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Thread: The health care debate thread.

  1. #421
    Quote Originally Posted by Ma'ake View Post
    Clearly, this is a major error in an individual case.

    The drug is still in its patent period, the Pharmaceutical is recouping the costs of R&D, marketing, and getting a handsome profit for their shareholders. Was this a case of the U being completely "off" in their markup, or was the U getting worked by the Pharma compared to the pricing Intermountain got? Something's not adding up.

    I would have your friend reach out to Senior VP of Health Sciences Vivian Lee, who is a directing the U's effort to better quantify the costs that makeup the "price" of a procedure, healthcare stay, medication, etc.

    I've met Dr. Lee, she's the real deal, the U is lucky to have her level of leadership and impact. I'm certain Dr. Lee would want to hear from your friend, this is the kind of situation she's been talking about, internally.
    I'm not sure that is correct. The drug has been around for close to 20 years. The pharma company offers reimbursement of up to 20k per year to individuals for their out-of-pocket costs. However, the reimbursement is not available for out-of-pocket costs of anyone with medicare or medicaid.

  2. #422
    Quote Originally Posted by UTEopia View Post
    I'm not sure that is correct. The drug has been around for close to 20 years. The pharma company offers reimbursement of up to 20k per year to individuals for their out-of-pocket costs. However, the reimbursement is not available for out-of-pocket costs of anyone with medicare or medicaid.
    When I worked at the U, United Health, even Medicare supplements, was out of network which meant much higher charges. Not sure if that's still the case


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  3. #423
    Quote Originally Posted by Diehard Ute View Post
    When I worked at the U, United Health, even Medicare supplements, was out of network which meant much higher charges. Not sure if that's still the case


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    The U is in network on this plan.

  4. #424
    Quote Originally Posted by UTEopia View Post
    I'm not sure that is correct. The drug has been around for close to 20 years. The pharma company offers reimbursement of up to 20k per year to individuals for their out-of-pocket costs. However, the reimbursement is not available for out-of-pocket costs of anyone with medicare or medicaid.
    I wonder if this drug falls into the niche of being generic, but there not being enough demand to generate competition, sort of a less provocative version of the Martin Shlecki / Epi-pen controversy last year?

    I have a teammate with severe RA. I'll ask them.

    The potential of personalized medicine is immense, but it runs headlong into the historic way we've created medicines: FDA / Patents / generics / market size constraints.

  5. #425
    Quote Originally Posted by Ma'ake View Post
    I wonder if this drug falls into the niche of being generic, but there not being enough demand to generate competition, sort of a less provocative version of the Martin Shlecki / Epi-pen controversy last year?

    I have a teammate with severe RA. I'll ask them.

    The potential of personalized medicine is immense, but it runs headlong into the historic way we've created medicines: FDA / Patents / generics / market size constraints.
    You actually can't make a generic. Remicade is made from biological cells. So you can make a "bio-similar" medication but not an actual generic copy.


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  6. #426
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Ma'ake View Post
    Clearly, this is a major error in an individual case.

    The drug is still in its patent period, the Pharmaceutical is recouping the costs of R&D, marketing, and getting a handsome profit for their shareholders. Was this a case of the U being completely "off" in their markup, or was the U getting worked by the Pharma compared to the pricing Intermountain got? Something's not adding up.

    I would have your friend reach out to Senior VP of Health Sciences Vivian Lee, who is a directing the U's effort to better quantify the costs that makeup the "price" of a procedure, healthcare stay, medication, etc.

    I've met Dr. Lee, she's the real deal, the U is lucky to have her level of leadership and impact. I'm certain Dr. Lee would want to hear from your friend, this is the kind of situation she's been talking about, internally.
    Isn't she the one that started a movement for hospitals to actually calculate the cost of treatment for pricing purposes as opposed to the "waving of hands" that generally is used to determine prices?

  7. #427
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by concerned View Post
    I bet Trump will try to sabatoge the existing structure to get it to fail thru regulation etc., so that the Democrats come to him. I'll bet nothing happens legislatively for a while, maybe not until after the 2018 elections. I personally think the Freedom Caucus did the Repubs a favor--the bill was so bad it would have made it much more difficult for the Repubs to run on it in 2018.

    http://www.nbcnews.com/health/health...m_npd_ms_tw_ma
    The idea that Trump will sabotage the current law seems to be a theme that the Democrats are promoting. We will see if it is true. This morning in a press conference Ryan seemed to say that the healthcare reform effort was not dead yet in this session of Congress. We'll see about that too.


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    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  8. #428
    Sam the Sheepdog LA Ute's Avatar
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    I was quoted in this article yesterday. See the third paragraph for what it is worth.

    *****

    AHCA vote called off: 10 reactions

    March 24, 2017
    By Kelly Gooch

    The expected House vote on the American Health Care Act was cancelled Friday. Here are 10 reactions to the news.

    All of the reactions were emailed to Becker's Hospital Review.

    Lowell C. Brown, partner and chairman of National Health Care Law Group at Arent Fox. "To me, the collapse of the GOP's effort really began seven years ago when the key players on both sides refused to pass bipartisan health reform. The American healthcare system can't be reformed effectively on a partisan basis. In 2010 the Democrats enacted a massive reform that was 100 percent partisan, and in 2017 the GOP has answered with a replacement that was equally partisan. Our system is a wickedly complex patchwork of policies, designed to satisfy dozens of competing interests. Without significant compromise, there's no workable solution. Social Security and Medicare, for example, had bipartisan support and they endure to this day."

    Garrett Fenton, member in the health, welfare and ACA compliance practice areas of Miller & Chevalier: "It appears that the ACA will remain the law of the land, at least for now, with the Trump administration and Congressional GOP leaders eager to move on to tax reform, infrastructure and other priorities. One open question is whether and how the federal agencies in charge of implementing the ACA will take action at the administrative level to effectuate changes in the law. This previously has been referred to as 'stage 2' of the ACA repeal and replacement process. But with the legislative efforts in 'stage 1' falling flat, at least for the time being, it's not clear how much that will impact the stage 2 initiatives at the regulatory level. Many of the details of ACA implementation were delegated to the agencies, particularly HHS, meaning those same agencies still wield a great deal of ability to alter the trajectory of the law, and the insurance and healthcare markets as a whole. It also remains to be seen whether the Senate will proceed with its own ACA repeal and replacement initiatives, notwithstanding the House's failure to reach a consensus."

    Bea Grause, president of the Healthcare Association of New York State. "Today the U.S. House of Representative GOP leadership pulled back from plans to hold a vote on the AHCA, the bill that would repeal much of the Affordable Care Act, after it was determined the votes for passage were not there. The Healthcare Association of New York State, New York's statewide hospital and health system association, has opposed AHCA, as it would increase by 24 million the number of uninsured nationwide, including 2.7 million New Yorkers, upend the Medicaid program, and burden hospitals and health systems with fewer resources and more uninsured or underinsured patients. HANYS urges Congress and the administration to embrace working to modify and improve the ACA to ensure meaningful healthcare coverage is as least as expansive as it is today and the healthcare delivery system made stronger."

    David Herd, DC, president of the American Chiropractic Association. "The bill considered today by the U.S. House of Representatives needs further work to truly enhance patient access to affordable conservative care. The American Chiropractic Association is particularly concerned with the repeal of the essential health benefits provision within ACA, which outlines the list of benefits plans in the exchange and the private markets must contain. Our greatest concern is that the only affordable plans that will be available will contain minimal coverage, limiting patient access to chiropractors and other providers who offer non-drug, noninvasive conservative approaches to healthcare."

    Dr. Herd added: "There was little opportunity for stakeholder input throughout this [repeal and replace] process. We remain ready to work with the administration and Congress on issues to protect the millions of patients who have coverage and to ensure access to cost-effective, conservative treatments provided by doctors of chiropractic."

    Jeffrey Hulburt, CEO of Beth Israel Deaconess Care Organization. "The House of Representatives withdrew voting on the AHCA — that's great news for Massachusetts. If the ACA was repealed as proposed in the AHCA, our state stood to lose much more than health insurance coverage. Hospitals, physicians and employees no doubt would have suffered immeasurable consequences.

    What's more, the AHCA threatened to reverse the gains we've made in the shift toward a value-based model of care that rewards providers for the quality of care they provide. As one of the early adopters of value-based care, we've seen first-hand that it is possible to achieve cost-effective, high-quality health outcomes when providers and hospitals form partnerships to coordinate all aspects of patient care and share financial risk. Our model works. Recent results from CMS found that BIDCO achieved $55 million in savings while improving care quality for Medicare patients. Massachusetts is leading the nation on healthcare access, quality and cost control. We thank our Congressional Delegation for their dedication to this issue and look forward to working with them to ensure that problems identified in the ACA are addressed in thoughtful way, and future reform efforts protect the extraordinary access to healthcare and innovation that has developed in Massachusetts and across the nation."

    Chip Kahn, president and CEO of Federation of American Hospitals. "As the Congress regroups after the consideration of the AHCA, we hope moving forward that policy makers will focus on improving access to affordable healthcare coverage for Americans, protect and strengthen the Medicaid program for the most vulnerable, and restore needed Medicare funding so community hospitals have sufficient resources to continue to deliver high quality care to seniors and the disabled.

    If the Congress chooses to go back to the drawing board on ACA repeal and replace legislation in the future, it is important that a recrafted plan puts patients first. We stand ready to work with lawmakers on next steps."

    Margaret Murray, CEO of the Association for Community Affiliated Plans. "While ACAP opposed the AHCA, safety-net health plans continue to believe in the importance of health coverage for all Americans at higher quality and lower cost. This moment gives Congress an opportunity to take a different approach to improve the healthcare system. ACAP has offered constructive ideas on how to improve the ACA to make it work for more Americans and we believe the opportunities for genuine improvement are abundant. ACAP is eager to engage in productive bipartisan discussions around reforming the healthcare system. We hope to join other healthcare stakeholders in engaging Congress in a productive dialogue on how to make a healthcare system that works for all Americans."

    John Sculley (CMO) and Ravi Ika (CEO) of RxAdvance. "Even if the bill had passed, like Obamacare, it still wouldn't seriously address the crucial $750 billion in waste due to avoidable medical costs. Of these costs, half are due to physician/hospital misuse/incompetency and the other half is due to avoidable, drug-impacted medical costs. If Medicare, followed by Medicaid and commercial insurers, adopt the silver bullet solution of creating preferred physician/hospital networks with risk contracts to manage the uninsured and underinsured and select the right pharmacy benefit partner with risk contracts respectively, we can cut these costs in half and still have more than enough to cover the uninsured and underinsured."

    Chris Van Gorder, president and CEO of San Diego-based Scripps Health. "Now that Republican leaders in the House of Representatives have pulled the new healthcare bill, the obvious question is what will happen next.

    Clearly this is far from being over. The political battle waged over the last two months has created a great deal of uncertainty for everyone in the health care industry, including healthcare providers like Scripps Health.

    At the same time, maintaining the status quo isn’t an attractive option. While extending insurance coverage to millions of more Americans under the Affordable Care Act has been a great accomplishment, we can all agree that the original legislation has some flaws that need to be addressed.

    Perhaps this pause in the partisan firestorm in Washington offers the perfect opportunity to find consensus in this incredibly important debate.

    I believe these priorities offer the keys to success: Making sure as many Americans as possible have insurance coverage; ensuring that coverage is affordable; and giving health care providers a seat at the table to hammer out the details since we are the ones who better understand the downstream impact of health reform legislation.

    Just as Obamacare represented the will of the Democrats, Trumpcare or Ryancare represents the interests of the Republicans. Such partisan-based approaches will always be handicapped by the opposite party's out-of-hand rejection. Instead, we should all be joining forces to create America'sCare — legislation based on compromise and flexibility.

    Acting in a truly bipartisan effort will provide a foundation to sustain the provisions of a healthcare law for years to come and to fix the inevitable problems that will surface as we move from political legislation to real-world experience. And it will move us closer than ever to the goals we all share — insurance coverage for all Americans, better access to care and improved quality."

    Harold Wimmer, president and CEO of the American Lung Association. "Speaker Ryan made the correct choice in pulling the AHCA. This was the right call for lung health and the more than 32 million Americans living with lung disease.

    Together with 10 leading patient organizations, we have put forward Consensus Healthcare Reform Principles that identify the fundamental healthcare needs of Americans. The American Lung Association is ready to work with the Congress and the administration on commonsense steps to ensure the healthcare system provides affordable, accessible and adequate healthcare coverage and preserves the coverage provided to millions through Medicare and Medicaid."

    Article Link: http://www.beckershospitalreview.com...reactions.html

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  9. #429
    Quote Originally Posted by LA Ute View Post
    The idea that Trump will sabotage the current law seems to be a theme that the Democrats are promoting. We will see if it is true. This morning in a press conference Ryan seemed to say that the healthcare reform effort was not dead yet in this session of Congress. We'll see about that too.


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    If trump wanted to he could kill the ACA with one move: Get rid of the cost share reimbursement (CSR). The CSR basically lets people purchase platinum plans at Bronze prices. If Trump said they wouldnt reimburse it anymore no Insurance company would be left in the market.
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  10. #430
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Mormon Red Death View Post
    If trump wanted to he could kill the ACA with one move: Get rid of the cost share reimbursement (CSR). The CSR basically lets people purchase platinum plans at Bronze prices. If Trump said they wouldnt reimburse it anymore no Insurance company would be left in the market.
    He would be raked over the coals for depriving millions of people of access to insurance.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  11. #431
    I was reading this morning that Trump can sabotage the private insurance market, and make it more difficult or impossible to buy a policy through an exchange. He can't, however, do much to sabotage medicaid or its expansion (and the Kansas Senate voted for expansion yesterday). The net result might be to make medicaid much more important, especially in those states that have expanded it, which ironically might mean effectively moving the US closer to a sinqie payer system.

    And it isnt just Democrats raising the spectre of sabotage. Trump has implied as much, and basically said those were his instructions to Tom Price in nominating him.

  12. #432
    Sam the Sheepdog LA Ute's Avatar
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    NY Times:

    Affordable Care Act Repeal Is Back on the Agenda, Republicans Say


    Republican members of Congress said they hoped that revisiting the issue would lead this time to a solution and a vote in the House.

    “I think everyone wants to get to yes and support President Trump,” said Representative Dave Brat, Republican of Virginia and a Freedom Caucus member. “There is a package in there that is a win-win.”

    Representative Raúl Labrador of Idaho, another Freedom Caucus member, said he hoped the discussions would yield a compromise that brings the party together after a divisive debate that revealed deep fissures. “I think we will have a better, stronger product that will unify the conference,” Mr. Labrador said.
    Blah, blah, blah blah. I am sick of these people.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  13. #433
    Quote Originally Posted by LA Ute View Post
    NY Times:

    Affordable Care Act Repeal Is Back on the Agenda, Republicans Say




    Blah, blah, blah blah. I am sick of these people.

    After the house caucus meeting this morning, the Administration said it was moving on from health care to tax reform, etc., and wasn't actively going to do anything to bring it back.

  14. #434
    Quote Originally Posted by Diehard Ute View Post
    You actually can't make a generic. Remicade is made from biological cells. So you can make a "bio-similar" medication but not an actual generic copy.
    Nice catch.

    We're starting to employ immunotherapy and some other advanced therapeutics in fighting cancer. Hard to see how the price of these treatments can come down, dramatically.

  15. #435
    Quote Originally Posted by U-Ute View Post
    Isn't she the one that started a movement for hospitals to actually calculate the cost of treatment for pricing purposes as opposed to the "waving of hands" that generally is used to determine prices?
    Yes, Dr. Lee is a big pusher in this movement. More accurate cost accounting in healthcare is a big mountain to climb, and badly needed.

  16. #436
    Administrator U-Ute's Avatar
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    Quote Originally Posted by LA Ute View Post
    NY Times:

    Affordable Care Act Repeal Is Back on the Agenda, Republicans Say



    Blah, blah, blah blah. I am sick of these people.

    I hope you have insurance for that.

  17. #437
    Quote Originally Posted by LA Ute View Post
    He would be raked over the coals for depriving millions of people of access to insurance.
    He wouldn't be depriving they just that you get a bronze plan at a bronze price

    Sent from my SM-G930T using Tapatalk
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  18. #438
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Mormon Red Death View Post
    He wouldn't be depriving they just that you get a bronze plan at a bronze price

    Sent from my SM-G930T using Tapatalk
    You need to learn to think like a liberal.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  19. #439
    Malleus Cougarorum Solon's Avatar
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    Quote Originally Posted by LA Ute View Post
    I was quoted in this article yesterday. See the third paragraph for what it is worth.


    Lowell C. Brown, partner and chairman of National Health Care Law Group at Arent Fox. "To me, the collapse of the GOP's effort really began seven years ago when the key players on both sides refused to pass bipartisan health reform. The American healthcare system can't be reformed effectively on a partisan basis. In 2010 the Democrats enacted a massive reform that was 100 percent partisan, and in 2017 the GOP has answered with a replacement that was equally partisan. Our system is a wickedly complex patchwork of policies, designed to satisfy dozens of competing interests. Without significant compromise, there's no workable solution. Social Security and Medicare, for example, had bipartisan support and they endure to this day."


    Article Link: http://www.beckershospitalreview.com...reactions.html
    Way too reasoned and moderate, LA. I'm calling this out as 'fake news.'
    σοφῷ ἀνδρὶ Ἑλλὰς πάντα.
    -- Flavius Philostratus, Life of Apollonius 1.35.2.

  20. #440
    Medicare for all. Single payer is the most cost effective, humane, and fair method. Health insurance companies are leeches profiting on sickness and death.

  21. #441
    Quote Originally Posted by Hayes6 View Post
    Medicare for all. Single payer is the most cost effective, humane, and fair method. Health insurance companies are leeches profiting on sickness and death.
    I'm coming around to that view. But putting the government completely in charge of something that big and complex is a scary thought.
    Dyslexics of the world, untie!

  22. #442
    Quote Originally Posted by Hayes6 View Post
    Medicare for all. Single payer is the most cost effective, humane, and fair method. Health insurance companies are leeches profiting on sickness and death.
    It shows how little you know about this subject.

    Sent from my SM-G930T using Tapatalk
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  23. #443
    Quote Originally Posted by Mormon Red Death View Post
    It shows how little you know about this subject.

    Sent from my SM-G930T using Tapatalk
    His word choices are harsh, but it's not an unfair assessment. Insurance is a gambit. You can't deny that, and there are certainly insurance companies more concerned with making a profit than they are with fulfilling their self-mandating mission. Which in and of itself is highly problematic, because what checks and balances are there to regulate said self-mandate? A free market? So long as there is no collusion, but you can't guarantee that can you?

    In an ideal world, a free market healthcare system is the best option. But we don't live in a world where the ideal is necessarily possible. So, if one believes that access to health care is an inalienable right, then Hayes6's perspective is valid, especially in it's simplicity. How to achieve what he is suggesting, and at the same time show respect for and allow for quality insurance providers and health care institutions to do the many good things they do is the challenge. Hence the problems with Obamacare and the idiocy that was the Trump initiated plan to repeal and replace it.
    Last edited by tooblue; 03-29-2017 at 09:40 PM.

  24. #444
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Hayes6 View Post
    Medicare for all. Single payer is the most cost effective, humane, and fair method. Health insurance companies are leeches profiting on sickness and death.
    I think the problem can be fixed in the private market if we can get competition and cost transparency (a precursor to competition) in the hospital health care market.

  25. #445
    Quote Originally Posted by tooblue View Post
    In an ideal world, a free market healthcare system is the best option....
    The biggest problem with applying the free market to healthcare is the need for healthcare is highly atypical.

    - How many people shop around when they're having a heart attack?

    - Why did Reagan sign the law that allows anyone to show up for emergency care, regardless of ability to pay?

    - Why is it acceptable to deny car insurance coverage to somebody who has multiple DUIs, but then everyone condemns the health insurance company for figuring out a family has a high rate of breast cancer, and jack up their rates, accordingly?

    The truly stupid thing is Republicans denigrated and undermined Obamacare - which was based on Romneycare, and both are based on the Heritage Foundation's conservative response to the Hillarycare single payer model - and the Republican demonization of ACA accelerates us toward a single payer model.

    Now that he's openly declared war on the freedom caucus, wouldn't it be ironic if Trump turned to Democrats and moderate Republican to fix Obamacare, which would essentially help to save Republicans... from themselves?

  26. #446
    Quote Originally Posted by U-Ute View Post
    I think the problem can be fixed in the private market if we can get competition and cost transparency (a precursor to competition) in the hospital health care market.
    No it can't. If I can't afford a Ferrari, then I can buy a Lexus, a Toyota, a used Chevy, take the bus, or a myriad of other options. If I get cancer, then I either get the same treatment anyone else would get or I die. Just like the fire truck shows up at the burning hovel as it does the burning mansion, if we are humane at all, then everyone should be given the same life saving treatment regardless of their ability to pay. The most cost effective way of doing that does not involve grossly overpaid insurance executives and hospital administrators. It involves allowing the Federal Government to use its buying power to drive down costs and spreading the risk over the entire population. Every other developed country has it and gets better care for less money.

  27. #447
    I don't chime in on this thread because Im an amateur on this topic. However, on the whole, unless the product is identical for the person in NY as it is in CA as it is in IA as it is in LA etc..... such as military, border protection or infrastructure needs, then the federal government is typically not the most effective or efficient entity to provide that service. It just isn't built to pivot and move with changing healthcare needs among millions and millions of people. It moves with the speed of mountains and eventually becomes bloated with layers and layers of bureaucracy. My dad was a WW2 vet and received care at the SL VA Hospital. Supposedly that VA Hospital is one of the better ones in the region/country (rated 4 out of 5 stars), and he felt the care he received at the VA vis a vis its market place counterparts was so inferior that he simply stopped going. He could be a poorly chosen exception to the rule, but his experience was one of a dysfunctional system. My sense is that veteran care under Obama deteriorated. Note that he voted straight democrat last election, so its not as if he was anti-government. Also my bias is clear as I lean libertarian.....keep the federal government as small as possible. I totally get why one would want a simple single-pay system, but, the feds just don't give me confidence that it wouldn't end up being a complete cluster down the road....and once that entitlement is entrenched, good luck with making meaningful changes to fix it.
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  28. #448
    Quote Originally Posted by mUUser View Post
    I don't chime in on this thread because Im an amateur on this topic. However, on the whole, unless the product is identical for the person in NY as it is in CA as it is in IA as it is in LA etc..... such as military, border protection or infrastructure needs, then the federal government is typically not the most effective or efficient entity to provide that service. It just isn't built to pivot and move with changing healthcare needs among millions and millions of people. It moves with the speed of mountains and eventually becomes bloated with layers and layers of bureaucracy. My dad was a WW2 vet and received care at the SL VA Hospital. Supposedly that VA Hospital is one of the better ones in the region/country (rated 4 out of 5 stars), and he felt the care he received at the VA vis a vis its market place counterparts was so inferior that he simply stopped going. He could be a poorly chosen exception to the rule, but his experience was one of a dysfunctional system. My sense is that veteran care under Obama deteriorated. Note that he voted straight democrat last election, so its not as if he was anti-government. Also my bias is clear as I lean libertarian.....keep the federal government as small as possible. I totally get why one would want a simple single-pay system, but, the feds just don't give me confidence that it wouldn't end up being a complete cluster down the road....and once that entitlement is entrenched, good luck with making meaningful changes to fix it.
    People get sick in New York of the same things they do in California and need the same medicine and treatment. Single payer isn't the VA model, it's the Medicare model. Ask anyone over 65 if they would prefer to go back to the insurance system and be prepared to have your face laughed in. You say the government has too many layers of bureaucracy, but insurance companies and hospitals are worse and more expensive.

  29. #449
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Hayes6 View Post
    No it can't. If I can't afford a Ferrari, then I can buy a Lexus, a Toyota, a used Chevy, take the bus, or a myriad of other options. If I get cancer, then I either get the same treatment anyone else would get or I die. Just like the fire truck shows up at the burning hovel as it does the burning mansion, if we are humane at all, then everyone should be given the same life saving treatment regardless of their ability to pay. The most cost effective way of doing that does not involve grossly overpaid insurance executives and hospital administrators. It involves allowing the Federal Government to use its buying power to drive down costs and spreading the risk over the entire population. Every other developed country has it and gets better care for less money.
    I understand what you're saying, but what you need to ask yourself is "why is it so expensive to begin with?"

    The truth of the matter is that there is no concrete reason why healthcare is so expensive. Transparency in cost and competition among hospitals would naturally drive those prices down making insurance more affordable.

    There may need to be special consideration to the Martin Shkreli's of the world and have some sort of price regulation in the pharmacological market.

  30. #450
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Hayes6 View Post
    People get sick in New York of the same things they do in California and need the same medicine and treatment. Single payer isn't the VA model, it's the Medicare model. Ask anyone over 65 if they would prefer to go back to the insurance system and be prepared to have your face laughed in. You say the government has too many layers of bureaucracy, but insurance companies and hospitals are worse and more expensive.
    I think if you ask physicians and other providers if they'd like a system where Medicare was simply expanded to cover everyone you'd get an earful from most of them. Medicare already imposes a one-size-fits-all bureaucracy on providers who participate (which is nearly everyone). I think it would be a nightmare if they were the only game in town -- in the nation, actually.


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