American Healthcare continues to go backward

[mugatu]

So for the Drs. What happens hypothetically if someone comes into a surgery with this insurance. Does the surgeon have to ask if anesthesia is cut off at the time limit or to be continued out of pocket? Imagine expecting things to be covered and there's some small complication that causes the surgery to take longer. I'm assuming the hospital isn't gonna just eat that.

 

[mugatu]

Tons of companies put profits over human life, but I guess when your job is to protect human life and you put profits over life it hits a bit different?

Yeah. I'd argue no part of the health industry should be for profit but that would make me a socialist or something.

 

[mugatu]

Ammunition used in CEO’s killing had 'Deny,' 'defend' and 'depose' written on it, AP sources say

The gunman who stalked and killed the CEO of UnitedHealthcare in Manhattan used ammunition emblazoned with the words “deny,” “defend” and “depose."

apnews.com

Casings had "deny" "defend" and "depose" written on them... seems like maybe it was a message to the company and/or industry.

 

[steross]

So for the Drs. What happens hypothetically if someone comes into a surgery with this insurance. Does the surgeon have to ask if anesthesia is cut off at the time limit or to be continued out of pocket? Imagine expecting things to be covered and there's some small complication that causes the surgery to take longer. I'm assuming the hospital isn't gonna just eat that.

I don't think so. This is basically putting the anesthesia on the same capitated plan they have already screwed the surgeons with. If you are having a bowel resection, the surgeon gets paid a set amount for the entire assessment, the surgery, and a 90 day follow-up period. I'm not an expert at this, but I believe the only way that can be changed is if there is an unexpected complication such as the bowel tumor had eroded into the ureter so the surgeon had to add a ureteral resection.

I suspect they will now want to give a set payment to the anesthesiologist also. So, if the surgery goes long, etc, tough, you were already paid.

Oh, and BTW, the hospital won't be eating anything. Facilities fees are different, and, unlike professional fees, have been increasing, not decreasing. Well, they do eat something, independent doctors. Hospitals get paid more, docs less. Hospital offers doc a sweetheart contract to become an employee. That contract then gets eaten piecemeal or replaced with a worse one, but then the doc is owned.

 

[mugatu]

I don't think so. This is basically putting the anesthesia on the same capitated plan they have already screwed the surgeons with. If you are having a bowel resection, the surgeon gets paid a set amount for the entire assessment, the surgery, and a 90 day follow-up period. I'm not an expert at this, but I believe the only way that can be changed is if there is an unexpected complication such as the bowel tumor had eroded into the ureter so the surgeon had to add a ureteral resection.

I suspect they will now want to give a set payment to the anesthesiologist also. So, if the surgery goes long, etc, tough, you were already paid.

Oh, and BTW, the hospital won't be eating anything. Facilities fees are different, and, unlike professional fees, have been increasing, not decreasing. Well, they do eat something, independent doctors. Hospitals get paid more, docs less. Hospital offers doc a sweetheart contract to become an employee. That contract then gets eaten piecemeal or replaced with a worse one, but then the doc is owned.

Has there been any portion of healthcare not ruined by greed?

Side question. I've heard rumors that hospitals set crazy prices for everything knowing virtually no one will pay the actual full rate (insurance is negotiated way down and cash patients often get reduced rates) so that anything not paid can be deducted from the annual taxes by being written off as lost revenue. Do you know if there's any truth to that?

 

[Stillwater Townie]

Ammunition used in CEO’s killing had 'Deny,' 'defend' and 'depose' written on it, AP sources say

The gunman who stalked and killed the CEO of UnitedHealthcare in Manhattan used ammunition emblazoned with the words “deny,” “defend” and “depose."

apnews.com

Casings had "deny" "defend" and "depose" written on them... seems like maybe it was a message to the company and/or industry.

That's why the country needs Medicare For All. But that won't happen as long as those in Congress gets paid off by lobbyists for private health insurance companies.

 

[Big Huck]

That's why the country needs Medicare For All. But that won't happen as long as those in Congress gets paid off by lobbyists for private health insurance companies.

Personally, I would be a fan of not living in a country where "Is curing patients good for business?" is a question the companies charged with keeping us alive get asked at investor conferences.

But there are people on this board who'd call me a communist for that.

 

[cowboyinexile]

Personally, I would be a fan of not living in a country where "Is curing patients good for business?" is a question the companies charged with keeping us alive get asked at investor conferences.

But there are people on this board who'd call me a communist for that.

 

[mugatu]

Personally, I would be a fan of not living in a country where "Is curing patients good for business?" is a question the companies charged with keeping us alive get asked at investor conferences.

But there are people on this board who'd call me a communist for that.

But think of the shareholders... they need the stock prices to go up a few more points and that can't happen if we aren't maximizing profits. Make people sick (or think they are) and then treat all while milking them for every penny.

 

[mugatu]

So looks like they changed their minds on the anesthesia coverage cut. Wonder why...

 

[CowboyJD]

So looks like they changed their minds on the anesthesia coverage cut. Wonder why...

Not worth getting murdered over?

 

[steross]

Has there been any portion of healthcare not ruined by greed?

Side question. I've heard rumors that hospitals set crazy prices for everything knowing virtually no one will pay the actual full rate (insurance is negotiated way down and cash patients often get reduced rates) so that anything not paid can be deducted from the annual taxes by being written off as lost revenue. Do you know if there's any truth to that?

I think all insurance based health care has been ruined by greed. Years ago i was the treasurer of a small emergency medicine group. We would have discussions like, "Did you know we can bill for a pulse-oximetry reading if we document a full interpretation?" "Wow, we get one on every patient, that could be a lot of money." "Yea, but we aren't going to bill some 20 year old with a broken ankle for a pulse oximetry reading." etc,etc.
Now, they are charging women for skin contact time with newborns. I'm not saying that there were not greedy docs in the past, but once those decisions got passed to health care administrators, the money went from one of the considerations to the only thing of importance.

As far as your second question, yes, they do put out a chargemaster with inflated prices. I do not believe (not sure) that they can deduct payment under those as a tax expense. But, they do charge some cash pay the full chargemaster price if they think they can get away with it. Also, insurance rates are negotiated off the chargemaster. Insurance is now in a strange game of wanting lower prices at times, but also wanting higher prices at other times. Because, Obamacare made insurance co payout 80% of revenue as health care costs. So, to grow profits, they have to pay out more (to make the 20% bigger, the 80% has to be bigger). But, if they are near that 80% payout, they don't want to pay anything at all.

 

[Vakarian74]

I think all insurance based health care has been ruined by greed. Years ago i was the treasurer of a small emergency medicine group. We would have discussions like, "Did you know we can bill for a pulse-oximetry reading if we document a full interpretation?" "Wow, we get one on every patient, that could be a lot of money." "Yea, but we aren't going to bill some 20 year old with a broken ankle for a pulse oximetry reading." etc,etc.
Now, they are charging women for skin contact time with newborns. I'm not saying that there were not greedy docs in the past, but once those decisions got passed to health care administrators, the money went from one of the considerations to the only thing of importance.

As far as your second question, yes, they do put out a chargemaster with inflated prices. I do not believe (not sure) that they can deduct payment under those as a tax expense. But, they do charge some cash pay the full chargemaster price if they think they can get away with it. Also, insurance rates are negotiated off the chargemaster. Insurance is now in a strange game of wanting lower prices at times, but also wanting higher prices at other times. Because, Obamacare made insurance co payout 80% of revenue as health care costs. So, to grow profits, they have to pay out more (to make the 20% bigger, the 80% has to be bigger). But, if they are near that 80% payout, they don't want to pay anything at all.

So it’s better to have things done towards the beginning of the year?

 

[cowboyinexile]

 

[PF5]

why would he be carrying all this evidence??!! very weird...

Who is Luigi Mangione, person of interest in UnitedHealthcare CEO shooting axios


Luigi Mangione, 26, was apprehended by police on Monday in connection with the homicide of UnitedHealthcare CEO Brian Thompson in New York City.
The big picture: Thompson's shooting on Wednesday sparked a massive manhunt but no arrests had been made prior to Monday.

Driving the news: Mangione has not been charged with any crime, though he is expected to face gun charges in New York and Pennsylvania, NYPD Chief of Detectives Joe Kenny said during Monday's press briefing

• He was detained at a McDonald's in Altoona, Pennsylvania.
• Mangione's last known address was in Honolulu, Hawaii.

Context: Thompson was shot and killed outside of a midtown Manhattan Hilton at about 6:40am ET on Wednesday by a masked man.

• Thompson had been received threats, his wife said, possibly related to health care coverage.

Zoom in: A McDonald's employee who recognized Mangione called local police, New York City Police Commissioner Jessica Tisch said on Monday. Tisch said his behavior was suspicious during questioning.

• Mangione was carrying multiple fraudulent IDs, a U.S. passport, a gun and a suppresser consistent with those used in the attack.

• A fraudulent New Jersey ID was consistent with one used to check into a New York City hostel ahead of the shooting.
• "Officers recovered a handwritten document that speaks to both his motivation and mindset," Tisch said.

What's next: NYPD officers will interview Mangione further.

 

[Duke Silver]

why would he be carrying all this evidence??!! very weird...

Who is Luigi Mangione, person of interest in UnitedHealthcare CEO shooting axios


Luigi Mangione, 26, was apprehended by police on Monday in connection with the homicide of UnitedHealthcare CEO Brian Thompson in New York City.
The big picture: Thompson's shooting on Wednesday sparked a massive manhunt but no arrests had been made prior to Monday.

Driving the news: Mangione has not been charged with any crime, though he is expected to face gun charges in New York and Pennsylvania, NYPD Chief of Detectives Joe Kenny said during Monday's press briefing

• He was detained at a McDonald's in Altoona, Pennsylvania.
• Mangione's last known address was in Honolulu, Hawaii.

Context: Thompson was shot and killed outside of a midtown Manhattan Hilton at about 6:40am ET on Wednesday by a masked man.

• Thompson had been received threats, his wife said, possibly related to health care coverage.

Zoom in: A McDonald's employee who recognized Mangione called local police, New York City Police Commissioner Jessica Tisch said on Monday. Tisch said his behavior was suspicious during questioning.

• Mangione was carrying multiple fraudulent IDs, a U.S. passport, a gun and a suppresser consistent with those used in the attack.
• A fraudulent New Jersey ID was consistent with one used to check into a New York City hostel ahead of the shooting.
• "Officers recovered a handwritten document that speaks to both his motivation and mindset," Tisch said.

What's next: NYPD officers will interview Mangione further.

Why is he still in the country?

 

[cowboyinexile]

why would he be carrying all this evidence??!! very weird...

Who is Luigi Mangione, person of interest in UnitedHealthcare CEO shooting axios


Luigi Mangione, 26, was apprehended by police on Monday in connection with the homicide of UnitedHealthcare CEO Brian Thompson in New York City.
The big picture: Thompson's shooting on Wednesday sparked a massive manhunt but no arrests had been made prior to Monday.

Driving the news: Mangione has not been charged with any crime, though he is expected to face gun charges in New York and Pennsylvania, NYPD Chief of Detectives Joe Kenny said during Monday's press briefing

• He was detained at a McDonald's in Altoona, Pennsylvania.
• Mangione's last known address was in Honolulu, Hawaii.

Context: Thompson was shot and killed outside of a midtown Manhattan Hilton at about 6:40am ET on Wednesday by a masked man.

• Thompson had been received threats, his wife said, possibly related to health care coverage.

Zoom in: A McDonald's employee who recognized Mangione called local police, New York City Police Commissioner Jessica Tisch said on Monday. Tisch said his behavior was suspicious during questioning.

• Mangione was carrying multiple fraudulent IDs, a U.S. passport, a gun and a suppresser consistent with those used in the attack.
• A fraudulent New Jersey ID was consistent with one used to check into a New York City hostel ahead of the shooting.
• "Officers recovered a handwritten document that speaks to both his motivation and mindset," Tisch said.

What's next: NYPD officers will interview Mangione further.

What's going to be interesting is when 10000 people swear they saw him miles away from the crime scene when it happened.

 

[Duke Silver]

What's going to be interesting is when 10000 people swear they saw him miles away from the crime scene when it happened.

He almost could have blended in without the mask.

 

[PF5]

this is either the most incompetent killer in the last 94 years, or he's a patsy...if I had done this (I would never, c'mon man) and my picture was made public, I sure as hell would not be in plain sight with no changes to my hair, face, clothing, mask, etc. I would not be carrying the murder weapon, my only fake ID, and a manifesto a mere 230 miles from the scene of the crime...why not just wear a sign on jacket that says, "yep, I'm him" and an ID sticker with "Hi, my name is Luigi Mangione, AKA: the CEO shooter...if this was a movie script, it would be shredded and you would be put on probation from writing scripts for 68 months...

 

[CowboyJD]

this is either the most incompetent killer in the last 94 years, or he's a patsy...if I had done this (I would never, c'mon man) and my picture was made public, I sure as hell would not be in plain sight with no changes to my hair, face, clothing, mask, etc. I would not be carrying the murder weapon, my only fake ID, and a manifesto a mere 230 miles from the scene of the crime...why not just wear a sign on jacket that says, "yep, I'm him" and an ID sticker with "Hi, my name is Luigi Mangione, AKA: the CEO shooter...if this was a movie script, it would be shredded and you would be put on probation from writing scripts for 68 months...

Let's hope he's a patsy.....for one of the insurance competitors.