sactowndog

Is agreement on healthcare possible?

155 posts in this topic

23 hours ago, Jackrabbit said:

The lefties can laugh all they want about the struggling gop.    This debate is good.  The problem is that the dem party is too far out there to be part of it.  Now the gop can't act because half the party would make good democrats.

Your stance is the problem with the ideologues of both parties, there is no compromise even within their own party. If you are unwilling to make any concessions or compromises within your own party, it is pretty hopeless to expect any deals with the other side. There are factions like this on both sides, although those on the right seem more powerful and better organized. 

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12 minutes ago, Mano said:

Your stance is the problem with the ideologues of both parties, there is no compromise even within their own party. If you are unwilling to make any concessions or compromises within your own party, it is pretty hopeless to expect any deals with the other side. There are factions like this on both sides, although those on the right seem more powerful and better organized. 

For some, their world view is "black and white" and compromise is a four letter word.

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On 3/26/2017 at 10:56 AM, Mano said:

Your stance is the problem with the ideologues of both parties, there is no compromise even within their own party. If you are unwilling to make any concessions or compromises within your own party, it is pretty hopeless to expect any deals with the other side. There are factions like this on both sides, although those on the right seem more powerful and better organized. 

Organizing the Republican party has always been like herding cats.  Nothing new.   Very different with the dems.

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4 hours ago, Jackrabbit said:

Organizing the Republican party has always been like herding cats.  Nothing new.   Very different with the dems.

It has been very easy to get the GOP in lockstep to vote against things, the voting for something, not so much.

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On 3/26/2017 at 0:30 AM, thelawlorfaithful said:

Only you could construe my posting of a link that attacks my position for at least 75% of the article, with the only exception being a half-hearted defense that admits it falls on deaf ears, and think "this is biased." You don't want compromise, you don't even want discussion. You can't stand anything that presents you any data that refutes or doesn't coincide with yours or the EPI's view.

 

As for not wanting compromise, given I am willing to listen to any approach to address the problem I fail to see how you reach that conclusion.  If your point is I am unwilling to compromise in stating a problem exists depending on market demand curves for segments of the pharmaceutical industry, guilty as charged.  

It would seen to me the person who is unwilling to compromise is the person who consistently argues their is no problem when the evidence clearly shows otherwise and numerous articles are written pointing to the problem.

 

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2 hours ago, Mano said:

It has been very easy to get the GOP in lockstep to vote against things, the voting for something, not so much.

It would be better if most things done in DC was voted against.

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19 minutes ago, sactowndog said:

As for not wanting compromise, given I am willing to listen to any approach to address the problem I fail to see how you reach that conclusion.  If your point is I am unwilling to compromise in stating a problem exists depending on market demand curves for segments of the pharmaceutical industry, guilty as charged.  

It would seen to me the person who is unwilling to compromise is the person who consistently argues their is no problem when the evidence clearly shows otherwise and numerous articles are written pointing to the problem.

 

You've laid out 8 parts to your plan and I have stood firm objecting to just one of them, saying nothing of the other 7. I've posted lots links here and in numerous other threads outlining why your solution to the "problem" would be catastrophic for innovation. I won't assent to something that completely screws the future so those in the present can benefit off of the investment by those who came before them.

But instead of "compromising" and leaving 1 of the 8 eight ideas you put forth off the table for the greater good of the 7, it has to be all your way. Your solution is a terrible solution for a problem that it hardly targets at all.

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1 hour ago, thelawlorfaithful said:

You've laid out 8 parts to your plan and I have stood firm objecting to just one of them, saying nothing of the other 7. I've posted lots links here and in numerous other threads outlining why your solution to the "problem" would be catastrophic for innovation. I won't assent to something that completely screws the future so those in the present can benefit off of the investment by those who came before them.

But instead of "compromising" and leaving 1 of the 8 eight ideas you put forth off the table for the greater good of the 7, it has to be all your way. Your solution is a terrible solution for a problem that it hardly targets at all.

As to the 8, most of those 8 parts I have adjusted from other peoples comments.  So it would be hard to say they are mine.   Plus most of the ones you agreed to are top Republican priorities with which I proactively agreed.  Your model of behavior is typical "party of no" Republican behavior.  Agree to those proposals which come from your side,  stonewall anything coming from the other side, then claim the other side isn't compromising.   It is the Republican and Freedom Caucus behavior since day 1 except this time it bit them on the ass.  You do a great impression of it.  

On pharma, you claim to want cost control but leave out the fastest growing component of healthcare (by almost double), one that is almost 20% of out of pocket expenses, and one where the US pays significantly higher prices than the rest of the world.   To ignore it just isn't realistic by any stretch of the imagination. It is especially not realistic when both the President and the Democrats are focused on it as a top priority.   Quite frankly, if this were real life you should be thankful I am open to proposals because many on the left of me would be much less generous.  It is why many Republican moderates are turning to the Democrats because they are done negotiating with people like you.  

As for my "solution" to the problem, I haven't outlined one.   I recognize the issue you raise about innovation and offered to listen to proposals that would potentially address the cost issue and insured continued innovation.  You have offered nothing but a demand curve model that has been "proven' to be ineffective for significant parts (but not all) of the pharmaceutical market.   The industry most like pharmaceuticals from a market standpoint is the utility industries (not books) and they already have boards to manage rate increases.  Somehow they manage to innovate.  Given the headlines if the Democrats win power the industry will be lucky if they end up in a utility model.   Pharma may convince hard core right wingers like yourself to protect them now but it will only end in more draconian actions down the line.    

Lastly no one is proposing alternative pricing/return models for Sildenifil.   Nobody's life is at stake if they can't get a boner.   Generics and other alternatives are readily available.   And despite evidence of price fixing that will only further get this industry further in trouble, I am still not proposing any action in the case where generics apply.  

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1 hour ago, sactowndog said:

As to the 8, most of those 8 parts I have adjusted from other peoples comments.  So it would be hard to say they are mine.   Plus most of the ones you agreed to are top Republican priorities with which I proactively agreed.  Your model of behavior is typical "party of no" Republican behavior.  Agree to those proposals which come from your side,  stonewall anything coming from the other side, then claim the other side isn't compromising.   It is the Republican and Freedom Caucus behavior since day 1 except this time it bit them on the ass.  You do a great impression of it.

I stonewalled one proposal back on the first page before almost all the comments in the thread. It's a terrible proposal and it's worth killing the whole thing on that alone. The rest of this is just whining. I gave you 7 yeses right out the gate and you still complain that I'm the party of no? Call Ryan and Boehner, they'll tell you nobody wants to hear you whine when you can't get to yes.

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On pharma, you claim to want cost control but leave out the fastest growing component of healthcare (by almost double), one that is almost 20% of out of pocket expenses, and one where the US pays significantly higher prices than the rest of the world.   To ignore it just isn't realistic by any stretch of the imagination.

I've never claimed to want to "cost control," that doesn't sound like me at all. In any case, on average out of pocket drug costs are decreasing. Drug prices are responsible for only 30% of the rate at which drug costs are rising, inflation and the increase in prescriptions are equally to blame. Yet all you can wrap your head around is a handful of expensive examples which makes you want to target this 30%, despite the fact it has been repeatedly explained to you that price controls will destroy innovation. The same goes for the price we pay compared to other countries. We subsidize their costs, we do so because we want amazing new drugs, and if we didn't we nor they would get very many.

The fact that you are so obstinate on the issue when it is abundantly clear that targeting this area the way you do will have a vastly disproportionate effect on innovation compared to costs actually saved, a result targeting other areas wouldn't, shows a clear lack of imagination or a denial of reality. Ask @Jack Bauer or @NMpackalum the difference between the generic drugs they could prescribe when they first started their careers versus now. Then ask them what a world of difference the generic drug options will be in 20 years. All of these expensive wonder drugs becoming dirt cheap, the amazing entities that haven't even been dreamed of hitting the market. This can happen just as long as we don't screw everyone over the way that you and "your ilk" want to do.

Quote

It is especially not realistic when both the President and the Democrats are focused on it as a top priority.   Quite frankly, if this were real life you should be thankful I am open to proposals because many on the left of me would be much less generous.  It is why many Republican moderates are turning to the Democrats because they are done negotiating with people like you.

I'm not really sure what your point is here. Just because Trump and Sanders and the like think something is a good idea doesn't give it any value. Those guys are idiots. In any case all our representatives will gladly spend other people's money and screw over the future for their own short term political benefit. So it's not surprising they think this way. But it doesn't give the idea any more merit than if they didn't feel this way.

Quote

 As for my "solution" to the problem, I haven't outlined one.   I recognize the issue you raise about innovation and offered to listen to proposals that would potentially address the cost issue and insured continued innovation.  You have offered nothing but a demand curve model that has been "proven' to be ineffective for significant parts (but not all) of the pharmaceutical market.  

And I quote: 1) Life saving drugs and equipment were get a longer patent life but also are price controlled associated with a companies direct R&D costs to develop the drug plus a set return.  No more pricing against a vertical demand curve.

Just because you didn't give specifics to your general idea doesn't mean it isn't a generally terrible idea. Your talking about price controls in exchange for a longer patent, and your doing it by creating a special class of drugs and equipment that will be almost arbitrarily deemed "life saving." Price controls will reduce the incentive for investment, they always do, and any price control that would achieve the kind of cost difference you're hoping for will kill innovation entirely. "Life saving" will not be where the money is made, so companies will play the lotto in other less vital areas of the drug research game. Congrats, you've killed R&D into the drugs that people are counting on to save their lives.

Quote

The industry most like pharmaceuticals from a market standpoint is the utility industries (not books) and they already have boards to manage rate increases.  Somehow they manage to innovate.  Given the headlines if the Democrats win power the industry will be lucky if they end up in a utility model.   Pharma may convince hard core right wingers like yourself to protect them now but it will only end in more draconian actions down the line.

They're nothing alike. Once the intellectual property is created and brought to market the drugs are dirt cheap to produce. The need in the market is for more innovation, different intellectual property, better drugs. Utilities need to innovate to become more efficient at production, but they aren't coming up with new ways to make water, electricity, natural gas and the like.

And I'm glad you admit this isn't about good ideas or thinking about the future of healthcare. What's important is getting draconian with those mean old drug companies. That'll show them what they get for making medical breakthroughs at great cost with no guarantee of success at the outset.

Quote

 Lastly no one is proposing alternative pricing/return models for Sildenifil.   Nobody's life is at stake if they can't get a boner.   Generics and other alternatives are readily available.   And despite evidence of price fixing that will only further get this industry further in trouble, I am still not proposing any action in the case where generics apply.  

How thoughtful of you not destroy the entire drug market all at once. With generics being 86% of all prescriptions  your self denial is admirable. Best to make a mountain of that 14% molehill and see how much damage you can do there first.

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8 hours ago, thelawlorfaithful said:

I stonewalled one proposal back on the first page before almost all the comments in the thread. It's a terrible proposal and it's worth killing the whole thing on that alone. The rest of this is just whining. I gave you 7 yeses right out the gate and you still complain that I'm the party of no? Call Ryan and Boehner, they'll tell you nobody wants to hear you whine when you can't get to yes.

I've never claimed to want to "cost control," that doesn't sound like me at all. In any case, on average out of pocket drug costs are decreasing. Drug prices are responsible for only 30% of the rate at which drug costs are rising, inflation and the increase in prescriptions are equally to blame. Yet all you can wrap your head around is a handful of expensive examples which makes you want to target this 30%, despite the fact it has been repeatedly explained to you that price controls will destroy innovation. The same goes for the price we pay compared to other countries. We subsidize their costs, we do so because we want amazing new drugs, and if we didn't we nor they would get very many.

The fact that you are so obstinate on the issue when it is abundantly clear that targeting this area the way you do will have a vastly disproportionate effect on innovation compared to costs actually saved, a result targeting other areas wouldn't, shows a clear lack of imagination or a denial of reality. Ask @Jack Bauer or @NMpackalum the difference between the generic drugs they could prescribe when they first started their careers versus now. Then ask them what a world of difference the generic drug options will be in 20 years. All of these expensive wonder drugs becoming dirt cheap, the amazing entities that haven't even been dreamed of hitting the market. This can happen just as long as we don't screw everyone over the way that you and "your ilk" want to do.

I'm not really sure what your point is here. Just because Trump and Sanders and the like think something is a good idea doesn't give it any value. Those guys are idiots. In any case all our representatives will gladly spend other people's money and screw over the future for their own short term political benefit. So it's not surprising they think this way. But it doesn't give the idea any more merit than if they didn't feel this way.

And I quote: 1) Life saving drugs and equipment were get a longer patent life but also are price controlled associated with a companies direct R&D costs to develop the drug plus a set return.  No more pricing against a vertical demand curve.

Just because you didn't give specifics to your general idea doesn't mean it isn't a generally terrible idea. Your talking about price controls in exchange for a longer patent, and your doing it by creating a special class of drugs and equipment that will be almost arbitrarily deemed "life saving." Price controls will reduce the incentive for investment, they always do, and any price control that would achieve the kind of cost difference you're hoping for will kill innovation entirely. "Life saving" will not be where the money is made, so companies will play the lotto in other less vital areas of the drug research game. Congrats, you've killed R&D into the drugs that people are counting on to save their lives.

They're nothing alike. Once the intellectual property is created and brought to market the drugs are dirt cheap to produce. The need in the market is for more innovation, different intellectual property, better drugs. Utilities need to innovate to become more efficient at production, but they aren't coming up with new ways to make water, electricity, natural gas and the like.

And I'm glad you admit this isn't about good ideas or thinking about the future of healthcare. What's important is getting draconian with those mean old drug companies. That'll show them what they get for making medical breakthroughs at great cost with no guarantee of success at the outset.

How thoughtful of you not destroy the entire drug market all at once. With generics being 86% of all prescriptions  your self denial is admirable. Best to make a mountain of that 14% molehill and see how much damage you can do there first.

Dude you are a classic.  Straight from Republican obstructionism 101.   Are you a member of the Freedom Caucus per chance?  

You follow the playbook to a T.   Take the most fundamental component from the other side and obstruct like hell.  Agree with the little stuff and use it to call the other person intransigent.   Just the opposite of what someone who really wants a deal..

Republicans as a whole did it with the mandate.  Instead of offering reasonable forcing mechanisms they blocked.  Obama couldn't go forward without young people compelled to sign-up so he went forward without them.  They could have had a continuous coverage model coupled with you can only discharge medical debts via bankrauptcy if you had a certain level of insurance.   Or found another carrot/stick approach but they didn't even try.

Freedom Caucus did it with covering pre-existing conditions.   They had no intention of agreeing to the bill.   They knew if the demanded that removal the whole thing would fall apart.

You do it with prescription drug costs which is the Dems #1 priority.   No deal without something addressing that point.  So you hold firm and refuse to offer up possibilities.  Classic behavior.  You should be proud of yourself you would fit right in.  Perhaps you should run for Congress from Northern Idaho.

 

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1 hour ago, sactowndog said:

Dude you are a classic.  Straight from Republican obstructionism 101.   Are you a member of the Freedom Caucus per chance?  

You follow the playbook to a T.   Take the most fundamental component from the other side and obstruct like hell.  Agree with the little stuff and use it to call the other person intransigent.   Just the opposite of what someone who really wants a deal..

Republicans as a whole did it with the mandate.  Instead of offering reasonable forcing mechanisms they blocked.  Obama couldn't go forward without young people compelled to sign-up so he went forward without them.  They could have had a continuous coverage model coupled with you can only discharge medical debts via bankrauptcy if you had a certain level of insurance.   Or found another carrot/stick approach but they didn't even try.

Freedom Caucus did it with covering pre-existing conditions.   They had no intention of agreeing to the bill.   They knew if the demanded that removal the whole thing would fall apart.

You do it with prescription drug costs which is the Dems #1 priority.   No deal without something addressing that point.  So you hold firm and refuse to offer up possibilities.  Classic behavior.  You should be proud of yourself you would fit right in.  Perhaps you should run for Congress from Northern Idaho.

 

tumblr_ma52qzVsRo1rvwttvo1_500.gif

If Dems think price controls for 14% of drug prescriptions are a top priority in order to fix what's wrong their godawful healthcare law they are even dumber than Trump.

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6 minutes ago, thelawlorfaithful said:

tumblr_ma52qzVsRo1rvwttvo1_500.gif

If Dems think price controls for 14% of drug prescriptions are a top priority in order to fix what's wrong their godawful healthcare law they are even dumber than Trump.

Keep deflecting.  Good job.  Someone had to play the Freedom Caucus role on this board and you stepped up admirably.   Even Tools eventually came up with an alternative which is more than can be said for you.

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1 minute ago, sactowndog said:

Keep deflecting.  Good job.  Someone had to play the Freedom Caucus role on this board and you stepped up admirably.   Even Tools eventually came up with an alternative which is more than can be said for you.

BWAAAAHAHAHA Deflecting? I have annihilated each of your points throughout this thread. There is nothing to discuss. You've got nothing.

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27 minutes ago, sactowndog said:

Keep deflecting.  Good job.  Someone had to play the Freedom Caucus role on this board and you stepped up admirably.   Even Tools eventually came up with an alternative which is more than can be said for you.

He's roundly explained to you why what you've suggested would be rotten for the drug industry and innovation, and said yes to pretty much everything else.

And to some people it is a big deal if they can get a boner.  Sexual health and being close with ones sexual partner is a big deal to people and contributes heavily to quality of life. 

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1 hour ago, Jack Bauer said:

He's roundly explained to you why what you've suggested would be rotten for the drug industry and innovation, and said yes to pretty much everything else.

And to some people it is a big deal if they can get a boner.  Sexual health and being close with ones sexual partner is a big deal to people and contributes heavily to quality of life. 

I get his point.  I don't agree however innovation requires unlimited pricing power.   It doesn't in any other industry and typically generates waste which is exactly what you saw from one of the articles I posted about manufacturing processes.   In that article a process engineer was frustrated because Pharma processes are so inefficient.   Largely because instead of being more efficient they just pass costs on to the consumer.

As to the other as you know many generic alternatives exist.   

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