Announcement

Collapse

The Rules of Pacers Digest

Hello everyone,

Whether your are a long standing forum member or whether you have just registered today, it's a good idea to read and review the rules below so that you have a very good idea of what to expect when you come to Pacers Digest.

A quick note to new members: Your posts will not immediately show up when you make them. An administrator has to approve at least your first post before the forum software will later upgrade your account to the status of a fully-registered member. This usually happens within a couple of hours or so after your post(s) is/are approved, so you may need to be a little patient at first.

Why do we do this? So that it's more difficult for spammers (be they human or robot) to post, and so users who are banned cannot immediately re-register and start dousing people with verbal flames.

Below are the rules of Pacers Digest. After you have read them, you will have a very good sense of where we are coming from, what we expect, what we don't want to see, and how we react to things.

Rule #1

Pacers Digest is intended to be a place to discuss basketball without having to deal with the kinds of behaviors or attitudes that distract people from sticking with the discussion of the topics at hand. These unwanted distractions can come in many forms, and admittedly it can sometimes be tricky to pin down each and every kind that can rear its ugly head, but we feel that the following examples and explanations cover at least a good portion of that ground and should at least give people a pretty good idea of the kinds of things we actively discourage:

"Anyone who __________ is a liar / a fool / an idiot / a blind homer / has their head buried in the sand / a blind hater / doesn't know basketball / doesn't watch the games"

"People with intelligence will agree with me when I say that __________"

"Only stupid people think / believe / do ___________"

"I can't wait to hear something from PosterX when he/she sees that **insert a given incident or current event that will have probably upset or disappointed PosterX here**"

"He/she is just delusional"

"This thread is stupid / worthless / embarrassing"

"I'm going to take a moment to point and / laugh at PosterX / GroupOfPeopleY who thought / believed *insert though/belief here*"

"Remember when PosterX said OldCommentY that no longer looks good? "

In general, if a comment goes from purely on topic to something 'ad hominem' (personal jabs, personal shots, attacks, flames, however you want to call it, towards a person, or a group of people, or a given city/state/country of people), those are most likely going to be found intolerable.

We also dissuade passive aggressive behavior. This can be various things, but common examples include statements that are basically meant to imply someone is either stupid or otherwise incapable of holding a rational conversation. This can include (but is not limited to) laughing at someone's conclusions rather than offering an honest rebuttal, asking people what game they were watching, or another common problem is Poster X will say "that player isn't that bad" and then Poster Y will say something akin to "LOL you think that player is good". We're not going to tolerate those kinds of comments out of respect for the community at large and for the sake of trying to just have an honest conversation.

Now, does the above cover absolutely every single kind of distraction that is unwanted? Probably not, but you should by now have a good idea of the general types of things we will be discouraging. The above examples are meant to give you a good feel for / idea of what we're looking for. If something new or different than the above happens to come along and results in the same problem (that being, any other attitude or behavior that ultimately distracts from actually just discussing the topic at hand, or that is otherwise disrespectful to other posters), we can and we will take action to curb this as well, so please don't take this to mean that if you managed to technically avoid saying something exactly like one of the above examples that you are then somehow off the hook.

That all having been said, our goal is to do so in a generally kind and respectful way, and that doesn't mean the moment we see something we don't like that somebody is going to be suspended or banned, either. It just means that at the very least we will probably say something about it, quite possibly snipping out the distracting parts of the post in question while leaving alone the parts that are actually just discussing the topics, and in the event of a repeating or excessive problem, then we will start issuing infractions to try to further discourage further repeat problems, and if it just never seems to improve, then finally suspensions or bans will come into play. We would prefer it never went that far, and most of the time for most of our posters, it won't ever have to.

A slip up every once and a while is pretty normal, but, again, when it becomes repetitive or excessive, something will be done. Something occasional is probably going to be let go (within reason), but when it starts to become habitual or otherwise a pattern, odds are very good that we will step in.

There's always a small minority that like to push people's buttons and/or test their own boundaries with regards to the administrators, and in the case of someone acting like that, please be aware that this is not a court of law, but a private website run by people who are simply trying to do the right thing as they see it. If we feel that you are a special case that needs to be dealt with in an exceptional way because your behavior isn't explicitly mirroring one of our above examples of what we generally discourage, we can and we will take atypical action to prevent this from continuing if you are not cooperative with us.

Also please be aware that you will not be given a pass simply by claiming that you were 'only joking,' because quite honestly, when someone really is just joking, for one thing most people tend to pick up on the joke, including the person or group that is the target of the joke, and for another thing, in the event where an honest joke gets taken seriously and it upsets or angers someone, the person who is truly 'only joking' will quite commonly go out of his / her way to apologize and will try to mend fences. People who are dishonest about their statements being 'jokes' do not do so, and in turn that becomes a clear sign of what is really going on. It's nothing new.

In any case, quite frankly, the overall quality and health of the entire forum's community is more important than any one troublesome user will ever be, regardless of exactly how a problem is exhibiting itself, and if it comes down to us having to make a choice between you versus the greater health and happiness of the entire community, the community of this forum will win every time.

Lastly, there are also some posters, who are generally great contributors and do not otherwise cause any problems, who sometimes feel it's their place to provoke or to otherwise 'mess with' that small minority of people described in the last paragraph, and while we possibly might understand why you might feel you WANT to do something like that, the truth is we can't actually tolerate that kind of behavior from you any more than we can tolerate the behavior from them. So if we feel that you are trying to provoke those other posters into doing or saying something that will get themselves into trouble, then we will start to view you as a problem as well, because of the same reason as before: The overall health of the forum comes first, and trying to stir the pot with someone like that doesn't help, it just makes it worse. Some will simply disagree with this philosophy, but if so, then so be it because ultimately we have to do what we think is best so long as it's up to us.

If you see a problem that we haven't addressed, the best and most appropriate course for a forum member to take here is to look over to the left of the post in question. See underneath that poster's name, avatar, and other info, down where there's a little triangle with an exclamation point (!) in it? Click that. That allows you to report the post to the admins so we can definitely notice it and give it a look to see what we feel we should do about it. Beyond that, obviously it's human nature sometimes to want to speak up to the poster in question who has bothered you, but we would ask that you try to refrain from doing so because quite often what happens is two or more posters all start going back and forth about the original offending post, and suddenly the entire thread is off topic or otherwise derailed. So while the urge to police it yourself is understandable, it's best to just report it to us and let us handle it. Thank you!

All of the above is going to be subject to a case by case basis, but generally and broadly speaking, this should give everyone a pretty good idea of how things will typically / most often be handled.

Rule #2

If the actions of an administrator inspire you to make a comment, criticism, or express a concern about it, there is a wrong place and a couple of right places to do so.

The wrong place is to do so in the original thread in which the administrator took action. For example, if a post gets an infraction, or a post gets deleted, or a comment within a larger post gets clipped out, in a thread discussing Paul George, the wrong thing to do is to distract from the discussion of Paul George by adding your off topic thoughts on what the administrator did.

The right places to do so are:

A) Start a thread about the specific incident you want to talk about on the Feedback board. This way you are able to express yourself in an area that doesn't throw another thread off topic, and this way others can add their two cents as well if they wish, and additionally if there's something that needs to be said by the administrators, that is where they will respond to it.

B) Send a private message to the administrators, and they can respond to you that way.

If this is done the wrong way, those comments will be deleted, and if it's a repeating problem then it may also receive an infraction as well.

Rule #3

If a poster is bothering you, and an administrator has not or will not deal with that poster to the extent that you would prefer, you have a powerful tool at your disposal, one that has recently been upgraded and is now better than ever: The ability to ignore a user.

When you ignore a user, you will unfortunately still see some hints of their existence (nothing we can do about that), however, it does the following key things:

A) Any post they make will be completely invisible as you scroll through a thread.

B) The new addition to this feature: If someone QUOTES a user you are ignoring, you do not have to read who it was, or what that poster said, unless you go out of your way to click on a link to find out who it is and what they said.

To utilize this feature, from any page on Pacers Digest, scroll to the top of the page, look to the top right where it says 'Settings' and click that. From the settings page, look to the left side of the page where it says 'My Settings', and look down from there until you see 'Edit Ignore List' and click that. From here, it will say 'Add a Member to Your List...' Beneath that, click in the text box to the right of 'User Name', type in or copy & paste the username of the poster you are ignoring, and once their name is in the box, look over to the far right and click the 'Okay' button. All done!

Rule #4

Regarding infractions, currently they carry a value of one point each, and that point will expire in 31 days. If at any point a poster is carrying three points at the same time, that poster will be suspended until the oldest of the three points expires.

Rule #5

When you share or paste content or articles from another website, you must include the URL/link back to where you found it, who wrote it, and what website it's from. Said content will be removed if this doesn't happen.

An example:

If I copy and paste an article from the Indianapolis Star website, I would post something like this:

http://www.linktothearticlegoeshere.com/article
Title of the Article
Author's Name
Indianapolis Star

Rule #6

We cannot tolerate illegal videos on Pacers Digest. This means do not share any links to them, do not mention any websites that host them or link to them, do not describe how to find them in any way, and do not ask about them. Posts doing anything of the sort will be removed, the offenders will be contacted privately, and if the problem becomes habitual, you will be suspended, and if it still persists, you will probably be banned.

The legal means of watching or listening to NBA games are NBA League Pass Broadband (for US, or for International; both cost money) and NBA Audio League Pass (which is free). Look for them on NBA.com.

Rule #7

Provocative statements in a signature, or as an avatar, or as the 'tagline' beneath a poster's username (where it says 'Member' or 'Administrator' by default, if it is not altered) are an unwanted distraction that will more than likely be removed on sight. There can be shades of gray to this, but in general this could be something political or religious that is likely going to provoke or upset people, or otherwise something that is mean-spirited at the expense of a poster, a group of people, or a population.

It may or may not go without saying, but this goes for threads and posts as well, particularly when it's not made on the off-topic board (Market Square).

We do make exceptions if we feel the content is both innocuous and unlikely to cause social problems on the forum (such as wishing someone a Merry Christmas or a Happy Easter), and we also also make exceptions if such topics come up with regards to a sports figure (such as the Lance Stephenson situation bringing up discussions of domestic abuse and the law, or when Jason Collins came out as gay and how that lead to some discussion about gay rights).

However, once the discussion seems to be more/mostly about the political issues instead of the sports figure or his specific situation, the thread is usually closed.

Rule #8

We prefer self-restraint and/or modesty when making jokes or off topic comments in a sports discussion thread. They can be fun, but sometimes they derail or distract from a topic, and we don't want to see that happen. If we feel it is a problem, we will either delete or move those posts from the thread.

Rule #9

Generally speaking, we try to be a "PG-13" rated board, and we don't want to see sexual content or similarly suggestive content. Vulgarity is a more muddled issue, though again we prefer things to lean more towards "PG-13" than "R". If we feel things have gone too far, we will step in.

Rule #10

We like small signatures, not big signatures. The bigger the signature, the more likely it is an annoying or distracting signature.

Rule #11

Do not advertise anything without talking about it with the administrators first. This includes advertising with your signature, with your avatar, through private messaging, and/or by making a thread or post.
See more
See less

Ok in another attempt to stimulate discussion....

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Ok in another attempt to stimulate discussion....

    I want to ask another question to see how you feel about a topic.

    Todays topic is near & dear to my heart & in this one case our friends from across the pond as well as those north of the border can bring some first hand knowledge to help us along.

    Socialized health care vs. Private pay as you go health care.

    Where do you stand on the issue and why?

    I'd like to see where this goes.


    Basketball isn't played with computers, spreadsheets, and simulations. ChicagoJ 4/21/13

  • #2
    Re: Ok in another attempt to stimulate discussion....

    I think our health care system is a mess (as far as costs go). It's really a case where I feel the genie is far out of the bottle and I don't know how you get it back in there.

    Costs haven't been based on market forces directly of the consumer but instead on the deep pockets of insurance and government. The unchecked greed and spiraling costs have led to insurance rates increasing which just makes things even tougher at a certain income level.

    I'm inclined to think that employers offering medical benefits has been a bad thing in the long run as it's become part of the problem, not the solution. And spiraling costs have not been good for employers either.

    A system where the consumer directly controls the money they spend might be the best compromise, but now that prices are where they are at I'm just not sure how it would ever balance out. Right now, the checks and balances are mostly gone.

    I'd like to read other's thoughts on this. Against my normal leanings, I find myself leaning toward socialized medicine. At least to some degree.

    -Bball
    Nuntius was right for a while. I was wrong for a while. But ultimately I was right and Frank Vogel has been let go.

    ------

    "A player who makes a team great is more valuable than a great player. Losing yourself in the group, for the good of the group, that’s teamwork."

    -John Wooden

    Comment


    • #3
      Re: Ok in another attempt to stimulate discussion....

      I believe that there should be public health care in these areas:

      Pre-natal
      Childhood to age 16

      Taking care of health issues in these areas would result in such a massive reduction in health issues & costs later in life - as well as simply being society protecting its' children - that I completely support it.

      I'd have to ask Kaufman if he knows the latest numbers but what's the payoff in health care costs for taking care of pregnant women and children - 5:1? 10:1?

      Whatever it is, it's well worth the $$$.
      The poster formerly known as Rimfire

      Comment


      • #4
        Re: Ok in another attempt to stimulate discussion....

        Originally posted by Bball
        [B
        Costs haven't been based on market forces directly of the consumer but instead on the deep pockets of insurance and government. The unchecked greed and spiraling costs have led to insurance rates increasing which just makes things even tougher at a certain income level.[B]
        -Bball
        Perfect statement Bball. The habit or continued fleecing by the Medical Institution (this includes hospitals, clinics, and Drs.) of the patients is vampirism. How many assorted tests are ordered that a patient really doesn't need? For years there has always been the story if this country went to some type of socialized medicine we would no longer get the quality care. That if a test we needed was too expensive or if little Jimmy needed a heart then you're SOL. This is no joke, Dr.s are told to order tests that a patient doesn't need to make more money. The more expensive the test (not needed) the better.

        What's even scarier is the wonderful trend of outsourcing. You think it's bad when you have to call another country for support to find out a problem with your computer, your telephone, credit card, etc. Well thats not even close to being a problem when compared to your medical records being shipped out somewhere else and now your xrays are being read by Drs. in other countries. It is taking place right now.

        One final personal thought. Back to the old Jimmy doesn't get a heart thing because of socialized medicine. This maybe true, but because of the deep seated problems now Uncle Jerry and Aunt Em can't afford their medicines the way things are now either. This may explain why the VA use to get a number of their drugs from Canada.
        You know how hippos are made out to be sweet and silly, like big cows, but are actually extremely dangerous and can kill you with stunning brutality? The Pacers are the NBA's hippos....Matt Moore CBS Sports....

        Comment


        • #5
          Re: Ok in another attempt to stimulate discussion....

          This issue is so complex, that I don't have the time right now to even address half of what needs to be discussed. But I do want to say that instead of socialized medicine, I strongly believe we need to go in the exact opposite direction, we need to make it more like a free enterprise system. With the patients controlling their helath care dollars, what doctors they go to, and we also need to do something about the high cost of medical malpractice

          Comment


          • #6
            Re: Ok in another attempt to stimulate discussion....

            UB, I take it you wouldn't have a great deal of confidence in a Wal-Mart doctor?
            You know how hippos are made out to be sweet and silly, like big cows, but are actually extremely dangerous and can kill you with stunning brutality? The Pacers are the NBA's hippos....Matt Moore CBS Sports....

            Comment


            • #7
              Re: Ok in another attempt to stimulate discussion....

              Just curious, Peck. Is Medicare socialized medicine in your definition? What about Medicaid?

              If one sees any form of governmental involvement in paying for health care as socialistic, then there is no sense having this discussion. As far as I can see, there is no solution to our current health care financing mess that does not include significant governmental financing and coordination.

              Yet I do not believe that socialized health care vs. private pay-as-you-go health care are the only choices.

              I prefer a mixed system where the government helps assure access to affordable health care for everyone, but minimizes governmental control. At the same time consumers (taxpayers) must be given maximum control and choice over how one spends their own health care dollars. Giving citizens some control over how their own health care dollars are spent is a major step we need to take, if we have any hope of containing the growth of health care costs.

              Like it or not, I believe we can assume Medicare as it now exists, with prescription drug coverage, will continue to be tweaked and stay as the basis for how seniors get their health care.

              What to do about the rest of society is the question.

              I think most would agree that every child in America deserves to get adequate health care. Kids can't pick their parents; kids are also society's greatest asset. So, for practical reasons alone, humanitarian and moral reasons not even considered, we need a better plan to provide health care to our young.

              It seems clear to me that this country should find the will and money to formalize a program where families, as part of the tax system, get to choose a health care plan for their child, one that will assure affordable and necessary coverage. Governments at all levels already spend billions of dollars on health care coverage for kids, but much of the money spent is for paperwork and bureaucracy. In America today many kids wind up with inadequate health care because their parents don't have or can't afford family coverage at work, or who don't know how to enroll in government health care programs they already qualify for, or who don't have insurance and at the time of the illness don't qualify for government assistance.

              Figuring out a health care plan for all children --- one that makes sense financially --- should be a high priority for this country.

              So, it turns out, the most interesting and controversial aspect of the health care financing debate should be what to do about the rest of the population, the part that are not young nor yet of Medicare age. The part of the population that includes nearly all of us on this board.

              Comment


              • #8
                Re: Ok in another attempt to stimulate discussion....

                Get health care costs off the backs of industries that are trying to compete with competitors in other countries where employers don't bear the cost.

                sixthman's post is very sound, but I'd go all the way. Let's have a single-payer, multiple-provider system.
                And I won't be here to see the day
                It all dries up and blows away
                I'd hang around just to see
                But they never had much use for me
                In Levelland. (James McMurtry)

                Comment


                • #9
                  Re: Ok in another attempt to stimulate discussion....

                  Originally posted by Unclebuck View Post
                  This issue is so complex, that I don't have the time right now to even address half of what needs to be discussed. But I do want to say that instead of socialized medicine, I strongly believe we need to go in the exact opposite direction, we need to make it more like a free enterprise system. With the patients controlling their helath care dollars, what doctors they go to, and we also need to do something about the high cost of medical malpractice
                  UB, you are exactly right! The problem with the spiraling costs, is that the hospitals and doctors know the money isn't really yours. Your insurance company controls it, and their pocekts are WAY deeper than yours. My employer (a large local Pharma for those that don't know) recently announced a sea change in our insurance plans. People are up in arms over it, but they are looking at right now versus the big picture. The new plans have a sort of spending account feel to them, where there is money deposited on behalf of the insured. The money is given to us by our employer, but WE control who gets the money. If there is money left over at the end of the year, it rolls over on top of next years deposit. They cap your out of pocket max at a percentage of your salary, so a major surgery won't bankrupt you. They are trying to force us to make better decisions, to shop around so to speak. It's going to be a painful transition for a lot of folks, but it will be better in the long run when hospitals see that they aren't going to be able to price their services in the same way for much longer.

                  [edit] I forgot to mention, under these new plans, ALL preventative care is covered at 100% without dipping into the deposit made on our behalf. This includes vaccinations, yearly physicals, mammograms, prostate exams, etc...[/edit]

                  Comment


                  • #10
                    Re: Ok in another attempt to stimulate discussion....

                    Originally posted by Putnam View Post
                    Get health care costs off the backs of industries that are trying to compete with competitors in other countries where employers don't bear the cost.
                    There has not been enough conversation about the bad effects of an employer based health care system.

                    Not only is the high cost of health insurance not a good deal for those companies trying to compete internationally, but it is not a good deal for the consumer either. Employees are much better off with a system of affordable health care that can come from somewhere besides work, if something good is not available at work.

                    The notion that employers are the best, and for practical purposes, only source to purchase health insurance, is obviously a flawed notion that is not in the best interests of Americans.

                    Comment


                    • #11
                      Re: Ok in another attempt to stimulate discussion....

                      Originally posted by U2
                      Don't believe them when they tell me there ain't no cure
                      The rich stay healthy, the sick stay poor
                      I, I believe in love


                      .
                      And I won't be here to see the day
                      It all dries up and blows away
                      I'd hang around just to see
                      But they never had much use for me
                      In Levelland. (James McMurtry)

                      Comment


                      • #12
                        Re: Ok in another attempt to stimulate discussion....

                        Does socialized medicine provide good care for anyone? No, clearly.

                        Does free-enterprise for medicine work? Not really.

                        Does it make any sense to add the burden of employee healthcare cost to employers? No.

                        But on the other hand, consumers get better "rates" for group policies vs. individual policies, so if not by employers, how do you effectuate group policies? (Hint: employer-sponsored groups in which the employees bear most of the cost.)

                        Healthcare is expensive for many reasons:

                        (1) To cover everyone's malpractice insurance. You get the lawyers out of healthcare and the costs will start to come down. But that's not a popular answer in today's, "I've got the right to sue anybody for any reason, even if I have no chance of actually winning but I might get a settlement" culture.

                        (2) As said above, most of the costs are currently absorbed by employers and are, therefore, invisible to the end-users. Many of which treat it like its "Monopoly money."

                        (2) To cover "charity", because like it or not, people are entitled to certain levels of health care whether they afford to pay or not, so ultimately society is going to pay for this whether via taxes (so that the government compensates the medical providers for their efforts) or just higher prices for everyone at the doctor's office. Since this is inevitable, we just need to figure out how we're going to deal with it. Right now, we're paying via both channels.

                        (3) Because of the goofy constraints by insurance that exist solely to protect the insurance companies from spending a lot of money on "optional" healthcare. For example, my knee surgeries were not a life-and-death decision, but they sure helped my quality of life. But how many extra doctor visits, physical therapy, and tests did I endure between (1) the decision that surgery was the best resort, and (2) the surgery itself? Many.

                        (4) Because companies engaged with medical research and development spend a LOT of money, and deserve to be compensated for that spend of capital (which is a real problem when other countries have less-rigorous standards for the approval of drugs and devices and therefore don't allow the innovators the opportunity to compensated for their efforts, shifting all the burden onto the US consumers). I wish the pharma companies would stop selling products in the EU at prices that are based on the costs to manufacture, not the costs to develop, until the patents expire. If the EU doesn't want to pay for the development, they can wait for the "generics." But can you imagine the outcry if Merck (or Lilly) or whomever announced such a policy?

                        Ultimately, because IMO certain levels of medical care are a necessity (and should be considered a "right") and others are optional (and should be considered a "privilege") then some type of hybrid system is unavoidable.

                        What is avoidable is to continuously ignore the opportunites to fix the problem. Socialized heathcare, which would have many, many flaws in its implementation, would be an improvement over the current hodge-podge system. But, unfortunately, once you go there, there is no turning back.

                        Jay's_Wife@Section19's grandmother recently passed away. She was 93, and she out-lived her life savings by a few months and eventually qualified for Medicaid. Its interesting to note the difference in quality of service given out in a mixed-pay facility, as the private-pay and medicare patients were able to receive more attention from the under-staffed nurses than the "charity"/ medicaid patients were. Not for medical care, per se, she'd get her medications on time and stuff like that, but for the little things that go a long way toward maintaining someone's dignity when they have lost most of the capacity to do things themselves.
                        Why do the things that we treasure most, slip away in time
                        Till to the music we grow deaf, to God's beauty blind
                        Why do the things that connect us slowly pull us apart?
                        Till we fall away in our own darkness, a stranger to our own hearts
                        And life itself, rushing over me
                        Life itself, the wind in black elms,
                        Life itself in your heart and in your eyes, I can't make it without you

                        Comment


                        • #13
                          Re: Ok in another attempt to stimulate discussion....

                          This all reminds me of a recent Indy Star piece exposing pricing practices. It seems that the highest prices go to the uninsured. As I understood the article, hospitals set a 'suggested price'. Insurers then negotiate the fees they pay regardless of that 'suggested price' (it's only a starting point for the negotiated fees). Uninsured people don't have any such leverage. Hospitals can offer a 'cash price' but it is not nearly the discount that insurance companies get.

                          Very interesting article. Maybe someone can find it.
                          EDIT- I found out... see post below...

                          -Bball
                          Nuntius was right for a while. I was wrong for a while. But ultimately I was right and Frank Vogel has been let go.

                          ------

                          "A player who makes a team great is more valuable than a great player. Losing yourself in the group, for the good of the group, that’s teamwork."

                          -John Wooden

                          Comment


                          • #14
                            Re: Ok in another attempt to stimulate discussion....

                            http://www.indystar.com/apps/pbcs.dl...NESS/609030432

                            Sticker shock: same care, different hospital bills
                            Uninsured Hoosiers often charged far more than insurance companies


                            By Daniel Lee
                            daniel.lee@indystar.com
                            Kellie Holland checked into the emergency room doubled over in pain from what turned out to be kidney stones.


                            Those stones soon passed from her system, but the Plymouth woman's anger over her hospital bill burns on.

                            Holland, who had no health insurance at the time, said she received $2,080 in hospital charges -- plus a few hundred more in doctor bills -- for what she described as a 1 1/2-hour visit to the ER at St. Joseph Regional Medical Center in Plymouth.

                            She claims the hospital would have received only about $400 for the same visit had it been handled by Medicare.

                            Even after receiving the hospital's standard 20 percent discount for the uninsured, Holland said her charges were still excessive compared with amounts paid by insurance companies.

                            "I was treated unfairly," she said. "It's just that simple."
                            Hospitals across the nation, in fact, charge some of their highest rates to those least likely to be able to pay: the uninsured. Experts say those without health benefits can face bills three times higher than what health insurance companies would pay for the same services.

                            For instance, Clarian Health Partners, the region's biggest hospital system, has a list price of about $8,143 for an uncomplicated birth, a price far greater than the $2,200 to $2,700 Anthem Blue Cross and Blue Shield would typically pay.

                            Hospitals say they offer the uninsured discounts based on income or, in many cases, free charity care for the poor and indigent. However, those discounts can still leave the uninsured with hefty bills.

                            St. Vincent Indianapolis Hospital charges $7,200 for that birth. The hospital said a family of three earning $30,000 a year would qualify for free care, but a family of three making $60,000 a year would still be left with a $6,000 bill.
                            "This is gouging," said J. Patrick Rooney, founder of the Fairness Foundation, an Indianapolis advocacy group that focuses on the uninsured. "This is taking people for all they have."

                            In the complex world of health-care pricing, it all comes down to something called the "chargemaster," or a hospital's master price list. It's a little bit like the sticker price on a new car -- a starting point for negotiations.
                            A hospital's chargemaster price often is three times higher than its actual costs, said Jennifer Tolbert, principal analyst with the Kaiser Family Foundation in Washington.

                            Typically, big health insurers negotiate deep discounts from that list price. The uninsured have no such clout.

                            Bills from a lengthy hospital stay can quickly ruin a person's credit or add up to tens or even hundreds of thousands of dollars in debt, especially for those who do not qualify for charity care or government assistance.
                            "When you as an uninsured person walk into a hospital, you have no bargaining power at all," said Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins University's School of Public Health. "None of us like to get a bill we can't pay, and we certainly don't want to get a bill that's three times what everybody else is paying for the same thing."

                            A major illness or injury quickly can push even a family with health insurance to the financial brink.

                            Almost half of Americans filing for bankruptcy do so because of mounting medical expenses, according to a Harvard study published last year. Of those with medical bankruptcies, the average out-of-pocket cost was $11,854, according to the study.

                            Bills can pile up fast, especially if you're one of the more than 46 million people nationwide, including about 800,000 in Indiana, who have no health insurance.

                            Many of the uninsured are poor, unemployed or transient. Others have lower-paying jobs that don't provide health benefits. Some own homes and have savings but may be between jobs, or have medical conditions that make it difficult for them to afford individual coverage.

                            Not wanting to pay high monthly premiums, still others could afford coverage but are betting that they won't need costly health care.
                            Holland, for instance, admits that she was taking a "calculated risk" by going uninsured after losing her health benefits when her job was eliminated. "It wasn't between health insurance and eating," said Holland, who owns a small farm.

                            But she added that the $300 a month it would have cost to extend her benefits through the federal program COBRA was too expensive.
                            Faced with the ER bill, Holland refused to fill out financial-aid forms at the hospital where she was treated, saying she feared putting her assets at risk.
                            "I begrudgingly paid the bill," said Holland, adding that she wrote on her checks that she was making the payments only to preserve her credit. Holland now pays $137 a month for an independent plan with a $5,000 deductible.

                            St. Joseph's said it does not comment on individual patients' cases, but the hospital said it has a policy that offers a minimum discount of 20 percent to the uninsured, with deeper discounts or free care depending on a patient's income.

                            Hospitals of all sizes provide millions of dollars worth of free care for the poor and indigent. In addition, hospitals frequently offer financial aid to the uninsured or help eligible patients enroll for government programs.
                            Indianapolis-based Community Health Network, for example, said that its uninsured patients are given at least a 30 percent discount off its list price, with additional help available depending on a patient's financial situation.
                            "We work with each individual patient to understand their financial means," said Tom Fischer, Community's chief financial officer. "We don't sell full sticker price to anybody."

                            The issue of health-care billing for the uninsured has risen to prominence in recent years, with more than 60 class-action lawsuits filed against hospitals alleging excessive and unfair pricing, according to research from the Kaiser Family Foundation.

                            In one case, California nonprofit hospital chain Sutter Health last month settled a class-action suit by providing eligible uninsured patients with refunds or deductions of 25 percent to 45 percent off their bills.
                            "The uninsured are victims of an exceedingly complex health-care system in which larger insurers and government payers set prices that are deeply discounted from hospital charges," Tolbert of Kaiser said, "while the uninsured have little negotiating power and are left to pay full charges."
                            Price discounts negotiated by the insurance companies are often well below the original list price but still allow the hospital to turn a profit.
                            Conversely, Medicare and Medicaid reimburse at rates that in many cases are lower than the hospital's costs. Hospitals also lose money when they provide charity care.

                            Many uninsured patients, though, do not pay their bills. Hospitals typically collect only a dime from every $1 charged to the uninsured, Anderson said.
                            For instance, Jay Brehm, CFO for St. Francis, said more than half of the uninsured patients being treated at St. Francis end up being turned over to collection agencies.

                            Terry Hamilton, executive director of finance for St. Vincent Indianapolis Hospital, said many uninsured people don't take advantage of available help.
                            "We're not in business at all to drive people into ruin," Hamilton said. "But what sometimes happens is some people get scared and they don't respond to calls."

                            For his part, advocate Rooney said the uninsured who are aggressive in battling the hospitals can often get as much as 50 percent knocked off their bills.

                            "If you fight this and have a good attorney," he said, "it turns out that the hospital will usually cave."

                            -----------------------

                            POSSIBLE PRICES FOR 2 PROCEDURES

                            Insurance companies can negotiate big discounts with hospitals; the uninsured usually are billed far more.

                            Here's a look at the range of prices for two procedures culled from six area hospitals, and what an insurance company would pay for the same procedure:

                            CHILDBIRTH
                            (without complications)
                            $4,500 to $8,238
                            at area hospitals
                            $2,955 to $3,100
                            with UnitedHealthcare insurance

                            DEFIBRILLATOR IMPLANT
                            (no cardiac catheterization)
                            $73,200 to $128,754
                            at area hospitals
                            $27,000 to $35,000
                            with Anthem insurance
                            Nuntius was right for a while. I was wrong for a while. But ultimately I was right and Frank Vogel has been let go.

                            ------

                            "A player who makes a team great is more valuable than a great player. Losing yourself in the group, for the good of the group, that’s teamwork."

                            -John Wooden

                            Comment


                            • #15
                              Re: Ok in another attempt to stimulate discussion....

                              Originally posted by Jay@Section19
                              But on the other hand, consumers get better "rates" for group policies vs. individual policies, so if not by employers, how do you effectuate group policies? (Hint: employer-sponsored groups in which the employees bear most of the cost.)
                              Jay, I'm not sure of the parentheses at the end of the quote indicates your preferred solution.

                              Why should one's quality of health care depend on the ability of his or her group to exert leverage...to negotiate lower prices, or simply to obtain coverage at all? Just because a person works for a small employer with less leverage, why should they get less coverage or none at all?

                              The only group that makes sense is the entire citizenry of the nation. There's a group with some leverage on the insurance companies.
                              And I won't be here to see the day
                              It all dries up and blows away
                              I'd hang around just to see
                              But they never had much use for me
                              In Levelland. (James McMurtry)

                              Comment

                              Working...
                              X