Permanent Health Care for All" Plan like the one outlined here is our only choice. We all understand the reasons why.

The unfulfilled opportunity is getting THIS Plan + Karl the visibility it/he deserves.

In addition, I am a woman of action who seeks to move good ideas into the world where they can be utilized. So writing/blogging about The Plan without acting on it is not an option for me.

Here's what I wrote recently to the site Admin. when trying to get "back in" with an old login.

"The essence of this conversation is about branding and positioning your message. Giving your supporters the tools and a plan for rolling it out and then letting it go. Bottom up is the way forward IN THIS STAGE. Look, you took control of YOUR OWN PERSONAL HEALTH and WELL-BEING, right?! Why? Because it starts with YOU. It had to start with you. Why is this any different? You are a messenger Denninger. Why not go a bit deeper into the thing by crafting it into a movement that your supporters (and their friends) can act upon? Taking mindful ACTION in the world is our only hope."

I promised Karl a Roadmap document something we could use to get traction. A simple one/two page overview that makes a case for itself in a logical progression for maximum comprehension. It will need to be reviewed and improved with your feedback. Am in the process of finishing it.

Once the content is set, we can format it for consumption. I have a friend working on a visual signature (logo) for the plan. He will most likely offer several versions for you to choose from.

This document is just the beginning. Like a cover page. We also need to craft a supporting piece that offers the PROOF the detail and facts. Karl has already written The Plan and support details/facts. I am merely offering to help arrange the material into a marketable form/format.

Like many of you, I have a busy life (my choice). My goal is to get the first Roadmap document to Karl this week.

Lets see whats possible!
Aztrader
Posts: 7750
Incept: 2007-09-10

Scottsdale, AZ
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Does anyone know what the income tax and VAT taxes are in the Nordic countries to pay for all this free stuff? I know a family from Holland and he told me his income tax rate pushed 65% and you literally pay double for a car vs the costs here in the U.S. He told me that there is always a long wait to see a doctor unless it's a major emergency. The quality of care isn't great and that is why they moved here.
There is no such a thing as free anything and there is always a cost to someone to pay for everyone else. Any system that steals from one person to support another is a failure. Their population is nothing compared to the U.S. and the larger the numbers, the more difficult it is to socialize. I deal with the Swiss and their attitude towards SOCIALIZED is amazing. The pay huge taxes, but don't have property taxes. Their total population is a touch over 8 million and is much easier to manage. When comparing entitlements, we have to look at the real numbers too.
Krzelune
Posts: 5676
Incept: 2007-10-08

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I gave up reading maybe 1/2 way through the posts, so maybe I missed something. Why do so many people think everyone needs to be, or wants to be controlled like a pet hamster? The easiest solution is to make each individual pay for their own damn lifestyle and consequences. What could be more fair?

There is so much rampant dumb out there rotting society, I'm beginning to think we need to add some more chlorine to the gene pool.
Thorvold
Posts: 181
Incept: 2013-09-12

NY
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The medical racket seems to be garnering more attention lately. From a 3/29/2017 article by Elisabeth Rosenthal in the NY Times:

"Each billing decision, then, can be seen as a battle of coder versus coder. The coders who work for hospitals and doctors strive to bring in as much revenue as possible from each service, while coders employed by insurers try to deny claims as overreaching. Hospital coders teach doctors and doctors pay to take courses to learn how they can upcode their charts to a more lucrative level with minimal effort. In a doctors office, a Level 3 visit (paid, say, at $175) might be legally transformed into a Level 4 (say, $225) by performing one extra maneuver, like weighing the patient or listening to the lungs, whether the patients illness required that or not. [Let that sink in.] E.R. doctors, for example, learned that insurers might accept a higher-reimbursed code for the examination and treatment of a patient with a finger fracture (usually 99282) if in addition to needed interventions a narcotic painkiller was also prescribed (a plausible bump up to 99283), indicating a more serious condition."

Coding has become an industry; 170k coders now in the American Academy of Professional Coders, up from 70k in 2008. These jobs pay well and we all pay for them whether or not we're the ones using the medical establishment.

The woman featured in the NYT article:

"Nearly simultaneously, she received a one-page bill for the hospital portion of her care, broken down only into the broadest categories, including $111,162 in room charges, $34,755.75 for pharmacy, $19,653 for labs, $8,640 for the operating room, $8,325 for anesthesia, $1,143 for the recovery room, $44,524 for medical supplies and $40,489 for radiology services, totaling $356,884.42. The bill informed her that the medical center was prepared to offer her its standard 20 percent discount for patients who are uninsured, leaving a what you owe now fee of $285,507.58."

If the problem is addressed at all other than by collapse, my guess is the Medicare for All "solution" rather than the simpler and more effective KD approach. There's just too much money to be made scamming people, even if the pot becomes a bit smaller.
Tickerguy
Posts: 148437
Incept: 2007-06-26
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I want to know why someone who gets a bill like this doesn't find 100 others and show up with pitchforks and torches.

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Winding it down.
Keenan
Posts: 247
Incept: 2013-01-11

Western PA
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RE: the NYT article referenced by Thorvold on the "strategic" medical coding games:

snip:
Roughly $250 billion is moving through those codes, [says Steve Parente, professor of finance at the Carlson School of Management at the University of Minnesota]. On top of that, about 80% of medical bills contain errors, according to Christie Hudson, vice president of Medical Billing Advocates of America, making already-expensive bills higher. Todays complex medical-billing system, guided by hundreds of pages of procedure codes, allows fraud, abuse and human error to go undetected, Hudson says. Until the fraud is detected in these bills the cost of health care is just going to increase. Its not accidental. Weve been fighting these overchargesthey continue to happen and we continue to get them removed from bills. These errors, which are hard to detect because medical bills are written in a mysterious code, can result in overcharges that run from a few dollars to tens of thousands....

...Accounts of medical billing errors vary widely. While the American Medical Association estimated that 7.1 percent of paid claims in 2013 contained an error, a 2014 NerdWallet study found mistakes in 49 percent of Medicare claims. Groups that review bills on patients behalf, including Medical Billing Advocates of America and CoPatient, put the error rate closer to 75 or 80 percent....

...Twenty-five percent of United States hospital spending the single most expensive sector in our health care system is related to administrative costs, including salaries for staff who handle coding and billing, according to a study by the Commonwealth Fund. That compares with 16 percent in England and 12 percent in Canada.

...Whats less understood is the extent to which our current medical-billing system itself is responsible for the high prices patients are charged. There are, of course, many factors that have led to the United States record-breaking $3 trillion health care bill But all of those individual price increases have been enabled indeed, aided and abetted by the complex system of billing and coding that underlies bills like those sent to Wickizer.



Whole article here:
https://myaccount.nytimes.com/auth/login....
Tickerguy
Posts: 148437
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One of the first things you learn in Stats class:

An "error" is normally-distributed. Over a large enough sample size (n > 100, typically) an actual error will trend toward zero in aggregate, and very reliably will be within 1SD. Over even larger sample sizes this becomes even more-true. Confidence range shrinks as sample size rises, in other words.

An "error" that always goes one way, especially when the sample size is huge (e.g. n > 10,000) is not an error -- it is fraud.

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Winding it down.
Capcon
Posts: 20
Incept: 2016-04-11

Tulsa
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@Trinityalpsgal,

"A simple one/two page overview that makes a case for itself in a logical progression for maximum comprehension."

This is what I have also been thinking needs to happen for Karl's message to gain traction. An "executive summary" , if you will. Our host is excellent at fleshing out the Issue and its solutions regarding health care, but the gist of his message sometimes gets lost in the depth of his ideas. Trinity, I applaud you for stepping up, and I hope you are successful in pushing Karl's efforts out the door through the use of a concise marketing / Action plan.
Let me add, IMHO if you are trying to market this plan of action to gain support from our elected officials, the "blowing up of the federal and states budget" would likely be an effective angle. However, if a more grassroots approach is favored, the general public is not likely to give a rats ass whose budget is blown to smithereens unless it is their own. The difficulty for the average Joe to draw a straight line between the government's fiscal demise, and his own needs to be overcome if this is to gain wide-spread support.
Most likely, a two-pronged approach is needed concurrently: State and Federal representatives > shown a path forward to fiscal survival and economic vitality, Joe - public > shown path forward to health care cost transparency, lower insurance premiums, lower complexity and costs overall regarding health care.

Reason: Spelling
Wearedoomed
Posts: 4194
Incept: 2009-01-14

slightly red state
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I'm trying to get a city councilor I know to do something about it. It's... taking some work. He tried to play the "the state/feds handle that ****" card, which I promptly rebutted - no response from him yet.

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Pass the buck or pass the baton / But you can't pass the police or the Pentagon / The IRS or the upper echelon / I think it's time to make a move on the contradiction - Michael Franti and Spearhead, Rock the Nation
Trinityalpsgal
Posts: 25
Incept: 2017-03-30

Weaverville, CA
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Karl,

Please address your vision for implementation.

Start from a big-picture point of view, where you explain a phase-in or "flip a switch" roll out, a timeline, impact on various groups, the ramp up (who is most likely to jump on board quickly/how we transition from new and old Plans, and so on. Assume the transition/implementation is a choice and not a rescue from a collapse.

Even if interested folks fully understand your Plan, the next concern is likely implementation - which becomes an obstacle without some additional clarity on navigating the path.

If you can explain HOW we get from where we are now to where we would be with your Plan - then you will have crossed into a realm where NO ONE has gone. This alone might be a key to how your Plan is received.

It's not enough to explain what happens if we don't have the plan.
Tickerguy
Posts: 148437
Incept: 2007-06-26
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Follow up Ticker, probably..... let me write it up. May take me a couple of days.

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Winding it down.
Burya_rubenstein
Posts: 1224
Incept: 2007-08-08

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I had been thinking something along the lines of, Trump wakes up one morning, summons his Attorny General into the Oval Office, and issues him new orders: Prepare charges against {list of med companies, doctors, et al} for any and all violations of 15USC1 that you can find.
Asimov
Posts: 109341
Incept: 2007-08-26

East Tennessee Eastern Time
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Burya: Might be wise to say that from X date forward, everybody that can be, will be charged. Trying to charge for past crimes, while the right thing, is simply impossible.

We can't shut down our entire medical industry by putting 95%+ of them in jail - and that's exactly what would happen if you tried to prosecute past crimes.

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It's justifiably immoral to deal morally with an immoral entity.

Festina lente.
Dennisglover
Posts: 586
Incept: 2012-12-05

Huntsville, AL
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Rubenstein's thought is sort of a fond dream of mine as well. It's frustrating when we see nothing of any impact coming to the fore, so we hope something is in "the works".

For all we know such a move is already in play. Think about the scope and dimensions of something like that! Think of the opposition it will bring, if and when it ever starts. When it does start the steamroller must already be up to speed, and must never be allowed to slow down, for any "backoff" will be hailed as a "retreat" by the opposition (and the opposition will be huge).

In the meantime, we cannot afford to wait for TPTB to do something! Absolutely not, in no way. Susan Marie (Trinityalpsgal) has read this Ticker, and it seems to me she must have read all of the others, too, and she's trying to move it forward into some kind of concrete and workable action plan. Many of us are "working the street" in our own ways, and as certain as it is that steel sharpens steel, we must look for ways to coalesce into a "force" of some kind.

I am working on blog posts attacking the problems (many, many problems exist, and very many more will be invented by the opposition), and it takes time to research, especially the economic and demographic data, in an attempt to find measurable correlations and causal chains. When such are found it takes a mature and honest approach toward how to use the information.

Susan Marie is, if I interpret her right, attempting to nudge "us" toward some collaboration, some cooperation, and a whole lot of reasoned preparation leading to execution and success. Forwarding Tickers, quoting Karl in great and perfect detail in our writing and talking, using social media of some variety, looking for "like minds" among people we know and meet (and enlisting them when possible), these are all useful tools, but they are not going to turn any tides or stop any avalanches.

Tides get turned by things like breakwaters and jetties, massive fortifications able to withstand the onslaught. How are "we" going to put together the requisite bulk, the strength, to take on the opposition in meaningful ways?

As I've mentioned, one has said that there has been a whole lot of thought in getting to this point, a whole lot of research has been done; but the thought and research have not, to this point, been sharpened and refined so that they are in fact useful both offensively and defensively. I believe this is precisely what is needed (and everything is always needed) at this time. I can write blog entries until my frustration level peaks, but if no one reads them, or if they are too dense to understand, or they are too "whatever", they will never gain any traction, any mass. The way to avoid, to guard, against such frustration is to let steel sharpen steel during a process of maturation toward action, focused through collaborating and cooperating.

The idea of "two or three" working together is both attractive and useful. My thoughts, and especially my ways of expressing them, very much need to be reviewed, digested, "rolled around in the mind and under the tongue", accepted or disputed or rejected based on their content and delivery, and that requires two things: (1) I must accept criticism and use it properly to refine my work; and (2) collaborators must offer honest criticism and helpful suggestions. We are not trying to forward "my ideas" or "your ideas"; no, we are trying to crystallize, focus, formulate, strengthen, and place into the public square our ideas, our concerns and goals and plans, so that we speak with a common intent and a unified voice. This is how "grassroots" movements work; it is not going to be a "Strong Man", "community organizer" kind of thing.

All right, I'm getting off the cheerleader merry-go-'round now, because it's time to ask the inevitable question, and here it is:

Who will work with me and allow me to work with them, without strings, no long-term commitment, with little more than raw hope that what we are thinking, writing, and saying might make a difference? I'm talking about creating a "cell" (a "few people") here. Once a "cell" have taken a few chances among themselves, giving and taking, forgetting personalities, working toward a goal that might well be unknown in the beginning and for quite a while thereafter, maybe have fallen apart with former members seeking new "other voices", then cells can start to build something bigger and better. Success rarely depends ultimately upon one voice. So who wants to try to work with me?

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TANSTAAFL
Vernonb
Posts: 1759
Incept: 2009-06-03

East of Sheol
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Keenan posted:
Quote:
Today's complex medical-billing system, guided by hundreds of pages of procedure codes, allows fraud, abuse and human error to go undetected, Hudson says. Until the fraud is detected in these bills the cost of health care is just going to increase. Its not accidental.

Reminds me of a system of purposefully obscured financial accounting by mobsters where things were encoded - not for efficiency as this medical pile of crap that has been pushed but for obfuscation to prevent fraud detection. Then we have accounting systems where two sets of books are being kept one of the actual record (the physician's notes) and the one being presented (the patient's bill).

Once physicians code directly into this pile of crap without human readable notes it makes fraud detection near impossible. It also makes them ALL physicians complicit in conspiracy.

I am curious who came up with this medical billing system - a mobster in the Federal prison system or the mobsters elected to congress? I see no real difference.

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"Mass intelligence does not mean intelligent masses."
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