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  1. #53
    BamaNation Hall of Fame Bodhisattva's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bamabuzzard View Post
    Wage control is a great idea as long as it's not "your" wages. Or like "minor" surgery. It's only "minor" when you're not the one going under. LOL!
    Funny how that works, isn't it?
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  2. #54
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    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    I
    But the solution is basically government-run healthcare (at least in part), which many people (mostly Republicans) have been conditioned to fear. So to be frank, folks need to either embrace the solution or stop complaining.
    Conditioned to fear? Could very well be. Or, it could be that folks see how the government handles taxes, education, infrastructure, and a myriad of other "issues", and then decide that maybe the government ain't the best stewards of our healthcare.

  3. #55
    BamaNation Hall of Fame CharminTide's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bama 8Ball View Post
    Conditioned to fear? Could very well be. Or, it could be that folks see how the government handles taxes, education, infrastructure, and a myriad of other "issues", and then decide that maybe the government ain't the best stewards of our healthcare.
    Dunno, people seem to like Medicare.


  4. #56
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    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    Dunno, people seem to like Medicare.

    Well, medicare accounts for roughly 17% of the US population, vs. 67% for private insurance. I wonder if the sheer numbers were reversed, if that chart would look different. Honestly I am surprised that current or former employer paid insurance is so high at 69%. After 18 years in healthcare and hearing all the complaints, I would have guessed it was much lower.

  5. #57
    BamaNation All-American bama_wayne1's Avatar
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    Re: ACA holding...

    Healthcare costs skyrocketed when physicians and insurance companies got in bed together in the 80's. I was paying the doctor $18 without PMD and at the flip of a switch I paid $15 and BCBS paid another $26 for an office visit. I don't know about the rest of you but that seems like a big raise to me.

  6. #58
    BamaNation Hall of Fame Bodhisattva's Avatar
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    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    Dunno, people seem to like Medicare.
    It doesn't surprise me that people like things that are free (for them) or heavily subsidized.
    Bodhi


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  7. #59
    BamaNation Hall of Fame Chukker Veteran's Avatar
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    Re: ACA holding...

    Paul Waldman at the Washington Post has a column up today with some relevant thoughts:

    ...Republicans, on the other hand, would like everyone to believe that providing affordable, secure coverage to everyone is simply beyond the reach of human ingenuity, like achieving faster-than-light travel or inventing a pill that will allow you to eat all you want without ever gaining weight.

    That position is somewhat undercut by the fact that every advanced democracy on earth except for the United States has managed universal coverage.
    https://www.washingtonpost.com/opini...=.c0f5cdd48a6c

  8. #60
    BamaNation Hall of Fame CharminTide's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bodhisattva View Post
    It doesn't surprise me that people like things that are free (for them) or heavily subsidized.
    No doubt. But that's missing the point from earlier in the thread. Essentially any comparison between Medicare and private insurance shows that Medicare is able to "negotiate" lower prices and reduces the overall cost of healthcare for the same services performed by the same doctors. If people are interested in actually reducing overall expenditures rather than tossing the hot potato back and forth, this has proven an effective model. The CBO has a quick powerpoint with some basic price comparison data. This slide shows the variance in reimbursement from private insurers compared to Medicare.



    Now, what would the consequences of a Medicare-for-all system be for medical professionals? No idea. If overall reimbursement is reduced, hospitals would presumably have to decide between juicy administration bonuses, buying that fancy new MRI machine, or keeping their physicians and staff happy. Personally, I find it hard to imagine a system where public insurance entirely supplants private insurance. More likely, both would exist concurrently, a la the German healthcare system. That said, German physicians get paid trash money, so many of them leave to practice in Switzerland or elsewhere.

    But granting all that uncertainty, we do know that a large central negotiator like Medicare can reduce overall U.S. healthcare costs, which is what folks were asking about earlier in the thread. I forget which analysis showed that a Medicare-for-all plan would cut overall U.S. healthcare spending by hundreds of billions over ten years. And costs would drop even more if Medicare were finally permitted to negotiate prescription drug prices. The obvious catch, however, is that the burden of payment would shift largely from insurers and consumers to the federal government. Despite Medicare being far more efficient than private insurers (2% administrative costs vs. 17%, LINK), some are conditioned to reflexively fear this.
    Last edited by CharminTide; December 18th, 2018 at 03:37 PM.

  9. #61
    BamaNation Hall of Fame Bodhisattva's Avatar
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    Re: ACA holding...

    Yeah, I understand the argument. I'm just very skeptical due to my experience in government. Nothing the government does is done well. Not even the simplest of things.
    Bodhi


    Lily (age 6): Daddy, I know what I want to be when I grow up: an artist.
    Bodhi (internally groaning): Yeah? What kind of artist?
    Lily: A balloon animal artist!
    Bodhi (face palm)

  10. #62
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    Re: ACA holding...

    Quote Originally Posted by Bodhisattva View Post
    Yeah, I understand the argument. I'm just very skeptical due to my experience in government. Nothing the government does is done well. Not even the simplest of things.
    No organization can afford to go it alone anymore. Corporations such as General Electric and General Motors, etc. have such large retiree medical obligations as to not be solvent in the future. The problem that any business that offers medical coverage today faces is all of the cost shifting that occurs from the uninsured receiving their primary care at emergency rooms. All levels of government as well are facing huge current and retired employee obligations that cannot be funded.
    The only choice will be to pass all of that cost off to individuals or create a more efficient medical delivery system that will have far less duplication and price gouging that makes the US spend double per capita than the rest of the developed world.

    I would also point out that Medicare does not administer the health care system. That is contracted out to the Blues, Aetna, Et al. who have the systems and expertise to negotiate pricing with providers and process claims.

  11. #63
    BamaNation Hall of Fame Bamaro's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bodhisattva View Post
    It doesn't surprise me that people like things that are free (for them) or heavily subsidized.
    That's what happens when congress gives voters something for nothing. aka, buying votes

  12. #64
    Senior Administrator TIDE-HSV's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bamabuzzard View Post
    What type "investments"? Also, since we've done away with insurance about four posts up. How do you address their ability to afford to pay for lawsuits filed against them? Without liability insurance they would have to be literally personally liable for any claims against them. Would these "investments" produce enough constant stream of income to cover that? Because at $150,000/year and doing no telling how many surgeries in any given year. There's no way they could save enough from that type income to cover legal cost of a claim filed against them. Would we have to now ask lawyers to lower their fees in the name of the greater good, so doctors can afford legal counsel?
    I thought the issue was doing away with medical insurance, not liability insurance? Maybe I didn't read closely enough...
    "The cure for boredom is curiosity. There is no cure for curiosity. - Ellen Parr"

    'If today were the last day of my life, would I want to do what I am about to do today?' - Steve Jobs

    I would rather live my life as if there is a god and die to find out there isn't, than live my life as if there isn't and die to find out there is. Albert Camus

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  13. #65
    Senior Administrator TIDE-HSV's Avatar
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    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    No doubt. But that's missing the point from earlier in the thread. Essentially any comparison between Medicare and private insurance shows that Medicare is able to "negotiate" lower prices and reduces the overall cost of healthcare for the same services performed by the same doctors. If people are interested in actually reducing overall expenditures rather than tossing the hot potato back and forth, this has proven an effective model. The CBO has a quick powerpoint with some basic price comparison data. This slide shows the variance in reimbursement from private insurers compared to Medicare.



    Now, what would the consequences of a Medicare-for-all system be for medical professionals? No idea. If overall reimbursement is reduced, hospitals would presumably have to decide between juicy administration bonuses, buying that fancy new MRI machine, or keeping their physicians and staff happy. Personally, I find it hard to imagine a system where public insurance entirely supplants private insurance. More likely, both would exist concurrently, a la the German healthcare system. That said, German physicians get paid trash money, so many of them leave to practice in Switzerland or elsewhere.

    But granting all that uncertainty, we do know that a large central negotiator like Medicare can reduce overall U.S. healthcare costs, which is what folks were asking about earlier in the thread. I forget which analysis showed that a Medicare-for-all plan would cut overall U.S. healthcare spending by hundreds of billions over ten years. And costs would drop even more if Medicare were finally permitted to negotiate prescription drug prices. The obvious catch, however, is that the burden of payment would shift largely from insurers and consumers to the federal government. Despite Medicare being far more efficient than private insurers (2% administrative costs vs. 17%, LINK), some are conditioned to reflexively fear this.
    People, even those on Medicare, don't understand how it works and why it's so efficient. I wish I hadn't thrown away my most recent Medicare statement, so I could repeat the actual reimbursements. However, my "list price" for my heart bypass a few years ago was something like $120K.* The doc got paid well, but, it was something like $6K. When I had the first BCC surgery in October, the fee was reduced from $1.2K+ to something like $700, because it was the second surgery he'd performed that day. I was chatting with my Mohs surgeon while he did my surgery a week ago. He does eight patients in a ten hour day (without counting the drive back and forth from B'ham). He confirmed he only got paid the full fee for his first patient. He went further and told me that, if I'd needed additional cosmetic surgery, he would have not been compensated for that. He said "I would never think about leaving you with any disfigurement I could prevent." I will save my next Medicare statement and post the numbers. It's abundantly clear from this thread that many, if not most do not begin to understand how Medicare works...

    *With my asset structure, had I not been either on Medicare or privately insured, they could have taken it out of my hide. If not, with the bypass, stents, colon resection and cancer surgery, I would have been driven into bankruptcy, like so many thousands in the US are every year. I do not understand why this is not understood as a national disgrace and is regarded as such by the rest of the civilized world...
    "The cure for boredom is curiosity. There is no cure for curiosity. - Ellen Parr"

    'If today were the last day of my life, would I want to do what I am about to do today?' - Steve Jobs

    I would rather live my life as if there is a god and die to find out there isn't, than live my life as if there isn't and die to find out there is. Albert Camus

    "When Fascism comes to America, it will be wrapped in the flag and carrying a cross." - Sinclair Lewis

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