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Akkula

Why Warren and Sanders are Strongest Against Trump

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1 hour ago, THEUniversityofNevada said:

https://thehill.com/opinion/healthcare/466289-why-isnt-mayor-pete-talking-about-the-indiana-program-that-works-better

”Both of Indiana’s programs achieve these remarkable outcomes by pairing a traditional health insurance plan part of whose annual premium is paid for by the state with a health savings account into which the state deposits an amount equal to the annual deductible every single year.   

Those annual gifts ensure financial security because they guarantee that participants always have enough money to cover out-of-pocket costs. But they also provide a strong incentive for comparison shopping and prudent decisionmaking because they give participants some skin in the game. In particular, there is a strong incentive to keep costs under control because participants are told – truthfully – that any money they don’t spend in a given year is theirs to keep and will roll over in their health savings accounts to the next year. “

I’ve advocated for something like this for years. Allow people to build Health Savings Accounts that are then tied to their deductible. As the balance in their HSA increases, increase their deductible, which SHOULD (in theory) lower their insurance premium.

Works privately and works as a government provided system to low income Individuals. Adds “skin in the game” incentive for individuals to control costs on their own by shopping for lower cost healthcare options that are lacking in traditional single payer systems like those in the UK and Canada.

Well I agree to an extent but I also think a lot of the overutilization is caused by the doctors and the medical profession.  If you go to the doctor for a headache in the USA you will probably be treated with $20k worth of unnecessary diagnostic tests just to "rule out" some exotic disease that you almost certainly don't have.  Have you ever tried to ask a doctor how much his proposed treatment may cost?  They look at you like you are an alien or something.  Every few blocks in the USA there are these advanced medical centers with all these fancy machines that need to be paid for by utilization.  The process of never ending referrals and precautionary steps is quite incestuous and lucrative for the medical community.  Why rule things out with a simple and inexpensive treatment?  You say "IT IS THE LAWYERS" but I am sure a lot of doctors aren't turning down referrals when that new MRI machine needs to be paid for.  Lawyers are certainly also loving this system too!  There is lots of money slushing around in healthcare in the USA just waiting to be sucked up by someone all while the end customer is left in bankrupcy.  I kinda think it is funny sometimes that the insurance companies get blamed for high health costs when they are really just the unnecessary middle men.  The secret that most other countries know is that 99% of ailments are easily treatable with drugs that were invented generations ago.  The USA just figures out how to charge 100x more for those drugs and treatments and where is that money going?

There is a boat load of money in the USA healthcare system and until we stop having sacred cows and talk about where that money is really going and have them justify it...we won't be able to afford private, socialized or any other type of healthcare any longer.  The blank check is about to bounce.

Mister no strategy who can't plan past his next tweetstorm isn't going to save us...but neither is "let's just continue to kick the can down the road" guy....

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16 hours ago, toonkee said:

Exactly, though. Not understanding the big picture, or criticism for that matter, hasn’t ever given him any pause. Why does it stop him here?

I can’t explain the machination’s of Trump’s reptilian brain. I try, but I don’t believe he has any coherent big picture ideas about most things.

With healthcare in particular he doesn’t seem to have any understanding of the complexities of the healthcare system, and with most things he’s not interested in even attempting to rectify his ignorance. He showed no leadership during the healthcare reform debate in 2017 because he doesn’t have any ideas about the system at all. The failure to repeal Obamacare was an embarrassing political bloody nose that he has no interest in repeating. So any real pressure he might want to put on the allies on the issue is a third rail he won’t touch. 

We’re all sitting in the dugout. Thinking we should pitch. How you gonna throw a shutout when all you do is bitch.

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13 hours ago, SalinasSpartan said:

Well I just am going to have to disagree that doctors are just going to leave the profession em masse if M4A passes. 

Well what do you mean by en masse? If it’s 2% that’s a very expensive problem not being accounted for by these pie in the sky proposals. If it’s closer to 5% that is an unmitigated disaster.

We’re all sitting in the dugout. Thinking we should pitch. How you gonna throw a shutout when all you do is bitch.

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1 hour ago, Akkula said:

Well I agree to an extent but I also think a lot of the overutilization is caused by the doctors and the medical profession.  If you go to the doctor for a headache in the USA you will probably be treated with $20k worth of unnecessary diagnostic tests just to "rule out" some exotic disease that you almost certainly don't have.  Have you ever tried to ask a doctor how much his proposed treatment may cost?  They look at you like you are an alien or something.  Every few blocks in the USA there are these advanced medical centers with all these fancy machines that need to be paid for by utilization.  The process of never ending referrals and precautionary steps is quite incestuous and lucrative for the medical community.  Why rule things out with a simple and inexpensive treatment?  You say "IT IS THE LAWYERS" but I am sure a lot of doctors aren't turning down referrals when that new MRI machine needs to be paid for.  Lawyers are certainly also loving this system too!  There is lots of money slushing around in healthcare in the USA just waiting to be sucked up by someone all while the end customer is left in bankrupcy.  I kinda think it is funny sometimes that the insurance companies get blamed for high health costs when they are really just the unnecessary middle men.  The secret that most other countries know is that 99% of ailments are easily treatable with drugs that were invented generations ago.  The USA just figures out how to charge 100x more for those drugs and treatments and where is that money going?

There is a boat load of money in the USA healthcare system and until we stop having sacred cows and talk about where that money is really going and have them justify it...we won't be able to afford private, socialized or any other type of healthcare any longer.  The blank check is about to bounce.

Mister no strategy who can't plan past his next tweetstorm isn't going to save us...but neither is "let's just continue to kick the can down the road" guy....

Here are the top 6 drivers of why healthcare costs are so high in the United States ranked in order:

1) Administrative Costs

2) Drug Costs

3) Defensive medicine (Drs ordering multiple tests because they’re afraid they’ll get sued)

4) Expensive mix of treatments 

5) Wages

6) Branding

So railing against the cost of the actual doctors is fine but it’s not the main reason health care costs are so high in this country (they’re the 4th and 5th cause).  If you trump the fat with administration and drug costs, the cost of providing healthcare will plummet. 
 

https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp

thelawlorfaithful, on 31 Dec 2012 - 04:01 AM, said:One of the rules I live by: never underestimate a man in a dandy looking sweater

 

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18 hours ago, renoskier said:

It wasn't and isn't "all good". It's ridiculously expensive and previously many folks were left uncovered or were locked into employment situations because of pre-existng conditions. 

It was and is ridiculously good. If you want say it’s ridiculously expensive, look at what’s being proposed to remedy it and look what was driving it.

Medicare and Medicaid are responsible for 37% of health care expiditures. These programs reimburse doctors and hospitals at a much lower rate, causing these healthcare providers to charge higher rates to private insurers to break even let alone make any money. These already low reimbursement rates fell drastically with the implementation of Obamacare, to the point that these government programs pay 40% less than private plans and are scheduled to get much worse. When 40% of expenditures pays 40% less, the overcompensation on the rest is going to have to be ridiculous.

 D77994-FD-E0-F1-461-D-97-F7-280-EA432382

 

18 hours ago, renoskier said:

Yes, if we want to make it more affordable, somebody is going to take a haircut. Maybe the doctors, a little, but IMO it should mostly be the insurance companies.

A 40% cut to what you already have to charge to make up for the 40% cut rates you take in anyway isn’t a haircut. That’s a scalping.

18 hours ago, renoskier said:

 

Regarding pharma: 5 of the 10 largest companies in the world are based in countries with "socialized" medicine. Their governments actively negotiate or set prices. It doesn't seem to hinder their financial position or their ability to bring new drugs to the market. Medicare/medicaid should be able to negotiate drug prices. Canada, Mexico, etc., shouldn't be paying less than we are for the same drug.

They make their money in America. If that market gets similarly reduced to levels of the “socialized” medicine countries, you get a lot less drugs everywhere. It’s one of the infelicities of our position as global and economic hegemon. 

We’re all sitting in the dugout. Thinking we should pitch. How you gonna throw a shutout when all you do is bitch.

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4 minutes ago, mugtang said:

3) Defensive medicine (Drs ordering multiple tests because they’re afraid they’ll get sued)

4) Expensive mix of treatments 

5) Wage

So railing against the cost of the actual doctors is fine but it’s not the main reason health care costs are so high in this country (they’re the 4th and 5th cause).  If you trump the fat with administration and drug costs, the cost of providing healthcare will plummet. 

I know a lot of people don't like google etc. having medical data, but I think there is a possibility medicine could be made a lot more simple by having most things diagnosed with a computer algorithm at home.  If you need a test done, go get a blood sample done and sent to a lab.  There really isn't a need to see a doctor in most cases.  So you could really trim 3/4/5 with a lot more technology added and cutting into what hospitals are billing.

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22 minutes ago, mugtang said:

Here are the top 6 drivers of why healthcare costs are so high in the United States ranked in order:

1) Administrative Costs

2) Drug Costs

3) Defensive medicine (Drs ordering multiple tests because they’re afraid they’ll get sued)

4) Expensive mix of treatments 

5) Wages

6) Branding

So railing against the cost of the actual doctors is fine but it’s not the main reason health care costs are so high in this country (they’re the 4th and 5th cause).  If you trump the fat with administration and drug costs, the cost of providing healthcare will plummet. 
 

https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp

Well, that is good information but if you look at cost drive #2,3,4 those largely have the medical practicioners as the gatekeepers or causes of those high costs.  Who is prescribing the drugs, praciticing defensive medicine, and prescribing the expensive treatments?  Doctors!!

But at least you are admitting we have a PROBLEM and that is a good start.  The one thing I am sure we can agree on is that Republicans have NO PLANS to reform the system and that was proven after the flailing effort to repeal healthcare under Trump.  The only conversations that are even taking place are with Democrats and that is one of the reason Democrats are able to wipe the floor with Republicans talking Qanon.  

Universal Healthcare helps a lot on #1...but it is no panacea and it will fail if the other issues aren't also tackled.  At the end of the day if something is SUPER expensive...it will be hugely difficult to pay for no matter if paying privately, publicly, or whatever.

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48 minutes ago, mugtang said:

Here are the top 6 drivers of why healthcare costs are so high in the United States ranked in order:

1) Administrative Costs

2) Drug Costs

3) Defensive medicine (Drs ordering multiple tests because they’re afraid they’ll get sued)

4) Expensive mix of treatments 

5) Wages

6) Branding

So railing against the cost of the actual doctors is fine but it’s not the main reason health care costs are so high in this country (they’re the 4th and 5th cause).  If you trump the fat with administration and drug costs, the cost of providing healthcare will plummet. 
 

https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp

At the risk of being accused of implicitly advocating death panels, it’s also end of life care. I read in an article a while back that, for the average person, 50% of the cost of actual care comes in the last 6 months of their life. As a society we have a fixation on prolonging life irrespective of its quality. 

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20 minutes ago, Old_SD_Dude said:

At the risk of being accused of implicitly advocating death panels, it’s also end of life care. I read in an article a while back that, for the average person, 50% of the cost of actual care comes in the last 6 months of their life. As a society we have a fixation on prolonging life irrespective of its quality. 

I’m an advocate for allowing people to decide when to end their own lives.  Call it euthanasia or whatever you want but if I have a terminal illness I should be able to say to the doctor “look, I’m going to die anyway so when I no longer have a good quality of life I want you to inject me with some drugs to put me to sleep...permanently”. 

thelawlorfaithful, on 31 Dec 2012 - 04:01 AM, said:One of the rules I live by: never underestimate a man in a dandy looking sweater

 

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50 minutes ago, Akkula said:

Well, that is good information but if you look at cost drive #2,3,4 those largely have the medical practicioners as the gatekeepers or causes of those high costs.  Who is prescribing the drugs, praciticing defensive medicine, and prescribing the expensive treatments?  Doctors!!

But at least you are admitting we have a PROBLEM and that is a good start.  The one thing I am sure we can agree on is that Republicans have NO PLANS to reform the system and that was proven after the flailing effort to repeal healthcare under Trump.  The only conversations that are even taking place are with Democrats and that is one of the reason Democrats are able to wipe the floor with Republicans talking Qanon.  

Universal Healthcare helps a lot on #1...but it is no panacea and it will fail if the other issues aren't also tackled.  At the end of the day if something is SUPER expensive...it will be hugely difficult to pay for no matter if paying privately, publicly, or whatever.

I’m against a government that is $21 trillion in debt taking on any new spending programs until we get our fiscal house in order.  But I think there are other things we can do to drive down the costs like eliminating a lot of the red tape, tackling drug costs, etc. 

thelawlorfaithful, on 31 Dec 2012 - 04:01 AM, said:One of the rules I live by: never underestimate a man in a dandy looking sweater

 

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7 minutes ago, mugtang said:

I’m an advocate for allowing people to decide when to end their own lives.  Call it euthanasia or whatever you want but if I have a terminal illness I should be able to say to the doctor “look, I’m going to die anyway so when I no longer have a good quality of life I want you to inject me with some drugs to put me to sleep...permanently”. 

I say we give people a one way all expenses paid ticket to whatever tropical donation with pockets full over opiods.  Reminder....this is a ONE WAY ticket.  :hookah:  Way cheaper than 6 months in the ICU.

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3 minutes ago, Akkula said:

I say we give people a one way all expenses paid ticket to whatever tropical donation with pockets full over opiods.  Reminder....this is a ONE WAY ticket.  :hookah:  Way cheaper than 6 months in the ICU.

Oooo, oooo, I wanna go to Thailand!

 

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On 11/11/2019 at 10:13 AM, SalinasSpartan said:

So you think we will see doctors just say, “eff it, had a good run, guess I’ll go sell cars now”?

Many doctors already have including me.

These government systems in every country have a shortage of doctors.   Way easier to make more money doing other things now, with medicare being your only source being a doctor will pay less than being a welder.

https://www.fraserinstitute.org/article/canadas-doctor-shortage-will-only-worsen-in-the-coming-decade

https://www.theguardian.com/society/2019/mar/21/shortage-of-gps-will-never-end-health-experts-say

https://fee.org/articles/why-the-uk-suddenly-is-suffering-from-a-physician-shortage/

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1 hour ago, Old_SD_Dude said:

At the risk of being accused of implicitly advocating death panels, it’s also end of life care. I read in an article a while back that, for the average person, 50% of the cost of actual care comes in the last 6 months of their life. As a society we have a fixation on prolonging life irrespective of its quality. 

That is how most socialist systems keep costs down.  They ration care especially diagnostic testing.  If you don't treat cancer right a way you don't have to spend much treating it because the patient is dead.

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2 hours ago, thelawlorfaithful said:

I can’t explain the machination’s of Trump’s reptilian brain. I try, but I don’t believe he has any coherent big picture ideas about most things.

With healthcare in particular he doesn’t seem to have any understanding of the complexities of the healthcare system, and with most things he’s not interested in even attempting to rectify his ignorance. He showed no leadership during the healthcare reform debate in 2017 because he doesn’t have any ideas about the system at all. The failure to repeal Obamacare was an embarrassing political bloody nose that he has no interest in repeating. So any real pressure he might want to put on the allies on the issue is a third rail he won’t touch. 

Probably so. I wonder if Mitch basically told he'll never bring anything to the floor anyway and just let the Dems go hang themselves on m4all.

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26 minutes ago, bluerules009 said:

That is how most socialist systems keep costs down.  They ration care especially diagnostic testing.  If you don't treat cancer right a way you don't have to spend much treating it because the patient is dead.

I said last six months.

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6 minutes ago, bluerules009 said:

It is the last 6 months for many cancer patients if you have a waiting list for diagnostic testing at least by the time they get diagnosed.

Guess that’s why there’s a better life expectancy in Cuba. Better routine care. 

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19 hours ago, soupslam1 said:

Current doctors won’t. But many will retire early. On top of that you are going to see a lot less students going into the medical field if you have government telling them how much they can charge and regulating patient care. Less doctors mean longer wait times. 

And what makes anyone think government can administer the health care system any more efficient than the current private insurance industry? Look how well they run the VA system. 

Speaking of the VA system, as a veteran I can go to a VA hospital and receive treatment for near free. I’ve been twice and walked out both times. I’d rather pay for my own health insurance and see my own private doctor. 

Government isn’t the solution to our health care industry, it’s the problem. 

Well if we are going to be honest in this thought exercise, if M4A is passed in the near future it likely means a Bernie Sanders presidency. That means students would be graduating from med school at public universities would have far less debt, maybe none.  

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