NYC assassination news thread - Please no politics (1 Viewer)

[uwillbsoon]

Also, the MA market is quite large: 50+ million members. And growing. I believe it overtook traditional Medicare in membership last year. Or will this year.

 

[culdeus]

With that said, I'd also be fine with weighing out restricting or eliminating pharmaceutical ads on television the way other countries do.

A related effect would be the catastrophic impact on media revenue and that moves into a different conversation as well.

The ads on NFL games are for diseases that impact such a tiny subset of people. How is that even a good idea? I get the Ozempic-type ads, and the viagra ads, but some funky skin conditions impacting like 1/10000 to 1/50000 people, how does this even make sense to do?

 

[uwillbsoon]

With that said, I'd also be fine with weighing out restricting or eliminating pharmaceutical ads on television the way other countries do.

A related effect would be the catastrophic impact on media revenue and that moves into a different conversation as well.

The ads on NFL games are for diseases that impact such a tiny subset of people. How is that even a good idea? I get the Ozempic-type ads, and the viagra ads, but some funky skin conditions impacting like 1/10000 to 1/50000 people, how does this even make sense to do?

I'd guess because they cost a lot and/or are highly profitable. You can spend a lot on finding the needle in the haystack if the needle is worth a lot.

 

[Sparky Polastri]

The problem isn't a lack of nutritional knowledge or advice in the medical community.

The problem is that many (most?) people choose to ignore this advice. Or even common sense (e.g. consume more calories than you burn = weight gain)

I'd suggest this is PART of the problem. I know many here want this to be an either/or situation. It's not. It's a both/and situation. We need to address both sides of this. We need to figure out how to educate people in a way that they make the right decisions while also removing the forces that are directly/indirectly telling them to do otherwise.

Avoid salt, sugar and fatty foods. Balance your intake of meats, carbs and vegetables. Don't eat too much. Whole foods are better than processed foods.

That's going to solve 90% of so-called "nutritional" problems.

It's not rocket science

Message is a simple message, no doubt. It's getting it out effectively that's a rather large problem. There are significantly more of the "bad" messages out there drowning this message out.

 

[Stoneworker]

The problem isn't a lack of nutritional knowledge or advice in the medical community.

The problem is that many (most?) people choose to ignore this advice. Or even common sense (e.g. consume more calories than you burn = weight gain)

I'd suggest this is PART of the problem. I know many here want this to be an either/or situation. It's not. It's a both/and situation. We need to address both sides of this. We need to figure out how to educate people in a way that they make the right decisions while also removing the forces that are directly/indirectly telling them to do otherwise.

Avoid salt, sugar and fatty foods. Balance your intake of meats, carbs and vegetables. Don't eat too much. Whole foods are better than processed foods.

That's going to solve 90% of so-called "nutritional" problems.

It's not rocket science

Message is a simple message, no doubt. It's getting it out effectively that's a rather large problem. There are significantly more of the "bad" messages out there drowning this message out.

Don't disagree. I suppose I just believe that individuals ultimately control the information they consume and have the power to tune out the "bad" messages

 

[matttyl]

Also, the MA market is quite large: 50+ million members. And growing. I believe it overtook traditional Medicare in membership last year. Or will this year.

For what it’s worth I don’t like MA plans, nor do I sell them. I know the government likes them as it shifts people off their rolls, and onto the rolls of a private insurance company. I do sell Medicare supplement plans, though.

 

[Sparky Polastri]

The problem isn't a lack of nutritional knowledge or advice in the medical community.

The problem is that many (most?) people choose to ignore this advice. Or even common sense (e.g. consume more calories than you burn = weight gain)

I'd suggest this is PART of the problem. I know many here want this to be an either/or situation. It's not. It's a both/and situation. We need to address both sides of this. We need to figure out how to educate people in a way that they make the right decisions while also removing the forces that are directly/indirectly telling them to do otherwise.

Avoid salt, sugar and fatty foods. Balance your intake of meats, carbs and vegetables. Don't eat too much. Whole foods are better than processed foods.

That's going to solve 90% of so-called "nutritional" problems.

It's not rocket science

Message is a simple message, no doubt. It's getting it out effectively that's a rather large problem. There are significantly more of the "bad" messages out there drowning this message out.

Don't disagree. I suppose I just believe that individuals ultimately control the information they consume and have the power to tune out the "bad" messages

I'm not sure this is the case. I have no control over what commercials come on my television for example. Ability to "tune out" the bad messages is likely decided at the individual level. But the underlying assumption of that premise in the first place is that they know the difference between the good ones and bad ones. That isn't all that clear nationally.

 

[GroveDiesel]

My question would be... are these chronic conditions a result of subpar healthcare or does the American way of life contribute more to unhealthy lifestyles and the healthcare system is struggling to keep up?

This is an easy one IMO. If you travel outside the US at all, one of the things you notice immediately is that Americans are fatter than everybody else. We all know that's true because we've seen the statistics, but when you actually see it with your own two eyes in the real world, it's impossible to ignore. Why are Americans so fat? It's probably not mono-causal and we can debate how assorted cultural and policy variables play into this, but it's obviously not your doctor's fault or your insurance company's fault.

And once you see that the US is an outlier on obesity, it should occur to you that we're an outlier on other dimensions too. We drive a lot more than people in other first-world countries. More driving means more auto accidents, and those are clustered among younger people. We have way more guns and much more gun violence than other first-world countries, and gun fatalities are clustered among younger people. Those types of things really mess up "life expectancy at birth" calculations and result in excess deaths that seem out of whack but have nothing to do with health care.

No, obviously the health care industry is not causing people to get diabetes or monkeypox or a gunshot wound. Those are all things that people chose, in a manner of speaking.

This is all true, but i also think our for profit system compounds the issue and leads to poor outcomes too often.

We are fat, other countries' populace still smoke like crazy. We all have our differences in risks and poor choices, and that is certainly one part of the equation.

If you don't know people that don't take of minor things because they aren't covered, its not worth their insurance rates increasing, etc. then we have very different experiences. Imo the way our heath system is set up also greatly contributes to people not taking care of themselves and just waiting until it is something catastrophic.

For being the bestest, richest country on the planet it is embarrassing to see stats on the things I believe should be basic things like health and education.

I do know people who don’t take care of the minor things because they aren’t covered (though their insurance rates wouldn’t increase because of that). I see it all the time (as an insurance agent) and I try to talk folks (mainly the younger and healthier folks) out of going uninsured and obtaining a policy. They either don’t think it’s worth it (and honestly, they are often correct there), they don’t trust insurance companies, but often it’s because they don’t think it’s affordable/valuable - yet they are fine with Starbucks, new/newer cars, on and on. I mean I’m literally quoting folks on the exchanges (individual market) all the time who are eligible for a subsidy which would knock their premium down substantially, to under $200 a month for decent coverage and they say no. I see the same thing with employees of some of my employer group plans choosing not to enroll for themselves and family members, even though the employer would pick up 80% of the cost. Again, just like is often the case with poor health outcomes, it comes down to personal responsibility.

I get all this, but I still circle back to my main point that humans are humans. There has to be a good number of these choices and behaviors going on around the world. We can't be the only country who makes dumb choices for ourselves.

When it comes to “health insurance”, we pretty much are as we’re the only country that has a system like ours. People in most of Europe, for instance, don’t have the choice to go uninsured/not pay for health insurance.

I would say we’re now getting way off topic, but actually this might be getting us back on topic re the motive of the accused killer.

But that's also the point.

Compared to a European hospital bill, a US hospital bill will typically be significantly higher for the same procedure, with individual line items like room charges, doctor fees, and even basic tests often costing considerably more in the US due to the structure of the healthcare system, where costs are often driven by profit margins rather than standardized pricing in most European nations; essentially, a US bill will show a much higher overall cost for similar medical services.

Key differences:

• Overall Cost:
  A US hospital bill for a standard procedure will generally be several times higher than a comparable bill in most European countries.
  
  
• Itemized Charges:
  • Room Charges: While room costs can vary depending on the facility and location, US hospital rooms often have significantly higher per-night charges compared to European hospitals.
    
    
  • Doctor Fees: Physician fees on a US bill can be substantially higher than in Europe, as doctors often have greater billing flexibility.
    
    
  • Diagnostic Tests: Even routine lab tests and imaging procedures may be priced much higher on a US hospital bill.
    
    
  • Administrative Fees: US bills might include additional administrative charges not commonly seen in Europe.

Reasons for the disparity:

• Private vs. Public Healthcare:
  Most European countries have primarily public healthcare systems with price controls, while the US relies heavily on private insurance companies, leading to higher costs due to market competition.
  
  
• Profit Incentives:
  US hospitals and healthcare providers often operate with a profit motive, leading to higher charges compared to European systems focused on patient care.
  
  
• Drug Costs:
  Prescription drugs can be significantly more expensive in the US compared to Europe, further inflating medical bills.

Example Comparison:

• Appendectomy in the US: Could cost upwards of $30,000.
  
  
• Appendectomy in Europe (average): Might cost around €600 (equivalent to roughly $650).

Oh, fully agree 100%. I’m the one on the top of the mountain screaming that the reason your health “insurance” costs as much as it does is because the cost of the care that it’s paying for is so high. If your appendectomy costs $650 rather than $30k, then the cost of the insurance to cover that appendectomy wouldn’t need to be so high.

Now while the insurance industry might not be completely innocent in allowing the cost of that appendectomy to reach $30k, ultimately it’s the provider who is choosing to charge that amount for it. Maybe they can justify that cost, maybe they can’t - but I’d like to at least have them explain why it is.

Amen. There is very little price discovery/transparency in U.S. medical care.

A little story that has be told here before (in other threads) - and some background, I’ve been a life/health insurance agent for 20+ years.

When my son was going to be born, wife and I go to hospital and we get her all nice and settled in the delivery room. We have some time, so one of the nurses says to me that the billing dept will need her insurance info (they kinda rushed her in and didn’t have a chance to do that part). I said no problem, got her insurance card and made my way to their billing office. I have the nice lady the card, she input the information into the system, confirmed that it was valid and active coverage (I guess their “system” could directly communicate with Aetna’s), and she said it was all good. I then asked her, knowing I wouldn’t get an answer, but really just to see what response I’d get - “so how much will this all cost?” She looked confused and answered, “what do you mean?” I responded - “well, my wife is about to have a baby, she’s upstairs in a room in your hospital - let’s assume she has a normal deliver and she and baby come home tomorrow or the next day, you have her insurance information on the computer in front of you, you see her plan info, what will the total charges be that the hospital will bill under that assumption?”

She looked at me like I had three heads. “I have no idea, and I have no idea how to even get that answer for you.” I mean, I knew I wouldn’t get an answer, but let’s be real here - this person works in the hospital billing department, if they don’t know and don’t even know where to get that answer, how would anyone else?

Yeah, hospitals were supposed to make pricing public and easy to find. I do think that healthcare costs are at least partially due to people having no idea what they’re even being charged which means they can’t even shop around. Not all hospitals will charge the same amount for the same thing, and yet consumers/patients have no clue what those costs even are. Not to mention that the way things are setup now you could be charged by the hospital, the doctor who rents space there that sees you, the anesthesiologist who treated you, etc. all as separate bills/co-pays.

 

[GroveDiesel]

The problem isn't a lack of nutritional knowledge or advice in the medical community.

The problem is that many (most?) people choose to ignore this advice. Or even common sense (e.g. consume more calories than you burn = weight gain)

I'd suggest this is PART of the problem. I know many here want this to be an either/or situation. It's not. It's a both/and situation. We need to address both sides of this. We need to figure out how to educate people in a way that they make the right decisions while also removing the forces that are directly/indirectly telling them to do otherwise.

Avoid salt, sugar and fatty foods. Balance your intake of meats, carbs and vegetables. Don't eat too much. Whole foods are better than processed foods.

That's going to solve 90% of so-called "nutritional" problems.

It's not rocket science

At this point, I would wager that most folks have no clue how many calories anything actually is. Which makes it pretty hard to eat healthy when you have no idea what a good portion size really is. Using a calorie tracking app was one of the best things I did for my eating habits.

 

[matttyl]

You’ve always been charged separately between the doctor and the hospital (if seen by both). I mean that’s why we have Medicare part A (hospital coverage) and part B (doctor coverage).

As for the charging different things - it’s even crazier than you wrote. Different hospitals will charge different amounts to different insurance carriers for the same thing. Say I have my coverage with BCBS, the next guy with United and the next guy with Aetna and we all get the exact same MRI. The same hospital will charge each carrier a different (pre-negotiated) amount. Then the old guy on Medicare get his MRI, that’s a completely different (and generally much lower) amount - but we all got the exact same service. And if we’d all gone to the next hospital down the road, all of those amounts could be different for each of us. In fact it could be a different payment schedule between the BCBS PPO policy and the HMO one.

 

[Dezbelief]

Luigi Mangione was ID’d by San Francisco cops days before alleged UnitedHealthcare CEO killer was arrested: report

Mangione’s face was known to cops in California because he’d been reported missing by his family just weeks earlier on Nov. 18, the sources added.

nypost.com

 

[Dezbelief]

UnitedHealthcare CEO killing latest: Suspect not member of UnitedHealthcare, company says

Prosecutors at the Manhattan District Attorney's Office have begun presenting evidence to a grand jury as they work to secure an indictment against Luigi Mangione.

www.google.com

 

[matttyl]

Grocery stores have more space for processed foods vs Whole Foods because more individuals are making the choice to buy processed foods. If more people purchased whole food rather than processed foods, the grocery stores would have to provide more floor space for it. They are a business after all.

As to the obesity example - you’re blaming the advertising of the pharmaceutical company if I’m reading you correctly. To me, that’s not the health care (provider) company - nor is it the health insurance company.

ETA - sounds like a lot of assigning blame not on the individuals making their own choices (and consequences of those choices), and placing it on other targets (who might be easy to point at, granted).

People buy processed foods because the are cheaper (subsidies) and addidictive (Big Food). Food companies pay for shelf space.

In the 1980s, R.J. Reynolds and Philip Morris, another tobacco company, acquired several major food companies, including Kraft and General Foods. These acquisitions gave tobacco companies a large share of the American food supply and allowed them to make billions of dollars in sales.

A study found that foods owned by tobacco companies were more likely to contain high levels of carbs, sodium, and fat. The study also found that tobacco companies used the same colors and flavors they developed for cigarettes to create popular children's beverage brands, such as Kool-Aid, Hawaiian Punch, Capri Sun, and Tang

The food industry is by no means innocent, I’m not trying to argue that they are. My point is that we (as individuals) have a choice. We have lots of choices, far more than just about any human has had, ever.

I can tell you one choice I don't seem to have - a family health insurance plan that doesn't cost $1K/month+ and still spend $1000s on health costs a year.

First, I totally get where you’re coming from, but You can choose to go uninsured. I wouldn’t recommend it. I have clients/prospects who do just that, purposely. (And I don’t mean to get personal with you specifically with this, but depending on your or your spouse’s skill set, you could choose to work for an employer that provides better coverage or a lower premium plan, or both - it was a very large deciding factor for my wife in her last job search).

Yes, I get I have a choice: expensive, subpar insurance or no insurance.

And yes, we made choices in our careers. I work part time (used to be stay at home dad), and she is a vet. We made that choice so somebody could be home more for the kids. What you are getting at is something else that I think is a terrible system - making the insurance tied to work. It is pretty messed up that people have to make that choice. I know too many people detesting where they work and are miserable because they had to get better insurance or their spouse's changed and got too expensive. She now works for a more regional company as a relief vet for the area. It is slightly better insurance because it's a bigger company, but we just submitted those forms and our insurance is about $1200/month, and that is just medium tier with probably too high of deductibles for us, but that's where we are at. It's not uncommon for our health bills (premium + OoP) to approach $20K in a year. Again, outrageous. I fully understand the hatred people have for the system and insurance companies.

First off, thank you for sharing. I didn’t mean for you to get into your personal story, but I do thank you for doing so. I agree with a lot of what you’re saying here.

I will say that if we did de-couple health insurance from employers/employment (without something also happening in conjunction with it), the uninsured rate would skyrocket. Said another way, a huge percentage of our population has coverage only because of their employment, and wouldn’t obtain it on their own if it wasn’t.

As for the $20k a year - yeah, I get it. In the individual market, if you don’t receive a subsidy, it’s not out of the question for a 60 year old to be paying g $1k a month in premiums alone, before the first claim. $20k all in for a family of 4+? That’s Im sure what my family of three is at as well, if you account for the portion my and my wife’s employer pays towards the coverage they provide. Why is that? Because the appendectomy is $30k.

Again, thank you for sharing - I didn’t mean to “get personal” or anything.

Not that I doubt you, as you are obviously in the know here. Just curious what you base the bolded on. I would think that more competition and detaching it from the workplace would drop prices a bit and give people more choices and flexibility. Or at the very least get them the insurance and doctors they WANT for the same price instead of just whatever package their employer decided to offer.

To piggyback on my other response to this, a few other quick facts. Recent stat is that 56% of Americans can’t come up with $1k for an emergency. A quarter of folks don’t even get their full retirement match from their employer (free money). 72% don’t have a fully funded emergency fund (defined as 3-6 months of exp lenses in cash). 47% of adult credit card holders carried a balance last year.

So if we’d did de-couple coverage from employment, and even if the “money saved” by employers did fully trickle down to the employees, do you really think they’d all then use that money to buy health insurance for themselves and their families?

 

[RCon]

So if we’d did de-couple coverage from employment, and even if the “money saved” by employers did fully trickle down to the employees, do you really think they’d all then use that money to buy health insurance for themselves and their families?

Without a mandate of some kind? Of course not. I don't think anyone is credibly arguing that would happen.

That said, coupling health insurance to employment has lots of negatives for workers.

 

[Terminalxylem]

The problem isn't a lack of nutritional knowledge or advice in the medical community.

The problem is that many (most?) people choose to ignore this advice. Or even common sense (e.g. consume more calories than you burn = weight gain)

I'd suggest this is PART of the problem. I know many here want this to be an either/or situation. It's not. It's a both/and situation. We need to address both sides of this. We need to figure out how to educate people in a way that they make the right decisions while also removing the forces that are directly/indirectly telling them to do otherwise.

Avoid salt, sugar and fatty foods. Balance your intake of meats, carbs and vegetables. Don't eat too much. Whole foods are better than processed foods.

That's going to solve 90% of so-called "nutritional" problems.

It's not rocket science

While I agree with your general premise, sentence two is off-base imo, which just illustrates how complex the problem is. Pop science has blurred the message of general nutrition, and the science itself is conflicting/challenging to interpret.

Anyway, that’s certainly waaaay off topic, so I’ll leave it at that.

 

[Terminalxylem]

With that said, I'd also be fine with weighing out restricting or eliminating pharmaceutical ads on television the way other countries do.

A related effect would be the catastrophic impact on media revenue and that moves into a different conversation as well.

The ads on NFL games are for diseases that impact such a tiny subset of people. How is that even a good idea? I get the Ozempic-type ads, and the viagra ads, but some funky skin conditions impacting like 1/10000 to 1/50000 people, how does this even make sense to do?

I'd guess because they cost a lot and/or are highly profitable. You can spend a lot on finding the needle in the haystack if the needle is worth a lot.

Yep. And despite the perception that scores of doctors are “getting paid” to prescribe, those ads are targeting patients.

 

[matttyl]

So if we’d did de-couple coverage from employment, and even if the “money saved” by employers did fully trickle down to the employees, do you really think they’d all then use that money to buy health insurance for themselves and their families?

Without a mandate of some kind? Of course not. I don't think anyone is credibly arguing that would happen.

That said, coupling health insurance to employment has lots of negatives for workers.

I was responding to the question of why I thought if we did decouple the health insurance/employment connection that the uninsured rate would skyrocket. He referred to that connection being a terrible system. It’s not perfect, but it’s what we have built, and if we did away with it (without something else in its place like single payer or Medicare for all), the uninsured rate would spike overnight.

It also has some advantages for workers, too. Generally employment based coverage is stronger than anything available in the individual markets (far more PPO/larger network options, lower deductible/OOPs). Also, I believe in most places by law, the employer must pay a minimum of 50% of the employee only cost (they can pass the dependent cost on to the employee). Lastly, unless counting subsides, employer based coverage tends to be less expensive than individual policies (as in total cost, before the employer/employee split).

 

[the moops]

I hate that insurance is coupled with employment, but love that my employer covers the full premium for me and my family.

I am so conflicted!

 

[KarmaPolice]

Grocery stores have more space for processed foods vs Whole Foods because more individuals are making the choice to buy processed foods. If more people purchased whole food rather than processed foods, the grocery stores would have to provide more floor space for it. They are a business after all.

As to the obesity example - you’re blaming the advertising of the pharmaceutical company if I’m reading you correctly. To me, that’s not the health care (provider) company - nor is it the health insurance company.

ETA - sounds like a lot of assigning blame not on the individuals making their own choices (and consequences of those choices), and placing it on other targets (who might be easy to point at, granted).

People buy processed foods because the are cheaper (subsidies) and addidictive (Big Food). Food companies pay for shelf space.

In the 1980s, R.J. Reynolds and Philip Morris, another tobacco company, acquired several major food companies, including Kraft and General Foods. These acquisitions gave tobacco companies a large share of the American food supply and allowed them to make billions of dollars in sales.

A study found that foods owned by tobacco companies were more likely to contain high levels of carbs, sodium, and fat. The study also found that tobacco companies used the same colors and flavors they developed for cigarettes to create popular children's beverage brands, such as Kool-Aid, Hawaiian Punch, Capri Sun, and Tang

The food industry is by no means innocent, I’m not trying to argue that they are. My point is that we (as individuals) have a choice. We have lots of choices, far more than just about any human has had, ever.

I can tell you one choice I don't seem to have - a family health insurance plan that doesn't cost $1K/month+ and still spend $1000s on health costs a year.

First, I totally get where you’re coming from, but You can choose to go uninsured. I wouldn’t recommend it. I have clients/prospects who do just that, purposely. (And I don’t mean to get personal with you specifically with this, but depending on your or your spouse’s skill set, you could choose to work for an employer that provides better coverage or a lower premium plan, or both - it was a very large deciding factor for my wife in her last job search).

Yes, I get I have a choice: expensive, subpar insurance or no insurance.

And yes, we made choices in our careers. I work part time (used to be stay at home dad), and she is a vet. We made that choice so somebody could be home more for the kids. What you are getting at is something else that I think is a terrible system - making the insurance tied to work. It is pretty messed up that people have to make that choice. I know too many people detesting where they work and are miserable because they had to get better insurance or their spouse's changed and got too expensive. She now works for a more regional company as a relief vet for the area. It is slightly better insurance because it's a bigger company, but we just submitted those forms and our insurance is about $1200/month, and that is just medium tier with probably too high of deductibles for us, but that's where we are at. It's not uncommon for our health bills (premium + OoP) to approach $20K in a year. Again, outrageous. I fully understand the hatred people have for the system and insurance companies.

First off, thank you for sharing. I didn’t mean for you to get into your personal story, but I do thank you for doing so. I agree with a lot of what you’re saying here.

I will say that if we did de-couple health insurance from employers/employment (without something also happening in conjunction with it), the uninsured rate would skyrocket. Said another way, a huge percentage of our population has coverage only because of their employment, and wouldn’t obtain it on their own if it wasn’t.

As for the $20k a year - yeah, I get it. In the individual market, if you don’t receive a subsidy, it’s not out of the question for a 60 year old to be paying g $1k a month in premiums alone, before the first claim. $20k all in for a family of 4+? That’s Im sure what my family of three is at as well, if you account for the portion my and my wife’s employer pays towards the coverage they provide. Why is that? Because the appendectomy is $30k.

Again, thank you for sharing - I didn’t mean to “get personal” or anything.

Not that I doubt you, as you are obviously in the know here. Just curious what you base the bolded on. I would think that more competition and detaching it from the workplace would drop prices a bit and give people more choices and flexibility. Or at the very least get them the insurance and doctors they WANT for the same price instead of just whatever package their employer decided to offer.

To piggyback on my other response to this, a few other quick facts. Recent stat is that 56% of Americans can’t come up with $1k for an emergency. A quarter of folks don’t even get their full retirement match from their employer (free money). 72% don’t have a fully funded emergency fund (defined as 3-6 months of exp lenses in cash). 47% of adult credit card holders carried a balance last year.

So if we’d did de-couple coverage from employment, and even if the “money saved” by employers did fully trickle down to the employees, do you really think they’d all then use that money to buy health insurance for themselves and their families?

Yes, I did. I guess I look at it differently. All of those things you listed to me are separate and different decision points. For example, I don't check all those boxes but we do have health insurance. Unless employers require people to have health insurance, we are already talking about people who are choosing to have it vs. go uninsured. So from my POV for people choosing to be insured a better option would be that same insurance not tied to their employer so they have more choices about their employment - like I said, I know too many people who are at a crap job just for the insurance - they want it/need it, it's just tied to a job they hate. Even better option would be to have more competition, lower prices, and not tied to employment. I am not holding my breath for any of that to happen, just trying to explain my thoughts when making that post.

 

[matttyl]

They are “choosing” to have it because the employer is funding much if not nearly all of it. They wouldn’t be able to afford it if that weren’t the case.

 

[GoBirds]

Grocery stores have more space for processed foods vs Whole Foods because more individuals are making the choice to buy processed foods. If more people purchased whole food rather than processed foods, the grocery stores would have to provide more floor space for it. They are a business after all.

As to the obesity example - you’re blaming the advertising of the pharmaceutical company if I’m reading you correctly. To me, that’s not the health care (provider) company - nor is it the health insurance company.

ETA - sounds like a lot of assigning blame not on the individuals making their own choices (and consequences of those choices), and placing it on other targets (who might be easy to point at, granted).

People buy processed foods because the are cheaper (subsidies) and addidictive (Big Food). Food companies pay for shelf space.

In the 1980s, R.J. Reynolds and Philip Morris, another tobacco company, acquired several major food companies, including Kraft and General Foods. These acquisitions gave tobacco companies a large share of the American food supply and allowed them to make billions of dollars in sales.

A study found that foods owned by tobacco companies were more likely to contain high levels of carbs, sodium, and fat. The study also found that tobacco companies used the same colors and flavors they developed for cigarettes to create popular children's beverage brands, such as Kool-Aid, Hawaiian Punch, Capri Sun, and Tang

The food industry is by no means innocent, I’m not trying to argue that they are. My point is that we (as individuals) have a choice. We have lots of choices, far more than just about any human has had, ever.

I can tell you one choice I don't seem to have - a family health insurance plan that doesn't cost $1K/month+ and still spend $1000s on health costs a year.

First, I totally get where you’re coming from, but You can choose to go uninsured. I wouldn’t recommend it. I have clients/prospects who do just that, purposely. (And I don’t mean to get personal with you specifically with this, but depending on your or your spouse’s skill set, you could choose to work for an employer that provides better coverage or a lower premium plan, or both - it was a very large deciding factor for my wife in her last job search).

Yes, I get I have a choice: expensive, subpar insurance or no insurance.

And yes, we made choices in our careers. I work part time (used to be stay at home dad), and she is a vet. We made that choice so somebody could be home more for the kids. What you are getting at is something else that I think is a terrible system - making the insurance tied to work. It is pretty messed up that people have to make that choice. I know too many people detesting where they work and are miserable because they had to get better insurance or their spouse's changed and got too expensive. She now works for a more regional company as a relief vet for the area. It is slightly better insurance because it's a bigger company, but we just submitted those forms and our insurance is about $1200/month, and that is just medium tier with probably too high of deductibles for us, but that's where we are at. It's not uncommon for our health bills (premium + OoP) to approach $20K in a year. Again, outrageous. I fully understand the hatred people have for the system and insurance companies.

First off, thank you for sharing. I didn’t mean for you to get into your personal story, but I do thank you for doing so. I agree with a lot of what you’re saying here.

I will say that if we did de-couple health insurance from employers/employment (without something also happening in conjunction with it), the uninsured rate would skyrocket. Said another way, a huge percentage of our population has coverage only because of their employment, and wouldn’t obtain it on their own if it wasn’t.

As for the $20k a year - yeah, I get it. In the individual market, if you don’t receive a subsidy, it’s not out of the question for a 60 year old to be paying g $1k a month in premiums alone, before the first claim. $20k all in for a family of 4+? That’s Im sure what my family of three is at as well, if you account for the portion my and my wife’s employer pays towards the coverage they provide. Why is that? Because the appendectomy is $30k.

Again, thank you for sharing - I didn’t mean to “get personal” or anything.

Not that I doubt you, as you are obviously in the know here. Just curious what you base the bolded on. I would think that more competition and detaching it from the workplace would drop prices a bit and give people more choices and flexibility. Or at the very least get them the insurance and doctors they WANT for the same price instead of just whatever package their employer decided to offer.

To piggyback on my other response to this, a few other quick facts. Recent stat is that 56% of Americans can’t come up with $1k for an emergency. A quarter of folks don’t even get their full retirement match from their employer (free money). 72% don’t have a fully funded emergency fund (defined as 3-6 months of exp lenses in cash). 47% of adult credit card holders carried a balance last year.

So if we’d did de-couple coverage from employment, and even if the “money saved” by employers did fully trickle down to the employees, do you really think they’d all then use that money to buy health insurance for themselves and their families?

Great points, I’d say the majority would not.

 

[KarmaPolice]

They are “choosing” to have it because the employer is funding much if not nearly all of it. They wouldn’t be able to afford it if that weren’t the case.

Part of your question included if the employer increased wages to offset. Yes, I agree if there is a $2k policy that only costs somebody $500 through work, they wouldn't stay insured if they had to pay all $2k without an increase in wages. That is not what I had in my head when answering and not how I read your post.

I realize my experience with this isn't what others is because career-wise I am not a typical FBGer, and my wife works for small clinics that also can't afford to get great policies. That is probably clouding my judgement and responses. I would be willing to bet the majority of FBGers have much better policies and experiences.

 

[KarmaPolice]

My larger point is that by tying it to employment people don't have much of a choice - they get what their employer offers (which in my experience is usually a crap option that costs too much) or they go uninsured. What I was getting at is that I know people that either take that and pay out the nose for health care or maybe find a job they hate that has good health care. I just find it to be an absurd system for the best country in the world. Consider yourself lucky if you have a job you love that has great, cheap health insurance. Too much power in the hands of the employers, and I am for putting more power and options in the hands of the employees.

 

[IvanKaramazov]

They are “choosing” to have it because the employer is funding much if not nearly all of it. They wouldn’t be able to afford it if that weren’t the case.

Part of your question included if the employer increased wages to offset. Yes, I agree if there is a $2k policy that only costs somebody $500 through work, they wouldn't stay insured if they had to pay all $2k without an increase in wages. That is not what I had in my head when answering and not how I read your post.

I realize my experience with this isn't what others is because career-wise I am not a typical FBGer, and my wife works for small clinics that also can't afford to get great policies. That is probably clouding my judgement and responses. I would be willing to bet the majority of FBGers have much better policies and experiences.

What you're describing strikes me as a serious problem in the health insurance market. I'm a state employee -- we have a bunch of people in "the system," so it's an easy one to underwrite. I completely believe that small businesses, start-ups, entrepreneurs, etc. have it much worse than I do because of the small number of people involved. The insurer can't rely on the law of large numbers when they're dealing with a clinic with 12 employees.

The other factor with getting insurance through your employer is that you lose your health insurance if you lose your job, which is perverse. That's bad policy design. I get what @matttyl is saying, but it would be nice if we could decouple these.

 

[matttyl]

They are “choosing” to have it because the employer is funding much if not nearly all of it. They wouldn’t be able to afford it if that weren’t the case.

Part of your question included if the employer increased wages to offset. Yes, I agree if there is a $2k policy that only costs somebody $500 through work, they wouldn't stay insured if they had to pay all $2k without an increase in wages. That is not what I had in my head when answering and not how I read your post.

I realize my experience with this isn't what others is because career-wise I am not a typical FBGer, and my wife works for small clinics that also can't afford to get great policies. That is probably clouding my judgement and responses. I would be willing to bet the majority of FBGers have much better policies and experiences.

What you're describing strikes me as a serious problem in the health insurance market. I'm a state employee -- we have a bunch of people in "the system," so it's an easy one to underwrite. I completely believe that small businesses, start-ups, entrepreneurs, etc. have it much worse than I do because of the small number of people involved. The insurer can't rely on the law of large numbers when they're dealing with a clinic with 12 employees.

The other factor with getting insurance through your employer is that you lose your health insurance if you lose your job, which is perverse. That's bad policy design. I get what @matttyl is saying, but it would be nice if we could decouple these.

To your first paragraph, that went away with the ACA. There is no more “underwriting”. The clinic would be throw into a much larger group with every other small employer with that carrier in that state. They aren’t underwritten and not rated any different than any other small group. The rates are set in stone. The issue that smaller employers have, though, is that they generally offer weaker plans compared to larger ones, and they don’t pay as much of it. My wife’s last employer was smaller and they paid like 69% of her coverage and none towards our son (so he was on my employer plan). Her new employer is larger and pays pretty much all of hers and a huge chunk towards him (which kinda gave me a raise in pay once I removed him).

As to the second paragraph, if you lose your job (with a large employer, 20+ ee’s), then you’re offered COBRA continuation coverage (ability to continue on the exact same plan) for up to 18 months. Most people reject that offer of COBRA due to cost, but what they rarely realize is that it’s the same cost it was before, just now without the employer subsidizing it. People are floored when they hear the cost - which goes back to my statement that people wouldn’t pay for coverage independently (at such a high rate) if it wasn’t connected to their employer.

 

[KarmaPolice]

They are “choosing” to have it because the employer is funding much if not nearly all of it. They wouldn’t be able to afford it if that weren’t the case.

Part of your question included if the employer increased wages to offset. Yes, I agree if there is a $2k policy that only costs somebody $500 through work, they wouldn't stay insured if they had to pay all $2k without an increase in wages. That is not what I had in my head when answering and not how I read your post.

I realize my experience with this isn't what others is because career-wise I am not a typical FBGer, and my wife works for small clinics that also can't afford to get great policies. That is probably clouding my judgement and responses. I would be willing to bet the majority of FBGers have much better policies and experiences.

What you're describing strikes me as a serious problem in the health insurance market. I'm a state employee -- we have a bunch of people in "the system," so it's an easy one to underwrite. I completely believe that small businesses, start-ups, entrepreneurs, etc. have it much worse than I do because of the small number of people involved. The insurer can't rely on the law of large numbers when they're dealing with a clinic with 12 employees.

The other factor with getting insurance through your employer is that you lose your health insurance if you lose your job, which is perverse. That's bad policy design. I get what @matttyl is saying, but it would be nice if we could decouple these.

This also doesn't take into consideration other things that we have encountered such as an employer changing insurance to a lesser one without much notice and usually any increase in insurance results in it coming out of the employee's end and/or reduction of other bonuses or benefits. Again, back to my point of way too much power on the employer's end of the equation.

 

[culdeus]

With that said, I'd also be fine with weighing out restricting or eliminating pharmaceutical ads on television the way other countries do.

A related effect would be the catastrophic impact on media revenue and that moves into a different conversation as well.

The ads on NFL games are for diseases that impact such a tiny subset of people. How is that even a good idea? I get the Ozempic-type ads, and the viagra ads, but some funky skin conditions impacting like 1/10000 to 1/50000 people, how does this even make sense to do?

I'd guess because they cost a lot and/or are highly profitable. You can spend a lot on finding the needle in the haystack if the needle is worth a lot.

This is maybe one of those things that people nod along to and say "well if they put it on tv they must be smart". Same concept as "if it got you talking about it that was the goal" but I wonder if either of those are true for these ads. I couldn't even tell you what half the diseases are they are treating and even if I had a mild form of non-hodgkins tuberculosis type 4 they cover the sickness so fast that you might not even hear it. The game last night ran three of these in a row.

 

[uwillbsoon]

With that said, I'd also be fine with weighing out restricting or eliminating pharmaceutical ads on television the way other countries do.

A related effect would be the catastrophic impact on media revenue and that moves into a different conversation as well.

The ads on NFL games are for diseases that impact such a tiny subset of people. How is that even a good idea? I get the Ozempic-type ads, and the viagra ads, but some funky skin conditions impacting like 1/10000 to 1/50000 people, how does this even make sense to do?

I'd guess because they cost a lot and/or are highly profitable. You can spend a lot on finding the needle in the haystack if the needle is worth a lot.

This is maybe one of those things that people nod along to and say "well if they put it on tv they must be smart". Same concept as "if it got you talking about it that was the goal" but I wonder if either of those are true for these ads. I couldn't even tell you what half the diseases are they are treating and even if I had a mild form of non-hodgkins tuberculosis type 4 they cover the sickness so fast that you might not even hear it. The game last night ran three of these in a row.

If you were suffering from the disease and heard it, you'd pay attention.

 

[uwillbsoon]

UnitedHealth's Optum left an AI chatbot, used by employees to ask questions about claims, exposed to the internet | TechCrunch

Optum's AI chatbot was found exposed online at a time when the healthcare giant faces scrutiny for its use of AI to allegedly deny patient claims.

techcrunch.com

In the realm of healthcare’s grand domain
Where policies and rules often constrain
A claim arrives, seeking its due
But alas, its fate is to bid adieu.

The provider hopes, with earnest plea,
For payment on a service spree,
Yet scrutiny reveals the tale,
And reasons for denial prevail.

 

[Uruk-Hai]

As to the second paragraph, if you lose your job (with a large employer, 20+ ee’s), then you’re offered COBRA continuation coverage (ability to continue on the exact same plan) for up to 18 months. Most people reject that offer of COBRA due to cost, but what they rarely realize is that it’s the same cost it was before, just now without the employer subsidizing it.

EDIT: I posted under a misunderstanding on my part on how this works. I'm gonna delete the rest of what I typed since it's wrong.

 

[matttyl]

As to the second paragraph, if you lose your job (with a large employer, 20+ ee’s), then you’re offered COBRA continuation coverage (ability to continue on the exact same plan) for up to 18 months. Most people reject that offer of COBRA due to cost, but what they rarely realize is that it’s the same cost it was before, just now without the employer subsidizing it.

I'm retiring at the end of the year and am 2 years out from Medicare. I'm using COBRA as a bridge for a month or two to give myself time to work through the available plans. I've got too much other time-sensitive stuff I want/need to get done by the end of December. The COBRA cost is steep, but it's short-term and affords me some peace of mind that I don't have to rush a decision.

To be honest, I didn't see much surface-cost difference between COBRA and what's in the marketplace. But I haven't done an apples-to-apples comparison yet and may be way off on that thinking.

You’re in Va, so you know I’m happy to help. This might not be the best plan, as you can’t just choose to drop COBRA to go to the individual market (choosing to drop cobra isn’t a “qualifying event”). The EXPIRATION of cobra is, which is 18 months down the road.

So either shift to an individual plan now (effective 1/1), or keep cobra for the entirety of 2025 and plan to shift to an individual plan in 2026.

ETA - when I say “now” above, I mean it. Open enrollment ends tomorrow (for plans to start 1/1 in the individual market - you have until 1/15/25 to sign up for coverage effective 2/1/25).

 

[GroveDiesel]

So if we’d did de-couple coverage from employment, and even if the “money saved” by employers did fully trickle down to the employees, do you really think they’d all then use that money to buy health insurance for themselves and their families?

Without a mandate of some kind? Of course not. I don't think anyone is credibly arguing that would happen.

That said, coupling health insurance to employment has lots of negatives for workers.

I was responding to the question of why I thought if we did decouple the health insurance/employment connection that the uninsured rate would skyrocket.

Well, unless it changed to single payer of course.

 

[Uruk-Hai]

As to the second paragraph, if you lose your job (with a large employer, 20+ ee’s), then you’re offered COBRA continuation coverage (ability to continue on the exact same plan) for up to 18 months. Most people reject that offer of COBRA due to cost, but what they rarely realize is that it’s the same cost it was before, just now without the employer subsidizing it.

I'm retiring at the end of the year and am 2 years out from Medicare. I'm using COBRA as a bridge for a month or two to give myself time to work through the available plans. I've got too much other time-sensitive stuff I want/need to get done by the end of December. The COBRA cost is steep, but it's short-term and affords me some peace of mind that I don't have to rush a decision.

To be honest, I didn't see much surface-cost difference between COBRA and what's in the marketplace. But I haven't done an apples-to-apples comparison yet and may be way off on that thinking.

You’re in Va, so you know I’m happy to help. This might not be the best plan, as you can’t just choose to drop COBRA to go to the individual market (choosing to drop cobra isn’t a “qualifying event”). The EXPIRATION of cobra is, which is 18 months down the road.

So either shift to an individual plan now (effective 1/1), and keep cobra for the entirety of 2025 and plan to shift to an individual plan in 2026.

ETA - when I say “now” above, I mean it. Open enrollment ends tomorrow (for plans to bring 1/1 in the individual market - you have until 1/15/25 to sign up for coverage effective 2/1/25).

I apparently misunderstood what I was told. Shot you a PM so as not to clutter up this thread with me spouting incorrect information.

 

[SoBeDad]

The other factor with getting insurance through your employer is that you lose your health insurance if you lose your job, which is perverse. That's bad policy design. I get what @matttyl is saying, but it would be nice if we could decouple these.

Add on the time it takes to get a new job, plus the typical 90 day waiting period in Florida for the new insurance to kick in and many individuals have a big gap in health insurance coverage. I work in a hospital and lower paid employees such as medical assistants wait 90 days for coverage, but highly paid administrators, who usually have COBRA from a prior job, get coverage on day 1.

We have a medical assistant who is a "navigator" for the new expensive anti-amyloid infusion drugs for treating Alzheimer's Disease. To qualify for treatment, an expensive PET scan or cheaper spinal tap is needed to prove the presence of a high level of amyloid in the brain. Most patients prefer the less invasive PET scans, which our medical assistant said United Medicare Advantage was denying. Until last week. Coincidence?

 

[matttyl]

The other factor with getting insurance through your employer is that you lose your health insurance if you lose your job, which is perverse. That's bad policy design. I get what @matttyl is saying, but it would be nice if we could decouple these.

Add on the time it takes to get a new job, plus the typical 90 day waiting period in Florida for the new insurance to kick in and many individuals have a big gap in health insurance coverage. I work in a hospital and lower paid employees such as medical assistants wait 90 days for coverage, but highly paid administrators, who usually have COBRA from a prior job, get coverage on day 1.

We have a medical assistant who is a "navigator" for the new expensive anti-amyloid infusion drugs for treating Alzheimer's Disease. To qualify for treatment, an expensive PET scan or cheaper spinal tap is needed to prove the presence of a high level of amyloid in the brain. Most patients prefer the less invasive PET scans, which our medical assistant said United Medicare Advantage was denying. Until last week. Coincidence?

Huh, I would have guessed the PET would have been cheaper than the spinal tap (which they called a “lumbar puncture” when my son had to have them). That took a pediatric anesthesiologist, and quite a few doctors and nurses and what seemed to be a lot of expensive medical equipment.

To your insurance related stuff above, everyone has a cobra offer between jobs (assuming they worked for a company with 20+ employees). That’s generally the best choice to avoid having the gap in coverage you’re referring to, it’s just that most people don’t take the cobra offer thinking it’s too expensive. (But again, it’s the same price it’s always been).

 

[SoBeDad]

Huh, I would have guessed the PET would have been cheaper than the spinal tap (which they called a “lumbar puncture” when my son had to have them). That took a pediatric anesthesiologist, and quite a few doctors and nurses and what seemed to be a lot of expensive medical equipment.

A spinal tap in our center for older adults requires a doc or NP/PA and assistant and the lab work. The procedure takes about 15-30 minutes. Plus a wait to check for leaks and a follow-up phone call. Kids must be more challenging.

An amyloid PET scan requires a certified technologist and up to 2 hours including the injection of a radioactive tracer, waiting for uptake and scanning. The amyloid tracers are expensive, a 2-hour half live, delivered via currier from few production centers. Plus a radiologist read. The demand for PET scans has increased primarily due to new tracers for cancers, but these new anti-amyloid drugs will also increase demand. New PET scan centers are popping up every month in south Florida. We have limited unrestricted funds to pay for PET scans. We just re-priced them from $2,700 to $4,3000.

Another tangent: the elderly are a large and powerful lobby. These anti-anyloid drugs have only a small clinically meaningful benefit in slowing down (not reversing) Alzheimer's Disease, and the expense includes a baseline PET scan, multiple MRI scans to monitor a common serious side effect. The first anti-amyloid drug Aducanumab, was approved prematurely by the FDA in 2021 (but not covered by CMS) due to intense lobbying by groups like the Alzheimer's Association. That drug removed amyloid from the brain but didn't show definite efficacy on functional metrics. CMS made the right decision. The 2 new drugs (Leqembi & Kisunla) remove amyloid and show a small benefit in delaying cognitive & functional decline. CMS is on board. The drugs cost about $26,000 per year. TBD is when to stop the drugs once amyloid levels drop.

lt's early days, these are baby steps. Consistent with the discussion above, personal habits seem to reduce risk and delay the onset of the symptoms of Alzheimer's, but genetics (Apoe gene) play a major role. There are accurate blood-based biomarkers for amyloid; when they get FDA approval for general use in primary care (maybe next year) the market for these expensive drugs will surge.

 

[Ministry of Pain]

After some time to reflect on all of this and at the mercy of those who view it as I mostly do, cold blooded killer/murder...
-I was moved when they brought him into jail in the orange jumpsuit
I DO NOT CONDONE this man's violent and cowardly act and taking a life based on vigilante justice
At the same time, what an opportunity to study and get inside the head of the killer so maybe we can curtail future violence

You could see instantly the pain from which this violence erupted when they pushed him inside the jail/court
Do I feel sorry for the arrested suspect? No I do not but I can clearly see that something evil triggered this abominable act he decided to embark on
I wish he would have channeled his energy and emotions into something more like a weekly podcast that hammers the health insurance industry
My guess, those podcasts likely exist already since they have a podcast now for almost every walk of life or vertical in a capitalistic society

-I hope we can learn and grow. This killer will likely spend the rest of their lives behind bars, what a waste of an intelligent mind that should have been used for the good of mankind
I was happy they made the arrest and then when I saw him trying to speak out as he was being arrested, I started wrestling with some things and I was curious if anyone else felt that
I want to know what happened to lead him down this road. We may never know and the immediate superficial theories I have read, don't hold water IMO

 

[matttyl]

…and someone will have to pay for it. At $26k a year. Is that justifiable? It’s not for me to say yes or no, but when people complain about the cost of health insurance - look at the cost of the drugs that it’s (potentially) covering. On average, roughly a quarter of every health insurance premium dollar spent is going directly to pay for Rx. Not doctors, not hospitals, not insurance CEO bonuses - directly for drugs.

 

[uwillbsoon]

…and someone will have to pay for it. At $26k a year. Is that justifiable? It’s not for me to say yes or no, but when people complain about the cost of health insurance - look at the cost of the drugs that it’s (potentially) covering. On average, roughly a quarter of every health insurance premium dollar spent is going directly to pay for Rx. Not doctors, not hospitals, not insurance CEO bonuses - directly for drugs.

And all the major insurers own PBMs that serve as a middleman making money off those drugs .

There was a bipartisan bill released this week to force insurers to divest their PBMs. Doubt anything will come of it, though.

 

[TripItUp]

There was a bipartisan bill released this week to force insurers to divest their PBMs. Doubt anything will come of it, though.

the middlemen should be completely cut out.

 

[Judge Smails]

I’ve worked in the healthcare software business all my life. While a great career, the promise of fixing a broken system has never been realized. One of my bigger regrets. We were supposed to go to value based care vs fee for service a long time ago. Focus on preventative health and better outcomes. Never happened en masse. System is ripe with fraud. At one point more MRI’s in Miami Dade county than the rest of the country. And insurance companies making money hand over fist. PBM’s too. Pharma. All of those middlemen need to be gone and we need to go to single carrier. But it won’t happen. The lobbyists and $$ are too powerful.

 

[fatness]

You could see instantly the pain from which this violence erupted when they pushed him inside the jail/court

His (first) lawyer addressed that, saying Mangione's outburst was mostly due to having no legal representation.

Dickey said Mangione’s anger was in part because of his lack of legal representation until that moment. After the lawyer and Mangione met, his demeanor changed, Dickey told CNN. “Look at the difference between when he went in and when he came out, once he … finally had legal representation and now he has a spokesperson and someone that’s going to fight for him.”

 

[Dezbelief]

Public donations for Luigi Mangione’s ‘defense fund’ surpass $100,000

The anonymous fundraiser for Luigi Mangione had surpassed more than $100,000 by Sunday

www.independent.co.uk

The anonymous fund “December 4th Legal Committee” surpassed more than $100,000 in donations on the crowdfunding website GiveSendGo by Sunday morning.

 

[Terminalxylem]

The other factor with getting insurance through your employer is that you lose your health insurance if you lose your job, which is perverse. That's bad policy design. I get what @matttyl is saying, but it would be nice if we could decouple these.

Add on the time it takes to get a new job, plus the typical 90 day waiting period in Florida for the new insurance to kick in and many individuals have a big gap in health insurance coverage. I work in a hospital and lower paid employees such as medical assistants wait 90 days for coverage, but highly paid administrators, who usually have COBRA from a prior job, get coverage on day 1.

We have a medical assistant who is a "navigator" for the new expensive anti-amyloid infusion drugs for treating Alzheimer's Disease. To qualify for treatment, an expensive PET scan or cheaper spinal tap is needed to prove the presence of a high level of amyloid in the brain. Most patients prefer the less invasive PET scans, which our medical assistant said United Medicare Advantage was denying. Until last week. Coincidence?

Huh, I would have guessed the PET would have been cheaper than the spinal tap (which they called a “lumbar puncture” when my son had to have them). That took a pediatric anesthesiologist, and quite a few doctors and nurses and what seemed to be a lot of expensive medical equipment.

To your insurance related stuff above, everyone has a cobra offer between jobs (assuming they worked for a company with 20+ employees). That’s generally the best choice to avoid having the gap in coverage you’re referring to, it’s just that most people don’t take the cobra offer thinking it’s too expensive. (But again, it’s the same price it’s always been).

Lumbar punctures are pretty easy in cooperative, thin patients. A internist can do it single-handedly*, with local anesthetic. All that is needed is a long hollow needle, and tubes to collect the spinal fluid.

PET scanners cost up to $500-$750K, require specialized techs to run them, and radiologists to interpret the results. It’s not surprising getting one isn’t cheap.

*To be fair, many internists have stopped doing procedures, due to time constraints, and lack of interest. They are often punted to interventional radiologists, who are among the highest compensated physicians. Even though their level of expertise is probably unnecessary 90% of the time, nobody cares about the added expense, because both patients and providers are so detached from the cost of healthcare.

ETA @SoBeDad beat me to it

 

[Navin Johnson]

One reason people consume processed versus healthier choices is cost, with healthier choices being significantly more expensive.

And if you don't have FBGs money, choosing the healthy option might not even be an option for you.

Okay, so you are correct that processed foods generally -- broadly speaking -- cost more less than healthy foods. That is true, but of course, that also has nothing whatsoever to do with the health insurance industry or your provider. It certainly doesn't justify assassinating anybody who works at UHC.

To your second point, let's be real here. People don't eat junk food because they're poor, or because they don't know any better. They eat junk food because junk food tastes good and broccoli doesn't. It's entirely an issue of personal choice. Maybe it's different for people below the poverty level or something, but the average American is overweight and poorly-nourished because they chose that. You have agency, and what you choose to eat is in your locus of control.

Edit: Whoops.

Many people prefer the taste of broccoli to junk food (i would be one), people get used to the foods they eat when they're young, if they're raised on crappy food they'll be more likely to continue to eat it. I do think many people are poorly educated on proper nutrition and that's a factor. Also cooking healthy meals takes time vs. buying processed meals. Some people may have the time but many people are just lazy.

Broccoli baked with a little olive oil and pepper is delicious, as good as French fries imo.

It and Brussels sprouts are staples in our diet, things I rarely ate growing up - I was a latchkey kid, raised on fast food and tv dinners. Though it requires some effort, it’s amazing how malleable the palate can be.

Cauliflower. Cook in air fryer with a little olive oil. Add a little salt, pepper and a bit more Tajin. Thank me later.

how long do you cook for? pretty green with the air fryer here

 

[djmich]

One reason people consume processed versus healthier choices is cost, with healthier choices being significantly more expensive.

And if you don't have FBGs money, choosing the healthy option might not even be an option for you.

Okay, so you are correct that processed foods generally -- broadly speaking -- cost more less than healthy foods. That is true, but of course, that also has nothing whatsoever to do with the health insurance industry or your provider. It certainly doesn't justify assassinating anybody who works at UHC.

To your second point, let's be real here. People don't eat junk food because they're poor, or because they don't know any better. They eat junk food because junk food tastes good and broccoli doesn't. It's entirely an issue of personal choice. Maybe it's different for people below the poverty level or something, but the average American is overweight and poorly-nourished because they chose that. You have agency, and what you choose to eat is in your locus of control.

Edit: Whoops.

Many people prefer the taste of broccoli to junk food (i would be one), people get used to the foods they eat when they're young, if they're raised on crappy food they'll be more likely to continue to eat it. I do think many people are poorly educated on proper nutrition and that's a factor. Also cooking healthy meals takes time vs. buying processed meals. Some people may have the time but many people are just lazy.

Broccoli baked with a little olive oil and pepper is delicious, as good as French fries imo.

It and Brussels sprouts are staples in our diet, things I rarely ate growing up - I was a latchkey kid, raised on fast food and tv dinners. Though it requires some effort, it’s amazing how malleable the palate can be.

Cauliflower. Cook in air fryer with a little olive oil. Add a little salt, pepper and a bit more Tajin. Thank me later.

how long do you cook for? pretty green with the air fryer here

12 minutes, 370-380 degrees.

 

[Max Power]

I don't understand the thinking or media coverage of the "but" angle. Where someone influential can say this was a tragedy and they don't support violence, but Americans are upset and its time to have a conversation about healthcare. It's like there is an implication that if you use this event to spark a conversation, you're condoning the shooter's actions.

I'm of the belief that if you can see public sentiment brewing, ignoring it isn't the answer.

 

[Mister CIA]

The SAP commercials airing during NFL broadcasts are not good.

 

[thecatch]

I don't understand the thinking or media coverage of the "but" angle. Where someone influential can say this was a tragedy and they don't support violence, but Americans are upset and its time to have a conversation about healthcare. It's like there is an implication that if you use this event to spark a conversation, you're condoning the shooter's actions.

I'm of the belief that if you can see public sentiment brewing, ignoring it isn't the answer.

It creates a perverse incentive to use a murder as a vehicle to address the murderer's manifesto.

 

[Max Power]

I don't understand the thinking or media coverage of the "but" angle. Where someone influential can say this was a tragedy and they don't support violence, but Americans are upset and its time to have a conversation about healthcare. It's like there is an implication that if you use this event to spark a conversation, you're condoning the shooter's actions.

I'm of the belief that if you can see public sentiment brewing, ignoring it isn't the answer.

It creates a perverse incentive to use a murder as a vehicle to address the murderer's manifesto.

I get it, but is ignoring the perceived issues within our healthcare system the better solution?