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Jeffrey Singer: The Man Who Was Treated for $17,000 Less
The Wall Street Journal ^ | August 21, 2013 | JEFFREY A. SINGER

Posted on 08/22/2013 7:55:12 AM PDT by Hojczyk

When the man arrived at the hospital for surgery, the admitting clerk reviewed the terms of his policy and estimated the amount of his bill that would be paid by insurance. She asked him to pay his estimated portion in advance. (More hospitals are doing that now because too often patients don't pay their portions of the bills after insurance has paid.)

The insurance policy, the clerk said, would pay up to $2,500 for the surgeon—more than enough—and up to $2,500 for the hospital's charges for the operating room, nursing, recovery room, etc. The estimated hospital charge was $23,000. She asked him to pay roughly $20,000 upfront to cover the estimated balance.

Most people are unaware that if they don't use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the "list" price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.

I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance

(Excerpt) Read more at online.wsj.com ...


TOPICS: Editorial
KEYWORDS: healthcare; healthinsurance; obamacare

1 posted on 08/22/2013 7:55:12 AM PDT by Hojczyk
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To: Hojczyk

Great example! We need a free market!

Get the govt out of health insurance, it only causes prices to rise.


2 posted on 08/22/2013 8:01:53 AM PDT by Ray76 (Common sense immigration reform: Enforce Existing Law)
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To: Hojczyk

I helped a friend get a prescription

They originally filled it with a name brand medicine, for $400, and told her her ‘co-pay’ would be $40. They thought she had insurance through a certain company.

When she told them she had no insurance, they re-filled it with a generic brand for $25. (made by the same manufacturer, without the name brand bottle)

People have NO INCENTIVE to shop around, even when it would have saved her $15 more. the pharmacy would not have told her about the other medicine by their own volition.

Only in an idiotic system like ours is this possible.


3 posted on 08/22/2013 8:02:10 AM PDT by Mr. K (Lies, Damned Lies, Statistics, and then Democrat Talking Points.)
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To: Hojczyk

So it is insurance that creates the cost problem in medical treatment. The government solution is to force everyone to buy insurance. Makes total sense! If your only goal is to put the government in charge.


4 posted on 08/22/2013 8:04:18 AM PDT by scottteng (Tax government employees til they quit and find something useful to do)
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To: Ray76
Get the govt out of health insurance, it only causes prices to rise.

That and quality to fall through the floor.

5 posted on 08/22/2013 8:05:24 AM PDT by Standing Wolf (No tyrant should ever be allowed to die of natural causes.)
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To: Hojczyk
ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?

Oh, they've already learned. What they learned is that to control health-care is to control life.

Slavery, anyone?!

6 posted on 08/22/2013 8:05:42 AM PDT by DakotaGator (Weep for the lost Republic! And keep your powder dry!!)
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To: scottteng

Don’t get me started on prescriptions. I have finally arranged life so that most of mine are on the dreaded Walmart $10 list. Except for the one that I have to order from Canada to get a decent price.


7 posted on 08/22/2013 8:06:52 AM PDT by scottteng (Tax government employees til they quit and find something useful to do)
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sfl


8 posted on 08/22/2013 8:08:15 AM PDT by phockthis (http://www.supremelaw.org/fedzone11/index.htm ...)
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To: Ray76

This is what the GOP needs to talk about

put together a list of all these stories and use that as a basis for ‘change’ to the health care system

starting with putting the shopping around for bargains back in the consumers hands

FIRST and MOST IMPORTANT: When you go to a hospital or pharmacy you pay a PERCENTAGE, not a ‘co-pay’ (fixed amount that is the same no matter where you go). That way you can shop for the place that will minimize your costs.

SECOND- ALL insurance policies are for catastrophic illnessed only. I dont expect my car insurance to pay every time I go get my oil changed or spark plugs- even if I want my oil changed every week or 12 sets of new spark plugs per year. I want them to pay only when there is an accidetn. (companies are REQUIRED by the government to pay for all things)

THIRD- Shoot all medical malpractice lawyers... wait- did I say that out loud?


9 posted on 08/22/2013 8:18:45 AM PDT by Mr. K (Lies, Damned Lies, Statistics, and then Democrat Talking Points.)
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To: Hojczyk

Bookmark.


10 posted on 08/22/2013 8:26:33 AM PDT by SunTzuWu
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To: scottteng
I have finally arranged life so that most of mine are on the dreaded Walmart $10 list. Except for the one that I have to order from Canada to get a decent price.

I just looked at the Walmart $10 list on their website. It shows the dosages (pill sizes) available, but does not show the daily quantities used. If you take (for example) three 500mg pills a day is the cost $10 for 90 days? Or is the cost $30 for 90 days?

11 posted on 08/22/2013 8:28:49 AM PDT by Senator_Blutarski
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To: Mr. K
THIRD- Shoot all medical malpractice lawyers

Don't shoot all of them. Doctors are very good at covering up acts of gross negligence committed by their colleagues. It's rare, but it happens.

So keep just a few medical malpractice lawyers around to keep the doctors honest.

12 posted on 08/22/2013 8:30:08 AM PDT by Leaning Right
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To: scottteng
So it is insurance that creates the cost problem in medical treatment.

I believe the situation is more complex. If it were just the insurance companies, they'd be making enormous profits. They are profitable, but not to the extent that one would think.

The problem is a combination of cost shifting (paying for people who don't pay, or who are bad insurance risks) and the presence of multiple middle-men.

The great Ludwig von Mises wrote in his "Human Action" that the failure of socialism was one of ineffiency due to the fact that prices were centralized and thereby inhibited the natural pricing mediaton of supply and demand.

If you look at US medicine, not only now, but for the past generation, you'll see that no one knows what anything costs. It all depends on who you ask, and what pricing club is your vehicle for interacting with the vendor. That fits von Mises' observation very well.

13 posted on 08/22/2013 8:34:44 AM PDT by Pearls Before Swine
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To: Hojczyk

wow


14 posted on 08/22/2013 8:36:22 AM PDT by GeronL
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To: scottteng

insurance inflates the price the same way college loans inflate the price of college tuition


15 posted on 08/22/2013 8:43:38 AM PDT by GeronL
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To: Ray76
“Great example! We need a free market!”

Yes, but what we are getting is so very different. In modern medicine physician fees are not the major expense. If all physicians worked for free, and nothing else at all changed, we would still see steadily increasing costs and care that is way too expensive for all but the wealthiest to pay out of pocket.

Obamacare is resulting in centralization of medical care into large hospital systems, so physicians like the ones involved in this article have less and less options to ‘shop around’ for facilities that will give their patients a break on cost. Further, private physicians are giving up on staying independent, and are joining these big hospital systems. The result is that we are creating a bureaucratic medical monopoly in which physicians have little voice, and competition is diminished.

Further, the ability of physicians to create unique new facilities, targeted to specific medical needs, has been suppressed by law. This is very problematic, and hurts the consumer, IMHO. If a bunch of oncologists, hematologists, oncological surgeons, hospitalists, and other related practitioners and allied health care personnel want to start a stand alone cancer treatment hospital, in which focused care results in better care and decreased costs, they will have a very hard time. The same would be true for cardiologists and cardiothoracic and vascular surgeons joining together to start a heart/cardiovascular hospital. These types of ventures could be very efficient, and thus increase quality at the same time they decrease costs. But they are suppressed.

Market principles are most definitely not at play.

16 posted on 08/22/2013 8:48:10 AM PDT by pieceofthepuzzle
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To: Hojczyk

Should be Economics 101 to any Freeper!

Anything subsidized, which removes market forces, will become not only more expensive, but GREATLY more expensive.

A safer and much cheaper plan would be ONLY catastrophic insurance to cover, and here an honest discussion could take place, anything over 5%, 10%, 50%, 75% of your yearly income.

Once an appropriate number is agreed to, market forces would work at suppressing costs below that target number.

If you don’t have skin in the game (dangerous statement given our president) you do not pay as much attention to costs.

Just in the last month we went over 2 dentist bills only to discover that the 2 separate dentists had agreed to the insurance reimbursement for a covered procedure per their contract, then proceeded to charge us $230 and $260 more than they had agreed upon.

We had to do our own analysis as even our Insurance provider (which, believe it or not, my wife works for) could not figure out what the hell the dentists were doing.

Seems this is the racket they are all playing hoping people will just pay and not question so they end up with way more money than the procedure was to have cost.

Both dentists admitted their “ERROR” and have refunded the over charge but I guarantee you the vast majority of their other patients are being gouged by this practice.

CHECK EVERY BILL like you are paying for it, because you are regardless of insurance coverage.


17 posted on 08/22/2013 8:49:29 AM PDT by Wurlitzer (Nothing says "ignorance" like Islam! 969)
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To: Hojczyk

I used to think that “School Administrators” were the highest paid “migrant workers” in the country, but based on what I have seen with hospitals, I think that I need to add “Hospital Administrators” to the list. Just as in education, how do you justify paying some jerk $500k per year to “run” a hospital?


18 posted on 08/22/2013 8:53:03 AM PDT by vette6387
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To: Senator_Blutarski

it does depend I have one that I take 2X per day and the 180 pills I need for the 90 days is charged at $10 I used to take a time release version of the same med that is still outrageously expensive. I have had them charge me $20 for an eyedrop because they said my script spec’d too much for 90 days but the price was still reasonable compared to list. I have been through ordering from Mexico, Canada, changing meds to get decent prices you have to have a physician that is willing to adjust your meds to suit your purse. Walgreens has a decent program too but it costs a membership fee. I still maintain it because there is one drug that is $30 through their program that is over $60 at walmart.


19 posted on 08/22/2013 8:56:13 AM PDT by scottteng (Tax government employees til they quit and find something useful to do)
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To: Mr. K

My insurance policy through my former employer required a $10.00 co-pay for prescriptions. I left my job and did not continue my insurance. When I got my prescriptions filled, same drugs, same quanity, the cost was $8.25 each.


20 posted on 08/22/2013 9:00:17 AM PDT by dirtymac (Now is the time for all good men to come to the aid of their country.)
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To: GeronL

“insurance inflates the price the same way college loans inflate the price of college tuition”

GL, same passel of RATs getting rich. Academia is probably worse than Medicine in that most of what passes for “education” today is about as useful to the recipients as taking courses in “underwater basket weaving.” As least in Medicine you usually get something of value for your inflated costs. The other thing about academia is that most of the professors don’t teach. I owe my engineering education at UC Berkeley to Indian graduate students, not any Nobel Lauriates. They were all too busy collecting fat paychecks and contemplating their navels to teach anything. Napolitano will fit right in!


21 posted on 08/22/2013 9:00:39 AM PDT by vette6387
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To: Senator_Blutarski

Call them, they will have an answer for you while you are on the phone.

Based on my experience, however, it will be $30.


22 posted on 08/22/2013 9:01:23 AM PDT by Balding_Eagle (When America falls, darkness will cover the face of the earth for a thousand years.)
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To: Leaning Right
This is a link to an article about Hospital CEO pay for 25 top grossing ‘not for profit’ hospitals.

http://www.beckershospitalreview.com/compensation-issues/ceo-compensation-of-the-25-top-grossing-non-profit-hospitals.html

This is just the tip of the iceberg, and for each one of these there are a ton of highly paid non-clinical bureaucrats beneath them. In any other industry faced with rising costs that consumers couldn't afford, there would be a move to decrease administrative costs. Not the case in medicine.

Here's another article about CEO pay at Children's hospitals.

http://www.beckershospitalreview.com/compensation-issues/health-affairs-childrens-hospital-ceo-pay-needs-more-accountability.html

I'm not saying that CEO pay is the major driver of health care expense, but I am saying that increased expense related to those who do not have a direct role in patient care is a problem, and it is growing.

23 posted on 08/22/2013 9:03:44 AM PDT by pieceofthepuzzle
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To: Mr. K

you are exactly right.
The GOP needs to start the conversation about de-regulating healthcare. I have been on the adminstrative side for more that 35 years and the majority of the rising cost of health care are artificially driven. That and trying to buy medical supplies and equipment where the price is tripled.


24 posted on 08/22/2013 9:03:56 AM PDT by dirtymac (Now is the time for all good men to come to the aid of their country.)
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To: Mr. K

Bump. I am not a doctor (I play one on TV). Remove any tax incentives for the employer concerning health care. So now the employer AND the government are out of the health business.


25 posted on 08/22/2013 9:13:05 AM PDT by VRW Conspirator (Producing Talk Show Prep since 1998.)
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To: pieceofthepuzzle
I'm not saying that CEO pay is the major driver of health care expense...

The same thing is going on in private industry. Back in the 1950's top executive pay was something like 40 times the pay of the average worker.

Now top executive pay is well over 400 times the pay of the average worker. The Boards of Directors are allowing the top executives to literally loot the companies.

That's bad for business, bad for employee morale, and bad for the country. But hey, you gotta pay for top talent, the Board members say as they're off to another all-expenses-paid meeting in Hawaii.

26 posted on 08/22/2013 9:15:52 AM PDT by Leaning Right
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To: scottteng

Oklahoma City hospital posts surgery prices online; creates bidding war

http://kfor.com/2013/07/08/okc-hospital-posting-surgery-prices-online/


27 posted on 08/22/2013 9:20:00 AM PDT by Rusty0604
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To: Standing Wolf

You think the only reason Doctors give quality care is because the gov’t makes them? LOL


28 posted on 08/22/2013 9:21:39 AM PDT by Rusty0604
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To: Mr. K

you are exactly right.
The GOP needs to start the conversation about de-regulating healthcare. I have been on the adminstrative side for more that 35 years and the majority of the rising cost of health care are artificially driven. That and trying to buy medical supplies and equipment where the price is tripled.


29 posted on 08/22/2013 9:33:35 AM PDT by dirtymac (Now is the time for all good men to come to the aid of their country.)
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To: Ray76

it all the state and fed coverage mandates that cause the rates to rise


30 posted on 08/22/2013 9:36:05 AM PDT by markman46 (engage brain before using keyboard!!!)
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To: VRW Conspirator

that would be number 4

AND!!! 5- make health insurance costs deductable (like mortgage interest)

why should you pay taxes on money used to keep your health (that’s just EVILLLL)


31 posted on 08/22/2013 9:40:30 AM PDT by Mr. K (Lies, Damned Lies, Statistics, and then Democrat Talking Points.)
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To: Leaning Right

6) Any doctor who covers up the gross negligence of another is GUILTY OF THE SAME crime and negligence. Most industries are self-weeding. We have had engineers who deisgned stuff that would fail- we put them in charge of storing the blueprints.


32 posted on 08/22/2013 9:43:00 AM PDT by Mr. K (Lies, Damned Lies, Statistics, and then Democrat Talking Points.)
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To: Standing Wolf

I disagree that it would make quality “fall through the floor”. Medicine is business and most small business owners want the best for their customers, especially customers you become intimately acquainted with.

I belonged to a medical co-op when I was homeschooling. It involved paying for everything up front and being reimbursed. It was quite an education in how much less you pay when you have cash.


33 posted on 08/22/2013 9:48:14 AM PDT by rbbeachkid (Get out of its way and small business can fix the economy.)
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To: Hojczyk

bkmk


34 posted on 08/22/2013 9:48:49 AM PDT by Sergio (An object at rest cannot be stopped! - The Evil Midnight Bomber What Bombs at Midnight)
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To: DakotaGator

AND people who DON”T VOTE DEMOCRAT will NOT GET the CARE that a DEMOCRAT WILL?


35 posted on 08/22/2013 10:13:28 AM PDT by Ann Archy (Abortion......the HUMAN Sacrifice to the god of Convenience.)
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To: Hojczyk

Works with dentistry too.

I pay cash, have all my life. Dental insurance would be more expensive than paying cash.


36 posted on 08/22/2013 10:30:55 AM PDT by Persevero (Why does my tagline keep disappearing)
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To: Hojczyk

This highlights the exact reason why Obamacare will be mandatory.

Obamacare isn’t about health care, it’s about extorting money from those who have some and using it to finance Obama’s wealth redistribution economy.


37 posted on 08/22/2013 10:35:48 AM PDT by Iron Munro (To learn who rules over you, simply find out who you are not allowed to criticize - Voltaire)
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To: scottteng

Can you give me the name of a good Canadian pharmacy? Do they require that you supply a prescription before providing service? Thanks.


38 posted on 08/22/2013 10:36:57 AM PDT by LifePath
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To: LifePath

https://www.northwestpharmacy.com/Default.aspx
They are large and reliable have locations in Europe as well they do require a script from your doctor. I have ordered from Mexico without scripts being needed but these are BP meds not anything that is usable recreational wise.


39 posted on 08/22/2013 10:43:57 AM PDT by scottteng (Tax government employees til they quit and find something useful to do)
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To: Wurlitzer

The NHS was created out of the ideal that good
healthcare should be available to all, regardless
of wealth. When it was launched by the then
minister of health, Aneurin Bevan, on July 5
1948, it was based on three core principles:
that it meet the needs of everyone
that it be free at the point of delivery
that it be based on clinical need, not ability
to pay.

‘Free at the point of delivery’. Has there ever been an instance of more colossal ignorance?


40 posted on 08/22/2013 11:24:17 AM PDT by pluvmantelo (Tuffy Gessling, George Zimmerman:They can crash at my pad anytime they like)
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To: scottteng
So it is insurance that creates the cost problem in medical treatment. The government solution is to force everyone to buy insurance. Makes total sense! If your only goal is to put the government in charge.

The truth is, the reason medical costs rose to the point they did even before Bozocare came to be, was because of medicare, which in turn sparked all type of other insurance. Docs began abusing Medicare so prices went up, people(Unions) started demanding companies pay for their insurance so prices went up. Before that there was catastrophic insurance, but not full coverage the way we have today, at least not for the average person.

True story, in 1946 I was 4 years old, my mother was a single mom because my dear daddy decided to run off with another woman when I was 3. Mom worked at a place called Westco Water paints and, at the time, was paid less than the men who worked there doing the same job, back in the day these things really did exist. At any rate my tonsils always acted up in the winter, this was during a time period when removing tonsils was almost an industry in itself. She would call Docs and they would make house calls and she could afford to pay them, even though we lived in a trailer. Bottom line, they took me to a hospital, took out my tonsils, I stayed in the hospital 3 days(they kept you longer in those days)and my mother, without insurance, was able to pay for it even on her low wage, of course she had to have a payment plan, but still she paid for it, kept us fed(me and my brother and her), and housed and didn't have to declare bankruptcy.

That was how it was back in the day before Medicare and other Insurance drove medical costs sky high.

41 posted on 08/22/2013 11:34:33 AM PDT by calex59
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To: pieceofthepuzzle
Government works its malignancy on free markets in many ways.

An example: an area hospital wanted an MRI machine (in the 1990's). A permit was required, and it was denied. The reason given was that "excess use" of the machine would be made so as to increase billing & hence income. The hospital ended up joining with several other hospitals to share a MRI machine available on a rotating basis. The MRI was in the "trailer" portion of a tractor-trailer, which was dropped off every week or two for several days.

Government imposed scarcity no doubt negatively impacted care available at each hospital. It also restricts sales of MRI manufacturers, meaning that costs of developing and producing the machines is spread over fewer sales, meaning higher prices for each MRI machine.

Insurance is another toxin. And now that a huge government bureaucracy is being implemented to oversee every aspect of health care provision and insurance - itself already an overhead - costs will/are becoming astronomical.

The Central Planners require a gargantuan bureaucracy inquiring into every minutia so that THEY may make a decision for YOU. The Central Planners and their bureaucrats certainly don't work for free, they do not produce accurate results, and they have not the right. You and I each have the right to make our own decisions.

The Central Planners need to dry up and blow away. Their communist ideas are contrary to our freedom, our Constitution, our Declaration of Independence - notwithstanding the opinion of nine attorneys in costumes.

42 posted on 08/22/2013 11:57:02 AM PDT by Ray76 (Common sense immigration reform: Enforce Existing Law)
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To: GeronL

Agree 100%


43 posted on 08/22/2013 11:58:04 AM PDT by Ray76 (Common sense immigration reform: Enforce Existing Law)
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sfl


44 posted on 08/22/2013 5:46:03 PM PDT by phockthis (http://www.supremelaw.org/fedzone11/index.htm ...)
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To: Ann Archy
Count on it.

Obamacare is rationed-care. Once it kicks in, there will never be enough capacity. That will mean rationing which will mean death panels composed of bureaucrats answering only to their political masters.

And it is a dead certainty that those who possess the moral depravity to support this abomination possess the political will to deny lifesaving care to those who do not support their evil way of thinking.

BTW, like your “handle”. And your tag-line is dead on!

45 posted on 08/22/2013 5:46:17 PM PDT by DakotaGator (Weep for the lost Republic! And keep your powder dry!!)
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To: DakotaGator

Thanks.


46 posted on 08/23/2013 3:51:01 AM PDT by Ann Archy (Abortion......the HUMAN Sacrifice to the god of Convenience.)
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To: Ray76

In this article the author made an important observation: 3rd party pay system caused the healthcare inflation. That include all the private insurance on the market today. Obamacare tries to contain the health inflation, but his direction is wrong. Instead of requiring everyone to have insurance, government should make health insurance with a deductible less than $20,000 illegal. That is only way to remove 3rd party pay system. The system before Obamacare wasn’t working, and the author knows that.


47 posted on 08/23/2013 6:07:42 AM PDT by gs03ssl (Make insurance illegal and the health cost will come down)
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