Best of the Comment Section

[Gas_Doc]

WCI has written so many articles that I can't begin to go through the comment section of all of them. In many of them, particularly the insurance posts, I find hilarious written by or replying to angry financial services people. What's your favorite comment to a blog post on the WCI site? I have a feeling a lot of them will be from WCI himself. (Note: this is meant to be lighthearted)

 

A recent favorite was after reading Jim's LEAP article. This is from an insurance agent:

"..Don't forget, EVERYONE is selling something. Even doctors get paid on scripts they write. So I shouldn’t see [a commission] if [WCI] gets paid by the pharma company?"

 

I'm not sure what I'm doing wrong, but I want a part of that script-writing money...

[nachos31]

Shhh guys, no one tell Gas_Doc how to get in on the script-writing money!

[Zaphod]

I have heard that before too, and at first dismissed it as ignorance. However, sure enough some docs do get paid because they are injecting/infusing/giving a medicine. I find that very strange.

It was discussed a few years back when an optho in florida was using the high priced drug instead of a generic and same outcome one because he made more injecting the fancy one. A perverse incentive.

[CM]

Zaphod wrote:

I have heard that before too, and at first dismissed it as ignorance. However, sure enough some docs do get paid because they are injecting/infusing/giving a medicine. I find that very strange.

It was discussed a few years back when an optho in florida was using the high priced drug instead of a generic and same outcome one because he made more injecting the fancy one. A perverse incentive.

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I did not know that.

[Zaphod]

Yes, super weird right?

[pulmdoc]

Lots of doctors do balance billing where they bill for the cost of the medication as well as the injection/infusion procedure itself. Medicare caps the profit to do this at 6% of the wholesale price of the drug. The downside to the doctor is they infuse a $1000 drug today and get reimbursed $1060 in 3-4 months. Anything happens to interrupt the billing cycle and a practice can end up with a cashflow problem.

The massive problem with CMS publishing physician payment data is that they publish gross payments only. Every one of the top paid doctors was a speciality that relies on balance billing of expensive medications-oncology, rheumatology, optho. $20M of billing in a year sounds ridiculous, but $1.2M profit is great but not over the top.

Optho docs make more money injecting Lucentis than Avastin, however Lucentis is FDA approved for macular degeneration and Avastin is not. So while the profit motive exists, it's not the only reason.

[Gas_Doc]

Anyone else have a favorite?

[FCP]

EVERY SINGLE QUOTE by "James C." and EVERY SINGLE HILARIOUS RESPONSE to the quotes by "James C." in the comment section of this timeless link:

 

https://www.whitecoatinvestor.com/6-reasons-to-have-a-high-early-savings-rate/

[Anesthesia84]

I wonder how James C. is doing now. He should follow up.

[Zaphod]

pulmdoc wrote:

Lots of doctors do balance billing where they bill for the cost of the medication as well as the injection/infusion procedure itself. Medicare caps the profit to do this at 6% of the wholesale price of the drug. The downside to the doctor is they infuse a $1000 drug today and get reimbursed $1060 in 3-4 months. Anything happens to interrupt the billing cycle and a practice can end up with a cashflow problem.

The massive problem with CMS publishing physician payment data is that they publish gross payments only. Every one of the top paid doctors was a speciality that relies on balance billing of expensive medications-oncology, rheumatology, optho. $20M of billing in a year sounds ridiculous, but $1.2M profit is great but not over the top.

Optho docs make more money injecting Lucentis than Avastin, however Lucentis is FDA approved for macular degeneration and Avastin is not. So while the profit motive exists, it’s not the only reason.

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Yes, those things are awful for those reasons. It can make it look like a 20 person practice has one guy pulling in 25 million which is ridiculous, and family practicioners making an average of 500k...before all costs, sure. ugh

[Zaphod]

Anesthesia84 wrote:

I wonder how James C. is doing now. He should follow up.

Click to expand...

Indeed.

[StarTrekDoc]

Like PoF's Dr A, B, C, D scenario -- Most of us tend to be Dr. B or C.  There are certainly Dr A extreme FIRE types, but the question of why go through the trouble of medicine training only to hang it up completely in 10?  -- Agree with Rex -- that's crazy.   James C appears to be a Dr. D type; which I'm sure 2 years down the road is not in any financial trouble.   It's hard to get into trouble with high earnings.   That was a very entertaining thread -- especially about us Christians and tithing  

 

 

 

[janettebournes]

Anesthesia84 wrote:

I wonder how James C. is doing now. He should follow up.

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I'm still amused he loved an Audi TT that much

[Craigy]

I remember those comments by James C.  I tend to agree with a lot of what he has to say, but also agree with the ed that you can do both.

 

And yeah that Audi TT.  Woo-woo.  Those Audi guys though love their Audis.  Worse than the Porsche guys.

[wideopenspaces]

I'm pretty sure James C is WCI's deusche-y alter ego or a character he created to prove his point, using satire. It's just too over the top to be a real person . . . right?? Otherwise, as a woman (or hot broad, or female that is willing to "spend time" with a guy just because he drives an audi or whatever other insulting way in which he refers to the ladies) I feel sad about humanity.