Midterm Election Gameday Thread

[TakeYouToTasker]

38 minutes ago, billsfan89 said:

 

It does drive costs down and I would argue that the "Three Prongs" argument is very flawed because you have Universality in any system that adheres to the Hippocratic oath which states you can't deny care to someone who needs it simply because they can't afford it. So then your argument comes down to quality vs. affordability which is also flawed because US Healthcare outcomes are mid-level to upper mid-level despite the US spending the most on healthcare per-capita and by far the largest portion of GDP. So the US system is universal, unaffordable, and not the best quality for a variety of factors. I also fail to see where a black market would arise? 

 

I have yet to hear an argument that is compelling and fact based that  the current system can be corrected by deregulation and free market forces (Healthcare is also not an elastic product which makes it less susceptible to market forces) as long as the Hippocratic Oath exists. Yes if you wanted to treat healthcare like an actual commodity (one where a doctor or provider can deny treatment to those in need) then you probably could drive costs down. But unless you want to live in a society where people are left to die because they can't afford healthcare then a for profit system won't be able to drive down costs. 

 

I would also argue that every system rations care. As I said before Healthcare is not an elastic product, its not easy to create more of it and you can't ethically deny people access to it. In the US we ration care off of how big your wallet is (Not even wither or not you work because self-employed people and people who work for a small business don't always have insurance, and even full time workers for big companies can be underinsured.) In single payer countries they go by medical need. So it is an outright scare tacit to claim rationing of care when 10-40k people die from lack of medical access in the US.

 

The Main reasons Healthcare in the United States is so unaffordable and lacks general quality for a system so expensive is due to billing, prescription drug prices, lack of preventative care, and the profit motive. 

 

The US private Healthcare system spends 14-20% on billing, Medicare spends about 4% on billing most single payer systems spend about 3-8% on billing. That's mainly because if you have dozens of health insurance companies with dozens of plans each of them have their own billing codes and each plan is its own soup of benefits. You also have each insurance provider looking to get its own pricing for services for each of their providers in their own network. That means each provider needs to have people to navigate and negotiate with each insurance company patient by patient. In single payer systems they have a singular billing code and singular models of pricing. Hospitals can also get paid in lump sums yearly as opposed to having to get paid on a per-patient basis. This is not a result of the government being better at doing something but rather universality and simplicity winning out over a more complex and unnecessary network of middle men. 

 

Prescription Drugs also add to the cost of care because the Medicare system is driven up against the private system. Corruption is also at play because thanks to legalized bribery known as campaign contribution the drug industry is a powerful lobby. The US also sees worse outcomes and more costs because uninsured and under insured people will not get preventative care do to cost and they will wait for things to get worse because of costs. When things are found sooner they are cheaper to treat. In the US we have a system where we don't have great access to catch thing early and then we treat people later on when a condition has progressed worse. 

 

Then there is the profit motive. Profits in the US Healthcare system are 2% or less of the system. Certainly it would be nice to get rid of that 2% but we aren't being driven to the cleaners for 2% or less (Usually less.) But the profit motive is one that creates a perverse relationship between the patient and their insurance company. A private insurance company has an incentive (profit) to not pay out a claim, this generates a lot of back and forth between the insurance company and the provider (More bureaucracy) it also ends up with insurance companies not paying out claims (Often for frivolous reasons) and then placing the costs onto the patient who will go bankrupt or pay the full inflated costs. 

 

There are also other benefits to a single payer system where the government can have access to rates across the whole system and bring down costs (Why does X procedure cost less in this other hospital.) I have laid out a detailed and specific argument for single payer driving down costs and recording better outcomes. Can you please tell me how more free market drives down costs while still having the Hippocratic Oath?

 

No, it does not drive down costs.  It shifts costs towards markets which aren't tracked.  In nations which have single payer there are massive black markets for health care. 

 

The "three prongs" argument is in no way flawed because health care is a finite commodity, and you cannot simply wish away the laws of supply and demand.

 

Universal care will either be low quality, because you'll have to lower standards to increase supply; or incredibly expensive because you'll have to provide financial incentives to drastically increase the supply.  There is no other way to increase supply to meet demand.

 

To the rest of your argument: 

 

Please explain the magical phenomenon in which monopoly and price fixing are a net consumer good.

 

Please explain how increased government bureaucracy lowers costs, and how that would scale up in a takeover of 20% of the domestic economy.

 

Please explain why it is desirable to place unaccountable government bureaucrats between patients and their care.

 

Please explain how profit motivation  does not lead to dynamic innovation in industry.

 

Once you've sufficiently answered those query's I promise I'll have follow-ups. 

 

Edit:   I'll also add that US healthcare is not a free market model.  It's highly regulated, and has no consumer price transparency.    

Edited December 4, 2018 by TakeYouToTasker

[billsfan89]

21 minutes ago, DC Tom said:

 

I didn't ask "what is the use case?"  I said "define it."

 

The point I would eventually get it is that "triage" - like many denials of care in the medical industry - is driven by scarcity of services and resources, and time.   There is no "universality," because it is a finite resource.  "Triage" is a single illustration of that: it exists because doctors cannot treat everyone, because they are a limited exclusive-use resource.  Not because of fiscal constraints.

 

You simply don't understand the concepts in effect here.  That you think that, because doctors ascribe to an oath that they treat anyone, that they therefore must treat everyone, is such a basic failure of reasoning that it makes it obvious that you simply don't have the skills to have the discussion you're attempting here.

 

Universality exists in the sense that a doctor will not deny someone due to inability to pay. If you need care a doctor or service provider will do their best to take care of you regardless of your ability to pay. I never argued that everyone gets treatment but rather that no one gets denied treatment because of inability to pay. Thus it does not operate in a true free market commodity fashion. I understand very well that in any system rationing of care exists (Which destroys the conservative argument that single payer healthcare would lead to rationing of care.) I understand fully the concepts in play here. 

 

A common conservative argument against single payer is that healthcare can be 2 out of 3. Affordable, Quality, or Universal. I argued that because doctors and providers do not deny people due to inability to pay that the system in the US and any system that will not deny people based off of inability to pay is universal. That there will be people that can't afford treatment and unless you deny them treatment those costs will be absorbed into the general system either way. 

[billsfan89]

15 minutes ago, TakeYouToTasker said:

 

No, it does not drive down costs.  It shifts costs towards markets which aren't tracked.  In nations which have single payer there are massive black markets for health care. 

 

The "three prongs" argument is in no way flawed because health care is a finite commodity, and you cannot simply wish away the laws of supply and demand.

 

Universal care will either be low quality, because you'll have to lower standards to increase supply; or incredibly expensive because you'll have to provide financial incentives to drastically increase the supply.  There is no other way to increase supply to meet demand.

 

To the rest of your argument: 

 

Please explain the magical phenomenon in which monopoly and price fixing are a net consumer good.

 

Please explain how increased government bureaucracy lowers costs, and how that would scale up in a takeover of 20% of the domestic economy.

 

Please explain why it is desirable to place unaccountable government bureaucrats between patients and their care.

 

Please explain how profit motivation  does not lead to dynamic innovation in industry.

 

Once you've sufficiently answered those query's I promise I'll have follow-ups. 

 

Edit:   I'll also add that US healthcare is not a free market model.  It's highly regulated, and has no consumer price transparency.    

 

I have illustrated specifically that it will drive costs down. There are real world examples of countries implementing these systems and spending much less to get the same or better healthcare outcomes. As a whole the US spends more on billing in the private system, the US has the low levels of preventative care which drives up costs, the US has a horrid prescription drug system which drives up costs, and the US doesn't do basic thing like lump sum payments that can make costs for providers much more stable. 

 

Just to be clear we both agree that Healthcare is a finite commodity thus rationing of care happens in any system. Thus you can't argue that rationing of care would happen as a result of single payer. My point in regards to universality is that anyone will get treated by the healthcare system in the US to the best of its ability regardless of your ability to pay. So we have a universal system of care where costs for people who get treated but are unable to afford it are absorbed into the general system. Creating a single payer system where everyone has a baseline form of insurance actually accounts for those costs. Having the current system where you ask hospitals and providers to do charity care or overcharge insurance companies on other patients is the unaccounted costs systems. And yes as DC Tom point out there are times when the system can't treat everyone but who and how it treats people are not determined by your ability to pay but rather by medical need. 

 

To the rest of your specific points

1- Please explain the magical phenomenon in which monopoly and price fixing are a net consumer good.

Single payer systems are able to negotiate using their collective bargaining power and through price transparency. There is a reason why treatments in Canada and other single payer systems are much cheaper. You can't have one hospital charging 10 times more for a procedure without justification in a single payer system. Whereas in the US even if you had full price transparency people in emergency scenarios can't shop around like a typical commodity. So in the real world you have the US spending 17.9% of GDP on healthcare whereas the average developed nation spends 10.7%, the next highest system is the Swiss who spend 12.7% of GDP on healthcare. We don't look at police and fire fighters as commodities who are monopolies and priced fixed.

 

2- Please explain how increased government bureaucracy lowers costs, and how that would scale up in a takeover of 20% of the domestic economy.

A private system has dozens if not hundreds of insurance providers, each provider has many different plans. A hospital or provider has to bill each patient and navigate each different insurance billing system to do so. The private system generates far more bureaucracy. Hospitals have to have specialists for each major insurance provider they deal with. A hospital has to hire staff to negotiate rates every year with many providers. In a single payer system that is consolidated into one negotiation. 

 

As I said before real world examples show the US private system spends 14-16% on billing, Medicare spends about 4% because Medicare only has one set of codes and a limited amount of plan. Even Medigap insurance uses Medicare codes. Other nations which just have one set of billing codes that 90% of their patients use. Even private over the top insurance in those nations bills with similar codes and pricing. Imagine having to have police insurance to call the police and the police have to bill 32 different providers to get paid and each provider has different billing and different plans. Single payer systems offer payment in lump sums too where hospitals can operate off of a yearly budget as opposed to having to nickle and dime each patient and go back and forth with insurance. 

 

Also the issue of scale makes no sense to me. About 50% of insurance is paid for by the public through Medicare, Medicade, and the VA. The government already has the infrastructure in place its just a matter of scaling a tax (A payroll tax most likely) to incorporate the rest of the population. So I don't see scaling what is already in place (Medicare) as a major burden. The most conservative studies still say that Medicare for all saves general healthcare spending 2 trillion dollars over a 10 year period. 

 

3- Please explain why it is desirable to place unaccountable government bureaucrats between patients and their care.

Why is it more desirable to have a company who will make more money not covering your claim in between patients and their care? Insurance companies are no better than bureaucrats. I don't argue that a single payer system is perfect but I argue that it is the best system we have to pay for healthcare. Why do you have the government between you and the police? Why do you have the government heavily regulating you and your water? Healthcare is a basic human need not a commodity. 

 

4- Please explain how profit motivation  does not lead to dynamic innovation in industry.

Because as you said healthcare is a finite product that can't be ethically denied to lack of payment. The US doesn't spend that much more money on R and D than single payer countries. In fact many drugs that are on the consumer market were researched and developed at Universities and then drug companies buy the patents from the Universities on the cheap. US insurance companies are mandated by law to make the most money, thus they are mandated to pay out as little claims as possible. That's a perverse system. 

[Foxx]

when has the cost of anything the government puts it's fingers into cost less?

[DC Tom]

How did we go from mid-terms to polemics about health care from a bloviating babboon who doesn't understand the basic concept of "scarcity?"

[TakeYouToTasker]

9 minutes ago, DC Tom said:

How did we go from mid-terms to polemics about health care from a bloviating babboon who doesn't understand the basic concept of "scarcity?"

 

He's wishcasting away reality by conflating "do no harm" with universality with a bit of handwavium; while willfully (or ignorantly) ignoring the fact that scarcity plays out in universal systems.

 

For instance:  in those nations the obese and smokers are denied access to surgeries, end of life treatment can be denied by law, wait times are absurdly long etc.

 

And the systems are still collapsing under their own weight.

 

Even their "outcome" metrics are apples to oranges comparisons because a by legislatively denying treatment to those more likely to have bad outcomes drastically impacts outcome statistics.

 

Don't even get me started on denying the existence of secondary and black market costs when calculating expense. 

[Warren Zevon]

Where is the Republican outrage for NC-09?

 

@TakeYouToTasker should be calling for a change to the law so Leslie Dowless can be hanged. 

Edited December 4, 2018 by peace out

[TakeYouToTasker]

31 minutes ago, peace out said:

Where is the Republican outrage for NC-09?

 

@TakeYouToTasker should be calling for a change to the law so Leslie Dowless can be hanged. 

 

I'm sorry, you must have me confused with someone who has an ounce of respect for you or believes you to have a drop of intellectual honesty or personal integrity.

 

In the future, please remember that I find you to be a cancerous tumor on honest and productive dialogue.

 

If anyone else would like to opine about NC-09, I'd be happy to engage them, but I won't engage you, because you're a race baiting, libelous piece of *****.

[Koko78]

26 minutes ago, TakeYouToTasker said:

 

I'm sorry, you must have me confused with someone who has an ounce of respect for you or believes you to have a drop of intellectual honesty or personal integrity.

 

In the future, please remember that I find you to be a cancerous tumor on honest and productive dialogue.

 

If anyone else would like to opine about NC-09, I'd be happy to engage them, but I won't engage you, because you're a race baiting, libelous piece of *****.

 

So tell us... how do you really feel about Gary?

[Warren Zevon]

24 minutes ago, TakeYouToTasker said:

 

I'm sorry, you must have me confused with someone who has an ounce of respect for you or believes you to have a drop of intellectual honesty or personal integrity.

 

In the future, please remember that I find you to be a cancerous tumor on honest and productive dialogue.

 

If anyone else would like to opine about NC-09, I'd be happy to engage them, but I won't engage you, because you're a race baiting, libelous piece of *****.

 

LOL

 

It doesn't take much to trigger a faux libertarian incel like yourself

[TakeYouToTasker]

2 minutes ago, peace out said:

LOL

 

It doesn't take much to trigger a faux libertarian incel like yourself

 

Yes, yes, Gary.

 

Your libel and rabid race baiting are giggle inducing hilarity, a real boost to the board, as well as being the pinnacle of maturity; and are certainly worth the time of engaging you on serious topics.

 

And of course I'm "triggered", rather than discerning.

 

You keep on doing you, Gary; and I'll continue to ask the reader to judge the worthiness of our respective content.

[TakeYouToTasker]

12 minutes ago, Koko78 said:

So tell us... how do you really feel about Gary?

 

Eh, I don't generally read anything he writes beyond when I get notifications that he's tagged me in a post specifically and solely for the purpose of making baseless charges of racism or libelous character attacks.

[billsfan89]

3 hours ago, Foxx said:

when has the cost of anything the government puts it's fingers into cost less?

 

Why do other countries who have government insurance pay drastically less for insurance and get the same or better outcomes? Even the Swiss who have a more free market oriented approach have a more heavily regulated system that results in better care for significantly less? Healthcare is a utility not some product subject to free market forces. 

Edited December 4, 2018 by billsfan89

[billsfan89]

2 hours ago, TakeYouToTasker said:

 

He's wishcasting away reality by conflating "do no harm" with universality with a bit of handwavium; while willfully (or ignorantly) ignoring the fact that scarcity plays out in universal systems.

 

For instance:  in those nations the obese and smokers are denied access to surgeries, end of life treatment can be denied by law, wait times are absurdly long etc.

 

And the systems are still collapsing under their own weight.

 

Even their "outcome" metrics are apples to oranges comparisons because a by legislatively denying treatment to those more likely to have bad outcomes drastically impacts outcome statistics.

 

Don't even get me started on denying the existence of secondary and black market costs when calculating expense. 

 

If these single payer systems in other nations are so horrendous and result in such terrible wait times then why aren't these nations rushing to switch to free market systems? Why is it that the US has a horribly unpopular system despite having the most free market oriented system in the developed world? If the single payer systems were so horrible surly in Canada during the highly conservative Harper administration they would have begun to switch to a privatized system to get out from under the horrid single payer system? The answer is because single payer healthcare remains popular. 

 

Even a majority of American doctors now prefer single payer health care (54% for, 42% opposed.) I also never denied that scarcity exists in a single payer system. In fact your argument about rationing is destroyed by your own point about scarcity (every system will have rationing.) The bottom line is that in any healthcare system there will be people that can't afford treatment. In America we do not deny treatment to people on the basis that they can not afford it. Thus there are costs that are absorbed by the general system no matter what. So the idea that there are these 3 pillars and universality is one of them is absurd due to the fact that you can not ethically withhold care from people just on the grounds that they can't afford it. Thus everyone even those who can't afford it has access to care, thus you cannot have cost be a barrier to entry for extreme needs of care. 

 

I also brought up very specific points about billing, preventative care, profit motive, and drug costs that point to specific ways that single payer drives costs down whereas your only argument against it is the government sucks. Despite the fact that in the real world there are outcomes and data that show you otherwise. 

[B-Man]

A SMALL BUT SIGNIFICANT VICTORY: Republican Raffensperger Wins Georgia Secretary of State Runoff Election.

 

 

 

 

 

.

 

 

[Buffalo_Gal]

Wisconsin Republicans Approve Bills Stripping Power From Incoming Democratic Governor
 

</snip>
 

The package of bills, which now awaits Mr. Walker’s signature, would limit early voting and, for the coming months, give lawmakers, not the governor, the majority of appointments on an economic development board. They also prevent Mr. Evers from banning guns in the Wisconsin Capitol without permission from legislators.

The bills would also require Mr. Evers to get permission from lawmakers to seek adjustments on programs run jointly by federal and state governments, such as public benefit programs.

And they would bar Mr. Evers from installing any political appointee whose confirmation is rejected by the Senate. (Current law allows a governor to renominate such appointees or allow them to serve as a provisional appointment.) The measures also include a provision requiring the corrections department, at lawmakers’ request, to publish online the names of prisoners pardoned by the governor or released before finishing their sentences.

</snip>

[Koko78]

8 hours ago, B-Man said:

A SMALL BUT SIGNIFICANT VICTORY: Republican Raffensperger Wins Georgia Secretary of State Runoff Election.

 

More racism and election fixing from the GA GOP. Even though there's no evidence of voter fraud in a state where there are far more Republicans than Democrats, the only way that the GOP could possibly have won over the party of virtue and purity is by racism, voter suppression, and fixing the election. Or something.

[Buffalo_Gal]

‘Not prepared’: Broward’s election self-analysis on what went wrong
 

After the counting is over, counties are required to report election problems to the state. Broward listed 'staffing shortages and procedural violations.'
 

</snip>
 

By law, every county must file a "conduct of election" report with the state, signed by the three members of each county's canvassing board, which includes two Broward judges and Snipes herself.
 

The reports focus on the election, not recounts. The Times/Herald obtained the reports under the public records law.
 

</snip>
 

Read Broward's post-election report here.
 

</snip>

[Buffalo_Gal]

 

[Buffalo_Gal]

Cuomo warns Long Island holdout: Just pick Pelosi as speaker
 

Gov. Andrew Cuomo is using his political muscle to promote Nancy Pelosi as House speaker and warned holdout Long Island Rep. Kathleen Rice that she’s helping Republicans by opposing the California Democrat.
 

“It’s not about you,” Cuomo said of Rice on WNYC radio Monday. “It’s about electing a Democratic Congress to stop bad things from happening” with President Trump.

“Don’t aid and abet the Republicans by jeopardizing her leadership,” he said.
 

But Rice, one of 32 Democrats to vote against Pelosi at the caucus level, isn’t backing down.
 

</snip>