so waht ya doin today?

[fiver]

so I watched the army-navy football game today.
I'm always well? 'impressed' by how that game is played, and I get pretty well moved by the singing at the end of the game.
I don't think it would matter if one team had won every game all year and the other lost every game, it would still be a well played game full of drama of some sort and it would be pretty hard to pick a winner before hand.

 

[Pistolero]

Bret said:
It's kind of funny that no one bats an eye when the 22 year old guy with 4 accidents in 3 years, one of them DWI, has an outrageous auto insurance bill, but when someone 50 with a so called "pre-existing" medical issue (or worse when someone with a drug habit or other risky lifestyle) has to pay more than someone 20 with no issues they scream about "rights" and the unfairness of it all. Makes no sense to me.

Yeah, agreed. And good point it isn't insurance, but a care plan. One key ingredient that is missing somehow is the cost
factor. Who would turn their car in for service with no clue what the charge was going to be - unless they had the extended
warranty and someone else was paying. AFAIK, it is impossible to even find out what any sort of a medical care procedure
will cost - other than Lasik, which has competition because it is not covered by 'insurance' plans. And, AFAIK, Lasik is the only
medical care process which has dropped from $5K per eye in the middle 80s to about $500 per eye today. Competition. I
would guess that all other medical care has gone pretty much exactly the opposite. Something that was $500 in the mid
80s is probably $5K today.

Seems to be entirely missing from the health care system. Not sure how to put it back in, but I think it would be a good thing.

Bill

 

[462]

Bill,
Medicare statements detail the costs of doctors' visits, surgeries and procedures, lab work, etc. It is very enlightening to see the price listed in one column, the "insurance" payment in the next, and due from patient in the last.

My take is, given that the medical profession knows exactly what "insurance" will cover, their prices are inflated accordingly.

Similarly, government back student loans inflate the cost of higher education.

Take away medical "insurance", and higher education loans, and capitalistic competition will reduce their prices to the real world level.

 

[CZ93X62]

The Army-Navy game is my idea of a "Super Bowl".

 

[Brad]

Never say with words what can better be said with a flamethrower.

I was not aware of how the ignition system worked.

 

[Ian]

Great channel, been subbed for years. Long-haired, skinny, left-handed gun nut named Ian, what's not to like?

I think that's the first time I noticed him not trying to shoot something left-handed.

 

[Pistolero]

Interesting demo. I have enjoyed a number of his looks at odd and forgotten weapons. Always
does a good job. Same here in no idea on ignition system before.

Of course, now days we are probably way too civilized with our warfare to use a weapon like
this. Sad to say.
IMO, in a war all things should be OK.

Bill

 

[Bret4207]

Competition. I
would guess that all other medical care has gone pretty much exactly the opposite. Something that was $500 in the mid
80s is probably $5K today.

Seems to be entirely missing from the health care system. Not sure how to put it back in, but I think it would be a good thing.

Bill

Amen brother! Some sectors of our economy seem to be very well protected. Don't get me going on the higher education industry!

 

[Rick]

I've been pretty much avoiding this health care conversation because of the political part of it but the truth is that health care costs started soaring the same day gubmint got involved in it. Nuff said.

 

[Chris]

Bret said:
It's kind of funny that no one bats an eye when the 22 year old guy with 4 accidents in 3 years, one of them DWI, has an outrageous auto insurance bill, but when someone 50 with a so called "pre-existing" medical issue (or worse when someone with a drug habit or other risky lifestyle) has to pay more than someone 20 with no issues they scream about "rights" and the unfairness of it all. Makes no sense to me.

Yeah, agreed. And good point it isn't insurance, but a care plan. One key ingredient that is missing somehow is the cost
factor. Who would turn their car in for service with no clue what the charge was going to be - unless they had the extended
warranty and someone else was paying. AFAIK, it is impossible to even find out what any sort of a medical care procedure
will cost - other than Lasik, which has competition because it is not covered by 'insurance' plans. And, AFAIK, Lasik is the only
medical care process which has dropped from $5K per eye in the middle 80s to about $500 per eye today. Competition. I
would guess that all other medical care has gone pretty much exactly the opposite. Something that was $500 in the mid
80s is probably $5K today.

Seems to be entirely missing from the health care system. Not sure how to put it back in, but I think it would be a good thing.

Bill

Bill, take a look here and in particular check their prices:

https://surgerycenterok.com/about/

I suspect that some careful investigation would reveal competitors in the surgical market. I took a squint at their pricing and many procedures are within range of self-funding in desperate situations.

 

[Rally Hess]

I believe there are more products available in a super market than there are medical procedures, and they are all priced before purchase. Seems the medical community needs to take lessons from Wal~Mart!

 

[RBHarter]

Lawyers . Perod .

Ambulance rides costs $1000 not because of the 2 people on board or the greedy owner . It costs that because ;
The box with the Ambulance package is $45,000.+-2 gas/diesel.
The gurney set up is $1200.
Oxy is another $1000 and $17-25 per run .
Every item inside the box that is packaged whether it's single pack Band-Aids or potassium cloride glucose bags , epi pens or bottled water has a shelf life of 6-12 months , yes gauze wrap , and sanitary napkins have a 12 mo shelf . The items must be replaced with new from a certified trackable source , all of them . Bang that $4.50 100 count bottle of store brand aspirin now cost $15/10 . $2 Bait Barn gauze is $24/6 that combined might have that much .
The tracability costs because every sale has to be logged and stored hard copy for 10 yr soft for 2 in addition to the hard copy . Every dispatch station has to keep use /restock information for 5 yr in station meeting the above 10/20 also . Most services pay for upkeep of certificate which starts at $250 per yr per attendant . The attendants have to keep up special drivers license endorsements and in many states background checks annually . That gets more expensive as they go from EMT basic up to Paramedic whom is really of about the same education level and knowledge base as an LPN but has to recertify every 2 yr .
The typical Ambulance has a life span of 10 yr and a typical annual operation cost of $8-10k rural and probably closer to $150-200 k in urban areas with attendants .

Step into the hospital . The malpractice insurance for a general practitioner starts at $100,000 per yr for up to 125 patients on the books it goes up $1000 per patient to 175 then it goes up 1250 per in 25 patient increments . Carry 126 patients may as well have 149 because it'll cost the same $125 k . With no claims . Add any speciality to the door and it goes up $25,000/yr plus scale 50k if it has to do with the children . 2 nurses , or 1 and a PA , and a clerck/book keeper/receptionist and you can add an additional $90-125 k plus the 140-200k for the building .

I cringe to think what a trauma center with 200 MDs and 4-500 nurses servings 2,000/day or more must cost .

An LPN , RN , MD or EMT didn't write the laws nor do they enforce them . They do occasionally lend names to lobby for settlement caps . No sirs , it was an Esquire . It probably started with 6 yr band-aid and a bottle of horse liniment in a first aid station at a county Fair 2 counties over from Pudduka 30 miles down a dirt road and a young mother that got tetnus . (No slight intended it's just for Podunk example) .
Yeah I'll take my lumps because this post is probably well over anything that might be protected by the fuzzy grey .......
Probably shouldn't have posted it .........

 

[Will]

I also feel they take full advantage of people who have insurance.
Last December I pulled a dumb move while releasing a raccoon from my coyote trap. I didn’t have the catch pole cinched up tight enough and the coon rolled and bit me on my index finger. To make a long story short I ended up in the ER for rabies shots.
When I received the itemized bill the shocker was the $1100 charge for admission which was them taking my blood pressure and sitting me on a bed.

Grand total billed to the insurance was $11,000 then I had to go back for one shot a week for 4 weeks which was 4 other bills.
Also later found out my insurance had a clause for ER visits.

Let’s just say it was an expensive lesson. Now the raccoons just get a 22 out of the single six like everybody else.

 

[Bret4207]

Lawyers . Perod .

Ambulance rides costs $1000 not because of the 2 people on board or the greedy owner . It costs that because ;
The box with the Ambulance package is $45,000.+-2 gas/diesel.
The gurney set up is $1200.
Oxy is another $1000 and $17-25 per run .
Every item inside the box that is packaged whether it's single pack Band-Aids or potassium cloride glucose bags , epi pens or bottled water has a shelf life of 6-12 months , yes gauze wrap , and sanitary napkins have a 12 mo shelf . The items must be replaced with new from a certified trackable source , all of them . Bang that $4.50 100 count bottle of store brand aspirin now cost $15/10 . $2 Bait Barn gauze is $24/6 that combined might have that much .
The tracability costs because every sale has to be logged and stored hard copy for 10 yr soft for 2 in addition to the hard copy . Every dispatch station has to keep use /restock information for 5 yr in station meeting the above 10/20 also . Most services pay for upkeep of certificate which starts at $250 per yr per attendant . The attendants have to keep up special drivers license endorsements and in many states background checks annually . That gets more expensive as they go from EMT basic up to Paramedic whom is really of about the same education level and knowledge base as an LPN but has to recertify every 2 yr .
The typical Ambulance has a life span of 10 yr and a typical annual operation cost of $8-10k rural and probably closer to $150-200 k in urban areas with attendants .

Step into the hospital . The malpractice insurance for a general practitioner starts at $100,000 per yr for up to 125 patients on the books it goes up $1000 per patient to 175 then it goes up 1250 per in 25 patient increments . Carry 126 patients may as well have 149 because it'll cost the same $125 k . With no claims . Add any speciality to the door and it goes up $25,000/yr plus scale 50k if it has to do with the children . 2 nurses , or 1 and a PA , and a clerck/book keeper/receptionist and you can add an additional $90-125 k plus the 140-200k for the building .

I cringe to think what a trauma center with 200 MDs and 4-500 nurses servings 2,000/day or more must cost .

An LPN , RN , MD or EMT didn't write the laws nor do they enforce them . They do occasionally lend names to lobby for settlement caps . No sirs , it was an Esquire . It probably started with 6 yr band-aid and a bottle of horse liniment in a first aid station at a county Fair 2 counties over from Pudduka 30 miles down a dirt road and a young mother that got tetnus . (No slight intended it's just for Podunk example) .
Yeah I'll take my lumps because this post is probably well over anything that might be protected by the fuzzy grey .......
Probably shouldn't have posted it .........

That's a great deal of it no doubt. Another part is people. Go to your local ER any weekend night, or when there's anything approaching a full moon, holiday or sports event and you'll see the place packed with extras froma zombie movie, all demanding service and lot of them not paying a cent for it. It all comes down to some regular Joe down the line paying a percentage to cover the thousands of those folks that have no qualms about using the system.

 

[Pistolero]

I just got an email this AM from a small businessman friend. One man shop. He is shocked
by health care cost going from $700/month (he is unmarried) to $1000 a month soon.

Not just theoretical. I think he is on a pre-FederalCare insurance.

RBHarter - I wonder if the ambulance is a monopoly set up for the city or county by the government
or a competitive business where anyone can get into it, as long as the folks are trained, equipment meets
specs? All sorts of stuff, when no competition, gets bad service and high costs.

We used to have only one garbage pickup service. Over time, costs went up, service started getting bad.
Another company came into our area, about half the neighborhood switched. Our service perked up,
costs stopped increasing, and it looks like the competitors are holding each other in line.

I wonder if that can happen with ambulance services? Seems like I have heard that they are usually
a monopoly on a given area, but maybe that is wrong, and maybe different all over the country.

I was helping a burned, semi-conscious teen at the site of a car fire/wreck years ago and was surprised
that the Fire Dept chickette who brought the O2 system over asked me to use it, so I did. I have used
them before for my father, so had no problems opening the valve, putting the mask on her and setting
the flow up to make sure it was running. But, she was a rural area FD, maybe even a volunteer, I don't
know. That kid got on a helo, and I was glad for it, happy that she made it to the hospital.

Bill

 

[Brad]

Bill, the amount of federal and state red tape in the medical industry is amazing. They don’t care if you ever provide care as long as the paper work is done.

I always tell my staff at work to never make things more difficult, we have an entire corporate office, insurance industry, and government and they don’t like competition.

 

[Pistolero]

Yeah, and having to pay all those paper pushers, as opposed to actual medical people,
certianly does nothing to lower the costs. I have heard that a bureaucracy is the only
immortal thing.... and it may be true.

As long as the paperwork is done.....yep, I can easily believe it.

Bill

 

[RBHarter]

I don't how it works with Ambulance service as far as open market . I suspect it would be something like each wrecker service getting an exclusive call out week for tow service . I know Reno has at least 3 independent but connected to county services . 2 of them offer a flat rate per yr program for services as needed with restrictions yadda yadda yadda . $54/yr $78 family 1 ride or 10 . There's something about age/Medicare/cade something or other and a travel radius of like 70 miles ...... 1 ride in 5 years is worth it 1 in 10 is a break even , really it's not a bad deal you'd take a couple of years pay off a ride even at $25/ mo so $6 isn't bad for insurance . It's $300 in Mineral Co NV 100% volunteer county owned equipment . County pays EMT training with a 2 yr promise to do Ambulance/FF service . They pay for recertification . 5 towns , at one time 6 departments , now 3 . It is more or less the same nation wide .

 

[Pistolero]

My wife had a ambulance ride years ago, bicycle accident. That is our entire history in
ambulances. Over 135 years between us. Probably won't do the prepaid.

The volunteer service sounds good. My wife's father was the Fire Chief in his small town
Fla for a couple decades, volunteer. I was on the dept for a while in college, but wasn't
around enough to do much, a car fire and a brush fire. I like the idea of volunteer emergency
services, people helping their neighbors is a good thing.

Bill

 

[smokeywolf]

Nice write-up, RBHarter. As I think I read in your post, much of the time, the exp. dates on first aid/primary response supplies are more applicable to the packaging than the object or substance contained within the packaging. As the packaging ages it loses its ability to keep its contents in a condition that is 100% dependable for its intended use.

With regard to hospital billing; had a $175,000 hospital bill about 17 years ago. My insurance (same as Rick's) paid $14,000 & change, with my part of the bill being $700. Had I not had insurance, I'd have been responsible for the whole $175,000, but the insurance company gets a 90+% discount.
Are those without insurance being billed more so that the medical industry can give discounts to the insurance industry? Insurance dollars undoubtedly account for more profits than payments from individuals, so doctors and hospitals might be inclined to compete for insurance business by offering discounts, while trying to force individuals to make up for any perceived loss in profits.

On the other hand, I had to go to the ER a couple of years ago and like Bill, was between insurance coverage, so was an 'out of pocket' customer. My bill was about $11,000, but when I asked the clerk what the price was if I paid the total bill right then and there, she came back with an "adjusted total" of approx. $1700. Needless to say, I paid the bill on the spot.