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Thread: Moderate Democrats are quitting on Obamacare

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by cpwill View Post
    No, lower. Thanks to the wonderful laboratory of Democracy, we actually have an increasingly good idea of what kinds of reforms are capable of reducing costs (or, at least, holding them steady) while continuing to provide equal or greater actual health care.

    The chief problem with our current healthcare system is an abundance of awkward and disruptive government interference. This has led to the dominance of a third-party-payment model which discourages cost-awareness and encourages over-consumption among health care consumers. Government pays for roughly half of our healthcare consumption, and of all third-party payment options, government is the one least likely to be capable or willing to nimbly find ways to impose cost awareness on those capable of sending it bills. The result is a healthcare system in which costs rapidly spiral out of control (we have a similar problem in our higher education industry). Any system which does not alter that disruption and incentivize cost-awareness among consumers for the vast majority of medical purchases will not address the chief underlying flaw of our current system, and we will continue to see costs spiral outside of the control of the citizenry and government.

    Reforms which have pushed cost-awareness back onto consumers have demonstrated impressive results at lowering 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".

    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 industry standard.

    So we know what works, because we've seen it. It's simply that implementing what works means less power in our nations capitals, which means less cash for our nations' politicians, which means less support for implementing it in the first place.



    Oh, we'll just magically "reroute" it. sure. We'll hit the "reroute" button because people treat purchasing goods and services exactly the same way they treat paying taxes.



    Yeah, raising taxes. Except as I've already demonstrated, never in the history of our country have we raised enough taxes to "reroute our spending" into the federal coffers. You're simply not going to get it, especially once you factor in the fact that when you raise the cost of employment by (for example) 9%, you reduce demand for employees. These people think that making rates higher by 9%-15% would fund UHC? When our rates were 60 % higher we didn't raise enough to fund UHC.

    But I'm open to being convinced. Average revenues in the pre-Great Recession Era were about 18.5% of GDP. If you can describe for me a single tax structure in American history that collected 6% of GDP over that amount for a 5 year period, I will re-assess my statement on the utter implausibility of the pie-in-the-sky notion that we can afford a massive new entitlement program.
    Actually, you skip a lot. Much of advances in medicine are done at state schools doing work on the government dollar. Your programs you mention are all limited and have very small effect, thus not capable of actually doing the job required. So while it may impress some who don't understand the scope of our problem, the fact remains that you can't piecemeal this problem like that. Many are uninsured. Business pays quite a bit for insurance, and it hurts us in the world marketplace. Even with the reforms you mention, we till pay more and get less for or money than the rest of the world.

    Not, as for you merely saying 6% can't be done, you are right that we can't do what we don't try to do. Remove obstructionists from any body working to solve problems, and you might be surprised what can be done. The point is, a plan was linked. The question is always more about whether we will work toward a better plan, or merely keep trying to stall progress?

    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: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by cpwill View Post
    Worth noting: if you want to provide universal coverage to American citizens, then I have already described how that can be accomplished without the fairy tale of magical mountains of tax revenues that we have never seen in our past and are unlikely to see in our future. It even has the added benefit of helping our low-income and poorer populations build wealth and have actual access to healthcare (since Medicaids' reimbursement schedules are lower, many providers cannot afford to take, or have to limit their acceptance of Medicaid recipients).
    You're easily impressed. Indiana ranks a whopping 31st in health care systems:

    How States Rank on Health Care
    Last edited by Boo Radley; 07-27-13 at 05:10 AM.

    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: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Boo Radley View Post
    Actually, you skip a lot. Much of advances in medicine are done at state schools doing work on the government dollar.
    Indeed. But you are confusing "advances in medical science" with "advances in health care".

    Your programs you mention are all limited and have very small effect, thus not capable of actually doing the job required
    This is like saying that because only one person out of a group of ten eats right, exercises, and is thus not obese, that eating right and exercising would not get the other nine in better shape. The programs are indeed limited to companies and states. Which means that right now, in the US, they have a better and more proven track record than single-payer, which no state has implemented.

    So while it may impress some who don't understand the scope of our problem, the fact remains that you can't piecemeal this problem like that. Many are uninsured.
    Many are. But not our poor - they have Medicaid. Furthermore, the policy proposal that you are refusing to address solves that by issuing them a health insurance plan at public expense.

    Business pays quite a bit for insurance, and it hurts us in the world marketplace.
    and in your model they would pay quite a bit for UHC and the effect would be the same, except that whereas before health insurance specifics were at least somewhat responsive to the consumers, now it is unresponsive [i]entirely. Oh, and that you would also wreck a large portion of our economy by turning it into a state enterprise.

    Even with the reforms you mention, we till pay more and get less for or money than the rest of the world.
    1. That is incorrect. We pay more than the rest of the industrialized world and we get more than the rest of the industrialized world.
    2. The reforms I mention would indeed put downward pressure on prices, as that is what they do when they are enacted as demonstrated.

    Not, as for you merely saying 6% can't be done, you are right that we can't do what we don't try to do. Remove obstructionists from any body working to solve problems, and you might be surprised what can be done. The point is, a plan was linked. The question is always more about whether we will work toward a better plan, or merely keep trying to stall progress?
    Oh, we'll all work together, remove obstruction, don't know until we try, pass the bill so we can find out what's in it, eh? Yeah. that works great. OR we can try to actually improve our healthcare system rather than simply turning over the rationing function to unelected bureaucrats while crashing the federal budget. You'll forgive me if I have a hard time looking at the ruins of socialism (and state control of the means of production of health care goods and services is absolutely that so don't start with the "oh no this is something totally different because socialism has no definition nor has anyone ever really tried it" crap) and saying "aha! here is progress!"

    If you could show me where it was possible to collect that revenue you would have done so. However, even when top marginal tax rates were in the 90s, we didn't get anywhere close to the amount of money you are blithely insisting that we could bring in if we "all work together to a better plan"



    But hey, I remain open to actual argument. Please demonstrate to me where any combination of rates (and we had some whoppers, back around the mid-20th-century) have ever produced the kind of additional tax revenue that you are suggesting we can pull in.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Boo Radley View Post
    You're easily impressed. Indiana ranks a whopping 31st in health care systems:

    How States Rank on Health Care
    Take a look at your own link, Boo. Notice how part of it reads "20070613" ? Now go click on the link and then go to the bottom and choose "View Source Articles".


    That score is from a study that was released in June of 2007.


    Indiana's medicaid reforms have been hugely successful, with an approval rating by participants of 98%. You're so big on preventative care? Indiana's program increased the amount of Medicaid recipients who sought out and received it from 39 to 59% in 12 months.

    Woops?
    Last edited by cpwill; 07-27-13 at 08:11 AM.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by cpwill View Post
    This is like saying that because only one person out of a group of ten eats right, exercises, and is thus not obese, that eating right and exercising would not get the other nine in better shape. The programs are indeed limited to companies and states. Which means that right now, in the US, they have a better and more proven track record than single-payer, which no state has implemented.
    It's worth noting, now that I think back on it, that this is not entirely correct. We do have one model to look at to see how a single-payer model would function in this country. That program is Medicare. Massive amounts are lost to Fraud every year, the number of doctors willing to accept it is shrinking, and the costs (and that, after all, is what we are studying) are exploding, threatening to bankrupt the federal government in a short handful of years.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by cpwill View Post
    Enjoy

    Fully 2% of Canada's populace at one point or another has left the country in order to seek medical care, while another 8% have had to move around within the country to find healthcare that their local government providers apparently couldn't give them.

    Five Key Drivers of Canadians seeking care elsewhere:
    1. Shorter Waiting Periods and Access to Care
    2. Comparable or Better Quality Care
    3. Ability to Afford Out-of-Country Costs
    4. Access to services not available in Canada
    5. Cosmetic Services

    The Most Common Reasons Why Canadians Leave to Find Healthcare:
    1. Orthopedic Procedures
    2. Neurosurgery / Neurology
    3. Weight Loss / Liposuction
    4. Cosmetic / Plastic Surgery
    5. Dental Procedures
    6. Cardiovascular Procedures
    7. Oncology
    8. Fertility
    9. Sex Reassignment

    Those highlighted in blue are those that I believe are being referenced here. Those being struck out appear to be people seeking actual purely because-I-want-it care.

    This, I would say, doesn't qualify as "just because I want it":
    CPwill, you have shown me diddly squat. Do you realize that our provincial governments pay some border US clinics and hospitals to take care of some of our patients? Why? Because it's cheaper that having to open more hospitals and clinics.

    What you have proven to me is zilch. Tell me how many people go to the US for treatment and pay out of their own pockets? I'd guess that number is very very low.

    By the way, the list you provided is interesting. Why is dental on the list? Dental is not covered my our universal healthcare.
    No men are anywhere, and Im allowed to go in, because Im the owner of the pageant and therefore Im inspecting it, Trump said... Is everyone OK? You know, theyre standing there with no clothes. Is everybody OK? And you see these incredible looking women, and so I sort of get away with things like that.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by American View Post
    I have a good insurance policy, with very low co-pays.
    How much do you have to pay out of pocket each month? Also, do you have to pay a deductible for everything you get done?
    No men are anywhere, and Im allowed to go in, because Im the owner of the pageant and therefore Im inspecting it, Trump said... Is everyone OK? You know, theyre standing there with no clothes. Is everybody OK? And you see these incredible looking women, and so I sort of get away with things like that.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Middleground View Post
    I can't speak for other countries, but I can assure you that a patient in Canada with lung cancer will be taken care of with the highest amount of urgency and care, no matter the initial prognosis. However, the guy who needs the knee replacement might have to wait a bit longer. And our Supreme Court made the right decision... I truly believe that for profit healthcare is a human rights violation.

    Your nationalistic super-pride doesn't change the statistics that show survival rate for cancer in Canada is still less than that in the US.

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    Re: Moderate Democrats are quitting on Obamacare

    Democrats have done a 180 the second the unions started crying about Obamacare.

    Obama started at first issuing waivers to unions for Obamacare but realized that labor unions are a substantial part of the work force and that issuing waivers to all unions would do more harm than good for his proposed tyrannical plan.

    The only reason this idiot is even in his position is because he's half black. Thank God for term limits otherwise the retards would give him the FDR treatment..

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by jmotivator View Post
    Your nationalistic super-pride doesn't change the statistics that show survival rate for cancer in Canada is still less than that in the US.
    And our survival birth rate better is that your... na-na-na-na-na-na!

    And my nationalistic pride has nothing--I mean nothing--to do with why I think our healthcare system (as far from perfect as it is presently) is eons better than yours.
    No men are anywhere, and Im allowed to go in, because Im the owner of the pageant and therefore Im inspecting it, Trump said... Is everyone OK? You know, theyre standing there with no clothes. Is everybody OK? And you see these incredible looking women, and so I sort of get away with things like that.

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