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Obamacare, Otherwise Known as The Affordable Care Act (ACA)

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  • Originally posted by redrover View Post

    The current bill is just another example of republican oppression, for those chafing under the yoke of republican tyranny I suggest you do as I do and seek comfort in the holy bible. Currently my favorite verse is ISIAH 49/26. http://biblehub.com/isaiah/49-26.htm
    It's not Republicans who are the oppressors. And I do take comfort in knowing that all is in the hands of God and all things work towards his will.

    מה מכילות החדשות?


    • Originally posted by OldmanDan View Post

      It's not Republicans who are the oppressors. And I do take comfort in knowing that all is in the hands of God and all things work towards his will.
      In other words. https://www.youtube.com/watch?v=azxoVRTwlNg

      מה מכילות החדשות?


      • Originally posted by OldmanDan View Post

        Obamacare established a whole bunch of cooperatives, they all failed.
        That's because Obama's administration used some "good old boy network" rules when setting up the coop system. Here's one example.
        Mismanagement, mis-pricing, low enrollment and high enrollment have all been blamed for the co-ops' failure. The Daily Caller found that 18 of the 23 CO-OPs were paying top executives up to half a million dollars a year.

        But Obamacare itself is responsible for the most recent co-op bankruptcies.
        https://www.forbes.com/sites/sallypi.../#3033ed85d5b4

        Obamacare structure was responsible for a large number of for-profit insurance companies dropping out, as well. The cooperative experiment, restricted to intra-state operation, is an example of "large numbers" needed for insurance to succeed. If a cooperative is starting up (less experienced) and is limited to one state's population, it will struggle under the best conditions. Add to that the quick & dirty formulation of Obamacare -based on gummint and insurance sector fantasy, rather than the reality within the health care industry. Guaranteed failure.

        מה מכילות החדשות?


        • Originally posted by OldmanDan View Post
          Medical costs, like college costs and all other things where the government is involved in the cost and regulation structure is doomed to failure. There is no supply and demand pressure to keep those costs in check. As long as someone else is paying the bill, I have no reservation in going to the doctor for the most minor thing. Maybe even a free ambulance ride downtown if I have no other way of getting there. As long as the government requires me to purchase a plan that covers pregnancy and birth control, I can't make a choice to purchase a lower cost plan. As long as government is involved in any business transaction, it will cost vastly more. Half of the cost of our medical system today is government required documentation
          Noting that for-profit institutions (comparable, both have full campus, etc.) of higher education tend to charge more for a degree than a gummint-run institution, you can explain how that translates to a greater efficiency. We observe that you provided no link to back up your claim that half the cost of our medical system is spent on gummint regulations ("documentation"). While you dig that one up, let's see what my previous post link has to say on that issue...
          A more recent cross-national study of total administrative costs of hospitals, including also costs other than billing insurers, found that “the proportion of hospital costs devoted to administration was highest in the United States, at 25.3%” and that “reducing US per capita spending for hospital administration to Scottish or Canadian levels would have saved more than $150 billion in 2011” in hospital costs alone. In its 2012 The Best Care at Lower Cost report, the Institute of Medicine estimated that excess administrative costs in US health care in 2009 amounted to $190 billion.
          http://jamanetwork.com/journals/jama...rticle/2631518

          Gosh. What a surprise. Some people insist that for-profits will solve this whole problem, without explaining why a for-profit business would be remotely interested in providing a product or service to masses of people who can't afford to pay for it. We are pissing away a lot of time and money arguing about that very claim, rather than studying other countries that already jumped thru the circus hoops. Look at why we are arguing about an issue that is already settled (the target consumer of every for-profit enterprise). Then bury the issue and move on to more important ideas and solutions. Doesn't mean the for-profits won't participate in health care, it just means they will be participating as partners with other sectors; non-profits and gov't. are also involved for this to work.

          מה מכילות החדשות?


          • Originally posted by radcentr View Post
            Noting that for-profit institutions (comparable, both have full campus, etc.) of higher education tend to charge more for a degree than a gummint-run institution, you can explain how that translates to a greater efficiency. We observe that you provided no link to back up your claim that half the cost of our medical system is spent on gummint regulations ("documentation"). While you dig that one up, let's see what my previous post link has to say on that issue...

            http://jamanetwork.com/journals/jama...rticle/2631518

            Gosh. What a surprise. Some people insist that for-profits will solve this whole problem, without explaining why a for-profit business would be remotely interested in providing a product or service to masses of people who can't afford to pay for it. We are pissing away a lot of time and money arguing about that very claim, rather than studying other countries that already jumped thru the circus hoops. Look at why we are arguing about an issue that is already settled (the target consumer of every for-profit enterprise). Then bury the issue and move on to more important ideas and solutions. Doesn't mean the for-profits won't participate in health care, it just means they will be participating as partners with other sectors; non-profits and gov't. are also involved for this to work.
            Why don't the pubs give it up and admit that they are not smart enough to do health care. Susan Collins is the kind of republican I could vote for.

            מה מכילות החדשות?


            • Originally posted by radcentr View Post
              Noting that for-profit institutions (comparable, both have full campus, etc.) of higher education tend to charge more for a degree than a gummint-run institution, you can explain how that translates to a greater efficiency. We observe that you provided no link to back up your claim that half the cost of our medical system is spent on gummint regulations ("documentation"). While you dig that one up, let's see what my previous post link has to say on that issue...

              http://jamanetwork.com/journals/jama...rticle/2631518

              Gosh. What a surprise. Some people insist that for-profits will solve this whole problem, without explaining why a for-profit business would be remotely interested in providing a product or service to masses of people who can't afford to pay for it. We are pissing away a lot of time and money arguing about that very claim, rather than studying other countries that already jumped thru the circus hoops. Look at why we are arguing about an issue that is already settled (the target consumer of every for-profit enterprise). Then bury the issue and move on to more important ideas and solutions. Doesn't mean the for-profits won't participate in health care, it just means they will be participating as partners with other sectors; non-profits and gov't. are also involved for this to work.
              Yes, those other countries that are the size of Oklahoma.

              מה מכילות החדשות?


              • Originally posted by OldmanDan View Post

                Yes, those other countries that are the size of Oklahoma.
                ...Or Texas (compare to France). Or bigger than Texas, if we look at all of western Europe. Back to the serious question, which I'd like anyone (Bernie Sanders, where are you?) to ask the Capitalist Unicorns in Congress: "If you think that capitalism is the only economic sector that should handle health care, how will they provide expensive medical procedures to all working people, the majority of whom can't afford those procedures out of pocket?" I know Ryan and Paul would give an honest unicorn answer (insert horse "whinny", here). The others on the right would pretend to answer, while doing an impressive dance to avoid going anywhere near one of two positions: Rand or Realist.

                The lefties in Congress? Maybe they fail to go realist because "challenging" capitalism is easily labelled as "communist" (or better, "Islamo-fascist" for extra "zing"). This isn't an attack on capitalism, lefties. It is a challenge to understand capitalism, and press one's opponents to understand it's benefits and limits as well., Capitalism (unsubsidized) only works when the customer base can afford their products. Pretty easy, no attack on a recognized human instinct (to profit on some situations) is needed. No leftist hypocrisy is practiced (fe the socialist complaining about Big Business as he drives his Toyota vehicle down the road). Just a simple statement on the limits of capitalism to provide some products or services, for a simple reason -cost/profit has to work.

                -Capitalism does work for producing machines and other durable products in medical care. Volume, or mass production lowers cost. Likewise, it works in some aspects of pharmaceutical development. Some medications were/are subsidized by public university research labs, but others are independently developed and tested at low enough cost that most patients could afford them (IOW, capitalist-financed). Others could be tested on wealthy patients due to high up-front cost, with costs coming down later (fe generic drugs).

                Weave through all aspects of medical care, sort out which ones are best provided by capitalism, private non-profits, private optional (profit alternating with "break even", fe family owned business), or gov't. Piece it together, using the strategy proposed above (medical staff & patient advocacy groups provide first proposal, then industry giants/gov't. provide their proposal). I'm certain that once the socialists and capitalists accept the fact that their favorite economic system won't be the Comic Book Hero that Rescues Everything, a solution can be found.

                מה מכילות החדשות?


                • Originally posted by radcentr View Post
                  ...Or Texas (compare to France). Or bigger than Texas, if we look at all of western Europe. Back to the serious question, which I'd like anyone (Bernie Sanders, where are you?) to ask the Capitalist Unicorns in Congress: "If you think that capitalism is the only economic sector that should handle health care, how will they provide expensive medical procedures to all working people, the majority of whom can't afford those procedures out of pocket?" I know Ryan and Paul would give an honest unicorn answer (insert horse "whinny", here). The others on the right would pretend to answer, while doing an impressive dance to avoid going anywhere near one of two positions: Rand or Realist.

                  The lefties in Congress? Maybe they fail to go realist because "challenging" capitalism is easily labelled as "communist" (or better, "Islamo-fascist" for extra "zing"). This isn't an attack on capitalism, lefties. It is a challenge to understand capitalism, and press one's opponents to understand it's benefits and limits as well., Capitalism (unsubsidized) only works when the customer base can afford their products. Pretty easy, no attack on a recognized human instinct (to profit on some situations) is needed. No leftist hypocrisy is practiced (fe the socialist complaining about Big Business as he drives his Toyota vehicle down the road). Just a simple statement on the limits of capitalism to provide some products or services, for a simple reason -cost/profit has to work.

                  -Capitalism does work for producing machines and other durable products in medical care. Volume, or mass production lowers cost. Likewise, it works in some aspects of pharmaceutical development. Some medications were/are subsidized by public university research labs, but others are independently developed and tested at low enough cost that most patients could afford them (IOW, capitalist-financed). Others could be tested on wealthy patients due to high up-front cost, with costs coming down later (fe generic drugs).

                  Weave through all aspects of medical care, sort out which ones are best provided by capitalism, private non-profits, private optional (profit alternating with "break even", fe family owned business), or gov't. Piece it together, using the strategy proposed above (medical staff & patient advocacy groups provide first proposal, then industry giants/gov't. provide their proposal). I'm certain that once the socialists and capitalists accept the fact that their favorite economic system won't be the Comic Book Hero that Rescues Everything, a solution can be found.
                  "If you think that single payer is the only economic sector that should handle health care, how will they provide expensive medical procedures to all working people, the majority of whom can't afford those procedures out of pocket?" Where will the money come from?

                  מה מכילות החדשות?


                  • Originally posted by OldmanDan View Post

                    "If you think that single payer is the only economic sector that should handle health care, how will they provide expensive medical procedures to all working people, the majority of whom can't afford those procedures out of pocket?" Where will the money come from?
                    Good question. I don't know. Just as you don't know how a "pure capitalist" system could afford to provide those same procedures. As I said, time to get started on a realistic solution. I'm sure the both of us would object to some aspects of the solution, since it won't fit our conception of "proper" socialism or capitalism in healthcare. But, if it functions well, that is the objective.

                    מה מכילות החדשות?


                    • Originally posted by radcentr View Post

                      Good question. I don't know. Just as you don't know how a "pure capitalist" system could afford to provide those same procedures. As I said, time to get started on a realistic solution. I'm sure the both of us would object to some aspects of the solution, since it won't fit our conception of "proper" socialism or capitalism in healthcare. But, if it functions well, that is the objective.
                      Before health insurance was invented, we pretty much had a free market health care system. Prices didn't escalate hugely because people couldn't pay them. Then insurance came along and prices shot through the roof because someone else was paying the bill. Programs like medicare and medicaid came along and did the same because someone else was paying the bill. The free market only works when it is allowed to work without outside influence.

                      מה מכילות החדשות?


                      • Before medicare, before prices escalated in the double digits, there were few major (and costly) procedures that even existed. Open heart surgery, cancer treatment, organ transplants to name a few.

                        The good old days of general practice, stitches for cuts, basic lab tests, other treatments of less serious ailments. That cost less, and still does. Maybe a couple of exceptions, like setting compound fractures or C-section birthing, but even those costs could still be afforded by regular insurance or paying out of pocket, compared to the cost of recent medical advances. If one wishes to prohibit the working class from expecting the more expensive procedures, why not propose that in Congress, OMD? Because they would lose elections to those who would include the working class for things like cancer treatment. The alternative is providing hospice care and opioid script for less painful checkouts, while advising families to make sure their life insurance is up to date. Ryan and Paul are prepared for that strategy, but that's a very small minority.

                        BTW, do you think organ transplants would suddenly become affordable if only 10% of the current patient base expected and received them? That is ignoring the cost of organization, education, technology and materials necessary to perform an organ transplant. It wasn't gov't. or insurance that determines most of that cost, either. Once robots can do the surgery, and organs can be "cultivated" from the recipient's tissue at low cost, (maybe) then it becomes affordable to the working man. Until then, it's expensive, for reasons that should be obvious. Too expensive to afford without subsidy.

                        מה מכילות החדשות?


                        • Originally posted by radcentr View Post
                          Before medicare, before prices escalated in the double digits, there were few major (and costly) procedures that even existed. Open heart surgery, cancer treatment, organ transplants to name a few.

                          The good old days of general practice, stitches for cuts, basic lab tests, other treatments of less serious ailments. That cost less, and still does. Maybe a couple of exceptions, like setting compound fractures or C-section birthing, but even those costs could still be afforded by regular insurance or paying out of pocket, compared to the cost of recent medical advances. If one wishes to prohibit the working class from expecting the more expensive procedures, why not propose that in Congress, OMD? Because they would lose elections to those who would include the working class for things like cancer treatment. The alternative is providing hospice care and opioid script for less painful checkouts, while advising families to make sure their life insurance is up to date. Ryan and Paul are prepared for that strategy, but that's a very small minority.

                          BTW, do you think organ transplants would suddenly become affordable if only 10% of the current patient base expected and received them? That is ignoring the cost of organization, education, technology and materials necessary to perform an organ transplant. It wasn't gov't. or insurance that determines most of that cost, either. Once robots can do the surgery, and organs can be "cultivated" from the recipient's tissue at low cost, (maybe) then it becomes affordable to the working man. Until then, it's expensive, for reasons that should be obvious. Too expensive to afford without subsidy.
                          Because there is no supply and demand in the marketplace. What downward force is there on the cost of anything in the medical field? Everyone knows or expects that deep pockets federal government will be there to pay the bill if the patient can't.

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                          • "Republicans" great promises LOL

                            A lot of talk and no action.

                            They just look boring & stupid

                            ---------------------------------

                            ....

                            If decent health insurance is off the table, we should at least demand that Republicans entertain us.

                            http://www.anncoulter.com/columns/20...html#read_more

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                            • Originally posted by OldmanDan View Post

                              Because there is no supply and demand in the marketplace. What downward force is there on the cost of anything in the medical field? Everyone knows or expects that deep pockets federal government will be there to pay the bill if the patient can't.
                              Piece of cake, as far as putting downward pressure on prices. Examples:
                              -Specialist MD's charging Big Bucks for their treatment, without exception? Gov't. offers a deal to those medical students of high skill and low income: You work at discount rates in non-profits or gov't. hospitals (state/local or federal) for 10 years, and your medical degree from a land grant university is paid in full. That 10 years is an additional 3 years over the newly graduated student's 7-year residence, and they get a nice bump for their resume if or when they jump into that comfy position as a specialist in the private sector.
                              -Allow the gummint to negotiate prices on meds (medicare/medicaid). You already knew that the gummint is prohibited from negotiating price lists for meds, didn't you? What a strange law that is, proposed and passed by people who claim to be pro-capitalist. What capitalist would prohibit a consumer from attempting to negotiate the price for a product or service? No capitalist that I know of. If the US pharm industry is responsible for this little gem of a law, then allow the US gov't. to negotiate with Canadian pharmacies. They'll cave soon enuf, and negotiate, like the capitalists they claim to be.
                              -A more difficult idea follows: The gov't. tells the unwashed masses (IOW, almost all of us) that we're not going to get Buck Rogers level of chemotherapy, organ transplants, etc. The expensive tier of medical care is going to be tested on those who can better afford it, but not on me. Maybe some day, costs will come down and the average citizen gets a cloned organ when one fails. Not a big deal, since the mediocre treatment we get from lower cost specialties is still better than the treatment got by 90% of the world's population. This is going to be a tough sell for obvious reasons. I'm a big boy and can accept the reality of cost vs.fancy treatment on a mass scale. Some voters are going to balk at that political pitch, however. It means a persistent, broad coalition of politicians, right to left, that are brave enough to explain that condition to the nation, and stick to it. If a significant number of politicians cave in, try to promise the cutting edge (most expensive) treatment to everyone, then this last idea to cut costs will fail. It's obvious that my fellow lefties in political office would promise the Best for Everyone, but the right is also subject to corruption on this issue. They will subsidize cutting edge technology (fe using resources from land grant universities), but fail to negotiate an IOU with the companies/hospitals developing the Fancy Treatment. That might be good for Senator Righty's future career at the medical institution, but voters need to pay attention and vote out those party sociopaths who fail to set up a proper quid pro quo: The institute cuts back the patent time as a sign of gratitude for help received from the university research system. New technique hits the whole market sooner, dropping prices more quickly.

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                              • Originally posted by radcentr View Post
                                Piece of cake, as far as putting downward pressure on prices. Examples:
                                -Specialist MD's charging Big Bucks for their treatment, without exception? Gov't. offers a deal to those medical students of high skill and low income: You work at discount rates in non-profits or gov't. hospitals (state/local or federal) for 10 years, and your medical degree from a land grant university is paid in full. That 10 years is an additional 3 years over the newly graduated student's 7-year residence, and they get a nice bump for their resume if or when they jump into that comfy position as a specialist in the private sector.
                                -Allow the gummint to negotiate prices on meds (medicare/medicaid). You already knew that the gummint is prohibited from negotiating price lists for meds, didn't you? What a strange law that is, proposed and passed by people who claim to be pro-capitalist. What capitalist would prohibit a consumer from attempting to negotiate the price for a product or service? No capitalist that I know of. If the US pharm industry is responsible for this little gem of a law, then allow the US gov't. to negotiate with Canadian pharmacies. They'll cave soon enuf, and negotiate, like the capitalists they claim to be.
                                -A more difficult idea follows: The gov't. tells the unwashed masses (IOW, almost all of us) that we're not going to get Buck Rogers level of chemotherapy, organ transplants, etc. The expensive tier of medical care is going to be tested on those who can better afford it, but not on me. Maybe some day, costs will come down and the average citizen gets a cloned organ when one fails. Not a big deal, since the mediocre treatment we get from lower cost specialties is still better than the treatment got by 90% of the world's population. This is going to be a tough sell for obvious reasons. I'm a big boy and can accept the reality of cost vs.fancy treatment on a mass scale. Some voters are going to balk at that political pitch, however. It means a persistent, broad coalition of politicians, right to left, that are brave enough to explain that condition to the nation, and stick to it. If a significant number of politicians cave in, try to promise the cutting edge (most expensive) treatment to everyone, then this last idea to cut costs will fail. It's obvious that my fellow lefties in political office would promise the Best for Everyone, but the right is also subject to corruption on this issue. They will subsidize cutting edge technology (fe using resources from land grant universities), but fail to negotiate an IOU with the companies/hospitals developing the Fancy Treatment. That might be good for Senator Righty's future career at the medical institution, but voters need to pay attention and vote out those party sociopaths who fail to set up a proper quid pro quo: The institute cuts back the patent time as a sign of gratitude for help received from the university research system. New technique hits the whole market sooner, dropping prices more quickly.
                                Again, fantasy land. No politician who wants to get reelected would support any of that. If a Republican proposed any of that, the left wing MSM would have him for lunch.

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