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Xae posted:Wow I'm glad to hear you've got it all figured out! Interesting, I hadn't heard that the real solution was to unskew the liberal medical statistics industry. How about this: gently caress all the stuff you talked about, let's try literally any other system at random, they're all better.
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Mar 20, 2017 22:14
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evilweasel posted:
Its also one of the things the AMA is dead set on getting killed no matter what else. http://freakonomics.com/podcast-tag/bad-medicine/ TL;DR: One of the problems with the American Healthcare system is that Doctors are still viewed as unerring Demigods who can't be judged by mere mortals. call to action posted:Interesting, I hadn't heard that the real solution was to unskew the liberal medical statistics industry. I was hoping you would bother to google a few of those things and in doing so you would find out a huge part of the reason why Healthcare is more expensive in the US. Instead you took the stupid and lazy way out. My hopes were dashed, but somehow I'm not surprised. Xae fucked around with this message at 22:17 on Mar 20, 2017 |
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Mar 20, 2017 22:14
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Obamacare attacked that problem as well! One of its major goals was to "bend the cost curve", adjusting the incentives in the medical system to encourage better and more efficient results.
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"Sure, we have literal MSF-style medical encampments in the poorest areas of the US where people don't have access to even basic medical or dental services, and people break down crying when they get a $100 treatment for free, but in reality ICD10 and MRIs means this doesn't happen" liberal propaganda:  loving MRIs killing our children! liberal CDC is agenda 21!!! call to action fucked around with this message at 22:19 on Mar 20, 2017 |
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Mar 20, 2017 22:17
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Twerk from Home posted:I see a larger risk in a public/private hybrid system for the states to gently caress things up. I'd be thrilled if we had Obamacare with full 50-state medicaid expansion, but instead we have a situation where a Texas family with $5k in income last year makes too much money to qualify for Medicaid and too little money to get any ACA subsidies. Well that and, if we don't commit to a fully public program we will always be living on a knife-edge of the GOP deregulating the poo poo out of whatever public-private symbiosis foisted upon us and we spiral into the loving profit-driven thunderdome hellscape we currently inhabit. LeeMajors fucked around with this message at 22:19 on Mar 20, 2017 |
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Mar 20, 2017 22:17
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SousaphoneColossus posted:One thing that has always struck me as weird is that the left in the US is so narrowly focused on single payer to the exclusion of other models. Lots of countries are not strictly speaking single payer UHC but their systems work well, and some would probably argue better than Canada or the UK. Perfect is the enemy of good just like gently caress you is the enemy of poo poo.
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Mar 20, 2017 22:19
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call to action posted:"Sure, we have literal MSF-style medical encampments in the poorest areas of the US where people don't have access to even basic medical or dental services, and people break down crying when they get a $100 treatment for free, but in reality ICD10 and MRIs means this doesn't happen" the basic point here is you think this is a simple problem because you are too ignorant and stupid to realize what's difficult about the problem so you have no useful things to say, hence your trumpposting about how simple it all is
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Mar 20, 2017 22:21
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evilweasel posted:
So to continue the trend of reducing inefficiency, what about a modest proposal of gradually lower the age in which Americans become eligible for Medicare while also encouraging supplier competition?
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Mar 20, 2017 22:27
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evilweasel posted:the basic point here is you think this is a simple problem because you are too ignorant and stupid to realize what's difficult about the problem so you have no useful things to say, hence your trumpposting about how simple it all is I've got one big savings immediately: allow providers to bulk-import drugs from Canada and align our FDA requirements so that if it's fine in Canada it's fine here.
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Mar 20, 2017 22:28
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LeeMajors posted:Well that and, if we don't commit to a fully public program we will always be living on a knife-edge of the GOP deregulating the poo poo out of whatever public-private symbiosis foisted upon us and we spiral into the loving profit-driven thunderdome hellscape we currently inhabit. You can always privatize anything, if you really want. As a practical matter though it's not politically possible to abolish private health insurance without the public getting plenty of exposure to your new plan and switching over to it over time. Too many voters have good enough health insurance and (reasonably, given how important it is) fear the unknown of being put onto an unproven plan. The backlash would make the backlash to Obamacare look like a minor objection. It's not the best place to end up, but that's the reality of where you can go from here. People just aren't going to be ok with being moved to UHC before its been proven, so a public-private thing is a necessary intermediate step.
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Mar 20, 2017 22:34
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Twerk from Home posted:I've got one big savings immediately: allow providers to bulk-import drugs from Canada and align our FDA requirements so that if it's fine in Canada it's fine here. That's a backdoor way to accomplish what's much better off done through the front door. What you want is price caps on drugs along the lines of Canada's. So just legislate those caps, either explicitly or through allowing medicare to negotiate drug prices. If you only legalize drug importation from Canada there's too many avenues for drug companies to throw sand in the gears - supplying Canada with only enough for Canada, supplying it only under contracts that prohibit export, etc. And you're not going to face significantly less opposition since the drug companies know whats up, so they'll fight both proposals just about as hard.
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Mar 20, 2017 22:39
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call to action posted:"Sure, we have literal MSF-style medical encampments in the poorest areas of the US where people don't have access to even basic medical or dental services, and people break down crying when they get a $100 treatment for free, but in reality ICD10 and MRIs means this doesn't happen" Many Americans believe we need to make changes to better handle healthcare for others in the country. What literally every effort at reform runs into, though, is that somewhere north of 60% of insured Americans rate their coverage as "good" or "excellent". Many of these people are eager for reforms, even if it means paying more, for those who are currently underserved. A sort of regulatory NIMBYism takes over when you ask these (if my math is right) 100m+ people to change the health care they and their family rely on. You've stumbled into a rare d&d thread featuring people who know what the gently caress they're talking about (and also people who fantasybook the legislative process). You can read the thread to become more educated about a topic you clearly care about... or you can continue angrily flailing your way into a fuckbarreling. Twerk from Home posted:I've got one big savings immediately: allow providers to bulk-import drugs from Canada and align our FDA requirements so that if it's fine in Canada it's fine here. If you're referring to the Sanders/Klobuchar amendment from January, I'll note that Paul, Lee, and Cruz all crossed the aisle to support it. Generally, any time that trio is together on a bill/amendment with bipartisan opposition - especially as it relates to government regulation and consumer protection - Americans are about to get hosed for the benefit of "overregulated" corporations.
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Mar 20, 2017 22:51
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SousaphoneColossus posted:It kinda reminds me how people in Seattle were stuck for years and years on the idea of monorails, to the exclusion of all other grade-separated rail, for expanding public transit.
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Mar 20, 2017 23:00
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Confounding Factor posted:I can agree with that and one of the problems I see in healthcare debates is that its so focused on "who pays?" rather than focusing on why healthcare costs so much in America. We spend the most per capita and get the least benefit, in fact we spend far and away more than other developed countries. Not really the point of the thread, but how the gently caress is Spain so far above the curve? The only place I've seen that's more in love with smoking tobacco is Cuba.
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Mar 20, 2017 23:47
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PT6A posted:Not really the point of the thread, but how the gently caress is Spain so far above the curve? The only place I've seen that's more in love with smoking tobacco is Cuba. http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801
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Mar 20, 2017 23:50
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Xae posted:Look at the surrounding countries like Italy, Portugal and Greece. The problem with adopting that diet in America is you need to also adopt their culture ie it's impossible.
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Mar 21, 2017 00:25
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The changes are here, folks! http://www.politico.com/story/2017/03/obamacare-repeal-bill-changes-236278quote:The amendment would establish a reserve fund of at least $75 billion for tax credits to help the core constituency that propelled Trump to the White House: Americans between 50 and 64, who would see their premiums skyrocket under the current repeal plan. But the amendment would not set up the tax credits – it would instruct the Senate to do so, forcing House Republicans to take a vote on something the upper chamber would do later. Lmao. Looks like they finally found a strategy: pass a bill that makes other people come up with the actual "replace" part.
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Mar 21, 2017 00:31
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Confounding Factor posted:The problem with adopting that diet in America is you need to also adopt their culture ie it's impossible. Then the UK is doing pretty well with a national diet nearly as bad as the USA.
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Mar 21, 2017 00:33
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Badger of Basra posted:The changes are here, folks! http://www.politico.com/story/2017/03/obamacare-repeal-bill-changes-236278 This is continuing to look more and more like a game of "I didn't kill the bill, you guys did!" hot potato among GOP lawmakers/politicians.
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Mar 21, 2017 00:34
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Paul Ryan sends a bill to Mitch McConnell with the text "I.O.U."
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Mar 21, 2017 00:35
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Badger of Basra posted:The changes are here, folks! http://www.politico.com/story/2017/03/obamacare-repeal-bill-changes-236278 It's the same "repeal and replace, write your own replace in your imagination and vote on the assumption we do that!" tack. Also what the hell is this: quote:There is also a targeted change to Medicaid funding that’s specifically designed to garner support from New York’s delegation. It would attempt to transfer more Medicaid spending from counties to the state, by blocking New York from obtaining federal reimbursements for payments made by counties.
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Mar 21, 2017 00:38
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Actually I assume the ambiguity of the $75b reserve fund is to make it completely impossible to score or predict what effect it will have on any one particular person, so AARP can't explain to their members how poo poo it is.
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Mar 21, 2017 00:40
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BarbarianElephant posted:Then the UK is doing pretty well with a national diet nearly as bad as the USA.
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Mar 21, 2017 00:42
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Phase 2 and 3 will fix this bill so good; you won't believe it!
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Mar 21, 2017 00:42
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evilweasel posted:It's the same "repeal and replace, write your own replace in your imagination and vote on the assumption we do that!" tack. I can't tell. Maybe Republicans don't like the county governments in New York and want to give more power to Cuomo? So glad NY State has such a great governor 
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Mar 21, 2017 00:43
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BarbarianElephant posted:I'm not sure they are entirely wrong. If UHC got passed, I can't see employers saying "Since we don't need to pay for your healthcare any more, here's a $1,000 a month pay rise." UHC of course isn't likely but there is no way it would happen withought deliberately capturing all the existing healthcare income streams one way or another. And one reason that's necessary is the size of healthcare. Nearly 20% of the economy can't be changed or cost reduced overnight.
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Mar 21, 2017 02:09
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I have to appreciate the cynicism of setting up a 75 billion dollar subsidy reserve fund for old white people, but then also forcing the senate to come up with the actual mechanics of how that fund would work. 
CAPS LOCK BROKEN fucked around with this message at 02:26 on Mar 21, 2017 |
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Mar 21, 2017 02:24
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Monkey Fracas posted:Phase 2 and 3 will fix this bill so good; you won't believe it! I think they basically just added prong 1.5 now too
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Mar 21, 2017 02:27
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Paracaidas posted:The GOP can still escape this by following the Cruz path and having Pence overrule the parliamentarian about whether or not their other prongs can be passed via reconciliation. That broadens what they can put in to appease both wings in the house, but risks a pretty epic revolt in the Senate. There's also the chance that the parliamentarian rolls over if this becomes a real threat, to avoid the destruction of the office. This will have serious and far-reaching consequences. If Pence, a de facto member of the executive branch, decides to interfere in the internal procedures of the Senate in this way, it would be a massive power transfer to the executive branch from the legislative. I can see some Senate Republicans blocking this to preserve the power of the Senate as an institution, and a bill passes as a result of this, the judiciary may even set aside the enrolled bill rule and review it.
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Mar 21, 2017 03:51
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HappyHippo posted:UHC countries tend to spend less on drugs, because larger purchasers can negotiate better prices. It's not the size that results in lower drug prices. ESI negotiates with the purchasing power of like 100 million members
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Mar 21, 2017 04:28
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Confounding Factor posted:The problem with adopting that diet in America is you need to also adopt their culture ie it's impossible. I'd actually say adopting the culture around food (not eating so loving much, and eating slower in general) is the most important change that could be made. God knows the French aren't avoiding butter or cream, and the Spanish are not avoiding red meats and/or cured meats, as we are commonly advised -- they just eat far less of it. The only other thing I notice is that Europe is much less fond of putting sugar in loving everything. Why do American breads and bagels taste like cake? It's gross as gently caress to me, even though Canadian bread is still well higher in sugar than most European bread.
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Mar 21, 2017 05:58
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PT6A posted:I'd actually say adopting the culture around food (not eating so loving much, and eating slower in general) is the most important change that could be made. God knows the French aren't avoiding butter or cream, and the Spanish are not avoiding red meats and/or cured meats, as we are commonly advised -- they just eat far less of it. there is a long version of this story, and a short version of this story, and one of the two of them is "corn subsidies".
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Mar 21, 2017 06:01
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Ze Pollack posted:there is a long version of this story, and a short version of this story, and one of the two of them is "corn subsidies". See, I don't understand that. Sure, corn syrup is cheap as gently caress, but it's still more expensive than not putting corn syrup in at all. Unless they're literally being paid to add corn syrup to things?
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Mar 21, 2017 06:06
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Paracaidas posted:In all seriousness: Lurk More. You are clearly passionate about our healthcare system being a steaming pile of poo poo for many who must rely on it, but you seem to have bought the line that literally any other (first - world system) would be better and the only thing preventing that is politicians are too dumb/corrupt/selfish to propose it. This isn't an unfair criticism at all, and the lovely incrementalism the Democrats tried that coincidentally happened to enrich a bunch of their donors has still left a lot of a people screwed and suffering for the foreseeable future, and is likely to be eroded anyway? I'd be curious to read about how the UK/Canada/whatever went from laissez-faire healthcare to the NHS/province provided healthcare/etc. ?
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Mar 21, 2017 08:20
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I'm pretty sure the NHS was created almost immediately after the U.K. was bombed to poo poo during WW2.
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Mar 21, 2017 09:14
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tekz posted:This isn't an unfair criticism at all, and the lovely incrementalism the Democrats tried that coincidentally happened to enrich a bunch of their donors has still left a lot of a people screwed and suffering for the foreseeable future, and is likely to be eroded anyway? Fun fact: Literally any policy enacted by the Democrats will enrich a bunch of their donors, thanks to how campaign finance works in the US. May as well complain about them groveling at the demands of their oxygen breathing base.  Big O2You blame lovely incrementalism, I blame the specific portion of the base who stayed home in 2010 and the Supreme Court. I've also yet to see a credible proposal for reorganizing 20% of the economy and the majority of well-regarded current coverage into a single payer system: The AHSA (2013 model) was riddled with showstopping problems, Green Mountain Care was a nice idea (and not Single Payer) that proved unworkable in the best of circumstances, and Colorado saw their single payer plan lose 80-20 despite seeing Clinton and Bennett victories and majorities for the expansion of marijuana and hiking the minimum wage. In the meantime, Republicans control both chambers and the White House and are struggling mightily to replace Obamacare despite it being the keystone of their platform for the last 6 years. Right now the smart money is still that they're unable to make substantial changes. The changes they do make will continue to screw people over. Generally, though, I'd chalk up survival under Endured rather than Eroded. There remain flaws in the ACA that screw segments of the population and allow them to fall through the cracks. A public option gets part of the way to resolving that. Funding the risk corridors, (despite *enriching donors*) gets part of the way there. Rewriting the language of the Medicaid Expansion to survive Roberts gets part of the way there. If you have any content to contribute about how we can convince people to risk the coverage they currently enjoy and enact Single Payer or about ways to move towards UHC under the ACA, I'm all ears. If you'd prefer to whinge about the self-evident corruption of Democrats, I'll direct you to either of our subforums (depending on the flavor of your complaint) or nearly any other thread in this forum. skull mask mcgee posted:I'm pretty sure the NHS was created almost immediately after the U.K. was bombed to poo poo during WW2. They were well down the road during the war, though it wasn't implemented until after. The Brits also "enriched their donors" (or rather, bribed the opposition) to help get it through, but I'll tap out here since I'm far from an expert on the topic. His legacy among the current Left (to the extent that we count Corbyn voters in Labour as the Left) has suffered a bit though-despite building much of what Thatcher aimed to destroy, only 43% named him one of their favorite Labour leaders (choosing up to 3), compared to 65% for Jeremy.
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Mar 21, 2017 14:11
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Paracaidas posted:There remain flaws in the ACA that screw segments of the population and allow them to fall through the cracks. A public option gets part of the way to resolving that. Funding the risk corridors, (despite *enriching donors*) gets part of the way there. Rewriting the language of the Medicaid Expansion to survive Roberts gets part of the way there. If you have any content to contribute about how we can convince people to risk the coverage they currently enjoy and enact Single Payer or about ways to move towards UHC under the ACA, I'm all ears. If you'd prefer to whinge about the self-evident corruption of Democrats, I'll direct you to either of our subforums (depending on the flavor of your complaint) or nearly any other thread in this forum. When Democrats retake the Senate and house (whenever that happens) I'm sure they'll try to enact reforms like this, resulting in healthcare costs only growing by a few percentage points for a few years, and then it'll all be torn away by the next Republican administration. Meanwhile, millions of Americans will still be without healthcare, American healthcare costs will still be the highest in the world, and people will continue to wear bracelets with poo poo like "i'm too poor, don't call an ambulance" written on them. Liberal incrementalism has failed, you might as well go for broke and push for single payer.
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Mar 21, 2017 14:44
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Reminder: https://www.youtube.com/watch?v=LT3Px11xN-0
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Mar 21, 2017 14:54
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tekz posted:This isn't an unfair criticism at all, and the lovely incrementalism the Democrats tried that coincidentally happened to enrich a bunch of their donors has still left a lot of a people screwed and suffering for the foreseeable future, and is likely to be eroded anyway? that is exactly an unfair criticism and "lovely incrementalism" is basically a way to whine that other people realize that reality sometimes places constraints on what you can do
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Mar 21, 2017 14:56
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It'd be great if there was a party like this on the side pushing for UHC.
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Mar 21, 2017 15:00
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tekz posted:It'd be great if there was a party like this on the side pushing for UHC. We will use the splintered bones of our enemies to write the Universal Healthcare Legislation IN BLOOD!!!
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Mar 21, 2017 15:03
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