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Re: 24 million people to lose health insurance [sch340] [ In reply to ]
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It is SO HARD to have a serious, rational debate about healthcare because supporters of the ACA or a single payer system only care about one metric: "Lives Covered"

Except that is not the only number folks care about. Infant mortality, life expectancy, cost per patient, bankruptcies to medical costs, number of emergency room visits, ... they all matter (along with many more). You have done nothing more than create a strawman. Reducing the number of bankruptcies due to medical costs would be good, right? How do the two plans stack up? Life expectancy?
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Re: 24 million people to lose health insurance [RZ] [ In reply to ]
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I don't know why it would be so difficult to just expand medicare to cover everyone. Then let insurance companies fight over the Part B supplement scraps, and "cadillac plans" that some people might want to opt for. The only way for costs to go down is to have some kind of price regulation introduced, and the medicare system is already in place (and arguably proven to work) for 15% of the population.

What seems to be missing in all of this are in my view the two most important numbers/metrics - cost per user and outcomes. Next door in Canada, we have the dreaded "Universal Healthcare": Cost per user per year = about $5000. In the U.S. with your system the cost per user per year is about $10,000!! In terms of out comes - Canada as a country scores high on an overall health index, with average life-span still going up! Whereas in the U.S., I read somewhere recently that the average life-span number is dropping!

So whatever you are doing in the U.S. you are paying WAY more, and getting a less, better outcome out of it!


Steve Fleck @stevefleck | Blog
Last edited by: Fleck: Mar 15, 17 16:19
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Re: 24 million people to lose health insurance [Fleck] [ In reply to ]
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How much of that price difference is the vast cost of research done in the US that other countries reap the benefits of?

Another question, does Canada allow advertising for new drugs? I swear 1/2 the commercials here are for drugs for conditions I didn't even know existed. How much would the cost go down without all those advertising dollars?

I miss YaHey
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Re: 24 million people to lose health insurance [justgeorge] [ In reply to ]
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justgeorge wrote:
How much of that price difference is the vast cost of research done in the US that other countries reap the benefits of?

Another question, does Canada allow advertising for new drugs? I swear 1/2 the commercials here are for drugs for conditions I didn't even know existed. How much would the cost go down without all those advertising dollars?

Only the US and New Zealand allow for direct to consumer advertising. The amount spend on ads in the US ($5b in 2015) is actually much less than the spend on marketing to doctors and pharmacies. The high prices you are seeing for drugs are a result of the high cost of clinical trials, including the cost of failed trials due to strict FDA regulations, which need to be recouped as well.

Drugs are only 10% of all US healthcare costs though, (https://www.cms.gov/...loads/highlights.pdf), versus 52% for hospital & doctor care, so the reducing costs on the latter should really be the focus.

Strava
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Re: 24 million people to lose health insurance [oldandslow] [ In reply to ]
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oldandslow wrote:
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It is SO HARD to have a serious, rational debate about healthcare because supporters of the ACA or a single payer system only care about one metric: "Lives Covered"


Except that is not the only number folks care about. Infant mortality, life expectancy, cost per patient, bankruptcies to medical costs, number of emergency room visits, ... they all matter (along with many more). You have done nothing more than create a strawman. Reducing the number of bankruptcies due to medical costs would be good, right? How do the two plans stack up? Life expectancy?

Here you go again comparing the "two plans", as if that were our only choice and I was a GOP supporter. Ever think outside the box?

You are the one creating the straw man, using "lives covered" as a proxy for health outcomes, i.e. more coverage = healthier populace, which will somehow decrease the maladies you cite above. You or other single payer supporters can't prove a causal link between the two and so headlines are created such as "CBO report: 24 million fewer insured by 2026 under GOP health care plan" (CNN). Not once in this article does CNN state that health outcomes will be worse under the plan, but that is somehow a given, and accepted without proof.

In reality, if you mandate coverage, the system will either get too expensive at the current standard of care, or health outcomes will decrease. Something must bend. You must reduce cost and regulation instead of squabbling over how many people are covered under the current system. Money doesn't grow on trees - if you are really "old" as your moniker suggests, I would think this would be clear by now.

Strava
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Re: 24 million people to lose health insurance [sch340] [ In reply to ]
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sch340 wrote:
TheForge wrote:


1. Free market - Not going to happen, people like you morally have a problem with letting people who make bad decisions suffer the consequences of their actions.


Sadly true. If there were a free market in health care, you would most likely find that the population as a whole would make better preventative health decisions as they could no longer rely on the current redistribution scheme. Lack of exercise/poor diet/drugs etc would be a much more expensive proposition. I know of number of people who never exercise and eat crap because they can fall back on Lipitor, etc instead of controlling their cholesterol naturally.

I'm not sure I believe this. The ultimate price for poor lifestyle choices isn't increased medical spending. It's a shorter expected life; i.e.: death. You think that people who don't care that they will most likely die sooner will somehow care because of money?
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Re: 24 million people to lose health insurance [SailorSam] [ In reply to ]
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SailorSam wrote:

I'm not sure I believe this. The ultimate price for poor lifestyle choices isn't increased medical spending. It's a shorter expected life; i.e.: death. You think that people who don't care that they will most likely die sooner will somehow care because of money?

Actually, both life expectancy and instance of chronic disease are increasing in the US (google and you will find some trends)

What does that mean? Well, clearly lifestyle choices are getting worse, but people are living longer. Healthcare quality is the only other variable that could make both of these stats trend the way they are. Many diseases that were death sentences 25, 50, 100 years ago are being managed by new developments in medicine and other innovations, e.g. HIV, cancer, diabetes. Note that not all of these are due to poor lifestyle choices, but many chronic diseases are

In terms of incentives, I can only offer anecdotal evidence that people would be motivated to get healthy for a monetary reward - look at work step challenges, etc.. also, my company offers a $600 bonus if you complete a number of wellness incentives over the course of the year (getting checkups, education, working out) - a number of my colleagues who wouldn't otherwise be bothered to work out are hitting the gym to get that reward.

Strava
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Re: 24 million people to lose health insurance [sch340] [ In reply to ]
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sch340 wrote:

In reality, if you mandate coverage, the system will either get too expensive at the current standard of care, or health outcomes will decrease. Something must bend. You must reduce cost and regulation instead of squabbling over how many people are covered under the current system. Money doesn't grow on trees - if you are really "old" as your moniker suggests, I would think this would be clear by now.

Your argument is not true - there are a ton of wasted medical efforts in our country due to our patchwork for profit health and care sector.

I spent all day Monday getting unneeded medical care paid for my Medicare for my dad who is a DNR to assuage the lawyers at the corporate assisted living he lives at.

I missed a day at work. Doctors spent time with him. All so he could get a note to get filed away with the lawyers to prove it was not their fault if something happened. He was not allowed home til they had their get out of jail free note. There was zero benefit to my dad other than an exhausting dad of being poked and prodded.

This is how resources are used in our patchwork system of "healthcare".

There is zero outcome implication to eliminating this cost.

We need to create a second tier hospice paid at a lower rate for those not necessarily within 6 months of death but with a terminal illness and the correct legal protections for them in for profit assisted living to avoid ambulance rides and ER visits that don't add any value.

There are tons of things we can do to reduce costs.

What % of medical expenses are to make lawyers happy rather than patients?
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Re: 24 million people to lose health insurance [Jim @ LOTO, MO] [ In reply to ]
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Jim @ LOTO, MO wrote:
A meaningless number. What matters is health care, not health insurance. When your health insurance policy costs $11,000 a year and includes a $6,000 deductible (thank you, Obozo), you don't have true health care.

Wrong, it means you don't understand the real problem. $11,000 roughly the equivalent of a 1 night hospital stay.
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Re: 24 million people to lose health insurance [Moonrocket] [ In reply to ]
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Another unnecessary cost- My friend lives in a crappy school district - they require a doctor's note for a sick day. Every time her child has a fever they have to go to the doctor to comply with the school's truancy policy. It has nothing to do with health outcomes and probably leads to more illness toting around sick children for a letter that says yes they are sick. Where in my school if my child has a fever I call and tell them and let her stay snuggled in bed fighting whatever is wrong with her.

Not to mention the wasted time for doctors to see children with colds.

Should we add annual sports physicals for healthy kids to the questionable medical benefit pile?
Last edited by: Moonrocket: Oct 18, 17 12:19
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Re: 24 million people to lose health insurance [Moonrocket] [ In reply to ]
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Moonrocket wrote:
Another unnecessary cost- My friend lives in a crappy school district - they require a doctor's note for a sick day. Every time her child has a fever they have to go to the doctor to comply with the school's truancy policy. It has nothing to do with health outcomes and probably leads to more illness toting around sick children for a letter that says yes they are sick. Where in my school if my child has a fever I call and tell them and let her stay snuggled in bed fighting whatever is wrong with her.

Not to mention the wasted time for doctors to see children with colds.

Should we add annual sports physicals for healthy kids to the questionable medical benefit pile?

And if people actually had to pay for their own fuvking healthcare they wouldn’t be going to the doctor every time they got the sniffles.

Duh.

Civilize the mind, but make savage the body.

- Chinese proverb
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Re: 24 million people to lose health insurance [Duffy] [ In reply to ]
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There should be some sort of warning when people resurrect old threads. I start reading the first page and I'm thinking "Forge is back?

They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

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Re: 24 million people to lose health insurance [len] [ In reply to ]
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len wrote:
There should be some sort of warning when people resurrect old threads. I start reading the first page and I'm thinking "Forge is back?

that's exactly what i thought. and also, "sweet, this place just got exciting"
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Re: 24 million people to lose health insurance [treimink] [ In reply to ]
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Chuckles

They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

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Re: 24 million people to lose health insurance [Duffy] [ In reply to ]
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Duffy wrote:
Moonrocket wrote:
Another unnecessary cost- My friend lives in a crappy school district - they require a doctor's note for a sick day. Every time her child has a fever they have to go to the doctor to comply with the school's truancy policy. It has nothing to do with health outcomes and probably leads to more illness toting around sick children for a letter that says yes they are sick. Where in my school if my child has a fever I call and tell them and let her stay snuggled in bed fighting whatever is wrong with her.

Not to mention the wasted time for doctors to see children with colds.

Should we add annual sports physicals for healthy kids to the questionable medical benefit pile?

And if people actually had to pay for their own fuvking healthcare they wouldn’t be going to the doctor every time they got the sniffles.

Duh.

I think it would be interesting to survey parents why they are at the doctor for a common illness.

I think we should study unnecessary medical visits. Most of these people are given antibiotics for something which a significant portion of the time should resolve on it's own. So they probably think they need antibiotics.

But I think we really need to look at why our health care is more expensive and has worse outcomes than many nations. The main things I see are waste with kids and the elderly- so a focus on that would be great but apparently politically impossible.

https://www.washingtonpost.com/...m_term=.d4a38feb6a95

Another interesting take...
http://www.weeklystandard.com/...ight/article/2010062
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Re: 24 million people to lose health insurance [Moonrocket] [ In reply to ]
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User pays.

Problem solved.

Civilize the mind, but make savage the body.

- Chinese proverb
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Re: 24 million people to lose health insurance [len] [ In reply to ]
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len wrote:
There should be some sort of warning when people resurrect old threads. I start reading the first page and I'm thinking "Forge is back?

TheForge is back. He now goes by swimwithstones.
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