Rayman Mathoda - October 27, 2008
2 women walk into a hospital with acute stomach pain. One is a highly paid lawyer at a top law firm who is covered by her company’s health insurance plan and the other is a working class American without health insurance. Both women get the exact same diagnostic tests and medical care, and both stay in the hospital for the exact same number of nights. Do the two women pay the same amount for the health care they consume (in total, including payments made by the insurance company on behalf of the lawyer who has health insurance)? Likely not, if the above happens in the USA.
Does this make any sense? I believe the answer is clearly no….and yet this unfair practice has been allowed to go on for decades….and is still going on today. The reason for this is that insurance companies in America directly negotiate “bulk pricing” directly with hospitals and other healthcare providers. This pricing is usually significantly lower than the “list price” of a product or service. However, when an individual (e.g., uninsured worker, foreign national, etc.) who is paying for their health care expenses out of pocket walks into a health care provider, they pay the “list price”. It’s ironic that this leads to price discrimination against the same (generally poorer) individuals who couldn’t afford health insurance in the first place.
So here’s a simple solution for ending health care price discrimination in America: Mandate that every hospital or health service provider can only charge uninsured individuals the average of the pricing they have negotiated with their health insurance companies. This would eliminate much pain and suffering….and right a basic wrong in our health care system today.
November 1, 2008 Update:
Today, I received an "Explanation of Benefits" Statement from my health insurance provider which I think proves my point above:
Service Date: October 16, 2008
Type of Service: Outpatient Services (a generic term to say this is for a minor outpatient procedure performed about 2 weeks ago)
Total Billed (to health insurance company): $5,665
Patient Savings: $4,767
Coinsurance Copayment Amount: $89.80
Claims Payment: $808.20
In other words, the total cost to the insured party (in this case me) and the insurance company was $898...or 16% of the amount billed. So we saved $4,767 for only one reason: we had the insurance company negotiating with the provider, auditing the bill etc.
Digg this entry
Add to Del.icio.us
Share on Facebook
Subscribe
Posted by Rayman Mathoda at October 27, 2008 09:36 AM
Oh yeah...that's what we need...the govt putting price controls on health care...
I paid $2.39 for gas today...but somewhere somebody bought it for $2.29....we need govt intervention right now!!
Do you folks on the left just sit around and daydream things for the govt to get involved in?
Here's how your little scenario above unfolds:
We mandate these controls that you're so excited about. The hospitals look around and say, "wow, we've gotta raise our base rate, and not negotiate it down."
The insurers look around and say, "hey, costs are going up, we'd better pass it on!"
The business owner, who is up to his ears in debt, and busting his ass to cover expenses while providing health coverage for his employees..takes a look at his new insurance premiums and says, "screw it, they want insurance, the'll have to buy it themselves." He has a company meeting, tells his 19 employees they'll have to pay for their own insurance, and only 4 of them can afford to do so.
Soooo....here we go....the little liberal world of touchy feely 'good ideas' comes face to face with the 'law of unintended consequences.' But you'll feel good for having passed the law...Because you care.....
Now, if you'll excuse me, I think I'll fire up the woodstove in my garage, and enlarge my carbon footprint....just to give y'all something else to bellyache about.....
Oh, by the way...the working class woman may just do what Craig did...not pay it at all....the lawyer probably paid the deductible....so who actually paid the most?
in the conservative blog toolbox, first up: sarcasm.
good words, phrases and approaches to use:
-- anything that seems to diminish the opposition, size-wise, i.e., little, little, little.
-- oppositional pronouns, with one side being inclusive and the other being exclusive, i.e., we versus you.
-- locker-room and domestic-beer-bar slang -- i.e., busting asses, screw it.
-- old-timey anti-liberal buzzwords, esp. if they contain hints of softness or sexual ambiguity,, i.e, touchy-feely.
-- obviously insincere politeness, i.e., if you'll excuse me.
-- a close that magnifies the supposed macho character of the writer, i.e., references to wood-stoves, fires, hunting, beer, sex, and unapologetic stances on contra-green ways of living.
-- a final word that implies the opposition is always whining.
Sheesh!!
Heigh-ho, want to read some really fine oppositional writing? Check this out:
http://www.newyorker.com/talk/comment/2008/11/03/081103taco_talk_hertzberg
It's f-ing funny and f-ing right on target. It speaks the truth. Canya take it, oh large carbon footprint man?
so flabs...
u bleated the other that if given a choice u'll vote for bushnut again...
soooo...if he was all that how come we are in such deep doodoo?
dont u think its about time u saw the freakin' lite...dude... like so many of the smart repubs who are leaving their effed up party in huge numbers...or are u that stubborn or like that multi guy would say... delusional? whew!!!!!!!!!!!
#1, Cost you???? No the state.....almost got me to comment.....but not there yet!
Well...maybe......as I recall .....you were grateful....ALMOST thankful.....but what do I know?
For those who care, that #6 post by "empyrius", is not I, Craig Jones, empyrius.
Riversylph I left my passwords on your computer didn't I! I am not going to go all over and change my passwords everywhere, but please be careful with them . . .
You be careful as well.
I love you.
Aloha Rayman
The cost at the hospitals is systemic of a country that is the victim of affluence. The China Study by T. Colin Campbell explains that the power is at the end of the fork. Hmmm and very interesting your doctor won't tell you that. He/She would be out of such an extensive job. We eat and we die and can do it a lot easier without animal, fish or poultry. Click my name for the whole article:
Let’s tell the story:
Once upon a time in India, two unknown Doctors: Madhavan T. and Gopalan C. published research in 1968 in an obscure Medical Journal that suggested a direct relation between animal protein and cancer.
Madhavan T. and Gopalan C .The Effect of dietary protein on carcinogenesis of aflatoxin
Meanwhile in the Philippines:
Doctor Campbell, an American Researcher, is trying to find a solution for malnourishment in poor populations by feeding them food with high protein content: peanuts in this case. Unfortunately he encounters a problem with a fungus called Aflatoxin.
What is Aflatoxin?
Aflatoxin is a fungus, a mold, a potent toxic, highly carcinogenic, mutagenic, and immunosuppressive agent.
The crop of peanuts that Dr. Campbell was promoting and giving to the poor and malnourished children of the Philippines, were contaminated by this carcinogenic mold.
Peanuts are very rich in Protein but Aflatoxin was promoting Liver Cancer in the poor, but not only to the poor...
The trouble with Aflatoxin:
During a conversation with President Marcos’s personal doctor, Dr. Campbell discovers that even the wealthiest kids from Manila, Philippines had cancer of the liver and at a greater rate than the poor. The wealthy kids had access to numerous protein sources including meats and dairies. Could it be that there was a link between animal protein and cancer, like in the Indian study?
This was the start of one of the greatest adventures in the modern history of medicine.
Destiny (and irony) took T Colin Campbell, a man who dedicated all his energy in the study and promotion of protein, especially animal protein, and led him to become the greatest advocate against it.
The Mission:
Colin Campbell, with two separate research teams, spent the next 35 years conducting research on the relation between animal protein and cancer.
First logical step: to corroborate the Indian Research
Method:
Take two groups of laboratory rats:
Feed the first group with 20% protein and feed the second group with 5% protein.
Give both groups enough Aflatoxin TO GET CANCER and then wait...
Results:
Every single rat fed with 20% protein had liver cancer or precursor lesions
Not a single rat in the second group had cancer or lesions.
Implications:
It is a 100% versus 0% success rate; we’ve discovered a very dangerous chemical like Dioxin which can promote cancer, and the name of this product is Animal Protein. Or maybe the experiment was faulty?
Second logical step, increase the level of Aflatoxin
Method:
Take two groups of laboratory rats:
One will be fed with a high Aflatoxin dose and a low protein Diet.
One with a low Aflatoxin dose and a high protein Diet.
Results:
The rats with the high-aflatoxin dose fed with a
Low 5% protein Diet.
LESS FOCI* OF CANCER
The rats with the low-aflatoxin dose feed with a
High 20% protein Diet.
MORE FOCI OF CANCER…
*Foci: Pathology The regions of a localized bodily infection or disease. In this case group of cancer cells.
Implications:
A. The link is established between the quantity of protein consumed and cancerous cell development.
B. Protein was more detrimental in increasing the number of cancer foci than a dangerous carcinogen like Aflatoxin.
Third logical step: challenging the results and evidence acquired so far:
Method:
Take two groups of laboratory rats:
The group with the high-aflatoxin dose and a low protein Diet 5%
WILL NOW BE SWITCHED TO A HIGH PROTEIN DIET IN A SECOND PHASE
AND THEN BACK AGAIN TO A LOW PROTEIN DIET…
Results:
Foci INCREASE in size and number at the level of 20 % protein intake.
Foci DECREASE in size and number at the level of less than 10 % protein intake.
First implication:
The body could remember early carcinogen insults and they could be “restarted” or,
if you prefer, “Jump started” just by increasing protein Intake.
Second amazing implication:
FOCI GROWTH COULD BE REVERSED, INCREASED OR DECREASED, BY SWITCHING THE AMOUNT OF PROTEIN BEING CONSUMED AT ALL STAGES OF FOCI DEVELOPMENT
The China Study T. Colin Campbell PHD p 56
Third amazing implication:
This is the first time in History that we know what could be the biggest cause for the cancer epidemic, Animal Protein.
Fourth amazing implication:
This is also the first time that we can take personal control against this disease by preventing it or reversing it!
Nobody is powerless anymore in the fight against cancer.
Genetics Versus Nutrition:
A report prepared for the US Congress in 1981, estimated that genetics only determines about 2-3% of total cancer risk. In China the counties with the highest rates of some cancers where more than 100 times greater than counties with the lowest rates.” (1)
Mapping Cancer and discovering its relation with nutrition was incredibly revealing.
This is a 10,000% HIGHER RISK if you have the wrong diet versus a 2 - 3 % if you have the wrong genetics.
Fourth logical step: check if all protein has the same effects on cancer:
This was also tested by Doctor Campbell and his teams of researchers. Protein used in these experiments was made up of 87 % casein from cow milk. In these experiments plant protein did not and could not promote cancer growth, even at the higher level of intake (1)
(1)The China Study T. Colin Campbell PHD p 59
Implication:
That casein from milk could increase production of cancer cell in rats. However, plant protein did not promote growth of cancer cells. Curiously most of the practitioners of alternative medicine, very early in time, recommended their patients to switch to a vegetarian diet. See for example: the pioneers Max Gerson in 1946. Ann Wigmore 1960 just to cite a couple.
Next Dr.Campbell conducted research on mice infected with liver cancer induced by hepatitis B.
And he got essentially the same results (1)
(1)The China Study T. Colin Campbell PHD p 63
Food for thought:
The level of protein intake causing tumor growth in rats is at the same level that humans consume in this country (1) or in most of the Western Countries.
(1)The China Study T. Colin Campbell PHD p 66
Implication:
The results of these, and many others studies, showed Nutrition to be far more important in controlling cancer promotion than the dose of the initiating carcinogen”
The China Study T. Colin Campbell PHD p 66
Nobody mentions animal protein as a threat for people with cancer.
Why? Because it's bad business.
No one advises cancer patients on the danger of animal protein. The National Food and Nutrition Board in its last report recommended: “To raise up our allowed caloric intake from fat by 35 % and protein up by 35 %.” Nobody in history has ever seen a recommendation with such a high number. This is absolutely criminal. Read more in The Health Sentinel for the mechanisms working against American Health
National Academy of Sciences Press Release. “ Report offers new eating and physical activity targets to reduce chronic disease risks “ sept 5 2002 Washington DC.
The National Food and Nutrition Board should be tried in court because more than half of the board has ties with the meat, egg, and dairy industries.
A taxpayer voting for Obama...is like a chicken voting for Colonel Sanders! (sarcasm)
WE (repubs) gonna whup YO'(dems) ass! (covering the oppositional pronouns, and the locker room slang)
Obama...he gonna talk to our enemies! He gonna have tea and crumpets!! (old timey lib buzzwords, you know...sexual ambiguity!) He probably wears pink panties!
Think I'll go have me a beer, and cook me up a steak on the grill! (Just feeling a little bit macho!)
Now y'all go on, cry buckets of tears, as you watch MacPalin ascend to the presidency... (well, heather....y'all do whine all the time!!)
:)
Brother Norm:
Gloria La Riva POTUS!
Click my name iffin you want to know the political party of Jesus!
Peace
You mean...The Fourth Jesus? I can see Deepak's book cover now...Obama on a white horse...splitting the clouds...halo of fire...beats any scene from Brother John's movie on the Isle of Patmos.....
Craig....I've been looking at some trucks in Washington....I'm planning to purchase in February. Maybe if I fly out in January...we can have lunch? Then maybe you can report back...that I'm really a well spoken handsome, athletic stud? :)
Socialist advice for schoolchildren 1910
looks pretty well balanced
http://www.poptel.org.uk/leedspostcards/929socialist.jpg
Hell yes Norm! It would be awesome to meet you in person brother!
Keep me posted on what happens with the truck deal.
Peace
says flabs...
"Craig....I've been looking at some trucks in Washington....I'm planning to purchase in February. Maybe if I fly out in January...we can have lunch? Then maybe you can report back...that I'm really a well spoken handsome, athletic stud? :)"...
dude...i don't think they make airplane seats big enuff to fit ur jumbo ass!!!!!...hehe!
word is, flabs plans to vote for 'bama...truth be known, he's really a closet southern democrat...
i guess when the votes are in we'll then know who will be crying in their beer and cancelling that trip to the PNW....dang!
Thanks for signing in, . Now you can comment. (sign out)
(If you haven't left a comment here before, you may need to be approved by the site owner before your comment will appear. Until then, it won't appear on the entry. Thanks for waiting.)Thanks for signing in, . Now you can comment. (sign out)
(If you haven't left a comment here before, you may need to be approved by the site owner before your comment will appear. Until then, it won't appear on the entry. Thanks for waiting.)i guess when the votes are in we'll then know w
says flabs...
"Craig....I've been looki
Hell yes Norm! It would be awesome to meet you
Socialist advice for schoolchildren 19
Craig....I've been looking at some trucks in Wa
My emergency appendectomy last year cost me over 25 thousand dollars, which is now in collections, add that to the 50 thousand + school loans in collections, on top of the 10 thousand child support in arrears; you should see what a ten dollar an hour paycheck looks like after they are done, well no, you would not want to see!
This brother cannot afford to live, they should have just given me some pain killers and let the appendicitis take care of the rest.
I want my right to legally die with dignity! Is Kervorkian out yet?!?
Oh well, as long as they keep the homeless shelters open in the winter I suppose all is well.
Peace