A letter will not do- you need to attach it to some non existant scandal and have it go internet viral. Take a picture of a random person walking out of planned parenthood - add a really good rant (no facts required). Then add your letter and you can be the internet health hero. That's how things work these days.

ETA you need a really inflammatory title too- Like Critical solution to stop the ACA from killing babies (that tied with a PP pic should get 30% click through.)

Interesting article for those concerned about rate increases. Analysts is showing 2/3 of this year's increase is due to uncertainty in operating environment.

http://money.cnn.com/...rump-fail/index.html

I wonder if they do continue to get the subsidies if they will refund consumers money, or hold it back for lower future rates, or just use this as the new baseline to reap profits from going forward at the expense of the consumer? Hmm, which could it possibly be?

A government doesn't provide anything for "free". A government must first take money from its citizens in order to provide anything. IOW, everyone pays either through taxes or higher cost of goods. Nothing from a government is free.

I'm a tax accountant so do understand how the tax system works and how governments are funded.

Socialist governments want to provide a host of things they purport to be free. In doing so they drive up the cost for everything, hurting the people at the bottom and creating more people who "need" government assistance. Things that were once affordable for the masses become less and less affordable, and people look to the government to "give" them these things. Socialism always fails, just at different rates. People are deceived into believing socialism works because some countries haven't failed...yet. They will.

First, I am a free market believer and know that there has never been a true successful socialist government but socialized medicine has worked well in other countries and is working far better than the current model in the U.S., in terms of both cost and the amount of people with insurance. That doesn't mean that it could work there but that it is working in a lot of places. The U.S system is broken and will get worse so to hold that up as a model for others is not going to get a lot of support.

That said, every country in the world that has an ageing population with increasing longevity, low birth rates, increasing automation leading to less jobs, stagnant wages and a population intent on getting fat is going to have a failing healthcare system. People are relying more and more on government to keep them "healthy" instead of taking care of themselves.

The solution isn't dependent on who sits in the Oval office, particularly when that person (or party) really isn't interested in a solution. People want the government to solve the problem, they just don't want to pay for it. Remember when Michelle Obama was working to deal with child obesity. Agree or disagree but at least she was out trying and showing an interest and she was roundly blasted for it. Now, Trump doesn't seem to understand it at all and the Republicans had 7 years to come up with an alternative and didn't so that kind of proves they aren't really that interested, so another 4 years will go by and nothing will change.

Here is the book with the study that says we are first in life expectancy. Sweden 6th. "Priceless: Curing the Healthcare Crisis (Independent Studies in Political Economy)" Hardcover – June 1, 2012
by John C. Goodman (Author)

Your premise about wait times is not true.

We have over 40 million people with chronic disease and growing. We have issues like Indian health. We are not the same as these other countries.

We need to fix medical education. We need a much more intelligent consumer. We need more competition, less waste, less regulation, and legal reform.

 
[/b]That said, every country in the world that has an ageing population with increasing longevity, low birth rates, increasing automation leading to less jobs, stagnant wages and a population intent on getting fat is going to have a failing healthcare system. People are relying more and more on government to keep them "healthy" instead of taking care of themselves.

The solution isn't dependent on who sits in the Oval office, particularly when that person (or party) really isn't interested in a solution. People want the government to solve the problem, they just don't want to pay for it. Remember when Michelle Obama was working to deal with child obesity. Agree or disagree but at least she was out trying and showing an interest and she was roundly blasted for it. Now, Trump doesn't seem to understand it at all and the Republicans had 7 years to come up with an alternative and didn't so that kind of proves they aren't really that interested, so another 4 years will go by and nothing will change.
[/quote]
I just looked at a study that looked at baby boomers and seniors, and the EXCESS cost of just obesity and smoking is $238B annually, of which $134B is financed by care/caid.

I have another study that says that 70% of healthcare cost drivers are behavioral choices.

There are many studies that show the U.S. very far from 1st in life expectancy.



Indian as in native American? There are many countries with impoverished indigenous populations. Australia kicks the U.S' ass, generally speaking.


What is "medical education?" How to navigate the health care markets and manage health-related finances? Or understanding physiology and medical science? I'd argue that many Drs and other medical professionals are more annoyed at "educated patients" than those that just accept the professional advice they're given. There's a aphorism that Drs. make the worst patients. Of course, generally speaking, more education is better than less in most areas of life.




Those are just aspirational aphorisms, though, until you hash out the details. What "regulations" do you want to remove? And what would the side effects be? When you do "tort reform" how do you still provide legal pathways for genuine malpractice (which exists)? There are many aspects of healthcare that are not conducive to competitive markets.

I'm not disagreeing, generally, though. I just think it would take months of hard work with a lot of stakeholders. Not 5-6 old, white senators sequestered in a back room piecing together talking points for a few days.

The right person to initiate the process needed for all that hard work is probably the President (for the U.S.). But he shows little desire for work, or little interest in health care at all.

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Noone seems to pick up on this, though I've repeatedly posted; We subsidize the world (especially Canada). We pay far more than elsewhere for drugs than elsewhere (I've seen examples as much as 40x). Here's an example from a lefty approved article:

"A prescription for Nexium, a popular remedy for acid reflux disease and other stomach ailments, costs $215 on average in the U.S., which is more than 3.5 times the cost in Switzerland, the second-most-expensive nation for Nexium prescriptions, and almost 10 times more than what Dutch people pay."

http://www.huffingtonpost.com/...costs_n_5160819.html
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http://www.huffingtonpost.com/...da8fe4b0e66ad4c89449
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Canada gets another boost from savings on expensive equipment that can be covered when needed by sending people to the states.

Heard a discussion on NPR where a doctor pointed out that the number of docs is relatively stable from decades ago, but the administrative staff has exploded by 300%. Not sure of exact numbers, but the costs to comply with govt, coding for multiple different insurance companies,etc has certainly gone way up in the last 30 years. Enforcing a common coding regime seems like something the govt could actually do, but again most of the reasons we get screwed are because these large industries or corporations have our pols in their pockets.

No shit. Do you have any idea how much time and money is spent on regulations and paperwork? As for tort reform, you must find a way to divorce actual malpractice from CYA. CYA is expensive and generally unnecessary. Which aspects would be negatively affected by competitive markets? Of course this is not a simple problem to solve.

Controlling for one major way people die when calculating life expectancy sounds like massive cheating to me. The difference between a fatal and a non-fatal accident is very often a function of emergency services, which is a major part of a health care system.

I'd provide more detailed responses to the rest, but have a flight to catch and work to do...maybe later.

The 300% increase is only on the paid front too. Imagine if you billed for user hours - paying bills, figuring out coverage and best plans, dealing with HSAs.

The difference in just using health care now vs. 20 years ago is mind boggling. I used to just check in and give the doctor $20 and never think about it again. My company had one plan there were no enrollment periods except when you joined the company or had a baby.

Now every year I have analyze high deductible vs super high deductible vs hmo. Set up HSA. Charge co pays to hsa, pay bills from hsa. Figure out tax implication of hsa at tax time.

It is much more complicated than it was.

The CIA?


https://www.cia.gov/...korder/2102rank.html


I'm not sure why you would exclude accidents, that's an important component of any health system.

Fatal car accidents contribute to life expectancy but not to quality healthcare.

Well, it seems that fatalities in the US are about 10 in 100,000. I have a hard time believing that makes a huge difference in life expectancy.

If anything, fatal car accidents should make healthcare cheaper, not more expensive. Since you don't have all the expenses of chronic disease for those people.

You are conflating issues. Because we have great actual medical care, we keep people alive longer, which costs more.

And yet we still have one of the highest life expectancies in the world when you factor out fatal injuries

I read an article in Forbes a while back called "The Myth of America's Poor life Expectancy"

It's not really a good idea to look at life expectancy as proof of the quality of medical care because of things like accidents. If you want to judge the quality of medical care the better approach would be to look at life expectancy after you were diagnosed with a disease. For example, if you have a heart attack or diagnosed with cancer, how long is your life expectancy.

When they did that, the U.S led the 18 countries studied (developed nations), Canada was 2nd and Japan, the one with the longest life expectancy was in the middle of the pack. The difference was due to the relatively higher number of car accidents and homicides (another story) in the U.S.

Another factor is likely the higher levels of poverty in the U.S compared with places like Japan. Poverty has a strong link to life expectancy.

This report has some of that data

http://www.commonwealthfund.org/...a-global-perspective

Well this is what seems to be on the table in congress:

1) repeal and replace once they figure out what they want
2) repeal a few mandates no one likes (med device tax, individual/employer mandates)
3) repeal and replace with what we got now.

The only one I can see maybe passing is #2, but without an individual mandate, there goes any chance of lowering costs. We seriously can't figure out a better solution?

Sure we can but you have to unwind the ACA with people who are now getting money or a benefit that didn't before. Its like the tax code. There are plenty of ways to make it better but you have to take benefits away to do that and we seem to still think we have unlimited money so it's not an emergency yet.

The only way this is going to work is if they can work with the Dems to produce a bipartisan bill. Congress needs both sides of the isle to pass bills that take away benefits. And major legislation only lasts when it either gives lots of benefits or is significantly bipartisan.

I don't have much confidence in that but it is possible that McCain might pull it off to cement his legacy.