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Thread: extra income

  1. #1
    Senior Member shacha's Avatar
    Join Date
    Feb 2002
    bonita springs, fl

    extra income

    i have been lookng or something i could do around takin care of my husband, to make extra money well i have found it and i a willing to share with anyone out there who is intrsted. just e-mail me and i will talk with you or you can go to the company web site if ou go to the we site and decide to sign up please use my broker # 19368.
    i work when i want and i am maing good money a bit more than just extra income.
    there is no up front money so give it a try. ican only tell you that i dont sweat the bills anymore. hope to hear from you :coo

    [This message was edited by shacha on Aug 31, 2002 at 02:36 PM.]

  2. #2
    Senior Member BJ's Avatar
    Join Date
    Jul 2001
    Denver, CO USA

    extra income

    Please repost the link, it is coming up not found.

  3. #3
    Senior Member Max's Avatar
    Join Date
    Jul 2001
    Montreal,Province of Quebec, CANADA

    I get extra income...

    by selling old magazines, stamps, some soveneers on e-bay

    " They say "Seeing is believing" but the true question is: What do you believe you've seen? Throughout history, the search for faith has lead man to look to the stars and the heavens for answers, but only by looking into ourselves may we truly find it." Outer Limits(Josh)

  4. #4

  5. #5
    Agreed. Nice assist Dr. Young.

  6. #6
    Schacha, I just looked at the Premier-Healthlink site but don't understand what the organization does and how it does it. In fact, much of what it promises seems too good to be true, i.e. 40-60% discounts for hospitalization costs and fees, and 10-30% for primary care physician and specialist fees (for example, see this site). Premier Healthlink appears to be the merger of two companies, Premier, Inc. and Healthlink. Healthlink is a hospital information management consulting firm.

    Premier Healthlink is apparently not an insurance company but is a "national healthcare program that when presented to a given networkof medical providers, entitles you to reduced rates of up to 80% on your medical care. These providers include physicians, hospitals, dentists, vision centers, pharmacies, chiropractors, hearing centers, home health care nurses, ancillary providers, and many, many more."

    The cost to join is $20-$55 per month for a family. This seems almost too good to be true. It appears to be a free lunch and it is not clear at whose expense. I was thinking that this might be the "Enron" of healthcare. So, I tried to find out more about this company and this program.

    Here is what I have found out so far, in chronological order of development.

    • On 24 Sep 1999, Premier introduces a web-based catalog in conjunction with two major medical distributors, to allow 60% of its 1800 members order through the web.

    • On 13 Oct 1999, Premier inks a $100 million deal with Xerox Corp that provides hardware, documentat management services, and advanced document technology for the medical healthcare industry.

    • On 7 Mar 2000, Premier sold a subsidiary called Premier Health Exchange, a 1800 member purchasing alliance for not-for-profit hospitals and delivery systems, to who will develop electronic commerce technology to improve the efficiency of the purchasing system while Premier will continue to develop buying arrangements for Medibuy and encourage its business partners to use Medibuy.

    • 20 Dec 2001. Premier is pioneering a variety of methods of improve efficiency of purchasing and delivery by requiring bar-codes on all the produces that it purchases.

    • 26 March 2001. Premier and Medibuy launch a "procurement portal" including 400 manufacturers and distributors. They will provide software for resource and materials management, etc.

    • 4 April 2001. Houston-based Healthlink (a leading medical information source) becomes the "preferred consulting firm for HIPAA assessment and training services for San Diego-based PremierÃ*s 1,800 hospitals. Such endorsements generally enable hospitals to obtain services at reduced pricing."

    • 8 Jun 2001. Premier endorses MedSeekas the web site maker for their hospital alliance. They will provide interactive web services for hospitals.

    • 27 Aug 2001. Premier contracts with ADAM for medical information contents

    • 14 Dec 2001. Premier offers a database which allows hospitals to submit patient information to conduct financial or clinical performance, compare the data with other hospitals.

    • 19 Feb 2002. Premier launches a free online newsletter concerning patient safety.

    • 1 Apr 2002. Premier announces a partnership with Healthlinks, the largest U.S. supplier of medical health information and contents, to allow hospitals to track their health care delivery but still remain in compliance with U.S. Federal privacy regulations
    press release

    • 25 Jul 2002. Premier offers to members free access to clinical trial listings on its web site TrialLink, including newly approved drugs, and profiles of nearly 2000 drugs int he development pipeline and their performance in clinical trials

    From these press announcements, it is clear that Premier Healthlink is the biggest and most successful of hospital management and information services. They are a true behemoth, probably controlling over 10% or more of the health care industry in the U.S. It is interesting that one cannot find a single critical analysis of this business on Internet except for press announcements that are clearly controlled by the company and advertisements. I am impressed how it has kept out of the news.


  7. #7

    Group Purchasing Organizations

    Premier is a very interesting company. It is a Group Purchasing Organiziation (GPO), owned by about 200 not-for-profit hospitals that it services. Together, nearly 1600 hospitals that Premier provide services to have an operating budget of $128 billion, 278000 beds, and 61 million patient-days. They offer a wide variety of services to hospitals, from performance services to purchasing and healthcare informatics. Because both Premier and Healthlink are privately owned, there are virtually no news articles, stock information, or anything that is available on Internet concerning the management or value of the company.

    Premier-Healthlink claims to be the nation's leading GPO but there are others that claim to be the nation's largest GPO, such as Novation. Medbuy (Canada's larges GPO) and Neoforma have a partnership. Other big GPO's include VHA, UHC, HPPI. Such companies, although mosstly out of the public eye, literally control hundreds of billions of dollars of medical healthcare purchases. They can make or break a device companies, force drug companies to their knees by boycotting or even delaying a given product. Such power may have consequences. So, following this link, I finally found several articles on Internet:

    Posted: Thursday, August 29, 2002

    Government Regulation of Hospital Purchasing -- Michigan Patients Pay a Heavy Price

    ByÂ*Â*Dr. Wolfgang Grassl
    Regulation-happy government institutions have recently found another way to keep themselves busy. Having succeeded in imposing restrictions on the accounting profession, the U. S. Senate has, seemingly in search of another Enron, recently taken to investigating purchasing structures in hospitals. With a series of articles ìuncoveringî supposedly unethical operations of voluntary purchasing groups in health care, the New York Times joined in the choir. Though it may seem to be just political grandstanding, the consequences for Michigan health care consumers are severe.

    Companies in any sector often join together in Group Purchasing Organizations (GPO). These are voluntary firms, usually of a for-profit nature, that have a single purpose: to benefit their members by reducing the costs of supplies. GPOs use the greater clout vis-‡-vis sellers that stems from larger, bundled purchase volumes to negotiate lower prices than their members would obtain individually. Consumers know such organizations under names like SamÃ*s Club and Costco.

    For hospitals, the leading GPOs (among six major competitors) are Premier Inc. and Novation LLC. Novation helps about a third and Premier about a quarter of American hospitals buy medical supplies at lower rates. They serve primarily the smaller hospitals, which are under greatest pressure. GPOs have now raised the suspicion of senators, who blame part of last yearÃ*s rise in hospital prices on inefficient and even unethical purchasing practices. At the same time, the Federal Trade Commission (FTC) is investigating whether rising medical costs are due to violations of antitrust law.

    What are the charges? The U. S. General Accounting Office claims to have found out that GPOs do not always offer hospitals lower prices. They are accused of having discouraged competition among medical suppliers. Some have developed their own private-label product lines. Now they are charged with pursuing their own commercial interests instead of working on behalf of their members.

    The truth of the matter is that health care is one of the industries most plagued by government regulation, and such regulation can work against the interests of patients. Federal actors in the regulation game include institutions such as the Department of Health and Human Services, the Occupational Safety and Health Administration (OSHA), and the Centers for Medicare & Medicaid Services. The State of Michigan regulates health providers through licensing and certification, authorizes certain capital expenditures by health agencies, and licenses persons who practice medicine and provide other health services.

    This socialist system, which involves not only providers of services under Medicare and Medicaid but also private hospitals, drives up the cost for consumers. Government mandates on product standards and medical procedures and a system of rigid price controls, originally developed by the military healthcare system Tricare, guarantee that market forces in medicine will be hobbled.

    Take the Diagnostic Related Guidelines (DRG), a true nightmare for physicians and hospital administrators since their inception in 1983. Compliance with DRG has become a science of its own, with a booming consulting profession maneuvering hospitals through the jungle of rules. Hospitals are paid on a per-case basis regardless of the intensity of care provided to each patient, except for extraordinary outlier costs. Just consider the following formula for calculating the ìthreshold amountî to be plugged into the definition of ìoutlier paymentî: Outlier Payment [= 80% of (Standard Cost ñ Threshold) x adjustment factor for childrenÃ*s hospitals] = {[Fixed Loss Threshold x((Labor-Related Share (.7110) x Applicable wage index) + Non-labor related share (.2890) x National Operating Standard Cost as a Share of Total Costs] + [DRG Base Payment (wage adjusted) x (1 + IDME)]}. All clear? This is how hospitals get reimbursed from Medicare, Medicaid ñ and from ìprivateî health insurers. Oh, yes, and there are two tiers of DRGs, different for Medicare and Medicaid.

    At present, hospitals can receive a reimbursement of $3,108.62 for treating a fractured femur (DRG 235) and $2,959.38 for a fractured hip and pelvis (DRG 236). Given the market power of the government programs, on which the majority of healthcare providers rely for revenue, even ìprivateî insurers like Blue Cross or Aetna nearly always take the DRG as their price ceilings.

    Add the fact that hospitals can increase their number of beds only if the state government certifies a need. In Michigan, beds can be transferred from one hospital to another belonging to the same organization only within a radius of two miles. Hospitals intending to start, replace or expand certain clinical services such as neonatal intensive care, open heart surgery, cardiac catheterization, lithotripsy, C.A.T. scan, M.R.I., air ambulance, and certain specialized psychiatric services, or those making capital expenditures in excess of $2,352,000 for a clinical service area or $3,528,000 or more for non-clinical service areas, must obtain a Certificate of Need from state government before proceeding.

    Any possible economies of scale, which are naturally limited in a service-intensive business, are thus thwarted. Prices being largely fixed by government rules, and hospitals having a capacity fixed by government rules, the only flexibility at all for becoming profitable is in lowering the costs of supplies and of labor.

    There is, of course, another way out: lowering the quality of medical services at given reimbursement rates. Hospitals themselves already must absorb the costs of patients staying longer than the time allotted under DRG. This imposes on hospitals a painful choice between financial survival and the medically best treatment of patients. Michigan hospitals have not yet reached that crisis point, but recent government strictures may push them over the edge.

    As a result of the passage of the U. S. Needlestick Safety and Prevention Act in November 2000, one major Detroit-area healthcare organization saw the price of IV catheters skyrocket from $0.60 to $1.50 each, and the price of lancets for infants (ìheelsticksî) from $500 to $11,000 a year. On another product line, extension sets, the new law costs this business, conservatively, an extra $500,000 a year. Hospitals must produce surpluses for reinvesting in equipment and training in a sector that is subject to rapid change of technology and medical knowledge, and all of this at largely fixed (because government-imposed) revenues.

    Is it then not understandable that they try to buy as cheaply as they can? It is practically the only lever their management can still use short of making doctors and nurses spend less time on patients. Hospitals will hardly join a GPO if they do not reap a substantial benefit through cost savings. They are free to exit. Most hospitals buy parts of their supplies through GPOs, and the rest directly from suppliers. Why does government get involved at all?

    Healthcare is a sad story. Governments at various levels first regulate healthcare providers by fixing both prices and possible output, and then attempt to dismantle self-help organizations of the industry ñ all under a guise of antitrust law and corporate ethics. And if hospitals merge in order to profit from any efficiencies larger businesses might still find, the FTC investigates them under antitrust rules. U. S. health care is a case study in policy failure ñ but not in market failure.

    This most recent government incursion on health care is grandstanding and counterproductive at best, and most harmful for patients at worst. No new Hospital Advisory Commission instituted by MichiganÃ*s governor will redress the calamity of overregulation. Politicians at all levels should leave healthcare to the institution that can provide it best: the free market.

  8. #8
    Wise, Thanks for the follow up - you beat me to it!

    Tough times don't last - tough people do.

  9. #9
    Senior Member
    Join Date
    Oct 2001

    could it be amway?

    i checked out the site sounds kind of interesting but has anyone tried using there service? it clearly says patient must pay doctor bills and there is no guarantee of a discount?

    the main guy is a chiropracter??????????

    i have been hitup a hundred times by amway reps they no longer mention amway because of the reputation all hype & no money. if it is connected to amway be sure to check prices, amway is usually way higher than name brands the opposite of what there brochures say. funny thing is amways sales pitch is almost identical to this one huge profit potential lol, diamond. pyramid scheme deluxe.

    i went to one of amways bigshot meetings they were selling fake rolex watches & preaching the importance of looking succesful, hmm wonder why they need fake watches? it was also noted to never mention your income just say im very comfortable or something to get there imagination going let the brochure intice them.

  10. #10
    Senior Member shacha's Avatar
    Join Date
    Feb 2002
    bonita springs, fl
    thanks Dr. Wise for your input.

    his is not amway nor is it connected with amway. and yes i use the program, i was paying 6000.00 a year in premiums with another company, then there was the 900.00 deductable which i only ever met once, now i just pay the cost of the program and what the po would pay my dr. it is much better or me all around.
    it is not going to be a good thing for everyone but then again there re a lot of things that are not right for everyone. i jst wanted to share with others so they can make up their own minds. thanks every one.

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