Worlds Most Powerfull 4 stroke OB
 

NOYB wrote:

"Harry Krause" wrote in message
news:D9-dnWZdto38aK3dRVn-

For many people, providers as well as patients, the way we handle
"managed care" is a disaster. My wife has two masters'-level psychiatric
social workers at her office who spend most of their day fighting with
insurance companies

You've nailed the problem right there. When did medicine start accepting
assignment of benefits for routine office visits? If patient's paid when
services were rendered, and then filed with the insurance company on their
own (dentistry calls it "direct reimbursement"), your wife's office could
use those psychiatric social workers more efficiently.



The problem is, it takes someone with an advanced degree to work through
the maze of pre-cert and post-paym as it were.

Worlds Most Powerfull 4 stroke OB
 

On Mon, 16 Feb 2004 11:52:05 -0500, Harry Krause wrote:


Rx companies now spend as much on marketing as they do on research, and
a lot of that marketing is spent on prime-time television, convincing
Americans to ask their doctors for drugs they may not even need.

Some of those ads scare the hell out of me with there potential side
effects. Sure your headache will be gone, but you'll end up with the
runs, insomnia, and hair loss. ;-)

Worlds Most Powerfull 4 stroke OB
 

"Harry Krause" wrote in message
...
NOYB wrote:

"Gene Kearns" wrote in message
...
On Mon, 16 Feb 2004 10:27:19 -0500, Harry Krause
wrote:


The reason why health insurance policies typically place a low cap on
annual dental charges is directly related to the outrageous prices
many
dentists charge for their work and the work of their "assistants," and
the mark-up on work they send out to their labs.

I was moved by a television show I saw the other day. In many
cultures, care givers will not charge for their services.... relying
for their livelihood on donations from their patients. These care
givers consider money charged for helping others. who are sick or in
pain, as tainted money.

Name one culture in which a person spends 12 years in school, 4 years in
college, 4 years in medical school, and 2-4 years in a residency...and
then
doesn't get compensated for his/her work. Donating a couple of chickens
and
a cow will not help repay a school loan of $250,000...nor will it pay
malpractice insurance premiums equal to or greater than that amount.

My wife has had a bit more school than you have, and, in fact, is
pursuing her second doctorate, although this one is a PhD in
statistics/research. By choice, she does not receive compensation for 50
per cent of her professional time as a psychotherapist, and her
educational loans are pretty high.

Good for her. There are several problems with you comparing her situation
to mine, however. Dental school is a lot more expensive than psych school.
She also isn't the sole provider in your household...and you don't have
three children to raise together. You guys are DINKs.



Oh...and the culture she lives in is...this culture, here in disUnited
States.

We're united...united in ridding this country of liberalism.

Worlds Most Powerfull 4 stroke OB
 

thunder wrote:

On Mon, 16 Feb 2004 11:52:05 -0500, Harry Krause wrote:


Rx companies now spend as much on marketing as they do on research, and
a lot of that marketing is spent on prime-time television, convincing
Americans to ask their doctors for drugs they may not even need.

Some of those ads scare the hell out of me with there potential side
effects. Sure your headache will be gone, but you'll end up with the
runs, insomnia, and hair loss. ;-)


There are a few out there whose possible side effects include death.

Worlds Most Powerfull 4 stroke OB
 

WaIIy wrote:

On Mon, 16 Feb 2004 18:04:46 GMT, "NOYB" wrote:


"Harry Krause" wrote in message
news:D9-dnWZdto38aK3dRVn-

For many people, providers as well as patients, the way we handle
"managed care" is a disaster. My wife has two masters'-level psychiatric
social workers at her office who spend most of their day fighting with
insurance companies

You've nailed the problem right there. When did medicine start accepting
assignment of benefits for routine office visits? If patient's paid when
services were rendered, and then filed with the insurance company on their
own (dentistry calls it "direct reimbursement"), your wife's office could
use those psychiatric social workers more efficiently.


They don't have a secretary to deal with the insurance companies?

Hmmm


No, Wally, it takes two full-time master's level assistants to run the
maze. My wife doesn't give up on patients in her practice...if they need
serious care, they get it, no matter how much effort it takes to get
them a placement or to beat up on the insurance company.

Worlds Most Powerfull 4 stroke OB
 

On Sun, 15 Feb 2004 08:12:10 -0800, "Lloyd Sumpter"
wrote:

On Sun, 15 Feb 2004 10:17:37 +0000, Harry Krause wrote:

Lloyd Sumpter wrote:

On Sat, 14 Feb 2004 22:07:48 +0000, Lloyd Sumpter wrote:

On Sat, 14 Feb 2004 12:44:58 +0000, FishFan wrote:

"Clams Canino" wrote in message
news:fbVWb.17180$_44.19735@attbi_s52...
Mercury Marine unveils the new Verado today.

Supercharged even. :)

http://www.mercurymarine.com/

-W

Anybody look at the weight?

649 lbs for a 225!!


In fact, isn't that about the weight of a 220hp I/O ? (5L V8)

Lloyd

(and I'm guessing it's NOT FWC !

Lloyd



Actually, the V8 I/O's weigh more, I believe. My F225 Yamaha weighs close to 600
pounds.

What's really troubling about all these new high-tech outboards is that for
anything other than routine maintenance, you need a highly skilled mechanic, and
I wonder sometimes what the average dealership is doing to cope.

That's a common problem these days. Have you looked at some of the modern
"sportbikes"? Have you seen anything on them that you or I would identify as an
"engine"? (let alone "spark plugs", "carburetor", etc.) Same with the
high-output, turbocharged, intercooled, goober-modulated diesels.

My bike has an old-style V-twin engine, with plugs and carburators. My boat has
a normally-aspirated diesel. My van has the Venerable 4.3L V6. I can repair them
all myself, mostly without a computer.

Lloyd Sumpter
"Far Cove" Catalina 36 - engine ALMOST done!

You must be riding a Moto Guzzi, Lloyd. Great bikes. I've got almost
180,000 miles on just two of them.

John H

On the 'Poco Loco' out of Deale, MD
on the beautiful Chesapeake Bay!

Worlds Most Powerfull 4 stroke OB
 

"Gene Kearns" wrote in message
...
On Mon, 16 Feb 2004 17:55:50 GMT, "NOYB" wrote:


While I don't endorse socialized medicine,

Sure you do. Afterall, you embrace a system where the caregiver will not
charge for his/her services.


I never suggested that it was appropriate to this culture.... I think
it would be a sad refection on our values as a nation. I don't think
that socialized medicine is the best solution.... not by a long shot.
However, if the private sector can't fix the problem by itself, you
can count on regulation by the government.


I can certainly see how those who choose to spend their money on luxuries
such as multiple TV's, new cars, CD's, and vacations to exotic places,
rather than on health insurance, would much rather have physicians
sacrifice
their lifestyles rather than vice versa.


I didn't know that this was a problem. Do you have any statistics to
back this up?

I just have a lot more anecdotal evidence than you on this issue.

I foolishly assumed

Yes you did.

it was people having trouble with
the rent and a car payment.... I didn't realize it was other well
heeled people like yourself that went on enjoying "multiple TV's, new
cars, CD's, and vacations to exotic places" right through that
toothache or abscess. What *was* I thinking?

I can grasp the simple concept that people who work hard deserve their
just
rewards. I can also grasp the fact that somebody has to pay the school
loan
bills, and high insurance premiums. The fact that physicians are also
helping people is an added bonus.


While I, too, believe that "people who work hard deserve their just
rewards," I'm not sure we define just rewards in quite the same way.
Price gouging, in my book, is not "just rewards."

As you see that helping people is only an aside to your corporate
structure, I assume that you won't complain when your corporate greed
causes the populace to vote for governmental regulation of your
income.

Let them. You think HMO medicine is bad, now? Wait until the government
has a chance to **** with it. They'll be boutique-style doctor and dental
offices popping up all over the place to provide refuge for the unfortunate
masses that grew tired of the government-run programs. Sure, you could wait
a couple of months to go to a public clinic for free...but that's not the
choice that people with who can afford to go elsewhere will make.


The majority of dentistry done today is elective. That's why tooth
whitening and veneers are so prevalent. It's a billion dollar industry and
growing. Socialized medicine won't affect my practice one bit. Almost 70%
of my patients have no dental insurance and pay at time of service anyhow.
The other 30% also pay at time of service and then submit the insurance
forms for reimbursement.

Socialized medicine *will* affect the quality of my access to health care,
however. That is precisely why I oppose it.

Trust me, something has to give as the upwardly spiraling
cost of health care reaches a point that it is no longer unacceptable.

I'm hoping it's the insurance industry. It's time to undo the
McCarron-Ferguson Act. Insurance is the one arena in which I think the
Federal government can do a better job than the state governments.



When it comes to a vote, will there be more doctors or more patients?

I already told you that, as a doctor, I don't care if socialized medicine
passes. As a patient, I care a lot.

Worlds Most Powerfull 4 stroke OB
 

"Gene Kearns" wrote in message
...
On Mon, 16 Feb 2004 18:48:37 GMT, WaIIy
wrote:

On Mon, 16 Feb 2004 10:18:28 -0500, Gene Kearns
wrote:

It is truly a shame that in America a physician has to operate at a
loss to stay in business. Maybe he'll post an address so that we can
send donations to our resident health care provider so that he won't
have to go hungry.

4 boats in 3 years. Two at one time. Nice.

If you would like to enjoy what NOYB has, go to dental school.
Problem solved.

I don't need to go to dental school, thanks. I like what I do and I
don't think I would enjoy being a dentist. I have enough material
"stuff" and don't begrudge others that may have more than I do. I
don't think, however, I could enjoy those boats knowing I was
charging more for services than the average Joe can afford.... knowing
that some guy is looking at these artificially inflated prices and
making a decision between healthcare for his kids and the rent
payment.

You're assuming an awful lot here, Gene. My prices are just below the
median for my area. Sure, many fees in dentistry are more than the average
Joe can afford. However, that has more to do with the high cost of
delivering services today, than it does with any "price gouging".

Averaged out, my expenses are 69% of my collections. I get to keep 31 cents
of every dollar I produce.

That's a pretty high margin for a company producing in the millions, but
pretty darn low for a 5-employee business like mine.

In 1 1/2 hours, I do a crown and buildup...and gross $950...or I can do
maybe 3 fillings...and gross $375-450.

For the crown, I dedicate another 1/2 hour appointment when I cement it.
So, that's two hours of work...with $250/hr in expenses...plus $150-200 lab
bill. Therefore, I net $250-300...which is $125-150/hr. Not bad!

For the fillings, I have no lab bill, but I still have the $250/hr overhead
to cover. In 1 1/2 hours, my overhead is 375. Therefore, I net between $0
and $75...which is $0-50/hr. Not good!

I could make a lot more money by simply increasing production (since most of
my expenses are "fixed" or "fixed variable"), but I choose to see one
patient at a time.

Worlds Most Powerfull 4 stroke OB
 

If the government is so eager to meddle in the health care field, let them
create a consumer affairs division that can handle the pre-certs and
post-payments for the patients.


"Harry Krause" wrote in message
...
NOYB wrote:

"Harry Krause" wrote in message
news:D9-dnWZdto38aK3dRVn-

For many people, providers as well as patients, the way we handle
"managed care" is a disaster. My wife has two masters'-level
psychiatric
social workers at her office who spend most of their day fighting with
insurance companies

You've nailed the problem right there. When did medicine start
accepting
assignment of benefits for routine office visits? If patient's paid
when
services were rendered, and then filed with the insurance company on
their
own (dentistry calls it "direct reimbursement"), your wife's office
could
use those psychiatric social workers more efficiently.



The problem is, it takes someone with an advanced degree to work through
the maze of pre-cert and post-paym as it were.

Worlds Most Powerfull 4 stroke OB
 

"Harry Krause" wrote in message
...
NOYB wrote:

"Harry Krause" wrote in message
...
NOYB wrote:

"Gene Kearns" wrote in message
...
On Mon, 16 Feb 2004 10:27:19 -0500, Harry Krause
wrote:


The reason why health insurance policies typically place a low cap
on
annual dental charges is directly related to the outrageous prices
many
dentists charge for their work and the work of their "assistants,"
and
the mark-up on work they send out to their labs.

I was moved by a television show I saw the other day. In many
cultures, care givers will not charge for their services.... relying
for their livelihood on donations from their patients. These care
givers consider money charged for helping others. who are sick or in
pain, as tainted money.

Name one culture in which a person spends 12 years in school, 4 years
in
college, 4 years in medical school, and 2-4 years in a
residency...and
then
doesn't get compensated for his/her work. Donating a couple of
chickens
and
a cow will not help repay a school loan of $250,000...nor will it pay
malpractice insurance premiums equal to or greater than that amount.

My wife has had a bit more school than you have, and, in fact, is
pursuing her second doctorate, although this one is a PhD in
statistics/research. By choice, she does not receive compensation for
50
per cent of her professional time as a psychotherapist, and her
educational loans are pretty high.

Good for her. There are several problems with you comparing her
situation
to mine, however. Dental school is a lot more expensive than psych
school.
She also isn't the sole provider in your household...and you don't have
three children to raise together. You guys are DINKs.

Psych school? Heheheh. My wife is not a psychologist. She never attended
a "psych" school. She has the power of the pen. Oh...the doctorate she
is pursuing now costs around $1,000 a credit hour, and I believe 64
credit hours are required, plus her book.

These are the licensed professions providing the bulk of psychiatric
care these days:

There are physicians who are psychiatrists. The majority of these
provide no therapy, but do examine patients on an initial and ongoing
basis, and prescribe the meds. There are still psychiatrists in
psychoanalytic practice, though. MD or higher.

Psychiatric social workers, master's level or higher. These folks
provide the bulk of psychotherapy in this country.

Psychologists, most of whom, however, provide testing services, and not
therapy. Master's level or higher.

Psychiatric nurses, who provide the bulk of 24-7 care in quality psych
hospitals. RN's, typically with a master's degree.

Mental health counselors, some with master's degrees.

As to your having three children, that was your choice. You could have
had less and perhaps been in a position to do a lot of pro bono work.
There are a lot of children in this country going without dentistry, and
hundreds of times as many around the world who need dental care.

I chose to do pro bono wife on my own kids.