Drudge Retort: The Other Side of the News
Saturday, July 20, 2019

Everyone will save money under Medicare-for-All, and we will have a far, far healthier population to show for it. All other claims are lies. Global statistics prove this fact. Nobody pays more for mediocre health than Americans, as a percent of the national GDP.

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Been on Medicare foe a couple years now. If you dont like it, you dont understand how wonderful it is.

Nothing is perfect, but the coverage is good, and affordable. It is much easier to work with than the private insurance we have had previously.

Much better than private health policies which are based upon 'delay, deny, and hope you die' basis of private health care insurers.

#1 | Posted by oldwhiskeysour at 2019-07-20 10:53 AM | Reply | Newsworthy 3

I read this headline of this article in Bernie Sanders' voice. I'm sure lot of people will listen. But most won't react in the way the author hopes. The only use MFA has in this campaign is for candidates who aren't for it to distinguish themselves from the socialists.

#2 | Posted by sentinel at 2019-07-20 10:55 AM | Reply

"Everyone will save money under Medicare-for-All..."

Total bullschitt.

The high-end worker will be asked to take insurance around the 70th percentile, with a 20% copay, while his boss will be expected to pay the same higher premiums to get lesser coverage.

The author clearly understands neither the equation, nor the industry.

#3 | Posted by Danforth at 2019-07-20 11:00 AM | Reply

I have relatives in Canada. They never talk about health insurance worries, bills or denied care. They never worry that losing or changing jobs will affect their insurance. They never think about pre-existing conditions. They never worry that an illness will bankrupt them.

Canada has the second worse health care system of wealthy countries.

#4 | Posted by bored at 2019-07-20 11:05 AM | Reply | Newsworthy 1

If you really want the US to move closer a healthcare system like Canada's, then building on the ACA is the way to go. Trying to go All or Nothing will end up with... nothing.

#5 | Posted by sentinel at 2019-07-20 11:15 AM | Reply

"I have relatives in Canada. They never talk about health insurance worries, bills or denied care. They never worry that losing or changing jobs will affect their insurance. They never think about pre-existing conditions. They never worry that an illness will bankrupt them."

When I lived in the US, I never worried about any of that either.

And I didn't need to worry about staying in an open bay if I had to see a doctor. Or wait weeks for an MRI.

Ask your Canadian relatives about wait times.

#6 | Posted by madbomber at 2019-07-20 11:26 AM | Reply | Funny: 1

"Or wait weeks for an MRI."

Huh?

I tore my knee two years ago, and had to wait over a month for an MRI. Here, in America.

"When I lived in the US, I never worried about any of that either."

Well, no, not if you're a member of the military, and your health insurance is being provided for you by the taxpayers.

#7 | Posted by Danforth at 2019-07-20 11:43 AM | Reply

#1 | POSTED BY OLDWHISKEYSOUR AT 2019-07-20 10:53 AM | FLAG: Agree, but do note that your, and your employers [their match] have paid into the program for many decades before you can could access the program -- and with all those people paying i advance Medicare is already in fiscal 'straights'. Now picture close to 200 million now accessing care having paid little on nothing into the program. I cannot begin to imagine how high taxes will need to be raised to fund this and no matter how much someone tells us it will cost, like any govt program their guesstimate will lower than reality. One good thing is that it is a payroll tax so even those exempt from paying fed income taxes will be unable to avoid this one - as it should be.

#8 | Posted by MSgt at 2019-07-20 11:51 AM | Reply

#6 | POSTED BY MADBOMBER

#7 | POSTED BY DANFORTH

You two doofuses never learn ...

Overuse of Magnetic Resonance Imaging

jamanetwork.com

Overuse of health care services such as magnetic resonance imaging (MRI) has become an increasingly recognized problem.1,2 We studied the appropriateness of requests for outpatient MRI of the lumbar spine and of the head for headache, as these are common indications and might be frequently inappropriate.

Of the annual ~ $3 trillion spent on healthcare, one-third of this [nearly $1 trillion] is waste with no benefit to patients -- like too many MRIs.

I've explained this problem to you two knuckleheads for years on this very website.

But by all means, continue arguing against one of America's most prestigious medical journals -- because you two know better.

#9 | Posted by PinchALoaf at 2019-07-20 12:01 PM | Reply

I will not even consider M4A until our government demonstrates it can pay for the obligations it already has. The trajectory of SS/Medicare/Medicaid (all 3 taken as a whole) is unsustainable. These 4 things absolutely must happen:

1. Raise the FICA cap. Even if it's raised only a few grand that will generate a ton of revenue.

2. Increase FICA taxes. Just a point on each side will generate a ton of revenue.

3. Make Medicaid a block-grant to the states. This will trim costs.

4. Raise the age of eligibility. 1 year, 10 years from now and 1 more year 20 years from now. This will save a TON in liabilities.

Tweak the numbers as necessary to make it work. The ONLY way it works is either cutting benefits or increasing revenue AND cutting costs. The numbers are so stark that revenue increases alone don't get us there.

Any candidate that pushes these things will have my support. If the Democratic Party were to support either of the tax increases PLUS raising the eligibility age and I'd probably vote a straight Dem ticket.

#10 | Posted by JeffJ at 2019-07-20 12:06 PM | Reply

#9 | POSTED BY PINCHALOAF

Every time this discussion pops up you treat single payer as if it will create Utopia.

You NEVER acknowledge the problems and negative tradeoffs. It's almost like a religion with you.

#11 | Posted by JeffJ at 2019-07-20 12:08 PM | Reply

M4A is fools gold. It will never pass congress and if the Democrats were to try and push for it really hard the pushback would make ACA seem like a legislative cake-walk.

You can get there gradually with a public option. The reason being is with the public option the government becomes a player in the market. But the government is also the rule-maker and the referee. It could essentially regulate private insurance out of the market over a period of several years.

#12 | Posted by JeffJ at 2019-07-20 12:11 PM | Reply | Funny: 1

#6 Canadian wait times for non-urgent services are a bit longer than the US, but few opt to pay to shorten the wait. The complaint I hear is that many people don't have a regular GP to see. I know one person that swears by play.google.com for telehealth.

Like I said, Canada has the second worst health system of rich countries.

There is room for radical improvements in access to care and cost reduction, if the provider and insurance oligopolies can be crushed.

#13 | Posted by bored at 2019-07-20 12:22 PM | Reply

Why raise the age? If I get close to that number, it's pushed away.

No, cut spending, like military. Stop making people, like me, see my benefits I've been paying for years further away.

As for military spending, WWII ended. Korea, Vietnam, etc. We dont need to have bases anywhere except to protect the US.

#14 | Posted by Petrous at 2019-07-20 12:26 PM | Reply

#12 M4A as an opt in is the way to go. If you want more than medically necessary services, you need optional private insurance.
Killing off the income verification in Medicaid and the 25% overhead of private insurance for medically necessary services would pay for the care of poor people.

#15 | Posted by bored at 2019-07-20 12:28 PM | Reply

Every time this discussion pops up you treat single payer as if it will create Utopia.

You NEVER acknowledge the problems and negative tradeoffs. It's almost like a religion with you.

#11 | POSTED BY JEFFJ

I ALWAYS acknowledge the problems ...

1. too many tests, treatments, surgeries, prescriptions, etc.

2. Poor healthcare quality of what is done (medical errors and patient harm).

3. Doctors get medical decisions right only half the time (like when to order an MRI).

4. We, as Americans, over-consume healthcare services like tearing into family-sized bags of Doritos per person (for those who have access/insurance).

You treat your right-wing ideology as a religion, while ignoring the fact that these healthcare problems can solved by Congress if they were ever to do the right thing.

#16 | Posted by PinchALoaf at 2019-07-20 12:30 PM | Reply

I have really good insurance from BCBS but I would be ok with medicare for all if it was similar to what I have now. I would say just make it a deduction that is percentage based off your income. So it comes straight out of your check. Maybe have a max contribution so the wealthy aren't excessively penalized.

#17 | Posted by byrdman at 2019-07-20 12:50 PM | Reply

You treat your right-wing ideology as a religion, while ignoring the fact that these healthcare problems can solved by Congress if they were ever to do the right thing.

#16 | POSTED BY PINCHALOAF

I'm actually not opposed to single payer. My precondition is that we fully fund all of our other obligations first.

When I say you refuse to acknowledge the problems, you refuse to acknowledge the problems with single payer.

It's not Utopia no matter how much you try to claim otherwise.

#18 | Posted by JeffJ at 2019-07-20 01:59 PM | Reply

"My precondition is that we fully fund all of our other obligations first."

The point of your "precondition" is that you know full well we will never fully fund all our other obligations first.
Yes or no.

#19 | Posted by snoofy at 2019-07-20 02:01 PM | Reply

"I've explained this problem to you two knuckleheads for years on this very website."

And I've probably responded that believing 100% of excessive MRIs are going away overnight is childishly foolish.

"But by all means, continue arguing against one of America's most prestigious medical journals"

I'm not; I'm arguing against one of America's most clueless idiots when it comes to reality 101.

#20 | Posted by Danforth at 2019-07-20 04:30 PM | Reply

"My precondition is that we fully fund all of our other obligations first."

While you vote against fulfilling that precondition at every turn.

Now pull the other leg.

#21 | Posted by Danforth at 2019-07-20 04:31 PM | Reply

"And I've probably responded that believing 100% of excessive MRIs are going away overnight is childishly foolish."

You're making the good the enemy of the perfect.

#22 | Posted by snoofy at 2019-07-20 04:33 PM | Reply

"You're making the good the enemy of the perfect."

No, I'm pointing out suggesting the "perfect" is instantly attainable by M4A is foolish. The two aren't even connected.

#23 | Posted by Danforth at 2019-07-20 04:58 PM | Reply

And I've probably responded that believing 100% of excessive MRIs are going away overnight is childishly foolish.

I'm not; I'm arguing against one of America's most clueless idiots when it comes to reality 101.

#20 | POSTED BY DANFORTH

Who's being childish?

Congress can legislate changes that fix healthcare, but that would mean telling America the truth.

One example of the truth;

Just because a patient's knees and back hurt, and they have insurance, they don't need dozens of x-rays, MRIs, cortisone injections, and surgeries.

Why?

Because they're still relatively young at 47 years old, but they weigh damn near 400 lbs. So, they're going to do physical therapy and see a dietician instead of being wheeled into surgey for expensive hardware and prosthetics that isn't clinically appropriate, per evidence based medicine.

See what I mean? I've explained this dozens of times. And people complain about the rising costs of healthcare while complaining about government regulation that would actually fix this dysfunctional mess.

Again ... Congress can always tell their constituents the truth while legislating the right fixes ... but that would take balls, spine, intestinal fortitude, and above all, integrity.

#24 | Posted by PinchALoaf at 2019-07-20 05:15 PM | Reply

Because they're still relatively young at 47 years old, but they weigh damn near 400 lbs. So, they're going to do physical therapy and see a dietician instead of being wheeled into surgey for expensive hardware and prosthetics that isn't clinically appropriate, per evidence based medicine.
See what I mean? I've explained this dozens of times. And people complain about the rising costs of healthcare while complaining about government regulation that would actually fix this dysfunctional mess.
Again ... Congress can always tell their constituents the truth while legislating the right fixes ... but that would take balls, spine, intestinal fortitude, and above all, integrity.

POSTED BY PINCHALOAF AT 2019-07-20 05:15 PM | REPLY

ROFLMMFAO

#25 | Posted by LauraMohr at 2019-07-20 05:25 PM | Reply

No, I'm pointing out suggesting the "perfect" is instantly attainable by M4A is foolish. The two aren't even connected.

#23 | POSTED BY DANFORTH

It can be done.

If we can dole out trillions of dollars in 2008 to bail out the crooked banks on Wall Street at the drop of a hat ... then we can immediately do single-payer, Medicare-for-all, universal healthcare [whatever we're going to call it] ...

It's doable, period.

#26 | Posted by PinchALoaf at 2019-07-20 05:25 PM | Reply | Newsworthy 1

"It's doable, period."

Of course it is.

But if you're not going to admit the massive speed bumps before the trek, you've lost before you've begun.

For example, what's your pitch to the highest end folks, who pay very little now, but will be expected to pay 20% under M4A?

#27 | Posted by Danforth at 2019-07-20 05:33 PM | Reply

For example, what's your pitch to the highest end folks, who pay very little now, but will be expected to pay 20% under M4A?

#27 | POSTED BY DANFORTH

Tough ----, that's what I'm telling them.

Congress can do it if they want.

It's only the truth, and it's only doing what's right.

I really don't think we're far apart on this issue ... I'm just being as straight to-the-point as possible to help people (not you) to understand what really needs to be done.

If we can't pay for now, when the economy is good and there's battalions of billionaires in America, then we'll never fix healthcare.

We'll just get so fat and sick as a country we'll sink down so far into the Earth's crust, right where AC/DC's Bon Scott resides -- and America will be bankrupt.

#28 | Posted by PinchALoaf at 2019-07-20 05:47 PM | Reply | Newsworthy 1

"For example, what's your pitch to the highest end folks, who pay very little now, but will be expected to pay 20% under M4A?"

I haven't followed this closely, whose proposal maths out this way?

#29 | Posted by snoofy at 2019-07-20 05:51 PM | Reply

"Tough ----, that's what I'm telling them."

Spoiler alert: you lose.

"I really don't think we're far apart on this issue "

Nonsense. You bring up excessive MRIs, and then pretend M4A would address the issue.

"Congress can do it if they want."

Stop pretending there won't be huge losers. I had lunch with two folks yesterday who were all for M4A, until I told them they'd have to accept lesser coverage than they have now. And that was before they heard about their new 20% copay.

#30 | Posted by Danforth at 2019-07-20 05:53 PM | Reply

"whose proposal maths out this way?"

Medicare's: Medicare pays roughly 80%, and expects YOU to pick up the rest. Many retirees opt for supplemental plans.

And reality's: If you're currently getting coverage in the 95th percentile, with little-to-no copay, you're NOT going to like the change.

#31 | Posted by Danforth at 2019-07-20 05:59 PM | Reply

Spoiler alert: you lose.

"I really don't think we're far apart on this issue "

Nonsense. You bring up excessive MRIs, and then pretend M4A would address the issue.

#30 | POSTED BY DANFORTH

Congress has to decide whether they want to be reelected, or do the right thing and fix healthcare.

And excessive MRIs is just one example of the nearly ~ $1 trillion in healthcare costs wasted annually.

#32 | Posted by PinchALoaf at 2019-07-20 06:04 PM | Reply

"Congress has to decide whether they want to be reelected, or do the right thing and fix healthcare."

Good God, I hope you're not holding your breath.

"And excessive MRIs is just one example of the nearly ~ $1 trillion in healthcare costs wasted annually."

And M4A would address that problem...exactly how???

#33 | Posted by Danforth at 2019-07-20 06:07 PM | Reply

And M4A would address that problem...exactly how???

#33 | POSTED BY DANFORTH

Evidence based medicine ...

Congress can legislate not only the right changes to Centers for Medicare and Medicaid Services in setting the right kind of reimbursement rates ...

en.m.wikipedia.org

They can also legislate the same kind of changes to private insurance, or, simply eliminate private insurance and expand medicare to cover everyone.

It's about unraveling the dysfunction ...

Way less expensive aggressive healthcare and way more cheaper conservative healthcare, while setting the reimbursement rates for doctors and hospitals accordingly, while also incentivizing the whole system to practice evidence-based-medicine.

Congress can do all this. They're Congress, they legislate the laws.

I don't care what it's called, nor do I care a whole lot about whether there's a private insurance component -- though it'd be easier to do this without them ...

It's about getting all Americans access while fixing the poor healthcare quality that has medical error being the 3rd leading cause of death in America.

#34 | Posted by PinchALoaf at 2019-07-20 06:32 PM | Reply

"Evidence based medicine ..."

Word salad claptrap.

"Congress can legislate not only the right changes to Centers for Medicare and Medicaid Services in setting the right kind of reimbursement rates ..."

Again, that doesn't address the problem of too many MRIs.

" or, simply eliminate private insurance "

Now you're talking crazy. Private insurance will never disappear.

"Congress can do all this."

Or keep their jobs. Your analysis.

#35 | Posted by Danforth at 2019-07-20 06:39 PM | Reply

If it's anything like expanded Medicaid, doctors will be ordering all kinds of unnecessary tests, and "accidentally" making errors so those tests have to be repeated and billed each time.

#36 | Posted by sentinel at 2019-07-20 06:43 PM | Reply

Again, that doesn't address the problem of too many MRIs.

#35 | POSTED BY DANFORTH

Again, too many MRIs is just one example, doofus.

Also, again, nearly $1 trillion dollars of wasted healthcare costs annually, which includes too many MRIs.

The rest of your post is gibberish because you don't know what you're talking about.

#37 | Posted by PinchALoaf at 2019-07-20 06:47 PM | Reply

If it's anything like expanded Medicaid, doctors will be ordering all kinds of unnecessary tests, and "accidentally" making errors so those tests have to be repeated and billed each time.

#36 | POSTED BY SENTINEL

Congress can legislate severe penalties and fines by putting teeth into preventing what you're describing ...

while raising reimbursement rates significantly to pay doctors and hospitals to do the right things by not over-treating patients and to making the right evidence-based clinical decisions ...

which are cheaper, more cost effective, and most importantly produce better patient-care and medical outcomes.

#38 | Posted by PinchALoaf at 2019-07-20 06:56 PM | Reply

"Evidence based medicine ..."

Word salad claptrap.

^
I expect better from you, Danforth.
en.wikipedia.org
Clinical decision making
Beginning in the late 1960s, several flaws became apparent in the traditional approach to medical decision-making. Alvan Feinstein's publication of Clinical Judgment in 1967 focused attention on the role of clinical reasoning and identified biases that can affect it.[6] In 1972, Archie Cochrane published Effectiveness and Efficiency, which described the lack of controlled trials supporting many practices that had previously been assumed to be effective.[7] In 1973, John Wennberg began to document wide variations in how physicians practiced.[8] Through the 1980s, David M. Eddy described errors in clinical reasoning and gaps in evidence.[9][10][11][12] In the mid 1980s, Alvin Feinstein, David Sackett and others published textbooks on clinical epidemiology, which translated epidemiological methods to physician decision making.[13][14] Toward the end of the 1980s, a group at RAND showed that large proportions of procedures performed by physicians were considered inappropriate even by the standards of their own experts.[15] These areas of research increased awareness of the weaknesses in medical decision making at the level of both individual patients and populations, and paved the way for the introduction of evidence-based methods.

#39 | Posted by snoofy at 2019-07-20 07:23 PM | Reply | Newsworthy 1

Through the 1980s, David M. Eddy described errors in clinical reasoning and gaps in evidence.[9][10]

#39 | POSTED BY SNOOFY

Dr. Eddy is prominently featured in chapter 1 of the book 'Demand Better: How to Revive our Broken Healthcare System' ...

www.scientificamerican.com

Questioning the unquestionable

The problem is that physicians don't know what they're doing. That is how David Eddy, MD, PhD, a healthcare economist and senior advisor for health policy and management for Kaiser Permanente, put the problem in a Business Week cover story about how much of healthcare delivery is not based on science.

Plenty of proof backs up Eddy's glib-sounding remark.

The plain fact is that many clinical decisions made by physicians appear to be arbitrary, uncertain and variable.

Reams of research point to the same finding: physicians looking at the same thing will disagree with each other, or even with themselves, from 10 percent to 50 percent of the time during virtually every aspect of the medical-care process -- from taking a medical history to doing a physical examination, reading a laboratory test, performing a pathological diagnosis and recommending a treatment.

Physician judgment is highly variable.

Here is what Eddy has found in his research.

Give a group of cardiologists high-quality coronary angiograms (a type of radiograph or x-ray) of typical patients and they will disagree about the diagnosis for about half of the patients.

They will disagree with themselves on two successive readings of the same angiograms up to one-third of the time.

Ask a group of experts to estimate the effect of colon-cancer screening on colon-cancer mortality and answers will range from five percent to 95 percent.

Ask fifty cardiovascular surgeons to estimate the probabilities of various risks associated with xenografts (animal-tissue transplant) versus mechanical heart valves and you'll get answers to the same question ranging from zero percent to about 50 percent.

(Ask about the 10-year probability of valve failure with xenografts and you'll get a range of three percent to 95 percent.)

Give surgeons a written description of a surgical problem, and half of the group will recommend surgery, while the other half will not.

Survey them again two years later and as many as 40 percent of the same surgeons will disagree with their previous opinions and change their recommendations.

Research studies back up all of these findings, according to Eddy.

Because physician judgment varies so widely, so do treatment decisions; the same patient can go to different physicians, be told different things and receive different care.

When so many physicians have such different beliefs and are doing such different things, it is impossible for every physician to be correct.

... consider deep-vein-thrombosis (DVT) prophylaxis, that means therapy to prevent dangerous blood clots in vessels before and after operations in the hospital.

Research offers solid, Grade-A evidence about how to prevent DVT in the hospital.

But only half of America's hospitals follow these practices. That begs an important question: Why?

We have the science for that particular sliver of care. How come we still can't get it right?


I've posted this excerpt numerous times.

#40 | Posted by PinchALoaf at 2019-07-20 07:45 PM | Reply

I appreciate Danforth's aggressive defense of the status quo by but I think it's become recalcitrant.

You guys don't need to have this conversation weekly.

#41 | Posted by snoofy at 2019-07-20 07:47 PM | Reply

"I expect better from you, Danforth."

So are you telling me Doctors don't currently practice "evidence-based medicine"?!? Because that's the "change" Pinch is claiming M4A is going to bring.

#42 | Posted by Danforth at 2019-07-20 07:50 PM | Reply

I would not consider the ADA an advocate for health, but rather for dentists making money.
Regardless, even they are onborad the evidence based train.
ebd.ada.org

#43 | Posted by snoofy at 2019-07-20 07:50 PM | Reply

You guys don't need to have this conversation weekly.

#41 | POSTED BY SNOOFY

Actually, it's been awhile, but I heed your point.

#44 | Posted by PinchALoaf at 2019-07-20 07:51 PM | Reply

"Again, too many MRIs is just one example, doofus."

WTF are you talking about?!? M4A doesn't change the medical structure, just the payment mechanisms. You don't suddenly stop overprescribing MRIs the day M4A takes effect.

I can't believe I have to explain this BASIC ----.

#45 | Posted by Danforth at 2019-07-20 07:53 PM | Reply

#40 | POSTED BY PINCHALOAF

Lets not forget the Dentists ...

It's much less scientific -- and more prone to gratuitous procedures -- than you may think.
www.theatlantic.com

#46 | Posted by AndreaMackris at 2019-07-20 07:53 PM | Reply

So are you telling me Doctors don't currently practice "evidence-based medicine"?!?

#42 | POSTED BY DANFORTH

The link in post # 40 cites the 2003 RAND Study that healthcare quality and safety experts like Dr. Eddy still cite today ...

that doctors get their clinical decisions right only half the time (55% of the time).

So the answer to your question is, no ... not as nearly as often as they should.

Sorry, Snoofster, I just had to say this one last thing.

#47 | Posted by PinchALoaf at 2019-07-20 07:58 PM | Reply

"Danforth's aggressive defense of the status quo "

I'm not defending a damn thing, except common sense.

"You guys don't need to have this conversation weekly."

I'm hoping the answer to "What will you tell the biggest losers, who are coincidentally the highest earners?"...will become something other than "Tough schitt."

#48 | Posted by Danforth at 2019-07-20 08:02 PM | Reply

WTF are you talking about?!? M4A doesn't change the medical structure, just the payment mechanisms. You don't suddenly stop overprescribing MRIs the day M4A takes effect.

I can't believe I have to explain this BASIC ----.

#45 | POSTED BY DANFORTH

Doctors will change in how they practice medicine if you incentivize them by paying them to practice evidence-based medicine.

Same with hospitals when it comes to infection-control and enforcing general safety and quality measures.

#49 | Posted by PinchALoaf at 2019-07-20 08:02 PM | Reply

"Tough schitt."

#48 | POSTED BY DANFORTH

That's my pitchfork talking ... wealth inequality, remember?

#50 | Posted by PinchALoaf at 2019-07-20 08:04 PM | Reply

"...the 2003 RAND Study"

A lifetime ago in the medical field. My SIL runs a medical department, and 15 years ago came around to knowing Google can keep up with more than any medical school or any medical student.

"the answer to your question is, no ... not as nearly as often as they should."

Why would changing the payment system ALONE alter the medical structure?

#51 | Posted by Danforth at 2019-07-20 08:06 PM | Reply

"...evidence-based medicine."

Is this the same "evidence" that brought us the food pyramid with emphasis on carbs? Or the one that decided eggs were good for you, then bad for you, then good for you?

#52 | Posted by Danforth at 2019-07-20 08:13 PM | Reply

"...the 2003 RAND Study"

A lifetime ago in the medical field.

Why would changing the payment system ALONE alter the medical structure?

#51 | POSTED BY DANFORTH

2003 RAND Study is still being cited today.

In fact, it's the 1999 Institute of Medicine's 'To Err is Human' report that launched the modern healthcare quality and safety movement ... and it's also still being cited today because the problem of medical error and poor quality is getting worse, not better.

IOM To Err is Human reference here ... youtu.be

Another here ... youtu.be

As for payment models, I've repeatedly explained that paying doctors and hospitals to practice evidence-based medicine will produce better patient outcomes and cost less ...

With the clinical outcome itself also factoring in payment.

Incentivizing the whole system to stop over-treating the expensive aggressive healthcare and instead prescribing cheaper more conservative care that'll produce better outcomes -- and getting paid MORE to do it.

#53 | Posted by PinchALoaf at 2019-07-20 08:35 PM | Reply

"WTF are you talking about?!? M4A doesn't change the medical structure, just the payment mechanisms. You don't suddenly stop overprescribing MRIs the day M4A takes effect."

Evidence suggests otherwise.

Physicians with an ownership stake in an imaging practice are 2-3x more likely to order imaging studies, compared to their peers that don't have an ownership stake.

#54 | Posted by snoofy at 2019-07-20 08:36 PM | Reply | Newsworthy 1

I'm hoping the answer to "What will you tell the biggest losers, who are coincidentally the highest earners?"...will become something other than "Tough schitt."

Well, our system tells the current biggest losers, who are arguably the working poor in non-Medicaid expansion states, the same thing, so the problem isn't the answer, per se.

#55 | Posted by snoofy at 2019-07-20 08:37 PM | Reply | Newsworthy 1

"My precondition is that we fully fund all of our other obligations first."
----
While you vote against fulfilling that precondition at every turn.

Now pull the other leg.

#21 | POSTED BY DNC DAN

OK. Please point out to me which Democrat is even acknowledging the problem, much less making a serious proposal to address it. I'll wait.

#56 | Posted by JeffJ at 2019-07-20 09:01 PM | Reply

Like I said, Loaf. You are preaching single-payer as Utopia. Do you seriously not understand that Danforth actually favors single payer over what we have now? He's actually in your camp as it pertains to the end-goal.

#57 | Posted by JeffJ at 2019-07-20 09:07 PM | Reply

"Please point out to me which Democrat is even acknowledging the problem"

The ones who voted against the tax cut you supported, Jizz-Swallowing Jeff.

" much less making a serious proposal to address it."

STFU. You voted for the folks promising to EXACERBATE the problem, and now you're clutching your pearls about "our obligations".

#58 | Posted by Danforth at 2019-07-20 09:20 PM | Reply | Newsworthy 1

Like I said, Loaf. You are preaching single-payer as Utopia. Do you seriously not understand that Danforth actually favors single payer over what we have now? He's actually in your camp as it pertains to the end-goal.

#57 | POSTED BY JEFFJ

I really don't care what it's called, so long as all Americans have access to high quality healthcare.

The problem is people, even people who work in healthcare, vastly underestimate the sheer amount of poor quality rampaging thru out the entire healthcare system.

Single-payer, Medicare-for-all, Universal health-care, Obamacare ... what matters is evidence-based-medicine while reducing both patient harm and tamping down costs -- and Congress could legislate these fixes if there was the political will to do the right thing.

#59 | Posted by PinchALoaf at 2019-07-20 09:25 PM | Reply

"Well, our system tells the current biggest losers, who are arguably the working poor in non-Medicaid expansion states, the same thing, so the problem isn't the answer, per se."

Our system has told them that since time immemorial. But it's like you have NO IDEA what will happen when you try the same thing on the wealthiest earners.

Tell me:
1) Will folks who currently have coverage above the 70th percentile get better coverage, worse coverage, or the same coverage?
2) Since Medicare covers about 80%, will M4A cover 80%?
3) If M4A covers 80%, what do you tell the folks whose current coverage is closer to, say, 95%?

#60 | Posted by Danforth at 2019-07-20 09:29 PM | Reply

Jizz-Swallowing Jeff.
STFU.

#58 | POSTED BY DANFORTH

Entering Reinstag and Abortion_Munster territory.

That means Jeff has you cornered.

#61 | Posted by SheepleSchism at 2019-07-20 09:31 PM | Reply

#60 | POSTED BY DANFORTH

Just because insurance covers a test, procedure, or treatment doesn't mean that it's clinically needed ...

That's why there's so much overtreatment and wasted costs.

Medical decisions are supposed to be evidence-based, backed up by science.

#62 | Posted by PinchALoaf at 2019-07-20 09:35 PM | Reply

"I really don't care what it's called, so long as all Americans have access to high quality healthcare."

I really don't care what it's called, so long as roughly 40 million Americans lose their super high-quality healthcare.

"even people who work in healthcare, vastly underestimate the sheer amount of poor quality rampaging thru out the entire healthcare system."

Altering the system, and altering the payment system, are two different things.

"Congress could legislate these fixes"

By what...the "No Useless MRIs Act"?!? How does one legislate away human error, or overcautiousness? Realistically: what % of that trillion bucks are you planning to save, by changing the payment system?

#63 | Posted by Danforth at 2019-07-20 09:38 PM | Reply

"Just because insurance covers a test, procedure, or treatment doesn't mean that it's clinically needed ... "

How does the payment system change the doctor's decision-making, unless you're also proposing a new system which usurps the doctors' calls?

"That's why there's so much overtreatment and wasted costs."

No it's not; it's repetition and duplication due to overcautiousness, for fear of lawsuits. They'd always rather be safe than sorry.

#64 | Posted by Danforth at 2019-07-20 09:49 PM | Reply

Realistically: what % of that trillion bucks are you planning to save, by changing the payment system?

#63 | POSTED BY DANFORTH

There are bundled payment models that forces specialties to coordinate care, tying payment to patient outcome.

That said, the future is integrated healthcare ... vimeo.com

#65 | Posted by PinchALoaf at 2019-07-20 09:52 PM | Reply

"tying payment to patient outcome."

Great. Your plan is to incentivize false reports.

And exactly which doctors' choices are you planning on vetoing...my doctor, the next time I blow out my knee?!?

#66 | Posted by Danforth at 2019-07-20 10:01 PM | Reply

"Great. Your plan is to incentivize false reports."

But the reports aren't being written by the doctors.

#67 | Posted by snoofy at 2019-07-20 10:02 PM | Reply

"And exactly which doctors' choices are you planning on vetoing...my doctor, the next time I blow out my knee?!?"

The surgery on your knee.
Is it medically indicated?
If so, then it should be covered.
If not, then there should be some hurdles to jump, and it's likely that some won't make it.

#68 | Posted by snoofy at 2019-07-20 10:08 PM | Reply | Newsworthy 1

"Do you seriously not understand that Danforth actually favors single payer over what we have now?"

He has a strange way of showing it.

#69 | Posted by snoofy at 2019-07-20 10:10 PM | Reply

"Why would changing the payment system ALONE alter the medical structure?"

Is the medical structure of a HMO any different from a PPO?

Because the only difference between them is the payment system.

#70 | Posted by snoofy at 2019-07-20 10:13 PM | Reply

"the reports aren't being written by the doctors."

Is it written by ANYONE in the payment chain? Same diff.

"Is it medically indicated?"

Depends. Do I have to walk with a cane and a limp otherwise?

"If so, then it should be covered."

But it's not my doctor's' decision any more; or my decision to choose insurance that covers my knee...is that what you're telling me?

#71 | Posted by Danforth at 2019-07-20 10:14 PM | Reply

"Is the medical structure of a HMO any different from a PPO?"

Would either structure change for the sole reason the payment system changed?

#72 | Posted by Danforth at 2019-07-20 10:15 PM | Reply

"He has a strange way of showing it."

Some idiots still pretend M4A will still have a 70% approval rating when all the details come out.

#73 | Posted by Danforth at 2019-07-20 10:16 PM | Reply

"But it's not my doctor's' decision any more; or my decision to choose insurance that covers my knee...is that what you're telling me?"

Is that what they tell people in other modern countries?

I'll steer you towards their answers, with a side of "tough schitt."

Do we still have a problem?

#74 | Posted by snoofy at 2019-07-20 10:17 PM | Reply | Newsworthy 1

"I'll steer you towards their answers, with a side of "tough schitt." Do we still have a problem?"

Only if you plan to pass M4A.

Let's cut to the chase: why do you keep pretending folks with the deepest pockets in America, who will be told to pay a lot more to get a lot less, will take these massive, expensive changes with open arms?

#75 | Posted by Danforth at 2019-07-20 10:22 PM | Reply

I'll steer you towards their answers, with a side of "tough schitt."

Is this how "people in other modern countries" are treated?

If so ... I kinda wanna keep my coverage, and we kinda have a problem ...

#76 | Posted by AndreaMackris at 2019-07-20 10:23 PM | Reply

"Is it medically indicated?

Depends. Do I have to walk with a cane and a limp otherwise?"

That should be covered, unless you present some other medical reason to think surgery is not advisable.

#77 | Posted by snoofy at 2019-07-20 10:24 PM | Reply | Newsworthy 1

"who will be told to pay a lot more to get a lot less"

I still haven't seen that math.

#78 | Posted by snoofy at 2019-07-20 10:25 PM | Reply

"My precondition is that we fully fund all of our other obligations first." - Jeff
----
While you vote against fulfilling that precondition at every turn.

Now pull the other leg.

#21 | POSTED BY DNC DAN

You are so transparently partisan.

On the revenue side, where are your beloved Democrats really at?

Hmmmm....well...no specifics that I have seen regarding increasing taxes but, God Damn, are they up in arms about the SALT cap so that rich people in high-tax states can get a tax-cut...

What about spending? Any cuts? Military - maybe a bit. What about unfunded liabilities? Nothing . Zero. Zilch. Nada.

So, on top of doing almost nothing to address our fiscal trajectory, your beloved Democrats want to add: Reparations, Medicare for all, "free college", Student loan forgiveness, Oh, and the creation of a brand new energy industry that can't work in the near-term even with unicorns running it.

THAT

#79 | Posted by JeffJ at 2019-07-20 10:34 PM | Reply

"I still haven't seen that math."

Try addressing the questions I brought up the last time you said as much.
1) M4A would be at (roughly) the 70th percentile of coverage....agree or disagree?
2) Medicare covers 80%, so it follows M4A covers 80%...agree or disagree?
3) Higher-end W-2 earners generally have plans with better coverage and lower (less-than-20%) out-of-pocket costs...agree or disagree?

Therefore, according to "the math"...

Folks currently above the 70th percentile (roughly 40 million workers) will be getting worse coverage, and paying a lot more out of pocket.

See it yet?

#80 | Posted by Danforth at 2019-07-20 10:34 PM | Reply

"who will be told to pay a lot more to get a lot less"

I still haven't seen that math.

#78 | POSTED BY SNOOFY

Take a look at a UAW plan. Look at how much the union worker contributes. Look at what is covered and what isn't. Look at co-pays, deductibles, etc.

Then, compare that with what a UAW worker would lose if they lost their coverage and were forced onto a government plan

Then, tack on the tax burden that would necessarily follow such a massive government spending program and compare it with what said union worker takes home under current tax rates.

#81 | Posted by JeffJ at 2019-07-20 10:38 PM | Reply

"You are so transparently partisan. "

You don't seem to know what that word means. Voting for folks who do what you want isn't partisan. Voting for folks who DON'T do what you want, because they're your tribe, is partisan. That "transparency" you see is actually a mirror. You're like the unfaithful husband who has to believe all are unfaithful, to salve his conscience.

"On the revenue side, where are your beloved Democrats really at?"

They want to repeal the Trump code, and increase taxes on the rich. Meanwhile, you keep voting for the agenda that exacerbates the problems you clutch your pearls over.

"are they up in arms about the SALT cap so that rich people in high-tax states can get a tax-cut..."

Four blue states are paying for the SALT cap...because the authors wanted to specifically hurt blue states. Don't believe me? Ask the authors: www.bloomberg.com

#82 | Posted by Danforth at 2019-07-20 10:44 PM | Reply

"Take a look at a UAW plan. Look at how much the union worker contributes."

You mean, how much a current union worker contributes to a retiree's UAW health insurance?

Because non-retired UAW just get to choose a BCBS PPO/HMO. www.bcbsm.com

#83 | Posted by snoofy at 2019-07-20 10:45 PM | Reply

Try addressing the questions I brought up the last time you said as much.
1) M4A would be at (roughly) the 70th percentile of coverage....agree or disagree?
2) Medicare covers 80%, so it follows M4A covers 80%...agree or disagree?
3) Higher-end W-2 earners generally have plans with better coverage and lower (less-than-20%) out-of-pocket costs...agree or disagree?

These are reimbursement rates, right?
70% of what commercial insurance pays, is what you're saying.
Reimbursement rates will probably have to come up; but not losing the statutorily permitted 15% to commercial plan overhead would be pretty close to meeting in the middle, which is what we pay the bean counters to do now anyway.

#84 | Posted by snoofy at 2019-07-20 10:49 PM | Reply

You guys keep talking about insurance are missing the whole point of why healthcare costs continue to rise.

It's about the medicine and whether the clinical decision is appropriate ... not because you want a procedure done and if your insurance covers it.

#85 | Posted by PinchALoaf at 2019-07-20 10:53 PM | Reply

#82 | POSTED BY DNC DAN

You didn't refute a single thing I said.

So, I guess that you favor:

Medicare for All
Reparations
Free college
Student debt forgiveness
Massive spending for Solyndra 2.0 whilst pushing clean, abundant natural gas out of existence.

And this will be funded by raising the tax burden on rich people in low tax states but then offset that by giving refunds back to rich people in high tax states.

That is what you gleefully and reflexively vote for. That is what you are trying to shame me into voting for. How is that working out so far, by the way? The vote shaming?

#86 | Posted by JeffJ at 2019-07-20 10:57 PM | Reply

EVERY patient will save money. For doctors it should a wash, though some of their scams will be restricted. Why you ask? Because many health insurers rake in 30% profits after burning 10-15% on administrative costs. Medicare and Social Security burn 3% on administrative costs.

But there are even more savings because of all the time and staff US doctors burn getting insurance companies to pay. It consumes an unreasonable amount of their time. Nobody anywhere else in the world hasto put up with the -------- requirements of insurance companies. Without the help from doctors and nurses most patients wouldn't jump through the right hoops to get covered and paid. Welcome to our insane society.

#87 | Posted by bayviking at 2019-07-20 10:59 PM | Reply | Newsworthy 2

You guys keep talking about insurance are missing the whole point of why healthcare costs continue to rise.

It's about the medicine and whether the clinical decision is appropriate ... not because you want a procedure done and if your insurance covers it.

#85 | POSTED BY PINCHALOAF

3rd person payments bring a whole slew of problems that a single payer system simply doesn't fix, and in some ways makes worse.

An HSA-based system with catastrophic coverage coupled with no-charge well-care visits makes more fiscal and market-based sense than single payer.

#88 | Posted by JeffJ at 2019-07-20 11:00 PM | Reply

You guys keep talking about insurance are missing the whole point of why healthcare costs continue to rise. ~ Pinch

I agree, but you dance around the issue, its not about over prescription of treatments ...

Its about over paying .... and until you say, Doctors and Hospitals you aren't going to make as much ... I don't think you are serious.

#89 | Posted by AndreaMackris at 2019-07-20 11:06 PM | Reply

#88 | POSTED BY JEFFJ

High deductibles isn't bad, but Healthcare is just costly.

#90 | Posted by AndreaMackris at 2019-07-20 11:07 PM | Reply

3rd person payments bring a whole slew of problems that a single payer system simply doesn't fix, and in some ways makes worse.

An HSA-based system with catastrophic coverage coupled with no-charge well-care visits makes more fiscal and market-based sense than single payer.

#88 | POSTED BY JEFFJ

You're chasing your tail.

Doctors, patients, medicine, the right clinical decisions -- simple.

How it's delivered matters, but not as much as just getting the clinical right.

And if it means that private insurance goes away in making the delivery of healthcare easier, then so be it and all the better.

#91 | Posted by PinchALoaf at 2019-07-20 11:13 PM | Reply

Its about over paying .... and until you say, Doctors and Hospitals you aren't going to make as much ... I don't think you are serious.

#89 | POSTED BY ANDREAMACKRIS

What can be more serious than getting medical decisions right?

Medical error is the 3rd leading cause of death in America.

I don't think you're serious.

#92 | Posted by PinchALoaf at 2019-07-20 11:16 PM | Reply

"You didn't refute a single thing I said. "

I don't mind heading in a better direction, knowing many idiotic ideas won't come to fruition.

"How is that working out so far, by the way? The vote shaming?"

You keep voting for folks who enable the behavior you pretend to hate. I don't expect you to change; you're a partisan.

"So, I guess that you favor..."

Riiiiight...the same way you favor white nationalists.

"Medicare for All"

It's eventually going to be our only choice. Math, you know....

"Reparations"

No, against.

"Free college".

It's certainly an investment in the long equation.

"Student debt forgiveness"

I'm for ameliorating some of the damage we've done to a generation of college kids. My generation's debt didn't come close.

"Massive spending for Solyndra 2.0 whilst pushing clean, abundant natural gas out of existence."

No, and no.

So you were wrong more than you were right.

#93 | Posted by Danforth at 2019-07-20 11:27 PM | Reply

"3rd person payments bring a whole slew of problems that a single payer system simply doesn't fix, and in some ways makes worse."

^
Can't make heads or tails of that word salad.

#94 | Posted by snoofy at 2019-07-20 11:39 PM | Reply | Newsworthy 2

"And if it means that private insurance goes away in making the delivery of healthcare easier, then so be it "

You can't actually believe private insurance is ever going away.

For example, do you actually believe there won't be Supplemental Insurance with M4A, like there is currently with Medicare? In what bizarro world?!?

In reality, M4A will give birth to an entirely new cottage industry of boutique health insurance.

#95 | Posted by Danforth at 2019-07-20 11:40 PM | Reply

#82 | POSTED BY DNC DAN
You didn't refute a single thing I said.
So, I guess that you favor:
Medicare for All
Reparations
Free college
Student debt forgiveness
Massive spending for Solyndra 2.0 whilst pushing clean, abundant natural gas out of existence.
And this will be funded by raising the tax burden on rich people in low tax states but then offset that by giving refunds back to rich people in high tax states.
That is what you gleefully and reflexively vote for. That is what you are trying to shame me into voting for. How is that working out so far, by the way? The vote shaming?
#86 | POSTED BY JEFFJ AT 2019-07-20 10:57 PM

Can't.. resist.. the fat.. juicy.. low-hanging...

SCREW THE RICH. IN THE EAR. IN THE REAR. ON A GOAT. IN A MOAT MINUS FLOTATION DEVICE. OUT THE FRIGGIN' AIRLOCK.

[whew] that feels a little better. Now..

"tax burden on rich people", meaning what - you oppose a 90% marginal tax rate? I don't.

Not just "people" but "corporations who are legally people" too.

Greed needs to be curb-stomped, bro.

"You get Fluevogs and YOU get Fluevogs - EVERYONE GETS FLUEVOGS!"

#96 | Posted by redlightrobot at 2019-07-20 11:40 PM | Reply

For example, do you actually believe there won't be Supplemental Insurance with M4A, like there is currently with Medicare? In what bizarro world?!?
In reality, M4A will give birth to an entirely new cottage industry of boutique health insurance.

#95 | POSTED BY DANFORTH AT 2019-07-20 11:40 PM

I am fine with the rich buying extras like concierge doctors and whatever extras they can afford. M4A will ensure that Joe Average still gets the basics like regular checkups and meds. Nobody should be dying from things like not being able to afford insulin or chemo.

#97 | Posted by byrdman at 2019-07-21 12:01 AM | Reply | Newsworthy 1

"EVERY patient will save money. "

Not true at all. Take the high-powered salesman with a current plan in the 95th percentile of plans. He'll have to pay more (20% copay) to get 70th percentile coverage.

How does he save money? Please show the math.

#98 | Posted by Danforth at 2019-07-21 12:07 AM | Reply

An HSA-based system with catastrophic coverage coupled with no-charge well-care visits makes more fiscal and market-based sense than single payer.

Posted by JeffJ

Jeff, HSAs are fine for people who can afford them.

That's the problem with goldbrickiing sites like this. Most work white collar jobs and don't have the foggiest idea what people who don't go through to make ends meet. Since Reagan began the destruction of unions, wages haven't kept up. Used to be one man could earn enough for a family of 4 or 5 and even take a vacation. That simply isn't the case for most blue collar workers anymore.

So, forget about HSAs. Millions of Americans live paycheck to paycheck and couldn't come up with $1000 for an emergency let alone fund an HSA.

#99 | Posted by AMERICANUNITY at 2019-07-21 12:07 AM | Reply | Newsworthy 3

HSA is Latin for Prepay your Medical Expenses to get an upfront Tax Deduction.

#100 | Posted by Danforth at 2019-07-21 12:20 AM | Reply

"He'll have to pay more (20% copay) to get 70th percentile coverage."

Oh, and in that equation that (purportedly) "pays" for it? That guy's boss is expected to keep paying the same premium to get the lesser coverage.

#101 | Posted by Danforth at 2019-07-21 12:22 AM | Reply

#80 | Posted by Danforth

I'm curious as to what's behind your opposition to M4A.

Is it because you're getting yours through your union?

Thanks to the PPACA ('Obamacare'), my wife and I buy ours through Healthcare.gov, a program Republicans are hell bent on destroying. Why TF are they so eager to kill it? We pay premiums. It isn't 'government run healthcare' or anything close to it. It's private insurance finally available to individuals like us who are self employed. WTF is their problem?

#102 | Posted by AMERICANUNITY at 2019-07-21 12:23 AM | Reply

But But what about the privileged upper class with great insurance, We must not switch to medicare for all and help the majority of the people to stay healthy and alive we must think about privileged upper class and the corporate insurance companies first
posted by Danforth

#103 | Posted by PunchyPossum at 2019-07-21 12:28 AM | Reply

"I'm curious as to what's behind your opposition to M4A."

I'm not opposed to it at all. I'm opposed to some of its woefully uninformed proponents, who seem hell-bent to ignore all the hurdles ahead.

"Is it because you're getting yours through your union?"

I haven't had Union coverage in years; my tax biz has taken over my life. I get coverage on the Marketplace, even though I shouldn't, since we don't qualify for any subsidy. But I do it more as a catastrophic insurance policy, in case I have another heart attack and can't work, or my wife's charity goes belly up.

"Why TF are they so eager to kill it?"

They aren't eager to kill the Affordable Care Act...but they'll do ANYTHING to kill Obamacare. One guess.

#104 | Posted by Danforth at 2019-07-21 12:29 AM | Reply

"Is the medical structure of a HMO any different from a PPO?"

Would either structure change for the sole reason the payment system changed?

#72 | Posted by Danforth

It certainly would change. Folks on traditional Medicare have NO 'networks' they have to adhere to. You get sick in another state, no problem, you're covered. Walk into any hospital and get treatment? No problem, you're covered.

HMOs and PPOs limit patients to doctors and hospitals to their own 'network' or you have to foot the bill. If you like a doctor who isn't in your 'network' or get treatment in a hospital that isn't in your 'network,' tough ----, you're out of luck ... and out of pocket.

#105 | Posted by AMERICANUNITY at 2019-07-21 12:33 AM | Reply

#101 There is no need for copays for preventative or necessary care.
The overhead of administering private insurance is about 25% compared to the 3% of other single payer systems.

Lots of insurance paper shufflers will lose their jobs, so they will resist vigorously. They can be retrained like the coal miners.

#106 | Posted by bored at 2019-07-21 12:34 AM | Reply

"But But what about the privileged upper class with great insurance..."

Good question. They'll be lining up foursquare against you. You'd better be ready for that, or you'll be blindsided when it happens.

"We must not switch to medicare for all and help the majority of the people to stay healthy and alive we must think about privileged upper class and the corporate insurance companies first
posted by Danforth"

What kind of shameless -------- are you? How awful is your stance, that you're reduced to complexly lying about my positions? I'm not saying "we must not switch", I'm saying YOU DON'T BELONG AT THE ADULTS' TABLE if you're not even going to address the central problems you'll face.

Of course, why am I arguing with someone who thinks changing the payment system will suddenly end all needless medical procedures? That should have been my first hint.

#107 | Posted by Danforth at 2019-07-21 12:35 AM | Reply

"There is no need for copays for preventative or necessary care."

There isn't now for preventive. And "necessary" is defined....exactly how, and by exactly whom?

"The overhead of administering private insurance is about 25% compared to the 3% of other single payer systems."

That's not enough money to provide coverage to all the uncovered.

#108 | Posted by Danforth at 2019-07-21 12:39 AM | Reply

They aren't eager to kill the Affordable Care Act...but they'll do ANYTHING to kill Obamacare. One guess.

#104 | Posted by Danforth

No need to guess ... we both know the answer to that. And they always leave on the "Patient Protection" part of the PPACA. Which benefits each and every one of them, especially if a serious illness affects them or their family.

Tonight my wife said "if they called universal health coverage 'Trumpcare' it'd be law by next week." Quite insightful of her :)

#109 | Posted by AMERICANUNITY at 2019-07-21 12:42 AM | Reply

And they always leave out the "Patient Protection" part of the PPACA.

#110 | Posted by AMERICANUNITY at 2019-07-21 12:43 AM | Reply

" "if they called universal health coverage 'Trumpcare' it'd be law by next week.""

Oh, please. Mitch wouldn't even bring it for a vote.

#111 | Posted by Danforth at 2019-07-21 12:47 AM | Reply

107 | Posted by Danforth at 2019-07-21 12:35 AM | Reply | Flag

No Dan I am not lying about your position at every medicare for all post you scream it cant be done because of a very few privileged have great insurance.

yes you are saying we cant switch, though when challenged you will make a feeble statement saying it can be done BUT, then basically say once again it cant be done.

as for the adult table being a shill for the insurance companies makes you a sucker not a adult

#112 | Posted by PunchyPossum at 2019-07-21 12:49 AM | Reply

a new study from the Political Economy Research Institute (PERI) at the University of Massachusetts-Amherst finds that single-payer health care will save the US $5.1 trillion over a decade while drastically cutting working-class Americans' health spending. It's the most robust, comprehensive study yet produced on Medicare for All, which has long been in need of easily citable research.

The study analyzes Sen. Bernie Sanders's Medicare for All Act from top to bottom, elaborating on several key aspects of the bill, including what the transition to a fully public, comprehensive, free-at-the-point-of-use health care system might look like and what impact the program will have on US residents. Most significantly, it answers the most common question single-payer advocates face: "How will we pay for it?"

Economic Analysis of Medicare for All
www.peri.umass.edu

#113 | Posted by PunchyPossum at 2019-07-21 12:56 AM | Reply

"They'll be lining up foursquare against you. You'd better be ready for that, or you'll be blindsided when it happens."

BTW...have you done the math on that?

How many people are covered by workplace plans?
330 Mil ppl, 91% covered, 55% of covered by employers = 165 million

How many of those are currently covered by better plans? 30%, assuming Medicare is a 70th percentile plan

You're almost at 50 million people whose situation is going to get worse...and that 50 million is concentrated among the deepest pockets in America.

#114 | Posted by Danforth at 2019-07-21 12:59 AM | Reply

"Most significantly, it answers the most common question single-payer advocates face: "How will we pay for it?""

No it does not. It overstates possible savings, and it completely ignores the underlying assumption: employers currently paying top-dollar for 95th percentile Insurance will be more than happy to continue paying top dollar, while their workers get 70th percentile coverage.

Here are the "assumed" savings (and my reactions):

Administration 9%. (Understandable)

Pharmaceutical price reductions 5.9%. (Neither party did this when each had control)

Uniform Medicare rates for hospitals and physicians/clinics 2.8% (So LOWER rates than the current, unsustainable ones)

Improved service delivery/reduced waste and fraud 1.5%. (There's that GIANT savings on MRIs and other unneeded procedures)

#115 | Posted by Danforth at 2019-07-21 01:16 AM | Reply

"Pharmaceutical price reductions 5.9%."

This assumes a drop in pharmaceutical prices of 40%. Page 44 of the linked report. They even show their math.

Show of hands...who's banking on a 40% drop in prices from Big Pharma?

#116 | Posted by Danforth at 2019-07-21 01:29 AM | Reply

" "if they called universal health coverage 'Trumpcare' it'd be law by next week.""

Oh, please. Mitch wouldn't even bring it for a vote.

#111 | Posted by Danforth

If Dems told Trump they were going to legally name it "Trumpcare," he'd be out selling it to the country and Mitch, who's up for reelection next year, wouldn't have a choice. Trump is so in love with himself he couldn't resist. LOL

#117 | Posted by AMERICANUNITY at 2019-07-21 01:32 AM | Reply

"Uniform Medicare rates for hospitals and physicians/clinics 2.8% "

Based on the analysis of the Medicare Payment Advisory Commission in its 2017 report to Congress, Medicare rates for physician and other health services were, on average, 22 percent lower than commercial rates. A study by the Government Accountability Office (GAO) found that Medicaid fee-for-service (FFS) payments were 27 to 65 percent lower than private insurance and managed care payments ranged between 31 to 65 percent lower.
Page 53

So 22% lower than commercial rates.

#118 | Posted by Danforth at 2019-07-21 01:40 AM | Reply

#118 | Posted by Danforth

"Managed care" is exactly what HMOs and PPOs are. Most people with employer provided health insurance are very familiar with those terms because one or the other term is printed on their insurance cards.

Private insurance is entirely different.

BTW, my wife was joking about Trumpcare because of how much he loves himself.

#119 | Posted by AMERICANUNITY at 2019-07-21 01:49 AM | Reply

Problems with Value-Based Payment Programs
The difficulties that we have summarized specifically with respect to successfully implement- ing ACOs are part of a broader problem with the establishment of "value-based payment" programs that have been established under both the ACA as well as, more recently, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). As an important case in point, MACRA mandated a payment method through which Medicare would assess the quality, value and results of care physicians provided to their patients. Under this model, the physicians that were rated higher according to the MACRA quality standards were rewarded financially while those that were rated poorly were penalized.
The problem with this model is that it is difficult to obtain evidence through which the relative quality of care being provided by physicians is measured reliably. In particular, the measures currently being used fail to account adequately for differences in patients' socio- economic and health status. These differences, in turn, have the effect of skewing quality scores in favor of practices that care for higher-income, better-educated and less-complex patients.
Page 58

So much for compensation being tied to outcomes.

#120 | Posted by Danforth at 2019-07-21 01:49 AM | Reply

"No Dan I am not lying about your position at every medicare for all post you scream it cant be done because of a very few privileged have great insurance."

You're a ------- illiterate idiot. That's what I'm screaming. If you're hearing something else...

...it's because you're a ------- illiterate idiot. If you truly want M4A...do it a favor, and stay out of the discussion.

#121 | Posted by Danforth at 2019-07-21 02:09 AM | Reply

"Managed care" is exactly what HMOs and PPOs are

Not quite.
Managed Care = HMO
Fee For Service = PPO

States may offer Medicaid benefits on a fee-for-service (FFS) basis, through managed care plans, or both. Under the FFS model, the state pays providers directly for each covered service received by a Medicaid beneficiary. Under managed care, the state pays a fee to a managed care plan for each person enrolled in the plan. In turn, the plan pays providers for all of the Medicaid services a beneficiary may require that are included in the plan's contract with the state.
www.macpac.gov

#122 | Posted by snoofy at 2019-07-21 02:12 AM | Reply

"a very few privileged have great insurance."

50 million.

And they'll be told to pay more to get less.

When you call it "a very few", you're using Republican Math™. Don't use Republican Math™.

#123 | Posted by Danforth at 2019-07-21 02:14 AM | Reply

So much for compensation being tied to outcomes.
#120 | POSTED BY DANFORTH

^
You're making the good the enemy of the perfect again.

I'm sure you'll agree that so long as there's a profit motive, there's a system to be gamed.

So, saying the system can be gamed isn't saying anything new, or a step in the wrong direction, because it's already a feature of the system we have.

#124 | Posted by snoofy at 2019-07-21 02:15 AM | Reply | Newsworthy 1

#121 | Posted by Danforth at 2019-07-21 02:09 AM | Reply | Flag

Dan it seems your having a complete meltdown over my comments maybe your a little too childish to be at the big boy table on this discussion, everything I said about you is true your just a shill here.

there's plenty of studies saying how medicare for all will be cheaper and better than private insurance you just want to deny it

#125 | Posted by PunchyPossum at 2019-07-21 02:20 AM | Reply

Another reason Medicare for all will save enormous mountains of money is that the monopolistic drug industry can be brought into line with pricing consistent with what the rest of the world pays. Some of these legalized drug cartels are marking up their products 1000%. While they average 14% of US healthcare costs for some US patients requiring patented drugs they can run $20,000 a month or you die.

But adding the figures from #87, on average, the overall cost of eliminating privatized for profit health care should result in an immediate savings of 50% plus reduce much wasted health care time processing insurance company paperwork.

#126 | Posted by bayviking at 2019-07-21 02:23 AM | Reply | Newsworthy 2

"maybe your a little too childish"

You've got to love the self-retorting retort.

"everything I said about you is true"

Gee...I guess that makes us even.

#127 | Posted by Danforth at 2019-07-21 02:32 AM | Reply

"there's plenty of studies saying how medicare for all will be cheaper and better than private insurance you just want to deny it"

I don't deny it at all. I've never denied it, because I know the large equation works that way. So you're lying about me AGAIN.

What YOU won't admit is there are going to be HUGE losers. Your one and only answer is "tough schitt". If you actually want M4A, that's your express lane to losing.

#128 | Posted by Danforth at 2019-07-21 02:35 AM | Reply

if M4A was a thing I think you would see better compensation packages from businesses. I recently went on some interviews and health insurance was half the conversation. Maybe we could see the return of better retirement packages. The people against it need to look at big picture. It means freedom for the employee and employer.

#129 | Posted by byrdman at 2019-07-21 02:36 AM | Reply | Newsworthy 1

"and better than private insurance"

Not for those currently with 70th percentile or higher coverage.

Stop with the Republican Math.

#130 | Posted by Danforth at 2019-07-21 02:38 AM | Reply

"It means freedom for the employee and employer."

Not for the employer expected to pay 95th percentile rates for 70th percentile coverage.

#131 | Posted by Danforth at 2019-07-21 02:39 AM | Reply

"But adding the figures from #87, on average, the overall cost of eliminating privatized for profit health care should result in an immediate savings of 50%"

Your math does not add up.

#132 | Posted by Danforth at 2019-07-21 02:48 AM | Reply

128 | Posted by Danforth at 2019-07-21 02:35 AM | Reply |

No my real answer it in the end will be better for them, to have a healthy society with cheaper drug prices where they will not have to worry about there children's health care when they grow up and their neighbor's health care in the end will be better for them.

#133 | Posted by PunchyPossum at 2019-07-21 02:51 AM | Reply

Excuse me if I don't shed a tear if a 1% doesn't get their Cadillac plan if it means a construction worker or a bus driver doesn't have to die from a easily preventable illness. Not everyone is going to be happy but I will side with providing everyone with a slice of the pie.

#134 | Posted by byrdman at 2019-07-21 02:54 AM | Reply | Newsworthy 3

"No my real answer it in the end will be better for them, to have a healthy society with cheaper drug prices where they will not have to worry about there children's health care when they grow up and their neighbor's health care in the end will be better for them."

That's an upgrade from "Go eff yourself, and pay more while you're doing it".

Baby steps.

#135 | Posted by Danforth at 2019-07-21 02:55 AM | Reply

"Excuse me if I don't shed a tear if a 1% doesn't get their Cadillac plan if it means a construction worker or a bus driver doesn't have to die from a easily preventable illness."

Excuse me if you actually believe folks who pay for a 95th percentile plan are going to be happy with getting much worse coverage than they currently have, while being expected to pay the same.

And I've noticed NO ONE has addressed the 20% copay everyone with Medicare knows about.

#136 | Posted by Danforth at 2019-07-21 02:57 AM | Reply

"Not everyone is going to be happy"

And the least happy will be the best-paid 50 million workers in America.

#137 | Posted by Danforth at 2019-07-21 02:58 AM | Reply

"Pharmaceutical price reductions 5.9%."

This assumes a drop in pharmaceutical prices of 40%. Page 44 of the linked report. They even show their math.

Show of hands...who's banking on a 40% drop in prices from Big Pharma?

#116 | Posted by Danforth at 2019-07-21 01:29 AM

How the U.S. Pays 3 Times More for Drugs

In Britain the world's 20 top-selling medicines are three times cheaper than in the U.S.

LONDON (Reuters) - U.S. prices for the world's 20 top-selling medicines are, on average, three times higher than in Britain, according to an analysis carried out for Reuters.

The finding underscores a transatlantic gulf between the price of treatments for a range of diseases and follows demands for lower drug costs in America

#138 | Posted by PunchyPossum at 2019-07-21 03:01 AM | Reply

"How the U.S. Pays 3 Times More for Drugs"

Oh, I know this. That wasn't my point.

When Republicans had control, they voted to disallow volume price discounts. When Democrats had control, they voted to disallow volume price discounts.

THAT was my point.

"demands for lower drug costs in America"

Demands which have been going on since my first health committee meeting in the 1980s. How's that goin' for ya?

#139 | Posted by Danforth at 2019-07-21 03:05 AM | Reply

A study published in Health Affairs in December 2009 found that high-cost health plans do not provide unusually rich benefits to enrollees. The researchers found that 3.7% of the variation in the cost of family coverage in employer-sponsored health plans is attributable to differences in the actuarial value of benefits. 6.1% Of the variation is attributable to the combination of benefit design and plan type (e.g., PPO, HMO, etc.). The employer's industry and regional variations in health care costs explain part of the variation. The researchers conclude
en.wikipedia.org

#140 | Posted by PunchyPossum at 2019-07-21 03:10 AM | Reply

Demands which have been going on since my first health committee meeting in the 1980s. How's that goin' for ya?

#139 | Posted by Danforth at 2019-07-21 03:05 AM | Reply |

We haven't had major politician before actually pushing for Medicare for all plans until very recently
so right now it's going pretty well

#141 | Posted by PunchyPossum at 2019-07-21 03:13 AM | Reply

"We haven't had major politician before actually pushing for Medicare for all plans until very recently"

Harry Truman on line #1 for you.
www.pbs.org

Claims you pull out of your ass help no one.

#142 | Posted by Danforth at 2019-07-21 03:18 AM | Reply

Danforth one thing you aren't looking at is that once everyone gets on single payer adjustments could be made to make the coverage better. Maybe the 20% can be on a sliding scale based on income? You act like it is going to be bargain basement coverage which wouldn't be the case at all. I imagine it would be something similar to the silver plan offered which isn't that bad.

#143 | Posted by byrdman at 2019-07-21 03:26 AM | Reply

"...high-cost health plans do not provide unusually rich benefits to enrollees."

Sure, if you get to define "unusually rich".

When I ask clients how they like their coverage, the ones with the higher numbers on 12DD of their W-2 are happier, in general.

Also, 10 years ago was a different demographic than today, and there has been a lot of pressure in between to increase compensation via health insurance routes: for example, I'm seeing high end W-2 workers getting an HSA, as well as maximum HSA funding.

#144 | Posted by Danforth at 2019-07-21 03:31 AM | Reply

We haven't had major politician before actually pushing for Medicare for all plans until very recently"

Harry Truman on line #1 for you.
www.pbs.org

Claims you pull out of your ass help no one.

#142 | Posted by Danforth at 2019-07-21 03:18 AM

Yes Truman did indeed try to push for it, that was about 69 years ago how about the past 40 years how many have stood up for it? and right now the polls for medicare for all among the Dems and repubs and independents are favor for it

"Seventy percent said they supported providing "Medicare for all," also known as single-payer health care, for Americans, according to a new American Barometer survey.
thehill.com

Of course we can sit on our behind and say it can't be done like your past seem to suggest and we will make sure it will never happen

#145 | Posted by PunchyPossum at 2019-07-21 03:39 AM | Reply

like your past seem to suggest = like your POST seem to suggest

#146 | Posted by PunchyPossum at 2019-07-21 03:41 AM | Reply

And I've noticed NO ONE has addressed the 20% copay everyone with Medicare knows about.

#136 | Posted by Danforth

$70-290 a month for a Part G (same as F w/$183/yr deductible) plan that covers everything Medicare doesn't?

IMO, that's a good deal.

#147 | Posted by AMERICANUNITY at 2019-07-21 03:45 AM | Reply

"Seventy percent said they supported providing "Medicare for all," also known as single-payer health care, for Americans, according to a new American Barometer survey. "

You'd have to be an idiot to believe that's actually meaningful. The respondents just like the concept of M4A. When faced with reality, support will plummet.

#148 | Posted by Danforth at 2019-07-21 03:55 AM | Reply | Funny: 1

"Yes Truman did indeed try to push for it, that was about 69 years ago how about the past 40 years how many have stood up for it?"

IOW, when you said it hadn't been done before, you didn't know what you were talking about.

Just be sure to put those goalposts back where you found them when you're done.

#149 | Posted by Danforth at 2019-07-21 04:02 AM | Reply

#93. So you oppose all of those things yet that's how you fervently vote. And then you call me partisan for voting for a mixed bag when it comes to policies I favor.

Want to know the definition of irony?

Look in the mirror.

#150 | Posted by JeffJ at 2019-07-21 07:48 AM | Reply

I see some here want to see Medicare for all payments to be based on income [obviously in place of a payroll tax] so that would be a boon to employers.

#151 | Posted by MSgt at 2019-07-21 10:32 AM | Reply

Everything that reduces the cost of doing business is a boon for business, including schools, telephones, roads and even flush toilets... this most certainly also includes lowering health care costs while providing expanded coverage.

#152 | Posted by bayviking at 2019-07-21 10:47 AM | Reply

"Canada spends the equivalent of 10 per cent of its gross domestic product on health care in 2014 – the most recent year for which figures were available – more than higher-ranked health care systems in United Kingdom, New Zealand, Norway and Australia.

The United States, meantime, doled out the equivalent of 16.6 per cent of GDP for the shoddiest results among the 11 countries."

www.theglobeandmail.com

Canada GDP - 1.7 trillion x10% = 0.170 Trillion
USA GDP - 19.39 trillion x16.6% = 3.22 Trillion

The Canadian system is better and cheaper. UK, NZ, Nor, Aus systems are even better and cheaper.

#153 | Posted by BruceBanner at 2019-07-21 12:02 PM | Reply | Newsworthy 1

"So you oppose all of those things yet that's how you fervently vote."

No, I don't oppose all those things. Good God, man, you can't even read.

"Want to know the definition of irony? Look in the mirror"

Okay, so you don't understand the word "irony" either. Got it.

#154 | Posted by Danforth at 2019-07-21 01:29 PM | Reply

#148 | Posted by Danforth at 2019-07-21 03:55 AM |

You have to be a Godamm idiot not to believe it is meaningful you fhking fool

#155 | Posted by PunchyPossum at 2019-07-21 11:01 PM | Reply

"So you oppose all of those things yet that's how you fervently vote."

No, I don't oppose all those things. Good God, man, you can't even read.

"Want to know the definition of irony? Look in the mirror"

Okay, so you don't understand the word "irony" either. Got it.

#154 | POSTED BY DANFORTH

You just admitted that you oppose some key planks to an overwhelming majority of the 2020 Dem hopefulls.

Yet, you will vote for them anyway?

Why?

Well, from what I can gather you are weighing the positives and negatives of both parties and you conclude that, on the whole Democrats check more positive boxes than the GOP and fewer negative boxes than the GOP.

FINE

Switch the parties and that's where I am at.

Why you persist with this childish nonsense is beyond me.

I'm done with this crap.

Going forward, if you want to play this game I will either ignore your BS, or if I feel you really need to know I read your crap I'll respond with the Ashton Stamp.

To be clear - this only pertains to this stupid vote-shaming game you've been playing for the past few months.

#156 | Posted by JeffJ at 2019-07-21 11:49 PM | Reply

"You just admitted that you oppose some key planks to an overwhelming majority of the 2020 Dem hopefulls. "

Out of...what, 22? Of course I'll disagree. I have no belief private insurance will be going away, regardless what Bernie Sanders has to say about it.

"Yet, you will vote for them anyway? Why?"

Well, none of the Dems plan on borrowing $2.3 Trillion for tax giveaways, caging children for their parents' misdemeanors, or turning women into second-class citizens. Besides...at this point, I'm not voting FOR anyone; I'm voting AGAINST Trump. At this point, the Democrats could nominate a yellow dog.

"Why you persist with this childish nonsense is beyond me."

I'm just pointing out the chasm between what you post and how you vote.

"this stupid vote-shaming game "

I'm stating the truth about how you vote, and how it flies in the face of your pearl-clutching. The fact you believe it's "shaming" is your construct, not mine.

" I will either ignore your BS, or..."

Do whatever you want; I don't give a ----. And I'm sure I'll keep pointing out how you bitch about the same things you enable.

#157 | Posted by Danforth at 2019-07-22 12:36 AM | Reply

#157 | POSTED BY DANFORTH

[stamp]
Please explain. Your claim is ridiculous. Stop repeating what you hear and educate yourself. What exactly was that supposed to prove? When your point is based entirely on an assumption, you didn't have a point to begin with. In order to make your point, you had to make something up completely. See the problem? Anything else that you would like to make up? The rest of your post was just mindless. I think you have only shown that you assume too much.
Do you ever actually understand what you are commenting on or does stupidity just take hold? Does anyone really understand what this person is babbling about?
[/stamp]

#158 | Posted by JeffJ at 2019-07-22 09:20 AM | Reply | Newsworthy 2

#158

Wow. You look ridiculous.

Probably time to go vote for another Trump enabler.

#159 | Posted by Danforth at 2019-07-22 10:33 AM | Reply

When you say "enabler", what specifically are you talking about, and more importantly, why should I be opposed to this enabling?

I've asked you this before but you didn't answer.

#160 | Posted by JeffJ at 2019-07-22 02:20 PM | Reply

"When you say "enabler", what specifically are you talking about"

You didn't vote for Trump, but you did, and still do, vote for every Republican who enables him.

You know...the dictionary definition.

#161 | Posted by Danforth at 2019-07-22 02:26 PM | Reply

"Well, from what I can gather you are weighing the positives and negatives of both parties and you conclude that, on the whole Democrats check more positive boxes than the GOP and fewer negative boxes than the GOP.
FINE
Switch the parties and that's where I am at."

No, it's not where you're at.
You didn't do that.
You voted third party.

Plus, you didn't weigh the positives and negatives of both parties, you weighed the positives and negatives of your assessment of both candidates. It was Clinton and Trump that repulsed you, not a big list of policy checkboxes about the GOP and DNC.

To sum up: Everything you said you did... isn't what you did.

#162 | Posted by snoofy at 2019-07-22 02:26 PM | Reply

You didn't vote for Trump, but you did, and still do, vote for every Republican who enables him.

That doesn't answer my question.

What are Republicans 'enabling' that I should be opposed to?

Why should I vote for Democrats. You know my policy preferences well enough to make a case for me to vote for Democrats.

Make your case.

#163 | Posted by JeffJ at 2019-07-22 02:30 PM | Reply

"What are Republicans 'enabling' that I should be opposed to?"

Trump.

#164 | Posted by snoofy at 2019-07-22 02:31 PM | Reply

"Why should I vote for Democrats."

They're on the ballot against today's Republicans.

Those are the ones who want to cut taxes even more, use purposeful cruelty to address immigration, and turn back the clock on women's rights over their own body.

#165 | Posted by Danforth at 2019-07-22 02:41 PM | Reply

"What are Republicans 'enabling' that I should be opposed to?"

Every pearl-clutching post you've ever made in the last two and a half years.

#166 | Posted by Danforth at 2019-07-22 02:43 PM | Reply

I see that DNC Dan decided to put on the Donkey Suit today.

#167 | Posted by Rightocenter at 2019-07-22 02:45 PM | Reply

"I see that DNC Dan decided to put on the Donkey Suit today."

I see RetardOfCenter still can't tell the difference between bashing Republicans and supporting Democrats.

Feel free to find the posts where I praise Dems...as I've posted about a dozen times before.

#168 | Posted by Danforth at 2019-07-22 02:53 PM | Reply

Feel free to find the posts where I praise Dems...as I've posted about a dozen times before.

#168 | POSTED BY DANFORTH

Every time you respond to somebody bashing Dems it's with a deflection, whataboutism or the GOP is worse.

Every. Single. Time.

#169 | Posted by JeffJ at 2019-07-22 04:17 PM | Reply | Newsworthy 1

DNC DAN,

Your reflexive need to defend Dems under all circumstances would be far less of an issue if you didn't try to constantly - and oftentimes baselessly - accuse others who are less partisan than you of being hyper- partisans.

#170 | Posted by JeffJ at 2019-07-22 07:01 PM | Reply

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