patrick.net

I agree that some regulation is necessary to keep the free market working. For example, anti-monopoly laws.

Two other modest regulations that I like to harp on:

1. require presentation of prices in advance of treatment for non-emergencies, so people can use the market to shop around
2. fix emergency treatment prices by law, since there is no time to shop

If prices are secret (or very hard to discover), there is no free market anyway, and no incentive for any provider to keep prices down.

RC2006 says

It's another thing that is never brought up when comparing the US to other countries that have very successful public healthcare because their populations are healthier.

Which countries do you feel are healthier and what is healthier to you? Ireland, England, NZ, Australia, Canada are all within 2-3% of US obesity. Many countries have much, much higher smoking rates especially in europe.. Alcohol consumption in the US is very moderate compared to Europe or commonwealth countries. What is your criteria?

bob2356 says

Medicare pays the advantage carriers. Period.

Wrong. Your Medicare account pays if you have enough employed quarters in your work history. OR the payment can be subsidized if you are poor, like any govt subsidy.

You are digging a deeper whole proving you don't know how medicare works. FYI: I sell about 30 medicare policies/month.

CBOEtrader says

Wrong. Your Medicare account pays if you have enough employed quarters in your work history. OR the payment can be subsidized if you are poor, like any govt subsidy.

That's not what Bob was even arguing. He said that for Advantage Part C plans. medicare still pays everything except the tiny monthly premium paid by the person. The difference is with Medicare part A - medicare pays the provider directly. With Part C, Medicare pays Insurer who pays the provider.

anotheraccount says

Free market without regulation creates ridiculous monopolies that abuse their pricing power.

Monopolies are almost always govt induced, exactly as they are here in dozens of blue cross counties. Your example is a data point showing the error of a govt intervention.

W/o intervention there would be thriving competition.

bob2356 says

Which countries do you feel are healthier and what is healthier to you?

https://goo.gl/images/s3pYbg

bob2356 says

Ireland, England, NZ, Australia, Canada are all within 2-3% of US obesity.

nope, wrong again.

It's not our healthcare that causes lower life expectancy and higher infant mortality rates, it's our lifestyle decisions.

Those lifestyle decisions are largely cultural issues falling along racial lines. New Hampshire is as healthy as any European country whereas Mississippi is a disaster.

anotheraccount says

I am kind getting tired of arguing about this for almost ten years and yet most Democrats will not admit that Obama missed the opportunity to do something big in a positive way in healthcare

The so-called Blue Dog democrats would have voted with the Republicans to torpedo single payer. The votes just were not there.

anotheraccount says

yet most Democrats will not admit that Obama missed the opportunity to do something big in a positive way in healthcare

What's to admit ? Nobody denies there were many better solutions we could have had. The question is, if he had tried, would he have been able to get it thorough.

Obama himself said single payer would be better, but look how hard it was for him to get the Heritage foundation plan through. He made the decision that he wouldn't be able to get a plan through that changes the system that drastically. I guess it might be an open question as to whether it might have been better in the long run for him to have tried to make the drastic change and failed, than what he did get through.

Certainly anyone with a so called "preexisting condition" would be glad he went the route he did. Others might feel that we should have held out for either no change or a complete change all at once. And nothing in between.

The hypothesis of single payer makes some sense, but it would be a disaster in execution as is most government-owned agencies, which are riddled with inefficiency and red tape because politicians are purely motivated about getting re-elected. This means making agencies bigger with more free goodies for the public, who doesn't know what's good for them. Government forcing price reductions would hurt innovation and our quality of care. As Patrick said, we need 100% price transparency and that will start reducing the cost of care, which is the root of the problem.

Another bullshit myth: Exercise is necessary to lose weight.

Intake to your Mouth is 80-90% of Weight Loss. All Exercise does for weight loss is maybe let you have dessert once or twice a week or help you burn an extra half-pound every so often, depending on how fat you are.

Fucking Planet Fitness hands out Pizza Rolls, "Oh, I'm so healthy, I did 30 minutes on the Tread Mill after I had half a dozen Bagel Crisps." Dumbass, get back on the Treadmill for another hour to burn off those carbs.

TwoScoopsPlissken says

Another bullshit myth: Exercise is necessary to lose weight.

+1000

marcus says

Certainly anyone with a so called "preexisting condition" would be glad he went the route he did. Others might feel that we should have held out for either no change or a complete change all at once. And nothing in between.

Your line of reasoning is the justification that happened much later after the law was passed closer to 2012 election. Obama simply gave in to healthcare industry and Republicans. I was here on this board arguing against the strategy that Democrats took. It one of the main reasons why Trump got elected too - it gave Republicans a talking point for 6 years.

The way I see it is that during Republican administrations in the last 30 years things get screwed up - unpaid for tax cuts, stupid legislation such as Medicare Part D giveaway to pharma. Then Democrats have a chance to fix things and they only go 1/3 of the way at best. When Republicans are in power, they get passed everything they wanted to pass. Tax cut last year is a prime example and Democrats did not even put much of a fight.

If iwog was here, even he would agree with this assessment.

MisterLefty says

The so-called Blue Dog democrats would have voted with the Republicans to torpedo single payer. The votes just were not there.

The vote should have taken place to show where everyone stands.

WarrenTheApe says

What do you mean that you sell medicare policies?

You can be a broker for supplemental to Medicare Part A and B and Medicare part C plans (plans run by insurers - paid by Medicare). I don't think you can sell Medicare Part A or B itself.

WarrenTheApe says

What do you mean that you sell medicare policies?

He must be talking about so called supplemental policies.

anotheraccount says

Your line of reasoning is the justification that happened much later after the law was passed closer to 2012 election

No. I was not happy at the time that he wasn't going for single payer, and OBama clearly explained, he would have liked to, but he didn't believe it could be done, and that it would be too "disruptive" or something to that effect. In other words there were too many interests, insurance, pharma lobbyinsts etc that would not allow it to occur. IT's either what he determined or what his advisors told him. So he didn't even try.

Remember the state of the economy too. Destroying the whole health insurance market was probably part of what the "disruptive" comment was about (or whatever the wording was.

anotheraccount says

unpaid for tax cuts, stupid legislation such as Medicare Part D giveaway to pharma

Don't forget wars put on the credit card - literally not funded.

ThreeBays says

What would be wrong with raising taxes by 10% or whatever it took,

When CA toyed with the idea of "single payer" the "whatever it took" came at additional 15% state income tax, iirc. It's way more than "raising taxes by 10%".

I have never seen a cost effective government problem that had no unintended consequences.

They fuck everything up, and stay in business because they can just tax us for their mistakes.

CBOEtrader says

bob2356 says

Which countries do you feel are healthier and what is healthier to you?

https://goo.gl/images/s3pYbg

bob2356 says

Ireland, England, NZ, Australia, Canada are all within 2-3% of US obesity.

nope, wrong again.

It's not our healthcare that causes lower life expectancy and higher infant mortality rates, it's our lifestyle decisions.

Cdc and most other sources say 35-36%. So it;s 4% not 3% difference mea fucking culpa.

Lifestyle choices like drinking and smoking which most of europe does a lot more of? Oh no of course not, no one has ever died from smoking or drinking.

ThreeBays says

What would be wrong with raising taxes by 10% or whatever it took, if it replaced the cost paid out of pockets and payrolls? Healthcare already costs $10,000 per person.

Forest not trees. That is what we are searching for.

Nothing in theory (except the real possibility not funding it like medicare D and simply ringing up more debt) other than it simply shifts the same high costs around. We are looking for a reduction in health care costs, not moving around the deck chairs on the titanic. Continuing to do exactly what we do now with a different payer isn't going to reduce costs much. Medicare is simply another insurance company, with somewhat lower overhead, but still more of the same.

Throwing around the term single payer like it is some kind of magic is both meaningless and absurd. Other countries have made hard choices about health care for their citizens of which single payer is only a part of the overall puzzle.

If you want a government run system, then copy one that works better (or less badly) than what we have, e.g. the UK NHS as noted in Bob's table above. BTW, Bob's table omits Japan, which has also a better (or less bad) system including hospital price controls. Japan leads the world in high tech medicine and life expectancy, while spending half as much per capita as the USA.

In the USA, Medicare is part of the problem. The cost disparity between the USA and the rest of the world began with Medicare. Other insurance follows mostly Medicare coverage on a somewhat higher fee-for-service basis. In 50 years of Medicare, costs have increased exponentially while life expectancy increased only 3 years among the covered cohort, mostly due to fewer people smoking. Since Obamneycare mandated insurance, costs have continued to increase, while life expectancy has fallen.

The biggest revenue recipient from both Medicare and Obamneycare is the American Hospital Association, based in Chicago. It would require willful ignorance to believe a Chicago politician would have no connection to that patronage network. There was real momentum towards change in 2008, but it got subverted in 2009 and 2010. Research got cut, protecting subsidies for entrenched revenue models against potentially disruptive innovation. American hospitals charge now more than 10 times what Japanese hospitals charge, and many of the Japanese hospitals have better technology and better results.

Draining the Medicare and Obamneycare patronage swamp would require a leader independent of it and willing to endure the slings and arrows of outrageous media misrepresentation. When the current President proposed ending subsidies for essentially disproved mental "health" modalities that have a 90%+ failure rate, the revenue recipients diagnosed him as crazy, and millions afflicted with TDS believed them. Commercial media depend on patronage including DTC ads from PhRMA and insurance and now even hospital corporations advertise on TV; the networks stoke TDS to prevent anyone disrupting their subsidies.

curious2 says

BTW, the biggest revenue recipient from both programs is the American Hospital Association, based in Chicago. It would require willful ignorance to believe a Chicago politician would have no connection to that patronage network. There was huge momentum towards change in 2008, but it got subverted in 2009 and 2010. Research got cut, protecting subsidies for entrenched revenue models against potentially disruptive innovation.

Hey, some people think getting millions in donations from Uranium One affiliates and Russian Oligarchs and Financiers has nothing to do with somebody voting for approval for a foreign company buying a strategic asset. The donations beginning with the application and tailing off after the approval.

curious2 says

If you want a government run system, then copy one that works well

There isn't one that works well, that's the problem. People think government is the solution, but the fact is that government is the problem.

FortWayne says

There isn't one that works well....

I updated to rephrase: "one that works better (or less badly) than what we have." You may call one glass half full or half empty, but when you compare several different glasses with clearly different levels, some are clearly more or less full than the others.

FortWayne says

There isn't one that works well, that's the problem. People think government is the solution, but the fact is that government is the problem.

Still waiting for the list of countries doing so well with the solution of free market health care rather than the problem of public health care. It is coming soon ins't it?

TwoScoopsPlissken says

Hey, some people think getting millions in donations from Uranium One affiliates and Russian Oligarchs and Financiers has nothing to do with somebody voting for approval for a foreign company buying a strategic asset. The donations beginning with the application and tailing off after the approval.

and some people believe a foreign company would spend millions to acquire a strategic asset by bribing 1 voter out of 9. Still waiting to hear about what they paid everyone else. for their votes. and waiting, and waiting, and waiting.

Paranoia Will Destroy Ya!

The way out of the myriad of governmental decisions via lobbist is to push for a federal proposition set up like cali where the voters actually have a voice. Push for this one item and all corrupt legislation is at risk.

Strategist says

WarrenTheApe says

The whole reason why health care is expensive is because of the government. Period.

Because most politicians are in the pockets of special interests.

Still waiting for a list of government ran healthcare of our national size better than ours...

bob2356 says

FortWayne says

There isn't one that works well, that's the problem. People think government is the solution, but the fact is that government is the problem.

Still waiting for the list of countries doing so well with the solution of free market health care rather than the problem of public health care. It is coming soon ins't it?

Still waiting for a list of government run healthcare of our national size, with proportional legal immigration coverage, and also servicing illegal immigrants free of charge.

FortWayne says

Still waiting for a list of government ran healthcare of our national size better than ours...

bob2356 says

FortWayne says

There isn't one that works well, that's the problem. People think government is the solution, but the fact is that government is the problem.

Still waiting for the list of countries doing so well with the solution of free market health care rather than the problem of public health care. It is coming soon ins't it?

FortWayne says

Still waiting for a list of government ran healthcare of our national size better than ours...

BlueSardine says

Still waiting for a list of government run healthcare of our national size, with proportional legal immigration coverage, and also servicing illegal immigrants free of charge.

Pretty absurd statements since the only countries of our national size or larger are china and india. Yet the same people have no trouble at all comparing US health care to places like Canada or England or Singapore all the time. Totally amazing.

Where are all the free market health systems that are the examples of how the US should do health care? You guys keep saying how great it works and will be 75% less to boot. Show us the money. Crickets chirping. wating, and waiting, and waiting, and waiting. Is there more to this tap dance?

All the public health systems cover legal immigrants. If you have residency you have health care. I've done it. Canada, Germany, Australia, Hong Kong, Switzerland, Singapore, Isreal, Lebanon, Sweden, Austria, Ireland, New Zealand, Luxembourg, Cyprus, and a whole bunch of small countries all have a higher portion of immigrants than the US. Pretty flukey how google doesn't work on some peoples computers.

The only health care illegals get is ER and they are triaged away if they don't really need an ER. Health care worst case scenario according to forbes (that well know liberal rag with long a history of supporting the cause of illegals, ROFLOL) for illegals is 18 billion https://www.forbes.com/sites/theapothecary/2018/02/26/how-american-citizens-finance-health-care-for-undocumented-immigrants/#18885fe12c47 This is .5% of a 3.3 trillion health care system or half a cent for every dollar spent. Not where health spending is going off the rails.

bob2356 says

The only health care illegals get is ER and they are triaged away if they don't really need an ER.

The very article you linked disproves this statement.

bob2356 says

Canada, Germany, Australia, Hong Kong, Switzerland, Singapore, Isreal, Lebanon, Sweden, Austria, Ireland, New Zealand, Luxembourg, Cyprus, and a whole bunch of small countries all have a higher portion of immigrants than the US.

Nice try: most of countries on the list have much tighter control on who is admitted. We have a fucking semi-open border with a 3rd World country and catch-and-release policy.

It would be interesting to watch what happens in Sweden now that they admitted so much of refugees from shitholes.


www.youtube.com/embed/lvRZdNoHEf8

Satoshi_Nakamoto says

bob2356 says

The only health care illegals get is ER and they are triaged away if they don't really need an ER.

The very article you linked disproves this statement.

So you are saying forbes is wrong about 18 billion. So why don't you post the real number along with the research that came up with it. It's true because I believe it should be true doesn't count.

Satoshi_Nakamoto says

Nice try: most of countries on the list have much tighter control on who is admitted. We have a fucking semi-open border with a 3rd World country and catch-and-release policy.

You didn't manage to follow the conversation somehow. The statement was.

BlueSardine says

with proportional legal immigration coverage

What does catch and release have to do with legal immigration? Nothing. All of the countries on my list have a higher percentage of legal immigrants than the US and public health care with lower health care costs than the US.

When will we be seeing the research that proves forbes wrong on the cost of illegals?

bob2356 says

Satoshi_Nakamoto says

Nice try: most of countries on the list have much tighter control on who is admitted. We have a fucking semi-open border with a 3rd World country and catch-and-release policy.

You didn't manage to follow the conversation somehow. The statement was.

BlueSardine says

with proportional legal immigration coverage

What does catch and release have to do with legal immigration?

This quote from your message:

bob2356 says

bob2356 says

The only health care illegals get is ER and they are triaged away if they don't really need an ER.

It wasn't me who introduced illegals into the conversation, m'kay?

Therefore it wasn't me who didn't manage to follow the conversation. Somehow.

anotheraccount says

WarrenTheApe says

What do you mean that you sell medicare policies?

You can be a broker for supplemental to Medicare Part A and B and Medicare part C plans (plans run by insurers - paid by Medicare). I don't think you can sell Medicare Part A or B itself.

Medicare part A (hospitalization) is paid for directly by social security for free if you paid into it for at least 40 working quarters, but costs up to $422 (about) if you havent paid enough into ss taxes.

Part B is paid for based on your income level from 2 years prior, and is paid automatically out of ss benefits. Depending on your income part B can be free or just over $400/month.

To cover the gaps in coverage, everyone who can afford to goes w an additional Medicare Suppliment or medsup and usually part D as well for prescriptions. Additionally, dental coverage is separate.

An agent gets paid for Medsup/D and dental.

If that package is too expensive, the customer can go w a Medicare part c or advantage plan instead. An agent gets paid the most for advantage plans. (Although cross selling life and critical illness coverage are the big money makers.)

Medicare advantage typically covers all bases in one policy BUT is limited to a carriers network, which often is quite smaller than the general Medicare network. Social security will pay advantage carriers for covering their responsibility AND the client will cover some of the premium as well.

Carriers such as Blue Cross, Aetna, Humana, Scott and White, etc... make a huge amount of money selling Medicare plans and they spend an enormous amount on advertising and marketing to grow their customer base.

I was a trader in my last career. Medical insurance makes finance look like and fair business by comparison. The govt regulations are literally transferring hundreds of billions per year from the average person to the insurance companies and medical care providers. It's fucking sickening... but I do make a lot of money doing it :)

That was a comprehensive description of how Medicare insurance works.

CBOEtrader says

Medicare advantage typically covers all bases in one policy BUT is limited to a carriers network, which often is quite smaller than the general Medicare network. Social security will pay advantage carriers for covering their responsibility AND the client will cover some of the premium as well.

Exactly what I said. Medicare is paying the carriers. The premiums are a small part of what is paid out.

CBOEtrader says

Carriers such as Blue Cross, Aetna, Humana, Scott and White, etc... make a huge amount of money selling Medicare plans and they spend an enormous amount on advertising and marketing to grow their customer base.

f

Which makes my point exactly, although I still believe the amounts spent on capturing medicare advantage patients is small compared to what is spent capturing patients in private insurance. . Huge amounts are expended that have nothing to do with caring for people, but just to move the money around and provide profits every step of the way..

CBOEtrader says

Medical insurance makes finance look like and fair business by comparison. The govt regulations are literally transferring hundreds of billions per year from the average person to the insurance companies and medical care providers. It's fucking sickening... but I do make a lot of money doing it :)

Those would be the regulations written by industry lobbyists at the behest of libertarian politicians bought and paid for by the industry because everyone knows that free market health insurance is so much cheaper than government programs. In any other country that would be considered bribery and corruption. In the US it0 is called political free speech. Trust me the rest of the world is laughing at this.

You just trumped your own free market ace you know.

How is that different from how this government collects taxes?

Framework is already in place.

APOCALYPSEFUCKisShostikovitch says

If anything fucks with the gravy train, the doctors will have only one choice: getting their patients PIN numbers at gun point and shooting them after emptying their bank accounts. Libby fucks have no clue.