cookingmyserver
Joined 6 years ago
Joined 6 years ago
Same goes for any business venture including private equity. No more corporate veil. Every dollar or stake in ownership needs to be attributable back to an individual that can be held financially responsible. Each individual can have some amount of assets protected from claw backs, liens, judgements, etc. Enough to cover a functional used vehicle, 3 bed two bath house in their zip code, 50k in cash, and their retirement account. This gives most normal people the freedom to invest with less worry. Still, if you want to make money, it will behoove you to not take on risk by investing in organizations that flout the law, cause environmental damage, or harm others.
Your mother and woman example is perfect! It would not be appropriate to most people to change the definition of woman to a female that had or has an offspring. You are taking a definition that describes an attribute of the subject (gender) and throwing in criteria that is based on a relationship. That makes no sense!
If it is important for you to make a distinction on whether an astronomical body has cleared its neighborhood then you can create a new word or compound word.
The IAU...resolves that planets and other bodies, except satellites, in the Solar System be defined into three distinct categories in the following way:
(1) A planet [1] is a celestial body that (a) is in orbit around the Sun, (b) has sufficient mass for its self-gravity to overcome rigid body forces so that it assumes a hydrostatic equilibrium (nearly round) shape, and (c) has cleared the neighbourhood around its orbit.
(2) A "dwarf planet" is a celestial body that (a) is in orbit around the Sun, (b) has sufficient mass for its self-gravity to overcome rigid body forces so that it assumes a hydrostatic equilibrium (nearly round) shape [2], (c) has not cleared the neighbourhood around its orbit, and (d) is not a satellite.
(3) All other objects [3], except satellites, orbiting the Sun shall be referred to collectively as "Small Solar System Bodies".
The definition here only applies to bodies in the Solar System.
Still a bad definition IMO. According to the definition if a catastrophic event were to occur that cluttered the neighborhood of a planet it would cease to be a planet until it was cleaned up. The definition of a planet should be based in the physical attributes of the celestial body itself, not in its role or relationship with other bodies. I'm a bit of an extremist on this front. Even our Moon would be a planet in my opinion. Seems silly when you think about our barren moon but there are for sure habitable moons out there. I can't imagine asking an alien "What planet are you from?" and them responding "erm, actually we are from a moon/planetary satellite".
Bill forgiveness doesn't necessarily target the for-profit hospitals. Not talking about debt discharge. It actually probably isn't even the right term. Essentially what shouldn't be allowed is non-profit hospitals counting discounts for low-income individuals as charity performed by hospital. The value of the charity shouldn't be sticker price but actual cost of services. Maybe that is already the case, but what I hear from randoms suggest that is why some hospitals are happy to "work" with you on your bill. I shouldn't have included "tax-deductible" in there, this is more about maintaining non-profit status.
RE ER. I don't see how keeping the ER and Urgent Care separate matters. In a combined system you would still have two sets of doctors, two sets of CAT scan machines and operators and radiologists, okay maybe not separate but the capacity for both (an appropriately reserved). In the current system you actually have more overhead from having a whole separate billing system, HR, building, landscaping, etc. Yes, the ER still needs to stabilize a patient whether they can pay or not but that becomes *cheaper* when you have a whole other pipeline to send them to. You aren't engaging a highly paid ER doctor and set of ER nurses to prescribe antibiotics to the homeless person that just came in. You can have the RN, or an internal medicine doctor do it instead in the area down the hall. If at any point that homeless person starts to code or the RN/Internal Med doc identifies something concerning, they can get them over to the ER. But again, if you are the hospital why would you do this? You can take in that homeless patient and charge them big money for some antibiotics and hopefully get reimbursed by the government. It's not like the hospital would even lose money on it, you would still charge for the urgent care services, just at the reduced reasonable price it takes to provide them plus a little more. Heck, I'm sure that an urgent care wing incorporated into an ER would beat any standalone urgent care in the business sense, you've generally got a whole waiting room full of prospective customers.. but alas.. you would cannibalize your ER "sales".
And if that cannibalization of ER sales would leave the ER unprofitable, then raise your prices! I don't think any reasonable person would be mad if you charged what it actually costs to provide lifesaving care. Insurance companies would be okay with paying real costs for the fewer cases of legitimate emergencies if they know that the much more common cases of people going to the ER for more minor things would be much cheaper. I would posit that with urgent care support you would need less ER capacity as you wouldn't have it filled up with non-emergent cases.
And yeah, it would be ideal to have them in the same building close together. Retrofitting would be hard or impossible. It would mostly be for new hospitals going forward. It all boils down to designing hospitals to be the most efficient as possible at providing care to patients, not efficiency on generating the most profits.
Theoretically because you are not the sole provider offering that service and the patient could go elsewhere, or in this case, the insurance company would require the patient to go elsewhere. Obviously, this sucks absolute donkey balls and health care will always involve a healthy dose of "I can't just shop around for where to get help for a heart attack".
In my naive opinion banning discriminatory pricing (no special negotiated insurance pricing), the sale of medical debt, and counting bill forgiveness as tax deductible charity would be a good start. With the absolute technical and capital-intensive marvel that is modern health care I just don't see anyone being able to reasonably get away with no insurance. Maybe there is a mandated co-insurance for all plans that could be covered by HSA accounts that everyone would get access to. That way there is a cost that is transparent to the patient that scales. At that point though I would just go to single payer.
(Rant incoming) Another thing that might need to happen is billing caps based off of certain outcomes. Especially in the emergency medicine realm. If you go to the emergency room and rack up a huge bill for something simple there should be a cap on the amount the hospital can actually recover. All I see is (rightfully) constant bitching and moaning from ER staff that people should be going to primary care or urgent care for issues which are less resource intensive and cheaper. The issue is the ER could provide those same services for just as cheap. Build out those same capabilities in or near the ER. The triage nurse can then send those low priority patients to the facility right down the hall. The issue is hospital admins have no incentive to do that, because as you said, why bill $200 when you can bill a minimum of $2,000 when you have your patient captive.
I also think it is silly we ask people to self-triage. It externalizes a lot of the costs to other parts of society. I can attest to this from the constant Volunteer Fire Department air-raid sirens I hear followed by a "EMS to Well Now Urgent Care for Patient in Distress". I'm sure the volleys love having their evening interrupted when it could have been a simple walk down an aisle.
Fuzzy isn't even the best word to use though. It's not fuzzy but lacking detail while at the same time my brain isn't comprehending that it is lacking detail. It is almost as if my brain can only focus on a few aspects of the picture at once with the most striking characteristics being rendered while the other parts are inferred or filled in with the most perfect placeholder - something that perfectly represents the idea of what is missing, but which it is not.
None of my other senses suffer from this. I can smell pumpkin pie or treated lumber on command. I can conjure music in my head all day (and often do without trying). I can metalize the feeling of cold or warmth. I too can taste spaghetti and meatballs. When I read that my mind immediately went to those cheap pre-made meatballs in the frozen section, my teeth cutting through those dense almost hard meatballs that are somehow so bland yet over spiced.
I also wonder how much of our differences are often our inability to communicate our experiences in a sufficient manner.