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Post by mike on Jul 5, 2020 17:11:43 GMT -5
dr. BiPAP Sachin, your question reminds me of one George Carlin posed: If a really stupid person becomes senile, how can you tell?
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Post by Dr. BiPAP Sachin on Jul 5, 2020 17:23:26 GMT -5
dr . BiPAP Sachin, your question reminds me of one George Carlin posed: If a really stupid person becomes senile, how can you tell? LOL! Good one.
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Post by darthoso on Jul 5, 2020 17:25:32 GMT -5
The issue with a Medicare Buy In is that it doesn't do anything to address the underlying problem: price. Not the cost of the insurance, the cost of care. I don't know a lot about the Swiss system but I'd bet money that all of their insurance plans operate off a system wide fixed price model. A hip replacement costs your insurance X regardless of where you get your coverage. I know that sounds commie but there is no other method to do price discovery since free market economics and healthcare don't mix. The current system of providers and insurance companies pulling numbers out of their ass is bankrupting the country, we can't keep spending nearly 18% GDP on healthcare. Here's an example of the insanity: Biogen sells Spinraza to Duke for $125,000 per dose, Duke then bills Blue Cross $765,709 which gets "negotiated" down to $365,306.03. Putting Biogen aside (at least they kinda invented something), that's a quarter million dollar profit for Duke every 4 months per patient. Labs, doctor fee, PT eval, procedure, and recovery are billed separately. All Duke did for that profit is fax the doctor's letter and PT eval to Blue Cross for preauth, then Biogen to order the drug. NC Medicaid only pays Duke a $10,000 profit. These numbers are made up by Duke and BC, they are based on nothing. Medicare for All would establish a fixed price schedule, which means that providers could greatly reduce their overhead since they don't need an army of admins to file insurance. We easily could see a 40% premium increase in 2021 post COVID. We already have caps on % of premiums that go towards overhead and profit and insurance is barely cheaper in states with multiple companies competing. Premiums largely reflect costs. 18% GDP is $3.6 trillion, health insurance overhead is only ~$275 billion of that, that's nothing. Doesn't matter what system we use unless we fix provider cost first. What's even more insane is that even with $3.6 trillion, a lot of rural hospitals are collapsing. So I don't get where that money is going beyond outright waste and inefficiency. The other issue with Medicare Buy In is exactly what mike said. The Medicare Buy In will be sabotaged to make it noncompetitive. Medicare for All can't be sabotaged just like traditional Medicare can't be sabotaged, because everyone is on it. Now if you want to build private coverage on top of Medicare, like Medicare Advantage, at least you're operating on top of the Medicare system. Can this be solved by requiring providers to accept Medicare with no balance billing? That would inherently give Medicare power over how much they pay. Any competitive advantage given to Medicare will eventually fold due to lobbying from the insurance industry and providers. We're already seeing this with private Medicare Advantage plans being authorized to cover more than traditional Medicare. The ACA took so much political capital that it made future changes impossible. A future healthcare reform will take a similar effort that it has to be able to stand on it's own. You have to reboot the system as Single Payer then introduce private plans if desired.
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Post by matisse on Jul 5, 2020 17:29:28 GMT -5
Can this be solved by requiring providers to accept Medicare with no balance billing? That would inherently give Medicare power over how much they pay. Any competitive advantage given to Medicare will eventually fold due to lobbying from the insurance industry and providers. We're already seeing this with private Medicare Advantage plans being authorized to cover more than traditional Medicare. The ACA took so much political capital that it made future changes impossible. A future healthcare reform will take a similar effort that it has to be able to stand on it's own. You have to reboot the system as Single Payer then introduce private plans if desired. It seems to me we are in a different political atmosphere than with Obamacare. I think Medicare for those who want it would have a good shot, particularly since so many are opposed to Medicare for all.
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Post by wonk on Jul 7, 2020 6:13:40 GMT -5
John Cleese recorded this yesterday for everyone in this thread. He did not record it in the 1980s
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Post by IcarusFellOnce on Jul 7, 2020 11:44:48 GMT -5
I look at things a bit differently than many people, and here is how I see things vis-a-vis current events: Most people don't deliberately say or do things that seem to themselves inherently stupid, but rather say & do things that conform to what they believe. In the past however, we mostly watched network news and read the mainstream media. Not that it was automatically accurate, but we were all receiving essentially the same stories, ergo we didn't diverge significantly in our views. Today however, we can choose our information sources, and they often present markedly different viewpoints. Watch left leaning news and you'll get a very different picture than if you watch right leaning news sources. Neither is probably telling outright lies, but they leave people with very different opinions. As a consequence, there are widely different perceptions of politics & events. Unfortunately people frequently think others are stupid or ignoring facts, when they are simply reflecting their news sources. Present the same story in the same way and both people would probably have similar views, but that often isn't the case. People are generally intelligent, and make decisions based upon the information they receive. But they're receiving very different information. Take a contentious issue, and imagine yourself being persuaded to a different viewpoint based upon some argument advanced by someone else. Not likely to happen, but the reverse is also true, you're unlikely to change the other person's viewpoint. If you think you can digest both sides & find the truth somewhere in the middle, that's like standing with one foot on a block of ice & the other on a blowtorch - on the average you would be comfortable - right? I'm reminded of a discussion between someone who was claiming the moon landing was faked, to which the other person replied sarcastically "Tch...you believe in the moon?" At one point ascribed to all this. When it comes to forming policy I ascribe to aspects of this... but we in the US anyways are getting so divided, I'm not interested in compromising with a "side" that are apologists for white supremacists... that say there are good people on both sides during the protest in Virginia.. but when people get upset because a young black man that's on the spectrum and anemic wears a face covering to stay warm gets killed by the police.. when they post pics mocking him at the sight of his death after... when I watch Ahmaud Arbery murdered by 3 white men that thought they had the right to be judge jury and executioner... when we the people protest for that... we are thugs.. we are criminals... and we are portrayed as such by that "side". Fuck that... I don't need to compromise or give any credence or work with racists.. bigots.. extremists... NOW.. if we are talking purely policy.. you know if conservatives were true conservatives and wanted to talk small government and low taxes... and not trying to take away the rights of LGBTQ+ or women or people of color.. then I'd be willing to compromise and see their viewpoint. BUT right now as they are.. in the way we are... I'm tired of hearing... listen to both sides. I've been that.. I've done that.. and I've watched this nation, through the tyranny of the MINORITY and the electoral college, elect one of the worst presidents we will ever have. AND media are just chasing ratings and speaking to their bases.. I don't blame media.. media is a reflection of what we want.. just like I don't blame Trump for Trump... I blame ALL OF US. He is a reflection of where we are as a nation. I'm not here to make friends anymore.. that's what we did after the civil war... that's what we did by allowing Jim Crow... NOW it's about rallying the people.. rallying the votes to make racists marginalized and ashamed again... To make them think two... three.. four times before they rear they fucking ugly heads again. It's time to make hate afraid again. AND WE DO THAT by drowning out their voices.. overwhelming their voices... and in doing so FORCE THEM to abandon that tactic and be about low taxes and small government again. Just my two cents.. really not interested in what anyone thinks about this personally. So respond if you want. For me this is where I'm at.. you don't have to like it.. you don't have to give a shit about it.
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Post by IcarusFellOnce on Jul 7, 2020 11:55:57 GMT -5
Putting yourself in the center of politics is comforting but I feel it is intellectually contradictory. Those in the center generally want this to calm down and return to a more normal "normal". That's fair, but the center has zero policy prescriptions that achieve that objective. The split in American politics, or more accurately the evacuation of the center, is a result of the failure of the center to offer policies that achieve any desirable outcome that releases the tension. The center is now occupied by those who are politically comfortable and feel they have something to lose if Left or Right is successful (economic if the Left wins, social if the Right wins. The center's failure to recognize the times is maddening since doing nothing just accelerates exactly what they fear. The Center is the Center's own worst enemy. I considered myself a moderate for years until I recognized the country was sick and that changes were needed to maintain political balance. My personal leaning towards FDR Progressivism is based on a historical record of what works to release the tension powering alternative political models, people forget the US had a legit Nazi movement too in the 30s. The 1990s are dead, welcome to the 1930s. Intellectually comforting and actually is also cowardly.. Intellectually cowardly... actually cowardly... just cowardice at this point in what we are seeing and going through as a nation. Agree with what you are saying for sure.
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Post by pam on Jul 7, 2020 12:26:23 GMT -5
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Post by someonerandom on Jul 7, 2020 13:18:11 GMT -5
Well I don’t identify as a “socialist” but I take it the video intends the term to be synonymous with people like me who think Trump and his supporters are trash, so I watched. A guy arguing against a letter that a socialist wrote. Cool. Good thing Biden isn’t a socialist. So now can you tell us why you support Trump, instead of posing arguments against what his opponent ISN’T?
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Post by Deleted on Jul 7, 2020 13:54:23 GMT -5
Honestly, I think this is one of the biggest issues in the US. There's so much trash on facebook, like this rhetorical nonsense, that gets shared and liked by the uneducated masses giving it a false sense of validity.
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Post by pam on Jul 7, 2020 15:44:19 GMT -5
Honestly, I think this is one of the biggest issues in the US. There's so much trash on facebook, like this rhetorical nonsense, that gets shared and liked by the uneducated masses giving it a false sense of validity. I resent being called uneducated. I have a right to believe what I want. At least for now, however, I'm sure you would like to take my rights away.
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Post by pam on Jul 7, 2020 15:51:00 GMT -5
Well I don’t identify as a “socialist” but I take it the video intends the term to be synonymous with people like me who think Trump and his supporters are trash, so I watched. A guy arguing against a letter that a socialist wrote. Cool. Good thing Biden isn’t a socialist. So now can you tell us why you support Trump, instead of posing arguments against what his opponent ISN’T? Really, what are you? I think Biden/whoever his running mate is are socialists, they may not admit it. Well, the main reason is that Trump is not a socialist, the economy was good (before the governors shut down the states) and unemployment was very low. I dont want to be like China or North Korea, where they tell you what to do and when to do it. I am afraid it will come to that. That's what all these young college kids want. I'm glad I'm older and dont have too many years left. I dont want to see it get bad.
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Post by darthoso on Jul 7, 2020 16:01:36 GMT -5
Well I don’t identify as a “socialist” but I take it the video intends the term to be synonymous with people like me who think Trump and his supporters are trash, so I watched. A guy arguing against a letter that a socialist wrote. Cool. Good thing Biden isn’t a socialist. So now can you tell us why you support Trump, instead of posing arguments against what his opponent ISN’T? Really, what are you? I think Biden/whoever his running mate is are socialists, they may not admit it. Well, the main reason is that Trump is not a socialist, the economy was good (before the governors shut down the states) and unemployment was very low. I dont want to be like China or North Korea, where they tell you what to do and when to do it. I am afraid it will come to that. That's what all these young college kids want. I'm glad I'm older and dont have too many years left. I dont want to see it get bad. Do you consider every industrialized country besides the US to be socialist? Do you consider Medicare/Social Security to be socialist, if so do you not plan on participating?
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Post by IcarusFellOnce on Jul 7, 2020 17:31:00 GMT -5
Honestly, I think this is one of the biggest issues in the US. There's so much trash on facebook, like this rhetorical nonsense, that gets shared and liked by the uneducated masses giving it a false sense of validity. I resent being called uneducated. I have a right to believe what I want. At least for now, however, I'm sure you would like to take my rights away. That is a false argument. You have the right to illustrate your ignorance and say EXACTLY what you want. Just like we have the right to offer our opinion in whatever form we want. Your video is trash... DOT.. PERIOD.. I am not about socialism.. I don't like those labels even. I hold the constitution sacred...and our resultant democratic republic as sacred. THAT BEING SAID.. I also believe in social programs. Everyone here should.. well everyone here that wants to support those living with a disability... unless we are just objects to some. Not saying that's what we are to those here. Just need to stay away from trash videos like this.. I mean it's your right to post ignorance.. it's our right to call you out on it. Goes both ways. No one is trying to take away your right to free speech. Just as.. even though I abhor racists.. I'm not trying to take away their right to vote. What I am trying to do is galvanize the community to make them afraid to spew their hate publicly... they are allowed to be racists fucks and vote their racist conscience. See the difference... I'm all about our rights. You don't get to exercise your free speech without us getting to exercise the same.
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Post by IcarusFellOnce on Jul 7, 2020 17:33:53 GMT -5
Really, what are you? I think Biden/whoever his running mate is are socialists, they may not admit it. Well, the main reason is that Trump is not a socialist, the economy was good (before the governors shut down the states) and unemployment was very low. I dont want to be like China or North Korea, where they tell you what to do and when to do it. I am afraid it will come to that. That's what all these young college kids want. I'm glad I'm older and dont have too many years left. I dont want to see it get bad. Do you consider every industrialized country besides the US to be socialist? Do you consider Medicare/Social Security to be socialist, if so do you not plan on participating? A LOT of ignorance when it comes to definitions.. why I don't pay any mind when the most ignorant throw that term of socialist around. Working together to make healthcare a right does't make me socialist. What it does make me is someone that believes in the SOCIAL CONTRACT that is our constitution... and believes that we can work together to make healthcare accessible and affordable for all.. which could include social programs and aspects of socialized medicine. Some of us are a little more nuanced than just resorting to calling someone socialist simply for the reason they believe in social programs... and programs that are created because of our social contract and us coming together as a society to work together.. LIKE.. our public education.. our roads.. our highways.. I mean I could keep going.
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