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Excellent summary of US Healthcare

Posted by esh_ga z7 GA (My Page) on
Wed, Sep 18, 13 at 11:58

What is wrong with it, why it is better elsewhere and why there is no "single" fix for what ails us.

At over 7 minutes it is long, but the stuff just keeps coming.

Here is a link that might be useful: Link to video


Follow-Up Postings:

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RE: Excellent summary of US Healthcare

That was incredibly entertaining and really fun to listen too. And of course the man is absolutely correct. I wish those congress critters would just give it a chance, but they can't. The ACA is the gold standard in legislation - congress has been trying to pass a health care law for decades and guess who managed to do it? It makes the opposition blind with rage. .


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RE: Excellent summary of US Healthcare

Very good find, esh!

Take away phrases:

Centralized negotiation -- and we don't have it.

Treating health care costs as political theater -- that we have, and then some.


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RE: Excellent summary of US Healthcare

Yep, he nailed it. Just what I was talking about in the other thread, right? If government seriously takes on the role of negotiating with providers then all the craziness goes away.

I didn't know how it worked until I saw how much my government insurance offered my providers for care during an emergency incident. The provider's idea was to bankrupt me because I was unlucky enough to need care. If I had negotiated with them on my own I'd probably have paid 25-50% of the bill, and that still would have blown a big hole in my financial situation, and still would have been quite unreasonable judged by what all other services go for. MA gave them about 2% (private insurers give 50% or so which leaves tons of profit for the shareholders of hospitals and drug companies, etc, and makes it seem like they are doing a job while workers pay the insurers a huge amount of money to be in collusion).

The message is pretty clear: quit with the BS costs. So if this happened on national scale some very wealthy people would see exponential drops in their income stream. Obviously these people are connected and hence the current shenanigans in Congress.


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RE: Excellent summary of US Healthcare

I woke up this morning thinking that I need to start sending emails to republican legislators asking them to put an end to their nonsense. How can we call ourselves a country that believes in "rule of law" if we can't accept the fact that a law was passed that needs to be followed. I have a real problem with this particular form of republican anarchy.


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Great idea jerzee, but how many legislators that are acting that way would actually to listen to someone that called them out on it?


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Maybe if they got enough emails they will start listening. I am really angry about these guys wasting time while there are more important things to deal with at the moment. They know once the ACA starts it is going to be popular beyond their wildest dreams and they are doing everything in their power to prevent that.


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RE: Excellent summary of US Healthcare

It seems to me that inaccessible, non-affordable health care is one of the reasons our country has so many individuals ready to break down and commit atrocious acts against others unknown to them.

And it seems to me that one of the common threads running through countries without this kind of mayhem is socialized medicine.

Something to ponder...


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RE: Excellent summary of US Healthcare

The numbers aren't all in, but they're mounting. I'm glad I don't live in VT. Keep telling me how my premiums are going to go down? Who is going to foot this bill again? Affordable is the wrong word for this Act.

Here is a link that might be useful: Average INCREASE is 24%


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RE: Excellent summary of US Healthcare

Rob: You didn't read to the end of the article.

UPDATE 1: After we published our map, the office of Gov. Paul LePage (R., Maine) reached out to us to correct our pre-ACA Maine data. It turns out that a number of significant reforms enacted by the Maine legislature from 2011 to 2013 drove down the price of individually-purchased health insurance in Maine. The results of those reforms started to show up on the Maine insurance market on July 1; our examination of Maine pre-ACA rates had taken place in late June. The updated results, which we independently verified, are incorporated into the interactive map.

These changes have had a significant, albeit temporary, effect on the Maine insurance market; previously, the average price of a Maine individual-market policy was $1,228 a month; today, it’s only $316 a month: a 74 percent drop. Obamacare drives the average back up to $366 a month; the average rate increase is 14 percent. I will examine Maine’s 2011-13 reforms in a separate article.


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RE: Excellent summary of US Healthcare

Funny how the Forbes piece doesn't just show what the exchanges in each state offer in the way of policies and premiums.

Which everyone will be able to do in on Oct 1st.


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RE: Excellent summary of US Healthcare

Trader Joe's healthcare decisions recently got a little press. Here is a response by them:

Last week I wrote about Trader Joe's decision to cut health insurance benefits for employees who work fewer than 30 hours a week. After that, one reader forwarded along a response received from Trader Joe's after inquiring about the matter. It's one of the more thorough explanations I've seen from a company cutting in benefits, so I've posted it here. It acknowledges, surprisingly bluntly, that some employees will be worse off for the decision and that others might benefit. Here is the full response:

Thank you for writing to us. It's possible you have been misled, at least to some degree, by the headlines in some articles regarding our reasons for implementing the [Affordable Care Act] in January. We'd like to take this opportunity to clarify some facts.

For over 77% of our Crew Members there is absolutely no change to their healthcare coverage provided by Trader Joe's.

The ACA brings a new potential player into the arena for the acquisition of health care. Stated quite simply, the law is centered on providing low cost options to people who do not make a lot of money. Somewhat by definition, the law provides those people a pretty good deal for insurance ... a deal that can't be matched by us -- or any company. However, an individual employee (we call them Crew Member) is only able to receive the tax credit from the exchanges under the act if we do not offer them insurance under our company plan.

Perhaps an example will help. A Crew Member called in the other day and was quite unhappy that she was being dropped from our coverage unless she worked more hours. She is a single mom with one child who makes $18 per hour and works about 25 hours per week. We ran the numbers for her. She currently pays $166.50 per month for her coverage with Trader Joe's. Because of the tax credits under the ACA she can go to an exchange and purchase insurance that is almost identical to our plan for $69.59 per month. Accordingly, by going to the exchange she will save $1,175 each year ... and that is before counting the $500 we will give her in January.

While we understand her fear of change, at her income level this is a big benefit that we will help her achieve.

Clearly, there are others who will go to the exchanges and will be required to pay more. That is usually because they have other income and typically a spouse who had a job with no benefits and they do not qualify for the subsidies under the ACA.

One example of that we had yesterday was the male Crew Member who worked an average of 20 hours per week but had a spouse who is a contract consultant who makes more than $200,000 per year. The Crew Member worked for the medical benefits and unfortunately for them they are likely to have to pay more because of their real income. We understand how important healthcare coverage is to our Crew Members and we are pleased to be able to provide and support this program.

We do hope this information helps, and we appreciate your interest in Trader Joe's.

Edited to add: Just one example of a real business making real decisions both for their benefit, and surprisingly, in some ways (where possible) for the benefit of their employees. A very thoughtful explanation.

Here is a link that might be useful: source

This post was edited by esh_ga on Thu, Sep 19, 13 at 11:12


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RE: Excellent summary of US Healthcare

I did read further, but obviously you didn't. It says, they weren't comparing correctly. What people cared about was how am I paying compared to last year. I fully agree with that! Instead of the BS answer Kaiser gave. Try again.

I'm still waiting for the magic to happen. People are still sick, still incur claims, and it still has to get paid for. Just because the government stops funding medicare and medicaid doesn't mean the hospitals can foot the bill. It just moves the cost burdens elsewhere. Two and two still equal four, it didn't become three in some alternate universe. I know I'm banging my head here, just like always, but y'all don't have a true handle on what is actually happening. The reality. The nonparitsan reality. The people's reality. You're gonna see it some day.

The costs are still there, they're still increasing and the burden shifted. You'll get it some day. Just not today.


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RE: Excellent summary of US Healthcare

Yes David, we may all have a better picture come October of this year, but a really good view next year. I'm still reserving my thoughts on this one. It'll work or it won't. It'll get funded by higher premiums and/or taxes or it won't. We will see. You're lucky that you live in reduction state. Great for you! Equalization isn't bad for everyone.


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RE: Excellent summary of US Healthcare

I did read further, but obviously you didn't. It says, they weren't comparing correctly. What people cared about was how am I paying compared to last year. I fully agree with that! Instead of the BS answer Kaiser gave. Try again.

In the final paragraph of the article:

But Jon makes a fair point in Obamacare’s defense, which is that it’s a good thing if exchange premiums�"and therefore exchanges subsidies�"come in at rates that are lower than expected. “If the real cost of insurance turns out to be lower than CBO expected, then the federal government won’t have to spend as much on subsidies, and it will end up saving more money.”


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Simple greed is a major factor when a company raises the price of a drug by around 400% changing a $50 a month script into $250 a month script that Medicair & Medicaid paid.
Rising health care costs are for the most part the result of continued marketing strategies like this.
This is 10 years later & this is still being haggled over in courts.

It only came up again as a juror became a fly in the ointment drawing attention to this dragged out old case of Greed vs Greed.

The case may not initially strike us as the stuff of social justice: two multibillion dollar companies fighting over potentially hundreds of millions of dollars in revenue while paying multimillion dollar law firms millions of dollars to do it. But in the blink of an eye, the lawyers went from talking about "unfair competition" to talking about "antigay discrimination."

The case revolves around the price of an HIV drug and whether one company's decision to quadruple the drug's price violates unfair competition laws. At jury selection time, one of the attorneys used his right to exclude certain members from the jury pool to, ostensibly, exclude a gay person. We don't know for sure that this is what happened; these are allegations and proof is always hard to come by in these circumstances. But if the allegations are true, the act is troubling, at best: the lawyer was suggesting that a gay person cannot be impartial in a case involving an AIDS drug.

The case now asks: Can a person be excluded from a jury simply because of his or her sexual orientation? The answer's importance extends beyond the narrow confines of the jury room. It reminds me of the Prop 8 proponents' distasteful motion to vacate Judge Vaughn Walker's decision declaring Prop 8 unconstitutional because he is gay and was at the time of the case in a long term same-sex relationship.

Here is a link that might be useful: old news


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RE: Excellent summary of US Healthcare

I bet healthcare "costs" in the uS are inflated at least 50%.

I agree with what the guy in this OP is saying: the reason countries with free healthcare have lower costs than we do is not because people there pay more taxes or because they get inferior service, it is because the government doing real negotiating rather than a pretense of negotiation as happens here.


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RE: Excellent summary of US Healthcare

Brown: "I agree with what the guy in this OP is saying: the reason countries with free healthcare have lower costs than we do is not because people there pay more taxes or because they get inferior service, it is because the government doing real negotiating rather than a pretense of negotiation as happens here."

Another POV on why, or maybe just an expansion of Brown's:

"...In fact, one of the main reasons that the United States pays so much for health care, including the items listed in this article, is precisely because it does not have a free market in large sectors of the health care industry. Of course it severely restricts the admission of immigrant doctors into the country, driving up the pay of physicians to two or three times what they would receive in other wealthy countries.

Perhaps more importantly, it grants patent monopolies to drugs and medical devices..."

Here is a link that might be useful: Patents Drive Costs Up


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elvis is right. Utilization is one of three factors in higher costs. That is an industry known.


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One of these years, the US will move on from the mediaeval practice of forced imposition of blood sucking leeches upon the sick.

While the Republicans rally to the ramparts to restore the leeches to their pre-Obama administration take. Back to the glory days of health insurance CEO's pulling down $100 million a year, not the barely subsistence $10 million a year imposed by that Kenyan Socialist. Back to the glory days where insurance company employees were paid premiums for refusing payments to the sick!!!

¡Viva los sanguijuelas!


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RE: Excellent summary of US Healthcare

Thank you, David, for introducing me to a new word today.

And I also learned that sanguijuelas have an average life span of 27 years.

Las sanguijuelas son famosas por aparecer como esas criaturas que se pegan a la piel y chupan la sangre de la gente, pero eso sólo lo hace la más famosa de ellas, la conocida como sanguijuela medicinal. Pero lo cierto es que hay una amplia variedad de sanguijuelas, todas pertenecientes los hirudíneos. Las hay marinas, de agua dulce, terrestres y arborícolas. Llegan a medir hasta 20 cm de largo, y son muy longevas, viven unos 27 años de promedio.

The Italian word is sanguisuga.

Raise the fist, and repeat after me: Che guadagnino milioni le sanguisughe medicinali!


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RE: Excellent summary of US Healthcare

Hard to believe but leeches have made a comeback in modern medicine. They are used to help skin heal.

Then, in 1985, a Harvard physician was having great difficulty in reattaching the ear of a five-year-old child; the tiny veins kept clotting. He decided to use leeches and the ear was saved. This success established leeches in the modern medical world. Since then, leeches have saved lives and limbs, reducing severe and dangerous venous engorgement post-surgery in fingers, toes, ear, and scalp reattachments; limb transplants; skin flap surgery; and breast reconstruction.

Here is a link that might be useful: link


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RE: Excellent summary of US Healthcare

Maggots, too:

"From ancient times until the advent of antibiotics, physicians used maggots to help clean injuries and prevent infection. Because the maggots feed solely on dead flesh, doctors did not have to worry about bugs feasting on healthy tissue. The arrival of antibiotics relegated medical maggots to an artifact of an earlier era."

Maggots & leeches. Doubt there's a patent on those.

Here is a link that might be useful: Affordable health care


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So this OP is wrong in asserting that Americans use health care less than in countries with "free" care?


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I don't think I have ever heard anyone who is fortunate enough to live in a country that supports universal health care call it free.

We are not stupid. We understand how our health care is funded and the vast majority are OK with the manner in which we pay for it.

Health care, like education , requires a willingness on the part of the public to fund it from the collective purse, for the collective good.

No free rides.....just priorities.


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RE: Excellent summary of US Healthcare

Well stated, Chase.

I recall you making this statement a number of times back in the day when Obama was trying to pass a health care reform bill.

A whole lot of conservatives disagreed with you and tried to tell you Canadians what lousy health care you had and, oh! The months of waiting for an appointment!

And nobody in this country was losing their home due to health care bills. That was just a lousy lie all the libruls were spreading, trying to fix what wasnt even broken.

Remember?


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But I also remember that it wasn't going to "cost us any more than premiums we were already paying". I still believe, costs are going to go up (a high amount!!!) and that middle America, who is already strained enough, will foot that entire bill. Does everyone still stand behind that? Because it's looking more and more like that reality of "where will that money come from?" is coming home to roost. I haven't forgotten all those who said it wasn't going to change many many times. I loved hearing it'll be no different! and hoping it won't be.

Is there back-pedalling or is everyone else still waiting to see as I am? Equalizing will make a difference. It may get higher in some areas, less in some and maybe not all that many. I'm waiting. And I'm really waiting to see if they can wrangle those who are avoiding payments to offset the costs. It will matter. It's so complicated, it's probably going to take a long time to filter.


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RE: Excellent summary of US Healthcare

I still believe, costs are going to go up (a high amount!!!) and that middle America, who is already strained enough, will foot that entire bill.

Once the exchanges kick in and the people start buying insurance, there should be enough competition between the various insurers to get new clients that hopefully the costs will be kept down. You have to remember the insurers are going to try to get as many people as possible to sign up because that of course helps their bottom line.


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RE: Excellent summary of US Healthcare

Yea, it's why I am still waiting (reserving full judgement). Everybody hang on!


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