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I want to know who it will be. I have never supported Trump. As I've pointed out many times the DNC is still arguing that those of us that want UHC simply need to get over it.
No. Does that mean Trump wins again? It might. How is it that the DNC does not understand this?
IMHO- Trump is the nexus, his election was more about peoples rejection to over 25 years of partisan politics and a candidate from outside the beltway and the stench of the Washington elite. The DNC nor the GOP will understand anything that upsets the perfect world they occupy, they know we live under an oligarchy and they profit from the relationship, and they will fight against any changes to the arrangement. I think, and I hope, that Trump may actually be a catalyst to wake a sleeping giant in this country which is the apathetic majority. I doubt there are many people who don't have a passionate concern for the direction of the country at this point and since the beginning of this administration, news bias, social media, foreign intervention, partisan politics, is a big problem.
I've been pointing this out for years. For voters, yes this is a problem. Granted, someone like Trump will acknowledge the problem but do nothing but (D)'s refuse to even admit there is a problem here.
Obama completely blew his opportunity to address the mess that is the V.A.
Can the next VA leader break the cycle of corruption?
We should NOT still be asking this question. I've pointed this out before........this gives those who are against UHC a winning argument against it. It MUST be addressed.
Thank you for the article. This is a big problem in this country.
What programs are they abusing? This is about medical care. It's really tough for a medicaid patient to 'abuse' the system, in most places there aren't enough primary care physicians who will see medicaid patients so it's not like they can waste 'your' money by making podiatry appointments and having their toenails trimmed, or having tummy tucks. At least in California, it pretty much sucks to be on medicaid, or the California equivalent "medi-cal", unless you opt to spend hours in the ER there is usually a wait of at least a few weeks to get an appointment to see an physician.
If a person is legitimately eligible to be on Medicaid, that is fine. I am referring to people that are not......those that are working off the books or illegally and not paying taxes for example. They are not showing their actual income which would make them ineligible for these benefits. That is fraud, times this by millions. Provider fraud is also devastating to the system. Sorry I am off topic but needed to address this post.
What programs are they abusing? This is about medical care. It's really tough for a medicaid patient to 'abuse' the system, in most places there aren't enough primary care physicians who will see medicaid patients so it's not like they can waste 'your' money by making podiatry appointments and having their toenails trimmed, or having tummy tucks. At least in California, it pretty much sucks to be on medicaid, or the California equivalent "medi-cal", unless you opt to spend hours in the ER there is usually a wait of at least a few weeks to get an appointment to see an physician.
At least some of the abuse comes in the form you allude to, going to an ER for minor non emergency ailments, a triage nurse can put a low priority on their case, but they can't turn them away. I've seen it, using ER services for coughs, headaches, sniffles, pulled muscle, splinters, etc. I have good insurance, and I usually self treat for most of those minor annoyances. An ER has to cost significantly more than a clinic, ER's are for emergencies. Too long to wait? Too bad, it takes me time (sometimes weeks) to get an appointment too. Besides, if you're asking the public for help, you probably shouldn't expect to have the same level of access to health care as those who can pay for better plans. Is that a class issue? Probably, but no different than anywhere else. We have friends who live in Whales, of course they have universal care, but they go to state run clinics and hospitals, the wealthy people have private insurance and go to the doctors of their choice.
Health insurance works when everyone pays into it and the risk is spread among a large enough group that it is affordable.
We consume on average over $10,000 to $12,000 per person per year of health CARE (depending on the estimate). Therefore, as surely as night follows day, the price of health care INSURANCE must be on average about $10,000 to $12,000 per person per year just to pay for the underlying health CARE. Then, you need to talk on to that administrative costs and profit.
So, when you spread $10,000 to $12,000 plus administrative costs and profit around a large group -- the whole USA, does it then become affordable? Nope. It still costs $10,000 to $12,000 plus administrative costs plus profit. That is Too Damn Expensive.
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Originally Posted by 2sleepy
As far as "knowing months in advance when you will have a baby so F you, just save up for the bills" that's all well and good if you have a normal delivery and a healthy baby but what if you don't? If people had to save up for every potential bad outcome from childbirth they would be 50 before they could afford to have children.
You miss the point. There is no "F you," as you write above. The issue is insurance is a highly inefficient way of paying for the predictable and foreseen. Bad outcomes are not foreseen, of course, and insurance is a good way to cover that.
But is insurance the most efficient way to finance baby delivery and maternity care? Because that is what we are really talking about here -- how to finance that expensive baby delivery and maternity care, and, that is the wrong question. The right question -- or rather the right issue -- is "it costs too damn much for normal baby delivery and maternity care, and we need to fix that, and not by kicking a mom to the curb an hour after she gives birth." Insurance is not going to fix the high cost of the underlying medical care; indeed, I believe insurance is a big part of the problem.
Let's all remember there is a difference between cost and price. We all talk about the cost of healthcare, what we really mean is the price of healthcare. We know that in a functioning marketplace, price tends to marginal cost. We also know the marketplace for healthcare is anything but functional. The actual marginal cost of, say, an X-Ray is modest - a few minutes of a technician's time and some consumables (they used to do X-Rays on film, but nowadays they are mostly done digitally where there are zero consumables), and toss in a few pennies of electricity. That's it. There is no economic justification for a doctor or a hospital charging several thousand dollars for that X-Ray, but that is what happens, with insurance companies then knocking it down to a pre-negotiated fee of $300 or whatever.
Quote:
Originally Posted by 2sleepy
I think this comes down to a simple difference in our beliefs. Some of us believe health care is a right and others of us think it should be reserved for only those who can pay for it.
I think everyone in a civilized society believes in a responsible social safety net. I know I do. That isn't the issue.
Left on its current course, health care costs will one day consume on average across the USA an inflation adjusted $15,000 per person. Then $20,000 per person, adjusted for inflation. Then $50,000 per person adjusted for inflation, and then $100,000 per person.
It isn't about health insurance spreading the risk among a sufficiently large population -- the real problem is health care just costs too damn much and all the smart people just seem to be flailing around and our highly partisan legislature is focusing on how to pay for health care insurance rather than on why the damn health care costs so much in the first place.
OK, I'll get off my soap box.
Quote:
Originally Posted by 2sleepy
The biggest problem with the ACA was leaving employer provided insurance to operate outside of the system.
It certainly didn't help. But insurance isn't the root cause of the problem -- health care is the root cause of the problem.
Let's all remember there is a difference between cost and price. We all talk about the cost of healthcare, what we really mean is the price of healthcare. We know that in a functioning marketplace, price tends to marginal cost. We also know the marketplace for healthcare is anything but functional. The actual marginal cost of, say, an X-Ray is modest - a few minutes of a technician's time and some consumables (they used to do X-Rays on film, but nowadays they are mostly done digitally where there are zero consumables), and toss in a few pennies of electricity. That's it. There is no economic justification for a doctor or a hospital charging several thousand dollars for that X-Ray, but that is what happens, with insurance companies then knocking it down to a pre-negotiated fee of $300 or whatever.
It certainly didn't help. But insurance isn't the root cause of the problem -- health care is the root cause of the problem.
That is the crux of the problem with costs, they're artificially inflated! They're just making sure they get their compensation when all is said and done, so they play the game and we're caught in between. When I was a kid in the 50's and 60's, few people had health insurance, doctors dealt with families one to one, you asked for his services, you said "how much?", you paid him. I don't recall what they charged for, say an office visit, but my dad din't make a lot of money and there were 5 of us kids, and I don't recall missing a meal because we had a big medical bill.
As far as who's at fault? It's the system we've allowed to take over our health care and it's going to be tough getting that genie back in the bottle.
Neither solve the problem, which is the price of health care is too damn expensive.
A personal locally posted a hospital bill from 1947. The first thing I found interesting was that they did have insurance. A nights stay was $8. A blood transfusion was $2.25. I believe they had were there 8 days. The bill came to just shy of $190 and the person was responsible for $63 after insurance.
$63 was a good bit when the average salary was $3500 but that was still only just over a weeks wages.
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They're just making sure they get their compensation when all is said and done, so they play the game and we're caught in between. When I was a kid in the 50's and 60's, few people had health insurance, doctors dealt with families one to one, you asked for his services, you said "how much?", you paid him. I don't recall what they charged for, say an office visit, but my dad din't make a lot of money and there were 5 of us kids, and I don't recall missing a meal because we had a big medical bill.
