Miscellaneous And Off Topic Subjects

[Wild Hoss]

I don't think you need to pretend that healthcare was great in 2008, nor do you need to pretend Obama didn't win on that issue amongst other things. I do think it's fair to point out 2008 in response to the partisan hyperbole of death in the streets and such.

The problem people had in 2008 wasn't solely coverage, it was, IMO at least 50/50 costs and coverage. That was certainly my complaint. The ACA increased coverage making it shit near impossible to ever reduce costs. So, it's not going to happen. We will move to single payer and people will think it's "free". As if. The upside is that rich Canadians will no longer come to the US for healthcare. I consider that a huge win!

The real awesomeness will be when you couple Socialized Healthcare with increased immigration!

I stipulate that snark in response to gutter funerals is appropriate. I also agree that the fewer Canucks running around down here, the better...we should have shut that shit down after Michael J Fox.

I don't think immigration is going to be a problem. Quite the opposite; in regards to healthcare soley, we need the influx of younger people to offset the aging and lowering birth rates of the native populace. More selectivity however.

[iam416]

Well, I'm open-minded on the immigration point. Agree on the rest, and applaud and will appropriate "gutter funerals."

[hack]

It's almost as if folks have no inclination whatsoever to actually engage in an honest balancing of costs and benefits.

You and I are certainly coming from a different place on that, but, yes. I agree. People use the inherent uncertainty as a weapon sometimes, and at other times do not. Any forecast comes with assumptions. We know that. Sometimes those assumptions are used to cast doubt on the whole thing and are enlisted as a reason to do nothing. Sometimes they aren't. It's the choice of exactly when to be suspicious of forecasting and when not to that is the real problem.

I don't think anybody's enacting policy based on a low-odds worst-case scenario. I think you can paint it as such if you really want to, and pretend that people actually in power of something more than their own politically-charged facebook feed are ignoring cost/benefit, but I don't think you'd have much of a leg to stand on arguing that. Politicians understand that they are aiming for the best system they can afford. Every single-payer system in the world is a result of that exercise, as would be any single-payer system here.

Which redirects this right back to where the debate really belongs -- this is about how to slice the pie. If this were about affordability there wouldn't be a big tax cut for corporations coming down the pike, and a bogus amnesty on overseas income. This is about shifting more wealth to the wealthy.

[THE_WIZARD_]

No worries...Dr. Nikolas Van Helsing is here to serve your medical needs...and all for a drive across the country...

[froot loops]

I'm going to bet Oren Cass does have health insurance.

I do like that headline, the ACA saves no lives. Buried in that word salad it says the ACA provides access to expensove procedures to prevent life threatening situations and that it should still be the case post ACA. It kind of contradicts the headline.

[hack]

It's not stupid. You trust the federal govt to make these decisions? I trust employers to want better benefits to attract talent more than someone in DC to make a decision on my behalf.

So I don't think it's stupid. A single payer is going to happen. I have no doubt. I think people are naive in what that means.


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OK, well, why don't you quantify the risks you see in a person in DC making that decision then? I've quantified the risk of a for-profit entity making it. The more health care you get, the less profit they get. I think there's a pretty clear link to be made there. Can you make a clear link between ``person in DC" and ``personal risks to you and your health care"?

[froot loops]

It's not stupid. You trust the federal govt to make these decisions? I trust employers to want better benefits to attract talent more than someone in DC to make a decision on my behalf.

So I don't think it's stupid. A single payer is going to happen. I have no doubt. I think people are naive in what that means.


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1. The Federal Government makes these decisions for Medicare and seniors typically love Medicare.

2. First and foremost, people go for salary. And in the time I've been employed, employers have consistently whittled away health care insurance. I bet very few companies today offers similar health care to what they offered 20 years. I can't imagine any company offers better insurance than they did 20 years ago, unless they were offering 20 years and we're forced to due to some law. When a recession hits, that's when a company really slashes it, they know jobs are scarce.

3. A lot of people were stuck at jobs due to pre-existing conditions, they couldn't leave because they might be disqualified from coverage at their new job.

[hack]

Ah -- OK, I understand "I trust employers to want better benefits to attract talent more than someone in DC to make a decision on my behalf" now. I think Froot has a good response. The system has been this way for long enough that you don't have to put any blind trust in it. You can take a look and see.

But, if you do want to just trust in the idea of that system, I think you have to root it in basic economics. Employers only have that need to compete for talent by offering better benefits when there are more available jobs than there are available workers. When there are more workers than there are jobs, they don't need to improve their offering to attract talent.

[entropy]

I don't even know where to start. I know nobody personally who is in love with Medicare. I only hear complaints. Not to make my experience the norm, but in my family.. it's the exact opposite. Seniors who are friends we know are not happy with Medicare.

And people choose jobs for a variety of reasons. Benefits are one of them.. so is work life balance..so is travel.. so is.. Again, not to use my experience as the norm, but my benefits are much better than 13 yrs ago when I started with this company. My deductible is higher, but my options and choices are much much better. I know others who feel the same. Not all industries have behaved the same.

Number 3 I agree with..

[entropy]

hack...

I have never heard anyone say "I can't wait to get off these corporate benefits to move to medicare."

[entropy]

hack..

Assuming I'm correct and we go to a single payer system and lets say it's an expansion of medicare... Do you really believe Health systems will provide the same services as today? Do you really think when budgets are tight, decisions won't be made to cut services? Do you really think lobbyist have your best interest?

I'm not saying the current system is not without flaws. It is.. those without jobs are a glaring issue for our health economy. But my experience is govt's are slow.. slow to adopt.. slow to change.. slow to respond.. I've seen health systems struggle to payments from certain states. I've seen the writeoffs due to not paying for care. I don't see people in large numbers electing to go to gov't owned health systems over non for profits or for profits. So I'm not "excited" about a gov't owned monopoly of decisions. At least today there are competing entities to keep each other in a loose form of checks and balances.

[entropy]

talent..

Your question/thoughts on cost vs benefit is really impossible to answer. Someone with a condition will have a different answer than someone without health issues and only sees the spend as waste.

Ultimately, with limited $$$'s decisions have to be made on what is a benefit and what is not necessary. Under a single payer I think there are risks in who makes those decisions where at least today there are options (though fewer than in the past).

My bias is preventative care, and choice. I know that bias is not universally shared.

[froot loops]

1. Medicare rates very high among its recepients when polled. But it sounds like those people don't speak with entropy. Maybe he thinks they should get rid of it and substitute market forces for the seniors. I had a mother-in-law that just passed away, who was in poor health for a long time, almost as long as I knew her. A few times, she was literally at deaths door and they would figure out what was wrong and she would recover.and be good for a few years. She never once complained about medicare, in fact she marveled at the care she got. But it was nothing earth shattering, just changing medications for her heart and diabetes. Sometimes a hospital stay.

2. For my point of view, having a higher deductible makes the coverage worse. And when companies bring in plans that have higher deductibles it is a negative for me. It is for most people, apparently not for entropy. So yeah if you eliminate the deductible from the analysis, I can see how you approve.

[Wild Hoss]

My bias is preventative care, and choice. I know that bias is not universally shared.

Its not a bias....its what we'd all prefer. How do you make that choice affordable for those without a large employer to assist in offsetting costs though? That's the question.

A choice between healthcare and food or rent is no choice.

[entropy]

agree hoss.. that is something the R's have not addressed well