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30th January 2017, 09:55 AM | #401 |
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30th January 2017, 09:56 AM | #402 |
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Sufficiently advanced Woo is indistinguishable from Parody "There shall be no *poofing* in science" Paul C. Anagnostopoulos Force ***** on reasons back" Ben Franklin |
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30th January 2017, 10:37 AM | #403 |
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Yes indeed, that would be a life well lived. Imagine if you lived a long healthy life, needed very little medical care and then just one day died in your sleep of old age. I hope that's the way I go. If we all could live like that, we would spend so much less on health care. Isn't that the goal? Health care should be something you don't need to use very often. But that's not the way it works. We continue to live unhealthy lives and develop debilitating chronic diseases that require wheelchairs, multiple medications, pacemakers, amputations, oxygen tanks, etc. That leads to much lower quality of life and a long, slow, painful, expensive death.
So, while I realize that ponderingturtle was trying to be ironic, he/she's actually right on the nose. |
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30th January 2017, 10:57 AM | #404 |
Penultimate Amazing
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Here's what health insurance has meant to one family, and what losing it could mean to everyone like her:
http://www.slate.com/articles/busine..._repealed.html |
30th January 2017, 11:07 AM | #405 |
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That article doesn't really cover what you are discussing. It isn't about whether or not universal treatment is cheaper than universal prevention; it's about the plain fact that other countries spend much less than the US for healthcare than we do. The million dollar question is: Why? The article attempts to explain:
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30th January 2017, 11:08 AM | #406 |
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30th January 2017, 12:01 PM | #407 |
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Link fixed. Apologies.
http://www.slate.com/articles/busine..._repealed.html |
31st January 2017, 12:08 PM | #408 |
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So I've been sitting here at my desk for most of the day listening to my co-worker try and figure out the awesomeness that is the US healthcare system. I've been getting a play by play as well as hearing her side of the conversation.
She has insurance from our company which is a PPO and it's decent insurance. She was referred by her primary care doctor for an ultrasound. - Doctor suggested going to spot X, but wait... we're not sure if that's in network... I mean it should be, but it's not showing up in our system. *waits a while* Nope, can't get it to show up, but it SHOULD be in network. Call your insurance company to be sure. - Calls insurance company. Ok, it is in network. And she's responsible for an $850 deductible? huh? How much could this ultrasound cost? Shouldn't that be covered? How do I find out how much this will cost? - Calls doctor back. Insurance says it's in network, how much will this cost? Insurance will cover it? That didn't sound like what they said. - Calls ultrasound office. Verify it is in network. Asks for cost. No I am not going to have the procedure then wait for a bill. I don't want a surprise $800 bill from you. Someone has to be able to tell me how much this is going to cost. *waits for call back* - Call back comes $235 out of pocket. Other coworkers with same plan say that can't be right - they've never been charged for an ultrasound outside of a small copay. It's not like she wasn't asking the right questions. It's been 3+ hours and she still isn't sure if this is going to cost her $200+ (which is a LOT for her) or next to nothing. |
31st January 2017, 12:35 PM | #409 |
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I have no idea how much her ultrasound should cost. But I note that this kind of confusion and conflict and multi-level negotiation is a big part of why 25% of total U.S. health care expenditures go to administration. In universal health care systems, that number is as low as 10%.
http://www.bloomberg.com/news/articl...ance-companies |
31st January 2017, 12:39 PM | #410 |
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31st January 2017, 12:54 PM | #411 |
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When I was still living in Canada, I had my now wife visit me. We were planning a nice vacation. She spent a week with me, we were going to spend a week driving across the country, and then I would spend a week out with her in Seattle.
Well, when we were packing up the car, I slipped, and ended up breaking my foot. We did a trip to the ER. 3 hours later, Xrays, a cast, and I was handed crutches to be sent on my wife. My (now) wife, being an American, asked where we went to pay. I looked at her like she had grown a second head, and said 'Pay? You don't pay for health care...' |
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31st January 2017, 03:54 PM | #412 |
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31st January 2017, 04:28 PM | #413 |
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It's not simple by any stretch of the imagination. If you can get people to change habits by threatening to punish them, I don't really know. They are already being punished to some extent by poor decisions/poor genetics. Does society have to add to that? Do we need insurance companies to appoint lifestyle police when as a matter of public policy, single-payer UHC is cheaper in both prevention and cure? In the aggregate.
Because the potential bill for health care is orders of magnitude greater than the maximum liability in other situations. I knew a family with a $3 million health-care bill for a son who later died very young of a freak accident. Their assets have been permanently attached, and they are OK with this. They are both retired USAF veterans. Many Americans don''t have that kind of coverage. This kid, Chris, ended up getting cared for as an indigent part of the time, because the care made him indigent PDQ. (This was before he could have been insured under his parents' plans.) Lots of effort to save his leg after he was smacked, flipped and dragged 250 yards by a drunk driver while he was crossing the street - on foot and buzzed. He tried to stand up with bones sticking out of his legs, but he was entangled somewhat with the car whose driver hadn't noticed hitting him. Maybe too much effort was expended on saving his leg which ultimately was amputated due to hospital-acquired MRSA. His mom ended up stressed to the max trying to cope and her Type 2 diabetes got out of control and she became both insulin dependent and obese. Then Chris died anyway in a different freak accident. And during this whole time she was a foster mom who adopted 2 young boys, a social good, probably, but still, is her insulin dependence her own fault? Yes according to you. I asked for numbers regarding nature vs. nurture in maintaining health. If I find you have posted them, I will take a look. |
31st January 2017, 04:44 PM | #414 |
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31st January 2017, 04:54 PM | #415 |
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2nd February 2017, 11:37 AM | #416 |
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*grumble* Or one develops life-threatening fibroids that hemorrhage and land one in the ER with blood transfusions, 4 months of incredibly expensive specialty drugs to keep one from dying, and a very expensive surgery so one can keep on living. Or maybe one goes on to develop frequent migraines that interfere with quality of life overall. Or maybe ends up with a diagnosis of epilepsy later in life that has massive impacts to how one goes about everything in one's life.
Or, hey novel idea, maybe one is unlucky enough to end up with all three of those happening. That would be me. I suppose I'm just not taking good enough care of myself. Maybe it's righteous and appropriate that I either die from lack of care or face bankruptcy to cover the bills. That seems perfectly reasonable and compassionate. ****** Look, I get your point, and there is some validity to it. But I also feel that you're glossing over a significant amount of things that are completely outside of the control of the individual. You seem to approach it as if the huge majority of medical costs are from easily avoided chronic conditions... and that's not really true. I've said it before, and I'll say it again. Over half of the cost of care in the US is from non-chronic acute conditions, congenital illnesses (some of which are extremely costly like hemophilia), neonatal complications, and cancers. If you add in trauma events, and the repertoire of injuries and contagion, you end up with around 65% to 70% of the costs being non-avoidable, non-chronic instances. So you've got 30% to 35% of the costs that are from *both* lifestyle-related chronic conditions, mental health conditions, *and* preventive & routine care. And of those chronic conditions, not all of them are perfectly avoidable. Just eating well and exercising won't prevent someone with a genetic predisposition from developing diabetes. Just exercising and avoid smoke won't perfectly prevent COPD. Short story: please stop over-simplifying this quite so much |
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2nd February 2017, 11:43 AM | #417 |
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2nd February 2017, 11:45 AM | #418 |
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2nd February 2017, 02:53 PM | #419 |
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Suffering is not a punishment not a fruit of sin, it is a gift of God. He allows us to share in His suffering and to make up for the sins of the world. -Mother Teresa If I had a pet panda I would name it Snowflake. |
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2nd February 2017, 05:39 PM | #420 |
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Redundant
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2nd February 2017, 06:27 PM | #421 |
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Which wasn't my point. Both prevention and care are covered. I am not comparing "universal prevention to universal treatment." It's cheaper to do it all for everybody. The whole thing. Less money, better outcomes. There are fat Canadians, I'm sure, but they spend less to get better outcomes.
Possibly because we don't have single-payer UHC. The patient would be seen, maybe required to attend four classes about diabetes, or sign up for smoking cessation, or offered alternative ways of nicotine delivery. Instead you very arbitrarily IMO say "it was your own damn fault, pay for it yourself." Why is stigmatizing people a higher priority in your view than UHC, which is cheaper and has better outcomes? Seriously? There are tons of chronic diseases not caused by lifestyle factors. Type 1 diabetes isn't, rheumatoid arthritis isn't, lupus isn't, ALS isn't; polycystic kidney disease isn't, high blood pressure isn't, totally. Wider use of bariatric surgery could help the obese. Do you think these people LIKE being sick? Maybe we have more chronic disease because the system sucks? Pause to consider the variables. My mom has dementia and peripheral vascular disease. She's 92. Her fault? She was a smoker for about 20 years early in life - before people knew it was bad for you. I suspect she drank a bit after losing my father - is that why she has no short-term memory? My father and his 2 brothers died of prostate cancer. He also developed Type 2 diabetes, then rapidly became insulin-independent as a result of a course of prednisone having to do with the cancer. So we've got at least 2 chronic diseases, prostate cancer and insulin dependence. This is a man who got his testicles removed to slow down prostate cancer. By all means, let's punish my parents. Even though all 3 sons in the family died of prostate cancer. They are people. They are imperfect. Go figure. Read "The Spirit Catches You and You Fall Down." Seriously. Or we could make it simpler still: have UHC do all it can to prevent and treat diseases that have a behavioral component. No need to have second-class citizens, which you assume to insist on because - reasons? Don't know. My dad should have picked different parents, perhaps. You talk as if there would be no judgment calls; no shades of gray. You ignore who would make those decisions. We'd have to have some rationing system, which maybe could double as a death panel. I'm not totally against that concept. You are missing the main point: I am not comparing the cost of universal prevention and universal treatment. They're both health care. Other countries do more with less treatment which is that we could offer health care for all for less money with better outcomes. The patient would be seen, educated and maybe some of it would stick. Getting checkups would be a patriotic duty. Instead you very arbitrarily IMO say "it was your own damn fault, pay for it yourself." Why is stigmatizing people a higher priority in your view than UHC, which is cheaper and has better outcomes.? Wider use of bariatric surgery could help the obese. My mom has dementia and peripheral vascular disease. Her fault? She was a smoker about 40 years ago. I suspect she drank a bit after losing my father - is that why she has no short-term memory? Well, she is 92. My father and his 2 brothers died of prostate cancer. He also developed Type 2 diabetes, then rapidly became insulin-independent as a result of a course of prednisone having to do with the cancer. So we've got at least 2 chronic diseases, prostate cancer and insulin-dependent diabetes. This is a man who got his testicles removed to slow down the cancer. By all means, let's punish both my parents. Even though all 3 sons in the family died of prostate cancer. No. See highlighted. I refuse to let you get by with "I think the data is clearly with me." This took 2 minutes:
Originally Posted by Forbes
Or we could make it simpler still: have UHC do all it can to prevent and treat diseases that have a behavioral component. No need to have second-class citizens, which you assume to insist on because - reasons? Don't know. My dad should have picked different parents, perhaps. You talk as if there would be no judgment calls; no shades of gray. You ignore who would make those decisions. We'd have to have some system; maybe it can double as a death panel. End-of-life care often costs a ton. So, even if we can offer prevention and treatment to all for less money, we should have what, lifestyle police to spy on people or force them away from fast-food windows? That's your "simple" solution? BTW we would STILL be overspending and STILL having worse outcomes. Please give some examples/citations of how it works in other facets of the insurance industry. I want to see how analogous these comparisons really are. IMO, a lot of health care expense can be saved if the patient has a support system. Rides to PT if they don't drive. Getting Mom to walk more. Helping figure out if she needs to go to the ER (almost took her today then didn't). My mom's has more support than many people. She pays a higher Medicare premium based on means. But not based on smoking from age 25-40 and having a couple of drinks at night. How the hell would you draw the line? |
Last edited by Minoosh; 2nd February 2017 at 06:37 PM. Reason: This may be a bit choppy with redundancies. Can't editot more |
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2nd February 2017, 06:35 PM | #422 |
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2nd February 2017, 06:59 PM | #423 |
Nasty Woman
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When you make a stupid promise because it makes a great campaign slogan, no worries, you can just change the slogan when your bluff is called and pretend that's what you said all along. In a week, no one will notice.
"Repeal and replace" Obamacare has now become "repair" Obamacare. And, Paul Ryan is claiming, "you have to repeal and replace it in order to repair it." No Senator Ryan, we're not that stupid, though maybe your base doesn't care that you've been lying to them for 6 years. |
2nd February 2017, 08:10 PM | #424 |
Penultimate Amazing
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Some GOP congress members are using the word "repair."
There should be a broader choice of coverage IMO. There's no "shopping around" in my state and my BlueCross BlueShield coverage was dropped for something called Ambetter, which has 2 plans this year in my state, but no choice to pick a different company. This one has something to do with Health Net. I'm not sure the insurance-across-state-lines is a good idea. I can afford a pretty high deductible, but my actual income is paltry. The 2 choices were essentially $600 or $700. I will probably get some money back because my income is so low. I don't want to go without insurance. In my state there are just 2 choices - both from the same company. Ambetter has a monopoly and is subsidized by the government - I would like to see more transparency at least. At least my benefits are portable. I hope they're not crappy! I'm kind of afraid to look. |
2nd February 2017, 08:29 PM | #425 |
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Suffering is not a punishment not a fruit of sin, it is a gift of God. He allows us to share in His suffering and to make up for the sins of the world. -Mother Teresa If I had a pet panda I would name it Snowflake. |
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2nd February 2017, 11:09 PM | #426 |
Penultimate Amazing
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I had to get turned down for health insurance, than stay uninsured for 6 months, after which I was very simply covered by transitional Obama care. My state did not have a high-risk pool so I was directly insured by the federal government. And they wanted to keep me insured.
I would have even waived coverage for my biggest pre-existing condition, since treatment is not terribly effective. Just to get insured. So now the premiums are much higher, but the Obamacare one was cheaper at $271 or something. The stupid thing is I have put off the full physical I should be getting. Some bloodwork a couple of years ago was normal. So I'm part of the behavioral problem too. Not using the doc for too much, but for too little. |
3rd February 2017, 01:39 AM | #427 |
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. You seem to be brushing aside the idea that the USA is a different country with a different population makeup. There is no guarantee that in the US, prevention+treatment for all = less money with better outcomes. And better outcomes is debateable. What criteria? This has been argued about in the literature for awhile now.
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3rd February 2017, 02:28 AM | #428 |
Becoming Beth
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When the tobacco industry, or the asbestos industry, or the mining industry (etc.) find themselves in court their primary tool for absolving themselves of responsibility is to argue that it couldn't be proven their product was responsible for any particular individual case of illness. That it could have come from other sources.
Why should it be different when contemplating responsibility for getting the illness? The same logic applies. So. No need to look for blame when considering the cost of treatment. Just take care of them. |
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3rd February 2017, 03:57 AM | #429 |
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“If only it were all so simple! If only there were evil people somewhere insidiously committing evil deeds, and it were necessary only to separate them from the rest of us and destroy them. But the line dividing good and evil cuts through the heart of every human being. And who is willing to destroy a piece of his own heart?” Aleksandr Solzhenitsyn, The Gulag Archipelago |
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3rd February 2017, 04:26 AM | #430 |
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In every other developed nation that has implemented UHC healthcare outcomes are better and healthcare costs are lower. You can't in all good conscience argue that the USA is a special snowflake country with special snowflake citizens. (well you could, but you'd be very wrong)
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NRT is based on the premise that it's the mostly nicotine that's addictive. Which is fundamentally flawed Nicotine plays a part, but it's smoking that's addictive, it's a combination of nicotine and ritualistic behaviour and other things too.
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3rd February 2017, 04:32 AM | #431 |
Penultimate Amazing
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3rd February 2017, 05:30 AM | #432 |
Penultimate Amazing
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Looks like there are parts of ObamaCare that they want to keep. ("We like that part of the plan, we can keep it.")
I propose the combination be called either ObumpCare or TraumaCare. |
3rd February 2017, 09:14 AM | #433 |
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Free markets do not guarantee that consumers have a lot of choice. In my area we only have two supermarket chains. Most retail segments are dominated by one or two big box stores. If I want cable TV service or high speed Internet the only choice is Comcast. On the other hand the highly regulated Obamacare exchange gives me seven choices for health insurance providers.
Your insurance costs are high because medical costs are high and people in your age group tend to require a lot of medical care. The only way to significantly lower the cost of comprehensive health insurance is to go after medical costs. The cost of prescription medications is clearly a problem. As are the costs of routine MRI scans and other testing. Hospital billing practices in the US are best described as insane. Even the people sending out the bills can't explain what is going on. BTW: This will give you a quick estimate of insurance costs and subsidies. |
3rd February 2017, 09:18 AM | #434 |
Pi
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I recommend having the government pay for a massive number of scholarships for doctors that ensure the doctors can graduate without debt and contain a rider that they must work for a reasonable rate at a government hospital for, say, seven years after completing their residency. Just, in the parlance of my US friends, spitballing, really. |
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3rd February 2017, 09:35 AM | #435 |
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He has no plan.
Too busy pissing off leaders around the world and replacing science with Jesus? CNN
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3rd February 2017, 09:52 AM | #436 |
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3rd February 2017, 09:54 AM | #437 |
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Becoming a doctor in the US requires four years of college, three years of medical school and one year as a resident. From what I understand it doesn't take as many years in many other nations including the UK. And I have seen no evidence to suggest that UK doctors are less competent than those trained in the US.
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3rd February 2017, 10:39 AM | #439 |
Penultimate Amazing
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Wow. So did Price actually admit that he has not been working with the President?
Did Brown actually ask the appropriate question, "So have you been working with the President on a replacement plan that is nearly finished and will be revealed after your confirmation?" I think it's pretty obvious that the answer is no, of course. Then again, nowadays, the GOP is not talking about repeal, but "repair." And if that is the case, they oughta be slapped. Figuratively, too. It's been 6 years. If there were a plan to "repair" ObamaCare that actually does fix the supposed problems, why haven't they brought it up? Why have they wasted all their time with meaningless repeal attempts, instead of actually trying to make it work? Because if there were some great way to make it better, and they deliberately did not try to implement it, it clearly demonstrates that they are not there to govern or to serve the people. "We have a great plan to help the American people. However, we won't let anyone know about it because it would require admitting that the ACA is not completely evil, and it would mean that we were working with Obama. Since we can't have that, we see to America, **** you. Continue to suffer." |
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3rd February 2017, 10:54 AM | #440 |
Nasty Woman
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The latest lie told by some Congressman last night on the news: the increase in numbers of people covered was because of the improved economy and not because of the ACA.
Look for it coming soon to a Trumpette near you. |
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