U.S. Politics: Hairpiece In the Middle East Part 2

[Kalbear]

1 minute ago, Rippounet said:

Hear hear!

Why is everything health-related so expensive in the US anyway?

That's a difficult question to answer, but a lot of it has to do with the employer-based insurance model that the US has. The lack of government control on overall costs and overall services combined with a really huge deduction in employer-based insurance means that employers for a lot time had a really nice carrot to give to people - insurance that could cover almost anything. And insurers could charge crazy prices for this, and hospitals could in turn charge those insurers pretty hefty prices. Plus the hospitals pretty much had to, because they had to make up for the cost of giving those without insurance care - which they were required to do. 

There was no incentive for making costs go down. 

There were no incentives for outcome-based care.

There were no incentives for preventative care.

Basically, hospitals had an incentive to charge a ton, insurers had incentive to charge a ton, and employers were getting bailed out by tax breaks to give this money away. Who paid for this is the taxpayer. Shockingly, the health insurance system doesn't want this to go away, and as most employees are very happy with their insurance THEY don't want it to go away. 

The other cost, of course, is the 20% of Americans who didn't have any kind of insurance and would either suffer emergency room treatment to deal with symptoms or would just, ya know, not get treated at all. 

[DMC]

Just now, Rippounet said:

I think the main difference is that Madison, Jefferson or Washington are remembered  for many other things than owning slaves.
Guys like Robert E. Lee or Jefferson Davis are primarily remembered for their role in the Civil War and what they stood for in that specific conflict. Sorry for the Godwin point, but it seems to me very much like having monuments to Nazi generals in Germany...

Yep.  I think what you're saying is MJW (yeah, I just made that) are celebrated for reasons entirely removed from slavery, whereas Lee's (and most certainly Davis') monuments are altars for white supremacists.  I agree.

[Cas Stark]

5 minutes ago, TrueMetis said:

Well yeah, it the exception. It's also why healthcare insurance exists, at least in places that don't just cover healthcare automatically. So that if you are one of the unlucky people who get hit with millions in healthcare costs you aren't fucked. So that fact that you aren't, hopefully ever, spending that kind of money on healthcare is irrelevant. I'm 24, people my age dying is the exception no the norm, I still have a life insurance policy. (admittedly this is a mandated one as per my occupation but still, good idea to have it)

This is my last post on the subject.  But, we might do better if "health insurance" had many many more option than what ACA offers...and if we tied the pricing at least to some degree to risk factors...like in the old days...and where you could purchase the amount of insurance you wanted, if you wanted everything, fine, if you only wanted insurance for catastrophic events, and those lower premiums were important to you, you could have that too.  What we have now, despite bronze, silver and gold branding, is one size fits all...no real substantial choices about the kind of insurance you have.

[TrueMetis]

2 minutes ago, Cas Stark said:

This is my last post on the subject.  But, we might do better if "health insurance" had many many more option than what ACA offers...and if we tied the pricing at least to some degree to risk factors...like in the old days...and where you could purchase the amount of insurance you wanted, if you wanted everything, fine, if you only wanted insurance for catastrophic events, and those lower premiums were important to you, you could have that too.  What we have now, despite bronze, silver and gold branding, is one size fits all...no real substantial choices about the kind of insurance you have.

You could do better in a lot of ways, unfortunately you have the Republican Party, who's idea of healthcare is "fuck you".

[Fragile Bird]

Just now, Cas Stark said:

<snip>

From what I've seen of your posts, basically what you are telling us is that your health care is being subsidized by people who have insurance, all those patients of your doctor and other providers who do not get 70% discounts.

The way health care should work is that everyone should be enrolled, and indeed, the healthy subsidize the sick. It's one of the reasons why single-payer nations are starting to feel a crunch, baby boomers are aging and there are not enough workers to feed into the system. All those slackers who decided not to have children.  

[DMC]

4 minutes ago, Kalbear said:

That's a difficult question to answer

It's really not.  The difficult question is how do we lower costs while still appeasing the health insurance lobby?

[LongRider]

Listening to the first  part of the Marketplace radio show this afternoon they were talking the new budget and it was pretty funny.  First they had Mulvaney proudly tell us the name of the budget 'A New Foundation for American Greatness' (can I just say here that the title alone is sooooo Making American not just Great Again, but Newly Great Again) 

Then Mulvaney was taking everyone to task because they just couldn't seem to get behind the awesome, and I mean really, bigly, awsomest 3% a year growth you ever saw!  None of that mealy 1.8% growth from that girly man Obama, nuh uhh, 3% gar-enn-teeed growth because he said so.

Then they went into the magic math of the 2$ trillion that's gonna happen because this time, the MAGA tax cuts are gonna pay for themselves and boy howdy, they're gonna pay for themselves and then that 2$ trillion is gonna get teed up to do some more magic in the budget!  First the tax cuts pay for themselves like never happened before, because the previous tax cuts weren't MAGA and stuff, and then the magic will just ooze out again. 

Applause applause applause..........wait, why were the Marketplace folks not so impressed with this magical budget?  Just some pantywaists on the radio throwing shade 'cuz they like facts and stuff.  Party poopers. 

 

 

[Kalbear]

6 minutes ago, Cas Stark said:

This is my last post on the subject.  But, we might do better if "health insurance" had many many more option than what ACA offers...and if we tied the pricing at least to some degree to risk factors...like in the old days..

In the old days we tied the pricing and the ability to even get it based on risk factors, but mostly we tied the pricing to your ability to get a job. 

The notion that the price of it was based on risk factors is not at all borne out by history. For most people, getting insurance at all was either possible and cheap, or impossible, or entirely irrelevant to their health whatsoever.

Just now, dmc515 said:

It's really not.  The difficult question is how do we lower costs while still appeasing the health insurance lobby?

That's a different question. Why things are so expensive in the US is a weird combination of factors. What we can do to lower costs is another weird answer, given that you have to appease not only the health lobby but also everyone who gets their insurance via employers, which is the bigger majority of people. That's a tough sell. I know at my company (Microsoft) there were a TON of people who were totally pissed off that their insurance was changing for the worse, even though it was still better than 95% of everyone out there. 

[Cas Stark]

2 minutes ago, Fragile Bird said:

From what I've seen of your posts, basically what you are telling us is that your health care is being subsidized by people who have insurance, all those patients of your doctor and other providers who do not get 70% discounts.

The way health care should work is that everyone should be enrolled, and indeed, the healthy subsidize the sick. It's one of the reasons why single-payer nations are starting to feel a crunch, baby boomers are aging and there are not enough workers to feed into the system. All those slackers who decided not to have children.  

LOL. Yes, certainly, god forbid that anyone, even a doctor, take any personal initiative, even to the point of reducing their own fee.  

[OldGimletEye]

Just now, Cas Stark said:

snip

I think we'd better if we passed a basic single payer plan that covered everyone (though I'd want it to be fairly robust). And then let private companies sell supplemental plans on top of the basic single payer plan.

Also, there is many reasons to think our healthcare system, compared to other systems, is not very efficient. We need to drive those efficiency out both for humanitarian reasons and for long term fiscal reasons.

[OldGimletEye]

Just now, Nasty LongRider said:

Then they went into the magic math of the 2$ trillion that's gonna happen because this time, the MAGA tax cuts are gonna pay for themselves and boy howdy, they're gonna pay for themselves and then that 2$ trillion is gonna get teed up to do some more magic in the budget!  First the tax cuts pay for themselves like never happened before, because the previous tax cuts weren't MAGA and stuff, and then the magic will just ooze out again. 

Orange Swamp Thingy math is the best.

[Fragile Bird]

2 minutes ago, Cas Stark said:

LOL. Yes, certainly, god forbid that anyone, even a doctor, take any personal initiative, even to the point of reducing their own fee.  

Well, he's giving you private charity, isn't he?

I wonder if he writes you off as a tax deduction, which would mean the public actually pays for you.

[OldGimletEye]

Just now, Fragile Bird said:

The way health care should work is that everyone should be enrolled, and indeed, the healthy subsidize the sick.

This sounds suspiciously like insurance.

[LongRider]

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[Cas Stark]

3 minutes ago, Fragile Bird said:

Well, he's giving you private charity, isn't he?

I wonder if he writes you off as a tax deduction, which would mean the public actually pays for you.

Yeah, private charity is a good thing.....it's voluntary.  Of course, I doubt that he really needs to charge over $300 for an office visit, which is the insurance paid fee he gets....which is undoubtedly why he doesn't take exchange insurance.

[Gareth]

10 minutes ago, Cas Stark said:

LOL. Yes, certainly, god forbid that anyone, even a doctor, take any personal initiative, even to the point of reducing their own fee.  

You might not be getting special discount.  Its probably the same discount that an insurance company negotiated with the doctor for their subscriber.  Or the same discount that CMS (Centers for Medicare & Medicaid Services) or your state's dept of health is able to negotiate for their subscribers.

Edited to say that there are complicated federal laws about discounting, especially for out-of-networks providers (which this could be your case).  If your provider isn't covered by your insurance (i.e. out-of-networks), what he/she doing by offering you discount is potentially illegal via kickback laws.

[Kalbear]

4 minutes ago, Fragile Bird said:

Well, he's giving you private charity, isn't he?

I wonder if he writes you off as a tax deduction, which would mean the public actually pays for you.

It's actually worse; he forces the government and those with good insurance to pay for him. Cas Stark is basically living on the charity of others. 

[LongRider]

They tried Voodoo Economics, now it's time for MAGA Math.  Lucky us. 

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[Cas Stark]

3 minutes ago, Gareth said:

You might not be getting special discount.  Its probably the same discount that an insurance company negotiated with the doctor for their subscriber.  Or the same discount that CMS (Centers for Medicare & Medicaid Services) or your state's dept of health is able to negotiate for their subscribers.

It's a discount, I know what they charge for a regular office visit and I know they do not take ACA exchange insurance because he says they would lose money. And I know he hand writes the $$ on the form every time I go there.

[OldGimletEye]

I think I like MAGA math. No theorems to remember or any of that crap.

If you get stuck, just make shit up!