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The Sad Case of the Patient Protection and Affordable Care Act

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  • Re: The Sad Case of the Patient Protection and Affordable Care Act

    Originally posted by FreshFish View Post
    No argument there.

    At the same time, if you had to fight, which of these two do you choose for your opponent: an insurance company, or the IRS?
    The IRS at least has to follow administrative rules which are codified and set forth in the Federal Register. If they fail to do so, your appellate rights are set out for you.

    If an insurance company fails to follow its own rules, there's almost nothing you can do. You can sue them for breach of contract, but it's almost always less costly and far easier to win an administrative appeal in front of an administrative law judge than it is a full fledged civil trial.

    As someone who's been on both sides of the table, I'd rather go up against a government agency than a mega-corporation any day of the week and twice on Sunday.
    Last edited by unofan; 11-09-2012, 06:43 PM.

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    • Originally posted by unofan View Post
      The IRS at least has to follow administrative rules which are codified and set forth in the Federal Register. If they fail to do so, your appellate rights are set out for you.

      If an insurance company fails to follow its own rules, there's almost nothing you can do. You can sue them for breach of contract, but it's almost always less costly and far easier to win an administrative appeal in front of an administrative law judge than it is a full fledged civil trial.

      As someone who's been on both sides of the table, I'd rather go up against a government agency than a mega-corporation any day of the week and twice on Sunday.
      Government lawyers make less than corporate lawyers.
      CCT '77 & '78
      4 kids
      5 grandsons (BCA 7/09, CJA 5/14, JDL 8/14, JFL 6/16, PJL 7/18)
      1 granddaughter (EML 4/18)

      ”Any society that would give up a little liberty to gain a little security will deserve neither and lose both.”
      - Benjamin Franklin

      Banned from the St. Lawrence University Facebook page - March 2016 (But I got better).

      I want to live forever. So far, so good.

      Comment


      • Re: The Sad Case of the Patient Protection and Affordable Care Act

        Originally posted by joecct View Post
        Government lawyers make less than corporate lawyers.
        But I thought us government employees were paid more than the private sector, what with our lavish honda civics and offices that get renovated every third decade?

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        • Re: The Sad Case of the Patient Protection and Affordable Care Act

          Add Papa Johns to the list.
          http://www.huffingtonpost.com/mobile...usaolp00000003
          CCT '77 & '78
          4 kids
          5 grandsons (BCA 7/09, CJA 5/14, JDL 8/14, JFL 6/16, PJL 7/18)
          1 granddaughter (EML 4/18)

          ”Any society that would give up a little liberty to gain a little security will deserve neither and lose both.”
          - Benjamin Franklin

          Banned from the St. Lawrence University Facebook page - March 2016 (But I got better).

          I want to live forever. So far, so good.

          Comment


          • Re: The Sad Case of the Patient Protection and Affordable Care Act

            Originally posted by joecct View Post
            So he no longer wants to add an extra nickel and dime to the price of a pizza he's just going to part time employees? Which will actually force him to hire more employees to fill in those hours. I guess he's got some job creation going for him. Although he'll probably just make fewer work harder.

            Kind of like that Applebees guy needing an extra 50 cents a sandwich. How poorly is your business doing when that's going to make or break your entire franchise?

            Clearly these guys treating their employees as disposable assets is a good long term business plan.

            Comment


            • Re: The Sad Case of the Patient Protection and Affordable Care Act

              Originally posted by unofan View Post
              But I thought us government employees were paid more than the private sector, what with our lavish honda civics and offices that get renovated every third decade?
              This cracked me up because it is right on the money. Mr Les hasn't seen a real reno in his space for about 20 yrs and has been waiting for the AC for all 31 yrs of his tenure (imagine a triaining room in the exact center of the gym with no AC and inadequate ventilation- 100+ degrees smells very nice during august camps), he does drive a Honda tho- it is really lavish- the brakes work and there are no cracks in the windshield

              On the other hand they won't put him to part time to save his bennies- he just works 7 days a week, is salaried and never gets to take all his vacation.

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              • Re: The Sad Case of the Patient Protection and Affordable Care Act

                Originally posted by ScoobyDoo View Post
                None. Fighting insurance companies is not easy.
                In the early years of practice it was much easier. Jenny would get on the phone with them and win perhaps 75% of the time for our patients. If she could not get through to them she would put me on and we would win perhaps another 10-15%. As time went by the percentages dropped precipitously. I would spend hours of the day trying to explain a situation to someone who was totally incoherent who would then turn me over to a supervisor who simply kept reading from a script. By 20001 I was spending 4 hours a day with patients and perhaps an equal amount of time on the phone with insurance companies. I was actually told by one supervisor-"Don't you understnad when NO means NO?" This is one of the reasons we are semi retired and do not get involved with insurance companies unless it is to argue with them about our own individual claims.
                Take the shortest distance to the puck and arrive in ill humor

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                • Re: The Sad Case of the Patient Protection and Affordable Care Act

                  I've changed my mind, Papa Johns needs to cut employees. How else can he afford to keep his modest... castle. Or his 22 car underground garage with valet and carwash?

                  *****http://i.imgur.com/AeEbi.jpg******

                  Srsly? This ****er can't afford to spare any profit for his employees to have health care?

                  Comment


                  • Re: The Sad Case of the Patient Protection and Affordable Care Act

                    Originally posted by Foxton View Post
                    I've changed my mind, Papa Johns needs to cut employees. How else can he afford to keep his modest... castle. Or his 22 car underground garage with valet and carwash?

                    *****http://i.imgur.com/AeEbi.jpg******

                    Srsly? This ****er can't afford to spare any profit for his employees to have health care?
                    Maybe Obama can take over the company, that would teach him.
                    I swear there ain't no heaven but I pray there ain't no hell.

                    Maine Hockey Love it or Leave it

                    Comment


                    • Originally posted by walrus View Post
                      Maybe Obama can take over the company, that would teach him.
                      Yea that makes a whole lot of sense.

                      Comment


                      • Re: The Sad Case of the Patient Protection and Affordable Care Act

                        Originally posted by Foxton View Post
                        I've changed my mind, Papa Johns needs to cut employees. How else can he afford to keep his modest... castle. Or his 22 car underground garage with valet and carwash?

                        *****http://i.imgur.com/AeEbi.jpg******

                        Srsly? This ****er can't afford to spare any profit for his employees to have health care?
                        In Montgomery County, MD if the property is over 5 acres and you have (I think) 3 horses, it qualifies as agricultural land and subject to less property tax.
                        CCT '77 & '78
                        4 kids
                        5 grandsons (BCA 7/09, CJA 5/14, JDL 8/14, JFL 6/16, PJL 7/18)
                        1 granddaughter (EML 4/18)

                        ”Any society that would give up a little liberty to gain a little security will deserve neither and lose both.”
                        - Benjamin Franklin

                        Banned from the St. Lawrence University Facebook page - March 2016 (But I got better).

                        I want to live forever. So far, so good.

                        Comment


                        • Re: The Sad Case of the Patient Protection and Affordable Care Act

                          Originally posted by Foxton View Post
                          Yea that makes a whole lot of sense.
                          Made enough sense when it came to General Motors that he did it...

                          Comment


                          • Re: The Sad Case of the Patient Protection and Affordable Care Act

                            obviously lots of you have never written a business plan, budget or understand bank covenants
                            Originally posted by mtu_huskies
                            "We are not too far away from a national championship," said (John) Scott.
                            Boosh Factor 4

                            Originally posted by Brent Hoven
                            Yeah, but you're my favorite hag.

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                            • Re: The Sad Case of the Patient Protection and Affordable Care Act

                              Originally posted by Foxton View Post
                              I've changed my mind, Papa Johns needs to cut employees. How else can he afford to keep his modest... castle. Or his 22 car underground garage with valet and carwash?

                              *****http://i.imgur.com/AeEbi.jpg******

                              Srsly? This ****er can't afford to spare any profit for his employees to have health care?
                              He's a job creator. What the **** is he paying taxes for?
                              **NOTE: The misleading post above was brought to you by Reynold's Wrap and American Steeples, makers of Crosses.

                              Originally Posted by dropthatpuck-Scooby's a lost cause.
                              Originally Posted by First Time, Long Time-Always knew you were nothing but a troll.

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                              • Re: The Sad Case of the Patient Protection and Affordable Care Act

                                Originally posted by ScoobyDoo View Post
                                He's a job creator. What the **** is he paying taxes for?
                                It's not for the monopoly. He who controls the gold makes the rules.

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