Our healthcare system is such a mess

Ever have to pay for something, and I emphasize something because you don't really know what you are paying for, which has two different prices (neither of which are told to you up front), and both of which are excessive?  That's reality for many Americans today and is why our healthcare system is such a mess. Imagine this:  you get into a car accident that is your fault and you have to go to the auto repair place.  You have a $1500 deductible, but thankfully it isn't bad and likely won't cost that much.  The auto repair place says that they will fix your car, but they will charge you to look over the damages and then you will have to bring it in a few times in order to repair it completely.  You ask how much it will cost, they say they don't know.  You ask your insurance company, who has told you to go to this "preferred" repair place, and they have a website that says repairs like this typically cost $25-30 each time you visit.  So, you bring your car in for a "diagnostic" visit, where they ask you a few questions about your car and take a quick look before sending you on your way 30 minutes later, telling you to return in 2 weeks.  A week later you get a bill for $220.  You show up 2 weeks later to your 2nd appointment, they repair the first part of your car and again tell you to return in 2 weeks.  A week later you get a bill this time for $200, but learn that the "contract rate" for your first appointment will be $120 instead of $220.  When you ask why a 30 minute appointment costs $120 (or $220), nobody knows.  When you ask how much you'll end up paying for your $200 appointment, again, nobody knows.  When you ask how much you would have paid if you had gone to the guy down the street, nobody knows.  When you ask why the insurance website estimates each appointment would be $25-30, nobody knows.

As bizarre as this whole situation would sound for a car repair, this is actually how my "High Deductible" health insurance plan works.  The current health care billing system is clearly broken, this behaves so much differently than almost any other industry yet somehow they get away with it.   I signed up for this plan in 2011 because I had a financial incentive to do so, and because I was a little curious about how this would all pan out especially since at the time the health care debate was all over the news.

So what have I learned?  The idea of moving away from the "open bar" of most HMO's to a "cash bar" of a high deductible plan I honestly believe is the ticket to fixing health care in this country.  Just knowing the cost of an appointment or treatment is enough to make one "shop around" or at least make sure they truly need to be treated.  Removing ALL costs or deductibles from any "preventative care" is also a key element, as it encourages regular checkups to prevent issues from going undetected.  With that said, in order for a system like this to work well, there are many areas that first need to be improved and I have been less than satisfied with my experience thus far (although most likely I will have saved a significant amount of money this year over an HMO).

With only a minor injury requiring some basic physical therapy and a few visits to a chiropractor (not a complex issue such as a serious illness or undiagnosable symptoms), I've observed the following:

• Each doctor you visit can tell you how much they bill for each service, but they don't know what service they will bill you and they don't know what the "contract rate" the insurance company has negotiated for each service which you will end up paying.  So the doctor bills a "MSRP", the insurance company turns around and tells its customer they only have to pay the sale price, which is 50% off the MSRP for this service and 35% off for that service
• The insurance company knows the contract rate, but they don't know the "service code" that the doctor will bill, so they can't tell you how much something will cost or where the cheapest and best qualified doctor in the area is.
• The insurance company "cost estimator" must be accurate and easy to use.  If someone isn't able to "shop around" and select a provider that has a good track record of service and affordable prices, this system will fail.  After all, that is the whole point, to allow one customer to go for the top shelf tequila and another to go for the "well" tequila
• The cost that someone without insurance pays for a basic service is excessive.  In my case, a 30 minute "diagnostic appointment" with a physical therapist (keep in mind I already had a diagnosis from my doctor of what was wrong) would have cost me $220 if I had no insurance, instead of the $120 i actually paid.  I can only imagine what it would cost if I had a serious injury

Passion and goals

Coming from Wired.com this is a great speech on goal setting and underwear.  Okay, mostly goals, a brief mention of passion, and a really weak analogy involving underwear.  I pasted the speech below. Something I've given a lot of thought to lately is the idea of passion, interestingly, mostly in regards to dating and the type of person I want to date.  I'm a very passionate person and have many things I'm passionate about, in fact so many that I get frustrated that I can't find enough time to do everything I love.  Earlier in my 20's I would have told you I only wanted to date someone that shared many of the same interests, but if you ask me today I would say that while common interests are nice, finding someone that is truly passionate about something (anything!) is far more important (and passion for one's job doesn't count).  I haven't yet figured out why this is such a turn on for me, but I'd have to guess it has something to do with personality attributes such as determination, loyalty, and that inner fire to make the most of life.

So what is my goal at the moment?  I'd like to run my first marathon, and do so in less than 3 hours and 5 minutes to qualify for the Boston Marathon.  That will take me at least a few years to achieve, and still makes me shudder a bit about how hard that will be to train for.  You probably know where to find me most weekend mornings though...

Grit is not just about stubborn persistence. It’ no use persisting, after all, if a goal is truly impossible. While you’ve no doubt been bombarded with successful people telling you that dreams always come true, that we just need to believe, that if you can imagine it then it can happen, the dismal reality is that not every goal is worth pursuing. I might want to play in the NBA, but I’m not Spud Webb. I still want to compose the Great American Novel, but I also know that my college creative writing professor was right: I have no talent for fiction. Unless I’m honest about my limitations, I’ll waste time chasing a farfetched future, which quickly gets very very frustrating. Because dreams do come true. But first we need to pick the right one.

So how can we sort the useful long-term goals from the futile ones? How can we make sure that all of our struggle and practice and sacrifice will be worth it? Well, here’s my advice: ask yourself if the goal passes the underwear test.

Let me explain. One of the most deep seated features of the human mind is that it quickly takes things for granted, becoming numb to the predictable perceptions and pleasures of the world. Just think of your underwear. Do you feel it? Are you conscious of it? Of course not. That’s because you’ve adapted to the feel of underwear, habituated to the touch of cotton on your bum.

And this isn’t just about underwear. Psychological adaptation also explains why the first bite of chocolate cake is better than the second, and the second is better than the third. It explains why the first time you use that new iPhone you’re pretty excited, but before long it will just be another thing in your pocket. And then, a few weeks after that, you’ll start complaining that your phone (your phone!) can only hold 10,000 songs or that it downloads streaming videos from Netflix so slowly. The delight has vanished, replaced by the usual dissatisfaction. This is because our brain is designed to be ungrateful, every pleasure a fleeting thing.

What does this have to do with grit and long-term goals? Well, the only dreams worth pursuing are those that pass the underwear test. These are the pursuits that don’t bore us, even after we put in 10,000 hours of practice. They contain the kind of subtle thrills that don’t get old, that we don’t adapt to, that keep us motivated and interested for years and years at a time. Sure, there will be frustrations along the way, but these frustrations don’t feel permanent, which is what allows us to keep on working and learning and improving. Because that’s what it takes to succeed, to accomplish something interesting. Perhaps you want to invent the cure for malaria, or bake a perfect baguette, or create the next Facebook. Whatever – don’t apologize for your obsession. Just be grateful you are obsessed with something, that you’ve found a goal worth getting gritty over. Because if your goals ever feel tedious, if you find them as unnecessary as that last bite of chocolate cake, then you’re never going to put in the necessary work. Grit requires passion. Grit requires love. And love is just another name for what never gets old. Love is the opposite of underwear.

Source - Wired.com

Earthquakes and Twitter

I'm sure everyone has heard about the earthquake that was felt yesterday on the east coast and in Boston.  It was the first one I've ever felt, thankfully it was over before I realized what was happening (and not that I was dizzy and about to faint as I sat in my chair at my desk).  What amazed me most about this experience was how I immediately reacted to this event.  I didn't call or text someone, I didn't use Google, and I didn't use Boston.com as I may have done in the past.  Within 10 seconds of the earthquake I had opened up my browser, went to Twitter, and searched for earthquake.  Instantly I realized that no, it wasn't just my building randomly shaking (which it is strangely prone to doing on occasion), but that something had clearly happened as within the past 20 seconds folks from Philly, DC, and NY had all tweeted that the just felt exactly the same thing I did.  It took CNN, Google, Boston.com and I'm sure many other news sites at least a few minutes to respond, but I know that if I want immediate information (albeit "unofficial"), Twitter is best suited.

Baseball and steroids

According to STATS (via Men's Health), in the 2011 Major League Baseball season at the All-Star break the number of runs per game was down 20 percent from 2000 and home runs had dropped 31%.  It will be interesting to see these stats trend over the next few years, but assuming it does I guess this answers once and for all how big of a problem there was with steroids, huh? Interesting chart, with each # representing a MLB player (http://baseballsgreatesthitters.com/Steroids_and_HomeRuns.html)

Rank	40+ HR seasons	50+ HR seasons	60+ HR seasons	70+ HR seasons
The Dead Ball Era	0	1	0	0
Babe Ruth Era	18	4	1	0
Baseball During WWII	11	5	0	0
Baseball 1950's-mid 1960's	50	3	1	0
Pitching Era	27	2	0	0
The Last Clean Era	18	0	0	0
Steroid Era	83	11	4	2
Baseball After Steroids	52	7	0	0