Obamacare? Trump Care?

[pmclaine]

I think the two sides are asking the wrong question in this debate.

One asks how can we change the medical system so we can get more votes and the other is asking how can we change the medical system so that we can control people. Similar questions with one being a bit more nefarious in my mind.

I think they are refusing to ask the real question that matters though.....How the fuck did an ambulance ride ever get to the point it cost $1K?

I just went and picked up some type 1 diabetes supplies - 2 types of insulin, test strips and hypos - cost $160 out of pocket, insurance pays the rest.

Looking at the items and considering the maturity of technology on the products I'm thinking $160 is the real cost of what I paid for. In reality though the bill through insurance is going to be close to $1K.

I understand in the 70s a bottle of insulin cost $20, a lot of money back than but still not the $600 or so cost when covered by insurance. More often than not that $20 was born out of pocket entirely by the patient.

The only answer to the question I think that needs to be asked concerning health care is that the ambulance ride costs $1K because we decided through insurance and the participation of the medical/pharmaceutical industry that we could rob you blind paying for something that you absolutely must buy.

​​​​​We would be the political/insurer/power class.

 

[Rthur]

I'm of the opinion that lobbying is why it costs so much.
Also a litigious society, wonder who benefits from this...
This is also how we end up with 600 dollar epipens.

R

 

[oneshot86]

my exwife was a pharmacist, you would not believe the markup from wholesale to retail...
something that cost the pharmacy 7 could go out at 320, many many more examples some lower and many much more dramatic...
everyone is on the take

 

[pmclaine]

Its only since the first of the year we have noted the big jump in costs.

Its working exactly as Obamacare was planned to work. We pay for insurance and because we can we must also pay for others that get "free" medical care until the point we cant pay anymore. Than under duress we are supposed to ask for more govt and socialized health care to give us what is no longer affordable.

At least Obamacare had a plan as evil as it was. The end game was socialized medicine and control of the people.

Im not sure what Trumpcare is going to bring but when the priority is "Give us anything so we can say we did something" I dont have high hopes.

Anyway Trumpcare isnt going anywhere. The senate will crush it.

Tort reform certainly needs to play a role.

Sensible regulation rather than onerous regulation could cut costs.

Perhaps not having the govt mettle in the free market would also allow the laws of economics to play a role.

Letting people know there is no "free ride" would help. Too many people go to the hospital, flash some form of govt health care ID and get a total free ride - no co pays. Fine if you did something to earn that but otherwise there has to be some sort of co pay to put toward the common good. Local hospitals are getting killed by all the "free" care they provide.

 

[Maggot]

my exwife was a pharmacist, you would not believe the markup from wholesale to retail...
something that cost the pharmacy 7 could go out at 320, many many more examples some lower and many much more dramatic...
everyone is on the take

A friend of mine is subject to a recurring skin condition. the salve they presribe for himat retail cost is $400 or so. He gets low income medical assistance and pays $2.55 per tube, what it probably costs to manufacture it.

I think that Obummer actually wanted to make it better, but just fucked t up through incompetence and the battle with the right. As mentioned above, Trumpet and company dont give a flying goddamn about you or me, they are just going for the votes.

 

[Rthur]

I find it sad how quick everyone already considers it something "we" should get from the government.

R

 

[Maggot]

We are being governed by snakes, and morons.

And the rest of the story:

-------------------------------------------


PoliticsBusiness Insider Here's why Congress exempted itself from the new healthcare bill


Last week, Vox dug into the Republican healthcare bill and found a provision that would exempt...

 

[hlee]

Just for the record, the packaging that medication comes in (whether it be tylenol or a prescription) usually costs more to produce than the actual medication. That is the point at which pharmaceutical companies stop process development on drugs.

 

[EGwhisper]

The problems with healthcare costs are 1. Lawsuits our courts award and 2. Lack of responsibility - Guy goes in with cancer, going to cost $700k to research, experiment, and attempt to cure. Sure, sign me up, insurance will cover it. Would he have been all up for the $700k if we didn't have an insurance system? Probably would have been a little more frugal and questioning on whether all that research is really necessary, and if he really needed the $700 gown. Too many medical facilities are offering "great new technology" with stupid associated costs that don't even provide any value.

Guy goes back in and has an allergy reaction to the treatment not listed on the medication, $500k lawsuit. Guess who's paying for that? Drug company today, yes, but later on they'll just tack it on to the cost of future medication... Insurance pays for it, guess who pays for that? Insurance rate goes up.

 

[Tucker301]

Whether we like it or not, whether we prefer to or not, we all pay for each other's care, and we all pay for those who cannot and will not pay for each other's care.
Insurance is not a solution, as it merely adds costs and overhead while having negative impacts on quality of care and quality of life.

The whole thing needs to be dismantled and rebuilt from scratch, with the mindset that insurance is a completely alien concept.

Determine realistic goals, which in my own opinion are preventative medicine and counseling, and positive reinforcements of living healthy lives and eating healthy foods.

Waiting for your engine to seize up is not the best way to determine when an oil change is needed. Providers need to be rated and rewarded based on performance metrics and feedback from their patients.
As it is in the insurance model, the patient and the customer are two different and often opposing viewpoints and entities, each seeking completely different results from the same provider.

Insured healthcare is Socialized medicine, only with capitalist profits. It's two opposing concepts thrown together to create one of the greatest cons that there has ever been.
It's a fleecing, and little else.

Any of you my age (mid 50's) or older can remember when you were kids and got sick or injured. You were taken to the doctor once deemed to not be treatable in the home with conventional remedies.
The doctor's office typically was comprised of the doctor(s) and nurses. One of the nurses, or perhaps the doctor or their wife, did the bookkeeping. There was no army of people processing claims, because there were no claims. Your folks paid the doctor or made arrangements to do so.
If a prescription was warranted, a similar scenario occurred at the pharmacy. Same deal. Paid or put on a bill to be paid.
The incentive to pay was quite simple.
1. People were honest and honorable
2. If you didn't pay you didn't get anything next time

Now those same dollars go to feed, clothe, house, and insure (irony) literally dozens of other people in the insurance claims and processing industries. It builds their buildings. It buys their vehicles and office equipment. It pays their utilities. It pays their shareholders dividends. It pays and pays and pays, until there's next to nothing left for the doctor and the pharmacist. Most of the money leaves town and it does not come back.

If insurance were such a great way to buy expensive things, then we'd all be paying monthly premiums so that when we needed a new rifle or scope, we could get a small fraction of our money back to go and spend on it.

Abolish insurance and let the true costs be determined by the markets.

Sure, there will be times when there will be a need that outweighs the financial resources of the individual, but we somehow got all the way up to 1971 without that being an issue.

<iframe width="560" height="315" src="https://www.youtube.com/embed/87tqj0RS7ys" frameborder="0" allowfullscreen></iframe>

 

[pmclaine]

The family Doc was Dr Szwarc. He worked out of his Victorian, working on the first floor, living on the second. Great guy, Korean MASH vet. I think my father did some plumbing stuff for him which probably was in trade for some doctor stuff.

All that is gone.

I was working a few weeks ago and a woman pulled up asking for directions to a certain hotel. I realized there was a crap ton of traffic going in there and I asked what the reason was. It was a medical seminar about health care.

I made the comment that I had sympathy for them as things are in such flux. She came back with Trump is ruining it and we need single payer.

I asked how she liked the registry of motor vehicles and I asked how things got so screwed up that we lost the likes of Dr Szwarc and now we have replaced the human touch for big business. We talked for ten minutes or so. Hopefully she had some different ideas to present in her seminar.

 

[MarkCO]

I spent 3 years working in the Pharmaceutical manufacturing industry. The regulation and red tape is extreme, although some of it is good, some of it is pure fluff. Lawyers make everything more expensive, and insurance and health care are two of their favorite things to make more money from. HealthCare (IMO) is so expensive for a lot of reasons, but attorneys are the biggest reason. They drive the laws, lobbyists, class actions, insurance. Tort reform will curb some costs. Preventing direct to consumer marketing of prescription pharma to consumers will also help. Cleaning out the mess that is the FDA will also help. Americans stop smoking and costs start to go down, but now American is on to Opioids and Pot in record numbers. Some of it is just crappy lifestyle too, so making it so I don't have to pay for that will help. We got here by not paying attention as a collective and I truly believe it can not be fixed given the current political and social climate. I agree with Tucker's post #10 that there is no fix. Just a stop, blow it up and rebuild from the bottom up.

My insurance costs were almost $20K a year with a HDHP and a $5K stop-pay. So at $25K in annual medical for a family of 4 before I got any benefit from what I had been paying for. Opted out and went to an ACA approved Co-op. Now $5100 a year and stop-pay at $5K. So assistance kicks in at $10K out of pocket. No coverage for drug or alcohol treatment, abortion and a few other "choice" induced medical conditions. Someone was benefitting from the $20K. What is incredibly interesting is that paying cash, we are getting discounts from 15 to 70% for the same services by cutting out the insurance company. That should tell you most of what you need to know.

 

[quietmike]

Insurance overuse is a big cause.
You don't file a claim with your auto insurance if you need new tires or a replacement alternator, yet health insurance is expected tocover checkups, flu shots, and every damn thing else.

If we went back to health insurance only covering catastrophic events, insurance and healthcare would be much cheaper.
Fwiw-the same happened to college tuition when government loans seperated students from the colleges.

 

[spaniel]

Trumpcare will fail in the long run for the same reason as Obamacare...both fail to address the real problem, which is cost, not coverage.

And anyone who goes on about the cost of drugs only highlights their ignorance of the system. Drugs are about 15% of total healthcare spend, and it's been pretty stead since the 1950s. People whine about it because drugs are the cost insurance companies have chosen to expose people to the most.

If you had a $1000 copay each time you went to the hospital, or $150 for a routine doctor's visit, your perspective would change.

I'm all for capitalism, but the healthcare system is a prime example of where a little regulation can go a long way. The whole system has evolved to make pricing and the transfer of value so confusing that virtually nobody can understand it. For one thing, all providers should be forced to provide a price list for standard services so people can comparison shop. RIght now nobody knows what they are going to be liable for going in, so providers can charge whatever they want. People SHOULD be on the hook for a portion of their care, because that inventivizes people to use the system wisely and seek to lower costs. My wife used to work in the ER, and the worst patients were the once with Medicaid because they had nothing better to do than spend their evenings in the ER faking symptoms to try and get painkillers on the taxpayer dime.

People should be careful what they wish for with single payer. The grass is not greener. Take cancer for example. In many single payer countries patients don't get to make choices about their own care. The government literally places a value on a life/year, and if your care cost goes over that go write your will, you will not receive the treatment. Care is rationed, wait times are long. Doctors are basically or literally gov't employees. In return people may massive value-added taxes. Take a look at Europe, their economy is stagnate, and such socialist policies are to blame.

The tough truth is that since we are the last man standing as a true capitalist society, we shoulder the burden of the advancement of healthcare for the world. If we adopted the kind of price controls on drugs used by the UK or Germany, innovation would essentially cease as the US alone is responsible for about 60% of all pharmaceutical profits. People hate pharma companies until they need their products. Then they complain about talk about how much it costs to make a pill without bothering to educate themselves that 99% of the cost of that pill was not making it, but the 10-15 years of R&D it took to bring it to market.

 

[Michael]

I would be Ok letting the dumb shits in congress go to a single payer system.
We stop 100% of foreign aid and use that to pay for med care.

Buttttttttttttttttttttttttttttttttttt, as long as congress and blondie meddle with it nothing will be done.

 

[pmclaine]

Trumpcare will fail in the long run for the same reason as Obamacare...both fail to address the real problem, which is cost, not coverage.

And anyone who goes on about the cost of drugs only highlights their ignorance of the system. Drugs are about 15% of total healthcare spend, and it's been pretty stead since the 1950s. People whine about it because drugs are the cost insurance companies have chosen to expose people to the most.

If you had a $1000 copay each time you went to the hospital, or $150 for a routine doctor's visit, your perspective would change.

I'm all for capitalism, but the healthcare system is a prime example of where a little regulation can go a long way. The whole system has evolved to make pricing and the transfer of value so confusing that virtually nobody can understand it. For one thing, all providers should be forced to provide a price list for standard services so people can comparison shop. RIght now nobody knows what they are going to be liable for going in, so providers can charge whatever they want. People SHOULD be on the hook for a portion of their care, because that inventivizes people to use the system wisely and seek to lower costs. My wife used to work in the ER, and the worst patients were the once with Medicaid because they had nothing better to do than spend their evenings in the ER faking symptoms to try and get painkillers on the taxpayer dime.

People should be careful what they wish for with single payer. The grass is not greener. Take cancer for example. In many single payer countries patients don't get to make choices about their own care. The government literally places a value on a life/year, and if your care cost goes over that go write your will, you will not receive the treatment. Care is rationed, wait times are long. Doctors are basically or literally gov't employees. In return people may massive value-added taxes. Take a look at Europe, their economy is stagnate, and such socialist policies are to blame.

The tough truth is that since we are the last man standing as a true capitalist society, we shoulder the burden of the advancement of healthcare for the world. If we adopted the kind of price controls on drugs used by the UK or Germany, innovation would essentially cease as the US alone is responsible for about 60% of all pharmaceutical profits. People hate pharma companies until they need their products. Then they complain about talk about how much it costs to make a pill without bothering to educate themselves that 99% of the cost of that pill was not making it, but the 10-15 years of R&D it took to bring it to market.

And companies deserve to make their profit if they did the R&D The patent system is set up to account for that. Its amazing how the profit motive leads to huge gains in medical science. Dr Salk would be the worlds richest man if he was born 50 years later...

Problem is that even aspirin is being charged at a rate way beyond its level of technology.

Things have changed for the worse lawyers, regulation, insurance are all contributing.

I see no signs to to reset any of this and a hard control, alt, delete is whats needed.

 

[pmclaine]

I would be Ok letting the dumb shits in congress go to a single payer system.
We stop 100% of foreign aid and use that to pay for med care.

Buttttttttttttttttttttttttttttttttttt, as long as congress and blondie meddle with it nothing will be done.

If it was really America First our seniors, sick and legitimate poor would want for little.

 

[johnnycat]

Regulations are a large part of the increased costs - regulations on Pharmaceutical companies, regulation on Healthcare Providers, regulation on hospitals, regulation on insurance providers. All of this is supposed to make us safer, but all it really does is make healthcare more expensive.

 

[vh20]

Just for the record, the packaging that medication comes in (whether it be tylenol or a prescription) usually costs more to produce than the actual medication. That is the point at which pharmaceutical companies stop process development on drugs.

Can you provide your reference for that information?

 

[thejeep]

oh shit they mentioned performance metrics

 

[ArmyJerry]

The government will bring you into the earthly life and snuff you out of this life, you are now owned by the government lock stock and two full fkn barrels. Hope you get what you all voted for, you deserve it. Ultimate people control. Just like when the cops on here say "you must comply" like blind ignorant fkn robots. You will get the treatment the party in power things you deserve, think about it, these fkrs just spied on 10's of thousands of american citizens trying to say a election, dont think they will not take revenge on your ass. LEMMINGS.

Nowhere is federal government control of our medical system mentioned mentioned in the Constitution. When I say control I mean they actually outlawed private insurance so you now effectivly have full party / state control of your whole goddam life. Dont think this enslaving legislation wont be used to disarm you, implement envrio crazy controlling schemes all to benefit your health and reduce the cost to the fellow comrades. Just watch you stupid fkrs.

 

[Tucker301]

10 years of W2's - 25% subsidies
20 years of W2's - 50% subsidies
30 years of W2s - 75% subsidies
40 years of W2 - 100% subsidies

Want healthcare? Get a job.

 

[ArmyJerry]

who is paying those subsides? The money fairy? take a look at any program, I mean any, they gets subsidies, they costs go out of control immediately, college tuition is a great example but really if you subsidies sand the cost would go up in the sahara. Simple economics here gents.

 

[fmaglin]

I was reading an article that showed the annual income for the various insurance company CEO's. The smallest income was in the millions. These greedy fuckers aren't about to get off their gravy train; instead, they want more. They lobby the shit out of our govt to keep getting more, because they have something people need to survive. Change the healthcare system to a non profit and maybe things would change; however, big money won't ever let it happen.

 

[oneshot86]

If it was really America First our seniors, sick and legitimate poor would want for little.

big effin amen, well said...

 

[Michael]

In all this, the larger image has not changed, nor will it.
No matter who is in that white building, congress is about themselves.
Once they get something into their house, it is never going to come out from under their control. Get ready for single payer, it will be deemed the only way to fix this by congress within the next couple years.
I did have some small hope that blondie might bully his way to some inroads but it remains clear that the only way to get all this back under control might just be to burn the whole place down and let the survivors build it to their tastes.

 

[ArmyJerry]

The monster we let fester will kill millions of Americans under the guise of fairness and taking care of the citizens before it gets burnt to the goddam ground. This bill seals the fate that America wont be fixed through the ballot box. It wont be long now. I thought the interesting events would fall to my kids or grand kids generation but I am now thinking I might live to see the burning.

In all this, the larger image has not changed, nor will it.
No matter who is in that white building, congress is about themselves.
Once they get something into their house, it is never going to come out from under their control. Get ready for single payer, it will be deemed the only way to fix this by congress within the next couple years.
I did have some small hope that blondie might bully his way to some inroads but it remains clear that the only way to get all this back under control might just be to burn the whole place down and let the survivors build it to their tastes.

 

[Mike Casselton]

Trumpcare will fail in the long run

If you had a $1000 copay each time you went to the hospital, or $150 for a routine doctor's visit, your perspective would change.

Part of the problem with this line of thinking is that once you're in the Dr office they will see you for what ails you.
You and I and everyone else here knows that's not how it works.
When you go to see the doc, it's for only one thing.
If you have two, three or four issues, then you need separate appointments to have them taken care of.
They don't want to do multiple items per visit because the more visits, the bigger the paycheck.
The system is set up to allow that to happen. Hell, look at how the coding system has changed in the last three years. It's completely ridiculous.
If you had a car mechanic tell you he can only fix one thing per visit, you'd find a different mechanic.
Plenty of people that work in the health care industry don't see these problems because the doc will just take care of his people because he wants them in the office making money, not out on a personal day seeing another doc.

 

[fx77]

Obamacare is socialized medicine contrive by the democrats paid for with "Taxes on the Rich."

Trumpcare is socialized medicine contrived by the republicans paid for by taking on more "NationalDebt."

Now go to Elfster's series of videos on this forum, note the outstanding personal care he received at Mayo clinic ,and bid that kind of care.... good bye!

 

[spaniel]

Part of the problem with this line of thinking is that once you're in the Dr office they will see you for what ails you.
You and I and everyone else here knows that's not how it works.
When you go to see the doc, it's for only one thing.
If you have two, three or four issues, then you need separate appointments to have them taken care of.
They don't want to do multiple items per visit because the more visits, the bigger the paycheck.
The system is set up to allow that to happen. Hell, look at how the coding system has changed in the last three years. It's completely ridiculous.
If you had a car mechanic tell you he can only fix one thing per visit, you'd find a different mechanic.
Plenty of people that work in the health care industry don't see these problems because the doc will just take care of his people because he wants them in the office making money, not out on a personal day seeing another doc.

So people who work in the healthcare industry are never patients as well? They don't go to see their doctor?

If my doc refused to deal with more than one issue per visit, I'd find another doc. That is how the free market works.

 

[spaniel]

And companies deserve to make their profit if they did the R&D The patent system is set up to account for that. Its amazing how the profit motive leads to huge gains in medical science. Dr Salk would be the worlds richest man if he was born 50 years later...

Problem is that even aspirin is being charged at a rate way beyond its level of technology.

Things have changed for the worse lawyers, regulation, insurance are all contributing.

I see no signs to to reset any of this and a hard control, alt, delete is whats needed.

You lost me. Aspirin in the store is generic and cheap. Now these "pharma companies", which really aren't, taking epi pens and generics which only have one manufacturer and jacking the prices just because they can are a scourge to be eliminated.

 

[101stinfantry]

Well boys, this has been going on longer than ObamaCare/Trumpcare. Before Obama Care I had a surgery, $9,000, but since I was a Blue Cross Blue Shield member it was only $1,900, BCBS didn't pay a fuckin' dime. Go in any General Surgeons office and ask how much such, and such surgery is..............guess what? They won't tell you, it's all well it depends. No other industry can get away with that kind of shit. Just wait, all you guys are eventually gonna find out what its like to use the VA.

 

[pmclaine]

You lost me. Aspirin in the store is generic and cheap. Now these "pharma companies", which really aren't, taking epi pens and generics which only have one manufacturer and jacking the prices just because they can are a scourge to be eliminated.

Yes aspirin in the store is cheap but in the hospital they bill you about $30 per pill. That info is about ten years old based on a bill from the hospital when my kid was born. It's probably $90 now.

I agree regards "pharma companies" but how do you control it and still be a free market society? Is there some level of profit that we define as gouging? 7%, 15, 50, 100, 200%?

Thats part of the problem.

Should something be done about CEOs now compensated at 100s of times more than line employees? Should the Communist ice cream makers Ben & Jerry be our CEO model?

Part of the problem is that no one in the country has a sense of "shame" any longer. "If its good for me screw the other guy and the country" seems to be the norm. Actually that has probably always been the norm but at least in the past the robber barons would build a town library to assuage any guilt they felt.

 

[Mike Casselton]

So people who work in the healthcare industry are never patients as well? They don't go to see their doctor?

Try reading it again. Never said or implied that.
My point was that most docs will take care of their own employees. That keeps them making money for him/ her instead off being out of the office for a visit elsewhere.
Thought I was pretty clear on that.

If my doc refused to deal with more than one issue per visit, I'd find another doc. That is how the free market works.

I have the option to see any doc I want. Some people don't. Limited network providers, small town, long travel distance, etc.
Some people continue to see the same doc out of some form of perceived obligation. (Like being afraid to change hair dresser, even within the same shop)

My mom keeps going to the same lousy doc for this very reason.
Between myself and my sister, we got her to go elsewhere and she got better care for a recent issue.

Sometimes, people don't know any better.

 

[Michael]

Yes aspirin in the store is cheap but in the hospital they bill you about $30 per pill. That info is about ten years old based on a bill from the hospital when my kid was born. It's probably $90 now.

I agree regards "pharma companies" but how do you control it and still be a free market society? Is there some level of profit that we define as gouging? 7%, 15, 50, 100, 200%?

Thats part of the problem.

Should something be done about CEOs now compensated at 100s of times more than line employees? Should the Communist ice cream makers Ben & Jerry be our CEO model?

Part of the problem is that no one in the country has a sense of "shame" any longer. "If its good for me screw the other guy and the country" seems to be the norm. Actually that has probably always been the norm but at least in the past the robber barons would build a town library to assuage any guilt they felt.

It's interesting that we can define price gouging with the oil companies when speculators drive up retail prices, but no such outrage exists for the healthcare industry.
My Local med center, Lake Granbury Medical Center, is top 50 in the US for medical overbilling. ( Look it up )
Recent example; Colonoscopy. Going rage $1100.00 for the median hospital. Bill from LGMC was over $11,000.00.
So where is the congressional outrage over this behavior?

 

[ArmyJerry]

oil industry is largely unregulated, there is no NYMES for medical care, thats why you pay more for bottled water than you do for gas. The gouging being done is being done by our governments control of your life and death medical care.

 

[pmclaine]

A lot of medical industry is "non profit".

I suspect "non profit" means "Shit we may show a profit so raise compensation, issue bonuses and make donations to friendly political entities in order to make the possible "profit" a cost and we end up at "net zero".

 

[pmclaine]

It's interesting that we can define price gouging with the oil companies when speculators drive up retail prices, but no such outrage exists for the healthcare industry.
My Local med center, Lake Granbury Medical Center, is top 50 in the US for medical overbilling. ( Look it up )
Recent example; Colonoscopy. Going rage $1100.00 for the median hospital. Bill from LGMC was over $11,000.00.
So where is the congressional outrage over this behavior?

It's my understanding that what ever the oil companies take in "profit" per gallon of gas sold, taxes from state and federal requirements take a higher cut. You will never hear the congress blame itself for gouging.

Please correct me if that anecdote is in error.

 

[oneshot86]

I have the option to see any doc I want. Some people don't. Limited network providers, small town, long travel distance, etc.
Some people continue to see the same doc out of some form of perceived obligation. (Like being afraid to change hair dresser, even within the same shop)

My mom keeps going to the same lousy doc for this very reason.
Between myself and my sister, we got her to go elsewhere and she got better care for a recent issue.

Sometimes, people don't know any better.

you said a mouthful there, buddy...

 

[Greg Langelius *]

Giddyap, Dobbin...