US Politics Mega-thread - Page 7333

On April 13 2017 23:51 Krikkitone wrote:


While there are inefficiencies in competition, there are usually worse inefficiencies in oligopoly/monopolies. And the problem is US healthcare is made up of multiple local/regional oligopolies/monopolies.

In many areas a hospital/insurance company can prevent another hospital/insurance company from opening in the same area. (that's part of what those legal teams are for... to stop competition)
Employer insurance often gives you only a limited set of options.

Emergency care is Often more expensive than preventative care (although part of the US problem is too much expensive, preventative care). But uninsured patients are definitely a problem, because the hospital knows if the cost to the hospital was $100,000 they need to charge $500,000 because 80% of that won't be gotten back due to people who can't pay $100,000 (at least among uninsured...if you have insurance, they only charge the insurance company $100,000 dollars because they know the bill will be paid)


The system could be significantly improved in a number of different ways... but any significant improvement would require getting rid of the thing that most people are afraid of losing in the current system (employer provided insurance)

On April 13 2017 23:32 Buckyman wrote:
The United States is a special case regarding health care. We fund a disproportionate amount of the world's medical research, which the rest of the developed world mooches off of. So of course our medical care is more expensive, right?

Nope, it turns out that the government has tied private medicine's hands behind its back! To start with, the Affordable Care Act has severely reduced the ability of consumers to customize their health insurance policy, which is one of the main draws of an open market. The health care itself hardly fares better; The electronic medical records mandates cost roughly as much as a physician's salary to implement, and complying with Medicare and Medicaid essentially requires one administrative employee per physician.

Local government has a tendency to compound the issue; A lot of places in the USA restrict building new hospitals to limit 'redundancy'. That leads to some local monopolies. Other places, such as New York, place unfair burdens on for-profit hospitals. Even where their hospitals are overpriced, and competition would drive those prices down dramatically, hospital companies can't enter the market.

These factors combined drive up health care costs by at least a factor of two.

No wonder single payer looks attractive - a single payer system wouldn't need to deal with the government sabotaging it at every turn.

(There's even more going on, but this post is already in tl;dr territory)

On April 13 2017 23:50 Buckyman wrote:

In practice, the main effect right now is transferring large amounts of money from doctors and hospitals to software vendors.

On April 13 2017 23:51 Krikkitone wrote:

Not poster asked, but I don't think it is terrible, I do think it has significant flaws, which the British will tend to avoid for the same reason the (employed) people in the US like their system, it sort of works (just like the post office/DMV) and changing it would expose people to a lot of risk that a new system might be much worse.

On April 13 2017 23:59 {CC}StealthBlue wrote:
Yep...

https://twitter.com/GMA/status/852489652606951425

On April 14 2017 00:00 KwarK wrote:

In my experience we all love it and just wish the government would fund it properly. To give an idea of how underfunded it is. If we spent what you guys spend then we could have the NHS and give $7000/year to every man, woman and child in the country. Or we could have a second NHS and keep the hospitals open and staffed but closed to the public in case anything ever went wrong with the first NHS. That's how underfunded it is.

On April 14 2017 00:00 KwarK wrote:

This is the answer of a man who isn't yet sure how many of his conversations were recorded.

On April 13 2017 23:56 KwarK wrote:
If you can't do this without googling you probably shouldn't be customizing your healthcare plan.

On April 13 2017 23:55 LightSpectra wrote:
Giving people free preventative care saves thousands of dollars per-capita in the long run. There is really no good reason why there should be any poor people without regular checkups, vaccines, etc.

On April 14 2017 00:05 Buckyman wrote:


Are you assuming people would try to customize their healthcare plan without using google?

Just days before the state visit of Japanese Prime Minister Shinzo Abe to Mar-a-Lago, President Donald Trump’s Palm Beach private club, Florida restaurant inspectors found potentially dangerous raw fish and cited the club for storing food in two broken down coolers.

Inspectors found 13 violations at the fancy club’s kitchen, according to recently published reports — a record for an institution that charges $200,000 in initiation fees.

Three of the violations were deemed “high priority,” meaning that they could allow the presence of illness-causing bacteria on plates served in the dining room.

According to their latest visit to the club Jan. 26, state inspectors decided Mar-a-Lago’s kitchen did meet the minimum standards.

But they had a field day with elements that could give members of the high-class club and foreign dignitaries some pause:

▪ Fish designed to be served raw or undercooked, the inspection report reads, had not undergone proper parasite destruction. Kitchen staffers were ordered to cook the fish immediately or throw it out.

▪ In two of the club’s coolers, inspectors found that raw meats that should be stored at 41 degrees were much too warm and potentially dangerous: chicken was 49 degrees, duck clocked in a 50 degrees and raw beef was 50 degrees. The winner? Ham at 57 degrees.

▪ The club was cited for not maintaining the coolers in proper working order and was ordered to have them emptied immediately and repaired.

The other violations weren’t so serious. Water at the sink where employees wash their hands was too cold to sanitize hands. And Mar-a-Lago was also written up for keeping rusted shelves inside walk-in coolers.

In the past, Trump, who has spent most weekends at the club so far this year and hosted Chinese leader Xi Jinping there last weekend, was often involved personally in the day-to-day operations.

It wasn’t rare to see him check out the kitchen and give directions to the club’s floor personnel.

At the time, Mar-a-Lago passed inspections with flying colors, with one or two violations at most.

But as Trump jumped into presidential politics, so did the number of health violations.

There were 11 last year compared to just two in 2015.

Mar-a-Lago General Manager Bernd Lembcke did not return calls for comment.

On April 14 2017 00:05 Buckyman wrote:
...nor is preventative care necessarily unavailable to the uninsured. When I lost health insurance recently, I switched from a network doctor to a cash-only clinic that charges roughly what my copay was for the network doctor.

On April 14 2017 00:28 farvacola wrote:
Everyone knows Mar-a-Lago serves the best lukewarm ham this side of the Mississippi.

On April 14 2017 00:05 Buckyman wrote:


Are you assuming people would try to customize their healthcare plan without using google?




...nor is preventative care necessarily unavailable to the uninsured. When I lost health insurance recently, I switched from a network doctor to a cash-only clinic that charges roughly what my copay was for the network doctor.

On April 13 2017 23:50 Buckyman wrote:

In practice, the main effect right now is transferring large amounts of money from doctors and hospitals to software vendors.

On April 14 2017 00:22 LightSpectra wrote:


You're not desperately poor, evidently. You might not realize it, but millions of Americans are living in the kind of poverty where they have to pick between paying the water bills or eating lunch for the next month. Telling them "just go to the nearest free clinic and pay $20 for vaccines" is not an option.

Last year, Alaska’s Obamacare marketplaces seemed on the verge of implosion. Premiums for individual health insurance plans were set to rise 42 percent. State officials worried that they were on the verge of a “death spiral,” where only the sickest people buy coverage and cause rates to skyrocket year after year.

So the state tried something new and different — and it worked. Lori Wing-Heier, Alaska’s insurance commissioner, put together a plan that had the state pay back insurers for especially high medical claims submitted to Obamacare plans. This lowered premiums for everyone. In the end, the premium increase was a mere 7 percent.

...

Premiums in the individual market went up a lot last year. The national average was a 25 percent hike. Alaska was bracing for an even higher 42 percent increase from its one remaining Obamacare insurer, Premera Blue Cross.

That’s when Wing-Heier and other Alaska officials had an idea. The state already had a tax on insurance plans (not just health but also life and property insurance). Usually the money goes to a general Alaska budget fund, but the state decided to divert $55 million of the tax revenue into a reinsurance program.

This would give Obamacare insurers — at this point, just Premera — extra money if they had some especially large medical claims. Reinsurance essentially backstops insurers’ losses; it guarantees they won't be on the hook for the bills of a handful of exceptionally sick patients.

The new reinsurance program convinced Premera to only raise rates 7 percent in 2017. Alaska suddenly went from having one of the highest rate increases in the nation to one of the lowest.

Alaska officials say the Trump administration has so far been easy to work with, helping them make sure the application looks right and moves quickly toward review.

On April 13 2017 23:50 KwarK wrote:

Do you believe that healthcare is terrible in Britain? Serious question. If yes, why do you think the British and their statistics disagree? If no, do you believe that it's just the US government that is incapable of running a healthcare system?

On April 14 2017 00:50 Buckyman wrote:


My own inability to afford Marketplace rates aside, if someone's choosing between adequate nutrition and safe drinking water, preventative care is probably not the best way to improve their health.

That said, vaccine campaigns are a special case where government involvement makes sense, but on a local or state level rather than a federal level.