U.S. Politics: The Bipartisan Dismemberment of the VA

[TerraPrime]

I used to wonder about states like Maine who would elect people like LePage to these high-profile positions. 

Then I was in Illinois when Rauner was elected and I no longer wonder quite as much.

[Shryke]

LePage win a 5 candidate race and then a 3 candidate race, achieving a majority neither time.

So at least slightly less depressing then it seems!

[TrackerNeil]

20 hours ago, TerraPrime said:

I used to wonder about states like Maine who would elect people like LePage to these high-profile positions. 

Then I was in Illinois when Rauner was elected and I no longer wonder quite as much.

I'd like to feel superior, but Pennsylvania is still doing penance for Rick Santorum.

[ThinkerX]

8 hours ago, TrackerNeil said:

I'd like to feel superior, but Pennsylvania is still doing penance for Rick Santorum.

I know how you feel, since it was my home state that spawned Palin.

[Shryke]

Re: The Media

I love this tweet. LePage truly is like a perfect test case:

 

[Martell Spy]

Racist Maine Governor Denies Resignation "Rumors" That He Started Himself This Morning

http://www.slate.com/blogs/the_slatest/2016/08/30/maine_gove

[Maithanet]

4 minutes ago, Martell Spy said:

Racist Maine Governor Denies Resignation "Rumors" That He Started Himself This Morning

http://www.slate.com/blogs/the_slatest/2016/08/30/maine_gove

That link doesn't work.  Try this.

 

[A Horse Named Stranger]

And LePage should be a warning for the general election what can happen if the votes split too much.

As far as the US cost for health care are concerned. It's a nice mixture of different actors thinking of the best of the Americans, their money.

You have healthcare providers, who can ask for the moon, and they get it, because the insurance providers have little to no bargaining power. You have a defacto oligopoly on the side of the pharmaceutical companies and medi-tech firms. 

I give a short summary of the argument for the high prices on the side of the pharma and medical supply/technology firms.

"We are charging that much, because innovation and research is expensive. In exchange you get new experimental medical equipment and drugs fresh from the shelf." Which is partly true, but you are getting overcharged nonetheless.

Let's look at the health providers

Health providers (Hospitals): "You get state of the art of medical treatment, and the best doctors. Medical devices like an MRI-Scanner are expensive, and the best doctors want the best pay. If you pay peanuts you get monkeys, do you want your surgery performed by a monkey?" Again, there's some truth to it. And MRI-Scanner is really expensive, not sure if the newer generation scanners are as sensible as the first generation, but back then you needed a special room for those, that was shielded from the earths magnetic field. Yet, that does not explain 20$+ for an Aspirin at a Hospital. But yes, at the very top you get the very best treatment.

The Doctors will say: "Look, we had to study to get into our jobs, we are highly trained professionals, and we have student loans we have to pay off. And we do not really earn much money during our first years on the job." And they kinda have a point.

You can try to pass legislation to cap the expenses for a certain medical procedure, which would take aim at the health providers (and indirectly at the Doctors), but I don't think you will be succesful in doing so. Because you are up against a very powerful lobby. So good luck getting any legislation passed in that congress. And it's against free enterprise and totally unamerican btw.

 

[The Anti-Targ]

Why does a "secretive spy unit within the defence department that advises on intentions and capabilities of foreign nations and entities" (DIA) have a twitter account? Is the first question. And the second one is how can the DIA give access to that account to someone who is so badly diplomatically unaware?

Ref, the hullabaloo over the DIA tweet about Obama's arrival in China.

[Commodore]

On 8/30/2016 at 1:23 PM, Notone said:

As far as the US cost for health care are concerned. It's a nice mixture of different actors thinking of the best of the Americans, their money.

You have healthcare providers, who can ask for the moon, and they get it, because the insurance providers have little to no bargaining power. You have a defacto oligopoly on the side of the pharmaceutical companies and medi-tech firms. 

I give a short summary of the argument for the high prices on the side of the pharma and medical supply/technology firms.

 

 

You left out the FDA

[Crazydog7]

I don't know if this counts as an election story but the woman who pretty much trail blazed modern conservatism is dead

http://www.nytimes.com/2016/09/06/obituaries/phyllis-schlafly-conservative-leader-and-foe-of-era-dies-at-92.html?_r=0

As some of have said good or bad, handsome or ugly, rich or poor, they are all equal now.

[aceluby]

On 8/30/2016 at 1:23 PM, Notone said:

You have healthcare providers, who can ask for the moon, and they get it, because the insurance providers have little to no bargaining power. 

This is simply not true.  Insurance companies and hospitals barter on many bills, and will 'settle' for as little as 10% of the total bill depending on the relationship the insurance company has with the hospital.  I developed an app that did this automatically for an insurance provider a few years ago.

[MerenthaClone]

17 hours ago, aceluby said:

This is simply not true.  Insurance companies and hospitals barter on many bills, and will 'settle' for as little as 10% of the total bill depending on the relationship the insurance company has with the hospital.  I developed an app that did this automatically for an insurance provider a few years ago.

Medicare, in my very uninformed knowledge of the topic, is fairly hamstrung in its ability to bargain, though, no?  And given the demographics of people who rack up very large hospital bills, Medicare is probably going to be very involved in paying for that.  

[aceluby]

8 minutes ago, MerenthaClone said:

Medicare, in my very uninformed knowledge of the topic, is fairly hamstrung in its ability to bargain, though, no?  And given the demographics of people who rack up very large hospital bills, Medicare is probably going to be very involved in paying for that.  

Nope, they have HUGE bargaining power when it comes to hospital care.  They pay some of the lowest reimbursement rates out there to hospitals and doctors.

[Larry of the Lawn]

Wasn't sure if this goes in this thread or the election one, but pretty disappointed that Clinton hasn't said anything about the Dakota Pipeline.  Seems like a good opportunity for her to emphasize this part of her platform.

 

Eta:.  This silence is making me angrier and angrier.  This would be time for HRC to demonstrate to a lot of people thinking about voting Green or thinking about staying home that she isn't going to shy away from taking stand against Wall Street and corporate interests when they destroy the environment and violently attack protesters in the name of profits.

[A Horse Named Stranger]

On 5.9.2016 at 3:48 PM, Commodore said:

You left out the FDA

How exactly is the FDA involved in driving up prices? 

Unless you think demanding from the pharma corps comprehensive testing before their products get approved by the FDA?

On 6.9.2016 at 3:39 AM, aceluby said:

This is simply not true.  Insurance companies and hospitals barter on many bills, and will 'settle' for as little as 10% of the total bill depending on the relationship the insurance company has with the hospital.  I developed an app that did this automatically for an insurance provider a few years ago.

http://healthaffairs.org/blog/2013/03/06/no-competition-the-price-of-a-highly-concentrated-health-care-market/

Though the author arrives at a nice little plot twist I did not think possible.

Quote

 Research indicates that hospitals can change their business practices and control their costs effectively when faced with competitive pressure, but health care markets have concentrated in the last few decades. Providers simply haven’t had to compete to offer high-value care.

Commercial health plans have little bargaining power when they negotiate prices with monopolistic providers. In fact, even insurance industry lobbyists admit that private health plans cannot hold down the cost of health care. Insurers choose instead to adapt to this non-competitive environment. Sometimes they resort to collusion, as was the case with Partners Health, a massive provider group that entered into an ethically dubious arrangement with Massachusetts Blue Cross, as the Boston Globe reported in 2009. In that deal, Partners agreed to ensure that no other health insurer would pay lower rates than Blue Cross.

I must admit, I didn't think that insurance companies would pay more on purpose to block competitioners from getting a contract with the same health care provider. That was a twist that surprised me.

[White Walker Texas Ranger]

49 minutes ago, Notone said:

How exactly is the FDA involved in driving up prices? 

Unless you think demanding from the pharma corps comprehensive testing before their products get approved by the FDA?

http://healthaffairs.org/blog/2013/03/06/no-competition-the-price-of-a-highly-concentrated-health-care-market/

Though the author arrives at a nice little plot twist I did not think possible.

I must admit, I didn't think that insurance companies would pay more on purpose to block competitioners from getting a contract with the same health care provider. That was a twist that surprised me.

For generic drugs, like epinephrine, the FDA makes it very difficult to produce competitors to the epipen.

for drugs still covered by patent, it's a much thornier issue.

[A Horse Named Stranger]

Patents in the pharma industry is somewhat tricky. And I think it's really not easy to arrive at a fair solution there. I will explain what I mean.

Without some sort of protection from patents costs for medication would probably drop very fast short term. That is true. The reason is, that other drug companies would produce generic drugs (same substance different name). But it would make research pretty unattractive mid to long term.

Let's say Company A.)  has developed a new drug that can cure some specific form of cancer. That company has spent years and billions of dollar on the research and FDA approval and so on and so forth. Of course they want (and deserve) a return of investment. What do company B.) C.) and D.) do? They don't bother with the initial research, they simply throw out their generic drugs on the market and undercut prices for company A.). And they can do that easily because they did not spend that much cash on research. So they are really freeriding. So if you are pharma company would you bother to pump big money into research under those circumstances? 

In my opinion there should be some sort of protection for company A.) in place, so that they can benefit from their research. 

The whole thing of course gets problematic, when company A.) decides to simply milk the cash cow (the health care system) and jacks up prices.

It's really not that easy to come up with a fair solution imo. You can try to do it by putting an expiration date on medical patents. You can do it by limiting the patent to the way the drug is produced. So Company B.) C.) and D.) have to do some research on their own on how to synthesize a drug instead of simply copying company A.)

[DireWolfSpirit]

Do we have examples of cases where big Pharma or the Biotech firms have been hurt from "lack" of protections though? They seem comfortably profitable and well represented (legislative wise) within the current framework.  If additional measures were created for them, I'd wonder if we werent getting into corporate welfare? I mean this is an industry that already practically crafts its own bills due to heavy lobbying and influence. 

At this point we need to take a look at worrying about the consumers and some balance to all parties imo.

[A Horse Named Stranger]

They are, I made (or tried to make) the counter factual argument. The what would happen without some sort of protection.