Can we now call Øbamacare a failure?

[kalm]

There's something pretty different about health insurance and car insurance.

I'll let you put on your thinking cap here.

No kidding sherlock.

Doesn't change the business model for any type of insurance (or any for profit business for that matter) which is they shouldn't be forced by the govt to sell a product at a loss...

You do know there's risk involved with business, right? and you understand that insurance is shared risk, right?

[BDKJMU]

No kidding sherlock.

Doesn't change the business model for any type of insurance (or any for profit business for that matter) which is they shouldn't be forced by the govt to sell a product at a loss...

You do know there's risk involved with business, right? and you understand that insurance is shared risk, right?

Of course. There a difference between insuring something that is likely to be profitable, with a risk of it being a $$ loser, and being forced to insure something that is a guaranteed money loser. Example an insurance company shouldn't be told they have to insure a person who has a certain condition, can only charge X a year to said person in premiums, for that said condition that costs on average 5X or 10X a year to treat.

[Vidav]

Health insurance is dumb. We should just cover everyone via taxes.

[CID1990]

Health insurance is dumb. We should just cover everyone via taxes.

That's what's coming

We'd save money if we sent everyone to Canada or France for a year

They'd come back less enthusiastic about single payer

(Or not- I never cease to be amazed at the resilience of the belief that government holds the answers to everything)

[kalm]

Health insurance is dumb. We should just cover everyone via taxes.

That's what's coming

We'd save money if we sent everyone to Canada or France for a year

They'd come back less enthusiastic about single payer

(Or not- I never cease to be amazed at the resilience of the belief that government holds the answers to everything)

It doesn't but it's not as if our for-profit insurance system is kicking ass. A classmate of mine just died of brain cancer and needed a gofumdme campaign to help keep his family afloat. You see that shit all the time. USA! USA!

Its not as if we aren't seeing significant wait issues here either. Dermatologists in Spokane are booked out anywhere from 3-6 months. I know a lady who's had to wait 9 months for knee replacement.

Yeah anecdotal, but still.

If we do move to a Medicare for all type system does it have to be exactly like the U.K. and Canada or can we maybe innovate and lesson some of their drawbacks?

[Skjellyfetti]

French medical tourism seems nice.

21 days in Toulouse. Airfare included. Loding included. Personal driver included. Sight seeing tours included. All meals included.

And, total cost 65% less than the same medical procedure in the US.

http://sanfrancisco.cbslocal.com/2014/0 ... alth-care/

[kalm]

French medical tourism seems nice.

21 days in Toulouse. Airfare included. Loding included. Personal driver included. Sight seeing tours included. All meals included.

And, total cost 65% less than the same medical procedure in the US.

http://sanfrancisco.cbslocal.com/2014/0 ... alth-care/

[CID1990]

That's what's coming

We'd save money if we sent everyone to Canada or France for a year

They'd come back less enthusiastic about single payer

(Or not- I never cease to be amazed at the resilience of the belief that government holds the answers to everything)

It doesn't but it's not as if our for-profit insurance system is kicking ass. A classmate of mine just died of brain cancer and needed a gofumdme campaign to help keep his family afloat. You see that **** all the time. USA! USA!

Its not as if we aren't seeing significant wait issues here either. Dermatologists in Spokane are booked out anywhere from 3-6 months. I know a lady who's had to wait 9 months for knee replacement.

Yeah anecdotal, but still.

If we do move to a Medicare for all type system does it have to be exactly like the U.K. and Canada or can we maybe innovate and lesson some of their drawbacks?

I have two thoughts about this-

In your very first sentence you nailed it. Our pre-ACA system wasn't perfect, and I don't think anyone has ever claimed that it was. But the ACA wasn't a fix- it made things worse for the middle class, and ultimately is going to self destruct. It's a case study in how government is bad at these kinds of things.

A better way forward (since it's poor people who we are talking about here... they're the ones who go to the ER for basic care) would be to extend Medicare to higher income brackets. Say, the less than 50k per year household income level. Still expensive, still clunky, but it doesn't jam the middle class, and the cries of "uninsured people" would not be as much of an issue.

The second thing was your last question- I have zero faith in this government's ability to do that. In fact, I don't even consider it in my thinking anymore. When people use the terms "learn from others mistakes" or "innovate" or "learn" in association with government practices I place those conversations in the same category with "why don't we designate warp drive and travel to Betelgeuse"

[Skjellyfetti]

A better way forward (since it's poor people who we are talking about here... they're the ones who go to the ER for basic care) would be to extend Medicare to higher income brackets. Say, the less than 50k per year household income level. Still expensive, still clunky, but it doesn't jam the middle class, and the cries of "uninsured people" would not be as much of an issue.

Medicare is for old people. Medicaid is for poor people.

Medicaid expansion to higher income brackets was part of ACA. Up to 400% of the poverty level - since it varies by location.

Unfortunately, the Supreme Court ruled the federal government couldn't force the states to expand Medicaid. So, it was left up to the states.

The states that expanded Medicaid are doing much better than the states that didn't.

[CID1990]

A better way forward (since it's poor people who we are talking about here... they're the ones who go to the ER for basic care) would be to extend Medicare to higher income brackets. Say, the less than 50k per year household income level. Still expensive, still clunky, but it doesn't jam the middle class, and the cries of "uninsured people" would not be as much of an issue.

Medicare is for old people. Medicaid is for poor people.

Medicaid expansion to higher income brackets was part of ACA. Up to 400% of the poverty level - since it varies by location.

Unfortunately, the Supreme Court ruled the federal government couldn't force the states to expand Medicaid. So, it was left up to the states.

The states that expanded Medicaid are doing much better than the states that didn't.

Sorry- I've typed Medicare before and my autocorrect took over

I'm aware that it was a part of the ACA- the bottom line is that it is NOT affordable for many people it was intended to benefit, and a pure single payer system for lower income brackets is the only answer if we truly give a sh1t about the dregs that don't have health insurance

I'm ok with that tax burden, because we assume the cost of it one way or the other anyway. Forcing everyone into a really crappy insurance plan just to make the risk pool palatable is not the answer.

[Pwns]

It doesn't but it's not as if our for-profit insurance system is kicking ass. A classmate of mine just died of brain cancer and needed a gofumdme campaign to help keep his family afloat. You see that shit all the time. USA! USA!

Its not as if we aren't seeing significant wait issues here either. Dermatologists in Spokane are booked out anywhere from 3-6 months. I know a lady who's had to wait 9 months for knee replacement.

Yeah anecdotal, but still.

If we do move to a Medicare for all type system does it have to be exactly like the U.K. and Canada or can we maybe innovate and lesson some of their drawbacks?

This will get much worse under SP system. I know I sound like a broken record, but we have to pull our heads out of our collective ass when it comes to the number of health care providers we have.

[kalm]

It doesn't but it's not as if our for-profit insurance system is kicking ass. A classmate of mine just died of brain cancer and needed a gofumdme campaign to help keep his family afloat. You see that shit all the time. USA! USA!

Its not as if we aren't seeing significant wait issues here either. Dermatologists in Spokane are booked out anywhere from 3-6 months. I know a lady who's had to wait 9 months for knee replacement.

Yeah anecdotal, but still.

If we do move to a Medicare for all type system does it have to be exactly like the U.K. and Canada or can we maybe innovate and lesson some of their drawbacks?

This will get much worse under SP system. I know I sound like a broken record, but we have to pull our heads out of our collective ass when it comes to the number of health care providers we have.

Why can't the market adjust? If demand increases, why can't the number of providers? If there's demand for faster service, why wouldn't certain providers fill that niche? There's a place in Spokane called Franklin Park Urgent Care that's already specializing in this. They advertise quick, affordable care, even for the uninsured. It's kind of a dumpy place so their overhead is reduced, but they are amazingly efficient and fast. Took my youngest there a couple of years ago for a last second sports physical and we were in and out in (walkin) in about 45 minutes and IIRC they charged $30 cash. But they also take insurance.

[Ibanez]

That's what's coming

We'd save money if we sent everyone to Canada or France for a year

They'd come back less enthusiastic about single payer

(Or not- I never cease to be amazed at the resilience of the belief that government holds the answers to everything)

It doesn't but it's not as if our for-profit insurance system is kicking ass. A classmate of mine just died of brain cancer and needed a gofumdme campaign to help keep his family afloat. You see that shit all the time. USA! USA!

Its not as if we aren't seeing significant wait issues here either. Dermatologists in Spokane are booked out anywhere from 3-6 months. I know a lady who's had to wait 9 months for knee replacement.

Yeah anecdotal, but still.

If we do move to a Medicare for all type system does it have to be exactly like the U.K. and Canada or can we maybe innovate and lesson some of their drawbacks?

How about this. My mother had to a biopsy and scans of her lungs last May but had to wait until September for the results. That's just quality healthcare.

[Pwns]

This will get much worse under SP system. I know I sound like a broken record, but we have to pull our heads out of our collective ass when it comes to the number of health care providers we have.

Why can't the market adjust? If demand increases, why can't the number of providers? If there's demand for faster service, why wouldn't certain providers fill that niche? There's a place in Spokane called Franklin Park Urgent Care that's already specializing in this. They advertise quick, affordable care, even for the uninsured. It's kind of a dumpy place so their overhead is reduced, but they are amazingly efficient and fast. Took my youngest there a couple of years ago for a last second sports physical and we were in and out in (walkin) in about 45 minutes and IIRC they charged $30 cash. But they also take insurance.

I am in favor of beefing up the number of residency positions and opening up more seats at medical schools.

[kalm]

It doesn't but it's not as if our for-profit insurance system is kicking ass. A classmate of mine just died of brain cancer and needed a gofumdme campaign to help keep his family afloat. You see that shit all the time. USA! USA!

Its not as if we aren't seeing significant wait issues here either. Dermatologists in Spokane are booked out anywhere from 3-6 months. I know a lady who's had to wait 9 months for knee replacement.

Yeah anecdotal, but still.

If we do move to a Medicare for all type system does it have to be exactly like the U.K. and Canada or can we maybe innovate and lesson some of their drawbacks?

How about this. My mother had to a biopsy and scans of her lungs last May but had to wait until September for the results. That's just quality healthcare.

Yet somehow, it would be for worse under SP despite the fact that outcomes are no worse if not better in other OECD countries.

[GannonFan]

How about this. My mother had to a biopsy and scans of her lungs last May but had to wait until September for the results. That's just quality healthcare.

Yet somehow, it would be for worse under SP despite the fact that outcomes are no worse if not better in other OECD countries.

Differences between us and other OECD nations go far beyond the delivery of the health care or the system itself.

With that said, I don't think it would be all that different under a SP than it is now. The wealthy will be able to afford whatever they want (cutting edge drugs, top of the line surgical procedures by the best in the business, and whenever they want/need it) and everyone else will muddle through with less and with delayed services. The outcome difference with other nations will continue to exist since, as I said, the delivery isn't the reason for the difference, and we can move the debate to why the rich have it better than the poor. So, basically where we are with virtually every other issue.

[kalm]

Why can't the market adjust? If demand increases, why can't the number of providers? If there's demand for faster service, why wouldn't certain providers fill that niche? There's a place in Spokane called Franklin Park Urgent Care that's already specializing in this. They advertise quick, affordable care, even for the uninsured. It's kind of a dumpy place so their overhead is reduced, but they are amazingly efficient and fast. Took my youngest there a couple of years ago for a last second sports physical and we were in and out in (walkin) in about 45 minutes and IIRC they charged $30 cash. But they also take insurance.

I am in favor of beefing up the number of residency positions and opening up more seats at medical schools.

Need to also figure out how to reduce the education and malpractice insurance costs.

[Pwns]

How about this. My mother had to a biopsy and scans of her lungs last May but had to wait until September for the results. That's just quality healthcare.

Yet somehow, it would be for worse under SP despite the fact that outcomes are no worse if not better in other OECD countries.

What "outcomes" are these, kalm? I'm just asking because the ones that are cited by SPHC advocates are usually things that depend on diet and lifestyle factors that vary country to country and things like infant mortality which the definition also varies by country.

I know that cancer survival and care for chronic diseases are much better in the US than anywhere else.

[GannonFan]

I am in favor of beefing up the number of residency positions and opening up more seats at medical schools.

Need to also figure out how to reduce the education and malpractice insurance costs.

So that's it then, all we have to do is to solve the rising cost in education, control the cost of litigation, and then we should be able to complete the hat trick and be able to provide awesome medical care at minimal cost. Doesn't seem too difficult.

[Skjellyfetti]

No one knew healthcare could be so complicated.

[Ibanez]

No one knew healthcare could be so complicated.

Right? It's only eluded every president that tried to implement some sort of universal health care- going as far back as FDR.

Shoving the ACA down our throats was irresponsible. I support parts of it and hate others.
Sent from my iPhone using Tapatalk

[SDHornet]

This will get much worse under SP system. I know I sound like a broken record, but we have to pull our heads out of our collective ass when it comes to the number of health care providers we have.

Why can't the market adjust? If demand increases, why can't the number of providers? If there's demand for faster service, why wouldn't certain providers fill that niche? There's a place in Spokane called Franklin Park Urgent Care that's already specializing in this. They advertise quick, affordable care, even for the uninsured. It's kind of a dumpy place so their overhead is reduced, but they are amazingly efficient and fast. Took my youngest there a couple of years ago for a last second sports physical and we were in and out in (walkin) in about 45 minutes and IIRC they charged $30 cash. But they also take insurance.

Doctor shortage: Undegrad...then med school...then tests...then long residency...and then enter a practice...

...and if you can't get a residency they you've effectively wasted your time (and mountains of cash).

I'm willing to bet over regulation/purposeful limiting of the med school/doctor vetting process also comes into play in this issue...

...kind of along the lines of qualified doctors from over seas not being "a real doctor" and therefore cant start a practice because he/she doesn't have the right piece of paper on the wall.