yzerman19

St Clair has to be hurt or else Hak is playing head games

allowing guilty men to go free is a small price to pay to avoid innovent people going to prison. You also can not condone vigilantism. There are times where force is justified, if it is measured. You can't simply walk around waiting for someone to wrong you or to find the opportunity to "make ammends" for some previous wrong committed against you. Agree that the current statist approach of choosing to obey or not obey laws based upon the discretion of the executive branch is scary. This is not new, but appears to have taken a giant leap of late.

Convicted criminals do get fewer rights.

The east bank mall area is not ugly at all...very classic.

No need to name call or get the testosterone up on an Internet forum. Violence ain't cool. There are times when it is appropriate if you had to defend your life, someone else's life, or your property. In those rare situations it also must be commensurate with the threat you face or else you change from the victim to the aggressor. The DA will weigh that. That guy in Texas who beat to death ( with his fists) the man sexually assaulting his little girl- no charges, because a reasonable person would likely have done the same thing. As a father, I probably would too in the heat of the moment. A stolen car, a pipe beating...just seems excessive. I had a car stolen once...I felt no need to beat the guilty party.

The DA will use discretion. If the guy had been reasonable in his violence- i.e. a punch or two there would not be charges. It wouldn't be worth anyone's time and energy. Clearly the beating was worse than that, and included a pipe...that is beyond a reasonable "violent" response to having your car stolen.

Current insurance practices are income agnostic.

Question, but if she's maxed out at Altru and unhappy with her comp and hours, why not move? Or get a job at a different hospital within an hours drive...I live in Mpls, and people drive an hour all over town here for work. Sorry about the medical error- they happen, but that is a bad deal.

First, I assume you mean MRI. Second, charges mean nothing. Third, MRI is a generic term like "car" there is a difference between a Ferrari and a Taurus. How powerful a machine, which body part, contrast or no contrast, walk-up, inpatient, freestanding or in hospital- tons of variables. Your example is an unusual one as well, because typically there is a longer wait for services in Canada. The ACA isn't to blame for anything other than drying up capital at this point. That is because financial markets are leading indicators. It will negatively impact the health and healthcare industry and will redistribute costs of care via subsidies- which simply means taxes paid by higher income earners will be used to buy lower income earners their insurance. Sounds like socialism to me.

I won't take the bait, but lets just say I spent 8 years on the west bank of the Mississippi in a city to the SE of GF. I've also got 15 years of professional experience working on the payor and provider side in industry and as a consultant. I do not ignore the growth of healthcare costs, but I do fully understand the drivers. Health insurance is expensive, because healthcare is expensive. It is driven by a multitude of factors, but predominantly utilization increases including both volume and complexity of care. There are many more drivers, but utilization is the big one. Don't forget the quality of life indicators, life expectancy, and survival rates of chronic and catastrophic illness have all dramatically improved over that same 20 year time horizon.

But you were not the norm (with so very few services)...you were subsidizing people who were using more services in your same rating band. Now there is only one rating, so the gap you are describing will only grow via ACA. You are correct that cost shifting has been happening for a long time. As has the purpose of insurance. True insurance is not pre-paid medical. True insurance is stop-loss protection for unlikely events that you can't pay for yourself. In a lot of ways, the migration of insurance to pre-paid medical can be tied to continued pressure on wages and completely inaccurate reporting of inflation. If the vast majority of Americans aren't liquid $2000, they can't "self-insure" at all.

keep the Kauker out of this!! I would disagree on how the business could fail- 1. Revenue compression due to adjustments at the federal level, such as reductions in Medicare reimbursement which is real and part of ACA. 2. Employer/insurer cost shifting to patients via more out of pocket costs in order to keep premiums lower, resulting in a greater portion of revenue "at-risk" to providers. Bad debt is a huge issue for all providers. 3. Continued technology and innovation driven inflation for medical advancements. 4. Continued scarcity of resources for top skill jobs increasing wages- even though cost of living is lower in GF than say Mpls, they have to pay doctors and nurses equal or greater salaries to get them to stay in GF.

And 990's are tax accounting, not financial reporting. They are not for profit, so they should be holding close to flat. Debt if structured well" which theirs is, is a good thing when the weighted average cost of capital is less than 4 percent. If they were making tons of money, the community would come unglued for monopolistic behavior. They are well balanced, solvent, and simply adjusting for the future- as many have said.

Sicatoka beat me to it, but is exactly right. The long term impact of affordable care act will be to impact jobs and access to healthcare. Communities like GF will be hardest hit.

They are very aware of impacts. The mandate isn't in effect yet, the exchanges just opened. Major adjustments haven't happened yet, but they will. This is being done to prepare for the future, not because they are in trouble. Their awareness and adjustments show that they are paying close attention, not the other way around.

Do a days cash on hand analysis. Check their bond rating. Get an MBA. The financials are very strong and stable. There is an alternative to their plan, they could raise the cost of healthcare.

this has started to turn political. End of the day, money doesnt grow on trees

Only senior staff is taking a paycut. They are not in trouble financially. They are missing a budget target. If I have a million in savings, but my monthly expenses are running a thousand bucks in the red, do I stop investing? Do I pull out of savings? No, I'd rather do things like spend less on beer. Read the bios of senior staff- masters degrees and twenty plus years in the business- they get it.

Also, regarding the initial post, capital investment is always looked at differently than operating income decisions.

This new normal is reality under the ACA. Rural hospitals that are too big to be "critical access" are going to get crushed from all sides.

Altru will not sell. The Mayo affiliate partnership was designed to ensure independence in perpetuity. Healthcare economics are not like typical economics- competition does not lower costs, it raises them. Federal reimbursement is also dramatically cut if a community hospital ceases to be a sole community provider. That revenue to Altru is federally funded. Add a second hospital, that money goes to California or wherever else the feds decide to send it. Decisions are being made looking out the windshield. One result of the ACA is that access to capital has tightened up in the industry making financing options more limited. You have to be prepared for that to be the new normal. If Medicare reimbursement goes down, and access to capital tightens, and commercial insurers cut allowed amounts...result is less revenue and less cash than before. You don't stimulate demand in healthcare, so you have to tighten your belt. The senior staff decision to cut pay for the remainder of the year is simply an optics play- but a good one in my opinion- tough to justify higher comp for senior staff during a bad year

They didn't used to...but...my statements are supposed to be politically agnostic

Never said they didn't make a profit. If I take risk and can lose, shouldn't I also be able to win? And if I do it smartly, I should win more than I lose, just like any financial institution. They don't "win" by not paying claims- that would be short term and they'd be out of business in a couple years. Insurance company profit margins are not from what you think of as insurance...they are from investment income and from selling ancillary products

As an expert, I will have to disagree. Blaming insurance companies for the cost of insurance is akin to blaming your local gas station for the cost of gas. Important things to note: 1. If you're employed by a larger company, your policy is likely self-insured and as a result, your employer, not the insurer actually determined your benefits. 2. Your employer wants to pay as little for healthcare benefits as possible. 3. Insurance companies will ( if legal and administrable) pay for any benefit, it just raises the premium. 4. The percent of premium that sticks with the insurer is significantly less than the average negotiated discount for healthcare services they provide access to. Would you pay fifteen percent to save fifty percent? That's the insurance value prop. Out of that fifteen they are also paying taxes and broker commissions. The fifteen percent number goes to below ten percent on self insured. 5. Insurance companies are required to carry huge reserves in order to prove solvency in a crisis- a large chunk of insurance company profits are due to investment income on those mandated reserves. 6. The other driver of insurance company profits is the underwriting cycle, when one out of every five years or so the cost of care is lower than predicted by the actuaries. This is a risk premium. They also lose sometimes. Do you fault the casino for winning more than losing? Please note- no politics in this post, simply facts and business.

blaming insurance companies for everything