Cronyism in big government -- we should expect something different! 

Before you bet started with the holier than thou postings, I will admit that BOTH parties needs major changes.  How can we start the process of change?  Elect different people?  Sounds good to me, how come 90% get reelected?  The state and federal governments need to be purged.

Before who starts with the "holier than thou" postings? Who do you suggest gets purged? Name ONE democrat you'd kick out of office if you could, and I don't mean locally. How do they get re-elected? People keep voting for them. I've voted for democrats in the past, NEVER again unless the party comes to it's senses and kicks out the socialists. But I won't vote for someone just because there is an R before their name. Can you say the same about voting for people with a D in front of their names?

One may dislike Ann Coulter.  However, her latest column shows how  a Republican supporter tips the scales of influence, as well.

http://www.anncoulter.com/

I wonder if the most ardent dem's can support Hillary Clinton knowing that Rupert Murdoch approves of her:

politics of 2016

By Howard Kurtz

Published April 11, 2014

FoxNews.com

Rupert Murdoch, the chairman of News Corp and 21st Century Fox.reuters

Also...

Rush vs. Colbert

Rupert Murdoch, Hillary Clinton and the Politics of 2016

 

Some folks may be surprised by an interview in which Rupert Murdoch declares: "I could live with Hillary as president." 

Yes, he added, "We have to live with who we get. We don't have any choice." But when asked by Fortune magazine whether he could envision himself supporting Hillary Clinton, Murdoch did not laugh off the suggestion: "It would depend on the Republican candidate totally." 

 

The comments by the chairman of News Corp. and 21st Century Fox, published yesterday, won't shock those who closely follow New York politics. While Murdoch's New York Post once relentlessly bashed the Clintons back in the day, he reached a rapprochement with her in 2006. Murdoch hosted a fundraiser for Hillary's Senate reelection campaign. She expressed her gratitude and appeared along with Murdoch at a Georgetown party for "Fox News Sunday." 

Some liberals weren't thrilled with the alliance, and Hillary still came in for vocal criticism at the time from some Fox News folks.

 

Two years later, Murdoch donated the maximum $2,300 to Clinton's presidential primary campaign -- as did his son, James -- although the Post wound up endorsing Barack Obama.

 

http://www.foxnews.com/politic...6/?intcmp=latestnews

most doctors see a windfall from AHA. some are from MS.

Most people should know this, I vote democrat (except for 2 times in my life).  If I changed my way of voting, I'd be voting for the INCUMBENT republicans.  Best, if you vote in Alabama, you are voting for and reelecting the same republican incumbents.

I'm in favor of two terms and out.  Stay away from politics as long as you were in.  This includes lobbying

Really jt? Do you mean to tell me that Romney was president?

Oops, you got me.

 I was thinking of representatives and senators, state and federal.

I forgot about that one

Well I have looked at the website, and some of the numbers do stand out.  First off, I will be the first to admit that there are probably some physicians out there who abuse the system,just like there are patients and drug comapnies that do the same.  Much like there is corruption in the welfare programs and food stamp programs.  however, if they were truly interested in finding out if this guy was corrupt all they have to do is to audit his charts.  Most of these guys are being reimbursed for medications given in the office.  Some of these meds can cost hundred and thousands of dollars, and there is no profit margin on them.

Some docotrs, especially in this area, may have a Medicare population of 60-75% of their patients, so that reimbursement may be the total office income which is used for overhead and staffing.

AS to QD's febile attempt to drag me into this with his above posting, I challenge him to prove anything he has to complain about.  The floor is open, step up or shut up.

teyates, tell me if this is true.

If you go to a doctor, the bill is sorta inflated (in Tn $165 to $260 for a simple office call).  The bill gets sent to an adjuster and it will be reduced to $95.  The insurance company pays this and pays the adjuster 20% of the savings.  The Bill Frist family is the ones that established those inflated rates.  On some compounded cancer drugs, the insurance company is billed for thousands and the adjuster reduces it to hundreds, and the adjuster gets his cut.  Most of the excessive medical tests ordered are not something the doctor wants, but the hospital wants to generate money to pay for the latest medical toys.

An adjuster told me this, is there anything to it?

Jt, Welcome to the torted world of medical billing.

Your doctor typically sets a fee based upon what others in his area and expertise charge.  It may be $130 for an office vist with workup (say this is your first visit).

The bill gets a CPT code (for office visit) and ICD-19 code which is the diagnosis that you presented with or the doctor diagnoses you with.

This "bill" then goes to the submitting office.  At this point it does not matter which insurance you have, the bill is $130.

Mdicare or medicaid  NEVER pay this amount.  They may only reimburse $65 for the visit (Medicaid is usually lower).  If you have a supplemental insurance they may pay the other $65.  If not, then you are not typically balanaced billed, unless you signed something saying you agreed to pay the difference.

Now say, you had BCBS.  They may have an agreement with this doctor that they pay a certain percentage of what is billed (these are typically called Preferred Providers).  BCBS may pay $100, and the docotr can only collect the copay from the person if that is part of the policy (copay may be $20, BCBS pay $100= $120 for the $135 bill). If the docotr is not part of the network, then you may be liabale for all of the $135 if you have not met your deductible.

Some insurances, rarely, will pay what they are billed.  We used to refer to these as third party payors. And they are now very rare.  They typically would pay whatever was billed fater the deductible was met.

Medicare and Medicaid are esspecially troublesome to deal with since they can take 75 days or more to reimburse after you submit for payment.  then they may only pay 50-60% of what is billed.  Tough to plan on meeting your payroll when your monies are held for this long.

you are right most billing comapnies get a percentage, on average it is about 10% of collections.  In return they deal with the insurance companies and billing issues.  In the long run it is cheaper in some cases to pay them to do it rather than to have to navigate the tricky waters of government billing.  We have ausitors who check codes and make sure everything is document.

I can't speak for the reason you tihnk prices are being inflated in TN.  It may be due to the type of office visit.  Not all are the same.  An office visit for a presciption refill should not be the same as a first visit for complicated illness (diabetes, heart failure, COPD).

I would also not listen to the "adjuster".  Hospitals and labs cannot do anything without an order for it.  You are right that many things are not needed, but they are necessary in the world of CYA medicine.  No one wants to be sued, and the fear of missing something causes undue testing in most cases.  does everybody that gets a little hit on the head need a CT?  Not necessarily, but if one gets thru and has a hemorrhage or subdural then it can be devastating.

There are some doctor's offices who have in office labs and xray equipment, and the numbers show that that tend to use them more frequently than those without.  This in some areas is called self referral which is illegal and can be the origin of many of these Medicare fraud issues.

Thanks