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LakersFan writes in Post #1610 (in response to xraymd):

Congratulations!
My doctor is an internist and runs a very busy walk-in clinic with a few other doctors. They are Primary Care Physicians for a number of HMOs and PPOs, but they also speak Spanish and have their offices in the lower income part of town and do quite a bit of cash business. (And probably a decent amount of Collections too).


. . .

Good luck,
LakersFan



Is it farfetched to read this as saying that Hispanic people who get medical services on credit don't pay their bills?


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already commented on this.

nuff said.

Lady I.
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Is it farfetched to read this as saying that Hispanic people who get medical services on credit don't pay their bills?

Very farfetched.

Try reading it as: People who don't have insurance (a.k.a. "cash customers") have difficulty paying their medical bills.
I'm sure xraymd can confirm this.

LakersFan
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They are Primary Care Physicians for a number of HMOs and PPOs, but they also speak Spanish and have their offices in the lower income part of town and do quite a bit of cash business. (And probably a decent amount of Collections too).

So now I get it! Since it's "obvious" that people doing a cash business have a "decent amount" of collections cases, you were just pointing it out. Not for emphasis, but because it's obvious . . .

They speak Spanish and that is why they are popular in the community! (not because they are letting anyone slide on this "probable" collections work). ("Sorry doctor, I can't afford to pay." "No problema, amigo, let us hablemos español junto!")

It's really just coincidental that the offices are in the lower income part of town. They could just as well be in a better part of town. But service to their community of Spanish-speaking patients is paramount, so they locate there to have that convenience. We let the reader know that it's in a lower income part of town just for their own edification.

We give the reader more facts than necessary, just cause it's nice to do, not because we are making any assertions about any groups! I get it.

Silly me.

I wonder why the friendly doctors in the low-income community where they get to use their Spanish language ability don't just have their clients rely on "Medi-cal", the state's low income medical assistance program?

http://www.lao.ca.gov/analysis_2002/health_ss/healthss_07_4260_anl02.htm
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It's really just coincidental that the offices are in the lower income part of town. They could just as well be in a better part of town. But service to their community of Spanish-speaking patients is paramount, so they locate there to have that convenience. We let the reader know that it's in a lower income part of town just for their own edification.

Actually, it's not coincidental at all. They have two offices. The one in the lower income part of town does a LOT more business. That's because low income people often don't have health insurance and can't go to the other health care facilities.

We give the reader more facts than necessary, just cause it's nice to do, not because we are making any assertions about any groups! I get it.

I mentioned the Collections, because I didn't want to give xraymd the impression that I was unaware that there are significant costs involved with Collections in the medical field, especially when you are dealing with un-insured patients.

wonder why the friendly doctors in the low-income community where they get to use their Spanish language ability don't just have their clients rely on "Medi-cal", the state's low income medical assistance program?

It's not that easy to qualify for Medi-Cal. You have to be extremely poor, you have to be able to prove it, and you have to be in this country legally. You provide the link, but apparently didn't bother to read:
Almost all Medi-Cal eligibles fall into two broad groups of people. They either are aged, blind, or disabled or they are in families with children. More than half of Medi-Cal eligibles are welfare recipients...
Undocumented immigrants who qualify in any category are limited to emergency services (including labor and delivery and long-term care)


LakersFan
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Actually, it's not coincidental at all. They have two offices. The one in the lower income part of town does a LOT more business. That's because low income people often don't have health insurance and can't go to the other health care facilities.

So the doctors willingly take this "cash" business and allow themselves to be "stiffed" by the unpaying, uninsured (that if they do speak Spanish, the doctors can readily communicate). I get it now: this was your roundabout way of saying that the office the doctors have has a probable number of Spanish-speaking people who don't pay bills. (It isn't "collections" if the doctors agree to do it for free . . .)

I mentioned the Collections, because I didn't want to give xraymd the impression that I was unaware that there are significant costs involved with Collections in the medical field, especially when you are dealing with un-insured patients.

See, now, in your last post you were instructing everyone how "obvious" it was a cash business involves collections, but you decided (to clear matters up with xraymd of course!) to point out the obvious as if xraymd, who has knowledge of the field, wouldn't know this! It was to show that you sympathized with the medical community against those non-payers! Entiendo bien!

It's not that easy to qualify for Medi-Cal. You have to be extremely poor, you have to be able to prove it, and you have to be in this country legally. You provide the link, but apparently didn't bother to read:
Almost all Medi-Cal eligibles fall into two broad groups of people. They either are aged, blind, or disabled or they are in families with children. More than half of Medi-Cal eligibles are welfare recipients...
Undocumented immigrants who qualify in any category are limited to emergency services (including labor and delivery and long-term care)


The part that you obviously failed to read was about "partial payment" Medi-Cal, where low and moderate income Californians can receive a subsidy for medical care. Medi-Cal, it turns out, is the second largest item in the California budget, after education. Even undocumented workers are permitted, under emergency circumstances, to use Medi-Cal.

Is it possible that doctors set up in low-income areas of your state because of the presence of Medi-Cal? How much doctoring do you honestly think would be going on in low-income communities, if a substantial amount of "Collections" were involved? Have you ever heard of "third-party factoring" of receivables?

I'm unconvinced. Post #1610 sounds to me like the medical-assistance version of the "crisis of the student-loan deadbeats" (schemers, rule-beaters, etc.) that you try to sell here every now and again.




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I get it now: this was your roundabout way of saying

No you don't get it. All medical offices have collections. Medical offices that take non-insured patients have even more Collections. You're the only one who has drawn a connection between speaking Spanish and Collections.

It was to show that you sympathized with the medical community against those non-payers!

I never said, implied or thought such a thing. You've developed a habit of trying to put words in my mouth on this topic and others. It's very obvious, and it's not an honest way to have a discussion about anything.

Even undocumented workers are permitted, under emergency circumstances, to use Medi-Cal.

This isn't an Emergency Room, so undocumented workers can not use Medi-Cal there, they have to the Hospital emergency room. That's how Medi-Cal works. And most Medi-Cal patients have to use the County Health Services for their non-emergency health care, so they wouldn't be going to this clinic either.

Is it possible that doctors set up in low-income areas of your state because of the presence of Medi-Cal? How much doctoring do you honestly think would be going on in low-income communities, if a substantial amount of "Collections" were involved

And you accuse me of making slurs? I don't know where you come up with these types of assumptions, but you are totally off base. Go read my original post. These are great, caring doctors, who care enough to speak the language that a lot of their patients speak. I don't know what issue you are trying to make here, but it is all in your head.

It's obvious you don't care one iota about this topic, other than to pick fights with me. I wrote a nice and positive post to xraymd to give him information about a good, successful, medical practice. I will not discuss this matter with you any further.

LakersFan
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No you don't get it. All medical offices have collections. Medical offices that take non-insured patients have even more Collections. You're the only one who has drawn a connection between speaking Spanish and Collections.

No, the original post (yours) said:

"My doctor is an internist and runs a very busy walk-in clinic with a few other doctors. They are Primary Care Physicians for a number of HMOs and PPOs, but they also speak Spanish and have their offices in the lower income part of town and do quite a bit of cash business. (And probably a decent amount of Collections too).
FYI...Several years ago, this clinic was purchased/affiliated with a single large HMO. After about a year, the doctors bought back their practice because they did not like the control being exerted by the HMO."

Sure, Spanish and Collections can have nothing to do with each other in your original intentions when you wrote it. But it's not farfetched to say, esp. based on your prior work: hmmm, this is saying something about the "morals" of the people of that community versus the "selfless" doctors.

Me: It was to show that you sympathized with the medical community against those non-payers!

LakersFan: I never said, implied or thought such a thing. You've developed a habit of trying to put words in my mouth on this topic and others. It's very obvious, and it's not an honest way to have a discussion about anything.


I dunno. The whole Post #1610 seems to express sympathy and admiration for the doctors, and you purposely mention, in contrast, the "obvious" collections. So what was the point? It's like when you say defaulters are "not persons of their word", and then go on to create two exceptions.

Maybe the problem is that you are not very clear about what you really mean.

I'd like to know if you feel there are any other times that you think I "put words in your mouth". It sounds to me like you want to come here and make insinuations and judge people, and then don't want to be challenged.

This isn't an Emergency Room, so undocumented workers can not use Medi-Cal there, they have to the Hospital emergency room. That's how Medi-Cal works. And most Medi-Cal patients have to use the County Health Services for their non-emergency health care, so they wouldn't be going to this clinic either.

So the doctors are really serving the Hispanic middle-class who frequent the low-income area. It sounds like most other possible candidates wouldn't use them.

Me: Is it possible that doctors set up in low-income areas of your state because of the presence of Medi-Cal? How much doctoring do you honestly think would be going on in low-income communities, if a substantial amount of "Collections" were involved?

Lakers Fan: And you accuse me of making slurs? I don't know where you come up with these types of assumptions, but you are totally off base. Go read my original post. These are great, caring doctors, who care enough to speak the language that a lot of their patients speak. I don't know what issue you are trying to make here, but it is all in your head.



Where's the slur? You obviously have never heard of the problem of medical care for the rural poor. Doctors simply don't set up where there is little possibility of being paid. (The ridiculous student loan system and its cost pressures are partly responsible for that, by the way.) Doctors don't set up where a substantial number of people don't pay them--it's that simple. Someone has to pay (State, PPO, HMO, self-pay).

I notice you didn't have much to respond to about third-party factoring. Bascially, the unpaid bills get farmed out, and specialist companies handle collections. Occasionally, they will even buy the receivable from the doctor at a discount.

Foreign language ability? "They are Primary Care Physicians for a number of HMOs and PPOs, but they also speak Spanish and have their offices in the lower income part of town and do quite a bit of cash business. (And probably a decent amount of Collections too)."

This doesn't sound like a compliment of their abilities. It sounds like they speak Spanish and have their offices in the lower income part of town (which turned out to be only partly true--they have a second office in another neighborhood) and do quite a bit of cash business. You are telling the reader:

- but they also speak Spanish
- they have their offices in the lower income part of town
- they do quite a bit of cash business

- AND Oh! (Ehem, "obviously") probably a decent amount of Collections too.

I don't think its farfetched to conclude that you mean that the people who speak Spanish in the lower-income part of town provide cash business, but are the source of a "decent amount" of collections (i.e. they use the service and don't pay). I don't see what got twisted. That is what you say in that sentence. People who speak Spanish are getting services and not paying for them--a "decent amount" of services no less.

I think "twist" is more like when you claim that I tell people to default or otherwise not ever pay back student loans, and insinuate that your purpose here is to "stop" that. That's "twist" . . .





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just to comment here -

I also read it as low income people don't pay their bills.

I am a low income person, and I pay my bills. It might take me a bit longer, but I pay every one of them. (assuming it's a legitimate bill, and I don't need to dispute it.)

Perhaps you should read your posts over before hitting the submit button. It may help to avoid these types of confusions.


Lady I, not agreeing with W505, but not disputing the inference implied by the original post.

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I am a low income person, and I pay my bills. It might take me a bit longer, but I pay every one of them. (assuming it's a legitimate bill, and I don't need to dispute it.)

Lady I, not agreeing with W505, but not disputing the inference implied by the original post.


Lady,

Once again, you're making the inference and implications that just aren't there.

Medical offices have tons of collections. They deal with a ton of paperwork (insurance, Medicare, etc.) and many have fairly poor billing offices. Errors are very common. Even people with insurance can get sent to collections if the insurer doesn't "recognize" the charge or for some other reason doesn't pay the bill.

The big factor here is that this is a WALK-IN clinic that sees a lot of uninsured patients. No appointment, no referral, no insurance necessary. For the un-insured, medical bills can get very expensive, very fast and I doubt that these doctors would turn away a patent simply because they didn't have money. Many (most?) doctors offices will not see you without an appointment, a referral from another doctor and insurance, so the average doctor doesn't take the same risk that this office does. Any walk-in facility is going to have higher collections. This is a fact that can't be ignored (and a major reason that emergency rooms and clinics are being shut down everywhere).

It sounds like you've been lucky enough to never deal with this situation, but believe me, you don't have to have low income to be in collections from medical bills. Virtually any medical facility will let you make arrangements to make payments to keep yourself out of collections, but like student loans, you have to keep on top of it, or it gets out of control quickly. I think honest people with low income may be MORE conscientious about paying their debts, even if it takes longer. Often, the less people have, the more they appreciate the credit, kindness, and generosity others have extended to them.

LakersFan


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**
Once again, you're making the inference and implications that just aren't there
**

quit being so defensive. I was just stating that I read it that way the first time I read it. After you explained it, it was done and over with.

I was just pointing out that it could be read that way. (and in my case was.) Nothing more, nothing less, not infering anything _again._

It's always good to look at things from both sides sometimes.

Lady I.
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<<Is it farfetched to read this as saying that Hispanic people who get medical services on credit don't pay their bills?>>

Whether it is or is not farfetched, I find it more offensive that you would suggest that such a statement is a racist "slur" than I find the statement itself, which I personally interpreted more as praise for a doctor who would work in an "underprivileged" community, than some sort of evil-intended insinuation about a particular ethnic group ( a group which can be legitimately and reasonably seen as being underprivileged in many if not most areas, with economic challenges that make health less unaffordable - leading to collections issues).

But why look for racism in this way or sink to this level? Why not fight racism where it exists, rather than hunt for it where it can only be discerned by the most speculative subjective interpretation? Why waste your or our time with this sort of thing? This mentality creates far more problems than it seeks to address....
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which I personally interpreted more as praise for a doctor who would work in an "underprivileged" community

Thanks. That is exactly what was intended.

LakersFan
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This thread had kind-of "died out", so . . .

<<Is it farfetched to read this as saying that Hispanic people who get medical services on credit don't pay their bills?>>

Whether it is or is not farfetched, I find it more offensive that you would suggest that such a statement is a racist "slur" than I find the statement itself, which I personally interpreted more as praise for a doctor who would work in an "underprivileged" community, than some sort of evil-intended insinuation about a particular ethnic group ( a group which can be legitimately and reasonably seen as being underprivileged in many if not most areas, with economic challenges that make health less unaffordable - leading to collections issues).


You have to know the whole situation. This goes to a series of skewed comments made by the poster, over two years down, the latest one before that being that people who didn't pay their bills on time weren't "moral".

Several people interpreted it the way you did; others saw it my way. The reason it rose to "comment status" is I don't want the board turning into a place where cheap shots are routinely laid against people struggling with debt--no matter what community they are from. Most everyone here that uses the boards to post are making their way with an economic albatross---the student loan---and few people want to hear about whether they are "moral" or not if they are engaging in any restructuring of the debt, or if they had fallen on hard times.

I don't think it was "evil-intended" comment making as much as from a narrow mindset that paints the world in stark colors rather than hues. It just sounds like lower-middle-class California whites complaining about how the Hispanics come here "illegally" and "just take all our stuff without paying", and how upper-middle-class college graduates "get student loans and don't pay for them". In the world of the lower-middle-class, everyone else "gets", and they:

- allegedly never get

- are the ones "who end up paying"

and it just gets tiresome after a while, because life isn't like that at all, and some people with less-than-happy-lives make their own beds. Rather than look in the mirror, it's more satisfying to poke at the alleged flaws of other people (those struggling with debt and other socio-economic underdogs.)


But why look for racism in this way or sink to this level? Why not fight racism where it exists, rather than hunt for it where it can only be discerned by the most speculative subjective interpretation? Why waste your or our time with this sort of thing? This mentality creates far more problems than it seeks to address....

Yeah, well, it goes back to my dialogue about why-point-out-the-language-in-the-first-place? (Or alternatively, why point out the part about "collections"?) The issue was pretty much laid to rest until you decided to comment on it, now, in the forum versus e-mail, several weeks later. Where you say, "speculative subjective interpretation", I think that's "protesting too much". The original sentence was right in the league with something like "the people waited in the welfare line, and then go home and eat fried chicken and grits." And certainly there are people who a) wait in welfare lines, and b) eat fried chicken and grits. But the sentence phrase says something more, doesn't it?

5000fingers, I of course welcome and respect your views, but my own feeling is that the original post (1710? or thereabouts), coming on what had been said, lent itself to an equally valid interpretation that a comment was being made about "people who speak Spanish". So as much as anyone else would want to have their say, I want to have mine, too.
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Okay, everybody, look up at the top of the page, and you'll see a nice little link that says "ignore thread..."

while I have my definite opinions about who's in the right about this one, better, I think, to let the whole matter drop.
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This thread had kind-of "died out", so . . .

But you couldn't let it, could you?

I don't want the board turning into a place where cheap shots are routinely laid against people

Then you should stop making them. You are the only one who partakes in this behavior on this board, and most of your cheap shots are directed at me.
I think people should pay their debts. That is not a cheap shot. If you can't handle that, too bad.

It just sounds like lower-middle-class California whites complaining about how the Hispanics come here "illegally"

No. It sounds like your New Jersey, "I pay more than anyone else in taxes and therefore I should take advantage of the system more than anyone else" whining. Oh wait -- that's you!

Fact is, you don't know a damn thing about me. You don't know if I am lower-middle-class and you don't know if I'm a Latina. And you certainly don't know my beliefs about immigration. So who's making the incorrect assumptions?

The original sentence was right in the league with something like "the people waited in the welfare line, and then go home and eat fried chicken and grits."

No it wasn't. Stop trying to distort my words and repeating this worn out lie. The original statement was along the lines of:
They run a walk-in clinic. They're in a lower income part of town. They have lots of uninsured patients. They probably have collections.

LakersFan

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Me: This thread had kind-of "died out", so . . .

Nellie: But you couldn't let it, could you?


Well, when I count back on the thread list, after 5000fingers' post, I see one from you, so it sounds like the Nellie "pot" is calling the W5 "kettle" . . .

Me: I don't want the board turning into a place where cheap shots are routinely laid against people

Nellie: Then you should stop making them. You are the only one who partakes in this behavior on this board, and most of your cheap shots are directed at me.
I think people should pay their debts. That is not a cheap shot. If you can't handle that, too bad.


I think the "cheap" part related to the language about the "lack of morals" of those who don't pay back. You have a very selective memory, and that's no "shot". That's fact.


Me: It just sounds like lower-middle-class California whites complaining about how the Hispanics come here "illegally"

Nellie: No. It sounds like your New Jersey, "I pay more than anyone else in taxes and therefore I should take advantage of the system more than anyone else" whining. Oh wait -- that's you!

Fact is, you don't know a damn thing about me. You don't know if I am lower-middle-class and you don't know if I'm a Latina. And you certainly don't know my beliefs about immigration. So who's making the incorrect assumptions?


In New Jersey, we pay a lot of taxes--but as I remember it, I recall the explanation as one, that since New Jerseyites pay a lot of taxes, they couldn't necessarily be "free riding" off of (I think it was) your tax money. Then I showed how Californians as a whole get more from the government than New Jerseyites, who end up paying well in excess of what they get back. It was a popular link by the way. A lot of people don't realize what the higher-income states pay.

The "take advantage of the system" crack, however, sounds like one of those things you say you never do here . . .



Me: The original sentence was right in the league with something like "the people waited in the welfare line, and then go home and eat fried chicken and grits."

Nellie: No it wasn't. Stop trying to distort my words and repeating this worn out lie. The original statement was along the lines of:
They run a walk-in clinic. They're in a lower income part of town. They have lots of uninsured patients. They probably have collections.


Yeah, I guess if the original quote were just that, there would have been no issue . . .
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Not that anyone asked me or anything, but ...

I've made a few comments in my life that someone else found to be offensive. Sometimes this happened because I was ignorant, sometimes it happened because I was misunderstood.

At any rate. I've found that the best, simplest, briefest, and most pleasant way to deal with these situations is as follows:

Person1: <something offensive, or potentially offensive, or unoffensive but perceived to be offensive>

Person2: You know, I don't know if you meant it this way, but what I heard you say was <something offensive>. That hurt my feelings, because <explanation>.

Person1: Wow, I'm glad you brought that to my attention, because I didn't mean it that way at all. What I meant was <re-statement>. Alternative response: Wow, I'm surprised that you were hurt by that. Could you explain why, to help me understand?

Person2: I'm glad that you didn't mean it that way.

Person1: I'm glad that you explained it to me.

Person2: Would you like a lifesaver?

THE END

Of course, this doesn't always work. I once tried to explain to a "friend" why the phrases "don't Jew (e.g. haggle) me down in price" and "don't be Jewish (e.g. stingy) with the mustard" were upsetting, only to have him patiently explain that I shouldn't find those phrases upsetting, since Jews really were cheap and stingy. Needless to say, he got no lifesavers.
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