461–470 of 537 posts
Earlier quoted context omitted.
They have lower profit margins than most tech companies like apple.
Apples and oranges.
Earlier quoted context omitted.
It leaves us overspending on health care by a huge amount, raises everyone's insurance, and ultimately takes away everyone's employer-provided care, which the majority of Americans who have it like. If it was cutting our expenses in half, the cost savings might sell it. But 10%?
> ultimately takes away everyone's employer-provided care Really? Even the NHS system allows a parallel employer provided system to run alongside it, it's just only common for higher-paying jobs and those with US parent companies.
Earlier quoted context omitted.
Why would I be excited about a proposal to totally restructure an industry that every American comes into contact with and that represents something approaching 20% of our economy just for the prospect of a ten percent savings ? Take any family complaining today about the cost of a Silver plan on an ACA exchange, offer them a 10% savings, and see if they're OK with what they're paying.
You literally just said "It's not perfect, so I don't want it". Don't let perfect be the enemy of improvement. Constant improvement is what the system needs, and anything that improves it is good and should be done.
If the proposal had no costs, it would obviously be worth pursuing.
But it's a historically disruptive proposal. For changes on that scale, we should be targeting significant fixes. 10% is just nibbling at the edge of the problem --- to put it another way, if the cost savings is 10%, then a few years after the change was enacted, we'd be right back where we are now.
You can't iterate on restructuring the economy; it's not a PHP program. You can iterate on incremental fixes, but that's not what M4A is.
Earlier quoted context omitted.
I would like to see some hard numbers for this. Otherwise I believe this is just self-serving propaganda by drug manufacturers.
Especially when you consider most pharma companies seem to make around 15-30% profit after all costs/R&D... not many industries manage those kind of numbers.
Earlier quoted context omitted.
As I said below: The upward pressure on prices is also from the insurers. Insurers have an "80/20 rule" from Obamacare that only 20% of their revenue can be spent on non-medical expenses (ie. profit, insurance administrative overhead, etc.). They pretty quickly hit the caps, and now only by increasing medical expenditures (the other 80%) can the pie slice that contains their profit grow year after year.
This issue existed before Obamacare 80/20 rule. In a free market the way for a profitable insurer to grow is by growing marketshare -- whether 80/20 rule exists or not. And the way to grow marketshare is to offer cheaper insurance. To offer cheaper insurance insurers have to push service prices down. Somehow this is not happening.
Earlier quoted context omitted.
Sufficiently advanced regulation is indistinguishable from single-payer - insurance is completely reliable, covers everything, and is completely fungible. Who cares what name is on the card? The easiest way to accomplish that is just to have a single government insurer. But you can finagle your way in the back door by regulating the shit out of insurance companies too. One-third of the US population is on a US single…
Germany has a split system between mandatory government healthcare and voluntary private healthcare, once you pass a certain income threshold (about 80% above average income) or are self-employed. There are differences. The voluntary insurance usually pays 2x to 3x of the mandatory one and covers more treatments that are seen as optional by the government insurance. E.g. physiotherapy is covered by government insuran…
It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…
This is common PhRMA talking point that needs perspective. Large pharmaceutical companies spend twice the their readers h budget on marketing, a good percentage of now is that is spent on patient oriented marketing. (e.g. “Talk your doctor about Xyzzy!”) If there would be a loss of revenue, any reduction in R & D costs lies purely with c-suite’s priorities. https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-p…
Earlier quoted context omitted.
It's not that it's more expensive at one place or another for the most part. When you go in-network you are seeing providers that your insurance has a contract with. This contract includes agreed amounts for procedures. Providers will often grossly overbill (mostly because it's easier to let the billing backend resolve these limits than bill accurately in the first place) and your insurance will respond with the amou…
I understand this, but don’t understand why millions of people are ok with the system. It has a lot more in common with a protection racket than with patient care in my view.
This would be a grave defect if the purpose of democracy was to achieve good government, but in fact we haven't the faintest idea how to get good government, democracy is a fix for bloodshed during the inevitable power transitions. So, a bunch of idiots with no clue are still in charge, but now a _different_ bunch of idiots can take over without having to murder a bunch of people to do it.
Earlier quoted context omitted.
No, the US needs to stop over-paying their doctors. And doctors need to stop being corrupt by reducing supply of doctors through restrictive medical school entry.
Then, you should be targeting lobbyists and politicians. Front line workers (including doctors) are a very poor target for pressure if you want to achieve the same level of care for a cheaper price (including cheaper docs). The only result of your conspirationistic views will be worse care for a higher price. But, I suppose no one will be able to sway you from your current opinion...
There's an odd balancing act in Canada. On one hand it was doctors that fought (tooth and nail) against the introduction of "single-player" (we just call it Medicare) back in Saskatchewan in the 60s, including going on an (unsuccessful) strike. And they are continually in a battle with the provincial governments about rates, because in Canada (unlike the NHS in the UK) doctors are independent businesses and not on salary (unless they're in the hospital system I believe?)
On the other hand, doctors in Canada have become huge advocates of our Medicare system and a big political opponent of privatization and tiered medicine generally. Not completely, but on the whole and through their professional organizations. 50ish years of working with the medicare system and seeing its outcomes, and seeing the failure to our south I think has made our doctors advocates of our system.
Canada's system is by no means perfect. It's probably not a good model for the U.S. as it is. But it's much better than what the U.S. has.
In general wait times here are a product of restricted resources, not institutional inefficiences per se. MRI machines are expensive, and doctors ration their use based on evidence-based criterion. E.g. no MRIs and back surgeries for non-specific low back pain, etc. because medical science doesn't really support it.
It's also worth pointing out that it was a huge battle to get it here. A big struggle that was successful at the time because at that point Canada's left wing was much stronger, and we had no strongly entrenched insurance mafia like in the U.S. Also Canada, as a British ex-colony, had the U.K's NHS as a model, and politics here was still _very_ strongly influenced by U.K. politics, where the Labour party was very strong.
I'm not sure what the path to U.S. single payer would be, but it would be very difficult one.