UpWIthTheSunDoc

Music, medicine and the occasional rant against unfairness

[Monday Q Info @acaseofthegolf1]

🏮🏮News I’ve been dying to share🏮🏮

Big Break returns to @GolfChannel in August and I am hosting the “Meet the Contestants” part of the show.

I travel to all 12 players homes and we all get to know them.

I loved this show so much when it was on, I cannot believe I’m part of its return. I didn’t get this far in my dreams honestly.

I don’t even know what to say besides thank you to GC @goodgood_golf and @GOLFPASS for making this possible. And all of you for the support.

There are some amazing stories that will be on the show, some I knew, others I didn’t. And i can’t wait for you to meet all of them.

I can’t believe I’m a host on Big Break. Blows my mind.

[INDYCAR on FOX @IndyCarOnFOX]

JOSEF NEWGARDEN WINS AT @WWTRaceway!

[🏎 Chris Blair 🏁 @ChrisBlair4B]

Thank you @wbuxtonofficial for sharing and I'll add a little more to it. My first call of the day with the folks @IndyCarOnFOX occurred at 6 a.m. There were numerous conversations, text messages, zoom calls, etc. with them along with @jdouglas4 - In addition, we had incredible support from @NWS and @bam_weather - we had a lot of tough choices to make but the most important one was to deliver a quality show to the fans. I appreciate the fact that everyone at FOX and INDYCAR work so well together and keep the fans (home and tuned in) as a priority. In my more than 30 years of event promotion, yesterday was one of the most challenging in trying to do the right thing. It was painful at times but, in the end, all the parties involved delivered a hell of a show.

[Christopher Hale @ChristopherHale]

“If you think the world is selfish and rotten, go to the cemetery at Colleville-sur-Mer overlooking Omaha Beach. See what one group of men did for another on D-Day, June 6th, 1944.” — Andy Rooney

[UpWIthTheSunDoc @smithson_stacy]

@MidwestGolfJake @Top100Rick 3 beers and Waffle House…

[Matt Archuleta @indy44]

Fair warning. If you decide not to watch the #IndyCar #Bommarito500 because of start time you're taking a big chance of missing one of the best races of the year.

[Dutch Rojas @DutchRojas]

𝐌𝐚𝐧𝐡𝐚𝐭𝐭𝐚𝐧 𝐢𝐬 𝐨𝐟𝐟𝐢𝐜𝐢𝐚𝐥𝐥𝐲 𝐫𝐮𝐫𝐚𝐥.

At least according to Medicare.
See what your lobby dollars can buy?

NewYork-Presbyterian.
2,850 beds.
$9.3 billion in revenue.
Classified as rural.

So is Cleveland Clinic.
$7 billion. Rural.

Cedars-Sinai, Los Angeles.
$4.3 billion. Rural.

UCSF San Francisco.
$6.1 billion. Rural.

AdventHealth Orlando.
$6.2 billion. Rural.

A Johns Hopkins researcher pulled a decade of CMS Medicare cost reports.

A 2016 CMS rule change let urban hospitals hold both urban and rural classifications simultaneously.
Urban wage index for Medicare payment.

Congress wrote the rural benefit for donations and to screw over the American people.

[Neil Floch MD @NeilFlochMD]

“You can keep your doctor” was the great Obamacare lie because the implementation of the #ACA caused private practice primary care doctors to become financially unstable. They simply had to either be taken over by large health systems or become concierge doctors. All were gone!

[Dave Portnoy @stoolpresidente]

This mofo is 1,000 years old and has been in politics for twice as long saying time for the status quo is over. Can’t make it up.

[UpWIthTheSunDoc @smithson_stacy]

@IndyCarOnFOX it was a glorious Weiner!!!! Awesome job announcers!!!

[Dutch Rojas @DutchRojas]

Five companies quietly took 76% of a federal drug discount program created for poor patients.

Three of them also sell the insurance, run the PBM, administer the plan, and dispense the drug.

That is not a safety net.
That is a toll booth wearing a hospital gown.

Let's 🧵 together...

[Dutch Rojas @DutchRojas]

In 1720, the British Parliament passed the Bubble Act, ostensibly to protect investors from fraudulent stock schemes. In reality, it was written by the directors of the South Sea Company to eliminate their competitors.

American healthcare regulation follows the same pattern. Certificate-of-need laws don't protect communities. They protect incumbent hospitals from competition. Scope-of-practice restrictions don't protect patients. They protect physician staffing models from substitution. COPA agreements don't ensure fair pricing. They give merged monopolies regulatory cover.

Every one of these regulations has a named author, a named beneficiary, and a traceable lobbying expenditure. The capture is not hidden. It's documented in SEC filings, lobbying disclosures, and Congressional testimony.

The problem isn't that we don't know. The problem is that knowing doesn't seem to matter.

[Dustin Nickerson @DustinNickerson]

Looney Tunes hasn’t aged well

[UpWIthTheSunDoc @smithson_stacy]

@PoliticalStacy Love your name🤗

[UpWIthTheSunDoc @smithson_stacy]

@OnDisasters I believe that accident led to development of the SAFR barriers now used…thank God😢

[UpWIthTheSunDoc @smithson_stacy]

@BretBaier false reporting still happening at NYT 125 years later…and still pathetic…well done sir!!!

[Christine Price @HEALTHCOSTtruth]

Sometimes I think I've seen it all... and then this.
Patient goes in as uninsured - Bill is $21,885 - gets 40% cash discount. Balance = $13,131.
Patient files indemnity claim.
Indemnity pays a flat rate - $1100.
Hospital reverses cash discount because there was an insurance logo on the card.
New balance AFTER the $1100 indemnity payment = $16,000+. The balance due went UP by over $3000 because of the "network discount".

It should be illegal - it's not.
Look at the far-right column on this chargemaster: "Standard Charge | United Healthcare | Indemnity | Negotiated Dollar".

Quick reality check: Fixed indemnity plans are classified as "excepted benefits" under the ACA. The federal government does not consider them health insurance. They're required to display notices saying "THIS IS NOT HEALTH INSURANCE." They pay a fixed dollar amount per service. Regardless of charges. That's the whole legal definition.

That dog don't hunt in my world. The plan isn't insurance. It pays a fixed amount and walks away. But the hospital built an entire chargemaster column around it — to justify reversing the cash discount and stick the patient with the difference because a logo was on the card.

The hospital is pricing a non-insurance product like insurance to extract more money from patients who don't know the difference. Nobody's watching. That's why they get away with it. They won't this time.

[Dutch Rojas @DutchRojas]

Regulatory capture sounds abstract until you name names.

Pick any major CMS rule from the last decade. Find the person who drafted it. Check where they worked two years later.

It is just a LinkedIn search.

The system isn't captured by shadowy forces.
It's captured by specific people making specific career moves.
And it's all public record.

[Senator Chris Van Hollen @ChrisVanHollen]

Glasses were placed in front of us but we did not drink them. I know that may be a confusing concept for Director Patel.