Medical Mysteries

Elisabeth Rosenthal of the Times has an endless article on the high cost of hip replacement surgery in the US (Spoiler alert - its the greedy medical device manufacturers fault). A barrel of ink later, however, some seemingly-obvious questions are never addressed.

Her lead:

WARSAW, Ind. — Michael Shopenn’s artificial hip was made by a company based in this remote town, a global center of joint manufacturing. But he had to fly to Europe to have it installed.

Mr. Shopenn, 67, an architectural photographer and avid snowboarder, had been in such pain from arthritis that he could not stand long enough to make coffee, let alone work. He had health insurance, but it would not cover a joint replacement because his degenerative disease was related to an old sports injury, thus considered a pre-existing condition.

Uhh, he is 67 years old - why doesn't Medicare cover this? Every Earnest Lib knows that Medicare is the answer to everything (see Gross v. Net, below), but we never learn why it doesn't cover this patient. After many, many intervening paragraphs we do learn this about Medicare:

With artificial joints, cost-trimming efforts have been similarly ineffective. Medicare does not negotiate directly with manufacturers, but offers all-inclusive payments for surgery to hospitals to prompt them to bargain harder for better implant prices. Instead, hospitals complain that acquiring the implant consumes 50 percent to 70 percent of Medicare’s reimbursement, which now averages $12,099, up 25 percent from $9,645 in 1993. Meanwhile, surgeons’ fees have dropped by nearly half.

This 2008 paper has more than I care to know on the topic.

GROSS V. NET  Crooks and Liars lives up to its billing with this headline:

Study: Medicare For All Would Save Half-Trillion In First Years

Per the linked stoiry, the gross savings woiuld exceed half a trillion, but $343 billion would promptly be spent providing expanded coverage to the currently uninsured.

 

Comments

[henry]

Medicare won't pay for artificial joints? I bet the Obamacare death panels won't pay for as little as an aspirin for that guy... Improper sharing of wealth that could instead pay for crack via food stamp card fraud.

[JIB]

Hate to go OT but are you as smart as an 8th grader? An 8th grader in Bullitt County, Kentucky, in 1912?

How far we have fallen in regard pragmatic education that prepares us for the real world instead of the reality based community.

[pagar]

"Medicare won't pay for artificial joints? I bet the Obamacare death panels won't pay for as little as an aspirin for that guy.."

Now if he were an illegal immigrant!

[henry]

Pager, a couple months from now illegal immigration will be legal (sinister right wing plot to deny benefits to Latinos).

A more serious note: the ACA excise tax on medical devices (from toothpicks & band aids to joint replacement hardware) drives up the prices hospitals must pay. Manufacturers get less money, hospitals get less money, doctors get less money, people get less healthcare. Just wait until the rest of Obamacare kicks in.

[But that was Medicare, and Medicare's gone.]

I once asked a doctor if a history of recreational running as an adult might disqualify someone from Medicare coverage for knee replacement with the rationale that it was a destructive life style choice. He had a ready answer, that the question had been studied and that the benefits of running overall outweighed the destruction to the knees.
===========

[Danube on iPad]

I understand Mr. Lukindo had Obama's Kenyan birth certificate on his person, but it has now disappeared. Coincidence? I don't think so...

"An American diplomat who police say was speeding, crossed the center line in his SUV and rammed into a full mini-bus, killing a father of three whose widow is six months pregnant, officials said Friday. U.S. Embassy officials in Nairobi rushed Joshua Walde and his family out of Kenya the next day, leaving the crash victims with no financial assistance to pay for a funeral and for hospital bills for the eight or so others who were seriously injured. Amongst those killed was Haji Lukindo, who leaves behind his pregnant wife Latifah Naiman Mariki, 38, without a source of income..."

[He says. But he's not natural born, so why should we believe his allegiance?]

C'mon, DoT, he was born in Hawaii, has had Indonesian citizenship, and at some unknown age and for an unknown reason, has repudiated Islam.
==============

[Danube on iPad]

You left out his youthful British citizenship.

[JIB]

DoT,

Very reminiscence of an incident for one of my people in Venezuela back about 15 years ago. The son of one of our division Presidents was driving a rental car in Caracas and a typical Caracian fraudster stepped out as he was pulling out of a parking lot. The kid was doing 5 mph and the guy somehow was catatonic and dying on the spot.

The police came and gave him a citation as the "relatives" delivered their intent to sue the young man and his family (by name BTW, how the hell did they know that:). We sent up a security team from BA to hustle him out of country. Back before Chavez so they still needed us there.

My amateur tip of the day is never rent a car in Latin America. Leave the driving to others, especially vetted locals.

[Elliott]

One would be remiss not to note that today is the anniversary of the birth of a remarkable and inspiring man, who overcame such setbacks as the death of his father in his childhood. Despite his naivete in dealing with homo sovieticus, he leaves a legacy of which we shall never see the equal.

[Drudge has the shortest Arctic summer on record up.]

No, son, his father was a British citizen, which would have raised the hackles of our country's founders. Natural born is no longer good enough, though, to reliably measure allegiance, so this episode with Obama will probably lead to more thought put into the issue than has recently been the case.

You seem remarkably naive about the case. Are you a newbie to the issue? You should study up, it's populism getting the bit between its teeth.
=============

[JIB]

Elliot,

And like a North Korean dictator he went out on his birthday and shot a remarkable round of 18 at the Andrews AFB links:)

[Danube on iPad]

"his father was a British citizen"

And thus so was he, in accordance with the British Nationalty Act of 1948. Because he took no action to retain it, his British citizenship lapsed on August 4, 1982.

Try familiarizing yourself with a few of the basic facts before weighing in.

[Account Deleted]

Kim,

That's clear evidence the SkyDragon is pumping heat into the vasty deep at an ever increasing rate. The poor people of Guam will be boiled alive when it tips over.

[Elliott]

I find that unlikely, JiB. I believe that by the time the base and golf courses were built, Raoul Wallenberg had finished his studies and left the United States.

[JIB]

Elliot,

You are so sly:) I thought you were talking about dear leader himself.

[It's about allegiance, educated fool.]

Well, DoT, you hammer the case into boiler tightness. What would the founders do?
=============

[narciso]

There's a medical mystery here, namely how often Christie is in need of a chiropractor;

http://hotair.com/archives/2013/08/04/george-will-if-he-thinks-libertarianism-a-dangerous-thought-people-may-think-christie-himself-is-dangerous/

[Jeff Dobbs]

DoT:
I understand Mr. Lukindo had Obama's Kenyan birth certificate on his person, but it has now disappeared.

Am I missing something, or was that provoked in some way. Does it have to do with hip replacements or something said prior on this thread?

I can't find any reference to Lukindo prior to your comment.

I was under the impression that you have long since claimed you would *only* respond. Not instigate.

Has something changed?

Or have I misremembered?

[narciso]

In other news, just slightly more probable;

http://therightscoop.com/video-interview-peter-capaldi-revealed-as-the-twelfth-doctor/

[narciso]

Alright, what does this really mean,

http://weaselzippers.us/2013/08/04/senior-u-s-official-intercepted-al-qaeda-communications-indicate-planned-attack-big-strategically-significant/

[narciso]

Yet another round of mirroring:

http://legalinsurrection.com/2013/08/mostly-white-male-bloomberg-news-house-republicans-set-to-defy-obama-are-mostly-white-men/#comments

[Jim Miller]

Warsaw, Indiana is a remote town?

First, and most obvious, nowhere in Indiana is remote. But Warsaw is even less remote than most towns in Indiana. Glancing at a map, I see that it is about an hours drive from Fort Wayne or South Bend, and little more than two hours from Indianapolis or Chicago.

Is it time to recycle the famous New Yorker
cover? I think so.

(Full disclosure: I have visited Warsaw, Indiana.)

[Danube on iPad]

Hit, some of us feel a duty to a higher power to expose vile conspiracies wherever they occur. Others of us are simply sick.

[Account Deleted]

"Alright, what does this really mean,"

My interpretation is that it means there has been entirely too much talk about NSA capabilities without any illustration as to the rationale for its existence. Dunno if AQ is actually going to celebrate President Obama's Declaration of Peace but we've certainly been placed on high alert.

Kinda like cowering Bostonians hiding in their houses from an unarmed sixteen year old who security forces were unable to kill with a fifty shot fusillade. Perhaps security forces will do better post-Butch. I hear they have every UMC congregation in the US pinpointed and infiltrated.

[Danube on iPad]

Major report on puffins at NBC News. Summary: global ocean warming threatens their food supply. "Run, Bamby, it's man!"

[Jeff Dobbs]

Get well soon, DoT.

[pagar]

"pinpointed and infiltrated."

http://www.usatoday.com/story/news/nation/2013/08/04/fbi-informant-crimes-report/2613305/

"Exclusive: FBI allowed informants to commit 5,600 crimes"

Remember this is only one agency's report.

[bull-whip cracker]

Thanks for that pagar.

That's the flip-side of what Danube of thought asserts as an unlikely occurrence.

He assures us that CI's don't commit crimes with impunity.

[narciso]

It's a tricky deal, when dealing with clandestine criminal activities, the assets with the most knowledge, are almost as likely to be involved in the organization. Natapoff has a certain agenda against law enforcement use of informants, typified by that film 'Snitch;

[So It Shall Be Written, So It Shall Be Done]

And to think that our blessed Lord Jesus suffered excruciating pain on His cross for six hours before His body succumbed to that pain and HE died. The thought of which should at least bring tears to your eyes. A muffled sob? The courage to endure in silence what He suffered for us, you spineless narcissistic whining crybaby thumb-sucking wussy ass-scratching weenies

[narciso]

About a thousand seazoned operatives, released from Benghazi to Bagram, do raise concerns;

http://www.breitbart.com/Big-Government/2013/08/04/DeMint-Al-Qaeda-More-of-a-Threat-than-Before-9-11-Because-They-Think-Obama-Is-Weak

[bull-whip cracker]

"It's a tricky deal..."

It's especially tricky for James Settenbrino whose son was entrapped by DOJ's CI . The CI was a punk with a history, but like all the CI's known to recent history, the goal is arrests to make your numbers, and get promoted, not justice. But it is the best justice system in the world.

[bull-whip cracker]

BTW;

Here's the legal definition of entrapment.

Entrapment is a defense to criminal charges when it is established that the agent or official originated the idea of the crime and induced the accused to engage in it.

[narciso]

I would like an explanation behind this;

http://m.charlestoncitypaper.com/charleston/blogs/Post?basename=lindsey-graham-opponent-nancy-maces-biggest-obstacle-her-association-with-fitsnews&day=03&id=HaireoftheDog&month=08&year=2013

[rich@gmu]

Posted by: Rick Ballard | August 04, 2013 at 07:44 PM

So the rational is to spook people so they hide under their bed?

heard that they extended the shelter in place for a few more days in some places.

Evening all.

[Nick N.Y.]

At 8:28. Islamic fundamentalists weren't too thrilled when obtuse Liberals nominated a Jew, Joe Lieberman to be our VP at a time when friction between Jew and Muslem were quite intense enough already, and Clinton's equally irresponsible behavior with respect to the bombing of two embassies and the Cole and a refusal to take bin Ladin prisoner twice, also, emboldened Muslim terrorists to do on 9/11 what they've been emboldened by Obama to do again soon.

Stop blaming Republicans for the screw ups by Democrats, the latter of whom have shown you a thousand times that they can not be trusted to protect Americans. As a diehard Democrat, your view of the forest is blocked by the trees, mein dummkopf. Either that, or you are obtuse intentionally, i.e., deliberatelly deceitful with insidious ulterior motives, but too cutesy by half. Indeed, you know better than what you pretend.

[narciso]

So I figure at least one of the cell leaders, is a Saudi or possibly North African, whose been active in Syria or Equatorial Africa, that's a rough guesstimate, it could be a European convert like at Woolwich or La Defense, however.

[Jeff Dobbs]

I find general celebrations that prog triumphs like Obamacare are failing to be commendable.

Down with central authoritarian control!

Such celebrations that do not take into account that some people may not have made their fortune prior to Obama taking the reins -- as if not having made that fortune before that point is somehow complicit in the plans Obama has -- are gratuitous and not laudatory.

All hail those who made such a fortune!

Please don't dance on the graves of those of us who didn't.

It's not for lack of trying. We want to try. We accept the same risks you took in accumulating your fortune. We happen to not have the fortune of trying to build our fortune during the presidency of Reagan.

The failure you laud is the opportunity we are lacking.

But still you woot. You got yours, and that is to be commended. Woot to you.

[bull-whip cracker]

Wtf are you on about. i was responding to 8:20, . Non-seq.

[syncopated sequences of sequins.]

This time you hold the pigeon and I'll shit on it.
================

[Jim Miller]

Tom - You may want to add a correction to the post.

According to the print version -- at least out hear on the West Coast -- Shopenn "ultimately chose to have his hip replaced in 2007, when he was 60". So he wouldn't have been elegible for Medicare.

(There are some exceptions to the 65 or older rule, but they aren't mentioned in the article.)

[BC]

He is 67 now, but the surgery was in 2007...why he wasn't covered by medicare should not be a mystery.

[Odds Botkins]

I say, bloom'n good show, eh wot?

[Jim Miller]

hear = here, elegible = eligible

[Jeff Dobbs]

For those keeping score at home...

$emanticleo and I had a rather cordial relationship via email in 2011. Until I posted some rather innocuous comment here and Dana got all verklempt and wrote off our relationship. It was an email to end all diva emails that he initiated.

I can't blame him -- I have a tendency to afflict the comfortable, like I did for him at that point.

Fuck me, right?

Eat your own, Semen.

[Account Deleted]

Rich,

The Eutopians are rather concerned. France and Holland have issued threat warnings. Have you followed the New Zealand botulism recall at all? I'd be looking at something like that rather than splodeydopes. Water supply contamination or anthrax love letters would do much more damage than bombs.

Who knows where the Methodists will strike next.

[Army of Davids]

Single Payor (i.e. Medicare for all) can work w/ a smaller, well educated, resource rich country (i.e. Norway).

It gets harder when underlying economies go South, people get older and fiscal risks rise (see several in Europe, Japan and in time the UK)

Legacy healthcare obligations have contributed to a lot of bankruptcies (Detroit most recent).

There will be many more in the decade ahead. The real question is do leftists learn from this.

Not that there aren't plenty of other reasons to reject socialized medicine.

[Army of Davids]

Single Payer (sp correction)

the holy grail for the Fabian Socialist

[Danube on iPad]

WSJ:

"The lesson for Americans is that Democrats who passed ObamaCare didn't even understand what they were doing to themselves, much less to everyone else. But you can bet Democrats will never extend to ordinary Americans the same fixes that they are now claiming for themselves. The real class divide in President Obama's America is between the political class and everyone else."

[narciso]

He starts on the right track, then blows the transaxle;

http://hotair.com/headlines/archives/2013/08/04/were-living-1984-today/

[Danube on iPad]

"He assures us that CI's don't commit crimes with impunity."

Nonsense. You claimed that CI's commit crimes by entrapping innocent people into committing crimes, in particular by making drug buys. I pointed out, first, that entrapment is not a crime, but can be presented as a defense to a criminal charge. Now you're making absurdly untruthful assertions about what I said.

[gad-fly]

Lest we forget - among the unread pages of Obamacare is the new tax on artificial joints. Funny how that was "overlooked" by a Fish Wrap reporter visiting Warsaw, IN where unemployment is rising due to reduced sales demand being experienced by medical device manufacturers located there.

[narciso]

Funny how he seems to have lived everywhere, CO, NC, but Indiana,

[So It Shall Be Written, So It Shall B Done]

Betchu the Aztecs and the Incas wish that they had Hit 'n Run to encrypt their writings in a way that they, too, would look intelligent for as long as noobody could decipher them.

[Jim Miller]

gad-fly - From the article: "The Affordable Care Act tries to recoup some of the medical device manufacturers' profits by imposing a 2.3 percent tax on their revenues, effective this year."

According to the article, the county has the "lowest unemployment in Northern Indiana". That still could be rising, of course, but I would like to see those numbers before accepting your claim.

[Threadkiller]

"And the British Nationalty Act of 1948. Because he took no action to retain it, his British citizenship lapsed on August 4, 1982"

Barack Obama was born August 5, 1982?

Try to familiarize "And thus so was he, in accordance with the British Nationalty Act of 1948. Because he took no action to retain it, his British citizenship lapsed on August 4, 1982"

Barack Obama was born August 5, 1982?

Try to familiarize yourself with the difference between "born" and "21 years after you were born"

While you are at it, try to familiarize yourself with the actual statute; you got the year wrong.

From your friend (complete with an apology from factcheck):

http://naturalborncitizen.wordpress.com/2009/09/04/factcheck-org-capitulates-admits-error-in-obama-kenyan-citizenship-analysis/ with the difference between "born" and "21 years after you were born"

While you are at it, try to familiarize yourself with the actual statute; you got the year wrong.

From your friend (complete with an apology from factcheck):

http://naturalborncitizen.wordpress.com/2009/09/04/factcheck-org-capitulates-admits-error-in-obama-kenyan-citizenship-analysis/

[Threadkiller]

What a mess.

Good luck with my post.

[Joan]

Well, I read the posts/comments, and I usually can keep up, however a few of these are way out and really perplexing (I usually recognize the irritating and unwelcome one and what his rants are about--not this time.) So, I'll give you all something to smile about, I hope. :) This is a link to a short story I uploaded to Kindle and you all can read it for free. I think you will enjoy it.

http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=J.J.%20Minor%20Let%20Me%20Entertain%20You

[DublinDave]

The President was born in Kenya,everybody knows this. For the sake of preserving the Republic we all stay quiet.

Because we run the media completely no Republican wilL ever be taken seriously on this subject.

The President was born in Kenya.

[Danube on iPad]

"Barack Obama was born August 5, 1982?"

No, you dumb shit. He was born on August 4, 1961. His British citizenship lapsed, by law, on August 4, 1982.

[DublinDave]

Because I'm a member of the Hilsborough county Democratic party and sadly on the team charged with delivering the I-4 corridor for the Clintons in 2016(it's not going to happen) I get invited to a lot of wine and cracker get togethers around Lakeland (alot of old old money,good people and an endearing love of Lawton Chiles). So I was in the presence of Tampas most prominent Democrats last night and every one of them to a tee expressed a deep regret about having voted Barack Obama into office. It was an interesting evening and as a Clintonista who warned against an Obama Presidency(much to the chagrin of my fellow Tampa dems) I found a lot of my old friends telling me I was absolutely right.

[Threadkiller]

Our Aug. 29, 2008, Ask FactCheck item asking whether Obama has Kenyan citizenship… stated that Obama did have dual citizenship as a child but that it expired as an adult.  But Leo Donofrio, a former lawyer, argues that we got the year wrong. He’s right about that, and we have corrected the item.Initially, we said that Obama’s citizenship expired in 1982, on Obama’s 21st birthday. In fact, however, the Kenyan Constitution provides a two-year window during which one can decide which citizenship to keep. So, President Obama’s Kenyan citizenship expired on Aug. 4, 1984, not 1982, as we had initially reported.We regret the error.

http://www.factcheck.org/2009/09/obama-and-kenya-again/

Dumb fuck.

[Every day in every way, things are getting better and better in this best of all possible worlds.]

Sorry I brought it up. No I'm not. No I didn't. Yes, that's a good point, and it explains why his draft registration is so irregular. He was a British citizen then, how convenient, and isn't now, even more convenient.
===========

[Janet --- -... .- -- .- ... ..- -.-. -.- ...]

A really good Sultan Knish - http://sultanknish.blogspot.com/2013/08/five-lessons-from-egypt-and-arab-spring.html

"The Arab Spring represented political chaos in a lawless society, not social change or cultural enlightenment. Pundits and columnists fell to scribbling nonsense about the transformation of the region because they didn't understand that simple fact. They made the same mistake that Americans have been making with democracy promotion all along. Culture and society don't follow political systems. It's the other way around. Politics grows out of a culture and a society. Even tyranny. Or perhaps, especially tyranny."

[lol, he'll haha. Ill he are.]

I wish to amend a previous comment. At some unknown age and for an unknown reason Obama repudiated Islam, purportedly.
===============

[We are CIVILIZATION!]

J, check out the bellydancer at Legal Insurrection.
==================

[Janet --- -... .- -- .- ... ..- -.-. -.- ...]

from LI - "Yup, that perception pretty much sums up the current situation. Not only aren’t we the strong horse, we not even the strong dancer."

[Janet --- -... .- -- .- ... ..- -.-. -.- ...]

This LI post is very good too - http://legalinsurrection.com/2013/08/is-washington-dc-the-new-hollywood//#more

"fter one term that unique “temperament” that they touted was reduced to “arrogant and thin-skinned.” Of course the earlier characterization was not based on any observable evidence. It was based on projection: this is what we want and, by God, Obama personifies it. It was a conjured image. The arrogance was already on display for anyone who cared to look."

It's all a fraud.

[Thomas Collins]

So, the latest on the A-rod watch is that he will be suspended for the rest of this year and 2014, but can play while he appeals the suspension; and is scheduled to return to the Yankees lineup today. Thanks to the baseball gods that the Red Sox trade for A-Rod before the 2004 season fell through.

[narciso]

Just another travesty of a mockery of a sham, or a day ending in y.

[narciso]

TM's not kidding, the piece is interminable,. . .very long, among it's premises the Belgian govt, which is represented by that wonderful lady, we've referred to before, can make the determination,Belgium who didn't have a govt six months ago, there are no comparisons about how many hip replacements are done in Belgium or Canada, vs the US,

[Jack is Back!]

narciso,

There's always tomorrow, a day not ending in y.

Here's a head's up from Frederick's Space Camp at Embry-Riddle: The Comet Ison will be visible, 30 minutes before sunrise in the east/southeast sky from December 1st, 5th, 9th, 13th and 17th. It will be brightest on the 1st when it will be its lowest on the horizon. It will be at 7 O'clock from a visible Mercury just to lower left from a crescent moon.

More later on the ISS.

[narciso]

Didn't know about that one, with all the 'chunk of the sun will kill us all' hype, of last week, so they are using the excuse of Benghazi for the Full Ostrich.

[jimmyk]

Back from a long weekend in the Adirondacks, with limited internet. So how many terrorists will escape detection during this "high alert" because our limited resources are used to check little old ladies and seven-year-olds. And wasn't AQ decimated by the death of OBL at the hands of our fearless leader?

[Extraneus]

They're on the run, Jimmy.

[Janet --- -... .- -- .- ... ..- -.-. -.- ...]

"al Qaeda is on the run ... in the direction of US embassies." ~ Neo

[Landru]

I call BS on the 'pre-existing condition' claim. My own policy from Aetna (Indiv plan, not employer sponsored) spells it out that it only applies for the first 12 months after your effective date. And of course, if you had prior creditable coverage within 63 days of coverage starting, the length you were coverered previously satisfies that 12 month exclusion. I don't believe a sports injury from decades earlier is a 'pre-existing condition'. Unless he had just recently enrolled in the new policy and did not have prior creditable coverage to offset the 12 month waiting period, maybe.

Sounds more like the Medicare remibursement rate did not pay enough to cover it. My own policy also says it won't pay for anything that a person is eligible to be covered under Medicare for. Catch-22, Medicare doesn't reimburse enough to cover it fully. Something along these lines. The 'pre-existing condition' claim sounds completely bogus. The Slimes is just covering for the lack of payment by Medicare with it.

[jimmyk]

Seems like BC@10:08pm has a point that the guy was only 61 at the time of the surgery. But I agree, the preexisting condition thing sounds dubious.

[Thomas Collins]

"(it's not going to happen"

What's not going to happen? Are you saying that Hillary C. doesn't run, Hillary C. loses the I-4 undecideds in the Fla. Dem primary, or Hillary C loses the I-4 undecideds in the 2016 POTUS election? Or are you saying something else?

[Carol Herman]

A story from Israel. Turns out they don't do liver transplants are any patients older than 65. Meir Dagan (who once headed the Mossad, was 67. And, in need of a liver transplant.) So he went to Belarus. It saved his life.

[Free porn XXX]

Thanks very nice blog!