Trump as tragicomedy

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moda0306
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Re: Trump as tragicomedy

Post by moda0306 » Tue Jul 31, 2018 10:35 pm

Xan wrote:
Tue Jul 31, 2018 9:35 pm
Kriegsspiel wrote:
Tue Jul 31, 2018 9:19 pm
ochotona wrote:
Tue Jul 31, 2018 5:50 pm
Not insurance... but we need human life cycle health care financing for women and men coupled with highly competitive reverse auction features! Call it what you want, that is what we need
Like, unlimited financing? Do we keep throwing money at people until the end of their life cycle, or do we need death panels to let us know when to stop throwing good money after bad. How much is a human life worth, anyway, and are they all worth the same?
Also, why do we not have this financing for, say, food? Housing? Why not everything!
Why not food, basic housing & healthcare?

Like really why not?

Maybe they should be subsidized or guaranteed? Our government facilitated the genocidal capture of 2.3 billion acres of land and resources to basically be given to a relative few for them to market to others. It's not outside the realm of reason to suggest a basic floor on human dignity and survival as a sort of "citizen's dividend."

Although I agree with you that liberals should get more comfortable asking the questions about where the limits stop on government healthcare. Seems to me many other countries have found a decent balance.

I'd prefer similar benefit levels but perhaps less of a patchwork system. A 65+ senior has a lot of healthcare protection compared to a pre-Obamacare 60-year-old. I think there are ways we could level out benefits a bit.
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Re: Trump as tragicomedy

Post by boglerdude » Wed Aug 01, 2018 1:52 am

I hear a lot of trash talked about the NHS, but they seem to take very good care of alcoholics. As in the documentary, Louis Theroux: Drinking To Oblivion
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Re: Trump as tragicomedy

Post by Kriegsspiel » Wed Aug 01, 2018 10:14 am

moda0306 wrote:
Tue Jul 31, 2018 10:35 pm
Xan wrote:
Tue Jul 31, 2018 9:35 pm
Kriegsspiel wrote:
Tue Jul 31, 2018 9:19 pm


Like, unlimited financing? Do we keep throwing money at people until the end of their life cycle, or do we need death panels to let us know when to stop throwing good money after bad. How much is a human life worth, anyway, and are they all worth the same?
Also, why do we not have this financing for, say, food? Housing? Why not everything!
Why not food, basic housing & healthcare?

Like really why not?

Maybe they should be subsidized or guaranteed?
We can't even pay for the stuff government does now.

Although, I could probably agree we could do something like that, if Americans were willing to accept a standard of living much lower than the current one.
Our government facilitated the genocidal capture of 2.3 billion acres of land and resources to basically be given to a relative few for them to market to others. It's not outside the realm of reason to suggest a basic floor on human dignity and survival as a sort of "citizen's dividend."
What is your point?
Although I agree with you that liberals should get more comfortable asking the questions about where the limits stop on government healthcare. Seems to me many other countries have found a decent balance.
I think Megan McArdle has done a good job showing that other countries with socialized medicine aren't doing that great and are running into problems, or will shortly. Government-run healthcare is such a recent phenomenon that skepticism is prudent.
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Re: Trump as tragicomedy

Post by Kriegsspiel » Wed Aug 01, 2018 10:19 am

Desert wrote:
Wed Aug 01, 2018 7:57 am
Regarding Canada, I think their system is far superior to ours, just looking at outcomes and spending per person.
Didn't Canada's Supreme Court rule that it was a human rights violation to force their citizens to rely solely on their nationalized healthcare?
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Re: Trump as tragicomedy

Post by flyingpylon » Wed Aug 01, 2018 11:19 am

Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
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Re: Trump as tragicomedy

Post by Maddy » Wed Aug 01, 2018 11:53 am

flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.
Ding! Ding! Ding!
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Re: Trump as tragicomedy

Post by moda0306 » Wed Aug 01, 2018 12:26 pm

flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
Isn't one of the main ideas behind single-payer to actually engage a negotiation framework that allows for universal coverage AND lower prices, rather than one or the other?

And yes it was about Trump... we meander around here.
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Re: Trump as tragicomedy

Post by Xan » Wed Aug 01, 2018 1:00 pm

flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
As my earlier anecdote noted, by opting out of the insurance system, you can save 90% off the sticker price, no questions asked. That sounds like a way to get around the exorbitant prices.
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Re: Trump as tragicomedy

Post by moda0306 » Wed Aug 01, 2018 5:57 pm

Xan wrote:
Wed Aug 01, 2018 1:00 pm
flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
As my earlier anecdote noted, by opting out of the insurance system, you can save 90% off the sticker price, no questions asked. That sounds like a way to get around the exorbitant prices.
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?

I think I must be misinterpreting.
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Re: Trump as tragicomedy

Post by D1984 » Wed Aug 01, 2018 6:16 pm

moda0306 wrote:
Wed Aug 01, 2018 5:57 pm
Xan wrote:
Wed Aug 01, 2018 1:00 pm
flyingpylon wrote:
Wed Aug 01, 2018 11:19 am
Perhaps we should be asking why we allow the health care industry to operate like a giant cartel instead of debating the best way to pay their exorbitant prices.

Besides, I thought this thread was about Trump?
As my earlier anecdote noted, by opting out of the insurance system, you can save 90% off the sticker price, no questions asked. That sounds like a way to get around the exorbitant prices.
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?

I think I must be misinterpreting.
I think it was back when he talked about having an elbow re-set for around $300 instead of circa $3000.

I would like to add a couple of points, though:

One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.

Two, the plural of anecdote is not data; just because Xan got a good price as a cash-paying patient does not mean most people will; in fact, as per the chargemaster example noted above, the uninsured usually get hit with the WORST prices. The local hospital system in my city has essentially a monopoly and their charges to uninsured patients are as follows: If you make the poverty level or less, free or nominal; if you make from 100% of the FPl to 200% of FPL, prices are based on a sliding scale from almost nothing to roughly what BCBS of Georgia would pay; if you make one cent above that you pay the FULL chargemaster rate, no ifs, ands, or buts (with the singular exception that certain imaging services get 10% or 15% off the chargemaster price). oh, and even if the hospital does discount its prices due to your being poor enough, the doctors who work on you can (and generally do) still charge the full amount.

Three, every other country that has health care prices lower than ours (which is pretty much....all of them) has the government directly or indirectly negotiate prices; this is true whether the system in single provider (UK, Spain, New Zealand, plus Hong Kong as far as hospital care is concerned); single-payer (Canada, Taiwan, South Korea), or some form of private or nonprofit universal coverage (Germany, Netherlands, Japan, Israel, Switzerland, etc) or a hybrid of single-payer and private non-profit (France). Strangely enough, none of them rely on patients acting as cost-control kamikazes and trying to negotiate rates with providers themselves. They all have lower prices (see the IFHP reports if you don't believe me) as a result. Funny how that works.
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Re: Trump as tragicomedy

Post by Maddy » Wed Aug 01, 2018 6:22 pm

moda0306 wrote:
Wed Aug 01, 2018 5:57 pm
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?
I regularly get 40 percent off the sticker price from an orthopedist for paying cash on the barrelhead. He says that's about the same discount the insurance companies are getting. My one other experience with discounts comes from my participation in a health care sharing ministry. They are associated with a company (the Karis Group) that negotiates bills on behalf of member-patients--mostly major stuff. From what I've heard, they routinely get much larger discounts than that.
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Re: Trump as tragicomedy

Post by ochotona » Wed Aug 01, 2018 9:30 pm

What D1984 said. Basically, we're suckers but we think we live in this great utopia. Sorry about the thread drift.
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Re: Trump as tragicomedy

Post by Xan » Wed Aug 01, 2018 9:45 pm

D1984 wrote:
Wed Aug 01, 2018 6:16 pm
One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.
This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
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Re: Trump as tragicomedy

Post by boglerdude » Thu Aug 02, 2018 1:06 am

https://johnhcochrane.blogspot.com/2018 ... pathy.html

From the comments
"And one thing about the Canadian system: it is a big free rider on the inventions of others, mainly the American medical and pharma industry. Canada does not invent anything, does not produce any significant output in medical devices and pharmaceutical drugs (and neither do many other countries). Canada free rides on America to do all this (and on Americans to pay for all this).
All that equipment for those surgeries you had? They were probably invented and/or produced in the US."
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Re: Trump as tragicomedy

Post by ochotona » Thu Aug 02, 2018 9:14 am

Desert, bingo for you
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Re: Trump as tragicomedy

Post by moda0306 » Thu Aug 02, 2018 3:41 pm

Xan wrote:
Wed Aug 01, 2018 9:45 pm
D1984 wrote:
Wed Aug 01, 2018 6:16 pm
One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.
This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
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Re: Trump as tragicomedy

Post by moda0306 » Thu Aug 02, 2018 3:44 pm

Maddy wrote:
Wed Aug 01, 2018 6:22 pm
moda0306 wrote:
Wed Aug 01, 2018 5:57 pm
I grazed back... where is this anecdote? Are you really saying that you think folks can regularly offer care providers 10% of their insurance-reimbursed rates with cash and they'll accept your offer?
I regularly get 40 percent off the sticker price from an orthopedist for paying cash on the barrelhead. He says that's about the same discount the insurance companies are getting. My one other experience with discounts comes from my participation in a health care sharing ministry. They are associated with a company (the Karis Group) that negotiates bills on behalf of member-patients--mostly major stuff. From what I've heard, they routinely get much larger discounts than that.
Is it really a discount if everyone gets it? Who doesn't get the discount?

I'm not accusing anyone of being shady... it's just that it seems like everyone wants to have this healthcare discussion as if somehow we're all getting screwed, and (insert THE ONE THING here) is the cause of it... until you look two layers deep and realize that not only are there (LOTS OF THINGS), but (THE ONE THING) isn't even really one of them...

That said, I've heard horror stories of people paying huge amounts for pills and pads at the hospital... why do I get the feeling that the insurance companies are in-fact NOT paying these rates!? Maybe because they're not negotiating in a moment of weakness with an IV & a bed pan as their legal counsel.
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Re: Trump as tragicomedy

Post by Xan » Thu Aug 02, 2018 3:58 pm

moda0306 wrote:
Thu Aug 02, 2018 3:41 pm
Xan wrote:
Wed Aug 01, 2018 9:45 pm
D1984 wrote:
Wed Aug 01, 2018 6:16 pm
One, you will basically never get 90% off the price an insurer (BCBS, Medicare, etc) would pay...the 90% he got off was likely off the ridiculous "chargemaster" price which is a pie in the sky price that only the uninsured get soaked with.
This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
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Re: Trump as tragicomedy

Post by moda0306 » Thu Aug 02, 2018 4:18 pm

Xan wrote:
Thu Aug 02, 2018 3:58 pm
moda0306 wrote:
Thu Aug 02, 2018 3:41 pm
Xan wrote:
Wed Aug 01, 2018 9:45 pm


This was the ridiculous "chargemaster" price that NOBODY pays. If you don't have insurance, you get 90% off. If you do have insurance, you'll get 90% off. Insurance is just there for... Well I don't know what!
That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
You didn't say "giant cartel," but the person you responded to an answer did, and you seemed to agree with them. You also seemed to be agreeing with their claim, but I'm reading between the lines a bit to try to establish an assertion pattern.

What $$ amount would you consider catastrophic?

And how is catastrophic insurance outlawed?
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Re: Trump as tragicomedy

Post by Xan » Thu Aug 02, 2018 4:39 pm

moda0306 wrote:
Thu Aug 02, 2018 4:18 pm
Xan wrote:
Thu Aug 02, 2018 3:58 pm
moda0306 wrote:
Thu Aug 02, 2018 3:41 pm


That doesn't seem to be what you were saying earlier when you were stating that "by opting out of insurance you save 90% off the sticker price" of the "giant cartel" that the healthcare industry was accused of being by the previous commenter.

Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
You didn't say "giant cartel," but the person you responded to an answer did, and you seemed to agree with them. You also seemed to be agreeing with their claim, but I'm reading between the lines a bit to try to establish an assertion pattern.

What $$ amount would you consider catastrophic?

And how is catastrophic insurance outlawed?
I believe the traditional definition is a $10,000 deductible. It was outlawed in that I used to have it, and then the price quintupled because, I was told, I had "bad insurance that nobody should be allowed to have", and my plan was now required to cover well-visits, maternity, and a thousand other things in addition to being just plain insurance against a catastrophe.
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Re: Trump as tragicomedy

Post by moda0306 » Fri Aug 03, 2018 9:32 am

Xan wrote:
Thu Aug 02, 2018 4:39 pm
moda0306 wrote:
Thu Aug 02, 2018 4:18 pm
Xan wrote:
Thu Aug 02, 2018 3:58 pm


I never said anything about a "giant cartel", nor claimed that there's any particular problem. Well, I did say that the expectation of employee-provided health insurance was a major problem. All I'm saying is that insurance is a joke, and that the only useful insurance (catastrophic) was outlawed.
You didn't say "giant cartel," but the person you responded to an answer did, and you seemed to agree with them. You also seemed to be agreeing with their claim, but I'm reading between the lines a bit to try to establish an assertion pattern.

What $$ amount would you consider catastrophic?

And how is catastrophic insurance outlawed?
I believe the traditional definition is a $10,000 deductible. It was outlawed in that I used to have it, and then the price quintupled because, I was told, I had "bad insurance that nobody should be allowed to have", and my plan was now required to cover well-visits, maternity, and a thousand other things in addition to being just plain insurance against a catastrophe.
While I generally agree with you about how to use insurance vs retaining risk & saving on an individual level, I wouldn't blame someone for thinking that if the government IS going to get involved in creating a floor of human suffering one shouldn't fall below, that $10k in annual medical expenses is way too much to expect the average citizen to maintain. Especially since if you're tossing out $10k in medical expenses per year every year, you're probably limited in your ability to work and tend to your family and home.

I think this comes down less to exactly how you view retaining vs transferring risk and more about what kind of floor the government should create for folks and how... obviously they get sort of intertwined so it's tough to detangle the conversations.
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Re: Trump as tragicomedy

Post by Maddy » Fri Aug 03, 2018 9:59 am

moda0306 wrote:
Thu Aug 02, 2018 3:41 pm
Well if the "exorbitant sticker price" of healthcare is a fake price that nobody pays (not the insurer or the individual), then that can't be the source of the problem... right? That means that there's no real "giant cartel" because the prices used to accuse them of that are "fake prices"...?
I'm not sure that's true. I travel two hours to be seen by the orthopedic group that gives me a 40% cash discount because the best deal I can get locally is 10 percent off a sticker price that's many times what my guy is charging.

Case in point: I recently had a minor surgical procedure performed on my hand, and the doc was kind enough to agree to do it in the office. Total cost: Less than $300. Just out of curiosity (and motivated by my desire to avoid a two-hour drive), I had checked beforehand with some other groups in the immediate vicinity, none of which were willing to do the procedure in the office. Total quoted price: Over $7,000 after their cash-pay discount. Had I not been an established patient who this doc knew wouldn't be a pain in the ass (and who's brought him grass-fed beef at every appointment), I would have had no choice but to pay the larger amount. I'm sure the majority of uninsured folks do.
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Re: Trump as tragicomedy

Post by clacy » Fri Aug 03, 2018 3:08 pm

Manufacturing jobs growing at fastest pace in 23 years despite Obama telling us that they were "never coming back" and "Trump doesn't have a magic wand"...

(or does he?)

https://www.marketwatch.com/story/heres ... =bigcharts
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Re: Trump as tragicomedy

Post by clacy » Fri Aug 03, 2018 9:12 pm

Lol saving the middle class by bringing back jobs isn’t a risk.

It’s gotta be getting hard to be anti Trump by now isn’t it?
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Re: Trump as tragicomedy

Post by Don » Sun Aug 05, 2018 8:24 pm

4.1% GDP. Unemployment at 3.9%.

Pretty, pretty, good.
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