Saturday, March 11, 2017

True





21 comments:

andy blatchford said...

That's been changed. It was originally She I am a libertarian etc.

Pretty much depends on what echo chamber you are in to which version you see.

Matt Franko said...

Interesting Andy that is other side of the spectrum...

Over here now you have those 2 cohorts fighting it out over healthcare where you have the pure socialists wanting 'single payer' and the libertarians wanting 'no payer'...

Neither extreme seems to understand the economics...

Auburn Parks said...

Actually Matt, the only side that understands the economics is the single payer camp. The conservative market camp is the one we are in currently and it has led to quite possibly the worst health care system in the world when evaluated on a cost to outcome basis.

Six said...

Matt, I think the single payer people want socialist health insurance (risk sharing), but keep the current non-socialist providers.

andy blatchford said...

Call us socialist if you like Matt but no one goes bankrupt in the UK because of medical bills.

Kristjan said...

Aubyrn Parks said:

"Actually Matt, the only side that understands the economics is the single payer camp. The conservative market camp is the one we are in currently and it has led to quite possibly the worst health care system in the world when evaluated on a cost to outcome basis."

Yes you are right that the healh care system in US is bad. There is an interesting Video explaining why US can't get universal health care. You don't have to agree with what is said in the video. Why do you think US canõt have it?

https://youtu.be/_wg6_hqu2Ck

Matt Franko said...

I don't think the single payers understand the economics if they did then we would have it...

Six the current providers are all nonprofit socialists they are mostly university systems.... i.e. "Just pay us what we say to pay us and go away..."

Auburn Parks said...

matt

we dont have single payer because our congressional system is based on bribery and corruption and its not in any of the major player's biz interests to cut $900 B in revenue (national spending on health care necessary to compare w canada the next highest spending country). It has nothing to do with not understanding how to do it, oobviousy as we already have it for like 60 million ppl over 65 and 10s of millions more on medicaid.

Auburn Parks said...

It has to do w prioriites. The priorities of our elected officials are to serve their donors not to serve the country or even their specific constituents. How do you not know this basic stuff about how our Govt works?

Matthew Franko said...

Yes but you have to look at how the WHOLE system gets its required revenues...

If the system gets the majority of its revenues from the firms who hire insurance companies to represent them with providers then if you cut the price of ALL of the claims down to what the current portion of 'single payer' cohort pays then the system will fail...

This is like Dylan Mathews at Vox saying Medicaid was the "lowest cost" program that is because the govt morons think they are out of "money" and keep cutting the unit price of what they will pay for the individual procedures via Medicaid...

Many providers simply will not see you if you are on Medicaid...

other providers who have a large majority of insured patients will see a Medicaid patient because they know they are making bank with the majority of their patients who are insured by the big insurers who pay a fairer amount for the services...

You have to look at the whole system... which is harder and requires more skill/knowledge...

If it becomes too complicated for people, they just bail out intellectually and say "single payer!" because they dont possess the technical training and competency in systems theory to figure it out...

Same with the libertarians, they are too stupid to figure it out so they throw their hands up bail out intellectually and say "just leave it up to the free market!" or some shit like that...

"Clowns to the left of me, jokers to the right..." Steve Miller Band

Matthew Franko said...

" we already have it for like 60 million ppl over 65 and 10s of millions more on medicaid."

Yes but what are the prices for the individual procedures the govt (the 'single payer') is willing to pay?

If those unit prices were extended to all citizens would that be adequate to supply the needed revenues to the whole system then?

I don't think it would be... the system would collapse... this is sort of what is happening with the ACA as we speak in the "individual group"...

the firms who pay for employee insurance do the heavy lifting and supply the big munnie to the providers ultimately... the insurers pay higher unit prices for the same treatment codes and the totals are higher for those citizens than those under 'single payer' type of coverage...

How can you be advocating for 'single payer' when the 'payer' thinks "we're out of money!".. its dangerous thinking...

Let the GOP get this tax refund into everybody's account on the first of the month and then we can start to fund/build out a real network of providers cutting out the insurance middlemen... let the providers debit the HSAs of the recipient's on the first of the month and get the USDs in advance and then just agree to provide care to that cohort for the month...

Once the tax credit gets in there the provider networks can start lobbying Congress to begin increasing the amount of the credit if the initial credit proves to be too small... and put in COLAs, etc...

I think this approach is better than single payer as the moron payer thinks they are "out of money!"...

Matthew Franko said...

Because we know that "govt spends first and then collects the taxes" the "deficit!" shouldnt go up as the increase in leading flow will result in higher tax deposits..

Then without an increased "deficit!" the provider networks should have political cover to lobby Congress to seek an increase in the credits from the current 4k for individual and 14k for household to whatever would be more adequate if needed...

Tom Hickey said...

Most medical expenses are owing to people on Medicare, or Medicaid after they have exhausted their funds. Those prices are already set by what government will pay.

The rest is the luck of the draw.

Other countries handle this fine. The US is the exception.

There is no need to go to elaborate systems of tax credits, etc.

Just federally insure everyone.

I would also have the federal government greatly expand spending on preventive care, healthcare R&D including pharma, and funding of medical and healthcare training.

Just take ambulance services. Could be run out of the fire department. All fire department personnel are qualified in EMS. Just add some more fire personnel and ambulances and make it a free service like fire fighting.

A healthy population is one of the greatest opportunities for return on public investment.

The cost of capital for the federal government is zero. Affordability is a non-issue. The issue is availability of real resources and government is capable of brining those resources online as effectively and efficiently as the private sector.

Tom Hickey said...

Then without an increased "deficit!" the provider networks should have political cover to lobby Congress to seek an increase in the credits from the current 4k for individual and 14k for household to whatever would be more adequate if needed...

We know that but do they, and would it pass?

I don't see this happening for the simple reason that the attack is on in the GOP against extending subsidies at all. So any subsidies that might make through the political process would likely be inadequate. Obama wanted the mandate since he figured that subsidies without skin in the game would never pass. What the Ryan plan does is back-load the fees with a hike in premiums for those not signing up right away. The opposition is citing this also as Obamacare-lite.

Matthew Franko said...

"Just federally insure everyone. "

Why use an insurance scheme at all???

Just let provider networks charge a fixed fee per month for providing healthcare to the members...

Channeling your inner Warren Buffet?

Tom Hickey said...

Just let provider networks charge a fixed fee per month for providing healthcare to the members...


Right. What would happen is that government beancounters would figure the costs in an area and set payments for services accordingly while distributing fixed costs.

Government would fund investment for expansion based on population.

"Socialized medicine" met resistance from physicians in the past (AMA) since they were mostly in private practice and acting as entrepreneurs. The tendency lately has been toward physicians joining institutions to take advantage of institutional efficiencies and decreased risks and burdens. Now many physicians favor a system like this.

This is contingent on recognizing that there is no affordability problem for the federal government as currency issuer. Price stability should be addressed through functional finance.

Matthew Franko said...

"might make through the political process would likely be inadequate."

Tom,

Maybe a bit "inadequate" but you get a taste of success.... and then just beat their f-ing disgraced skulls in with it... blow them the f out...

Matthew Franko said...

"Ryan plan does is back-load the fees"

How is it back loaded when they are crediting the tax refund on the first of the month????

that is 'front loading'...

they are going to put it in on the first day of the fiscal interval....

Matthew Franko said...

the GOP plan is month to month as if someone without coverage ends up obtaining it thru employment, etc.. then they stop getting the tax credit that same month...

And if the provider networks were smart, once the credit was passed they would send out door to door people in the poor neighborhoods banging on doors signing households up for the $1200/mo... you get 250,000 uninsured households signed up at 14k annual and its $3.5B (with a B) annual then you are talking some real sweet munnie and no middleman you have to share it with... suuuuuweeeeeeeet!

Matthew Franko said...

Put a 2x price to sales ratio on that 3.5B and you get a market cap of 7B for the provider network just from the previous uninsured business... not too shabby...

Tom Hickey said...

With Obamacare, there is an individual mandate and a penalty if one doesn't sign up.

With RyanCare, there is no individual mandate upfront but if one waits to sign up for insurance until later, like when one needs it, the the penalty is applied.

According to critics, it's essentially the same, the difference being when the penalty is applied, front or back.