Joe Ferguson forever Posted July 25 Posted July 25 22 hours ago, leh-nerd skin-erd said: I think the reality is that most members of the medical profession enter into the profession to help people, but at the same time, but often possess the same prey drive for profit as any other business owner. In that regard, they look out for number one (as Fergie has stated numerous times), and that can come into conflict with what is right and just for a patient treatment plan and the greater good. not true. I had about 25% Medicaid pts and took uninsured (who actually paid pretty well). But it's a biz like any other. You need to cover overhead before you take anything home. generally, overhead is around 50%. I think most people do go into it to help people but not all. There are financial realities however, that can't be ignored. re concierge, I don't see how the govt can stop people from buying it out of their own pocket. Insurance is not involved. Additionally, all kinds of private endeavors like aesthetics clinics and testosterone/impotence clinics would have to close. There's a burgeoning industry for GLP 1's (weight loss drugs) that is entirely self pay. It's not only the wealthy that use this services.
Joe Ferguson forever Posted July 25 Posted July 25 11 hours ago, leh-nerd skin-erd said: Yes, I agree that cost has increased and also that this was the outcome planned by Obama and the architects of the ACA, at least for most working Americans. We do that now…those who contribute help fund those that don’t. Those that are in good health subsidize those that aren’t. Private subsidizes Medicaid and Medicare. I appreciate the guess at 15%, but you’re suggesting 15% on top of federal and state income tax already in existence, plus all the other tax we pay already? Property…sakes…excise etc? Ah, ok. A wealthy guy like Fergie kicks in his full 15%, but then funds his concierge service over and above. Interesting. I think that putting removing the private CO’s from the market is an absolute recipe for disaster, and would result in substantially higher costs and drastically reduced options….but if you’re going down ragtag path, I’d agree with this with maybe an additional surcharge on the concierge service. Maybe like a grand , two or three above and beyond. yes, cost shifting as I've repeatedly said. In medicare for all, there would still be cost shifting but eventually even a 30 yo is going to need expensive care. Some of this could be paid for by taxing vices more heavily: smoking, drinking. But everyone would still pay and likely less than they are now due to lower admin costs in medicare and no profit taking. Additionally, employers would save billions in premiums. Perhaps they could be taxed for that benefit. I pay $80per month for concierge, so about $1000 per year which gives me access to an outstanding doc, 24/7. In socialized medicine, eg UK, you can still go private pay to see the best or be seen or operated on sooner. Seems to work fine there.
leh-nerd skin-erd Posted July 25 Posted July 25 11 minutes ago, Joe Ferguson forever said: not true. I had about 25% Medicaid pts and took uninsured (who actually paid pretty well). But it's a biz like any other. You need to cover overhead before you take anything home. generally, overhead is around 50%. I think most people do go into it to help people but not all. There are financial realities however, that can't be ignored. Agreed. This is simply human nature. 11 minutes ago, Joe Ferguson forever said: re concierge, I don't see how the govt can stop people from buying it out of their own pocket. Insurance is not involved. Additionally, all kinds of private endeavors like aesthetics clinics and testosterone/impotence clinics would have to close. There's a burgeoning industry for GLP 1's (weight loss drugs) that is entirely self pay. It's not only the wealthy that use this services. I agree they won’t stop it, but the govt can certainly develop a surcharge or tax on the service to level the playing field. Reddog suggested that partakers in elite-level-access services pay a health insurance tax (15% of income as a suggestion) prior/along with whatever the law they want to do. If the goal is to level the playing field and fair share the deal, that makes sense. 1
Joe Ferguson forever Posted July 25 Posted July 25 1 hour ago, leh-nerd skin-erd said: Agreed. This is simply human nature. I agree they won’t stop it, but the govt can certainly develop a surcharge or tax on the service to level the playing field. Reddog suggested that partakers in elite-level-access services pay a health insurance tax (15% of income as a suggestion) prior/along with whatever the law they want to do. If the goal is to level the playing field and fair share the deal, that makes sense. Wait. I haven't seen you complain about disproportionate tax breaks for the rich in the big bill. I'm already paying for Medicare and a supplement and paid into Medicare at the highest rate over my working life. Why should I pay even more to be able to choose a concierge doc?
JFKjr Posted July 25 Posted July 25 1 hour ago, Joe Ferguson forever said: Wait. I haven't seen you complain about disproportionate tax breaks for the rich in the big bill. I'm already paying for Medicare and a supplement and paid into Medicare at the highest rate over my working life. Why should I pay even more to be able to choose a concierge doc? You can either rely on Medicare or pay for better than Medicare. Just like you can rely on Social Security or also have a retirement plan. 1 1
leh-nerd skin-erd Posted July 25 Posted July 25 1 hour ago, Joe Ferguson forever said: Wait. I haven't seen you complain about disproportionate tax breaks for the rich in the big bill. I'm already paying for Medicare and a supplement and paid into Medicare at the highest rate over my working life. Why should I pay even more to be able to choose a concierge doc? Ironically, I have seen you complain about tax breaks for the rich in the big bill, and then acknowledge you aren't willing to anything beyond the minimum for the greater good unless mandated by law. This would be one of those compulsory requirements from you (the rich) to help those less fortunate. You paid at the highest rate over your working life because you were economically privileged, and in this case, the money came directly from the people we're looking to protect with the new program. There are some (let's call them socialists) who might feel your wealth was stolen from those in need of your services, but I don't see it that way. You studied, worked, produced and offered a service people wanted and needed, no diff than an electrician, plumber or bridge welder. You should pay more because you can, as evidenced by your fancy concierge doctor arrangement. The subscription payment (and revenue to the doctor) obviously fall outside the traditional model, and the opportunity cost is substantial when considering the blossoming popularity of boutique medicine with high net worth Americans. I do not imagine it would be much-Would you be comfortable paying the $80 per month for service, plus a $60/month surcharge matched by your fancy concierge doctor? That's literally $2/day each. Maybe don't think of it as "paying more", consider it "contributing at a higher level".
Joe Ferguson forever Posted July 25 Posted July 25 8 minutes ago, leh-nerd skin-erd said: Ironically, I have seen you complain about tax breaks for the rich in the big bill, and then acknowledge you aren't willing to anything beyond the minimum for the greater good unless mandated by law. This would be one of those compulsory requirements from you (the rich) to help those less fortunate. You paid at the highest rate over your working life because you were economically privileged, and in this case, the money came directly from the people we're looking to protect with the new program. There are some (let's call them socialists) who might feel your wealth was stolen from those in need of your services, but I don't see it that way. You studied, worked, produced and offered a service people wanted and needed, no diff than an electrician, plumber or bridge welder. You should pay more because you can, as evidenced by your fancy concierge doctor arrangement. The subscription payment (and revenue to the doctor) obviously fall outside the traditional model, and the opportunity cost is substantial when considering the blossoming popularity of boutique medicine with high net worth Americans. I do not imagine it would be much-Would you be comfortable paying the $80 per month for service, plus a $60/month surcharge matched by your fancy concierge doctor? That's literally $2/day each. Maybe don't think of it as "paying more", consider it "contributing at a higher level". I already paid more in mandatory deductions in pay. I have no problem with that. In effect it's progressive taxation and yeah, it benefits low earners. Your argument is akin to saying people should pay more for investment income (capital gains) above social security income. In fact, trump just made the opposite true.
leh-nerd skin-erd Posted July 25 Posted July 25 4 minutes ago, Joe Ferguson forever said: I already paid more in mandatory deductions in pay. I have no problem with that. In effect it's progressive taxation and yeah, it benefits low earners. Your argument is akin to saying people should pay more for investment income (capital gains) above social security income. In fact, trump just made the opposite true. It wasn't my suggestion, it was a conversation with Red that lead to this discussion. I was just taking it through to its natural conclusion based on our conversation. Let's see that through. Much of your discussion deals with you...how things impact you...how you earned what you did...how you paid what you did...and what you want to do moving forward. Over the last two posts, you've talked about what you did in the past, and frankly that's irrelevant to the future. Thank you, of course, though as you were contributing so were the collective we--each doing our part--but beyond that we need to deal with the now. You should stop thinking "I" and focus on "We". Assuming you're 65 or so, the SS actuarial charts suggest a typical male is expected to live another 17.4 years. Beyond that, you've been financially successful, seem to be in good health and so it's reasonable to assume your actual results will vary. Let's assume 25 years for Doc Ferg. Between the upfront costs (Red suggests 15% of your income as tax), let's say $25k, the $720 from you, the $720 from the Doc the numbers add up very quickly--like a million-two. Would you miss it, Fergs?
Joe Ferguson forever Posted July 25 Posted July 25 11 minutes ago, leh-nerd skin-erd said: It wasn't my suggestion, it was a conversation with Red that lead to this discussion. I was just taking it through to its natural conclusion based on our conversation. Let's see that through. Much of your discussion deals with you...how things impact you...how you earned what you did...how you paid what you did...and what you want to do moving forward. Over the last two posts, you've talked about what you did in the past, and frankly that's irrelevant to the future. Thank you, of course, though as you were contributing so were the collective we--each doing our part--but beyond that we need to deal with the now. You should stop thinking "I" and focus on "We". Assuming you're 65 or so, the SS actuarial charts suggest a typical male is expected to live another 17.4 years. Beyond that, you've been financially successful, seem to be in good health and so it's reasonable to assume your actual results will vary. Let's assume 25 years for Doc Ferg. Between the upfront costs (Red suggests 15% of your income as tax), let's say $25k, the $720 from you, the $720 from the Doc the numbers add up very quickly--like a million-two. Would you miss it, Fergs? It is about "we". It is about fairly sharing costs. Whether I would miss it is irrelevant. These programs and their rules apply to everyone.
leh-nerd skin-erd Posted July 25 Posted July 25 1 hour ago, Joe Ferguson forever said: It is about "we". It is about fairly sharing costs. Whether I would miss it is irrelevant. These programs and their rules apply to everyone. As would this one. Folks availing themselves of the elite level services are asked/compelled to contribute at a higher proportionate level than those who cannot afford such extravagances. It’s quite progressive. I’m not suggesting a country club surcharged to fund health care, it’s literally in the same family of services. You’ve got a lot yet to give but don’t seem to want to participate. I’ll put you down for “you’ll miss it”. 1 1 1
Joe Ferguson forever Posted July 25 Posted July 25 (edited) 2 hours ago, leh-nerd skin-erd said: As would this one. Folks availing themselves of the elite level services are asked/compelled to contribute at a higher proportionate level than those who cannot afford such extravagances. It’s quite progressive. I’m not suggesting a country club surcharged to fund health care, it’s literally in the same family of services. You’ve got a lot yet to give but don’t seem to want to participate. I’ll put you down for “you’ll miss it”. nope. It's a service I purchase on the free market. Is it fair that some people buy expensive wines or foods at Wegmans while some go to a food bank? Of course not but then you're talking full blown socialism. Most capitalist countries have national health care programs without affecting the free market in other areas. stop being ridiculous. The health care system is already tiered: those with Medicaid or no insurance and limited doctor choices. Those with commercial insurance and more choices. And those willing to pay for concierge services who have the most choice. Do you think everyone with commercial insurance should pay even more because they're getting more choice than Medicaid patients? Edited July 25 by Joe Ferguson forever
leh-nerd skin-erd Posted July 25 Posted July 25 (edited) 16 minutes ago, Joe Ferguson forever said: nope. It's a service I purchase on the free market. Is it fair that some people buy expensive wines or foods at Wegmans while some go to a food bank? Of course not but then you're talking full blown socialism. Most capitalist countries have national health care programs without affecting the free market in other areas. stop being ridiculous. You should check the tax(es) on alcohol and compare it to the tax on Wonder Bread and Milk at Wegmans. If you pay extra for a concierge shoppers at either location, ask them for the downlow. I’m suggesting what you’re already doing. Beyond that, part of the argument deals with health care as a human right, and last I checked, there was not an Affordable Whiskey Boozin Alchy Act. You say you want and support X, but seem to actually favor X minus U. That’s what’s a bit ridiculous to me. Anyway. It was just an exercise, and everyone gets a seat at the table in a “Let’s Talk with Leh-nerd” sit down. Appreciate your feedback. You’re a good sport sometimes. Edited July 25 by leh-nerd skin-erd 1
Joe Ferguson forever Posted July 25 Posted July 25 (edited) 5 minutes ago, leh-nerd skin-erd said: You should check the tax(es) on alcohol and compare it to the tax on Wonder Bread and Milk at Wegmans. If you pay extra for a concierge shoppers at either location, ask them for the downlow. I’m suggesting what you’re already doing. Beyond that, part of the argument deals with health care as a human right, and last I checked, there was not an Affordable Whiskey Boozin Alchy Act. You say you want and support X, but seem to actually favor X minus U. That’s what’s a bit ridiculous to me. Anyway. It was just an exercise, and everyone gets a seat at the table in a “Let’s Talk with Leh-nerd” sit down. Appreciate your feedback. You’re a good sport sometimes. but the ta on alcohol is the same for everyone. It doesn't depend on your income. Even for 3 buck chuck at Trader Joes. Edited July 25 by Joe Ferguson forever
CoudyBills Posted July 25 Posted July 25 8 hours ago, Joe Ferguson forever said: not true. I had about 25% Medicaid pts and took uninsured (who actually paid pretty well). But it's a biz like any other. You need to cover overhead before you take anything home. generally, overhead is around 50%. I think most people do go into it to help people but not all. There are financial realities however, that can't be ignored. re concierge, I don't see how the govt can stop people from buying it out of their own pocket. Insurance is not involved. Additionally, all kinds of private endeavors like aesthetics clinics and testosterone/impotence clinics would have to close. There's a burgeoning industry for GLP 1's (weight loss drugs) that is entirely self pay. It's not only the wealthy that use this services. Out of curiosity, what did your malpractice insurance premiums look like? As bad as they say?
Joe Ferguson forever Posted July 25 Posted July 25 3 minutes ago, CoudyBills said: Out of curiosity, what did your malpractice insurance premiums look like? As bad as they say? Initially, about 12k per year. went down after virginia severely capped award amounts and I didn't have any lost cases. I'm assuming that's like car insurances and no accidents.
BillsFanNC Posted July 27 Posted July 27 Could just as easily go in the non existent democrat self reflection thread. 1
JFKjr Posted July 27 Posted July 27 On 7/25/2025 at 6:18 PM, Joe Ferguson forever said: Initially, about 12k per year. went down after virginia severely capped award amounts and I didn't have any lost cases. I'm assuming that's like car insurances and no accidents. Doctors tend to be herd animals unfortunately. That's why most of them went along with the 'brand new gene therapy touted as a vaccine.' They didn't even know enough to protect their patients. (pregnant women! kids! babies!) The CDC is not to be trusted in this regard.
Joe Ferguson forever Posted July 28 Posted July 28 1 hour ago, JFKjr said: Doctors tend to be herd animals unfortunately. That's why most of them went along with the 'brand new gene therapy touted as a vaccine.' They didn't even know enough to protect their patients. (pregnant women! kids! babies!) The CDC is not to be trusted in this regard. Doctors are the most heterogenous group I can think of. There's the brilliant science guys that go into research, academics, pathology etc. There are analysts who love to solve mysteries- Medicine. There's the visual thinkers who look at films all day. There'are the idealists: Pediatricians, Ob/gynecologists, Family practice Internal medicine. There are folks that are great with their hands and sometimes brilliant (I hope my neurosurgeon is). I remember most of my med school colleagues fondly.
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