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Health Care Reform is Dead

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
The risk group needs to be EVERYBODY.

Can you imagine the *freedom* that the people of this nation would suddenly realize they had if they didn't have to fucking THINK about HDHP/PPO/HMO/deductible bullshit?
Reliance on corporate provided health insurance is our modern version of Indentured Servitude.
 

Pesqueeb

bicycle in airplane hangar
Feb 2, 2007
42,161
19,588
Riding past the morgue.
I just wanted to go on the record as having said, "Fuck you, Cory Gardner."
Good Company.



Golden quote by possibly the least self aware man; ever.
“We have elected a group of individuals who don’t have the capabilities to manage or run a Dairy Queen, let alone guide, advise and run the world’s largest capitalistic society and business,” wrote Robert Blaha, who served as chairman of Trump’s Colorado campaign.
 

Toshi

butthole powerwashing evangelist
Oct 23, 2001
40,083
8,982
There needs to be rationing. Set a threshold for price per quality adjusted year of life. Have public single payer insurance cover that. Want more? Buy more insurance on the private market or pay list.

Just because it relates to health care doesn't mean that potentially futile treatments at exorbitant prices should be covered.
 

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
There needs to be rationing. Set a threshold for price per quality adjusted year of life. Have public single payer insurance cover that. Want more? Buy more insurance on the private market or pay list.

Just because it relates to health care doesn't mean that potentially futile treatments at exorbitant prices should be covered.
But free market pricing of life saving/changing is immoral because the price people will pay is everything they have.

How much would you pay for say a cure for pancreatic cancer for a family member?
 

Toshi

butthole powerwashing evangelist
Oct 23, 2001
40,083
8,982
But free market pricing of life saving/changing is immoral because the price people will pay is everything they have.

How much would you pay for say a cure for pancreatic cancer for a family member?
We need universal single payer coverage because people are idiots and won't buy insurance, yet come begging after the fact. Everyone pay in via payroll taxes or whatever and then no coverage issues. Like I said, though, there has to be rationing since resources are not unlimited yet the prices that drug companies can ask for are.

Example:

https://www.nice.org.uk/advice/lgb10/chapter/judging-the-cost-effectiveness-of-public-health-activities

Set the threshold at 30,000 GBP and let people pay for extra insurance in advance (e.g. no signing up with pre-existing conditions for this one else the risk pool would be uber-fucked) if that's their thing.
 

6thElement

Schrodinger's Immigrant
Jul 29, 2008
17,447
14,950
Everyone pay in via payroll taxes or whatever and then no coverage issues.
Which is exactly how it works in the UK, your employer deducts your taxes and your national insurance contribution.

I'd never had to complete a tax return in my life working in the UK, as for a simple earner it's deducted at source with no random "deductions" to claw back later.

It's not perfect, immigration has had a negative impact. But at least you know if you get ill or have a health issue you will get seen eventually and won't get saddled with a crippling debt.
 

Westy

the teste
Nov 22, 2002
56,289
22,310
Sleazattle
Which is exactly how it works in the UK, your employer deducts your taxes and your national insurance contribution.

I'd never had to complete a tax return in my life working in the UK, as for a simple earner it's deducted at source with no random "deductions" to claw back later.

It's not perfect, immigration has had a negative impact. But at least you know if you get ill or have a health issue you will get seen eventually and won't get saddled with a crippling debt.
But the freedomless suffering?
 

Adventurous

Starshine Bro
Mar 19, 2014
10,921
10,062
Crawlorado
Cross-post from today's GMT and a reason why I have a hard time envisioning staying in this country so long as we continue to rely upon for profit insurers and a medical industry that isn't even remotely transparent about the costs of service. I'm young and healthy, I can't imagine the burden for older folks.



The bill came yesterday for the wife's trip to the clinic last month for a UTI. Her PCP was unable to see her that day and she tried to get an apt at a Planned Parenthood to no avail, so we had to settle for going to a local clinic that told her over the phone it was a $175 fee to be seen. We were there for 20 minutes, she peed in a cup, a doctor came in to give her a prescription for antibiotics and we were on our way.

That apparently becomes, in out of pocket terms:
Doctor fee = $197
Urology lab = $75
Clinic fee = $4,600

Almost $5,000 out of pocket billed to me for a single urine test, 20 minutes sitting in a bed, and a prescription. This better be a fuck of of epic proportions on their end otherwise I'll be seeking every single possible avenue, legal or otherwise. That's ridiculous beyond ridiculous.
 

StiHacka

Compensating for something
Jan 4, 2013
21,560
12,509
In hell. Welcome!
Cross-post from today's GMT and a reason why I have a hard time envisioning staying in this country so long as we continue to rely upon for profit insurers and a medical industry that isn't even remotely transparent about the costs of service. I'm young and healthy, I can't imagine the burden for older folks.



The bill came yesterday for the wife's trip to the clinic last month for a UTI. Her PCP was unable to see her that day and she tried to get an apt at a Planned Parenthood to no avail, so we had to settle for going to a local clinic that told her over the phone it was a $175 fee to be seen. We were there for 20 minutes, she peed in a cup, a doctor came in to give her a prescription for antibiotics and we were on our way.

That apparently becomes, in out of pocket terms:
Doctor fee = $197
Urology lab = $75
Clinic fee = $4,600

Almost $5,000 out of pocket billed to me for a single urine test, 20 minutes sitting in a bed, and a prescription. This better be a fuck of of epic proportions on their end otherwise I'll be seeking every single possible avenue, legal or otherwise. That's ridiculous beyond ridiculous.
Is the clinic in your insurance network? The billing should go through the insurance first and chances are, they'll cut down some of those to the pre-mediated levels. If you are out of network or outside of insurance, you're totally screwed.
 

Adventurous

Starshine Bro
Mar 19, 2014
10,921
10,062
Crawlorado
Is the clinic in your insurance network? The billing should go through the insurance first and chances are, they'll cut down some of those to the pre-mediated levels. If you are out of network or outside of insurance, you're totally screwed.
That was post-insurance. They did me a great favor by cutting the doctor fee from $340 to $197 but it appears that they are passing on the rest.
 

Pesqueeb

bicycle in airplane hangar
Feb 2, 2007
42,161
19,588
Riding past the morgue.
Cross-post from today's GMT and a reason why I have a hard time envisioning staying in this country so long as we continue to rely upon for profit insurers and a medical industry that isn't even remotely transparent about the costs of service. I'm young and healthy, I can't imagine the burden for older folks.



The bill came yesterday for the wife's trip to the clinic last month for a UTI. Her PCP was unable to see her that day and she tried to get an apt at a Planned Parenthood to no avail, so we had to settle for going to a local clinic that told her over the phone it was a $175 fee to be seen. We were there for 20 minutes, she peed in a cup, a doctor came in to give her a prescription for antibiotics and we were on our way.

That apparently becomes, in out of pocket terms:
Doctor fee = $197
Urology lab = $75
Clinic fee = $4,600

Almost $5,000 out of pocket billed to me for a single urine test, 20 minutes sitting in a bed, and a prescription. This better be a fuck of of epic proportions on their end otherwise I'll be seeking every single possible avenue, legal or otherwise. That's ridiculous beyond ridiculous.
Christ on a crutch. My daughter has had a chronic UTI problem pretty much since birth. If we had to shell out 5g's every time she had one we'd be proper fucked.

Best healthcare system in the world, amiright?
 

maxyedor

<b>TOOL PRO</b>
Oct 20, 2005
5,496
3,141
In the bathroom, fighting a battle
Insurance is fucked, Obama Care or not, because of $5k clinic fees and drugs that cost eleventy million dollars. Until you fix that, health insurance can't work, single payer or not.

Mexican drug prices are astonishing if you're used to US prices. I was just down there and my wife managed to get bit by god knows what, and got an epic welt, doctor visit, topical steroid prescription lunch w/ beers was all under $75. The topical steroid was $3.80, for a made in USA drug, somebody was still making money at both the wholesale and retail level on that. Grabbed a few other things to restock my first aid kit, $2-15 for large boxes of meds, and again, there was still enough money in that sale to support a pretty nice pharmacy, and pay a decent wage to a knowledgeable pharmacist. Meanwhile, my copay on just one of the drugs I picked up there would have been $100, plus whatever my insurance is picking up. No wonder insurance is unaffordable for most people.
 

StiHacka

Compensating for something
Jan 4, 2013
21,560
12,509
In hell. Welcome!
Insurance is fucked, Obama Care or not, because of $5k clinic fees and drugs that cost eleventy million dollars. Until you fix that, health insurance can't work, single payer or not.
It starts with paying $200k+ for the education, then there's the stock market casino and people's retirement savings in healthcare and drug companies and all suppliers' stocks that would need to take a massive cut as well. A half of the society would have to be taken apart in order to see meaningful changes IMO.
 

Adventurous

Starshine Bro
Mar 19, 2014
10,921
10,062
Crawlorado
It starts with paying $200k+ for the education, then there's the stock market casino and people's retirement savings in healthcare and drug companies and all suppliers' stocks that would need to take a massive cut as well. A half of the society would have to be taken apart in order to see meaningful changes IMO.
https://www.theatlantic.com/health/archive/2017/08/are-you-sure-you-want-single-payer/537456/

The author argues that we are too far down the road of privatized medicine to be able to adopt single payer vs. Europe that has decades of cost suppressing efforts under their belts. Moving to single payer would deliver healthcare to the uninsured while providing worse healthcare to those insured who are generally pretty happy with their employer sponsored plans.

Frankly I think the argument of being "too far down the road" is a poor excuse. Would there be temporary upheaval while the system adjust/disrupts itself? You bet. But at this point it is well established that we are on an unsustainable trajectory. Both sides agree on that. To not make changes because it's too hard is the one choice you can't make. Hell, I pay $1,400 a year for the privilege of having health insurance that I don't even use because it's easier to avoid the doctor in the first place than it is trying to understand the nuances of the system and how to get the care I need without incurring an absurdly high bill (see above). The system is simply fucked and it's hard to envision future prosperity for a country that spends inane amounts of money with mediocre outcomes.
 

syadasti

i heart mac
Apr 15, 2002
12,690
290
VT
Most countries with single-payer still have private insurance for those that want additional coverage so that argument is extremely weak.
 

Pesqueeb

bicycle in airplane hangar
Feb 2, 2007
42,161
19,588
Riding past the morgue.
https://www.theatlantic.com/health/archive/2017/08/are-you-sure-you-want-single-payer/537456/

The author argues that we are too far down the road of privatized medicine to be able to adopt single payer vs. Europe that has decades of cost suppressing efforts under their belts. Moving to single payer would deliver healthcare to the uninsured while providing worse healthcare to those insured who are generally pretty happy with their employer sponsored plans.

Frankly I think the argument of being "too far down the road" is a poor excuse. Would there be temporary upheaval while the system adjust/disrupts itself? You bet. But at this point it is well established that we are on an unsustainable trajectory. Both sides agree on that. To not make changes because it's too hard is the one choice you can't make. Hell, I pay $1,400 a year for the privilege of having health insurance that I don't even use because it's easier to avoid the doctor in the first place than it is trying to understand the nuances of the system and how to get the care I need without incurring an absurdly high bill (see above). The system is simply fucked and it's hard to envision future prosperity for a country that spends inane amounts of money with mediocre outcomes.
I too read that earlier, and I agree. Weak sauce argument = weak sauce.

Burn it down, start over.
 

jimmydean

The Official Meat of Ridemonkey
Sep 10, 2001
43,390
15,534
Portland, OR
Single payer doesn't pay the bills

Neidorff earned a total of $22 million in 2016, making him the highest-paid executive of the eight largest publicly traded health insurers, according to a review of filings with the Securities and Exchange Commission.
You can't expect him to raise a family on less than that and he won't make that with a single payer system.