Quote :

"how about if i'm against it because i don't want to be forced to pay for your service?"

It's your right to be a douche. Out of curiosity, do you terribly mind paying taxes for everything the state and federal government does?

9/11/2009 1:47:21 PM

yes. clearly disagreeing with you makes one a douche

9/11/2009 1:53:41 PM

^^nope...not everything

i have no issue paying money for the military to keep terrorists out of my country


and i don't mind funding my state

[Edited on September 11, 2009 at 2:00 PM. Reason : sdfgf]

9/11/2009 1:59:39 PM

Quote :

"how about if i'm against it because i don't want to be forced to pay for your service?""

Do you have health insurance? Because if you do, you are being forced to pay for other people's services.

9/11/2009 2:10:02 PM

no. she chooses that

9/11/2009 2:13:15 PM

yeah...that's the key

i want health insurance so i know that's part of the deal

i don't have to have the insurance and i could just pay for myself whenever i needed to go to the doctor


but if i chose not to have insurance of my own then why should i have to pay for someone else's

9/11/2009 2:20:57 PM

Quote :

"no. she chooses that"

And if she "Chose" not to have health insurance, we would be footing the bill for her treatments, or she would face bankruptcy and we would still be footing the bill. Let's quit acting like health insurance is a choice.

9/11/2009 2:25:23 PM

not entirely true, smackr. If she could pay for it herself, and let's not pretend like we know the state of her finances, then WE would not be footing the bill for her. I seriously doubt that I will be footing the bill for her to go see her local doctor. quit being obtuse

9/11/2009 2:27:45 PM

That's pure bollocks. Of course the vast majority of people can pay the cost of routine doctor visits out of their own pocket book, but that isn't what the healthcare debate is about.

Any sort of catostrophic event that requires hospital stays or extensive treatment and the bulk of the American people would be completely unable to pay for it themselves, that's why they have health insurance.

9/11/2009 2:34:19 PM

if only that were why people had health insurance, then we wouldn't be in the mess we are in today. That is the model that insurance should be. That is not how insurance operates today, thanks to, YOU GUESSED IT, gov't meddling.

9/11/2009 2:36:44 PM

your stupid is like the Universe--finite and boundless.

9/11/2009 2:40:14 PM

i'll take that as an admission of defeat

9/11/2009 2:42:16 PM

Quote :

"That is not how insurance operates today, thanks to, YOU GUESSED IT, gov't meddling."

9/11/2009 2:45:01 PM

care to support your assertion that the gov't hasn't meddled in the health insurance world? Before you answer, let me remind you of a thing called "Medicare." And a thing called "Medicaid." Note, also, that state gov'ts can also be guilty of meddling

9/11/2009 2:49:05 PM

That might be the most seriously retarded thing ever spewed forth from your lips.

You claim health insurance is broken because of government meddling. Yet, instead of showing how government meddling has broken health insurance, you decide to go with the tautology route and claim your argument valid because of government health care programs, while not once addressing how those possibly could have contributed to the system being broken in the finite discussion of catostrophic coverage.

I'll provide you are hint on why medicare, medicaid, and high-risk pools were created--the free market failed to deliver those services.

[Edited on September 11, 2009 at 2:53 PM. Reason : .]

9/11/2009 2:52:59 PM

riiiiiiiiiight.

medicare pays far less than market value. price skyrockets.

fucking proof already.

9/11/2009 3:01:44 PM

Do you have down syndrome?

Also, what is market value. Define that for me and you see why you last statement was completely fucking retarded.

[Edited on September 11, 2009 at 3:03 PM. Reason : .]

9/11/2009 3:03:07 PM

I think it is amusing to see how a person will start ad hominem attacks once they realize their argument is not valid.

9/11/2009 3:04:32 PM

well, it's kind of obvious if medicare is paying less than what the doctors charge, then they are not "paying market value." Or do you deny that medicare says it will only pay a percentage of what the doctor charges, no matter what they charge?

come on, gov't meddling is plain and obvious.

9/11/2009 3:05:22 PM

Again, do you understand what market value means?

Why is it, the people who claim to be the biggest proponents of free market capitalism have no idea what the terms associated with it mean and thus throw them about ever so cavlierly?

9/11/2009 3:10:23 PM

so, do you deny that medicare will NEVER pay what the doctor asks?

9/11/2009 3:20:11 PM

Again, it is a simple freakin' question. Do you understand what market value means?

If so, explain what it means. If after that you do not see the flaw in your argument, you are beyond help.

9/11/2009 3:35:33 PM

answer the question, trollsmackr

9/11/2009 3:50:54 PM

I will answer your question as soon as you can probably define market value. This is the problem when you attempt to use words and phrases without knowing what they mean--see strawman, market value, etc.

9/11/2009 3:58:06 PM

ahhh. when you can't win an argument, buckle down on semantics.

I appreciate you at least admitting defeat this time. later, trollsmackr

9/11/2009 3:58:55 PM

Your entire tangent (remember the original argument about why we don't treat insurance as catostrophic insurance because of the government, which you've yet to even attempt to address) is based upon the market value.

Why don't you just admit you have no idea what market value actually means?

[Edited on September 11, 2009 at 4:03 PM. Reason : .]

9/11/2009 4:02:33 PM

fair market value is the estimate of value of property that a knowledgeable, willing, and unpressured buyer would pay and/or a knowledgeable, willing, and unpressured seller would sell. it can be based on previous costs or determined by agreement between both parties. it has nothing to do with the value each may individual might put on the property or service because of their circumstance or preference.

fair market value is the opposite of imposed value which is set by the government in some fashion as the absolute value of a good or service.

Quote :

"Reimbursement for Part A services For institutional care such as hospital and nursing home care, Medicare uses prospective payment systems. A prospective payment system is one in which the health care institution receives a set amount of money for each episode of care provided to a patient, regardless of the actual amount of care used. The actual allotment of funds is based on a list of diagnosis-related groups (DRG). The actual amount depends on the kind of diagnosis made at the hospital. There are some issues surrounding Medicare's use of DRGs because if the patient uses less care, the hospital gets to keep the remainder. This, in theory, should balance the costs for the hospital. However, if the patient uses more care, then the hospital has to cover its own losses. This results in the issue of "upcoding," when a physician makes a more severe diagnosis to hedge against accidental costs. Reimbursement for Part B services Payment for physician services under Medicare has evolved since the program was created in 1965. Initially, Medicare compensated physicians based on the physician's charges, and allowed physicians to bill Medicare beneficiaries the amount in excess of Medicare's reimbursement. In 1975, annual increases in physician fees were limited by the Medicare Economic Index (MEI). The MEI was designed to measure changes in costs of physician's time and operating expenses, adjusted for changes in physician productivity. From 1984 to 1991, the yearly change in fees was determined by legislation. This was done because physician fees were rising faster than projected. The Omnibus Budget Reconciliation Act of 1989 made several changes to physician payments under Medicare. Firstly, it introduced the Medicare Fee Schedule, which took effect in 1992. Secondly, it limited the amount Medicare non-providers could balance bill Medicare beneficiaries. Thirdly, it introduced the Medicare Volume Performance Standards (MVPS) as a way to control costs.[30] On January 1, 1992, Medicare introduced the Medicare Fee Schedule (MFS). The MFS assigned Relative Value Units (RVUs) for each procedure from the Resource-Based Relative Value Scale (RBRVS). The Medicare reimbursement for a physician was the product of the RVU for the procedure, a Geographic Adjustment Factor (GAF) for geographic variations in payments, and a global Conversion Factor (CF) which converts RBRVS units to dollars. From 1992 to 1997, adjustments to physician payments were adjusted using the MEI and the MVPS, which essentially tried to compensate for the increasing volume of services provided by physicians by decreasing their reimbursement per service. In 1998, Congress replaced the VPS with the Sustainable Growth Rate (SGR). This was done because of highly variable payment rates under the MVPS. The SGR attempts to control spending by setting yearly and cumulative spending targets. If actual spending for a given year exceeds the spending target for that year, reimbursement rates are adjusted downward by decreasing the Conversion Factor (CF) for RBRVS RVUs. Since 2002, actual Medicare Part B expenditures have exceeded projections. In 2002, payment rates were cut by 4.8%. In 2003, payment rates were scheduled to be reduced by 4.4%. However, Congress boosted the cumulative SGR target in the Consolidated Appropriation Resolution of 2003 (P.L. 108-7), allowing payments for physician services to rise 1.6%. In 2004 and 2005, payment rates were again scheduled to be reduced. The Medicare Modernization Act (P.L. 108-173) increased payments 1.5% for those two years. In 2006, the SGR mechanism was scheduled to decrease physician payments by 4.4%. (This number results from a 7% decrease in physician payments times a 2.8% inflation adjustment increase.) Congress overrode this decrease in the Deficit Reduction Act (P.L. 109-362), and held physician payments in 2006 at their 2005 levels. Similarly, another congressional act held 2007 payments at their 2006 levels, and HR 6331 held 2008 physician payments to their 2007 levels, and provided for a 1.1% increase in physician payments in 2009. Without further continuing congressional intervention, the SGR is expected to decrease physician payments from 25% to 35% over the next several years. MFS has been criticized for not paying doctors enough because of the low conversion factor. By adjustments to the MFS conversion factor, it is possible to make global adjustments in payments to all doctors.[31]"

there you go...that excerpt shows that Medicare determines what they are going to pay the doctors...regardless of what the doctors charge....that's IMPOSED value...not fair market.

so, while aaronburro used fair market value incorrectly, basic economics can explain how higher costs get put on the rest of us....the doctors have to make their money back somehow to cover the loss they take with Medicare payments....

[Edited on September 11, 2009 at 4:05 PM. Reason : i was a business major....i took 7 econ classes...i learned all about the market]

9/11/2009 4:04:18 PM

Quote :

"i have no issue paying money for the military"

Don't mind paying money to fund the military, do mind paying money to provide healthcare to Americans. Hey, as long as this is out on the table, then we know what we're working with. I find this point of view decidedly douchey.

Don't read into this that I mind paying for the military, I just think taking care of Americans might be as worthy as protecting them.

9/11/2009 4:04:39 PM

thank you, LP. I had no need to define FMV, as it is entirely irrelevant. Thus, trollsmackr, you were jerking off to semantics instead of actually addressing the argument: that medicare inflates the price. Which is GOVT MEDDLING. HOLY FUCKING SHIT!!!

^ so, as long as someone disagrees with you, they are a douche, right?

[Edited on September 11, 2009 at 4:06 PM. Reason : ]

9/11/2009 4:06:17 PM

here in lies the problem with using terms such as fair market and market value when it comes to health insurance.

Health Insurance does not function in free market system. It operates in its own insurance negotiated system to where the fair market value is what the insurance companies (medicare, medicaid, BCBS) are willing to pay providers for the services rendered.

Quote :

"I had no need to define FMV, as it is entirely irrelevant. "

and yet you still have no idea what the concept means.

Quote :

"that medicare inflates the price. Which is GOVT MEDDLING. HOLY FUCKING SHIT!!!"

Medicare as opposed to any sort of insurance, which sets the price it will pay providers. This is still no where close to home on your argument about the government meddling forcing health care insurance away from merely being catrsophic insurance.

furthermore, the creation of medicare and medicaid, and high risk pools are still resultant in the failure of the "free market," and are merely stop gap measures in our competely and utterly fucked up health care system.

[Edited on September 11, 2009 at 4:13 PM. Reason : .]

9/11/2009 4:09:54 PM

Quote :

"my point is simply this... I'm a heartless, right-wing, nut job, Bible thumping, gun toting, redneck SOB because I don't think that my government should use my tax money to pay for anybody's health INSURANCE... *notice I didn't say health CARE....I said health INSURANCE...I'm not altogether opposed to a government funded free clinic-type set up where those that truly can't afford health care can go when they are really in need of medical attention...but I am very much opposed to paying the coverage for every Tom, Dick, and Harry that's too worthless to get a job or do anything productive with their lives other than sit around and have more kids that I'll have to pay for whether they even use it or not... Yet, for some reason, it's not heartless for the same people that think I want all poor black people to die to say they don't think coverage should be provided for every Juan, Ricardo, and Paco that are here illegally, working 3 jobs, and putting some money back into the economy and government... If you want to save everybody...you have to save EVERYBODY....or else you're just as heartless as you claim I am... very few people that argue in favor of this type of legislation are actually arguing about the policies included that would cause this bill to pass/fail...they are arguing that everybody opposed to it thinks it's okay for people to die..."

my response from the other thread....off topic but the first part of it covers the bases for ^^^ question



[Edited on September 11, 2009 at 4:15 PM. Reason : adsf]

9/11/2009 4:10:23 PM

your dick must be sore from jerking off to semantics, smackr.

ANSWER THE QUESTION:
DOES MEDICARE PAY LESS THAN WHAT THE DOCTOR CHARGES

9/11/2009 4:12:04 PM

you're just making yourself look like more for a rube.

9/11/2009 4:14:20 PM

Quote :

"DOES MEDICARE PAY LESS THAN WHAT THE DOCTOR CHARGES"

They all do. BCBS, Cigna, Medicare, Medicaid, etc. They all pay less than what the Doctor asks for. Again, the asking price is not the market value. If a doctor does not want to accept Medicare patients, the doctor doesn't have to, just like a doctor doesn't have to accept BCBS, Cigna, HealthSouth, etc. By chosing to accept patients from the various health care coverage providers, they are in turn accepting what those coverage providers are willing to pay as the market value.

All of which still doesn't address your argument that government meddling forced health care insurance away from being simply catostrophic coverage.

9/11/2009 4:16:41 PM

^^^^Well, see, now that's less douchey...providing alternatives. I like it.

There is no healthcare reform plan that will keep everyone healthy and cost nothing. There is no perfect plan.

Is Obama's plan worse than doing nothing? Is there an alternative (like the free clinics that you mention) that can be implemented in the short term?

Quote :

"^ so, as long as someone disagrees with you, they are a douche, right? "

When the point of contention is whether we should help the less fortunate get health care.

[Edited on September 11, 2009 at 4:19 PM. Reason : ^]

9/11/2009 4:17:57 PM

nice strawman. I never stated that medicare forced insurance away from being catastrophic coverage. I stated that medicare pays less than what the doctor charges. Meaning the doctor has to charge more. It's the same with insurance, yes. Doesn't change the point.

Medicare isn't the only instance of gov't meddling. I said as much far before you started jerking off

at least you stopped jerking off to semantics.

Quote :

"Is Obama's plan worse than doing nothing?"

Yes. By a long shot. Mainly because it simply seeks to implement more of the problem.

Quote :

"When the point of contention is whether we should help the less fortunate get health care."

I fail to see how such disagreement makes one a douche. But that's OK. Liberals tend to demonize any one who disagrees with them instead of actually debating the merits of anything. You aren't anything new

[Edited on September 11, 2009 at 4:20 PM. Reason : ]

9/11/2009 4:19:01 PM

i wish people would stop saying Obama's Plan

he doesn't have a plan


there is the House bill and a few bills in the Senate that haven't been approved


but Obama himself doesn't have a plan

9/11/2009 4:20:20 PM

Quote :

"nutsmackr: Any sort of catostrophic event that requires hospital stays or extensive treatment and the bulk of the American people would be completely unable to pay for it themselves, that's why they have health insurance."

Quote :

"aaronburro: if only that were why people had health insurance, then we wouldn't be in the mess we are in today. That is the model that insurance should be. That is not how insurance operates today, thanks to, YOU GUESSED IT, gov't meddling."

9/11/2009 4:21:40 PM

maybe burro should go back to oogling tennis players and complaining about queefs

9/11/2009 4:24:27 PM

i think the point he was trying to make is that people should be able to afford their primary care and only require insurance for the big stuff

but due to medicare and medicaid imposed value payments the doctors end up charging WAY more for the basic things than they should

[Edited on September 11, 2009 at 4:25 PM. Reason : sdfasd]

9/11/2009 4:24:38 PM

It's simpler to say Obama's plan than the ostensible collection of bills that make up health care reform. Also:

http://www.whitehouse.gov/issues/health_care/

Quote :

"The President's Plan"

It's not like we're suggesting it's an executive order written by the President or anything.

9/11/2009 4:24:44 PM

well i've read some of that piece of crap that came out of the House and there is a vast portion of it that i wouldn't want my name attached to if i were him

but i'm not

9/11/2009 4:26:51 PM

Quote :

"i think the point is was trying to make is that people should be able to afford their primary care and only require insurance for the big stuff"

Which you by and large can do. Medicare and Medicaid have nothing to do with that and the current health care reform debate isn't even about that.

Quote :

"but due to medicare and medicaid imposed value payments the doctors end up charging WAY more for the basic things than they should"

It isn't because of Medicare and Medicaid. It is because your doctor and your insurance provider have agreed to a set charge. The only time this bites someone in the ass is when they are without insurance and do not have the negotiating abilities that larger pools possess.

for instance, for care that is not covered by insurance, LASIK, cosmetic, the prices have dropped largely do to the competetive free market system that exists for those treatments, where as 20 year old covered proceures (MRI) is at a stagnant price.

[Edited on September 11, 2009 at 4:29 PM. Reason : .]

9/11/2009 4:26:53 PM

however, it still stands to reason the medicare and medicaid are examples of gov't meddling. which was what I was saying, before you started jerking off

9/11/2009 4:29:02 PM

Quote :

"however, it still stands to reason the medicare and medicaid are examples of gov't meddling. which was what I was saying, before you started jerking off"

Medicare, Medicaid, TriCare, VA Benefits are all government sponsored health care coverage. No one is arguing against that.

At least in the case of Medicare and Medicaid, they came about directly due to the failures of the health care market. Without medicare and medicaid, there would be a larger health care crisis in this country.

All of which, does nothing to address your argument that government meddling forced health care insurance away from being catostrophic insurance.

9/11/2009 4:34:51 PM

you don't think that a massive gov't insurance program had any effect on the insurance market? are you stupid or just being difficult?

Medicare is an example of gov't meddling.
state mandates on what insurance covers are examples of gov't meddling
state prohibitions against buying insurance across state lines are examples of gov't meddling.

you are being purposefully difficult.

9/11/2009 4:38:41 PM

Do you even know why Medicare exists? It exists because the health insurance companies were either incapable or unwilling to provide health care insurance to seniors. That is why the government stepped in and created it.

As for your second part, yes, those are examples of government regulations. That does not at all address your argument that "Government meddling" has turned health care insurance away from being catostrophic insurance coverage.

9/11/2009 4:44:32 PM

it doesn't matter why the gov't created it. It still affects insurance companies today. durrrrrrr


so, you don't think that state mandates on what insurance must cover (ie, you gotta cover more than just catastrophic stuff) would affect the role of insurance moving away from catastrophic coverage?

it's clear you are trolling at this point.

9/11/2009 4:48:24 PM

insurance companies still wouldnt be covering seniors.

9/11/2009 4:57:05 PM

we'll never know, will we?

9/11/2009 4:59:33 PM