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      10-01-2015, 07:13 AM   #243
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Originally Posted by Fundguy1 View Post
Learn your history before looking stupid.

First there would have been no isis to speak of if the US hadn't pulled out of Iraq and Obama hadn't backed Tha Arab spring allowing isis to germinate in Syria then spread into the power vacuum we left behind in Iraq.

Second the US isn't, wasnt, has never once been imperialistic. We liberate some but always leave and let the liberated people rule themselves democratically.

Third the Taliban were backed by us in afghanistan, not formed by us. They have been around forever in Afghanistan and were backed and trained by us to fight the soviets.

Fourth Al-queda was created and took over with the Taliban's consent afghanistan by OBL. He was angry the Saudis turned to the US and not him for protection against Sadam and that the Saudis let infidels into their country so close to mecca so he thought it would be a good idea to fight the US.

Fifth the US never carpet bombed civilians since Vietnam. And then only because the VC had hidden military assets among civilians and the technology to do pinpoint bombing wasn't mature yet.

I said I wish they had in that they should have bombed the Al-queda fighters who were fleeing with their families to Pakistan. Those civilians in effect were their support system and future breeding ground for more radicals and as we know we're radicals themselves and women and children were also and are fighters alongside the men delivering suicide bombs, iuds etc.

Maybe you missed the leaders of Iran's speech on Israel and the US. I'll post it after this. I like the Iranian people. They are progressive, western loving, good people. But the 10% in charge are fundamentalist radicals oppressing them. When the people of Iran rose up a couple of years ago to try to liberate themselves, Obama turned a blind eye. Now he gave the government the funding it needs to keep repressing them. If you should be mad at anyone, it's Obama.


Khamenei: Israel will no longer exist in 25 years
In a Sept. 9 speech, Iranian Supreme Leader Ayatollah Ali Khamenei warned about US intentions toward Iran and said that there will be no negotiations with the United States outside of the nuclear deal reached in July.

In one of his strongest anti-US speeches, Khamenei spoke about US support for the government of Shah Mohammad Reza Pahlavi, who was overthrown in the 1979 revolution, asserting, “All of the pillars of the monarchy, from the administration to the shah himself, were dependent on America. And all of the American officials, through their puppets, used to rule like Pharaoh over the oppressed people of Iran. But Imam [Ruhollah Khomeini], like the Moses of his time, with the backing of the people, dismantled this arrangement in this ancient land.”

According to Khamenei, putting an end to US “illegitimate interests” in Iran is the primary reason for the United States' “endless enmity” toward Iran. On Ayatollah Khomeini calling the United States the “Great Satan,” Khamenei said, “The head of all the satans is the devil. But the work of the devil is only seduction and deception, whereas America seduces and also kills, sanctions, deceives and [is hypocritical].”

Of those in Iran who advocate better relations with the United States, Khamenei asked, even if “religion and being a revolutionary is put aside, what happens to loyalty, to the interests of the country and reason? What reason and conscience permits us to put makeup on crimes such as America’s and paint it as a friend and trustworthy?”

Khamenei added, “A devil who was kicked out by the people through the door is determined to return through the window, and we must not permit this.” As an example of US hostility, Khamenei commented, “The days after the nuclear agreement, a fate which is still not clear in Iran and America, Americans in Congress were busy with designs and plans to create problems for Iran.”

The way to resist the United States, according to Khamenei, is “to become strong in a way that the Great Satan becomes disappointed in the effectiveness of its enmity.” He said, “America, in a way, has divided its duties with Iran and behaves in a twofold way; some smile while others are busy producing legislation against Iran.”

During the nuclear negotiations, Iranian and American officials had occasion to hold bilateral meetings, which Khamenei viewed as an excuse for the United States to try to gain influence in Iran. Khamenei stated, “We only gave permission to negotiate on the nuclear issue, for clear and stated reasons, [and] the negotiators emerged well from this arena, and in other fields we will not negotiate with the Americans.”

Given that the nuclear negotiations brought US-Iranian cooperation to a peak over the last 36 years, some believe Tehran and Washington could cooperate on regional issues as well. When a reporter asked President Hassan Rouhani Sept. 8 whether Iran would work with the United States and Saudi Arabia to address the civil war in Syria, he said yes. Rouhani, along with other influential figures in Iran, among them Ayatollah Ali Akbar Hashemi Rafsanjani, believe that improving relations with the United States is to Iran’s benefit. The supreme leader, along with the Islamic Revolutionary Guard Corps and other security and military bodies, however, are worried that more cooperation will increase US influence in domestic Iranian politics.

While tensions with the United States have decreased slightly as a result of the nuclear deal, animosity toward Israel remains unchanged. Khamenei said, “Some Zionists have said that due to the outcome of the nuclear negotiations, we have been relieved from worry about Iran for [the next] 25 years. But we say to them, you will essentially not see [what will happen in] the next 25 years, and with the grace of God, something by the name of the Zionist regime will no longer exist in the region."



Read more: http://www.al-monitor.com/pulse/orig...#ixzz3nG4Ib7Cp
Since you are such an expert in history and obviously have a lot of time on your hand, maybe you should mention that in 1953, the CIA did overthrew the democratically elected prime minister Dr Mosadegh government and put in their puppet Shah.that was the start of all animosity between the two countries. The Shah was a corrupt self loving leader who transferred the country into a semi modern society but made wealthy people wealtier and poor people poorer, hence the 1979 revolution. Put two and two together, without US intervention, mullahs wouldn't be ruling the country now.
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      10-01-2015, 07:36 AM   #244
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Um no. You should really learn your heritage. He was the last ruling shah whose lineage that ruled Iran continuously since Cyrus goes back 2,500 years. He took power in 1941. For a brief time the oil industry was nationalized but it was opened up to the US and British in 1953.

As for why he was dethroned it was mostly a radical minority who didn't like being westernized and an economic slump in 1978 that stemmed from the failed carter economic policies creating a worldwide recession.

No. Not the CIA installing a puppet. No, not in 1953.
https://en.m.wikipedia.org/wiki/Mohammad_Reza_Pahlavi
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      10-01-2015, 09:37 AM   #245
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Originally Posted by Fundguy1 View Post
It's from a house select committee on television where the CEO of planded parenthood was grilled . 86% of revenues comes from abortions that comprise 3% of their procedures. Most are other mundane things like pregnancy tests orr birthcontrol. All others are covered by obamacare. They do zero mammograms. They made $127million profit last year. They were caught on tape that has been independently verified as uneditted for content showing workers harvesting baby parts for profit while laughing about it and saying how this would pay for their Lamborghini. What's incorrect?
After listening to the parts of the hearing that dealt with this issue, it seems like you have a bit of misunderstanding about what Ms. Richards was saying. She said that 86% of their non-government revenue comes from abortions. Sounds like people are paying for those, and the gov't isn't reimbursing them for it. She also said that abortions can be a much more costly procedure than other things they provide, so yes that revenue would constitute more of the NON-GOVERNMENT funding.

The way you make it sounds, it's as if Planned Parenthood takes in $1.2 billion (86% of their funding) from abortions, which is just not true. You are spewing incorrect information.

And in regards to the video you mentioned, that has been debunked over and over. Feel free to keep believing the bullshit you spew, but you've lost any credibility with your mis-truths.
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      10-01-2015, 11:39 AM   #246
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The videos are absolutely not debunked. They were edited only for time content. The full videos are out there also and the content is 100% correct. If you take the time to look the "debunkers" are all eating crow now and they have been independently verified to be 100% . That was released the day she testified so you're operating on old info.
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      10-01-2015, 01:35 PM   #247
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Originally Posted by Fundguy1 View Post
The videos are absolutely not debunked. They were edited only for time content. The full videos are out there also and the content is 100% correct. If you take the time to look the "debunkers" are all eating crow now and they have been independently verified to be 100% . That was released the day she testified so you're operating on old info.
Edited for time only??

The mere fact that it was edited does not indicate that they had nefarious intentions, but the content that they spliced is absolutely meant to convey a certain agenda.

If the allegations that the video shows are true, there would be criminal investigations. Where are those investigations?

Also, as someone said above....the 3% procedures/86% of revenue is completely misleading.
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      10-01-2015, 01:40 PM   #248
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Originally Posted by other_evolved View Post
Edited for time only??

The mere fact that it was edited does not indicate that they had nefarious intentions, but the content that they spliced is absolutely meant to convey a certain agenda.

If the allegations that the video shows are true, there would be criminal investigations. Where are those investigations?

Also, as someone said above....the 3% procedures/86% of revenue is completely misleading.
I'll admit Fundguy was right about the 3% procedures metric. It's calculated by the sheer number of abortions done vs. all other services. To keep the 3% of procedures apples to apples with revenue, they should've given abortions as a percent of revenue since abortions can be $1,000+ while a pregnancy test (a service they also offer) can cost you about $10.

Still, 86% of revenue would be a lie, I believe the assertion is that it's 86% of non-government revenues, which make up for less than 25% of Planned Parenthood's annual revenue. You can't use government funding for abortions. So in aggregate, a lot of Planned Parenthood's revenues do not come from abortions.
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      10-01-2015, 01:43 PM   #249
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Originally Posted by fecurtis View Post
I'll admit Fundguy was right about the 3% procedures metric. It's calculated by the sheer number of abortions done vs. all other services. To keep the 3% of procedures apples to apples with revenue, they should've given abortions as a percent of revenue since abortions can be $1,000+ while a pregnancy test (a service they also offer) can cost you about $10.

Still, 86% of revenue would be a lie, I believe the assertion is that it's 86% of non-government revenues, which make up for less than 25% of Planned Parenthood's annual revenue. You can't use government funding for abortions. So in aggregate, a lot of Planned Parenthood's revenues do not come from abortions.
I think the 3% metric is a bit of a downplay by the liberal side, but the 86% is an outright lie.

With the 3% of services vs. abortions being bulk of what they do....there is a vast difference between a 1st term abortion (a series of pills taken at home, from my understanding) versus a LTA. The former is likely the VAST majority of abortions that PPH provides, versus the latter. That's why I don't think either scenario (3% vs bulk) is accurate, and like everything, the truth is in the middle.
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      10-01-2015, 02:35 PM   #250
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Originally Posted by other_evolved View Post
Edited for time only??

The mere fact that it was edited does not indicate that they had nefarious intentions, but the content that they spliced is absolutely meant to convey a certain agenda.

If the allegations that the video shows are true, there would be criminal investigations. Where are those investigations?

Also, as someone said above....the 3% procedures/86% of revenue is completely misleading.
Zero splicing for content. Zero. As I said, full videos were also released.
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      10-01-2015, 02:37 PM   #251
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Originally Posted by Fundguy1 View Post
Zero splicing for content. Zero. As I said, full videos were also released.
They were edited for time, and had certain pieces snipped to convey a certain message.

For example...

The entire, unedited, nearly three-hour version of the video that CMP also released contains several sections that were edited out and contradict the group's assertions. For example, as the unedited transcript shows, Dr. Nucatola says, "Nobody should be 'selling' tissue," and repeatedly refers to "tissue donation" during the conversation. The edited video also jumps ahead nearly eight minutes in the middle of a discussion about money in an attempt to falsely frame Nucatola's comments as having to do with the sale price of tissue, but the unedited version reveals that she was actually discussing reimbursements costs for legal donation during those missing minutes.
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      10-01-2015, 02:38 PM   #252
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I think the 3% metric is a bit of a downplay by the liberal side, but the 86% is an outright lie.

With the 3% of services vs. abortions being bulk of what they do....there is a vast difference between a 1st term abortion (a series of pills taken at home, from my understanding) versus a LTA. The former is likely the VAST majority of abortions that PPH provides, versus the latter. That's why I don't think either scenario (3% vs bulk) is accurate, and like everything, the truth is in the middle.
Ture. But....
1. Why us the American public paying for any?
2. Why haven't they arrested people for the illigal stuff in the videos
3. Why are we allowing funding a profitable organization that then in turn lines Democrat campaign coffers who in turn fund them more? Double payoffs with our money
4. Why do we fund them at all when everything they do is covered by Obama care and or available over the counter except abortions?
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      10-01-2015, 02:42 PM   #253
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Originally Posted by Fundguy1 View Post
Ture. But....
1. Why us the American public paying for any?
2. Why haven't they arrested people for the illigal stuff in the videos
3. Why are we allowing funding a profitable organization that then in turn lines Democrat campaign coffers who in turn fund them more? Double payoffs with our money
4. Why do we fund them at all when everything they do is covered by Obama care and or available over the counter except abortions?
1. The american public isn't paying for any abortions. It's illegal due to title X.

2. Because there is no hard evidence (as of yet) of any illegal activities. The videos, themselves, do not constitute a violation of the law. I'm glad they are investigating them, and pending the outcomes, action being taken.

3. That question could be applied to MANY organizations. I can get on board with removing PPH's direct funding from the Federal government (states are a different matter)....but that's a smaller portion of the total amount they receive via medicare/caid payments.

4. See response in #3. I'm not sure why, at the Federal level, they receive direct funding. Someone using medicair/cade at PPH is a non-issue. It would be the same as someone using a subsidized health care plan to go there....male or female.
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      10-01-2015, 03:33 PM   #254
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Here's the easy solution.
Separate the abortion from pph. Make it two separate businesses.
Stop financial contributions to political campaigns from all private companies who receive government funding and probably form those who work at federal government agencies. It's a conflict of interest. Too much quid pro quo.

I could care less if they abort. But because they comingle government funds with private funds it should be stopped. And they should be seriously investigated.
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      10-01-2015, 03:39 PM   #255
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Originally Posted by Fundguy1 View Post
Here's the easy solution.
Separate the abortion from pph. Make it two separate businesses.
For what practical reason? Because peoples feelings?

Quote:
Originally Posted by Fundguy1
Stop financial contributions to political campaigns from all private companies who receive government funding and probably form those who work at federal government agencies. It's a conflict of interest. Too much quid pro quo.
Agreed!

Quote:
Originally Posted by Fundguy1
I could care less if they abort. But because they comingle government funds with private funds it should be stopped. And they should be seriously investigated.
Again, Title X. They are not commingling funds...that would be illegal to use government funds to go towards abortions.

And they are being investigated....thus far, with little to report (see recent MO report).
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      10-01-2015, 04:54 PM   #256
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I'm certainly not a benefits consultant/expert, not by a long shot, so there's only so much I can say regarding how ACA works, and the majority of it is based on publicly available info not having analyzed the details of ACA, to say nothing of your firm's overall and individual employee profiles, financial position, available plans, etc.
My wife is a public accountant who expertise is audit. Her firm, one of the largest in the state has an entire division dedicated to healthcare. In addition, my father's best fried, a long time family friend is the administrator for a network of 5 hospitals in Indianapolis. Aside from what i've heard from them, i don't know much about the ACA either.

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Originally Posted by tony20009 View Post
Red:
ACA requires the insurance carries cover birth control, all methods except condoms and abstinence () I believe, and they must cover at least one modality for each method of birth control. (http://obamacarefacts.com/obamacare-birth-control/) There are, however, some exceptions (see the info at the link), one of which has to do with "grandfathered plans," although it seems odd that your plan, which formerly covered your spouse's pills would be a grandfathered plan with regard to those pills, even if it is with regard to other things.

There is a "catch" of sorts, as well. Even though plans must cover most contraceptive methods, they are not required to cover every brand of every method. So, for example, if there are some 40 kinds of birth control pills available, insurers are required to cover only one of them. That they cover any of the remaining 39 is up to the insurer's discretion. They may, for example, cover one pill in their "bronze" plan and cover all of them in their "platinum" plan.
The ACA may require insurers to cover BC, but that doesn't mean they have to do it at no expense to the insured. For instance, if my wife were to purchase enough birth control to exceed our deductible, the insurance company would pay for it at that point. Used to be a $25 copay for the shot and a $25 copay for the gyno to administer the shot. Now, it's full price for the shot and full price for administering the shot.

Speaking with my health ins broker, he explained that the administering of the shot isn't covered because of the way the Dr.'s office codes the cost. The Dr has figured out that if he codes the cost differently, he doesn't have to a accept the insurance company's lower negotiated pay rate and there by makes a larger GM on that service.

And again, if she were to purchase enough BC and service for administering the BC the insurance company would then kick in contributions to the expense. But seeing that she gets BC 4 times a year and our deductible is $9k, that's not gong to happen.

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Originally Posted by tony20009 View Post
Blue:
Not that it's relevant to this discussion, but I have never understood the point of multiple terms for what, no matter how I look at it, amounts to "money I must pay out of my pocket." "Coinsurance," "co-pay," "deductible." Insurance has never not been a complicated thing. Why insurers invented even more ways to say "money the patient must pay on their own" is beyond me; it only makes the whole thing even more complex. No, it's not the most complicated thing about health insurance, but still...it's complexity that could have been avoided.
It's complex because someone profits from it.

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Originally Posted by tony20009 View Post
Green:
Well, what do you expect? Even in restrained forms of capitalism, "the best" will cost more than will the "less good" alternatives. One cannot say, "I/we want the best possible treatment modalities," and yet expect to pay the price of something less than "the best" possible treatments. Porsches, Ferraris, Camaros, Mustangs, M3s, and Lambos are all sports cars, but they perform differently. A Lincoln and a Bentley are both luxury cars, but one is "better" or more luxurious at least than the other. Consumers must pay for the "extra" performance or extra luxury. The same basic principle applies to insurance products and to health care treatments. At the slightest hint that things stop being that way, conservatives will drag out the "socialist/socialism" label.
Well, you said your health insurance hasn't gone up one bit. Someone else in Vegas said the same. I doubt we get better health care in FL than you do or the people in Nevada get. Maybe if i were able to shop for health insurance in Nevada, my health insurance would be lower as well. Then lots of people might do that and force the health insurance companies in FL to lower their prices. ??

That seems like a very easy, inexpensive bit of legislation to pass which would benefit likely ALL people who purchase health insurance immediately.

Why does it seem as if that isn't even an option worth talking about for our elected political representatives?

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Pink:
Well, yes. That's as it should be under capitalism. Tell me, do you or do you not model your business policies, processes, pricing strategies, etc. around what you believe is most desirable to the majority of your target customers? I would wager that to the best of your ability, everything about your business is geared toward your primary base of customers.

To give a simple example, McDonald's apparently determined that most customers don't ask for mustard. Therefore McDonald's (at least the one closest to my parents' home) no longer routinely stock and dispense mustard packets. They have mustard, and if you ask for it, they'll pour some into a cup for you, but that's the best they can do.

How'd I learn this? I happen to be one of the few folks who likes mustard on my breakfast sandwich. I went in, ordered one and asked for mustard. I'd done so in the past and received a couple packets of mustard. The last time I ordered a breakfast sandwich at Mickey D's, I was told "we don't have mustard." My reply, "Don't you put mustard on your burgers?" "Yes," the employee told me, "but we don't have it packaged." "That's okay. I asked for mustard, not a mustard package. I'll accept the mustard any way you can provide it. If you want to put in a cup, okay. If you want to put a dollop of it on the sandwich, or on a sandwich wrapper, okay."

Sidebar:
Nevermind my frustration over the her answering the question she thought I asked rather than the one I did ask, and/or her not confirming that what she thought I wanted was indeed what I wanted. Curiously, even in the cheapest places in the PRC, I routinely find that the employees there make the effort to confirm their understanding of what I say to them. I don't have a good explanation for why the difference in communication skills exists.
End of sidebar.
Yes i do. But the government isn't placing regulations between me and my vendors and me and my customers. Nor is the government penalizing my customers for not buying my goods and services.

And one of those regulations is stopping me from shopping for the best deal the insurance provides this country has to offer.

I know it's not this simple, but it's not straight up capitalism if it's regulated by the government.


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Originally Posted by tony20009 View Post
At the end of the day, one either "buys into" capitalism and it's boons and bitch factors, or one doesn't. Frankly, short of government regulation, I don't see any natural way around the fact that businesses will always optimize to the advantage of their largest and best customers.

The other things I infer from your "pink" comment:
  • Decent -- Do similarly situation small businesses pay better or worse rates that your firm? Your rate may be decent and reasonable given your circumstances and the "new rules of the healthcare game." That's not the same as it's merely being lower, which, of course and naturally, is what you want it to be.
  • Reasonable -- It seems to me that as the company owner, you've made a conscious choice to try to manage your business using the "old paradigm's" parameters. One of those choices has to do with your staffing model and strategy. Another has to do with business growth. Has it occurred to you that growing the size/profitaility of your business will allow you to take on more employees and thus have a larger group?

    I'm not at all suggesting that you devise your top level business strategies around your desire to purchase health insurance. What I'm saying is that the thing you should be doing -- growing your business -- will organically ameliorate your health insurance problem. My suggestion is that you identify more rapid ways to grow your business, ways that achieve that outcome faster than the ones you've been pursuing, or previously overlooked, and implement one or several of them. That's my suggestion because whereas you have control over the direction your business takes, you by and large have no control over the direction the healthcare industry and policy takes. Unlike non-business owners, you have more options that to merely choose a different employer, stop working, or go into business for themselves.
It's not straight up capitalism if it's regulated by the government.

I don't want the largest flooring company in the state. There are plateaus in which the fixed cost of doing business can support. It may not be elegant but it's worked for many years. I turn away jobs that put too much of a strain on our fixed cost staff. My current fixed cost staff can support about $7mil in annual revenue. Much more over that and i'll have to hire more support staff forcing me to generate about $9mil in annual revenue. That puts a strain on everything. Logistics, capital, real-estate space, etc... So i'd rather stay at an annual revenue that is about 90% of my current fixed staff's capacity. This also keeps me from having employee turn over based on fluctuating revenue.

When we're doing less business we can focus on doing higher margin business which i will take everyday of the week over low margin high volume business.

I want health insurance to be an individual option for every citizen in the country, employed or otherwise. Health insurance shouldn't be hinged upon an employer. I'd rather have to raise my compensation rates for all my employees and be freed from all health care regulations the government is placing on me as an employer.

Quote:
Originally Posted by tony20009 View Post
Purple:
Your anecdote doesn't at all demonstrate that the insurance industry "is the" cause for "inflated" prices; moreover, that a hospital and/or doctor is willing to accept a lower profit margin than they initially solicited doesn't remotely suggest that the initial sum(s) either requested in exchange for their services is "inflated."

You are a business owner and you sell "whatever" at prices that will return a profit that is in accordance with your business goals. I suspect from time to time you grant price concessions. Does that you do necessarily imply that the non-discounted price is inflated? Of course, it doesn't. Your list price is merely the selling price that corresponds to the optimal rate of return you'd like to earn for the good/service you deliver, and it represents the maximum rate of return you believe you can expect to earn from some percentage of your customers. There's nothing that says that your list price does or should reflect the minimum rate of return you seek to obtain.

There's nothing wrong with that model. That's how people manage businesses, although some business managers do it in a more sophisticated and precise fashion than do others. Why would you imply that anything different should be in play for businesses that sell healthcare treatments? Though it's useless for circumstances such as your M-I-L's, the best suggestion I can offer is that one seek the services of not-for-profit hospitals (pretty much any doctor will have a profit motive), and doctors who have privileges at them, rather than for-profit hospitals. Also, if one is actively looking for a doctor, or even if one isn't but is of the mind that doctors and the care they provide is largely undifferentiable, I suggest contacting various doctors to find out what they charge and where they have hospital privileges before one actually needs to avail oneself of them. That market research will be more useful to one who has an 80/20 or POS insurance plan than it will, say, to someone in an HMO/EPO or PPO.
The anecdote was just an illustration of how inflated health care costs are due to negotiations of insurance companies. As i've learned from my father's pal, the hospital administrator, the insurance companies a long time ago went to doctors and told them they have a HUGE network of Dr.s and an even larger network of potential patients. Those same insurance companies concluded that the easiest way to find those patients was to tell corporations that they have the largest network of the best Drs around and they should offer health insurance to their employees as a benefit. Then the get the Dr to join their network, but wait a minute, this is what we plan on paying your for these types of appointments and procedures. The Dr agrees thinking he was going to be inundated with patients due to his joining of said network. Then the Dr, not being a wonderful business man, rightfully so, realized he's never going to make any money doing things this way. They lack of business experience causes them to simply raise their rates for said appointment and procedures so that the net amount paid to them actually covers their cost and leaves them with some profit as well.

We consulted my father's friend before taking with the local hospital about the bill that none of us could afford. That conversation took about 5 minutes because all he said was, their costs were likely around $20k for her stay and treatment, scans, etc... He said they would likely reduce the cost of the bill to about 1/3 of it's original amount. And he was right, without batting an eye, the financial person we talked to offered to accept the reduced amount within 2 minutes of us sitting down at her desk.

I know it's anecdotal, but i've heard it from a fair amount of people as well. So again, it seems to me that the cause of high healthcare costs are due to insurance companies.

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Originally Posted by tony20009 View Post
The Cost of Healthcare: It's due mostly to providers, but also to insurers:

Providers:
I am sure that insurers have an impact on the cost of healthcare; however, theirs isn't the primary driver to the costs. Technology is. (I presume you haven't read the research I provided here.) That said, there's little question that when the idea of healthcare reform seemed gained support among the electorate, health insurance companies did what any good business does: they saw change was coming and viewed it not as a threat but as an opportunity, namely an opportunity to increase profits. Someone in this thread earlier wrote that the ACA was about control of any number of nebulous and hard-to-control things. They are dead wrong; it's about profits for everyone in the healthcare industry, and the insurers stand to reap the greatest profits.

(You see rather than gripe about the cost of health insurance, I opted to expand my position in health insurance company stocks. I know an opportunity when I see one just as most well run businesses do. )

If you've never had an MRI scan, or seen the equipment that performs various tests, it may not be apparent just how much tech is involved in the delivery of healthcare services. It's all over the place, except in doctor's offices, which, by contrast have the types of tech with which most of us are familiar: computers, monitors, and so on.

I mentioned an MRI machine because a basic new one costs about $150K. Fancy ones cost ~$1.2 million. The state-of-the-art ones run ~$3 million. Now, as a patient, do you want your hospital to have the best possible MRI machine or the basic one? As a typical consumer of healthcare services, do you have any way to know how to answer that question? I sure wouldn't. But you know what, I have insurance and I know that at the most, I'll only pay a few hundred dollars no matter what machines a hospital uses to diagnose and treat my ailments; thus my knee-jerk response would be, "By all means, I prefer that hospitals have the state-of-the-art equipment, and not just MRI machines." In the abstract, I want the hospital to also have the best "blood spinners," and microscopes, and best and safest x-ray machines, and work class workflows, and the best business and medical software, and the best 3-D mammography machines, and the best CAT scanners, and on and on and on....

Now let's look at the same MRI machine from the hospital's point of view. The hospital has to compete, to an extent, with other hospitals in their geography. The hospital administrators know that 80% of the services and goods they deliver fall into the "routine" category. The know too that the $150K MRI machine may well be just fine for 90% of the cases that call for using one, but it may not be as effective for the rest. Hospital managers also know that from a business process and training perspective, they can either have multiple different types of MRI machines made by various producers, or they can have multiple machines of the same type/brand.

Now, I ask you, if your area has multiple hospitals, if they advertise, is the message in their ads "we are the best" at "this, that and the other," or do they say they are "good enough for most stuff that will happen to you?" You and I both know damn well that the latter message isn't the one they put out.

Do hospitals even attempt to compete on a "value for dollar spent" basis? No, they don't. Why don't they? Branding. Branding is the thing that distinguishes a commodity market from a monopolistically competitive one, and that's the form of competition that is largely unregulated and that allows sellers to charge whatever they want for their product. In fact, it's the only form of competition where buyers inherently, regardless of whether it's true, use price as a gauge of what is good, better and best. For a business, that's very important; it's "make or break" important.

The other thing to keep in mind is that hospitals, like pretty much any entity doesn't stop charging for the cost of its equipment just because it's paid for it. That multimillion dollar MRI machine may be received in FY 2013 and paid for in FY 2015. The hospital will decide it's got an accounting useful life of five years. If in 2022 it uses that machine to treat someone, the hospital isn't going to charge a lower fee to MRI users/beneficiaries in 2022 than they charged in 2015 because it's fully depreciated the machine. And from day one, the hospital will attempt to MRI scan as many patients as they possibly can, and though the profit motive may not be the prime mover behind doing so, make no mistake, it's a motive that is present in the minds of doctors and hospital managers. It's more a matter of if the procedure is plausibly needed, they'll order it done. At the very least, if things "go south" with the patient, the doctors and hospital can say they "tried as much as they reasonably could."

The cost of defensively and entrepreneurially practicing medicine isn't directly the point. The point is that as businesses, hospitals have a legitimate business need to invest in property, plant and equipment. In fact, in many ways, the delivery of healthcare services is quite like the delivery of electricity. In the energy industry, state regulators define the rate of recovery for services, so the way to get that rate upped is to buy more infrastructure, mainly because regulators base the rates on what they deem an appropriate rate of recovery on infrastructure investments an energy supplier makes. Healthcare providers have their recovery rates constrained by insurers, but it's a fixed rate per procedure, so the thing to do is provide more procedures. You can only provide so many human-delivered services/procedures, but the more machines you have, the more "stuff" you can provide. Thus the incentive, albeit tacit, to buy technology. There are other reasons as well that are less "subversive."

Insurers:

Within the context of health insurance, although there has long been, say, Allstate, United Healthcare, Aetna, etc., that they exist as brands really hasn't meant much in terms of whether consumers of health insurance perceive one as being materially better or worse than the other. Sure, customers may feel that "so and so" has lousy customer service, but they generally don't perceive one company's health insurance product as being any better or worse than another's. Moreover, most consumers don't directly buy health insurance; instead, they buy through groups.

Since prior to ACA most health insurance was bought via a group, insurance companies tailored their offerings and their business model around a business-to-business sales model rather than a consumer goods sales model. In the former marketing environment, branding is considerably less important.

Business buyers, when evaluating the merit of, or negotiating terms of, a sales/purchase proposal or contract, focus on tangible and objective factors, and almost not at all, if at all, on emotional "triggers" like brand reputation. (At best reputation and other intangibles may play into to whom they extend requests for proposals.) However, with ACA came exchanges that involve more consumers, end-users, to directly choosing the insurance product and insurer they want. And what do we see now? We see things like "catastrophic," "bronze," and "silver" to describe the levels of coverage insurers offer. In other words, we see branding, and we see the pricing models and strategies that accompany branded marketing.

We also see the insurers retaining the group model in their offerings structure. And why wouldn't they? The group model, which is little more than volume purchasing, allows insurers to charge one rate to all members even though that rate must accommodate the least healthy members of the group. Now it's not that that pricing model differs now from what it was before. It's just that before, insurers had ways to exclude from the group the individuals who were/are least healthy.

I think the OP of this thread (Fundguy1) griped that healthy people now have to pay for less healthy people. That's no different than it was before. It's merely that the average "healthiness of the group" was higher before than it is now. Make no mistake, however. Before ACA, men's premiums paid, say for pap smears and women's paid for prostate exams. What people in group plans didn't pay for was the care of a chronically sick person who switched jobs, and thus insurance, or the chronically sick person who formerly could not get insurance at all. Seen in that regard, allows people with group health insurance coverage, and who have pre-existing conditions, to change jobs without fear of not having health insurance coverage related to their condition. (The pre-existing condition clauses are still allowed for individual and family policies.)

All the best.

P.S.
I hope your M-i-L has recovered fully and is well.
I get that they are here to provide a service in return for a profit. I have no issue with that and i know how business is done.

Thanks, she hasn't, but who knows why. Dr.s say it's due to her mental attitude and that her denied depression is what's holding up her physical rehabilitation. that's a whole other thread. lol

I don't think i have the answers but i know something needs to be done about the increasing costs. My health insurance broker tells me the sam things Funguy says about the costs in 2016 are going to hurt a lot more that the increases i've seen so far.

I'm sorry i'm not allocating the same amount of time and energy you're putting into you responses. But it's tough babysitting these employees while trying to have a life as well.
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      10-01-2015, 05:43 PM   #257
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1. The american public isn't paying for any abortions. It's illegal due to title X.

2. Because there is no hard evidence (as of yet) of any illegal activities. The videos, themselves, do not constitute a violation of the law. I'm glad they are investigating them, and pending the outcomes, action being taken.

3. That question could be applied to MANY organizations. I can get on board with removing PPH's direct funding from the Federal government (states are a different matter)....but that's a smaller portion of the total amount they receive via medicare/caid payments.

4. See response in #3. I'm not sure why, at the Federal level, they receive direct funding. Someone using medicair/cade at PPH is a non-issue. It would be the same as someone using a subsidized health care plan to go there....male or female.
1 they get our money, they get abortion fees. They put it into the same basket. Its in effect a loophole. This is the problem.
2 I agree . Needs to be done
3 I don't mind state money. Federal should be left out. And all organizations and businesses and I feel government employees should not be allowed to contribute to any party or candidate.
4 Obama care made the need pph was serving dissappear. Our funding should too.
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      10-01-2015, 06:11 PM   #258
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Um no. You should really learn your heritage. He was the last ruling shah whose lineage that ruled Iran continuously since Cyrus goes back 2,500 years. He took power in 1941. For a brief time the oil industry was nationalized but it was opened up to the US and British in 1953.

As for why he was dethroned it was mostly a radical minority who didn't like being westernized and an economic slump in 1978 that stemmed from the failed carter economic policies creating a worldwide recession.

No. Not the CIA installing a puppet. No, not in 1953.
https://en.m.wikipedia.org/wiki/Mohammad_Reza_Pahlavi
Are you denying that CIA overthrew Dr, Mosadehg's government? Even the CIA and the current administration has admitted it short of supplying an apology. You need to know this since you're an expert...

Lol at" it was the recession that caused the Islamic Revolution"

https://en.m.wikipedia.org/wiki/1953..._d%27%C3%A9tat

Please tell me Wikipedia's information is wrong. This is what I'm talking about when I talk about US intervening in other countries only for profit and not due to humanitarian reasons. Irons oil was just discovered back then and Mosadegh dared to make it a national property. There was only one solution for that and that was to get rid of him and bring Shah in period.

Ps: I'm delighted to see most people here disagree with you on various subjects, there is faith in humanity yet...

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      10-02-2015, 07:12 AM   #259
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The shah was the ruler of the country legitimately since 1941.
The pm was newly elected and was trying to do something similar to what the Muslim brotherhood tried. Take over control of the country and reverse it's western leaning direction.

The us and UK probably wouldn't have cared except he tried nationalization of the oil, shutting out the world.

So we backed the shah to regain power from this chuckle head and put Iran back on its progressive western course just like now in Egypt where we backed the Egyptian military and not the regressive Muslim brotherhood.

Was it the right thing to do? Hell yes. Should carter have backed the shah in 1978? Absolutely. But he didn't and now 90% of Iran's population which is pro western, persian, and shah, is repressed by the 10% that is in power.
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      10-02-2015, 07:22 AM   #260
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Originally Posted by Fundguy1 View Post
The shah was the ruler of the country legitimately since 1941.
The pm was newly elected and was trying to do something similar to what the Muslim brotherhood tried. Take over control of the country and reverse it's western leaning direction.

The us and UK probably wouldn't have cared except he tried nationalization of the oil, shutting out the world.

So we backed the shah to regain power from this chuckle head and put Iran back on its progressive western course just like now in Egypt where we backed the Egyptian military and not the regressive Muslim brotherhood.

Was it the right thing to do? Hell yes. Should carter have backed the shah in 1978? Absolutely. But he didn't and now 90% of Iran's population which is pro western, persian, and shah, is repressed by the 10% that is in power.
Well first you denied that it even happened, and when I gave you proof you turn it around and try to justify it. Do you even know the meaning of "democratically elected"?

Do you know how silly you sound? A democratically elected prime minister tried to nationalize the oil, meaning the oil belongs to the Persians and not US or UK. And they didn't like it so they backed shah who would bring all your agents in to do whatever they want with it. If that's democracy and you be,rive that then you are exactly what's wrong with this world. You're the example of your country's implaialism and aggression. Good luck with the way you believe and see how that's gonna help in future.
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      10-02-2015, 07:56 AM   #261
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Well first you denied that it even happened, and when I gave you proof you turn it around and try to justify it. Do you even know the meaning of "democratically elected"?

Do you know how silly you sound? A democratically elected prime minister tried to nationalize the oil, meaning the oil belongs to the Persians and not US or UK. And they didn't like it so they backed shah who would bring all your agents in to do whatever they want with it. If that's democracy and you be,rive that then you are exactly what's wrong with this world. You're the example of your country's implaialism and aggression. Good luck with the way you believe and see how that's gonna help in future.
I never denied anything. The shah was in power the whole time.
An upidy pm tried to gain more power and he was shut down by the shah with help by the US and UK.

Moressy was democratically elected too but did the same stuff in Egypt. And just like iran, the people and other leaders said no and got rid of him.

The brits, soviets, french, germans, and dutch have been imperial. The us never. Imperial means you take over and rule a country. We don't do that. We do give back countries to the people in them, and the rulers who legitimately belong there, but we don't rule other countries.

The shah was the best thing iran had as well as the military in Egypt. The oppressive medieval mullahs and ayatollahsee are a scourge against humanity and worst of all to their own people. There have been several attempts to overthrow them in Iran since they took power but they keep all the guns so the 10% has been dictatorin the 90% now for 40 years as a result.
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      10-02-2015, 08:49 AM   #262
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Another complete disaster of a jobs report today. Only 142k jobs created in September (while 236,000 jobs were LOST), and August was revised down lower to 136k from 173k. Weekly earnings also declined from $868.46 to $865.61. Add this on to the horrible manufacturing numbers from yesterday, and this is all spiraling quickly out of control.
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      10-02-2015, 08:55 AM   #263
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1 they get our money, they get abortion fees. They put it into the same basket. Its in effect a loophole. This is the problem.
2 I agree . Needs to be done
3 I don't mind state money. Federal should be left out. And all organizations and businesses and I feel government employees should not be allowed to contribute to any party or candidate.
4 Obama care made the need pph was serving dissappear. Our funding should too.
1. Incorrect, again. They are able to segregate dollars, just like any other for profit, or non profit entity.

4. Again, i disagree with this. Medicair/cade funds, or subsidized ACA plans....both would still = money going to PPH if the individual chooses to go there. Nothing has changed.

Quote:
Originally Posted by NickyC View Post
Another complete disaster of a jobs report today. Only 142k jobs created in September (while 236,000 jobs were LOST), and August was revised down lower to 136k from 173k. Weekly earnings also declined from $868.46 to $865.61. Add this on to the horrible manufacturing numbers from yesterday, and this is all spiraling quickly out of control.
Stronger dollar is what is leading to manufacturing stress, nothing more, really. Job openings at record highs, consumer spending surging, etc.

We'll likely see a pickup into the year end, but that means the Fed likely won't act until early 2016.

The point is, looking at one factor, while ignoring others, doesn't make a solid case. I'm just glad no one has brought up the LFPR fallacy yet, lol
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      10-02-2015, 09:00 AM   #264
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1. Incorrect, again. They are able to segregate dollars, just like any other for profit, or non profit entity.

4. Again, i disagree with this. Medicair/cade funds, or subsidized ACA plans....both would still = money going to PPH if the individual chooses to go there. Nothing has changed.



Stronger dollar is what is leading to manufacturing stress, nothing more, really. Job openings at record highs, consumer spending surging, etc.

We'll likely see a pickup into the year end, but that means the Fed likely won't act until early 2016.

The point is, looking at one factor, while ignoring others, doesn't make a solid case. I'm just glad no one has brought up the LFPR fallacy yet, lol
You're in a dream land man.

Spending has gone up, while savings have gone down. People are digging into their savings just to get by, and a record number of people are now dipping into their retirement savings just to make ends meet. Median incomes collapsing, record number of people unemployed.

Yeah, it's all just rosy out there.
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