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Healthcare costs -- the Brill article


TPS

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PS - I'm surprised that you haven't mentioned the one industry where the largest players absolutely benefit from access to government's resources, and where that access is a huge differentiator and reason for survival....

I didn't want to slander your industry....
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Just heard about the rates for exchange programs in CT: 95% of Medicare rates. Probably will be the same everywhere else. Goodbye American health care system and good luck finding a doctor.

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Just heard about the rates for exchange programs in CT: 95% of Medicare rates. Probably will be the same everywhere else. Goodbye American health care system and good luck finding a doctor.

not sure what you mean by exchange programs but since Jan 1, medicaid has been paying 100% medicare rates for board certified primary care docs. that's actually a significant increase.

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not sure what you mean by exchange programs but since Jan 1, medicaid has been paying 100% medicare rates for board certified primary care docs. that's actually a significant increase.

Meaning the health insurance exchanges.

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Just heard about the rates for exchange programs in CT: 95% of Medicare rates. Probably will be the same everywhere else. Goodbye American health care system and good luck finding a doctor.

 

according to the article, Medicare reibursement rates are more in line with the actual cost of the related service (I am not sure that is 100% correct assumption)... so if we are trying to reduce costs, this will force providers/ facilities to streamline and provide less expensive care, at least in theory, reducing overall expenditires while making the system more agile. I still don't think it solves the cost issues as patient/ providers are still unaware what the actual cost of care is (at least if you're not runing an private practice)... so they are not incented to do less rather than more... not that patients or MD run up costs on purpose....

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according to the article, Medicare reibursement rates are more in line with the actual cost of the related service (I am not sure that is 100% correct assumption)... so if we are trying to reduce costs, this will force providers/ facilities to streamline and provide less expensive care, at least in theory, reducing overall expenditires while making the system more agile.

 

So I suppose you would also agree and support Paul Ryan's Premium support ("voucher") plan as well?

Edited by Magox
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So I suppose you would also agree and support Paul Ryan's Premium support ("voucher") plan as well?

 

I am intrigued by the plan, it is basically the Affordable Care Act (the core aspect of premium support, not he reglautory details) for Seniors... if it is good enough for the Nation under 65, why not over 65? My only contention with the premium support model is confusion is might add for Senior's who already suffer from memory and congnitive issues... many Seniors had problems with Medicare Part D when it was rolled out- My preference would be to protect out Seniors from an undue mental stress, but if the program was simple to understand and fit the billl and cost less, why not? The issue would be by privatizing Medicare, would it actually cost less, being you now add another layer of expense with a third prrty insurer that tends to be more administratvely expensive than Medicare...

 

and to add, I still think Deductible Plans are the best way to curb spending on healthcare. If I have to pay my first 10K, you bet I am askign more questions about test and service neccesity than is a $30 copay covers it all... its the "its not my money" mentility, but coincidentially in the long run it is your money...

Edited by B-Large
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I am intrigued by the plan, it is basically the Affordable Care Act (the core aspect of premium support, not he reglautory details) for Seniors... if it is good enough for the Nation under 65, why not over 65? My only contention with the premium support model is confusion is might add for Senior's who already suffer from memory and congnitive issues... many Seniors had problems with Medicare Part D when it was rolled out- My preference would be to protect out Seniors from an undue mental stress, but if the program was simple to understand and fit the billl and cost less, why not? The issue would be by privatizing Medicare, would it actually cost less, being you now add another layer of expense with a third prrty insurer that tends to be more administratvely expensive than Medicare...

 

and to add, I still think Deductible Plans are the best way to curb spending on healthcare. If I have to pay my first 10K, you bet I am askign more questions about test and service neccesity than is a $30 copay covers it all... its the "its not my money" mentility, but coincidentially in the long run it is your money...

 

Good points.

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They do not have a leg up any more than any other company is answerable to its customer.

Bull.

And you are absolutely correct.

I know.

Dealing with a dysfunctional customer leads to bad business practices, which leads to weak profits and extreme cases, bankruptcy.

There are times, depending on the contract, where it leads to ridiculous profits. Been there. Seen it.

Defense contractors are not immune to the basic tenets of business, despite the myths.

No argument there, though they can get through leaner times based on relationships more easily than many industries.

 

if it is good enough for the Nation under 65, why not over 65?

You know why.

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Bull.

 

I know.

 

There are times, depending on the contract, where it leads to ridiculous profits. Been there. Seen it.

 

No argument there, though they can get through leaner times based on relationships more easily than many industries.

 

 

You know why.

 

Again, if that were true, defense contractors' margins would be well above industry averages. But they're not. You're focusing on the revenue side thinking that in lean times, contractors' revenues don't decline like the other industries. That may be true to an extent, but you're also ignoring the higher costs and more inefficiency that goes along with a big government contract. The contractors have to go through greater hurdles to meet certification, compliance & codes that don't exist in the private sector. Never mind the massive cuts firms like Lockheed need to go through if a major project gets cut. Take a look at a company called Geoeye and how its fortunes changed in a blink of an eye when NGA funding stopped. It's the ame on the services side and why companies like CSC and Xerox got hammered by the analysts because they had a lot of bad government contracts that they needed to work through.

 

It's not only about the revenue, and even at that, contractors are not guaranteed a life.

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Again, if that were true, defense contractors' margins would be well above industry averages.

No, I'm not. I don't want to get into a whole thing about how it truly works but the margins are what they are because most of the companies are purposely built to be inefficient with low margins.

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No, I'm not. I don't want to get into a whole thing about how it truly works but the margins are what they are because most of the companies are purposely built to be inefficient with low margins.

Just looking at a couple companies, it looks like R&D expenditures are allowed to be included as overhead in cost of sales. They are highly leveraged too. In the case of Lockheed-Martin, 99% of their sales are government related. The US government should hold a majority equity stake in this company since it owes its existence to US.
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Just looking at a couple companies, it looks like R&D expenditures are allowed to be included as overhead in cost of sales. They are highly leveraged too. In the case of Lockheed-Martin, 99% of their sales are government related. The US government should hold a majority equity stake in this company since it owes its existence to US.

Care to break out those "government" sales?

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Care to break out those "government" sales?

According to their 10K,

 

Care to break out those "government" sales?

Sorry, their revenues were actually 82% from government contracts.
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Just looking at a couple companies, it looks like R&D expenditures are allowed to be included as overhead in cost of sales. They are highly leveraged too. In the case of Lockheed-Martin, 99% of their sales are government related. The US government should hold a majority equity stake in this company since it owes its existence to US.

 

Why wouldn't R&D be included in cost of sales? Lockheed-Martin didn't build that company, the government did? Should the government own 99% or 82% of its stock? Are you Hugo Chavez's replacement?

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Why wouldn't R&D be included in cost of sales? Lockheed-Martin didn't build that company, the government did? Should the government own 99% or 82% of its stock? Are you Hugo Chavez's replacement?

They currently wouldn't exist without the government; but we need them to exist to build war machinery. Majority means just over 50%. If you're uncomfortable with that, how's a minority stake of 49%? Or how about we make it preferred shares like we did when we saved AIG and the banks? Without the government, L-M would not be an on-going concern, and the current shares would therefore be worthless.

 

Accounting rules make cost of Sales reflect variable costs only. The government has allowed defense companies to include R&D. I'm sure it's done because the cost of planes like the F-35 aren't determined in a market; more likely some type of cost-plus contract arrangement.

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It's a private entity. Why nationalize or have a stake in it? The difference between AIG and the banks is huge. For starters those entities were about to go bankrupt without the assistance of the US, and two those private corporations were viewed by the government as essential to allowing the economy to expand. Right or wrong, those were the views by the government and some private analysts. Neither of those two apply to Lockheed. You're making a specious argument, which is " well, without the government they wouldn't exist, therefore the government should have a stake in it"

 

Just because we have a huge appetite for their goods does not give our government the right to demand a stake in it. We don't owe them anything, who cares that most of their sales are to our government? That's real demand, they aren't producing it just to get a handout. If you think there is a lot of wasteful spending there then point your finger to the politicians that allow themselves to get bought off by lobbyists and influenced by their local constituencies that are looking more so at their local economies than the overall waste and debt to the country.

 

Again, all your solutions come from the left-wing. More regulations, higher taxes, spend spend spend and now nationalization.

 

Geez

Edited by Magox
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