Trump as tragicomedy

[boglerdude]

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."

[ochotona]

Desert, bingo for you

[moda0306]

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"...?

[moda0306]

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.

[Xan]

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.

[moda0306]

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?

[Xan]

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.

[moda0306]

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.

[Maddy]

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.

[clacy]

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

[clacy]

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?

[Don]

4.1% GDP. Unemployment at 3.9%.

Pretty, pretty, good.

[stuper1]

We've never seen an administration this corrupt.

You should check on the personal wealth of Bill Clinton and Barack Obama. Then compare that against what they did in practical terms to deserve that wealth. As far as I know neither of them invented a better mousetrap or ran multinational corporations. They're just bloviating politicians, but somehow they have accumulated immense wealth . . . makes one wonder.

[Mark Leavy]

I'm with you on ol Bill, but Obama appears to have a decent accounting for his wealth. Writing books can be lucrative, apparently.

snip - grifters, adulterers, etc...

I do a lot of reading. And I have read the Obama books.

Did you conclude that the book royalties were reasonable market compensation for the writing? I have read better - but I don't presume to understand the market.

I tend to be somewhat cynical and I always suspect that compensation to politicians for books, speeches, art sales, real estate deals and board seats are more graft than payment for value.

But, then again, I'm cynical.

[Kriegsspiel]

Nothing corrupt about that. Publishers probably know that people will read a former president's book, no matter how big a piece of shit it is. The same effect can be seen in TV, which will air anything featuring a Kardashian.

[Xan]

Yeah. Once you reach a certain level of fame, for whatever reason, you can write a book or hit the "speakers circuit" and just rake it in for doing nothing other than bloviating.

[stuper1]

It is so bad that a sort of grandeur creeps into it.

I can picture someone writing this about Trump's speaking style.

[Maddy]

Yeah. Once you reach a certain level of fame, for whatever reason, you can write a book or hit the "speakers circuit" and just rake it in for doing nothing other than bloviating.

Except that nobody really cares about the book or the speech. It's simply a pretext for the quid pro quo that flows to the politician who understands who's in charge and who doesn't buck the system.

[moda0306]

Yeah. Once you reach a certain level of fame, for whatever reason, you can write a book or hit the "speakers circuit" and just rake it in for doing nothing other than bloviating.

Except that nobody really cares about the book or the speech. It's simply a pretext for the quid pro quo that flows to the politician who understands who's in charge and who doesn't buck the system.

I realized this with regards to speeches, but aren't book royalties pretty directly related to your sales? IOW, not nearly as much a hidden way of rewarding establishment politicians but actual public interest in the book?

Not that this interest isn't built on the ridiculous "hero-worship" of the American Presidency, and worthy of a different kind of skepticism, but it seems less-likely to be a result of obvious corruption.

[Xan]

Yeah. Once you reach a certain level of fame, for whatever reason, you can write a book or hit the "speakers circuit" and just rake it in for doing nothing other than bloviating.

Except that nobody really cares about the book or the speech. It's simply a pretext for the quid pro quo that flows to the politician who understands who's in charge and who doesn't buck the system.

I realized this with regards to speeches, but aren't book royalties pretty directly related to your sales? IOW, not nearly as much a hidden way of rewarding establishment politicians but actual public interest in the book?

Not that this interest isn't built on the ridiculous "hero-worship" of the American Presidency, and worthy of a different kind of skepticism, but it seems less-likely to be a result of obvious corruption.

I think often most of the money from these book deals comes as an advance.

[ochotona]

Death panel... United Healthcare

https://amp.cnn.com/cnn/2018/08/15/heal ... index.html

[boglerdude]

^ how would that situation play out in England/Canada/France

Also, thats why im in the PP. Never know when you might need to drain it all.

[ochotona]

^ how would that situation play out in England/Canada/France

Also, thats why im in the PP. Never know when you might need to drain it all.

Healthcare must always be rationed. Otherwise each person would demand infinite resources.

Would you rather the rationing be done by a panel which includes doctors and medical ethicists which is trying to allocate limited resources to do the most for the most people, or,

By a CEO a$$hat who wants to make his numbers so he can make another $25 million a buy a Bentley for his mistress?

[Xan]

^ how would that situation play out in England/Canada/France

Also, thats why im in the PP. Never know when you might need to drain it all.

Healthcare must always be rationed. Otherwise each person would demand infinite resources.

Would you rather the rationing be done by a panel which includes doctors and medical ethicists which is trying to allocate limited resources to do the most for the most people, or,

By a CEO a$$hat who wants to make his numbers so he can make another $25 million a buy a Bentley for his mistress?

Isn't that true of everything? The mechanism we have for "rationing" absolutely everything else is the price mechanism. In healthcare that mechanism has been badly broken.

[moda0306]

^ how would that situation play out in England/Canada/France

Also, thats why im in the PP. Never know when you might need to drain it all.

Healthcare must always be rationed. Otherwise each person would demand infinite resources.

Would you rather the rationing be done by a panel which includes doctors and medical ethicists which is trying to allocate limited resources to do the most for the most people, or,

By a CEO a$$hat who wants to make his numbers so he can make another $25 million a buy a Bentley for his mistress?

Isn't that true of everything? The mechanism we have for "rationing" absolutely everything else is the price mechanism. In healthcare that mechanism has been badly broken.

The price mechanism works great when markets are efficient. Would you consider health services, insurance and drug markets to be efficient?

Why do you think government works better in some areas than others? (I don't mean that snarky... just something I think about a lot)