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  #201  
Old 12-06-2018, 02:54 PM
Shodan Shodan is offline
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Originally Posted by CarnalK View Post
My point is that you wouldn't be giving something up if your socialist medical insurance chose the best drugs for you. I didn't think I was being mysterious.
If we cut dramatically what we spend on drugs, which we would have to do if M4A is going to work, then we would be giving something up - namely, expensive drugs that may or may not work better than a cheaper version. Hence my example of statin drugs. And I think, some people will react badly to that, just as they would if the doctor said they couldn't have what they saw on TV. Certainly they do that now to some extent - it would just be somewhat more common, and for more commonly currently prescribed drugs, than it is now.

Something related is people complaining about doctors' reluctance to prescribe opiates for pain. In that case it is because of fear of addiction rather than cost, but people still complain about it, and not always because they are drug-seekers.

Regards,
Shodan
  #202  
Old 12-06-2018, 03:05 PM
ElvisL1ves ElvisL1ves is offline
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If we cut dramatically what we spend on drugs, which we would have to do if M4A is going to work, then we would be giving something up - namely, expensive drugs that may or may not work better than a cheaper version.
We'd be giving up the expensiveness, which is mainly due to administrative bloat and rent-seeking. Only we are saddled with it, not the civilized world.
  #203  
Old 12-06-2018, 03:12 PM
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If we cut dramatically what we spend on drugs, which we would have to do if M4A is going to work...
Why? Someone is paying for them now. Somebody would pay under M4A. Please explain this to me.
  #204  
Old 12-06-2018, 03:23 PM
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As I see it:

1. I can understand some people are wary of the government "running" health care. The government doesn't know how, doesn't have the expertise, goes the argument.

2. Either we all pay insurance companies for private care, or we all pay the government for public care (assuming a simplified one size fits all system).

3. Part of the money we currently pay insurance companies is for their profit.

4. Take out the profit by abolishing the insurers, and the overall cost for everyone is decreased.

5. The government hires the now out of work health care administrators, who presumably have some almost unfathomable, ultra-high competent level of expertise, to run the new M4A system, and

6. Everyone is happy.

Last edited by Fiddle Peghead; 12-06-2018 at 03:26 PM. Reason: clarity
  #205  
Old 12-06-2018, 05:10 PM
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Try2B Comprehensive Try2B Comprehensive is offline
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Originally Posted by k9bfriender View Post
You don't have insurance for free from your employer. You have insurance as part of your benefits package. Is your PTO and 401k also for free?

Your employer is paying your premiums on your behalf, and sounds like they are paying 100%, good deal for you.

Now, since you work for such a good employer that provides you this benefit, should things change and so they no longer have to pay for your insurance, do you think that your employer will pocket the savings, or that they will pass them to you?

If they pass them to you, then you are coming out ahead on your paycheck. If they don't pass them on to you, then you would be blaming UHC for a decision that your employer chose to make.

So, if pay goes up by $3000 a year, and your taxes go up by $2000 a year, and in the process you get to eliminate those out of pocket healthcare costs, as well as extend the benefits that you enjoy on to your fellow citizen, would you still be adverse?
I have a union job. I get ~3% raise every year, unless there is a big spike in inflation. I didn't get a raise due to the corporate tax cut, so I highly doubt I'd see a raise after UHC. OTOH, I make decent money and don't have an issue with pay/raises.

My attitude is that I basically have achieved my idea of the American Dream, and what's next is to arrange for everyone else to have it, too. So, my pointing out potential problems with rolling out UHC wasn't to disparage the plan but just an attempt to "be real." Maybe it Would end up costing me more. Depending on how big a sacrifice we're talking, I might still support it since I pretty much "got mine."

So yeah, if it turned out as rosy as you say, I'd support it for sure!

Also, another bit of skepticism that the plan is to slash pay for doctors and nurses. I am not an expert on all of this, but I thought savings would come from ending insurance profit margins and the bureaucratic redundancy in our current system. Plus maybe lower drug prices. I dunno. Is there a concrete M4A plan put forward, or can we all only speculate?
  #206  
Old 12-06-2018, 05:29 PM
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Originally Posted by Shodan View Post
If we cut dramatically what we spend on drugs, which we would have to do if M4A is going to work, then we would be giving something up - namely, expensive drugs that may or may not work better than a cheaper version. Hence my example of statin drugs. And I think, some people will react badly to that, just as they would if the doctor said they couldn't have what they saw on TV. Certainly they do that now to some extent - it would just be somewhat more common, and for more commonly currently prescribed drugs, than it is now.
You must not be old enough to remember when pharma did not advertise prescription medications in/on popular media – or so old that your mind has decayed to the point that you think they have always advertised Brlofiprindol, et al, on TV. Frankly, there is little benefit to widespread prescription medication advertising, information that is much better handled by professionals who (should, at least) understand the issues.

I mean, we do not allow nicotine products to be advertised, so why should we allow Nargblex to be pushed to the ignorati? Freedom of speech is just not a good enough excuse.
  #207  
Old 12-06-2018, 05:44 PM
k9bfriender k9bfriender is offline
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Originally Posted by Fiddle Peghead View Post
3. Part of the money we currently pay insurance companies is for their profit.

4. Take out the profit by abolishing the insurers, and the overall cost for everyone is decreased.
It's not just profit. It is operating costs, employee wages, rent for offices, utilities and all that associated with an industry whose only function is to stand between a person and the medical care that they need.

If you don't have adjusters denying claims, you not only don't have claims being denied, you don't have to pay that person to come up with reasons to deny the claim.
  #208  
Old 12-06-2018, 05:58 PM
bump bump is offline
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Originally Posted by k9bfriender View Post
I don't know about you, but I would ather spend a few hours in line at the DMV than at the hospital. You know, a large, impersonal corporate clinic where you go in, wait in some massive, shabby waiting room with a bunch of grungy people (who'll probably give you some disease), and then get a cursory visit with an overworked private doctor who happens to be on duty that day. Then they'll tell you that you need treatment/surgery X, but the wait time on getting approval from your insurance 2 years for that. Or that you have some condition that they don't cover, and that you're doomed.
First, I didn't say that's what it'll be. I said that's what a lot of people think it'll be.

Second, most people go to their primary care doctor and/or are referred to specialists for the majority of their health care. Hospital visits are likely few and far between for the vast majority of people. For example, I've been a hospital patient four times (knee injuries) and that's more than most people I know who aren't elderly.


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Originally Posted by k9bfriender View Post
that *is* the current outcome from out privatized care.
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Originally Posted by k9bfriender View Post
I know that Shodan keeps insisting that nurses and other providers would be paid less, but I have not seen any reliable source that backs his claim.
https://www.nytimes.com/2018/06/08/b...m-doctors.html

Somewhere between 11-13% and 40% less.


I have to admit that the idea that M4A is going to get rid of administrative bloat by moving it TO the government's administration is hysterically funny. I agree about the rent seeking part.

Ultimately the main problem is that profit motives and best outcomes can and often are opposed to each other. I don't like the idea that my doctor is somewhat hamstrung in what he can prescribe me affordably, because some drugs are not on the insurance's formulary, or they require him to try cheaper drugs first before prescribing the more potent and expensive ones. Presumably he knows what he's doing and has a reason for prescribing what he does, better than the bean counters in the bowels of the insurance company.
  #209  
Old 12-06-2018, 06:17 PM
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It's not just profit. It is operating costs, employee wages, rent for offices, utilities and all that associated with an industry whose only function is to stand between a person and the medical care that they need.

If you don't have adjusters denying claims, you not only don't have claims being denied, you don't have to pay that person to come up with reasons to deny the claim.
Absolutely. I was just keeping it simple to make a point.
  #210  
Old 12-06-2018, 06:22 PM
k9bfriender k9bfriender is offline
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First, I didn't say that's what it'll be. I said that's what a lot of people think it'll be.
Well, you are saying it as if you agree with them.

I know people that think that rainbows will taste like grapes. They are as relevant as your opinion on what other people think.
Quote:
Second, most people go to their primary care doctor and/or are referred to specialists for the majority of their health care. Hospital visits are likely few and far between for the vast majority of people. For example, I've been a hospital patient four times (knee injuries) and that's more than most people I know who aren't elderly.
Well, yeah, and under a UHC they would do the same. You were the one who brought up hospital visits.

Why do you (or not you, but other whole lot of people that you are currently channeling) think that there would be a change of that sort?
Quote:

https://www.nytimes.com/2018/06/08/b...m-doctors.html

Somewhere between 11-13% and 40% less.
That is not what that article says.

Some things that it did say:
Quote:
But cutting their pay directly probably wouldn’t happen, nor would it make sense.
...
Non-monetary working conditions are also important determinants of job satisfaction. Switching to a single-payer system promises significant reductions in many of the everyday hassles confronting doctors under private insurance systems.

One difficulty is having to wrangle with insurance companies that deny payment for tests and procedures that their policies seem to cover. If you complain often and loudly enough, you may eventually get paid, but the process takes a toll — not just on consumers but on doctors, too.
...
Billing disputes are far less common under single-payer systems. Canadian doctors, for example, are less than one third as likely as their American counterparts to report that they “spend an excessive amount of time on paperwork or disputes related to medical bills.”
...
So, on reflection, I’d say that the switch to a single-payer system wouldn’t require unreasonable sacrifices from anyone.
I have to admit that the idea that M4A is going to get rid of administrative bloat by moving it TO the government's administration is hysterically funny. I agree about the rent seeking part.
[/quote]
Because a privately run bureaucracy is always better? You get savings just from the fact that the government is already doing more than the amount of work that would be needed to administer a UHC. Eliminating means testing would streamline this further.

Essentially, you are getting rid of all the salaries of people who come up with reasons why you shouldn't get the treatment that your doctor recommends. That actually could be enough to pay for the treatment that your doctor recommends in and of itself.

I find it hilarious that you find several duplication of effort in the private sector of paying people for the purpose of decreasing the amount of healthcare offered to not be bloat in and of themselves.
Quote:
Ultimately the main problem is that profit motives and best outcomes can and often are opposed to each other. I don't like the idea that my doctor is somewhat hamstrung in what he can prescribe me affordably, because some drugs are not on the insurance's formulary, or they require him to try cheaper drugs first before prescribing the more potent and expensive ones. Presumably he knows what he's doing and has a reason for prescribing what he does, better than the bean counters in the bowels of the insurance company.
Yeah, and that is you, with insurance that is probably pretty good. Now, imagine if you didn't have it, or it wasn't as good.
  #211  
Old 12-06-2018, 06:25 PM
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I have to admit that the idea that M4A is going to get rid of administrative bloat by moving it TO the government's administration is hysterically funny. I agree about the rent seeking part.
I know where you're coming from, at least in my pre-conceived notions about the inefficiency of the US government. I do wonder though how much of that is for real, and how much is just "myth". Probably better suited to another thread...
  #212  
Old 12-06-2018, 06:38 PM
survinga survinga is online now
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My post wasn't a "defence of Ocasio-Cortez. If I had intended to offer a defense of Ocasio-Cortez then I would that would have been crystal clear: but that wasn't my intent. I'm not lying.

I'm going to sit here again and offer to clarify things for you but it seems clear that you aren't interested in hearing it, and as my responses seem to be increasingly making you angry its probably best I don't interact with you any more.
Deflecting is a defense. You were defending by deflecting.

People who are pro-Trump do it all the time, when they are defending Trump. Whataboutism is a trademark defense tactic in politics. You were defending ACO (which I don't care about, because she gets too much attention as it is). But it's strange that you would deny something so obvious.
  #213  
Old 12-06-2018, 09:13 PM
Kimstu Kimstu is online now
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I know where you're coming from, at least in my pre-conceived notions about the inefficiency of the US government. I do wonder though how much of that is for real, and how much is just "myth".
Fairly mythy, it appears:
Quote:
[...] data from the Congressional Budget Office (CBO) and the Center for Medicare and Medicaid Services (CMS) demonstrate definitively that private insurance is increasingly less efficient than Medicare. [...]

Medicare Has Controlled Costs Better Than Private Insurance [...]

Medicare Has Lower Administrative Costs Than Private Plans.

- According to the Kaiser Family Foundation, administrative costs in Medicare are only about 2 percent of operating expenditures. Defenders of the insurance industry estimate administrative costs as 17 percent of revenue.
- Insurance industry-funded studies exclude private plans’ marketing costs and profits from their calculation of administrative costs. Even so, Medicare’s overhead is dramatically lower.
- Medicare administrative cost figures include the collection of Medicare taxes, fraud and abuse controls, and building costs. [...]

Medicare Is Publicly Accountable, Private Plans Are Not [...]

A closer look at the data shows that, contrary to Goodman and Saving’s claims, Medicare delivers health care more efficiently than private insurers. Medicare’s public accountability and bargaining power give it the ability to drive system change and control skyrocketing health care costs, while profit-driven private insurers have offered no solution.
  #214  
Old 12-07-2018, 09:17 AM
bump bump is offline
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I know where you're coming from, at least in my pre-conceived notions about the inefficiency of the US government. I do wonder though how much of that is for real, and how much is just "myth". Probably better suited to another thread...
I don't know... I do work for a municipal government, and while I'd say most people are dedicated to their jobs, the place isn't really engineered for efficiency, in that it's very difficult and/or time-consuming to fire people, even for cause. In addition, the motivation tends to be almost strictly professional- there's not the carrot and stick approach of private business (i.e. they give you incentives/bonuses/options, and they threaten to shit-can you if you don't perform). I mean, they still can fire you if you really suck, but they have to jump through flaming hoops to do so. And from what I understand, there's little in the way of merit raises either- most everyone gets a fixed percentage every year. As a result, the power balance between workers and management is more skewed toward the workers than it is in private enterprises.

If I wanted something to be done efficiently, promptly and at minimum cost, I don't think I'd make it part of a public institution as a result; the motivation's just not there. Now as far as somewhere to work? It's really good if you've come from a background of relatively coercive management that always holds the unspoken threat of firing you if you don't perform, and doubly so if that same management was obnoxiously stingy with raises and promotions.
  #215  
Old 12-07-2018, 09:35 AM
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Well, you are saying it as if you agree with them.

I know people that think that rainbows will taste like grapes. They are as relevant as your opinion on what other people think.
I don't necessarily agree with them- most of what I'm saying is dumb-ass stuff my parents and relatives say. I'm just saying it with the same fervor for emphasis.

I will say that I'm skeptical that some kind of M4A or other single payer system can be implemented without beggaring the government or raising taxes significantly on the average middle-class person.

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Originally Posted by k9bfriender View Post
Well, yeah, and under a UHC they would do the same. You were the one who brought up hospital visits.
I didn't mention hospitals at all. The fear on a lot of people's part is that rather than be able to go to their PCP whenever they want, that a government-run healthcare system is going to force them to go to basically what amounts to a huge free clinic where they'd basically hang around like it was jury duty or the DMV and finally end up seeing some random doctor who they've never met before. I think a lot of it may come from experience with the military medical system in the 1960s and 1970s actually, and they're expanding that and conflating it with other slow and shabby government offices. And on my parents' part, I know that they were part of an HMO back in the 1980s that required just that- you had to go to the HMO's clinic for primary care and then they could refer you. They hated it- it was inconvenient and rather cattle-call like.

I agree that the fears are not terribly realistic, but that's the fear I've heard from more than one oldster of my acquaintance. The M4A/single payer side needs to make a point of smoothing the ruffled feathers of those folks- if for no other reason than the oldsters vote consistently and in large numbers.

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Originally Posted by k9bfriender View Post
That is not what that article says.
My bad.... I copied the wrong URL.

https://www.washingtonpost.com/busin...=.1f86625197fb

Quote:
Originally Posted by k9bfriender View Post
Because a privately run bureaucracy is always better? You get savings just from the fact that the government is already doing more than the amount of work that would be needed to administer a UHC. Eliminating means testing would streamline this further.

Essentially, you are getting rid of all the salaries of people who come up with reasons why you shouldn't get the treatment that your doctor recommends. That actually could be enough to pay for the treatment that your doctor recommends in and of itself.

I find it hilarious that you find several duplication of effort in the private sector of paying people for the purpose of decreasing the amount of healthcare offered to not be bloat in and of themselves.


Yeah, and that is you, with insurance that is probably pretty good. Now, imagine if you didn't have it, or it wasn't as good.
I didn't mean that it wouldn't reduce some kinds of bloat, but that in general efficiency and lean, streamlined processes are NOT the province of government agencies. See my last post for my commentary about working for the government- that's my personal experience, but having had relatives and friends who have worked for most of their careers for other cities and for the state, it holds very true there as well. I can't imagine that it suddenly changes at the Federal level.

And my insurance is... ok. It used to be much better overall prior to Obamacare. Prior to about 2009, everywhere I'd worked had pretty much the same insurance- a co-pay for doctor visits, 80/20 otherwise, no deductible. Then in 2009, it all changed, and ever since it's been some combination of a multi-thousand dollar deductible, somewhere between 70/30 above that, much more restrictive in-network providers, and copays or incentives to visit urgent care clinics instead of your PCP.
  #216  
Old 12-07-2018, 10:04 AM
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If I wanted something to be done efficiently, promptly and at minimum cost, I don't think I'd make it part of a public institution as a result; the motivation's just not there. Now as far as somewhere to work? It's really good if you've come from a background of relatively coercive management that always holds the unspoken threat of firing you if you don't perform, and doubly so if that same management was obnoxiously stingy with raises and promotions.
The post 213 directly above this cites research showing Medicare is run more efficiently than private insurance. Maybe your instincts on motivation are off.

Last edited by CarnalK; 12-07-2018 at 10:05 AM.
  #217  
Old 12-07-2018, 10:21 AM
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And my insurance is... ok. It used to be much better overall prior to Obamacare. Prior to about 2009, everywhere I'd worked had pretty much the same insurance- a co-pay for doctor visits, 80/20 otherwise, no deductible. Then in 2009, it all changed....
That's strange, because Obamacare wasn't enacted until 2010 and phased in over several years....
  #218  
Old 12-07-2018, 10:59 AM
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How is "they get to keep their current provider" remotely a sensible concern in a switch to M4A? No, you probably wouldn't. If you trying some German style hybrid maybe but if you want a funded government universal healthcare insurance program, you can't let a bunch of people opt out.
"Provider" in this case meant doctor, not insurance.

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Originally Posted by Shodan View Post
Or a related concern, that patients could no longer take specific medications because they cost too much, and therefore had to take other, cheaper meds, or OTC instead. As in "your arthritis drug costs too much - take aspirin instead" or "we don't prescribe statin drugs for patients your age, because it isn't clear that they reduce mortality overall".

Already happening under the current system. That's what insurance companies do.

Quote:
As I have mentioned before, Americans want a health care system that
  • gives the best care available
  • is available to everyone, and
  • at a reasonable cost.
Pick any two, but not all three.
Do we currently have even one?

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Why would patients listen to a commercial on TV instead of their own doctor?
Why is irrelevant, as they do. Or at least bring up specific medicines with their doctors instead of relying solely on the doctor's first recommendation.

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Originally Posted by CarnalK View Post
As I've said numerous times, not everyone rolling their eyes at some of AOC's comments are Trump supporters so going on about him is not pointing out hypocrisy.
Valid point. Still not seeing a lot of anti-AOCers hitting current sitting Republicans hard for their stupidities.


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First, I didn't say that's what it'll be. I said that's what a lot of people think it'll be.
And he's saying that's what it is already like.

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Originally Posted by bump View Post
And my insurance is... ok. It used to be much better overall prior to Obamacare. Prior to about 2009, everywhere I'd worked had pretty much the same insurance- a co-pay for doctor visits, 80/20 otherwise, no deductible. Then in 2009, it all changed, and ever since it's been some combination of a multi-thousand dollar deductible, somewhere between 70/30 above that, much more restrictive in-network providers, and copays or incentives to visit urgent care clinics instead of your PCP.
Those changes were already happening. Happened to me in 2005.
  #219  
Old 12-07-2018, 11:06 AM
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"Provider" in this case meant doctor, not insurance.
Fair enough but Shodan seemed to make the same mistake as he answered that point with:

'This will be an especially tough sell, particularly after "if you like your plan, you can keep your plan".'
  #220  
Old 12-07-2018, 11:17 AM
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Nobody has directly addressed the other half of the argument: the defense budget. It is a major liberal cause, cutting the absurdly large amount of revenue we pump into the MIC. But just cutting defense (which ought to happen) does have significant ramifications. My neighborhood has more than half a dozen large bases in a fairly compact area, that support several cities and towns. Those communities would suffer or collapse with those bases shut down or severely curtailed, as would almost certainly happen with realistic cut to the defense budget.

Even if the money is just accounting errors, some of it finds its way into the economy, into which Defense is deeply intertwined. Anyone who advocates for deep cuts fucking well better be putting forth a plan to offset the serious effects that those cuts will have on the lives of ordinary Americans.
  #221  
Old 12-07-2018, 11:23 AM
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Nobody has directly addressed the other half of the argument: the defense budget. It is a major liberal cause, cutting the absurdly large amount of revenue we pump into the MIC. But just cutting defense (which ought to happen) does have significant ramifications. My neighborhood has more than half a dozen large bases in a fairly compact area, that support several cities and towns. Those communities would suffer or collapse with those bases shut down or severely curtailed, as would almost certainly happen with realistic cut to the defense budget.

Even if the money is just accounting errors, some of it finds its way into the economy, into which Defense is deeply intertwined. Anyone who advocates for deep cuts fucking well better be putting forth a plan to offset the serious effects that those cuts will have on the lives of ordinary Americans.
[gravelly Mafia-esque voice]
"Ya'd better keep pumping the funds into this base, or the mom-and-pop down the road gets it!"
[/]
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  #222  
Old 12-07-2018, 12:03 PM
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Originally Posted by Fiddle Peghead View Post
Why? Someone is paying for them now. Somebody would pay under M4A. Please explain this to me.
Maybe I don't understand your question. If we pay the same drug prices under M4A as we would anyway, what's the advantage of M4A?

The premise of the report previously cited was
  • We dramatically cut payments to health care providers
  • We dramatically cut drug prices
  • We cut administrative costs
  • We charge the same in taxes that people now pay in premiums

The alleged effect is that we then save $2T over ten years, which is offset by the fact that it will increase the federal budget deficit by an undetermined amount, and also doesn't account for increased utilization.

Just saying "well somebody will pay for it anyway" is AOC thinking.

Regards,
Shodan
  #223  
Old 12-07-2018, 12:18 PM
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It doesn't matter because your point, that we'd lose out on drug advances if we don't buy potentially effective expensive drugs, defies reality in two ways. Private insurance is already reluctant to pay for those drugs and there's plenty of pharmaceutical research in countries with universal health coverage.
  #224  
Old 12-07-2018, 12:31 PM
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Maybe I don't understand your question. If we pay the same drug prices under M4A as we would anyway, what's the advantage of M4A?
[/URL].

Regards,
Shodan
I am saying that even if drug prices stay the same, there are other benefits to M4A. Why does not cutting drug prices invalidate the whole thing?
  #225  
Old 12-07-2018, 12:47 PM
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IOW, in comparing single payer to private insurance, set aside for the moment the things that will be needed for both. In this case, drugs. Then only consider the cost reductions for things that can be gotten rid of, like profit, some administrative costs, and the like. Then, even if drug prices stay the same, there will still be economic benefits for the insured.

Last edited by Fiddle Peghead; 12-07-2018 at 12:47 PM. Reason: clarity
  #226  
Old 12-07-2018, 01:06 PM
Punoqllads Punoqllads is online now
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She seems somehow to believe that we can squeeze $21 trillion out of a total yearly budget of almost $700 billion. This is the kind of fresh, outside reality the box thinking that we need in Congress.
If only there was some way to Google where she got her figure of $21 trillion of missing money from.

In Shodan's defense, the number is from both Defense and HUD.
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  #227  
Old 12-07-2018, 05:03 PM
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The alleged effect is that we then save $2T over ten years, which is offset by the fact that it will increase the federal budget deficit by an undetermined amount, and also doesn't account for increased utilization.

Just saying "well somebody will pay for it anyway" is AOC thinking.

Regards,
Shodan
Dude, for one you are citing the Daily Caller. That is Tucker Carlson's outfit i.e. sheer propaganda. It might be useful as toilet paper except I am getting the digital version. Fox and the GOP promote the idea that tax cuts for the wealthy increase revenues because they are owned by the same wealthy interests. Tax cuts btw are the sole legislative achievement of full Fox control of Congress and the WH. Your people have lost the right to lecture anyone about finances.

For two, the claim that it Has to increase the deficit is a bare assertion. Pubbies have all apparently forgotten that revenues can be set to match expenditures, and then there is a balanced budget. So, socialize medicine And balance the budget and the deficit does not increase.

For three, your link covers the same ground we have already covered. She asks, "How do you pay for something that is cheaper?" Because, we are already paying for it.

OK. All I want is better cites for the costs of the current system and the M4A system. Don't cite Tucker Carlson if you want to be taken seriously.
  #228  
Old 12-07-2018, 06:18 PM
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… all apparently forgotten that revenues can be set to match expenditures, and then there is a balanced budget. So, socialize medicine And balance the budget and the deficit does not increase. …
There was a guy a couple decades ago who got the deficit down to nil (perhaps even into positive territory) and managed to do it while getting head. Lamentably, that guy also signed the repeal of Glass-Steagall.
  #229  
Old 12-07-2018, 06:29 PM
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...the bit "you already quoted" is out of context. My post wasn't a "complaint" about "how bad Giuliani is". Its obvious you didn't read my entire post. Perhaps you should do that before accusing me of being "like the people who defend Trump with It's not like he's Hitler." Subtly and nuance really don't seem to be your thing.



My post wasn't a "defence of Ocasio-Cortez. If I had intended to offer a defense of Ocasio-Cortez then I would that would have been crystal clear: but that wasn't my intent. I'm not lying.

I'm going to sit here again and offer to clarify things for you but it seems clear that you aren't interested in hearing it, and as my responses seem to be increasingly making you angry its probably best I don't interact with you any more.
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Originally Posted by survinga View Post
Deflecting is a defense. You were defending by deflecting.

People who are pro-Trump do it all the time, when they are defending Trump. Whataboutism is a trademark defense tactic in politics. You were defending ACO (which I don't care about, because she gets too much attention as it is). But it's strange that you would deny something so obvious.
Thanks for this. It was getting really frustrating when it was indeed so obvious.

Last edited by CarnalK; 12-07-2018 at 06:32 PM.
  #230  
Old 12-07-2018, 07:30 PM
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There was a guy a couple decades ago who got the deficit down to nil (perhaps even into positive territory) and managed to do it while getting head.
He did it with an assist in the form of a tax hike by H W. Who then got creamed in the next election, teaching the GOP a valuable lesson: the best interests of the country are for suckers. Better to team up with our adversaries to cheat at elections.
  #231  
Old 12-09-2018, 10:57 PM
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You asked about the effect on the deficit.

Do the math for me: if we double federal income tax, and it doesn't cover the cost of M4A, does the deficit go up, or down?

And my cite said rather clearly Which is what I said it said.

Regards,
Shodan
After this past year, and looking at how Trump and the Republicans deliberately blew up "the deficit" (which is bullshit anyway) with their own personal tax give-away to themselves, and then tried to use that as an excuse to gut everything that doesn't line their pockets, all I can say is

Fuck them and their deficit hawk bullshit.
  #232  
Old 12-09-2018, 11:27 PM
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Just saying "well somebody will pay for it anyway" is AOC thinking.

Regards,
Shodan

it is also apparently Trump thinking, because apparently "somebody will pay for it anyway" is why he signed the massive tax gift to corporations and the wealthy.

you miserable piece of shit.
  #233  
Old 12-10-2018, 04:58 AM
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https://www.nytimes.com/2018/06/08/b...m-doctors.html

Somewhere between 11-13% and 40% less.
Is that a "through the bank" conversion, or localized? US salaries are higher in a direct exchange rate than those in most other countries, but that's for every profession and like I said, direct exchange. Once you take cost of living into account, or look at "after taxes and other unescapable expenses" (such as the amount paid monthly for healthcare insurance, which depending on the country is a tax or not), the difference isn't anywhere near as large.
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  #234  
Old 12-10-2018, 10:24 AM
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Is that a "through the bank" conversion, or localized? US salaries are higher in a direct exchange rate than those in most other countries, but that's for every profession and like I said, direct exchange. Once you take cost of living into account, or look at "after taxes and other unescapable expenses" (such as the amount paid monthly for healthcare insurance, which depending on the country is a tax or not), the difference isn't anywhere near as large.
Don't know- the article doesn't say.
  #235  
Old 12-10-2018, 10:32 AM
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Another benefit of universal healthcare not usually discussed is that it could take away the need for a lot of litigation. If there's no medical costs to recover, there's a lot less reason to sue someone for an injury.

Last edited by CarnalK; 12-10-2018 at 10:32 AM.
  #236  
Old 12-11-2018, 02:13 AM
Gary Kumquat Gary Kumquat is offline
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Originally Posted by Shodan View Post
If we cut dramatically what we spend on drugs, which we would have to do if M4A is going to work, then we would be giving something up - namely, expensive drugs that may or may not work better than a cheaper version. Hence my example of statin drugs.
This is completely untrue. You are paying far more for the SAME drugs; the exact same drug, from the exact same manufacturer.

Have a look at insulin, where in the US prices for the latest slow release versions have gone up by a factor of 6 in 12 years.

Monthly supply of Lantis in the US - $3300*
Monthly supply of Lantis in the UK - $460**

Same drug. Same manufacturer. 9 times the cost.

Or to use your example, statins:***:

"The cost of statins in the US is radically higher than the costs paid for the same brands in the UK, and many more insured Americans are prescribed statins, raising the overall costs in that country [1]. According to Dr Hershel Jick (Boston University School of Medicine, MA) and colleagues, who used 2005 numbers for their analysis, statin costs were as much as 400% higher in the US than in the UK"

You have decided to take a politician to task for not being able to properly check their sums, and then done the very same thing yourself.

There is no challenge for the US to pay for universal health care. As I've pointed out repeatedly, as a nation you are already paying far more, for a lower grade of service. Please would you stop making demonstrably untrue claims (that you would get worse drugs, or somehow a lower cost to the country would increase your deficit) purely because your ideology finds the idea of UHC repugnant.



*https://www.goodrx.com/blog/why-is-l...-can-you-save/
**http://gmmmg.nhs.uk/docs/cost_comparison_charts.pdf
***https://www.medscape.com/viewarticle/756771
  #237  
Old 12-11-2018, 02:45 AM
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I suspect the weed that Shodan is smoking is the "If the U.S. wasn't paying high prices for these drugs, pharmaceutical R&D would grind to a halt. Therefore the US is subsidizing the rest of the world's cheaper drugs." type.
  #238  
Old 12-11-2018, 08:47 AM
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I suspect the weed that Shodan is smoking is the "If the U.S. wasn't paying high prices for these drugs, pharmaceutical R&D would grind to a halt. Therefore the US is subsidizing the rest of the world's cheaper drugs." type.
Perhaps he should try smoking this article. According to it, only 17% of the pharmaceutical dollar goes to Research. Larger shares go to 'Marketing,' 'Profit' and 'Other.' (AFAICT truecostofhealthcare is a respected, frequently-cited site.)

And, as the article points out, Research is defined broadly. Pay a doctor to prescribe a drug to his patients as part of a s'study' and the fees paid to doctor are counted as 'research.' And of course some of the 'research' is to find patentable replacements for nearly-equivalent off-patent drugs.
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  #239  
Old 12-11-2018, 09:22 AM
Damuri Ajashi Damuri Ajashi is offline
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Dude the entire OP was discredited due to basic misunderstandings of his own cite. Her detractors remind me of haters of a certain other politician as well. Now that that politician is out of the spotlight they need to aim their ire at someone else.
No. No it wasn't. The OP correctly points out a pretty mind numbing error by AOC.

Shodan's error was perhaps misreading a sentence.

AOC's error was having such a lack of familiarity with the budget that she could make a statement like that. She needs to spend a little more time familiarizing herself with the guts of governing, I'm sure she'll get there.

She is going to keep putting her foot in her mouth but ultimately her point is that we can afford medicare for all if we are willing to reduce other spending (or heaven forbid, increase taxes).

With that said, I am rooting for her. I particularly liked how she called out the establishment Democrats for letting Wall Street and the Chamber of commerce effectively run their freshman orientation. The cozy relationship between wall street and the democrats should have ended in 2008.
  #240  
Old 12-11-2018, 09:37 AM
Damuri Ajashi Damuri Ajashi is offline
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Originally Posted by Grim Render View Post
The notion that US military spending is bigger than US healthcare spending is actually one I've run across several times on forums and social media. It seems to be a natural fit to the narrative that destruction is prioritized by the establishment over social spending. A lot of people simply don't seem to grok how large US healthcare spending is.
Defense spending is more than medicare OR Medicaid but not as large as medicare and medicaid combined.

Quote:
I am assuming the 21 T number is over 10 years. It sounds roughly accurate that way. Which does mean that the statement from Vox "That means 66% of Medicare for All could have been funded already by the Pentagon." is, strictly speaking, accurate.
Sure, I suppose if we got rid of all defense spending we could afford all the nice shit that European countries have like universal health care and free college tuition but SOMEBODY'S got to defend Europe.

Quote:
Current Medicare spending is 0,7 T, with current military spending being 0,7 T that is 1,4 T or 66 % of Medicare for all.

The catch is that to do this, the entire military would have to be decommissioned and shut down, which is very far from being any kind of good thing. But yes, you could get up to 66 % that way.
If we reduced our military to the same percentage of our GDP as China, we would save over 300 billion per year. Go back to a Clinton tax regime and you end up with enough money for European style socialism.
  #241  
Old 12-11-2018, 09:43 AM
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Originally Posted by Dacien View Post
Oh and by the way, Charles C.W. Cooke detailed some factors that were baked in to the cost estimate in order to reach the $32 trillion price tag over ten years:
  • Force every doctor and hospital in America to accept Medicare reimbursement rates for all patients — these are 40 percent lower than the rates paid by private insurance — while assuming that this would have absolutely no effect on their capacity or willingness to provide services
  • Raise taxes by 10 percent of GDP
  • Explain to the 150 million people with private insurance that the rules have been changed so dramatically that (a) they can no longer keep their plans, and (b) henceforth, tens of millions among them will be paying more in taxes than they were previously paying in both premiums and out-of-pocket costs

In short, things that will never happen for $32 trillion, Alex.
Wait, the 32 trillion price tag INCLUDES a tax increase that offsets the insurance premium savings?
  #242  
Old 12-11-2018, 09:54 AM
k9bfriender k9bfriender is offline
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Originally Posted by Damuri Ajashi View Post

If we reduced our military to the same percentage of our GDP as China, we would save over 300 billion per year. Go back to a Clinton tax regime and you end up with enough money for European style socialism.
Well, you've solved everything. Let's do it.
  #243  
Old 12-11-2018, 10:07 AM
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Originally Posted by Shodan View Post
If doubling federal income taxes is insufficient to cover the cost of M4A, then it is necessary for the deficit to increase.
No. M4A requires that most current health care premiums be converted into taxes. MOST healthcare premiums are paid by employers. Why are we letting employers off the hook with a mere doubling of their historically low corporate tax rates?

Have current premiums paid in taxes (the math isn't too hard) and add a reversion to Clinton era taxes and you are there.

Quote:
Actually what I am saying - or rather, what the report is saying - is that IF we dramatically cut payments to health care providers, and IF we dramatically cut drug prices, and IF we cut administrative costs, and IF we double federal income taxes, we will increase the deficit.

Regards,
Shodan
I read the report and I don't find it convincing at all.

The average family plan is about 18K, employers pay about 12K of it.

This is more than large employers pay in corporate taxes generally. IOW, if you told large employers you would either double their corporate taxes or double their health care costs, most of them would rationally choose to double their current historically low taxes.

http://files.kff.org/attachment/ehbs...ry-of-findings
  #244  
Old 12-11-2018, 10:18 AM
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Originally Posted by CarnalK View Post
I suspect the weed that Shodan is smoking is the "If the U.S. wasn't paying high prices for these drugs, pharmaceutical R&D would grind to a halt. Therefore the US is subsidizing the rest of the world's cheaper drugs." type.

Shodan, is CarnalK onto something here? If so, would this be related to my question from a few posts up?

Quote:
I am saying that even if drug prices stay the same, there are other benefits to M4A. Why does not cutting drug prices invalidate the whole thing?
If not, could you please answer it? I want to understand what you mean by this.

Last edited by Fiddle Peghead; 12-11-2018 at 10:19 AM. Reason: typo
  #245  
Old 12-11-2018, 11:00 AM
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Why does it have to be either or? Instead of single payer health care, how about just single payer medicines/drugs?
  #246  
Old 12-11-2018, 11:28 AM
Damuri Ajashi Damuri Ajashi is offline
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Originally Posted by wguy123 View Post
I believe this great post is getting buried under debates of "whataboutism". Would any of the several conservative folks like to take a stab at challenging this post? We are already paying more for healthcare in the US than most countries with universal healthcare. Wouldn't it make sense to try out one of these less expensive models? I know there will be the "death boards" and "one year wait to get a wart removed" topics thrown out, but you also support doing away with coverage of pre-existing conditions. There must be a way to improve our immensely over-expensive system.
A well constructed universal health care system is about it. Every band aid along the way is probably MORE expensive.
  #247  
Old 12-11-2018, 11:32 AM
Damuri Ajashi Damuri Ajashi is offline
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Here we have yet another post from Grand Dragon Shodan affirming another person of color is stupid as shit.

I know this'll upset my patchouli smelling liberal friends but there is nothing wrong with whatbaboutism. Although whataboutism is a tool of white supremacy, it is also one of the only tools that white supremacists understand. White liberal reluctance to use the rhetorical tools of white supremacy is the reason white supremacists are winning, and you’re not. White folks don’t speak in truth, they speak in equivocation and whataboutery. In fact, white folks, in my view, are incapable of recognizing the fucking truth. We saw this with Dr. Ford.

Whataboutism is effective in pointing out hypocrisy. Pointing out that white supremacists like Grand Dragon Shodan is holding 29-year-old not-sworn-in congresswoman to a higher standard than the President of the United States says a lot about his (white supremacist) frame of reference. You have the President of the United Stated – elected by white people – get on national television and claim that Frederick-fucking-Douglas is out here fighting the good fight against slavery, and Grand Dragon Shodan - who collects children of color like beanie babies - was too busy virtue signaling to comment. He is literally an ambulatory dumpster-fire of white supremacy.

What you see Grand Dragon Shodan do is exactly what people of color experience in our lives at work. We. Have. To. Be. Perfect. If a white man misspells potato, it is not taken it as an indictment on his intelligence; if a black man misstates a fact (like 57 states), it taken as an indictment of his stupidity. Grand Dragon Shodan perpetuates the same trope for other people of color (like Ms. Ocasio-Cortez).

If this were a video game, Grand Dragon Shodan would be a level 999 racist. He's mastered coded language to the point where he instinctively attacks the intelligence of people of color. I don’t even think he thinks about it. He just does. It's quite an achievement. Grand Dragon Shodan even went down the path of arch-racists like Laura Ingraham and David French and adopted a person of color not to just appear more cosmopolitan but to virtue signal in order to deflect accusations of racism.
AFAICT, he pretty much thinks ALL liberals are stupid. I've never seen him denigrate stuff said by Condoleeza Rice or Nikki Haley. I don't recall him saying Clarence Thomas is stupid or that Alan West is of inferior intelligence.

On the other hand I've seen him call quite a few white liberals stupid.

The fact that most people of color are liberals might make it seem like he is a racist but he is MOSTLY just partisan. He might be racist as all hell but its not because he thinks that all liberals are stupid.
  #248  
Old 12-11-2018, 11:43 AM
Damuri Ajashi Damuri Ajashi is offline
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Do you honestly think that the fact that women [and most of us] care about their appearance is a relevant response/rebuttal to the point I raised?
Well, your statement does come off as oversensitive. YMMV
  #249  
Old 12-11-2018, 11:52 AM
Damuri Ajashi Damuri Ajashi is offline
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Are you saying that the ability for people to keep their current providers (i.e. doctors) isn't a major concern for people? Or that people are just going to suck that up because M4A is so awesome?

That's going to piss a LOT of people off- many have built up decades long relationships with their doctors (primary care & specialists both), and will not take kindly to being told that they don't get to choose or continue to go to their current one (the same thing, ultimately).
Many universal health care systems are not closed systems. They allow for supplemental health care insurance. This usually falls into 2 categories. Your supplemental health care provides ALL the compensation to the health care provider so you effectively pay twice (once through taxes and once through your supplemental (kind of like sending your kids to private school), the other kind pays for stuff that the universal healthcare doesn't pay for (covers deductibles and pays for stuff that your insurance simply won't treat), this would be like sending your kids to afterschool enrichment classes after their public school curriculum is over.
  #250  
Old 12-11-2018, 11:56 AM
Damuri Ajashi Damuri Ajashi is offline
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This is the math that most people don't have the emotional capacity to hang onto or understand, particularly when it goes up against political faith-based beliefs like "if the government is involved, it's going to be worse"; the person who figures out how to make this concept stick is the person who leads us out of the quagmire.
The problem is that it is only true for maybe 80% of the population. The other 20% pay more and too many people think they are in the top 20% or will be soon.
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