Random Thought Thread

beeinak said:
5 lbs of flour covers much more area than you would expect
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Made a similar discovery a few weeks ago. I managed to swing my (full) coffee pot into the handle of a cast iron skillet that was hanging over the countertop a bit. I achieved a nice, thin film over most of the floor, and splattered the cabinets, fridge and various miscellaneous things. Think some glass shards are still lurking somewhere, waiting for a bare foot.

So that's how I ended up cleaning the kitchen at 5am with a burnt foot and no caffeine. I was a bit cranky.
 
I spent some time with a really good friend today. We're only 30 miles apart, but we just don't get together enough. Anyway, Stuart forged up this nice little petty, (started off bigger, like probably most pettys do, lol!) and it's impressive to me how much competence he has in moving the steel to exactly where he wants it.

Me? Not so much, lol! I started with a 5" long by 1"(?) round bar of DH3 old ass W2, and now have kind of a sword type object which weighs about 10 pounds. I used his press to draw it out, but that was lots of hammering on my part. I'm happy enough with it to normalize it and start figuring out what's under all those gnarly hammer marks and seeing it I can salvage something from the bar of steel I molested for several hours today.

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Stuart made this knife awhile ago, and I was I stole it while he wasn't looking- it's an awesome piece.
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Nathan the Machinist said:
The cost of health care in this country is one of this country's single largest problems. ...snip...

Back in the old days when I was working as a design engineer I would frequently work on medical device designs and one of the products that I designed, which has been very successful, is still in production today. I learned that it cost about $4 to manufacture it. Now there's some assembly in there and there's a lot of steps that go into making it sterile and FDA approved, but we would mark it up to $40 bucks to our customer. The customer being a medical device provider that you have heard of that I won't name here.

They in turn would mark it up to $400 bucks for their customer, the hospital.

And then they would mark it up to $4000 bucks, to the patient.

It was very striking to me when I learned about this, because everybody who touched it added a zero.
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And yet when I would charge $275 to spend an hour admitting a sick child to the hospital, Medicaid would pay me $20 (many years ago). The hospitals were raking it in while overcharging for everything, and making it so that the medical providers got the droppings that fell off the table. The hospitals charging $4000 for that item service were not being ethical, in my view as a physician.

Mind you, I had to pay a receptionist, a billing clerk, an office manager, a nurse, and a medical assistant an hourly wage and health insurance, to staff my office from 8AM to 6PM, plus pay a $4000 mortgage, and pay for all of my supplies and bills before paying myself.
 
DocJekl said:
And yet when I would charge $275 to spend an hour admitting a sick child to the hospital, Medicaid would pay me $20 (many years ago). The hospitals were raking it in while overcharging for everything, and making it so that the medical providers got the droppings that fell off the table. The hospitals charging $4000 for that item service were not being ethical, in my view as a physician.

Mind you, I had to pay a receptionist, a billing clerk, an office manager, a nurse, and a medical assistant an hourly wage and health insurance, to staff my office from 8AM to 6PM, plus pay a $4000 mortgage, and pay for all of my supplies and bills before paying myself.
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One lesson learned from being on both sides of this... if you are ever hospitalized, ask for an itemized bill. It's amazing the $41x they try to charge you for, in terms of goods and services you did not receive.
 
Hatchet_Jack said:
Let’s say a low socio economic person finds an odd lump and wants to have it checked out. Then is recommended to have ultrasounds and MRI’s. This indicates that it needs to be removed and tested but they don’t have private healthcare or the money to pay for it do they still get care? What happens if they’re unable to foot the bill?
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quick and dirty answer; they's f*cked.
according to some minor research, roughly 1/2 million American families declare bankruptcy every year due to medical expenses.
people who are too poor to be able to access any medical attention outside of the emerg fortunately escape bankruptcy because they're so poor they literally have nothing, so they die instead. Most of us don't know or interact with this demographic of human beings, but there are a lot of them.

I really hope that things get better for people, because there's literally no GOOD reason why they shouldn't, but concepts of plans ain't gonna cut it.
 
fnordmorph said:
One lesson learned from being on both sides of this... if you are ever hospitalized, ask for an itemized bill. It's amazing the $41x they try to charge you for, in terms of goods and services you did not receive.
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fnordmorph said:
We're whining about the price of scalpels while Lorien Lorien is beating steel into blades.
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Having been previously tipped off about such practices, I asked for an itemized bill after my daughter was born in a local hospital. We were charged $14.00 per dose of aspirin (2 pills) for a dozen doses. I could have brought my own bottle of aspirin and had plenty of doses to spare for less than $14.00.

We were later presented a bill for over $20,000.00 for delivery and recovery. This didn't make sense as we had already prepaid most of those costs and had paid well above our deductible and out-of-pocket maximum (which are the same, yet different concepts, depending on the insurance rep I spoke to). Note that I had good insurance through an employer at the time and the reps knew me by name as I had called them almost weekly to confirmthe exact amounts I would be responsible for. Fortunately for me, a call to the hospital and a call to my insurance company cleared the bill away: the insurance company had processed my bill under an incorrect plan and had effectively denied coverage. How many people lack the time, experience, and wherewithal to challenge every bill from a hospital and go into debt to pay bills they may not be responsible for?

One more fun tidbit: just because a hospital or particular doctor is in network does not mean that all doctors or specialists who work in that hospital are also in network. I was rigorous in confirming that my wife's OBGYN was in our network, as were her nurses and the hospital where we delivered. But, I did not suspect that the anesthesiologist who worked at the hospital was effectively contract labor and not in-network, nor were the lactation specialists who swarmed my wife after delivery. I like the idea of a free market, but I don't have much bargaining power or time to shop around for in-network specialists when they say "She's 7cm dilated, it's now or never for the epidural." Fortunately we had an HSA at the time with enough funds remaining to cover the specialists. Otherwise we'd have gone into debt.
 
oldmanwilly said:
Having been previously tipped off about such practices, I asked for an itemized bill after my daughter was born in a local hospital. We were charged $14.00 per dose of aspirin (2 pills) for a dozen doses. I could have brought my own bottle of aspirin and had plenty of doses to spare for less than $14.00.

We were later presented a bill for over $20,000.00 for delivery and recovery. This didn't make sense as we had already prepaid most of those costs and had paid well above our deductible and out-of-pocket maximum (which are the same, yet different concepts, depending on the insurance rep I spoke to). Note that I had good insurance through an employer at the time and the reps knew me by name as I had called them almost weekly to confirmthe exact amounts I would be responsible for. Fortunately for me, a call to the hospital and a call to my insurance company cleared the bill away: the insurance company had processed my bill under an incorrect plan and had effectively denied coverage. How many people lack the time, experience, and wherewithal to challenge every bill from a hospital and go into debt to pay bills they may not be responsible for?

One more fun tidbit: just because a hospital or particular doctor is in network does not mean that all doctors or specialists who work in that hospital are also in network. I was rigorous in confirming that my wife's OBGYN was in our network, as were her nurses and the hospital where we delivered. But, I did not suspect that the anesthesiologist who worked at the hospital was effectively contract labor and not in-network, nor were the lactation specialists who swarmed my wife after delivery. I like the idea of a free market, but I don't have much bargaining power or time to shop around for in-network specialists when they say "She's 7cm dilated, it's now or never for the epidural." Fortunately we had an HSA at the time with enough funds remaining to cover the specialists. Otherwise we'd have gone into debt.
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What a flippin joke.

My wife is about to pop out baby no.4 and so far the previous three have cost us $0.

Mind you, she had a couple of issues early on with this pregnancy and may have needed a c-section. It would have been free at our local hospital but we looked at going private in the city. Without insurance it was going to be $10k. Thankfully that issue resolved itself.
 
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Lorien said:
quick and dirty answer; they's f*cked.
according to some minor research, roughly 1/2 million American families declare bankruptcy every year due to medical expenses.
people who are too poor to be able to access any medical attention outside of the emerg fortunately escape bankruptcy because they're so poor they literally have nothing, so they die instead. Most of us don't know or interact with this demographic of human beings, but there are a lot of them.

I really hope that things get better for people, because there's literally no GOOD reason why they shouldn't, but concepts of plans ain't gonna cut it.
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Most people who get the raw deal are not necessarily at the lower end, because they likely have Medicaid. The biggest financial burden is for those who either have no insurance, or those who do but not enough coverage. Many people think that insurance coverages are similar, but co-pays and things not covered can vary drastically. Some of my patients were excited about the Affordable Care Act, only to find that they had outrageous deductibles and many medications they had been on were no longer covered. Same with Medicare- plans differ drastically.
 
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