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OracleOutlook
Fiat justitia ruat caelum
8hr ago
atheists to be outperforming the LDS by far.
Don't they? (Stephen King, JK Rowling, etc)
Otherwise it sounds like we're in agreement here... until you used the term "gnostic theology." Catholicism is pretty anti-gnostic. Bodies are great, Jesus has a glorified body, we'll have one in the resurrection of the dead in the world to come.
Throwaway05
8hr ago
Are we talking high co-insurance costs here? I've never been on or been offered a health plan with a significant co-insurance burden although I'm aware they could hypothetically exist.
Interestingly, google-gpt says about 20% of plans have co-insurance.
So they certainly exist but aren't common.
If you are paying co-insurance charges would matter more but that dovetails into the rest of the discussion on this topic.
Outside of co-insurance - am I brain farting on anything other than: premium, deductible, co-insurance, co-pay? I guess uncovered nonsense.*
*Out of network costs are a separate problem that I forgot to mention in the other line of questioning (which is why my point is that shit is stupidly complicated!). Health systems don't really control who is and is not in network, it's usually a insurance fucking the consumer and hospital mechanism since canceling a scheduled surgery because Phil is the only anesthesia provider networked and he's off today or because the thing is emergency. This is one of the reasons why the hospital "know" they usually know what they charge, rarely know what the price is, and have zero ability to control and generally predict what the insurance company will pass along to the patient especially in uncontrolled situations like a hospital stay.
But yes thank you for reminding me of some of the other insurance related expense elements that I don't think about as they aren't in my plan, I dont think this alters the thrust of my argument though which is that the insurance is in charge of how much a patient pays and they have lots of ways to change that number away from the "price" and "charge."
A_Wee_Hearts_Toll
8hr ago
Cialdini's Influence is about why people don't listen to advice. Hickman on Twitter wrote:
Many times, "advice-giving" has little to do with advice, and more to do with posing thought experiments that expose weakness in men.
The guys with energy, who got "the juice" say OK, you're right, go try it. The low-energy types just get madder than hell, seethe over the advice, say it's "bad advice" but can't say why -- and the guys who don't need the advice are perfectly secure, well-aware they don't need it.
netstack
Texas is freedom land
8hr ago
Much like Moldbug’s “demotism,” that model sounds dramatic, but doesn’t hold up under scrutiny. The bits which resemble each other are not the ones with explanatory power.
If nothing else, the U.S. comes out way ahead on body count. We have a distinct lack of Holocaust or Holodomor or Great Leap Forward. Surely that reflects a difference in methodology.
Tenaz
8hr ago
These difference might help explain why the rest of modern society likes the fictional contributions of the LDS more than devout Catholics in the past 20 years.
It's not just "the rest" of modern society though; Meyer has sold more works to Catholics than any living Catholic author.
It's got to be more complex than just that LDS theology is more materialist than Catholic. If this were the case you'd expect atheists to be outperforming the LDS by far.
I do think there are theological second-order effect. In some ways LDS theology may speak to materialists more than Catholic theology. We have totally different answers to the most fundamental questions in religion--the problem of evil, the nature of God, the nature of sin, etc. This trickles down to inform author worldviews and sprouts in new and interesting ways from the gnostic theology that has dominated Western philosophy over the past couple thousand years. Maybe that's all it is--we're saying new, interesting things.
RoyGBivensAction
Zensunni Scientologist
8hr ago
FDR’s USA
Interesting how the wiki entry for the National Industrial Recovery Act makes no reference to fascism despite it being part of FDR and the brain trust's inspiration for the act.
OracleOutlook
Fiat justitia ruat caelum
8hr ago
Do you mean Out of Pocket Maximum when you say deductible?
After reaching deductible the patient still pays more money the more money is spent. It is possible to reach the Out of Pocket Maximum (I did one unfortunate year). At that point they can't take any more money.
Most of the time I give birth I reach the deductible, but other considerations can make the amount I pay in addition to insurance anywhere from 2k to 6k. And these other considerations don't have much to do with how hard the birth was to manage - I always have a natural birth, 1 day hospital stay, pretty much the same experience every time. The things that change are things like an out-of-network admitting OB.
Out of Pocket maximums are going to be pretty high, like 12k even on a good plan.
magicalkittycat
8hr ago
If you believe that state ownership of private enterprise is a good thing for the nation then you don't need to talk about "the other side" to begin with, you can justify it off the merits of state ownership.
If you don't believe it's a good thing for the nation, then why would you want the country to harm itself?
Throwaway05
8hr ago
I didn't mean your specific situation, apologies if it came across that way.
In this case, there is a pre-negotiated master charge list
Those numbers should still have been negotiated with some bullshit juju thought right?
One of the crazy things
Ahh shit, I meant to also blame providers in my post and may not have. Yes it's not uncommon to see someone and have them go "oh I can't handle that" and send you to the ED. A good chunk of that is absolutely to shift liability and is inappropriate but common. Biggest issue is when you say something unrelated to a specialist. Tell your endocrinologist that you checked your blood pressure at home and it was 160 over something and they'll send you to the ED even if that isn't quite appropriate. Another common problem is increasing specialization leading to specialists not knowing as much outside their field and PCPs being limited in what they can do and know (especially with midlevels). Lastly you have legitimately complicated shit, I don't really do peds at all IIRC from med school people are super fucking careful with kids that young. I think an urgent care would probably also sent you to the ED especially if ultrasound was standard of care.
Incidentally peds providers get paid way way way way way less than adult medicine.
If our child was on telemetry
It sounds like you were paying for hospital level of resources and in ye olden days your kid would have been admitted but now instead it can be managed conservatively outpatient - but you need inpatient level equipment (the ultrasound). One of those weird gaps.
Ultrasound is in a weird spot because it's evolving from a "nobody in the ED to can do this" to "we are starting to train everyone from day one to do this because its safe and cheap" but we are in the middle of that process. Wouldn't be shocked if in 5-10 years most PCP offices were doing it.
hydroacetylene
9hr ago
I know Texas state reps are happy to(have their staffers) research obscure state regulatory issues for constituents who call complaining about it, at least if you are a precinct chair in the same party.
I would suggest reaching out to local republican Apparatchiks to ask state legislators if they can find the regulation.
urquan
Hold! What you are doing to us is wrong! Why do you do this thing?
9hr ago
I've never actually watched either Stargate or Battlestar!
My parents are boomers, so they watched Star Trek and The Next Generation when they aired, and especially saw the films when they started coming out. Talking to them about movies is an interesting experience: they remember a time when movie theaters were everywhere, and going to see a movie was almost an everyday occurance. My dad talks about how when Star Wars came out in 1977, he saw it several times before it left theaters.
So I grew up on watching Star Wars films with my parents, we'd pull the lounge chair into the center of the living room and I'd curl up with my dad and watch the OT. When the prequels came out, we watched those too, but my favorite was Empire, obviously. When I was a little older we started watching Star Trek too, I remember liking Star Trek 1 and I was surprised when I got older and found out everyone hates it. But I also was obsessed with the Voyager probes as a child, so I guess it hit the spot for me.
Star Trek and Star Wars have always been the most mainstream of the space franchises, so I grew up with them as normal popcorn movies that my parents liked. Now, if you start talking to my mom about Lord of the Rings, that's where you'll start finding the nerdiness.
So part of this is that I grew up on a bit of an older wave of nostalgia, and I don't know what the Xer and Millennial parents of my cohort raised their kids on.
Even though it's super awkward, this is my favorite norm of the rationalist community, because you don't realize how reluctant people are to make specific, testable predictions until working out the terms of the bet forces them to.
Yep.
I think its less awkward when its actually a norm, but sometimes it does get used as a backhanded way to 'beat' someone by claiming "hah, you don't actually believe [thing] unless you put money on it!" Sometimes there's just too much uncertainty or the terms are inherently poorly-defined, even if the belief is tightly-held.
But that said, man, when you know there's some status hanging in the balance (i.e. if you 'lose' a few bets people might keep using that to undermine your arguments in the future), even if you're perfectly calibrated (i.e. you win your 50% bets 50% of the time) a couple losses in a row can make you feel like you're losing face.
Prediction markets offer a decent alternative because it makes the situation less directly adversarial. I would kill for there to be a way to publish your own positions in a way that others can verify and take positions 'against' yours, without it locking both of you into "one must win, the other must lose" proposition.
dev
9hr ago
The hospital negotiates with the insurance by saying X and the insurance says 1/4X and then the hospital says 1/2X and that's what the insurance decides to pay.
In this case, there is a pre-negotiated master charge list with a million cells in by code and by insurer. There must have been negotiation in agreeing to that list, but what we paid was the list price, the insurer did not do any negotiation to lower the chargers. I think this is a newer development, I remember ten years ago or so getting bills where it would say one charge, and then have a lower "this is what your insurer negotiated." But that is not how it worked for this bill. At this point, it looks like the cash pay rates are generally lower than the insurance negotiated rates.
The ED is for if you are dying, if you are not dying you are not supposed to be there, and it is expensive in the way that you'd expect for "this is the place where you are dying."
One of the crazy things is that for a 3mo infant this is not actually how it works. We went to our PCP first, in fact, spent almost 5 hours there before finally getting diagnosed with a UTI...and then they sent us to the ER because our PCP wanted a catheter sample and she did not feel comfortable doing that, so she said we had to go to the ER, that was the only option. Our child did not have a fever, but did have a UTI that needed antibiotics, but the only way to get those antibiotics was an ER visit. From what I have read since then, the type of antibiotics they will prescribe depends on if the UTI is deep in the kidneys, which is why they want to do an ultrasound. We could have easily gone to an urgent care facility during business hours if that was an option, but that was not an option, so instead we spent 6 hours in a packed waiting room which was a hot-box of germy kids.
In the ED nurses have few patients, numerous types of staff you might not even think about are running around constantly (like the lady whose only job is to get people's insurance), people are in and out of your room, labs come back stat, people are constantly checking if you are dying or not. Most patients in the ED are on telemetry, most patients admitted to the hospital aren't. All these things are extremely expensive and a lot of them happen outside of patient understanding and line of sight.
If our child was on telemetry and had people checking in on him constantly that may have justified and expensive level 4 or level 5 charge, but he was not. He was clearly fine and low priority. We were just waiting hours for admission and then after that many hours for for the ultrasound so we could get the antibiotics prescription.
Throwaway05
9hr ago
Pretty normal to essentially charge for "doctor - seeing you, thinking about you, and documenting you" and "things doctor did to you."
However in this case you could alternatively summarize it as "random blender of shit put together in an attempt to get the insurance company to pay enough for the hospital to stay afloat."
Throwaway05
9hr ago
Agree with the other poster and - insurance companies practically practice medicine all the time by deciding what is covered and what isn't, they deny this is the case however "you can still get X thing we just won't pay for it" works very well as a legal smoke screen and in the case of things like malignancy they can absolutely drag their heels and turn your melanoma from a short procedure to life altering or death causing.
FCfromSSC
Nuclear levels of sour
9hr ago
...Has anyone ever heard of attempts to use freezing water to provide mechanical force for metalworking? Making pressings, for example?
hydroacetylene
9hr ago
Health care sharing is a thing. It's worse than real insurance but you're just getting what you pay for there. The one that's solidarity something is better than the one that's samaritan's something. I am not the expert on these things or how they work but there's plenty of people who's main medical expenses are child-related who are very happy with them.
DuplexFields
Ask me how the FairTax proposal works. All four Political Compass quadrants should love it.
9hr ago
What a lot of people never learn is how much the modern imperial states (Fascist Italy, Nazi Germany, FDR’s USA, the Soviet Union and Communist China) resembled each other, differing mostly in how their philosophers describe them and how much (and how often) their governments are perceived to be allowed to violate their citizens’ and enemies’ human rights.
The opposite of libertarian isn’t communism, it’s totalitarianism.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9hr ago
I think the only person who dislikes the gameplay of HD2 is Cjet, or at least I think he was the person who says it's a grenade chucking sim. He prefers the Starship Troopers game, which is a highly confusing stance! I got my money's worth out of HD2 even though I only played sporadically of late. I also got my money's worth out of ST, if only because he gifted me a copy haha.
I'd love to join in, assuming there's room!
hydroacetylene
9hr ago
Your best bet when dealing with medical bills Act Like a Dot Indian. 'I'm not paying that, it is too much'. They'll knock it down eventually.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9hr ago
Say what you will about the British government, they have a unified, highly legible design for all their official websites. When I was filling up my DS-160 for a US visa, I was struck by how positively antiquated it was in comparison.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9hr ago
Aight, I let it through. But you should probably put the submission statement in the body of the post, probably easier to parse once people start commenting. You can do both that and include a link without issue.
hydroacetylene
9hr ago
I mean, you can always cartelize healthcare providers and insurance companies and leave them aligned, together against the patient.
I am happy to award you Bayes points for (likely) being right in our discussion. I could have sworn that we had a monetary bet myself, but I had looked for it a while back and didn't find anything. If even my 90% CI is unmet, can I interest you in a $10 giftcard from Amazon or equivalent? That would be from me to you, no need to pay if I'm right.
I hope that SpaceX finally figures out a single solid Starship configuration and flies it, but to their credit, they're consistently pushing the envelope and have the money to burn/blow up. I don't think anyone else would be crazy enough to imagine catching skyscrapers with chopsticks, and pull that off too.
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