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Caros posted:You can do both. Saying that it is dumb without also pointing out that it is a lie isn't great. Honestly, this is the best way to do statistics in any field. Statistics without qualitative narratives misses important details (and often emotional impact). Qualitative narrative without statistics misses scope and scale.
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May 8, 2017 20:54
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Yeah, that kind of "consult" bullshit happens all the time, and has been happening for a long time. When I brought back from botflies from Belize in 2010, the doctor I consulted with charged $500 to tell me "we think you have botflies" (no poo poo, you can see their breathing tubes, and I told you that when I came in) and then refer me to a surgeon. The surgeon charged another $800 for the consult, and wanted to put me under general because he'd never done the procedure before (he also looked a bit grossed out). Ended up finding an awesome doctor from Mexico instead who cut 'em out with local for $150...
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May 8, 2017 23:55
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I'm a bit confused. If they had actually got to the vote when they wanted to, would they have had to wait for these determinations? Or would the bill have to go back to the senate if these determinations came later? I'm sure McConnell would have just overruled the parliamentarian in the end, rendering it all moot (and opening the door to single payer with 50 votes!)
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Jul 22, 2017 00:05
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DAD LOST MY IPOD posted:so I’ve never been on exchange insurance before, always employer, but I’m about to move back to MA and will probably shop on the Connector. What’s this about income? I should estimate it higher to get a better plan? The "estimate high" is only relevant if you a) live in a state that refused to expand Medicaid, and b) fall in the Medicaid expansion gap where you make too much to qualify for Medicaid, but not enough to get a subsidized CSR plan. Fortunately, MA is not such a state! It might also apply if for whatever reason you qualify for Meicaid but would prefer to pay for a CSR plan, but don't quote me on that - I'm not sure if there's some penalty mechanism there.
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Oct 28, 2017 01:24
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From a policy perspective, I think the real take-away is that hard income cut-offs for benefits are never a good idea. If making a few extra dollars causes you to loose more than that few extra dollars in benefits, there's real incentive to fudge your numbers. It makes taxes more of a pain for everyone, including the IRS. For the ACA, that means both the CSR cut-off and the 400% FPL limit if insurance costs continue to rise faster than income. This problem could have been eliminated by simply scaling the CSR benefits and then including CSR benefits in repayment/additional subsidies calculations at tax time. I suppose this would, however, add a calculations of the amount of out-of-pocket maximum, co-payements, and deductible over- or under-used. This would require health expenditures in those two categories to be IRS reportable, but that seems easier than than auditing everyone's income to find the "cheaters" (who may not have intentionally cheated at all).
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Oct 28, 2017 20:21
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Peven Stan posted:Maybe the government should craft and implement policy that benefits everyone and not this means tested horseshit Who'd have known healthcare was so easy?
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Oct 29, 2017 03:48
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You have to remember that the PPACA also introduced basic coverage requirements, eliminated coverage and enrollment consideration for preexisting conditions, did away with yearly/lifetime maximums, and introduced out-of-pocket maximums. These are all huge changes to the way health insurance worked. Together with the availability of low-cost, low-deductible, low-copay CSR plans, I hope you can see why prior data on usage would only be tenuously related to post-ACA usage. Even if you had information on usage by previously uninsured individuals, prior to the ACA those individuals would likely be a) moving to catastrophic plans, b) moving to Medicaid, or c) moving to employer coverage, all of which are very different situations from obtaining a CSR plan. Reik obviously knows more about this than me, but I imagine all of those factors needed to be considered in the models, and modelling each would require many many assumptions for which there was no quality data.
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Nov 1, 2017 00:26
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Crashrat posted:I honestly believe it's just barriers being put in someone's way. The letters are all automatically generated. In fact the *filenames* are more descriptive than the letters. Have you tried taking this to a news outlet or senator yet? It sounds like if there's no reasonable way to get answers through the system, blowing it up through the news might get some action before people start getting dropped.
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Jan 17, 2018 21:58
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Rhesus Pieces posted:https://twitter.com/aaronlinde/status/958004158161854465 This is despicable. Wouldn't it make more sense to work with hospitals so that ERs could invest more resources in screening patients and send non-emergencies to an adjacent urgent care? The cost discrepancy between ERs and urgent care is horrifying.
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Jan 29, 2018 21:17
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Ze Pollack posted:we need to sloooow this down. it's not that we're against the concept of medicare for all, it's just that we're against it happening so -fast-, you see. we need to find a solution that doesn't make Doug Holtz-Eakin not mad at us. that, is, after all, how gay marriage got passed, right? we all got Pat Robertson onboard through Reasoned Debate, and then suddenly opposition evaporated? it wasn't that conservatives fought it tooth and nail at every loving point, and continue to fight it today even after the supreme court has made it legal, heavens no. Apparently 100+ years of universal healthcare discussion just isn't enough for the man.
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Feb 11, 2018 00:34
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blackmet posted:On the one hand, I have a co-worker who found out she was a Type 2 diabetic through my company plans yearly weigh in and blood draw (optional, of course...unless you don't want the $300 HSA reward for scoring a 71 or above or increasing your health score by 5 points). They found her blood sugar level to be at 800...literally telling her to "go to the ER, NOW!" She thought her weight loss, tiredness, and thirst were due to her recently quitting smoking and going to the gym a lot. And I got help on my cholesterol from my doc after going to one. I strongly suspect that program outcomes would be much much better in general if the incentive was offered to just go in to a doctor for a yearly checkup + health advice, with health fairs offered at the workplace as a checkup option. Don't tie incentives to any ridiculous "activity" measure (or at least make only a minority of the incentives tied to "performance"), and don't tie them to employment at all. Make it a national/ state program.
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Mar 6, 2018 19:10
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Defenestration posted:I wonder what cherry picked polling they get "most people are satisfied with their employer's insurance" from I suspect that most people who haven't yet used their insurance for anything major are satisfied with it, and that probably gets you a good way towards "most" Americans.
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Apr 7, 2018 08:34
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Ytlaya posted:There's no reason to trust that it would actually transition to single payer, particularly given that it's being offered in response to an actual-single-payer bill and can very easily be sabotaged through limiting how competitive the public option is. This is absolutely essential for any wonk analysis. Any Democratic healthcare bill is going to be sabotaged in a variety of interesting ways from day one, and the only way to make sure that it survives in an effective form is to make sure that any Republican sabotage directly negatively impacts a majority of Americans.
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May 19, 2018 17:21
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Ytlaya posted:This is true; I think Willa may have been focusing on the "the entire country pays into Medicare/whatever" aspect rather than the "only the government (the 'single payer' in question) covers everyone." It's also extremely important that everyone in the country has skin in the public option. Any system is going to be under immediate and continuous attack from the right, so if it's going to be successful it needs to be set up in a way that makes it very difficult for Republicans to section out select groups of people to screw without directly affecting everyone.
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Jun 11, 2018 07:20
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Reik posted:All those people with type 1 diabetes should have just taken better care of themselves. Genetic disorders are clearly your parents' fault. How else are we going to ensure that they can't afford to have any more kids and you won't grow up to pass on your bad genes?
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Jun 14, 2018 18:40
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Raldikuk posted:As he himself was receiving social security checks making it possible for him to even pursue a career in politics. So does that mean that if Republicans give all the Social Security money to themselves and other rich people they can't be politicians anymore? Might actually be a worthwhile buyout! (I kid, most of our government expenditures already go to the ultra wealthy and very rich)
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Aug 27, 2018 23:02
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silence_kit posted:Calling tax benefits which provide the biggest benefit to the wealthy 'expenditures' is a little disingenuous. You could declare any sort of revenue generated by a private company or individual not collected as taxes as 'expenditures' if you were so ideologically inclined. Tax expenditures aren't just a function of income, though - they're targeted reductions in tax liability (or credits) that are designed to promote or facilitate certain behaviors. They are functionally equivalent to direct payments, but reduce the logistics. Deductions and exclusions designed to accurately count income, like the employee income reduction. For instance, take the exemption for employee-sponsored medical insurance contributions (the largest expenditure, estimated to be ~$235 billion for FY2018). That's functionally equivalent to $235 billion* in direct spending to support the employer insurance mandate - public funding that goes to employers for the privilege of choosing what (now subsidized) insurance options their employees get, and then directly to insurance companies. Back when the corporate tax rate was progressive, this used to lead to regressive disbursement, too, since companies with smaller tax liabilities would receive a smaller effective per-employee disbursement. Now that the corporate taxes are flat, that's no longer true, at least until post a loss and then have to wait until your next posted profit for the effective disbursement. The other programs you mentioned are similar - mortgage interest deductions are designed to promote home ownership (well, "ownership"), and effective disbursements flow through the middle class to mortgage companies and home sellers. Differential tax rates for capital gains & dividends are effectively a direct subsidy on investments over other types of income (and because of progressive tax rates, it's a regressive subsidy in terms of disbursement per investment dollar earned). SALT deductions are designed to promote taxes and spending by local and state governments (except it turns out blue states use this to provide services, so gently caress you blue states). You do have a point, tax expenditures are all relative to tax liability in our progressive tax system (though the totality of the tax system is significantly less progressive). However, they are functionally equivalent to disbursements in control, targeting, and effect, so unless you're willing to call all disbursements and benefits for people with net-positive income "tax adjustments", it makes much more sense to consider them as government expenditures . *As an aside more relevant to the thread, if you throw that together with Medicaid and Medicare spending ($1.25 trillion), you get $1.5 trillion in government subsidies for healthcare, which is already over Canada's $1.1 billion in government spending for their universal system (adjusted to US population and USD). And that's before all the other types of government health spending in the US, such as our defacto insurance system for the uninsured poor (propping up hospitals with ERs required to take patients regardless of ability to pay).
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Aug 28, 2018 16:46
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Zauper posted:That's called Medicare, just FYI. Don't need to count it twice. DSH payments are part of Medicare. Thanks! I didn't realize that was under the Medicare umbrella. VVVV The Congressional Budget Office and Department of the Treasury: noted sophists that just "want to tax rich people more". VVVV Stickman fucked around with this message at 22:13 on Aug 28, 2018 |
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Aug 28, 2018 19:24
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BRAKE FOR MOOSE posted:Reposting this here because USPOL is mostly the Trump Made A Tweet thread. Perfect plan, let's keep healthcare tied to employment 
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Jan 30, 2019 21:00
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hobbesmaster posted:Employers also have to pay the ridiculous cost of American healthcare out of their own pocket though But in exchange, they get a (subsidized, through tax exemptions) way to 1) use the fear of loss of health insurance as an employee retention tool, and 2) make healthcare decisions for their employees (they call it "competing on benefits"). E: Honestly, any MfA single-payer plan should include a requirement that current employer insurance expenditures be rolled over into salaries instead of being recaptured by stakeholders. Probably the maximum expenditure for the previous X years, to avoid employers reducing expenditures to avoid the rollover. Stickman fucked around with this message at 21:33 on Jan 30, 2019 |
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Jan 30, 2019 21:29
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CAPS LOCK BROKEN posted:Also don't forget large incumbents get to muscle out startups when it comes to the health issue. It's easy for a big, self insured employer like IBM to offer better cost sharing on health insurance than a plucky startup that has to take its chances on the group market. Pretty much the story of American capitalism - all suboptimal prisonor's dilemmas because we've bought in to the myth that economic anarchy magically maximizes efficiency and equity of resource distribution. (Maybe "sold the lie" is a better way to put it)
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Jan 30, 2019 21:46
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Even if you're a conservative, unhealthy people are unproductive people. It seems like a no-brainer until you remember that loss of healthcare is the cudgel used to keep employees compliant their labor cheap.
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Jun 22, 2019 08:35
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Basically importing from Canada is a work-around that says “we’ll let Canada regulate prices for us and then add extra distribution steps that burn fuel.” It’ll actually work better than the current system, at least to the degree that it’s not full of caveats and restrictions and roadblocks, but it’s a loving stupid “solution” and it’s certainly not “free market” or however the loving Republicans are going to try spinning it. E: I should also throw in that on top of government-enforced monopolies and our complete lack of price regulations, pharmaceutical research benefits from a massive amount of public funding. Gobbeldygook posted:Drug reimportation works until pharmaceutical companies stop tolerating it and implement rationing in Canada. CBO estimated it would reduce prescription drug spending by 1%. Yeah, this as well. We need to regulate our own pharmaceuticals, not outsource it overseas and pretend like Pharma won’t respond. That and I imagine running an giant export business that undercuts Pharma’s US prices would weaken Canada’s negotiation position enough that they might ban exports rather than face price hikes for subsidizing our own lovely unregulated system. Stickman fucked around with this message at 19:10 on Dec 18, 2019 |
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Dec 18, 2019 18:59
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| # ¿ May 3, 2024 06:28 |
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Employer insurance has never been good. It’s always been a crapshoot that’ll screw you over in creative ways if you actually need to use it. And then if you have serious problems, you lose it when you lose your job! AND, prior to the ACA that would often trigger pre-existing-condition clauses, meaning your condition would never be covered again. Some people get lucky and haven’t needed it or manage to avoid all the surprise billing/restricted network/unclear coverage/deductible timing minefields.
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Apr 1, 2020 18:47
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