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Aeson
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orangesoda
Nov 2001
time: 22:36
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quote:
Originally posted by Asher
If it was your intent to make a point, you failed miserably. |
In your case yes. We obviously have no communication on this issue. It is obvious you don't understand, and so my point hasn't been conveyed. Both the reader and writer can be to blame for lack of communication.
quote:
Just how much math have you actually done? It's all about the context. |
And you ignore the context by saying my intent (which is the context of my post whether you like it or not) is irrellevent.
You continually refute what you are saying.
quote:
You were trying to make the point that non-profit organizations are somehow more efficient |
I'm sorry, but this is just too much! I never said non-profit organizations are more efficient. Again you say my intent isn't important... and then you conjure an intent... why? If it's not important you don't need an intent to argue with. You certainly shouldn't be making up intent to attribute to me that are in contradiction to my own admitted intents.
My intent was to show the correllation between profit margin and price, all else equal. You should stick with "that's irrellevent" instead of trying to argue against other perceived intents that are only a product of your miserable failure of an imagination.
BTW, for future reference, I view non-profit organizations as generally less efficient than for-profit. (obviously a good non-profit can do things better than a bad for-profit though, it's just a generalization)
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You did it by posting two equations with parallel structure, and it's very clear that the implication was the one with the variable plus another variable is higher than the one with the originally variable only. |
Obviously. It was designed to isolate profit margin and price from other factors (whatever they may be).
quote:
Perhaps you were underestimating the intelligence of the reader, because the reader called you on the ridiculousness of the statement, something you cannot even fathom yet... |
Overestimating in your case and this situation. You're a smart guy in most regards, but you have no flexibility. In a way you're a fundamentalist. You refuse to even acknowlege anything which may undermine your 'beliefs'.
In purely technical matters, this means you generally know what you are talking about, because those 'beliefs' are founded in scientificly sound ideas. Outside that realm, where 'belief' becomes less and less fact and more opinion, you superimpose your opinion onto other people and blatantly ignore their stated opinions. You then argue with a person as if they were upholding your own conjured opinion, rather than address what they say or explain their own to actually be.
This is why you fail to see the implication of my intent on the context the initial post. Because you can't admit that my intent differs from what you assumed my intent would be. Your 'belief' in that matter is fundamental and cannot be changed even in the face of fact (or as close as we can get to it on a matter of opinion, ie. the statement of that opinion by it's holder).
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Harry Tuttle
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of the Hoople Heads
Mar 2003
time: 00:36
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quote:
Originally posted by notyoueither
Couldn't need for profit from procedures be reduced by rates for stays per day being profitable as well? What would prevent that? |
Well, the system sort of works like that nowadays. Patients that can travel are usually asked to leave the hospital as soon as possible and recover at home. Most times its perfectly fine and can lead to a quicker recovery. Charging more for a room as a stay gets longer is also a way, but therin lies a problem.
A lot of times, as is witnessed with lower income patients, psyche ward patients, and overly ill patients (ones with lots of problems) the patient will not want to leave because they have no where to go or just can't leave because of a debilitating disease. These people run up the costs of stay well past the reimbursable time alotted by their healthcare provider, be it an insurance or govt program.
These un-reimbursable costs should get passed on to the patient, but a lot of times with the groups described above, it becomes impossible to collect. Ultimately, these costs get passed on to the hospital in the form of bad debts and excess overhead.
Sad but true. The hospital business is a world of contracts, reimbursments, high costs, and old A/R.
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Asher
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Calgary, Alberta
Nov 1999
time: 22:36
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quote:
Originally posted by Aeson
In your case yes. We obviously have no communication on this issue. It is obvious you don't understand, and so my point hasn't been conveyed. Both the reader and writer can be to blame for lack of communication. |
No, only the writer -- you can never blame the reader. It's one of the rules of writing... 
In your case, there's nowhere else to put the blame. From your "Exactly Spiffor!" comment identifying with his beliefs to backing them up with a formula which basically says one price with the extra profit added into the equation is higher. If that's not what you meant, perhaps you should do a helluva lot better job, because that's clearly what it looks like.
quote:
And you ignore the context by saying my intent (which is the context of my post whether you like it or not) is irrellevent.
You continually refute what you are saying. |
This makes no sense at all. I'm not refuting anything I'm saying...
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I'm sorry, but this is just too much! I never said non-profit organizations are more efficient. |
Then what was the "Exactly, Spiffor!" comment for? You agreed with him, no...?
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My intent was to show the correllation between profit margin and price, all else equal. You should stick with "that's irrellevent" instead of trying to argue against other perceived intents that are only a product of your miserable failure of an imagination. |
The intents were obviously speculation. Is that what you're having a fit about? The "that's irrelevant" point *IS* my point. It may be true in the mathematical respect, but not in the context of this thread, talking about a for-profit versus not-for-profit health system.
quote:
This is why you fail to see the implication of my intent on the context the initial post. Because you can't admit that my intent differs from what you assumed my intent would be. Your 'belief' in that matter is fundamental and cannot be changed even in the face of fact (or as close as we can get to it on a matter of opinion, ie. the statement of that opinion by it's holder). |
For the last time, I really don't care what your intent is. All I know is those statements, in the context of this thread, were wrong when I made the comment, and they are wrong now. I have no idea what you're *****ing about.
You say you used them to isolate profit margin -- such a thing is so fundamental that I have to believe you're shitting me.
See, the thing with the internet is I can't read your mind. All I have to go on is what you post here. It's not my fault you can't post what you want to say. The reason I'm attacking an opinion you think I "conjured" is because you can't communicate, and you expressed yourself poorly (extremely poorly, it would seem).
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Harry Tuttle
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of the Hoople Heads
Mar 2003
time: 00:36
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quote:
Originally posted by notyoueither
Seems an answer then might be to have the public cover a basic level of beds, and then let the public and private duke it out from there. |
Well... It depends, really on extended care needs for each patient, but I think you're on the right track.
There is a neat little extension that is written into Medicare here in the U.S. for minimal care for those patients who stay past the reimbursable periods. Problem is that it's only for a few weeks, the reimbursement to the hospital is still very near to cost or below, and it can only be used ONCE in a person's LIFETIME.
There are two solutions to the problem of meeting care needs and providing incentives to practioners to provide quality care:
1. Massive subsidies that will pay for lower margin/expensive procedures and entice good doctors to perform those services.
2. Reform the insurance industry through legislation so that reimbursements are higher, lower malpractice premiums, and cut down on million dollar malpractice suits.
Both are politically and monetarily cost prohibitive.
I think that #2 is our best bet as it will benefit both for and non profits, will clean up a lot of disparity in costs, and will open up the market to profitability again. #1 could work, but then you still have insurance problems and more and more taxes, and more of the same. FICA's a pain in the whazoo.
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Aeson
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orangesoda
Nov 2001
time: 22:36
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quote:
Originally posted by Asher
No, only the writer -- you can never blame the reader. It's one of the rules of writing... |
Are you saying a writer is then to blame if the 'reader' is illiterate?
You've been writing a lot of the posts in this conversation too, so it's your fault there is no communication in those cases. Right?
quote:
Then what was the "Exactly, Spiffor!" comment for? You agreed with him, no...? |
He said "Duh". I don't really know if he was replying to the original post, the prior post, or some other post... It's a joke...
quote:
The intents were obviously speculation. Is that what you're having a fit about? |
Nope. You're getting closer. I told you my intent, you ignore it and then conjure other conflicting intents.
The fit I'm having in this thread is one of laughter though...
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The "that's irrelevant" point *IS* my point. |
One of them. And one I agreed with because your context was different than mine. You still haven't realized that you are agreeing with me in that respect because you can't acknowlege the difference in context.
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It may be true in the mathematical respect, but not in the context of this thread, talking about a for-profit versus not-for-profit health system. |
The context of my post supercedes the context of this thread. My point may even be off-topic (most of what we've said here certainly is), but to assume my context is the same as everyone elses is stupid. Everyone has their own little angle, and if you want to communicate with them you'll just have to accept that it may not be the same as your angle (especially when they blatantly state that it is different).
quote:
I have no idea what you're *****ing about. |
Of course you don't understand. That's the whole point.
quote:
You say you used them to isolate profit margin -- such a thing is so fundamental that I have to believe you're shitting me. |
Ah... It's like posting that "doing drugs is illegal because it's against the law" in a legalize drugs thread... just to see someone so far gone ("drugs don't affect my brain, I think just as good as I always did") argue with it... by agreeing with it in other terms. That's personally my favorite. Religious nuts can fall for similar things. So can techies. 
Well, you've been 'disagreeing' with it for a few hours now. Take a bow!
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Asher
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Calgary, Alberta
Nov 1999
time: 22:36
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quote:
Originally posted by Aeson
Are you saying a writer is then to blame if the 'reader' is illiterate? |
If I were illiterate, I wouldn't be replying...
quote:
Nope. You're getting closer. I told you my intent, you ignore it and then conjure other conflicting intents. |
I ignore it because it doesn't make those statements any more true in the context they're in. Your claimed "intent" is so ridiculous that I sincerely doubt you were that stupid.
quote:
One of them. And one I agreed with because your context was different than mine. You still haven't realized that you are agreeing with me in that respect because you can't acknowlege the difference in context. |
I've acknowledged the difference in context repeatedly. The problem is, the context you put your post in had the opposite meaning than what you intended. Which is my point. Which you cannot seem to comprehend.
quote:
The context of my post supercedes the context of this thread. |
What kind of bullshit is this? Your post HAD no context, except a reference to a previous post in this thread, which was from a communist agreeing with the idea that a public, profit-free facility will be cheaper. In that context, you made that post. You've may have had some context in your head, but that doesn't work for everyone reading your post...
quote:
Ah... It's like posting that "doing drugs is illegal because it's against the law" in a legalize drugs thread... just to see someone so far gone ("drugs don't affect my brain, I think just as good as I always did") argue with it... by agreeing with it in other terms. That's personally my favorite. Religious nuts can fall for similar things. So can techies. |
I "fell" for it because I didn't think someone could post something so insanely stupid. Are congratulations in order? You sure fooled me... 
It's just easier for you to admit you're wrong than continue this bullshit, isn't it? 
quote:
Well, you've been 'disagreeing' with it for a few hours now. Take a bow! |
No, I've been slamming your post in the context of the thread, which is still valid now. You're all confused because you still are looking at it from the perspective you had when you posted it, but didn't communicate clearly.
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Aeson
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orangesoda
Nov 2001
time: 22:36
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quote:
Originally posted by Asher
If I were illiterate, I wouldn't be replying... |
It's the extreme example of the law you mentioned. Either a writer is always to blame (ie. "Only the writer [is to blame]"), or they aren't always to blame. So which is it? Are there exceptions?
quote:
I've acknowledged the difference in context repeatedly. The problem is, the context you put your post in had the opposite meaning than what you intended. Which is my point. Which you cannot seem to comprehend. |
You misinterpreted my intent. I'd even be willing to take that upon myself as the writer. Circumstance definitely had something to do with it, I can see how you'd misinterpret my response to Spiffor. I'm not familiar with Spiffor's standing on this (or any) issue.
I then plainly stated my intent, which you then proceeded to say doesn't matter. So first you say intent matters, then it doesn't. Lovely!
quote:
What kind of bullshit is this? Your post HAD no context, except a reference to a previous post in this thread, which was from a communist agreeing with the idea that a public, profit-free facility will be cheaper. In that context, you made that post. You've may have had some context in your head, but that doesn't work for everyone reading your post... |
I can understand that up until the point where... I told you what my intent was. After that, you have no ground to stand on.
quote:
I "fell" for it because I didn't think someone could post something so insanely stupid. Are congratulations in order? You sure fooled me... |
You don't understand the game very well. It's not about anything I did. I didn't even intend it to start it.
I made a comment which technically is correct, even if you find it simplistic. You, feeling something so simple couldn't have been stated intentionally, decided there must be some other meaning and blew it all out of proportion.
You 'disagreed' (by not acknowleging my explaination) with what you now admit as a simple fact. It's pretty funny.
That you started out by claiming my variable was a variable is even funnier though.
quote:
It's just easier for you to admit you're wrong than continue this bullshit, isn't it? |
You're the one that admitted I'm right. My point, that profit margin and price have a correllation, has not been refuted. My equations are mathmatically correct. It's all wrapped up nicely. The only argument you have against it is that it's too simple to argue. Which makes the fact that you've been arguing 'against' it all the more precious.
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Spiffor
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CPA - Evil Clone brigade
Nov 2001
time: 06:36
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Ah, Asher, always bent on introducing people in the fabulous world of the OT, eh?
Your demonstration is bollocks. Yes, costs of production are variable, but they remain closely related with the minimal costs for a service.
In the case of a hospital, you won't be able to very strongly reduce costs without also reducing the quality of service. Nurses, doctors, sterilization, extremely high-tech hardware and its maintenance, etc. This has a cost that won't magically melt when the hospital becomes profit driven.
The only arguable aspect of cost-efficiency, when it comes to the comparison of for-profit with non-profit organisms, is whether the waste usually attributed to non-profit's bureaucracy outweights the extra cost inherent to satisfying the shareholders of a profit driven organism.
Since there is not so much room for efficiency rises in the hospital, the answer is "non-profit wins". And the study only confirms the obvious.
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Asher
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Calgary, Alberta
Nov 1999
time: 22:36
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quote:
Originally posted by Spiffor
Ah, Asher, always bent on introducing people in the fabulous world of the OT, eh?
Your demonstration is bollocks. Yes, costs of production are variable, but they remain closely related with the minimal costs for a service.
In the case of a hospital, you won't be able to very strongly reduce costs without also reducing the quality of service. Nurses, doctors, sterilization, extremely high-tech hardware and its maintenance, etc. This has a cost that won't magically melt when the hospital becomes profit driven. |
I'm not picking a side, I'm saying the formulas don't necessarily hold true.
In theory, a private market introduces competition. When you do not have competition, you become complacent with costs. Beurocracy increases, innovation decreases, etc.
So the formulas he used wold be incorrect in the sense of saying that one will always be lower than the other.
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Adam Smith
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Maryland, USA
Jan 1970
time: 00:36
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In a previous life I did antitrust analysis of hospital mergers. In my current job I come across many of these cost issues as applied to transportation. While I appreciate any effort to get facts into economic debates, I very much doubt that this study is done correctly. The basic approach, divide costs by output, is correct. But the implementation is very likely wrong for two reasons.
First, what are the relevant costs? US hospital markets are usually not very because of the information problems associated with medical markets and because of government-imposed restrictions on entry. (If one hospital was earning monopoly profits, another hospital would need a government-approved “Certificate of Need” in order to expand facilities or enter the market.) If you simple divide revenues earned by for profit hospitals by their output you overstate the actual cost of care, because some of the revenues are not costs but monopoly profits. What you need to do is find out how much capital they use, and apply a market interest rate to that capital.
Not-for profit hospitals have a similar problem. If they fund their capital needs through revenues, or even if they get grants, that does not mean that the capital they use is free from society’s point of view. Suppose that a non-profit hospital used a billion dollars in capital to perform one operation. Do you think they would get many more grants? Again what you need to do is find out how much capital they use, and apply a market interest rate to that capital
The second problem is what is the relevant output? Its easy to say “divide costs by output”, but hospitals do many things: appendectomies, child birth, heart transplants, etc. Output is a vector, not a scalar. How do you compare output for a hospital that has 3 appendectomies, 4 births, and 5 transplants, with one that has 6 app, 8 births, and 10 transplants? The change in cost with respect to a change in scale of output is known as economies of scale. How do you compare output for a hospital that has 3 appendectomies, 4 births, and 5 transplants, with one that has 5 app, 4 births, and 3 transplants? The change in cost with respect to the change in the composition of output is known as economies of scope.
It is possible to address these issues, but it requires some fairly sophisticated economics and econometrics, which I suspect the authors, apparently not being economists, have not done. A quick search turned up an econometric study of Ontario hospitals which addressed these issues. The study found that Ontario hospitals tend to be too large and not exhibit economies of scope. Evidence supports the contention that non-profit hospitals have higher costs.
Abstract:
We estimate a translog multi-input/output model of variable costs for a sample of 187 acute care hospitals in Ontario. We rely on a unique data source--Resource Intensity Weights (RIW) developed by the Hospital Medical Records Institute--to account for variations in the case-mix across hospitals. Under the Ontario single payer system, the average hospital has too many beds and there are no scope economies between inpatient, out-patient and long-term care. [my emphasis] While nursing costs account for the largest proportion of variable costs, there is little substitutability between nursing and other inputs which reduces the options for reducing overall hospital costs.
COPY OF STUDY
edit: fixed url
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