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Why Medical Bills are Killing Us, by Steven Brill - Page 12

Forum Index > General Forum
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AnachronisticAnarchy
Profile Blog Joined July 2011
United States2957 Posts
February 24 2013 02:58 GMT
#221
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.
"How are you?" "I am fine, because it is not normal to scream in pain."
Sadist
Profile Blog Joined October 2002
United States7227 Posts
February 24 2013 03:04 GMT
#222
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.



This is BS if you read the article and watch the interview.

How do you go from where you are to where you want to be? I think you have to have an enthusiasm for life. You have to have a dream, a goal and you have to be willing to work for it. Jim Valvano
aksfjh
Profile Joined November 2010
United States4853 Posts
February 24 2013 03:08 GMT
#223
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.

My parents are part of a business that benefits heavily from government regulations (FAA) as well as government DOD contracts. Their stated biggest fear are increased taxes and overregulation, even though cuts in spending and regulations would likely kill their business, or at the very least cut it in half.

Moral of the story, people in the middle of these industries don't always know what's going on, especially when looking at the big picture.
Ropid
Profile Joined March 2009
Germany3557 Posts
February 24 2013 03:09 GMT
#224
On February 24 2013 11:54 terranu1 wrote:
Geat well ,I'll go on with my 0 faith in proven medicine with no worries. I had hearth surgery at the age of 3 and I forgot the number of times doctors told me to stay away from any kind of physical effort or prescribed me ridiculously expensive medicine just to prevent strokes. I never took most of those drugs because they were expensive and I never had any strokes despite my years of playing soccer and do all those things they strongly advised me not to, because I'd be dead soon.
You guys just go on and ignore my posts alltogheter now ,I might be a rare happy scenario and that's all.

The moment my father started to experiment with reducing the amount of the drugs he was told to take, those drugs relating to his heart problems and a past heart attack, he got a stroke. It was literally within the first month he started with his experiments.
"My goal is to replace my soul with coffee and become immortal."
Ghostcom
Profile Joined March 2010
Denmark4782 Posts
February 24 2013 03:11 GMT
#225
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.


Did you read the article? The part starting from page 7 directly disproves your (dads) statement:

"The ManorCare convalescent center, which Alan A. says gave him “good care” in an “O.K. but not luxurious room,” got paid $11,982 by Medicare for his three-week stay. That is about $571 a day for all the physical therapy, tests and other services. As with all hospitals in nonemergency situations, ManorCare does not have to accept Medicare patients and their discounted rates. But it does accept them. In fact, it welcomes them and encourages doctors to refer them."
Danglars
Profile Blog Joined August 2010
United States12133 Posts
February 24 2013 03:22 GMT
#226
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.

Exactly so. The government sets by fiat how much Medicare will pay for this and that. It's a huge market distortion that does not let prices gradually readjust to reflect the costs and scarcities involved. The government's got a heavy hand in the medical care industry, and it recently got bigger under the PPACA. Such reforms like getting your health benefits in a HSA to find the best bang for your buck would go a long way in fixing this mess. As it stands, costs will continue to rise as the government mandates what insurers must provide for and the prices that hospitals must accept.
Great armies come from happy zealots, and happy zealots come from California!
TL+ Member
Dagan159
Profile Joined July 2012
United States203 Posts
February 24 2013 04:30 GMT
#227
On February 24 2013 12:22 Danglars wrote:
Show nested quote +
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.

Exactly so. The government sets by fiat how much Medicare will pay for this and that. It's a huge market distortion that does not let prices gradually readjust to reflect the costs and scarcities involved. The government's got a heavy hand in the medical care industry, and it recently got bigger under the PPACA. Such reforms like getting your health benefits in a HSA to find the best bang for your buck would go a long way in fixing this mess. As it stands, costs will continue to rise as the government mandates what insurers must provide for and the prices that hospitals must accept.


Actually the government did a bang up job actually accounting for cost when they set the medicare thesholds. The government does not decide what prices the hospital must accept from insurers, only government programs, at least from my understanding. Hospitals still make a decent profit margin on medicare patients, its just the enourmous gains made on insurance or (God help you) uninsured patients.
The ultimate weapon. nuff said.
Ghostcom
Profile Joined March 2010
Denmark4782 Posts
February 24 2013 05:01 GMT
#228
On February 24 2013 13:30 Dagan159 wrote:
Show nested quote +
On February 24 2013 12:22 Danglars wrote:
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.

Exactly so. The government sets by fiat how much Medicare will pay for this and that. It's a huge market distortion that does not let prices gradually readjust to reflect the costs and scarcities involved. The government's got a heavy hand in the medical care industry, and it recently got bigger under the PPACA. Such reforms like getting your health benefits in a HSA to find the best bang for your buck would go a long way in fixing this mess. As it stands, costs will continue to rise as the government mandates what insurers must provide for and the prices that hospitals must accept.


Actually the government did a bang up job actually accounting for cost when they set the medicare thesholds. The government does not decide what prices the hospital must accept from insurers, only government programs, at least from my understanding. Hospitals still make a decent profit margin on medicare patients, its just the enourmous gains made on insurance or (God help you) uninsured patients.


This is the post that deserves the "Exactly so".
Jisall
Profile Blog Joined January 2011
United States2054 Posts
February 24 2013 05:35 GMT
#229
All I know if with the recent obamacare my place of work is looking at 20% of our franchisee's having to close their door's and pack up shop.

Personally I always felt that government drives up cost, and medicare was designed poorly in the first place.

Monk: Because being a badass is more fun then playing a dude wearing a scarf.. ... Ite fuck it, Witch Doctor cuz I like killing stuff in a timely mannor.
{CC}StealthBlue
Profile Blog Joined January 2003
United States41117 Posts
February 24 2013 05:38 GMT
#230
Of course Doctors and Hospitals willing accept Medicare as they know they will be paid rather than say someone with no insurance or even patients with private insurance.
"Smokey, this is not 'Nam, this is bowling. There are rules."
Dagan159
Profile Joined July 2012
United States203 Posts
February 24 2013 05:46 GMT
#231
On February 24 2013 14:38 {CC}StealthBlue wrote:
Of course Doctors and Hospitals willing accept Medicare as they know they will be paid rather than say someone with no insurance or even patients with private insurance.


A lot of upper management in healthcare cite that medicare patients cost the hospital money and therefor drive up cost to compensate for everyone else. It seems this is a lie, they do indeed make a healthy profit margin of medicare patients. This was one of the primary arguments agiasnt obamacare.
The ultimate weapon. nuff said.
Defacer
Profile Blog Joined October 2010
Canada5052 Posts
February 24 2013 06:19 GMT
#232
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.



Your father is biased. Of course he thinks his services are worth more than they actually are, and is willing to rationalize overcharging the uninsured for providing the same service to the insured.

The brutal truth is that cost of healthcare in the states can be attributed to administrative fees, marked-up drugs and straight-up price gouging. The US has the least efficient healthcare system in the world.
MoonfireSpam
Profile Blog Joined September 2010
United Kingdom1153 Posts
Last Edited: 2013-02-24 06:42:54
February 24 2013 06:33 GMT
#233
Just out of interest, is there anything stopping anyone from opening a hospital in the US as long as it meets government standards and undercutting current prices or are there just much easier ways to make dollars?

I mean everyone is saying there's a monopoly and stuff, but is that just because nobody else wants to try and make dollars from a hospital budget airline style?

Anyways, my take is that it's a common attidude found all over business. If you can make a dollar that's great, if you can make 10 dollars, thats 10 times as great. Why should healthcare be regarded with different rules and standards to invetment banking, it's all about bringing in profits isn't it?
Blargh
Profile Joined September 2010
United States2102 Posts
February 24 2013 07:47 GMT
#234
On February 24 2013 15:33 MoonfireSpam wrote:
Just out of interest, is there anything stopping anyone from opening a hospital in the US as long as it meets government standards and undercutting current prices or are there just much easier ways to make dollars?

I mean everyone is saying there's a monopoly and stuff, but is that just because nobody else wants to try and make dollars from a hospital budget airline style?

Anyways, my take is that it's a common attidude found all over business. If you can make a dollar that's great, if you can make 10 dollars, thats 10 times as great. Why should healthcare be regarded with different rules and standards to invetment banking, it's all about bringing in profits isn't it?


You would never get any profit out of it since almost all of your hospital patients are people who want the service as soon as possible. If a hospital were to undercut every other hospital's prices, they would possibly get a few more people, but most of the people who went there would still be emergency patients and whatnot. Someone could transfer after the initial emergency I suppose, but I don't think such a thing will ever be viable. It's a silly market.

Also, when you're talking about the health of everyone around you, the last thing you want is the #1 priority to be a profit. Health, unlike other businesses/services, is sort of a necessity to live. When I go to a hospital responsible for my life, survival, health, etc. I don't want them "in it for the money". Money is an incentive for better performance, but it's far easier to just cut corners (or very often, it is literally the opposite where they give you procedures/medicines/cures that do far more than necessary). In order to have a progressive society, health needs to be easily accessible for everyone. Society runs on everyone, after all.
BrTarolg
Profile Blog Joined June 2009
United Kingdom3574 Posts
February 24 2013 10:46 GMT
#235
On February 24 2013 10:59 Dagan159 wrote:
Show nested quote +
On February 24 2013 10:43 BrTarolg wrote:
On February 24 2013 10:35 Dagan159 wrote:
On February 24 2013 10:19 BrTarolg wrote:
I'm surprised that singapore isn't mentioned anywhere in this thread

It's private healthcare over there - the way it works is that every person is forced to put x amount of money (of various subsidised levels) aside, and people can choose how to use this money to spend on their healthcare (expensive or cheap)

It's capitalism at it's best. Theres HUGE competition for specialists and healthcare over there. If i don't like the price of one guy i can literally move 10 minutes down the road to find a cheaper guy

Costs seem very reasonable. One time i had an emergency with my breathing as i could barely move and breathing was hurting, so i admitted into a hospital (driven by my parents). The whole cost for that day ended up being about 200-300 dollars to be seen to by a doctor, given some time in the hospital and given a diagnosis + some treatment

Saw a sinus specialist there once, he advised me specifically on prices of stuff before we did it and suggested the most cheap route for what he thought was appropriate. Did an endoscopy, some tests, prescribed all the right treatment and medicine, all amounted to about 300-400 dollars

The healthcare there is fantastic. You can see a doctor on the day (from hundreds to choose from) for about 50 dollars cheap to 100 dollars (or more depending on who you choose)


----

I suspect prices are cheap because it's capitalism. Everyone has money saved away to spend on healthcare, and naturally people will choose what they can afford. Many spend that money on insurance, others choose not to and there is tons of competition between doctors and specialists (and hospitals) to get stuff checked out



I really like this train of thought. Some potential issues I can think of however include emergency care, and ambulance costs where its neccessary for to seek help from the closeest possible provider. Also, what if costs exceed the money you were required to set aside? Does the government step in?

A lot of Americans would be averse to being required to set aside money, but in my opinion its better than having the money pass in and out of the government. In my mind there are 2 distinct solutions, either more capitalism (more competition, however im not sure how to introduce this) or complete government oversight, and price regulations. Of course this is the main dividing line for the country, so nothing will ever get done,



AFAIK, ambulances are free for emergencies. They classify what is and isn't an emergency. Otherwise its a 180$ fee if it isn't an emergency

Also they will just take you to the nearest hospital in the case of an emergency (a real, life threatening one)

In my case, i was healthy enough to be driven by parents to a hospital of my choice (though not healthy enough to make it there on my own thats for sure haha)

edit:

let me clarify. An emergency ambulance will take you to a government hospital. You can of course, call a private hospital for a private ambulance if you so wish.


Interesting, so they have government hospitals that compete with the private sector? You can bet Americans would NEVER go for government run hospitals at the moment =P

This is proabably one of the very few instances in which the government could compete with the private market and win, it shoudnt be hard to beat 2000% markups.

Am I correct in understanding that they make you set aside money for healthcare, and most people use that money to buy insurance? How is this enforced?


Well it's like tax, you are forced to save some of your money deducted from your payroll for medical care. This money saved can accumulate to large amounts over time, and it can be pooled between family members etc.

There is public healthcare, but the key is that it's not free - almost nothing is free (except i think for immediate life and death such as an ambulance due to a car crash or heart attack etc.) The government actively competes against the private sector and of course the government self regulates its own pricing scheme

I think there are various levels of subsidy which determine how expensive something can be but nothing is ever free which stops people overusing the medical system to lavishly splash on expensive and exotic medical treatment (like in the UK). A lot of the time the public health cost is basically the same as the private cost

Government over there spends something like 3-4% of GDP on healthcare and government expenditure on healthcare is really low
wei2coolman
Profile Joined November 2010
United States60033 Posts
Last Edited: 2013-02-24 10:53:04
February 24 2013 10:51 GMT
#236
On February 24 2013 11:58 AnachronisticAnarchy wrote:
Unfortunately, Medicare and insurance companies underpay so much that the hospitals are losing a pretty penny treating people. Thus, hospitals are forced to markup the prices for the uninsured just so that they can keep their doors open.
For instance, did you know that without uninsured people and their markups, we would have no dialysis centers?
Did you know that many practices are forced to pass limits on how many patients with Medicare they can accept just so that they can stay in business?

Source: My father, who is an important doctor in his hospital and directly handles bills related to the parts pertaining to his job.

Actually, hospitals markup the prices for EVERYONE. If person is insured; insurance companies pay it out, insurance company can't really complain about medical bill prices tons of exuberent charges (over charged xrays; medication; room costs; care costs; ambulence fees; etc etc.). If person is uninsured; chance are they couldn't afford insurance in first place, can't even afford care; Hospital ends up footing the bill (supplemented a little by gov't). That's why costs are going up. Hospital end up having a lot of costs because of uninsured.
liftlift > tsm
Bill Murray
Profile Blog Joined October 2009
United States9292 Posts
February 24 2013 11:00 GMT
#237
a lot of people, including a mod i see, are kind of strawmanning here; i feel you're missing his point
i see you address that in terms of funds, but that's the purpose of it all - we don't want the money to run out

my real problem with all of this dips into our Capitalist society as a whole. It's ok for the blue collared man to get fucked, and have to mortgage his home, only to have it taken by a bank, but when the bubble bursts on wallstreet... bailout!!!

That isn't Capitalism, it's Socialism, and that's where this country is headed
2nd amendment be damned right now, I'm worried about my 1st. My voice is barely even heard over the convoluted social media with yolosluts trying to put up duckfaces when i do give a damn. I do give a damn.
University of Kentucky Basketball #1
Bill Murray
Profile Blog Joined October 2009
United States9292 Posts
February 24 2013 11:02 GMT
#238
On February 24 2013 14:38 {CC}StealthBlue wrote:
Of course Doctors and Hospitals willing accept Medicare as they know they will be paid rather than say someone with no insurance or even patients with private insurance.

what do you mean here? and you werent the mod i was referring to...
i'm fairly ill informed on the matter, which is funny, and somewhat ironic, but i won't get into that

I have bluecross, and blueshield. What is the difference between that, and say, "wellcare"? Is that what you mean by it being "private"?
University of Kentucky Basketball #1
Bill Murray
Profile Blog Joined October 2009
United States9292 Posts
February 24 2013 11:05 GMT
#239
Seems that by 2017 a lot of states are going to opt out of Obamacare
University of Kentucky Basketball #1
Doublemint
Profile Joined July 2011
Austria8510 Posts
February 24 2013 11:49 GMT
#240
On February 24 2013 20:00 Bill Murray wrote:
a lot of people, including a mod i see, are kind of strawmanning here; i feel you're missing his point
i see you address that in terms of funds, but that's the purpose of it all - we don't want the money to run out

my real problem with all of this dips into our Capitalist society as a whole. It's ok for the blue collared man to get fucked, and have to mortgage his home, only to have it taken by a bank, but when the bubble bursts on wallstreet... bailout!!!

That isn't Capitalism, it's Socialism, and that's where this country is headed
2nd amendment be damned right now, I'm worried about my 1st. My voice is barely even heard over the convoluted social media with yolosluts trying to put up duckfaces when i do give a damn. I do give a damn.


Absolutely correct. It basically is "Socialism for Managers". As soon as this scheme where banks hold the tax payer hostage is not tackled ("Too big to fail, sorry you can't take money from us or you will get hurt too in the process", that's where the main financial problems come from in mere numerical terms. Bailouts, people losing jobs, losing their home, losing their insurance, can't pay their bills and provide a good environment for their children, need assistance from somewhere - most of the time it's the government with a safety net. That's doing huge economic damage.

While the Dow hits over 14k again. Something is terribly wrong here.
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