Forum Members with COVID-19

Other discussions not related to the Permanent Portfolio

Moderator: Global Moderator

glennds
Executive Member
Executive Member
Posts: 881
Joined: Mon Jan 28, 2013 11:24 am

Re: Forum Members with COVID-19

Post by glennds » Fri Feb 26, 2021 2:03 pm

mathjak107 wrote:
Thu Feb 11, 2021 6:06 pm
For those who want to know the difference between having a for profit insurer as your gate keeper vs not for profit govt Medicare I will give you an example.

A friend had an advantage plan ..she bragged all the time about how little she was paying .

Well she got pituitary gland cancer ....one side was cancerous,the other side not great shape ..her doctors wanted both haves removed ...her insurer denied both halves ...they only approved one side and she had to wait for the other side to possibly turn cancerous and spread .

Her doctors appealed and argued Medicare always pays to remove the entire gland ..

The insurer told them they can’t say what Medicare would have done in this cases, their patient does not have Medicare ....

So the insurer administering your plan has total say because you can’t say what govt Medicare would have done , you don’t have government Medicare..with an advantage plan you have a for profit insurer deciding your course of treatment...
I absolutely believe this story. From a hospital administration perspective, I can tell you with certainty, healthcare is one place where the invisible hand of everyone acting in their own best interests will magically work out. The interests of the for-profit insurance company and the insured (and even the provider) are adversarial. Unfortunately the individual patient has the least amount of leverage of anyone.
The model for Medicare Advantage plans is pretty simple. Collect 92% of what Medicare would have otherwise paid on average per insured per month. Then ration/deny benefits as much as possible, and the best trick, compose a network of only the very cheapest providers in the market and penalize the insured for going out of network. There are also some claims adjudication and slow payment tricks, and these directly affect the providers more than the patients. In a nutshell, that's about it.

There is a mechanism for a third party Quality Improvement Organization (QIO) in every market who handles appeals and tries to keep the MA plan honest, but they play the averages that only a small % of patients will exercise those rights.

The only parties that do well with the for-profit health insurers, both commercial and MA, are the hospital systems that basically have a monopoly in their market where the insurer simply cannot have a complete network without that particular hospital system. If their network is not complete, they cannot compete with the commercial insurance in the large employer market. So they have to pay the piper, and in turn raise insurance rates on the commercial side on the smaller employers (this is why you hear about insurance rates going up 20, 30, 50% at renewal), and cram down other providers to try and make up the margin on the MA side. The crammed down providers try to make it up in volume (doctors who see 50+ patients/day, inpatient providers who shorten length of stay and run a revolving door model).

Most of healthcare in the US works off monopolistic practice and market leverage, whether we're talking pharmaceutical companies, hospitals, insurers, dialysis providers, large lab providers. I know the government sucks in every respect, but the alternative, which in the US is the private for-profit healthcare system, is a complete blood sport.
flyingpylon
Executive Member
Executive Member
Posts: 888
Joined: Fri Jan 06, 2012 9:04 am

Re: Forum Members with COVID-19

Post by flyingpylon » Fri Feb 26, 2021 2:40 pm

glennds wrote:
Fri Feb 26, 2021 2:03 pm
Most of healthcare in the US works off monopolistic practice and market leverage, whether we're talking pharmaceutical companies, hospitals, insurers, dialysis providers, large lab providers. I know the government sucks in every respect, but the alternative, which in the US is the private for-profit healthcare system, is a complete blood sport.
Isn't it the government that contributes to it being that way?
User avatar
mathjak107
Executive Member
Executive Member
Posts: 3810
Joined: Fri Jun 19, 2015 2:54 am
Location: bayside queens ny
Contact:

Re: Forum Members with COVID-19

Post by mathjak107 » Fri Feb 26, 2021 3:15 pm

Govt medicare is pretty liberal in individual specific cases which have grey areas ....advantage plans which are for profit as a gate keeper can be a big issue if they disagree with your doctors course of action
User avatar
vnatale
Executive Member
Executive Member
Posts: 6612
Joined: Fri Apr 12, 2019 8:56 pm
Location: Massachusetts
Contact:

Re: Forum Members with COVID-19

Post by vnatale » Fri Feb 26, 2021 4:10 pm

mathjak107 wrote:
Fri Feb 26, 2021 3:15 pm

Govt medicare is pretty liberal in individual specific cases which have grey areas ....advantage plans which are for profit as a gate keeper can be a big issue if they disagree with your doctors course of action


I had no idea of any idea of any of this when I chose Medigap over Advantage but, now in retrospect, it underscores that I fortunately made the right choice.
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats."
User avatar
mathjak107
Executive Member
Executive Member
Posts: 3810
Joined: Fri Jun 19, 2015 2:54 am
Location: bayside queens ny
Contact:

Re: Forum Members with COVID-19

Post by mathjak107 » Fri Feb 26, 2021 4:17 pm

People get fooled because they read that advantage plans have to cover what govt medicare does ...but that is only true in a broad sense not specific case ....

When course of treatment is challenged by your for profit gate keeper , ultimately they have the say ...you can’t prove what medicare would have allowed or done in your case since you don’t have medicare
glennds
Executive Member
Executive Member
Posts: 881
Joined: Mon Jan 28, 2013 11:24 am

Re: Forum Members with COVID-19

Post by glennds » Fri Feb 26, 2021 8:42 pm

flyingpylon wrote:
Fri Feb 26, 2021 2:40 pm
glennds wrote:
Fri Feb 26, 2021 2:03 pm
Most of healthcare in the US works off monopolistic practice and market leverage, whether we're talking pharmaceutical companies, hospitals, insurers, dialysis providers, large lab providers. I know the government sucks in every respect, but the alternative, which in the US is the private for-profit healthcare system, is a complete blood sport.
Isn't it the government that contributes to it being that way?
How so?
flyingpylon
Executive Member
Executive Member
Posts: 888
Joined: Fri Jan 06, 2012 9:04 am

Re: Forum Members with COVID-19

Post by flyingpylon » Sat Feb 27, 2021 4:58 am

glennds wrote:
Fri Feb 26, 2021 8:42 pm
flyingpylon wrote:
Fri Feb 26, 2021 2:40 pm
glennds wrote:
Fri Feb 26, 2021 2:03 pm
Most of healthcare in the US works off monopolistic practice and market leverage, whether we're talking pharmaceutical companies, hospitals, insurers, dialysis providers, large lab providers. I know the government sucks in every respect, but the alternative, which in the US is the private for-profit healthcare system, is a complete blood sport.
Isn't it the government that contributes to it being that way?
How so?
The government creates the framework of laws and regulations that allows these companies to operate the way they do. It doesn’t just happen organically.
User avatar
mathjak107
Executive Member
Executive Member
Posts: 3810
Joined: Fri Jun 19, 2015 2:54 am
Location: bayside queens ny
Contact:

Re: Forum Members with COVID-19

Post by mathjak107 » Sat Feb 27, 2021 5:08 am

It is actually lack of proper laws and regulations that creates a lot of the situation
flyingpylon
Executive Member
Executive Member
Posts: 888
Joined: Fri Jan 06, 2012 9:04 am

Re: Forum Members with COVID-19

Post by flyingpylon » Sat Feb 27, 2021 8:58 am

mathjak107 wrote:
Sat Feb 27, 2021 5:08 am
It is actually lack of proper laws and regulations that creates a lot of the situation
Whether it's the existence of laws you don't like or the absence of laws you do, the constant is that our government doesn't always serve the interests of its people.
User avatar
mathjak107
Executive Member
Executive Member
Posts: 3810
Joined: Fri Jun 19, 2015 2:54 am
Location: bayside queens ny
Contact:

Re: Forum Members with COVID-19

Post by mathjak107 » Sat Feb 27, 2021 9:01 am

Politicians serve themselves .... no party serves us anymore
glennds
Executive Member
Executive Member
Posts: 881
Joined: Mon Jan 28, 2013 11:24 am

Re: Forum Members with COVID-19

Post by glennds » Sat Feb 27, 2021 10:24 am

flyingpylon wrote:
Sat Feb 27, 2021 8:58 am
mathjak107 wrote:
Sat Feb 27, 2021 5:08 am
It is actually lack of proper laws and regulations that creates a lot of the situation
Whether it's the existence of laws you don't like or the absence of laws you do, the constant is that our government doesn't always serve the interests of its people.

Well neither do the large corporations whose duty is to themselves and their stockholders, not the patients. Perhaps to some neither is worse than the other in the context of the health care industry, just two alternate forms of poison from which to pick. Even if you happen to hate one option more, it doesn't necessarily make the other option "good".
Do you agree?
Last edited by glennds on Sat Feb 27, 2021 11:09 am, edited 1 time in total.
User avatar
pugchief
Executive Member
Executive Member
Posts: 4747
Joined: Tue Jun 26, 2012 2:41 pm
Location: suburbs of Chicago, IL

Re: Forum Members with COVID-19

Post by pugchief » Sat Feb 27, 2021 11:05 am

mathjak107 wrote:
Sat Feb 27, 2021 5:08 am
It is actually lack of proper laws and regulations that creates a lot of the situation
:o
The last thing health care needs is more regulations. Less rules would would create a better market based solution. But of course, that's way to Libertarian of a perspective, so never mind.
flyingpylon
Executive Member
Executive Member
Posts: 888
Joined: Fri Jan 06, 2012 9:04 am

Re: Forum Members with COVID-19

Post by flyingpylon » Sat Feb 27, 2021 12:01 pm

glennds wrote:
Sat Feb 27, 2021 10:24 am
flyingpylon wrote:
Sat Feb 27, 2021 8:58 am
mathjak107 wrote:
Sat Feb 27, 2021 5:08 am
It is actually lack of proper laws and regulations that creates a lot of the situation
Whether it's the existence of laws you don't like or the absence of laws you do, the constant is that our government doesn't always serve the interests of its people.

Well neither do the large corporations whose duty is to themselves and their stockholders, not the patients. Perhaps to some neither is worse than the other in the context of the health care industry, just two alternate forms of poison from which to pick. Even if you happen to hate one option more, it doesn't necessarily make the other option "good".
Do you agree?
I agree with the basic statement, but it’s a false dichotomy. The situation is typically positioned as government vs corporations, when in reality it’s government + corporations that have gotten us to where we are today. Together they often stifle innovation and competition to preserve the status quo. Given the nature of our government, applying more of it doesn’t seem like a solution.

I don’t claim to have the answer, which I realize is unusual behavior in an Internet forum.
User avatar
dualstow
Executive Member
Executive Member
Posts: 11915
Joined: Wed Oct 27, 2010 10:18 am
Location: https://goo.gl/maps/pJecuAUsCapAMSFL7
Contact:

Re: Forum Members with COVID-19

Post by dualstow » Mon Aug 30, 2021 8:53 am

Feel better soon, KBG
RIP COLIN POWELL, 84.
User avatar
Smith1776
Executive Member
Executive Member
Posts: 2358
Joined: Fri Apr 21, 2017 6:01 pm

Re: Forum Members with COVID-19

Post by Smith1776 » Wed Sep 01, 2021 2:29 am

dualstow wrote:
Mon Aug 30, 2021 8:53 am
Feel better soon, KBG
Dualstow, that is the best avatar this forum has ever seen.

And damn it, now I’m hungry!!!
I act as if God exists.

https://youtu.be/SG7mKcIVvQQ
User avatar
dualstow
Executive Member
Executive Member
Posts: 11915
Joined: Wed Oct 27, 2010 10:18 am
Location: https://goo.gl/maps/pJecuAUsCapAMSFL7
Contact:

Re: Forum Members with COVID-19

Post by dualstow » Wed Sep 01, 2021 9:34 am

Really? Not a lot of thought went into it. O0
I tend to use a lot of cheeeseburger and pizza avatars. They’ll be back, taking your mind off of more complicated things.

I’m digging the TaliPug these days.
RIP COLIN POWELL, 84.
whatchamacallit
Executive Member
Executive Member
Posts: 486
Joined: Mon Oct 01, 2012 7:32 pm

Re: Forum Members with COVID-19

Post by whatchamacallit » Wed Sep 15, 2021 3:39 pm

I just got my results.

IgG Covid19 Antibody
Your Value
Positive

It won't be COVID-19 that kills me.
pp4me
Executive Member
Executive Member
Posts: 1105
Joined: Wed Apr 29, 2020 4:12 pm

Re: Forum Members with COVID-19

Post by pp4me » Wed Sep 15, 2021 3:45 pm

whatchamacallit wrote:
Wed Sep 15, 2021 3:39 pm
I just got my results.

IgG Covid19 Antibody
Your Value
Positive

It won't be COVID-19 that kills me.
They didn't give you a number? My wife works in a medical testing lab and they did antibody testing after the required vaccinations. Everybody got a number. Hers was 6, a friend was over 100, but most people were zero. No idea what it means but I assume zero would translate to negative.
User avatar
Tortoise
Executive Member
Executive Member
Posts: 2673
Joined: Sat Nov 06, 2010 2:35 am

Re: Forum Members with COVID-19

Post by Tortoise » Wed Sep 15, 2021 4:11 pm

whatchamacallit wrote:
Wed Sep 15, 2021 3:39 pm
I just got my results.

IgG Covid19 Antibody
Your Value
Positive

It won't be COVID-19 that kills me.
For what it's worth, my brother got a positive result on a Covid antibody test last year around April/May (I think the test was just +/- and didn't report a number), so he chose not to get vaxxed since he assumed he was naturally immune. Then, a few weeks ago, he got Covid and felt so sick that he went to the hospital (wasn't admitted; was just sent home with Tylenol).

I suspect either (a) his positive antibody test result from last year was borderline, so his immunity wasn't very strong, or (b) he got sick because a new variant (delta?) made it past whatever Covid immunity he may have had.
whatchamacallit
Executive Member
Executive Member
Posts: 486
Joined: Mon Oct 01, 2012 7:32 pm

Re: Forum Members with COVID-19

Post by whatchamacallit » Wed Sep 15, 2021 4:29 pm

Mine was a rapid so no number.

I already knew answer due to known consistent exposure and some symptoms.

I just wanted for my records really.
whatchamacallit
Executive Member
Executive Member
Posts: 486
Joined: Mon Oct 01, 2012 7:32 pm

Re: Forum Members with COVID-19

Post by whatchamacallit » Wed Sep 22, 2021 12:56 pm

I did second quantitative test. I did have vaccine shot 5 months ago. I had two negative pcr test after week of knowing exposed. Symptoms I assume related were mild.

SARS-CoV-2 Semi-Quant Total Ab
>2500.0

Antibodies against the SARS-CoV-2 spike protein receptor binding
domain (RBD) were detected. It is yet undetermined what level of
antibody to SARS-CoV-2 spike protein correlates to immunity against
developing symptomatic SARS-CoV-2 disease. Studies are underway to
measure the quantitative levels of specific SARS-CoV-2 antibodies
following vaccination. Such studies will provide valuable insights
into the correlation between protection from vaccination and
antibody levels.

SARS-CoV-2 Spike Ab Interp
Positive
Roche Elecsys Anti-SARS-CoV-2 S
User avatar
dualstow
Executive Member
Executive Member
Posts: 11915
Joined: Wed Oct 27, 2010 10:18 am
Location: https://goo.gl/maps/pJecuAUsCapAMSFL7
Contact:

Re: Forum Members with COVID-19

Post by dualstow » Wed Sep 22, 2021 2:25 pm

Thank you, Whatchamacallit.

How are you feeling?
RIP COLIN POWELL, 84.
whatchamacallit
Executive Member
Executive Member
Posts: 486
Joined: Mon Oct 01, 2012 7:32 pm

Re: Forum Members with COVID-19

Post by whatchamacallit » Wed Sep 22, 2021 3:05 pm

dualstow wrote:
Wed Sep 22, 2021 2:25 pm
Thank you, Whatchamacallit.

How are you feeling?
I guess feeling blessed for having whole household exposed with minimal effect. Some people are obviously not so lucky.

Symptoms wise, completely well.



I would recommend at least a dose of the vaccine if you are over 30 and haven't already had the virus.

Personal experience. No way young kids need vaccine.
Kbg
Executive Member
Executive Member
Posts: 2171
Joined: Fri May 23, 2014 4:18 pm

Re: Forum Members with COVID-19

Post by Kbg » Sat Sep 25, 2021 12:24 am

Last week I worked a full week and have been on pretty strenuous mountain bike rides the past two Fridays...so I think I'm at 98% pre-covid. I'd say 100% but I have this weird continuing mild cough and random energy crashes. Hopefully they will also pass with some more time.

I'm hoping to make this one of my last covid posts because it is a topic I'm thoroughly sick of...but for the record; I think even if you are healthy but over say 40-45, you're nuts if you don't get vaccinated. There have been not a few people where I live in their 40s who have died from it with no pre-existing conditions other than non-vaccinated. We even had two Apple News headlines...two mothers in their 40s each with several children died. With the delta variant it seems to be a total roll of the genetic dice. Why take the risk of dying over something like this?

My wife and I are both in our 50s and both vaxxed. She's had zero covid anything. Lucky me got what I described earlier. I will say there were a couple of nice side benefits. I'm down 15lbs and broke a serious Diet Coke addiction.

Peace, out.
User avatar
vnatale
Executive Member
Executive Member
Posts: 6612
Joined: Fri Apr 12, 2019 8:56 pm
Location: Massachusetts
Contact:

Re: Forum Members with COVID-19

Post by vnatale » Sat Sep 25, 2021 6:22 am

Kbg wrote:
Sat Sep 25, 2021 12:24 am

Last week I worked a full week and have been on pretty strenuous mountain bike rides the past two Fridays...so I think I'm at 98% pre-covid. I'd say 100% but I have this weird continuing mild cough and random energy crashes. Hopefully they will also pass with some more time.

I'm hoping to make this one of my last covid posts because it is a topic I'm thoroughly sick of...but for the record; I think even if you are healthy but over say 40-45, you're nuts if you don't get vaccinated. There have been not a few people where I live in their 40s who have died from it with no pre-existing conditions other than non-vaccinated. We even had two Apple News headlines...two mothers in their 40s each with several children died. With the delta variant it seems to be a total roll of the genetic dice. Why take the risk of dying over something like this?

My wife and I are both in our 50s and both vaxxed. She's had zero covid anything. Lucky me got what I described earlier. I will say there were a couple of nice side benefits. I'm down 15lbs and broke a serious Diet Coke addiction.

Peace, out.


Keep us informed if you maintain that weight loss or whether it comes back slowly or quickly....
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats."
Post Reply