Ewwww: Blue Shield screws Kos.
 Kos of the DailyKos blog lets fly at Blue Shield for the nightmarish, deceptive way that they’ve dealt with him. After lying to him and to the Anesthesiologist who helped his wife give birth for months on end
Give that woman a medal!
about payment of a claim, they’ve invented a new lie and used it as the basis for not paying the claim, even though Kos pays $800 a month in premiums. When he asked the rep he was speaking to for her last name, she hung up on him.
Oh. Well that’s a horse of a different color. Really sucks, actually, whether it’s Kos or anybody else. Of course, putting these matters into the hands of government agencies is the surest way to improve service.
Just ask Megan McArdle. (h/t Reynolds)
Someone should have a look at what Medicare does in such situations. In short, they determine what can be charged for given services/procedures, which is basically what Blue Shield has done here. Except there’s no ifs, ands or buts about it.
The administrative runaround is certainly frustrating enough but anyone who thinks that’s going to improve under government control has never dealt with a government agency.
Except the contract says “you pay your premiums, we pay the preferred rate”, and it’s the contract that rules, not what you want it to be.
Sounds to me like he’d have been better served by catastrophic care insurance and an HSA.
Wonder why he’s surprised she didn’t give the last name. Best-case scenario, it’s terribly generic and the customer can’t track you down and harrass you with a simple google search. If *I* gave someone my last name, well, all google searches using my name point to me; there is apparantly no-one else in the world (or at least, the internets) with the same name as me, and it wouldn’t be terribly easy to track me down if you had that.
Echo the same thing with “and he’s hoping health care gets nationalized?!” sentiments too.
err, “wouldn’t be terribly hard to track me down”
Sounds as if Markos owes the anesthesiologist about $600. I recommend negotiation. If you’re truly strapped for cash, it’s amazing what concessions you can extract.
That presumes the “strapped for cash” part, though. Still, you can negotiate practically anything.
I’ve always thought it funny that liberals accuse the religious right of “shoving their morals down others’ throats,” in light of welfare, medicare, medicaid, and now, universal health care.
Every year we struggle with BC/BS, as a provider. But there are few others as well-respected. We return to their fold with higher rates and deductibles, for to cover the ever-increasing costs dropped in the laps of the medical industry, by those who won’t or can’t pay.
Seems Mrs. KOS would’ve need the Anesthesiologist to cover pre-existing conceptive demands. Or the mailman, maybe.
They’re just testing our gag reflex, Randy.
Are you sure the Anesthesiologist wasn’t helping her deal with being married to Kos? It can’t be much more pleasant than giving birth and would explain the “months on end” bit.
I find it amusing when he complains of the unaccountability of Blue Cross and it’s employees. Does he really believe a government run system would be accountable? I mean, when’s the last time anyone has heard of any government employee anywhere being fired for anything?
Like, for instance, refusing a job assignment?
How these things do resonate, sometimes.
Still, this story makes me yearn, a bit, for the golden days of yesteryear, when there were no anesthesiologists; women would just put down their bushel baskets, squat and deliver right there in the lap of Mother Gaia.
Yes, I’m so sure the bureaucratic nightmare that is insurance companies is SO going to improve under Silky Ponies “you are going to be forced to have annual checkups” or Hillary!’s “you are going to have to have insurance to get a job” plans.
I haven’t gone to read the original Markos whine, but didn’t anyone tell him to SHOP for insurance so he wouldn’t be paying $800/mo? That’s more than what I was paying to insure me/spouse/three kids including dental and vision.
A government run agency where the agency is the provider, the payor, and the regulator is going to be very accountable. Really. Trust me, I’m a lawyer.
The problem here is the impenetrable beaurocratese.
Kos and his wife misunderstood what Blue Cross agreed to pay. The claim letter agreeing to payment may have mischaracterized their payment request…but BCBS was agreeing to pay the only thing it would EVER have agreed to pay….that portion of the claim that they would pay if the Anaesthesiologist were a participating provider in the plan.
Anaesthesiologists freqently refuse to participate in plans, and neonatologists also often refuse.
They are free to set their own fees, within guidelines the hospital that allows them to practice on their premises may or may not set.
That means, for new moms and dads, when the bill comes, may get a shock.
There is no insurance coverage of the charge, or only partial coverage.
In my case some years ago, my son’s neonatologist ( who gave him a cursory exam after birth, since he was a c-section baby) did not participate in my plan. My insurance, (BCBS) would pay any physician who treated me. But it would pay only a certain amount, on its fee schedule.
I had a list of physicians who would agree to take that as payment in full ( less copays and deductibles), but neonatologists generally find it more lucrative to take a larger fee from their captive audiences, and mine was not on that list).
What this meant for me, is BCBS provided partial payment.
Kos probably, given the tiny premium he pays relative to the going rate for an open plan, has more restricitons on his providers. His insurance may refuse to cover any provider not participating on the plan if one on the plan is available. So if there had been HMO guy, and non-HMO guy, and they decided to use non-HMO guy, the insurance company would not reimburse a penny.
In plans where circumsances like emergency or limited availability of plan providers arise limiting choice, an insurer will, on a case by case basis, sometimes agree to pay the fee they would have paid a participating provider. (sometimes the law makes them do this).
Sometimes a physician will agree to accept this payment as payment in full.
In Kos case, that’s what preferred rate means to BCBS – we will pay the payment amount we set for our participating providers and would have paid if you had used one. They aren’t saying exactly why, but it is actually because Kos and his wife were in a position where you could not choose your provider. Again, an insurer that limits access to non-plan providers will only do this after reviewing circumstances to make sure there was no other reasonable option for the plan participants ( Kos and wife) – on a case by case basis.
The anaesthesiologist has no intention of accepting BCBS payment as payment in full. He will accept it as partial payment. He is entitled to be paid his full fee and to collect it by standard means. Kos and his wife have always been and will always be on the hook to the physician for the fees, even if an insurer is on the hook to Kos and wife to reimburse all or a portion of physician fees. The physician isn’t a participant in that plan and is free not to be. This is a free country and he is not obligated to be a wage slave for anyone.
BCBS isn’t refusing to pay something it owes, or ever contracted or otherwise (through that letter it mailes to Kos and wife) agreed to pay. It said, ok, we IN THIS SPECIFIC case, agree to pay what we would have paid if that anaesthesiologist had been a participating provider, even though we normally won’t reimburse fees to non-participating providers at all. Unsaid: that’s because you had no reasonable option to stay within the plan’s list of providers.
Kos and his wife thought that they were ok and covered, no matter who treated them at that hospital, and they were always mistaken.
Insurance is hard to understand and the language mush has not assisted them. But I could have told them this would happen before they got to the hospital, and to nail down who will be treating them, ahead of time, if possible, and to get waivers from insurance and physicians, if possible.
Socialized care would protect Kos and his wife in this way – in general, no fighting about which wage slave treated them. But that creates its own set of problems.
Sounds to me like Kos got balance-billed.
This happened to my wife and I in a very similar situation. Our hospital was officially “in-network” for our insurance, but some of the services the hospital ran (under the same billing number, no less) were considered “out of network.” We got stuck with a $4000 bill.
This is a contract issue. When a hospital agrees to take your insurance, and signs a contract with your insurer, they’re generally prohibited from “balance billing” the patient. That is, the insurance company pays the hospital a set amount for a given procedure, and that’s all the hospital gets. It’s called the “usual and customary” rate, and it’s often far less (up to 70-80% less) than what the physician or hospital charged for the procedure. The hospital or physician is prohibited from going after the patient for the difference… but ONLY if they’ve signed a contract with that insurer.
If they have no contract, the hospital or physician can bill the patient for the difference between what the insurer paid (their out-of-network “usual and customary” amount), and what the doctor or hospital actually charged.
It’s the kind of lawyerly BS move (“it’s in your contract, Sir”) that makes people foolishly agitate for socialized medicine, on the rationale that the govt. would somehow be more compassionate and up-front about it. Try dealing with CMS before you ask for a govt. takeover… bureaucratic nightmare writ large.
It is unfortunate that this lady hung up on him. Poor customer service, at best. However, given Kos’ displayed personality, my guess is that this was not a real civil discussion up to that point. Plus, would you want to become the object of scorn du jour for the Kossacks?
The Newguy – that’s exactly what happened.
Would I?!
Except the contract says “you pay your premiums, we pay the preferred rateâ€Â, and it’s the contract that rules, not what you want it to be.
When The Hillarycare Revolution comes, there will be no more fine print. Just an infinite number of government health & insurance workers, and an infinite amount of money to pay them.
“an infinite number of *competent* workers,” I should say.
I feel sorry for Kos, if this is his first big run-in with insurance red tape. I got it hot and strong early on, and by the time my oldest was in kindergarten BC/BS had paid a third of a million for her. Pretty much all of the trouble I had to unsnarl was the result of muddle, not malice, on the part of the insurance or the healthcare provider. There are plenty of people out there who really ought to be stocking the salad bar at Golden Corral, and not messing around with medical records.
The Golden Corral has a salad bar?
But medical stuff will improve exponentially if Hitlery gets the job, right? We can get rid of BC/BS.
This stuff goes far beyond this surface ripple.
My doctor is the last one in my county who will take state insurance (CT). And what they do is give him a bullshit amount of money (their “rate” per procedure), and then ship his bills to some bureaucrat, who then decides to cut his payment by, say, twenty dollars. Mind you, the stated rate is ridiculously low to start with.
If my doctor wants to fight any of these “cuts”, he has to do it individually – he can’t take a group of bills and bundle them together. Therefore, if it goes to court, he has to hire a lawyer to fight for $20. Hmmmm. Let me think. I think the first ring on MY lawyers phone costs about $200.
Also, the reason all the GP’s where I live won’t take government insurance is that if you take one person, you have to take ANY person with state insurance who walks through the door – and if you sit in my doctors waiting room for any amount of time, it soon becomes obvious that a whole fuckin’ lot of these people are demanding, obnoxious, and stupid beyond belief. Why would you cop an attitude with a doctor who is trying to help you? I have actually heard a patient call the doctor a “stupid fuck”.
He is a better man than I, Gunga Din.
Because I would give a pissant like that a prescription for 80 mgs of Warfarin a day, and then refuse to see him when he came back scared shitless because he was pissing grape juice.
Government healthcare? What a fucking joke. If Hillary gets her way, she’s going to be awfully busy taking care of patients whose doctor’s have said “Fuck this. I’m going to paint houses”
His wife gave birth for months on end? No wonder the pain-killer bills were high!
This is not uncommon and a problem with the hospital and the anesthesiologist (if it’s a problem at all) rather than the insurer. We were told WHILE I WAS IN LABOR that we’d likely be billed extra for the epidural – bad time to hear this! But I for one considered it $200 VERY well spent!
The problem does seem to be ignorance on the part of Kos because he hasn’t encountered this type of issue before or failed to educate himself ahead of time. He just decided to air his ignorance in a public forum. It’s not the firsy or last time he’ll embarrasss himself publicly.
I think if he takes a big dump, some of the absominal pain he complains about in his post will probably be reduced. He frequently looks pretty constipated to me.
1) Wait a minute: Kos is STRAIGHT? I think I need to take my gaydar into the shop for a checkup.
2) Yes, indeed. It’s foolish to expect a government-run service to be any better.
Personal anecdote: When I was a kid, I worked as a scutmonkey in a pharmacy (register jockey, stocker, you name it…). My job description included any job that someone higher on the food chain didn’t want to do, in particular trying to persuade the various insurance companies (public and private) to pay their damned bills. While both the private insurors and the state Medicaid people were larcenous sacks of shit, the private companies COULD usually be convinced to pay if you were persistent enough and had your facts and paperwork in order. Medicaid was a different story. Their clients couldn’t generally go elsewhere, their employees were rude, unfireable bureaucrats, and threatening to sue the state for a $50 ‘scrip is a non-starter.
Scenario: Dr. Smith writes a prescription for his ol’ buddy William Q. Jones, Jr., who he’s been seeing for 50 years. Unfortunately, he writes it for “Bill Jones”.
Private insuror: Rejects claim, but will usually pay it upon getting the required mountain of paperwork which demonstrates that Bill and William Q. Jr. are one and the same.
Medicaid: Not going to pay it. Ever. Even though Bill had his Medicaid sticker with his SSAN (I hope they’re not still doing that) for the prescription, and even though the doctor was willing to vouch for his identity. You’re just going to eat that one unless you’re extremely lucky, say, by getting a greenhorn clerk at the Medicaid office who still has a lingering sense of ethics and justice (hence the assignment of this task to the lowest-paid scutboy in the store — since the monetary return per hour of argument was low, it wasn’t cost-effective to have someone more highly paid do it).
I hope things have improved since then, but something tells me that they haven’t.
Refusing Medicaid outright wasn’t an option for that pharmacy — it was in a rather exciting part of town, so not taking Medicaid would’ve reduced the customer base by at least 75%. That also meant that we got the occasional customer who decided to self-prescribe some Schedule II’s and pay for them with a handgun. Thank Bog never while I was on shift.
“The administrative runaround is certainly frustrating enough but anyone who thinks that’s going to improve under government control has never dealt with a government agency.”
People who are wronged by the denial of government benefits don’t see right again.
Spies, Brigands – Kos is STRAIGHT?
He might be ambidextrous. Is that wrong?
The shock of which team Kos is on is far less than the fact that there is a woman out there that was willing to bear his child.
Andy – You are a tool.
Kos should have gone to Havana for that great free medical care Mikey Moore was raving about…
Drumwaster – Great idea! They go on and on and on about how healthcare is better in Cuba, San Salvador, the Ivory Coast, etc … yet you never see these people taking their kids there for medical services, or having their children being born there. When it comes down to it, when it is the health and safety of themselves and their loved ones, they choose the good old US of A for their care. Fucking liars, they are.
Good points about the “free health care” in GenericThirdWorldHellhole.
I was highly amused when Michael Mooreon’s favorite country imported a surgeon from Spain when Fearless Leader got sick.
The Kos is strapped for cash? Funny, I thought he was on the way to becoming the first blog millionaire.
“Drumwaster – Great idea! They go on and on and on about how healthcare is better in Cuba, San Salvador, the Ivory Coast, etc … yet you never see these people taking their kids there for medical services, or having their children being born there.”
Don’t know about the others, but Cuba is a destination for medical tourism. It is, however, illegal for Americans to do go there. Canadians, however, seem to go:
http://www.choicemedicalservices.com/
“Don’t know about the others, but Cuba is a destination for medical tourism.”
We understand that andy, the question is not the destinations, but the points of departures. Do you see a pattern there? Why is “medical tourism” not catching on in the US, do you suppose?
I think it says something that Canadians go to Cuba for health care.
But I don’t think it says what andy thinks it says.
“Do you see a pattern there? Why is “medical tourism†not catching on in the US, do you suppose?”
What makes you say its not catching in on the US? Google “americans medical tourism.” This 2006 CNN article./a> tells of half a million americans going abroad for health care. I don’t know if that includes people who buy foreign prescriptions online.
andy – does not know the difference between bargain shopping and buying quality.
Or people going for plastic surgery/lipo, etc.
Plenty of Canadians do their medical tourism trips to the United States… I’ve taken care of many.
My favorite was the elderly Canadian gentlemen who’d been having heme-positive black stools intermittently for months (GI bleeding, for the laymen among us). He’d been unable to get in with a Gastroenterologist in Canada, and he had another episode when he came on vacation to the US, where I saw him in the ER. He clearly had melena (black, tarry stools) from an active GI bleed. I got him admitted, seen by a GI doc, and scoped the same day. He was extremely grateful, and very impressed with the way we treated him.
His travel insurance company was also very easy to deal with. I’ve had many occasions to deal with the Travel Insurance that Canadians buy (it’s quite expensive, and their normal national health insurance doesn’t cover them out of the country). The people I’ve dealt with there are uniformly pleasant, reasonable, conversant in the lingo (usually a nurse), and they virtually never fight with you over a treatment. American insurers could learn a thing or two from some of the Canadian customer service people.
The absolute WORST is dealing with CMS (medicare), Medicaid, or Tricare. The latter has been known to pull some really dangerous stunts in an effort to stay “in network” (ie. save money). CMS is the worst bureaucracy you could ever imagine. It takes months to get your medicare approval, your medicare number, and actually get paid. If they “lose” your paperwork (this has happened to me), you have to start over, and the clock resets. Here’s the problem… medicare refuses to play claims older than 6 months. If you go through a few cycles of “filled out incorrectly,” “we can’t find it,” “we never received it,” (and they don’t accept certified mail or delivery confirmation packages so you could prove that you sent it… no shit), you end up past the 6-month mark, and all those older claims never get paid at all. In short, you saw them for free, all because of govt. incompetence.
Ask me how much I hate the thought of govt. healthcare… the fools agitating for it have NO IDEA what they’re in for.
“andy – does not know the difference between bargain shopping and buying quality.”
That is exactly the difference. What is crappy about our system is price. Other places have crappy care for other reasons. People use foreign competition to avoid both of these problems.
Clearly the answer is not a change in culture to greater responsibility, virtue, and honor. No, it must be greater central government planning.
Ah, so we should just outlaw inflation.
“Ah, so we should just outlaw inflation.”
Price controls have their place — such as price floors in the stock market — but I don’t think that would be the fix to health care costs here. Something like better bargaining power for consumers might work.
“What is crappy about our system is price. Price controls have their place  such as price floors in the stock market  but I don’t think that would be the fix to health care costs here. Something like better bargaining power for consumers might work.”
So you support deregulation, then?
“So you support deregulation, then?”
How does that follow?
Adam Smith had some thoughts on this
The only way I know to increase bargaining power is to increase competition, offer more choices. The obvious way to achieve this is would be to break up the AMA monopoly. What do you have in mind?
“The only way I know to increase bargaining power is to increase competition, offer more choices.”
Thats very little that you know. Now you know more: You can increase bargaining power by increasing competition of sellers or decreasing competition among buyers: ie, joining together. An insurance company does that when i can negotiate lower rates with its doctor’s than I could by myself. But that don’t necessarily save me money, because I am only negotiating with the insurance company on my behalf. Maybe my employer could pool all of us together and get a good rate. Or everyone in the state could be pooled together and get an even better rate.
“The obvious way to achieve this is would be to break up the AMA monopoly.”
I don’t think the AMA is a monopoly. AMA members compete with each other.
“I don’t think the AMA is a monopoly.”
Nice talking to you, andy. I don’t think I can get around that level of ignorance or denial, whichever it is.
I also like the idea of increasing my bargaining power by giving it away. That is special.
andy has helped me understand why I talk past lefties on this issue: when he says insurance company he seems to actually be refering to a purchasing co-op.
“Nice talking to you, andy. I don’t think I can get around that level of ignorance or denial,”
Its an interest group. The National Association of Manufacturers is not a monopoly, for example.
Or are you talking about how only accredited doctors can practice medicine? You want to change that?
“I also like the idea of increasing my bargaining power by giving it away”
Thats how cartelization works. It’s not just suppliers that can do it. Buyers can too. OPEC countries have more bargaining power when their members give up their bargaining power to the cartel.
“andy has helped me understand why I talk past lefties on this issue: when he says insurance company he seems to actually be refering to a purchasing co-op.”
The insurance company IS pooling all the people it insures together when it goes on the market for medical services. And the more market share of medical consumers it represents, the more bargaining power it will have. But it most certainly is not a purchasing co-op. That was clear from my comment, when i said:
“But that don’t necessarily save me money, because I am only negotiating with the insurance company on my behalf”
“Or are you talking about how only accredited doctors can practice medicine? You want to change that?”
Yes.
“OPEC countries have more bargaining power when their members give up their bargaining power to the cartel.”
No andy, the cartel has more bargaining power, the member nations have none. When you give your bargaining power to an insurance company, the insurance company gains more bargaining power, but you have none. You just gave it all away. You have to accept whatever is given you, because you can no longer bargain for anything else. You have no bargaining power. Is this simple enough for you to understand, or should I bring in Dick and Jane and fucking Spot to give a try?
“The insurance company IS pooling all the people it insures together when it goes on the market for medical services. And the more market share of medical consumers it represents, the more bargaining power it will have. But it most certainly is not a purchasing co-op.”
That is the exact definition of a purchasing co-op. Your comment does nothing to change that, and isn’t clear about anything.
Nurse practitioners? Never heard of them.
Cognitive dissonance sucks ass.
“No andy, the cartel has more bargaining power, the member nations have none.”
The member nations get to participate in deciding how the cartel uses its power. The idea being that they’re better off being in the cartel. They pool their power and use it collectively.
But thats not how your insurance company works. It does, however, pool the demand of its insured together. However it takes its cut, and you still have to bargain by yourself with the insurance company. Thats not quite how OPEC operates.
But you get the point, that it is not true that the only way to reduce costs to consumers is to break up the AMA.
“You just gave it all away. You have to accept whatever is given you, because you can no longer bargain for anything else.”
Sure you can. You can leave the cartel.
“That is the exact definition of a purchasing co-op”
I don’t think its the exact definition. I think its missing a key part: the cooperative part. Insurance company costumers aren’t relating to each other in a co-op. They’re just consumers of the same business. Wal-mart aggregates all of its consumers in order to negotiate lower prices for its goods. But that doesn’t make it a purchasing coop.
Wikipedia gives me that a co-op is:
“A cooperative (also co-operative or co-op)is defined by the International Co-operative Alliance’s Statement on the Co-operative Identity as an autonomous association of persons united voluntarily to meet their common economic, social, and cultural needs and aspirations through a jointly-owned and democratically-controlled enterprise”
An insurance company is not a jointly owned and democratically controlled enterprise. Not by the people who it is pooling together at least.
“The member nations get to participate in deciding how the cartel uses its power. The idea being that they’re better off being in the cartel. They pool their power and use it collectively.”
“An insurance company is not a jointly owned and democratically controlled enterprise. Not by the people who it is pooling together at least.”
Then why are you comparing the two?
“Sure you can. You can leave the cartel.”
In which case the cartel has no real power then, why would I deal with a cartel whose members have the option to refuse the deal? Do you have any idea what any of these words mean?
“…the International Co-operative Alliance’s Statement on the Co-operative Identity…”
Nice source, by the way.
“Then why are you comparing the two?”
I’ve made clear what they do have in common: aggregation of interests, thus increasing market power in order to negotiate lower prices.
That was all because you thought the only way to make prices lower was to reduce the market power of sellers. Not so. You can also increase the market power of buyers. Which makes sense in a trivial way: because there are two sides to the market, the buyer and the seller. Your line:
“The only way I know to increase bargaining power is to increase competition, offer more choices.”
only saw one side.
“In which case the cartel has no real power then, why would I deal with a cartel whose members have the option to refuse the deal?”
Thats what lots of cartels are like. Countries can leave OPEC (or even cheat it) when they like.
Or you could sign contracts with each other to prevent this from happening. Likely you wont leave your buyers cartel, because you will probably get a better deal within the cartel than outside it. So long as your interests are similar to the others in your cartel.
Anybody want to try to explain the difference between market power and bargaining power to andy? My neighbor is on vacation and I need to go make sure his trees haven’t run away.
They overlap enough for our purposes. See:
http://en.wikipedia.org/wiki/Economic_power
Where monopoly power there is what I have been referring to as market power. Is that there your definition of bargaining power? If not, what are you using?
And we haven’t even gotten into information asymmetries…
But we have come a long way from when you thought the only way to reduce prices was to lower the market power of sellers.
Isn’t that cute — actus thinks he’s educating.
actus thinks
Isn’t this phrase in itself somewhat philosophically problematic?
I’m pretty sure that he’d fail any serious Turing test.
“But we have come a long way…”
We haven’t went anywhere. I have stood in the same place watching you skip around in circles tossing rhetoric and jargon about like confetti.
According to you, if all the corn growers in the world pooled their crops and hired a broker to sell it, and all the corn consumers pooled their investment and hired a purchasing agent to negotiate a deal with the corn broker, everyone would have more bargaining power than if they all negotiated individually. That is patently absurd.
“I have stood in the same place watching you skip around in circles tossing rhetoric and jargon about like confetti.”
Words like market power, information asimmetry, cartel, cooperative, have meanings. Meanings which reflect economic concepts and means of industrial organization. Meanings which one could get from learning some microeconomics — though not necessarily in school. I’ve at times provided links so you could look them up for yourself. And I’ve even once asked you for your definition of a term to see if it matched the one I linked to. If you think that you can indeed wave them away as jargon and rhetoric, then we certainly are still at the beggining where only the market concentration of one side of the market matters. Good luck promoting your healthcare policy of “breaking up the AMA monopoly.”
“According to you, if all the corn growers in the world pooled their crops and hired a broker to sell it, and all the corn consumers pooled their investment and hired a purchasing agent to negotiate a deal with the corn broker, everyone would have more bargaining power than if they all negotiated individually.”
Market power is relative. Now you have two monopolies. The ones that step out of these monopolies are going to be dealing by themselves with a monopoly. Good luck. Note though that there is great incentive for these brokers to break up the other side’s cartel. And there will be great incentive for people to leave the cartels.
But there is no doubt that the market prices would be more pro-seller if the sellers all consolidated in one unit, whether it was a coop, a corporation, or holding trust.
“Market power is relative. Now you have two monopolies. The ones that step out of these monopolies are going to be dealing by themselves with a monopoly. Good luck.”
Exactly. That is what we now have in the medical industry, and reinforcing the consumer side, or making participation mandatory, is not a solution.
“Good luck promoting your healthcare policy of “breaking up the AMA monopoly.â€Â
Why is it such a hard sell, do you think? And it that reason enough to not attempt it, because it will be difficult?
Sorry, but I don’t really have the time, nor the inclination, to look up and try to memorize a bunch of technical jargon so I can discuss this on a micro-economic level. I am more interested in trying to establish a big picture, common language dialog. Bargaining power is the term we were discussing, and its definition to me is pretty fucking obvious.
Right now my auto insurance rates are fairly negotiable. They cover unforeseen, catastrophic events such as accidents, theft and vandalism. Routing maintenance is either out of pocket, or covered in a seperate, even more negotiable plans. I have the choice of having any work done by accredited service people, or the kid next door, depending on the severity of the consequences. If it were legislated that all of this HAD to be covered by one umbrella policy, and only one group of self regulated mechanics could do the work, and all insurance agencies HAD to over the same basic coverage, I can imagine no definition of bargaining power that could be considered to have been increased.
I am on Blue Cross also. Even though I am a single, 50 year old man I have to pay for maternity coverage, I have to help pay for Markos little moonbat. I have no sympathy for someone bitching about being covered for a planned, elective medical cost when the money is coming out of my pocket, and they almost certainly make more money than I. But I have no bargaining power, it is mandated that Blue Cross include maternity coverage in all policies.
D’oh!
“That is what we now have in the medical industry”
Not really. there are lots of providers of health care, lots of insurance companies, and even more consumers.
“Why is it such a hard sell, do you think? And it that reason enough to not attempt it, because it will be difficult?”
Because its not really a monopoly. And the problem isn’t the AMA or the doctors. There are plenty of other things that go into health care besides doctors.
“Sorry, but I don’t really have the time, nor the inclination, to look up and try to memorize a bunch of technical jargon so I can discuss this on a micro-economic level. I am more interested in trying to establish a big picture, common language dialog.”
Well, if you want to talk about health care economics, you’re going to use economic principles.
“But I have no bargaining power, it is mandated that Blue Cross include maternity coverage in all policies.”
Sure you do. You could not have health insurance. Enjoy!
BMoe – I admire your persistence, I really do. But as I have said before, and I am the first to admit that I do not follow by own advise, you would have a better chance of explaining the laws of thermodynamics to a brick wall by standing in front of it and screaming at the top of your lungs, than you will have of Andy participating in an actual discussion. Confetti, strawmen, and gibberish is all that awaits you, my friend.
Yes, because Wiki is authoritative. Providing a link does not make your lack of an argument, your strawmen, and the silliness, any better of a position, andy. In the end, you are advocating a system that is demonstrably worse for Americans than the existing system, and an overall system, Communism, that has been a demonstrable failure everywhere it has been implemented.
“Yes, because Wiki is authoritative. ”
It can certainly quote authoritative sources. I’d be surprised if the wikipedia on thermodynamics was wrong. But find another. You see the point: I provided links to explain. But what I got in return was a refusal to understand
Or if you like, link to conservapedia.
“In the end, you are advocating a system that is demonstrably worse for Americans than the existing system, and an overall system, Communism, that has been a demonstrable failure everywhere it has been implemented.”
I haven’t talked about communism at all. If I were, I definitely wouldn’t be talking about market power, bargaining and prices. You’re the one with a lack of argument, with the sillyness.
I love dogs, and have often wondered what the fuck was going through their minds when they would chase their tails like little dervishes.
I still haven’t figured it out, but thanks for trying, andy.