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PostPosted: Tue Feb 12, 2019 7:39 pm 
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Man In Black wrote:
One problem the Democrats may have with their leftward shift is that it’s ultimately impossible to please the far left. There’ll always be a marginalised group or a new grievance that they need to iron out before they can archieve purity. Trying to pander to every grievance will fudge them. On the other hand, good centrist policies that put more money in your pocket and more food on the table is what should win. Fingers crossed.

You realize this is literally what happened the GOP in the mid terms even as the Dems were shifting left.


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PostPosted: Tue Feb 12, 2019 7:42 pm 
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Deadtigers wrote:
Bowens wrote:
If you had a medical emergency and needed money I would help you out. Universal healthcare is my #1 issue. The number of people who go bankrupt due to illness is shameful.


I just think it is ridiculous people have to decide between kemo and eating. The thing I don't get bro is why do people always think of the Canadian model when the German model which incorporates insurance companies wouldn't be a better fit for us.

Because it'd mean increasing lower and middle income taxes?


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PostPosted: Tue Feb 12, 2019 7:50 pm 
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goeagles wrote:
Bowens wrote:
They blame each other. What’s clear is costs are rising under the current system. And more to the point, it’s another unfulfilled Trump promise.

Quote:
The Hartford, Conn.-based insurer's announcement is intended to redirect blame for rising drug prices toward pharmaceutical companies. Meanwhile, Pharmaceutical Research and Manufacturers of America, a drug industry lobbying group, is fighting back with an ad campaign launched Thursday highlighting how insurance companies and pharmacy benefit managers block patients from applying cost-saving copay coupons to their deductibles.


https://www.modernhealthcare.com/articl ... /180329919


As someone who works with payers (not just insurance companies, most unions self insure on drug spend for their members as do many large companies) to lower their prescription drug costs, the drug manufacturers are absolutely to blame for rising drug costs. Pick any drug and I can tell you how much they've raised their prices on it over the last 10 years. Those coupons they're talking about were instituted by drug companies to milk payers for every last penny and to circumvent plan designs. Any attempt by payers to control costs or manage utilization and the drug companies go nuts. The PBMs (not all, just some) who do a poor job of utilization management are complicit in rising prices because they're basically doing the drug companies' bidding in doing nothing to combat rising prices so the idea that the drug companies are shifting the blame to PBMs is laughable. The drug companies really are reprehensible.


I have no love for drug companies at all. Appreciate the insights.


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PostPosted: Tue Feb 12, 2019 7:51 pm 
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saffer13 wrote:
Obamacare has don't it's fair share in the rising insurance cost department. Why not create a free market for insurance companies to comete, driving costs down.

Obamacare bit the bullet on pre-existing conditions which the US had been avoiding for years. In a pure market none of these things get covered. If the likelihood that you will require expensive medical treatment is 1, who is going to insure you at an affordable rate? The whole point of insurance is that risk is pooled.


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PostPosted: Tue Feb 12, 2019 8:00 pm 
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paddyor wrote:
saffer13 wrote:
Obamacare has don't it's fair share in the rising insurance cost department. Why not create a free market for insurance companies to comete, driving costs down.

Obamacare bit the bullet on pre-existing conditions which the US had been avoiding for years. In a pure market none of these things get covered. If the likelihood that you will require expensive medical treatment is 1, who is going to insure you at an affordable rate? The whole point of insurance is that risk is pooled.

Good thing the Donald was pre-existing conditions to be covered as well :thumbup:


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PostPosted: Tue Feb 12, 2019 8:04 pm 
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What he says and what he does are two different things. He ran as a populist (to the left on some issues) and governs as a typical American conservative. He was smart to tap into the political trends here and elsewhere but he has to run on his record now, not empty promises.

https://www.ama-assn.org/delivering-car ... -condition


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PostPosted: Tue Feb 12, 2019 8:05 pm 
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Bowens wrote:
goeagles wrote:
Bowens wrote:
They blame each other. What’s clear is costs are rising under the current system. And more to the point, it’s another unfulfilled Trump promise.

Quote:
The Hartford, Conn.-based insurer's announcement is intended to redirect blame for rising drug prices toward pharmaceutical companies. Meanwhile, Pharmaceutical Research and Manufacturers of America, a drug industry lobbying group, is fighting back with an ad campaign launched Thursday highlighting how insurance companies and pharmacy benefit managers block patients from applying cost-saving copay coupons to their deductibles.


https://www.modernhealthcare.com/articl ... /180329919


As someone who works with payers (not just insurance companies, most unions self insure on drug spend for their members as do many large companies) to lower their prescription drug costs, the drug manufacturers are absolutely to blame for rising drug costs. Pick any drug and I can tell you how much they've raised their prices on it over the last 10 years. Those coupons they're talking about were instituted by drug companies to milk payers for every last penny and to circumvent plan designs. Any attempt by payers to control costs or manage utilization and the drug companies go nuts. The PBMs (not all, just some) who do a poor job of utilization management are complicit in rising prices because they're basically doing the drug companies' bidding in doing nothing to combat rising prices so the idea that the drug companies are shifting the blame to PBMs is laughable. The drug companies really are reprehensible.


I have no love for drug companies at all. Appreciate the insights.


Cheers. I also don't have a lot of love for PBMs (part of my job is auditing contractual pricing performance and some of the ways they screw over payers are ridiculous) but the blame needs to go where it's due and in the case of rising drug costs, it's 95% due to the drug companies.


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PostPosted: Tue Feb 12, 2019 8:43 pm 
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saffer13 wrote:
paddyor wrote:
saffer13 wrote:
Obamacare has don't it's fair share in the rising insurance cost department. Why not create a free market for insurance companies to comete, driving costs down.

Obamacare bit the bullet on pre-existing conditions which the US had been avoiding for years. In a pure market none of these things get covered. If the likelihood that you will require expensive medical treatment is 1, who is going to insure you at an affordable rate? The whole point of insurance is that risk is pooled.

Good thing the Donald was pre-existing conditions to be covered as well :thumbup:

He plays that guy on TV alright. It's spreading the cost that's the nettle he won't grasp. How does he intend to pay for it?


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PostPosted: Tue Feb 12, 2019 9:02 pm 
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Bowens wrote:
Early poll shows Bernie, Tulsi running ahead of Trump:

https://ivn.us/2019/02/08/ivn-poll-inde ... -for-2020/

About IVN, a nonpartisan website:

https://mediabiasfactcheck.com/independ ... twork-ivn/


Makes sense. Tulsi really seems to be a likeable and 'on it' person.


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PostPosted: Tue Feb 12, 2019 9:42 pm 
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Bowens wrote:
Early poll shows Bernie, Tulsi running ahead of Trump:

https://ivn.us/2019/02/08/ivn-poll-inde ... -for-2020/

About IVN, a nonpartisan website:

https://mediabiasfactcheck.com/independ ... twork-ivn/

But Hillary...


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PostPosted: Tue Feb 12, 2019 10:08 pm 
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Bowens wrote:
Early poll shows Bernie, Tulsi running ahead of Trump:

https://ivn.us/2019/02/08/ivn-poll-inde ... -for-2020/

About IVN, a nonpartisan website:

https://mediabiasfactcheck.com/independ ... twork-ivn/


I saw some polling showing that virtually any Democrat in a 1:1 against Trump has an 8 point lead or greater. That will obviously narrow but does show the problem Trump has - he's pandered to his base so.much that he's alienated almost everyone else. It's going to be hard from here to recover that, unless the Democrats pick a candidate that he can really demonize

Cue the Democrat self destruct button in 5...4...3...2...


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PostPosted: Tue Feb 12, 2019 10:13 pm 
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paddyor wrote:
saffer13 wrote:
paddyor wrote:
saffer13 wrote:
Obamacare has don't it's fair share in the rising insurance cost department. Why not create a free market for insurance companies to comete, driving costs down.

Obamacare bit the bullet on pre-existing conditions which the US had been avoiding for years. In a pure market none of these things get covered. If the likelihood that you will require expensive medical treatment is 1, who is going to insure you at an affordable rate? The whole point of insurance is that risk is pooled.

Good thing the Donald was pre-existing conditions to be covered as well :thumbup:

He plays that guy on TV alright. It's spreading the cost that's the nettle he won't grasp. How does he intend to pay for it?


Donald Trump wrote:
Nobody knew healthcare could be so complicated


Yeah Donny, pretty much everyone knew


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PostPosted: Tue Feb 12, 2019 10:21 pm 
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Oh Kamala, trying to be hip and cool... :lol:

Quote:
Democratic California Sen. Kamala Harris praised marijuana Monday as something that “gives more people joy,” and admitted to smoking the drug while in college.

“I have and I inhaled, I did inhale,” Harris told The Breakfast Club on Monday. “It was a long time ago, but yes. I just broke news.”

Harris went on to discuss her pot-smoking habits, claiming that she enjoyed smoking a joint in college while listening to Tupac and Snoop Dogg. However, Harris’s story came under scrutiny after several social media users pointed out that Harris graduated college in 1986, years before either Tupac or Snoop Dogg released their respective first albums. (RELATED: Kamala Harris Claims There Is ‘Racial Bias’ In Healthcare Delivery System)

Kamala Harris said she smoked weed while listening to Snoop & Tupac.

Kamala graduated from college in the 80’s.

Snoop & Tupac didn’t release their first albums til the 90’s.

This is basic rap history.

https://dailycaller.com/2019/02/12/kama ... fast-club/


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PostPosted: Tue Feb 12, 2019 10:36 pm 
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She got so stoned she couldn’t tell the difference between Tupac and Run DMC.


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PostPosted: Tue Feb 12, 2019 10:42 pm 
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Sure Kamala. And when Bernie was in college he did ayahuasca with Diplo at Burning Man.


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PostPosted: Tue Feb 12, 2019 10:43 pm 
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Bowens wrote:
Sure Kamala. And when Bernie was in college he did ayahuasca with Diplo at Burning Man.


That mental image. :lol: :lol: :lol:


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PostPosted: Tue Feb 12, 2019 11:14 pm 
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Bowens wrote:
Sure Kamala. And when Bernie was in college he did ayahuasca with Diplo at Burning Man.


:lol: :lol: :lol:


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PostPosted: Tue Feb 12, 2019 11:18 pm 
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flaggETERNAL wrote:
Oh Kamala, trying to be hip and cool... :lol:

Quote:
Democratic California Sen. Kamala Harris praised marijuana Monday as something that “gives more people joy,” and admitted to smoking the drug while in college.

“I have and I inhaled, I did inhale,” Harris told The Breakfast Club on Monday. “It was a long time ago, but yes. I just broke news.”

Harris went on to discuss her pot-smoking habits, claiming that she enjoyed smoking a joint in college while listening to Tupac and Snoop Dogg. However, Harris’s story came under scrutiny after several social media users pointed out that Harris graduated college in 1986, years before either Tupac or Snoop Dogg released their respective first albums. (RELATED: Kamala Harris Claims There Is ‘Racial Bias’ In Healthcare Delivery System)

Kamala Harris said she smoked weed while listening to Snoop & Tupac.

Kamala graduated from college in the 80’s.

Snoop & Tupac didn’t release their first albums til the 90’s.

This is basic rap history.

https://dailycaller.com/2019/02/12/kama ... fast-club/



I want that shit that gets you so stoned you get to hear the f#cing future!


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PostPosted: Tue Feb 12, 2019 11:40 pm 
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Bowens wrote:
Sure Kamala. And when Bernie was in college he did ayahuasca with Diplo at Burning Man.


:lol:


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PostPosted: Wed Feb 13, 2019 12:06 am 
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goeagles wrote:
Bowens wrote:
Sure Kamala. And when Bernie was in college he did ayahuasca with Diplo at Burning Man.


:lol:

:lol:

This race will be some great entertainment.


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PostPosted: Wed Feb 13, 2019 12:25 am 
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I have no strong opinion of Kamala Harris but surely when the entire point of a story is about how a person wsa smoking pot at the time, they should probably get a bit of a pass on misremembering some of the details?


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PostPosted: Wed Feb 13, 2019 12:30 am 
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Jay Cee Gee wrote:
I have no strong opinion of Kamala Harris but surely when the entire point of a story is about how a person wsa smoking pot at the time, they should probably get a bit of a pass on misremembering some of the details?


Thing is, the whole smoking pot thing is kind of done and dusted by now. Harris strikes me as another neo-liberal trying to up her progressive credentials by doing things like this. It comes across fake.


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PostPosted: Wed Feb 13, 2019 12:37 am 
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flaggETERNAL wrote:
Jay Cee Gee wrote:
I have no strong opinion of Kamala Harris but surely when the entire point of a story is about how a person wsa smoking pot at the time, they should probably get a bit of a pass on misremembering some of the details?


Thing is, the whole smoking pot thing is kind of done and dusted by now. Harris strikes me as another neo-liberal trying to up her progressive credentials by doing things like this. It comes across fake.


If people keep asking the question, the answer is generally gonna be some variation of "Yes, and I inhaled" more and more. It's entirely acceptable to do so and more and more people will have actually done so in their past.

The Tupac/Snoop thing is why this comes across as out of touch "How do you do, fellow kids" not because she's admitting to smoking pot.


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PostPosted: Wed Feb 13, 2019 12:57 am 
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Jay Cee Gee wrote:
flaggETERNAL wrote:
Jay Cee Gee wrote:
I have no strong opinion of Kamala Harris but surely when the entire point of a story is about how a person wsa smoking pot at the time, they should probably get a bit of a pass on misremembering some of the details?


Thing is, the whole smoking pot thing is kind of done and dusted by now. Harris strikes me as another neo-liberal trying to up her progressive credentials by doing things like this. It comes across fake.


If people keep asking the question, the answer is generally gonna be some variation of "Yes, and I inhaled" more and more. It's entirely acceptable to do so and more and more people will have actually done so in their past.

The Tupac/Snoop thing is why this comes across as out of touch "How do you do, fellow kids" not because she's admitting to smoking pot.


Ah ok I think I misread your post for some reason.

*tokes on joint*


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PostPosted: Wed Feb 13, 2019 4:46 pm 
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flaggETERNAL wrote:
Jay Cee Gee wrote:
I have no strong opinion of Kamala Harris but surely when the entire point of a story is about how a person wsa smoking pot at the time, they should probably get a bit of a pass on misremembering some of the details?


Thing is, the whole smoking pot thing is kind of done and dusted by now. Harris strikes me as another neo-liberal trying to up her progressive credentials by doing things like this. It comes across fake.


She is getting a hell of a lot of flack for her record as a prosecutor of really going after drug users https://thinkprogress.org/harris-record-weed-history-ce37afd239ce/

Also her criminal justice record makes me shudder, especially the wrongful convictions https://www.nytimes.com/2019/01/17/opinion/kamala-harris-criminal-justice.html


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PostPosted: Wed Feb 13, 2019 5:06 pm 
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Last night on Finding Your Roots (like Who Do You Think You Are) Tulsi learned that she has Kiwi ancestry. Her great-great grandfather was born in Auckland, moved to Apia and married a Samoan lady. Graham Henry should check his family tree because there’s a resemblance.

https://www.youtube.com/watch?v=2f3VNRLub-s&t=22m50s


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PostPosted: Wed Feb 13, 2019 5:28 pm 
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Bowens wrote:
Last night on Finding Your Roots (like Who Do You Think You Are) Tulsi learned that she has Kiwi ancestry. Her great-great grandfather was born in Auckland, moved to Apia and married a Samoan lady. Graham Henry should check his family tree because there’s a resemblance.

https://www.youtube.com/watch?v=2f3VNRLub-s&t=22m50s


She should definitely work "No Dickheads" into her campaign slogan or platform.


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PostPosted: Wed Feb 13, 2019 5:47 pm 
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PostPosted: Wed Feb 13, 2019 5:55 pm 
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How long til the 1st debates, 6 months?


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PostPosted: Wed Feb 13, 2019 6:14 pm 
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One for Kamala

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PostPosted: Wed Feb 13, 2019 6:35 pm 
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Re drug and health care costs, a few things. Some of these come from my mother who has ran finances at public hospitals for about 25 years now in a not prosperous region of the country.

1. She once told me Medicare pays 19 cents to the dollar. So if the hospital says a person on Medicare has a $100 bill, the government pays $19. So for one of the two examples of federal healthcare (the other being the VA, which my dad is a veteran and he refuses to use, not for political reasons), they just won't pay more than 80% of the bill.

2. When Obamacare was agreed, I'd occasionally ask her what it would mean for her. She'd always answer "we don't know yet". That went on for 2 years. I was visiting one week when she was reading through the paperwork for the 1st time at home of the "what does Obamacare mean for your hospital?", and she at one point incredulously said "they want to take $50 million away from us over the next 10 years". Her hospital system is it for that region, there's no one else, and there was a Guardian story a couple years ago I read of one remote corner of that region losing their hospital and the impact on the community. I can't sit and tell you "this caused that", but there's a good deal of probability that's what occurred.

3. The poor use the emergency room as a doctor's office. In a public hospital, they're required to take everyone (privates are only required to see someone if they could die). What that means is they come in, get whatever service they need, leave, bills get sent to them for a few months that go unpaid, and then it's written off as bad debt. In the end the people that can pay their bills are the ones that cover them. Part of being a public hospital from the financial side is they're required to give out so much free healthcare.

4. This is a general statement, but anecdotally, it's become more difficult to get stuff looked at post-Obamacare. To see a specialist you require a referral.

5. People overmedicate for everything. I'm not sure what if anything can be done about that. But that is the drug companies' best friend. I personally try to stay away from any medication unless I'm really sick and really need it. I'm young too, so I'm not representative of say the elderly. But I look at my grandparents who had it seems 6 pills they took every morning, and if you think a doctor actually knows how all those medications play well together and there's no side effects from random medication X being mixed with random medication Y, you're dreaming.

6. A lot of my personal problem with insurance companies is more the processing is ridiculous. I played a rugby match up in Detroit in the summer of 2015, an idiot teammate ran his head into mine running into a tackle, and I went to a Detroit urgentcare to get 17 stitches in my forehead from a Syrian doctor. Out of market, the urgentcare place didn't recognize my insurance card I gave them. I listed as a secondary the USA Rugby insurance (AIG), part of being a CIPP'd member. I think my insurance didn't take at all, AIG paid $10 (I'm not kidding), and TWO YEARS LATER I get the bill for the balance. Now that I'm a dad of young children, we get bills more regularly that insurance takes care of. I keep up on financial things better than most people I'm sure, but the actual process of saying what the bill is, who is paying for it, and how long it takes for that all gets accomplished is incredibly confusing. I hate to frame it this way because I hate Six Sigma, but as a guy that has worked his whole adult life in manufacturing, the whole thing is begging for a Six Sigma project to simplify it.

7. Market forces being a cure-all is not always correct. But in a business such as health care, competition is sometimes not allowed. This is an article about the air ambulance business from last year I remembered reading.

https://johnhcochrane.blogspot.com/2018 ... idies.html

Quote:
Tuesday, June 12, 2018

Cross-subsidies

Cross-subsidies are an under-appreciated original sin of economic stagnation. To transfer money from A to B, it would usually be better to raise taxes on A and to provide vouchers or otherwise pay competitive suppliers on behalf of B. But our political system doesn't like to admit the size of government-induced transfers, so instead we force businesses to undercharge B. Since they have to cover cost, they must overcharge A. It starts as the same thing as a tax on A to subsidize B. But a cross-subsidy cannot withstand competition. Someone else can give A a better price. So our government protects A from that competition. That ruins the underlying markets, and next thing you know everyone is paying more for less.

This was the story of airlines and telephones: The government wanted to subsidize airline service to small cities, and residential landlines, especially rural. It forced companies to provide those at a loss and to cross-subsidize those losses from other customers, big city connections and long distance. But then the government had to stop competitors from undercutting the overpriced services. And as those deregulations showed, the result was inefficiency and high prices for everyone.

Health care and insurance are the screaming example today. The government wants to provide health care to poor, old, and other groups. It does not want to forthrightly raise taxes and pay for their health care in competitive markets. So it forces providers to pay less to those groups, and make it up by overcharging the rest of us. But overcharging cannot stand competition, so gradually the whole system became bloated and inefficient.

A Bloomberg article "Air Ambulances Are Flying More Patients Than Ever, and Leaving Massive Bills Behind" by John Tozzi offers a striking illustration of the phenomenon, and much of the mindset that keeps our country from fixing it.

https://www.bloomberg.com/news/features ... sive-bills

The story starts with the usual human-interest tale, a $45,930 bill for a 70 mile flight for a kid with a 107 degree fever.

Quote:
At the heart of the dispute is a gap between what insurance will pay for the flight and what Air Methods says it must charge to keep flying. Michael Cox ... had health coverage through a plan for public employees. It paid $6,704—the amount, it says, Medicare would have paid for the trip.

The air-ambulance industry says reimbursements from U.S. government health programs, including Medicare and Medicaid, don’t cover their expenses. Operators say they thus must ask others to pay more—and when health plans balk, patients get stuck with the tab.

Seth Myers, president of Air Evac, said that his company loses money on patients covered by Medicaid and Medicare, as well as those with no insurance. That's about 75 percent of the people it flies.


Image

According to a 2017 report commissioned by the Association of Air Medical Services, an industry trade group, the typical cost per flight was $10,199 in 2015, and Medicare paid only 59 percent that.

So, I knew about cross-subsidies, but $45,950 vs. $6,704 is a lot!

OK, put your economics hats on. How can it persist that people are double and triple charged what it costs to provide any service? Why, when an emergency room puts out a call, "air ambulance needed, paying customer alert" are there not swarms of helicopters battling it out -- and in the process driving the price down to cost?

Supply is always the answer -- and the one just about everyone forgets, as in this article.

I don't know the regulation, and the article doesn't go near it, so I will hazard guesses.

a) Not just any helicopter will do. Look at any small airport. There are a lot of helicopters hanging around whose owners would jump in a flash for an uber-helicopter call that pays $45,000. So, it must be true that in every such case you have to have an air-ambulance. Which makes a lot of sense, of course -- the helicopter should have the standard kind of life-saving equipment on it. But clearly the emergency room is only going to call and allow a air ambulance.

b) Air-ambulances must be properly certified and licensed. OK, but there are still lots of people who could go in to this business, or the ones who are there could bid aggressively. That brings us to

c) I'm willing to bet part of the conditions for license is that operators must carry anyone regardless of ability to pay, and not ask any financial questions.

Competition for paying customers must be banned. Only such a ban can explain the crazy situation. If there were any way to compete for the paying customers, it would happen and the problem would evaporate.

The article comes close to confirming this suspicion.

Quote:
“I fly people based on need, when a physician calls or when an ambulance calls,” he [Seth Myers] said. “We don’t know for days whether a person has the ability to pay.”


The alternative? Well, pass a tax on air ambulance rides, and use the proceeds to pay for rides for the poor or indigent. It's the same thing -- except with a tax, there needs to be no regulation or bar on competition. Or pass an income tax surcharge and do the same thing. Yes, I don't like taxes any more than you do -- but given we're going to grossly subsidize air ambulance rides, a tax and subsidy is much more efficient than banning competition and allowing an ex-post free-for-all price gouge.

The article is most revealing, I think, that neither the author nor anyone he interviews even thinks of supply. Their explanations are as usual: demand, negotiating ability, and lack of regulation.

It is true that when faced with an emergency, a loved one needs an air ambulance and is in danger of dying, you are in a very poor position to negotiate. But supply competition should solve that problem. If you can get $45,000 for a 70 mile helicopter ride, competing helicopter companies would have representatives sitting in the emergency rooms! When you arrive at an airport at 11 pm and want a rental car, you're not in a great negotiating position either. Somehow they don't charge $45,000 then! Why not? Supply competition -- and the need to have good reputations in any business.

The ex-post negotiation is surreal.

Quote:
For people with private insurance, short flights in an air ambulance are often followed by long battles over the bill.

Consumer groups and insurers counter that air-ambulance companies strategically stay out of health-plan networks to maximize revenue.


[This is an increasingly common scam. The hospital may be in network, but many emergency room teams are out of network contractors. You find out when you wake up.]

Quote:
...the Cox family went through two appeals with their health plan. After they retained a lawyer, Air Methods offered to reduce their balance to $10,000 on reviewing their tax returns, bank statements, pay stubs, and a list of assets. The family decided to sue instead. [My emphasis]

“I felt like they were screening us to see just how much money they could get out of us,” Tabitha Cox said.


You got it Mrs. Cox. On what planet do you get on a helicopter with no mention of cost, and then the operator afterwards looks at your tax returns, bank statements, pay stubs and lists of assets to figure out how much you can pay? Only universities get away with that outside of health care!

The reporter put the blame squarely on ... wait for it... the lack of price controls and other regulations.

Quote:
Favorable treatment under federal law means air-ambulance companies, unlike their counterparts on the ground, have few restrictions on what they can charge for their services. Through a quirk of the 1978 Airline Deregulation Act, air-ambulance operators are considered air carriers—similar to Delta Air Lines or American Airlines—and states have no power to put in place their own curbs.

Air-ambulance operators’ special legal status has helped them thwart efforts to control their rates. West Virginia's legislature passed a law in 2016 capping what its employee-health plan—which covered West Cox—and its worker-compensation program would pay for air ambulances


It is a sad day in America that the average reporter, faced with insane pricing behavior, can only come up with the lack of price control and regulation as an explanation. If voters don't understand that consumer protection comes from supply competition, we cannot expect politicians to shove that enlightenment down our throats.

Does it take a genius to figure out what price controls mean? Well, Medicare, Medicaid and indigent people aren't about to pay the cost. So if the companies can't cover costs by looking at our tax returns and coming up with a tailored price gouge for each of us, that means less air ambulance flights. The kid with the 107 degree temperature will end up driving in rush hour traffic to the hospital that can help him. Some will die in the process. Actually, it means who "needs" an air ambulance will depend on connections.

That's the problem with negotiation as the answer to everything. Negotiation can shift costs from one person to another, but we can't all negotiate for a better deal.

Actually, there is some supply competition -- just not competition of the sort that brings down costs for non-indigent customers. The business has grown in response to its overall profitability.

Quote:
The number of aircraft grew faster than the number of patients flown. In the 1990s, each helicopter flew about 600 patients a year, on average, according to Blumen’s data. That's fallen to about 350 in the current decade, spreading the expense of keeping each helicopter at the ready among a smaller pool of patients.

While adding helicopters has expanded the reach of emergency care, “there are fewer and fewer patients that are having to pay higher and higher charges in order to facilitate this increase in access,” Aaron D. Todd, chief executive officer of Air Methods, said on an earnings call in May of 2015, before the company was taken private. “If you ask me personally, do we need 900 air medical helicopters to serve this country, I'd say probably not,” he said.

If there are too many helicopters for the number of patients who need them, market forces should force less-efficient operators out of business.


Now pick up your jaw off the floor. So, the answer to inadequate supply competition is to ... reduce supply!


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PostPosted: Wed Feb 13, 2019 11:59 pm 
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Quote:
5. People overmedicate for everything. I'm not sure what if anything can be done about that. But that is the drug companies' best friend. I personally try to stay away from any medication unless I'm really sick and really need it. I'm young too, so I'm not representative of say the elderly. But I look at my grandparents who had it seems 6 pills they took every morning, and if you think a doctor actually knows how all those medications play well together and there's no side effects from random medication X being mixed with random medication Y, you're dreaming.


No doubt. Doctors would rather overmedicate than undermedicate for legal reasons and possibly due to pressure from patients. Then you've got the people who think they need every drug even tangentially related to something they've experienced. I've seen data where a patient will be taking 20+ drugs a day, and we're not talking about truly necessary stuff like cancer, HIV, MS, etc. drugs. Drug advertising is partially responsible for this type of thing and really should not be allowed.

Speaking of which, I'd like to see some immediate tweaks to our drug system:

1. No drug advertising
2. Medicare allowed to negotiate on price
3. Require pharmacies to print the total cost (not just the copay) of a drug on the label
4. No more patent protection for "new" drugs that are either stereoisomers or extended release versions that don't show substantial clinical benefit over the existing drug. This is a real trick of the drug companies. Shortly before a major drug goes generic, they'll come out with with an extended release version, often with very little improvement over the original drug (example: Ambien CR vs regular Ambien was worth like an extra 8 minutes of sleep a night on average), and will get doctors to switch their patients over to the extended release version, which will have a much longer patent life with no generic competitors for years. Switch over the majority of your patients and you just basically doubled the patent life. They'll do similar with stereoisomers (same molecular formula, just flipped) and then come out with extended release versions of those too. It's a total gaming of the system.


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PostPosted: Thu Feb 14, 2019 2:22 pm 
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goeagles wrote:
Quote:
5. People overmedicate for everything. I'm not sure what if anything can be done about that. But that is the drug companies' best friend. I personally try to stay away from any medication unless I'm really sick and really need it. I'm young too, so I'm not representative of say the elderly. But I look at my grandparents who had it seems 6 pills they took every morning, and if you think a doctor actually knows how all those medications play well together and there's no side effects from random medication X being mixed with random medication Y, you're dreaming.


No doubt. Doctors would rather overmedicate than undermedicate for legal reasons and possibly due to pressure from patients.


That's a contributing cause for the opioid crisis.

Quote:
Speaking of which, I'd like to see some immediate tweaks to our drug system:

1. No drug advertising


TV Media would throw a fit. I'd be for it on principle, just don't see it have any success of becoming law.

Quote:
3. Require pharmacies to print the total cost (not just the copay) of a drug on the label


It'd be in the smallest font print they could find. It's not like regular people read the labels anyway.

Quote:
4. No more patent protection for "new" drugs that are either stereoisomers or extended release versions that don't show substantial clinical benefit over the existing drug. This is a real trick of the drug companies. Shortly before a major drug goes generic, they'll come out with with an extended release version, often with very little improvement over the original drug (example: Ambien CR vs regular Ambien was worth like an extra 8 minutes of sleep a night on average), and will get doctors to switch their patients over to the extended release version, which will have a much longer patent life with no generic competitors for years. Switch over the majority of your patients and you just basically doubled the patent life. They'll do similar with stereoisomers (same molecular formula, just flipped) and then come out with extended release versions of those too. It's a total gaming of the system.


The blame there also lies with lazy and/or corrupt doctors. Not sure when a few doctors became dumb idiots that do as little work as possible and just parrot drug companies' talking points, but they should probably have their license stripped.


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PostPosted: Thu Feb 14, 2019 9:27 pm 
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Flyin Ryan wrote:
That's a contributing cause for the opioid crisis.


Definitely

Quote:
TV Media would throw a fit. I'd be for it on principle, just don't see it have any success of becoming law.


They probably would, but it's definitely worth it. They probably threw a fit when they had to stop allowing cigarette companies to advertise on TV too.

Quote:
It'd be in the smallest font print they could find. It's not like regular people read the labels anyway.


Require it to be in the same font as everything else on the label. Maybe they won't read it, but it's a start.

Quote:
The blame there also lies with lazy and/or corrupt doctors. Not sure when a few doctors became dumb idiots that do as little work as possible and just parrot drug companies' talking points, but they should probably have their license stripped.


It's not just lazy or corrupt doctors. The vast majority of doctors do not concern themselves with price or cost/benefit and frankly have either zero idea what a drug costs or even if they do, they don't care as long as the patient's copay is roughly the same. Going back to Ambien, from their perspective if Ambien CR gets you an extra 8 minutes of sleep, then it is objectively better. Nevermind that it might cost our health care system substantially more. It's clinically better and that's that in their mind.


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PostPosted: Fri Feb 15, 2019 3:53 am 
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https://youtu.be/flIsRYN6vx8

Thought the Fox work has been done and the lie is the truth. The breakfast club went on Ari Member to call out the Fox lie on Harris.

Do better people!


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PostPosted: Fri Feb 15, 2019 4:01 am 
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eldanielfire wrote:
Deadtigers wrote:
White males, evangelicals, WWC, etc are also identity politics. So let's not act like it's new. When it is not about the aforementioned, it is identity politics but when it is, I guess it is the way things should be right?


What? Total bollocks.

You act like people haven't slaughtered and mocked these groups for the past two decades. How else was the Tea party received outside of it's narrow group? Or any republican to courted them against Obama? This board, the internet, the mainsteam media has for years mocked any extremist political ideology and identity politics under any brand for the most part. You seem to have a need to want to believe we need to go through the civil rights movement again despite the patent fact the vast majority of people are past that.


Try again. When a candidate discusses affirmative action, they are accused of pandering to blacks and minorities. When they discuss manufacturing jobs in the heartland, it is economic policy. You are the one full of shite.


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PostPosted: Fri Feb 15, 2019 4:21 am 
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Bernie might stand a chance but his lane is being eaten up and this time he has policy wonks to deal with so his whole "big thinker," light on the details shtick, like break up the banks, will be tougher to pull off.

Tulsi is DOA. She has to overcome the other legs of the Dem chair/stool and how she will win over gays after being pro conversion therapy and minorities with supportive tweets from Bannon, Duke and Spencer is funny to me.


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PostPosted: Fri Feb 15, 2019 4:24 am 
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FR and Goey, what are your thoughts on the US incorporating a Healthcare system similar to Germany that allows Insurers to exist and have variations in packages and what is covered but is heavily regulated to make sure prices are affordable and everyone is covered. I truly see this as the only way forward since we can't just get ride of insurers.


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PostPosted: Fri Feb 15, 2019 5:55 am 
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Deadtigers wrote:
https://youtu.be/flIsRYN6vx8

Thought the Fox work has been done and the lie is the truth. The breakfast club went on Ari Member to call out the Fox lie on Harris.

Do better people!


Wait so she was smoking weed and listening to Snoop in 1994 when she was a DA getting people locked up for doing the same thing? Sorry man this makes no sense. Read the comments under the original video. People (the usual audience) ain’t having it.

https://m.youtube.com/watch?v=Kh_wQUjeaTk

Also she was publicly against legalization until last year. Her home state legalized recreational marijuana in 2016. So she’s a hypocrite, a liar, or both.


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PostPosted: Fri Feb 15, 2019 6:05 am 
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Deadtigers wrote:
Bernie might stand a chance but his lane is being eaten up and this time he has policy wonks to deal with so his whole "big thinker," light on the details shtick, like break up the banks, will be tougher to pull off.


By who? Of the announced candidates only Tulsi, Warren and Andrew Yang (marginal at this point but seriously smart guy) have similar policies. The rest of the field are closer to the non-Bernie 2016 candidates. Most assume Tulsi and Bernie would run together if either made it through. So the competition “in his lane”’ is basically Warren who is polling at 7% and probably not going up.


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