Entrepreneurship

KHANNNNN! (another member of a continuing series)

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The ice storm that clipped both KC and Chicago today, coming as it does after several days of nasty weather, has a lot of us holed up inside and thinking wintry thoughts. We might wonder how the natives of one of the climatically harshest places on Earth deal with it. Or, perhaps, deel with it. So, after considering for a moment whether any other blog can provide puns in Mongolian, graze (Midwesterners [and Mongolians] don’t surf) on over to NYCMongol.com for all your clothing and shelter needs for when you “steppe out.” For those Chicagoan, er, Siberian winters, there’s the cotton quilted deel for a mere C-note-and-a-half, and don’t forget to pick up a pair of (somewhat more steeply priced) boots. Shelter? Get yer yurt right here. You’ll fit right in when our horde (another Mongolian-derived word) of genetically-engineered Temujin-class warriors conquers the world.

Or just pick up a few books. Whatever.

Previous members of series:

What Is Not Seen

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A few months ago the Senate Democrats here in the State of Wisconsin floated a plan to provide universal health care for all residents of the state.  The first question most will ask is “who is going to pay?”  The answer is that the plan ($15bb worth) will be funded through a payroll tax.

The plan is dead in the water as the Republicans who control our State Assembly are having nothing of it, but in the next election there is the distinct possibility that the Democrats will win back the Assembly, and will then control the Governor’s chair, the Senate and the Assembly.

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US “Free Market” Medicine

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There was a time when I actually believed that there was a functioning free market in US medical services. Experience has taught me that this is by no means the case.

I may have mentioned before that my wife is opening a primary care practice in Bolingbrook. It’s been a long haul but we’re finally open for business. One of the key matters in any business is setting prices. Here’s how it’s done these days in our “free market” us medical system.

1. Look up your Medicare geographic zone (set by the US Government)
2. Download the price list for that zone
3. Enter those prices in your billing software

There are all sorts of restrictions on price flexibility. Even if you don’t accept Medicare, even if you don’t accept Medicare assignment (ie, you’re not part of the program and the patient gets Medicare reimbursement at home after you’ve taken their money at the office), you still have a “limiting charge” that you’re not allowed to exceed if your patient is a Medicare participant.

You’re also not permitted to discount your prices under certain circumstances. If you accept insurance, cash patients are pretty much forced to pay the highest rates for your services even though they are your most preferred payers (you get your money quickest and with the least cost and fuss).

Clearly, if you can’t set your own prices but are largely cutting and pasting in numbers from a government provided spreadsheet, this situation is not a free market. Yet it’s also not socialized medicine. So what is it?