[ldrews]

Winstonm, on 2017-July-18, 18:03, said:

What you fail to mention is that if California adopts a single payer then none of the individuals or corporations would have to pay insurance premiums - that amount could be collected as taxes and eliminate the high administrative costs inherent in the current private payer system.

Are you really taking the position that government run enterprises are less costly and more efficiently run that private enterprises?

[Zelandakh]

ldrews, on 2017-July-18, 19:08, said:

Exactly. Trump seems to be establishing better relations with Russia.

Like William Hale Thompson established better relations with Al Capone?

[awm]

ldrews, on 2017-July-18, 19:14, said:

Are you really taking the position that government run enterprises are less costly and more efficiently run that private enterprises?

Insurance is a somewhat unusual business. Fundamentally it's about accurate assessment of risk -- in the case of health insurance, this means refusing to insure people who have (or are likely to develop) expensive medical conditions. Insurance companies also make money by finding legal loopholes to let them avoid paying when their enrollees get sick. Neither of these sounds ideal if our goal is that people be taken care of when they get sick?

Further, in many places health insurance is a monopoly. This is because another way they save money is negotiating with health providers and on this it helps to be big. Given the choice between private monopoly and government monopoly I'd prefer the latter... neither is likely to be super efficient but at least the governments primary goal isn't to make a profit off people's suffering.

Another way to put this is, health insurance doesn't generate a lot of bureaucracy because they are "inefficient" or because it is somehow complex to pay out insurance claims. They have a lot of bureaucracy because this makes them money, by creating opportunities to avoid paying when customers are too lazy to fill out the forms for small costs, or when they fill out the forms incorrectly! Government doesn't have any such incentive.

Note that this is very different in the realm of auto insurance because: 1. They can make money by being good at getting the "other guy's" insurance to pay, since most accidents have two parties while most health events don't 2. If they refuse to insure someone, that means a terrible driver is taken off the roads, which may be best for everyone 3. Economies of scale don't seem to kick in the same way, perhaps because if there is one main insurer the odds that there is no "other insurer" in an accident go up!

[RedSpawn]

ldrews, on 2017-July-18, 19:08, said:

Exactly. Trump seems to be establishing better relations with Russia. As the major nuclear weapon power in the world today, I think that is probably a good idea. Or would you prefer to have a confrontational relationship with Russia?

I prefer confrontational. It's good for that $700 billion military budget we just approved for 2018. It's time for some saber rattling with our enemies.

[RedSpawn]

Winstonm, on 2017-July-18, 18:12, said:

What he does? Like this?

Quote

When President Trump’s meeting with Russian President Vladimir Putin went for more than two hours, well past the scheduled half-hour, it was a major news event. But it turns out that wasn’t even the end of the conversation between the two men.

Ian Bremmer, president of the Eurasia Group, first reported the second meeting Tuesday. Other outlets also reported the news, and the White House confirmed it to Reuters. (BuzzFeed journalist Alberto Nardelli had previously reported about a meeting.) Trump reportedly met with the Russian leader for an additional hour of informal chats after a dinner of G20 leaders—though the White House in a statement reported late Tuesday by NBC’s Hallie Jackson called the encounter “brief” and denied it constituted a second meeting. While the first meeting was small—the only attendees were Trump, Putin, the Russian foreign minister, Secretary of State Rex Tillerson, and one interpreter from each country—this was even smaller: just Trump, Putin, and a Russian interpreter. Trump did not have his own interpreter.

Isn't this already mentioned in the Trump topic stream? What does Trump and Putin have to do with affordable and quality health care?

{grinning devilishly}

[Zelandakh]

RedSpawn, on 2017-July-19, 04:20, said:

What does Trump and Putin have to do with affordable and quality health care?

You are right. It is hard to imagine Trump having anything to do with affordable and quality health care, other than for himself and his family.

[Winstonm]

ldrews, on 2017-July-18, 19:14, said:

Are you really taking the position that government run enterprises are less costly and more efficiently run that private enterprises?

Just disputing that your half-story is the whole story. One area, anyway, that single payer is better is in administrative costs of healthcare.
(emphasis added)

Quote

Jacob Hacker:

These administrative spending numbers have been challenged on the grounds that they exclude some aspects of Medicare’s administrative costs, such as the expenses of collecting Medicare premiums and payroll taxes, and because Medicare’s larger average claims because of its older enrollees make its administrative costs look smaller relative to private plan costs than they really are.

However, the Congressional Budget Office (CBO) has found that administrative costs under the public Medicare plan are less than 2 percent of expenditures, compared with approximately 11 percent of spending by private plans under Medicare Advantage. This is a near perfect “apples to apples” comparison of administrative costs, because the public Medicare plan and Medicare Advantage plans are operating under similar rules and treating the same population.

(And even these numbers may unduly favor private plans: A recent General Accounting Office report found that in 2006 Medicare Advantage plans spent 83.3 percent of their revenue on medical expenses, with 10.1 percent going to non-medical expenses and 6.6 percent to profits—a 16.7 percent administrative share.)

[ldrews]

Winstonm, on 2017-July-19, 08:15, said:

Just disputing that your half-story is the whole story. One area, anyway, that single payer is better is in administrative costs of healthcare.
(emphasis added)

OK, just hyperbole.

[Winstonm]

ldrews, on 2017-July-19, 10:38, said:

OK, just hyperbole.

More like weaponized faulty generalization.

[barmar]

cherdano, on 2017-July-18, 15:25, said:

To the contrary, it is a sign of a majority social consensus that the government should help its citizens to get healthcare.

Is it really? Two of the GOP Senators who wouldn't vote for the bill said it was because it didn't cut enough.

I think one of the things that no one in the media really touches on is that a general philosophy of the Republican party is that the federal government shouldn't be in the loop on many things. Republicans who are against Obamacare are not necessarily against people getting health care, they just don't think the federal government should be managing and paying for it. If health care should be provided for people, it should be the states' responsibility, not the fed's.

This is why Mitt Romney was not necessarily being hypocritical when he came out against Obamacare, despite it being modeled on the Massachusetts system that was developed under his watch.

[barmar]

Winstonm, on 2017-July-18, 15:28, said:

That the number of insurers in states is reverting to the norm doesn't mean that the ACA is losing insurers.

There's a similar issue regarding premiums.

Many of the people who claim that Obamacare is imploding point to big increases in premiums in the past couple of years. But they fail to take into account that premiums dropped significantly when the ACA was first enacted, as a way to entice healthy people to get into the system rather than pay the penalty. Now the insurance companies are raising rates to catch back up.

This is an increase in the same way that a car dealers have a price increase during the week after President's Day.

[ldrews]

barmar, on 2017-July-19, 17:57, said:

There's a similar issue regarding premiums.

Many of the people who claim that Obamacare is imploding point to big increases in premiums in the past couple of years. But they fail to take into account that premiums dropped significantly when the ACA was first enacted, as a way to entice healthy people to get into the system rather than pay the penalty. Now the insurance companies are raising rates to catch back up.

This is an increase in the same way that a car dealers have a price increase during the week after President's Day.

That may be the case, but some people are still unable to afford them.

[Winstonm]

ldrews, on 2017-July-19, 20:51, said:

That may be the case, but some people are still unable to afford them.

No one - including Barrack Obama himself - ever claimed the ACA couldn't be improved. Obama actually called on Republicans to bring him a better bill and he would sign it.

We see how that went.

Now, the best option available is to fix as many of the law's problems as possible - but I think Trump is bigoted and so spiteful that he would veto any bill that does not repeal the ACA because he only cares about trying to ruin Obama's legacy.

That really is SAD!

[Winstonm]

Here is a problem that the capitalistic markets seem unable to fix driven by profits alone: pan resistant Gram negative bacteria.
For those unfamiliar, Gram negative bacteria have an outer shell that stains pink in tests and that outer shell makes them harder to penetrate with antibiotics.

Antibiotics are designed to use only 7-10 days. Cholesterol drugs are designed to be used for life. When a corporation is planning investment of $1 billion to bring a new drug to market, which would it make more economic sense to invest in: a drug that is bought once for 7 days or one bought monthly for 50 years?

The last company to invest in research and development of antibiotics was Pfizer, and they no longer do. What is the effect?

By allowing free markets total reign in healthcare research, doctors and patients now find themselves in the same situation as those who lived in the 1930s, before antibiotics could cure, and faced with the growing numbers of resistant bacteria.

Of course, it is not all the fault of the companies involved - it is the entire system that allows total freedom to manufacture and invest in the most profitable drugs while eschewing needed less profitable drugs. and the tort system with its lawyers waiting to pounce with class action lawsuits that must automatically be factored in to the cost of development.

The solution to the problem in the U.S. lies with Congress and the president - legislation could resolve it. But, of course, legislation and regulation is a kneejerk trigger for rejection by the small-government crowd. But those people choose to ignore these kinds of problems because the problems are damning evidence that in some situations regulation by government is not only the best reply but the only effective reply.