The underlying cost of healthcare continues to be ACA's Achilles heel
Well, Aetna's departure has more to do with they're playing hardball politics on the Humana merger. Still, I think you are right that the ACA is only a stopgap on our way to single payer.
Hillary's proposal to extend Medicare to age 55 could solve some of these issues in the short term. Statistically speaking, the older people are, the more they spend on health care. So taking the 55-64 year olds off the insurance market could help.
Of course that won't happen. Because GOP House.
the bills are ridiculous...i know someone that was in patient at a couple different short term mental health units (1-2 weeks)...the best care she got was being handed crayons and told to draw circles and that is billed as occupational therapy, the other place was worse....and they bill thousands of dollars per day to let you sit there and stare at the wall most of the day....the places actual foster psychosis....one they didn't even change her meds...just let her sit for a week....and handed her the original meds a couple times per day...
the one place actually confirmed what she said was true ..they think they provide great care and were happy to confirm her description..
How depressing the government is. They make a huge mess of healthcare. They then create the ACA which seems to be failing. And you know we're just dumb enough to run to a Single Payer system.
What a ship of fools we are. It's shameful.
terp said:
How depressing the government is. They make a huge mess of healthcare. They then create the ACA which seems to be failing. And you know we're just dumb enough to run to a Single Payer system.
What a ship of fools we are. It's shameful.
It's really a surprise that it came to this. I figured that with half the government trying to make it work and half trying to make it fail things would work out perfectly.
terp said:
How depressing the government is. They make a huge mess of healthcare. They then create the ACA which seems to be failing. And you know we're just dumb enough to run to a Single Payer system.
What a ship of fools we are. It's shameful.
I am unclear when things ever worked well in the US regarding healthcare. The ACA is trying to put lace on a bowling ball. Our healthcare is a mess that we have created. Its embarrassing that our costs are so high relative to our awful outcomes. Healthcare works better in just about all industrialized countries.
Then again, I am also unclear why having a toenail removed in the US costs $55,000.
What I do know is that congress will not help us out of this mess.
No. The Achilles heel is that there are not enough middle men between the provider and the patient. I don't know how many there are now, but if there were more with each additional entity cutting waste and improving efficiency, well, I'll bet we could get the cost pretty close to zero.
No. The Achilles heel is that there are not enough middle men between the provider and the patient. I don't know how many there are now, but if there were more with each additional entity cutting waste and improving efficiency, well, I'll bet we could get the cost pretty close to zero.
Woot said:
terp said:
How depressing the government is. They make a huge mess of healthcare. They then create the ACA which seems to be failing. And you know we're just dumb enough to run to a Single Payer system.
What a ship of fools we are. It's shameful.
I am unclear when things ever worked well in the US regarding healthcare. The ACA is trying to put lace on a bowling ball. Our healthcare is a mess that we have created. Its embarrassing that our costs are so high relative to our awful outcomes. Healthcare works better in just about all industrialized countries.
Then again, I am also unclear why having a toenail removed in the US costs $55,000.
What I do know is that congress will not help us out of this mess.
You don't know when things ever worked well because the government has been intervening longer than you've been alive.
Prices are ridiculous because the pricing mechanism has been completely broken in that market.
Red_Barchetta said:
No. The Achilles heel is that there are not enough middle men between the provider and the patient. I don't know how many there are now, but if there were more with each additional entity cutting waste and improving efficiency, well, I'll bet we could get the cost pretty close to zero.
Middle men play an important role in some markets. They sometimes match a consumer w/ the correct producer. Of course, since there are so many mandates now, it makes less sense.
Anyhoo, the ACA is falling apart. The Co-ops are going bust.
Aenta and United Healthcare were not going broke, their profits just weren't high enough for them
Single payer, pure and simple
They were hemmoraging $$ too with these activities. I think Aetna's lost over $400 Billion.
Relying on the young and healthy to sign up to fund the old and sick isn't going to work unless you really punish the young and healthy for not signing up. It's that simple.
The ACA was an attempt to get an entitlement without a new perceived tax. It is failing miserably. But of course, the geniuses that decry anyone who was against it think we just need more government. 
"normally" a big, complex new program, or even a substantial tax revision, is followed by years of technical corrections bills and adjustments, not by years of efforts to repeal the whole thing. Congress will not lift a finger to help make ACA work, only to repeal it, which (please keep in mind) would leave millions of citizens uninsured again, many of them people the insurance companies refused to insure at any price before ACA. Not to mention the increasing number of "gig" workers, and employees of companies that are dropping or restricting insurance coverage.
Is this what we want, really? And in what universe does it make sense that the first thing to happen when one is too ill to work is that one loses insurance coverage??
wrt the co-ops, our local co-op (which has provided reliable service at a reasonable price) was assured of a substantial start-up subsidy, which was subsequently cut by I think 90% by the Congress. Sort of put a wrench in their carefully considered business plan, right?
terp said:
They were hemmoraging $$ too with these activities. I think Aetna's lost over $400 Billion.
Relying on the young and healthy to sign up to fund the old and sick isn't going to work unless you really punish the young and healthy for not signing up. It's that simple.
That's really smart. Punish the young and healthy by forcing them to subsidize a healthcare system that is five to twenty times more expensive than the rest of the world. That does not solve the real problem.
Also, single payer won't help if you don't get costs down.
http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html
http://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html
http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html
http://www.bloomberg.com/news/articles/2016-08-23/insurance-startup-oscar-quits-markets-rethinks-obamacare-plans
Health insurance startup Oscar Insurance Corp. will reevaluate its approach to Obamacare after suffering significant losses under the U.S. program and will pull out of two markets next year.
Oscar, which pitches itself as a tech-savvy alternative to traditional health insurers, plans to end sales of Affordable Care Act plans in Dallas, a market it entered this year, and New Jersey. It’s part of a more conservative approach by the New York-based company as it plans to introduce insurance products for businesses next year.
All the news about the Epi-Pen rip-off shows that regulation is needed in the drug industry. The cost of drugs is rapidly approaching 50% of medical costs. drug companies are making record profits, and they are spending more and more on marketing and less and less on research. The system is broke with or without the ACA.
Medicare should be the single payer for all - despite all the complaints about it, the coverage for my parents is far better than my over priced plan from United health care and they have a far larger choice of doctors. And pay for it with taxes via payroll with a 50-50 split between the employees and corporations( and tax lower paid individuals at a lower rate). And people can buy supplemental plans to cover the gaps just like is done now.
Yeah, I know, lots of jobs will be lost (or shifted) but the system is broke and we need to fix it.
Maybe we can't hope to enact single payer any time soon. So maybe we should think about the Japanese system. If I remember correctly, national insurance doesn't pay for medical care, but the government sets maximum prices on every drug and procedure. That would prevent hospitals and doctors charging and pharmaceutical companies from charging whatever the f*ck they want, regardless of what is common or reasonable.
mikescott said:
drug companies are making record profits, and they are spending more and more on marketing and less and less on research.
While I don't completely disagree with your post, I do think that your comment above is not very misleading. In 1980, "Big Pharma" spent roughly $2 billion on R&D. In 2014 that number is estimated at $52 billion.
Pharma spends 18-20% of global sales on R&D. That is an extraordinary percentage that outpaces all industries except for very high tech (e.g semi-conductor). And they spend much, much more on R&D than on Marketing. You may be including Sales. Which can account for 5-8x the marketing budget.
And if you are referencing a Washington Post/John Oliver analysis, that analysis was very flawed in that it included Umbrella Corp budgets. For example: Johnson and Johnson, for whom appears to spend the more on Sales and Marketing than R&D, is a huge corporation primarily split into Consumer, Pharmaceutical and Medical Devices.
I can understand the "short hand" of combining Pharma and Med Devices under the label of "Pharmaceutical", but Consumer divisions dramatically distort your data. Consumer divisions are full of products that require high marketing and zero R&D. Johnson and Johnson sells products like Listerine or Baby Powder which do not need further R&D spend, but which require huge marketing spend to keep consumer products relevant.
broigus said:
http://www.bloomberg.com/news/articles/2016-08-23/insurance-startup-oscar-quits-markets-rethinks-obamacare-plans
Health insurance startup Oscar Insurance Corp. will reevaluate its approach to Obamacare after suffering significant losses under the U.S. program and will pull out of two markets next year.
Oscar, which pitches itself as a tech-savvy alternative to traditional health insurers, plans to end sales of Affordable Care Act plans in Dallas, a market it entered this year, and New Jersey. It’s part of a more conservative approach by the New York-based company as it plans to introduce insurance products for businesses next year.
Oscar's failings have almost nothing to do with this discussion. Oscar’s business model has always been all flash and no substance: a flashy app + expensive marketing and a lot of Venture Capital buzzwords, e.g. "disrupting the marketplace" etc. etc. The "Uber" of the insurance business.
It may be fine to be flashy and "disruptive", but you also have to carefully and intelligently plan to make a profit in the world of health insurance. They've done a lousy job and may or may not survive. The ACA has little or nothing to do with it.
Woot -- interesting. And I am not sure where I had read that R and D was at an all time low in terms of percentage.
Not sure what the answer is for drug companies. I hate to think we need to regulate the profits they can make on a drug if they are using those profits for R and D or giving medication to those who can't afford (or don't have insurance) but in too many cases it seems that all the drug company CEO's are taking home enormous paychecks.
No easy answers to the crisis but it would seem the first step is universal health care.
Who will subsidize the cost of research once the United States steps away?
Nobody I guess- but at least we'll all share in the misery. At least government will gain power over everyone's health decision and a massive portion of the economy.
Just wait till the Jesus Freak everyone seems so afraid of wins the White House and abortion is kept legal to have performed but illegal to spend taxpayer dollars on.
MY body my choice! As long as it pertains to abortion.
The leftist way- cause a problem, propose a solution. And it's always the same solution- more of other people's money, more government.
We already have a fistful of single payer government programs. They're super well run! Just ask them!
Leftists pay taxes too, so I don't understand why you say they always want more of other people's money. Seems to me that they prefer that their tax dollars support different things.
I normally enjoy and look forward to reading your comments, but I honestly have no idea what you are trying to say about abortion.
How do you think that the healthcare crisis can be solved without more government involvement? Who do you think has power over health decisions now? In many instances it is the insurance carrier.
I agree with your point that if the US stops funding R & D, no other country will, at least not to the same extent.
Jackson_Fusion said:
Who will subsidize the cost of research once the United States steps away?
Nobody I guess- but at least we'll all share in the misery. At least government swill gain power over everyone's health decision and a massive portion of the economy.
Just wait till the Jesus Freak everyone seems so afraid of wins the White House and abortion is kept legal to have performed but illegal to spend taxpayer dollars on.
MY body my choice! As long as it pertains to abortion.
The leftist way- cause a problem, propose a solution. And it's always the same solution- more of other people's money, more government.
Sweetsnuggles said:
Leftists pay taxes too, so I don't understand why you say they always want more of other people's money. Seems to me that they prefer that their tax dollars support different things.
I normally enjoy and look forward to reading your comments, but I honestly have no idea what you are trying to say about abortion.
How do you think that the healthcare crisis can be solved without more government involvement? Who do you think has power over health decisions now? In many instances it is the insurance carrier.
I agree with your point that if the US stops funding R & D, no other country will, at least not to the same extent.
Jackson_Fusion said:
Who will subsidize the cost of research once the United States steps away?
Nobody I guess- but at least we'll all share in the misery. At least government swill gain power over everyone's health decision and a massive portion of the economy.
Just wait till the Jesus Freak everyone seems so afraid of wins the White House and abortion is kept legal to have performed but illegal to spend taxpayer dollars on.
MY body my choice! As long as it pertains to abortion.
The leftist way- cause a problem, propose a solution. And it's always the same solution- more of other people's money, more government.
Couple thoughts- first, thanks for your kind words.
Second, the abortion crack is pointed at the fact that there is one medical procedure upon which no encumberance may be placed. It's protected by penumbras of the constitution and is almost a sacrament. It shall brook no interference.
Everything else, let government have at it.
Insurance carriers can be fired. Government cannot. If my health care sucks that bad I go to an employer with better benefits.
In any case- go check out the decisions facing the UK. They're ranked horribly for stroke, cancer, and heart attack outcomes. Their doctor's union (yes, union) is regularly threatening to strike. Leftists are screaming that any change that involves insurance is murder to the "poor", and that the only answer is to means test and increase taxation for care.
Looks great! But I gues SEUI can organize the doctors and we'll do great- every bit as good as patients at the VA.
Yeah, well the VA is another sore point. Why is it that there's always enough tax money to send soldiers to war, but not enough to take care of them when they return home?
Actually, Most people I know who use Medicare are satisfied with it, except the doctors who say they don't get paid enough. And that is government run. I can't say the same about any private health insurance carrier.
so give me medicare for all as a start.
@jackson_fusion, I don't care if private enterprise or government provides health insurance as long as it is effective and cost effective. If it's government, it needs sufficient funding. If it's private enterprise, it needs regulation, which includes price caps and perhaps profit margin caps.
Jackson_Fusion said:
Insurance carriers can be fired. Government cannot. If my health care sucks that bad I go to an employer with better benefits.
Only in America is quitting your job the answer to cheaper insurance.
ridski said:
Jackson_Fusion said:
Insurance carriers can be fired. Government cannot. If my health care sucks that bad I go to an employer with better benefits.
Only in America is quitting your job the answer to cheaper insurance.
It's also the answer to better work environment, better pay, more vacation, better benefits, better educational opportunities, better lifestyles...
The only question is whose labor will pay for it, yours or someone else's.
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Insurance providers are going broke or pulling out of exchanges since the cost of proving healthcare is proving too high for the premiums collected. So next year it is likely that about 1/4 of the nation will have only one company choice on the exchange and some will have zero.
http://www.bloomberg.com/news/articles/2016-08-16/insurer-exits-from-obamacare-turn-few-choices-into-none