Healthcare Predictions

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Re: Healthcare Predictions

Postby Spider » Wed Oct 18, 2017 9:37 am

phosphide wrote:.

Yes, it does matter. Our system could work if we eliminate inefficiencies, focus on quality of care rather than quantity, and hold insurance companies and hospital networks accountable. If health insurance was more affordable and government aid less complicated we wouldn't have many of these issues. Healthcare revenue cycle is probably the most inefficient industry in the entire country despite years of talking about electronic health records and blah blah blah.


Sounds great in principle, but in practice how much cooperation are you expecting from an enormously profitable industry to actually benefit the people at their own expense? There are so many people across so many sectors taking their taste in all of this...it's systemically corrupt. Which is of course the logical final outcome when we allow companies to profit on the suffering of the population.

Look, it doesn't really matter what major changes could happen we are still screwed. Why? Because 40% of adults and 19% of youth are obese. Half of all adults have a chronic disease and we have a very large and aging population.


You're not wrong.

Health insurance has an interesting concept of spreading risk. We aren't talking about the likelihood of car accidents or flood damage claims in particular zip codes...we're talking about the inevitable breakdown and death of every single person. Health insurance operates more like actual insurance when you're talking about whether the average 28 year old will need to make a claim because he fell down some stairs and broke his back. What we are actually working with though for the most part is the unavoidable spike in expense that comes with end of life, or chronic disease. This is less a risk than a known inevitability that may cost as little as this or as much as that. Health insurance is basically in the business of shifting wealth from the young to the old to cover these unavoidable expenses. This is an ever present condition in modern society...we need a system to handle the continuous birth/death cycle of the populace, and when we allow a for profit system to facilitate this (and badly)...what possible gain are we getting from it? We're going to die anyways. People are going to be born anyways. The associated expenses are going to be there. It's not a "risk", not really. It's a gamble on the relative magnitude of an inevitable cost.


Because of these things the insurance market will eventually fail. Why? Because a system designed to spread risk won't work if everyone is at risk. Will single-payer succeed? No. We will get older, fatter, and more unhealthy and it will take every last tax dollar you can imagine to pay for it. And I'm not going to pay into a system so a bunch of fat Americans can get their chronic diseases paid for. Maybe if we were a healthy society I would support it. I'm not entirely opposed to a basic level of coverage for all Americans and leaving the rest open to purchase catastrophic coverage. But alas, here we are.


We're going to get older, fatter, and sicker regardless of who's paying for it. Or not. So what possible reason could there be for lining the pockets of private insurers with gold for the simple reason that humans are mortal? It's f**k graft, if you think about it.

In any case...what you are saying basically amounts to "f**k 'em if they can't pay", just as I said. It really does, Phos. "Yeah, Grandma ate too many christmas cookies and now she has diabetes. But that's her fault. I'm not paying. Her time is up."

Honestly, the better solution might be to start treating the cause of the obesity itself, rather than simply letting people with lifestyle related health problems die off. In America, right now, anyone below a certain combination of income/number of kids gets free Doritos and Pepsi from the federal government. There are massive agricultural subsidies to keep food, particularly the exact food that causes these problems, to be gigantly cheap. Every effort to try to do something like tax fast food or reduce the size of sugar water servings is violently resisted on bizarre ideological grounds.

Maybe the poor, being the people that specifically can't afford to pay for these disorders, shouldn't be supplied with the exact sorts of things that cause those disorders in the first place?

I know, I'm a monster. You don't want to pay for sick people to get treatment, and I don't want to pay to make them sick in the first place. Surely there is some sort of common ground there?
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Re: Healthcare Predictions

Postby exploited » Wed Oct 18, 2017 10:31 am

Why are you trying to convince phosphide of the need for single payer? If, by now, he hasn't figured out that it is cheaper for him, while providing better results, he never will.

On issues of healthcare, gun control, environment, the electoral system, human rights and essentially any government program intended to redistribute wealth, Conservatives must be ignored. It is a waste of time. It is better to focus on building up the base than it is to dialogue with people who have chosen ignorance as an ideology. Talking amongst yourself to come up with a realistic alternative is a far better use of your time.

The Germans have a good model for American healthcare.
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Re: Healthcare Predictions

Postby phosphide » Wed Oct 18, 2017 6:13 pm

Kane wrote:This would allow for larger insurance corporations which would inevitably lead to larger power on their part over legislative/regulatory bodies. It could also lead to monopolization depending on who's in office.

Unless you're indicating you want them to become straight up GSEs? But then...why not just go single payer at that point?


Less payers is a good thing. It would reduce administrative costs associated with regional and national payers while simultaneously making it easier to regulate.

Kane wrote:ACA already does this...not sure about settlements but the whole point of the ACA was to cover people with pre-existing conditions without bankrupting them by increasing the level of care expected through the insurers.

You missed the point. Not to mention, the ACA had nothing to do with contracted rates between hospitals and insurance companies.

Co-pays are meant as a vehicle to get people to consider the cost of a doctor visit. GPs are inundated with daily visits by people that don't necessarily require one. They see shit on the internet and suddenly think that because they have 3 out of 10 symptoms they might have cancer. Co-pays make sure you have some skin in the game - it's trying to get the consumer to be more considerate and deliberate.

As for deductibles...people don't even know wtf that is half the time. The other half chooses the plan with the higher deductible because the premiums were literally unaffordable. I can tell you straight faced that before ACA I had seen co-workers with children pay for a plan with a $1,000+ premium a month. The mother worked to make the actual discretionary spending while the father worked to pay for healthcare or vice versa.

On top of that...plans even had annual limits on what amount they were willing to cover. If you needed over $1 million worth of healthcare for a given year and that was your provider's max, you're f**k. People do try to take this shit seriously but...have you ever been to an open enrollment meeting? The shit is obtuse. If you're not familiar with the terms, don't make a shit ton of money, you're probably just going to go with what you can afford.

Not sure why you're so angry at US consumers.


To the contrary, I'm helping US consumers. Here is how most of healthcare claims go: you walk into a facility and walk out. The bill arrives sometime later showing they billed the insurance company and you still owe X amount of dollars. You don't pay it. It goes to collections and hits your credit. You still don't pay it.

There. That's most patient responsibility claims. Why? Because most people can't afford to blow 4k on a whim. But you could afford to pay a small amount each month going forward. Likewise, it would reduce hospital administrative expenses trying to go after you to pay.

Kane wrote:Again, ACA already set out to do this.

http://consumersunion.org/research/heal ... -coverage/

That's not referencing at all what I said.

Kane wrote:I'm surprised to hear that you want us to go European.

Ok.

Kane wrote:Up to the executive right? I think Obama and past admins had higher priorities and white collar crime in general just doesn't seem to get the same amount of attention as a murder. But I'm all for creating an ultra super mega task force that takes this on.

About 10% of Medicare/Medicaid payments are fraud. So ya, it's worth taking a look at.

What does "fix patent system" even mean here? And dude...what you're prescribing whether you want to accept it or not supports paying into a system that rewards unhealthy people. Even before ACA you did this. We don't like the idea of leaving people out on the street to die. So we don't.

One word: EpiPen.

Until we do you can't escape that fact. Accept it and then move on and try to control costs like everybody else has been trying to do.

Everything I said would help control costs, especially administrative costs.
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Re: Healthcare Predictions

Postby fstarcstar » Wed Oct 18, 2017 10:11 pm

Kane wrote:What does "fix patent system" even mean here?


Really? The fact that you know nothing of issues with patents, intellectual property or the FDA approval system in healthcare means you shouldn't be debating at all.

https://www.bloomberg.com/view/articles ... sive-drugs
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Re: Healthcare Predictions

Postby Spider » Thu Oct 19, 2017 5:17 am

fstarcstar wrote:
Kane wrote:What does "fix patent system" even mean here?


Really? The fact that you know nothing of issues with patents, intellectual property or the FDA approval system in healthcare means you shouldn't be debating at all.

https://www.bloomberg.com/view/articles ... sive-drugs


Fstar...you don't get to make this post. Not ever. Its physiologically impossible to make my eyes roll that far. They are connected to the inside of my skull.
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Re: Healthcare Predictions

Postby Kane » Thu Oct 19, 2017 8:42 am

fstarcstar wrote:
Kane wrote:What does "fix patent system" even mean here?


Really? The fact that you know nothing of issues with patents, intellectual property or the FDA approval system in healthcare means you shouldn't be debating at all.

https://www.bloomberg.com/view/articles ... sive-drugs


Oh please, excuse me for requesting more specific details of the extremely vague claim that was made.

Get off your high horse and get back to trying to read titles before you comment.
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Re: Healthcare Predictions

Postby Kane » Thu Oct 19, 2017 9:00 am

phosphide wrote:
Kane wrote:This would allow for larger insurance corporations which would inevitably lead to larger power on their part over legislative/regulatory bodies. It could also lead to monopolization depending on who's in office.

Unless you're indicating you want them to become straight up GSEs? But then...why not just go single payer at that point?


Less payers is a good thing. It would reduce administrative costs associated with regional and national payers while simultaneously making it easier to regulate.


Pretend you didn't just disregard my entire point - what would prevent regulatory capture on part of the corporations?

phosphide wrote:
Kane wrote:ACA already does this...not sure about settlements but the whole point of the ACA was to cover people with pre-existing conditions without bankrupting them by increasing the level of care expected through the insurers.

You missed the point. Not to mention, the ACA had nothing to do with contracted rates between hospitals and insurance companies.


By rates do you mean prices? What are you talking about here? Insurers negotiate with hospitals on every line item. It's why I call for total transparency in the process - insurers won't like that because it'll hit their bottom line.
http://www.npr.org/sections/health-shot ... cares-cost

phosphide wrote:
Co-pays are meant as a vehicle to get people to consider the cost of a doctor visit. GPs are inundated with daily visits by people that don't necessarily require one. They see shit on the internet and suddenly think that because they have 3 out of 10 symptoms they might have cancer. Co-pays make sure you have some skin in the game - it's trying to get the consumer to be more considerate and deliberate.

As for deductibles...people don't even know wtf that is half the time. The other half chooses the plan with the higher deductible because the premiums were literally unaffordable. I can tell you straight faced that before ACA I had seen co-workers with children pay for a plan with a $1,000+ premium a month. The mother worked to make the actual discretionary spending while the father worked to pay for healthcare or vice versa.

On top of that...plans even had annual limits on what amount they were willing to cover. If you needed over $1 million worth of healthcare for a given year and that was your provider's max, you're f**k. People do try to take this shit seriously but...have you ever been to an open enrollment meeting? The shit is obtuse. If you're not familiar with the terms, don't make a shit ton of money, you're probably just going to go with what you can afford.

Not sure why you're so angry at US consumers.


To the contrary, I'm helping US consumers. Here is how most of healthcare claims go: you walk into a facility and walk out. The bill arrives sometime later showing they billed the insurance company and you still owe X amount of dollars. You don't pay it. It goes to collections and hits your credit. You still don't pay it.

There. That's most patient responsibility claims. Why? Because most people can't afford to blow 4k on a whim. But you could afford to pay a small amount each month going forward. Likewise, it would reduce hospital administrative expenses trying to go after you to pay.


Over how long? What's the payment based on? Interest charged? I don't see how this reduces cost if you're elongating out the payment period for everybody affiliated. Instead of the hospital going after people that didn't pay they now have to track untold numbers of people and their payments to make sure they don't miss payments. If the cost associated is a chronic issue and the charges continue to rack up then you have a classic scenario where the principal and the interest continue to balloon because the person will, 10/10 times, choose life over bankruptcy.

phosphide wrote:
Kane wrote:Again, ACA already set out to do this.

http://consumersunion.org/research/heal ... -coverage/

That's not referencing at all what I said.


Sure it does. It's not a tax/surcharge (it's a rebate to the affected party) but it's still a penalty for allocating funds in a specific manner that's not considered conducive to overall care. It's essentially the same thing, it's just constructed differently.

phosphide wrote:
Kane wrote:I'm surprised to hear that you want us to go European.

Ok.

Kane wrote:Up to the executive right? I think Obama and past admins had higher priorities and white collar crime in general just doesn't seem to get the same amount of attention as a murder. But I'm all for creating an ultra super mega task force that takes this on.

About 10% of Medicare/Medicaid payments are fraud. So ya, it's worth taking a look at.


It might be worse than that. Agree 100% on this.

phosphide wrote:
What does "fix patent system" even mean here? And dude...what you're prescribing whether you want to accept it or not supports paying into a system that rewards unhealthy people. Even before ACA you did this. We don't like the idea of leaving people out on the street to die. So we don't.

One word: EpiPen.


How would you fix it then?

phosphide wrote:
Until we do you can't escape that fact. Accept it and then move on and try to control costs like everybody else has been trying to do.

Everything I said would help control costs, especially administrative costs.


Debatable.
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Re: Healthcare Predictions

Postby fstarcstar » Thu Oct 19, 2017 5:57 pm

Spider wrote:
fstarcstar wrote:
Kane wrote:What does "fix patent system" even mean here?


Really? The fact that you know nothing of issues with patents, intellectual property or the FDA approval system in healthcare means you shouldn't be debating at all.

https://www.bloomberg.com/view/articles ... sive-drugs


Fstar...you don't get to make this post. Not ever. Its physiologically impossible to make my eyes roll that far. They are connected to the inside of my skull.


Maybe you should post a novel WITH SCREAMING CAPITAL LETTERS and other jibberish about why you feel you own the debate on anything or have the right to determine who can say what.
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Re: Healthcare Predictions

Postby exploited » Thu Oct 19, 2017 8:09 pm

fstarcstar wrote:
Spider wrote:
fstarcstar wrote:
Kane wrote:What does "fix patent system" even mean here?


Really? The fact that you know nothing of issues with patents, intellectual property or the FDA approval system in healthcare means you shouldn't be debating at all.

https://www.bloomberg.com/view/articles ... sive-drugs


Fstar...you don't get to make this post. Not ever. Its physiologically impossible to make my eyes roll that far. They are connected to the inside of my skull.


Maybe you should post a novel WITH SCREAMING CAPITAL LETTERS and other jibberish about why you feel you own the debate on anything or have the right to determine who can say what.


Spider is a moron, but in his defense, his instincts are more intelligent and coherent than anything you've ever thought.

I'm not a fascist, which means I'll always support your human rights, but if there is any argument for restricting franchise, you are it.
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Re: Healthcare Predictions

Postby fstarcstar » Thu Oct 19, 2017 8:35 pm

exploited wrote:
fstarcstar wrote:
Spider wrote:
fstarcstar wrote:
Kane wrote:What does "fix patent system" even mean here?


Really? The fact that you know nothing of issues with patents, intellectual property or the FDA approval system in healthcare means you shouldn't be debating at all.

https://www.bloomberg.com/view/articles ... sive-drugs


Fstar...you don't get to make this post. Not ever. Its physiologically impossible to make my eyes roll that far. They are connected to the inside of my skull.


Maybe you should post a novel WITH SCREAMING CAPITAL LETTERS and other jibberish about why you feel you own the debate on anything or have the right to determine who can say what.


Spider is a moron, but in his defense, his instincts are more intelligent and coherent than anything you've ever thought.

I'm not a fascist, which means I'll always support your human rights, but if there is any argument for restricting franchise, you are it.


Right, because I'm the guy that caused everyone on this forum to leave. Cool story bro.
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