The Collapse of Obamacare in North Carolina (1 Viewer)

[Helix]

Medicare is not "sucessful" because it competes as an "option" - it is "successful" because it sets prices on a take it or leave it basis and mandates "contributions" from all wage earners often for decades before the first benefit is ever paid. Once all prices for each and very medical procedure, device, drug and service are set by the government then many payers could survive (and profit) with lower contribution (premium) rates.

many other first world countries have something like medicare to cover all of their citizens, and they are experiencing the same or better outcomes for a fraction of the price.

 

[Helix]

I don't have to work in it, to know how it's funded.
Private and public research are both integral to medical advancement.

i've worked in both. when i worked in private research, i relied heavily on publicly funded studies as a resource, as do all other researchers, which is one reason that sequestration was so ****ing stupid. i lost my job largely because of that. i'm sure many others did, too.

as for private research, i'm sure that adopting a system similar to most other first world countries won't result in an economic apocalypse.

 

[Helix]

There is no political support for paying the kind of taxes that single payer would require. Ask the governor of Vermont about that.

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada’s taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Debunking Canadian health care myths – The Denver Post

 

[Harry Guerrilla]

i've worked in both. when i worked in private research, i relied heavily on publicly funded studies as a resource, as do all other researchers, which is one reason that sequestration was so ****ing stupid. i lost my job largely because of that. i'm sure many others did, too.

as for private research, i'm sure that adopting a system similar to most other first world countries won't result in an economic apocalypse.

I'm sorry you lost your job.
I don't want to end public research financing.

With that said, the issue is cutting profits from the medical industry has an effect on research and development.
Cut and paste works in excel, but not in designing a well functioning medical system.

A lot of these countries, that have adopted various schemes to deliver medical care, did so when formal institutions of research didn't exist.
They have grown organically, with their systems, just like we have.
Changing things is much, much more complicated than even the PPACA could have ever been.

 

[Helix]

Medicare is not an option - all wage earners and their employers must make Medicare "contributions".

i didn't argue that medicare was free. i argued that it is normal. give single payer a generation, and it will just be the way things are, as well. the world won't come to a screeching halt on its axis.

 

[Helix]

Wait, the government did such a bang up job screwing up the ACA, let's give them another crack at it. Only this time, let's give them the whole shebang. How about no.

the ACA was essentially the Heritage Foundation's alternative to Hillarycare in the 1990s, or the equivalent of Romneycare in the 2000s. basically, a half measure that democrats in conservative districts might find palatable. it was a missed opportunity and a great example of setting the goalposts incorrectly.

 

[ttwtt78640]

many other first world countries have something like medicare to cover all of their citizens, and they are experiencing the same or better outcomes for a fraction of the price.

Because of medical care price controls - the same reason that they spend less per student on education. The problem, of high medical care costs in the US, is not caused by private insurance companies making "obscene" profits.

A clearer way to think about this is profits -- and insurers aren’t where the big profits in the health-care system go. In 2009, Forbes ranked health insurance as the 35th most profitable industry, with an anemic 2.2 percent return on revenue. To understand why the U.S. health-care system is so expensive, you need to travel higher up the Forbes list. The pharmaceutical industry was in third place, with a 19.9 percent return, and the medical products and equipment industry was right behind it, with a 16.3 percent return. Meanwhile, doctors are more likely than members of any other profession to have incomes in the top 1 percent.

https://www.washingtonpost.com/news/wonk/wp/2014/01/13/what-liberals-get-wrong-about-single-payer/

 

[ttwtt78640]

i didn't argue that medicare was free. i argued that it is normal. give single payer a generation, and it will just be the way things are, as well. the world won't come to a screeching halt on its axis.

Very few countries have single payer systems yet they have much lower medical care costs.

There are few truly single-payer systems in the developed world. Canada has one, as does Taiwan. Most countries rely on many, many insurers. Germany, for instance, has more than 150 “sickness funds.” The Swiss and Dutch health systems look a lot like Obamacare’s health-insurance exchanges. In France, about 90 percent of citizens have supplementary health insurance. Sweden has moved from a single-payer system to one with private insurers. Yet all these countries pay vastly less for drugs, surgeries or doctor visits than Americans do.

Why? Because in every case the government sets prices for health-care services and products. Insurers in Switzerland don’t negotiate drug prizes with Pfizer. The Swiss government simply sets its drug prices and lets Pfizer decide whether to sell in Switzerland -- or not.

https://www.washingtonpost.com/news/wonk/wp/2014/01/13/what-liberals-get-wrong-about-single-payer/

 

[Helix]

I'm sorry you lost your job.
I don't want to end public research financing.

i appreciate that. after a few months, i landed another job on on the other side of the spectrum. a thousand a month to COBRA for those three months, though. that's another thing that other first worlders don't have to deal with. i do like my new job, though.

With that said, the issue is cutting profits from the medical industry has an effect on research and development.
Cut and paste works in excel, but not in designing a well functioning medical system.

A lot of these countries, that have adopted various schemes to deliver medical care, did so when formal institutions of research didn't exist.
They have grown organically, with their systems, just like we have.
Changing things is much, much more complicated than even the PPACA could have ever been.

i don't see medical research coming to a grinding halt if we adopt the same system that everyone else already has. sure, at first, upper management will throw a tantrum and fire everyone in order to keep their bonuses secure, but eventually, they won't be able to get anything done. the system will reset, they'll be forced to hire back their researchers that they canned. i've seen it happen during other market crises.

 

[countryboy]

the ACA was essentially the Heritage Foundation's alternative to Hillarycare in the 1990s, or the equivalent of Romneycare in the 2000s. basically, a half measure that democrats in conservative districts might find palatable. it was a missed opportunity and a great example of setting the goalposts incorrectly.

I'm a little surprised you would parrot this often repeated, utterly inaccurate, leftist talking point.

 

[Harry Guerrilla]

i appreciate that. after a few months, i landed another job on on the other side of the spectrum. a thousand a month to COBRA for those three months, though. that's another thing that other first worlders don't have to deal with. i do like my new job, though.

Good sometimes bad things end up turning into good things.

i don't see medical research coming to a grinding halt if we adopt the same system that everyone else already has. sure, at first, upper management will throw a tantrum and fire everyone in order to keep their bonuses secure, but eventually, they won't be able to get anything done. the system will reset, they'll be forced to hire back their researchers that they canned. i've seen it happen during other market crises.

Something as large and as integrated as our medical system or any medical system for that matter.
Everything has to be done in a slow, deliberate manner, so that the integration doesn't really screw people who need it.
The whole thing needs some real structural changes, from already existing programs like Medicair, Medicaid, SSI and SSD.
They have issues that have long gone unfixed and ignored.

 

[Helix]

Because of medical care price controls - the same reason that they spend less per student on education. The problem, of high medical care costs in the US, is not caused by private insurance companies making "obscene" profits.



https://www.washingtonpost.com/news/wonk/wp/2014/01/13/what-liberals-get-wrong-about-single-payer/

health care is an essential service with inelastic demand in which geographical immediacy is a significant factor. our best bet is to look at what other first world countries are doing, and to replace our system with the best parts of each one.

 

[Helix]

I'm a little surprised you would parrot this often repeated, utterly inaccurate, leftist talking point.

i'm aware that the right currently pretends that this isn't the case.

Heritage Rewrites History - WSJ

it is.

 

[countryboy]

i'm aware that the right currently pretends that this isn't the case.

Heritage Rewrites History - WSJ

it is.

Why don't you link to the actual details of the original plan, instead of an opinion piece from The WSJ? Other than the mandate, Obamacare bears no resemblance to said HF plan. But you already knew that.

 

[Helix]

Good sometimes bad things end up turning into good things.



Something as large and as integrated as our medical system or any medical system for that matter.
Everything has to be done in a slow, deliberate manner, so that the integration doesn't really screw people who need it.
The whole thing needs some real structural changes, from already existing programs like Medicair, Medicaid, SSI and SSD.
They have issues that have long gone unfixed and ignored.

i'm fine with incrementally fixing the system. we have to move away from employer-specific access to health care, though.

 

[Harry Guerrilla]

i'm fine with incrementally fixing the system. we have to move away from employer-specific access to health care, though.

No disagreement at all there.

 

[Helix]

Why don't you link to the actual details of the original plan, instead of an opinion piece from The WSJ? Other than the mandate, Obamacare bears no resemblance to said HF plan. But you already knew that.

you're a fast reader. did you see something there that you didn't like?

 

[countryboy]

you're a fast reader. did you see something there that you didn't like?

Yes, WSJ. Usually behind a paywall, and extremely biased. What's wrong with the original source?

 

[Helix]

Yes, WSJ. Usually behind a paywall, and extremely biased. What's wrong with the original source?

if you had read the article, you would see that the original source is quoted.

 

[ttwtt78640]

health care is an essential service with inelastic demand in which geographical immediacy is a significant factor. our best bet is to look at what other first world countries are doing, and to replace our system with the best parts of each one.

OK, that sounds great - step one is defining that system not by adding PPACA to Medicare, Medicaid and VA care. You have previously suggested expanding Medicare, now equally employee/employer funded with a flat rate (3.3%?) payroll tax, yet did not propose any specifics on changing its funding mechanism. What new Medicare payroll tax rate do you feel would cover the cost of such a system?

 

[ttwtt78640]

i'm fine with incrementally fixing the system. we have to move away from employer-specific access to health care, though.

Which just happens to be the core idea (85%?) of PPACA.

 

[Helix]

OK, that sounds great - step one is defining that system not by adding PPACA to Medicare, Medicaid and VA care. You have previously suggested expanding Medicare, now equally employee/employer funded with a flat rate (3.3%?) payroll tax, yet did not propose any specifics on changing its funding mechanism. What new Medicare payroll tax rate do you feel would cover the cost of such a system?

i imagine that we'd fund it like most other countries with single payer healthcare do. here's an example.

https://en.wikipedia.org/wiki/Health_care_in_Canada

 

[Helix]

Which just happens to be the core idea (85%?) of PPACA.

outside of letting kids stay on their parents' insurance and eliminating the pre-existing condition exclusion, i don't support the ACA as a permanent solution.

 

[countryboy]

if you had read the article, you would see that the original source is quoted.

Well then, had you and the author of the WSJ article actually read the original HF proposal, it would've saved a lot of needless back and forth. Like I said, the original proposal bears almost no resemblance to the ACA. It was so disliked by republicans at the time, it was never even considered as legislation. So, to make the bogus claim that this was somehow a "republican" plan, is just that.....BOGUS.

 

[ttwtt78640]

i imagine that we'd fund it like most other countries with single payer healthcare do. here's an example.

https://en.wikipedia.org/wiki/Health_care_in_Canada

OK, you wish to fund it, like Canada, primarily (94%?) at the state level.