PILOT SPIN
Spin Zone => Spin Zone => Topic started by: Little Joe on August 12, 2019, 07:04:25 AM
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1. Get rid of employer sponsored insurance and watch small business explode as more people start a business. Health insurance is one of the biggest banes and expenses of small businesses. Health insurance was one of the things I considered when I evaluated whether I could afford to hire more staff.
2. Give individuals the same tax deduction for purchasing health insurance that companies now get.
3. Keep the prohibition of "pre-existing" conditions for one year. That will give people time to find some sort of plan. Even if there has to be some short term government subsidy, or some sort of medicaid for the inevitable poor.
4. Make it easier for insurance companies to market directly to the public, including across state lines, but enforce standard terms and conditions. Unfortunately there will have to be some regulations to keep unscrupulous companies from cheating people.
5. Allow insurance companies to tailor plans to what the people need. I for one don't need free birth control or childbirth coverage. But some people might choose to pay for that.
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Good list! Especially like the allowance of Intra State COMPETITION for healthcare. Competition on a National level would help bring costs down.
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Add to that price transparency. The vast majority of medical care is non-emergency. Make it was for people to comparison shop for that knee replacement, etc.
-Dan
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With the help of government, health care insurance has become a cash cow for the companies providing coverage. This is why you see such a reluctance in congress to do away with the ACA and actually seek meaningful reform.
What Joe has suggested will work by letting the free market take over, but it will also reduce monster profits for some insurers, and it will reshape the entire industry. Honestly the healthcare industry has a powerful lobby and they own many congressmen and senators, as well as the bureaucrats running the show.
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1. Get rid of employer sponsored insurance and watch small business explode as more people start a business. Health insurance is one of the biggest banes and expenses of small businesses. Health insurance was one of the things I considered when I evaluated whether I could afford to hire more staff.
Are you suggesting that companies be prohibited from having sponsored insurance? If so, I don't agree.
I would suggest that complying with all the various payroll tax requirements is worse than health insurance.
(I still want to get employers out of the business of acting as agents for the IRS and the myriad of state/local tax agencies)
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Are you suggesting that companies be prohibited from having sponsored insurance? If so, I don't agree.
I would suggest that complying with all the various payroll tax requirements is worse than health insurance.
(I still want to get employers out of the business of acting as agents for the IRS and the myriad of state/local tax agencies)
I might not say companies would be prohibited from offering it as a benefit. But I would end the tax credits and deductions and regulations associated with offering it. And I would definitely end any rules requiring it, with the exception of workers compensation. If a worker is injured on the job, the company, or their insurance pays.
Oh, and I agree with you about employers being tax collectors. I am, and always have been a strong supporter of the "Fair Tax".
Let businesses get back to running businesses. Yesterday I was talking to my yard man. He has been doing that work for 40 years and he has occasionally hired help. But the business of managing employees, their taxes and their health insurance was just too much, so he wound up firing all his help and just doing all the work himself.
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1. Get rid of employer sponsored insurance and watch small business explode as more people start a business. Health insurance is one of the biggest banes and expenses of small businesses. Health insurance was one of the things I considered when I evaluated whether I could afford to hire more staff.
2. Give individuals the same tax deduction for purchasing health insurance that companies now get.
3. Keep the prohibition of "pre-existing" conditions for one year. That will give people time to find some sort of plan. Even if there has to be some short term government subsidy, or some sort of medicaid for the inevitable poor.
4. Make it easier for insurance companies to market directly to the public, including across state lines, but enforce standard terms and conditions. Unfortunately there will have to be some regulations to keep unscrupulous companies from cheating people.
5. Allow insurance companies to tailor plans to what the people need. I for one don't need free birth control or childbirth coverage. But some people might choose to pay for that.
Not a bad list.
How about when insurance companies drop someone?
What are lower income people supposed to do? Say, my elderly mother in law with cancer?
You address ways to lower the price of insurance by lowering the coverage and you'll get a slight drop in price by providing for competition. But neither of these are major drivers of insurance cost. How else can you affect price?
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....[snip] But neither of these are major drivers of insurance cost. How else can you affect price?
A better question would be what drives healthcare costs.
Certainly all the insurance paperwork doesn't improve healthcare and doesn't save money, but what are the healthcare cost drivers?
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Not a bad list.
How about when insurance companies drop someone?
What are lower income people supposed to do? Say, my elderly mother in law with cancer?
You address ways to lower the price of insurance by lowering the coverage and you'll get a slight drop in price by providing for competition. But neither of these are major drivers of insurance cost. How else can you affect price?
Thanks for bringing that up. It is another benefit of taking insurance away from insurers. I submit that is one of the chief ingredients that promoted the high cost of medical care. When the employer pays, not only is the employee insulated from the cost of medical care, they are also insulated from the cost of the insurance. Hospitals can charge anything they want and the insurance company pays because they just raise the rates to employers. If they had to market directly to individuals, those individuals would scrutinize what the are getting more, and change insurance companies when the rates increase.
But I think we are past the point of substantially reducing the cost of medical care. People don't want cheaper care. The want somebody else to pay for their medical care. That is the mentality that needs to change.
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By allowing companies to sell across state lines, are we going to do away with state insurance commissioners or just tell them that they have no jurisdiction here?
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By allowing companies to sell across state lines, are we going to do away with state insurance commissioners or just tell them that they have no jurisdiction here?
Other types of insurance (home, auto, marine, life, aviation) are sold across state lines. Why would health insurance be different?
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Other types of insurance (home, auto, marine, life, aviation) are sold across state lines. Why would health insurance be different?
Exactly. Today I can buy life insurance through the EAA, AOPA, AICPA, WICPA, AAA, Knights of Columbus, my credit union, and all that before being able to go straight to the life insurance companies.
Health insurance can operate similarly if given market freedom to do so.
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Other types of insurance (home, auto, marine, life, aviation) are sold across state lines. Why would health insurance be different?
A "right to health" concept emerged at some point, whence came government intrusion. You don't have a right to any of those other insured things in that same sense - and "health care" and "health insurance" have subsequently become synonymous in political discourse, regardless of the fact they refer to different concepts.
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A "right to health" concept emerged at some point, whence came government intrusion. You don't have a right to any of those other insured things in that same sense - and "health care" and "health insurance" have subsequently become synonymous in political discourse, regardless of the fact they refer to different concepts.
No one has a "right" to health insurance.
Not sure what the rest of your diatribe has to do with the conversation on various insurances sold across state lines.
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The source of the problem in a nutshell:
https://www.mercatus.org/publication/tax-exemption-employer-provided-health-insurance
After the feds created the tax exemption that tied health insurance to employment, this created the problem of losing your insurance when you retired hence the creation of Medicare, which is the second biggest driver of high cost partly due to rampant fraud.
There are several other contributing causes but these are the main ones.
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The source of the problem in a nutshell:
https://www.mercatus.org/publication/tax-exemption-employer-provided-health-insurance
After the feds created the tax exemption that tied health insurance to employment, this created the problem of losing your insurance when you retired hence the creation of Medicare, which is the second biggest driver of high cost partly due to rampant fraud.
There are several other contributing causes but these are the main ones.
um, when did the feds create the tax exemption for employer-provided health insurance?
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um, when did the feds create the tax exemption for employer-provided health insurance?
It dates from WWII when the feds froze wages and employers used health insurance which was not considered taxable at the time, to increase compensation. I don't recall offhand what year the IRS codified it.
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A "right to health" concept emerged at some point, whence came government intrusion. You don't have a right to any of those other insured things in that same sense - and "health care" and "health insurance" have subsequently become synonymous in political discourse, regardless of the fact they refer to different concepts.
If a “right to health” involves the forced involuntary servitude of another, then it’s not a right, it’s a taking.
Name another right that places a burden on someone else.
It is incumbent upon the adults in the room to advise these virtue signalers what words actually mean.
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If a “right to health” involves the forced involuntary servitude of another, then it’s not a right, it’s a taking.
Name another right that places a burden on someone else.
It is incumbent upon the adults in the room to advise these virtue signalers what words actually mean.
This is exactly correct. Government mandated socialized programs are a form of slavery. Taking your money through taxes is taking your time and labor. The government keeps what your labor produces (money) and redistributes it as the government sees fit, not as you, who earned it, sees fit. This has a suffocating effect on the economy.
I can’t wait to see what the voters are going to say about this in 20/20 with the Democrats proposing “free” healthcare for illegal aliens, paid for by American taxpayers.
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This is exactly correct. Government mandated socialized programs are a form of slavery. Taking your money through taxes is taking your time and labor. The government keeps what your labor produces (money) and redistributes it as the government sees fit, not as you, who earned it, sees fit. This has a suffocating effect on the economy.
I can’t wait to see what the voters are going to say about this in 20/20 with the Democrats proposing “free” healthcare for illegal aliens, paid for by American taxpayers.
(https://uploads.tapatalk-cdn.com/20190813/89280100d6f52f97fad5ff721742426c.jpg)
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This is exactly correct. Government mandated socialized programs are a form of slavery. Taking your money through taxes is taking your time and labor. The government keeps what your labor produces (money) and redistributes it as the government sees fit, not as you, who earned it, sees fit. This has a suffocating effect on the economy.
I can’t wait to see what the voters are going to say about this in 20/20 with the Democrats proposing “free” healthcare for illegal aliens, paid for by American taxpayers.
Simple. The mantra is "paid for by the government". It's still shocking how many dimwits will believe this and cannot understand where government money comes from.
Along the same lines as when someone receives a tax refund. Look at the number of people who can't connect that a refund is nothing more than an interest free loan they made to the government.
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It dates from WWII when the feds froze wages and employers used health insurance which was not considered taxable at the time, to increase compensation. I don't recall offhand what year the IRS codified it.
upon additional google-fu... it would appear that the IRS codified it in 1954.
With medicare being created in 1966 (afaik), I'm wondering why you said "After the feds created the tax exemption that tied health insurance to employment, this created the problem of losing your insurance when you retired hence the creation of Medicare"
Given the timing of IRS exemption and medicare creation contrasting with healthcare costs going up many many years later, I'm confused as to why the exemption and medicare are the biggest drivers.
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No one has a "right" to health insurance.
Not sure what the rest of your diatribe has to do with the conversation on various insurances sold across state lines.
It wasn’t a diatribe. No where did I say I agree with the concept at all. I was trying to explain what other people appear to be thinking and why their incorrect thinking lead to health insurance being treated differently than other types of insurance.
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If a “right to health” involves the forced involuntary servitude of another, then it’s not a right, it’s a taking.
Name another right that places a burden on someone else.
It is incumbent upon the adults in the room to advise these virtue signalers what words actually mean.
Absolutely agreed.
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Given the timing of IRS exemption and medicare creation contrasting with healthcare costs going up many many years later, I'm confused as to why the exemption and medicare are the biggest drivers.
Try this article, which includes a bullet list of major Federal laws and regulations affecting health care from 1910 to 2014:
“How Government Regulations Made Healthcare So Expensive”
https://mises.org/wire/how-government-regulations-made-healthcare-so-expensive (https://mises.org/wire/how-government-regulations-made-healthcare-so-expensive)
Quoting in part:
The U.S. “health care cost crisis” didn’t start until 1965. The government increased demand with the passage of Medicare and Medicaid while restricting the supply of doctors and hospitals. Health care prices responded at twice the rate of inflation (Figure 1). Now, the U.S. is repeating the same mistakes with the unveiling of Obamacare (a.k.a. “Medicare and Medicaid for the middle class”).
Nobel Prize-winning economist Milton Friedman wrote that medical price inflation since 1965 has been caused by the rising demand for health-care coupled with restricted supply (Friedman 1992).
This graph shows a comparison of medical CPI vs general CPI. The divergence starts around 1965. Hmmm.
(https://mises-media.s3.amazonaws.com/styles/full_width/s3/Holly1.png?itok=JUB7FvJY)
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My opinion - is economics based. Basic supply and demand, what drives prices up and what drives them down. At a very high level:
Current:
- Lower supply - when there are fewer doctors, prices go up. I suppose also localized supply could drive local prices up or down, but that's distribution, not numbers. Conversely, more doctors would lower the cost of medicine.
- Lower costs - this comes in many forms and I think is the true cause of high prices. #1 in my book is malpractice insurance. Not because doctors get sued and it's expensive for them to have insurance, that's a relatively small cost. But doctors know they can get sued and therefore they practice a legal defense first, before they practice medicine, resulting in extra procedures and extra costs.
Even then, with hundreds of medical journals out there, there is no way doctors can stay 100% current, it just isn't possible to read all that.
But malpractice insurance also causes doctors to limit their practice, This stratifies medicine and creates a deep layer effect which is most pronounced in hospitals. The layer effect means that company A hires company B who hires company C, keeping in mind that there are billing and escrow companies between all of them. I've done the math and easily found a personal situation where the depth was at least 15 - nuclear echo cardiogram + stress test, tyvm FAA. At 15 levels deep, the multiplier through rebilling is 417%. - Last, Higher demand increases prices. In one sense, we actually WANT higher demand because it means people are using services. But we don't want people arbitrarily using services and I think insurance distorts that a little. If it costs me $25 to see my doctor, then I'll go for almost anything or I'll got to an urgent care facility for simple matters.
Prescriptive:
- Increase supply. If we're going to spend money, let's do something that we know will lower the cost of medicine . Create some government medical schools and create a Health Corp of government doctors under the direction of the Surgeon General. In exchange for tuition, they will serve for a minimum of 6 years, then a graduated transition to private practice in a designated area. Any student who graduates from medical school has an internship with the Surgeon General and can opt into this program too for repayment of loans.
- Lower Costs - protect doctors better from malpractice insurance, perhaps requiring a positive action on their part rather than an inaction or inferior treatment. Let me emphasize, this isn't "let the doctor off the hook", it's limit this to actual malpractice. If a doctor leaves the scissors in your, that's big. If he used a knife instead of a laser scalpel, that's not. A litigant's lawyer can almost always find something in a medical journal that the doctor didn't do, despite being the recommendation at the time, so some level of malpractice win is a strong possibility. But at the same time, remember that the goal is to allow doctors to bring services back in house and undo the stratification of medicine. This lower costs by having everything in one place, with one doctor.
- Last - demand: Remembering that we want some demand, we need to give people incentives to care for themselves first. I don't know what this looks like, probably something like a HSA for primary payor responsibilities to encourage people to be a little more frugal.
Already too long and you probably didn't read...
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Name another right that places a burden on someone else.
The right to free Speech.
It is a burden on me to listen to some of those crybabies. But I want to preserve the right for myself, so I suffer them, because it is a right, but it is also a burden.
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upon additional google-fu... it would appear that the IRS codified it in 1954.
With medicare being created in 1966 (afaik), I'm wondering why you said "After the feds created the tax exemption that tied health insurance to employment, this created the problem of losing your insurance when you retired hence the creation of Medicare"
Given the timing of IRS exemption and medicare creation contrasting with healthcare costs going up many many years later, I'm confused as to why the exemption and medicare are the biggest drivers.
Thanks, I knew it was some time between WWII and the creation of Medicare.
When people started receiving insurance from their employer through group plans, it disconnected the patient as the customer. The company became the customer and the company paid the premium so removed any incentive for patients to self ration, which drove up demand as Jim’s post shows.
With Medicare covering the cost of the most expensive class of patient (the elderly) and again, the patient himself not paying directly, this gave big incentives to doctors and hospitals to maximize treatment, and to over treat, such as implanting pacemakers in people who don’t really need them, and no incentive to the patient, again, to self ration. The huge demand then raised prices not only for Medicare patients but for everyone needing that device.
I also agree with Flynn that liability is a huge reason, maybe number 3 in my mind. I just now got back from my doctor appointment. We talked about statins. He said there is ZERO evidence that statins do you any good at all, but it is such a huge money maker for the pharmaceutical companies and they have convinced the liability insurers that we need to take them if our cholesterol numbers are out of range that doctors now risk having their insurance company drop them if they refuse to prescribe statins to their patients. But statins are associated with cognitive decline and other problems. There are far better ways to treat your cholesterol profile but involve things not patented.
Flynn’s post is excellent on this subject as is Jim’s on supply/demand.
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My opinion - is economics based. Basic supply and demand, what drives prices up and what drives them down. At a very high level:
Current:
- Lower supply - when there are fewer doctors, prices go up. I suppose also localized supply could drive local prices up or down, but that's distribution, not numbers. Conversely, more doctors would lower the cost of medicine.
- Lower costs - this comes in many forms and I think is the true cause of high prices. #1 in my book is malpractice insurance. Not because doctors get sued and it's expensive for them to have insurance, that's a relatively small cost. But doctors know they can get sued and therefore they practice a legal defense first, before they practice medicine, resulting in extra procedures and extra costs.
Even then, with hundreds of medical journals out there, there is no way doctors can stay 100% current, it just isn't possible to read all that.
But malpractice insurance also causes doctors to limit their practice, This stratifies medicine and creates a deep layer effect which is most pronounced in hospitals. The layer effect means that company A hires company B who hires company C, keeping in mind that there are billing and escrow companies between all of them. I've done the math and easily found a personal situation where the depth was at least 15 - nuclear echo cardiogram + stress test, tyvm FAA. At 15 levels deep, the multiplier through rebilling is 417%. - Last, Higher demand increases prices. In one sense, we actually WANT higher demand because it means people are using services. But we don't want people arbitrarily using services and I think insurance distorts that a little. If it costs me $25 to see my doctor, then I'll go for almost anything or I'll got to an urgent care facility for simple matters.
Prescriptive:
- Increase supply. If we're going to spend money, let's do something that we know will lower the cost of medicine . Create some government medical schools and create a Health Corp of government doctors under the direction of the Surgeon General. In exchange for tuition, they will serve for a minimum of 6 years, then a graduated transition to private practice in a designated area. Any student who graduates from medical school has an internship with the Surgeon General and can opt into this program too for repayment of loans.
- Lower Costs - protect doctors better from malpractice insurance, perhaps requiring a positive action on their part rather than an inaction or inferior treatment. Let me emphasize, this isn't "let the doctor off the hook", it's limit this to actual malpractice. If a doctor leaves the scissors in your, that's big. If he used a knife instead of a laser scalpel, that's not. A litigant's lawyer can almost always find something in a medical journal that the doctor didn't do, despite being the recommendation at the time, so some level of malpractice win is a strong possibility. But at the same time, remember that the goal is to allow doctors to bring services back in house and undo the stratification of medicine. This lower costs by having everything in one place, with one doctor.
- Last - demand: Remembering that we want some demand, we need to give people incentives to care for themselves first. I don't know what this looks like, probably something like a HSA for primary payor responsibilities to encourage people to be a little more frugal.
Already too long and you probably didn't read...
I don't see how that explains things like the $50 aspirin on a hospital bill.
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I don't see how that explains things like the $50 aspirin on a hospital bill.
$0.02 for the aspirin and $49.98 to know where to put it.
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I don't see how that explains things like the $50 aspirin on a hospital bill.
Hospitals do that to make up for their losses because of Medicaid and Medicare underpaying.
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Hospitals do that to make up for their losses because of Medicaid and Medicare underpaying.
Just think what it will be like when we're all on Medicare ::)
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Just think what it will be like when we're all on Medicare ::)
All anyone has to do is look at the VA and how they run their health care program to see where "Medicare for all" would take us.
One of the major reasons in other countries that health care is affordable (I'm not talking about socialist countries) is lack of government involvement. When healthcare is treated like any other business the market will determine the cost.
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Prescriptive:
- Increase supply. If we're going to spend money, let's do something that we know will lower the cost of medicine . Create some government medical schools and create a Health Corp of government doctors under the direction of the Surgeon General.
Just reading that scares the bejeebies out of me. I certainly wouldn't want to have to depend on those doctors for my primary medical care. But maybe they could be assigned to jails, prisons and homeless shelters.
I strongly believe the argument that government meddling got us into this mess. I just don't believe that more government meddling will get us out. Like they say:
"If you want to get out of a hole, the first thing you have to do is stop digging".
Trying to make health care fair and available to everyone is what has made it un-affordable for almost everyone. Just like what the government did to college tuition.[/list]
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^^^^^Anything government touches, and controls becomes too large, inefficient, and often much less effective than its private sector alternative. There is just no incentive, nor competition for government to do so. What happens is that the government entity's goal becomes to sustain, and grow itself, not provide the necessary service. It is a recipe for disaster.
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^^^^^Anything government touches, and controls becomes too large, inefficient, and often much less effective than its private sector alternative. There is just no inventive, nor competition for government to do so. What happens is that the government entity's goal become to sustain, and grow itself, not provide the necessary service. It is a recipe for disaster.
Pournelle’s Iron Law of Bureaucracy.
http://americandigest.org/wp/pournelles-iron-law-bureaucracy/
Jerry Pournelle’s Iron Law of Bureaucracy states that in any bureaucratic organization there will be two kinds of people: First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.
Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.
The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization.
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I don't see how that explains things like the $50 aspirin on a hospital bill.
Someone has to pay the hospital for all the people who use the emergency room as a regular dr visit and don't pay the bill after.
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Just reading that scares the bejeebies out of me. I certainly wouldn't want to have to depend on those doctors for my primary medical care. But maybe they could be assigned to jails, prisons and homeless shelters.
I strongly believe the argument that government meddling got us into this mess. I just don't believe that more government meddling will get us out. Like they say:
"If you want to get out of a hole, the first thing you have to do is stop digging".
Trying to make health care fair and available to everyone is what has made it un-affordable for almost everyone. Just like what the government did to college tuition.[/list]
Agree completely. Keep the government OUT!
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Someone has to pay the hospital for all the people who use the emergency room as a regular dr visit and don't pay the bill after.
Exactly
https://www.npr.org/sections/money/2009/11/18_dollar_asprin.html
Of course it doesn't cost the hospital $18.02 for an aspirin. It doesn't cost $900 to do a shoulder MRI either. These numbers have almost nothing to do with actual costs. The hospitals essentially make them up. They charge more for things like MRIs and aspirin so they can cover other costs like 24-hour Emergency Rooms and patients who can't afford to pay their bills. It's a strange business model, and one that makes it really hard to tell if a hospital is running an efficient shop.
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Pournelle’s Iron Law of Bureaucracy.
http://americandigest.org/wp/pournelles-iron-law-bureaucracy/
Perfect example of what has happened to FedGov agencies: Departments of: Education, Agriculture, etc etc.
Look at all those beautiful, GIANT buildings in Washington DC. That is FedGov, in all of its bloat, waste, and self-preservation.
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I've been dealing with workers comp medical issues for a whole year next month. I've seen my primary dr, 4 specialists, multiple x-rays and mri's, countless PT sessions, chiropractor, 2 cortisone shots, 3 back surgeries (with a wrist surgery I need to schedule in the next few months). Someone told me that over 300 people in the hospital system alone have accessed my file. If you can't streamline the medical system, there is no way to decrease costs. Get the government involved, holy hell. I'm dealing with OWCP along with this and they are about as fucked up as a football bat, they got the billing and everything so screwed up. All because a few people at the hospital coded the billing wrong. Instead of OWCP calling them back and telling them to resubmit the bill with the right code, they just denied the bill. Now my insurance company has to go to subrogation to get refunded.
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Perfect example of what has happened to FedGov agencies: Departments of: Education, Agriculture, etc etc.
Look at all those beautiful, GIANT buildings in Washington DC. That is FedGov, in all of its bloat, waste, and self-preservation.
One problem is that agencies can only carry over a small emergency fund every fiscal year. The amount of money spent in the last month of the fiscal year to get down to a 0 balance is insane. I wish I could say that it is all spend wisely, but I know for a fact that some offices buy crazy stuff and go into a negative balance just because they know that there is money at the end of the year that will cover it. Then you have the whole GSA system scam.
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Totally. In my wife's experiences with worker's comp, they need a mountain of documentation and decline twice before accepting. I've heard this from many sources... decline twice then accept. I guess to see if you're serious. I think that they make it so that working at a job is easier than getting through the worker's comp process.
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Totally. In my wife's experiences with worker's comp, they need a mountain of documentation and decline twice before accepting. I've heard this from many sources... decline twice then accept. I guess to see if you're serious. I think that they make it so that working at a job is easier than getting through the worker's comp process.
I was lucky in that my case was approved right away and everything else was approved, when you have a history of multiple injuries to the same area, sort of hard to deny more claims. My dr officially declared me permanently disabled for my job last week, federal LEO, so know I have more paperwork to get from him and put on my file. I'm also getting letters from OWCP that I'm going to be possibly referred to career counseling and retraining, and possibly being involuntary medically separated from my agency. But the coding they use and the hospital use weren't the same. But instead of OWCP being proactive with billing, they just deny, and let you figure it all out months after.
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Totally. In my wife's experiences with worker's comp, they need a mountain of documentation and decline twice before accepting. I've heard this from many sources... decline twice then accept. I guess to see if you're serious. I think that they make it so that working at a job is easier than getting through the worker's comp process.
I tore my ACL a couple of years ago. I played college football, so I was embarrassed to tell the doc that I tripped over my wife’s rabbit fence around her vegetable garden. I used the word “accident.” What a mistake!
I’ve always had great luck with BC/BS, but the word “accident” had them looking for someone else to pay the bills. I was asked at least six times, over six months, by phone and mail, if anyone like a contractor was involved. I finally had to tell them that I’m not going to sue myself, so leave me alone and pay the damned bill! (I didn’t even have surgery - just Dr visits and an MRI.)
Can you imagine if FedGov was involved?
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Problem with medical care is it really doesn't work according to the economics that govern other things. If you want a car, you wait until you have the financial wherewithal, you then shop for the car that meets your specifications for the lowest price.
You never know when you're going to get sick or how bad. You simply can't plan for it. Moreover, once you're sick you're in no position to shop or bargain. You really can't be an informed consumer when it comes to health care. Market economics don't work for medicine, they never have.
What no one really realizes is the system we have was put in place to solve a problem, that's why it's there. The funny thing is it was put in place at least partially through the efforts of Richard Nixon, who I think would be regarded as a flaming liberal today, were he regarded at all.
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Market forces, and competition can, and do work in certain aspects of health care. I am a consultant to a major, regional health care system. It is technically structured as a "not for profit", but we all know how that works. They are in competition with other health systems (hospital groups) in the area, and have a huge incentive to keep operating expenses as low as possible while still providing excellent care. Other heath systems are incentivized like this also, as they are in competition for patients.
If this competition were allowed on a larger scale, and insurers were allowed to compete across state lines, health care costs would go down.
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Problem with medical care is it really doesn't work according to the economics that govern other things. If you want a car, you wait until you have the financial wherewithal, you then shop for the car that meets your specifications for the lowest price.
You never know when you're going to get sick or how bad. You simply can't plan for it. Moreover, once you're sick you're in no position to shop or bargain. You really can't be an informed consumer when it comes to health care. Market economics don't work for medicine, they never have.
What no one really realizes is the system we have was put in place to solve a problem, that's why it's there. The funny thing is it was put in place at least partially through the efforts of Richard Nixon, who I think would be regarded as a flaming liberal today, were he regarded at all.
Gee, if only here was an industry they helped to limit the risks of individuals not being able to plan for getting sick, where you pay a monthly fee and don’t have to shop around for the best price provider.
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Gee, if only here was an industry they helped to limit the risks of individuals not being able to plan for getting sick, where you pay a monthly fee and don’t have to shop around for the best price provider.
And if only people had the forethought to actually save a little bit so they could afford a few curve balls. My brother would probably have to sell his boat and camper trailer if he got sick and lost a few weeks work. I tell him he should sell the boat now and put the money into the bank until has at least a modest savings.
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Problem with medical care is it really doesn't work according to the economics that govern other things. If you want a car, you wait until you have the financial wherewithal, you then shop for the car that meets your specifications for the lowest price.
You never know when you're going to get sick or how bad. You simply can't plan for it. Moreover, once you're sick you're in no position to shop or bargain. You really can't be an informed consumer when it comes to health care. Market economics don't work for medicine, they never have.
What no one really realizes is the system we have was put in place to solve a problem, that's why it's there. The funny thing is it was put in place at least partially through the efforts of Richard Nixon, who I think would be regarded as a flaming liberal today, were he regarded at all.
Health insurance should be like home owner's insurance. There to pay for major catastrophe. Regular checkups and cases of the sniffles should be pay as you go out of pocket. In a true competitive free market it works, we know that because it used to. There were doctors for every socioeconomic level. If you had no cash, you bartered with the doc and paid him in chickens. Self treatment goes a very long way too.
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Free market works great with Lazik eye surgery.
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Free market works great with Lazik eye surgery.
Good point. I wonder what that would cost if it were covered by Obamacare. $20k? $30k But nobody would actually pay it because it is covered by insurance.
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Problem with medical care is it really doesn't work according to the economics that govern other things. If you want a car, you wait until you have the financial wherewithal, you then shop for the car that meets your specifications for the lowest price.
You never know when you're going to get sick or how bad. You simply can't plan for it. Moreover, once you're sick you're in no position to shop or bargain. You really can't be an informed consumer when it comes to health care. Market economics don't work for medicine, they never have.
What no one really realizes is the system we have was put in place to solve a problem, that's why it's there. The funny thing is it was put in place at least partially through the efforts of Richard Nixon, who I think would be regarded as a flaming liberal today, were he regarded at all.
So once again we have the perfesser pontificating on life from within his bubble.
Funny how "medical tourism" has increased. These are people that need or want a specific procedure, and rather than pay an over inflated cost go to another country and pay cash, saving thousands.
I have a good friend that had a surgical procedure done in Colombia for pennies on the dollar compared to the cost here. And it was a quality procedure. Back many years ago I was traveling and working in Asia. I broke a crown on a molar, went to a local dentist. Had the tooth base prepped and a new porcelain crown made and installed. Cost? $130us. Here in the US that's a $1500 procedure.
As previously mentioned, Lasik is another example. With competition that market is actually reasonable to have the procedure done.
Try getting a hospital or doctor office here to quote a procedure. Good Luck. The Insurance industry in cooperation with government has it so convoluted it's nearly impossible.
Take a look at what's happened to college education cost. Once government got into the student loan business, college cost escalated. Are we getting better education to go with that inflated cost? Nope, just more money and bureaucracy.
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So once again we have the perfesser pontificating on life from within his bubble.
Funny how "medical tourism" has increased. These are people that need or want a specific procedure, and rather than pay an over inflated cost go to another country and pay cash, saving thousands.
I have a good friend that had a surgical procedure done in Colombia for pennies on the dollar compared to the cost here. And it was a quality procedure. Back many years ago I was traveling and working in Asia. I broke a crown on a molar, went to a local dentist. Had the tooth base prepped and a new porcelain crown made and installed. Cost? $130us. Here in the US that's a $1500 procedure.
As previously mentioned, Lasik is another example. With competition that market is actually reasonable to have the procedure done.
Try getting a hospital or doctor office here to quote a procedure. Good Luck. The Insurance industry in cooperation with government has it so convoluted it's nearly impossible.
Take a look at what's happened to college education cost. Once government got into the student loan business, college cost escalated. Are we getting better education to go with that inflated cost? Nope, just more money and bureaucracy.
Let me know how your cancer treatment works out in Columbia.
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Let me know how your cancer treatment works out in Columbia.
First of all dimwit, it's "Colombia". You should seriously get a 5th grader to proof read your postings. ::)
Wow, so the US has the market cornered on cancer treatment and research? Hate to break it to you, but many many other countries are involved as well. And for a Doctor in "Colombia"? Lots of those guys have studied abroad as well.
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Let me know how your cancer treatment works out in Columbia.
Cancer would be when your catastrophic policy would kick in.
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Cancer would be when your catastrophic policy would kick in.
Problem is always in figuring out what’s “catastrophic” and what isn’t. Medical costs aren’t meristic or threshold, they’re quantitative. Should your illness fall just short of “catastrophic” you could be royally fucked.
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Problem is always in figuring out what’s “catastrophic” and what isn’t. Medical costs aren’t meristic or threshold, they’re quantitative. Should your illness fall just short of “catastrophic” you could be royally fucked.
Under our current quagmire, yes. Under a free market system without government intervention, not so much.
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Problem is always in figuring out what’s “catastrophic” and what isn’t. Medical costs aren’t meristic or threshold, they’re quantitative. Should your illness fall just short of “catastrophic” you could be royally fucked.
I thought “catastrophic” in the case of insurance was the point at which the covered medical bills reached the agreed upon out-of-pocket limit. That limit could be reached by getting treated for cancer, accident injuries, diseases, and so on. Paying the bills up to that limit isn’t getting fucked.
Example: our ACA mandated insurance premiums the last 5 years averaged $13,524/year and our out-of-pocket expenses were $5176/year (mostly due to periodic doc visits for my rheumatoid arthritis.) We never reached the deductible. When I checked the price of non-ACA compliant catastrophic insurance the rates were in the few hundred a month range - depending on deductible, amount and types of coverage, and so on. I think I estimated for roughly equivalent coverage I could more than cut our premium in half.
The premiums were where we were getting fucked, not medical bills. The ACA is downright evil against that portion of the middle class that are self-employed or having to buy individual insurance.
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“catastrophic” would certainly be relative. Kind of like having insurance on a house or car. Some could afford the loss of a house or car without blinking.
Someone pulling in $150,000 per year would typically be able to afford a one-time treatment for whatever (short of a double-lung transplant).
Someone pulling in $15,000,000 per year would likely be able to afford just about any medical treatment.
Someone pulling in $30,000 per year would have financial difficulty with even a joint replacement.
On the other hand, “catastrophic” shouldn't include elective procedures or should it?
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“catastrophic” would certainly be relative. Kind of like having insurance on a house or car. Some could afford the loss of a house or car without blinking.
Someone pulling in $150,000 per year would typically be able to afford a one-time treatment for whatever (short of a double-lung transplant).
Someone pulling in $15,000,000 per year would likely be able to afford just about any medical treatment.
Someone pulling in $30,000 per year would have financial difficulty with even a joint replacement.
On the other hand, “catastrophic” shouldn't include elective procedures or should it?
I don't know if there is, or should be, a definition of "catastrophic coverage". You should be given an opportunity to buy a high deductible plan or a zero deductible plan. If a $30 thousand medical bill would be catastrophic to you, then you would want a policy with a deductible less than that. The individual needs to determine their risk tolerance and the premium they can pay to manage that risk. The higher the deductible, the lower the premium. Of course, there are other details that go into determining the premium.
I would also tolerate some amount of government subsidy for those that cannot afford even a high deductible premium (and the high deductibles that go with them). But they wouldn't get a Cadillac plan.
As far as "routine care"; that should be up to the insurance company. If they think they can save money by preventing illnesses, or catching them early, then they may be able to reduce their premium and gain a competitive advantage. But only if competition is not restricted. But we would still need some sort of regulation to prevent frauds and liars from selling fake policies.
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At one point all medical care was paid for on the spot just like anything else. At that time doctors really couldn't do much, but they made house calls and medical care was inexpensive. As some point, once medical capabilities increased, that medical care got too expensive. I don't know when that was. But at that point insurers began offering coverage, and it went from being a luxury to a necessity for most.
There are still plenty of places you can show up and pay cash for simple medical issues, broken bones and the like. But if you get into any kind of complex medical issue it can get expensive very quickly indeed. I know people ruined by medical issues. It sux to be financially ruined just because you got sick.
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At one point all medical care was paid for on the spot just like anything else. At that time doctors really couldn't do much, but they made house calls and medical care was inexpensive. As some point, once medical capabilities increased, that medical care got too expensive. I don't know when that was. But at that point insurers began offering coverage, and it went from being a luxury to a necessity for most.
There are still plenty of places you can show up and pay cash for simple medical issues, broken bones and the like. But if you get into any kind of complex medical issue it can get expensive very quickly indeed. I know people ruined by medical issues. It sux to be financially ruined just because you got sick.
It also sucks to be financially ruined because an institution that someone invest their money into goes under. It sucks to be financially ruined due to such things as earthquakes, hurricanes, cyclones, fires, etc.
Originally health insurance was just that, insurance. It was there for the expensive items that would potentially destroy someone financially. Then it morphed into being "health care", i.e. pay for anything health related. The real downfall began when government got involved.
Open up insurance where it can be bought across state lines would be a huge benefit for the consumer. Bury the disastrous ACA. Put health insurance back in the free market where it belongs and prices will adjust accordingly.
Government is not the solution.
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There was a six month period of time that my wife had no insurance. She needed a knee procedure done. First up was a knee brace she needed we went to see the guy that handles that in the practice and he gave us some ridiculous number for the brace. We explained we were paying cash and did not plan on paying his number. He left to go consult and came back and offered it to us for $85. We negotiated a discounted price for the surgeon and outpatient surgical center. The anesthetist would not negotiate a discount.
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There are still plenty of places you can show up and pay cash for simple medical issues, broken bones and the like. But if you get into any kind of complex medical issue it can get expensive very quickly indeed. I know people ruined by medical issues. It sux to be financially ruined just because you got sick.
It also sucks to be dead. Not too long ago things were simple. You either got a cheap cure or you got dead. Cheap cures were all there was. Then technology advanced such that cures for complex things were found. But those cures tend to be very expensive. Simple things are still cheap. Complex things are expensive. It's been like that forever.
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There was a six month period of time that my wife had no insurance. She needed a knee procedure done. First up was a knee brace she needed we went to see the guy that handles that in the practice and he gave us some ridiculous number for the brace. We explained we were paying cash and did not plan on paying his number. He left to go consult and came back and offered it to us for $85. We negotiated a discounted price for the surgeon and outpatient surgical center. The anesthetist would not negotiate a discount.
This is a little known secret. We can negotiate cash out of pocket and sometimes it is LESS than the copay if we go through insurance. That’s how screwed up the system has become.
Also screwed up is the whole idea of “PCP”. Your general doctor used to handle most of your issues and you had a close relationship with him with mutual trust. Not any more. Dealing with the PCP these days is getting more difficult. People are turning to doc in a box for minor things. They take walk ins, they don’t grill you about your whole health picture other than the basics necessary to treat your minor ailment, and they act like they appreciate your business. The last three visits I made to urgent care were a pleasure. In and out in an hour. The last three times I moved and just tried to get in with a new PCP were a nightmare. I had to pull teeth just to get the first appointment.
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Government is not the solution.
Government IS the problem. It's not the solution.
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Government IS the problem. It's not the solution.
In just about all aspects of our life also. It has become so burdensome that people that succeed do so IN SPITE of government. The Nanny State is out of control and women have had a lot to do with that.
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If anyone wants to see just how good government run healthcare could be, just go talk to a veteran who uses the VA.
The VA healthcare system is a disaster as well as bureaucratic nightmare.
And ask why Canadians come to the US to purchase procedures rather than have it done under their socialist healthcare system back home.
Another point about government run healthcare for all. Say the perfessor needs a procedure that will save his life. A group of non medical bureaucrats will determine if the procedure is "warranted". They look at his age and determine "Sorry, but under our system you fall outside of the parameters by one month, if you want to appeal the appeal process can take up to one year". He has six months to live without the procedure. The bureaucrats say "Sorry, that's the rules......Next!".
Tell me how bad that would suck.
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If anyone wants to see just how good government run healthcare could be, just go talk to a veteran who uses the VA.
The VA healthcare system is a disaster as well as bureaucratic nightmare.
I have access to the VA system, but have never even thought of using it. It would be a last ditch desperation move.
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I have access to the VA system, but have never even thought of using it. It would be a last ditch desperation move.
A good friend of mine was partially disabled while in the Marines, during a training exercise. He uses the VA as that is what he can afford. I've gone with him a few times just to offer support and to see what it was like.
LONG waits, even when you have an appointment. Then when you do get to see a doctor, they do NOT address is issues, and just want to get rid of him with the most ridiculous, ineffective assessments you can imagine. It is always a crowded mess, of disorganization, and poor service. He is treated like a nuisance, as their is NO INCENTIVE for them to provide even mediocre service. They still have pictures of Obama up in most of their offices, so you know what you are dealing with.
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This is a little known secret. We can negotiate cash out of pocket and sometimes it is LESS than the copay if we go through insurance. That’s how screwed up the system has become.
Also screwed up is the whole idea of “PCP”. Your general doctor used to handle most of your issues and you had a close relationship with him with mutual trust. Not any more. Dealing with the PCP these days is getting more difficult. People are turning to doc in a box for minor things. They take walk ins, they don’t grill you about your whole health picture other than the basics necessary to treat your minor ailment, and they act like they appreciate your business. The last three visits I made to urgent care were a pleasure. In and out in an hour. The last three times I moved and just tried to get in with a new PCP were a nightmare. I had to pull teeth just to get the first appointment.
Under the dims plan of "healthcare for all" it will be illegal to pay for your own healthcare. These "doc in a box" locations would all go away. Instead we would get government buildings in a "district" that you would be assigned to. The doctors and other health professionals will be employees of the government, at government wages. 1 case or 100 cases, the pay is the same. Also, all decisions on treatment go to a panel of bureaucrats to decide, not the treating physician.
How anyone could see this as a viable alternative is just crazy.
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I have access to the VA system, but have never even thought of using it. It would be a last ditch desperation move.
Same here.
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This is a little known secret. We can negotiate cash out of pocket and sometimes it is LESS than the copay if we go through insurance. That’s how screwed up the system has become.
Also screwed up is the whole idea of “PCP”. Your general doctor used to handle most of your issues and you had a close relationship with him with mutual trust. Not any more. Dealing with the PCP these days is getting more difficult. People are turning to doc in a box for minor things. They take walk ins, they don’t grill you about your whole health picture other than the basics necessary to treat your minor ailment, and they act like they appreciate your business. The last three visits I made to urgent care were a pleasure. In and out in an hour. The last three times I moved and just tried to get in with a new PCP were a nightmare. I had to pull teeth just to get the first appointment.
That hasn’t been my experience. My wife, daughter and I got referred to a young female doctor in 2008 who was just out of residency. She is board certified in Internal Medicine, and is part of the Froedtert and Medical College of Wisconsin network, so it’s a teaching position as well. Access is almost always within the week if not within two days.
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That hasn’t been my experience. My wife, daughter and I got referred to a young female doctor in 2008 who was just out of residency. She is board certified in Internal Medicine, and is part of the Froedtert and Medical College of Wisconsin network, so it’s a teaching position as well. Access is almost always within the week if not within two days.
It varies a lot depending on location, and may be getting worse. When I lived in MI, I had a cardio/internist as a PCP and could usually get in to see him same or next day. Now my PCP is booked at least 4 weeks in advance, and one specialist I see who promised that I could see her within a couple of weeks as I am a returning patient, is actually booked closer to 3 months out regardless of patient status.
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It varies a lot depending on location, and may be getting worse. When I lived in MI, I had a cardio/internist as a PCP and could usually get in to see him same or next day. Now my PCP is booked at least 4 weeks in advance, and one specialist I see who promised that I could see her within a couple of weeks as I am a returning patient, is actually booked closer to 3 months out regardless of patient status.
It has been getting worse and worse ever since the ADA brought on more and more insurees, and ran off more and more doctors, and forced insurance companies to restrict the number of doctors they considered "in network".
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That hasn’t been my experience. My wife, daughter and I got referred to a young female doctor in 2008 who was just out of residency. She is board certified in Internal Medicine, and is part of the Froedtert and Medical College of Wisconsin network, so it’s a teaching position as well. Access is almost always within the week if not within two days.
We love Freodtert! It's like Mayo where you get coordinated care and not shuffled around the specialized medical silos that don't talk to each other.
We found that moving to a new area it's really hard to get a primary care physician. New patient appointments tend to be longer and harder to schedule. Being booked out months in advance is the new normal. The exception is if you can find someone fresh out of school who doesn't have an established patient base. Then it's much easier to get established and get appointments.
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It varies a lot depending on location, and may be getting worse. When I lived in MI, I had a cardio/internist as a PCP and could usually get in to see him same or next day. Now my PCP is booked at least 4 weeks in advance, and one specialist I see who promised that I could see her within a couple of weeks as I am a returning patient, is actually booked closer to 3 months out regardless of patient status.
It also depends on the quality of the doctor. New ones just starting out are easier to get in with and if they are excellent despite less experience then you have lucked out. But if you want in with an excellent doctor already established, it can be very difficult, even if they claim they are “accepting new patients”. They frickin vet you. They won’t even schedule the first appointment unless you have already named them as your insurance designated provider. How are you supposed to commit to that without even meeting the guy/gal?
And even if you do name them on your insurance they may still reject you.
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We love Freodtert! It's like Mayo where you get coordinated care and not shuffled around the specialized medical silos that don't talk to each other.
We found that moving to a new area it's really hard to get a primary care physician. New patient appointments tend to be longer and harder to schedule. Being booked out months in advance is the new normal. The exception is if you can find someone fresh out of school who doesn't have an established patient base. Then it's much easier to get established and get appointments.
Yes! It is great to be in a teaching environment. Well, except when you have something very personal like, say, a prostate biopsy, and you have two female nurses, a female PA doing the procedure, and two attractive female medical students observing.
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It also depends on the quality of the doctor. New ones just starting out are easier to get in with and if they are excellent despite less experience then you have lucked out. But if you want in with an excellent doctor already established, it can be very difficult, even if they claim they are “accepting new patients”. They frickin vet you. They won’t even schedule the first appointment unless you have already named them as your insurance designated provider. How are you supposed to commit to that without even meeting the guy/gal?
Actually my former PCP was an older and well-established doctor. My new PCP is a young guy, though he is not really just starting out. But yes, he is excellent, and in some ways, better than the older guy. Plus, his training is as an orthopod, and most of my recent complaints have been injuries and wear-and-tear stuff, so it is a good fit... or would be, if the waiting time wasn't so long.
Fortunately, the clinic he works at does have "acute care" appointments, so I can sometimes get in to see him that way... but with acute care, you get whoever is available, which in most cases is a PA.
I have not had any experience with being vetted by a prospective doctor, nor with having to name a PCP in advance with insurance - so that probably varies a lot.
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Yes! It is great to be in a teaching environment. Well, except when you have something very personal like, say, a prostate biopsy, and you have two female nurses, a female PA doing the procedure, and two attractive female medical students observing.
Yeah. I could see how that might be hard.
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Yeah. I could see how that might be hard.
LOL! So you're saying sometime Stan thinks with the other head?
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LOL! So you're saying sometime Stan thinks with the other head?
Actually, look up the procedure. “Unpleasant” is an understatement. It was more like a frightened turtle.
https://youtu.be/BEnKLhi83J8
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My half brother had a knee replacement earlier this year at the VA. When he was rehabbing, the PT told him they thought it was infected. He went to the doctor (surgeon) who told him it wasn't. Some time later, while in the bathroom, it opened up with fluid all over the floor. At the VA hospital they were slow to really treat the infection and they damn near killed him. They hadn't even assigned an infectious disease doctor to his case. The ended up having to put him into a coma and at one point called my sister to tell her to gather up the family. He did end up pulling through, but not until my sister brought a friend of hers that is a nurse with her and she started giving people hell. He had to have the knee taken out and a spacer put in. Apparently the spacer was the wrong size and it ended up turning. It was left like that until he had a new knee put in a few weeks ago. The only plus side to the whole adventure was the weight he lost through the ordeal.
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Actually, look up the procedure. “Unpleasant” is an understatement. It was more like a frightened turtle.
https://youtu.be/BEnKLhi83J8
I'm imagining a mini-drill bit auger like thing on the end of a catheter. *shudder*
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My half brother had a knee replacement earlier this year at the VA. When he was rehabbing, the PT told him they thought it was infected. He went to the doctor (surgeon) who told him it wasn't. Some time later, while in the bathroom, it opened up with fluid all over the floor. At the VA hospital they were slow to really treat the infection and they damn near killed him. They hadn't even assigned an infectious disease doctor to his case. The ended up having to put him into a coma and at one point called my sister to tell her to gather up the family. He did end up pulling through, but not until my sister brought a friend of hers that is a nurse with her and she started giving people hell. He had to have the knee taken out and a spacer put in. Apparently the spacer was the wrong size and it ended up turning. It was left like that until he had a new knee put in a few weeks ago. The only plus side to the whole adventure was the weight he lost through the ordeal.
Ouch! I hope his new knee is working now and pain free? No more arthritis?
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I'm imagining a mini-drill bit auger like thing on the end of a catheter. *shudder*
Nope.
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Yes! It is great to be in a teaching environment. Well, except when you have something very personal like, say, a prostate biopsy, and you have two female nurses, a female PA doing the procedure, and two attractive female medical students observing.
George Clooney would have that problem. You and me, not so much. :)
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George Clooney would have that problem. You and me, not so much. :)
Maybe not, but I during my last dermatology semi-annual exam I was attended to by a very pretty doctor and a beautiful young nurse. At 67 yrs old, the embarassing part was wondering what was going through their minds when they looked at my aging body. I got through it by imagining both of them naked. Does that make me a dirty old man? I suppose so. But if I wasn't naked, I probably wouldn't have done that.
For some reason, my health insurance changes approved dermatology offices every year so I have to see new dermatologists every year (since I do have a history of skin cancer). I could just pay out of pocket for the dermatologist I like, but so far I haven't really liked any of them. The last one removed a small basal cell carcinoma from my face. His "surgical" light was the same aluminum cone with an incandescent light bulb that I have in my garage from Home Depot.
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Maybe not, but I during my last dermatology semi-annual exam I was attended to by a very pretty doctor and a beautiful young nurse. At 67 yrs old, the embarassing part was wondering what was going through their minds when they looked at my aging body. I got through it by imagining both of them naked. Does that make me a dirty old man? I suppose so. But if I wasn't naked, I probably wouldn't have done that.
For some reason, my health insurance changes approved dermatology offices every year so I have to see new dermatologists every year (since I do have a history of skin cancer). I could just pay out of pocket for the dermatologist I like, but so far I haven't really liked any of them. The last one removed a small basal cell carcinoma from my face. His "surgical" light was the same aluminum cone with an incandescent light bulb that I have in my garage from Home Depot.
I am still young enough that if I was naked, imagining 2 beautiful women in a room with me were also naked, it would be pretty obvious to those women what I was thinking.
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I am still young enough that if I was naked, imagining 2 beautiful women in a room with me were also naked, it would be pretty obvious to those women what I was thinking.
Yeah. I remember those days.
It still takes self control though.