patrick.net

skibum,

who, which committe, which government body in this country presides over hospitals and determines that they charge too much? How can hospitals get away with whatever they want to charge? How do I know if the hospital is charging me $50 per cotton ball used? Shouldn't there be a better business bureau for hospitals only?

oo,

There are a few reasons, none of them great, for why hospitals charge so much. First and foremost, they CAN. Medicaire sets hospital and physician reimbursement rates, and insurers follow suit. Medicaire determines how much a hospital can bill for each type of patient visit - $800/night for a medical admission, $ 4000 for an outpatient surgery, or whatever. Needless to say, hospitals lobby congress super hard to support these reimbursement rates.

Second, hospitals are generally run in an incredibly inefficient way. That "miscellaneous" charge? It goes to everything from the nurses caring for you, to overhead, to the army of administrators whose job it is to contain costs.

Finally, I've said this in my moderated post, but hospitals (and MDs) practice defensive medicine on the one hand, and on the other hand, private hospitals in particular, overdo it on billable services to recoup investments on equipment and technology, so in general too many tests and procedures are done.

I am surprised no one is talking about the $1600/$800 checks we should be looking forward to pretty soon.

http://www.forbes.com/markets/feeds/afx/2008/01/17/afx4546502.html

"Bush is pushing for tax rebates of as much as 800 usd per person, or 1600 per married couple, but Democrats in Congress want a smaller figure to keep the cost down. A final figure is still to be determined."

who, which committe, which government body in this country presides over hospitals and determines that they charge too much?

oo,

In short, JCAHO, or the Joint Commission monitors hospital quality. Medicaire and the GAO audits hospitals and MDs for fraud and the like.

The Absolutely Shameless Shill Emeritus, Leslie Appleton Young, let fly today with these two statements, in the same press release:
“I think we are just about, if not already at, the bottom.”
AND
“You’re dealing with buyers now who are waiting until the end of the market downturn. No one rings a bell at the bottom of the market.”

Huh? You don't see an contradiction between statement 1 and statement 2? Really??? Isn't this about the fourth time in four months that you have rung exactly the same bell?

I wonder if this lady decided to stay at Kaiser because her ARM reset?

http://sfist.com/2005/03/07/the_old_lady_who_lives_in_a_hospital.php

I don’t know if Randy has noticed it in Marin, but many of the apartment and rental home owners I know (even my parents the cheapest people in the world) have realized that spending $10K on a unit (granite counter tops and new stainless steel appliances) in an apartment will often bring in an extra $200 a month and spending $20K on a rental home will often bring in an extra $500 a month

Not really. There are some decent SFH rentals (I haven't looked at apartments or even condos/townhouses, given my situation), but most of those are accidental landlords who are expecting to rent short-term, due to whatever reasons (usually delusions).

The veteran landlords and amateur-but-equity-heavy alike seem to put as little into their places as is possible without inducing criminal negligence charges. What I don't get is how much some of these otherwise fine houses have been beaten down to a point where it would take hundreds of thousands in repairs (mostly neglected water damage) for homes which could sell for well over $1mm, even in pre-bubble prices. My only explanation is that they don't care and will just leave the problems (and prop 13 status) to their ungrateful, neo-liberal, trustafarian Marin children.

This is a big part of the "premium" to owning a _house_ (SFH) in a place like this. No matter what you try to rent, it is never on the same level of quality you'd expect or can find when compared to buying even a modest house in a modest neighborhood.

mayor mccheese (Honorable)

I'm willing to bet there were (2) sides to that story? I worked Shore Patrol for the Navy in both San Diego and Long Beach, CA and the job basically consisted of sorting out which homeless people still were the Navy's problem?

You got spit at, cursed, threatened, kicked, had your vehicle damaged, and at one time (I think I had a "hex" put on me?) If this individual threatened staff, was a danger to himself and others and normal channels were exhausted... what are they supposed to do?

I don't know about the "applied make-up before speeding off" comment (I wasn't there) but after a scuffle with a homeless/intoxicated person I would think it normal to at least make sure you don't have any cuts/bruises etc.

Housing experts predict that many would-be home buyers may be forced to rent for years because the relationship between rents and home prices are out of whack. Rents remained at around 5% of home prices throughout much of the postwar period, but beginning in 1996, home-price growth rapidly outpaced rent growth. By the end of 2006, home prices had more than doubled while average rent was up just 48%, driving down the annual rent/price ratio to 3.48%.

A study by one former and two current Federal Reserve economists suggests that home prices will have to fall by 15% over the next five years while rents increase by 4% a year to return that rent/price ratio to normal.

http://finance.yahoo.com/real-estate/article/104224/Home-Sellers-Pain-Is-Renters-Gain;_ylt=AmYIx1Z4QR4B2KdZyvFVPsi7YWsA

eburbed,

For a more skeptical view of Silicon Valley population growth, check out

http://www.viewfromsiliconvalley.com/id377.html

Note also the data that shows that the job participation ratio is declining and job counts are barely moving.

There are also other articles on this site that will debunk f(intentionally flawed and otherwise flawed) data from the local media, including the SJMN.

Money being dropped from helicopter:

Bush Calls for $145 Billion Economy Plan
Bush Calls for Economic Package Worth About $150 Billion

WASHINGTON (AP) -- President Bush on Friday called for about $145 billion worth of tax relief and other incentives to stimulate a sagging economy and fend off a possible recession. He said a growth package must include tax incentives for business investment and "direct and rapid" tax relief for individuals.

Bush said that to be effective, an economic stimulus package would need to roughly represent 1 percent of the gross domestic product -- the value of all U.S. goods and services and the best measure of the country's economic standing. White House advisers say that, in current terms, 1 percent would amount to around $145 billion, which is along the lines of what private economists say should be sufficient to help give the economy a short-term boost.

"Letting Americans keep more of their money should increase consumer spending," he said.

Bush said that Congress should work as soon as possible to send him legislation to "keep our economy growing and creating jobs."

The president and Congress are scrambling to take action as fears mount that a severe housing slump and painful credit crisis could cause people to close their wallets and businesses to put a lid on hiring, throwing the nation into its first recession since 2001.

"This growth package must be big enough to make a difference in an economy as large and dynamic as ours, which means it should be about 1 percent of GDP," Bush said. He said the package should be built on "broad-based tax relief" that will directly affect economic growth.

"should increase consumer spending"

How about Pay Down Consumer Debt?

Watching Cramer interview Trump last night was right out of the Twilight Zone. Trump calling for Bernanke to reduce by a FULL POINT and "take control of the situation by getting ahead of the learning curve". WTF?

I hope Housing Perma-Bulls are happy now? If reducing us to humiliated, debt-craving junkies was your goal (you've succeeded!) Oh btw, Yun is now saying it was Wall Street that "created" the subprime mess. "They gambled big, and lost".

One more bit on medical costs (should I start a medical cost blog?):

I was in the Netherlands this summer, and my son needed stitches out. I just have a high-deductible plan, so I was preparing myself to pay $200 or so, especially given the cost of the Euro.

Pleasant surprise: we just walked into a Dutch doctor's office, she removed them on the spot, and she charged about $20. I love Holland!

The NY Times had an interesting article a few months ago about how more than 50% of US health care dollars are consumed by insurance administration.

Patrick

Patrick,

Have you watched SICKO?

Medical is european countries are either free or low cost ....

I am a US citizen now (H1B ==> Green Card ==> Naturalized US Citizen).
If I have to do it all over again, I would choose an European country like France.

Well, they do have a very high tax rate. I have an American friend who married a Dutch woman and is now a resident. He was complaining that more than half his income goes to taxes.

On the other hand, medical care is good and cheap, and many other things are heavily subsidized.

Holland is very prosperous and clean, so their high tax rate seems to work for them without killing the economy.

I did not see Sicko, but I plan to.

Oh man. That tax rebate check again. I wish all these morons stop trying to "kick-start" the economy. I know they won't stop, but that doesn't stop me from wishing that they stop.

So now people are going to buy house with these $500 checks ? Or they avoid foreclosure by 2 more weeks ?

If you want to fix the problem, encourage saving and investing - not spending. I want to remain optimistic about future but when I look at the leadership across a broad spectrum and people around me, it's hard not to get pessimistic. Maybe we really need a f*cking depression to cure us.

I am surprised no one is talking about the $1600/$800 checks we should be looking forward to pretty soon.

Hopefully [sic] $1600 will still buy me an ounce of gold. :)

The NY Times had an interesting article a few months ago about how more than 50% of US health care dollars are consumed by insurance administration.

I propose taking away tax credit for employer-sponsored health plans. We need to throw insurance companies to the fury of Free Market.

"avoid foreclosure by 2 more weeks" LOL!

Yeah, that's kinda' what I was getting at. In truth though (and I'm in Contrarian Friday Mode) the admin. DID try to encourage savings. They greatly increased IRA contribution limits, rolled out HSA's and lowered tax rates on dividends.

Didn't work.

We'll borrow and spend thankyouverymuch.

DinOR :

You are quite correct. Since none of those measures worked, it's kind of easy to forget them. But let's give credit where its due. Those changes were favorable to investing. Now I think about it, they also made day-trading more difficult. Yes, too late for dot-com but will help going forward.

So what needs to happen for Americans to understand the benefits of saving/investing ? God, I hope the answer is not another depression.

In moderation. Trying again.

DinOR :

You are quite correct. Since none of those measures worked, it’s kind of easy to forget them. But let’s give credit where its due. Those changes were favorable to investing. Now I think about it, they also made day trading more difficult. Yes, too late for dot-com but will help going forward.

So what needs to happen for Americans to understand the benefits of saving/investing ? God, I hope the answer is not another depression.

CA Medical Association compiles a report every couple years on how much money HMOs spend on patient care v. administration v. profits. A summary can be found here:

http://www.cmanet.org/publicdoc.cfm/2/1/presssection2/368

The last report is for 2005... the top 5 HMOs in CA came out as follows:
Tax Status % Med Care % Admin % Profit
Blue Cross ForProfit 78.9 11 10
Blue Shield NonProfit 83.4 11.3 5.2
HealthNet ForProfit 85.7 9.7 4.5
Kaiser NonProfit 93 3.6 3.3
PacifiCare ForProfit 86.1 8.9 4.9

You can watch Sicko for free, Moore put it on YouTube.

I wish I'd had the balls to take off for France when I was an early 20-something, easier to learn the language when you're young and they want either young bodies or older but well-educated/rich bodies, and the Empire has not provided the opportunities to become the second case, so I'd have been very smart to split the US and go there when young, at least all the hard physical jobs I'd done in the US would have been done there and with France's greater social mobility, I'd have gotten a degree, and done well.

Now, USA is like old USSR - only worse, old USSR had free medical, free education, you could rise up according to ability not race/class status.

Notice that except for those making up bubble-gum jingles or doing crappy commercial art, once an artist or musician makes it in the US they split for Europe.

you could rise up according to ability not race/class status

Oh really?

The history of all hitherto existing society is the history of class struggles.

We will always have people exploiting people, or the other way around.

To clarify re: Europe's health care, yes it's cheaper than the US, and yes the quality is very high. The problem is access. Not enough doctors makes for long waiting times for anything more than routine visits. This is the direct result of socialized medicine. Lower pay for physicians there means there are fewer MDs there, and in fact many of the good ones come to the US to practice.

The problem is access.

There is no free lunch. No matter how we manipulate the market, the level of resource remains.

Besides, even when health care is perfect, what is there to regulate population growth?

Market-driven health care coupled with catastrophe insurance is the most efficient and most sensible solution.

Lower pay for physicians there means there are fewer MDs there, and in fact many of the good ones come to the US to practice.

Honestly I think good doctors here are not paid enough.

Who would want to go through med school when they can hash up a virtual world and call it Web 2.0?

I had been enjoying a steady *decrease* in my rent for several years, but just recently, it increased 15%. Looking at the comps for my area, rents have definitely risen sharply in the Tri-Valley area. No idea why. We're not exactly experiencing a dot.com revolution out here (no new jobs, except for the new retail shops popping up). Like Patrick, my rent is back to where it was about 6 years ago.

StuckInBA,

Thanks for the considerate response. (Usually when I bring that up in conversation it either gets quickly dismissed or the "let them eat cake" type responses). As part of my ongoing and unending agenda I'll further my pet theory by saying MID/CGE is SO... seductive even ppl that are normally disciplined savers were... d-r-a-w-n to the music.

(Come with me, and witness the magic!)

Do-do-do-do-do

do-do-do-do-do-do-do

You are now under my POWER!

You will do as ONLY "I" command!

"Yes... mast___er"

Impale yourself upon that HELOC!

"Yes... mast___er"

You cheap renters ! When your fellow countrymen are seeing the home values drop by 10K every month, you are complaining about an increase of $100 ? A mere $100 ? Shame on you.

Since we are on a heatlthcare tangent, anybody want to comment on Sutter Health? Looks like my doctor, formerly part of Alta Bates Medical Group, threw in the towel and joined up with Sutter East Bay Medical Foundation (which has been dubbed Kaiser Lite by the press). Some doctors fear that they will lose their autonomy under their auspices. I know they have had success in the South Bay with the Palo Alto Medical Foundation. Anybody have comments? Interesting to see how market is "reforming" itself... The nonprofit Sutter-owned foundation will essentially run the business operations for the physicians in the medical group, which will operate as a for-profit entity. The foundation will negotiate with health plans, employ support staff and handle billing and other business functions, allowing doctors to concentrate on patient care, Alison said.

Servants! I command you leave my tent now...

(My "subject" and I wish some time... a-l-o-n-e)

Well...?

Be GONE you fools!

PermaRenter Says:

> Patrick, Have you watched SICKO?
> Medical is European countries are
> either free or low cost ….

What Michael Moore does not mention in the movie is that things that work in Europe will only work in places that are similar to Europe.

If they started full government run medical care like Holland and gave every man an assault rifle and hand gun like Switzerland in my neighborhood (Presidio Heights where most people work and are healthy and law abiding) everything would be fine.

If they tried to have full government health care and give every man a couple guns in Hunters Point (where most people don’t work and are not healthy or law abiding) it would be a complete disaster (but not as bad as if they tried the European model with health care and guns for everyone somewhere like Darfur)…

$100 goes a long way to support my sushi habit. ;-) No worries. I'm sure someone will bail me out.

EBGuy,
I have no complaints about Sutter around here (PAMF, as you mention). They are growing pretty rapidly, and as a result I feel they are diluting their pool of previously top notch MDs across the board. Some of their more recent "acquisitions" have included docs I have been less impressed with.

RE: the Shrub's "stimulus" package, can you believe the point of this all is to get "us consumers" to go out and spend it on crap? No, it's not to pay down credit card debt, pay one more month of a neg-am mortgage, or even a car loan payment. It's so we go out to a box store and buy more useless plastic crap to keep this sham of a "consumer-based" economy going.

To use a medical analogy (while we're still on that tangent), it's time to stop feeding the cancerous growth. It's time to "bite the bullet" and cut the darn thing off, for god's sake. And doing it with no anesthesia would be preferable, IMO...

FAB makes a very good point. Ethnically coherent European neighborhoods have very low crime, but introduce a bunch of different groups, some with no history of civilization, all rivals, and you'll get a bloodbath.

It's not politically correct to talk about this, but the best way to cure the problems in Hunters Point would be to fence it off, and drop in tons of guns and ammo. Give them 6 months. You might get 5 people left lol.

What if they break through the fence with the weapons?

We must instigate a market in which the right people breed more than the wrong people.

BTW, I believe Europe is falling apart because no welfare state can sustain without a massive cache of natural resources (God's gift).

things that work in Europe will only work in places that are similar to Europe.

Isn't England doing a triage of sorts for acces to the National Health Service? I heard they will start denying treatment to smokers, for instance. If one has to ration, denying specific treatments for diseases people bring on themselves seems fair.