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Comment Re:Amortization, Medical Interpetation, Bistromath (Score 1) 311

Sure, the cost of the machine has come down, but the cost the provider charges to use the machine continues to rise. Yes, there's heavy negotiate between provider and insurer but actual prices are driven on U&C (Usual and Customary) for the market. Unless there's a rouge provider in the market that lowers costs the U&C contracts are all about inflation adjustments.

Comment Re:PET, CAT and MRIs Are Cheap. We Overpay in the (Score 1) 311

That's a nice opinion, but the facts are there are plenty of first world countries that have private health insurance that delivery the same quality of care for a fraction of the price. The commonality is price controls. When someone needs urgent medical attention they are in no position to shop prices.

I've consulted for many health insurance companies. I've worked specifically around cost of care and price transparency. Let's look at this statement:

"Your $1500 MRI is not a fair market price. That price contains a massive subsidy for people on government programs."

So how exactly does a hospital subsidize a gov't program? Most of them are not-for-profits and pay no taxes. Most Hospitals are fine with people on gov't programs because they usually have insurance of some sort. They charge $1500 for the MRI because it's not an open market.

What brings costs up is greed and inefficiency. Massachusetts was once the poster child for out of control health care costs. While people tout RomneyCare for bringing down costs in actuality that did very little to control costs. What did get costs under control was gov't restrictions passed years after he left office on health care premium increases. That forced insurance companies, hospitals, drug makers, medical device suppliers and doctors to renegotiate contracts. They went from being the state with the highest rise in health care costs to one of the lowest. Starve the beast and somehow they found a way to all make money.

Comment Re:PET, CAT and MRIs Are Cheap. We Overpay in the (Score 3, Interesting) 311

Typically in Europe the MRI/CT imaging machine run 2-3 times as long daily. The capital cost of the machine can be spread much further. It's not uncommon in the USA to see the machines run from 7am to 1pm. The same thing applies to Operating Theaters US vs Europe too.

While I can understand this in more rural areas of the United States it holds true in dense urban areas as well.

Comment PET, CAT and MRIs Are Cheap. We Overpay in the US (Score 4, Informative) 311

A $1500 MRI in the United States is about $150 elsewhere. Same machine, same cost of living. The excess costs are come from time the machine isn't in use, how much we pay specialists to review the scans and how the machines are generally used as a profit center for providers.

Want to pay less, have a single price list for fees set by the gov't. That's what other countries do, even the ones with private health insurance.

Comment Several Chinese Airlines Already Do This (Score 1) 373

For at least a decade a number of Chinese Airlines have been doing this for their coach class customers. In particular on domestic segments where the planes are configured to be really tight. There are industry standard weight and balance calculations and they had to be updated in the late 90s because North Americans and Western Europeans all weigh more than they used to.

Comment Foxconn Isn't Chinese (Score 1) 104

They are a Taiwanese company and this is hardly the first factory they have opened outside mainland China. They have factories in South America, Mexico, Eastern Europe, USA, India, etc. I would contend they have little allegiance to mainland China and are more than willing to pull up stakes if need be.

Comment There will always be something better (Score 1) 126

Front end browser development is littered with dozens of front end frame works that have fizzled over the years. YUI, Prototype, script. aculo.us, etc. All popular in their day. jQuery is still active but certainly on the decline.

You want to be a good front end developer? Learn about the DOM model. Learn about HTTP, HTTP/2 and CSS. Learn the fundamentals of how all that stuff works together and then you'll never need to worry about picking up whatever front end framework is used by the cool kids.

Comment Re:Amazing and dreadful, simultaneously (Score 2) 381

Huh? Most contractors don't make time and a half but they are hourly workers. I make a lot of money as a contractor. Substantially more than a FT employee, even covering my own taxes, insurance and PTO days. Because working over 40 costs money they almost never ask for it. No one bothers me at home because they could easily rack up hours they don't have budgeted for.

As far as getting dismissed? Not really a factor. In most markets IT workers are in high demand. Canceling your contract risks being without a worker for weeks if not months. If the consulting firm finds out they dismissed after asking for unpaid hours that's likely to back fire.

Now if you're an H1B contractor? That's a different ball of wax. Employers can leverage your ability to stay in the country. Those guys can get screwed on wages and can be replaced easily.

If you are getting squeezed in your market then maybe it's time to move to a better place.

Comment Should We Trust Kaspersky? (Score 4, Interesting) 53

As we seem to be heading back down into the familiar territory of the cold war I often wonder if nationalism is something we should consider when thinking about security. For instance I believe that Kaspersky is a very talented company but I can't help but to feel that they would be quite willing to turn a blind eye to malware from their own government. I hear commercials for Kaspersky threat detection software all the time but I would be hard pressed to actually use any of it. It certainly seems China, Russia and parts of Europe are taking country of origin into account when evaluating American security products. Am I wearing a tin-foil hat in feeling we should think twice about trusting Kaspersky?

Comment Too Many Insurance Companies (Score 4, Insightful) 532

The issue is there are too many insurance companies. The core is the same, as in there's a claim and there's standardized billing codes for procedures. However, each insurance company has a different set of policies on how visits should be coded.

This has lead to health care providers hiring claims optimizers that help them code the visit to extract the most money from the insurance company. Which leads to insurance companies hiring claims optimizers to shape policy to reduce the amount they pay. Then times that by the number of insurance companies they might deal with. Add a little more complication if you're insurance is out of state and they use another companies network and policies. It's a giant clusterfuck.

This is also one of the major drivers of health care cost. There are plenty of other countries that have private health insurance. The difference is the gov't sets a common claims format and policy. They typically also set the base cost of each service (adjusted for cost of living for the area). That means the insurance companies compete on having lower administration costs and programs to make the members healthier.

To downgrade the human mind is bad theology. - C. K. Chesterton

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