birdog1960

with all the financial guys that frequent this board, it's surprising there hasn't been a raging debate on this newly publicized and highly debated topic. http://finance.yahoo.com/blogs/daily-ticker/hft-uproar-revives-calls-for-“trading-tax-”-other-bad-ideas-150311158.html/. comments?

yup. why not back it up with something like this? http://finance.yahoo.com/echarts?s=UNH+Interactive#symbol=UNH;range=2y. a very imperfect solution. single payor anyone?

much of the developed world is laughing at us because we have citizens getting care in church basements and tents from volunteers (some sent from more developed but less wealthy countries). well, it's not really laughter it's more like pity mixed with disbelief.

it means that half the states stonewalled medicaid expansion.

all of this brings down utilization of elective stuff while increasing utilization of preventive stuff. those are good things. they will help slow the increase in health care spending and eventually result in an absolute decrease. if you're paying high copays and high deductibles it makes even less sense to use an urgent care or er since the out of pocket costs are, by design, generally higher there as are the total costs to the system.. the design is far from perfect but these examples are solutions, not problems.

the oregon study, published in nejm, followed less than 6000 pt's for an average of 17 insured months. how many statin studies over how long of study periods we're needed before proof of the benefit of statins was shown (a much simpler question)? go back and look at that data and tell me with a straight face that this small, short study definitively answers the questions it posed. hell, in many offices it would be a 3-4 month wait to get an appointment after getting insurance, making the study period roughly 1 year. and even in that time, the financial impact of catastrophic events was completely mitigated for the newly insured. this is not a small matter. it means hospitals and doctors got paid for the catastrophic care they provided those pts. without it, many of the patients would have likely gone into bankruptcy and the providers would receive pennies on the dollar. no shite, medical care is a commodity. so is food. should we let people starve rather than provide food assistance? i don't know of a single patient or person for that matter that hasn't done something stupid that might have caused themselves harm. and in frequent cases, that involves repeated and continuous infractions. i don't see how that changes the ethical and moral response to suffering. can everyone get everything in regards to care? no, but basic care can be delivered as it is in many seemingly more advanced nations then us. i might have asked you this before but it bears repeating: did you write down thoughts like these in the "why i want to be a doctor" section of your med school applications or did you just lie and color yourself a humanist?

we need it to insure the millions of poor or near poor uninsured and stop people from standing in line to get care in tents from volunteers and med students like they do here in appalachia. we need to stop acting and looking to anyone with any interest, like a 3rd world country to a 6th of our population or so. we need it cuz it's the right, moral and ethical thing to do. we need it cuz health care is supposed to be about caring for people, not about making the most bucks. if that doesn't convince you. we need it to stop cost shifting by health care systems trying to stay afloat while medicare cuts aren't being offset by medicaid payments for currently uninsured patients.

hating lincoln and his party for decades after the civil war has nothing to do with being a democrat in spirit. like i said, people of the same ilk and backround can be found spearheading opposition to medicaid expansion. makes perfect sense if you think about it for a minute.

interesting. both those ideas we're born and raised to a large degree in the same states that are now opposing medicaid expansion.

yup. people that get 3x's what they pay in to medicare back as benefits aren't gonna like it much when costs begin to get reigned in. people playing the health care lottery choosing to go uninsured and really only putting the healthcare systems at risk cuz they have no where near the assets to cover a catastrophic illness aren't gonna like it when they're made to be responsible. and some people don't like it because many of the benefits (especially the medicaid expansion) haven't been fully implemented. add to that outright propaganda against it (every new or old problem in healthcare is blamed on the aca) and an outright war against it by the cons and the results you cited are hardly surprising. they will improve.

actually, not going to single payor was dumb no matter the cost of the aca. it wasn't politically feasable. but some think the aca is the trojan horse to get us there. i certainly hope so.

we're still waiting for the republican's amazing alternative plan...oh, wait! it looked very much like the aca initially until it didn't. and then it looked very much like the status quo. now it just looks like obstrutionism.

here's a prediction: medicaid expansion will happen in all but the most backward states within the next few years. why? because health care systems are pressuring their senators and congressmen to get it done. the partial offset for decreased medicare payments for them is increased medicaid payments for the previously uninsured. that's not happening even in many of the poorest states that desperately need those healthcare jobs and dollars (yup, that map again - the southeastern states are all nonadopters). in effect, the uninsured that would be eligible for medicaid are being used as pawns by the cons. so what else is new? but once that happens, game over.

no kidding it's not supposed to work like this. medicaid expansion was integral to the plan and you have nearly 1/2 the states refusing to play ball. for sh*ts and giggles, take a look at a map of those states. despite this, the plan is becoming cemented into the fabric of the system inching closer to politically untouchable status daily.

when you start from zero, it's not difficult to improve. so, who then do we hold responsible for starting from such a low place. are any of the likely suspects still around?

bs. they're trying their damdest to make sure all the political capital spent wasn't in vain. and they're winning. the aca today became a "buy" in most prognosticators view: it's much more unlikely to be repealed now than a couple days ago.. and someone said it was still a work in progress. kinda like that characterization.. i believe i've heard it before.

as a keen and avid bills observer for many years, i believe your assertions are correct. maybe someday, a tell all will come out documenting exactly what you assert.. but i don't see brandon writing it. he's a company guy. always was and always will be. and that's exactly why his leadership doesn't fill me with confidence. he's part of the long lived culture of losing in the organization. empowering him further empowers that culture. i think it's important to separate the goals of keeping the bills in buffalo and making the bills a winner. will brandon help keep the bills in buffalo? maybe but i think it's likely far beyond him. will he be integral in making them a winner? i don't think so. can both goals be attained simultaneously? i hope so but i don't see brandon being the one accomplishing it.

and the same logic holds for the string of underwhelming coaches that have been brought in over the last decade. when 2nd tier candidates say no to even an interview, there's clearly a problem. i guess that's how you end up with chan gailey and skeletor. had wilson sold earlier, it wouldn't have been an issue but then again the bills might be somewhere else by now.

i think the team has been effectively run by a trust for some time. at least, since wilson handed the reigns to brandon. and i think the mandate was to maximize roi and maintain or increase the value of the asset.. maybe the trustees will suddenly see winning as essential to achieving those goals but i wouldn't bet on it.

yup. if you explain things as clearly as that to your clients, generally, they're lucky to have you.

that's the best article i've read about buffalo, the bills and the fans in a very long time. he nailed it. i might finish that last sentence differently though.

i think this is the most charitable interpretation possible. i could imagine one just as uncharitable.

robbie built the stadium with private funds for $115 mil. rogers bought the stadium and naming rights. were either megalomaniacs? don't know.

i'm interested in whether there's a precedent. any other major sports owner have his team's stadium named after him?

agreed. is there not a "ralph wilson stadium"? did he not reap more than he sowed?