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Thread: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Who here has some consistent medical problem here? Diabetes, heart problems, etc...?

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by cpwill View Post
    precisely. he, like the Democrats, prefers non-solutions and cowardice that nonetheless comes along with easier electoral politics.
    You make as large a leap as the person I responded to.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by cpwill View Post
    precisely. he, like the Democrats, prefers non-solutions and cowardice that nonetheless comes along with easier electoral politics.
    Incorrect as you usually are. I prefer getting rid of all the waste in the healthcare industry. Let Medicare negotiate drug prices and the lot just as private insurance does. End unneeded prescriptions and procedures, don't forget Drs. are out to make a dollar too and are not going to cause themselves any losses, nor do I blame them, and make record keeping more efficient. All these things will save the system money.

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by cpwill View Post
    that is generally true - it does provide less. but both "plans" do that. the question is not whether we want to provide less, it's how do we want to provide less.

    Do we want individuals and their doctors deciding what to cut?
    Or do we want an unaccountable board of bureaucrats deciding when your care is no longer cost effective for the government?

    Do we want to make the cuts across the board, and those who can make up the difference themselves do so?
    Or do we want to means-test the entitlements to provide more help to the poor and less to the rich?

    Do we want to make the cuts Right Now, and just hope Seniors can keep up?
    Or do we want to give retirees time to plan for the newer system with fewer benefits?

    Do we want to keep the current payout structure, which drives up prices?
    Or do we want to introduce market pressure into the payout structure, which has a dampening effect on prices?




    THESE are the questions at hand. Not whether or not we want to cut medicare expenditures. Nobody wants to cut medicare expenditures. As we have no choice, it's the how that becomes the issue.
    You continue to present false choices. The government doesn't decide when your care is cost effective. Like your insurance company they decide when effective efforts they will pay for. Your are not forbidden for paying for more through other means. This is but one example of how you misrepresent the issue. Yes, there are choices that need to be addressed, but they must be presented honestly. And with neither the kill granny or the death panel silliness.

    And there is no evidence a completely market driven system would lower prices or increase access. That is more fanasty than anything else.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by tlmorg02 View Post
    Incorrect as you usually are. I prefer getting rid of all the waste in the healthcare industry.
    awesome. but you realize that A) this is an unattainable goal and B) if you want to nonetheless serious progress in it, you have to systemically alter Medicare in order to alter incentives?

    there is no "get rid of waste fraud and abuse" magic button - and whoever has sold you on the notion that there are serious savings to be had there is a fool or a fraud themself. When you hear someone on the television say they want to stick to getting rid of waste fraud and abuse, that's code for "I have no idea".

    Let Medicare negotiate drug prices and the lot just as private insurance does. End unneeded prescriptions and procedures, don't forget Drs. are out to make a dollar too and are not going to cause themselves any losses, nor do I blame them, and make record keeping more efficient. All these things will save the system money.
    not much. Medicare goes bankrupt within the decade - and, while we should certainly look into finding ways to alter the structure in order to reduce waste, your idea is sort of like trying to damn the Mississippi with a single sandbag.

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by Boo Radley View Post
    You continue to present false choices. The government doesn't decide when your care is cost effective.
    that is, in fact, the purpose of the IPAB.

    Like your insurance company they decide when effective efforts they will pay for.
    except that your insurance agency is beholden to you by contract to provide a set of services or face legal suit. the IPAB isn't beholden to give you anything it decides it does not want to spend the money on, and was deliberately made immune from suit.

    Your are not forbidden for paying for more through other means
    that is true - you are free to pay out of pocket. which will be easier for some than others, and is why I support means-testing.

    And there is no evidence a completely market driven system would lower prices or increase access.
    completely? who is talking about completely?

    as for introducing market pressure to drive down costs and expenditures?

    Indiana offered HSA's, which have patients save money in tax-free accounts (where it grows and remains theirs forever and ever unless theys pend it) matched with high deductible plans to it's employees. Employees began to respond to price signals, and medical costs per patient were reduced by 33% and expenditures to the state were reduced by 11%.

    Safeway has instituted a program that gave financial incentives to people who engaged in healthy behavior by allowing price signals in the insurance side of the market to work (Indiana worked on the medical side), and saw it's per-captia health care costs remain flat from 2005-2009; when most companies saw theirs jump by 38%.

    Whole Foods instituted HSA's, and let's the employees choose what they want the company to fund. This institutes price pressure on the medical side (WF covers the high-deductible plan 100%), and their CEO points out that as a result Whole Foods' per-capita costs are much lower than typical insurance programs, while maintaining employee satisfaction.

    Medicare Part D utilized market pressure on the insurance side, and saw expenditures come in at 40% UNDER expenditures - the only such government program in history to do so.

    Wendy's instituted HSA's, and saw the number of their employees who got preventative and annual checkup care climb even as they saw claims decrease by 14% (in one year).

    Wal-Mart's low cost clinics and prescriptions save us oodles of cash. Wal-Mart reports that "half of their clinic patients report that they are uninsured" and that "if it were not for [Wal-Marts'] clinics they would haven't gotten care - or they would have gone to an emergency room". Walmart - reducing costs and expenditures.

    all of these utilize the markets to lower costs and expenditures; and they are just the begining. Not using insurance to pay for every procedure, checkup, etc. reduces administrative costs, which in turn reduces medical costs - and as HSA's catch on (assuming that Obamacare - which criminalizes them - is repealed) we will see the positive effects of that on costs and expenditures as well.

    Dr Robert Berry runs a practice called PATMOS (payment at time of service). he doesn't take insurance at all - but simply posts the prices of his services. By removing the cost of dealing with mutliple insurance agencies, medicare, and medicaid, the prices he is able to list are one half to ONE THIRD of standard. That's huge.

    what do all these programs have in common? They use market price pressure. People start to make better informed, and more conscious decisions once they are compensated for doing so.






    That is more fanasty than anything else.[/QUOTE]

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Then let us look at this another way, a scientific way. Should we even be attempting to prolong the lives of those who have inherited diseases? If we continue to treat those and prolong the life of those who are prone to diabetes and heart disease aren't we really ensuring that such traits are passed forward into the gene pool? Perhaps we should desire that those who need much medical attention due to their weak constitutions should simply die off and in the future their diseases will disappear with them.

    Of course this would dramatically cut costs and we could all save money. Isn't that what is most important saving money? I think not. Yet if we create a system where people will indeed lose more access to medical care, as will certainly happen with Ryan's plan because once it is privatized and people have to make-up the difference in cost, the rising costs will prevent people from going and the deaths from treatable diseases and conditions will increase. Thus, lets just push it along and once the Baby Boomers are thinned out substantially, Medicare will once again be sustainable and may continue. Right?

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by cpwill View Post
    that is, in fact, the purpose of the IPAB.
    No, it isn't. You are factually incorrect.


    except that your insurance agency is beholden to you by contract to provide a set of services or face legal suit. the IPAB isn't beholden to give you anything it decides it does not want to spend the money on, and was deliberately made immune from suit.
    Yeah, that has slowed down insurance comapnies a lot. As evidenced by them continuely offering less while charging more.

    that is true - you are free to pay out of pocket. which will be easier for some than others, and is why I support means-testing.
    Yes it will, and I doubt there is much opposition to means testing accept among voters.


    completely? who is talking about completely?
    OK, so you acknowledge the need for forces other than the free market, like the government?


    as for introducing market pressure to drive down costs and expenditures?

    Indiana offered HSA's, which have patients save money in tax-free accounts (where it grows and remains theirs forever and ever unless theys pend it) matched with high deductible plans to it's employees. Employees began to respond to price signals, and medical costs per patient were reduced by 33% and expenditures to the state were reduced by 11%.

    Safeway has instituted a program that gave financial incentives to people who engaged in healthy behavior by allowing price signals in the insurance side of the market to work (Indiana worked on the medical side), and saw it's per-captia health care costs remain flat from 2005-2009; when most companies saw theirs jump by 38%.

    Whole Foods instituted HSA's, and let's the employees choose what they want the company to fund. This institutes price pressure on the medical side (WF covers the high-deductible plan 100%), and their CEO points out that as a result Whole Foods' per-capita costs are much lower than typical insurance programs, while maintaining employee satisfaction.

    Medicare Part D utilized market pressure on the insurance side, and saw expenditures come in at 40% UNDER expenditures - the only such government program in history to do so.

    Wendy's instituted HSA's, and saw the number of their employees who got preventative and annual checkup care climb even as they saw claims decrease by 14% (in one year).

    Wal-Mart's low cost clinics and prescriptions save us oodles of cash. Wal-Mart reports that "half of their clinic patients report that they are uninsured" and that "if it were not for [Wal-Marts'] clinics they would haven't gotten care - or they would have gone to an emergency room". Walmart - reducing costs and expenditures.

    all of these utilize the markets to lower costs and expenditures; and they are just the begining. Not using insurance to pay for every procedure, checkup, etc. reduces administrative costs, which in turn reduces medical costs - and as HSA's catch on (assuming that Obamacare - which criminalizes them - is repealed) we will see the positive effects of that on costs and expenditures as well.

    Dr Robert Berry runs a practice called PATMOS (payment at time of service). he doesn't take insurance at all - but simply posts the prices of his services. By removing the cost of dealing with mutliple insurance agencies, medicare, and medicaid, the prices he is able to list are one half to ONE THIRD of standard. That's huge.

    what do all these programs have in common? They use market price pressure. People start to make better informed, and more conscious decisions once they are compensated for doing so.
    All within the context of existing aid and also limited. Take Dr. Berry. His program works because others take who he won't. If all followed suit, not only would prices overall not decrease enough to matter, but even more people would lack access, or be left with something truely inferior.


    That is more fanasty than anything else.
    Yes, the completely market driven system is prue fanasty. If you want elements incorporated in with other elements, we might agree. But that doesn't seem to be what you are really arguing.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by tlmorg02 View Post
    Who here has some consistent medical problem here? Diabetes, heart problems, etc...?
    I have type 2 Diabetes, but it is well controlled by diet and exercise (very proud that I lost better than 150 lbs and need no medication).

    However, my wife has a chronic issue with phobias that requires many meds. These are expensive, even with insurance. So, it is a chronic condition.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

    Quote Originally Posted by tlmorg02 View Post
    Then let us look at this another way, a scientific way. Should we even be attempting to prolong the lives of those who have inherited diseases? If we continue to treat those and prolong the life of those who are prone to diabetes and heart disease aren't we really ensuring that such traits are passed forward into the gene pool? Perhaps we should desire that those who need much medical attention due to their weak constitutions should simply die off and in the future their diseases will disappear with them.

    Of course this would dramatically cut costs and we could all save money. Isn't that what is most important saving money? I think not. Yet if we create a system where people will indeed lose more access to medical care, as will certainly happen with Ryan's plan because once it is privatized and people have to make-up the difference in cost, the rising costs will prevent people from going and the deaths from treatable diseases and conditions will increase. Thus, lets just push it along and once the Baby Boomers are thinned out substantially, Medicare will once again be sustainable and may continue. Right?
    hmm......and how do we develop cures if not for treating those with the disease?

    i am becoming more and more fond of the idea of taking the entire medical profession out of the private market.

    Originally Posted by johnny_rebson:

    These are the same liberals who forgot how Iraq attacked us on 9/11.


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