tag:blogger.com,1999:blog-34323687.post8477121496157123527..comments2024-03-29T09:24:42.731+00:00Comments on Macro Man: Some People Just Like a Good MoanMacro Manhttp://www.blogger.com/profile/12324967552369915949noreply@blogger.comBlogger66125tag:blogger.com,1999:blog-34323687.post-65153336607742621762010-03-04T09:30:56.450+00:002010-03-04T09:30:56.450+00:00Must say, love how you guys all go/went off every ...Must say, love how you guys all go/went off every single time health care comes/came up.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-90859776513729508252010-03-04T07:27:07.777+00:002010-03-04T07:27:07.777+00:00OK, seriously. Health care is now a banned topic,...OK, seriously. Health care is now a banned topic, except as it impacts financial market pricing. There is really no point having (or in my case, hosting) a debate in which a significant portion of the participants essentially stick their fingers in their ears, close their eyes, and shout "the government are morons so there's no point even <i>trying</i> to change anything!!!"<br /><br />They are of course welcome to that opinion, and should they wish to express that view, they should feel free to visit the appropriate venue to vent. But after another day of being told "ooh, you Europeans just don't understand anything" by people whose idea of exotic travel is a visit to Bob's Country Bunker, I've had enough. <br /><br />Off topic health care posts now incur the risk of deletion.Macro Manhttps://www.blogger.com/profile/12324967552369915949noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-82266740110562685132010-03-04T04:41:12.368+00:002010-03-04T04:41:12.368+00:00MM says Cuba is "the rare poor country with e...MM says Cuba is "the rare poor country with excellent health care."<br /><br />I can tell you, having experienced the two-tier system of foreigners-only pharmacies vs. domestic pharmacies in Cuba, and watched helpless Cubans beg foreigners outside the pharmacies to purchase medicine for them, this is an incorrect analysis.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-33233094243023782672010-03-04T03:58:44.706+00:002010-03-04T03:58:44.706+00:00DD -- first of all a correction to what you wrote....DD -- first of all a correction to what you wrote... The "government" does not provide roads or anything else. TAXPAYERS pay for both roads and cars. <br /><br />Government doesn't pay for anything, it collects money, takes a chunk off the top for red tape / administrative overhead, and then dispenses TAXPAYER money<br /><br />While the insurance paperwork and conflicting covered/not covered nonsense needs improvement -- based on lots of other government services, I seriously doubt the government is going to have lower overhead than private insurance. And from what you describe, Medicare's coverage/non coverage isn't any more rational-- its just a bigger plan and thus the coverage rules are more widely known.<br /><br />The bigger problem with Medicare and government paid care is purely a management problem. Congress is simply inept; this has been proven again and again and again. With a monopoly system, there is no choice and no alternative.<br /><br />While [insert insurance company here] is annoying, bad companies eventually do go out of business. It might take longer than some would like, but it eventually it happens.<br /><br />By contrast, the criminals in Washington were still collecting a phone tax to cover the Spanish American War 80 years after the war ended.<br /><br />Washington has a "corporate culture" problem, and that needs to be fixed first -- no one will trust them unless and until after that change happens. And no, I am not holding my breath.<br /><br />Which is why US government sponsored health care is an ideal only idiots can support.<br /><br />Walmart invented $10 prescription fills, not Medicare, not Nancy Pelosi, not Obama, not whatever Republican you want to name. I don't like Walmart, but any honest person has to admit Walmart has done more to reduce health care costs than all politicians (both parties) combined... and once Walmart offered $10 prescriptions, all the other major pharmacies followed suit in competition.<br /><br />Yes, Walmart only offers generic prescriptions. Blame the intellectual property laws and the FDA for the nightmare of brand pharmaceuticals<br /><br />We have heard years of why the insurance companies, drug companies,etc are evil (and I am not claiming they are innocent)...<br /><br />We haven't heard much talk about Medicare fraud (which is rampant). We haven't heard about Medicare overhead (which is higher than private companies). We haven't heard much about Congress's annual failure to address intellectual property laws -- they somehow extended the patent on Mickey Mouse for Disney, but no politician has done anything about the time/expense of patenting a new drug.<br /><br />Instead, the criminals in Washington focus 100% of their time on expanding their own power and reach. That is what Obamacare is about -- its a power grab. Health care is just the marketing gimick they are using this time. ObamaCare is evil -- pure and simple.<br /><br />US Health care needs to be fixed -- Federal power does not need to be expanded. The two issues are not the same, no matter how many lies come out of the crooks in WashingtonGarynoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-92189606679996012442010-03-04T03:22:29.385+00:002010-03-04T03:22:29.385+00:00Gary, ultimately it's single payer; but the in...Gary, ultimately it's single payer; but the insurance industry can't withstand the revenue drain right now (think AIG a onetime major health insurer). If anything "mandatory" health insurance, like so many initiatives is about shoring up the financial structure first and other issues are secondary.<br />As for Medicare, the issue was insurance would not cover the elderly and young families couldn't afford their parent's healthcare. Medicare filled the void. <br />The cash and carry sounds good, but quite frankly it won't work on a large scale. Sure a few practices can free-ride off the base structure for a time; but overall the system crashes. The infrastructure is just too expensive ie what good are cars if there is no government supported street/highway infrastructure? <br />Just my take after 30+ years dealing with the bs.ddhttps://www.blogger.com/profile/05372482865160613159noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-29959677617170095382010-03-04T02:57:43.280+00:002010-03-04T02:57:43.280+00:00Towlie, you gave me such a laugh. Just let me say ...Towlie, you gave me such a laugh. Just let me say that doctors are not insurance agents. In the last go round and now again advised doctors to tell their patients, "I am not an insurance agent. I have no idea what your plan covers."<br />Large doctor groups have a cadre of employees that negotiate rates, track billings and provide wonderful pie charts. Individual doctors who negotiate rates are toast. There are so many HMOs, PPOs and insurance plans, then Medicare and Medicaid. The payments are generally pegged to Medicare and at best doctors know they will get Medicare rates plus whatever the negotiations yield. But a guy running his own office, only has a vague idea of the revenues and usually has a massive receivable; especially when states stop paying Medicaid.<br />Doctors are not lawyers and even lawyers can barely negotiate the legalisms of contorted medical insurance. Best bet is talking to the certified medical billers. They know the system, the coding, the deductibles, the co-pays, the discounts and the billings. It is a profession onto itself.ddhttps://www.blogger.com/profile/05372482865160613159noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-12385994671109466942010-03-04T01:43:09.913+00:002010-03-04T01:43:09.913+00:00Interesting post DD. A "cash only" pract...Interesting post DD. A "cash only" practice would be very interesting (for those that could afford it, of course).<br /><br />I had a knee injury and have been dealing with our health care system for several months now. Do you know the procedure for billing between doctors and insurance companies? Because I do not understand how the billing is done at all. To me, it appears that they spin a big wheel to decide what I initially owe and then adjust it to their liking later.<br /><br />First I get a "this is not a bill" letter telling me what they think I will owe. Then I get the actual bill. Then I get the "we received your money" letter. Then (this has occured 4/5 times) I get another saying that the insurance company didn't pay what was expected or changed how my visit was classified and I start all over again with another "this is not a bill" letter. Sometimes these billing changes result in me owing less than five dollars. One or two were changes for amounts that were clearly less than the postage on the letter, let alone the time for an employee to process it. So 5-6 letters later, I have payed my bill never really knowing what was charged or how my insurance plan covered it.<br /><br />It baffles me that the doctor can't look up my insurance plan, look at what procedure is being done and KNOW with 99% certainty what I will be charged.Towelienoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-28158938464716352342010-03-04T00:08:21.765+00:002010-03-04T00:08:21.765+00:00employer sponsored health care came about as a way...employer sponsored health care came about as a way to bypass federal government wage restrictions<br /><br />Its just another example of the incompetence and corruptness of the US government<br /><br />But pompous Europeans think they know everything and ask stupid questions like why we don't trust corrupt Congress to manage health care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-33626497720875669312010-03-03T23:51:51.831+00:002010-03-03T23:51:51.831+00:00That being said, employer sponsored healthcare is ...That being said, employer sponsored healthcare is madness.<br /><br />You lose your job, and then you get hit by a bus. Double ouch. Surely some risk-aggregation is useful there?<br /><br />And what happen if the employer overpromises, a la GM?<br /><br />Adverse selection, moral hazard, nontransparent pricing (I can have my heart surgery and be on the beach in Thailand for 1/5 the cost?) & information asymmetries/pushers (ok doctor, I'll, I'll scan if you say so), little care for outcomes (except when motivated by a lawsuit), subsidizing pharmaceutical development for the rest of the planet ... surely we can do things better<br /><br />I'd say the only thing that makes me really angry these days is farm subsidies: we undercut developing world farmers, pay to do so, and with horrendously-sized portions and hunter-gatherer brains, make ourselves fat as a result. Ugly Americans, indeed.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-57394453622099185892010-03-03T23:41:51.228+00:002010-03-03T23:41:51.228+00:00Adviser Frank Congemi is running radio spots this ...Adviser Frank Congemi is running radio spots this week lambasting government officials and Wall Street firms for the financial crisis, which he calls the “largest economic crime in history.” <br /><br />Mr. Congemi, an outspoken LPL adviser who manages $100 million in assets, is furious with Wall Street firms and equally furious with the government for bailing them out. <br /><br /><i>“We need a special prosecutor to investigate certain Wall Street firms for many different reasons and on many different levels,”</i> Mr. Congemi states in one of the ads. “These companies are a cancer on the soul of America and must pay the consequences. How the American people wound up being responsible for the losses of these Wall Street firms who were involved in reckless economic crime is in itself a crime.”Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-25965921342101179622010-03-03T23:34:58.585+00:002010-03-03T23:34:58.585+00:00volcker? what volcker?
(now we ll se The Great ...volcker? what volcker? <br /><br />(now we ll se The Great Moan)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-61597629991795176592010-03-03T23:03:33.291+00:002010-03-03T23:03:33.291+00:00Thanks for posting DD
This US Federal government ...Thanks for posting DD<br /><br />This US Federal government Medicare distortion is something Europeans (and Macro Man) simply don't grasp and don't bother to look at<br /><br />So much of our health care system is an artifact of existing Federal government "fixes" and Medicare related distortions<br /><br />Doctors have to "overbill" (which is all the Europeans see) to overcome Congressionally mandated medicare nonsense<br /><br />That in turn makes self payers (aka small businesses and employees) over-pay.<br /><br />The US Government is the problem with US health care, which is why it cannot be a solution.Garynoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-32733333553288191322010-03-03T22:09:24.941+00:002010-03-03T22:09:24.941+00:00It's pretty clear no one here has ever been in...It's pretty clear no one here has ever been involved with a medical practice. Looking at January billings the gross less "adjustments" (ie variance in Medicare/Medicaid/insurance reimbursements) is 35%. Assuming payments are made as billed, then overhead will chew up 55%. <br />Applying that to the $400 stitches it will be reimbursed at $140 less overhead is $63 to the provider. (Full disclosure in years past the reimbursements were generally better ie closer to 45-50% gross; but that has changed dramatically).<br />Surgeons are generally better reimbursed but that has changed as well. For example, reimbursement on many procedures is now at 20%. <br /><br />FYI: Medicare discourages physicians from cutting rates to self-paying patients below the stated rates and can in its discretion claw back "over-payments" based on reduced charges to self-pay. <br />At the moment most doctor groups are having heated discussions about going to cash, lowering the rates by 50%, and dismissing the legions of certified medical billers and the legal team necessary for the ever-expanding medicare compliance requirements. <br /> <br />Many doctors have received financial aid for their children but it is generally in the form of subsidized loans. This is not a complaint; physicians make a fine living once the practice is up and running. Please note they do not begin their careers until after 30 and if a surgeon it's closer to 35. Then the start up costs are astronomical and it's another 3 years or indentured servitude to some group before it's a good living. <br /><br /><br />ddddhttps://www.blogger.com/profile/05372482865160613159noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-30344684358377190352010-03-03T21:19:49.205+00:002010-03-03T21:19:49.205+00:00You're a good sport MM. It's not personal,...You're a good sport MM. It's not personal, just a sensitive time with this reconciliation fiasco and what not. Some less disciplined Anonymous partisans have been feeling a bit hot under the collar, y'know?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-39328130148576442452010-03-03T20:56:57.878+00:002010-03-03T20:56:57.878+00:00....and then I'll get blamed by some people fo.......and then I'll get blamed by some people for being a Communist and by others for being a capitalist leech. Fun for the whole family!Macro Manhttps://www.blogger.com/profile/12324967552369915949noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-88908776802128745752010-03-03T20:47:41.293+00:002010-03-03T20:47:41.293+00:00leftback: a non-bailout is likely to create proble...leftback: a non-bailout is likely to create problems for Greek, and by extension, German and US banks.<br /><br />It ain't over till an Italian bank fails<br /><br /><br />In the meantime, Geithner will bail out Goldman's losses using AIG. Citibank will record billions in losses; Abu Dhabi will sue Citi for not disclosing the probability of Citi making dumb loans. Deutche Bank will record losses and get a new CEO. RBS will attribute the losses to prior management and demand more bailout money.<br /><br />By this time, everyone will have forgotten Geithner's Goldman bailout, and Goldman will get on TV and say they avoided losses because they are smarter than everyone else and because they do God's work.<br /><br />Finally, someone will write a snide comment about deja vu on Macro Man's blogWilliamnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-17083279374079476282010-03-03T20:26:39.408+00:002010-03-03T20:26:39.408+00:00Quite.
Now, returning to the €, what will the FX...Quite. <br /><br />Now, returning to the €, what will the FX market's reaction be when people realize that a non-bailout is likely to create problems for Greek, and by extension, German and US banks. Furthermore, all the Euro shorts appear to have just covered.leftbacknoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-48047317818123089832010-03-03T20:10:25.558+00:002010-03-03T20:10:25.558+00:00"Opinions are like assholes....everyone has o..."Opinions are like assholes....everyone has one, and most of them stink." - Harry Callahan<br /><br />Anon @ 5.55/7.34 being a prime example.Macro Manhttps://www.blogger.com/profile/12324967552369915949noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-13658901995587088142010-03-03T19:49:33.902+00:002010-03-03T19:49:33.902+00:00"The man who is not a socialist at twenty has..."The man who is not a socialist at twenty has no heart, but if he is still a socialist at forty he has no head." - Aristide BriandAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-67027197969822486712010-03-03T19:34:54.567+00:002010-03-03T19:34:54.567+00:00MM: "Why don't you piss off down to Junck...MM: "Why don't you piss off down to Juncker's basement rather than poking a stick at your betters?"<br /><br />Both MacroMan and Madonna have delusions of being BritishAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-15628616857995965152010-03-03T19:31:04.298+00:002010-03-03T19:31:04.298+00:00Seriously. All you have to do is mention health ca...Seriously. All you have to do is mention health care reform and the blog is invaded by Anonymous Proctologists intent on performing unlubricated Colorectal Exams.<br /><br />I bet Clement Atlee didn't have these problems in 1945, maybe he got Nye Bevan to take the Tories out for a Beveridge.leftbacknoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-50659664590203755292010-03-03T18:50:25.418+00:002010-03-03T18:50:25.418+00:00LB, this health care palaver makes me feel like I ...LB, this health care palaver makes me feel like I am a senior partner at that august firm....Macro Manhttps://www.blogger.com/profile/12324967552369915949noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-65620075497711086482010-03-03T18:48:11.718+00:002010-03-03T18:48:11.718+00:00The letter to the SEC from Ben Dover comes from a ...The letter to the SEC from Ben Dover comes from a junior trader at Doone & McCafferty Securities. You probably know the partners, Ben and Phil.leftbacknoreply@blogger.comtag:blogger.com,1999:blog-34323687.post-8120984984329643712010-03-03T18:28:23.054+00:002010-03-03T18:28:23.054+00:00Gee, I don't know. Why don't you piss off...Gee, I don't know. Why don't you piss off down to Juncker's basement rather than poking a stick at your betters?Macro Manhttps://www.blogger.com/profile/12324967552369915949noreply@blogger.comtag:blogger.com,1999:blog-34323687.post-71897755549072481612010-03-03T17:55:06.921+00:002010-03-03T17:55:06.921+00:00I am still waiting to hear why MacroMan didn't...I am still waiting to hear why MacroMan didn't buy stock in all those "profiteering" medical providers so he could retire early<br /><br />This being a financial blog, I have the greatest respect for traders who put their money where their mouth is.<br /><br />Why aren't you retired MacroMan? If you believe your own comments, why didn't you buy into these profiteering companies? Why aren't you living it up on your yacht in Monte Carlo?Anonymousnoreply@blogger.com