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Thread: The health care debate thread.

  1. #511
    Quote Originally Posted by Rocker Ute View Post
    Yeah, the hat = brains stretch was devastating.


    Sent from my iPhone using Tapatalk
    Oh, sorry. You meant this kind of hat:


  2. #512
    So anyway, now that we've finally established Canadian superiority and the travel plans of tooblue's family...

    What has been established is there is no perfect healthcare system. I personally favor the healthcare model of the Netherlands since we are neck deep in ACA and we can't unring that bell. Mandatory basic level of insurance for all people and then you or your employer can pay for higher tiers of healthcare and long-term and end of life care. Creating this basic level of insurance will achieve goal number one which is providing basic access at an affordable cost to everyone and allow for continued private insurance and providers.

    Because aside from the cost of care, but tied to it, is the real problem is the poor and unhealthy don't have access to basic care, which means they either wait or use an emergency room as their primary care provider and then scoot the bill. Preventive care and easy access to basic services will reduce costs that hospitals are assuming and passing onto you and me. Basic service of course would not pay for tooblue's personal example of his breast augmentation because he felt sad, he'd need that next tier of coverage paid for individually.

    I also believe that everyone should have some skin in the game as the best way to reduce costs. If a hip replacement costs the same to the end consumer as a set of stitches ($500 deductible) then they utilize it the same way. I shared my 'gamma knife' example previously, when people assume the costs, suddenly a couple extra days of recovery seems a lot better than paying an extra $10k to recover slightly faster.

  3. #513
    Quote Originally Posted by Utah View Post
    We keep saying, "who will pay for it?"

    Yet, we currently pay more for healthcare and get the worst results.

    Why don't we take the money already being spent, and spend it better.

    Yeah, your taxes might go up. But your healthcare costs will go down, creating a wash, at worst.

    Odds are, costs would go down overall under single payer, because we already pay more than everyone else.
    Maybe California can be your guinea pig?......

    http://www.latimes.com/politics/la-p...525-story.html
    “Children and dogs are as necessary to the welfare of the country as Wall Street and the railroads.” -- Harry S. Truman

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  4. #514
    Quote Originally Posted by mUUser View Post
    Maybe California can be your guinea pig?......

    http://www.latimes.com/politics/la-p...525-story.html
    Awesome. Ignore the facts and just push forward on the single payer program.

    Ironically, Utah could probably do a pretty damn good job of a single payer program. But if you require this state to help carry states like California, forget it. It's a pipe dream and would be a nightmare

    I actually have some decent admiration for Governor Brown. He's an old school Democrat who still understands the need to be fiscally responsible. Swarzenegger was a train wreck. Brown has followed up with real practical governance of an almost ungovernable state.

  5. #515
    Sam the Sheepdog LA Ute's Avatar
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    What the CBO’s “Uninsured” Score Really Means

    It’s worth reiterating that should there be a drastic rise in uninsured Americans, it won’t be because the AHCA destroys their health insurance plans or makes coverage unattainable, it will be because in the absence of the individual mandate, many will simply opt out of health insurance entirely. At least until the market makes it more affordable.

    "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

  6. #516
    Quote Originally Posted by LA Ute View Post
    What the CBO’s “Uninsured” Score Really Means
    I'm sure that is true. To the extent it is healthy people choosing to not purchase health insurance, that to will increase the cost of insurance for those who remain.

    I can't imagine that the House version has any hope of surviving the Senate. If it does, it almost guarantees some change of Senate/House composition at the mid-term election. One of the problems with these partisan endeavors like Obamacare and Trumpcare (for lack of a better term) is that they are bound to be repealed and replaced at every election turn thereby preventing any serious longterm solution to both the rising costs of healthcare and the rising costs of health insurance. As a 60 year old, single payer, the increased costs of Obamacare have been significant. However, the CBO score of Trumpcare for people in my age/circumstances are downright frightening.
    Last edited by UTEopia; 05-25-2017 at 05:12 PM.

  7. #517
    Quote Originally Posted by UTEopia View Post
    I'm sure that is true. To the extent it is healthy people choosing to not purchase health insurance, that to will increase the cost of insurance for those who remain.

    I can't imagine that the House version has any hope of surviving the Senate. If it does, it almost guarantees some change of Senate/House composition at the mid-term election. One of the problems with these partisan endeavors like Obamacare and Trumpcare (for lack of a better term) is that they are bound to be repealed and replaced at every election turn thereby preventing any serious longterm solution to both the rising costs of healthcare and the rising costs of health insurance. As a 60 year old, single payer, the increased costs of Obamacare have been significant. However, the CBO score of Trumpcare for people in my age/circumstances are downright frightening.
    As a country we need to get over this notion of a single bill that is going to fix things in one fell swoop. We'd be a lot smarter to pass a bunch of individual smaller bills that address individual problems and then it will be easier to tweak things going forward.

    I was just thinking this because we recently completed a two-year project and I remember sitting at the start wondering how we would get this 36 part problem fixed and completed on scope, budget and time. We had to segment out the goals and problems into the 36 different parts, prioritize them and identify the easiest ones to fix/complete. This was all while keeping the existing systems functioning and swapping out parts. We joked it is like changing tires on a moving vehicle on the freeway. Then we tackled them individually and got the job done.

    So why can't we do this with healthcare. One issue - tort reform. Tackle that. Another issue is increasing cost of care - address that, compensation rates, etc etc.

    So let's talk about the good of ACA: Two obvious ones are allowing kids up to 26 to stay on parents plans. The other is covering pre-existing conditions. Keep that stuff. Something that is good but needs tweaking is the covered preventive care visits. Maybe that is the 'single-payer' start. We agree that everybody should be able to get two basic preventive care doctors visits a year in America for free. Then the dude with a cold goes and visits the doc before it ends up as pneumonia and an ER visit.

    Keep on movin' down the line. It is a solvable problem it is just we are passing these bills that nobody has read or understands because it is too complex.

  8. #518
    Lol. We pay more and get less than everyone else! But ours is better!

    It's fantastic.

    And do I hate America? Nope. My family is immigrants. I live a very nice lifestyle here in America.

    Hell, America (especially the healthcare system set up here) has been so good to me, I decided to take May and June off from work. I love this place.

    BUT, it can be better. I guess to the less mentally capable, improving something that is great = you hate that something.

  9. #519
    Quote Originally Posted by Utah View Post
    Lol. We pay more and get less than everyone else! But ours is better!

    It's fantastic.

    And do I hate America? Nope. My family is immigrants. I live a very nice lifestyle here in America.

    Hell, America (especially the healthcare system set up here) has been so good to me, I decided to take May and June off from work. I love this place.

    BUT, it can be better. I guess to the less mentally capable, improving something that is great = you hate that something.
    Really? I think most of us who would disagree with you do so because we don't think the government will improve something that is great to something better like you do. That's really not an outrageous thought, believe it or not.

    Typical liberal. If I disagree I'm "less mentally capable". Way to add that to the debate. Really helps your cause.

    And congrats on taking two months off. Glad you shared that with us. You must be awesome.

  10. #520
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Rocker Ute View Post
    As a country we need to get over this notion of a single bill that is going to fix things in one fell swoop. We'd be a lot smarter to pass a bunch of individual smaller bills that address individual problems and then it will be easier to tweak things going forward.

    I was just thinking this because we recently completed a two-year project and I remember sitting at the start wondering how we would get this 36 part problem fixed and completed on scope, budget and time. We had to segment out the goals and problems into the 36 different parts, prioritize them and identify the easiest ones to fix/complete. This was all while keeping the existing systems functioning and swapping out parts. We joked it is like changing tires on a moving vehicle on the freeway. Then we tackled them individually and got the job done.

    So why can't we do this with healthcare. One issue - tort reform. Tackle that. Another issue is increasing cost of care - address that, compensation rates, etc etc.

    So let's talk about the good of ACA: Two obvious ones are allowing kids up to 26 to stay on parents plans. The other is covering pre-existing conditions. Keep that stuff. Something that is good but needs tweaking is the covered preventive care visits. Maybe that is the 'single-payer' start. We agree that everybody should be able to get two basic preventive care doctors visits a year in America for free. Then the dude with a cold goes and visits the doc before it ends up as pneumonia and an ER visit.

    Keep on movin' down the line. It is a solvable problem it is just we are passing these bills that nobody has read or understands because it is too complex.
    I suspect the problem is because of the inter-dependencies of all of the parties involved. You can't fix one problem without pushing more pain onto someone else.

  11. #521
    Quote Originally Posted by Rocker Ute View Post
    As a country we need to get over this notion of a single bill that is going to fix things in one fell swoop. We'd be a lot smarter to pass a bunch of individual smaller bills that address individual problems and then it will be easier to tweak things going forward......

    Obamacare was doomed from day one. There's not a single organization in the world, public or private, that can write a bill or policy that stands 8 feet tall that would make any sense at all. It was a single party bill. It wasn't understood by anyone that voted for it. In fact, I'm not certain a single member of congress had read it front to back, much less understood what he/she was voting for.

    You are exactly right. This needs to be taken in tiny chunks. Start with the five or six provisions everyone can agree on, then monitor the unintended consequences of it, then move to improve it. Something as monstrous as health care legislation might even take a generation to get anywhere near "right."
    “Children and dogs are as necessary to the welfare of the country as Wall Street and the railroads.” -- Harry S. Truman

    "You never soar so high as when you stoop down to help a child or an animal." -- Jewish Proverb

    "Three-time Pro Bowler Eric Weddle the most versatile, and maybe most intelligent, safety in the game." -- SI, 9/7/15, p. 107.

  12. #522
    Quote Originally Posted by mUUser View Post
    Obamacare was doomed from day one. There's not a single organization in the world, public or private, that can write a bill or policy that stands 8 feet tall that would make any sense at all. It was a single party bill. It wasn't understood by anyone that voted for it. In fact, I'm not certain a single member of congress had read it front to back, much less understood what he/she was voting for.

    You are exactly right. This needs to be taken in tiny chunks. Start with the five or six provisions everyone can agree on, then monitor the unintended consequences of it, then move to improve it. Something as monstrous as health care legislation might even take a generation to get anywhere near "right."
    I think there's a catch-22. If a bill is 800 pages long, no one will read it, but its lack of transparency makes it passable. If an important bill is simple enough to be understood, it has almost no chance of passing. The "five or six provisions everyone can agree on" don't exist.

    Rocker's first item - tort reform. People agree this is needed, but there is no agreement as to how it should be done. No way any simple bill on tort reform gets through. The most wealthy and powerful lobbies in Washington (and therefore our elected representatives) would skewer it. Most of the little necessary fixes have a huge uphill battle.

  13. #523
    Sam the Sheepdog LA Ute's Avatar
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    Ummm, no, maybe this isn't the way to frame the debate.

    https://twitter.com/BigMeanInternet/...72869150859265

    "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

  14. #524
    Sam the Sheepdog LA Ute's Avatar
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    The debate is becoming very philosophical and high-minded:

    ● “On CNN, Montel Williams: GOP Plan Would Send 140 Million to ‘Death.’”
    —Headline, NewsBusters today.

    ● “Republicans are trying to pass a bill that could kill up to 27,000 in 2026 so they can give tax cuts to the wealthy.”
    —Deleted tweet by Bernie Sanders yesterday.

    ● “Let us be clear and this is not trying to be overly dramatic: Thousands of people will die if the Republican health care bill becomes law.
    —Not-deleted tweet by Bernie Sanders, yesterday.

    ● “Forget death panels. If Republicans pass this bill, they’re the death party.”
    —Not-deleted tweet by Hillary Clinton, yesterday.
    http://hotair.com/archives/2017/06/2...op-healthcare/

    "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

  15. #525
    Quote Originally Posted by LA Ute View Post
    The debate is becoming very philosophical and high-minded:



    http://hotair.com/archives/2017/06/2...op-healthcare/
    I hate scare tactics like this. They serve no legitimate purpose and prohibit reasonable discussion. I think it is fair to say, however, that the Senate bill will most benefit those who:

    1. Make over 200k per year. If you make over 1 million, you really benefit;
    2. Have a good job that provides quality group coverage;
    3. You don't lose that job and need to buy coverage in the individual market;
    4. You are under 50 and relatively healthy.

    If you can check all of those boxes, you will probably see a benefit. Unfortunately, I don't check any of those boxes. I don't make over 200k, I buy insurance on the individual market and I am over 50. While my health, in general, is pretty good, I receive an IV for an auto-immune condition about 6 times per year. The cost of the IV is now about 17k per infusion up from about 5k when I first started getting them in 2001.

    However, even people who check those boxes will want to watch what happens if insurance companies are allowed to eliminate certain coverages that are now mandatory, i.e. maternity care. If this happens, those who want to have insurance coverage for those items will pay a hefty premium.

  16. #526
    One of the new GOP tactics is to federalize healthcare, to not eliminate Medicaid, per se, but to move it all to the states, so if a state wants to expand Medicaid, it would be up to that state to raise taxes.

    When pressed on the number of people in Kentucky who would benefit from Medicaid, Paul said they need to have an "honest debate" in the Kentucky Legislature about whether people want to have high paying jobs with good insurance, or be on Medicaid, but the program needs to be paid for it with taxation at the state level. "But we would also need to consider that Tennessee has no state income tax, and so increasing spending on Medicaid will drives jobs to Tennessee from Kentucky".

    Aha - classic example of "race to the bottom".

    During the year long debate about the ACA, there was an insightful article in the LA Times about an ER physician who split his practice between LA and Honolulu. (In Hawaii, employers have to provide insurance if they have 3 or more employees, so the coverage rate for the population is really high... but the Hawaiian economy is largely immune from interstate competition. No tourism jobs move between Hawaii and Iowa.)

    The ER physician said the difference between practicing in Los Angeles and Honolulu was night and day. Patients coming to the ER in Hawaii had actual emergencies, since they almost all already had primary care physicians. In LA it was the classic "everyone already has healthcare because you can always go to the ER" scenario, and so ERs in LA were the disaster most people have come to know - long wait times, people bringing kids in with the common cold, etc.

    Race to the bottom politics are lazy, but effective.

  17. #527
    Sam the Sheepdog LA Ute's Avatar
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    Truth:

    The Simplicity of a Health Deal

    The GOP must realize protection for pre-existing conditions is here to stay.


    By Kimberley A. Strassel

    June 29, 2017 6:44 p.m. ET112 COMMENTS

    As Washington continues to boggle the nation with the complex minutiae of health-care reform, the contours of an actual deal aren’t nearly so mystifying. The success of the GOP effort comes down to one simple question: Will the most conservative members of Congress accept that the politics of health care have changed?

    Or more simply yet: Will they acknowledge that any reform must include continued protections for pre-existing medical conditions?

    It’s that easy. Yes, the media analysis is correct that there are two camps of defectors from the Senate’s reform bill. One consists of Republican moderates— Rob Portman, Dean Heller, Susan Collins, Lisa Murkowski —who claim the bill is too mean to poor and sick people. Cue mind-numbing media stories about Medicaid formulas and per capita spending caps and medical inflation, all of which make a compromise sound nigh impossible.


    Hardly. Here’s a tip: When a politician claims a bill “cuts too much,” that’s an invitation to be bought off. There’s a reason several senators who had been largely mum on the GOP bill (Jerry Moran of Kansas, Shelley Moore Capito of West Virginia) came out against it only after Majority Leader Mitch McConnell delayed a vote. They saw the other holdouts were about to get payola, and they wanted theirs.

    And there is cash to be had. With the stakes this high, the Senate leadership will gladly shuffle some money toward opioid treatment, rural health-care providers or Medicaid.

    So getting the “moderates” on board is simple and transactional. They name a price, they get pork, they vote yes.


    The conservatives are the sticking point, precisely because they have principles. Sens. Ron Johnson, Mike Lee, Rand Paul and Ted Cruz have been clear from the start that any bill must lower premiums, which involves getting rid of costly ObamaCare mandates. And there is no question that among the most expensive mandates are those designed to protect individuals with pre-existing conditions—in particular “community rating,” which requires insurers to charge the same prices regardless of health status.


    The House Freedom Caucus was so intent on getting rid of community rating that it nearly derailed the bill. Only after the conference added an amendment allowing states to apply for waivers from community rating did the most conservative members finally came on board.


    Even so, it was always clear that provision was never going to fly in the Senate—and for a simple reason. Freedom Caucus members tend to hail from inordinately conservative (and safe) congressional districts, whereas senators represent entire statewide populations. And a sizable majority of the public strongly supports retaining protections for pre-existing conditions.


    This is the true legacy of the Republican presidential loss in 2008, and the health-care law that resulted. Few Americans ever understood the stunningly complex means by which ObamaCare screwed up the individual insurance market, or the wider economy. To this day, most Americans haven’t intimately interacted with the law, as they receive their health care from an employer or Medicare.


    But every American remembers two particular provisions of the law—pre-existing conditions and coverage for children up to 26. These policies are simple and sound good. And they have become over the years a new standard in most people’s minds. A February poll from YouGov showed 77% support for protections for consumers with pre-existing conditions.

    Principles matter, but so does public will. Conservatives will argue their side just needs to do a better job explaining how these mandates drive up costs for everyone, or lower the quality of care. These are valid points, but they’ll count for little in the face of 2018 Democratic campaign ads that flash GOP names next to a graphic of a kid in a wheelchair with cancer who can’t get care. Republicans lost this argument nearly a decade ago, when Mr. Obama won. More than 90% of Senate Republicans understand this.

    Which is another way of saying that protections for pre-existing conditions are here to stay, and conservatives face a choice. They can work with their colleagues to minimize the costs of the mandates (there are innovative ways to do this) and build in different free-market reforms to lower premiums. The Congressional Budget Office estimates that the current Senate bill will reduce premiums by about 30%, and the GOP can and should build on this.

    Or they can kill the bill, and get no premium reductions at all, no deficit reduction, no Medicaid reform, no tax cuts, and no economic boost. Oh, and the protections for pre-existing conditions would remain. Plus, electoral disaster would loom.

    It’s a binary choice, rooted in blunt political reality, which ought to make it an easy call. The question is whether conservatives will be savvy enough to forge a face-saving compromise and seek victories elsewhere in the bill. The health-care debate has changed over the past decade, and Republicans can’t reverse it on a dime. But they can pass a bill that starts the walk back to freer health-care markets.

    Write to kim@wsj.com.

    https://www.wsj.com/articles/the-sim...eal-1498776293

    "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

  18. #528
    Healthcare reform is at the heart of it, a game of whack-a-mole.

    ACA was intended to address the insurance part, lower the amount of cost shifting from people with lack of insurance showing up to the ER with no insurance, etc. Many other parts of healthcare reform that also need to be addressed, but maybe - just maybe - Republicans understand this issue is not trivial, can't just be a 20 page bill.

    The Republican orientation is (generally) individualism / individual responsibility, which in healthcare insurance means "you're on your own". In offering cheaper individual plans, healthier people - with better genetics - get a huge cost reduction, because their risk is so much lower. The public is saying that's cruelty, Darwinism.

    Best course of action - patch up ACA, move on to Costs and Quality as the next items on reform.

  19. #529
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    Damn... Democrats seem to have to have some driving need to be ruled. They crave government direction.

  20. #530
    Sam the Sheepdog LA Ute's Avatar
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    The health care debate thread.

    And you guys think Utah politics are crazy.

    In blocking a bad single-payer healthcare bill, Assembly Speaker Anthony Rendon was not ‘cowardly’ – quite the opposite

    https://www.google.com/amp/www.latim...story,amp.html

    Battle breaks out in California over single-payer healthcare

    https://www.google.com/amp/thehill.c...althcare%3Famp

    Some Notes on California’s Single-Payer Health Care Plan

    http://www.motherjones.com/kevin-dru...lth-care-plan/
    Last edited by LA Ute; 07-02-2017 at 07:15 PM.

    "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

  21. #531
    Sam the Sheepdog LA Ute's Avatar
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    Ranking healthcare systems can be complex.

    NHS ranked 'number one' health system

    http://www.bbc.co.uk/news/health-406...ource=facebook

    "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

  22. #532
    Administrator U-Ute's Avatar
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    Contrary to Trump's claims, fivethirtyeight.com finds that the Obamacare insurance market is not in a "death spiral".

    https://fivethirtyeight.com/features...snt-imploding/

    To determine the mix of healthy and sick enrollees for risk-adjustment payments, the federal government assigns risk scores to people based on their age, sex and health diagnosis and then averages the scores for a plan. What CMS found was that those averages were relatively stable in 2016. That’s a good sign for the marketplaces, because stabilizing the mix of healthy and sick people buying on the marketplaces goes a long way toward stabilizing prices. Despite expectations that in the face of rising premiums, healthier enrollees would be less inclined to enroll last year, that doesn’t appear to have been the case.

  23. #533
    Today, Mike Lee killed McConnell's attempt to pass "Repeal and Replace" in the Senate.

    The President then called for a straight repeal, and McConnell seems headed toward a vote to do just that, with a 2 year delay, to allow Congress to start from scratch.

    If the Senate, House and Trump simply Repeal, this might backfire, in a thermonuclear way. Republican plans have had polling way below Obamacare, and combined with Trump's steadily eroding support, the job might fall to a Democratic House and/or Senate.

    Single Payer, anyone? It's hard to imagine the forces battling that one out, but in numerous ways, we're in uncharted waters, as a nation. The energy that resulted in the Republicans getting the House, then the Senate, then the White House, could easily spurn the current occupants. Just as Bernie Sanders got 15,000 Utah youngsters to show up at This is the Place monument, the equivalent energy on the Left has not yet been heard.

    I told the wife in 2004 that Obama would become president. I have fewer tea leaves to go by now, but my super-early, "don't be surprised" call for 2020 is Kamala Harris.

  24. #534
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    Quote Originally Posted by Ma'ake View Post
    Today, Mike Lee killed McConnell's attempt to pass "Repeal and Replace" in the Senate.

    The President then called for a straight repeal, and McConnell seems headed toward a vote to do just that, with a 2 year delay, to allow Congress to start from scratch.

    If the Senate, House and Trump simply Repeal, this might backfire, in a thermonuclear way. Republican plans have had polling way below Obamacare, and combined with Trump's steadily eroding support, the job might fall to a Democratic House and/or Senate.

    Single Payer, anyone? It's hard to imagine the forces battling that one out, but in numerous ways, we're in uncharted waters, as a nation. The energy that resulted in the Republicans getting the House, then the Senate, then the White House, could easily spurn the current occupants. Just as Bernie Sanders got 15,000 Utah youngsters to show up at This is the Place monument, the equivalent energy on the Left has not yet been heard.

    I told the wife in 2004 that Obama would become president. I have fewer tea leaves to go by now, but my super-early, "don't be surprised" call for 2020 is Kamala Harris.
    Single payer isn't the right answer, but I don't think anyone has the political will or power to implement the right answer (price transparency and competition).

  25. #535
    Quote Originally Posted by U-Ute View Post
    Single payer isn't the right answer, but I don't think anyone has the political will or power to implement the right answer (price transparency and competition).
    Cost transparency is a worthy goal, no question. Competition is a more muddled different issue.

    For example, most of the big downward pressure on costs has usually been led by Medicare/Medicaid, who physician practices chronically whine about, and some physicians simply won't take additional patients who are on a M or M. But a CMS study of practices where most of their patient load are MM patients have found that they've tightened their belts enough to become profitable.

    In terms of competition among insurers, the great irony is we spend about $300 Billion annually just for the privilege of having different insurance companies. Between the administrative cost overhead of private insurers, and providers needing to hire staff to play the various insurance company games, this is a case of the free market simply failing to meet the economies of scale and expertise of the big bad government. Put it differently, health insurance salesmen need to drive BMWs and Mercedes to impress potential employer-customers. Medicare bureaucrats just don't make that much money, and there are far, far fewer of them.

    If you really, REALLY wanted to bring down costs, allow more widespread use of Canadian pharmacies to charge Americans what the Canucks pay (which applies great pressure to Big Pharma for R&D funding, but when they spend more money on marketing ED drugs than R&D, the argument loses steam).

    Do like is happening with transatlantic airline competition - allow foreign MDs and nurses to come practice here, for far less than their American counterparts. This destroys the incentive for many young people to pursue careers in medicine, but as the Medical Tourism business shows, US trained physicians will work for far, far less, as their educations were paid for by their governments.

    I'm having a hard time believing there are so many Republicans / Trump voters who think we just need a free-market system. By kicking all the seniors out of Medicare, giving them a voucher and say "good luck getting insurance on the private market"?

  26. #536
    Quote Originally Posted by Ma'ake View Post
    Today, Mike Lee killed McConnell's attempt to pass "Repeal and Replace" in the Senate.

    The President then called for a straight repeal, and McConnell seems headed toward a vote to do just that, with a 2 year delay, to allow Congress to start from scratch.

    If the Senate, House and Trump simply Repeal, this might backfire, in a thermonuclear way. Republican plans have had polling way below Obamacare, and combined with Trump's steadily eroding support, the job might fall to a Democratic House and/or Senate.

    Single Payer, anyone? It's hard to imagine the forces battling that one out, but in numerous ways, we're in uncharted waters, as a nation. The energy that resulted in the Republicans getting the House, then the Senate, then the White House, could easily spurn the current occupants. Just as Bernie Sanders got 15,000 Utah youngsters to show up at This is the Place monument, the equivalent energy on the Left has not yet been heard.

    I told the wife in 2004 that Obama would become president. I have fewer tea leaves to go by now, but my super-early, "don't be surprised" call for 2020 is Kamala Harris.
    The repubs have had 8 years to figure out a replacement for Obamacare and don't have one. Their failure to do anything about healthcare in the Bush years was the moving force that led to Obamacare. I have a hard time believing they will figure anything out in the next two years. I see this as a way of delaying things to allow the Repubs to talk out of both sides of their mouth and get them past the mid-term elections without facing the tough choices that need to be made.

  27. #537
    Sam the Sheepdog LA Ute's Avatar
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    The health care debate thread.

    You more liberal guys should donate to Mike Lee. He saved Obamacare, which true liberals think is the greatest piece of legislation ever!

    [TIC]

    Actually, I think Lee would make a great mission president. A sensible Bob Bennett type should run against Lee and free him up for church service.
    Last edited by LA Ute; 07-20-2017 at 08:07 AM.

    "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

  28. #538
    Administrator U-Ute's Avatar
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    Quote Originally Posted by LA Ute View Post
    You more liberal guys should donate to Mike Lee. He saved Obamacare, which true liberals think is the greatest piece of legislation ever!

    [TIC]

    Actually, I think Lee would make a great mission president. A sensible Bob Bennett type should run against Lee and free him up for church service.
    I guess if you like your mission presidents to be stone cold political assassins.

    I find Lee's stance on this curious.

    His public statements is that TrumpCare didn't go far enough. But it seems short sighted to vote against a bill that doesn't go far enough to end up with nothing being done. It speaks of a politician who wants to score points in the short term with his conservative base (the 2018 election cycle is upon us) by yelling that it doesn't go far enough, but was really using his position to try and strong arm concessions out of Trump/McConnell. I believe that whether or not he actually has a strong opinion on ObamaCare is up for question.

  29. #539
    Sam the Sheepdog LA Ute's Avatar
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    The health care debate thread.

    Quote Originally Posted by U-Ute View Post
    I guess if you like your mission presidents to be stone cold political assassins.

    I find Lee's stance on this curious.

    His public statements is that TrumpCare didn't go far enough. But it seems short sighted to vote against a bill that doesn't go far enough to end up with nothing being done. It speaks of a politician who wants to score points in the short term with his conservative base (the 2018 election cycle is upon us) by yelling that it doesn't go far enough, but was really using his position to try and strong arm concessions out of Trump/McConnell. I believe that whether or not he actually has a strong opinion on ObamaCare is up for question.
    The important thing is that Mike is back there protecting the Constitution.

    Seriously, his presence in the Senate is exhibit A in the case against Utah's caucus system. All the polls showed that in a primary election, Bennett would have beaten Lee by double digits. And yet because of the caucuses, a well-organized, highly-motivated and well-funded minority can hijack the process and throw out a very sane and accomplished US senator in favor of a guy who has no business being in the U.S. Senate.

    The BYU political science department needs him.

    "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

  30. #540
    Five-O Diehard Ute's Avatar
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    Quote Originally Posted by LA Ute View Post
    The important thing is that Mike is back there protecting the Constitution.

    Seriously, his presence in the Senate is exhibit A in the case against Utah's caucus system. All the polls showed that in a primary election, Bennett would have beaten Lee by double digits. And yet because of the caucuses, a well-organized, highly-motivated and well-funded minority can hijack the process and throw out a very sane and accomplished US senator in favor of a guy who has no business being in the U.S. Senate.

    The BYU political science department needs him.
    It's Utah politics. Being sane is considered a detrimental quality.


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