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rj_oregon's comments:
on Water: From the Bottle or the Tap?
Is this kind of like buying carbon offsets?
posted 3 years, 2 months ago
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on Water: From the Bottle or the Tap?
rain water catchment - excellent. "Ownership," as you ask, depends on state or local law. As an earlier post mentioned, Colorado state might have limits on rainwater collection. I heard a radio program maybe a year or two ago talk about this, in some arid regions (or perhaps on arid western federal rangeland) you may need a permit to collect water. The irony was that cattle ranchers were collecting water into cisterns, then using it later to water their liverstock. They ran afoul of regulations and had to appeal their case, as I recall.It might have been Colorado, or Arizona / Nevada.
This was a fringe case in an arid region. In most states, older rainwater catchments were "grandfathered in" when regulations took effect. Western Oregon, I'd think it's unlikely that it is regulated but local building codes might dictate some constraints (keyword: cistern). So build yours now, in case Oregon tightens the rules.
If you can afford it, it's possible to install a large cistern tank underground to collect rainwater. A sturdy, fiberglass 5,000 gallon tank and fittings can cost on the order of $10,000 or double that. There is also excavation cost, gravel to back-fill around the tank, overflow drainage, possibly pumping to get it out, and access hatch to clean it out. And you really can't use that water for drinking without extensive extra $$ for systems and maintenance. I've heard people suggest using concrete septic vaults as cisterns, but the fittings to make a large tank out of multiple units will be prone to leak.
If a catchment system is independent from other indoor plumbing, it is useful for outdoor spigots, and toilet flushing. Water in a cistern can get dirty and build up a bit of coloration and sediment: dust on the roof is washed down, as is organic (plant) matter and bird poop.
posted 3 years, 2 months ago
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on Water: From the Bottle or the Tap?
Google "rust bacteria" or "iron bacteria"
Actually there are several causes of color in the water. You could see a flush of sediment in the lines; this is more likely to appear briefly and then go away. There are two other possible causes. Rust in galvanized pipes is one, the other is "rust bacteria." The latter is actually not rust, it is a deposit in the pipe laid down by a bacteria that builds up in wells and the delivery system pipes. ("These microorganisms combine dissolved iron or manganese with oxygen and use it to form rust-colored deposits.")
I have seen galvanized 1/2-inch pipes completely closed off by rust-bacteria deposits. This was in a rural farmhouse served by well water, out of state. Some areas are probably more prone to this infestation than others; in some areas virtually all wells will have this trouble.
posted 3 years, 2 months ago
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on RX: Health Care Costs
frankj,
Yes, let's hold some facts up to scrutiny (by the way, where did you find yours?) For a link to AMA report cards on payments, try looking at:
http://www.ama-assn.org/ama1/pub/upload/mm/368/reportcard-short.pdf
Look at it, then look up "claim adjustment reason codes" and you'll be able to decipher the most-used CARC code cited as the reason claims were rejected. Top reasons:
- For Medicare it was (CARC reason #16) the claim needs additional information (28.7% of rejections in 2008).
- For United Health Care was (CARC #27): Expenses incurred after coverage terminated (37.9% of the rejections)
- For Humanna it was CARC #27 also, 34.2% of rejections
- For Anthem BCBS was CARC #16, claim needs information (20.1%)
- For Coventry it was CARC #26, Expense incurred prior to coverage (occurred for 53.6% of rejections, wow)
- and so on
Now, you said, "I dont think people understand that health insurance is like car insurance if you want more covered you pay more it doesnt cover everything so... I would sugest that people who want pulic heath care get some more facts I have yet to hear a fact that actually hold up to any scrutiny."
Buying individual coverage outside of a group plan is not like buying car insurance. I'd suggest you consider the fact that health insurance companies deny the ability of us to buy coverage every day. They also exercise a right of recision: to deny coverage after you have been paying premiums for years (and they keep your money). Buying health insurance requires you to grovel and beg, knowing that any wrong answer on your 10-page application will result in rejection: doesn't happen as much in group policy underwriting, but happens all the time in the individual insurance market.
posted 3 years, 2 months ago
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on RX: Health Care Costs
frankj:
You raise the point that Medicare denies a larger number of claims ("last year 8.75%" in your message, 6.85% AMA report card for 2008) than private insurance. I'd point out that private insurers reject people from even getting coverage in the first place... But.
For insight into this, try a google search on:
denial rate of private health insurance claims
What I see at Health Care Economist seems, at first glance, to support your point. But read the comments posted to the article "medicare more likely to deny claims than commercial insurers." In the comments, Don McCanne MD notes,
"The implication that Medicare is not providing efficient claims processing is misleading. The 14 day delay is required by law. It has served as a budgeting gimmick to move two weeks of Medicare payments into the next fiscal year. (This is a criticism of governmental budgeting processes, but not of the administration of Medicare. The private sector uses similar measures such as shifting the completion and recording of sales between quarters to embellish their financial statements.)
"If you look at the AMA report cards, you’ll see that most claims denied by Medicare were due to billing errors (inadequate data on billing forms, wrong carrier, not enrolled in program, etc.). Also, some denials are for non-covered services such as routine physical exams. Medicare has been more effective in requiring compliance with the program, which is entirely appropriate considering that these are our taxpayer dollars that they are spending.
"In contrast, the relaxation of compliance standards by the private health plans has wasted funds that we have paid in as premiums. Charging us higher premiums so that they can pay dubious claims does not represent private sector efficiency. We are paying the private plans far more in administrative costs than we do for Medicare, yet they [private plans] are not providing the claims processing efficiency that we deserve. As an example, Medicare pays the contracted rate 98% of the time, whereas the private insurers do so only 66% to 84% of the time. The fact that they can’t get right the rates that they contracted for demonstrates the profound incompetence of the private insurance industry."
----------------------
posted 3 years, 2 months ago
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on RX: Health Care Costs
A re-posting, but think on it: the four necessary criteria for Healthcare:
+ Security
+ Justice
+ Freedom
+ Efficiency
I heard this years ago, from a leader at Harvard Med School and former head of the AMA, and again on radio, I think it was Marketplace 11/25/2008
posted 3 years, 2 months ago
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on Rx: Personal Values
A late posting, but think on it: the four necessary criteria for Healthcare:
+ Security
+ Justice
+ Freedom
+ Efficiency
I heard this years ago, from a leader at Harvard Med School and former head of the AMA, and again on radio, I think it was Marketplace 11/25/2008
posted 3 years, 2 months ago
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on Rx: Responding to Obama
mikejb:
Just to be clear, the recision you speak of is where the insurance company issues you a policy, but on later review, if they find a small error of any kind in your original application they will kick you off the policy and deny you coverage. (And once you are denied coverage, no other company will cover you either if you are applying as an individual - they check.) This doesn't happen because you made large claims. They can do it on a regular review of any policy, any time, for the smallest of reasons. If you didn't perfectly understand all the questions on the application form, if you don't have a perfect knowledge of all your medical history and reveal it on that application, if you just messed something up, or your doctor's office messed something up, you are outta here. And they keep the premiums that you paid in over those years. They call it "reducing costs."
posted 3 years, 2 months ago
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on Rx: Responding to Obama
Kind of late to reply, but for a longer look at what other countries are doing, read T.R. Reid's 2009 book, "The Healing of America," where he describes the systems (pros and cons): France, Germany, Japan, U.K, Canada, South Korea, Switzerland, and the U.S.
posted 3 years, 2 months ago
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on RX: Health Care Costs
emilatt:
During the president's February all-day health care reform summit, I think the figure discussed was that tort reform--- i.e. eliminating all the cost of medical malpractice insurance---would result in a 2% change in the total "health care economy." So, as a practitioner, I can sympathize that your malpractice insurance is a meaningful part of the cost of doing business, and the benefit of less agressive testing might lower some costs. But in the big picture, the systemic problems are much deeper than the cost of extra tests, frivolous lawsuits and malpractice insurance.
I tend to think the notion that "extra tests" and malpractice insurance are not the problem that has driven my premiums up 77% in 4 years; I think that's a red herring being distributed to take our attention from more substantive issues. Like: why would a ten-cent asprin cost $10 when administered at a hospital, or why do U.S. patients pay double the price for prescription medications that are sold for less elsewhere (the exact same pill from the exact same factory). As the legislator said, just say, "anti trust."
posted 3 years, 2 months ago
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on RX: Health Care Costs
I'm re-listening to the show. The Regence Blue Cross representative, when talking to caller Kathlene, claims that two years ago, Regence policyholders experienced a decrease in premiums. Kathlene said she didn't get a decrease that year. I did not, I got an increase that year as I have every year since 2006 when I joined OMIP (administered by regence Blue Cross of Oregon). Mr. Short, will you post a reply on this website to tell us, in the year you claim RBC issued lower premiums:
1) how many policyholders got that premium decrease?
2) In that year overall, how many got an increase, how many stayed the same, and how many got the decrease?
3) What was the mean and mediam dollar amount or percentage increase/decrease?
My guess: his reply will show that a very, very small number of people got a decrease, and it was probably for a group (employer) policy that had major bargaining power. So, Kathlene's question stands: who represents the little guy in gaining pricing leverage in the individual market? No-one. And that is why the individual is getting gouged first in this mess. If I'm wrong, appologies in advance to Mr. Short and I'll eat my words.
posted 3 years, 2 months ago
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on RX: Health Care Costs
Agree. The system as it stands today is obscene and immoral. I'd rather see the single-payer govt system. Or force the industry to make a fixed rate of return.
It seems time to decide which is more important: the people, the citizens of this country, or corporate entities. Since the Supreme Court ruled (this year) that corporate money can flow unchecked to finance political races, even from overseas, you will see corporate lobbying like never before. If the health industry is not nipped in the bud this year, health reform will never happen, ever.
But talking heads on major media have been on a rant that essentailly says non-profit healthcare is somehow, un-American, anti-capitalist. The U.S has the highest incidence of people who declare bancruptcy because they had to put their life savings, their house, everything they had into paying for a catastrophic medical event. Highest rate! Is this a part of capitalism that we want to cherrish to the grave? How many people die a year because they have no health coverage? How many mentally ill are there who go without treatment?
Single-payer does not preclude having a viable, for-profit insurance industry. In Switzerland, I think, and several other countries, the govt provides single-payer healthcare for all, but the insurance industry is not dead. They still have for-profit insurers picking up the holes in the government plan, i.e. to provide elective surgery, or procedures not covered by the govt plan like cosmetic surgery.
posted 3 years, 2 months ago
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on RX: Health Care Costs
trurl9: BMI should not be used to deny you from getting health insurance. If you have were denied coverage by the major health insurers, do look into OMIP, it should provide you with better than catastrophic coverage.
Rather than counting the 2700 pages, try downloading and reading this 11-page document:
http://www.whitehouse.gov/sites/default/files/summary-presidents-proposal.pdf
The reason it takes a 2700 page bill to paper up all the holes in "the system" is that it will take a lot to "un-do" the last 50 years of lawyering, lobbying and legislating that has created one of the most expensive systems with "15-th worse" or so health outcomes. Just read the 11 page proposal, please. And since you bring up that label "Obamacare" keep in mind that more than a few of the ideas were from the republican side, a list of those republican ideas can be found here:
http://www.whitehouse.gov/health-care-meeting/republican-ideas
posted 3 years, 2 months ago
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on RX: Health Care Costs
Thanks, thelundreport.org is an excellent website, I had not seen it before. And signing up for email updates is free.
posted 3 years, 2 months ago
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on RX: Health Care Costs
I agree, tying health insurance to work is a huge failing of the current market. That has to change. I lost CIGNA as an insurer because, although they write group policies in Oregon, they refused to write an individual policy in the state of Oregon. This illustrates how companies get away with cherry-picking clients state-by-state, where they should be forced to provide uniform services across all states in which they operate, or just nationally, period.
Speaking as someone who paid through COBRA for 18 months, I can say it was not a nightmare, and had very little paperwork. I don't know what was specific to your situation that led you to turn away from COBRA, but you passed up the only opportunity to extend the healthcare your employer provided.
I'm not saying it was cheap either, but I think I paid a little more than what my employer did.
What some people don't realize (because I hear it mis-stated often) is that COBRA is not a long-term or lifetime solution, it is an 18-month bridge betweeen jobs. You can only buy insurance through COBRA for 18 months! After that, you are out in the (cold) private insurance market, solo, or you have to find another job with health benefits. Due to your ages we both know that it is almost impossible to get insurance at all due to preexisting conditions that we all have at that age.
The crime is that the insurance industry gets away with insuring only healthy-young or no-risk people in the private market. At 10% unemployment (really 20%), they get to dump a large chunk of the population by the wayside. It's immoral.
posted 3 years, 2 months ago
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on RX: Health Care Costs
The basic concept is that if everyone is in the insurance pool, costs are spread over the largest possible population and net cost is lowest. That assumes no corruption driving up prices...
A few years back I heard a statistic (maybe head of public health policy at Harvard Med School or some such authority). He said 30%+ of the cost of providing health care in the U.S. is administrative cost, including rooms of people who review every claim and try to figure out how to deny claims of the insured. Let's review. We are paying 30%+ of our insurance dollar to people whose job it is to deny us coverage... to find a loophole that will reduce claims paid and thus control "loss" (increase profit).
That is why the reform elements of a healthcare bill are essential, and why it must be done across the board, not by regional markets or one state at a time. If insurance companies are forced by law (federal law, not different laws in each of 50 states) to cover preexisting condtitions, accept all customers, and pay claims, the screening cost will be reduced or eliminated. This is what has been found in many industrialized nations with better healthcare than the U.S. and administrative cost should be brought down, to a few percent. (See T.R. Reid's book "Healing America" for a comparison of worldwide health systems). That is a piece of the savings that should go hand-in-hand with reduced premiums, wider coverage, better coverage, lower out-of-pocket expenses.
(Actually, cutting administrative costs means some folks may loose their jobs. But at least they'll be able to get health insurance.)
posted 3 years, 2 months ago
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on RX: Health Care Costs
Cancel for 2 months? 50% of you would not get back on insurance after the 2 months is up, because the company woudl review your chart and find you have preexisting conditions.
posted 3 years, 2 months ago
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on RX: Health Care Costs
I have experienced double-digit healthcare premium increases since
entering the individual insurance market in 2005-2006. (I share my
insurance premims later in a posting above.) I think the president's
11-page health plan advanced Feb 22 2010 is going to be the best
compromise, and I want to see it passed. The only way to run a
sane health insurance scheme is to have everyone in the insurance
pool. That is insurance-econ-101. If you want to see how it's
done in the rest of the world, read T.R. Reid's book from 2009,
"Healing America." It's very clear that the US could pick the best
features used in other developed countries. There is even room for
insurance companies to make a profit.
Afer a career in high-tech, around the time I took time off to spend time with my dying father I decided to leave my Intel position. During that
time, I transitioned from my high-tech employer's plan to COBRA.
As the end of the COBRA 18-month interval approached, I asked the
insurance provider, CIGNA, what it would take to continue coverage:
sorry, although CIGNA was writing group policies for Intel in the
state of Oregon, they would not write an individual policy, period.
Near the end of my COBRA period, I had a small health complaint,
but did not schedule follow-up checks soon enough. Because this appeared
on my chart and was an unresolved question, two insurers (Regence
Blue Cross and ODS Health Insurance) flat-out refused to write me
a policy. So I was denied due to what is essentially what "could
be a preexisting condition maybe," just on the chance that it could be
something worse. Left with this choice, I discovered Oregon ran a plan
for persons who had been refused insurance
(note this is distinct and separate from the Oregon Health Plan
(OHP) for low-income individuals, where I am not qualified to enroll
due to inheritance from my dad)
I'm lucky to have a high income, but I still could not get health insurance
at all were it not for the state program.
If I have to move out of state due to my other parent being sick,
what will be my insurance options then, after being denied?
Being middle-aged and in the individual insurance
market is between a rock and a hard place.
And I thank State of Oregon for OMIP.
posted 3 years, 2 months ago
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on RX: Health Care Costs
My cost of insurance, with a decline in quality of coverage from
the group policy plan:
2005 to mid-2006, CIGNA, under COBRA:
medical $317.75/mo, dental $34.96/mo
Preferred provider plan, $20 copays, dental and vision coverage.
This was the same plan I had as an Intel employee.
After COBRA, in the Oregon insurance pool:
mid-2006 , OMIP "Portability-750" plan
This plan has $750 annual deductible, no dental or vision,
maximum out-of pocket is $3000 annual in-network, $6000 out,
co-pay for most things is 20% in-network, 40% out of network.
Lifetime benefit: $2 million. Premiums are:
Age 45-49: $333/mo. Age 50-54 $411, Age 55-59 $420, Age 60-64 $422
Now the price increases.
By 2008 I was paying $415/mo for the same OMIP plan.
(Keep in mind in 2007 I turned 50, so there is an increase in premium
because I bumped into the next higher age bracket.)
As of January 2010, my premium was raised to $588/mo, same plan.
So from 2006, the policy for a 50-54 year old went from $411 to $588,
a 43% increase over 4 years. My actual costs went from $333 to $588,
a 77% increase in real cost that I pay.
The OMIP plan is administereed by, who? Regence Blue Cross, the
same folks who turned me down; I find that ironic.
I'd like to point out also that the OMIP Portability-1500 plan, though
at cheaper rates, is kind of scary in the case of a catastrophic
event. The co-pays go up to 30%/50% for in/out-of-network, and
maximum out-of-pocket doubles from the other policy. But the
premiums are not half, they are $248/mo vs. $333, so about a 25%
decrease in premium but a 50% change in out-of-pocket. Just the
thing if I was 25 and didn't care, but not the ideal thing in my
50's. I think once you sign up for Portability-1500, you can't
bump up to the Portability-750 plan, but I'd have to double-check
that.
For those of you who don't want to have "governemnt tell you to buy
insurance," do you drive a car? Then you have auto insurance, don't
you? There is a reason people "have" to buy auto insurance: it
puts all drivers in the pool. Understand?
posted 3 years, 2 months ago
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on An Internet Speed Limit?
"A Broadband Utopia," Steven Cherry. IEEE Spectrum magazine, May 2006.
"A municipally owned network in Utah is poised to offer 100 megabits per second?and that's just to start... As it turns out, this Utopia, known formally as the Utah Telecommunication Open Infrastructure Agency, promises to be just that, a broadband utopia. And it is very much a real place, encompassing 14 cities in northeastern Utah. It delivers to each of its 3000 subscribers high-speed Internet access, telephony, and television programming through a fiber-optic cable at data rates that now reach 30 megabits per second. Soon, service providers there will be offering speeds of 50 and even 100 Mb/s. That's enough to download a 2-hour movie in about 6 minutes, 10 to 20 times as fast as the typical U.S. cable or digital subscriber line connection, 6 times as fast as Verizon Communications Inc.'s much-publicized fiber-to-the-home service (called FiOS) and twice as fast as the new DSL now being introduced in Europe by France Telecom and others."
The article describes the legal and business roadblocks as well as the technical aspects of the system. Guess which part was hardest?!
This may be available to IEEE members only, but try either
http://spectrum.ieee.org/may06/3434
or the online version of specturm at:
http://staging.spectrum.odaly.com/may06/3434
or your public library and the engineering libraries at state colleges will carry IEEE publications.
posted 5 years, 1 month ago
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