The babyjesuschristsuperstar on Board: filling the moral void of Clinton’s legacy

[sebastian_dangerfield]

Originally posted by ltl/fb
There's not just one price for insurers. All over the board. I think you are out of your depth, sweet pea.

True. Good point.

Can you answer a question for me? An insurer offers a doc a contract under which the doc agrees to take the insurers' patients in return for that business, and the guarantee of payment from the insurer at the rate set in the contract. The contract says nothing about the insurer being able to change the rate of payment unilaterally.

The contract has a four year duration. Two years later, the insurer lowers the rate of payment. The doc calls and asks why. Insurer says "we have the right to do so." Doc says "uh, uh... no you don't." Insurer says "take it or leave it."

Seems to me the doc has a lawsuit if he wants. Or am I missing some common industry custom here? In my dealings with isurers, I have learned that contracts tend to be narrow when they're enforcing them, and tend to be read rather expansively by insurers when they want to get around their terms.

ETA: BTW, why do insurers say things like "Oh, well, you have an old contract. The new ones don't say that anymore," when you try to enforce someone's rights? I find that baffling. Do some states have law that holds that subsequent contracts for similar benefits can modify the terms of previous contracts with other parties? That can't be the case, but I can't think of any other reason for an insurer to say something like that.

And its happened to me twice.

[taxwonk]

Originally posted by Spanky
Not that I want to start the argument, but I think to not provide medical care for those who can't afford it is a violation of the UMC.

Relatively speaking, I agree with you.

[ltl/fb]

Originally posted by sebastian_dangerfield
True. Good point.

Can you answer a question for me? An insurer offers a doc a contract under which the doc agrees to take the insurers' patients in return for that business, and the guarantee of payment from the insurer at the rate set in the contract. The contract says nothing about the insurer being able to change the rate of payment unilaterally.

The contract has a four year duration. Two years later, the insurer lowers the rate of payment. The doc calls and asks why. Insurer says "we have the right to do so." Doc says "uh, uh... no you don't." Insurer says "take it or leave it."

Seems to me the doc has a lawsuit if he wants. Or am I missing some common industry custom here? In my dealings with isurers, I have learned that contracts tend to be narrow when they're enforcing them, and tend to be read rather expansively by insurers when they want to get around their terms.

Fuck if I know.

ETA if it's really insurance you are talking about (and not just payments -- like, where I work, the company pays all claims, through a third-party administrator, who might also be an insurer (Aetna, BCBS, whatever) -- but it's not an insured arrangement. I think we may have stop-loss insurance for if an individual's claims exceed $X in a year, or over a lifetime, or whatever, but not sure), it's heavily regulated and it may be that if the insurer gets a new contract approved by the state regulators, it overrules the old contract.

[Replaced_Texan]

Originally posted by sebastian_dangerfield
True. Good point.

Can you answer a question for me? An insurer offers a doc a contract under which the doc agrees to take the insurers' patients in return for that business, and the guarantee of payment from the insurer at the rate set in the contract. The contract says nothing about the insurer being able to change the rate of payment unilaterally.

The contract has a four year duration. Two years later, the insurer lowers the rate of payment. The doc calls and asks why. Insurer says "we have the right to do so." Doc says "uh, uh... no you don't." Insurer says "take it or leave it."

Seems to me the doc has a lawsuit if he wants. Or am I missing some common industry custom here? In my dealings with isurers, I have learned that contracts tend to be narrow when they're enforcing them, and tend to be read rather expansively by insurers when they want to get around their terms.

Those agreements are usually fairly easy to get out of. Doc says no way, insurance company says fine, terminates the agreement, and moves on to the next doc.

Eventually, all of the local docs get frustrated, form a sub-specialty IPA, the one hold out doc (or the insurance company if none of the docs hold out of the IPA) start going after the IPA for antitrust violations. Usually the docs aren't integrated enough, though sometimes they can work the IPA to their advantage.

[sebastian_dangerfield]

Originally posted by Replaced_Texan
You would have awarded a film made by Palestinians to Israel? Taiwan to China?

Is there any larger waste of time than awards for actors? Robert Mitchum said acting was an award in itself, since it paid well and was way easier than actually working. I'm all for recognizing good art, but thosse ceremonies put me to sleep so fast... I keep thinking, "I'd be so much better served masturbating continuously, or trying to work my index finger into my sinus cavity."

[Gattigap]

Originally posted by SlaveNoMore
Did anyone else notice how the Hollywood Foreign Press last night awarded best foreign film to the country of "Palestine"

I guess they already have their own country. So fuck 'em.

First a Brokeback Mountain review, and now you're watching the Hollywood Foreign Press awards?

WTF's happened to you?

[Hank Chinaski]

Originally posted by sebastian_dangerfield
Is there any larger waste of time than awards for actors?

you're not real introspective, are you?

[SlaveNoMore]

Gattigap
First a Brokeback Mountain review, and now you're watching the Hollywood Foreign Press awards?

WTF's happened to you?

I've gone Cali, baby!!!!

[Spanky]

Originally posted by sebastian_dangerfield
Is there any larger waste of time than awards for actors? Robert Mitchum said acting was an award in itself, since it paid well and was way easier than actually working. I'm all for recognizing good art, but thosse ceremonies put me to sleep so fast... I keep thinking, "I'd be so much better served masturbating continuously, or trying to work my index finger into my sinus cavity."

2. I think Woody Allen sumarized it very well in Annie Hall. It was obnoxious enough to have the Golden Globes, the Oscars, the emmys, the MTV awards, people's choice awards, etc. but now they have these completely nauseating salutes. Like the one going to Al Pacino soon. For the love of God, they are entertainers. It's not like they have made the world a better place.....

[Mmmm, Burger (C.J.)]

Originally posted by Spanky
. For the love of God, they are entertainers. It's not like they have made the world a better place.....

I've they've distracted people from religion, then they have.

[Sexual Harassment Panda]

Originally posted by Spanky
2. I think Woody Allen sumarized it very well in Annie Hall. It was obnoxious enough to have the Golden Globes, the Oscars, the emmys, the MTV awards, people's choice awards, etc. but now they have these completely nauseating salutes. Like the one going to Al Pacino soon.....

HOO-yah! and Say hello to my little friend!!

[sebastian_dangerfield]

If you haven't done so yet, find and listen to all of Ray Nagin's comments of two days ago. I understand what he was trying to say, but what actually came out of his mouth was what I'd expect to see if the folks who did Best in Show did a movie on politics. His comment about "mixing milk and dark chocolate" and "making a delicious drink" was surreal. I haven't felt that embarrassed for anyone since watching Bush in the 2004 presidential debates.

[Gattigap]

Originally posted by sebastian_dangerfield
If you haven't done so yet, find and listen to all of Ray Nagin's comments of two days ago. I understand what he was trying to say, but what actually came out of his mouth was what I'd expect to see if the folks who did Best in Show did a movie on politics. His comment about "mixing milk and dark chocolate" and "making a delicious drink" was surreal. I haven't felt that embarrassed for anyone since watching Bush in the 2004 presidential debates.

Yeah, it's bad.

In some ways I think Nagin is a Democratic complement to (say) Jeff Sessions.

The distinction between them would be, presumably, that only the things Nagin actually says are borderline retarded.

[SlaveNoMore]

sebastian_dangerfield
If you haven't done so yet, find and listen to all of Ray Nagin's comments of two days ago. I understand what he was trying to say, but what actually came out of his mouth was what I'd expect to see if the folks who did Best in Show did a movie on politics. His comment about "mixing milk and dark chocolate" and "making a delicious drink" was surreal. I haven't felt that embarrassed for anyone since watching Bush in the 2004 presidential debates.

Had he said "Chocolate City" - they could have had this huge cross-promotion with Hersheys and the P-Funk All-Stars.

[Shape Shifter]

Originally posted by sebastian_dangerfield
If you haven't done so yet, find and listen to all of Ray Nagin's comments of two days ago. I understand what he was trying to say, but what actually came out of his mouth was what I'd expect to see if the folks who did Best in Show did a movie on politics. His comment about "mixing milk and dark chocolate" and "making a delicious drink" was surreal. I haven't felt that embarrassed for anyone since watching Bush in the 2004 presidential debates.

Sure, blame it on Clinton.