$250k = Rich. $172k = "Modest"

[OCinBuffalo]

I already posted my thoughts in this thread, but you probably missed it as it did not refer to you in any way. Getting your goat is predictable and easy and for a big picture type, you completely miss how we do it every time. Predictable and dumb is probably not how you picture yourself one imagines, but several of us have joked about how easy it is. We all use the some variation of the same tactic you boob. This bit is a gift, not a put-down, but I bet you don't get that either.

 

As to my thoughts, I will expound:

 

• 
   
  
• Eliminate all current federal taxes
  
• Eliminate the Social Security program or modify it so that people could manage the money in some fashion (people above 45 or so would continue to get benefits, everybody else, gets squat).
  
• Establish say a 3% tax on all income under 25k, which becomes progressive above that level. We can increase the percentage if Social Security is to be maintained, but my personal preference would be for say a set percentage that you could choose how to invest for yourself. The default would be a safe investment of some sort (is there such a thing anymore?)
  
• Once you pass a net worth of say five million, you get a small % of tax assessed to that wealth that is progressive is well.
  

 

I am more than willing to quibble over the numbers, but my plan seems more equitable and provides transparency. Everyone realizes what they are paying and has at least some some "skin in the game".

Swing and a miss. You were asked to provide legal and/or historical analysis of the basis for progressive taxation.

 

The key word there was not "progressive taxation" or "legal and/or historical".

The key word there was "analysis".

 

I purposely framed that sentence in that format because a linear thinker like yourself is incapable of analysis and/or abstract thought, and you neatly and completely proved that with your linear "dis is what id do" response. Your..."thoughts"? Please. Let's tell the truth here: These "thoughts" aren't yours. No different than your "contribution" to any thread on this board, you read what somebody else wrote, and suddenly the author's thoughts become "yours".

 

The only difference between you and conner is: his dipstickery is politically motivated and intentional. You simply don't know any better.

 

The truly funny pat is: you spent all that time on your post, only to walk right into it, again. Thanks for your "gift".

[OCinBuffalo]

This response is precisely why you're the biggest joke of this board. Very few people can actually pick fights with the right & left with equal fervor because none of them appreciate your brilliance.

Oh, please...another non-denial denial. You wish this was all a joke, don't you there "I'm gonna tell the teacher!" guy?

 

The problem for you GG is: It's not even that I don't give a f what you think, it's that actually, I can't. Truthfully. Unless you are the world's best troll, I recognize you. You are the same guy I have been crushing most of my life, telling me why "it can't be done", "costs too much", get's pissed when I convince his boss to ignore him, intransigent, petulant, etc. I have left a long line of defeated GGs in my wake, so I know a GG when I see one.

 

I'm simply not capable of caring what you think, because I've never gotten anything from it. What you think is always massively predicated on, and distorted by, protocol, method, and form while ignoring effectiveness and opportunity, and therefore, it's useless.

 

OTOH, people like you are 100% dependent on what people like me think, and always will be. The fun part is that you are obviously aware of that. Enjoy!

[OCinBuffalo]

i think it also has to do with the consideration of only one or two possibilities to explain findings. many explanations are not even imagined much less analyzed. for example, one option to agreeing or disagreeing with him (that he apparently didn't consider) is ignoring him. superficial analyses are almost always incorrect or at the very least, incomplete.

We have spent the last 10 years being right, every single time, about health care processes, and ALL external effects on them, including governmental, and health care in general. We have nailed root causes, over and over, because we have the only effective way to describe workflow(real workflow, not made up marketing tear-sheet buzzword = Cerner, McKesson, etc.) in health care...but there's a chance I might have missed something. Are you aware of the comprehensive understanding one must have to do this?

 

Look, if you want me to start writing 3 page posts on this material, its on your head. Otherwise, we will have to operate on the assumption that what I do, and the analysis based on it, is quite complete indeed.

Sorry but costs aren't going up because we, the care givers, don't know what we are about. Here's a hint: you (i.e. the non care givers, and that's a huge group of people ranging from the gubment, to the lawyers, to the insurance companies, to the patients, to yes, even IT) are the greatest part of the problem.

I said, "as an organization". You are absolutely right to say that INDIVIDUALLY, you all know what you are about....and that's a primary part of the problem. You don't know what anybody else is about, and most of you don't care...until whatever they are about effects one of you. Then, it's "throw money at it!", "who cares if we have to pay the nurses double time?!", "and no, I'm not interested in how we avoid throwing $232,458 away next time, I'm a doctor, and I have better things to do!"

 

Health care HAD no proven way of PROPERLY studying care processes, universally and in detail. Until you all do, costs will continue to rise.

 

Regarding those that serve your industry:

Put it this way: I agree 100% with you. But, while this is what you feel, it's what I KNOW. I know, because I have the quantitative data and/or information and/or analytics to prove it.

 

Put it another way: The last time I went to HIMMS, I couldn't find one person who could tell me the proper definition of workflow. Most of the IT people I have encountered in health care...would only be hired as IT people, in health care. It's not even incompetence...it's flat out ignorance. Right now, it suits me fine to be the only one eyed man in the kingdom of the "don't even know I'm blind".

Edited January 22, 2011 by OCinBuffalo

[OCinBuffalo]

But not to worry. The government's now involved; they'll straighten it out.

This is what boggles me about birdog's support of Obamacare. As if the state surveyors, joint commission, etc. don't cause enough problems....he wants CMS to have ANOTHER 1000s of pages of regulations that they can come in and waste even more millions of "care hours" on useless dreck that does nothing to improve quality or God Forbid, cut cost.

 

They don't even know the basics of quality assurance, as evidenced of every single work product I have seen from HHS. Hey Tom, I showed you some hysterical stuff last time. Want Moar Sauce?

 

And, with all these new regs....of course we will have to hire ANOTHER 20k people at HHS, and even more at the state level, all of whom will not improve the quality of care, anywhere in the country, one iota....and all of whom will force provider cost up by an order of magnitude.

 

All this while Birdog is telling me it's not about $$$, while at the same time telling me, "Obamacare is all about lowering costs!"

[Booster4324]

Swing and a miss. You were asked to provide legal and/or historical analysis of the basis for progressive taxation.

 

The key word there was not "progressive taxation" or "legal and/or historical".

The key word there was "analysis".

 

I purposely framed that sentence in that format because a linear thinker like yourself is incapable of analysis and/or abstract thought, and you neatly and completely proved that with your linear "dis is what id do" response. Your..."thoughts"? Please. Let's tell the truth here: These "thoughts" aren't yours. No different than your "contribution" to any thread on this board, you read what somebody else wrote, and suddenly the author's thoughts become "yours".

 

The only difference between you and conner is: his dipstickery is politically motivated and intentional. You simply don't know any better.

 

The truly funny pat is: you spent all that time on your post, only to walk right into it, again. Thanks for your "gift".

 

That is why my first sentence said, "I already posted my thoughts in this thread". Try to keep up.

 

Edit - Oh, and as to the gift, it was a genuine effort to point out your overwhelming character flaw on this board. One assumes you are not like this in your dealings with people face to face, as you are gainfully employed. Well, you say you are...

Edited January 22, 2011 by Booster4324

[GG]

The problem for you GG is: It's not even that I don't give a f what you think, it's that actually, I can't. Truthfully.

 

Is that why you're responding to my post 5 days later?

 

PS - Congrats on learning how the shift & all caps keys work.

[IDBillzFan]

We all have to make sacrifices. Not just doctors.

Yes, but you see, some have more than others. And the people who have more need to sacrifice more before those with less sacrifice anything. It's only fair. After all, it's only a drop in the bucket to those who have more. They can afford it.

[Doc]

I said, "as an organization". You are absolutely right to say that INDIVIDUALLY, you all know what you are about....and that's a primary part of the problem. You don't know what anybody else is about, and most of you don't care...until whatever they are about effects one of you. Then, it's "throw money at it!", "who cares if we have to pay the nurses double time?!", "and no, I'm not interested in how we avoid throwing $232,458 away next time, I'm a doctor, and I have better things to do!"

 

Health care HAD no proven way of PROPERLY studying care processes, universally and in detail. Until you all do, costs will continue to rise.

 

Regarding those that serve your industry:

Put it this way: I agree 100% with you. But, while this is what you feel, it's what I KNOW. I know, because I have the quantitative data and/or information and/or analytics to prove it.

 

Put it another way: The last time I went to HIMMS, I couldn't find one person who could tell me the proper definition of workflow. Most of the IT people I have encountered in health care...would only be hired as IT people, in health care. It's not even incompetence...it's flat out ignorance. Right now, it suits me fine to be the only one eyed man in the kingdom of the "don't even know I'm blind".

You are the one who used the example of the nurse manager to extrapolate what we "as an organization" don't know, and then launched into a tirade against doctors.

 

Look, it's easy to sit on the outside and claim you know what's wrong. The fact is too many people, many who shouldn't be making decisions about health care, have their hands in the cookie jar. Where we as doctors failed was allowing ourselves to be manipulated by the insurance companies, lawyers, and the government. But the problem is that lawyers run the government, and they make the rules, and many of those rules are used to favor big business like insurance companies, or companies that make medical products whose costs are jacked up 300% because it's medical equipment, and those costs get passed-on down the line. And we aren't allowed to unionize. Hell we can't even know what other providers get from insurance companies because that violates anti-trust laws, whereas insurance companies have no such restrictions. All the while we are obligated to take care of a population (Medicaid and Medicare) that is growing and sicker than privately insured patients, and getting sicker, for a large (in my case, it's 66%) discount. I guess we should have been spending more money on PACs and lobbyists, which feeds into another broken system that no one has the ability to change either.

 

Take a look at Obamacare, which we both agree is a huge mistake. Can you blame that on doctors, or "the organization?" There's your problem.

 

Oh and your answer to that nurse shouldn't have been "do you think I got into consulting to fill out time sheets," because that's how you get paid (same for the nurse, who could have said "do you think I got into nursing to punch a time clock"). Your answer should have been "you may not have gotten into nursing to be a manager, but you accepted the responsibilities when you took the nurse manager job." And likely she took the job because of budget cuts, or she needed more money but wasn't qualified to do the job. But who made her manager? The doctors? The administration, who mostly don't have medical degrees?

[OCinBuffalo]

That is why my first sentence said, "I already posted my thoughts in this thread". Try to keep up.

 

Edit - Oh, and as to the gift, it was a genuine effort to point out your overwhelming character flaw on this board. One assumes you are not like this in your dealings with people face to face, as you are gainfully employed. Well, you say you are...

But that's the trouble Booster: those aren't YOUR thoughts either. We can find everything you post in headlines or sound bytes. Or, more typically, we find it in what somebody else already posted here...which you read, and then say you "agree". Talking to you is like talking to a newswire, or, on the internet, a web service.

 

Let's try this again, please give us YOUR analysis of the basis for progressive taxation. You may use legal or historical concepts. The fun part is you can't, and my character has 0 effect on that.

 

Unless, in real life you aren't a low-level thinker. See, I can change how I behave, but you are stuck with stupid.

 

Is that why you're responding to my post 5 days later?

 

PS - Congrats on learning how the shift & all caps keys work.

I work? I am simply explaining so that you understand why I can't care about your "thoughts".

[Booster4324]

But that's the trouble Booster: those aren't YOUR thoughts either. We can find everything you post in headlines or sound bytes. Or, more typically, we find it in what somebody else already posted here...which you read, and then say you "agree". Talking to you is like talking to a newswire, or, on the internet, a web service.

 

Let's try this again, please give us YOUR analysis of the basis for progressive taxation. You may use legal or historical concepts. The fun part is you can't, and my character has 0 effect on that.

 

Unless, in real life you aren't a low-level thinker. See, I can change how I behave, but you are stuck with stupid.

 

Really? First, I doubt you even read what I am referring to. Second, I doubt you could match it up to anything someone here has said. Let's face facts, you suck at this whole debate thing, when it gets right down to it, all you can do is hurl insults. You certainly aren't capable of defending your ideas once one of us hurts your overweening pride. Now go "work/sulk" for 5 days.

[OCinBuffalo]

You are the one who used the example of the nurse manager to extrapolate what we "as an organization" don't know, and then launched into a tirade against doctors.

No, I am the one who illustrated the attitude I have encountered far more often than not. We don't extrapolate a damn thing. This is about accurate data. We have it. Organizations really don't know, and we prove it, on a consistent basis.

 

I find that health care managers are consistently duped into making bad decisions, based purely on anecdotes, or what they "know"(read: emote). I find that their people make all kinds of goofy decisions(i.e. hiding supplies in the false ceilings before the weekend, I get that one a lot) in an effort to deal with the fact that nobody truly has a grasp on WTF is happening at (insert health care organization here), big picture, or at any given point in the day.

Look, it's easy to sit on the outside and claim you know what's wrong.

But I don't. You don't get any more inside than us. You don't get a more accurate picture of what is actually happening on the inside than us...so spare me the platitudes please. And, ever heard of "can't see the forest for the trees"? Yeah, big time.

The fact is too many people, many who shouldn't be making decisions about health care, have their hands in the cookie jar. Where we as doctors failed was allowing ourselves to be manipulated by the insurance companies, lawyers, and the government. But the problem is that lawyers run the government, and they make the rules, and many of those rules are used to favor big business like insurance companies, or companies that make medical products whose costs are jacked up 300% because it's medical equipment, and those costs get passed-on down the line. And we aren't allowed to unionize. Hell we can't even know what other providers get from insurance companies because that violates anti-trust laws, whereas insurance companies have no such restrictions. All the while we are obligated to take care of a population (Medicaid and Medicare) that is growing and sicker than privately insured patients, and getting sicker, for a large (in my case, it's 66%) discount. I guess we should have been spending more money on PACs and lobbyists, which feeds into another broken system that no one has the ability to change either.

Sure. But, I'm not here to take a macroeconomic/Washington DC approach. How's that working for you? Rather, I am doing the opposite: creating a growing bottom up position based solely on unavoidable conclusions based on incontrovertible data. Sooner or later, the data we have will be statistically significant. When it is, the beatings will commence, starting with the regulators.

Take a look at Obamacare, which we both agree is a huge mistake. Can you blame that on doctors, or "the organization?" There's your problem.

I started on this 10 years before Obamacare, and I assure you, it has nothing to do with the root causes we have been identifying and going after. We agree because, based on the work I have already done, Obamacare does NOTHING to address the issues we have identified years ago. If anything it either has a negative effect, no effect, or simply moves the issue from one place to another.

 

You aren't getting what I am saying. "The organization" is everybody, because, it is. The janitor, the nurse, the housekeeper, everybody has an effect on everybody else, and all of it varies. In addition, the organization doesn't make widgets, i.e. not universal outcomes.

Oh and your answer to that nurse shouldn't have been "do you think I got into consulting to fill out time sheets," because that's how you get paid (same for the nurse, who could have said "do you think I got into nursing to punch a time clock"). Your answer should have been "you may not have gotten into nursing to be a manager, but you accepted the responsibilities when you took the nurse manager job." And likely she took the job because of budget cuts, or she needed more money but wasn't qualified to do the job. But who made her manager? The doctors? The administration, who mostly don't have medical degrees?

The point is: we all have to do administrative tasks, and no one is above it. The next point is: I should have said "review other people's time sheets". Believe me, this is a waste of my skill set, but I do it, and I don't complain about it.

 

The problem is: nurses AND doctors aren't trained as managers, of anything. Many attempts have been made to remedy this. Most have failed.

[birdog1960]

You are the one who used the example of the nurse manager to extrapolate what we "as an organization" don't know, and then launched into a tirade against doctors.

 

Look, it's easy to sit on the outside and claim you know what's wrong. The fact is too many people, many who shouldn't be making decisions about health care, have their hands in the cookie jar. Where we as doctors failed was allowing ourselves to be manipulated by the insurance companies, lawyers, and the government. But the problem is that lawyers run the government, and they make the rules, and many of those rules are used to favor big business like insurance companies, or companies that make medical products whose costs are jacked up 300% because it's medical equipment, and those costs get passed-on down the line. And we aren't allowed to unionize. Hell we can't even know what other providers get from insurance companies because that violates anti-trust laws, whereas insurance companies have no such restrictions.

amazing...common ground. i've spent many hours this month changing prescriptions to fit some mega mail -in insurance pharmacy profit center's ever changing formulary. i.e.: working to make them money. no benefit to the patient or me (i'm not reimbursed for any of this) and possibly harm to the patients. what oc seems to discount is that i see a huge volume of patients-there really isn't much more capacity in my practice and this stuff makes capacity even less. i'm actually heartened to see the overnight dearth of drug reps as they're finally recognized as unneccessary and probably harmful to the provision of cost effective care. i would love a national formulary, similar to the VA's. there's no evidence outcomes are improved with unlimited formulary choices and at least then, inclusions would be based on medical evidence as well as cost. in a previous thread i reached agreement with many posters (including you i believe) that administrative costs for medicare are significantly below current private insurance plans. why should this not hold true a single payer plan. 10's or even 100's of thousands of paper pushing private insurance jobs could be eliminated. all middleman profit removed.

 

the devils in the details. malpractice reform must also occur. right now, the insurance companies can refuse care (hospital days, drugs, diagnostic procedures etc without any liability risk while padding their profits and without reducing my risk. when the government starts rationing, my risk has to be minimized if i stay within guidelines and i believe it would be. nevertheless, it can't be much worse than the current situation. at least i'd be taking on the risk while providing care more equitably.

[OCinBuffalo]

Really? First, I doubt you even read what I am referring to. Second, I doubt you could match it up to anything someone here has said. Let's face facts, you suck at this whole debate thing, when it gets right down to it, all you can do is hurl insults. You certainly aren't capable of defending your ideas once one of us hurts your overweening pride. Now go "work/sulk" for 5 days.

Ok, after a search, here are the "thoughts" that you ascribe to yourself:

 

"Because you have more disposable income and can afford to invest it more efficiently. The actual percentage of taxes (all taxes) paid after a bare minimum cost of living is deducted from base salaries make it far closer percentage wise than people who only talk about the "fifty percent who do not pay taxes."

 

Again: Please give us YOUR analysis of the basis for progressive taxation. You may use legal or historical concepts.

[Peace]

"I am the man. Doctors make poor managers." doesn't add a lot. How about specifics?

[OCinBuffalo]

amazing...common ground. i've spent many hours this month changing prescriptions to fit some mega mail -in insurance pharmacy profit center's ever changing formulary. i.e.: working to make them money. no benefit to the patient or me (i'm not reimbursed for any of this) and possibly harm to the patients. what oc seems to discount is that i see a huge volume of patients-there really isn't much more capacity in my practice and this stuff makes capacity even less. i'm actually heartened to see the overnight dearth of drug reps as they're finally recognized as unneccessary and probably harmful to the provision of cost effective care. i would love a national formulary, similar to the VA's. there's no evidence outcomes are improved with unlimited formulary choices and at least then, inclusions would be based on medical evidence as well as cost. in a previous thread i reached agreement with many posters (including you i believe) that administrative costs for medicare are significantly below current private insurance plans. why should this not hold true a single payer plan. 10's or even 100's of thousands of paper pushing private insurance jobs could be eliminated. all middleman profit removed.

 

the devils in the details. malpractice reform must also occur. right now, the insurance companies can refuse care (hospital days, drugs, diagnostic procedures etc without any liability risk while padding their profits and without reducing my risk. when the government starts rationing, my risk has to be minimized if i stay within guidelines and i believe it would be. nevertheless, it can't be much worse than the current situation. at least i'd be taking on the risk while providing care more equitably.

What you don't seem to realize is that not only do I understand how many patients you see(85% Medicare, you better be), this variable is one of many we track, and tweak in simulations, as it does a fine job of stressing the system. In fact, I am counting on the # of patients/doc going up over time, especially if Obamacare isn't removed. Makes a great case for "guess you need to get more efficient then, don't you?". As I have said numerous time, Obamacare personally benefits my group massively, but we are still against it because all it does is obfuscate the problems.

 

What you also don't seem to realize is that pissing around talking about %6 cost, vs. 10% cost, administratively, is insignificant, when we talk about the sheer amount of wasted $$$ just in scripts...as you just got done defining. The amount of wasted food alone at most hospitals, extended to Medicare's level, makes your point silly.

 

Of course Medicare costs are going to be lower by volume, they insure 300 times the people as the average single state insurance company. They have no competition, and a forced revenue stream, which means they don't have to sell. And, they have an unlimited supply of capital if they go over budget. You are talking about a Walmart that doesn't have to spend a nickel on sales guys, and then asking why mom & pop have a higher cost per unit?....

 

"I am the man. Doctors make poor managers." doesn't add a lot. How about specifics?

No, because if I do that, the whining about the length of the post will begin.

 

It's not just doctors, it's everybody. And, the example I gave earlier is right out of the database. Yes, we did find a $250k waste of money that easily could have been avoided had everyone known the effect prior. That is 1(one) example. We have found hundreds of thousands.

Edited January 22, 2011 by OCinBuffalo

[Booster4324]

Ok, after a search, here are the "thoughts" that you ascribe to yourself:

 

"Because you have more disposable income and can afford to invest it more efficiently. The actual percentage of taxes (all taxes) paid after a bare minimum cost of living is deducted from base salaries make it far closer percentage wise than people who only talk about the "fifty percent who do not pay taxes."

 

Again: Please give us YOUR analysis of the basis for progressive taxation. You may use legal or historical concepts.

 

That is my analysis. What part did you not understand?

[birdog1960]

What you don't seem to realize is that not only do I understand how many patients you see(85% Medicare, you better be), this variable is one of many we track, and tweak in simulations, as it does a fine job of stressing the system. In fact, I am counting on the # of patients/doc going up over time, especially if Obamacare isn't removed. Makes a great case for "guess you need to get more efficient then, don't you?". As I have said numerous time, Obamacare personally benefits my group massively, but we are still against it because all it does is obfuscate the problems.

 

What you also don't seem to realize is that pissing around talking about %6 cost, vs. 10% cost, administratively, is insignificant, when we talk about the sheer amount of wasted $$$ just in scripts...as you just got done defining. The amount of wasted food alone at most hospitals, extended to Medicare's level, makes your point silly.

 

Of course Medicare costs are going to be lower by volume, they insure 300 times the people as the average single state insurance company. They have no competition, and a forced revenue stream, which means they don't have to sell. And, they have an unlimited supply of capital if they go over budget. You are talking about a Walmart that doesn't have to spend a nickel on sales guys, and then asking why mom & pop have a higher cost per unit?....

 

 

once again you fail to consider all or even most possibilities. the fact that i see a large number of patients doesn't necessarily mean i'm not efficient. in fact it could (and does, in my opinion) show just the opposite. i believe it means there's plenty of demand (even with 30%+ of the population uninsured-btw, i see the uninsured and for the most part, they are actually pretty good payors. your arguments about volume (economies of scale) and lack of competiton, need for advertising and marketing etc acually support the need for a single payor system in my view. these things are unnecessary, add nothing to actual quality of care (likely are detrimental to it) and are extremely costly to society benefitting a few at the expense of the many...the antithesis of my philosophy.

Edited January 22, 2011 by birdog1960

[OCinBuffalo]

That is my analysis. What part did you not understand?

So what is that....5 times I ask you for...what you already posted...and now, you finally get it?

 

Jesus. I honestly wasn't sure if you were going to get that...it was already funny, would have been even more funny if you went for round 6. For a little while this afternoon I honestly thought you might not have actually realized that what you posted was in fact an analysis. Lulz.

 

And, btw there is no legal or historical component in that analysis. You don't describe what the basis you defined is predicated on, or what justifies it legally or historically.

[OCinBuffalo]

once again you fail to consider all or even most possibilities. the fact that i see a large number of patients doesn't necessarily mean i'm not efficient.

No, I fully realize that. The point I am making should be clear: if Obamacare is allowed to live, the necessity for efficiency will rise exponentially.

 

You may be efficient now, but are you "Obamacare efficient^TM"?

in fact it could (and does, in my opinion) show just the opposite. i believe it means there's plenty of demand (even with 30%+ of the population uninsured-btw, i see the uninsured and for the most part, they are actually pretty good payors.

So then, why the need for a massive waste of tax dollars to staff up an already bloated HHS?

your arguments about volume (economies of scale) and lack of competiton, need for advertising and marketing etc acually support the need for a single payor system in my view. these things are unnecessary, add nothing to actual quality of care (likely are detrimental to it) and are extremely costly to society benefitting a few at the expense of the many...the antithesis of my philosophy.

Hey, there's no doubt that sales guys are a waste of money.

 

In all seriousness, let me take off my persona for a second. To the casual observer, what you wrote seems to make sense. Yes, all of the big buildings, luxury boxes, salaries, commissions, etc., that I found at both the large insurance companies that engaged me, are empty dollars in terms of providing care to patients.

 

But, in truth, this is a lesser of 2 evils argument, and Medicare is by far the greater evil.

 

What if we added fraud to the % cost of Medicare's administrative costs?

What if we actually looked a say, a skilled nursing facility, and looked at how much private pay revenue is used to make up for the short falls in Medicare/Medicaid reimbursement?

 

The "% of administrative cost of Medicare" thing is a myth, if you take an objective look at ALL the data.

Edited January 22, 2011 by OCinBuffalo

[birdog1960]

No, I fully realize that. The point I am making should be clear: if Obamacare is allowed to live, the necessity for efficiency will rise exponentially.

 

You may be efficient now, but are you "Obamacare efficient^TM"?

 

So then, why the need for a massive waste of tax dollars to staff up an already bloated HHS?

 

Hey, there's no doubt that sales guys are a waste of money.

 

In all seriousness, let me take off my persona for a second. To the casual observer, what you wrote seems to make sense. Yes, all of the big buildings, luxury boxes, salaries, commissions, etc., that I found at both the large insurance companies that engaged me, are empty dollars in terms of providing care to patients.

 

But, in truth, this is a lesser of 2 evils argument, and Medicare is by far the greater evil.

 

What if we added fraud to the % cost of Medicare's administrative costs?

What if we actually looked a say, a skilled nursing facility, and looked at how much private pay revenue is used to make up for the short falls in Medicare/Medicaid reimbursement?

 

The "% of administrative cost of Medicare" thing is a myth, if you take an objective look at ALL the data.

how bout we just fix the fraud. the reason self pay won't work is that almost no one can afford catastrophic care...and there needs to be an entity with gravitas that represents the populace to decide when those massive expenditures are justified.

Edited January 22, 2011 by birdog1960