3rdnlng Posted March 28, 2012 Posted March 28, 2012 maybe scalia read the forbes script? now who's reading the teleprompter talking points? Kagan and the smart hispanic woman? You have to be kidding me. Have you noticed the quality of Obama's appointments, throughout his administration? Who was that dufus arguing for Obamacare in front of SCOTUS today? Doc, if only we could sue Obama for malpractice--we could solve the deficit problem.
birdog1960 Posted March 28, 2012 Posted March 28, 2012 Kagan and the smart hispanic woman? You have to be kidding me. Have you noticed the quality of Obama's appointments, throughout his administration? magna cum laude from harvard law, dean of harvard law...i know, means nothing to you guys but there's a titanic sized boatload of lawyers who would give both their nuts for the credentials that this dufus holds. and yes,dc, appeal to authority...but it's very good authority that's being flippantly challenged here.
dayman Posted March 28, 2012 Posted March 28, 2012 (edited) i listened to kennedy and roberts question florida's lawyer and didn't come away thinking anything was a done deal. Just got done with the entire thing. Honestly it's almost as if that guy did more harm than good. Their first lawyer did such an outstanding job following the bumbling solicitor that they didn't need more. Then that guy got up their like Bill O'Reilly and was somewhat combative and generally brought a demeanor that hurt their cause, something the first guy was excellent at avoiding. Not that any of this will matter in the end I'm sure but it was interesting to see his approach. Edited March 28, 2012 by dayman
3rdnlng Posted March 28, 2012 Posted March 28, 2012 magna cum laude from harvard law, dean of harvard law...i know, means nothing to you guys but there's a titanic sized boatload of lawyers who would give both their nuts for the credentials that this dufus holds. and yes,dc, appeal to authority...but it's very good authority that's being flippantly challenged here. That means nothing anymore in the reality of life. I'm willing to bet that the only entity that worships those degrees is the government. I'm willing to bet that the people that actually pay the bills of this country lean more toward MIT or RIT grads or MBA's from Podunk University and Steve Jobs and Bill Gates. I've got you figured out now Birdog. You are an elitist that has underacheived and is now trying to make up for it.
Rob's House Posted March 28, 2012 Posted March 28, 2012 says the future law student. sure, kagan's got nothin on you. Your first mistake is assuming Kagan has any more regard for the constitution than you do. magna cum laude from harvard law, dean of harvard law...i know, means nothing to you guys but there's a titanic sized boatload of lawyers who would give both their nuts for the credentials that this dufus holds. and yes,dc, appeal to authority...but it's very good authority that's being flippantly challenged here. Again, you miss the point, but that's not surprising. These people aren't as naive as those of you touting their credentials. They have their own agendas beyond that which the constitution allows. The fact that people with these credentials can't come up with better arguments is the best evidence that there aren't good legal arguments to support their case. And regardless of who the authority is, if you can't explain your position in your own words you don't know the material well enough to discern between good & bad authority.
dayman Posted March 28, 2012 Posted March 28, 2012 These people aren't as naive as those of you touting their credentials. They have their own agendas beyond that which the constitution allows. It really just isn't true. Not true. There is probably nothing that would cause you to think otherwise though.
Rob's House Posted March 28, 2012 Posted March 28, 2012 It really just isn't true. Not true. There is probably nothing that would cause you to think otherwise though. You disappoint me. I see you have the potential to be someone of substance but choose to neglect it. And saying "no , not true" isn't analysis & it isn't interesting. Give at least some rational justification for your position other than because you're supporting a side you decided to identify with because it made you feel good about yourself.
dayman Posted March 28, 2012 Posted March 28, 2012 You disappoint me. I see you have the potential to be someone of substance but choose to neglect it. And saying "no , not true" isn't analysis & it isn't interesting. Give at least some rational justification for your position other than because you're supporting a side you decided to identify with because it made you feel good about yourself. They really do decide legal questions to the best of their abilities according to how they view the constitution. They don't have some "agenda that is beyond the constitution" that is precisely what they are sworn not to have and they all take that seriously. That is what I believe.
Rob's House Posted March 28, 2012 Posted March 28, 2012 They really do decide legal questions to the best of their abilities according to how they view the constitution. They don't have some "agenda that is beyond the constitution" that is precisely what they are sworn not to have and they all take that seriously. That is what I believe. I appreciate your innocence, and I mean that sincerely, but it's a bit naive to assume that members of the court never stretch the interpretation to say what they think it should say as opposed to what they think it does say. I don't have time now, I was just checking for updates & got sucked back in, but If you'd like I can give you a better explanation with examples tomorrow.
dayman Posted March 28, 2012 Posted March 28, 2012 (edited) I appreciate your innocence, and I mean that sincerely, but it's a bit naive to assume that members of the court never stretch the interpretation to say what they think it should say as opposed to what they think it does say. I don't have time now, I was just checking for updates & got sucked back in, but If you'd like I can give you a better explanation with examples tomorrow. It's a difficult job and they certainly may be guilty in "stretching" logic more in one direction than another to reach a determination more in line with their view of the constitution. But not to support party politics. This is a huge deal in terms of commerce clause jurisprudence. It is something they will all take seriously this case will be around long after Obama and the current Repubs. Edited March 28, 2012 by dayman
OCinBuffalo Posted March 28, 2012 Posted March 28, 2012 (edited) The system will continue to limp along with high prices and the same core issues as it did prior to the ACA being passed... Prices are not likely to go down anytime soon, it is simple a matter of better technolgies being adaopted everyday and people living much longer than they did even 50 years ago. We are also seeing a massive brick and sticks expansion as we try to make room for a large surge in demand, building although partly funded by private donation also take a very large chuck out of our hospital cash flow. Until the notion that we treat "everybody" regardless of ability to pay or have insurance, we will be in the same predicament. We wrote off 150 million in unreimbursed care last year, alot of it was indigent care but an even larger portion was just on people who failed to maintain insurance coverage. Until we are by law able to shut the door in the faces of those who cannot pay, we will continue to raise prices on testing and billiables to insurance compaines (not federal programs)to help offset the costs... It all get spaid for, directly or indirectly. We as a nation have decide whether we are going to hold each indivdual American to account, or simply whine when costs gets shifted onto the paying crowd. Yet, it doesn't matter whether you are reimbursed for your costs, or not, because you don't know your cost of doing business per patient, per day, week, minute, whatever. There is 0 indication that paying you for every single patient will stop your costs from increasing, or induce the customer to look for a provider who has the lower costs. good thoughts- I have long been an advocate of very high decuctible health plans where Amercians would be incented to get cost estimates, so they would "feel" the pain (no pun intended) of paying their bills... perhaps that would incent people to not be fat and lazy and stupid and start taking care of themselves. The contention with insurance carriers is pass-through money... why does it cost Cigna 30% of premium dollars to provide third party adminstration, when it costs Medicare 4%? They do the same thing, why the discepancy? The public option was proposed to have non-profit TPA's that had alower pass through cost, under 10% if not more. The Public Option could have been adminstered from the City of State Level, not the Federal Level and met the needs of citizens locally... but that was consider socilist or someting like that... heck, it would have been a nice solution, Liberals could habe their non-proficts cooperative and conservatives could habe still bought private insurance coverage from private compnaines, each side with high deductibel plans... The only problem with the first part is: it can't work because you don't know what your real costs are. Estimated or otherwise. Sure you can haul in a crate of milk to a unit, and a week later see that crate empty, and then financially allocate the cost of that milk to the unit and divide by the # of patients there that week....but that's ridiculous, right? That tells us very little about cost, and no more than next week's data, or the week's before. Six months of that data tells us less than nothing. How exactly are you going to itemize the milk consumed, and everything else you do for them, from admit to discharge, and then apply that to a single patient's high deductible...based on what you have financially allocated to the entire unit, or department for that matter? I am sorry, but charging somebody for 2.3 cartons of milk, when they only had 1 = EPIC FAIL. You better hire 3x the staff in your finance department, just to deal with the bill disputes, if this is your plan. The 4% vs. 30% is a myth propagated by the friggin' West Wing. It's perhaps the single largest apples to oranges comparison in politics. Look, I know what's wrong with how the average insurance company does business. This is not part of that. One, there are others, of their root cause issues is their inability to know whether you are ripping them off or not, because they don't know what your costs are either, so, they keep raising their rates just in case. It all comes down to nobody in the entire industry being able to say, with consistent certainty, what the cost of taking care of Mrs. Jones was yesterday, today, and certainly not tomorrow. And, I have news: sinking another $640 billion into clinical software, whose design is fundamentally incapable of telling you what you need to know, because it is fundamentally designed from the top-down, and fundamentally designed around protocols and plans, and not actual activity, is just about the dumbest idea there is. Edit: Oh, I forgot, making sure one hospital can tell another out-of-market hospital or insurance company, that it has no idea what the cost of taking care of their member was....doesn't help much either. It's great to know that somebody is allergic to penicillin, but it doesn't move the ball at all in terms of managing the business. Edited March 28, 2012 by OCinBuffalo
Alaska Darin Posted March 28, 2012 Posted March 28, 2012 That is what I believe. "There's one born every minute."
birdog1960 Posted March 28, 2012 Posted March 28, 2012 (edited) That means nothing anymore in the reality of life. I'm willing to bet that the only entity that worships those degrees is the government. you'd be wrong. doesn't come immediately to hand but there is data on the value of degrees from different institutions. some degrees are worth less than they cost (don't recall how podunk u did). the prestige schools deliver the big bucks (and i'll bet mit and rit did fine). do you really think highly motivated, mostly highly successful, rich parents doll out 50K+ a year for their kids to go to a prestige school so they can put a sticker in the back window of their merc? sorry, just a convenient myth propagated by, as dc said, your priests. I've got you figured out now Birdog. You are an elitist that has underacheived and is now trying to make up for it. wrong again. Edited March 28, 2012 by birdog1960
erynthered Posted March 28, 2012 Author Posted March 28, 2012 He was for it before he was against it, or wait...he was against it before he was for it. Never in my life have I ever seen such a worthless piece of shiiit.
birdog1960 Posted March 28, 2012 Posted March 28, 2012 Yet, it doesn't matter whether you are reimbursed for your costs, or not, because you don't know your cost of doing business per patient, per day, week, minute, whatever. There is 0 indication that paying you for every single patient will stop your costs from increasing, or induce the customer to look for a provider who has the lower costs. The only problem with the first part is: it can't work because you don't know what your real costs are. Estimated or otherwise. Sure you can haul in a crate of milk to a unit, and a week later see that crate empty, and then financially allocate the cost of that milk to the unit and divide by the # of patients there that week....but that's ridiculous, right? That tells us very little about cost, and no more than next week's data, or the week's before. Six months of that data tells us less than nothing. How exactly are you going to itemize the milk consumed, and everything else you do for them, from admit to discharge, and then apply that to a single patient's high deductible...based on what you have financially allocated to the entire unit, or department for that matter? I am sorry, but charging somebody for 2.3 cartons of milk, when they only had 1 = EPIC FAIL. You better hire 3x the staff in your finance department, just to deal with the bill disputes, if this is your plan. The 4% vs. 30% is a myth propagated by the friggin' West Wing. It's perhaps the single largest apples to oranges comparison in politics. Look, I know what's wrong with how the average insurance company does business. This is not part of that. One, there are others, of their root cause issues is their inability to know whether you are ripping them off or not, because they don't know what your costs are either, so, they keep raising their rates just in case. It all comes down to nobody in the entire industry being able to say, with consistent certainty, what the cost of taking care of Mrs. Jones was yesterday, today, and certainly not tomorrow. And, I have news: sinking another $640 billion into clinical software, whose design is fundamentally incapable of telling you what you need to know, because it is fundamentally designed from the top-down, and fundamentally designed around protocols and plans, and not actual activity, is just about the dumbest idea there is. Edit: Oh, I forgot, making sure one hospital can tell another out-of-market hospital or insurance company, that it has no idea what the cost of taking care of their member was....doesn't help much either. It's great to know that somebody is allergic to penicillin, but it doesn't move the ball at all in terms of managing the business. all of these calculations become much simpler if cost shifting to subsidize uninsured care is taken out of the equation. this was actually discussed by the supremes. someone (kagan?) mentioned a number of about $800/year that patients with insurance pay extra to cover this cost shifting.
Doc Posted March 28, 2012 Posted March 28, 2012 all of these calculations become much simpler if cost shifting to subsidize uninsured care is taken out of the equation. this was actually discussed by the supremes. someone (kagan?) mentioned a number of about $800/year that patients with insurance pay extra to cover this cost shifting. Taken out of the equation...and shifted to the taxpayers? And that's the solution?
dayman Posted March 28, 2012 Posted March 28, 2012 Taken out of the equation...and shifted to the taxpayers? And that's the solution? Well I think the idea is force those people into the system. And I thought the number they were going with was $1000 not $800 but could be wrong.
DC Tom Posted March 28, 2012 Posted March 28, 2012 Taken out of the equation...and shifted to the taxpayers? And that's the solution? Taken out of the equation...and then put back in?
birdog1960 Posted March 28, 2012 Posted March 28, 2012 Well I think the idea is force those people into the system. And I thought the number they were going with was $1000 not $800 but could be wrong. may well have been $1000. i think i hit traffic when that part came on. was it kagan or the feds' lawyer who said that?
dayman Posted March 28, 2012 Posted March 28, 2012 may well have been $1000. i think i hit traffic when that part came on. was it kagan or the feds' lawyer who said that? Don't remember. Gun to my head I would say Ginsburg said it IRRC.
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