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Health-care exchange sign-ups fall far short of forecasts

eohrnberger said:
Yeah, right Helix. Have you seen the VA lately? That's pretty much what's going to be in store for the whole country if you get what you want.

Thanks, I'll pass.
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yeah I know I keep asking them why they don't value they health or the health of their families.
I have yet to see a good reason.

they just come up with some nonsensical reply.
 
Helix said:
my guess is that it will more likely be Ryan in a couple of election cycles. he'll probably try to put Medicare on course for privatization, as well. i suppose we'll see how excited seniors are about that when we get there.
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I own two businesses in healthcare. I understand what you are saying about seniors' perceptions of Medicare. Medicare is insolvent. It could never be solvent over the course of generations. It is necessarily insolvent due to the aging population of generational cohorts. Larger cohorts will use up all the money leaving no money to pay for smaller cohorts. (In the immediate case, the baby boomers are the large cohort who will use all the money, leaving a deficit for generation X and absolutely NO coverage for Generation Y.

Social Security, Medicare Face Insolvency Over 20 Years, Trustees Report - WSJ

The entire system is based on the younger cohorts paying for the older cohorts. That would only be feasible if either a) every cohort was the same size or b) cohorts became progressively larger. Neither is possible.

It doesn't matter how "excited seniors are." They only way it would have worked properly is if everyone's withholdings from Medicare were set aside for them, rather than robbing peter to pay paul. A universal system is no different, except that the health care options would not be of high quality.

Medicare dictates prices to healthcare providers- many of whom are progressively refusing to take Medicare. Making them take a public option will just force good doctors out of medicine, stunt advances in medical technology and pharmaceutical R&D, and make the practice of medicine a less than lucrative option for anyone but the most bleeding hearts of college graduates.

America is a capitalist economic system. It is NOT a socialist system.
 
kamikaze483 said:
I own two businesses in healthcare. I understand what you are saying about seniors' perceptions of Medicare. Medicare is insolvent. It could never be solvent over the course of generations. It is necessarily insolvent due to the aging population of generational cohorts. Larger cohorts will use up all the money leaving no money to pay for smaller cohorts. (In the immediate case, the baby boomers are the large cohort who will use all the money, leaving a deficit for generation X and absolutely NO coverage for Generation Y.

Social Security, Medicare Face Insolvency Over 20 Years, Trustees Report - WSJ

The entire system is based on the younger cohorts paying for the older cohorts. That would only be feasible if either a) every cohort was the same size or b) cohorts became progressively larger. Neither is possible.

It doesn't matter how "excited seniors are." They only way it would have worked properly is if everyone's withholdings from Medicare were set aside for them, rather than robbing peter to pay paul. A universal system is no different, except that the health care options would not be of high quality.

Medicare dictates prices to healthcare providers- many of whom are progressively refusing to take Medicare. Making them take a public option will just force good doctors out of medicine, stunt advances in medical technology and pharmaceutical R&D, and make the practice of medicine a less than lucrative option for anyone but the most bleeding hearts of college graduates.

America is a capitalist economic system. It is NOT a socialist system.
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neither is Canada, and their system is more universal, efficient, affordable, and inclusive than ours.
 
Helix said:
neither is Canada, and their system is more universal, efficient, affordable, and inclusive than ours.
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But it's quality is not nearly as high. See below.

More than 52,000 Canadians travelled abroad for health care last year, study finds | National Post

And that is because they have to wait too long for care. See below

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2015-report

So I would argue that it is NOT more efficient than ours, though no since debating the differences in how we perceive the word "efficient." (Though in my view it means quickly, effectively, and inexpensively).
 
kamikaze483 said:
But it's quality is not nearly as high. See below.

More than 52,000 Canadians travelled abroad for health care last year, study finds | National Post

And that is because they have to wait too long for care. See below

https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2015-report

So I would argue that it is NOT more efficient than ours, though no since debating the differences in how we perceive the word "efficient." (Though in my view it means quickly, effectively, and inexpensively).
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it would be hard to design a system less efficient than ours. coverage varies wildly based on income level, geographical location, and most importantly, place of employment.

as for efficiency and outcomes, here's a good resource :

http://www.commonwealthfund.org/~/m...t_sys_comparison_12_nations_intl_brief_v2.pdf

we're better in some areas, worse in others, and we pay a lot more for all of it. well, some of us, depending on where you live, and, most importantly, where you work.
 
Helix said:
it would be hard to design a system less efficient than ours. coverage varies wildly based on income level, geographical location, and most importantly, place of employment.

as for efficiency and outcomes, here's a good resource :

http://www.commonwealthfund.org/~/m...t_sys_comparison_12_nations_intl_brief_v2.pdf

we're better in some areas, worse in others, and we pay a lot more for all of it. well, some of us, depending on where you live, and, most importantly, where you work.
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I can get seen tomorrow for a variety of maladies, in Canada I might DIE waiting to get diagnosed. **** SP.
 
It's funny...I was just at a large cardiology meeting in Rome last week, and literally every single cardiologist (from a developed country) I spoke to about the issue of health care coverage and national systems preferred their own nations system over the US system, including several who worked in both the US and the EU.
 
Absentglare said:
That's like saying that energy is a bad investment because Enron.
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More accurately, would you invest in another company run by ex-Enron executive management? I surely would not. I rather doubt that you would either.

Absentglare said:
Cherry picking one example and then declaring that the example's performance is necessarily linked to a single variable (public v private) is a huge logical jump.

The majority of the developed world manages healthcare far better than we do.
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The governments of those developed nations are not the same as the US federal government.
 
Renae said:
Oh look ! Helix posted a pointless list that that doens't give a real picture of anything and uses skewed reporting for mortality because he thinks it MEANS something!

https://www.fraserinstitute.org/stu...t-times-for-health-care-in-canada-2015-report
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how long do you have to wait in the US when you make too much to qualify for Medicaid, but too little to dump boatloads of money into treatment? what are the wait times if your insurance company weasels out of paying for a treatment? what are the wait times in the US by state? how about by insurance plan?

yeah, those are actually all things. quit pretending that the US is some monolith of hyper-fast care for all, regardless of location, place of employment, or ability to pay. here's some more data to mull over :

Health - 1.jpg

looks like both Canada and the US have some work to do, though they are paying about half of what we are for similar results.
 
Threegoofs said:
It's funny...I was just at a large cardiology meeting in Rome last week, and literally every single cardiologist (from a developed country) I spoke to about the issue of health care coverage and national systems preferred their own nations system over the US system, including several who worked in both the US and the EU.
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I'm so sure you did.
 
Helix said:
how long do you have to wait in the US when you make too much to qualify for Medicaid, but too little to dump boatloads of money into treatment? what are the wait times if your insurance company weasels out of paying for a treatment? what are the wait times in the US by state? how about by insurance plan?

yeah, those are actually all things. quit pretending that the US is some monolith of hyper-fast care for all, regardless of location, place of employment, or ability to pay. here's some more data to mull over :

View attachment 67206761

looks like both Canada and the US have some work to do, though they are paying about half of what we are for similar results.
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I had the Navy, and after that through my jobs, never had insurance not pay or try to dump us.

Sorry.
 
Renae said:
I had the Navy, and after that through my jobs, never had insurance not pay or try to dump us.

Sorry.
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this is a key part of my argument. in the US, your health care experience will be very different depending on your job, location, and economic situation. that's exactly what makes the system so haphazard.
 
eohrnberger said:
More accurately, would you invest in another company run by ex-Enron executive management? I surely would not. I rather doubt that you would either.
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Sure, and if you were on the board of directors for some energy company, you probably wouldn't nominate an ex-Enron executive, yet congress has an alarmingly high incumbency rate.

More specifically, whose fault is it that the VA has problems ?

eohrnberger said:
The governments of those developed nations are not the same as the US federal government.
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That's true; but people on medicare/medicaid seem genuinely pleased with the insurance, so that seems to indicate that single payer can be done well.
 
Helix said:
this is a key part of my argument. in the US, your health care experience will be very different depending on your job, location, and economic situation. that's exactly what makes the system so haphazard.
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It's not haphazard, it means you have to actually spend a little effort to make sure you are taking care of you.

I know you tink it's better to let the almighity Gubmint do that for you, but **** that.
 
Threegoofs said:
Thanks for the insightful post.

It's definitely in the top 10% of your posts on the issue.
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Hey, I heard it rained somewhere it hadn't rained there in a week, don't you have a AGW scare thread to go create?
 
Absentglare said:
Sure, and if you were on the board of directors for some energy company, you probably wouldn't nominate an ex-Enron executive, yet congress has an alarmingly high incumbency rate.

More specifically, whose fault is it that the VA has problems ?
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I would believe that the bureaucrats appointed there by the Fed. Government and the bureaucracy they created or were directed to create. So directly at fault are the bureaucracy that the bureaucrats that are running the place (or some fictitious/delusional version there of), and those that appointed them to those posts, congress, I believe (not sure - who appoints VA administrators? congress or the administration?) would be most appropriate to hold accountable for the problems at the VA.

Absentglare said:
That's true; but people on medicare/medicaid seem genuinely pleased with the insurance, so that seems to indicate that single payer can be done well.
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Based on the well established track record of US fed. government program failures, cost overruns, mismanagement and fraud (and the lack of control / enforcement of this fraud) I think you assessment is wildly and highly optimistic.

Fundamental to the problem is the perception the users of these federal benefit systems have, which is that it's free, well free to them which is all they care about, because someone somewhere always gets stuck with the bill. That which is perceived to be free isn't valued and is abused (why worry about the cost of procedures or care if it's free to me? By God I'm worth it, so bring it on! And the more and the more expensive the better!). This is clearly the case in the medicare / medicaid system, which suffers from huge fraud cases (in the millions of dollars - most recently a $16M / year scam ring busted by the FBI), all the time these fraud cases, while at the same time it's claimed that it isn't cost effective to spend on the needed investigation / prosecution to curb these fraudulent claims.

If you allow single payer direct access to the treasury's general fund for unlimited funding as needed, it's going to burn through money like no body's business. 65% of US federal budget is non-discretionary spending, medicare and medicaid among them, and this portion of the budget is increasing and eating up most any other needed spending. Putting everyone on the nation onto medicare and/or medicaid or like system is only going to significantly increase that.

If you put single payer on a budget, the government entity that's running the system is going to have to start making medical decisions as to who gets treatment and who doesn't and how long they have to wait to receive that treatment (excess capacity is an expensive waste don't you know). Is this something that you want the failed and failing bureaucrats and bureaucracy in charge of? The inevitable government cost control between the patient and the doctor.

If you look at cancer survival rates between countries as an example (the same applies to joint replacements and other procedures) single payer government run (rationed) care performs far less well than advertised.

While you may be optimistic as to the performance of government run single payer system it is legitimate to less optimistic about it.
 
Renae said:
It's not haphazard, it means you have to actually spend a little effort to make sure you are taking care of you.
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it isn't even close to that simple. coverage varies wildly depending just on where you work, not to mention where you live. you might have good insurance, and congrats for that. a lot of people don't, and we all pay for it in the form of ridiculous cost of care and higher deductibles and premiums. it's ridiculous.

Renae said:
I know you tink it's better to let the almighity Gubmint do that for you, but **** that.
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go back and actually read the chart that i posted. we should look at what higher ranking countries are doing, and then fix our system so that it isn't so overpriced, inefficient, and haphazard.
 
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