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#310796 - 02/07/19 06:56 PM Re: Healthcare [Re: chunkstyle]
jgw Offline
enthusiast

Registered: 05/22/06
Posts: 2556
Loc: Port Angeles, WA
Negotiating for drug prices should have been done long ago. If nothing else it tells us all where congress stands and it sure as hell is not standing with the nation.

The nations that have single payer understands. For profit healthcare is simply not in the interest of citizens. So, those single payer nations firmly regulate ANYTHING to do with healthcare. Drug companies are allows a small profit, for instance. Manufacturers of medical devices are also controlled (Obama made a run at that but Jackass dropped it).

My view is that when other nations have solved their healthcare and its working for them (France, for instance, is considered the gold standard when it comes to healthcare). Remember, whilst we are told we have the finest healthcare in the world our life expectancy continues to fall and childbirth deaths continue to climb. Basically we are now considered to be on the low end of heathcare for developed countries.

Its really kinda insane. Everybody agrees that if we continue down the current path we will be bankrupt because of our for profit healthcare system. This is a simple fact. We spend two times what other nations for less services. If nothing else one would think the financial savings alone would mandate a single payer system. I know, its socialism (plain baloney)

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#310807 - 02/08/19 03:25 AM Re: Healthcare [Re: jgw]
pondering_it_all Offline
veteran

Registered: 02/27/06
Posts: 8731
Loc: North San Diego County
There are certainly many other health care ripoffs going on. I just detailed drug pricing because I know it pretty well and I see some outrageous loopholes that drug companies use to drain money out of Medicare, Medicaid, and insurance companies. A big part of our expensive health care is precisely this.

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#310810 - 02/08/19 05:51 AM Re: Healthcare [Re: jgw]
rporter314 Offline
old hand

Registered: 03/18/03
Posts: 6777
Loc: Highlands, Tx
I think it is inappropriate to use the phrase "we have the best HC" unless everyone has access to said best HC.
_________________________
ignorance is the enemy
without equality there is no liberty

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#310811 - 02/08/19 08:33 AM Re: Healthcare [Re: rporter314]
pondering_it_all Offline
veteran

Registered: 02/27/06
Posts: 8731
Loc: North San Diego County
Quote:
unless everyone has access to said best HC.


I think you are proposing an impossibility, like saying everybody is above average. There is luxury healthcare, like private rooms in the hospital, suites so your caregiver can stay with you, gourmet meals, private nurses, etc. All things that don't necessarily contribute to the quality of healthcare delivered.

Then there is something called "standard of care" meaning the patient gets everything they need for the best outcome, but maybe not everything they want when they want it. I think in this case "better" is the enemy of "good enough". Everyone needs access to "good enough" health care.

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#310813 - 02/08/19 03:04 PM Re: Healthcare [Re: jgw]
chunkstyle Offline
member

Registered: 10/02/07
Posts: 1621
Access, Affordability Ho!

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#310814 - 02/08/19 04:03 PM Re: Healthcare [Re: pondering_it_all]
NW Ponderer Offline
Moderator
Carpal Tunnel

Registered: 09/09/11
Posts: 16972
Originally Posted By: pondering_it_all
Everyone needs access to "good enough" health care.
That is the perfect encapsulation. Some are shooting for the gold standard (and we should get there eventually) but I don't think that should be the initial goal. The ACA set a baseline for coverage. Medicare does. Medicaid does. Then the questions become: how do we enforce it?; How do we pay for it?

Eventually, for-profit companies need to be eliminated from the primary market, but they can still have a role in secondary markets, the way Medicare Advantage and Medigap plans do. Social Security provides a baseline of support in retirement, but it's subsistence-level. Most people need to supplement their retirement for a decent standard of living, but survival on SSA alone is possible. Similarly, Medicare provides a baseline of coverage for all enrollees, but over a third of them supplement that coverage with other plans. A significant difference between Medicare and the ACA, though, is coverage. Medicare doesn't need to cover things like pregnancy and birth control, for example, so it doesn't. Coverage is an issue that would HAVE to be addressed.

Another significant issue to resolve is taxation and cost sharing. One of the reasons American healthcare is so expensive is because the users pick up so much of the costs. But that is true in Medicare, too. Each doctor visit is $20-40, each prescription might be $20 to 20, 30, 50%. I recently paid over $300 for a single prescription, and that was only 20% of the "cost". Last year the same prescription was $72. A negotiated price would have brought that back to earth.

An ancillary, but directly related, issue is profit. Most universal healthcare systems do not contend with this directly, they just set compensating rates. Others do directly limit "administrative costs" including profit margins. Medications and medical supplies may be the first area to get scrutiny in the "marketplace", but eventually excessive executive compensation will have to be. Then it might get scrutiny in other markets beyond medical and insurance.

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#310815 - 02/08/19 04:14 PM Re: Healthcare [Re: pondering_it_all]
rporter314 Offline
old hand

Registered: 03/18/03
Posts: 6777
Loc: Highlands, Tx
I think we are saying the same thing only using different words.

Quote:
luxury healthcare

Yes we have this, which is not available to ordinary folk with the bare minimum of resources. I should note that in one source commented a stat worth mentioning. Hospital costs are high here. One cause is over-ultilization to which you mention ie most countries have average of 6 day stays and here we have 10 day stays.

Quote:
standard of care
Yes and you mention "good enough". Again it should be clear the results from other countries compares most favorably with the results here. So we should conclude there probably exists an equation which finds the "proper" equilibrium between adequate care and luxury care. The point being, high end care is available although not necessary.

ACA attempted to address this as a way to reduce costs i.e. cost effective care with the option to access high end care.
_________________________
ignorance is the enemy
without equality there is no liberty

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#310831 - 02/09/19 07:22 AM Re: Healthcare [Re: jgw]
pondering_it_all Offline
veteran

Registered: 02/27/06
Posts: 8731
Loc: North San Diego County
ACA has one weird twist this year: Insurance companies have to base their costs on the second cheapest silver plan in the area. So they have jacked up the cost of silver plans, so in some cases the gold plan (IE. lower deductibles, etc) is cheaper than the silver, once you take into account the benefits.

Last year we filled in the ACA qualification form for my wife and checked the wrong box by accident. It took months to get free of Medicaid even though we have WAY too much in assets to qualify. The ACA website had no way to fix it. It took dozens of phone calls and ACA kept cancelling my wive's policy every other month even though they cashed the checks. Thank God she turns 65 in September. You could die from the aggravation of dealing with ACA.

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#310835 - 02/09/19 11:36 PM Re: Healthcare [Re: pondering_it_all]
jgw Offline
enthusiast

Registered: 05/22/06
Posts: 2556
Loc: Port Angeles, WA
How about a little test of where the congress is. They have made 2 decisions, in the past and they are both i n the books right now - neither side has even suggested changing, or getting rid of them. The first is now allowing medicare to even discuss drug prices with the drug companies. The second is that they have made it illegal for an American citizen to buy their drugs in Canada (either by mail or going up there). My own feelings about these two is that they boldly define who congress is working and they obviously would have taken care of these two if the institution of the congress they actually gave a damn.

So, when the congress gets rid of these two, without legislating any new, and even more offensive laws, I will have more kindly thoughts about the congress. Both of these, incidentally, have survived under both sides.

Even if they do take care of these there are lots more where citizens lose. One of the more egregious are the ongoing efforts to destroy the institutions of the post office and the va. Nobody seems to give a damn about those either.

Just saying..........

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#310843 - 02/10/19 06:01 PM Re: Healthcare [Re: jgw]
chunkstyle Offline
member

Registered: 10/02/07
Posts: 1621
Couldn't agree more JGW.

This will hopefully be a crack in the centrist's armor going into the 2020 election and I hope the tip gets buried deep.
A very good analysis of the growing schism within the democratic party between the corporatists and the progressives and lef...

"While a spokesperson for Pelosi has (rather unconvincingly) insisted it was merely intended to be “a broad look at the healthcare environment and some of House Democrats’ legislative priorities over the next two years in a period of GOP control,” the presentation is a remarkable illustration of the contradictions inherent in the political practices of the so-called “Third Way”: institutionalized secrecy; excessive deference to markets and corporate (sorry, “stakeholder”) interests; crippling ideological conservatism; intellectual default to the logic of austerity; a pathological aversion to conflict with powerful private actors; right down to the sheer, naked, hypocrisy of assuming one posture in public then signaling quietly to these same actors that it’s essentially for show — in both form and content, it’s pretty much all here."

Full article

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