I'm thinking about letting the taxpayers subsidize me.

ay

rs.

nises that people don't shop around wisely when they get sick, so the free- market price pressure doesn't actually work.

p.

le being willing to spend any amount of money when they - or their nearest and dearest - get sick, and I've got personal experience of being offered a "free market" operation at a fixed price which it turned out that I didn't need.

ly

s in Mike's and my happy position of being able to say no. When my nephew w as lying in hospital with a cracked cervical vertebra and there was evidenc e of pressure on his spinal cord, my brother was very happy to spend heavil y on an operation that may not have been necessary.

it

ts

e.

Begging your pardon, since you're the one saying shopping won't produce functional price pressure on producers, you're supposed to have some evidence for that view before spitting out the "people not able to shop in an emergency" meme.

But, here, ER care in the US is somewhere between 2 and 10 percent of health spending.

Besides being inconsequential it's an irrelevant point--if non-urgent patients drive down the cost of MRIs, ER patients benefit too. IOW, the ER patients don't have to shop to reap the benefits.

Further, intelligent people ER can and *do* shop in the ER. Do you just walk in and let the furniture store (or any other) sell you whatever they want to? I certainly have questioned items while in the ER, and others in my family have too, saving enormous amounts.

All you have to do is ask "how much does that cost?"

It's not rocket surgery.

Recap: you objected "people shopping" won't control costs, because they can't shop in an emergency.

I've shown - Emergency care is a small fraction of U.S. health outlays, so your point doesn't apply to >90% of said spending, - that it's usually possible to shop in the ER, - and even in those few situations where you can't, you still benefit from general cost-reductions gained by others' shopping, such as lower MRI cost.

I said all this in the previous post, just more concisely.

Cheers, James Arthur

< major snippage>

Hi, Don:-

Thanks! Great, this is definitely happening.

I feel that fresh baked biscotti & cappuccinos made with beans I've roasted and ground myself (and lactose-free milk) has ummm similar utility..

--
Best regards,  
Spehro Pefhany 
Amazon link for AoE 3rd Edition:            http://tinyurl.com/ntrpwu8 
Microchip link for 2015 Masters in Phoenix: http://tinyurl.com/l7g2k48

:

pay

ot

cers.

ognises that people don't shop around wisely when they get sick, so the fre e-market price pressure doesn't actually work.

up.

ople being willing to spend any amount of money when they - or their neares t and dearest - get sick, and I've got personal experience of being offered a "free market" operation at a fixed price which it turned out that I didn 't need.

ully

d

is in Mike's and my happy position of being able to say no. When my nephew was lying in hospital with a cracked cervical vertebra and there was evide nce of pressure on his spinal cord, my brother was very happy to spend heav ily on an operation that may not have been necessary.

es it

fits

are.

I'd just adduced a representative example.

My nephew wasn't in ER when my brother made his choice. He was in a proper ward and had been for a day or so when the fact that there was pressure on the spinal cord became obvious.

This is another of your rhetorical slights of hand. People don't make good judgements in what they perceive to be an emergency, but pressing medical s ituations aren't confined to the Emergency Room - the Emergency Room exists to recognise the patients immediate problems, and stabilise them well enou gh to give medical staff enough time to examine the problem in detail.

What gets done after that isn't on the emergency care budget, but the peopl e who are agreeing to it feel themselves - correctly - to be in an emergen cy situation

ER patients - in the sense of patients who are in ER because of an emergenc y - can't shop around. The emergency doesn't necessarily go away once the i mmediate problems are stabilised, and the stabilised patient is rarely in a position to get a second opinion.

Emergency Reception deals with a wide range of patients. Some of them are p erfectly capable of shopping around, others need to be kept alive.

If you are in a state to ask questions. and if you are game to delay whatev er it was they were about to do until they can give you an answer - emergen cy reception staff are trained to save lives first and deal with patient re quests later.

Sometimes it is.

If "emergency care" is what is delivered in Emergency Reception this is tru e - and totally irrelevant. The state of emergency lasts until the patients condition is fully understood, properly stabilised and treated well enough that nothing exciting is likely to happen.

The "said spending" is that which want you want to want to define as emerge ncy spending - restricted to payments for emergency care, in Emergency Rece ption only. That isn't the way it works in real life.

That wasn't the spending I was talking about, as any reasonable interlocuto r would have been able to work out.

The reality is that most people who find themselves sick and in need of hos pital care don't know what's hit them - and it can take a while for their d octors to find out - and are in no position to make rational choices about what should be done to them. Few patients would be enthusiastic about an em ergency tracheotomy.

The better to conceal your misleading presuppositions.

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Bill Sloman, Sydney

No, my first answer was that doing NOTHING is better than doing something HARMFUL. Sorry if that wasn't clear enough.

Republican legislators have lots of great ideas on their websites--have you bothered looking?

The plans, generally, are to let people save their own money on the same tax-basis as employer-based insurance. People accumulate money they would've spent on premiums, co-pays, and paperwork.

People can then pay doctors cash for ordinary care, cut out the insurance overhead, and put competitive price-pressure on the providers to boot.

Insurance that covers disasters is then greatly simplified and much cheaper.

You're right--the Republicans aren't very articulate. No one's used to this propaganda thing, where the *government* spews constant falsities about its intentions and its program. We've never seen this before, and people don't know how to handle it.

That's what OBAMACARE did. OBAMACARE took what people had, built, and liked, destroyed it, and took them in by force.

If Obamacare were better, they wouldn't have to force people.

$167 a month sounds pretty reasonable, but if you had an HSA (Health Savings Account) you could've saved most of that in your bank account, and bought a cheap major medical policy for the big stuff.

But don't confuse insurance premiums with cost-control. Insurance itself defeats cost-control. The idea is to reduce the selling price of actual CARE. Not insurance, CARE. If CARE costs less, insurance drops too.

'Insurance' that covers ordinary daily needs isn't insurance, that's a high-overhead pre-paid medical plan. The consumer, having paid, has an incentive to consume as much as possible. The insurer benefits from higher prices (gets them more customers, and they make more per customer), as do the providers.

Pre-paid medical plans also hide the cost of care choices from the person who's consuming the care.

Roger that!

That was one of my points. Obamacare forces *everything* through that mess, which greatly increases the costs. Isurers have to staff up to handle that extra volume, increasing their overhead, and doctors have to staff up to deal with the insurance co. interactions.

That's all wasted. You'd be much better off just handing the lab $10 yourself, no middle-men, no insurance, no hassle, no wait. I once lived in a state that allowed that, and the savings (time and money) were amazing.

That's pretty well the substance of the various choice / free-market alternates to Obamacare.

Are you kidding? There is *no* chance of that happening--the Democrats won't allow it. Obama and his surviving O-crats are fanatically committed to their everyone-buys-more-insurance & government-dictates-price-and-practice approach.

Sound great. If insurers provide a useful product people want at a good price, fine, but with more efficient alternatives, why can't people choose? Freedom. That's good for everyone.

Okay, I'll type it more s l o w l y this time...

1. The overwhelming problem, by far, was cost.
2. If we all paid cash for our ordinary care, we'd save 40% right there.
3. If we shop and put price-pressure on providers, we'd save even more through competition.

We don't need a LAW to do THAT, and saving 50% is a better for everyone than Obamacare's hiking cost 20+%.

In case it isn't 18 trillion per cent clear, I'd REMOVE Obamacare completely because it forces the opposite path.

If I were to pass an additional federal law, it would be to tax health expenses the same, whether self-paid, personal, or employer-based insurance.

What I've just outlined doesn't solve *every* problem, but it greatly reduces the *worst* problem, making all the other problems smaller and easier to solve.

And, it works without taking, spying, or forcing anyone to do anything.

If you object to those things, you'd be horrified by the surveillance in Obamacare. Except that this is by your federal government, shared between agencies, and available to the IRS' next Lois Lerner.

The O-crats are a thousand times more intrusive. They want a say in every aspect of my daily life, my health care, what my doctor does (even the forms he's allowed to use), the car I drive, the power I can use, what I can do on my own property, what toilet I can flush, what shower-head I can buy, and so much more.

And when I'm all done they tell me "You didn't build that" and want to take it away. The Republicans aren't living up to their historical principles either. They've gone 'big government' too, but not as badly. Today's Republicans are yesterday's Democrats--liberal big-government spenders, with a smidgeon of concern about the deficit.

No, it was about keeping your plan, it wasn't an error, and he said he was sorry we misinterpreted his promise.

He and Gruber and the Congress also knew Obamacare wouldn't save money.

Already addressed, by detail.

Not true, and not an excuse for you to dictate my choices, or take what you want from other people without their permission.

Nope. If the government steals some of Mike and Joerg's care and gives it to you, sorry, that was never yours to start with. You're got no right to that.

Of course they don't. You can't ever have a "right" to something that takes someone else's labor to provide, because that infringes the other person's right to own and direct their own body, life, labor, and time on this earth. Other people do *not* owe you a living, or any part of it.

It also happens that letting people be free optimizes their prosperity, as well as society's as a whole.

But if you *want* people to have affordable care you sure aren't acting like it--you're supporting a COST HIKE, and IMPOSING it on others.

Mostly lies, in popular circulation, stemming from Liz Warren's 'study.' She 'found' a huge percentage of bankruptcies to be 'medically-caused,' by asking bankruptcy-filers whether they'd paid their doctors, essentially.

It turns out that people who can't pay their power bills often don't pay their doctors either. Whodda thunkit?

Soon to be dwarfed by all the Obamacare-caused bankruptcies, and no, I'm not kidding.

Sorry, your failure to look doesn't mean other people have been useless or passive. You have to actually try to find out what's being said, and don't expect your TV to find it for you.

The gummint is obviously the best of all insurers, as proven by them

*STILL* not being able to finish a basic website, 5 1/2 years later.

Who better to streamline and improve efficiency, than the parasites who skim 3.5% for the privilege of complying with their mandates (and still manage to lose money getting paid for doing nothing!!) ?

That's surely the most compassionate, cost-effective solution.

Cheers, James Arthur

care

you with health care when you need it may be a liberty, but probably a less restrictive and potentially damaging one.

Societies exist, in part, to collectively defend individuals. War, if needed. Completely legitimate.

That doesn't justify society taking Mike's health care and giving it to Rick.

Cheers, James Arthur

Never? Since Dubbya got the US to invade Irak by lying to the country about weapons of mass destruction, and claiming that Saddam had something to do with 9/11, James Arthur is either grossly imperceptive or grossly partisan

- I favour the latter explanation. James Arthur can be quite perceptive whe n finding evidence that appears to support his point of view.

Since James Arthur didn't complain about Dubbya' lies at the time - and it was pointed out here back then that Dubbya's case was less than substantial - he's got no business complaining about Obama now. In fact - since he sou nds exactly like a Republican apologist - it wouldn't be unreasonable to su spect that his claims about Obama are somewhat exaggerated for political ef fect, much as Dubbya's were about Sadam.

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Bill Sloman, Sydney

So the Affordable care act will raise my premium from $6,600 to $13,508, and then snatch away the subsidy that was used to entice me to switch? Mikek

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http://www.avast.com

h care

g you with health care when you need it may be a liberty, but probably a le ss restrictive and potentially damaging one.

Societies exist, in part, to collectively defend individuals. Infectious di seases have killed more people in plagues than wars ever did. The US medica l health system is poorer defense against plagues than it ought to be - rea d up on drug-resistant TB in the US if you find this hard to accept - and i t needs to be brought up to international standards

That does empower society to take some of Mike's health care and give it to Rick, if it improves the quality of the health care system in the process.

For somebody whose father was a doctor, you are rather unaware of the prima ry justification for the existence of a health care system. I have reminded you about this before, but you don't seem to have been sick recently and p resumably have decided that you are invulnerable, along with all your far-r ight-thinking friends.

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Bill Sloman, Sydney

I don't like coffee so I don't eat the damn things. But, then again, I don't eat the cheesecake or most of the *other* things that I bake, either! (The biscotti that *I* like are much softer, dunk in *milk*, etc.)

They're actually very easy to make. I just grumble because I am *always* making them -- for C, a neighbor, a friend, etc. E.g., even with just a couple oz of amaretto in each batch, we *still* end up buying 7 or 8

750ml bottles each XMAS (which is when they are always on sale -- often packaged with interesting "glasses"). And, when I have to "individually wrap" them (e.g., for shipping, transport, etc.) it becomes doubly tedious.

Mixing with wooden spoon gets frustrating cuz you *think* the stuff would "go into solution" a lot easier than it actually does! The dry's get splashed up along the sides of the bowl (which is why I said to avoid letting the *wets* get up there!) so you have to scrape it often (which isn't easy with those klunky spoons).

The real key is learning how long to do the second bake. And, the harder trick is sorting out how "wet" to leave the dough. Each time I make a batch, I make a mental note of the "viscosity" (?), the size of the eggs, amount of dry's that I "left out" -- then, query C after she's had them for a few days to see how well they are holding up (first day is ALWAYS "the best"; the longer they *seem* to stay AT "the best", the better the bake! When they start to taste "heavy" -- from age -- then I know I let the dough get too stiff/dense)

Costco sells a nice 2 lb bag of sliced almonds (we go through a lot of them) -- "Mariani Sliced Premium Almonds". But, I noticed that they didn't carry them back East (so, I suspect each Costco store has its own selected offerings)

There are other variations on the Rx. But, I've found that most folks prefer the "peasant food" style over the more exotic varieties.

Yes, the ACA is all about you!

--

Rick

And that gets you a blank stare by the doctor in an emergency room. I know from personal experience. I had a kidney stone (my 8th or 9th I think, so I'm used to the routine). The typical procedure is to perform an IVP to determine the location in case it is somewhere dangerous I guess (like in the kidney). Typically by the time they take the x-ray the stone has moved out of the kidney and they send me home with pain killers.

This time the doc wanted to do a CAT scan. My friend looked it up and the price would be over $1,000. I asked why a CAT scan and the doc shrugged. I asked why not an IVP (or a couple of hundred bucks) and she said they didn't have a radiologist to administer it on the weekends. The other scans can be done by a tech and read remotely. lol So much for price shopping. Fortunately the stone passed during all this and I went home.

Completely BS. ER visits often involve intense pain and no time to collect info much less pick a different provider.

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Rick

I've seen it happen, mostly in civil engineering cases. Something hit the fan, big corp conveniently vanished and "re-organized". But do whatever you want, it's your life and your family's financials, not mine.

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Regards, Joerg 

http://www.analogconsultants.com/

They can reorg a million times and that doesn't absolve them of liability. For that they have to go under. You are talking about small companies, not billion dollar outfits. Even so, your job still leaves you open to tons of liability. You designed it and it goes bad... you are the one the big companies go after... if you had any assets.

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Rick

Dream on. Minimizing exposure is one reason why they use high-priced lawyers as strategists during such moves.

For that they have to go under. You are talking about small

Nope, that's excluded in my agreements with them. If they don't sign that they will have to look for another consultant. But just like you that does not protect me when big corp goes under or re-orgs. However, proving liability in court will be extremely tough to impossible in case of production defects unless I was grossly negligent. Most such lawsuits happen after production defects, the ones that resulted or should have resulted in a recall. That scenario is very different for anyone involved in the actual procurement of the product. Production, marketing, sales, and so on. If you don't believe me talk to a product liability insurance specialist. I have.

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Regards, Joerg 

http://www.analogconsultants.com/

Really? So what magic do they use? GM had to go through bankruptcy to accomplish that.

Besides, you are just being silly. There is a lot of money in selling hardware and the risk is very minimal. Even if my company is sued, it is the company at risk, not me. The company is virtually pennyless.

An easy defense to production defects is to not make them. Design defects lay dormant for a long time. So *do* you have E&O insurance? Otherwise you are just fooling yourself.

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Rick

Or you! You're just as happy because you're getting the freebie, as I am pissed because I'm paying more, lots more, for less. I'm close enough to retirement that I could reduce my income low enough so I too could get a freebie. Certainly is something to think about. I could eliminate that 15.2% Social security tax, withdraw money from my IRA's, a little from the Roth's, just keep my income at a level so I pay maybe $20 a month for my $13,508 healthcare policy. With $8,700 less premium out go, and not having to pay $11,000 in SS taxes, I wouldn't need much to live on. Always have been frugal. What do you think rickman, Is it time for me to drop out of the producer class? Mikek

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I left class a long time ago. I've been working for some 40+ years. I can't say if you are ready to leave class yet or not.

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Rick

Most companies will do it that way.

Quote "Those seeking claims against Old GM would likely get nothing". Exactly what I am saying.

Oh man ... you never heard the expression "Piercing the corporate veil"? Seriously?

No, I don't, can't get any. Because med devices and aerospace exposure has even scared Llyods away. No kidding. If I was an old oil tanker that would be different. And as I said, I know that this entails risks if a client goes belly up.

However, most liability isn't design related but production related. Contract mfg decides to replace an item with a "more favorably priced" part ... poof. Before you know anything about that it can be too late.

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Regards, Joerg 

http://www.analogconsultants.com/

Yep, how often does a company like GM go this route? You are just being rediculous. The liability risk is microscopic.

Yes, a multi-billion dollar company will have to go under, then someone will have to find my corporation and find no assets, then they will have to decide to spend a lot of money to try to go after my not so bountiful personal assets. Again, you are grasping at straws. Just what do you think it requires to go after the officers of a corporation? Do you even have an idea? It requires nearly criminal negligence.

You keep telling yourself that. If the risk were not large or the likely claims not huge, the insurance companies would be happy to take your money.

The contract manufacturer uses the parts I specify, period. Even so, I am not liable, but you will always be liable for the design. I can get insurance, you can't... Cart/horse

I'm done with this conversation.

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Rick