Sunday 10 May 2020

Think it through on your own and summarise it by writing it down

It's very simple, and very effective. in 2019 rose to $7900 ($15,800 per family. ) To balance the increase in cost for the sick, healthier individuals were not only paying higher premiums for their coverage, but they were paying more out-of-pocket costs than ever before when they did not even require medical care. The problem was that the ACA did not concomitantly lessen restrictions on tax-free funds in Health Savings Accounts (HSA) to help with the out-of-pocket expenses. The trick here is to find the sweet spot of cost sharing through tax-free HSA accounts and third-party coverage. Emergency situations such as a stroke, heart attack, or a broken leg are prime examples of why we have insurance. These are crises that render us unable to use discretion when seeking acute medical care. When physically or mentally incapacitated, we cannot make such decisions but rely on the professionals to make rational decisions for us. Balance-billing laws prohibit the doctors who care for patients from billing them for emergency care if they are not in the restrictive insurance networks, which is to say, if they are out-of-network. People should not go bankrupt because they were unable to price shop or determine network status during an emergency situation. What about non-urgent health care needs, especially preventive care? So a freshly [checks notes] shorn sheep skin was fashioned into a bag for wine. Why did the ancients house their Cabernet inside dead animal flesh? I don't make the rules. I told you the Bible could be weird. Freshly pressed wine could only be poured into brand-new skins, because, as fermentation developed and the wine expanded, new wine skins could stretch with the process. They had a lot of give, not a lot of wear. Over time, though, after skins had been used for loads of parties and weddings and feasts and Tuesday nights, they would become brittle and stretched to capacity. Thus, Jesus explained, No one puts new wine into old wineskins. For the old skins would burst from the pressure, spilling the wine and ruining the skins.

New wine is stored in new wineskins so that both are preserved (Matthew 9:17 NLT. They learn that their life is better when they behave the right way and gets worse when they don't. For if you reward them for bad behaviour and don't punish it, then you're encouraging a routine that will grow and destroy your relationship. The best way to show them how much you care, is to act in the right way that teaches them how to be great for you. It sounds so clear and so logical, doesn't it, to say that when we have a lover, and especially since we love them, we won't want to spoil everything with tiresome, trailing arguments. Most arguments are silly squabbles, but through some utterly mysterious process, we briefly forget we love that person and -- bingo! -- we end up wounding them, and not just temporarily. Enough time passes by, and then our arguments become increasingly acrid. The danger point where you must stop yourself is the Always/Never Point: that is, when you both move beyond criticisms of this particular moment -- that was out of line or please listen to me or don't shout, and descend to always/never accusations about your relationship generally: why are you always so rude? or you are always such an inconsiderate pig! or you never, ever listen to me! Recommendations vary for cancer screenings, routine checkups, and most diagnostic imaging. I have my own opinions, but so do many other doctors. Because of this variability, it is important for the individual patient to make decisions based on their own risk-benefit analysis of this type of medical care. Rather than a one-size-fits-all approach, we are moving toward precision medicine, in which treatment options are tailored to an individual. This is promising because it encourages not only individual decision making but individual cost sharing. Including the cost in the equation gives a more accurate analysis of risk vs. benefit. If the sole financial responsibility is on the third-party payer, then there are no safeguards to ensure financially sound decisions are being made. It is much easier to gamble in Vegas if you are using someone else's ATM card.

The moment your own paycheck is at stake, you may prefer a more conservative approach and only go all in when you have aces in the hole. ) In other words, containers run their course. They hold the goods as long as they can, but after a season, they have stretched as far as they can go, they've become brittle, and the inevitable outcome of continuing to use them as holders is that everything gets destroyed--the delicious wine and the container. It's all a mess on the floor and Tuesday night is ruined. Dear one, the wine is still good. If you are asking hard questions, it is because you love the wine. You believe it is good and marvelous and worthy of consumption. It has real lasting power. The wine has managed to woo every generation since time began. You are asking questions of the wineskins, which is wise and appropriate, because they don't last. They stretch as long as they can, but at some point, they have to be replaced so the wine can keep flowing. To paint your lover's essential character or behaviour as permanently bad in this way moves your relationship irrevocably towards its end. While these disputes often appear to be about money or jealousy, underneath they usually aren't, really. They spring up from deeper antagonisms that, if we fixed the surface problems, still wouldn't go away: they'd just move on and shape-change into another symptom of the real discord. If you are fighting and you are in one of the following two types of relationships, I'm sorry to tell you that it's doomed. Be honest with yourself. Do either of these sound familiar? Sheer incompatibility. You have chosen someone for your life who is just incompatible. Most of the reasons why people break up or get divorced are already plain to see in the first weeks of the affair, or on the very morning you first pool property and move in together.

But fatally, you just gloss over these conflicts because you really want a relationship we can make it work! Imagine if we created a system in which the insurance companies would cover our catastrophic illnesses, such as a cancer diagnosis or a ruptured brain aneurysm, and as individuals we took steps to prevent those illnesses from occurring. We could re-create the ideal health insurance environment, where patients have stake in the game. For the nonemergent scenarios, the insurance company would provide a lump sum of money, and the patient would be responsible for determining where they go for their care. With a lump sum coupled with tax-free HSA accounts, people could budget the necessary with the unnecessary. This scenario would demand providing price transparency, improved HSA user ability, and low-cost alternative plans; all staples of most Republican health care proposals. I dare to take it one step further. In defiance of naysayers (it is easy to sound like the bad guy here), I challenge America not only to support these types of reforms but to look in the mirror and see what more can be done. Routine wellness checks and vaccinations are essential to keeping Americans as healthy as possible. As we age, we need to add cancer screenings like mammograms and colonoscopies to our routine. New ideas, new understanding, new forms, new perspectives--don't miss the result of these courageous expansions: both are preserved. You are not rejecting the wine but simply noticing the brittle places where the pressure is untenable, and, in choosing new wineskins, you save the whole enterprise. So many women tell me they've rejected the wine, but upon further examination, they just stuck with an old wineskin too long. It can be hard to distinguish between a burst container and the wine it spilled when it is lying in ruins together on the floor. I contend the wine is still as worthy as ever. Jesus is good. He is love and love alone. He is for us, never against us. He fixed the broken space between us and God.

He was the greatest living human (he slayed at humanity) and lives to intercede eternally for us still. . Then in time, as the honeymoon feeling wears off, the hard truth starts to get to you. That's why considering and listing in advance exactly what you want from a partner is terribly important. And so is presenting your lover with the real, never the sugar-coated version of yourself from the very start. If that seems like putting logic at the heart of love, well, that's exactly where it should sit. By blending logic with your feelings, essentially, you then avoid a lot of very painful heartache later on. Lack of feeling - and part of that is, lack of empathetic attachment. Some start a relationship ruckus just for love of drama, others do it because they're bored, others don't care if they hurt someone else, or they even positively enjoy that power trip. Unfortunately if you're on the receiving end of this, it's bizarre, because you're fighting against someone who won't feel any pain. However you respond, whatever your weapon. People need to work with their doctors to determine the most appropriate and beneficial schedule for them to maintain. They should also choose the doctor and location from which they want to receive care, based on price and satisfaction, not because their insurance company is directing them. This is where price transparency comes into play. Giving patients the freedom to choose their medical practitioners and sites where they receive care rather than forcing them into a provider network will encourage market competition. It will not only maintain prices but spur improvement in quality and patient satisfaction. The patients will reward themselves by budgeting and will have a surplus in their HSA accounts. Remove the restrictions associated with the tax-free funds and allow people to use them for other necessities such as toothpaste, menstrual products, and even gym memberships. The patients who are responsible for saving money while also utilizing preventive care should be rewarded for their efforts. The insurer could further reward them for meeting certain wellness metrics, acknowledging their efforts to reduce their chances of developing disease.

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