AP PHOTOS: Scenes from the life of Ed Koch

AAA??Feb. 1, 2013?10:11 AM ET
AP PHOTOS: Scenes from the life of Ed Koch
By The Associated PressBy The Associated Press, Associated Press??

FILE - In this March 23, 2010 file photo, former New York Mayor Ed Koch speaks during a publicity event in New York. A spokesman says Ed Koch, outspoken 3-term mayor who became brash symbol of NYC, died Friday morning Feb. 1, 2013 at age 88.(AP Photo/Seth Wenig, File)

FILE - In this March 23, 2010 file photo, former New York Mayor Ed Koch speaks during a publicity event in New York. A spokesman says Ed Koch, outspoken 3-term mayor who became brash symbol of NYC, died Friday morning Feb. 1, 2013 at age 88.(AP Photo/Seth Wenig, File)

FILE - In this Jan. 30, 1975, file photo, Jacqueline Kennedy Onassis, center left, and Bess Myerson, center right, walk with architect Philip Johnson, left, and Rep. Ed Koch, right, as they leave New York's Grand Central after holding a news conference for the "Committee to Save Grand Central Station." Koch, the combative politician who rescued the city from near-financial ruin during three City Hall terms, has died at age 88. Spokesman George Arzt says Koch died Friday morning Feb. 1, 2013 of congestive heart failure. (AP Photo/Harry Harris, File)

FILE - In this Dec. 14, 1980, file photo, New York Mayor Ed Koch stands among Beatles' fans paying tribute to the late John Lennon during a silent vigil that was called by Mayor Koch in New York's Central Park. Koch, the combative politician who rescued the city from near-financial ruin during three City Hall terms, has died at age 88. Spokesman George Arzt says Koch died Friday morning Feb. 1, 2013 of congestive heart failure.(AP Photo/Rene Perez, File)

FILE - In this Monday, April 7, 1980 file photo, New York Mayor Edward Koch greets a commuter who had walked across the Brooklyn Bridge upon his arrival on the Manhattan side, New York. Surrounded by news reporters, Mayor Koch told New Yorkers crossing the Brooklyn Bridge that they were on a ?bridge over troubled waters? but that the city would survive the transit strike. Koch, the combative politician who rescued the city from near-financial ruin during three City Hall terms, has died at age 88. Spokesman George Arzt says Koch died Friday morning Feb. 1, 2013 of congestive heart failure. (AP Photo/Carlos Rene Perez)

FILE - In this March 15, 1987, file photo, New York Mayor Ed Koch gets his head powered by a make-up artist before the start of his new television call-in program, "Koch on Call" at New York's Channel 5. Koch, the combative politician who rescued the city from near-financial ruin during three City Hall terms, has died at age 88. Spokesman George Arzt says Koch died Friday morning Feb. 1, 2013 of congestive heart failure. (AP Photo/Frank Franklin II, File) (AP Photo/David Bookstaver, File)

Ed Koch was part politician, part showman, and for many, he was the embodiment of the combativeness and tenacity that is New York City. In three tumultuous terms as mayor in the late 1970s and '80s, Koch dealt with fiscal problems, racial unrest and corruption scandals, always asking his constituents "How'm I doin?" And even after his days in office were over, in a whirlwind career in which he was an author, radio talk-show host, pitchman and even a TV judge, Koch never seemed to stop campaigning and cheering for the city he loved.

Here are scenes from the life and times of Ed Koch, who died early Friday of congestive heart failure at age 88.

Associated Press
People, Places and Companies: Ed Koch

Source: http://hosted2.ap.org/APDEFAULT/3d281c11a96b4ad082fe88aa0db04305/Article_2013-02-01-Obit-Koch-Photo%20Gallery/id-58b46a3225c74731a0daa2d28f114ef8

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Cheapest Family Health Insurance That Qualifies Under ObamaCare

Ding.

Comment by Patterico (89e117) ? 2/1/2013 @ 1:01 pm

I?ll take the penalty/tax, thanks.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 1:03 pm

You?ll get nothing, and pay for it.

Comment by SarahW (b0e533) ? 2/1/2013 @ 1:04 pm

Exactly and sign up when I get seriously ill.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 1:06 pm

The high deductible health policy choice offered by my employer (that still protected against catastrophe and risk of an impossibly big outlay for care) which I got for a pittance in premiums was very satisfactory for many years. Under Obamacare that puppy?s no longer an option. Thanks Dems.

Comment by elissa (0a4492) ? 2/1/2013 @ 1:12 pm

?If you like your insurance you can keep it.?

Comment by Patterico (89b580) ? 2/1/2013 @ 1:19 pm

?Under Obamacare that puppy?s no longer an option.?

elissa ? A high deductible cat policy won?t count toward avoiding the penalty/tax under Obamacare, but I?m unclear whether insurance companies will still be permitted to write them.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 1:22 pm

They might be able to write them, but you?d still pay the penalty/tax.

Comment by Sammy Finkelman (d22d64) ? 2/1/2013 @ 1:26 pm

That cannot be true, Elissa. If you like your insurance, you can keep it. Obama said so.

Comment by JD (b63a52) ? 2/1/2013 @ 1:28 pm

Yes, we were lied to, and yes, we got Obamacare.

But the lies were irrelevant to passing Obamacare. It isn?t as if the public only supported Obamacare because of the lies? as we both know, the public didn?t support Obamacare, period. The public didn?t believe the claims Obamacare supporters were making (a majority of the public felt Obamacare would result in their having to pay more money for less care).

We got Obamacare because the Democrats in Congress decided that it was something they were going to force down our throats. They knew the numbers didn?t work and they didn?t care.

Comment by steve (369bc6) ? 2/1/2013 @ 1:28 pm

If the numbers don?t work now, just wait until we add 12,000,000 more to the rolls.

Comment by JD (b63a52) ? 2/1/2013 @ 1:31 pm

I?m unclear whether insurance companies will still be permitted to write them.

Me too, but my guess is that they?re not going to be allowed to, as Obamacare sets minimum standards that policies have to meet (such as offering ?free? contraceptive coverage) and catastrophic only plans won?t meet that standard.

Comment by steve (369bc6) ? 2/1/2013 @ 1:31 pm

?They might be able to write them, but you?d still pay the penalty/tax.?

Sammy ? I noted that in my comment. My question is whether HHS would prohibit insurers writing policies which allow people to do an end run around Obamacare given the differential between the size of penalty/tax and the anticipated premiums. Early on I heard they were going to prohibit such policies, but I have not heard anything in a couple of years.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 1:35 pm

daley?yeah, I don?t know either. I think probably not. The beauty of it was that it wasn?t strictly a ?we wash our hands of you until it?s a catastrophe/hospital? deal. You still filtered all dr?s visits, tests and emergency room visits through the plan to get the benefit of any negotiated prices with the provider that were lower than billed amount. They didn?t pay uniil the high dedudctible was reached, but you benefitted from the group rates on services.

Comment by elissa (0a4492) ? 2/1/2013 @ 1:35 pm

For anybody wanting an insurance primer, the cost is going up for four reasons:

1 ? the minimum level of coverage is going up (as everything including the kitchen sink will have to be covered), driving up the cost (you ?get? more, you pay more).

2 ? forcing people with coverage to subsidize the free and below market coverage provided to those without coverage (xx% of your premium pays for ?your? coverage, the balance of your premium dollars pays for someone else to get coverage),

3 ? eliminating waiting periods, prior period exclusions, lifetime caps on coverage and risk-based pricing increases the expectation of outlay, resulting in higher premiums, and

4 ? medical care just costs more every year. There are very few breakthroughs that lowers the cost of providing care.

Comment by steve (369bc6) ? 2/1/2013 @ 1:38 pm

4 ? medical care just costs more every year. There are very few breakthroughs that lowers the cost of providing care.

LASIK

Comment by JD (448fa8) ? 2/1/2013 @ 1:39 pm

Obama bends the health care cost curve down, in his mind, the same place where he splits atoms.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 1:46 pm

That?s one, can you name a second?

Also, Lasik isn?t usually covered by insurance, so allow me to modify my point to say that there is very little that lowers the cost of what is covered by insurance. And where the cost for a given procedure or drug does go down, it is usually because it was replaced by a more expensive drug or procedure.

Unfortunately, medical care isn?t like computers, where we can expect to get a better machine for relatively less money than the year before.

Comment by steve (369bc6) ? 2/1/2013 @ 1:48 pm

The cost of routine care would go down if the market weren?t distorted by price-fixing, and this distortion protected by removal of the true consumer from the cost of care.

Prudential planning should be rewarded with tax breaks that employers get now ? employers should pay you a wage. You decide how to allocate. Your insurance costs should be fully deductible. HSA?s grow tax free with contributions also deductible.

The insurance market is then regulated by the states to make sure it provides what it promises.

The truly indigent or disabled are covered in part or whole by programs that CANNOT dictate other fee arrangements and insurers are also forbidden to collude or prevent negotiation of individual treatment.

Comment by SarahW (b0e533) ? 2/1/2013 @ 1:52 pm

Steve ? the costs for many diagnostic and surgical services go WAY down when self-pay when the provider is not forbidden from a cash-schedule or direct negotiation. MRI, ultra-sound, etc. Plain old tort liability and professional standards still apply, so quality is uncompromised.

Comment by SarahW (b0e533) ? 2/1/2013 @ 1:54 pm

?And where the cost for a given procedure or drug does go down, it is usually because it was replaced by a more expensive drug or procedure.?

steve ? I think the movement of many surgical procedure away from hospital settings to specialized clinics or outpatient facilities has had an impact on costs, but that would have to be confirmed by some of the docs on the board. The Obama Admin. does not particularly support physician owned hospitals or surgery centers based on my understanding.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 1:55 pm

the costs for many diagnostic and surgical services go WAY down when self-pay when the provider is not forbidden from a cash-schedule or direct negotiation. MRI, ultra-sound, etc.

I make a distinction between the cost of the service and the amount you have to pay ? defining ?cost? in two different ways, and my referring to ?cost? refers to the cost incurred by the provider in providing that service. Negotiating a price break doesn?t result in a lower cost of providing the service, it merely shifts the costs to someone else?s pocket. It?s the flip side of Obamacare mandating that coverage for X or Y is ?free?? not charging someone for that specific coverage doesn?t mean it doesn?t cost the provider to provide that service.

The same may apply to the ?cost? of outpatient surgery. While the insurance company may not pay as much, I don?t know if the actual cost of providing the service is any less in a different environment. (I think it?s being done because the surgeons can have a stake in the facility and thus can make more for themselves).

Comment by steve (369bc6) ? 2/1/2013 @ 2:05 pm

?And where the cost for a given procedure or drug does go down, it is usually because it was replaced by a more expensive drug or procedure.?

steve ? How about laparoscopic surgery which has become so common for many surgeries over time. While it may involve a higher technology investment than more invasive surgery, how does the shorter recovery time/hospital stay affect overall cost?

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 2:06 pm

Based on this report http://ehbs.kff.org/pdf/2012/8345.pdf
the average cost for a family plan with employeer provided coverage is 15,700$ for 2012. If i assume 3% inflation it goes up to 17,1000 for 2015. This is for an employeer plan, I assume that buying a plan for an individual family is more expensive but I have no idea how much. It doesn?t really look like this is too far off from what we?re currently paying.

Comment by time123 (066362) ? 2/1/2013 @ 2:10 pm

?I make a distinction between the cost of the service and the amount you have to pay?

steve ? I thought you were trying to make an analogy to a manufacturing type business, that the ?cost of goods sold? in the health care industry only moves in one direction due to technology or research advances. What people actually pay, negotiate to pay, or the government pays for the goods and services are separate questions.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 2:12 pm

Time ? the employer gets a tax break, and gets to play an employee with that plan and keep him. The self-purchase family plan ? NO BREAK AT ALL, except you don?t pay the fine.

Comment by SarahW (b0e533) ? 2/1/2013 @ 2:14 pm

Steve, the better way is to remove as much market distortion as possible, preserve liberty and reward private prudence.

Comment by SarahW (b0e533) ? 2/1/2013 @ 2:15 pm

It doesn?t really look like this is too far off from what we?re currently paying.

Raise your hand if you are paying this much.

Comment by JD (448fa8) ? 2/1/2013 @ 2:17 pm

according to my W2 the cost of my health care package is 11K to my employeer. My monthly is sums up to about 2,500 so i?m at 13,5 total.

Comment by time123 (066362) ? 2/1/2013 @ 2:23 pm

LASIK is different because it is not covered so competition lowers prices. I believe all health are would be like that but for government subsidies.

Comment by Patterico (399c43) ? 2/1/2013 @ 2:29 pm

standard healthcare pricing reflects the fact that many, if not all, non-capitated payors discount their payments, such as only paying 80% of the total charges?

capitiated payors, of course, pay a flat rate, no matter what.

that is why you, if you are going to purchase treatment yourself, can negotiate a lower price. it?s also why you will often get a bill from a provider after receiving care, demanding that you pay the difference between what they charged and what they were paid by your insurer.

Comment by redc1c4 (403dff) ? 2/1/2013 @ 2:33 pm

It?s good to know that you?re content and sanguine about all this, time123, and that you believe you are not negatively affected by ACA as so many of us already know we are. Maybe out there some where you can find a few more pipple who are happy, too, and start a little Omamacare fan club. I don?t think you?re going to need a very big meeting room, though.

Comment by elissa (0a4492) ? 2/1/2013 @ 2:34 pm

about your EMR?s as mandated by Obamacare

yeah, the DEA thinks they are entitled to them without a warrant demonstrating probable cause?

Comment by redc1c4 (403dff) ? 2/1/2013 @ 2:36 pm

The ideal is that the entire population will be attended to under the VA.
It is bound to cut SocSec costs.

Comment by askeptic (b8ab92) ? 2/1/2013 @ 2:48 pm

My turnip has no blood.

Comment by mg (31009b) ? 2/1/2013 @ 2:50 pm

Redc1c4 its worse than that, really. Medicare not only drives pricing, and distorts insurance payouts, but insurers actually forbid free negotiation or cash-for-service pricing that is better that their contract reimbursement. Moreover 3rd party reimbursements are nororiously shell games with real cost often disconnected from reimbursement.

Comment by SarahW (b0e533) ? 2/1/2013 @ 2:51 pm

Why is it that the more we discover about the PPACA, the more that out-of-pocket, first-party, CASH is the solution to spriraling out-of-control health-insurance (and care) costs?
This is a problem created seventy years ago that is finally bearing bitter fruit.

Comment by askeptic (b8ab92) ? 2/1/2013 @ 2:54 pm

An extra 7000 out of the family budget? What difference does it make?

Comment by SarahW (b0e533) ? 2/1/2013 @ 2:59 pm

The bullet train of single payer is up and speeding towards the station!

Comment by Patricia (be0117) ? 2/1/2013 @ 3:00 pm

Patterico ? exactly why I picked that example.

Comment by JD (448fa8) ? 2/1/2013 @ 3:01 pm

Ditto 10. and 38.

Comment by Joseph D (ece5cb) ? 2/1/2013 @ 3:09 pm

i was keeping it simple for the non-hc readers.

Comment by redc1c4 (403dff) ? 2/1/2013 @ 3:19 pm

SarahW ? if it?s true that health insurance purchased on the open market isn?t tax deductable, it seems like that?s something which should be fixed. (I don?t know, as I?ve always gotten insurance through an employer, so I?ve never had to find out.)

Comment by aphrael (009f82) ? 2/1/2013 @ 3:33 pm

I think our uruk hai is riffing off this;

http://www.motherjones.com/kevin-drum/2013/02/conservatives-shocked-discover-healthcare-america-really-expensive

Comment by narciso (3fec35) ? 2/1/2013 @ 4:11 pm

This is further proof, liberals think mathematics is a theory.

Comment by Kevin P. (1df29c) ? 2/1/2013 @ 4:48 pm

aphrael, you?re not getting the point. Obamacare was never meant to make health insurance more affordable.

Obamacare was meant to sabotage the last vestiges of whatever remains of the freemarket that hasn?t been killed off by all the other federal health insurance regulations since FDR?s new deal.

Obama and the Democrats intended this to fail so that they can get the single-payer system they always wanted.

It wasn?t intended to fix anything.

Barney Frank gives away the game. ?Saying we?ll do nothing until we get single-payer is a sure way never to get it.?

Yes, he says the best way to get single-payer is a ?strong public option.? But that doesn?t mean it?s the only way, as we are seeing.

Comment by Steve57 (104863) ? 2/1/2013 @ 4:50 pm

steve #15 ? one breakthrough that would lower the cost of providing care would be ?Loser Pays? ?

I don?t see our Pres?ent championing ?Loser Pays?, however ? (grin) ? he probably sees that as a racist personal attack ?

Comment by Alasdair (126343) ? 2/1/2013 @ 4:56 pm

Also see Jacob Hacker, Jan Shakowsky in 2009, and Obama in 2007,

Comment by narciso (3fec35) ? 2/1/2013 @ 4:57 pm

I wished it could have been a Happy Birthday for Andrew Brietbart today.

Comment by mg (31009b) ? 2/1/2013 @ 5:10 pm

#23: I don?t know. In addition to the capital costs of that and other device/technique improvements, I figure there?s also a chance that the quantity goes up, thus raising the costs.

#25, no to the manufacturing analogy. Yes to saying that lowering the ?cost? you?re charged for a particular procedure doesn?t mean that the costs of providing that procedure have gone down, only that those costs have been shifted to someone else to pay.

#30 While the consumer cost of Lasik has gone down, I don?t believe that?s the case with cosmetic surgery, which is also generally not covered by insurance. Nor, at least in my experience, has dental care which is often paid for on an out of pocket basis (the only dentists participating in my plan are ones I wouldn?t want to go to).

Comment by steve (e7e6c7) ? 2/1/2013 @ 5:19 pm

SarahW ? if it?s true that health insurance purchased on the open market isn?t tax deductable, it seems like that?s something which should be fixed. (I don?t know, as I?ve always gotten insurance through an employer, so I?ve never had to find out.)

aphrael, the problem is that once you start issuing tax deductions for purchasing health insurance on the open market, you further blow a hole in the alleged ?cost containment? of ObamaCare. But, you know, maybe that is just another bump on the road to single payer.

Comment by JVW (4826a9) ? 2/1/2013 @ 5:25 pm

It is kind of ironic that the Health Care reform outlawed true health insurance (#3) in favor of postpaid subsidized health services.

As is usual with the Blue ?safety net?, responsible people get penalized [um, taxed, and I denounce myself] and the deadbeats get the bennies.

Forward!

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 5:27 pm

Worst political class in history (and we?ve had some pretty bad ones), worst President in history.

Simply unbelievable.

Comment by SPQR (768505) ? 2/1/2013 @ 5:30 pm

You still filtered all dr?s visits, tests and emergency room visits through the plan to get the benefit of any negotiated prices with the provider that were lower than billed amount. They didn?t pay uniil the high dedudctible was reached, but you benefitted from the group rates on services.

And they kept that negotiated rate as low as possible so that your total stayed under their payment threshold.

This would be my ideal plan ? people focus on moronic things like whether a plan is 70/30 or 80/20, when the bulk of the savings occurs in the negotiated rate, even if the payments are 0/100 like you describe. And I?m covered if they have to scrape me off the pavement.

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 5:31 pm

SPQR?

Don?t know yet if he?s worse than Buchanan. A slide to civil war is pretty much the gold standard for worst.

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 5:33 pm

steve @50 ? Now you have totally lost me with your analysis. Your claim was that you could not think of one advance in drugs or medical technology which reduced costs.

You need to make up your mind what ?costs? you are talking about, the cost of providing a good or service or the ?cost? to the payor. Stop moving the goal posts.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 5:37 pm

Raise your hand if you are paying this much.

Two 59-year-olds on a gold-plated PPO (with PPO dental and glasses) ? $16K. I have to assume that two 40-year-olds with two kids and an HMO ought to be substantially less ? I could get an HMO plan TO-DAY for under $10K.

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 5:38 pm

typo. two 30-year-olds and two kids.

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 5:39 pm

This is further proof, liberals think mathematics is a theory.

And they think mathematics ends with arithmetic. I do wish one had to divide two numbers in one?s head in order to vote.

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 5:41 pm

I?ve always addressed the cost of providing the service. Who pays is a political shell game. Sorry if you haven?t been able to figure that out.

Comment by steve (e7e6c7) ? 2/1/2013 @ 5:44 pm

?aphrael, the problem is that once you start issuing tax deductions for purchasing health insurance on the open market, you further blow a hole in the alleged ?cost containment? of ObamaCare.?

JVW ? You can deduct premiums for individually purchased health insurance on Schedule A, subject to the 7.5% threshold of income base limit for medical expenses, the same way you can include the employee contribution of to purchasing employer sponsored health insurance. You can also deduct it elsewhere as a self-employed individual.

Nasty complications set in though if you get reimbursements from the insurance plan, which the IRS requires you to offset against the expense.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 5:47 pm

?I?ve always addressed the cost of providing the service. Who pays is a political shell game. Sorry if you haven?t been able to figure that out.?

steve ? You did exactly the opposite in comment 50 and emphasized it by disagreeing with the manufacturing example, talking about increasing the number of procedures performed from comment #23 and focusing on shifting payments.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 5:51 pm

?I?ve always addressed the cost of providing the service.?

steve ? Cost to who, the provider or payor, whoever that may be?

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 5:52 pm

Let me try s l o w e r

Medical providers incur a certain cost providing health care. Hospitals have fixed and variable costs, doctors incur costs (including an hourly rate for their time), drug companies have production costs of developing and manufacturing pills and so on. This is what I have been referring to as ?cost?.

My argument, which I think I have been consistent in arguing, is that these costs (1) with few exceptions, don?t go down, and (2) most of the argument over health care/insurance/Obamacare is over who has to pay those costs.

Comment by steve (e7e6c7) ? 2/1/2013 @ 6:06 pm

I understand that if I like my doctor, I can keep him. But if I don?t like my President, must I keep him ?

Comment by Elephant Stone (30e04f) ? 2/1/2013 @ 6:31 pm

No, you can?t, and you have no choice in the matter.

Comment by narciso (3fec35) ? 2/1/2013 @ 6:39 pm

Comment by Elephant Stone (30e04f) ? 2/1/2013 @ 6:31 pm

Hereby nominated for post of the week.

I?ve written about this before.
In 1960 a heart attack was treated by telling the person to stay in bed and rest. By 1970 one stayed in a special ?intensive care unit? to be monitored for life-threatening complications such as unstable heart rhythms. By 1980 people were having surgery to treat or prevent heart attacks. By 1990 even more people were having angioplasty. In inflation-adjusted dollars I don?t know if an angioplasty in 2013 is cheaper than surgery in 1980 or not. It certainly isn?t cheaper than being told to stay home and rest in the 1960?s when these fed programs were started.
Likewise kidney failure in 1960 was cheap, one died. Then dialysis came along and kidney failure treatment became expensive. Kidney transplants are cheaper in the long run (last time I heard anyway), but not cheap.
Genital herpes was not considered a common issue in 1970, now Valtrex is advertised as essentially a daily vitamin for all the otherwise healthy, smiling young folk who need to take it forever, and that nasty HIV hadn?t been heard of yet, but the cost of meds alone to treat it is in the $10,000+/yr.
A child with leukemia in 1960 died, now most live with treatment that involves a lot.

There are some advances that decrease cost, such as an angioplasty instead of open heart surgery, and laparoscopic gall-bladder surgery instead of an open, but as much of the advance in medicine is being able to treat what was once untreatable, one should expect the cost to increase.

But that is only a small part of the miriad of issues.

Comment by MD in Philly (3d3f72) ? 2/1/2013 @ 7:08 pm

?My argument, which I think I have been consistent in arguing, is that these costs (1) with few exceptions, don?t go down?

steve ? fine, except that you have not really addressed the specific examples of potentially lower costs offered in this thread, outpatient surgery, laparoscopic surgery and Lasiks.

The price paid by the payors, whoever they are, is a separate issue.

Comment by daleyrocks (bf33e9) ? 2/1/2013 @ 7:12 pm

MD, there are lots of things that cost less, too.

Get a bleeding ulcer today, and the treatment is generally non-invasive. In 1960, OMG. And many ulcers are solved with antibiotics before they get that far.

Break a femur in 1960 and you might well lose the leg; today you get a titanium replacement. Cost? Depends on what you count, but the cost of not having a leg is pretty high in lost productivity just to start with.

As far as ?death? costing little, again the living person may pay lots of taxes every year, which stop soon after death, even assuming that their contributions to society don?t count for government beancounters. Not all sick people are senile. Saving the productive is an investment, not a cost.

Then there are steroids, vaccines, statins, this/that/and the other-blockers, and lost of things that keep people active and unsick for years after they would otherwise succumb. Again, this may ?cost? but be quite cost-effective.

For every dialysis there?s another thing that makes up for it.

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 7:54 pm

*host

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 7:55 pm

I will do like most drivers in Texas do.. buy insurance a month before they have to have car registered, show the required proof of liability insruance, then cancel for 11 months, renew the 12th month..

Comment by Ric Mann (d9c7e5) ? 2/1/2013 @ 8:00 pm

Wonder what it costs to become a health insurance company for a month.. sign my family up,check the 1040 box in 2014 for ?covered? and go ?bankrupt? on April 16th? *it is what most insurance companies will do in about 3 years anyway.

Comment by Ric Mann (d9c7e5) ? 2/1/2013 @ 8:09 pm

As far as ?death? costing little, again the living person may pay lots of taxes every year, which stop soon after death, even assuming that their contributions to society don?t count for government beancounters. Not all sick people are senile. Saving the productive is an investment, not a cost.?
Then there are steroids, vaccines, statins, this/that/and the other-blockers, and lost of things that keep people active and unsick for years after they would otherwise succumb. Again, this may ?cost? but be quite cost-effective.
Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 7:54 pm

Oh, I agree 100% with you on this. In fact, I generally distrust anything that talks about ?cost effectiveness? in medicine (especially when talking about treating or letting die) because I don?t think they take such larger considerations into account.
But in this discussion, for example, the focus is only on what it costs for insurance and medical care, not what people and society get in return.
I guess, for example, one can look at health care costs as a percentage of GDP, but no one talks about the total GDP that was made possible by the health care.

Comment by MD in Philly (3d3f72) ? 2/1/2013 @ 8:12 pm

What did I say wrong in #71 and #72?

Comment by Rich Mann (777abd) ? 2/1/2013 @ 8:25 pm

This is further proof, liberals think mathematics is a theory.
Comment by Kevin P. (1df29c) ? 2/1/2013 @ 4:48 pm

? They believe in unintelligent design.

Comment by Icy (15c060) ? 2/1/2013 @ 8:32 pm

Comment by Rich Mann (777abd) ? 2/1/2013 @ 8:25 pm

If you are wondering why I did not make any reference to your posts, please do not assume anything was meant by it. There are at least 2 reasons that have nothing to do with your posts:
1) I think slow and type slower. I know I started on #73 before you posted #72, and maybe before #71 as well.
2) I was responding to something I had already posted on.

Comment by MD in Philly (3d3f72) ? 2/1/2013 @ 8:33 pm

Ric, you have to file, with your taxes, a statement on which months you had insurance3 and pay a pro-rated penalty for the months you didn?t. You can lie, of course, but the IRS may catch you at it.

Comment by Kevin M (bf8ad7) ? 2/1/2013 @ 8:43 pm

Maybe I will search out a LASIK facility that will discuss their actual costs of a procedure. In 2000, Better Half paid $5500 for both eyes. It now costs around $3000. The earlier prices were even higher. I cannot imagine that their costs have continue to go up while the price to the customer continues to go down. Maybe they had insane margins in 2000, and are just barely scraping by now.

Comment by JD (b63a52) ? 2/1/2013 @ 8:43 pm

My guess is that the economics of LASIK is more like that of consumer electronics, a new something that is neat but nobody needs to have. At first it is really pricey and only a few can afford, but as popularity increases and the overhead of production decreases the cost comes down.

I imagine cornea transplants, which have been around a lot longer, have not decreased in price, as it is something only a limited number of people get and only when they must.

Comment by MD in Philly (3d3f72) ? 2/1/2013 @ 8:51 pm

Also competition. When lasik was new there were relatively few who could do it, now the availability/supply is much greater.

Comment by MD in Philly (3d3f72) ? 2/1/2013 @ 8:52 pm

Source: http://patterico.com/2013/02/01/cheapest-family-health-insurance-that-qualifies-under-obamacare-20000/

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How Real-Time Bidding Could Save Mobile Advertising - Business ...

Programmatic buying is to digital advertising what high-frequency trading is to Wall Street. It involves computerized, algorithm-driven trading that allows for quick buying of ad impressions according to pre-set parameters.?

On the desktop, programmatic or automated buying of display ads has already made huge inroads. Its advocates say that it has led to a more transparent and efficient digital ad market.?But it is in mobile where programmatic buying may make the most difference.

In a recent report?from?BI?Intelligence?on programmatic bidding and real time bidding (RTB), we analyze how it?may help solve the mobile advertising CPM problem, detail its recent impact and successes, examine the potential obstacles to its widespread adoption, and look at how the holy grail of mobile advertising - controls and efficiencies - may be reached through its use.

Access The Full Report And Data By Signing Up For A Free Trial Today >>

Here's an overview of why programmatic buying could make the most difference in mobile:

• It could help solve the CPM problem:?The glut of ad inventory as global audiences rush into mobile has dragged on mobile display ad CPMs (CPMs refers to the cost per thousand impressions). That means publishers can't?monetize their mobile audiences effectively via ads. Advocates of programmatic ? or automated buying and selling ? say it can deliver the scale and efficiency needed to effectively match buyers and sellers and boost CPMs.
• Leveraging location data via real-time bidding (RTB):?RTB is a style of programmatic buying in which digital advertising opportunities are auctioned off in real-time. The auctions take place in milliseconds as advertisers bid on the right to show you an ad immediately after you open an app or click to a new web page.?On mobile, RTB could be extremely powerful ?because consumers take their devices everywhere ? to the mall, the car dealership, Starbucks, etc.?"You have a source of media that's with someone constantly," says Jamie Singer, director of client services at?Everyscreen Media, a platform for mobile RTB. "You're working in real-time, and getting information based on location."
• Helping to reach the holy grail of mobile advertising - controls and efficiencies: Believers in RTB and programmatic for mobile say they are?making giant strides in perfecting their technologies, so they'll have the ability to leverage consumer data on mobile and track users as they do on PCs (while still being sensitive to privacy concerns). That will include location, contextual, and demographic data layered on top of real-time ad requests.?
• Publishers already achieve higher CPMs with RTB than they do with traditional ad networks:?As a result, RTB is seeing wider adoption across the mobile ad ecosystem, and positive momentum on both sides of the equation. The sell-side is providing more premium inventory, and larger publishers requesting ads. And the buy-side is seeing more demand for RTB from advertisers and agencies.

To access BI Intelligence's full report on Programmatic Buying and RTB, sign up for a free trial subscription here.

Source: http://www.businessinsider.com/how-real-time-bidding-could-save-mobile-advertising-2013-2

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GameStick Android game console raises $648 thousand, should ...

A month after PlayJam launched a campaign to raise money for a new inexpensive Android-based video game console, the Kickstarter campaign for the GameStick has ended after surpassing the original goal by nearly 648 percent.

PlayJam was originally hoping to get about $100,000 in pledges from backers interesting pre-ordering the $79 game console, but ended up with $647,658 in pledges.

That falls pretty far short of the $8.6 million raised by the Ouya team ? another group creating an Android-based video game console. But it does show that there might be room for more than two different consoles designed to let you play Android-based games on a TV.

While the Ouya console is a $99 set-top-box that ships with a wireless gamepad and a custom user interface for downloading and playing games, the GameStick is? pretty much the same thing, but with a different user interface, a different controller, and a stick-shaped game console that has an HDMI port at one end, allowing you to plug the game console directly into your TV.

PlayJam is emphasizing portability with the GameStick. When you?re not using the game console you can actually slide it right into a slot in the gamepad for storage. That means you can carry your game console with you and use it on virtually any TV.

In the future the company also plans to offer wireless display support so that you can play games without even removing the stick from the gamepad and plugging it into the TV.

The GameStick features an Amlogic AM8726-MX ARM Cortex-A9 processor, 1GB of RAM, 8GB of storage, a microSD card slot, WiFi, HDMI, and Bluetooth. It runs a customized version of Google Android Jelly Bean.

PlayJam expects to ship the first GameStick units in April. Folks who didn?t get a chance to order one during the Kickstarter fundraising campaign will soon be able to place pre-orders at GameStick.tv.

If you're new here, you may want to subscribe to our RSS feed, follow us on Twitter, or "like" us on Facebook. Thanks for visiting!

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• Game formatDownloadable
• Controller typeWireless
• Video outputsHDMI
• Released04/01/2013

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Source: http://liliputing.com/2013/02/gamestick-android-game-console-raises-648-thousand-should-ship-in-april.html

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Vijay Singh withdraws from Phoenix Open

SCOTTSDALE, Ariz. (AP) ? Vijay Singh withdrew from the Phoenix Open on Thursday, a day after saying he used deer-antler spray and was "absolutely shocked" that it may contain a banned substance.

Singh cited a back injury in pulling out before the first round.

The 49-year-old Fijian first revealed he used the spray in an interview with Sports Illustrated. The magazine said Singh paid one of the owners of Sports With Alternatives To Steroids $9,000 last November for the spray, hologram chips and other products.

The magazine also reported Baltimore Ravens linebacker Ray Lewis sought help from SWATS in his recovery from a torn right triceps. The company says its deer-antler substance contains a banned performance-enhancer connected to human growth hormone.

Singh said in a statement Wednesday that while he used deer-antler spray he was not aware he may have been violating the PGA Tour's anti-doping policy.

"In fact, when I first received the product, I reviewed the list of ingredients and did not see any prohibited substances," he said. "I am absolutely shocked that deer-antler spray may contain a banned substance and am angry that I have put myself in this position. I have been in contact with the PGA Tour and am cooperating fully with their review of this matter. I will not be commenting further at this time."

PGA Tour spokesman Ty Votaw said the tour is "looking into the matter."

Singh won the last of his 34 PGA Tour titles in 2008. The three-time major champion also has 22 international victories. Early in his career, he was suspended from the Asian Tour for two years for altering his scorecard during a tournament in Indonesia.

Doug Barron is the only player to be suspended under the tour's anti-doping policy, missing part of 2009 and most of 2010. The one-year suspension was lifted in September 2010, and Barron was granted a therapeutic use exemption for low testosterone.

Source: http://news.yahoo.com/vijay-singh-withdraws-phoenix-open-151536909--golf.html

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10 Things to Know for Today

Medics carry an injured woman on a stretcher to an ambulance after a suspected suicide bomber detonated an explosive device at the entrance of the U.S. Embassy in the Turkish capital, Ankara, Turkey, Friday Feb. 1, 2013. The bomb appeared to have exploded inside the security checkpoint at the entrance of the visa section of the embassy. A police official said at least two people are dead. (AP Photo/Burhan Ozbilici)

Medics carry an injured woman on a stretcher to an ambulance after a suspected suicide bomber detonated an explosive device at the entrance of the U.S. Embassy in the Turkish capital, Ankara, Turkey, Friday Feb. 1, 2013. The bomb appeared to have exploded inside the security checkpoint at the entrance of the visa section of the embassy. A police official said at least two people are dead. (AP Photo/Burhan Ozbilici)

FILE - In this March 23, 2010 file photo, former New York Mayor Ed Koch speaks during a publicity event in New York. A spokesman says Ed Koch, outspoken 3-term mayor who became brash symbol of NYC, died Friday morning Feb. 1, 2013 at age 88.(AP Photo/Seth Wenig, File)

FILE- In this Jan. 9, 2013 file photo, the famous opalescent clock keeps time at the center of the main concourse in Grand Central Terminal is shown in New York. The country's most famous train station and one of its finest examples of Beaux Arts architecture in America turns 100 on Feb. 1. The building's centennial comes 15 years after a triumphant renovation that removed decades of grime and decay. (AP Photo/Kathy Willens, File)

Your daily look at late-breaking news, upcoming events and the stories that will be talked about today (times in EST):

1. SUICIDE BOMBER STRIKES U.S. EMBASSY IN TURKEY

Police say the attacker detonated an explosive device at the entrance to the embassy in Ankara and a report says two security guards were killed.

2. FORMER NEW YORK CITY MAYOR DIES

Ed Koch, the combative, acid-tongued politician who rescued the city from near-financial ruin and embodied New York chutzpah for the rest of the world, dies at 88.

3. AMBER ALERTS MAY BE A TURN OFF TO SOME

A new national alert system recently rolled out to cellphones that a child had been abducted has officials worried people will choose to opt out if their phones come to life unexpectedly.

4. SOMBER CEREMONY TO MARK SHUTTLE TRAGEDY

At 10 a.m., NASA will honor the seven astronauts who perished when the space shuttle Columbia disintegrated over Texas 10 years ago.

5. WHAT IS PROVING TO BE A QUANDARY IN TERROR FIGHT

AP's Lara Jakes finds that the U.S. is struggling to confront an uptick in threats from the world's newest jihadist hot spot ? North Africa.

6. JOBS REPORT EXPECTED TO BE A MIXED BAG

The January employment report released at 8:30 a.m. is expected to show that job growth remained steady last month even though Americans began receiving smaller paychecks that could keep the economy sluggish.

7. CHINA POISED TO CONTROL STRATEGIC PAKISTANI PORT

The port, not far from the Strait of Hormuz, gives Beijing another foothold in one of the most sensitive parts of the world.

8. RETIRED PRELATE ENSNARED IN ABUSE ALLEGATIONS

Los Angeles Cardinal Roger Mahony is relieved of his remaining duties as church releases thousands of pages of personnel files of priests accused of sexual abuse.

9. A CENTENNIAL AS GRAND AS ITS NAME

Grand Central, once in danger of being demolished, is celebrating its 100th birthday with speeches, a brass band and a rollback to 1913 prices.

10. WHY A POLITICAL ODD COUPLE IS BEING SHOWERED WITH PRAISE

James Carville and Mary Matalin are the faces of the host committee for New Orleans' biggest event in years ? the Super Bowl ? and say they're humbled by the gratitude of the locals.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/3d281c11a96b4ad082fe88aa0db04305/Article_2013-02-01-10%20Things%20to%20Know-Today/id-6a7ac659caa344a3b471209a78ef7142

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Pentagon expands probe of troubled components on fighter jet-sources

WASHINGTON (Reuters) - The Pentagon is inspecting other components of the F-35 fighter jet in addition to the faulty fuel lines blamed for the grounding of the Marine Corps version of the warplane, two sources familiar with the program said on Friday.

Vice Admiral David Dunaway, head of Naval Air Systems Command, asked for the expanded "material audit" this week after being briefed on plans by the Pentagon's F-35 program to resume training and test flights of the F-35B, the sources said.

"There's too much at stake here," said one of the sources, who was not authorized to speak publicly.

The grounding of the F-35B has raised questions about the ability of the $396 billion Joint Strike Fighter program to keep up with an aggressive flight test schedule for this year.

Dunaway wanted to be certain that other components made by Stratoflex, a unit of Parker Hannifin Corp, for the Lockheed Martin Corp F-35 fighter jet did not have the same problems as the fuel lines.

"He wants to assess the company's quality assurance practices and make sure they are doing business the right way," said the source.

Dunaway's office was not immediately available to comment.

It was not immediately clear how long the additional inspections would take and when the B-model would be cleared to start flying again. Dunaway is responsible for approving flights of the F-35Bs used for training, while the Pentagon's F-35 program office is responsible for approving test flights.

"This is a prudent step which will help to ensure that when we're ready to return to flight we do so with confidence," said a second source, who was not authorized to speak publicly.

The Pentagon this week began shipping fuel lines made by Stratoflex for CT scanning by an independent company in Minnesota after it determined improper crimping had caused a fuel line to detach just before a training flight at a Florida Air Force base on January 18, resulting in a grounding of the entire fleet of 25 F-35 B-model planes.

The Pentagon on Monday blamed the problem on faulty manufacturing, not the component's design or maintenance, and said both engine maker Pratt & Whitney, a unit of United Technologies Corp, and its subcontractor, Britain's Rolls-Royce, were taking steps to beef up their quality control procedures.

Stratoflex is a subcontractor to Rolls Royce.

U.S. military officials had already decided to have all the affected fuel lines produced by Stratoflex inspected using CT scans since problems could not be easily detected otherwise, but Dunaway decided to have other components made by the company inspected as well.

No comment was immediately available from Parker Hannifin, the parent company of Stratoflex.

Earlier this week, a Parker Hannifan spokeswoman said the company makes many other components for the aircraft and was working around the clock to support the Pentagon investigation.

Lockheed is building three different models of the F-35 fighter jet for the U.S. military and eight countries that helped pay for its development: Britain, Canada, Italy, Turkey, Denmark, the Netherlands, Australia and Norway.

The Pentagon plans to buy 2,443 of the warplanes in coming decades, although many analysts believe U.S. budget constraints and deficits will eventually reduce that overall number.

(Reporting by Andrea Shalal-Esa; Editing by Lisa Shumaker)

Source: http://news.yahoo.com/pentagon-expands-probe-troubled-components-fighter-jet-sources-015630909--sector.html

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