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I’d much prefer to see our greatly inflated health care costs go down.
Agreed. There's already enough money in the system to fully fund universal health care. The problem is it's all going to the wrong places. Instead of just funding medical professionals, we're also funding lawyers, administrators, insurance companies, and Wall Street.
Agreed. There's already enough money in the system to fully fund universal health care. The problem is it's all going to the wrong places. Instead of just funding medical professionals, we're also funding lawyers, administrators, insurance companies, and Wall Street.
I don't usually reduce situations like this to simplistic images - there is nearly always a more complex explanation of what's really going on, no matter how much someone might object to the process or results - but BigMed/BigPharm and their extraordinary lobbying power is accurately depicted as not just pigs feeding at a trough, but a feeding frenzy where they don't even notice if one of them gets eaten.
It's not quite as simple as an age cutoff.
...
The Freakonomics podcast once had an episode called "Glorious Sunsets"- the name of an imaginary insurance company that would give you a nice bonus- $40,000 or $50,000- if you chose palliative care instead of aggressive treatment. You can't do it because of the ethical issues, of course- Warren Buffett and Bill Gates could choose to take every measure possible without worrying about their family, but Jane Sixpack may forego treatment to leave money to help her grandchildren. Interesting thought exercise, though, that points out that unlimited health care has a cost.
Private health insurance and private payments are a different matter -- heroics are fine as long as the taxpayers aren't paying for it.
My point was that public health insurance/ Obamacare/ Medicare-for-all/ Medicaid -- whatever the US ends up with -- must have some boundaries. One of those boundaries needs to be a limit to end-of-life heroics, where huge amounts are currently spent. The reason age would be a good qualifier (maybe it should be 75 rather than 70) is that it is _equitable_
Once you introduce judgments ("who is strong enough to undergo this procedure", for example), you will inevitably politicize the public health insurance program. That leads to bad outcomes. "Death Panels" come to mind.
Once you introduce judgments ("who is strong enough to undergo this procedure", for example), you will inevitably politicize the public health insurance program. That leads to bad outcomes. "Death Panels" come to mind.
The concept is good. I can't see any way to implement it that would be.
Yes, there are people living lives of something between vegetables and death row prisoners who are kept alive at enormous cost. But what about someone, say, 72 who simply has a quiet life of no particular merit to anyone else? Are they 'worth' saving for another five years of quiet anonymity?
I suspect the answer might vary a bit between those who are hale, hearty, well-off and not that old, and those who... may be leading lives of 'little merit.'
And what of someone going through a bad stretch - depression, loss, financial reversal - who might be judged not worth saving because of that condition... but could recover in all ways and live another good stretch of life?
Good notion. Won't work until we fully reduce people to replaceable elements in every way, at which point you may pull my plug regardless of my age, condition or outlook.
But vastly reducing costs and overtreatment driven by uncontrolled billing and malpractice terror - no, not every kid with a sprained ankle needs an MRI - is definitely the direction to aim.
I believe so. I was responding to someone saying that “pizza” was a reason people are obese. I’m far from obese. I love pizza. I even make my own once in a while. There’s a lot more to it than just “pizza”.
Until we can find it in our hearts to prioritize our national spending we will be arguing forever over whether we need to build more and better killing machines for the sake of corporate profits, or, have better schools, hospitals, old folks homes, etc. not to mention better air, water, and food. The wowsers will continue to deflect our attention by their habitual alarm soundings, but in the end, our country will most likely evolve under pressure. And that pressure stems from too many greedy hands in our government's pockets, not to mention the rise of a plutocratic hand in all of government's affairs.
It's really about priorities, as Coretta King observed:
"Our Congress passes laws which subsidize corporation farms, oil companies, airlines, and houses for suburbia. But when they turn their attention to the poor, they suddenly become concerned about balancing the budget and cut back on the funds for Head Start, Medicare, and mental health appropriations. "
I believe so. I was responding to someone saying that “pizza” was a reason people are obese. I’m far from obese. I love pizza. I even make my own once in a while. There’s a lot more to it than just “pizza”.
Of course there is. But I pointed out that pizza==loads of cheese, and cheese is a relative newcomer to the American diet - from a minor ingredient and upscale snack to, well, I don't think there are any cheese-flavored breakfast cereals yet. It may be the single most prominent factor in US portion/calorie size and obesity increase. Pizza is just the most egregious example; burgers with more calories in the cheese than from the meat are another. Cheese all over salads (both as grated stuff and loaded into dressings). Cheese sticks by the dozen as snack food.
And we've been convinced that it's somehow a good thing, a natural food, something to be heaped on everything except - so far - ice cream and cereal. When there are few substances in the kitchen with a higher calorie density, except maybe for butter. (Which is likely 'healthy' margarine sitting atop the block of cheddar.)
Oh, and my goodness does it slam both the fat and salt buttons of our hindbrains.
The Budweiser argument doesn't work here, either. That most people eat cheese and many aren't fat is not a convincing argument. So yes, I think you did miss the point in making your point.
I don't usually reduce situations like this to simplistic images - there is nearly always a more complex explanation of what's really going on, no matter how much someone might object to the process or results - but BigMed/BigPharm and their extraordinary lobbying power is accurately depicted as not just pigs feeding at a trough, but a feeding frenzy where they don't even notice if one of them gets eaten.
According to CMS, prescription drug spending is only 10% of the pie. The high prices of a drug make headlines, but you are usually seeing the sticker price and not the actual cost after rebates, discounts, etc. Further, generics account for about 90% of the volume. Like each category, savings can be attained. However, pharmaceutical savings will not make much of a dent in driving down healthcare costs in the US.
Agreed. There's already enough money in the system to fully fund universal health care. The problem is it's all going to the wrong places. Instead of just funding medical professionals, we're also funding lawyers, administrators, insurance companies, and Wall Street.
The ACA mandates minimum loss ratios. What that means is that a health insurance company MUST pay out a minimum of (usually) 85% of the premiums it takes in as claims. The other 15% must cover everything else- CEO salaries, compensation and benefits for everyone else, advertising, agent commissions and..yes...profit, including any shareholder dividends. If they pay out less than that they must issue a dividend to policyholders. If they pay out MORE... well, tough luck.
So, the private insurance business is pretty much "cost-plus". They're passing on the cost of claims, plus a fairly modest markup (compared to, say retail stores and restaurants) onto their policyholders.
I agree with minimum loss ratios but we need to get at the root of the other 85% of the premium.
Of course there is. But I pointed out that pizza==loads of cheese, and cheese is a relative newcomer to the American diet - from a minor ingredient and upscale snack to, well, I don't think there are any cheese-flavored breakfast cereals yet. It may be the single most prominent factor in US portion/calorie size and obesity increase. Pizza is just the most egregious example; burgers with more calories in the cheese than from the meat are another. Cheese all over salads (both as grated stuff and loaded into dressings). Cheese sticks by the dozen as snack food.
And we've been convinced that it's somehow a good thing, a natural food, something to be heaped on everything except - so far - ice cream and cereal. When there are few substances in the kitchen with a higher calorie density, except maybe for butter. (Which is likely 'healthy' margarine sitting atop the block of cheddar.)
Oh, and my goodness does it slam both the fat and salt buttons of our hindbrains.
The Budweiser argument doesn't work here, either. That most people eat cheese and many aren't fat is not a convincing argument. So yes, I think you did miss the point in making your point.
Nope. All that is irrelevant to my post. I understand you are trying to get your own points in...as always. . They just have nothing to do with what I stated.
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. They just have nothing to do with what I stated.
