Gavin Newsome touches on problems in Democratic Party
- Thread starter ticket2ride04
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That would certainly cut down on the number of uninsured in the country, no?
I don't think a bipartisan panel would work because both sides are so partisan. This is where I think Trump could be effective. Both sides hate him, that's something they have in common so it's a start. I think he needs commision a bipartisan group. I wish he could do it in secret so there would be no pressure on the D's nor the R's. Put together a plan and see where we go.
Insurers are doing just fine. So are most large providers, but the industry is seeing increased consolidation because smaller, rural providers can't keep up with burdensome and costly administration and compliance. That's obviously bad for access to care.
Medicare has potential solvency issues, but the "current' version of Medicare and the future version of Medicare look very different in how they pay providers. HHS has set a goal (PDF) of tying 30 percent of Medicare fee-for-service payments to quality or value through alternative payment models by 2016 and 50 percent by 2018. HHS has also set a goal of tying 85 percent of all Medicare fee-for-service to quality or value by 2016 and 90 percent by 2018. They're not meeting these goals -- which are very aggressive -- but their intent is clear. Value will almost entirely supplant fee-for-service in the near term.
Providers are only required to provide emergency care for uninsured patients to remain complaint with EMTALA. The effects of uncompensated care on provider costs are generally overstated, and in any case most providers freely write off those costs to meet their charity care requirements.
If you want to understand what's really driving costs, go read the article I poasted. The one part that's quickly becoming outdated is #6, because contract negotiations between insurers and providers are moving away from guaranteed fee schedule increases towards payment for value, just like Medicare.
The most expensive 1% of patients in this country account for 28% of all healthcare costs. The most most expensive 5% of patients account for 50% of all healthcare costs. The data behind those numbers is 10 years old, but it's still incredible.
I'm fine with that as long as it involved both parties.
I can tell you that my family has hammered the insurance company this year. I'm probably in that 1-5% range.
Gov's job is to protect our country, not tell me what I have to purchase and not purchase.
I don't think it can be out in the open. Too much political pressure from both sides.
Can you give some examples? As you can guess I live in Canadia and it works pretty well here. NOT perfect as there are things that can be improved, but pretty well.
CC
Problem is nothing to blame but genetics and old age. Maybe I could sue my Mom.
Canada would be my exhibit A. Yes everyone has coverage. How long do you have to wait to get it though?
Vermont's also failed spectacularly.
I used to work for the Parks and Rec Department for the City of Tacoma (Washington). We were a few hours from the Canadian border. One of our most popular activities was a bus trip up to Vancouver. It always sold out almost as soon as it was listed, full of senior citizens heading up there to get their prescription drugs without a prescription at a fraction of the cost. We used to call it the "Drug Run" lol.
Prescription prices are outrageous. However, I worked in Pharma a few years and the testing that must happen is very expensive. This was blood plasma products though not pills. My question is do people seek out Canadian doctors because of the great advances and care like they do here.
I know, it's just a funny story I like to share. Agreed on the astronomical R&D costs. Pharma gets a bad rap, some of it earned, because of Pleasantville drug reps and stories like the Martin Shkreli case.
So since it's run by the govt. are you saying the US military sucks?
Are you saying a perfect govt would be just 1/10/n # of people in charge of that largest military in the world? (what could go wrong)
Now you would still pay taxes for that protection. Do they have to run their purchases by you? Hiring? If not aren't they telling you what you have to purchase with your taxes?
CC
I kind of agree with what you're saying. I've argued for years that taxes should be a la carte. Meaning, each individual is told what they have to pay in taxes and then that individual would then be allowed to decide where their money goes. For instance, I could put 20% towards infrastructure, 50% towards defense, and 30% towards healthcare. That way, we'd see what Americans truly want to support. I know that there are many holes in my suggestion but it's an interesting thought and it would make people feel a lot better about paying taxes.
I worked with rabbits, guinea pigs and mice. In the '90's the cost for them were $75, 35 and 15 respectively. No telling the cost now. That was just purchase price.
I see what you are saying and yes there are definitely problems. One of the issues I have with the military is the waste much like the rest of the government.
Our government did tell us we had to purchase healthcare approved by them and it's not right.
Wasn't saying it was a failure I've just never heard of someone leaving the US to get treatment in Canada. Also you didn't answer the other Poaster's question about wait times in Canada.
Didn't even know Vermont had single payer. Not sure how that would work on a state level but I'll look it up.
Can you clarify your wait question? Do you mean how long does it take to get care? Depends on the care. If its urgent you go to the ER like anywhere else. I think what most people hear is that you hurt your knee and it takes 6 months to get an MRI. This is true. Those with means will seek MRI's out of country. Many (me included) feel that private clinics that offer things like MRI's should be allowed but the govt is worried about a 2 tier system so they have nixed the idea.
Also, only basic health care is covered. Insurance companies still provide benefits for costs and items not covered (dental) by the gov.
CC
I'll also point out that Canada's population is about 36 million. Population numbers make a big difference in price. Their system wouldn't be sustainable here without a huge increase in tax revenue. And of course another problem is actually having enough doctors to see all of these people in a reasonable time frame.
Not sure about now but back in the 90's I had several friends go to Canada to get Lasik surgery. The main reason was the cost.
CC
Sorry - yes that is covered. By basic care I mean things like dental and optical (for adults) aren't included.
CC
I realize if you get hit by a truck or something that they'll take you right away. But what about semi-urgent things that aren't ER visits? Like someone with liver/heart disease or cancer or something like that? With long wait times - they could die before they ever got in to see a doctor.
And even for more minor things like a knee injury - who the hell wants to wait half a year to get someone to look at it? And why should we implement something and then essentially tell everyone "Don't worry that it sucks - you can always pay more on top of this to go get treatment in another country"?
Don't you mean you had several friends COME to Canada?
Where do you live in Canada?
It's really cool having someone from Canada participating. That was unexpected and will keep me tuned-in.
You are in charge of snacks and participation trophies!
None of that healthy crap either
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I can't speak on all issues but one of my wifes biker friends is currently going for cancer treatments and I think it was a pretty quick turnaround from diagnosis to treatment.
As for less urgent issues, yes it does suck that you do wait for certain things and I mentioned before it could be improved. But I feel it's a worth the trade off.
Another thing is that malpractice suits are far fewer up here and they practice "common sense" medicine. Meaning they will not run every (or sometimes any) test in the book just because you have a tummy ache. I remember the first time I went to the Dr. and said "this hurts". He said take some tylenol and see in two weeks if it still hurts.
CC
Don't you mean you had several friends COME to Canada?
Where do you live in Canada?
No, this was back when I lived in Raleigh.
I'm currently in Ottawa.
CC
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