from the ever-wonder-why-health-care-is-so-expensive dept.
Ever since her 14-year marriage imploded in financial chaos and a protective order, Amy Lankford had kept a wary eye on her ex, David Williams.
Williams, then 51, with the beefy body of a former wrestler gone slightly to seed, was always working the angles, looking for shortcuts to success and mostly stumbling. During their marriage, Lankford had been forced to work overtime as a physical therapist when his personal training business couldn't pay his share of the bills.
So, when Williams gave their three kids iPad Minis for Christmas in 2013, she was immediately suspicious. Where did he get that kind of money? Then one day on her son's iPad, she noticed numbers next to the green iMessage icon indicating that new text messages were waiting. She clicked.
What she saw next made her heart pound. Somehow the iPad had become linked to her ex-husband's personal Apple device and the messages were for him.
Most of the texts were from people setting up workouts through his personal training business, Get Fit With Dave, which he ran out of his home in Mansfield, Texas, a suburb of Fort Worth. But, oddly, they were also providing their birthdates and the group number of their health insurance plans. The people had health benefits administered by industry giants, including Aetna, Cigna and UnitedHealthcare. They were pleased to hear their health plans would now pay for their fitness workouts.
Lankford's mind raced as she scrolled through the messages. It appeared her ex-husband was getting insurance companies to pay for his personal training services. But how could that be possible? Insurance companies pay for care that's medically necessary, not sessions of dumbbell curls and lunges.
Insurance companies also only pay for care provided by licensed medical providers, like doctors or nurses. Williams called himself "Dr. Dave" because he had a Ph.D. in kinesiology. But he didn't have a medical license. He wasn't qualified to bill insurance companies. But, Lankford could see, he was doing it anyway.
As Lankford would learn, "Dr. Dave" had wrongfully obtained, with breathtaking ease, federal identification numbers that allowed him to fraudulently bill insurers as a physician for services to about 1,000 people. Then he battered the system with the bluntest of ploys: submit a deluge of out-of-network claims, confident that insurers would blindly approve a healthy percentage of them. Then, if the insurers did object, he gambled that they had scant appetite for a fight.
By the time the authorities stopped Williams, three years had passed since Lankford had discovered the text messages. In total, records show, he ran the scheme for more than four years, fraudulently billing several of the nation's top insurance companies — United, Aetna and Cigna — for $25 million and reaping about $4 million in cash.
Read the rest at ProPublica.
(Score: 5, Informative) by Rosco P. Coltrane on Sunday July 21 2019, @10:16AM (65 children)
a privatized health sector is Bad[tm]. I left the US for Europe 20 years ago, and I can tell you, that sort of shenanigans never happens here. And I pay less - if anything - for meds and visits to doctors and hospitals to boot...
When will Uncle Sam learn... Or more to the point, when will Americans rebel against unabashed raging capitalism destroying decency and common sense in community matters?
(Score: 2, Insightful) by The Mighty Buzzard on Sunday July 21 2019, @10:47AM (56 children)
I'm going to guess "never". You get to enjoy the quality of care you see today because "unabashed raging capitalism" dumps money by the truckload into medical research and development. The Soviet Union found out first hand what happens when you try to out innovate us unapologetic capitalists with top-down, communal idiocy. Apparently Europe either isn't bright enough to take a lesson or thinks we'll always be around to carry them while they play silly buggers.
My rights don't end where your fear begins.
(Score: 5, Insightful) by Rosco P. Coltrane on Sunday July 21 2019, @11:31AM (27 children)
You get to enjoy the quality of care you see today because "unabashed raging capitalism" dumps money by the truckload into medical research and development.
That's so naive it's almost cute...
The pharma industry dumps monye into whatever yields the best returns. So for instance, for cancer, malaria, AIDS or kidney failure, their priority is developing expensive meds that keep the patient alive but don't actually cure them - else the lucrative source of income would dry up. That's why your private pharma corps still havent come up with a malaria or AIDS vaccine. It takes a publicly-funded lab to pursue such unprofitable ventures.
(Score: 3, Insightful) by The Mighty Buzzard on Sunday July 21 2019, @12:09PM (25 children)
Check your medical history over the past hundred years or so. The majority of all significant advances are examples of US badassitude.
My rights don't end where your fear begins.
(Score: 1, Insightful) by Anonymous Coward on Sunday July 21 2019, @12:16PM (3 children)
Yup, that sure looks like one true setup for a Scotsman joke.
(Score: 2) by The Mighty Buzzard on Sunday July 21 2019, @12:42PM
Oh we're leading in insignificant advances as well, it's just less absurd to count only the things that make a major difference in the medical care you can receive rather than lumping zit creams and PET scans together.
My rights don't end where your fear begins.
(Score: 3, Insightful) by aristarchus on Sunday July 21 2019, @07:40PM (1 child)
The Buzzard just want to make America Great again, and is willing to "No True Scotsman" do make it so. As a bird of carrion, he has a lot in common with Big Pharma, and the Capitalist death-feeding industry.
(Score: 2) by c0lo on Monday July 22 2019, @04:53AM
Naaah, he just want to fish.
He's hoping that someone will MAGA, 'cause he heard promises.
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 0) by Anonymous Coward on Sunday July 21 2019, @03:47PM
There really have not been many advances since the 1950s, and most of those are by "crackpots" like Kary Mullis and Raymond Damadian.
(Score: 3, Insightful) by HiThere on Sunday July 21 2019, @03:59PM (9 children)
While you've got a bit of a point, it's worth noting that a lot of their "improvements" are the US patent office recognizing things as improvements which are trivially better than what was being done elsewhere. It *is* a benefit, in that it acts as a screening mechanism, because a whole lot of "what was being done elsewhere" is true shit, but it's not the kind of improvement you are thinking it is, and they add a whole bunch of costs.
Additionally, they *do* have a strong preference for things that are treatments rather than cures, for obvious financial reasons. So they don't fork out the kind of money for "human trials" for things that would cure diseases as they do for things that promise recurring payments. (Just consider the efforts they put into Viagra.)
So. You're partially right. But a different system is still needed. I would personally prefer that research be separated from marketing totally, but designing a workable system is not something I've convinced myself I could do. (I'm not talking about getting it implemented, just a flow-chart level design at the top level.) Saying "That other system was worse than our system" isn't much of a defense. For one thing, the Russians weren't really interested in broadly based medical care, beyond the basics, so your "proof" isn't a valid argument, but more specifically, there's more than two ways of organizing things. State supported academia, for instance, should not have been allowed to have partial ownership in pharmaceutical companies. Just how that law should have been written is not, however, clear. We do want to encourage state sponsorship of academia for multiple valid reasons.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 1) by fustakrakich on Sunday July 21 2019, @05:59PM (6 children)
We have to put the government (taxpayer funding) in competition, not cahoots with the industry.
La politica e i criminali sono la stessa cosa..
(Score: 2) by The Mighty Buzzard on Monday July 22 2019, @10:33AM (5 children)
Only works if one side of the competition doesn't get to use its bottomless pockets to put the others out of business by eating a loss longer than they can. That's got to be dealt with any time the government is allowed to compete in the private sector or there is no more private sector very soon.
My rights don't end where your fear begins.
(Score: 2, Insightful) by fustakrakich on Monday July 22 2019, @07:22PM (4 children)
It's our pockets, we can use them however we want. That's what voting is about, to determine how our tax dollars are spent. The government is our voice, and wallet. So if we want to compete, we have that right.
And it won't put honest people out of business, only the scammers will feel the pressure.
La politica e i criminali sono la stessa cosa..
(Score: 2) by The Mighty Buzzard on Tuesday July 23 2019, @04:45AM (3 children)
In an ideal world, yes. Not in this one though.
My rights don't end where your fear begins.
(Score: 1) by fustakrakich on Tuesday July 23 2019, @05:00AM (2 children)
Yes, in this one, right here, right now.
La politica e i criminali sono la stessa cosa..
(Score: 2) by The Mighty Buzzard on Tuesday July 23 2019, @09:55AM (1 child)
You probably want to seek psychological help. Specifically, have them check you for schizophrenia. That's a pretty severe departure from reality.
My rights don't end where your fear begins.
(Score: 1) by fustakrakich on Tuesday July 23 2019, @06:22PM
The world is a bit bigger than your view through the pinhole.
Your denials of what is in front of you are the real issue.
La politica e i criminali sono la stessa cosa..
(Score: 2) by driverless on Monday July 22 2019, @01:43AM (1 child)
It's not a benefit, unless you're referring to a financial benefit for the pharma companies. By continuously applying trivial tweaks to standard medicines, they make sure they never go off patent and become generics, which would affect their bottom line. They're not trivially better "improvements", they're trivially different patentable variations.
(Score: 2) by HiThere on Monday July 22 2019, @09:12PM
What you're talking about happens, but isn't what I was talking about. Generally the drugs that they tweak for new patents are their own drugs, not someone else's. I was thinking more of things like the way they took tea-tree oil, which had been used as a medicine in India since the Vedas were written, and got it patented in the US.
There's a reasonable argument that what you were talking about is a larger problem, but it didn't fit as directly into the discussion.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2, Insightful) by fustakrakich on Sunday July 21 2019, @06:09PM
No, THIS is the best example of US badassitude [brightspotcdn.com]
Hopefully, some day, This will be US badassitude [wp.com]
Capitalism: Wherever abuse the market collective will bear...
La politica e i criminali sono la stessa cosa..
(Score: 4, Informative) by PartTimeZombie on Sunday July 21 2019, @08:55PM (8 children)
Right, like Germ Theory (European)
Antibiotics (European),
X-Rays (European)
Magnetic resonance imaging (European)
To name just a few. What the US health system is really good for is monetizing those inventions.
(Score: 0) by Anonymous Coward on Monday July 22 2019, @12:05AM (3 children)
I didn't check the others but at least MRI is wrong:
https://en.wikipedia.org/wiki/Raymond_Damadian [wikipedia.org]
(Score: 2) by PartTimeZombie on Monday July 22 2019, @12:19AM (2 children)
It is not really wrong.
Peter Mansfield had something to do with it too. [wikipedia.org]
Also:
(Score: 0) by Anonymous Coward on Monday July 22 2019, @01:05AM (1 child)
If minor minor tweaks count as inventing something then good luck attributing anything to one country.
(Score: 2) by PartTimeZombie on Monday July 22 2019, @01:32AM
If making the first practical MRI scanner counts as a "minor tweak" then sure, OK.
Not that you're wrong though. Lots of people had a hand in that invention.
(Score: 2) by The Mighty Buzzard on Monday July 22 2019, @10:37AM (3 children)
Those are three good ones, yes. Three. Out of a whole lot more than three.
Also, it's a nit-pick but you don't get to claim all antibiotics by inventing the first.
My rights don't end where your fear begins.
(Score: 2) by PartTimeZombie on Monday July 22 2019, @08:09PM (2 children)
You're right, it is a nit-pick.
I am still wondering what fundamental discoveries the mighty US capitalist medical industry made?
I can't think of any, except maybe $3,000 ambulance rides.
(Score: 2) by The Mighty Buzzard on Tuesday July 23 2019, @04:48AM (1 child)
The majority, not plurality but majority, of medical advances in the past century or so were made in the US. If you can't even think of one, then you're actively blocking reality from entering your memory to keep it from upsetting your worldview.
My rights don't end where your fear begins.
(Score: 2) by PartTimeZombie on Tuesday July 23 2019, @07:56PM
But you can't post a link to even one?
OK then.
(Score: 3, Informative) by Runaway1956 on Sunday July 21 2019, @06:02PM
So, what you appear to be saying is, no one in the world has a publicly funded lab to pursue the vaccine for malaria? No one? None of the wealthiest countries in Africa? None of the wealthiest countries in Asia? None of the countries in the Pacific, or South America? Seriously?
I think that you have inadvertently made a case for capitalism. No one else can afford to chase after the medical advances that an unabashedly capitalistic country can explore.
And, remember, I'm not the greatest fan of capitalism. Capitalism is the worst form of economics and government on earth, except for all the rest.
(Score: 2) by istartedi on Sunday July 21 2019, @05:31PM (1 child)
I don't think either one of you has entirely got it right. A private healthcare sector has a place, and a public sector does too. Capitalism is good, but the government has to be the referee in the game they're playing. In US health care, we've got a FIFA ref overseeing the game. That needs to stop, but I wouldn't want all profit motives or competition to go away entirely.
Appended to the end of comments you post. Max: 120 chars.
(Score: 2) by The Mighty Buzzard on Monday July 22 2019, @10:38AM
Ed Zackery.
My rights don't end where your fear begins.
(Score: 4, Insightful) by Azuma Hazuki on Sunday July 21 2019, @10:01PM (25 children)
In this post, and all others of the same kidney, is the inherent, implicit assumption that money is on an equal footing with, if not a higher footing than, humanity itself.
Step back and ask yourself what the purpose of money and economic activity is. To promote human flourishing, no? In that case, even if a system is optimized for producing local maxima in terms of generating money, it is not necessarily producing optimal human flourishing...and indeed, by definition it cannot do so, since nothing directly ties "maximal revenue/profit" to "maximal human flourishing."
Many of your delusions about the world will drop away when you address this fundamental moral priority-inversion glitch in your systems.
I am "that girl" your mother warned you about...
(Score: 1, Offtopic) by The Mighty Buzzard on Monday July 22 2019, @10:41AM (24 children)
Blah, blah, and also blah. You're seeing what you want to see instead of what's there so you don't have to be wrong again. Money's not on a higher footing than humanity in capitalism any more than the engine in your car is on higher footing than the occupants. You're just talking out of your ass again.
My rights don't end where your fear begins.
(Score: 0) by Anonymous Coward on Monday July 22 2019, @02:27PM (1 child)
You're such an idiot, guess that explains 2016. Bunch of morons too angry to deal with reality.
(Score: 2) by The Mighty Buzzard on Monday July 22 2019, @02:43PM
You don't even know what the word capitalism means and you're trying to argue with me?
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Monday July 22 2019, @09:50PM (21 children)
The projection is incredible. Look, shitbird, just because *in theory* money isn't on a higher footing under capitalism doesn't mean that it isn't in practice. I'm talking about reality here, not some toy model your utopian gibbertarian friends like to masturbate to before they go to bed in their mothers' basements.
I am "that girl" your mother warned you about...
(Score: 1, Flamebait) by The Mighty Buzzard on Tuesday July 23 2019, @04:50AM (20 children)
I know it hurts your butt to hear that the people you want to hate aren't the monsters you want to paint them as but reality isn't going to change just because it doesn't suit you.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Tuesday July 23 2019, @09:53PM (19 children)
Monster is as monster does. You, somehow, think you're going to gain some advantage or other by pretending to be one of them. Unfortunately, the most you can manage is to be a annoying little dingleberry on one specific forum you have some editorial clout over.
This is because--spoiler alert!-- y o u a r e s m a l l t i m e.
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Thursday July 25 2019, @10:25AM (18 children)
I have plenty of coding clout and a moderate amount of admin clout but I don't have any more editorial clout than you do. Or rather any more than you would if you didn't routinely take a flying leap off the deep end of sanity.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Thursday July 25 2019, @11:42AM (17 children)
So you're even weaker than I expected then. And if you want to bitch about ad-homs, "flying leap off the deep end of sanity" is a perfect example. You project like the proverbial mile of movie theaters, and all here know it; you're pissing into the wind with that crap now. We've had plenty of time to show this forum what sort of people we are, and the verdict is long since in.
I am "that girl" your mother warned you about...
(Score: 1, Troll) by The Mighty Buzzard on Thursday July 25 2019, @01:35PM (16 children)
And yet you go on thinking you're the sane one. Interesting.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Friday July 26 2019, @06:57PM (15 children)
I've met people on large doses of quetiapine who are, in the aggregate, saner than you. And yes, that includes the ones who are convinced there's some kind of insane government plot going on.
I am "that girl" your mother warned you about...
(Score: 1, Troll) by The Mighty Buzzard on Saturday July 27 2019, @02:13AM (14 children)
Just a heads up: You have something massively wrong with your sanity scale. That's to be expected with some of the bat-shit-crazy things you believe without question though.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Saturday July 27 2019, @01:05PM (13 children)
Tell me, have you ever had a dissociative episode? Because the only way you could say something that completely un-self-aware and still be counted mentally competent is if you do. The projection is incredible. Your entire "libertarian" worldview is based on a false understanding, willfully held in the face of overwhelming evidence, of what "freedom" actually means. That, and an amazingly bloated ego.
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Saturday July 27 2019, @03:12PM (12 children)
Nope. Afraid I'm about as grounded in reality as it gets. Part of that means I don't go jumping through mental hoops to call comfort liberty. Liberty just means the government stays the fuck out of my choices and punishes people who seek to harm others in the most egregious manners. Not who make life more difficult others incidentally but without malice. And not those like you who actively seek to harm others, with malice, in lesser atrocious ways.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Saturday July 27 2019, @09:16PM (11 children)
Once again, you make my point for me...and you're so completely Klein-bottled up your own ass you don't even see how or why. Try this: "as simple as possible, but no simpler." Sometimes as simple as possible is quite complex indeed.
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Saturday July 27 2019, @10:48PM (10 children)
Only if you set out with the answer you want your reasoning to give you firmly in mind and distort everything along the way until you get there. If you're allergic to rhetorical bullshit and the changing of definitions to suit your needs, you end up where I am. Liberty and comfort are not the same. Liberty and security are not the same. Hell, even liberty and life are not the same. Pick whatever ideal you like and stand behind it but don't go trying to bullshit me about the one I've picked, because I know it a lot better than you do.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Sunday July 28 2019, @09:07PM (9 children)
You're missing the point: you have this weird, idealistic, oversimplified version of "liberty" that at bottom translates to "as few restrictions as possible." It shouldn't take more than a few seconds of logical thought to see the flaw in that definition. Yet somehow, you won't, or can't, do the necessary brainwork. This tells me you're either a lot stupider than even I thought, or you truly don't give a shit about anything except thinking you're correct and reality can go take a flying leap. Neither one speaks well of you.
It's very clear that what you actually mean is "liberty for me personally and to Hell with everyone else," and you just try and dress it up with libertarian talking points, points you only half-comprehend at that.
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Sunday July 28 2019, @11:23PM (8 children)
Nah, you just can't get that liberty does not mean anything but liberty. It has nothing to do with what choices you have available to you, only that you are free to make the ones you have. What you want is not liberty. What you want is a utopia that you've dreamed up in your own head and anyone violating what you think is best gets hell rained down on them. You're a genocidal despot in all but the power to do anything about your desires.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Monday July 29 2019, @10:22PM (7 children)
Unbelievable. You're saying that someone in 1880s America whose only choices were "work in a sweatshop or die" was *freer* than someone in modern Norway. Un-fucking-believable.
Your vision can be trivially reduced to absurdity in a near-infinite number of ways like the above. In fact, according to you, even when someone has only two choices, with death being one of them, they "have their liberty." That's insane. Certainly it doesn't comport with any understanding of the word "freedom."
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Tuesday July 30 2019, @12:28AM (6 children)
No, I'm saying that those were never their only choices. Only morons who think things have to be given to them for them to have them (a means of acquiring wealth in this case) are so blind that they think nonsense like that.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Thursday August 01 2019, @10:17PM (5 children)
I guess you're never going to get this until it happens to you, are you? Oh well. Odds are good you're coming back somewhere in China or India or the Sahel next time, after you've done your time in Hell. You'll figure it out eventually...
I am "that girl" your mother warned you about...
(Score: 1, Troll) by The Mighty Buzzard on Friday August 02 2019, @11:40AM (4 children)
Dumbass, it has happened to me. It's happened to everyone who ever faced a choice between putting in the work to acquire skills that can be bartered for a comfortable living, taking a risk on their own venture, or taking a shitty job. Don't cry to me because you're too lazy to put the effort in or too cowardly to risk financial ruin.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Saturday August 03 2019, @01:47PM (3 children)
You don't know either my current situation or my upbringing, so I will forgive you for the ignorance displayed in that post. I'll just say you're wrong, so far wrong you're not even on the map any longer. You owe me an apology, or would if you had the facts. As it is, I'll just chalk it up to that all-consuming ego of yours...
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Saturday August 03 2019, @02:02PM (2 children)
Yeah, your shit didn't turn out like you wanted it to so I must be wrong. Fucking please.
Here, let me state this as directly as I can: You are not entitled to jack shit as far as financial comfort or success goes. You are not entitled to pick any career you like and make a good living at it. You are not entitled to government protection of your means of making a living.
You, me, and everybody else has to make their own way in this world. Sometimes you get the bear, sometimes the bear gets you. Pissing and moaning for government help from a position at the bottom is no less bullshit than the banks asking for a bailout. Either one requires that your fist not stop swinging when it gets to my nose, or in this case wallet. I'm happy to help those in need but you can fuck right off with demanding help from me at gunpoint.
My rights don't end where your fear begins.
(Score: 2) by Azuma Hazuki on Saturday August 03 2019, @02:28PM (1 child)
"Fuck you, got mine, and damn the consequences." You talk too much for someone with so little to say.
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Saturday August 03 2019, @02:36PM
See? Denial of reality. And you still won't see it.
My rights don't end where your fear begins.
(Score: 0) by Anonymous Coward on Sunday July 21 2019, @03:45PM (6 children)
There is no capitalism in the US... Reuters current headline market/finance news:
- Pompeo to meet with Mexico's foreign minister to discuss immigration, trade
- A rally and a redirect: why the markets are so focused on the Fed
- Wall Street Week Ahead: Prospect of Fed cut pushing dividend investors into tech, energy
- U.S. adviser Bolton travels to Japan, South Korea amid trade dispute
- Chinese companies looking to buy U.S. farm products: Xinhua
- As U.S. 'superstar' cities thrive, weaker ones get left behind
- Stena Bulk has asked to visit crew of seized tanker
https://i.ibb.co/vH52FRW/finance3.png [i.ibb.co]
So, as usual there is only one headline that is not dominated by government activity. Great capitalist "free markets" you've got there...
Earlier analysis showing the exact same thing:
July 3: https://soylentnews.org/comments.pl?noupdate=1&sid=32428&page=1&cid=862800#commentwrap [soylentnews.org]
July 14: https://soylentnews.org/comments.pl?noupdate=1&sid=32582&page=1&cid=866921#commentwrap [soylentnews.org]
(Score: 2) by Azuma Hazuki on Sunday July 21 2019, @10:04PM (4 children)
Sounds like "state capitalism" to me. Just remember, the GOP wants to "run the government like a business." No, this is as pure as capitalism gets...but y'all suckers ain't the customers, or even the products: you're the raw materials. Think "human resources" with the emphasis on the second word. This is how the elite see other people. Realize this, and suddenly many things will make sense.
P.S.: As Mussolini's supposed quote says, "fascism should rather be called corporatism, for it is the merger of the state and the business." Get it yet?
I am "that girl" your mother warned you about...
(Score: 0) by Anonymous Coward on Sunday July 21 2019, @11:40PM (1 child)
Lol, the big bad GOP. Vote DNC instead!
(Score: 2) by Azuma Hazuki on Monday July 22 2019, @09:54PM
Until a better alternative comes along, yes. As it is, the Democrat party is split down the middle in a generational civil war; the DNC faction, as you mention, is essentially the GOP with less homophobia; they are the Clinton wing, the corporate Democrats, essentially where the Reagan administration and ideology ended up in a nation that shifted insanely far rightward over the course of 40-some-odd years. The progressive wing, mostly under 40 years of age with the exceptions of Sanders and maaaaaybe Warren, is the other side.
Prediction: Dems lose 2020 due to infighting and, likely, the DNC doing another 2016. GOP wins. Economy crashes. *Hard.* Suddenly people don't like the GOP so much. Dems win in 2024, hopefully running someone worth a good goddamn this time.
I am "that girl" your mother warned you about...
(Score: 1, Interesting) by Anonymous Coward on Monday July 22 2019, @07:51AM (1 child)
Our current system of corporatism is nothing like the capitalism as laid out in the Wealth of Nations. The only difference between the US and the Soviet Union is that instead of being run by corrupt alcoholic Russians we were ruled by corrupt Episcopalians and Irishmen that we traded for Jews as the 50s turned to the 60s. The only capitalists we have had in a hundred and fifty years are probably TR and Nixon. Capitalism as laid out in the Wealth of Nations was not this Libertarian pipe dream of NAP and non-regulation, it was enforcing pro-competition practices at the federal level including breaking up monopolies. Today we are instead ran by an oligarchy of the most powerful companies who instead use the federal government to squash small business and ensure continued corporate profits, this system is closer to the highly regulated soviet system with less starvation, a dressing of hope, and a sprinkle of freedom.
(Score: 2) by Azuma Hazuki on Monday July 22 2019, @09:57PM
Yup. State capitalism. Running the nation-state like a business for the material advantages of the heads of state. You took a lot of words to agree with me, and also threw in a bunch of weird ethnic and religious slurs.
I am "that girl" your mother warned you about...
(Score: 2) by The Mighty Buzzard on Monday July 22 2019, @10:42AM
There's some, just not enough.
My rights don't end where your fear begins.
(Score: 3, Insightful) by c0lo on Monday July 22 2019, @04:51AM
Those temporary embarrassed millionaires? Why would they (wake up from the American nightmare)?
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 3, Insightful) by choose another one on Sunday July 21 2019, @10:59AM (4 children)
Maybe in the US - don't know, never had US health insurance.
Elsewhere in the world, health insurers damn well do pay for this sort of stuff, because insurance is all about balancing risks, if you can ensure your policy holders are on average healthier to start with, e.g. with regular gym sessions, you can reduce claims and payouts overall. Insurers are not about what is medically necessary, they are about what is most profitable.
A quick few seconds on google shows that at least some US health insurers cover stuff like gyms too, and it's not new (e.g. https://www.cbsnews.com/news/hidden-health-insurance-benefits-you-may-have/ [cbsnews.com] - from 2011).
Was this guy a fraud? - sure looks like it. Was he automatically a fraud because he was a personal trainer billing a health insurer? - don't think so.
(Score: 5, Informative) by bzipitidoo on Sunday July 21 2019, @12:50PM (2 children)
> Insurance companies pay for care that's medically necessary
If only. Time and time again, insurers try to weasel out of paying for anything at all. There's always some technicality why they don't have to pay a claim. You haven't met your deductible yet. The doctor was out of network and it wasn't an emergency. You have to see your Primary Care Physician first, for a referral. That drug wasn't on the list of approved drugs. That service was performed at an outpatient clinic, and they only cover it if it's done in a hospital.
> Was this guy a fraud?
There are plenty of real, licensed doctors who push the boundaries if not commit outright fraud. They prescribe brand name drugs when there is a better generic available. That's assuming the prescription was necessary at all, and often it wasn't. They call for unnecessary tests, both to CYA and increase their profits. When their overly aggressive "care" causes more problems, from side effects and the like, their answer is ... wait for it ... even more care!
I've seen private hospitals shove a legal document at sick patients that says if the insurer won't pay for some equipment or care, the patient agrees to pay. This is usually done in connection with something expensive, like a massively overpriced relatively common item such as crutches, wheelchairs, splints, and so on. How does $1000 sound for a wheelchair? Not that they disclose that to the patient if they can help it. If the patient inquires about the price, they will say stuff like "don't worry about it, insurance will cover it", despite that they just asked for a signature on a legal document that suggests insurance might not pay. Or they will profess ignorance, or that they need days to determine the final price. That's the Fee for Service system at work.
(Score: 1, Interesting) by Anonymous Coward on Sunday July 21 2019, @03:50PM (1 child)
Yet, those are the people you want to turn to for "help". You are better off staying away from the entire healthcare industry at this point. Save the thousands of dollars per year you currently give away to the insurance company for a rainy day.
(Score: 2) by hendrikboom on Monday July 22 2019, @02:18AM
I do not believe I would be better off dying in pain than having my stomach cancer treated.
-- hendrik
(Score: 2) by driverless on Monday July 22 2019, @02:42AM
Interviewer: Mr.Sutton, why do you defraud HMOs?
Willie Sutton: Because that's where the money is.
Willie Sutton, addendum: And because it's pretty easy to do, you can run any scam you like for years, enforcement is lax, and monitoring is nonexistent.
(Score: 3, Flamebait) by Entropy on Sunday July 21 2019, @01:05PM (6 children)
Finds that her ex bought things for her children to enjoy. She makes it her mission to find something he did wrong in order to provide for his children, and get him in trouble for it. She's a peach.. Wonder why their marriage failed?
(Score: 3, Insightful) by khallow on Sunday July 21 2019, @01:57PM (2 children)
What kind of woman would marry that kind of guy? It's inevitable.
(Score: 1, Offtopic) by jasassin on Sunday July 21 2019, @10:35PM (1 child)
The kind of woman that found out about his shenanigans three years ago and didn't report him three years ago. Now they are divorced and she's not getting toys and fancy dinners, the gold digger couldn't throw him under the bus fast enough.
jasassin@gmail.com GPG Key ID: 0xE6462C68A9A3DB5A
(Score: 2, Insightful) by khallow on Sunday July 21 2019, @10:44PM
(Score: -1, Flamebait) by Anonymous Coward on Sunday July 21 2019, @04:27PM (2 children)
That journalism is going to make me barf with breathtaking ease.
They are divorced, and you can't have daddy giving presents to the kids that you can't hope to beat, woman scorned and all that.
Wonder if she hurt herself by biting the hand that feeds her alimony and child support, or will the state step in for payments and garnish what they pay out from her ex's earnings forever?
(Score: 1, Insightful) by Anonymous Coward on Sunday July 21 2019, @06:19PM (1 child)
Yes.
This will continue until men organize and demand that it end. Bitching about it on the internet and voting for a Nazi will not fix it. Flow of capital must be impacted before the capitalist class will consider absolving men of patriarchal expectations, and they will only consider it on the basis of what impact their refusal to do so has on the flow of capital. Bourgeoisie don't work two jobs to avoid jail because they're saddled with child support they can't afford for a child they're not ever allowed to see. Bourgeoisie don't need to fight expensive court battles to prove their innocence of fathering the child if they find evidence it's not theirs. Yet working class men do.
Everything else about this issue is Randian daydreaming about when the invisible hand in the sky finally gives you a slice of heaven. That will never happen, because reality does not work that way.
(Score: 1) by khallow on Sunday July 21 2019, @10:45PM
Won't help with my patriarchal expectations.
(Score: 1, Interesting) by Anonymous Coward on Sunday July 21 2019, @02:44PM (3 children)
A few years ago I found someone using my identity with VSP to get eye care. In a town over six hours drive, one way, from my address of record with them. Optometrist with one star ratings on line, no less, so I'm betting the office is nothing but fraud. When I reported this, their response was basically "Doc says it was too you, so it's your problem". They don't give a shit. Never signed up for vision insurance again. Sadly, the government doesn't give a shit about it either. No glamor for the prosecutors to go after insurance fraud. They're too busy trying to pad their conviction history so they can run for office.
(Score: 0) by Anonymous Coward on Sunday July 21 2019, @07:33PM (2 children)
So what negative impact did this situation have on you?
(Score: 0) by Anonymous Coward on Sunday July 21 2019, @10:26PM (1 child)
I was unable to use my vision insurance for coverage that year, despite paying for it, since someone else already had (they got their fix early January).
(Score: 0) by Anonymous Coward on Monday July 22 2019, @12:02AM
Vision care costs me a dollar a month and saves me $35 on an eye exam that costs $70 cash.
I've been meaning to drop it, but I'm too lazy.
(Score: 3, Touché) by shortscreen on Sunday July 21 2019, @04:08PM
How dare that guy bill insurance companies insane amounts for mundane services!
Oh wait, that's normal.
How dare that guy bill insurance companies insane amounts for mundane services... without having the proper license!
(Score: 2, Insightful) by bradley13 on Sunday July 21 2019, @05:25PM (2 children)
I've read about this more than one. Yes, I know what it is, but...seriously? I have an Internet friend who went to an "in network" hospital, only all of the actual doctors in that hospital were "out of network". WTF?
Obamacare seems to have destroyed the American healthcare system. Y'all either need to go single payer (and put all of the insurance companies completely out of business), or else you need to go back to something resembling a free-market system. Either of those can work, each has it's advantages and disadvantages. However, at the moment, the US seems to have the absolute worst of both worlds.
Everyone is somebody else's weirdo.
(Score: 3, Informative) by Runaway1956 on Sunday July 21 2019, @06:09PM
Obamacare didn't create those bullshit networks. I think Obamacare may have encouraged the networks, thus making them worse, but Obama didn't create them. I was hearing about in-network and out-of-network way back, maybe while Clinton was still in office. Definitely before Obama came out of the woodwork.
(Score: 1, Informative) by Anonymous Coward on Sunday July 21 2019, @07:30PM
Unless you've left the US more than 25 years ago, you would have seen the network distinction.
The fundamental thing for most outsiders to realize about the American system is that, outside of surgical and long term care, it is less of an insurance plan, but an (expensive) discount plan. That means, if you pay $100 per month to a company, they will try to negotiate a price per service, divided between that company and the customer, with local health care providers. That becomes the "network". So if you need a blood test and go to a network provider, you may get a bill for $30. Happen to go to a non-network provider, and you may get charged $3000 like you foolishly ordered the market price lobster in an expensive restaurant.
If medically necessary, the company will pay 80% of usual and customary rates, but now you're costing them money and you may have to fight them. Usual and customary cost for a blood test may be determined to be $500, so they may pay $400 (assuming you met your deductible), leaving you holding the bag for the remaining $2600. That is somewhat understandable, why should they pay imaginary prices demanded by some provider?