Bird
Rest in Peace
Re: Solved the energy shortage problem
Wingnut, I think you've got a pretty good handle on it.
Bird
Wingnut, I think you've got a pretty good handle on it.
Bird
Sloved the energy shortage problem
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cowboydoc
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Re: Solved the energy shortage problem
Wingnut,
First of all what I blame Bush for is not having a policy or doing anything to cap prices right now. In my mind we have an energy crisis, period. Now you can say all you want about suv's, etc. etc. but even without that, it's a small percentage, there is price gouging going on. I just finished watching report on the news about who's making the money. Here was the breakdown. .63 for cost of oil, .38 for cost of taxes, .22 to to retailer, and .52 for the refinery! They said the average price for refineries for the last twenty years has been .20 or less. It has risen to all time highs and above even .40 for the first time ever. You're going to see it again this winter with outrageous propane prices. I don't blame this on Bush but he is certainly not doing anything to fix the problem. His answer is conservation and build for the future. Which is true to a point, but it does nothing for the next ten years. Now I could care less about the mess CA has itself in. They did that to themselves. I feel sorry for the average Cal. though that did nothing to cause this. It was politics and env. wackos and mainstream public is paying the price as usual. I don't blame Bush for that nor should it be his responsibility. They have to take care of that in their own state. But what is wrong is states that do have plenty of energy and used to sell it for a reasonable price are holding CA hostage over the prices now. Yes I'm mad at Bush and he should be doing something. Yes Clinton and everyone else in that era created a damn mess. But regardless it's Bush's ballgame now and he has to fix it no matter who created the problem.
Lastly when you talk profit you're talking about only what goes to the shareholders. The profit margin is after every single pretax penny has been squeezed out of the company and every executive is given a nice fat check, which is fine as long as it's legal. How would you like to be Dick Cheney and as his retirement from an oil company he made $30 some million dollars for a few years of work. Hmmm you don't think that's a little outrageous?
Lastly you say for the farmers to go for it. Ok now you're paying double your income for energy, double your income for food, etc. How long do you think you'll be able to afford all of this nonsense? You know you say you can't believe me being upset over all of this. I can't believe that you would even question what is going on. I have no problem with anyone making a profit that's fine, but collusion and price gouging are wrong.
Lastly myself and every other farmer in the country would vote with you on removing every damn government program that there is. All it has done is keep the farmer down. But the government has it so screwed up now that there are only two choices in Iowa to sell your corn to. They come out and give you a price and say if you don't like it tough. Doesn't matter that the price they give you is a $1 under break even. Yet they sure don't sell it for less to Quaker. Government has got to police big business that is all there is to it. Again I don't blame Bush for this and never said that I blamed him for it. What I fault him for is not working on a plan to start fixing the problem.
Wingnut,
First of all what I blame Bush for is not having a policy or doing anything to cap prices right now. In my mind we have an energy crisis, period. Now you can say all you want about suv's, etc. etc. but even without that, it's a small percentage, there is price gouging going on. I just finished watching report on the news about who's making the money. Here was the breakdown. .63 for cost of oil, .38 for cost of taxes, .22 to to retailer, and .52 for the refinery! They said the average price for refineries for the last twenty years has been .20 or less. It has risen to all time highs and above even .40 for the first time ever. You're going to see it again this winter with outrageous propane prices. I don't blame this on Bush but he is certainly not doing anything to fix the problem. His answer is conservation and build for the future. Which is true to a point, but it does nothing for the next ten years. Now I could care less about the mess CA has itself in. They did that to themselves. I feel sorry for the average Cal. though that did nothing to cause this. It was politics and env. wackos and mainstream public is paying the price as usual. I don't blame Bush for that nor should it be his responsibility. They have to take care of that in their own state. But what is wrong is states that do have plenty of energy and used to sell it for a reasonable price are holding CA hostage over the prices now. Yes I'm mad at Bush and he should be doing something. Yes Clinton and everyone else in that era created a damn mess. But regardless it's Bush's ballgame now and he has to fix it no matter who created the problem.
Lastly when you talk profit you're talking about only what goes to the shareholders. The profit margin is after every single pretax penny has been squeezed out of the company and every executive is given a nice fat check, which is fine as long as it's legal. How would you like to be Dick Cheney and as his retirement from an oil company he made $30 some million dollars for a few years of work. Hmmm you don't think that's a little outrageous?
Lastly you say for the farmers to go for it. Ok now you're paying double your income for energy, double your income for food, etc. How long do you think you'll be able to afford all of this nonsense? You know you say you can't believe me being upset over all of this. I can't believe that you would even question what is going on. I have no problem with anyone making a profit that's fine, but collusion and price gouging are wrong.
Lastly myself and every other farmer in the country would vote with you on removing every damn government program that there is. All it has done is keep the farmer down. But the government has it so screwed up now that there are only two choices in Iowa to sell your corn to. They come out and give you a price and say if you don't like it tough. Doesn't matter that the price they give you is a $1 under break even. Yet they sure don't sell it for less to Quaker. Government has got to police big business that is all there is to it. Again I don't blame Bush for this and never said that I blamed him for it. What I fault him for is not working on a plan to start fixing the problem.
skent
Platinum Member
Re: Solved the energy shortage problem
Way-to-go Wingnut!!!/w3tcompact/icons/wink.gif
Steve
Way-to-go Wingnut!!!/w3tcompact/icons/wink.gif
Steve
Bird
Rest in Peace
Re: Solved the energy shortage problem
<font color=blue>what I blame Bush for is not having a policy or doing anything to cap prices right now</font color=blue>
Richard, I guess we all have our pet peeves, look for simplified answers, someone to blame, etc. I'm not at all happy about the energy situation, but you know a lot of us feel it would be much more important for him to put a cap on what doctors, hospitals, and pharmaceutical companies are doing to us. If you want to see price fixing, gouging, padded bills, overpaid executives, etc., that's one that easy to find./w3tcompact/icons/frown.gif We can blame insurance companies (and they deserve a lot of blame), but of course much of what they've done was because of gross overcharges in the past, so now they've gone too far in many cases. In other words, most of us know the solution to problems in professions we're not personally involved in, but can't seem to correct the ones in our own professions. Discouraging sometimes, ain't it?/w3tcompact/icons/wink.gif
Bird
<font color=blue>what I blame Bush for is not having a policy or doing anything to cap prices right now</font color=blue>
Richard, I guess we all have our pet peeves, look for simplified answers, someone to blame, etc. I'm not at all happy about the energy situation, but you know a lot of us feel it would be much more important for him to put a cap on what doctors, hospitals, and pharmaceutical companies are doing to us. If you want to see price fixing, gouging, padded bills, overpaid executives, etc., that's one that easy to find./w3tcompact/icons/frown.gif We can blame insurance companies (and they deserve a lot of blame), but of course much of what they've done was because of gross overcharges in the past, so now they've gone too far in many cases. In other words, most of us know the solution to problems in professions we're not personally involved in, but can't seem to correct the ones in our own professions. Discouraging sometimes, ain't it?/w3tcompact/icons/wink.gif
Bird
cowboydoc
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Re: Solved the energy shortage problem
Bird,
I'm the first one to admit that healthcare is ridiculous as well. I most certainly do do my part to help out as much as possible there. My fees are about a third of what I could charge. The only reason I'm that high is because I get cut 30% off the top by managed care. If I don't keep my fees somewhat high then I get cut 30% off of reasonable fees. My cash patients get the most reasonable rate that I can give them. If you don't have insurance my office visit is $36, hardly overcharging. As an example one of my colleagues charge to set a broken arm and cast non-surgical is $690, my charge is $250, if you don't have insurance it's $125. If you can't afford to pay I work something out with you. My office manager is always on me because I write so much off. I'm a member of the Iowa insurance for children where I make little of nothing, but I do it to help out kids that wouldn't otherwise get help. I volunteer my time to be the team doctor for the local high school and the college. I speak up at professional conventions and political functions about the outrageous prices of healthcare. I do everything I can to bring down prices so yes in my own profession I am doing all that I can to keep healthcare reasonable. I just expect other people to do the same in their profession.
Bird,
I'm the first one to admit that healthcare is ridiculous as well. I most certainly do do my part to help out as much as possible there. My fees are about a third of what I could charge. The only reason I'm that high is because I get cut 30% off the top by managed care. If I don't keep my fees somewhat high then I get cut 30% off of reasonable fees. My cash patients get the most reasonable rate that I can give them. If you don't have insurance my office visit is $36, hardly overcharging. As an example one of my colleagues charge to set a broken arm and cast non-surgical is $690, my charge is $250, if you don't have insurance it's $125. If you can't afford to pay I work something out with you. My office manager is always on me because I write so much off. I'm a member of the Iowa insurance for children where I make little of nothing, but I do it to help out kids that wouldn't otherwise get help. I volunteer my time to be the team doctor for the local high school and the college. I speak up at professional conventions and political functions about the outrageous prices of healthcare. I do everything I can to bring down prices so yes in my own profession I am doing all that I can to keep healthcare reasonable. I just expect other people to do the same in their profession.
WVBill
Veteran Member
Re: Solved the energy shortage problem
Richard:
I've been trying to understand the economics of health care for a while now. When my wife had carpal tunnel surgery a year ago, we got the Insurance statement that listed the hospital charge they paid (Anesthesiologist, hospital room, all the way down to the band-aid to cover the spot where they drew blood) as a total of $5,000. Shortly afterward, I got a statement from the hospital for the same services at a total of $8,000. I called them and they said: "Oh, you shouldn't have gotten that, we made a mistake in sending it to you - ignore it."
So I was wondering how it works. It seemed that, for the same service, the hospital would charge Joe No-insurance $8,000 and United Healthcare (UHC) $5,000. My guess is that UHC "cuts a deal" with the hospital and says "I'll send you all my carpal tunnel surgeries if you give me a good price, say - $5,000" So to get the "guaranteed business", the hospital takes the $5K price and makes maybe 5% profit on each one. Now their target profit is 10% so to make it up they charge our friend Joe No-insurance $8,000 - an extra $3,000.
I can see from your e-mail that you do just the opposite. You charge Joe N-I a lower rate than you charge me (through my insurance company). I realize that some portion of that is what the insurance company "charges" you (30%) and if you net out the same on both then I can understand. But if you make more profit on me (my insurance deal) than you do on Joe in order that your average profit is decent then isn't my insurance company (me, through my premiums) "paying" part of Joe's fair bill.
Really, I'm not pointing fingers here or laying blame, I'm just honestly trying to understand the micro-economics of "doctoring" a little bit.
Thanks for considering answering - and thanks for being in the profession you are.
Richard:
I've been trying to understand the economics of health care for a while now. When my wife had carpal tunnel surgery a year ago, we got the Insurance statement that listed the hospital charge they paid (Anesthesiologist, hospital room, all the way down to the band-aid to cover the spot where they drew blood) as a total of $5,000. Shortly afterward, I got a statement from the hospital for the same services at a total of $8,000. I called them and they said: "Oh, you shouldn't have gotten that, we made a mistake in sending it to you - ignore it."
So I was wondering how it works. It seemed that, for the same service, the hospital would charge Joe No-insurance $8,000 and United Healthcare (UHC) $5,000. My guess is that UHC "cuts a deal" with the hospital and says "I'll send you all my carpal tunnel surgeries if you give me a good price, say - $5,000" So to get the "guaranteed business", the hospital takes the $5K price and makes maybe 5% profit on each one. Now their target profit is 10% so to make it up they charge our friend Joe No-insurance $8,000 - an extra $3,000.
I can see from your e-mail that you do just the opposite. You charge Joe N-I a lower rate than you charge me (through my insurance company). I realize that some portion of that is what the insurance company "charges" you (30%) and if you net out the same on both then I can understand. But if you make more profit on me (my insurance deal) than you do on Joe in order that your average profit is decent then isn't my insurance company (me, through my premiums) "paying" part of Joe's fair bill.
Really, I'm not pointing fingers here or laying blame, I'm just honestly trying to understand the micro-economics of "doctoring" a little bit.
Thanks for considering answering - and thanks for being in the profession you are.
skent
Platinum Member
Re: Solved the energy shortage problem
Again, the blame can be spread across many places, but the allowable lawsuites that arise (some justified, most not) that not only tie up our court system, cause innocent people LARGE defense fees, allow lawyers to take 1/5 to 1/3 of the judgement (and I'm NOT kicking all lawyers, but many fit), all funnels back to increasing malpractice premiems and increased cost of liability insurance (building in a safety zone). Theres no short term fix, and there may be no fix at all (our system (political-that is) is better than most if not all) but when you have a system with checks and balances, two party system this will happen.
Furthermore I fully believe the situation in CA is GOING to move east, and there will come a time, sooner or later when we all have energy crunches. You can only keep putting so many controls on generating electricity before it gets too expensive to afford (supply and demand). Those who can afford to run outdoor dawn to dusk lights, all sorts of bells and whistles will be paying, and those of us who can't will use what we need at a minimum and then hit the switch.
Steve
Again, the blame can be spread across many places, but the allowable lawsuites that arise (some justified, most not) that not only tie up our court system, cause innocent people LARGE defense fees, allow lawyers to take 1/5 to 1/3 of the judgement (and I'm NOT kicking all lawyers, but many fit), all funnels back to increasing malpractice premiems and increased cost of liability insurance (building in a safety zone). Theres no short term fix, and there may be no fix at all (our system (political-that is) is better than most if not all) but when you have a system with checks and balances, two party system this will happen.
Furthermore I fully believe the situation in CA is GOING to move east, and there will come a time, sooner or later when we all have energy crunches. You can only keep putting so many controls on generating electricity before it gets too expensive to afford (supply and demand). Those who can afford to run outdoor dawn to dusk lights, all sorts of bells and whistles will be paying, and those of us who can't will use what we need at a minimum and then hit the switch.
Steve
cowboydoc
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Re: Solved the energy shortage problem
Bill,
Yes you're right on all accounts except for one and that is that I do not make anything up on insurance. In fact on most plans I lose more by charging insurance than if the patient payed cash. First of all I have to pay two full time people just to do insurance and billing. My postage alone every month just for sending insurance and billing is over a thousand dollars. Next I have to wait two to six months before I even see that money. They I spend an average of one to two hours a day just doing insurance paperwork, that's not even counting my regular notes. Then I have to have a computer and billing network with electronic billing capability just to be able to bill insurance. Then I have to go to cont. ed. seminars to see how to keep in compliance with everyone and how to bill. Then I have to keep up with medicare and medicaid compliances as well. That's not even all of it. If I could just charge each person $36 and get paid that day I'd be in seventh heaven. I'd cut my overhead by probably half and the frustration. I could concentrate on seeing patients and not worrying about every little detail I have to do to make sure that I get paid and job satisfaction would go way up. Don't get me wrong I love what I do but insurance is a royal pain in the rear and believe me it's not worth charging 10 times what my cash rate is.
Bill,
Yes you're right on all accounts except for one and that is that I do not make anything up on insurance. In fact on most plans I lose more by charging insurance than if the patient payed cash. First of all I have to pay two full time people just to do insurance and billing. My postage alone every month just for sending insurance and billing is over a thousand dollars. Next I have to wait two to six months before I even see that money. They I spend an average of one to two hours a day just doing insurance paperwork, that's not even counting my regular notes. Then I have to have a computer and billing network with electronic billing capability just to be able to bill insurance. Then I have to go to cont. ed. seminars to see how to keep in compliance with everyone and how to bill. Then I have to keep up with medicare and medicaid compliances as well. That's not even all of it. If I could just charge each person $36 and get paid that day I'd be in seventh heaven. I'd cut my overhead by probably half and the frustration. I could concentrate on seeing patients and not worrying about every little detail I have to do to make sure that I get paid and job satisfaction would go way up. Don't get me wrong I love what I do but insurance is a royal pain in the rear and believe me it's not worth charging 10 times what my cash rate is.
M. Sullivan
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Re: Solved the energy shortage problem
Here's an interesting perspective from the 'conspiracy theory crowd' on what's going on, as well as a reference to some new technology to allow the US to become self-sufficient. Seems too good to be true, and that it isn't explained in detail rasies questions. At any rate.....
http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=22911
Also, re. Bore in '04. Wouldn't vote for him for dog cathcer, just concerned Bush will get tagged with the whole mess. And if this admin. doesn't do a bigtime collusion investigation there's no way I'll vote for him, either.
Here's an interesting perspective from the 'conspiracy theory crowd' on what's going on, as well as a reference to some new technology to allow the US to become self-sufficient. Seems too good to be true, and that it isn't explained in detail rasies questions. At any rate.....
http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=22911
Also, re. Bore in '04. Wouldn't vote for him for dog cathcer, just concerned Bush will get tagged with the whole mess. And if this admin. doesn't do a bigtime collusion investigation there's no way I'll vote for him, either.
Bird
Rest in Peace
Re: Solved the energy shortage problem
Richard, I wish you lived and practiced in my area. The prices are considerably higher around here, and to make matters worse, the service frequently leaves a great deal to be desired, too, and I have my prejudices, too, partly because of encountering some truly imcompetent doctors in the last few years with my parents. I won't go into detail, but my brother & I did do our share to run one incompetent orthopedic surgeon out of town (with some help from an attorney, but without actually filing a lawsuit and without making any money). We found he'd been run out of other towns, and he may be practicing in your area now for all we know.
And WVBill, when I had my carpal tunnel surgery - one hand at a time and day surgery each time, no overnight stay (got there at 7:30 a.m. and gone by noon), the total bill was in excess of $19,000.
Bird
Richard, I wish you lived and practiced in my area. The prices are considerably higher around here, and to make matters worse, the service frequently leaves a great deal to be desired, too, and I have my prejudices, too, partly because of encountering some truly imcompetent doctors in the last few years with my parents. I won't go into detail, but my brother & I did do our share to run one incompetent orthopedic surgeon out of town (with some help from an attorney, but without actually filing a lawsuit and without making any money). We found he'd been run out of other towns, and he may be practicing in your area now for all we know.
And WVBill, when I had my carpal tunnel surgery - one hand at a time and day surgery each time, no overnight stay (got there at 7:30 a.m. and gone by noon), the total bill was in excess of $19,000.
Bird