Colbert CANCELED!!!

[Wolfgang]

43 minutes ago, Joe Ferguson forever said:

Death and taxes...everybody's got their dues in life to pay.

 

 

Spoken like an old man who doesn't know what time it is...

[Joe Ferguson forever]

20 minutes ago, Wolfgang said:

 

 

Spoken like an old man who doesn't know what time it is...

What time is it?  carpe diem.  Good advice for everyone, old, young or somewhere in between.

 

 

Edited July 24 by Joe Ferguson forever

[leh-nerd skin-erd]

2 hours ago, Joe Ferguson forever said:

Of course there's cost shifting.  It's the basis of our current system.  It needn't be.  Medicare for all could be collecting those outrageous commercial premiums at a lower cost while paying better. and providing better care.  No middle man.  very efficient administration costs (much lower than private payers).  everyone wins except the commercial insurers who are no longer necessary.

 

That’s a ridiculous premise.  Coverage and premiums are highly regulated under the ACA, and nothing happens outside the watchful eyes of government regulators.   The system is designed by the government, and you treat it as if it isn’t. What you’re advocating for is for the designers of the system to develop another system most likely to suck worse.  
 

[Joe Ferguson forever]

55 minutes ago, leh-nerd skin-erd said:

 

That’s a ridiculous premise.  Coverage and premiums are highly regulated under the ACA, and nothing happens outside the watchful eyes of government regulators.   The system is designed by the government, and you treat it as if it isn’t. What you’re advocating for is for the designers of the system to develop another system most likely to suck worse.  
 

Obama wanted to do it.  He said too many people would be unemployed in the insurance industry.  Yhat's true bur short term pain is better than long term.  lots of suits sucking the test.  Oh, and he needed John McCaine to pass it from his deathbed.  morbid but true.

Edited July 24 by Joe Ferguson forever

[reddogblitz]

3 minutes ago, Joe Ferguson forever said:

Obama wanted to do it.  He said too many people would be unemployed in the insurance industry.  Yhat's true bur short term pain is better than long term.  lots of suits ducking the test.  Oh, and he needed Kohn McCaine yo pass it from his deathbed.  morbid but true.

 

I knew as soon as congress while working on the ACA decided to invite insurance companies to testify and help we were screwed.  And we still are.

[Joe Ferguson forever]

3 minutes ago, reddogblitz said:

 

I knew as soon as congress while working on the ACA decided to invite insurance companies to testify and help we were screwed.  And we still are.

It would never have passed without big insurance getting what they paid for its political donations..  sigh, that's not likely to change.

[reddogblitz]

@Joe Ferguson forever - Was also going to add the ACA passed 243-173 in the House of Representatives and 60-39 in the Senate.  All yes votes by Democrats. They could have passed whatever they wanted and the ACA is what they chose to pass.

[Joe Ferguson forever]

6 minutes ago, reddogblitz said:

@Joe Ferguson forever - Was also going to add the ACA passed 243-173 in the House of Representatives and 60-39 in the Senate.  All yes votes by Democrats. They could have passed whatever they wanted and the ACA is what they chose to pass.

I remember and admire the thumbs down

https://time.com/5379164/mccain-health-care-legacy-aca/

 

 

Edited July 24 by Joe Ferguson forever

[reddogblitz]

1 minute ago, Joe Ferguson forever said:

I remember and admire the thumbs down

https://time.com/5379164/mccain-health-care-legacy-aca/

 

Quote

Many will remember McCain as the incidental savior of the Affordable Care Act, whose late-night thumbs-down vote halted his party’s most promising effort to overturn a major Democratic achievement — the signature achievement, in fact, of the Democrat who beat him to become president. It was a vote that earned him regular — and biting — admonishments from President Donald Trump.

 

 

https://time.com/5379164/mccain-health-care-legacy-aca/

 

That was to repeal it in 2017 after it had been law for 8 years.  So you like the ACA I take it since McCain killed the chance of killing it which you seem to think is heroic.

 

Serious question: You were a doctor pre and post ACA.  On a scale of 1 (sucked and hurt) to 10 (fixed health care for everyone), how much do you think it helped/hurt medical care in America all politics aside?

 

 

[Joe Ferguson forever]

57 minutes ago, reddogblitz said:

 

https://time.com/5379164/mccain-health-care-legacy-aca/

 

That was to repeal it in 2017 after it had been law for 8 years.  So you like the ACA I take it since McCain killed the chance of killing it which you seem to think is heroic.

 

Serious question: You were a doctor pre and post ACA.  On a scale of 1 (sucked and hurt) to 10 (fixed health care for everyone), how much do you think it helped/hurt medical care in America all politics aside?

 

 

7.  more people on medicaid.  more on the exchange *which I used myself).  Less people with no insurance: less ER visits for spider bites and bee sting,, less train wrecks who watched a lump in their breqst grow cuz they knew they couldn't afford treatment.  But it was farfrom perfect.   The EHR and quality indicators are a mess.  I wish they had gone for medicare for all.  But then it would have been repealed.

Why was McConnel lrubbing hid hands along with Cassidy who was a doc?

Edited July 24 by Joe Ferguson forever

[reddogblitz]

3 hours ago, Joe Ferguson forever said:

7.  more people on medicaid.  more on the exchange *which I used myself).  Less people with no insurance: less ER visits for spider bites and bee sting,, less train wrecks who watched a lump in their breqst grow cuz they knew they couldn't afford treatment.  But it was farfrom perfect.   The EHR and quality indicators are a mess.  I wish they had gone for medicare for all.  But then it would have been repealed.

Why was McConnel lrubbing hid hands along with Cassidy who was a doc?

 

Thanks for your insight.

 

As someone who isn't in the medical field although I did work with insurance and pharmaceutical companies.  Seems to me ACA is good deal if you're poor and get either Medicaid or a subsidy.  Everyone else has just been made to pay more with no real improvement in services and in a lot of cases you couldn't keep the Dr. you like.

 

If you're going to try to sell Medicare for all,you at least need to make sure everyone understands Medicare is not free. You gotta pay $250 or so that comes out of Social Security and there are co pays.  Bernie never mentioned this and thus many young people believe it to be free.  Maybe we could get there if we started to lower the Medicare eligibility age incrementally.  ie, now it is 65.  Next year it could be say 62.  The 3 years after that we drop it 60.  3 years later drop it to 55.  Slowly move into it and build up the infrastructure along the way until everyone is covered.  

 

Of course this would require a government that can think and act past the next election. A commitment that future leaders might stick to as opposed to throwing out all the old President's stuff with a large stack of Presidential Proclamations on inauguration day.  So good luck.

[Joe Ferguson forever]

7 hours ago, reddogblitz said:

s someone who isn't in the medical field although I did work with insurance and pharmaceutical companies.  Seems to me ACA is good deal if you're poor and get either Medicaid or a subsidy.  Everyone else has just been made to pay more with no real improvement in services and in a lot of cases you couldn't keep the Dr. you like.

one way or another, everyone pays more when an uninsured patient spends 10  days in the ICU.  This happens often.  And how do hospitals recoup the loss?  by cost shifting to private insurance carriers and self pays.  Seems to me the true cost would be more clear if we had Medicare for all - a giant risk pool that averages costs and risks. a healthy 30 yo should not cost $10k+ to insure.

Edited July 24 by Joe Ferguson forever

[leh-nerd skin-erd]

7 hours ago, reddogblitz said:

 

Thanks for your insight.

 

As someone who isn't in the medical field although I did work with insurance and pharmaceutical companies.  Seems to me ACA is good deal if you're poor and get either Medicaid or a subsidy.  Everyone else has just been made to pay more with no real improvement in services and in a lot of cases you couldn't keep the Dr. you like.

 

If you're going to try to sell Medicare for all,you at least need to make sure everyone understands Medicare is not free. You gotta pay $250 or so that comes out of Social Security and there are co pays.  Bernie never mentioned this and thus many young people believe it to be free.  Maybe we could get there if we started to lower the Medicare eligibility age incrementally.  ie, now it is 65.  Next year it could be say 62.  The 3 years after that we drop it 60.  3 years later drop it to 55.  Slowly move into it and build up the infrastructure along the way until everyone is covered.  

 

Of course this would require a government that can think and act past the next election. A commitment that future leaders might stick to as opposed to throwing out all the old President's stuff with a large stack of Presidential Proclamations on inauguration day.  So good luck.

Just wondering, with regard to "everyone made to pay more"...what, if anything, should the average American be asked to pay to contribute to the system in terms of annual cost, co-pays and/or deductibles, prescription meds and the like?   

 

Oh--and as Fergie points out, there is a growing field where physicians offer concierge services for a fee, catering to wealthier clients and discriminating against those less fortunate, and ironically, often most in need.  In the new medicare for all scenario outlined above--does the government allow this sort of program to exist where the axis tips toward the elites and draws money away from the system that is fair and right for everyone else?  

 

I think the reality is that most members of the medical profession enter into the profession to help people, but at the same time, but often possess the same prey drive for profit as any other business owner.  In that regard, they look out for number one (as Fergie has stated numerous times), and that can come into conflict with what is right and just for a patient treatment plan and the greater good. 

 

How do we balance that in the new system without setting guardrails in place that protect everyone? 

[reddogblitz]

 

 

6 hours ago, leh-nerd skin-erd said:

Just wondering, with regard to "everyone made to pay more"...what, if anything, should the average American be asked to pay to contribute to the system in terms of annual cost, co-pays and/or deductibles, prescription meds and the like?   

 

Oh--and as Fergie points out, there is a growing field where physicians offer concierge services for a fee, catering to wealthier clients and discriminating against those less fortunate, and ironically, often most in need.  In the new medicare for all scenario outlined above--does the government allow this sort of program to exist where the axis tips toward the elites and draws money away from the system that is fair and right for everyone else?  

 

I think the reality is that most members of the medical profession enter into the profession to help people, but at the same time, but often possess the same prey drive for profit as any other business owner.  In that regard, they look out for number one (as Fergie has stated numerous times), and that can come into conflict with what is right and just for a patient treatment plan and the greater good. 

 

How do we balance that in the new system without setting guardrails in place that protect everyone? 

 

Thanks for your response.  You raise some interesting points.

 

As to #1, this is a really tough question.  My original point with this primarily that since the passage of ACA prices for medical care have continued to rise a lot for people not on Medicaid or get a subsidy.    Do you think I'm wrong about this?  Didn't mean everyone should pay more.  The average American is already paying quite a bit.  Especially if you throw in the employer contribution to health insurance.   

 

We all pitch in for paying for roads, social security, military, snow plows etc. so when we need it we have it and everyone can take advantage.  Why not the same for healthcare?  Everyone goes into the world's largest insurance pool.  And no, it should not be free.  Would be funded by income tax or something.  I'll take a stab at it even though it would be low for some and high for others. 15%

 

#2 I don't care about this. If rich people want to pay their taxes AND their health care costs out of pocket let 'em.  They'd be paying premiums (taxes) and taking nothing out. Win. Win.

[JFKjr]

18 hours ago, Joe Ferguson forever said:

7.  more people on medicaid.  more on the exchange *which I used myself).  Less people with no insurance: less ER visits for spider bites and bee sting,, less train wrecks who watched a lump in their breqst grow cuz they knew they couldn't afford treatment.  But it was farfrom perfect.   The EHR and quality indicators are a mess.  I wish they had gone for medicare for all.  But then it would have been repealed.

Why was McConnel lrubbing hid hands along with Cassidy who was a doc?

 

Meaningful Use was a laugh riot.

[Joe Ferguson forever]

6 minutes ago, JFKjr said:

 

Meaningful Use was a laugh riot.

most of the document stuff was pure bs.  Took my attention away from patients.  Many agree.

[rusty shackleford]

In just a few pages this tread pivoted from why Colbert got sh*tcanned to what health coverage he plans he might discover in unemployment.

[leh-nerd skin-erd]

3 hours ago, reddogblitz said:

 

 

 

Thanks for your response.  You raise some interesting points.

 

As to #1, this is a really tough question.  My original point with this primarily that since the passage of ACA prices for medical care have continued to rise a lot for people not on Medicaid or get a subsidy.    Do you think I'm wrong about this?  Didn't mean everyone should pay more.  The average American is already paying quite a bit.  Especially if you throw in the employer contribution to health insurance.   
 

 

Yes, I agree that cost has increased and also that this was the outcome planned by Obama and the architects of the ACA, at least for most working Americans. 

 

3 hours ago, reddogblitz said:

 

We all pitch in for paying for roads, social security, military, snow plows etc. so when we need it we have it and everyone can take advantage.  Why not the same for healthcare?  Everyone goes into the world's largest insurance pool.  And no, it should not be free.  Would be funded by income tax or something.  I'll take a stab at it even though it would be low for some and high for others. 15%

 

We do that now…those who contribute help fund those that don’t.  Those that are in good health subsidize those that aren’t.  Private subsidizes Medicaid and Medicare.    I appreciate the guess at 15%, but you’re suggesting 15% on top of federal and state income tax already in existence, plus all the other tax we pay already?  Property…sakes…excise etc?  

3 hours ago, reddogblitz said:

 

#2 I don't care about this. If rich people want to pay their taxes AND their health care costs out of pocket let 'em.  They'd be paying premiums (taxes) and taking nothing out. Win. Win.

Ah, ok.  A wealthy guy like Fergie kicks in his full 15%, but then funds his concierge service  over and above.  Interesting.  I think that putting removing the private CO’s from the market is an absolute recipe for disaster, and would result in substantially higher costs and drastically reduced options….but if you’re going down ragtag path, I’d agree with this with maybe an additional surcharge on the concierge service.  Maybe like a grand , two or three above and beyond. 

[reddogblitz]

11 minutes ago, leh-nerd skin-erd said:

We do that now…those who contribute help fund those that don’t.  Those that are in good health subsidize those that aren’t.  Private subsidizes Medicaid and Medicare.    I appreciate the guess at 15%, but you’re suggesting 15% on top of federal and state income tax already in existence, plus all the other tax we pay already?  Property…sakes…excise etc?  

 

True.

 

I'm saying 15% (a wild guess) of your income for health care.  Between premiums, co pays,  inflated Rx prices I'm guessing we already pay that or close. What do you think it should be?

 

15% (or whatever) above federal and state income taxes.  you no longer pay for health premiums.  Many other government health assistance programs would no longer he needed.  In my state we have Apple Care as a state funded low income assistance program. That would no longer be needed for example.

 

I'm not married to this idea and admittedly don't have all the details.  But the current model is inefficient and over priced.  Do you disagree?

[leh-nerd skin-erd]

9 hours ago, reddogblitz said:

 

True.

 

I'm saying 15% (a wild guess) of your income for health care.  Between premiums, co pays,  inflated Rx prices I'm guessing we already pay that or close. What do you think it should be?

 

15% (or whatever) above federal and state income taxes.  you no longer pay for health premiums.  Many other government health assistance programs would no longer he needed.  In my state we have Apple Care as a state funded low income assistance program. That would no longer be needed for example.

 

I'm not married to this idea and admittedly don't have all the details.  But the current model is inefficient and over priced.  Do you disagree?

I’ll start with the end in mind and work backwards…I agree that the current model is inefficient (and a reminder, it’s exactly what the govt planned it to be), and to be completely candid have no idea if it’s over-priced or not.  Who can tell?  It’s a highly regulated industry with generations of political fingerprints all over it, the well-intentioned, the apathetic and monetarily influenced alike.  Much is made of ins cos lobbying, but let’s be fair and acknowledge the medical industry (docs, hospitals, clinics, phlebotomists, device manufacturers et al) is dollars deep in directing and controlling and virtually all want as large a slice of the pie as they can get.  
 

My preferred options would be a continuation of the govt-private industry model with an eye toward sensible regulation, sensible cost-control and all stakeholders thriving especially patients.  My biggest issue with the govt model is that politicians seek political answers to math problems time and time again.  Back when ACA was being pimped, substantial hubbub arose over coverage for “pre-existing conditions”.  While there were abuses in the regulatory side (quick reminder, the state/federal government established the rules to follow there), there were many individuals who actively and intentionally forewent health insurance to save premium, only to seek it out when they needed it.  That’s sad, but avoidable on a personal level.  Bottom line, all these programs can work if the math is right, but the math never works out to free (and I understand that’s not your suggestion here). 
 

So, govt-private alliance, the bureaucrats working out sensible rules and guidelines, sensible cost controls for routine procedures, private companies seeking out new and efficient ways to offer services on a national level.    Healthier people should earn better premiums, higher risk individuals should expect a higher commensurate premium with limitations on premium changes once a health issue occurs.  As always, a safety net should be in place with tight regulation and stiff penalties for those who abuse the system.