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The Amish health care system

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Re: The Amish health care system

#291

Post by bmelton »

pmiller2 wrote: post #285
bmelton wrote: post #253

Earlier quoted context omitted.

I didn't say that any of the M4A plans would ban private insurance. That doesn't change the fact that Bernie has stated that his M4A plan would, even where the plan he's put forward doesn't show that. I think it's fair (if a bit naive) to take politicians at their word on occasion. Moreover, I think it's more than a bit disingenuous to assert that plans that are disallowed by law from competing with Medicare services…

Your analogy is false, though. A more correct one would be "Netflix is allowed to show all initial movies in a franchise, but sequels are fair game to anyone." Do you understand the difference between primary and secondary / supplemental insurance coverage?

I don't believe that my analogy is false, or that supplemental coverage would be allowed for the kinds of care being provided by M4A. I think perhaps a more on-the-nose analogy would be that "Netflix is not allowed to distribute anything that Apple TV is distributing or claims to distribute."

Again, I'm not making the claim that it's what's in the policy, but it's what Bernie has said, and others have echoed. Reasonable people can disagree on what policies are practicable or likely, but if you're a person who believes their health insurance might change based on those statements, then it seems like a warranted fear.

Re: The Amish health care system

#292

Post by twobuy »

pmiller2 wrote: post #4
_fq4v wrote: post #2

I thought the most interesting part was the commentary on non-Amish care in the past > I asked my literal grandmother, a 95 year old former nurse, how health care worked in her day. She said it just wasn’t a problem. Hospitals were supported by wealthy philanthropists and religious organizations. Poor people got treated for free. Middle class people paid as much as they could afford, which was often the whole bill, b…

That inequality is still present, except that now, the system is: * Poor people either get hit with huge bills because they're uninsured, or, if they know how to navigate the system, sometimes get these bills written off through "financial aid." * Middle class people frequently have insurance, but get hammered by deductibles and out of pocket maximums, rarely qualifying for "financial aid." This can be ruinous. * The…

There are those that receive emergency room care without ever shouldering any of the cost.

Re: The Amish health care system

#293

Post by runamok »

mannykannot wrote: post #86
_fq4v wrote: post #2

I thought the most interesting part was the commentary on non-Amish care in the past > I asked my literal grandmother, a 95 year old former nurse, how health care worked in her day. She said it just wasn’t a problem. Hospitals were supported by wealthy philanthropists and religious organizations. Poor people got treated for free. Middle class people paid as much as they could afford, which was often the whole bill, b…

The past is not a useful guide, because until recently, there was relatively little that could be done medically, and costs were commensurably low. The elephant in the room is that medical technology has advanced to the point where any person's needs can potentially greatly exceed their lifetime's ability to produce. When there are relatively few who find themselves in this state, insurance (and what is described in…

I see what you are saying but prices are completely out of control precisely because an insurance company will pay a 6 or 7 digit bill.

If insurance was gone tomorrow and there was a cap on how much a single payer system would pay I am pretty sure million dollar surgeries would go down significantly in price.

I mean surgeons are paid well but a million dollars for a few hours of their labor?

Constraints on how many people are permitted to become doctor's also reinforce this issue.

Re: The Amish health care system

#294

Post by bmelton »

pmiller2 wrote: post #286
bmelton wrote: post #264

Earlier quoted context omitted.

Regarding the implementations I was talking about, the private market would exist exclusively for elective procedures "like cosmetic surgeries." [0] For any of the services covered by Medicare. Quoting the Kaiser Family Foundation, "private insurance would be prohibited from duplicating the coverage under Medicare." [0] The full quote here is "If you support Medicare for All, you have to be willing to end the greed o…

> For any of the services covered by Medicare. Quoting the Kaiser Family Foundation, "private insurance would be prohibited from duplicating the coverage under Medicare." That's correct. Supplemental insurance can still cover copays and other out of pocket expenses. It can also cover procedures not covered by Medicare. Now, tell me, how is that "banning private insurance" if insurance companies can still sell those p…

From a Bernie Sanders interview with NPR.

Q: "Does private insurance go away under Medicare for All?"

A: "Yes, it does, because you're not going to a have a need for private insurance"

A tweet[1] from Bernie Sanders: You're damn right we're going to get rid of greedy health insurance companies.

CNBC describes Bernie Sanders plan as "Bernie Sanders is pushing a “Medicare for All” bill, which would create a government-run program and end private insurance."[2]

The Hill's headline covering Bernie's policy is "You're Damn Right Health Insurance Companies Should Be Eliminated"[3] and references a quote in an interview from MSNBC in which Bernie says universal health care can't be achieved "unless you get rid of the insurance companies."

So feel free to quibble over the nuances of what "eliminate," "end," and "abolish" mean as much as you like, but if you're a person who is concerned that your private insurance is going to be eliminated, and you're listening to Bernie Sanders talk about it, it seems like his statements would reinforce that fear.

[1] https://twitter.com/berniesanders/status/1111363118867927040...

[2] https://www.cnbc.com/2019/07/18/these-2020-democrats-want-me...

[3] https://thehill.com/policy/healthcare/436033-sanders-youre-d...

Re: The Amish health care system

#295

Post by JoeAltmaier »

bmelton wrote: post #294
pmiller2 wrote: post #286

Earlier quoted context omitted.

> For any of the services covered by Medicare. Quoting the Kaiser Family Foundation, "private insurance would be prohibited from duplicating the coverage under Medicare." That's correct. Supplemental insurance can still cover copays and other out of pocket expenses. It can also cover procedures not covered by Medicare. Now, tell me, how is that "banning private insurance" if insurance companies can still sell those p…

From a Bernie Sanders interview with NPR. Q: "Does private insurance go away under Medicare for All?" A: "Yes, it does, because you're not going to a have a need for private insurance" A tweet[1] from Bernie Sanders: You're damn right we're going to get rid of greedy health insurance companies. CNBC describes Bernie Sanders plan as "Bernie Sanders is pushing a “Medicare for All” bill, which would create a government-…

Why are we still talking about Bernie Sanders?

Re: The Amish health care system

#296

Post by Consultant32452 »

empira wrote: post #280
Consultant32452 wrote: post #273

Earlier quoted context omitted.

I feel like all you've done is point out exactly the cost in the cost/benefit analysis I gave. You pointed out that some treatments are expensive without acknowledging the high price encouraged it to be invented in the first place. Nor did you acknowledge that the patents will eventually expire and then that treatment will tend to become available to basically everyone. We're talking about changing the velocity of in…

The drugs/treatment you mentioned where all developped thanks to public contributions, not purely private research. HPV vaccines were first developed by the University of Queensland in Australia [1] and further improved by the the University of Queensland, Georgetown University Medical Center, University of Rochester, and the U.S. National Cancer Institute [1]. CRISPR was discovered by several researchers from the Un…

>The drugs/treatment you mentioned where all developped thanks to public contributions, not purely private research.

There's no such thing as a new drug that reaches the market without massive investment from private companies to do things like pay for FDA certifications, drug trials, etc. These are different categories of activities besides research. I don't think we're in conflict here.

>What is the point to discover insuline if the price asked for a shot makes it impossible for some people to buy it ?

What is the point to avoid discovering ways to create insulin altogether just because some people might not be able to afford it while the patent is active? What are the regulatory hurdles preventing generics?

>Hip replacement won't suddenly or magically become cheaper in 5 years.

Regulatory capture by medical unions is a separate topic.

>I propose to contain the cost so that all who need can afford it. The net result could be the same.

The net result is NOT the same if the new treatment is never created in the first place. That's the whole point.

>Price controls, like other types of controls, are a necessary evil in lots of case.

Again, this whole thread is about making sure we acknowledge the "evil" part, which is long term increase in death and suffering but short term reduction in death and suffering. After that, you can decide on your own whether or not things are "necessary."

Re: The Amish health care system

#297

Post by zucker42 »

Noos wrote: post #284
kwhitefoot wrote: post #197

One of the most striking things in this article for me was the remark about Amish women having five to ten children. If this is the case and if all women have children then the Amish population should be increasing rapidly. Is it? This page: https://amishamerica.com/how-fast-are-the-amish-growing/ says that the doubling time is about 19 years. How do they find enough suitable land to practice their way of life?

I think the problem is that a lot of those amish children become non-amish very quickly. Leave the community.

Apparently, Amish communities have an 85% retention rate.

Re: The Amish health care system

#298

Post by pmiller2 »

bmelton wrote: post #294
pmiller2 wrote: post #286

Earlier quoted context omitted.

> For any of the services covered by Medicare. Quoting the Kaiser Family Foundation, "private insurance would be prohibited from duplicating the coverage under Medicare." That's correct. Supplemental insurance can still cover copays and other out of pocket expenses. It can also cover procedures not covered by Medicare. Now, tell me, how is that "banning private insurance" if insurance companies can still sell those p…

From a Bernie Sanders interview with NPR. Q: "Does private insurance go away under Medicare for All?" A: "Yes, it does, because you're not going to a have a need for private insurance" A tweet[1] from Bernie Sanders: You're damn right we're going to get rid of greedy health insurance companies. CNBC describes Bernie Sanders plan as "Bernie Sanders is pushing a “Medicare for All” bill, which would create a government-…

Nonetheless, the fact remains, no M4A plan proposed by any candidate in the 2020 race would disallow insurers from offering supplemental coverage. Bernie is just simplifying for purposes of making himself understood to the general public. Nobody would "need" private insurance under his plan:

> In other words, while Sanders' plan doesn’t ban supplementary coverage from private insurers, it does offer such generous coverage by the government that there's not much room left for private coverage to fill any gaps. This is the logic upon which both conservative critics — and supposedly nonpartisan mainstream reporters and pundits — hang the logic that Sanders' plan would "ban" private coverage. It's a dramatic "gotcha" question.... [0]

You're essentially reinforcing a right wing talking point that completely mischaracterizes what Bernie's M4A plan actually does.

---

[0]: https://theweek.com/articles/850638/no-really-wants-ban-all-...

Re: The Amish health care system

#299

Post by zucker42 »

kwhitefoot wrote: post #197

One of the most striking things in this article for me was the remark about Amish women having five to ten children. If this is the case and if all women have children then the Amish population should be increasing rapidly. Is it? This page: https://amishamerica.com/how-fast-are-the-amish-growing/ says that the doubling time is about 19 years. How do they find enough suitable land to practice their way of life?

> How do they find enough suitable land to practice their way of life?

It's a stupid answer, but I would guess they buy it, just like anyone else. I've heard about groups of Amish moving to new areas to start communities.

Re: The Amish health care system

#300

Post by bmelton »

pmiller2 wrote: post #298
bmelton wrote: post #294

Earlier quoted context omitted.

From a Bernie Sanders interview with NPR. Q: "Does private insurance go away under Medicare for All?" A: "Yes, it does, because you're not going to a have a need for private insurance" A tweet[1] from Bernie Sanders: You're damn right we're going to get rid of greedy health insurance companies. CNBC describes Bernie Sanders plan as "Bernie Sanders is pushing a “Medicare for All” bill, which would create a government-…

Nonetheless, the fact remains, no M4A plan proposed by any candidate in the 2020 race would disallow insurers from offering supplemental coverage. Bernie is just simplifying for purposes of making himself understood to the general public. Nobody would "need" private insurance under his plan: > In other words, while Sanders' plan doesn’t ban supplementary coverage from private insurers, it does offer such generous cov…

Whether he's simplifying or restating seems orthogonal to my point, which is that people who are worried that things are going to change and if they'd like to "just go to a private hospital instead," well - if Bernie is to be believed - in his vision of America, those may not be allowed to exist.
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