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cis autodrag posted:You'd go in with a replaced him and come out suffering alzheimers like symptoms and barely functional. I've always wondered if this is what happened to my cousin. He was hit by a car while crossing the street and had a number of orthopedic surgeries in the hospital, then was discharged into an SNF for physical therapy. Within about three months he was 95% blind and had severe dementia. Also lost bowel and bladder control. This is not exactly normal for someone in his 40s but okay! e: also when he finally passed away the nursing home waited a week before informing his family about it The Phlegmatist fucked around with this message at 17:43 on Feb 11, 2018 |
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The Phlegmatist posted:I've always wondered if this is what happened to my cousin. He was hit by a car while crossing the street and had a number of orthopedic surgeries in the hospital, then was discharged into an SNF for physical therapy. Within about three months he was 95% blind and had severe dementia. Also lost bowel and bladder control. The gently caress did they do to him?
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Feb 11, 2018 17:55
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Diabetes? Latent brain trauma from being hit by a car? Hospital acquired infection?  The Phlegmatist posted:Discharging patients into an SNF around here is basically a death sentence. They boomerang back and are readmitted inpatient on day 21 after the utilization manager kicks them out except now they have sepsis somehow.
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Feb 12, 2018 00:48
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https://twitter.com/cnnbrk/status/962817811600039938 Great system we have here, just a few minor technocratic tweaks and we should be fine
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Feb 12, 2018 02:06
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Dead Reckoning posted:Diabetes? Latent brain trauma from being hit by a car? Hospital acquired infection? You idiot. You go to a snf because you are old and had surgery and keeping you in the hospital for your rehab is MRSA city. Most snf admissions are routine aftercare for routine operations.
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Feb 12, 2018 02:39
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cis autodrag posted:You idiot. You go to a snf because you are old and had surgery and keeping you in the hospital for your rehab is MRSA city. Most snf admissions are routine aftercare for routine operations.
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Feb 12, 2018 03:33
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i am harry posted:Goon parents post itt the total cost of your child's day of delivery. $32,000 for a completely standard delivery with no complications. Total out of pocket was $20 that was paid during my wife’s first health visit. I am fortunate enough to have a mythological Cadillac plan due to the teachers union. This is in New Hampshire.
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Feb 13, 2018 01:20
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Rhesus Pieces posted:https://twitter.com/cnnbrk/status/962817811600039938 Yeah I've noticed some BCBS plans this year suddenly requiring prior authorizations for drugs that are clearly listed on the patient's insurnace formulary as *not* requiring prior authorization. So you know that informed decision-making the patient did to pick their health plan that fit them is all thrown into the wind as the provider has to submit the PA paperwork and the patient is left without their medication unless they want to pay cash for it - or they happen to go to an independent pharmacy that will front them some pills in advance while poo poo gets sorted out. It's probably the sort of thing that an insurance commissioner should deal with, but the state I live in the insurance commissioner is probably getting his dick serviced every night by a personal harem financed by the insurance industry.
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Feb 13, 2018 17:15
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Crashrat posted:Yeah I've noticed some BCBS plans this year suddenly requiring prior authorizations for drugs that are clearly listed on the patient's insurnace formulary as *not* requiring prior authorization. * Formulary is provided for entertainment purposes only. Rely on information contained in the formulary at your own risk. The plan document shall govern in all cases.** **Unless relying on the formulary would benefit the insurer*** ***You agree to binding arbitration by Blue Cross Arbiters Inc.
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Feb 13, 2018 17:40
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Crashrat posted:It's probably the sort of thing that an insurance commissioner should deal with, but the state I live in the insurance commissioner is probably getting his dick serviced every night by a personal harem financed by the insurance industry. You'd be looking at the federal government actually regulating PBMs, which have become completely insane in the past few years. e: there's this amazing six-way conflict of interest going on between pharmaceutical companies, PBMS, pharmacies, insurers, employers and patients that pretty much ensures Congress is not going to move on this The Phlegmatist fucked around with this message at 18:04 on Feb 13, 2018 |
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Feb 13, 2018 18:01
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Devor posted:* Formulary is provided for entertainment purposes only. Rely on information contained in the formulary at your own risk. The plan document shall govern in all cases.** My favorite was when United Healthcare sent my husband a letter saying that a medication he was on was in the "high cost" tier (it wasn't actually called that) from now on. The letter looked like this: quote:Dear Mr. Hedron, No, I didn't forget to make up more medication names. Those two lines really were just blank.
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Feb 13, 2018 18:29
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zonohedron posted:My favorite was when United Healthcare sent my husband a letter saying that a medication he was on was in the "high cost" tier (it wasn't actually called that) from now on. Yeah I love the letters patients get that say "Yes you were approved for X but..." And then lists a massive number of reasons that approval doesn't guarantee benefits in the event of pretty much any circumstance where anything goes wrong whatsoever with patient compliance or payment of premiums. I tell people to ensure their insurance premiums are drafted a few days before the end of the month with at least 3-4 business days inbetween drafting and month-end. Then make sure that poo poo actually got paid so they can't try to gently caress you. Which is a wonderful thing to tell people with chronic anxiety. "Yeah you're getting treated and things are looking up - look at how much better you are now compared to 8 months ago - just don't forget to make sure your insurance payment is processed every month or else everything will go to poo poo and all progress will be lost in a hellfire of bureaucratic despair and neverending hold music."
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Feb 13, 2018 19:09
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Crashrat posted:Yeah I love the letters patients get that say "Yes you were approved for X but..." I recall around the time of the ACA debate hearing stories about insurance companies intentionally sitting on on-time premium payments to trigger punitive coverage drops. I have so little faith in insurance companies and capitalism in general that this doesn't sound at all exaggerated.
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Feb 13, 2018 19:23
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Rhesus Pieces posted:I recall around the time of the ACA debate hearing stories about insurance companies intentionally sitting on on-time premium payments to trigger punitive coverage drops. When I worked for an insurance company (auto and home, granted), we went by postmark date. Mind you, if the person called in on the last postmark date and HAD to pay by mail (unbanked and money order people, usually), we did tell them to GO TO THE POST OFFICE AND WATCH THEM STAMP IT. I'm not sure why this was our rule, but it wasn't a bad one. My employer provided insurance has the strangest formulary for prescriptions. It's either next to nothing (generic Zoloft is 77 cents for a months supply), or just not covered (Genvoya for my partner under my plan would be 3K a month, which is why our health insurance is kept separate). One woman I work with gets her blood pressure meds for $1.22 a month. Asthma meds for her son? $250. I can understand some price difference between an old generic and a new name brand drug...but the swings are just insane.
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Feb 14, 2018 01:48
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Insurance "risk management" at work https://twitter.com/NYTHealth/status/963501093631164416 People who take PREP are theoretically a risky category of customers but insurance companies can't police people's sex lives so they irrationally incentivize the risky choice for the sake of appearances.
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Feb 14, 2018 01:56
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blackmet posted:My employer provided insurance has the strangest formulary for prescriptions. It's either next to nothing (generic Zoloft is 77 cents for a months supply), or just not covered (Genvoya for my partner under my plan would be 3K a month, which is why our health insurance is kept separate). One woman I work with gets her blood pressure meds for $1.22 a month. Asthma meds for her son? $250. *whipcrack* Welcome to the world of PBMs! and whatever the gently caress generic manufacturers are trying to pull as they're slowly priced out by India. Nothing makes sense right now because there's insane volatility to the point where the provider price for the generic your formulary covers might jump up 900% in price overnight so it gets risky to even cover a singular generic alternative in a class.
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Feb 14, 2018 03:19
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blackmet posted:When I worked for an insurance company (auto and home, granted), we went by postmark date. One thing I've found out is that doctors will prescribe whatever they thinks most effective for whatever reason without considering cost. I used to be on an expensive asthma med (around 300 for retail cost) and I finally let my doctor know that I couldn't afford it so she prescribed an inhaler with a generic version that was like $80 retail. So for the coworker I would definitely check to see if other meds would work and be covered. Of course it's pretty telling things to even be given as advice versus being allowed to take whatever med is prescribed without being bankrupt. 
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Feb 14, 2018 03:28
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zonohedron posted:My favorite was when United Healthcare sent my husband a letter saying that a medication he was on was in the "high cost" tier (it wasn't actually called that) from now on. I received the same letter when I was with UHC. I didn't switch away from UHC because of that though, because my healthcare provider is always decided for me by whatever company I'm working for at the time. Service Guarantees Givingashit
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Feb 14, 2018 06:46
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I had to fight to get my flu shot covered because BCBS was willing to pay for the medicine, but not the application of the vaccine. They would have covered it if I went to my primary care physician, but not if I went anywhere else. Anywhere else they said that my prescription coverage would cover the dose, but I would need my medical coverage for the application, and since I have an HMO, the pharmacy wouldn't cut it. It was obvious bullshit, but it pissed me off enough that I kept calling them for 3 weeks until they decided to change their system. In the meantime, a boatload of people probably just got tired and paid out of pocket.
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Feb 14, 2018 07:00
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Raldikuk posted:One thing I've found out is that doctors will prescribe whatever they thinks most effective for whatever reason without considering cost. I used to be on an expensive asthma med (around 300 for retail cost) and I finally let my doctor know that I couldn't afford it so she prescribed an inhaler with a generic version that was like $80 retail. So for the coworker I would definitely check to see if other meds would work and be covered. Inhaled meds are tricky sometimes. Most doctors are trained to prescribe based on the chemicals in the actual medications and what said chemicals do rather than trying to remember the brand name and generic name of every single drug that comes to market. The older ones get confused when patients complain of high prices because they don't understand why the gently caress it's 10 times cheaper to prescribe 2 separate controller inhalers vs. just prescribing a single inhaler that contains both controller medications. I used to work for a provider who was fairly diligent on minimizing patient cost, but even that was daunting as gently caress to keep track of. One month, most insurance companies are covering Anoro. 3 months later, they are only covering Stilolto for some reason. New Years hits and all of a sudden insurance companies A, B, and C will ONLY cover ProAir and NOT Ventolin while insurance companies D, E, and F will ONLY cover Ventolin and NOT Proair (even though it was the reverse scenario the year prior). Insurance company G will only cover Proventil and NOT ProAir or Ventolin. Prior Auths for COPD meds are constantly required every year for some more expensive meds because somehow a prior auth for a chronic lifelong condition expires on an annual basis (maybe god took the patient's COPD away!). It basically became impossible and the best we could do was have the patient themselves call their insurance company to see what IS covered, and we would write scripts for that. If it was a case were multiple insurance reps were giving contradictory information or answers to an 85 year old like "Uhhh I don't know you but should check out our website!" we would then write scripts for most of the equivalents of basic inhaled controller medications, explicitly explain to the patient to get only the cheapest one out of the three/four/five filled, have the pharmacy run a test claim through their insurance for each one, and pray to God the patient's pharmacy didn't have some rear end in a top hat white knight DEA cock sucking pharmacy manager on staff that would file a complaint with the state board of pharmacy for "willingly providing patient's multiple duplications of therapy prescriptions which could kill the patient if they got all 3 filled and took all 3 of them.". If you tried to do it the legitimate super paper trail way of 1 script this is what would often happen: patient takes script to pharmacy, insurance denies script, we get a fax from pharmacy 1-3 days later of the denial and request for PA/request for new script of alternative med, we then fax new script for different maybe covered brand (1-2 days after getting denial), pharmacy gets the fax and fills 1-2 days later, same loving thing happens, we fax/phone in script immediately, pharmacy gets it/checks their overloaded voice mail 1-2 days later, finally fills it, and patient picks up med. However, you would end up with a situation where sometimes a patient REALLY needed to be on a medication ASAP, we were out of samples of said medication and all equivalants, the above dance would happen, and the patient would end up going to the ER and getting hospitalized after not having the med for 1-2 weeks because of insurance fuckery and medical bullshit from crappy EMR systems on both sides of the fence. We ended up deciding that we would rather have the DEA or state board of pharmacy go after us for breaking stupid paperwork bullshit guidelines caused directly by insurance companies rather than perpetuate chains of bullshit that ultimately just got people hurt due to endless red tape. Patient needs to be on a LABA (basically long acting Asthma/COPD med)? gently caress it! Here's scripts for all 6 brands that we know of! Because for some reason it is against state law for us to just write: "Give the patient a loving LABA with directions for daily usage appropriate for whatever med chosen for [insert disease state here], we don't care which brand" because that means the dumb dumb Pharmacist who has a doctorate in Pharmacy would have to provide the medication strength and dosing and directions all by themselves to the patient even though they are technically way way more qualified to do so than most MDs (or at least loving should be). I think most Pharmacists would like to have much more autonomy with therapy anyways as they are trained to do so during pharmacy school, but then get out into the real world and can't do barely anything unless they are working in a hospital actively rounding with MDs or whatever. Insurance companies are basically black widows directly from the 1970s USSR spinning an intricate and massive spider web while riding on a merry-go-round in Chernobyl. They are designed to maximize inefficiency, break down as much as possible, and spew as much radioactive poo poo all over the place to maximize their income stream. Avalanche fucked around with this message at 13:15 on Feb 14, 2018 |
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Feb 14, 2018 13:05
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joepinetree posted:I had to fight to get my flu shot covered because BCBS was willing to pay for the medicine, but not the application of the vaccine. They would have covered it if I went to my primary care physician, but not if I went anywhere else. Anywhere else they said that my prescription coverage would cover the dose, but I would need my medical coverage for the application, and since I have an HMO, the pharmacy wouldn't cut it. It was obvious bullshit, but it pissed me off enough that I kept calling them for 3 weeks until they decided to change their system. In the meantime, a boatload of people probably just got tired and paid out of pocket. My boss ran in to the same thing with the insurer we work at. I think she had to submit the claims against her medical coverage separately because the pharmacy could only file drug claims or something, but they did eventually end up changing the system like in your case.
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Feb 14, 2018 16:38
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Avalanche posted:Inhaled meds are tricky sometimes. Most doctors are trained to prescribe based on the chemicals in the actual medications and what said chemicals do rather than trying to remember the brand name and generic name of every single drug that comes to market. The older ones get confused when patients complain of high prices because they don't understand why the gently caress it's 10 times cheaper to prescribe 2 separate controller inhalers vs. just prescribing a single inhaler that contains both controller medications. I honestly think sometimes that the switch from one covered drug to another equivalent drug has to be for no other reason than PBMs more or less taking bids for which manufacturer will give them a bigger profit (kickback) in exchange. And I honestly have no idea why retail pharmacists cannot be more involved in prescribing. It's infuriating that they don't do anything beyond running it through on their computer to process & bill it - stop if there's a medication conflict - and then hand it off to a pharmacy tech to fill it. Then recount it themselves if it's controlled. Why the gently caress does anyone need a doctorate to do that? Seriously. There's nothing in this chain of events requiring such high level education. If we're going to limit retail pharmacists to being nothing more than what you and I describe then retail pharmacy might as well just be a robot filling bottles. Hell I know UCSF already has an almost entirely automated pharmacy. I seem to remember it can even handle IV mixing including chemo/nuclear medicine. Ostensibly it was to get the pharmacists out doing actual mental work in the hospital working directly with the doctors, but gently caress if I know whether or not that's actually happening. I just sure as hell would not be going to pharmacy school. Those robots are coming to every drug store nationwide soon enough, and once they do there's going to be a veritable army of unemployed stupendously overeducated people that lost their field of work through no fault of their own. There's absolutely no way the hospital system could soak them up. From what I've read hospitals love the "synergy" poo poo that gets pushed by PWC/McKinsey & Co to "leverage" pharmacists into "creating value" - but since that's not something most pharmacists have done since they left school I only imagine none of them have any idea what the gently caress to do once they're not just counting pills. I mean we COULD take all these incredibly educated people and put them to work in a national program for pharmaceutical research to improve the world, but that's be socialism, or whatever buzzword someone comes up with to piss off dumb people into thinking that making their lives better is actually worse for them.
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Feb 15, 2018 15:35
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Crashrat posted:I honestly think sometimes that the switch from one covered drug to another equivalent drug has to be for no other reason than PBMs more or less taking bids for which manufacturer will give them a bigger profit (kickback) in exchange. They 100% determine preferred drugs within a therapeutic classification code based on which manufacturers they can negotiate a better price with, but these aren't really kickbacks because the PBMs are set up to pass these rebates to the insurer, leading to a reduction in overall costs which will translate in to lower premiums. There are definitely some kinks in that pipeline that need to be fixed, but for the vast majority of cases that is how PBMs work. With no real regulation on drug prices, we have placed the burden of keeping down drug costs on PBMs and/or health insurers, and it has the negative side-effect of having PBMs and/or insurers toeing the line of practicing medicine.
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Feb 15, 2018 18:14
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Reik posted:They 100% determine preferred drugs within a therapeutic classification code based on which manufacturers they can negotiate a better price with, but these aren't really kickbacks because the PBMs are set up to pass these rebates to the insurer, leading to a reduction in overall costs which will translate in to lower premiums. There are definitely some kinks in that pipeline that need to be fixed, but for the vast majority of cases that is how PBMs work. With no real regulation on drug prices, we have placed the burden of keeping down drug costs on PBMs and/or health insurers, and it has the negative side-effect of having PBMs and/or insurers toeing the line of practicing medicine. The PBM often ends up retaining a lot of the rebates. When contracting with self-insured employers the amount of rebates that the PBM passes along is part of the bid, and it's often opaque as to how much the PBM end up retaining and how much they pass through. I wouldn't consider them kickbacks, but the whole rebates-instead-of-prices negotiation paradigm is ridiculous and doesn't really benefit anyone other than the PBMs. If there's a benefit I can't see it.
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Feb 15, 2018 18:27
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http://www.ibtimes.com/political-capital/why-are-drug-prices-going-democratic-power-players-help-pharmaceutical-industryquote:When they were first conceived in the 1960s, PBMs held out the promise of using their power to negotiate price discounts, and in recent years, three companies — OptumRX, Caremark CVS, Express Scripts — have accumulated control of the vast majority of the market. That consolidation in the $250-billion-a-year market has not coincided with lower drug prices for consumers. Instead, spending on prescription medication spiked 20 percent between 2013 and 2015, according to Harvard researchers. This year, drug prices for Americans under age 65 are expected to rise nearly 12 percent, almost five times the expected growth in wages for 2017.
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Feb 15, 2018 18:31
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esquilax posted:The PBM often ends up retaining a lot of the rebates. When contracting with self-insured employers the amount of rebates that the PBM passes along is part of the bid, and it's often opaque as to how much the PBM end up retaining and how much they pass through. I've talked to some other actuaries about this and the best thing we could come up with is that manufacturers receive some kind of benefit for technically not dropping their price. Like, if they sell a drug to PBM X at a 50% discount, they'd have to sell it to CMS for that 50% discount as well, but if PBM X is getting a rebate of 50% of the price for having it on their formulary, they can still sell it to CMS for full price. PBMs and rebates do get squirrely for self-insured employers, but self-insured groups usually have more competition in their bids, and they have the ability to carve out their drug coverage if their medical coverage provider has a crappy PBM that is keeping too much of the rebates.
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Feb 15, 2018 18:50
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Reik posted:They 100% determine preferred drugs within a therapeutic classification code based on which manufacturers they can negotiate a better price with, but these aren't really kickbacks because the PBMs are set up to pass these rebates to the insurer, leading to a reduction in overall costs which will translate in to lower premiums. There are definitely some kinks in that pipeline that need to be fixed, but for the vast majority of cases that is how PBMs work. With no real regulation on drug prices, we have placed the burden of keeping down drug costs on PBMs and/or health insurers, and it has the negative side-effect of having PBMs and/or insurers toeing the line of practicing medicine. 1. Nobody really knows how much of the rebates they're actually keeping for themselves on a general level. Actually you wouldn't really know even if it's part of your contract with the PBM since MACs are kept quiet. That's why ES got sued by Anthem. 2. PBMs have a perverse incentive to cover meds with high list prices and rebate percentages so they make more money overall. That's why you'll see brands covered but not the generic equivalent sometimes. Or whatever they're making the most money on will be the brand on the formulary PDL and good luck trying to rx anything else unless you like PA appeals. 3. The big three are so loving huge and vertically integrated that they're able to bully drug manufacturers into giving them higher rebates by threatening to exclude other drugs the manufacturer might sell from the formulary they provide to plan sponsors. That's why poo poo drops off for a year and then comes back and formularies are so volatile now. And of course this has the result of patient care decisions being made by health execs from manufacturers and PBMs doing shady backroom deals. There's a reason why PBMs get sued so loving much for illegal poo poo (retaining more rebates than agreed to, bribery from manufacturers to delay coverage of generics, etc.)
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Feb 15, 2018 19:02
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The Phlegmatist posted:1. Nobody really knows how much of the rebates they're actually keeping for themselves on a general level. Actually you wouldn't really know even if it's part of your contract with the PBM since MACs are kept quiet. That's why ES got sued by Anthem. The purpose of a PBM is to reduce drug costs. If an insurer has two PBMs to choose from and one picks higher costs drugs for their formulary because they have a larger rebate on them and the other PBM picks the lower costs drugs for their formulary, the insurer will choose the lower cost PBM. If the PBM is wholly owned by the insurer, the insurer is liable for claims costs at the end of the day regardless, and if they shift claims dollars to their policyholders through weird pharmacy shenanigans that's just going to be reflected in a loss of premium revenue which will be leveraged by their margin. I've also never heard of drug manufactures as being "bullied". Those negotiations are uphill battles because many times insurers have to cover certain drugs and if there's only one or two manufacturers making that drug they do not have much leverage.
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Feb 15, 2018 19:39
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Reik posted:I've talked to some other actuaries about this and the best thing we could come up with is loving lmao "I talked with other people who are highly invested in our for-profit healthcare system continuing to exist and shockingly, none of us could figure out anything positive to do!"
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Feb 15, 2018 21:51
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WampaLord posted:loving lmao I think you misunderstood the topic.
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Feb 15, 2018 21:53
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Reik posted:I've also never heard of drug manufactures as being "bullied". Those negotiations are uphill battles because many times insurers have to cover certain drugs and if there's only one or two manufacturers making that drug they do not have much leverage. Doesn't matter if you have a billion dollar drug if ES cuts you off from its 80m patients. There are enough incredibly profitable multi-source areas (anything to do with diabetes and fibromyalgia right now, which is why everything changes year to year there) where PBMs have an incredible amount of leverage over manufacturers. One of the big three deciding to exclude/re-include something on the formulary can send manufacturer stocks swinging up to 15% in either direction. And of course it's designed to work as a cartel. Plan sponsors don't have to use the formulary with exclusions that PBMs offer (you can choose the one with exclusions or the one without) -- but plan sponsors are penalized for doing so because PBMs will withhold more rebates from them if they choose the one with more drugs included. There's no reason for doing this unless PBMs were explicitly using exclusion as a tool to extract concessions from manufacturers because they need to majority of covered patients on the exclusionary formulary for it to work. The patients getting yanked around from prescription to prescription at the whims of PBMs are the ones suffering most in this.
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Feb 15, 2018 22:29
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The Phlegmatist posted:Considering public support for Medicare For All evaporates the minute people hear the words "higher taxes" and nobody in DC is really rushing to fall on their own swords over it... Bullshit. Support for literally anything evaporates when you mention taxes, which is why you craft a message that doesn't focus on that. For some reason this need to gain public approval for every detail of implementation only seems to come up when discussing topics like universal healthcare. I wonder why that is? I think you should think long and hard about why you feel compelled to make this sort of argument. Even from a pragmatic perspective, it doesn't make any sense to start from a position of a bad, compromised solution. The only way to ever reach a future where an actually-decent UHC solution is possible is to begin promoting it now. Movements aren't born popular (and in the case of single-payer, it actually is popular unless you phrase it in the specific way you mention, and literally anything is unpopular if you mention it alongside increased taxes*). Even if you think it's unlikely it'll pass, it still makes sense to promote and vocally support it. The politicians don't actually want to pass this stuff, so they're not going to unless they feel like there's heavy pressure from their constituency (and that pressure obviously exists, or else we wouldn't have seen the recent vocal support for MfA by some Democratic politicians). I frequently use the analogy of abolitionism prior to its widespread acceptance for these situations, because it illustrates the real priorities of people making arguments like the one you're making here. If most people saw someone taking contrary positions against abolitionists during the 1820's (or whatever), they would correctly interpret that as either the person actually being in favor of slavery or being privileged enough that they can remain completely aloof about the issue and not comprehend its urgency. The exact same is true for people who make arguments like yours. It shows that the person is either 1. actually opposed to the idea or 2. privileged enough that they don't feel any urgency towards solving the problem in question. It simply doesn't make sense for anyone who perceives our healthcare situation as the genuine crisis it is to approach the issue in the way people like you do. * And I bet if you made the question even more accurate by including the actual change in cost for the individual in question, you wouldn't see the same decrease in support. A question that just says "paid for by an increase in taxes" is actually very misleading, because your average American likely isn't going to be two and two together and also take into account their cost savings.
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Feb 16, 2018 00:30
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Higher taxes on the rich have a 75% approval rate, but sure since I'm a black hole of soulless evil I'll argue that we just can't find a way to raise taxes on the rich to save thousands of lives a year.
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Feb 16, 2018 03:29
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VitalSigns posted:Higher taxes on the rich have a 75% approval rate, but sure since I'm a black hole of soulless evil I'll argue that we just can't find a way to raise taxes on the rich to save thousands of lives a year. We're more of an oligarchy than a democracy at this point. 95% of the American public could favor higher taxes on the rich, but as long as the rich don't like it it isn't happening.
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Feb 16, 2018 04:48
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Medicare for all is going to be an non-negotiable plank in the democratic platform within six years and the next democratic president is going to be under incredible pressure to deliver
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Feb 16, 2018 05:20
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DAD LOST MY IPOD posted:Medicare for all is going to be an non-negotiable plank in the democratic platform within six years and the next democratic president is going to be under incredible pressure to deliver Not if the Obama people have anything to say about it.
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Feb 16, 2018 05:27
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joepinetree posted:Not if the Obama people have anything to say about it. God, why are they so bad at everything?
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Feb 16, 2018 06:08
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Ytlaya posted:* And I bet if you made the question even more accurate by including the actual change in cost for the individual in question, you wouldn't see the same decrease in support. A question that just says "paid for by an increase in taxes" is actually very misleading, because your average American likely isn't going to be two and two together and also take into account their cost savings. Too bad I have a real world example of single payer failing miserably in Colorado and you have nothing but bizarre grasping analogies about slavery.
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Feb 16, 2018 10:58
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We did an excellent job of out the tax increase and cost savings in Colorado, and still only got 21% of the vote. There are some unique problems in Co that may have artificially lowered the Yes vote compared to other places. TABOR, which doesn't allow us to have any rainy day fund, is one...people are skeptical that they won't be asked to raise taxes again or lose coverage. The housing market is expensive and overheated due to a lot of newcomers and a rapid growth rate, while wages aren't keeping pace. This would bring even more growth, and even more expensive housing. We only semi-tolerate the potheads, ski-bros, and young professionals who come here in droves...but are really skittish about adding "everyone from Texas who's kid has a rare, expensive disease" to that mix. Toss out those two things and support goes to...maybe 30%? Our poor are still temporarily embarrassed millionaires just like everywhere else in America, and say things like "10% capital gains tax to pay for this! My word! How is that fair to the rich!" I don't think any individual state wants to be the guinea pig for UHC. It will need to be nationwide.
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Feb 16, 2018 13:55
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I guess in the meantime we'll just have to put up with poo poo like this: https://twitter.com/npr/status/964469156472131584
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Feb 16, 2018 16:34
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