Really glad I’m no longer running a private California medical practice

[MitchLevi]

Let’s get out our crayons and discuss curves and their meanings.

View attachment 377941

Yes!

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Members don't see this ad.

 

[Doctodd]

You don’t know what an Audi R8 looks like even with the help of Google. Lol.

 

[cowboydoc]

People are complicated.

You can have an opinion that's hypocritical and doesn't jive with your lifestyle.

What makes Leftist hypocrisy so maddening is the push for virtue signaling public policies that we all know are only being passed so people can say they voted for it.

Like this BS in California with electric vehicles when we all know very well the limitations of that industry. Teslas are amazing vehicles. Incredibly fast. Smart. Lots of options. They apparently are resilient vehicles from a manufacturing standpoint. Many Teslas are driving around with 400k miles on them...

But when the power goes out and you can't charge? How filthy is the mining process?

What about Apple? The Left idolizes Tim Cook and that dude sells phones made from slave labor FFS. Then again, Apple released that ridiculous video taking place in a board room with Mother Nature sitting at the head of the table and every demographic was represented in that video in a very specific and controlled manner. As long as Apple says the right stuff and gives us iPhones, we don't GAF who makes them or what happens overseas...I need to AirDrop stuff.


Here's another one:

Progressives in NYC have for many years railed against border states trying to enforce the border. NYC has called for sanctuary cities, and called itself a sanctuary city. Nope...Not for real though...NYC progressives just like that moniker. Those migrants can't ACTUALLY come here...I pay too much to live in this apartment.

"Mayor Eric Adams has called it a humanitarian crisis that will cost the city about $12 billion over three years. In the fall, he declared a state of emergency. In recent weeks, city officials have said they are running out of room.

The mayor has repeatedly asked the federal government — and has even traveled to Washington — for more funds and for expedited work authorizations for migrants, so they can become self-sufficient. He has said that President Biden has “failed” the city by not doing more."



This one right here though!!!

Mayor Adams has "asked a judge to relieve the city of some of its legal obligations under its unique 'right to shelter' mandate. He used an executive order to suspend some of the requirements under the mandate this spring, in anticipation of an influx of new migrants."

Hahahahaha!!!!


Migrants are crossing the border from 160 different countries. There are ENTIRE VILLAGES that have crossed as a group! There are a vast number of Africans flying into Central America en masse, and from there they migrate across the border. I have no problem with migrants from ANY country if they come legally, and my mentioning of Africans is just to show they're flying from all over the world. It isn't just Mexicans.

Another example, and right back to the OP (since I helped diverge the convo) is the minimum wage laws of late. Local politicians are celebrating their “championing the poor” with progressive increase in minimum wage to $12.50 over the next 2 years. Meanwhile, McDs pays $16 starting, which basically creates the basement for the market rate.

The law has no real impact, but makes it seem like the pols are doing something. Never mind the market pressures making things unaffordable for the poor. Never mind how robots doing basic jobs will further concentrate wealth beyond anything we’ve seen. (See market cost for basic labor and UAW demands) I’m sure our benevolent overlords will fairly redistribute the resources equitably without skimming off the top.

 

[bedrock]

Yes!

Yep. I looked at the curve posted by callmeanesthesia and I wondered if liberals are taught math differently than non liberals, because clearly the costs have accelerated in the past 5 years compared to prior.

Maybe there is a special type of math class that people take at liberal universities, that convinces them that massive handouts to lazy people and hugely wasteful government spending are somehow prudent national fiscal policy! 😂😂😂

 

[MitchLevi]

I'm loving the situation in NYC and Massachusetts. Two of the most elitist cities in America with huge opinions about migrants and border states and sanctuary status. The "Right to Shelter" is getting hammered.

NYC alone is projecting $12,000,000,000 over 3 years. LMAO...

The border states have been dealing with this BS for years.

All of this could have been avoided BTW.

Another example, and right back to the OP (since I helped diverge the convo) is the minimum wage laws of late. Local politicians are celebrating their “championing the poor” with progressive increase in minimum wage to $12.50 over the next 2 years. Meanwhile, McDs pays $16 starting, which basically creates the basement for the market rate.

The law has no real impact, but makes it seem like the pols are doing something. Never mind the market pressures making things unaffordable for the poor. Never mind how robots doing basic jobs will further concentrate wealth beyond anything we’ve seen. (See market cost for basic labor and UAW demands) I’m sure our benevolent overlords will fairly redistribute the resources equitably without skimming off the top.

Yeah, it's a photo opportunity. We support more pay for our struggling workers!

Hogwash.

You want to support workers? Decrease corporate tax rates...

 

[SSdoc33]

Yep. I looked at the curve posted by callmeanesthesia and I wondered if liberals are taught math differently than non liberals, because clearly the costs have accelerated in the past 5 years compared to prior.

Maybe there is a special type of math class that people take at liberal universities, that convinces them that massive handouts to lazy people and hugely wasteful government spending are somehow prudent national fiscal policy! 😂😂😂

medicare spending has actually slowed down

Medicare's Per-Person Spending Slows Down, And No One Can Explain Why - KFF Health News

The New York Times explores the mystery behind why Medicare's spending per beneficiary has yet to spike to expected levels — a saving grace for the federal budget but not one that experts don't understand.

kffhealthnews.org

 

[cowboydoc]

medicare spending has actually slowed down

Medicare's Per-Person Spending Slows Down, And No One Can Explain Why - KFF Health News

The New York Times explores the mystery behind why Medicare's spending per beneficiary has yet to spike to expected levels — a saving grace for the federal budget but not one that experts don't understand.

kffhealthnews.org

Really interested in the article, but paywall...

In my tiny slice of the world, a decent number seniors have been relatively sheltered the last couple years, avoided getting care, etc. Covid preferentially shortened life expectancy of some in this cohort. Medicare is doing a lot more to dissuade care (prior auths and denying procedures) than previous. Busting a few of the outfits that prey on Medicare recipients to bill for completely unnecessary DME/services can have a real impact on spending per beneficiary. (The NJ doc had $127M in fraudulent charges). All of these could play a role in diminishing costs.

Looking forward to the Freakonomics-style breakdown of this unexpected decrease in spending...

 

[SSdoc33]

Really interested in the article, but paywall...

In my tiny slice of the world, a decent number seniors have been relatively sheltered the last couple years, avoided getting care, etc. Covid preferentially shortened life expectancy of some in this cohort. Medicare is doing a lot more to dissuade care (prior auths and denying procedures) than previous. Busting a few of the outfits that prey on Medicare recipients to bill for completely unnecessary DME/services can have a real impact on spending per beneficiary. (The NJ doc had $127M in fraudulent charges). All of these could play a role in diminishing costs.

Looking forward to the Freakonomics-style breakdown of this unexpected decrease in spending...

this isnt the primary source material, but does give more info

Huge decline in spending on Medicare begs the question: Why?

Research shows that Medicare spending has leveled off for the past decade, morphing from something that experts worried might break the federal budget to an unexpected bright spot. | Medicare had once been seen as something that would one day break the budget. However, Medicare spending in the...

www.fiercehealthcare.com

in a shock to most people: i dont pay for a NYT subscription. my cheapness "trumps" my liberalism, i guess

 

[bedrock]

medicare spending has actually slowed down

Medicare's Per-Person Spending Slows Down, And No One Can Explain Why - KFF Health News

The New York Times explores the mystery behind why Medicare's spending per beneficiary has yet to spike to expected levels — a saving grace for the federal budget but not one that experts don't understand.

kffhealthnews.org

I’m the one who originally posted that Medicare information on this board.

 

[MitchLevi]

The current border crisis is the single biggest problem we're facing today, yet Joe Biden recently said white supremecy is the biggest threat to society. Haha.

 

[callmeanesthesia]

Yep. I looked at the curve posted by callmeanesthesia and I wondered if liberals are taught math differently than non liberals, because clearly the costs have accelerated in the past 5 years compared to prior.

Maybe there is a special type of math class that people take at liberal universities, that convinces them that massive handouts to lazy people and hugely wasteful government spending are somehow prudent national fiscal policy! 😂😂😂

Not sure what sort of math you’re doing but there’s been a fairly steady increase in the slope of that curve over the last 50 years.

 

[SSdoc33]

The current border crisis is the single biggest problem we're facing today, yet Joe Biden recently said white supremecy is the biggest threat to society. Haha.

wrong. he said white supremacy is the biggest TERRORIST threat

“White supremacy … is the single most dangerous terrorist threat in our homeland,” Biden said.

also, your idea doesnt jive with others:

Most important problem facing the U.S. 2024 | Statista

In February 2024, immigration was the top concern for Americans.

www.statista.com

personally, i think the list is pretty poor. the environment should be the #1 problem. but our crappy government and economy are also very high on the list

 

[bedrock]

Not sure what sort of math you’re doing but there’s been a fairly steady increase in the slope of that curve over the last 50 years.

🤦

 

[MitchLevi]

wrong. he said white supremacy is the biggest TERRORIST threat

“White supremacy … is the single most dangerous terrorist threat in our homeland,” Biden said.

also, your idea doesnt jive with others:

Most important problem facing the U.S. 2024 | Statista

In February 2024, immigration was the top concern for Americans.

www.statista.com

personally, i think the list is pretty poor. the environment should be the #1 problem. but our crappy government and economy are also very high on the list

Environment! Yes! That is a much bigger direct threat to you than hundreds of thousands of undocumented individuals pouring across the border each week.

160 different countries.

Nonassimilating individuals bringing fentanyl and a massive economic crisis along with them.

FBI known individuals crossing daily.

LOFL at climate being the biggest threat to you. Jesus Christ dude.

White supremacy is a bigger threat than actual terrorists crossing our border? GTFOOH...

Can't believe you'd buy that.

As of July, in fiscal year '23 there were 216 foreigners and Americans stopped at the border on the FBI watch list.

How many didn't get stopped?

...but the climate!

 

[SSdoc33]

Environment! Yes! That is a much bigger direct threat to you than hundreds of thousands of undocumented individuals pouring across the border each week.

160 different countries.

Nonassimilating individuals bringing fentanyl and a massive economic crisis along with them.

FBI known individuals crossing daily.

LOFL at climate being the biggest threat to you. Jesus Christ dude.

White supremacy is a bigger threat than actual terrorists crossing our border? GTFOOH...

Can't believe you'd buy that.

you are better than that

from CATO:
Fentanyl is primarily trafficked by U.S. citizens. The U.S. Sentencing Commission publishes data on all federal convictions, which includes demographic information on individuals convicted of fentanyl trafficking. Figure 1 shows the citizenship status of fentanyl traffickers for 2018 to 2021. Every year, U.S. citizens receive the most convictions by far. In 2021, U.S. citizens accounted for 86.3 percent of fentanyl trafficking convictions compared to just 8.9 percent for illegal immigrants.

https://www.cato.org/blog/fentanyl-smuggled-us-citizens-us-citizens-not-asylum-seekers

VAST majority of fentanyl comes in thru mexico via americans -- not illegal immigrants.


domestic terrorists are a way bigger threat than somebody on a watch list somewhere. white house, FBI, CIA, DOD all say so.

there is definitely a problem at the border. im not minimizing it. but im also not blowing it out of proportion.

 

[MitchLevi]

you are better than that

from CATO:
Fentanyl is primarily trafficked by U.S. citizens. The U.S. Sentencing Commission publishes data on all federal convictions, which includes demographic information on individuals convicted of fentanyl trafficking. Figure 1 shows the citizenship status of fentanyl traffickers for 2018 to 2021. Every year, U.S. citizens receive the most convictions by far. In 2021, U.S. citizens accounted for 86.3 percent of fentanyl trafficking convictions compared to just 8.9 percent for illegal immigrants.

https://www.cato.org/blog/fentanyl-smuggled-us-citizens-us-citizens-not-asylum-seekers

VAST majority of fentanyl comes in thru mexico via americans -- not illegal immigrants.


domestic terrorists are a way bigger threat than somebody on a watch list somewhere. white house, FBI, CIA, DOD all say so.

there is definitely a problem at the border. im not minimizing it. but im also not blowing it out of proportion.

Is $12B over 3 years in NYC alone a small problem or a big problem?

The drug smuggling occurs through US citizens and illegals both, because the border is wide open and anyone can cross it. I don't care who is bringing it in...Illegal, American, whatever.

Secure the border and less fentanyl gets into America. Why do you not understand that?

You're completely missing the point.

China will pump fentanyl down our throats as long as they can, and they'll do it bc they haven't forgiven the West for Gunboat Diplomacy, the Opium Wars and a Century of Humiliation.

 

[SSdoc33]

Is $12B over 3 years in NYC alone a small problem or a big problem?

The drug smuggling occurs through US citizens and illegals both, because the border is wide open and anyone can cross it. I don't care who is bringing it in...Illegal, American, whatever.

Secure the border and less fentanyl gets into America. Why do you not understand that?

You're completely missing the point.

China will pump fentanyl down our throats as long as they can, and they'll do it bc they haven't forgiven the West for Gunboat Diplomacy, the Opium Wars and a Century of Humiliation.

a very modest decrease if you "secure the border". you are not going to prevent americans from going to mexico and then returning.

yes, immigration is a problem. immigration wont get fixed without a functioning government, and that is #1 on the list I sent you. BTW, how is the GOP doing these days in the house? they cant get their own sh$t together. how in the world are we going to pass comprehensive immigration reform? i am all for being tougher at the border and enforcing the laws on the books. but from a practical standpoint, we have bigger fish to fry

 

[Ducttape]

i never said the government is ethical.

just look at the trump administration for perfect examples.

Secure the border and less fentanyl gets into America. Why do you not understand that?

this statement shows that you do not understand how fentanyl is being smuggled in to the US.

the vast majority of fentanyl is coming through legitimate border crossings.

===
interesting that there have been waves and waves of migration and "illegal" immigration throughout the entire history of the US, but this current wave of immigration is the gravest threat...

the same kind of talk occurred when the Irish and germans came over.

the same kind of talk occurred when italians and southern europeans came over

the same kind of talk occurred when southeast asians came over.


after all those waves of immigration that were supposed to destroy the US, the US has gotten more diverse and arguably stronger.

thats not to say that we want as much illegal immigration and there should be some controls - thats to saw that your chicken little doomsday talk about immigration dooming the US is hyperbole. the US has survived worse and will survive this wave



it might not survive threats to democracy posed by white supremacists.

 

[Doctodd]

why cant you guys remember current events regarding terrorists crossing an open border? And the reason US citizens try to cross the border with Fentanyl is because they think they can get in easily because they are US citizens. The illegals dont try to cross the border with Fentanyl because......wait for it. It will come to you.

Yea im sure we will be stronger with all those illegal muslim immigrants AOC and you want to bring in versus Egypt and Jordan. Those suckers! Have you seen a satellite photo of the area around the border next to Gaza? It is wide open uninhabited land, some of it is even waterfront. They can start fresh.

 

[Doctodd]

it might not survive threats to democracy posed by white supremacists.

again with "might" or "probably" or "could". Are you practicing to be a journalist?

 

[Ducttape]

no, i am talking the way i usually talk, in part because some people seize so utterly on absolutes.

 

[Ferrismonk]

medicare spending has actually slowed down

Medicare's Per-Person Spending Slows Down, And No One Can Explain Why - KFF Health News

The New York Times explores the mystery behind why Medicare's spending per beneficiary has yet to spike to expected levels — a saving grace for the federal budget but not one that experts don't understand.

kffhealthnews.org

They no longer cover sedation or 3rd level facets. They limit ESI and SIJ. They stopped paying for SI RFA. That's just in our field.

 

[SSdoc33]

They no longer cover sedation or 3rd level facets. They limit ESI and SIJ. They stopped paying for SI RFA. That's just in our field.

Limiting coverage and more pre-auths is definitely part of it.....

But i dont get it: we want to get paid for this stuff, but we dont want medicare to cost so much. Something's gotta give

 

[callmeanesthesia]

Limiting coverage and more pre-auths is definitely part of it.....

But i dont get it: we want to get paid for this stuff, but we dont want medicare to cost so much. Something's gotta give

Yeah, administrative costs. Too lazy to look it up but isn’t it something like 8% of Medicare dollars actually go to doctors? Not much savings to be had there.

 

[MitchLevi]

Medscape: Medscape Access

 

[bedrock]

Yeah, administrative costs. Too lazy to look it up but isn’t it something like 8% of Medicare dollars actually go to doctors? Not much savings to be had there.

Agree with you. And I think you are right about the number. Only 8-9% of healthcare care costs are physician professional fees.

Meanwhile there are 10 times as many “administrators” to deny care compared to 30 years ago.

Best way for Medicare to save money and not harm patients would be to cut a huge amount of the “ administrator” costs, paid to useless bureaucrats.

 

[jsaul]

The current border crisis is the single biggest problem we're facing today, yet Joe Biden recently said white supremecy is the biggest threat to society. Haha.

In 2017 and 2018 the government was controlled by one party and yet the only thing that was accomplished was to decrease corporate taxes. Obama care continued ans no immigration reform

 

[hyperalgesia]

In 2017 and 2018 the government was controlled by one party and yet the only thing that was accomplished was to decrease corporate taxes. Obama care continued ans no immigration reform

To be fair, Trump tried very hard to secure the border and did succeed to a degree with the Remain in Mexico agreement.

Democrats were off the wall with liberal journalists like Rachel Maddow literally crying on the air about "separating families" and "cages". They went all out to prevent any border wall funding so Trump couldn't accomplish his mission.

It's true that Republicans will never support a path of illegal immigrants until the border is secured. And Democrats want it open so here we are...

 

[Ducttape]

"separating families" and "cages" - yep not an issue.

Nearly 1,000 Migrant Children Separated From Parents at Border Haven’t Been Reunited, Data Shows

A federal task force has reunited 600 children with their families, DHS said.

www.wsj.com

the way to make the border secure is to make sure there is a path for people to legally immigrate. republicans have painted us in to a corner with no where to go.

 

[MitchLevi]

"separating families" and "cages" - yep not an issue.

Nearly 1,000 Migrant Children Separated From Parents at Border Haven’t Been Reunited, Data Shows

A federal task force has reunited 600 children with their families, DHS said.

www.wsj.com

the way to make the border secure is to make sure there is a path for people to legally immigrate. republicans have painted us in to a corner with no where to go.

A completely dud comment, just like your fentanyl comment above.

 

[Doctodd]

"separating families" and "cages" - yep not an issue.

Nearly 1,000 Migrant Children Separated From Parents at Border Haven’t Been Reunited, Data Shows

A federal task force has reunited 600 children with their families, DHS said.

www.wsj.com

the way to make the border secure is to make sure there is a path for people to legally immigrate. republicans have painted us in to a corner with no where to go.

Trump offered amnesty for millions of immigrants in a deal, but democrats refused the deal.

Donald Trump Backs Citizenship Pathway for Dreamers

President Donald Trump said he supported a pathway to citizenship for young, undocumented immigrants brought to the country by their parents, putting him in line with a bipartisan Senate group that had worked to come up with a solution to an immigration-policy impasse but putting him at odds...

www.wsj.com

https://www.washingtonpost.com/politics/trump-supports-path-to-citizenship-for-up-to-18-million-dreamers-in-new-white-house-proposal/2018/01/25/fa3f01aa-01e3-11e8-8acf-ad2991367d9d_story.html

 

[Ducttape]

yes. and he attached poison pills to that deal.

if he wanted, he could have just offered pathway to dreamers without attaching $25 billion for border wall or right to deport anyone and cut off family immigration pathway.

and i wonder who had majorities in the Senate at that time.

hmm. Republicans. 52-48.

im sure then that dems had majority of the House then, right?

oh snap. the 115th Congress. Republican majority. 238-194.

 

[Ferrismonk]

If you offer amnesty for illegal aliens brought over as a child without securing the border, then you'll just get more illegal immigration...

 

[Doctodd]

yes. and he attached poison pills to that deal.

if he wanted, he could have just offered pathway to dreamers without attaching $25 billion for border wall or right to deport anyone and cut off family immigration pathway.

and i wonder who had majorities in the Senate at that time.

hmm. Republicans. 52-48.

im sure then that dems had majority of the House then, right?

oh snap. the 115th Congress. Republican majority. 238-194.

What poison pills? Have a job and don’t break the law for 12 years? What else? You are correct and I expected you to say that. But the fact remains Trump offered amnesty to millions if they followed certain conditions, and the media and democrats poo-pood it. There was no “corner they were painted into”. Democrats wanted nothing to do with any deal Trump offered. How many democrats voted for it? Not 1 I bet.

 

[hyperalgesia]

Democrats could not allow Trump to succeed. That would have utterly destroyed their narrative and their entire brand.

They sacrificed a lot of good policy (bipartisan infrastructure, immigration reform, border security, etc) to save themselves.

 

[Ducttape]

What poison pills? Have a job and don’t break the law for 12 years? What else? You are correct and I expected you to say that. But the fact remains Trump offered amnesty to millions if they followed certain conditions, and the media and democrats poo-pood it. There was no “corner they were painted into”. Democrats wanted nothing to do with any deal Trump offered. How many democrats voted for it? Not 1 I bet.

the "right" to remove immigrants from any other country besides Mexico and Canada.

the "right" to get rid of residence visas. so family members and children cannot come to the US

oh and $25 billion to put another brick in the wall.