It's nov 8; where's the stock markets headed?

[TexasHusker]

Texas Husker says: The healthcare industry is draining our GDP in ways too profound to measure. I don't feel one bit sorry for them. All ACA did is place more burden on businesses and consumers but gave the healthcare industry a free pass to rape and pillage.

I think you probably mean that you are finding healthcare expensive. Because the healthcare sector adds to the GDP, not drains it. And I suppose it is very measurable. There are certainly some billing oddities that are maddening, but I think a big part of the reason for that is the prevalence of health insurance, not maliciousness on the part of the med tech who weighs us and check our blood pressure, the radiologist who runs the MRI, or the MD who evaluates our coughing and wheezing, or the office staff who interact with us and our insurance companies.

I actually meant what I said - healthcare is draining GDP by dominating it at the tune of 20% +/-. It is crowding out the other sectors like a cancer.

There is no correlation between healthcare charges and actual cost. That's because the free market has all but been removed from healthcare. The healthcare execs are loving it. I know - I was one of them.

In 1994, our average charges per discharge were $5,100, and average length of stay was 3.4 days. When I left in 2013, our average charges per discharge were over $40,000, and the ALOS was still about the same.

In 1994, that hospital stay was approximately 18 percent of annual median household income. In 2013, it has swelled to over 80 perecent of annual median household income.

No other business - except colleges which are eerily similar - could ever get by with this. My gosh, my customers were HOWLING when our haircut price went from $13 to $14 this year.

The healthcare ripoff has got to come to an end. It is choking our economy to a degree that is profound and unconscionable, if not downright criminal.

[disneysteve]

All ACA did is place more burden on businesses and consumers but gave the healthcare industry a free pass to rape and pillage.

Tell that to the 20 million Americans who now have health insurance who didn't before because it was unaffordable for them.

I have a few hundred patients who have flooded into our practice since the ACA took effect. Most of them hadn't seen a doctor for years despite, in many cases, having serious illnesses like diabetes and hypertension. We have friends who are both cancer patients in their late 50s. If not for their ACA plan, they would be uninsured and, most likely, bankrupt. I have a relative who retired at 55 a few years ago. The ACA is one of the things that made that possible. Without it, he probably wouldn't have been able to afford health insurance and he would have been stuck working until he was 65 and could get Medicare.

Yes, healthcare costs are out of control, but that is not the fault of the ACA.

[TexasHusker]

Tell that to the 20 million Americans who now have health insurance who didn't before because it was unaffordable for them.

I have a few hundred patients who have flooded into our practice since the ACA took effect. Most of them hadn't seen a doctor for years despite, in many cases, having serious illnesses like diabetes and hypertension. We have friends who are both cancer patients in their late 50s. If not for their ACA plan, they would be uninsured and, most likely, bankrupt. I have a relative who retired at 55 a few years ago. The ACA is one of the things that made that possible. Without it, he probably wouldn't have been able to afford health insurance and he would have been stuck working until he was 65 and could get Medicare.

Yes, healthcare costs are out of control, but that is not the fault of the ACA.

I beg to differ on your last statement. I am one of your 20 million. By LAW I had to buy that garbage. My family rate started out at $1300 PER MONTH, and 2 years later it was over $2000 PER MONTH. We never used it because the deductibles were so high. Luckily we were able to switch to a plan that was exempted from ACA due to its religious affiliaton. It's easy and convenient for you to sit and judge as an employee of a fat healthcare system. It is the hand that is feeding you and your 401K - I get it.

I am trying my damndest to run a real business in the real world WITHOUT government games.

Healthcare needs to do the same. If the gubmit would get the heck out of healthcare and colleges, and allow these behemoths to survive on their own in a free market economy, things would be in a lot better shape. I might even have a little money left over to invest in a 401K.

[TexasHusker]

As a side note, I was in healthcare administration for over 20 years, working for a large multi-hospital conglomerate.

[disneysteve]

It's easy and convenient for you to sit and judge as an employee of a fat healthcare system. It is the hand that is feeding you and your 401K - I get it.

I've been in practice for 23 years. All 23 of those years, I have worked for a small, independent, private practice. The first 7 years in one practice, where I had no 401k but did have some sort of small profit-sharing pension. When the practice was disbanded (a few years after I left), I got a payout of about 20K that I rolled into an IRA.

For the last 16+ years, I've been in an even smaller, 2-man practice. We struggle every day to keep the doors open. We are in a very poor area. I haven't had a raise for many, many years. My salary is about 3/4 of what the going rate is if I joined a "fat healthcare system". And no, I don't have a 401k there either, or any employer-based retirement plan.

I did recently take a per diem job with a local urgent care center owned by a hospital. I needed to bring in extra income to keep us going because the private practice income just isn't cutting it anymore.

I hope that clears up some assumptions you made about me.

[TexasHusker]

I've been in practice for 23 years. All 23 of those years, I have worked for a small, independent, private practice. The first 7 years in one practice, where I had no 401k but did have some sort of small profit-sharing pension. When the practice was disbanded (a few years after I left), I got a payout of about 20K that I rolled into an IRA.

For the last 16+ years, I've been in an even smaller, 2-man practice. We struggle every day to keep the doors open. We are in a very poor area. I haven't had a raise for many, many years. My salary is about 3/4 of what the going rate is if I joined a "fat healthcare system". And no, I don't have a 401k there either, or any employer-based retirement plan.

I did recently take a per diem job with a local urgent care center owned by a hospital. I needed to bring in extra income to keep us going because the private practice income just isn't cutting it anymore.

I hope that clears up some assumptions you made about me.

It does, thank you. Your opinion is shared by most of your colleagues I might add. The physician is looking at healthcare through the prism of the health and welfare of the human, which is the correct and proper perspective. I also believe that clinicians are victims of the system that Big Brother created. The healthcare finance conundrum (and higher education conundrum) are both direct results of governmental tampering. And the more the gubmit tries to intervene and fix it, the worse it gets.

Capitalism and socialism cannot coexist; we must opt for one or the other and move along.

My apologies.

[disneysteve]

In 1994, our average charges per discharge were $5,100, and average length of stay was 3.4 days. When I left in 2013, our average charges per discharge were over $40,000, and the ALOS was still about the same.

I totally agree that costs have skyrocketed. I totally agree that the system is broken. I would point out, however, that quality and outcomes are also far better. That may or may not justify the cost but it can't be ignored in the conversation either.

For example, in 1994, HIV was probably still pretty much a death sentence. Today, I have patients who have been HIV+ for 20 years and are living perfectly normal lives.

Or look at hepatitis C. Until just a few years ago, it was considered an incurable disease and was the #1 cause of liver transplants. Today, we have new meds like Harvoni that are showing a 90+% cure rate. The drug is horribly expensive but if it prevents thousands of liver transplants and all of the costs associated with that including lifelong antirejection meds, is it worth the price?

Cancer survival rates are phenomenally better than they were 20+ years ago. Most folks now classify cancer as a chronic illness, not a fatal disease. That's a huge paradigm shift - but it has certainly come with tremendous treatment costs.

My point is simply that it's very hard and misleading to compare numbers from today to those from a couple of decades ago. We just aren't comparing comparable things.

[TexasHusker]

I totally agree that costs have skyrocketed. I totally agree that the system is broken. I would point out, however, that quality and outcomes are also far better. That may or may not justify the cost but it can't be ignored in the conversation either.

For example, in 1994, HIV was probably still pretty much a death sentence. Today, I have patients who have been HIV+ for 20 years and are living perfectly normal lives.

Or look at hepatitis C. Until just a few years ago, it was considered an incurable disease and was the #1 cause of liver transplants. Today, we have new meds like Harvoni that are showing a 90+% cure rate. The drug is horribly expensive but if it prevents thousands of liver transplants and all of the costs associated with that including lifelong antirejection meds, is it worth the price?

Cancer survival rates are phenomenally better than they were 20+ years ago. Most folks now classify cancer as a chronic illness, not a fatal disease. That's a huge paradigm shift - but it has certainly come with tremendous treatment costs.

My point is simply that it's very hard and misleading to compare numbers from today to those from a couple of decades ago. We just aren't comparing comparable things.

The program problem is, the $400 chest X-ray you are being charged isn't going to R&D. It's going to things like this:

http://virtualglobetrotting.com/map/david-vandewaters-house/

[disneysteve]

The program problem is, the $400 chest X-ray you are being charged isn't going to R&D. It's going to things like this:

As I said, I wasn't disagreeing with you about the system being broken. I just don't think comparing 2016 costs to 1996 costs tells the full picture.

[sv2007]

Americans are tired of all of that, and exercised their will. Trump is far from a perfect candidate and I held my nose when I voted, but I could not in good conscience vote for a woman who has no respect for the law, has no concept of honesty, and is an abortion lover.

One thing I was counting on a Hillary win was to unload more of my guns. I'm unable to buy a handgun in CA, but I've sold more than 30 guns. The gun laws are just ridiculous.

[StormRichards]

How much do you have invested, just curious?
I'll guess $2.5m <-- am I close?

Not sure how much gains my investments made, but they are generally up too, esp my pharmaceutical stocks which make up a good % of my portfolio (they really went up a lot, like 5% just on 11/9).

So did you end up hedging?

If so, what was the net impact of the hedging and market gain?

[sv2007]

So did you end up hedging?

If so, what was the net impact of the hedging and market gain?

I kept my cash hedge. I didn't take on any FOREX position.

In this case, I didn't earn as much return since my cash is still the same while my stocks appreciated. Hedging is basically insurance to remove volatility so this outcome is expected in this case; i.e. you don't lose or win big during times of uncertainty; i.e. you want to reduce the gambling aspect and add a bit more smooth/predictability in the investments.

Now, the interesting thing is, had I taken my FOREX position, I'd make a lot of money on the Trump win (I hedge again lower probability outcomes, e.g. I hedge against BREXIT). Very interesting in the currency and stock movement (Trump = higher interest rate, which means strong USD and should lower market, but as you can see it isn't happening). Maybe there's arbitrage (playing their eventual divergent movements).