Show off your favorite abandoned-garbage-riverside-homeless-camps of 2022!

[SurfnFish]

Sorry to sidetrack… how can the medical field charge different rates for services for different people. Seems wrong to me.

Every hospital/hospital chain directly negotiates reimbursement for hospital services and procedures with insurance companies, there is no standard across the board reimbursement, and even Medicare reimbursement rates can differ based on location, hospital services, etc. When I worked for a teaching hospital, we received higher reimbursements than non-teaching hospitals because we were training doctors.

I think I heard medicare reimbursement rates have hardly changed in 20 years. I assure you that patients are generally more complicated and more sick then even 5 years AGO thus more expensive. That isn't even looking at the cost of staff increasing, the issues of the strain covid put on the system and so on and so on.

It's like the same people that come at us if a patient is discharged too quickly or into an unsafe situation are the same people not willing to pay for a longer stay...

you're right, they have changed very little, whch is why many doctors will not even see MediCare patients any longer. Conversely, carrying a Medigap F plan in addition to MediCare will get you that appt and open up a larger range of services. My wife is an insurance guru, and the F plan through AARP is excellent, costs $180 a month per.

Another metric used for evaluating patient safety/outcomes is the 'stay days' associated with procedures. And many for-profit hospitals have been sued for putting pressure on physcians and discharge planners to discharge those with 'flat rate' MediCare sooner than those with top tier private insurance that they can continue to bill.

Lot has been said about 'socialized medicine', with many thinking it's akin to a commie/socialist boondoogle. Wrong. Socialized medicine is no more than a capitated, single payor heath care system, and a handful of states have adopted it.
Kaiser was the first successful capitated health model, developed during WW2 to provide insurance for the workers building Liberty ships at the Oakland docks.
How capitated health care works, using Kaiser (a former client) as an example.
The total cost of doctors, staff, admin, facilities, equpment, depreciation, etc = X
The size of the contracted patient base =Y
X divided by Y = Z, the per patient cost to provide comprehensive services (Kaiser and all health insurance companies continually upgrade the demographic algorithms that project how many patients in the coverage groups will need emergency room visits, heart surgery, cancer care, routine care, etc) with an add for general overhead and contingencies.
The corporation that selects Kaiser pays the premiums, the patient pays reasonable co-pays based on sevice, Kaiser renders services, the patient doesn't get driven underwater by huge bills .
Does it offer the absolute top tier, go across the country to see the best surgeon for your issue possible? Nope.
Is it the most cost efficient way to deliver comprehensive health care services to a large patient base? Yep.
Is it like all other insurance plans, where the more you know how to manage the system the better the outcome? Yep.

Capitated Model | CMS

SPOTLIGHT & RELEASES Under the capitated model, the Centers for Medicare & Medicaid Services (CMS), a state, and a health plan enter into a three-way contract to provide comprehensive, coordinated care. In the capitated model, CMS and the state will pay each health plan a prospective...

www.cms.gov

 

[Coach Potter]

.

This may be an unpopular opinion but I encourage folks to look at what organizations spend on this issue. Even non profits. That's a tax status, not a business plan. I'm not going to name names but you can start with the city of Seattle. There is a homeless industrial complex. It's a ranch of sorrow and certain organisations are feeding at the trough. Now I agree that if you are working in this arena it's a hard job and you deserve to make a living. However, of the river of money flowing through the complex what amount actually gets to the business end of help? It's a fair question. There is little oversight and accountability especially at the government sector. Have a gander at some of the line items and you'll probably begin to see that this is a ranching business. Where there is crisis someone will always make money. The nicest buildings in my town are some sort of social service or addiction service. This is a problem where the "solutions" are the product as much as the "problem".

And before anyone thinks I'm some skeptical heartless cynic know this. I have taken homeless into my home. It was not easy and I was far from flush at the time. I wonder how many ultra compassionate sorts are willing or have done the same. I don't believe this is a problem you throw money at and it gets better. The Seattle and Portland data indicate the opposite. Now correlation isn't causation but one cannot ignore they are often related. I surmise if we did nothing. Literally nothing the problem would shrink rather than grow as it has with the added fuel of millions of dollars. Most of which not reaching the intended destination. I don't write this to be offensive or combative. I write this as an invitation to actually pull some financial docs and attempt to understand the flow of monetary resources in a ranch that needs cattle to function.

In the end the best gift you can give is the efficacy to help oneself. And that gift should be paid forward. You will not stop the suffering while perpetuating it.

Every hospital/hospital chain directly negotiates reimbursement for hospital services and procedures with insurance companies, there is no standard across the board reimbursement, and even Medicare reimbursement rates can differ based on location, hospital services, etc. When I worked for a teaching hospital, we received higher reimbursements than non-teaching hospitals because we were training doctors.

you're right, they have changed very little, whch is why many doctors will not even see MediCare patients any longer. Conversely, carrying a Medigap F plan in addition to MediCare will get you that appt and open up a larger range of services. My wife is an insurance guru, and the F plan through AARP is excellent, costs $180 a month per.

Another metric used for evaluating patient safety/outcomes is the 'stay days' associated with procedures. And many for-profit hospitals have been sued for putting pressure on physcians and discharge planners to discharge those with 'flat rate' MediCare sooner than those with top tier private insurance that they can continue to bill.

Lot has been said about 'socialized medicine', with many thinking it's akin to a commie/socialist boondoogle. Wrong. Socialized medicine is no more than a capitated, single payor heath care system, and a handful of states have adopted it.
Kaiser was the first successful capitated health model, developed during WW2 to provide insurance for the workers building Liberty ships at the Oakland docks.
How capitated health care works, using Kaiser (a former client) as an example.
The total cost of doctors, staff, admin, facilities, equpment, depreciation, etc = X
The size of the contracted patient base =Y
X divided by Y = Z, the per patient cost to provide comprehensive services (Kaiser and all health insurance companies continually upgrade the demographic algorithms that project how many patients in the coverage groups will need emergency room visits, heart surgery, cancer care, routine care, etc) with an add for general overhead and contingencies.
The corporation that selects Kaiser pays the premiums, the patient pays reasonable co-pays based on sevice, Kaiser renders services, the patient doesn't get driven underwater by huge bills .
Does it offer the absolute top tier, go across the country to see the best surgeon for your issue possible? Nope.
Is it the most cost efficient way to deliver comprehensive health care services to a large patient base? Yep.
Is it like all other insurance plans, where the more you know how to manage the system the better the outcome? Yep.

ttps://www.cms.gov/medicare-medicaid-coordination/medicare-and-medicaid-coordination/medicare-medicaid-coordination-office/financialalignmentinitiative/capitatedmodel

My 5-year experience with Kaiser was nothing short of absolutely miserable. I willingly left them and pay higher premiums today. The last conversation I had with a Kaiser doctor was, "the treatment I am receiving with your organization is exactly what I imagine socialized medicine would be like". I didn't know for certain that I was right about that, but it sounds like my hunch was correct. That thing was a massive bureaucratic mess! It made sense that the premiums were cheaper as it was commensurate with the care.

Having health insurance and not being treated is not that different from not having insurance and not being treated.

 

[Long_Rod_Silvers]

I surmise if we did nothing. Literally nothing the problem would shrink rather than grow as it has with the added fuel of millions of dollars.

It does appear that while this (below) is probably not the normal, there at least a certain number of individuals who are 'free rolling'. So yeah, doing nothing so to speak would probably decrease the problem to some extent. Just guessing though.

 

[charles sullivan]

I agree with all of the above with one exception. I don't think anybody here doesn't feel pity or doesn't want to help a single mother, family, or anybody with a child. That's a no brainer. Clearly vulnerable elements of our society we want to protect. I know for me I do, right or wrong, hold disdain for the young males that have an attitude about it and are basically living feral on drugs. I don't care if you do drugs, I don't care if you live feral. I do care if you are trashing the place, stealing, or preying on others. I believe we basically agree. Where I don't agree is that for that kind of money I need to see a dent in the problem or some kind of accountability. A growing problem with a growing budget makes me uneasy. Especially when you, yard, and myself are going to do this and save the people of Seattle 48 million. After which I'm going to buy you a giant steak dinner and give a nice speech about working together and our championing the human spirit.

I prefer grass fed steaks. They have a lot more flavor and since switching to grass fed, I have noticed that corn finished stuff looks like it came from a sick cow. The blood appears weak and the flesh turns a pale grey and is somewhat mushy. I'd happily accept a corn fed steak though to hear that speech.

I do think nearly everyone wants to help single moms and kids. I brought them up because they are often forgotten during these discussions because they are not as visible as other homeless types. I actually do believe that most single mom types can be rehabilitated for about $7,500.00 Canadian. The difference between being in crisis mode and being in control is small.

There are others that really can't be helped. That opportunity was lost a long time ago. They are the expensive ones. What we are doing now is expensive. Jail is expensive. Courts are expensive. Police are expensive. Social workers are expensive. However it's tackled is expensive in a country with due process.

 

[Robert Engleheart]

……..

I often wonder what might have become of him if drugs were legal, available and regulated. I know the first time he did meth (the drug that has really fueled his spiral) he did it thinking it was coke. Not that cokes some kind of pious fun, but that introduction to meth was not his intent. It's a problem with black markets.

I wonder what might happen if companies did not drug test, and judged him solely on the work he did and how he treated his coworkers. I wonder what he might me if he didnt have a string of possession/distribution charges, or if he would have burgled and battered drug dealers if he could have bought his score at 711. I wonder if he would have HIV if it weren't for dirty needles in underground drug dens.

Addiction and mental illness suck, they are some of the hardest parts of society to contend with. When people dont make choices in their own interest and repeatedly self destruct, it is difficult not to give up on them. I do wish, however, that as a society we could stop pretending that these issues can be legislated or enforced away. That there is any amount of border patrol that can keep drugs out. That there is any amount of policing that can stop people from chasing their addiction.

All it has led to is accidental ODs on unknown substances of unknown potency, inflated the price of a few hours escape into several days pay, created a whole class of "unemployables" with little chance of redemption, plunged the country into spiraling debt, imprisoned millions of our citizens and created the evil drug cartels we all despise.

I wonder how many people would be homeless if they were not criminals to begin with.

This made me think of the retired NYPD chief who said if drugs were legal 80-90% of crime would disappear. We’ve been in the “War on Drugs” for 50 some years and it’s only gotten worse; consider the prison-industrial complex that has grown exponentially since the inception of said war; Californias Department of Corrections and Rehabilitation budget for 2020 was $14.1 BILLION. With first hand knowledge of the system I am confident in saying much of that is drug related crime.
Consider Portugals approach to the problem: https://www.theguardian.com/news/20...licy-is-working-why-hasnt-the-world-copied-it
The money saved from the war on drugs could be used to help those who could benefit.

 

[Evan B]

This made me think of the retired NYPD chief who said if drugs were legal 80-90% of crime would disappear. We’ve been in the “War on Drugs” for 50 some years and it’s only gotten worse; consider the prison-industrial complex that has grown exponentially since the inception of said war; Californias Department of Corrections and Rehabilitation budget for 2020 was $14.1 BILLION. With first hand knowledge of the system I am confident in saying much of that is drug related crime.
Consider Portugals approach to the problem: https://www.theguardian.com/news/20...licy-is-working-why-hasnt-the-world-copied-it
The money saved from the war on drugs could be used to help those who could benefit.

I agree with that, but it's gotta be all or nothing. Oregon tried a half-ass measure to decriminalize drugs, but the other side of things never happened. If done right, I think it could work (anything is better than what we're doing now), but we need complete follow through on the treatment/cleanup solutions.

 

[Dustin Chromers]

I prefer grass fed steaks. They have a lot more flavor and since switching to grass fed, I have noticed that corn finished stuff looks like it came from a sick cow. The blood appears weak and the flesh turns a pale grey and is somewhat mushy. I'd happily accept a corn fed steak though to hear that speech.

I do think nearly everyone wants to help single moms and kids. I brought them up because they are often forgotten during these discussions because they are not as visible as other homeless types. I actually do believe that most single mom types can be rehabilitated for about $7,500.00 Canadian. The difference between being in crisis mode and being in control is small.

There are others that really can't be helped. That opportunity was lost a long time ago. They are the expensive ones. What we are doing now is expensive. Jail is expensive. Courts are expensive. Police are expensive. Social workers are expensive. However it's tackled is expensive in a country with due process.

Grass fed only for me as well. I like clean food. No feed lot beef and hormones. If I'm going to eat an animal I prefer it be a happy animal.

 

[Dustin Chromers]

This made me think of the retired NYPD chief who said if drugs were legal 80-90% of crime would disappear. We’ve been in the “War on Drugs” for 50 some years and it’s only gotten worse; consider the prison-industrial complex that has grown exponentially since the inception of said war; Californias Department of Corrections and Rehabilitation budget for 2020 was $14.1 BILLION. With first hand knowledge of the system I am confident in saying much of that is drug related crime.
Consider Portugals approach to the problem: https://www.theguardian.com/news/20...licy-is-working-why-hasnt-the-world-copied-it
The money saved from the war on drugs could be used to help those who could benefit.

I'm a drug law abolitionist. I don't think the act of using drugs is criminal if there isn't a victim other than the user. Once you steal I do care. If you are stealing for addiction I think that should trigger additional "penalties" in the form of mandatory treatment etc.

 

[Pink Nighty]

I agree with that, but it's gotta be all or nothing. Oregon tried a half-ass measure to decriminalize drugs, but the other side of things never happened. If done right, I think it could work (anything is better than what we're doing now), but we need complete follow through on the treatment/cleanup solutions.

Decriminalization is certainly half ass. Leaves the users at the mercy of the cartels, buying unknown compounds of unknown purity and with no recourse against being gouged in price or flat out robbed. It's just opening the city for criminal business.

 

[nwbobber]

Billy brought up the effects of meth on people. Recently I heard Ted Wheeler say pretty much the same thing, that the effects on peoples mental health was serious and irreversible. On the same program were people in the rehabilitation business saying that was not true. Wheeler attributed it to something called P2P meth. I have a neighbor who was a meth head, and did close to three years in prison because of it. He is employed and doing pretty well now so I believe there is hope for people unless this "new" meth is somehow different. I know nothing about the chemistry of meth, but I do feel that if drug users were not sourcing their drugs from criminal gangs things could be a lot different.

 

[EB590]

I prefer grass fed steaks. They have a lot more flavor and since switching to grass fed, I have noticed that corn finished stuff looks like it came from a sick cow. The blood appears weak and the flesh turns a pale grey and is somewhat mushy. I'd happily accept a corn fed steak though to hear that speech.

I do think nearly everyone wants to help single moms and kids. I brought them up because they are often forgotten during these discussions because they are not as visible as other homeless types. I actually do believe that most single mom types can be rehabilitated for about $7,500.00 Canadian. The difference between being in crisis mode and being in control is small.

There are others that really can't be helped. That opportunity was lost a long time ago. They are the expensive ones. What we are doing now is expensive. Jail is expensive. Courts are expensive. Police are expensive. Social workers are expensive. However it's tackled is expensive in a country with due process.

I'd pay 7500 a year to liberate a homeless person. I remember Sally Struthers said you could feed a hungry kid for like a buck a day too. I'd round up to 8000 and kill two birds with one stone.

 

[Cal I Baetis]

Billy brought up the effects of meth on people. Recently I heard Ted Wheeler say pretty much the same thing, that the effects on peoples mental health was serious and irreversible. On the same program were people in the rehabilitation business saying that was not true. Wheeler attributed it to something called P2P meth. I have a neighbor who was a meth head, and did close to three years in prison because of it. He is employed and doing pretty well now so I believe there is hope for people unless this "new" meth is somehow different. I know nothing about the chemistry of meth, but I do feel that if drug users were not sourcing their drugs from criminal gangs things could be a lot different.

Episode 1355 - Sam Quinones — WTF with Marc Maron Podcast

Journalist Sam Quinones blew Marc’s mind six years ago with his book Dreamland: The True Tale of America’s Opiate Epidemic. More recently, he devoted his research and reporting to understanding how America got caught in the clutches of newer, more addictive, and more lethal synthetic drugs. Sam’s la

www.wtfpod.com

 

[Cal I Baetis]

Episode 1355 - Sam Quinones — WTF with Marc Maron Podcast

Journalist Sam Quinones blew Marc’s mind six years ago with his book Dreamland: The True Tale of America’s Opiate Epidemic. More recently, he devoted his research and reporting to understanding how America got caught in the clutches of newer, more addictive, and more lethal synthetic drugs. Sam’s la

www.wtfpod.com

Explains P2P ^^^

 

[nwbobber]

Explains P2P ^^^

Thanks, I'll check it out.

 

[FinLuver]

Sorry to sidetrack… how can the medical field charge different rates for services for different people. Seems wrong to me.

Not really…
Electric
Housing
Food
Different rates are common placed these days.
BTW…I find it wrong as well

 

[FinLuver]

This made me think of the retired NYPD chief who said if drugs were legal 80-90% of crime would disappear. We’ve been in the “War on Drugs” for 50 some years and it’s only gotten worse; consider the prison-industrial complex that has grown exponentially since the inception of said war; Californias Department of Corrections and Rehabilitation budget for 2020 was $14.1 BILLION. With first hand knowledge of the system I am confident in saying much of that is drug related crime.
Consider Portugals approach to the problem: https://www.theguardian.com/news/20...licy-is-working-why-hasnt-the-world-copied-it
The money saved from the war on drugs could be used to help those who could benefit.

Oregon pretty much “legalized” drugs…
The results speak for themselves…
Crime, ODs, Homelessness, etc…
Are UP

 

[Dustin Chromers]

Oregon pretty much “legalized” drugs…
The results speak for themselves…
Crime, ODs, Homelessness, etc…
Are UP

They did but they also quit prosecuting actual crime too.

 

[nwbobber]

Yes to equate the current situation to the decriminalization of drugs would require one to ignore the fact that the DA in multnomah county will not prosecute. He has reasons... the lack of public defenders, jail space, the system is really broken badly. It's not simple though.

 

[FinLuver]

Yes to equate the current situation to the decriminalization of drugs would require one to ignore the fact that the DA in multnomah county will not prosecute. He has reasons... the lack of public defenders, jail space, the system is really broken badly. It's not simple though.

Well there was this one jail…that never went used.

 

[Dustin Chromers]

Yes to equate the current situation to the decriminalization of drugs would require one to ignore the fact that the DA in multnomah county will not prosecute. He has reasons... the lack of public defenders, jail space, the system is really broken badly. It's not simple though.

You can learn allot about people by training and observing animals. Behavioural conditioning is effective on both. Actions without consequence are repeated. This is why it's critical to follow an undesired action with a response reliably, definitively, and consistently. You can extinguish any undesirable behaviour in man or beast if those conditions are met. If not you will reinforce the undesirable behaviour. That's what Portland is doing.