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Posted
  On 11/20/2024 at 7:48 PM, Gil Bang said:

now the big dick toilet guy is ambassador to NATO? 

 

Perfect. 

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I am kind of surprised this didn’t take off. You go to Lowe’s or your contractor asks you “do you want the regular or big dick toilet for fifty bucks more?”  Everyone is getting the big dick version.  Even guys with really small dicks, like seven inches, they still buy the big dick version. 

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Posted

Back to Oz for just one more second. It’s gonna be fucking hilarious watching peoples heads explode if Trump delivers Medicare for all. 
 

https://www.forbes.com/sites/steveforbes/2020/06/11/medicare-advantage-for-all-can-save-our-health-care-system/?

 

Medicare Advantage For All Can Save Our Health-Care System

George Halvorson, former CEO of Kaiser Permanente, and Dr. Mehmet Oz propose here a quick and comprehensive way to provide Americans with universal health-care coverage and better health care, especially poor, underserved communities. How? By having health insurance bought through the highly successful Medicare Advantage program. One-third of people on Medicare have opted for Medicare Advantage because beneficiaries get better care thanks to competing plans. As the authors explain, Medicare Advantage could be expanded quickly and would be infinitely better than the highly-flawed idea of Medicare for All. A timely and important piece, to say the least!

 

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Posted (edited)
  On 11/21/2024 at 1:06 AM, 956 Worldwide said:

I am kind of surprised this didn’t take off. You go to Lowe’s or your contractor asks you “do you want the regular or big dick toilet for fifty bucks more?”  Everyone is getting the big dick version.  Even guys with really small dicks, like seven inches, they still buy the big dick version. 

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Totally. I need the big dick toilet bc even at an average 11 incher (super fat though), I like to have the peace of mind I won’t get splash back when dropping an epic shit.

 

Edited by Dnaguy
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Posted
  On 11/20/2024 at 2:05 AM, 956 Worldwide said:

FFS people why are you arguing Doctor Oz’ policy ideas and playing into that deflection? He’s a celebrity TV doc and it doesn’t make a shit what his policy ideas are, he has no business running the nation’s largest social benefit program.  “Well Bob Vila knows his way around a job site, let’s hear his ideas for HUD.”  

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You're exactly right. It's all deflection and distraction.

Assholes who spout bullshit, like someone with Jimi as their avatar and Oz, are stalking horses for really bad stuff. But I know firsthand that the impact of these stalking horses. Their greed and cruelty hurt real people. To see a poster here supporting the prior authorization process is infuriating because it adds to the cost of health care and suffering to enrich insurance companies.

American life expectancy is lower than comparable countries already, and these idiots are only going to make it worse.

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Posted
  On 11/21/2024 at 1:35 AM, ChiTownDoc said:

Medicare advantage is trash compared to Medicare.  Yeah I make a little more as a provider.  But they cut patient benefits off all the time and if you want to appeal you appeal to a doc hired by the Medicare advantage doc.  I think I know a little bit about this.  I run one of the ten largest groups in the country serving seniors.  Just a few million visits a year.  

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Frequently you get a nurse who doesn't know shit about fuck and who just wants to talk for the 10 min they need so they can justify a denial.

The overall cost to the system is increased because offices hire extra staff JUST TO COMPLETE PRIOR AUTHORIZATIONS. Doesn't even calculate the delay in patient care. Who cares about the patient anyway.

Medicare Advantage = privatizing social security.

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Posted
  On 11/21/2024 at 1:18 AM, Anastasis said:

Back to Oz for just one more second. It’s gonna be fucking hilarious watching peoples heads explode if Trump delivers Medicare for all. 
 

https://www.forbes.com/sites/steveforbes/2020/06/11/medicare-advantage-for-all-can-save-our-health-care-system/?

 

Medicare Advantage For All Can Save Our Health-Care System

George Halvorson, former CEO of Kaiser Permanente, and Dr. Mehmet Oz propose here a quick and comprehensive way to provide Americans with universal health-care coverage and better health care, especially poor, underserved communities. How? By having health insurance bought through the highly successful Medicare Advantage program. One-third of people on Medicare have opted for Medicare Advantage because beneficiaries get better care thanks to competing plans. As the authors explain, Medicare Advantage could be expanded quickly and would be infinitely better than the highly-flawed idea of Medicare for All. A timely and important piece, to say the least!

 

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Probably time to stop drinking man. “What if the GOP does Medicare for all?” is an obvious cry for help.

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Posted

Anastasis does make a really good point.  What if Dr. Oz is appointed to the role, and then he also becomes both chambers of Congress and drafts and approves groundbreaking new healthcare legislation that brings Medicare to all?
 

I will admit I did not consider that angle, really makes me rethink my stance that he has no qualifications to run a massive entitlement program. 

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Posted (edited)
  On 11/21/2024 at 1:41 AM, wildcat09 said:

Probably time to stop drinking man. “What if the GOP does Medicare for all?” is an obvious cry for help.

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Medicare Advantage is a scam that enriches insurance companies at the expense of govt and patient care. Privatization of the Veterans Admin is a comparable scam.

Trump would be smart to propose it because it's great marketing gimmick and would make him the messiah of the insurance industry. Trump will get huge kickbacks while the health of the country suffers.

The poster you're responding to has either drunk the kool-aid or doesn't have experience with real-life the system and he's flooding the zone with bullshit.

 

@956 Worldwide The big distinction is traditional medicare vs medicare advantage. The advantage program is just privatization of medicare.

Edited by quigley
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Posted
  On 11/21/2024 at 1:35 AM, ChiTownDoc said:

Medicare advantage is trash compared to Medicare.  Yeah I make a little more as a provider.  But they cut patient benefits off all the time and if you want to appeal you appeal to a doc hired by the Medicare advantage company.  I think I know a little bit about this.  I run one of the ten largest groups in the country serving seniors.  Just a few million visits a year.  
 

edit: look at all the massive fines.  Also yeah while you’re healthy the plans are great.  If you get really sick, you’re up shit creek.  My parents are on straight Medicare.  

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When my parents first enrolled on Medicare, I made sure that they didn’t take the bait on the Medicare Advantage plans. They have been able to see all the physicians that they’ve been established with for years and no friction in getting the care they need. My in-laws, on the other hand, are stubborn and don’t listen to my advice and are on a Medicare Advantage plan. The difference is a night and day experience compared to my parent’s experience. They are constantly shuffled around seeing different physicians that they have zero history with. They are just a number and their care has suffered as a result. It’s laughable that anyone thinks that putting organizations like United in charge of the care for seniors is a good idea. It’s just more corporate grift.

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Posted
  On 11/21/2024 at 1:57 AM, royiv said:

When my parents first enrolled on Medicare, I made sure that they didn’t take the bait on the Medicare Advantage plans. They have been able to see all the physicians that they’ve been established with for years and no friction in getting the care they need. My in-laws, on the other hand, are stubborn and don’t listen to my advice and are on a Medicare Advantage plan. The difference is a night and day experience compared to my parent’s experience. They are constantly shuffled around seeing different physicians that they have zero history with. They are just a number and their care has suffered as a result. It’s laughable that anyone thinks that putting organizations like United in charge of the care for seniors is a good idea. It’s just more corporate grift.

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Are medicare supplements a better deal?

My parents' "corporate" health insurance converted to a Medicare Supplement or Advantage, not sure which. that avoided all gaps in Medicare coverage and further reduced their liability for medical costs, reducing the Medicare contribution by 75% or more.

It was a good deal, whatever it was.

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Posted
  On 11/21/2024 at 2:03 AM, TwiceHorn said:

Are medicare supplements a better deal?

My parents' "corporate" health insurance converted to a Medicare Supplement or Advantage, not sure which. that avoided all gaps in Medicare coverage and further reduced their liability for medical costs, reducing the Medicare contribution by 75% or more.

It was a good deal, whatever it was.

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Absolutely. Stick with traditional Medicare with a Medicare supplement. 

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Posted
  On 11/21/2024 at 2:03 AM, TwiceHorn said:

Are medicare supplements a better deal?

My parents' "corporate" health insurance converted to a Medicare Supplement or Advantage, not sure which. that avoided all gaps in Medicare coverage and further reduced their liability for medical costs, reducing the Medicare contribution by 75% or more.

It was a good deal, whatever it was.

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Yes there’s gaps in Medicare when you’re healthy.  Some dental etc.  But when you get really sick it’s no doubt Medicare much better.  It’s cool though, Social Workers and insurance companies themselves are great at getting you info to get back on Medicare the minute you get crazy expensive.  So we all get fucked there.  Yay

  On 11/21/2024 at 2:11 AM, Sawbonz said:

Medicare advantage plans make their profit by withholding care from Medicare beneficiaries. 
 

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This. They get paid per beneficiary.  Whatever they don’t spend, they pocket.  

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Posted
  On 11/21/2024 at 1:18 AM, Anastasis said:

Back to Oz for just one more second. It’s gonna be fucking hilarious watching peoples heads explode if Trump delivers Medicare for all. 
 

https://www.forbes.com/sites/steveforbes/2020/06/11/medicare-advantage-for-all-can-save-our-health-care-system/?

 

Medicare Advantage For All Can Save Our Health-Care System

George Halvorson, former CEO of Kaiser Permanente, and Dr. Mehmet Oz propose here a quick and comprehensive way to provide Americans with universal health-care coverage and better health care, especially poor, underserved communities. How? By having health insurance bought through the highly successful Medicare Advantage program. One-third of people on Medicare have opted for Medicare Advantage because beneficiaries get better care thanks to competing plans. As the authors explain, Medicare Advantage could be expanded quickly and would be infinitely better than the highly-flawed idea of Medicare for All. A timely and important piece, to say the least!

 

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I’ll take it.

Posted
  On 11/21/2024 at 1:35 AM, ChiTownDoc said:

Yeah I make a little more as a provider.

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You make more as a provider because you have adopted the outcomes based reimbursement schemes and provide quality care, at least as far as it is defined by those schemes, correct? We could maybe agree I hope that in general pay for outcomes is better than pay for service. We could certainly probably dig into ways to improve those schemes and create systems where there are better aligned incentive structures, but I hope that we can at least agree on the basics here?

  On 11/21/2024 at 1:35 AM, ChiTownDoc said:

I run one of the ten largest groups in the country serving seniors.  Just a few million visits a year.  

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I know. 

  On 11/21/2024 at 1:35 AM, ChiTownDoc said:

My parents are on straight Medicare.  

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But in all fairness, the additional dental benefits provided compared to traditional Medical may not resonate with Sooners. Come on I keed. 

Posted
  On 11/21/2024 at 1:41 AM, wildcat09 said:

Probably time to stop drinking man. “What if the GOP does Medicare for all?” is an obvious cry for help.

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You literally have an oped written relatively recently by the newly nominated head of CMS advocating exactly for that. Figure how to make a win here guys. Jesus. 

Posted
  On 11/21/2024 at 2:18 AM, Anastasis said:

You literally have an oped written relatively recently by the newly nominated head of CMS advocating exactly for that. Figure how to make a win here guys. Jesus. 

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And people are telling you that MA is a highly flawed system that funnels money away from patient care and into the coffers of gigantic insurance companies. 

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Posted
  On 11/21/2024 at 1:35 AM, quigley said:

To see a poster here supporting the prior authorization process is infuriating because it adds to the cost of health care and suffering to enrich insurance companies.

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I am not a huge fan of PA per se and I have personally published peer reviewed research on the topic. Utilization management has a place though. It is part of traditional medicare. It is part of MA. It is part of every socialized medicine system in the world. You are rolling out simple talking points. 

Posted
  On 11/21/2024 at 2:16 AM, Anastasis said:

You make more as a provider because you have adopted the outcomes based reimbursement schemes and provide quality care, at least as far as it is defined by those schemes, correct? We could maybe agree I hope that in general pay for outcomes is better than pay for service. We could certainly probably dig into ways to improve those schemes and create systems where there are better aligned incentive structures, but I hope that we can at least agree on the basics here?

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Do you have any clue how much extra expense providers have to add to their practices for P4P? It’s not the concept, it’s the fact that the profits are unquestionably tilted toward the insurance company. The incentives are not aligned in the least.

Posted
  On 11/21/2024 at 2:21 AM, royiv said:

And people are telling you that MA is a highly flawed system that funnels money away from patient care and into the coffers of gigantic insurance companies. 

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Oh good, please tell me more. MA is not perfect. There is a pathway here to Medicare coverage for all. I don't personally love it. We (well not really you, but the other "we") have had in depth discussions on healthcare policy threads in the past. There are much better paths forward. But you play the cards you are dealt. And right now you are dealt Dr. Oz. 

Posted
  On 11/21/2024 at 2:26 AM, Anastasis said:

Oh good, please tell me more. MA is not perfect. There is a pathway here to Medicare coverage for all. I don't personally love it. We (well not really you, but the other "we") have had in depth discussions on healthcare policy threads in the past. There are much better paths forward. But you play the cards you are dealt. And right now you are dealt Dr. Oz. 

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Forgive me for not having a hard on for Oz and the prospect of deeply flawed public policy that funnels money to gigantic health insurance companies instead of to patient care. United is plenty big and powerful already. 

Posted
  On 11/21/2024 at 1:18 AM, Anastasis said:

Back to Oz for just one more second. It’s gonna be fucking hilarious watching peoples heads explode if Trump delivers Medicare for all. 
 

https://www.forbes.com/sites/steveforbes/2020/06/11/medicare-advantage-for-all-can-save-our-health-care-system/?

 

Medicare Advantage For All Can Save Our Health-Care System

George Halvorson, former CEO of Kaiser Permanente, and Dr. Mehmet Oz propose here a quick and comprehensive way to provide Americans with universal health-care coverage and better health care, especially poor, underserved communities. How? By having health insurance bought through the highly successful Medicare Advantage program. One-third of people on Medicare have opted for Medicare Advantage because beneficiaries get better care thanks to competing plans. As the authors explain, Medicare Advantage could be expanded quickly and would be infinitely better than the highly-flawed idea of Medicare for All. A timely and important piece, to say the least!

 

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And Mexico will pay for it! (Through tariffs)

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Posted

Important to note that "the number of heart-failure crises has been reduced by a third or more when people have enrolled in Medicare Advantage plans" statement made in the article has been disproven repeatedly. 

 

https://jamanetwork.com/journals/jamacardiology/fullarticle/2769882

https://jamanetwork.com/journals/jama/fullarticle/2799152?guestAccessKey=22614dfb-992f-4237-aaec-4277fbf35484&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=120622

 

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Posted
  On 11/21/2024 at 2:16 AM, Anastasis said:

You make more as a provider because you have adopted the outcomes based reimbursement schemes and provide quality care, at least as far as it is defined by those schemes, correct? We could maybe agree I hope that in general pay for outcomes is better than pay for service. We could certainly probably dig into ways to improve those schemes and create systems where there are better aligned incentive structures, but I hope that we can at least agree on the basics here?

I know. 

But in all fairness, the additional dental benefits provided compared to traditional Medical may not resonate with Sooners. Come on I keed. 

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We get more on fee for service (just regular patient visits) with Med Advantage vs straight Medicare.  They know not to piss off the docs that bad.  Yes we get checks based on outcomes but those are from both Med Advantage and Medicare. 

Do I think the concept could work?  Sure

But it's set up as Medicare gives a $1 to Med Advantage and Med Advantage makes money if they spend anything less than a $1.  That's just set up to deliver less care to patients.  Now some smaller groups are doing a better job but the United's of the world are just total pieces of shit that laugh at 300M fines because they're pocketing so much money on the front end.  The numbers are mind boggling what United makes by basically withholding care.  

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Posted
  On 11/21/2024 at 2:31 AM, royiv said:

Forgive me for not having a hard on for Oz and the prospect of deeply flawed public policy that funnels money to gigantic health insurance companies instead of to patient care. United is plenty big and powerful already. 

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Nobody should have a hard on for anyone in this administration, nor the last (notable exception for Tulsi should be granted freely). I don't care which system of financing healthcare you want to embrace. It is going to involve utilization management. In the insurance segment that most of us occupy (small or large employer group), it is your employer and not some big bad insurance company making those rules. We live in a world where there are drugs that cost in the millions of dollars per year. Yeah, someone is gonna want some confirmation before they scratch that check. 

Posted
  On 11/21/2024 at 2:48 AM, Anastasis said:

Nobody should have a hard on for anyone in this administration, nor the last (notable exception for Tulsi should be granted freely). I don't care which system of financing healthcare you want to embrace. It is going to involve utilization management. In the insurance segment that most of us occupy (small or large employer group), it is your employer and not some big bad insurance company making those rules. We live in a world where there are drugs that cost in the millions of dollars per year. Yeah, someone is gonna want some confirmation before they scratch that check. 

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Well, no shit, but drugs that cost in the millions of dollars per year impact a minuscule number of people in the healthcare system. Manage those all you want. UM has become way too far reaching and is a net added cost on the provider side of the house. And, forgive me, but fuck off with the gaslighting me for having a problem with the “big, bad insurance companies.” Big insurance maintains the largest profit margins of any segment in the system that far outweighs the benefits that they bring to the table.

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Posted
  On 11/21/2024 at 2:58 AM, royiv said:

Well, no shit, but drugs that cost in the millions of dollars per year impact a minuscule number of people in the healthcare system. Manage those all you want. 

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You're almost there. Now do the math on the various biologics and the condition prevalence as they expand across indications. Manage those all you want too, right? It's just a math equation at that point once you have conceded that you are just counting the beans. 

  On 11/21/2024 at 2:58 AM, royiv said:

Big insurance maintains the largest profit margins of any segment in the system that far outweighs the benefits that they bring to the table.

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Just objectively false information. Insurance is just a volume game, its not a margin play. The margins are the lowest in the whole sector. Pharma and hospital systems are the whales. Which are exactly the cost areas that payer UM tries to contain. Bring those in check and UM can be a thing of the past. 

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Posted

This is a chart from an advocacy group in favor of single payer. I can certainly find more data, but this is representative at least directionally of the profit margins across the system. 

profits_fixed.0.png

Posted
  On 11/21/2024 at 1:18 AM, Anastasis said:

Back to Oz for just one more second. It’s gonna be fucking hilarious watching peoples heads explode if Trump delivers Medicare for all. 

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Name an amount. Any amount. I will make that bet. 

Posted

No shortage of people whose heads need to explode…but I will give you any line you want on universal Medicare coverage that is delivered by the trump administration being the culprit. Name it. 

Posted
  On 11/21/2024 at 3:11 AM, Anastasis said:

This is a chart from an advocacy group in favor of single payer. I can certainly find more data, but this is representative at least directionally of the profit margins across the system. 

profits_fixed.0.png

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UHC had a margin double the 3% you show here and posted profits of $32 billion.

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Posted
  On 11/21/2024 at 3:19 AM, royiv said:

UHC had a margin double the 3% you show here and posted profits of $32 billion.

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You said "largest profit margins of any segment in the system". This is no world where that is close to accurate. 

Posted
  On 11/21/2024 at 3:18 AM, sidis said:

No shortage of people whose heads need to explode…but I will give you any line you want on universal Medicare coverage that is delivered by the trump administration being the culprit. Name it. 

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I'll take 5:1 on 1k for Trump administration proposal for Medicare expansion. Non-political charity of winner's choice. MLF would be my preference. No bet if Oz doesn't clear confirmation.   

Posted
  On 11/21/2024 at 3:40 AM, Anastasis said:

I'll take 5:1 on 1k for Trump administration proposal for Medicare expansion. Non-political charity of winner's choice. MLF would be my preference. No bet if Oz doesn't clear confirmation.   

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“Delivering Medicare for all” is now equivalent to some undefined, abstract notion of “expansion” that is proposed by the trump administration?

I can’t even think of a ridiculous cr-styled gif to post that conveys the level of disingenuousness of that nonsense. 

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Posted
  On 11/21/2024 at 1:06 AM, 956 Worldwide said:

I am kind of surprised this didn’t take off. You go to Lowe’s or your contractor asks you “do you want the regular or big dick toilet for fifty bucks more?”  Everyone is getting the big dick version.  Even guys with really small dicks, like seven inches, they still buy the big dick version. 

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It's the astronaut and cup size problem. This has already played out.

https://www.snopes.com/fact-check/spacesuit-envy/

Posted
  On 11/21/2024 at 3:29 AM, Anastasis said:

You said "largest profit margins of any segment in the system". This is no world where that is close to accurate. 

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And that’s fair. It was hyperbole on the margin side, but it’s not false that a single health insurance company has the largest profits of any company in the healthcare space. I’m never going to see eye to eye with you on insurance companies. I’ve spent 25+ years battling them and have never dealt with one that worked in good faith. There is a spectrum of super shitty to pretty shitty and, unfortunately the biggest one out there throws its weight around to make things super shitty for provider groups.
 

Getting back to Oz, if he really wants to make a dent he will continue the Biden administration’s program of negotiating drug prices with pharma companies and extend the pricing to the all Americans. That would be a huge benefit.

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Posted
  On 11/21/2024 at 3:40 AM, Anastasis said:

I'll take 5:1 on 1k for Trump administration proposal for Medicare expansion. Non-political charity of winner's choice. MLF would be my preference. No bet if Oz doesn't clear confirmation.   

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Boy, you really backtracked on that one.

Posted
  On 11/21/2024 at 2:03 AM, TwiceHorn said:

Are medicare supplements a better deal?

My parents' "corporate" health insurance converted to a Medicare Supplement or Advantage, not sure which. that avoided all gaps in Medicare coverage and further reduced their liability for medical costs, reducing the Medicare contribution by 75% or more.

It was a good deal, whatever it was.

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Pm me

Posted

 

  On 11/21/2024 at 4:06 AM, royiv said:

I’m never going to see eye to eye with you on insurance companies.

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I think that we would probably find lots of common ground if you wanted to dig it on the specifics. 

For example...

  On 11/21/2024 at 4:06 AM, royiv said:

Getting back to Oz, if he really wants to make a dent he will continue the Biden administration’s program of negotiating drug prices with pharma companies and extend the pricing to the all Americans. That would be a huge benefit.

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You want to talk leverage and price negotiating strategies I am all for it. The IRA scheme will always be two steps behind the trend. By design. 



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