THIS is what is wrong with health care....

[DoriC]

When the situation is black and white, many people make the right decisions.

When the situation is gray, honest people make the right decisions.

So Well, You look like someone who would say that! Very important! You've got me thinking of situations in my own life that were on the "gray" side and how I handled them. I think I did pretty well but it's good to be reminded of our actions once in awhile.

[mars]

If a lion could talk, we would not understand him.

Dunamis says at -

http://forums.philosophyforums.com/thre ... 585-6.html

The way that language works is said to be principally this: The capacity to say not only that object/situation X is called "a", but also the capacity to say something of the order X might look like "a" to you, but it really is "b". Its not just assigning a sign, but also the capacity to question that connection, intersubjectively (between others), and make up or decide that another sign is better. If a lion really possessed language, that lion would have this capacity. The way that others alternate between signs, "That looks like a stick, but it really is an insect", not only tells us something about the world, but communicates something about the speaker, "You think that is a friend, but it really is an enemy". Through the use of alternating terms we are able to draw conclusions about the state of the speaker. Perhaps we still think that such and such a person is a friend and not an enemy, despite what the speaker tell us. Our adherance to our belief causes us to ascribe beliefs (which we take to be wrong) to speakers who disagree. In this way we, through language, we are said to "understand" others. If a Lion is making alternate ascriptions to the world, some of which we might disagree with, "That antelope seemed weak, but he was just hopping oddly for a moment," we would necessarily be entering into an intersubjective network of ascribed beliefs. This is the nature of language. If we are able to translate the linguistic signs, we are able to translate the meaning of their choice by the speaker. I can not imagine that given the complexity and richness of recognizing the choices made by a speaking Lion, we would not come to "understand" that Lion in a way fundamentally different, in a more nuanced way, than if he did not speak. Think of the difference between a deaf, mute and a speaking person. We understand each, but one we are able to understand simply better. (It is of course impossible to have only one Lion as a speaker, with no other Lions who speak, because language is structured on the necessary existence of others)l

and then he says -

I think that when languaging, we are sharing something though of a Form of Life, which involves "choosing one form over another" and understanding that this choice is involved. This is why Wittgenstein likes to compare language to things like a game of chess. In chess a move not only has its meaning because of all the rules, but also because that move is meant to be considered as a choice, "This move rather than that move". This aspect of language seems to allow us to translate the moves others make in languages we don't initially understand. It allows us to ask questions such as "Why did she/he make that move, say that word, and not another move, say another word." Such questions immediately lead one to assign beliefs to another with a complexity of self-awareness that goes beyond non-verbal behavior.

(Enlarged by me to assist reading).

So there we have it.

We start off with Health Care, move into disputation, look at integrity, and end up with Wittgenstein.

I have learned so much from this forum. We could justifiably rename it "cpaptalk and philosophical tolerance-101.com".

This my 700th post. Getting used to the Forum now, once thought I never would.

cheers

Mars

[JohnBFisher]

Mars, I tend to stay away from these posts. I have little energy to devote to them. These debates tend to revolve around issues where most of us stand little chance of changing the minds of those who come to these debates. All too often people come with preset notions and are not truly willing to live the life examined. But when I sense a chance for change, I don't mind posting what I think. But as always, I make every effort to understand the point of view of others. And that is behind "cpaptalk and philosophical tolerance-101.com". Because we have a gathering of many who try to get others to hear their needs, we tend to have a group of individuals who TRY to understand the point of view of others. It matters. But it does not always get others to be willing to "live the life examined".

[So Well]

I personally would refuse extra supplies I do not need, unless I could give them away to someone who needed them but did not have the money. This would make me feel good about the transaction, and my integrity would be intact.

Glad to see this thread wandering deeper into the "gray" areas without getting into mudslinging.

So Mars, it may surprise you that I like to give money to charities and I also give some significant amount of my time to charities. I would like to give even more money to charities but cannot because my finances are, of course, limited.

So using your quoted principle of integrity, I could enter into fraudulent contracts and embezzle from my employer and my integrity would be kept intact by giving all of the funds to a good charity?

[plr66]

So using your quoted principle of integrity, I could enter into fraudulent contracts and embezzle from my employer and my integrity would be kept intact by giving all of the funds to a good charity?

We would call you Robin Hood!

[mars]

I personally would refuse extra supplies I do not need, unless I could give them away to someone who needed them but did not have the money. This would make me feel good about the transaction, and my integrity would be intact.

Glad to see this thread wandering deeper into the "gray" areas without getting into mudslinging.

So Mars, it may surprise you that I like to give money to charities and I also give some significant amount of my time to charities. I would like to give even more money to charities but cannot because my finances are, of course, limited.

So using your quoted principle of integrity, I could enter into fraudulent contracts and embezzle from my employer and my integrity would be kept intact by giving all of the funds to a good charity?

Hi So Well

Why do you think it would surprise me to know you like giving money to charity? What did I say to give you that idea?

What you are saying looks very much like "mudslinging" to me.

So Well wrote -
So using your quoted principle of integrity, I could enter into fraudulent contracts and embezzle from my employer and my integrity would be kept intact by giving all of the funds to a good charity?

As you quoted above I said - "I personally would refuse extra supplies I do not need, unless I could give them away to someone who needed them but did not have the money. This would make me feel good about the transaction, and my integrity would be intact."

No mention of doing anything fraudulent, and no mention of the integrity of anyone else.

So basically, you have totally misrepresented what I said. And it was not what I would call a grey area.

You obviously either did not read, or ignored, what I said to WilsonVilleUSA -

WilsonVilleUSA wrote:So taking the supplies with the intent of giving them away to others at the time you order them is ok?

I rerplied - I specifically said that is what would maintain my integrity. I did not say that others should do that, or that it was right or wrong.

These discussions are good and useful, and I like them. But discussing stuff with someone who misrepresents me is something I no longer do.

So I will leave it there, without getting into the "mudslinging" I would have got into in the past.

Mars

[Really]

I'll just paste my other reply here

• "So this is what happens when a nice guy tries to help out people he doesn't even know? Really?
  
  Then the Holier Than Tho people come out of the woods to bash the nice guy? Really??
  
  Then each is Holier than the the last?? Really??
  
  I think I'll just throw my new unused stuff in the trash. Really!!
  End of Story!"

Then add this is where the Holier Than Tho begin to eat their own. Really.
True Story!

[eric_burcham]

Hey guys. I'm new here to CPAP and new to this forum. I figured I would spell out my experience with my new BIPAP machine and then add my 2 cents. I'm sure others have gone through similar situations.

My GP referred me to a sleep lab near Dallas, TX (Grapevine, for those who know where that is) that provided what I felt was an excellent experience for the testing and diagnosis phases of my treatment. Clean lab, brand new everything, great technicians, friendly atmosphere, supply of books, TV, etc... To fall asleep to, clean comfortable beds, the whole nine yards really. I was diagnosed with severe obstructive sleep APENA and prescribed BIPAP with a pressure of 16/12. All was well up to this point.

Then the fun began. I was scheduled to meet them in their clinic to visit with an equipment provider and get set up with my new machine, hose, mask, etc... and learn how to use everything properly. They were to provide me a new VPAP Auto 25 from Resmed, and essentially whatever mask I wanted.

I got a call from their collections department information me that my insurance would cover the machine and supplies 100%, but only after my deductable, which is $3,000. I was going to have to come up with a check for $2,200 in about 48 hours. What???

I said I would have to shop around and see if I could do better, and the lady said that wherever I purchased the machine, the price would be $2,200 if I bought it from an insurance approved PPO provider, because that is the allowed amount. This, sadly, turned out to essentially be true. CPAP.com sells the same stuff for about $1,500, total.

As a side note it turns out that, in Texas, there are essentially no self-insured policies that cover this kind of thing. If I was not getting insurance through my company, which has preselected this deductable for me, I would be forced to pay cash up front for everything anyway, including all the diagnostics, which would have run an additional $6,000 or so.

I finally called my insurance company directly and asked if I could purchase the equipment myself and file a claim towards my deductable. I wanted to stay within my PPO so that I could have that credit towards my deductable, but did not want to pay the extra $700 or so that the "allowed" rate was shoving down my throat.

Ultimately, I was able to find an in PPO equipment provider, tell them I wanted to pay cash, and get a great price on my equipment. I paid $1,500 total. Then I filed it with Blue Cross/Blue Shield, and ultimately wound up getting the credit towards my deductable. Now I allow the equipment provider to file the supplies on my behalf because it basically costs me about the same either way. I'm not a fan of pushing paperwork.

Bottom line, unless something else (like a hospital visit) were to knock out my deductable beforehand, using insurance to pay for this machine via the "typical" route would have cost me an extra $700 or so. I just find that ridiculous. Not only that, but paying out the nose for the extra dough would have cost the insurance company more money if I had blown through the rest of that deductable in the rest of this year. So, the only person who wins is the equipment company.

The big problem is that the whole system ignores the concept of a free market economy. It stifles competition which drives cost up and quality down, generally speaking. I believe a free market is good for both consumers and competent businesses. All this contracted pricing is good for nobody in the long run.

[Patrick A]

Try dealing with......never mind.

[So Well]

Mars,

I think it is well established by contract law and court cases, that when a beneficiary receives benefits under a health insurance policy, said benefits are provided for the health of the beneficiary. To take these benefits and transfer them to another, whether by sale or gift, is fraud (a type of theft) which is punishable as a crime. I also maintain it is unethical.

BTW, I am a nearly lifelong student of ethics and am accustomed to having discussions like this in general terms and no personal criticism is meant or should be taken.

I loved the ethics classes I took many years ago in college. We learned by discussing many issues like this and having many disagreements, some of which were never resolved. But we were all still good friends at the end of the semesters.

Mimosa.

[So Well]

So using your quoted principle of integrity, I could enter into fraudulent contracts and embezzle from my employer and my integrity would be kept intact by giving all of the funds to a good charity?

We would call you Robin Hood!

Ah, the legend of Robin Hood is not so simple as it was during my childhood.

Today, it is common to say that Robin Hood did not steal from what we would call the rich. He stole from the nobles who were the government of the times and who were engaged in oppressive taxation.

Also, a book has been written recently citing evidence that Robin Hood did not give to the poor, but instead loaned to them and made nice profits off the loans.

One should also remember,

While Robin Hood has been the subject of countless interpretations in books, plays and films over the centuries, there is no actual evidence that he ever existed.

[WearyOne]

When I had insurance, I didn't take what the insurance said I could have when they said I could have it unless I needed it. I would never take insurance-provided supplies I didn't need and then sell them. But if, for example, I ordered a mask and it didn't work for me and I couldn't return it, I would try to trade it (on here) for something I thought might work or try to sell it. Also, I use the Hybrid (not Liberty), which comes with pieces you never use. I don't have a problem with trading or selling those since my DME wouldn't sell just the nasal pillows and oral cushion I do used.

My DME charged the insurance company for my machine and humidifier a lot more than cpap.com charges, but the insurance company didn't pay that amount, of course. Although what they paid was higher than cpap.com, it wasn't horribly higher. It was the rent-to-own type of thing for 10 months and it ended up less than $1,000. (And I didn't pay anything.)

[plr66]

Ah, the legend of Robin Hood is not so simple as it was during my childhood.

Today, it is common to say that Robin Hood did not steal from what we would call the rich. He stole from the nobles who were the government of the times and who were engaged in oppressive taxation.

Also, a book has been written recently citing evidence that Robin Hood did not give to the poor, but instead loaned to them and made nice profits off the loans.

That was my point, SoWell.

[roster]

The big problem is that the whole system ignores the concept of a free market economy. It stifles competition which drives cost up and quality down, generally speaking. I believe a free market is good for both consumers and competent businesses.

You have that correct, Eric.

Now why does it not operate as a free market economy?

It is because of government involvement. All fifty states have insurance commissions and lengthy regulations interferring in the markets and reducing competition and reducing consumer choice. These regulations prohibit interstate purchase of health insurance, dictate what coverage must be included in health insurance policies, favor one or two established insurance suppliers, and make it very difficult for new entrants to come into the market.

The federal government is involved in a big way paying just under 50% of all costs through Medicare, Medicaid and some other smaller programs. There is a bloated bureaucracy, complicated rules and large amounts of fraud.

This is not to mention all the damaging entanglements for personal benefit that elected officials have made with insurance companies.

The practice of employers providing health insurance is economically inefficient and this practice came about as a result of ill-advised federal regulations during WWII.

The excellent solution is deregulation of the markets. Put the individual consumer in control of what products he will purchase and what prices he will pay. Then the only way insurance companies will have power is by offering products customers want and are willing to pay for.

(No, big government fans, deregulation of markets does not mean doing away with laws prohibiting fraud, theft, deception and coercion.)