Socialism Fails Everytime ...

[volinbham]

Some of the factors impacting our cost per treatment.

1) the NIH funding that was brought up earlier prioritizes (to the nth degree) funding for research that promises greater efficacy (better outcomes) regardless of cost. A shift in funding priorities (even if a % of the budget) to research promising equivalent efficacy (as currently available) but with a lower cost basis could fundamentally change medical innovation.

2) in conjunction with 1) the FDA approval process is geared towards approval of better efficacy rather than equivalent. These 2 together promote innovation that does not take cost into consideration at all.

3) we aren't that far historically from a "fee for service" model where insurance paid what doctors billed. as we've moved towards more "managed care" models some of that "pay whatever it takes" mentality is changing but it still lingers in the system.

4) the payer mix (private/public) creates a situation where providers must charge the private side higher prices to compensate for the low reimbursements coming from the public side. Have too many public payer patients and you're screwed.

5) we have artificial supply shortages via limited number of spots in medical school and licensing requirements for what type of provider can do what procedure/treatment. We've been moving towards PA's and NP's but our providers are still highly paid relative to other places.

6) ham-fisted "cost reduction" policies such as CMS's penalties on reimbursement rates for hospital readmits. A patient comes back within 30 days and is readmitted and your reimbursement rate is docked (even though you already lose money on these reimbursements). It's bad with Medicare since older people tend to have co-morbidities and what brings them back to the hospital may not be related to your care but you still get hit with the penalty. All this means you have to max out the private insurance patients to cover the losses here.

Bottomline, it ain't a simple fix that "Medicare for All" changes and the reality is there are benefits in private insurance provision. Since this country's leaders are too childish to have a serious discussion to really fix the issue I'd rather we tweak around the edges as opposed to redo the whole thing with the current clowns in charge.

 

[volinbham]

I'm sold.

Me too but neither party would support it.

 

[CABVOL]

Some of the factors impacting our cost per treatment.

1) the NIH funding that was brought up earlier prioritizes (to the nth degree) funding for research that promises greater efficacy (better outcomes) regardless of cost. A shift in funding priorities (even if a % of the budget) to research promising equivalent efficacy (as currently available) but with a lower cost basis could fundamentally change medical innovation.

2) in conjunction with 1) the FDA approval process is geared towards approval of better efficacy rather than equivalent. These 2 together promote innovation that does not take cost into consideration at all.

3) we aren't that far historically from a "fee for service" model where insurance paid what doctors billed. as we've moved towards more "managed care" models some of that "pay whatever it takes" mentality is changing but it still lingers in the system.

4) the payer mix (private/public) creates a situation where providers must charge the private side higher prices to compensate for the low reimbursements coming from the public side. Have too many public payer patients and you're screwed.

5) we have artificial supply shortages via limited number of spots in medical school and licensing requirements for what type of provider can do what procedure/treatment. We've been moving towards PA's and NP's but our providers are still highly paid relative to other places.

6) ham-fisted "cost reduction" policies such as CMS's penalties on reimbursement rates for hospital readmits. A patient comes back within 30 days and is readmitted and your reimbursement rate is docked (even though you already lose money on these reimbursements). It's bad with Medicare since older people tend to have co-morbidities and what brings them back to the hospital may not be related to your care but you still get hit with the penalty. All this means you have to max out the private insurance patients to cover the losses here.

Bottomline, it ain't a simple fix that "Medicare for All" changes and the reality is there are benefits in private insurance provision. Since this country's leaders are too childish to have a serious discussion to really fix the issue I'd rather we tweak around the edges as opposed to redo the whole thing with the current clowns in charge.

^^^ What he said.

 

[CABVOL]

Some of the factors impacting our cost per treatment.

1) the NIH funding that was brought up earlier prioritizes (to the nth degree) funding for research that promises greater efficacy (better outcomes) regardless of cost. A shift in funding priorities (even if a % of the budget) to research promising equivalent efficacy (as currently available) but with a lower cost basis could fundamentally change medical innovation.

2) in conjunction with 1) the FDA approval process is geared towards approval of better efficacy rather than equivalent. These 2 together promote innovation that does not take cost into consideration at all.

3) we aren't that far historically from a "fee for service" model where insurance paid what doctors billed. as we've moved towards more "managed care" models some of that "pay whatever it takes" mentality is changing but it still lingers in the system.

4) the payer mix (private/public) creates a situation where providers must charge the private side higher prices to compensate for the low reimbursements coming from the public side. Have too many public payer patients and you're screwed.

5) we have artificial supply shortages via limited number of spots in medical school and licensing requirements for what type of provider can do what procedure/treatment. We've been moving towards PA's and NP's but our providers are still highly paid relative to other places.

6) ham-fisted "cost reduction" policies such as CMS's penalties on reimbursement rates for hospital readmits. A patient comes back within 30 days and is readmitted and your reimbursement rate is docked (even though you already lose money on these reimbursements). It's bad with Medicare since older people tend to have co-morbidities and what brings them back to the hospital may not be related to your care but you still get hit with the penalty. All this means you have to max out the private insurance patients to cover the losses here.

Bottomline, it ain't a simple fix that "Medicare for All" changes and the reality is there are benefits in private insurance provision. Since this country's leaders are too childish to have a serious discussion to really fix the issue I'd rather we tweak around the edges as opposed to redo the whole thing with the current clowns in charge.

Kind of hitting on #6, which I know you obviously know about but others may not, ACA had hospitals hire care coordinators (or many for large entities) whom one of their biggest jobs is to basically babysit chronic and non-compliant patients. They coordinate their visits to their provider when needed, ensure they are taking their meds appropriately, coordinating with family members to ensure they are complying, arrange for transportation when needed, get them in for wellness check-ups, etc.

The intention is to keep them out of the ED's, but we have found a very small percentage of success. Essentially, many of these patients keep eating whatever they want even though they are diabetic or morbidly obese, do not take their meds, or do not go to their scheduled appointments, etc. The intended outcome was a good idea, but it is extremely difficult to get people to just do what they should instead of what they want. They do not care.

 

[Mick]

Me too but neither party would support it.

One would definitely be more receptive than the other.

 

[volinbham]

One would definitely be more receptive than the other.

I disagree whole heartedly. The fine folks who brought you the ACA rejected the opportunity and went in the other direction.

 

[05_never_again]

Trump is starting to use the word "socialism" as a trigger word to his base. I think most of the people who become upset or angry when they hear "socialism" either don't understand what it is or don't realize that we have always used significant features of it. And the most socialistic move any President has ever undertaken was the bailout during the 2008 financial crisis... and who was responsible for that ? George W. Bush - a Republican.

The word "socialism" has always been a dirty word for his base. It's an older demographic, and when they hear socialism they think of the Soviet Union.

Younger people (Millennials and Gen Z) hear socialism and think "free" heath insurance, "free" college, and Denmark and Sweden. It isn't surprising that the concept of socialism is most popular among people who were born/grew up after the Soviet Union fell. It has much better branding now than it used to, and currently has better branding relative to capitalism.

 

[volinbham]

Meanwhile in Canada...

The serious flaw in Canada's healthcare system: prescription drugs aren't free

 

[Mick]

I disagree whole heartedly. The fine folks who brought you the ACA rejected the opportunity and went in the other direction.

And I disagree with that assessment. ACA had two good points the individual mandate and every state participation. The hardest part is going to be the restructuring of the existing medicare "insurance" program. I see it as a safety net tax, but for the sake of argument, the principal of taking money out of everyone's pocket is the same.

 

[Septic]

We were lucky if you can call it that. My wife had her gallbladder surgery at the end of January then shattered both the bones in her ankle in March. So she had 4 surgeries in 1 year.

Yeah... If you're going to get banged up, do it early.

 

[C-south]

And I disagree with that assessment. ACA had two good points the individual mandate and every state participation. The hardest part is going to be the restructuring of the existing medicare "insurance" program. I see it as a safety net tax, but for the sake of argument, the principal of taking money out of everyone's pocket is the same.

Take away subsidies and expanded Medicare and it might work.

 

[Septic]

Maybe 50% on $10 - $50 million and 80% on $50+ million.

 

[ClearwaterVol]

Meanwhile in Canada...

The serious flaw in Canada's healthcare system: prescription drugs aren't free

They still aren't demanding a change to the American model.

 

[AM64]

My personal opinion is that we need to get rid of all insurance and go to a cash system where providers are free to refuse service.

Or coverage for all.

So does that mean a healthcare provider can refuse service but not a baker?

 

[AM64]

Obama signed a 2 million dollar book deal less than a month after entering the Senate. He average an income of less than $300,000 annually before entering the senate, after which he averaged well over $2mil annually while serving in the senate. Michelle began making over $300,000/yr serving on various boards when he entered the senate.

He reworked his book deal for MUCH more money two weeks before swearing in as president. He entered gov't as upper middle class and exited as an EXTREMELY wealthy man.

What the hell were either of them doing that would justify being paid anywhere near $300K? Community orgasms must be worth a lot more than I could ever have imagined.

 

[C-south]

What the hell were either of them doing that would justify being paid anywhere near $300K? Community orgasms must be worth a lot more than I could ever have imagined.

Manchurian puppet

 

[AM64]

The word "socialism" has always been a dirty word for his base. It's an older demographic, and when they hear socialism they think of the Soviet Union.

Younger people (Millennials and Gen Z) hear socialism and think "free" heath insurance, "free" college, and Denmark and Sweden. It isn't surprising that the concept of socialism is most popular among people who were born/grew up after the Soviet Union fell. It has much better branding now than it used to, and currently has better branding relative to capitalism.

Don't forget Greece, Cuba, Venezuela, ... Socialism is a scam.

 

[NurseGoodVol]

Like the VA?

There are those who Won't touch on the topic of the VA, because that argument is a dead end. They can't justify gov involvement on a bigger scale, universal healthcare, because gov has failed hugely on a smaller scale, the VA.
There is no justification for failing our veterans.

 

[NurseGoodVol]

Highway to hell!

Oh stop... I've got a mental picture of you in the Angus bad boy English school boy outfit, sucking oxygen back stage after his cocaine induced stomp for 20 minutes. You are ruining my teenage memories.

 

[BigOrangeTrain]

Highway to hell!

Nervous Shakedown

 

[PointGuard]

I sure do hate to break it to you, but the United States economic system has always been a mixed economy that features characteristics of both capitalism and socialism. A mixed economic system protects private property and allows a level of economic freedom in the use of capital, but also allows for the government to intervene in economic activities in order to achieve social aims and for the public good.

The government of the United States has ALWAYS played some role in the economic affairs of the nation. The U.S. government controls or partially controls goods or services, such as education, courts, roads, hospital care and postal delivery. It also provides subsidies to agricultural producers (just as Trump has continued to do during his presidency), oil companies, financial companies and utility firms. Nearly every type of business and every form of economic exchange is affected by government policy in the United States including the Food and Drug Administration, the Federal Trade Commission and the Department of Labor.

The U.S, government also plays a role in the economy via financial policies that can influence inflation and business production. The Federal Reserve is charged with controlling monetary policy (which has to do with the quantity, velocity and availability of the circulating money supply), while Congress and the Executive branch handle fiscal policy (which focuses on raising government revenue or reducing government spending). Now, if you want to argue in favor of lower taxes, that's fine... but that doesn't change the fundamental system we are under - which is a mixed economy that features both capitalism and socialism.

Only a truly ignorant person, who doesn't understand that we are already (and have always been) a mixed economy would be this spooked by the word "socialism".

Toss the military/civil military like industries into that socialist like group that lives off all

Think Virgil at Tinker living off your backs.

 

[volinbham]

They still aren't demanding a change to the American model.

Duh.

 

[PointGuard]

Universal “healthcare”, the retardation of the left.

What does “healthcare” entail? How much will it cost everyone? Destroying a country for a service is idiotic.

Get some kind of a clue before you run off at the mouth instead of believing everything you read on some far right conspiratorial rag or worse listen th what Trumpturd says

 

[BigOrangeTrain]

I sure do hate to break it to you, but the United States economic system has always been a mixed economy that features characteristics of both capitalism and socialism. A mixed economic system protects private property and allows a level of economic freedom in the use of capital, but also allows for the government to intervene in economic activities in order to achieve social aims and for the public good.

The government of the United States has ALWAYS played some role in the economic affairs of the nation. The U.S. government controls or partially controls goods or services, such as education, courts, roads, hospital care and postal delivery. It also provides subsidies to agricultural producers (just as Trump has continued to do during his presidency), oil companies, financial companies and utility firms. Nearly every type of business and every form of economic exchange is affected by government policy in the United States including the Food and Drug Administration, the Federal Trade Commission and the Department of Labor.

The U.S, government also plays a role in the economy via financial policies that can influence inflation and business production. The Federal Reserve is charged with controlling monetary policy (which has to do with the quantity, velocity and availability of the circulating money supply), while Congress and the Executive branch handle fiscal policy (which focuses on raising government revenue or reducing government spending). Now, if you want to argue in favor of lower taxes, that's fine... but that doesn't change the fundamental system we are under - which is a mixed economy that features both capitalism and socialism.

Only a truly ignorant person, who doesn't understand that we are already (and have always been) a mixed economy would be this spooked by the word "socialism".

The Federal Reserve is a central banking system. That is one of the planks of Marcs Communist Manifesto. Socialism is one step before Communisim. The Federal Reserve is why we have our ridiculous personal income tax. Its why the value of the dollar has diminished over the years. In the Constitution, only the government had the power to,print money. Big time money men and bankers changed all that.

The fact that you seen to think Socialism is really no big deal shows a fundamental lack of understanding of what it represents. It also shows a growing trend of liberal democrats ideals. Socialism is an abject failure in every means possible. Tgere is no good that comes of it. Unless you are in favor of suppressed freedoms and mammoth government intervention. This post you made is very sad and pathetic and the same time. You should talk to some people who have studied Socialism. Your views would likely change.

 

[BigOrangeTrain]

Get some kind of a clue before you run off at the mouth instead of believing everything you read on some far right conspiratorial rag or worse listen th what Trumpturd says

I would love to hear your real retort to the questions.