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The PPACA Thread Part III - Let's have a healthy debate!

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Re: The PPACA Thread Part III - Let's have a healthy debate!

Obamacare solved one of the two biggest problems with healthcare. Ok, really two of three.

One, it mandated pre-existing conditions be covered. This was crucial. To be cast out because you drew a short straw in the genetic lottery is unfair.


Two, it solved the coverage gap. Sort of. We need to provide health care to everyone. It's beginning to fail on this account because of other problems. Not enough people choosing the exchanges, not enough young healthy people sharing the burden (baby boomers 2.0?), and because it doesn't fix the third and most important problem.

Of course that is the cost of health care. This needs to come down. Starting with hospitals and the big pharmaceutical companies. Hospitals are charging far too much for the care they provide. I know that's complex and it's a result of many, many other issues, but it needs to be fixed. Pharmaceuticals are raping the public. I'm a very firm believer in charging to cover the costs of R&D, but the marketing, executive pay, lobbying, and profits at the cost of affordability have got to go or be regulated.

bravo!!!!

this of course and the high administrative cost of higher education are the two big stones that need crushed to start to control those bills. sad to say however that these groups are big supporters of democrats. they also welcome universal purchases of their product to continue to get paid. if the government can pay them for their services that is all the more the better.

a conundrum to say the least.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

The National Association of Insurance Commissioners should have the leading role, not the Federal government. They can draft model legislation for states to use.

There are plenty of ways to make it work; as long as you let go of some one-size-fits-all, centralized, one single uniform solution that all must submit to. We need more experimentation and decentralization; the world has changed and we don't really know what will work; what we do know is what concepts have been successful. Flexibility, options, choice: not regimentation, compulsion, standardization.


Ok, so I was going to post a sarcastic response about how the president and president-elect of the NAIC were former executives at insurance companies, but this is so, SO much better:

http://www.naic.org/documents/topics_interstate_sales_myths.pdf
Some have suggested that allowing interstate sales of health insurance policies will make coverage more affordable and available. In reality, interstate sales of insurance will allow insurers to choose their regulator, the very dynamic that led to the financial collapse that has left millions of Americans without jobs. It would also make insurance less available, make insurers less accountable, and prevent regulators from assisting consumers in their states.

Maybe these guys aren't half bad :D :D :D
 
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Re: The PPACA Thread Part III - Let's have a healthy debate!

A sure fire sign that you're an 100% proof knuckledragger is when you keep repeating unworkable solutions in the hopes that after the billionth time someone will take you seriously.

Case in point, selling insurance across state lines. Okay, I say legalize that tomorrow. Now, what exactly does that do? If I in Massachusetts buy insurance from Kansas, the Mass doctors aren't going to accept Kansas rates for their service. So, unless I want to fly to Kansas, I fail to see what this does for anybody.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Have you ever heard of a government program that is efficient and cost effective?

Soo...per Forbes, the total healthcare industry was $3 trillion in 2012. http://www.forbes.com/sites/danmunro/2012/01/19/u-s-healthcare-hits-3-trillion/ The total healthcare insurance industry was $779 billion in 2015. http://www.ibisworld.com/industry/default.aspx?indid=1324

Can you tell me just exactly what insurance value add is worth nearly a quarter of all healthcare expenditures? If you can't answer that, then you have your answer about the government's ability to do it for less.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Soo...per Forbes, the total healthcare industry was $3 trillion in 2012. http://www.forbes.com/sites/danmunro/2012/01/19/u-s-healthcare-hits-3-trillion/ The total healthcare insurance industry was $779 billion in 2015. http://www.ibisworld.com/industry/default.aspx?indid=1324

Can you tell me just exactly what insurance value add is worth nearly a quarter of all healthcare expenditures? If you can't answer that, then you have your answer about the government's ability to do it for less.

The age to be forced to become on Medicare (in order to receive Social Security) is 65. For your stats, that's birth years 1947-1950. Gee, which generation had a lot of people born then... Not to mention, how many companies have been shoved out due to the complexities of the PPACA... Nice try.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

The age to be forced to become on Medicare (in order to receive Social Security) is 65. For your stats, that's birth years 1947-1950. Gee, which generation had a lot of people born then... Not to mention, how many companies have been shoved out due to the complexities of the PPACA... Nice try.

Quite the tangent (which I'm not even following).

But now that you bring it up...just how have companies been affected 'by the complexities' of the ACA? That notably communist rag, Fortune magazine, has a fairly comprehensive perspective:

"How well is the Affordable Care Act working?

The natural inclination is to look backwards—to judge whether the ACA has measurably improved the health care system in the last 6 years. Here, the answer is clearly yes. Nearly 19 million people have gotten insured. And health care inflation has been lower than at any time in the last 50 years, although drug costs are going up faster. Not bad.

A better way to evaluate the ACA is to look forward—to assess whether the law is setting the framework for a higher quality and lower-cost system. The best window on the future is the health care start-up sector.

Overall, 2015 was a record year for medical investing, including in biotech companies making new drugs. But it was also a record year for investing in start-ups aimed at improving quality or reducing costs. In 2011, just after passage of the ACA, about $1.1 billion was invested in “technology-centric, health-related companies that facilitate healthcare administration, delivery, or access.” In 2014 and 2015, that figured skyrocketed to over $4.3 billion.

Where is all this money going?

A lot of it is going where you might expect: new apps and technological innovations to deliver care more efficiently. But, perhaps surprisingly, many of these start-ups are working to redesign and reimagine parts of the health care system that already exist but aren’t working well or have been long ignored. Similarly, several companies have dedicated themselves to modernizing primary care practices by using big data. There are a string of new companies working to improve another problem area: mental and behavioral health. Still, others are rethinking traditional care using the Uber model. The ACA is also unleashing a flood of talented entrepreneurs into health care. Entrepreneurs who used to go to traditional Silicon Valley start-ups focused on search, shopping, sharing, and software are now migrating to health care."

http://fortune.com/2016/03/15/obamacare-affordable-care-act/

And best of all and unlike simple manufacturing, these are segments where the US must win or it fails. All in all, I'd say the complexities of the ACA have worked out just fine for the US.
 
Social security, for one.

And its going bankrupt again. The original principle was fine, but our political masters kept adding goodies and the cookies disappeared faster than the baker could make them. It didn't help that the baker was helping himself to the cookies before they got to the jar.

I would add the Smith-Lever and Hatch (the other one) Acts that funded Cooperative Extension and Cooperative Research Services.

NASA prior to 1970.

On the other hand the Patriot Act is/was a government boondoggle that had the taxpayers fork over another billion every time HSA farted.
 
And its going bankrupt again. The original principle was fine, but our political masters kept adding goodies and the cookies disappeared faster than the baker could make them. It didn't help that the baker was helping himself to the cookies before they got to the jar.

I would add the Smith-Lever and Hatch (the other one) Acts that funded Cooperative Extension and Cooperative Research Services.

NASA prior to 1970.

On the other hand the Patriot Act is/was a government boondoggle that had the taxpayers fork over another billion every time HSA farted.

Social security retirement has an overhead of less than one percent. Even the disability portion has an overhead of only 2.5 percent or so. I dare you to find a private sector program with similar efficiencies.

And it's running out of money because people live longer, not because it's somehow ineptly run or managed. And the fixes, while politically hard, are extremely simple mechanically.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

And its going bankrupt again. The original principle was fine, but our political masters kept adding goodies and the cookies disappeared faster than the baker could make them. It didn't help that the baker was helping himself to the cookies before they got to the jar.

I would add the Smith-Lever and Hatch (the other one) Acts that funded Cooperative Extension and Cooperative Research Services.

NASA prior to 1970.

On the other hand the Patriot Act is/was a government boondoggle that had the taxpayers fork over another billion every time HSA farted.
Sigh.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

And its going bankrupt again. The original principle was fine, but our political masters kept adding goodies and the cookies disappeared faster than the baker could make them. It didn't help that the baker was helping himself to the cookies before they got to the jar.

I would add the Smith-Lever and Hatch (the other one) Acts that funded Cooperative Extension and Cooperative Research Services.

NASA prior to 1970.

On the other hand the Patriot Act is/was a government boondoggle that had the taxpayers fork over another billion every time HSA farted.

To be fair, how much of social security bankruptcy came from administrations using it as a slush fund to balance the budget?
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Daraprim costs $750 a pill in the USA. You can buy 50 of them for $13 in Australia. However, some enterprising Sydney HS students spent $15 to make 3.7 grams of Daraprim which is worth ~$100,000 in the USA.

The WaPo article

Read it and weep Shkreli!!
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Daraprim costs $750 a pill in the USA. You can buy 50 of them for $13 in Australia. However, some enterprising Sydney HS students spent $15 to make 3.7 grams of Daraprim which is worth ~$100,000 in the USA.

The WaPo article

Read it and weep Shkreli!!

It doesn't matter what they can do if they can't market it.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

And there you have it. What drug companies do best: marketing.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Well, I was thinking more of patent laws, which is the only way Shkrelli could inflate the price of his drug by such margins. Those kids spent $15 to make 3.7g of Daraprim, so you know a generic pharma company will eventually do the same thing for an even lower cost.

Like it or not, patents were created to allow the inventors to garner greater-than-market returns on their new inventions. At the time they were originally conceived, life saving inventions weren't on anyone's minds. The US Government, and various international governments, would have to come together to make exemptions, or special alterations, for those companies from patent protections that would apply to other industries.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

While that is true, the problem is a generic lab cant do it because Turing holds exclusive rights to distribute X amount of years. That should be fixed for medicines because it not only creates a monopoly but it puts people's lives at risk.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

While that is true, the problem is a generic lab cant do it because Turing holds exclusive rights to distribute X amount of years. That should be fixed for medicines because it not only creates a monopoly but it puts people's lives at risk.

That is quite literally everything I just said, only made more succinct.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Can you tell me just exactly what insurance value add is worth nearly a quarter of all healthcare expenditures? If you can't answer that, then you have your answer about the government's ability to do it for less.

The idea that government can "do it for less" is a myth based on faulty data. They intentionally omit losses to fraud from their calculation of administrative costs. That is a basic accounting error.

They also omit the cost of capital from their calculation of administrative costs as well.

Finally, it is based on a static picture: there is no financial incentive to reduce costs or to innovate improvements. While government might fund basic R&D, it still has not on its own developed a single piece of equipment nor manufactured a single drug or vaccine.
 
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