Politics

[irishog77]

No one is going to argue that the VA provides great healthcare (or even average healthcare), but you are wrong to use the VA as why healthcare quality will fall if we do a single payer system. The VA is an extremely small set of doctors, thus limiting the amount of care that can be given. A single payer system on the other hand would encompass all of the doctors and hospitals in the nation (well almost all of the doctors some would choose to see only the rich who pay out of pocket though there is already a group of doctors doing this), so you are incorrect to assume that a single payer system would be similar in quality to the VA system. They are two completely different animals. One is a very small closed system, while the other would be a huge open system with 99% of doctors and hospitals being a part of it.

It's not an extremely small set of doctors. Compared to the entire population of the U.S., yes it is small. But we're still talking hundreds of thousands of employees overall and hundreds of thousands (millions?) of beneficiaries. Would a nationalized socialized program be different than the VA? Probably. But this belief that socialized medicine, on a national scale, will not negatively impact quality of care is all pie in the sky.

The overall number of doctors will decrease as well if the U.S. goes to a single payer system. Many doctors will simply stop practicing medicine with a socialized system, and fewer young people will choose that as a career path. It's simple economics-- less money, more restrictions, more bureaucracy will not cause the available or potential doctor pool to defy that and increase.

 

[irishog77]

No one is going to argue that the VA provides great healthcare (or even average healthcare), but you are wrong to use the VA as why healthcare quality will fall if we do a single payer system. The VA is an extremely small set of doctors, thus limiting the amount of care that can be given. A single payer system on the other hand would encompass all of the doctors and hospitals in the nation (well almost all of the doctors some would choose to see only the rich who pay out of pocket though there is already a group of doctors doing this), so you are incorrect to assume that a single payer system would be similar in quality to the VA system. They are two completely different animals. One is a very small closed system, while the other would be a huge open system with 99% of doctors and hospitals being a part of it.

Edit: Insurance companies aren't making your quality of care better, it is the access to doctors that makes it better or worse. Changing who is paying for it won't change the quality of care as long as the doctors available doesn't change.

I agree with your premise here on quality of care. Being able to, to an extent, pick and choose our doctors (market principles in play) is the reason quality of care may or not be better. Competition.

The VA network literally doesn't give a fuck. Why? Because the customers are stuck there and trapped to them.

 

[pkt77242]

It's not an extremely small set of doctors. Compared to the entire population of the U.S., yes it is small. But we're still talking hundreds of thousands of employees overall and hundreds of thousands (millions?) of beneficiaries. Would a nationalized socialized program be different than the VA? Probably. But this belief that socialized medicine, on a national scale, will not negatively impact quality of care is all pie in the sky.

The overall number of doctors will decrease as well if the U.S. goes to a single payer system. Many doctors will simply stop practicing medicine with a socialized system, and fewer young people will choose that as a career path. It's simple economics-- less money, more restrictions, more bureaucracy will not cause the available or potential doctor pool to defy that and increase.

You do realize the amount of bureaucracy that insurance companies force upon doctors right? Hell thanks to them most doctors have to have staff members just to navigate the damn system.

 

[ACamp1900]

You do realize the amount of bureaucracy that insurance companies force upon doctors right? Hell thanks to them most doctors have to have staff members just to navigate the damn system.

... And lord knows if there was ever a cure for bureaucracy and lack of efficiency, it was big government...

 

[irishog77]

You do realize the amount of bureaucracy that insurance companies force upon doctors right? Hell thanks to them most doctors have to have staff members just to navigate the damn system.

Yeah. So what? We all know this. How is adding to that going make care better?

Unless, you honestly believe, that making the government in charge of it will decrease the bureaucracy involved, system wide. If you actually believe that, then there is zero point in continuing this conversation.

 

[pkt77242]

... And lord knows if there was ever a cure for bureaucracy and lack of efficiency, it was big government...

Yeah. So what? We all know this. How is adding to that going make care better?

Unless, you honestly believe, that making the government in charge of it will decrease the bureaucracy involved, system wide. If you actually believe that, then there is zero point in continuing this conversation.

Don't judge Medicare/Medicaid based off of other parts of the government.

While I generally agree that the government is not efficient, we do know that by the numbers that Medicare and Medicaid are significantly more efficient then private insurance (there is a reason that overhead is at least twice as much for private insurance as it is for the public ones). The truth is that when it comes to medical insurance it pays for private insurers to have high levels of bureaucracy. The fact that you can't admit it even thought he numbers show it to be true shows that you are being biased not me.

You don't have to like a public option but Medicare has shown to be a particularly lean part of our government. In fact one of the critiques of it is that it needs more mechanisms in place to prevent fraud (especially medicaid), that get this it actually might be too lean.

Medicare's latest bureaucracy addition was to punish hospitals that had patients readmitted soon after they were released. Why because hospitals should make sure that the patients are truly healthy before sending them home and they should be punished for have a high level of re-admittance.

Bitch all you want about the rest of the government and its bureaucracy (I will join in most of the time) but Medicare and Medicaid have been pretty damn good in that area. Are they perfect, Hell no but to pretend that they are anywhere as bad as Private Insurance who literally profits off being bureaucratic (the more claims they deny and the longer they take to pay the claim the more money they make). From my understanding from the doctors that I do know (though this might not be true across the country) is that Medicare is much more prompt with their payments then private insurance (though they do pay less). Prompt payment is a sign of less bureaucracy.

Finally people always talk about doctors having to take a pay cut if we go to a single payer system. That is correct they will have too, but it isn't like they will be going poor. Here are the numbers

What If Doctors Got Paid Only Medicare Rates? - Doctors for America

 

[Polish Leppy 22]

You do realize that the number 1 reason for bankruptcies before the 2008 was healthcare bills, right? You do also realize that the majority of people filing for bankruptcy because of medical bills had some form of insurance?

Also you do realize that they are only not turned away from Emergency rooms which causes the cost of healthcare to skyrocket. People end up going to the EM for things that aren't emergencies, which costs us significantly more money. Also people don't go and get regular check-ups that could catch things early (like diabetes, heart disease, etc) that are much cheaper to treat when they are caught early. All of these things drive up the cost of healthcare which affects how much everyone else pays for their insurance/healthcare. Again a single payer system would lower the cost of healthcare by reducing emergency room visits, and by providing more preventative care.


If you don't think that a government who has a single payer system isn't controlling (not setting but controlling) the cost of healthcare then you are crazy. The only provider of something controls the market. Look at the cost for medicine in Canada vs the cost for it here, shockingly it is significantly cheaper in Canada. If you don't think that a single payer system, effectively controls the price of healthcare, then well you are living in a fantasy world.

Single payer systems also help control the cost of healthcare by reducing overhead costs and by the fact that they don't need to make a profit. Think about it, about 10-15% of your insurance premium goes to overhead costs, while Medicare is about half that amount (or less, especially traditional Medicare).

Here is an interesting article on what version of a single payer system (though not quite a true single payer system) would do. Federal Spending increases, Business spending increases, State spending on healthcare drops, and healthcare costs for individuals/households drops drastically.
Research Desk: How much would single-payer cost? - The Washington Post

No sense in arguing anymore with someone who believes in communist style health care. Have a good day.

 

[Polish Leppy 22]

This always makes me laugh, conservatives and their ability to disown their own candidates. When was the last time the GOP nominated a decent candidate? Nixon?



Well they are alive and give their opinions. We also have their election stances and can compare them.



I don't see a disaster. Still waiting for the promised disaster.

The stimulus failed to keep unemployment below 8%, but it didn't "make things worse." My no means a national catastrophe or anything close to a disaster. It patched some holes in state budgets for a bit. Meh.

Obamacare is not a disaster. When you have years and years and years of failure and the new program doesn't solve it, it's not a disaster.

You're going to need to elaborate on immigration and the rest. I don't see the disaster or the "fundamental transformation." Things I oppose? Definitely. Disaster? Wut.



You want to talk about how divisive Obama has been when there are TV networks and radio stations pumping 24/7 opposition to everything he does? When is the last time Rush Limbaugh or Fox News said something remotely positive about any policy Obama favored? "He's 100% wrong all the time" sums up their narrative.



Yawn.

GOP/ candidates: We haven't seen a true conservative nominee for Pres since 1984. That's a shame.

Obamacare: Have a feeling you're playing dumb just to mess with me. The guy unconstitutionally re-wrote the law on his own so that people could keep their doctors. Worst is yet to come, when he's out of office. When the supposed "solution" to the problem is WORSE than the original problem, it's a disaster. Thank you, big government.

Stimulus: Remember what it added to our debt? And what did we get out of it?

My post from this morning was a brief outline of what his fundamental transformation looked like, and that is with a Republican House from 2010 to 2016. Imagine what could've been with no "obstruction."

If you can't see it, there's nothing more I can do for ya pal.

 

[GoldenDomer]

Lol @ anyone on this board who have given this guy a dime. You lose.

<blockquote class="twitter-tweet" lang="en"><p>My uncle killed by sniper in WW2. We were taught snipers were cowards. Will shoot u in the back. Snipers aren't heroes. And invaders r worse</p>— Michael Moore (@MMFlint) <a href="https://twitter.com/MMFlint/status/556914094406926336">January 18, 2015</a></blockquote>
<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>

 

[connor_in]

Lol @ anyone on this board who have given this guy a dime. You lose.

<blockquote class="twitter-tweet" lang="en"><p>My uncle killed by sniper in WW2. We were taught snipers were cowards. Will shoot u in the back. Snipers aren't heroes. And invaders r worse</p>— Michael Moore (@MMFlint) <a href="https://twitter.com/MMFlint/status/556914094406926336">January 18, 2015</a></blockquote>
<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>

Apparently he has since stated he was not referring to Chris Kyle and did not reference American Sniper directly in his tweet. However, it is curious that he chose the weekend American Sniper opened wide and got tons of publicity and huge box office numbers that MM decided to make a statement about snipers completely outta the blue. I mean really, what are the odds, huh?

 

[phgreek]

Sure, a single payer system may help on overall costs. What's it do for quality of health care though? Ask anybody using the VA (myself included) if they are happy with the quality of their care they receive.

Long story short, Obamacare moved me into the VA system. I've been waiting 4 1/2 months for an appointment, with a doctor I had no part in selecting, for a date and time I have no say in, whose office will not return any of my phone calls. And in the meantime, I am encouraged , by the VA, to utilize the emergency room for healthcare needs if I don't want to wait. This also doesn't take into account the HOURS I've spent on hold and on the phone with them in simply trying to get an appointment, nor the general frustration and loathing .

And my story is not even close to an anecdotal one. This is everyday life, business as usual, at the single payer system that is the VA.

A single payer system will absolutely have a negative impact on the quality of care people receive.

I hear you, and I'm sorry, and embarrassed we've done this to people who hung their ass out there for this country. People have become used to asking more from you guys instead of living up to the promises made. Infuriates me. You earned Quality care that is available, and we should all be in the fight until you get it.

Now, the idea that Single payer could ever HELP cost or quality flies in the face of everything real people already know about government run anything. You have organizations with little ability to motivate, evaluate, and hold people accountable, much less innovate...and you have 0 ability as a consumer to enforce quality by taking your business elsewhere. AAAND this entire cluster fuck is often times run by appointees who don't know the first thing about the technical issues regarding decision making. But somehow those fundamental flaws are ignored so folks can stack organizations on them...with lofty goals, and flowery words, and cool charts...none of which mean shit until you fix how the workforce is lead and functions...so my personal opinion is folks should really focus on fixing the very basics of the civilian government organization...not adding to the cluster fuck.

 

[GoldenDomer]

Apparently he has since stated he was not referring to Chris Kyle and did not reference American Sniper directly in his tweet. However, it is curious that he chose the weekend American Sniper opened wide and got tons of publicity and huge box office numbers that MM decided to make a statement about snipers completely outta the blue. I mean really, what are the odds, huh?

It's obviously bullshit and he's a waste of space on this planet. Here is one Army sniper's reaction:

<iframe width="560" height="315" src="//www.youtube.com/embed/jmfXRuyyHd0" frameborder="0" allowfullscreen></iframe>

 

[Wild Bill]

That is your opinion. Can you post anything showing that not to be the case as all of the studies out there say it?

This is the study most people rely on:
HTML Version

If you were looking at another study, please let me know. You always find interesting stuff and I'd like to take a look. I have several issues with this particular study and I believe it's very misleading.

The study does not solely analyze medical debt, as your original comment suggested.

You do realize that the number 1 reason for bankruptcies before the 2008 was healthcare bills, right?

They looked at other factors to distinguish a medical bankruptcy from an ordinary bankruptcy:

We developed two summary measures of medical bankruptcy. Under the rubric “Major Medical Bankruptcy” we included debtors who either (1) cited illness or injury as a specific reason for bankruptcy, or (2) reported uncovered medical bills exceeding $1,000 in the past years, or (3) lost at least two weeks of work-related income because of illness/injury, or (4) mortgaged a home to pay medical bills. Our more inclusive category, “Any Medical Bankruptcy,” included debtors who cited any of the above, or addiction, or uncontrolled gambling, or birth, or the death of a family member.16

This chart breaks it down as well:
http://content.healthaffairs.org/content/vol0/issue2005/images/data/hlthaff.w5.63/DC1/Himmelstein_Ex2.gif

My biggest issue is that it isn't relevant whether a person has even a single dollar of medical debt. As long as the debtor cited illness or injury as the primary cause of the bankruptcy or missed two weeks of income due to illness, the filing was considered a "medical bankruptcy". Most people are not comfortable with critiquing their own financial failures. It's rare, if ever, someone actually admits to overspending. It's much easier to simply dismiss it as medically related, injury related or just bad luck. And keep in mind that these people just filed a bankruptcy petition under the penalty of perjury and they're trying to eliminate all of their debt. They're not going to sing like song birds about how they've mismanaged money and spent like drunken sailors, even if it is off the record.

If no medical debt is incurred by the injury or illness, two weeks of missed income is not enough, in my opinion, to characterize a filing as a "medical bankruptcy". If you're forced to file bankruptcy b/c you've lost 3% of your yearly income, you're living outside of your means.

The other issue is the relatively low out of pocket costs that qualify as a cause of "medical bankruptcy". $1,000 of uncovered medical expenses would never prompt a bankruptcy filing. To put that figure in perspective, the mere filing fee of a bankruptcy exceeds $300. There is no chance someone would rip a bankruptcy for a net savings of $700. Most practitioners would not file a bankruptcy for a prospective client unless their dischargeable debts exceeded $5,000. I think it would have been a more appropriate dollar amount to use.

 

[pkt77242]

No sense in arguing anymore with someone who believes in communist style health care. Have a good day.

LOL.
No point in arguing with someone who doesn't know the difference between socialism and communism.

 

[phgreek]

Apparently he has since stated he was not referring to Chris Kyle and did not reference American Sniper directly in his tweet. However, it is curious that he chose the weekend American Sniper opened wide and got tons of publicity and huge box office numbers that MM decided to make a statement about snipers completely outta the blue. I mean really, what are the odds, huh?

I think Michael Moore is a complete Jackass. I do think there is some level of historical basis in what he says about his uncle considering HOW wars were fought, and how enemies deployed snipers. However, to make the comparison to current American Snipers, and thier code of conduct is ridiculous, and typifies the willful ignorance of his ilk, and the ire they bring upon themselves.

 

[IRISHDODGER]

Lol @ anyone on this board who have given this guy a dime. You lose.

<blockquote class="twitter-tweet" lang="en"><p>My uncle killed by sniper in WW2. We were taught snipers were cowards. Will shoot u in the back. Snipers aren't heroes. And invaders r worse</p>— Michael Moore (@MMFlint) <a href="https://twitter.com/MMFlint/status/556914094406926336">January 18, 2015</a></blockquote>
<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>

perfect example of a limousine Liberal. Do as I say, not as I do.

 

[Polish Leppy 22]

LOL.
No point in arguing with someone who doesn't know the difference between socialism and communism.

Tell us all why the systems in Cuba and Venezuela suck. Why are their people suffering?

 

[IRISHDODGER]

Timeout.

I think Obama sucks. He has not been a good President. I can list my disagreements with him until I'm blue in the face. He has failed on a number of fronts.

That said, the last eight years have not been a disaster personally tailored by Obama. We have useless rhetoric from the Right that insinuates that the sky is falling, unemployment is 9000%, inflation is berserk, illegal Mexicans are raping and pillaging everything west of the Mississippi whilst possibly teaming up with Zombie Bin Laden to unleash mayhem on our children, that the White House administration is having a bukakke session on our Constitution, and that Obama loathes policemen because he's a Muslim. /hyperbole

The criticisms of Obama are so harsh that I actually have to defend the guy. I think it's especially absurd considering the guy he replaced sent thousands of Americans to their deaths for a pointless war, severely damaged American opinion around the world, increased the deficit by trillions so he could win elections, and was totally blind to the housing bubble that harmed tens of millions of Americans. I mean, you don't have to look that far back to find a President worse than Obama.

Can't we all shrug our shoulders and come to the realization that there isn't a Republican or Democrat who can really solve any major issues in this country because it has to go through a Congress that is so overwhelming controlled by their corporate daddies that the idea of a bill getting through there without corporate approval is just silly. That's the problem with this country. It's not the President.

Yes, to your last paragraph. As far as the hyperbole, we heard the same (if not worse) about GW Bush. "Evil", "Nazi"(never made any senesse), "reason for all that's wrong w/America", "100% reason why the economy tanked", etc.

I was no fan of W in the same way you aren't a fan of Obama. But (like you w/ Obama) I got sick of one person being blamed forall what's wrong w/ the country & called every name in the book. The fact that both of these guys were re-elected tells me there were some truly shitty choices to oppose them. Why would an "ideal" candidate ever run?

In the big picture, most of Congress (outside the far Left & far Right) don't believe in half the shit they vote for....it's all about toeing the party line to get reelected. There's hardly a dime's worth of difference between the two parties but the avg voter thinks the two parties are like oil & water.

 

[tommyIRISH23]

Just out of curiosity; wouldn't the best way to lower healthcare costs be to open up the market to make all insurance companies, especially small businesses available? For instance, I can't buy health insurance outside of nj, ny, pa, and de. There's only like a handful of companies to choose from so the rates get jacked up. Wouldn't it lower cost if I had the option to by health insurance from a small business in Texas or Arizona? Tbh I don't need Obamacare so I fell out of the loop a long time ago

 

[IrishinSyria]

Just out of curiosity; wouldn't the best way to lower healthcare costs be to open up the market to make all insurance companies, especially small businesses available? For instance, I can't buy health insurance outside of nj, ny, pa, and de. There's only like a handful of companies to choose from so the rates get jacked up. Wouldn't it lower cost if I had the option to by health insurance from a small business in Texas or Arizona? Tbh I don't need Obamacare so I fell out of the loop a long time ago

Depends on who you are. If you're a young, then yea, a wide open market can probably lead to reduced costs. But those low cost insurers aren't going to want to carry olds or people with preexisting conditions, so those people would get pushed into more and more expensive plans (if any plan at all).

 

[Buster Bluth]

Just out of curiosity; wouldn't the best way to lower healthcare costs be to open up the market to make all insurance companies, especially small businesses available? For instance, I can't buy health insurance outside of nj, ny, pa, and de. There's only like a handful of companies to choose from so the rates get jacked up. Wouldn't it lower cost if I had the option to by health insurance from a small business in Texas or Arizona? Tbh I don't need Obamacare so I fell out of the loop a long time ago

"Small" businesses have the wherewithal to get into the health insurance game? That'd be a surprise to me. Also that small business in Arizona would have to make agreements with the hospital network a thousand miles away. Seems unlikely, no?

 

[pkt77242]

Tell us all why the systems in Cuba and Venezuela suck. Why are their people suffering?

Why are you so caught up on those two countries? They are by no means the closest analog to the US, we would be better off discussing France, Canada, UK, Germany, or one of the other European countries as they are significantly more similar to us.

Having said that I will answer your question. They have shitty leaders who take all of the money and invest very little into taking care of their citizens.

Having said that Cuba's healthcare system isn't that bad no matter what you say about it. Their infant mortality rate is lower then ours (though to be fair their maternal mortality rate is much higher then ours), and their life expectancy is about the same as the US.

If you actually care to learn about their healthcare system here is a good article on it by doctors who have seen it first hand.
MMS: Error

Venezuela's healthcare system suffers from having a shitty leader who doesn't care about his people and doesn't properly fund it,


Here is a link that shows life expectancy around the world
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

List of countries by life expectancy - Wikipedia, the free encyclopedia

Here is an interesting ranking that was done by the WHO in 2000. Some people think it is flawed because a relatively large portion of the grade is based on the percent of the population covered.
World Health Organization ranking of health systems in 2000 - Wikipedia, the free encyclopedia

Now why don't we discuss the countries most similar to us such as the European countries or Canada, Then we can truly debate the merits of socialized healthcare,

 

[pkt77242]

I hear you, and I'm sorry, and embarrassed we've done this to people who hung their ass out there for this country. People have become used to asking more from you guys instead of living up to the promises made. Infuriates me. You earned Quality care that is available, and we should all be in the fight until you get it.

Now, the idea that Single payer could ever HELP cost or quality flies in the face of everything real people already know about government run anything. You have organizations with little ability to motivate, evaluate, and hold people accountable, much less innovate...and you have 0 ability as a consumer to enforce quality by taking your business elsewhere. AAAND this entire cluster fuck is often times run by appointees who don't know the first thing about the technical issues regarding decision making. But somehow those fundamental flaws are ignored so folks can stack organizations on them...with lofty goals, and flowery words, and cool charts...none of which mean shit until you fix how the workforce is lead and functions...so my personal opinion is folks should really focus on fixing the very basics of the civilian government organization...not adding to the cluster fuck.

Actually blanket statements like this are funny. For example Medicare is run more efficiently then private insurance companies. Also public prisons are more efficient, more safe and provide more services, while being similar in cost or cheaper to run. There is no doubt that in some ways the private sector is usually more efficient then the public sector but that doesn't always hold true in sectors such as healthcare and prisons. Arizona is spending significantly more to have private prisons vs public ones and that is even with the private citizens getting to take the inmates that they want while passing on ones who are sick or mentally ill to keep their costs down. Even with that built in advantage they are are best breaking even with the public prisons and usually costing significantly more (to the tune of over $1000 per inmate per year).
Private vs. Public Facilities, Is it cost effective and safe?
http://www.nytimes.com/2011/05/19/us/19prisons.html?pagewanted=all&_r=0

 

[Polish Leppy 22]

Why are you so caught up on those two countries? They are by no means the closest analog to the US, we would be better off discussing France, Canada, UK, Germany, or one of the other European countries as they are significantly more similar to us.

Having said that I will answer your question. They have shitty leaders who take all of the money and invest very little into taking care of their citizens.

Having said that Cuba's healthcare system isn't that bad no matter what you say about it. Their infant mortality rate is lower then ours (though to be fair their maternal mortality rate is much higher then ours), and their life expectancy is about the same as the US.

If you actually care to learn about their healthcare system here is a good article on it by doctors who have seen it first hand.
MMS: Error

Venezuela's healthcare system suffers from having a shitty leader who doesn't care about his people and doesn't properly fund it,


Here is a link that shows life expectancy around the world
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

List of countries by life expectancy - Wikipedia, the free encyclopedia

Here is an interesting ranking that was done by the WHO in 2000. Some people think it is flawed because a relatively large portion of the grade is based on the percent of the population covered.
World Health Organization ranking of health systems in 2000 - Wikipedia, the free encyclopedia

Now why don't we discuss the countries most similar to us such as the European countries or Canada, Then we can truly debate the merits of socialized healthcare,

Not quite. If you're going to argue that Cuba and Venezeula can't be compared to the US, then neither can countries like Canada, the UK, and Germany. Why? Those countries don't have our obesity rates and they aren't accountable for the care of 12-15 million illegal immigrants.

If an individual state wants to go single payer, I say go ahead and repeat Vermont's failures. That Forbes article I posted yesterday detailed WHY it failed, and other states will get the same result:

1. Vermont insisted on platinum plated insurance coverage

2. "We can move full speed ahead without knowing where the money's coming from." --- Vermont special counsel for health care reform

3. 160% tax increase: no matter how you slice it, this means more taxes

4. Plan required higher taxes AND paying doctors and hospitals less. They fought it.

5. They thought they were getting $267 million from DC for single payer. Only got $105 million. Solution? More taxes.

6. The plan STILL wouldn't have achieved single payer because of how much the feds are now involved in the health care game.

Wanna take a stab at one of the chief architects of this 6th grade math failure? Jonathan Gruber.

 

[connor_in]

#LiberalWarMovies

#LiberalWarMovies

In response to Michael Moore and others who have been commenting against "American Sniper", the hashtag #LiberalWarMovies has been popular...







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—
Alo Konsen (@OhioCoastie) January 20, 2015


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— BattleSwarm (@BattleSwarmBlog) January 20, 2015


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— BattleSwarm (@BattleSwarmBlog) January 20, 2015


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— Matt Reilly (@MattReilly928) January 20, 2015


#LiberalWarMovies Full Metal #Hashtag

— BattleSwarm (@BattleSwarmBlog) January 20, 2015

 

[phgreek]

Actually blanket statements like this are funny. For example Medicare is run more efficiently then private insurance companies. Also public prisons are more efficient, more safe and provide more services, while being similar in cost or cheaper to run. There is no doubt that in some ways the private sector is usually more efficient then the public sector but that doesn't always hold true in sectors such as healthcare and prisons. Arizona is spending significantly more to have private prisons vs public ones and that is even with the private citizens getting to take the inmates that they want while passing on ones who are sick or mentally ill to keep their costs down. Even with that built in advantage they are are best breaking even with the public prisons and usually costing significantly more (to the tune of over $1000 per inmate per year).
Private vs. Public Facilities, Is it cost effective and safe?
http://www.nytimes.com/2011/05/19/us/19prisons.html?pagewanted=all&_r=0

Well it seems the example you provide (that would open (NYT)) says IN A PART OF A STATE level Bureaucracy, privatization is ABOUT THE SAME, and both sides ignore parts of the cost determination...so. The biggest issue is in bold...I've seen numerous state level systems function marginally well...That said if I were AZ, I'd fire everyone who failed to make the numbers. oh, wait, AZ did a poor job identifying the criteria of what success looks like...for sure. All of that said, the state of Arizona is not the same as The US Federal Government...not even close.The Federal Civil Service is beyond management...for all the reasons I stated before. Fix those issues and I'd entertain single payer, or any other major program...this is management 101 stuff, and not worth chasing my tail. You think you are correct because you can find a far flung apples to Oranges comparison...fine. You think because some sources circa 2011 and 2012 say medicare is "more efficient" than private healthcare that it must be true. But clearly, by efficiency, you must mean more than holding down costs as compared to itself...right? Medicare is efficient at processing too right. Thats amazing for a government org. So you do know there isn't an army of civil servants doing claims processing ...right? Alot of that is contracted to whom???? The guys you are comparing Medicare to....insurance companies. So the government is availing itself of the processing efficiency created and constantly improved in the market place. I think Medicare is a bad example to tout for single payer.

 

[GoIrish41]

Timeout.

I think Obama sucks. He has not been a good President. I can list my disagreements with him until I'm blue in the face. He has failed on a number of fronts.

That said, the last eight years have not been a disaster personally tailored by Obama. We have useless rhetoric from the Right that insinuates that the sky is falling, unemployment is 9000%, inflation is berserk, illegal Mexicans are raping and pillaging everything west of the Mississippi whilst possibly teaming up with Zombie Bin Laden to unleash mayhem on our children, that the White House administration is having a bukakke session on our Constitution, and that Obama loathes policemen because he's a Muslim. /hyperbole

The criticisms of Obama are so harsh that I actually have to defend the guy. I think it's especially absurd considering the guy he replaced sent thousands of Americans to their deaths for a pointless war, severely damaged American opinion around the world, increased the deficit by trillions so he could win elections, and was totally blind to the housing bubble that harmed tens of millions of Americans. I mean, you don't have to look that far back to find a President worse than Obama.

Can't we all shrug our shoulders and come to the realization that there isn't a Republican or Democrat who can really solve any major issues in this country because it has to go through a Congress that is so overwhelming controlled by their corporate daddies that the idea of a bill getting through there without corporate approval is just silly. That's the problem with this country. It's not the President.

Careful Buster, you will be painted as a socialist Obama-loving hippy if you dare to suggest that the rhetoric about the President is over the top.

 

[pkt77242]

Not quite. If you're going to argue that Cuba and Venezeula can't be compared to the US, then neither can countries like Canada, the UK, and Germany. Why? Those countries don't have our obesity rates and they aren't accountable for the care of 12-15 million illegal immigrants.

If an individual state wants to go single payer, I say go ahead and repeat Vermont's failures. That Forbes article I posted yesterday detailed WHY it failed, and other states will get the same result:

1. Vermont insisted on platinum plated insurance coverage

2. "We can move full speed ahead without knowing where the money's coming from." --- Vermont special counsel for health care reform

3. 160% tax increase: no matter how you slice it, this means more taxes

4. Plan required higher taxes AND paying doctors and hospitals less. They fought it.

5. They thought they were getting $267 million from DC for single payer. Only got $105 million. Solution? More taxes.

6. The plan STILL wouldn't have achieved single payer because of how much the feds are now involved in the health care game.

Wanna take a stab at one of the chief architects of this 6th grade math failure? Jonathan Gruber.

Just because one group fucks it up, doesn't mean that it can't be done right (as all of Europe and Canada are proof).

Here is the projections from 2009 on what a single payer system would have done to the US.

Those numbers come courtesy of the Commonwealth Fund, which commissioned the Lewin Group to take a look at AmeriCare and a few other health-care proposals in 2009. The resulting study predicts that, because of a public plan’s lower provider reimbursement rates and administrative costs, as well as its ability to negotiate down drug prices, enacting the bill would have resulted in $58.1 billion less annual health spending in 2010. It would increase the federal deficit by $188.5 billion a year, and employers would pay $61.5 billion more annually, but state and local governments would save $83.6 billion, and households a whopping $224.5 billion.

Courtesy of: Research Desk: How much would single-payer cost? - The Washington Post

Also are you going to respond to anything about Cuba since you kept bringing it up?

 

[pkt77242]

Well it seems the example you provide (that would open (NYT)) says IN A PART OF A STATE level Bureaucracy, privatization is ABOUT THE SAME, and both sides ignore parts of the cost determination...so. The biggest issue is in bold...I've seen numerous state level systems function marginally well...That said if I were AZ, I'd fire everyone who failed to make the numbers. oh, wait, AZ did a poor job identifying the criteria of what success looks like...for sure. All of that said, the state of Arizona is not the same as The US Federal Government...not even close.The Federal Civil Service is beyond management...for all the reasons I stated before. Fix those issues and I'd entertain single payer, or any other major program...this is management 101 stuff, and not worth chasing my tail. You think you are correct because you can find a far flung apples to Oranges comparison...fine. You think because some sources circa 2011 and 2012 say medicare is "more efficient" than private healthcare that it must be true. But clearly, by efficiency, you must mean more than holding down costs as compared to itself...right? Medicare is efficient at processing too right. Thats amazing for a government org. So you do know there isn't an army of civil servants doing claims processing ...right? Alot of that is contracted to whom???? The guys you are comparing Medicare to....insurance companies. So the government is availing itself of the processing efficiency created and constantly improved in the market place. I think Medicare is a bad example to tout for single payer.

Why is it such a bad example? The federal government is always outsourcing work. Also if it is only efficient because it is outsourced why is Medicare's overhead about 1/2 to 1/3 the amount of the private insurance companies. Shouldn't in that case the private insurance companies have lower overhead? I know that you think government is inefficient but in the case of Medicare you have not proven anything (just that you dislike government).

One idea that I have seen floated around is to have a non-profit insurance company either run a program for the entire country or to do it state by state. It would be a company that gets its funding from businesses (on a per employee basis), individuals would pay monthly premiums, the state and federal government would pay in for older people and the poor. Thus while it would create in a sense almost a single payer system it would keep it one step removed from the government as well.


Here is a good article on the costs of private prisons in Arizona.
Fact Check: Are state prisons cheaper than private prisons?

The main point is here.

The debate over which prison type is cheaper is complicated because the state's private prisons house only healthy inmates.

Without adjusting for the increased medical costs imposed on state-run prisons, a 2010 Corrections Department study found that daily per inmate costs were cheaper in private prisons, at $57.97 as opposed to $60.66.

However, when adjusting for medical costs, the results flipped with daily per inmate costs cheaper in state-run prisons at $48.42 compared with $53.02 in private prisons.

So if you control for medical costs (since private prisons get to cherry pick only healthy ones) public prisons save the state about $1640 per inmate per year. That is a lot of money.

 

[Ndaccountant]

Just because one group fucks it up, doesn't mean that it can't be done right (as all of Europe and Canada are proof).

Here is the projections from 2009 on what a single payer system would have done to the US.



Courtesy of: Research Desk: How much would single-payer cost? - The Washington Post

Also are you going to respond to anything about Cuba since you kept bringing it up?

There are too many problems with the US health care system to list them all, but two of the most important ones are cost and coverage.

On coverage - There are two things going on in this space....actual coverage and differences in coverage. In a single payer, everyone obviously has coverage. But that doesn't mean they are equal. Without going into a long dissertation on this, I believe our system would look similar to England if we would go single payer. In their system, over 2/3rds of people earning more than $75K a year purchase private insurance. In Sweden, the number of people carrying private insurance has increased 5X in the last decade (this and the previous statement are according to Stanford's Hoover Institution). So, I think we would still have a clear difference in the type of coverage people receive based on their income. (BTW, this has become a bigger issue in the US with Obamacare due to forcing people into Medicaid and shrinking networks in state sponsored plans).

On cost - there is explicit cost and implied cost. I think the explicit cost would show a reduction. But, what would that reduction cost? As mentioned above, level of coverage could be quite different depending on your income. But it doesn't stop there. What types of innovation will be perused or not perused depending on lower reimbursement rates? For example, there is no question Americans pay more for prescription drugs. This does help offset the cost of development since other countries will not pay as much. But it's not like these companies are making Apple level profit margins. On average, major drug manufacturers are making under 17%. Generic drug companies make 5%. So, given the level of risk they take on, I am not sure there is much to gain there without altering R&D. Is that a cost we would want to take action on? Aside from drugs, lower reimbursement rates lead to hospitals looking for cost efficiency. Will the financial payoff be good enough to attract doctors as reimbursement rates fall? What happens to skilled nursing? Will some aspect of health care be done by a robot? Is that something we will want to entertain?

The point is, single payer doesn't end the debate, it changes the starting point (some might say this is progress, but insurance doesn't mean access to good health care). There is no silver bullet to what ales us. How these changes would be absorbed by the public would most likely depend on what type of service you get today. My hunch is that most people would not be happy with the level of service they would get in the future. Now, that doesn't mean they are or are not getting the right service, it just means their perception of the service would be unfavorable and, more importantly for those in DC, politically tough.

On a somewhat related note to those points above, my father is president of a medical coalition of doctors and is one of their representatives that meet with regional hospitals and state legislators in Ohio. The state is getting pressure from DC to nip "cash" and "no Medicaid" doctors trend in the bud. The % of doctors not accepting Medicaid or cash only is rapidly accelerating in the face of Obamacare rate adjustments. Over 30% of primary care doctors have completely shut their door to Medicaid patients and that number is expected to grow to over 50% by 2020. In a response, Washington is wanting the state to mandate that a doctor take a certain % of Medicaid patients or risk getting their license revoked. He is told this isn't just an Ohio thing either and that "dozens" of states are looking into similar action.