tag:blogger.com,1999:blog-8193628934721963907.post4632240527030097479..comments2024-03-28T02:32:09.047-05:00Comments on Give2Attain: Who Demands Compliance? DEM or GOPJohnhttp://www.blogger.com/profile/14991027705809503541noreply@blogger.comBlogger51125tag:blogger.com,1999:blog-8193628934721963907.post-68591123141759868862017-07-10T09:12:15.708-05:002017-07-10T09:12:15.708-05:00"We just have a whole lot of well paid people..."We just have a whole lot of well paid people in the system."<br /><br />And yet that marketplace is badly distorted by government regulation. Medicare tells doctors they can only get, say, $250 for an appendectomy (I have no idea, but) the doctor doesn't make a penny unless he charges at least $500. So he makes it up somewhere else or refuses to do it. If the doctor could charge, say $550, he might get "rich," but do we really want to hire the low-cost bidder for something like that? <br /><br />And by law, all insurance companies in Minnesota are "non-profit." Why would anybody get into that business? <br /><br />In fact, the whole idea seems illogical to me. If we had a free (or mostly free) market in health care, prices would be set by the millions of individual choices and implicit contracts made between providers and patients-- sellers and buyers. The best and/or scarcest goods and services would make those providers "rich" and everybody else would enter the market at the point where they saw a beneficial exchange, or exit the business for lack of business. Absolutely nothing wrong with that. jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-26599816650141266292017-07-10T09:01:46.599-05:002017-07-10T09:01:46.599-05:00Actually, they aren't mine; they come from a M...Actually, they aren't mine; they come from a Mayo study many years ago. They are:<br />1. Eliminate first dollar coverage. Every use of the system costs /something/ (a copay, IOW). <br />2. Eliminate fee-for-service. This is the big one. Rather than doing what is the quickest and best treatment, doctors are led to do what pays the best or, more likely, to add on something unnecessary just to cover their costs.<br />3. Eliminate third-party payers. Forget single-payer. Everybody pays their own fees or buys insurance on their own. If they get a stipend or a tax credit to do so, that's their own affair. <br />4. Eliminate defensive medicine. The malpractice system is out of control and drives up costs, not directly, but indirectly. <br /><br />To that we should add, now, deregulation of the health insurance industry. If I want, I should be able to buy a "catastrophic only" policy, or open an HSA or "prepaid care account," without government telling me I can't.jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-8019230580886379702017-07-10T08:51:37.982-05:002017-07-10T08:51:37.982-05:00It is also beneficial to many many millions of cit...It is also beneficial to many many millions of citizens who are employed in or indirectly benefit from the expensive and complicated system.<br /><br />From research labs to implantable companies to healthcare employees to IT companies to Accounting firms to insurance companies to companies near all of the above and on and on.<br /><br />The money doesn't just disappear into the pockets of wealthy people. We just have a whole lot of well paid people in the system.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-59410605111599310362017-07-10T06:58:17.502-05:002017-07-10T06:58:17.502-05:00Anyone who has spent time in the system sees ways ...Anyone who has spent time in the system sees ways to save money. America's health care system is structured to generate fees. That's the result of a Darwinian natural selection process, since it's a fee based system. The practical problem in undoing this system is quite simply immense since it means undoing the assumptions at the very heart of the system that are incredibly beneficial to incredibly powerful and wealthy people. It's like emptying an ocean one teaspoon at a time.<br /><br />--HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-3728214151523519122017-07-09T19:56:24.604-05:002017-07-09T19:56:24.604-05:00Please feel free to share these again.
"four...Please feel free to share these again.<br /><br />"four changes would reduce our total costs by about 50% without affecting quality"<br /><br />I'll post them as Jerry's Healthcare Improvement ideas, so do a good job with the rationale.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-7133477389443001222017-07-09T19:17:49.566-05:002017-07-09T19:17:49.566-05:00Healthcare requires money. Well said, but it make...Healthcare requires money. Well said, but it makes the glaringly erroneous assumption that the only way to deliver health care is exactly the way it is done today. As I've said before, four changes would reduce our total costs by about 50% without affecting quality. So should we NOT do those things, just because we might be able to lower taxes for somebody? I'm not understanding the reasoning, here. It looks like an attempt to keep a political argument alive, regardless of what the "right thing to do" might be. <br /><br />jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-45434047779635080042017-07-09T17:24:09.572-05:002017-07-09T17:24:09.572-05:00Jerry,
Keep believing as you wish...
Healthcare r...Jerry,<br />Keep believing as you wish...<br /><br />Healthcare requires money to pay the bills.<br />If the successful folks pay less, there is less money to do so.<br /><br />Even quite a few of the GOP Senators have figured that out. (ie latest post)Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-50274094615775430612017-07-09T16:24:52.809-05:002017-07-09T16:24:52.809-05:00Fairness lies not in equal outcomes but in equal o...Fairness lies not in equal outcomes but in equal opportunity. Those who have a rich Daddy and know how to make jewelry will fare better than those with no capital, two kids and no work ethic.<br /><br />So, let's talk real terms. Under the AHCA, Medicaid funding would increase roughly 50% in 10 years. Everyone now getting it would be grandfathered in so nobody "loses their health care." Things are turned back to the states, who have proven capable of more efficient and effective management. So, are the people claiming "people will lose health care to give tax cuts to the rich" lying, or simply repeating spurious Democrat talking points?jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-65874826680790253952017-07-09T15:08:00.966-05:002017-07-09T15:08:00.966-05:00I keep saying, the successful folks would save mon... I keep saying, the successful folks would save money and the unsuccessful folks would lose their medicaid and subsidies.<br /><br />Depends on what you mean by success. Lots of people who many people see as successful are broke. Donald Trump who many regard as a succesful businessman went bankrupt four times. On the other there are lots of people who have led rather ordinary lives who are in fact quite wealthy.<br /><br />As for whether taxing the Rich to pay for Health Care of the poor is "fair" or "unfair". <br /><br />Lots of things are fair and unfair. Was it unfair that Trump was wealthy enough to find a doctor who would get him out the army during the Vietnam era? It's arguable. Is it fair that the men and women who put their lives on the line today in the middle east are paid less than daughters of rich guys who market costume jewelry? Who really gets the better of the deal. Taxpayer who may for the military, or the wealthy folks who pay their wages? Where does the fairness lie?<br /><br />--HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-68122041897693327082017-07-09T15:02:34.223-05:002017-07-09T15:02:34.223-05:00So, putting taxes back the way they were is someho...So, putting taxes back the way they were is somehow a "tax cut for the rich"?<br /><br />If it isn't a tax cut for the rich why not just leave the money in Obamacare?<br /><br />But again, this is why Republicans govern so badly. They think see issues like health care and tax burdens can be meaningfully solved by quibbles and plays on words. Semantics can't cure the flu.<br /><br />--HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-73055123013963073832017-07-09T14:46:12.938-05:002017-07-09T14:46:12.938-05:00Yes it would be budget neutral... And from this po...Yes it would be budget neutral... And from this point in time it would be a tax cut..<br /><br />As I keep saying, the successful folks would save money and the unsuccessful folks would lose their medicaid and subsidies.<br /><br />Remember where this discussion has been.<br /><br />"rob people of health care to give tax breaks to the rich"<br /><br />As for whether taxing the Rich to pay for Health Care of the poor is "fair" or "unfair". I think it is likely unfair and yet necessary / effective since us citizens are not willing to make bigger different changes to eliminate poverty in our country.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-56133807107987823092017-07-09T13:30:33.874-05:002017-07-09T13:30:33.874-05:00If the taxes were added specifically to fund the A...If the taxes were added specifically to fund the ACA, then repeal of those taxes would be a budget neutral arrangement if the expenditures were also eliminated. So, putting taxes back the way they were is somehow a "tax cut for the rich"? The ACA taxes were unfairly targeting the rich? Both, or neither? <br /><br />And how much in taxes should government be spending before we cross into "forced compliance" territory? jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-73937146991696744602017-07-09T11:57:27.221-05:002017-07-09T11:57:27.221-05:00Jerry,
Since the taxes were added specifically to ...Jerry,<br />Since the taxes were added specifically to fund ACA, and they would be removed with the repeal of ACA... I think there is a pretty clear linkage in this case.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-36259926196875562592017-07-09T10:36:17.929-05:002017-07-09T10:36:17.929-05:00By the way, another odd thing I see a lot is the e...By the way, another odd thing I see a lot is the equation of having an opinion with having a bias. When did that happen?<br /><br />==HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-59126626039265080382017-07-09T08:24:34.171-05:002017-07-09T08:24:34.171-05:00I never have quite understood the benefit of drawi...I never have quite understood the benefit of drawing a line between something and how we pay for that something. In real life, the cost of things has an impact on the choices we make. It's a factor in a decision to go to the cabin for a vacation, and not to Europe. In health care, financial considerations are at play all the time. It's why we have some things and don't have others. It's why Mitch McConnell with his government paid health care, feels so comfortable in putting the health care of others who aren't lucky enough to have government jobs, at risk. As anyone who has dealt with insurance companies knows, what insurers will pay for and how they will pay for it, routinely affects care decisions.<br /><br />Generally speaking, Republicans govern badly because they allow political considerations to blind them as to how money works. This insistence that health care and how we pay for it are not intertwined is just one example of that.<br /><br />--HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-60879675004318003262017-07-09T08:22:42.310-05:002017-07-09T08:22:42.310-05:00If one stops funding for, say, Medicaid, then the ...If one stops funding for, say, Medicaid, then the Medicaid program gets less. It does NOT mean that the rich get any benefit at all. There is no linkage except in the mind of liberals. Pardon the insult. <br /><br />If, on the other hand, one slows the rise of Medicaid funding by adding efficiencies and "targeting" the most needy, how is that a bad thing? So on both ends of this meme, there is a hatred of anything and everything that doesn't increase government control. And remember, Medicaid as it is is the largest contributor to the debt and deficit, while producing essentially zero benefits for the recipients. Rightfully the whole program should be phased out and replaced with something better. A "public option" as Sean suggests and just following the words not Sean's meaning, might be one such solution. I'm thinking it would be some sort of "premium support" arrangement, or perhaps a refundable tax credit for purchase of private insurance.jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-49703738927587262642017-07-09T08:15:40.438-05:002017-07-09T08:15:40.438-05:00Let's consider Sean's suggestions. I didn...Let's consider Sean's suggestions. I didn't want to be rude, but notice the language-- "extend subsidies ...[to cover] rising premium costs", "increase penalties", "institute a public option", "payments where there is low competition." <br /><br />Don't those sound like they are all INCREASING government's control, stifling competition and arbitrarily driving total costs UP? Isn't the question of "who pays" one of government control versus individual freedom and responsibility? With a single payer system (which is what Obamacare intends to be) in which government pays for health care, do they not get to control your life and tell you that you cannot smoke or drink or vote Republican? jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-16747181930847933772017-07-09T08:01:57.110-05:002017-07-09T08:01:57.110-05:00And now I am a Liberal again...
"rob people ...And now I am a Liberal again...<br /><br />"rob people of health care to give tax breaks to the rich"<br /><br />This isn't an opinion it is just a fact... The rich and most all of us who pay income taxes are paying more... And that money is paying for the medicaid expansion and the subsidies.<br /><br />If one stops the funding source... The medicaid expansion and the subsidies go away unless another funding source is found.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-53923011162824810652017-07-09T07:57:45.737-05:002017-07-09T07:57:45.737-05:00Now with almost all low income people getting addi...Now with almost all low income people getting additional fiscal support through expanded medicaid or the subsidies, I am assume cost is less of an issue for them.<br /><br />As for the other issues. Please refere to <a href="http://give2attain.blogspot.com/2017/06/seans-healthcare-improvement-plan.html" rel="nofollow">Sean's proposed solutions</a>Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-36131535439607052502017-07-09T07:51:54.219-05:002017-07-09T07:51:54.219-05:00Now back to some actual facts and data. Pre ACA Ga...Now back to some actual facts and data. <a href="http://www.gallup.com/poll/123149/Cost-Is-Foremost-Healthcare-Issue-for-Americans.aspx" rel="nofollow">Pre ACA Gallup Poll</a><br /><br />Please remember what I have been saying... ACA did little to change healthcare in America, it mostly changed who was paying which bills.<br /><br />"Americans are broadly satisfied with the quality of their own medical care and healthcare costs, but of the two, satisfaction with costs lags. Overall, 80% are satisfied with the quality of medical care available to them, including 39% who are very satisfied. Sixty-one percent are satisfied with the cost of their medical care, including 20% who are very satisfied."<br /><br />""Close to 4 in 10 Americans (38%) -- by far the largest percentage mentioned for any issue -- cite the cost or affordability of healthcare as the nation's biggest healthcare problem.""<br />Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-30006053236399246362017-07-09T07:37:23.186-05:002017-07-09T07:37:23.186-05:00Sorry, just looked at the link. "Given what ...Sorry, just looked at the link. "Given what you know about..." It isn't surprising that you get to 50% approval. Most people are either uninformed or un-impacted by the law, or most likely both. The best evidence we have says that 10.5 million people approve, because they have signed up rather than paid the penalty. Put everybody else in the "approve or indifferent" column. <br /><br />And what is this "rob people of health care to give tax breaks to the rich" meme? Shouldn't you liberals find a new talking point every decade or so?jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-3530009828541492482017-07-09T07:25:07.296-05:002017-07-09T07:25:07.296-05:00Well, 86% of people were happy with the system BEF...Well, 86% of people were happy with the system BEFORE the ACA, too. <br /><br />The parents first asked to be allowed to take the child home to die and were denied. Then they asked to be allowed to take him for alternate treatment and were denied. Once the "medical professionals" decided he had to die "for his own good," they seized control that did not belong to them. They essentially acted as a "death panel," regardless of what was in the best interest of the child OR of the parents morally and (it used to be) legally responsible. jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-70282482185244422112017-07-08T22:55:43.294-05:002017-07-08T22:55:43.294-05:00Please remember that the majority of Americans app...Please remember that the majority of <a href="http://www.kff.org/interactive/kaiser-health-tracking-poll-the-publics-views-on-the-aca/#?response=Favorable--Unfavorable&aRange=twoYear" rel="nofollow">Americans approve of ACA</a> after years of living under it.<br /><br />Actually the court is acting upon the guidance of the medical professionals. Just as we do here when the Parents want to do something that is deemed harmful to the child. In this case the Parents are recommending a path that has little hope and is putting the child through pain. Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-69887779845147071052017-07-08T15:43:59.964-05:002017-07-08T15:43:59.964-05:00"Otherwise it was overall a good idea."
..."Otherwise it was overall a good idea."<br /><br />How would anybody know it was a good idea? We heard lots of promises and good intentions, but we had to "pass it to find out what's in it" and we did it without a single Republican vote. If it had any merit at all, wouldn't at least one Republican have signed on? The insurance companies are bailing out. The rollout of the exchanges was deeply flawed. Average premiums have gone UP an average of $3500. People are dropping out of Obamacare because they cannot afford it. Only half the people expected to be covered did so, and we only expected half of the uninsured to get it. Over 1 million people in Texas alone paid the penalty rather than buy something they didn't want and couldn't afford. Nobody understood the thing well enough when it was passed, I fail to see why we should try to untangle it now. Just ditch it and start over. <br /><br />As for Charlie Gard, it is STRICTLY about their system. The boy, regardless of his state, is being kept against his parents' will and by ruling of the government courts. Had things not changed (today), his death would have been ordered by the courts. Who should control in this tragic situation, the government or the parents?<br /><br /><br />jerrye92002https://www.blogger.com/profile/01858692298982859775noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-89330176889261499722017-07-08T13:41:10.539-05:002017-07-08T13:41:10.539-05:00As for Charlie Gard, it seems to me that terminati...As for <a href="http://www.independent.co.uk/news/uk/home-news/charlie-gard-mother-connie-yates-donald-trump-pope-offer-help-not-in-pain-terminally-ill-baby-boy-a7828601.html" rel="nofollow">Charlie Gard</a>, it seems to me that terminating life support is the correct things to do.<br /><br />And it looks like it has nothing to do with their single payer system.<br /><br />It is so strange that you are happy to rob people of healthcare insurance to give wealthy people tax breaks and yet you are concerned about an 11 month old brain damaged infant and want to let people use him as a lab rat.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.com