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Bronco Yoda
11-14-2013, 11:54 AM
This just in: Pres. Obama to allow canceled insurance plans to be renewed for one year.

Should be interesting to see how health coverage in America will\may evolve over time now. What will it look like in 2years? 5 years? 10 years? 25 years?

Rohirrim
11-14-2013, 02:37 PM
Everybody here knows my own ideas on that. I just think universal, single payer is inevitable. I don't even bother with the political argument over it anymore. I think it's just inescapably practical. Eventually, we will have no other option. I guess some people thought the ACA was some kind of sneaky stepping stone to that, but I never agreed with that take. I think the ACA was a last ditch effort by the insurance companies to avoid it. After all, ACA delivers everybody to the doorstep of the insurance companies. How anybody can think that's a stepping stone to single payer is beyond me, except maybe by the circuitous route that it will fail and then single payer will be inevitable. Me? I think it's inevitable either way. People on the single payer side of the equation are just waiting for common sense to lead everybody else to that same conclusion. ;D

BroncoBeavis
11-14-2013, 02:42 PM
Everybody here knows my own ideas on that. I just think universal, single payer is inevitable. I don't even bother with the political argument over it anymore. I think it's just inescapably practical. Eventually, we will have no other option. I guess some people thought the ACA was some kind of sneaky stepping stone to that, but I never agreed with that take. I think the ACA was a last ditch effort by the insurance companies to avoid it. After all, ACA delivers everybody to the doorstep of the insurance companies. How anybody can think that's a stepping stone to single payer is beyond me, except maybe by the circuitous route that it will fail and then single payer will be inevitable. Me? I think it's inevitable either way. People on the single payer side of the equation are just waiting for common sense to lead everybody else to that same conclusion. ;D

Refreshing to see a real true believer. Roh watchin' this whole thing unfold. Still dreamin' of the day he can create that account on ProctologyAppointment.GOV :)

The Lone Bolt
11-14-2013, 02:47 PM
Ro the Swiss have had a system just like the PPACA in place for the last 20 years and Massachusetts for the last 10. The PPACA will work too if given a chance. If the republicans manage to burn it to the ground then we can look forward to going back to spiraling premiums, denial of coverage for pre-existing conditions, cancellations when we get sick, etc.

Anybody here who thinks the republican party gives a rat's ass about HC reform is living in dreamland. They just want to deny the dems a political victory, drag us back to the mess we had before, and go back to ignoring the problem.

Rohirrim
11-14-2013, 02:49 PM
Refreshing to see a real true believer. Roh watchin' this whole thing unfold. Still dreamin' of the day he can create that account on ProctologyAppointment.GOV :)

Fun facts to know and share:
http://sickothemovie.com/checkup/

One example:
"The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds." "World Health Organization Assesses The World's Health Systems," Press Release, WHO/44, June 21, 2000.

UltimateHoboW/Shotgun
11-14-2013, 02:54 PM
Repeal

That is how you fix it.

Rohirrim
11-14-2013, 03:03 PM
Ro the Swiss have had a system just like the PPACA in place for the last 20 years and Massachusetts for the last 10. The PPACA will work too if given a chance. If the republicans manage to burn it to the ground then we can look forward to going back to spiraling premiums, denial of coverage for pre-existing conditions, cancellations when we get sick, etc.

Anybody here who thinks the republican party gives a rat's ass about HC reform is living in dreamland. They just want to deny the dems a political victory, drag us back to the mess we had before, and go back to ignoring the problem.

I suppose then you get into the ethical debate. I think, in a modern industrial society, health care should be a right. What's the best way to do it? Everybody agrees that you need to spread the risk as broadly as possible. In ACA, the mandate is supposed to accomplish that. So, if you're going to accept that premise, why have two payers? You pay to the insurance company, who takes some profit, then you pay the provider, who also takes some profit? Why?

The Lone Bolt
11-14-2013, 03:09 PM
I suppose then you get into the ethical debate. I think, in a modern industrial society, health care should be a right. What's the best way to do it? Everybody agrees that you need to spread the risk as broadly as possible. In ACA, the mandate is supposed to accomplish that. So, if you're going to accept that premise, why have two payers? You pay to the insurance company, who takes some profit, then you pay the provider, who also takes some profit? Why?

And under a single-payer system you pay government bureaucrats instead. And you can't take your money anywhere else so they have no incentive to provide quality service.

All the PPACA does is privatize the function of paying out from a pool of the insured to those who need it. And because it's being done by companies who are concerned about keeping customers they will look for ways to provide the best service at the lowest cost. I'd rather have that than a government bureaucracy controlling payments, as long as the insurance companies are properly regulated to prevent them from screwing their customers, which they are under the PPACA.

BroncoBeavis
11-14-2013, 03:10 PM
Ro the Swiss have had a system just like the PPACA in place for the last 20 years and Massachusetts for the last 10. The PPACA will work too if given a chance. If the republicans manage to burn it to the ground then we can look forward to going back to spiraling premiums, denial of coverage for pre-existing conditions, cancellations when we get sick, etc.

Anybody here who thinks the republican party gives a rat's ass about HC reform is living in dreamland. They just want to deny the dems a political victory, drag us back to the mess we had before, and go back to ignoring the problem.

There's virtually no employer-provided insurance in the Swiss model. The PPACA encourages it (or often mandates it). To say it moves us to the Swiss model when it maintains our biggest distinction from the Swiss model is pure wishful thinking.

The Lone Bolt
11-14-2013, 03:15 PM
There's virtually no employer-provided insurance in the Swiss model. The PPACA encourages it (or often mandates it). To say it moves us to the Swiss model when it maintains our biggest distinction from the Swiss model is pure wishful thinking.

Didn't say they are exactly the same. But they are similar enough to suggest that the PPACA will work if properly implemented.

I offer no guarantees. All I'm saying is give it a chance.

BroncoBeavis
11-14-2013, 03:41 PM
Didn't say they are exactly the same. But they are similar enough to suggest that the PPACA will work if properly implemented.

I offer no guarantees. All I'm saying is give it a chance.

Again, there's no logic behind thinking it will work, because it does nothing to address the American system's real flaw.

Too many consumers are removed from the real cost of their healthcare. On one level, because of overinsurance. And that is multiplied by the fact that many (probably most) consumers don't even pay (much) out of pocket for the insurance itself.

Americans need to know and care more about what health services and insurance really cost them. The ACA does what most past reforms have done... it tries to further mask the true cost.

So it won't work. It can't work.

The Lone Bolt
11-14-2013, 03:46 PM
Again, there's no logic behind thinking it will work, because it does nothing to address the American system's real flaw.

Too many consumers are removed from the real cost of their healthcare. On one level, because of overinsurance. And that is multiplied by the fact that many (probably most) consumers don't even pay (much) out of pocket for the insurance itself.

Americans need to know and care more about what health services and insurance really cost them. The ACA does what most past reforms have done... it tries to further mask the true cost.

So it won't work. It can't work.

Real-world evidence says you're wrong. I'll take that over your theories.

DenverBrit
11-14-2013, 03:55 PM
Again, there's no logic behind thinking it will work, because it does nothing to address the American system's real flaw.

Too many consumers are removed from the real cost of their healthcare. On one level, because of overinsurance. And that is multiplied by the fact that many (probably most) consumers don't even pay (much) out of pocket for the insurance itself.

Americans need to know and care more about what health services and insurance really cost them. The ACA does what most past reforms have done... it tries to further mask the true cost.

So it won't work. It can't work.

Explain why American healthcare costs double that of other industrial democracies and is generally less effective?

And what would bring down costs by 50% to bring it into line with those 'unsustainable' healthcare systems?

cutthemdown
11-14-2013, 04:10 PM
LOL they can't do this it will blow up the whole system. If they don't cancel those policies those 15 million people don't pay into the system. If they don't get the young people they don't either. All it takes now to completely blow Obamacare out of the water is a delay of the fines for not having insurance.

Obama is on the ropes and this is going to kill midterms for the conservative dems.

cutthemdown
11-14-2013, 04:10 PM
Explain why American healthcare costs double that of other industrial democracies and is generally less effective?

And what would bring down costs by 50% to bring it into line with those 'unsustainable' healthcare systems?

I thought USA had better cure and survival rates for cancer then the EU did?

BroncoBeavis
11-14-2013, 04:16 PM
Real-world evidence says you're wrong. I'll take that over your theories.

There is no comparable evidence from an employer-based coverage system of relevant size. Because we're the only one.

The 'evidence' generally given consists of the fruits of either greater market freedom, or greater price controls (rationing)

Smiling Assassin27
11-14-2013, 04:17 PM
an apology should be enough, right?

https://pbs.twimg.com/media/BZEWM4rIgAArjM3.jpg:large

The Lone Bolt
11-14-2013, 04:20 PM
There is no comparable evidence from an employer-based coverage system of relevant size. Because we're the only one.

The 'evidence' generally given consists of the fruits of either greater market freedom, or greater price controls (rationing)

As far as I can tell the employer-based coverage is not essential to the PPACA. I'm pretty sure that part can be removed and the system would work just fine.

Once again, real world evidence: Switzerland, Massachusetts. They have largely the same systems as the PPACA and they work. Real-world evidence trumps theory any day. And if we need to reform the PPACA to more closely match those systems in order for it to function better then so be it. There's no reason to think we can't.

BroncoBeavis
11-14-2013, 04:36 PM
As far as I can tell the employer-based coverage is not essential to the PPACA. I'm pretty sure that part can be removed and the system would work just fine.

Once again, real world evidence: Switzerland, Massachusetts. They have largely the same systems as the PPACA and they work. Real-world evidence trumps theory any day. And if we need to reform the PPACA to more closely match those systems in order for it to function better then so be it. There's no reason to think we can't.

So your evidence consists of comparing a country where 80% of coverage is employer or government based to one where virtually none of it is?

Should we disband Medicare/aid? Let's get on this Swiss Model.

DenverBrit
11-14-2013, 04:53 PM
I thought USA had better cure and survival rates for cancer then the EU did?

Generally I believe that is true. It's a variable and one that gets distorted by diet, age, smoking etc.

Do we really have the world’s best cancer care?
Survival rates also reflect normal distribution. There are over 200 types of cancers; most are treated similarly among industrialized nations. If we review survival rates from all cancers throughout the industrialized world, different countries lead in different cancers. Survival rates from head and neck cancers are higher in Canada than in the US. Germany has the highest survival rate in esophageal cancer; Austria in stomach cancers; Belgium in pancreatic cancer; etc.

There is the additional question of statistical versus clinical significance. Our five year survival rate for breast cancer is 83.9%, the highest in the world. The survival rate in Canada is 82.5%. Is this difference clinically significant?

Mortality rate, in contrast, reflects the number of people dying of a disease annually. This statistic eliminates the early diagnosis confusion, though over-diagnosis remains.

An intriguing study recently compared mortality rates from all treatable cancers among the US, the UK, France, and Germany. US mortality rates are better compared to our peers. Perhaps Americans do receive better treatment.

Here’s the catch. When mortality rates are restricted only to patients under 65, the US loses its lead – we are right in the middle. Only when we compare mortality rates among patients over 65 do we excel among our peers. Why? Possibly because Medicare gives older Americans the health care access they lacked when younger.

http://www.kevinmd.com/blog/2012/12/worlds-cancer-care.html

From the Lancet study. It varies in the US, Sate to Sate, black vs white.
Study Of 31 Countries Finds Wide Variations In Cancer Survival Rates
In the international comparison, the researchers saw the highest survival rates for breast and prostate cancer in the USA. They also noted Japan as having the highest survival for colon and rectal cancers in men and France as having the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers, while Algeria clearly claimed the lowest survival for all cancers in both men and women.

http://www.medicalnewstoday.com/articles/115086.php

But cancer isn't the only indicator of healthcare success.

According t Bloomberg, the US is ranked 46th, just ahead of Serbia, but just below Iran. :)
http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries

cutthemdown
11-14-2013, 05:00 PM
I think we can argue what country has best care till we are blue in the face but it matter little. The USA has such loose immigration policies for law skill labor you wonder if we compare to the Swiss etc who for the most part have very strict immigration laws. If everyone was a college grad, going to work, then we wouldn't have this problem. It's all the poor people without coverage.

Rohirrim
11-14-2013, 05:01 PM
And under a single-payer system you pay government bureaucrats instead. And you can't take your money anywhere else so they have no incentive to provide quality service.

All the PPACA does is privatize the function of paying out from a pool of the insured to those who need it. And because it's being done by companies who are concerned about keeping customers they will look for ways to provide the best service at the lowest cost. I'd rather have that than a government bureaucracy controlling payments, as long as the insurance companies are properly regulated to prevent them from screwing their customers, which they are under the PPACA.

But the government administrator doesn't take a profit. I've worked in a hospital for years, so I see Medicare and Medicaid work on the ground every day. I don't buy any of the hysteria about the government boogie man running health care. It works good enough.

There is no such thing as a perfect health care system. People die. People also get very sick, or old, and still hang on for a long time. It's a fact of life. For the best for the most, I still go with single payer. It's still the best solution for the big flaw in the ACA concept: There are millions of people living below the poverty line who are not going to be able to afford it and will still come to the ERs.

Rohirrim
11-14-2013, 05:02 PM
And under a single-payer system you pay government bureaucrats instead. And you can't take your money anywhere else so they have no incentive to provide quality service.

All the PPACA does is privatize the function of paying out from a pool of the insured to those who need it. And because it's being done by companies who are concerned about keeping customers they will look for ways to provide the best service at the lowest cost. I'd rather have that than a government bureaucracy controlling payments, as long as the insurance companies are properly regulated to prevent them from screwing their customers, which they are under the PPACA.

But the government administrator doesn't take a profit. I've worked in a hospital for years, so I see Medicare and Medicaid work on the ground every day. I don't buy any of the hysteria about the government boogie man running health care. It works good enough.

There is no such thing as a perfect health care system. People die. People also get very sick, or old, and still hang on for a long time. It's a fact of life. For the best for the most, I still go with single payer. It's still the best solution for the big flaw in the ACA concept: There are millions of people living below the poverty line who are not going to be able to afford it and will still come to the ERs. Not only that, it will significantly lower the cost of drugs with volume buying.

Taco John
11-14-2013, 05:10 PM
Everybody here knows my own ideas on that. I just think universal, single payer is inevitable.

Will never happen. The pendulum will swing back in the other direction before such a thing could ever become a reality, and there's no political will in DC to fight for such a thing. Who is going to do it? Where are they going to get their support? How will it get past the House? Or even the Senate?

This is fantasy. There is no political roadmap in existence right now for this to be a reality.

The Lone Bolt
11-14-2013, 05:11 PM
So your evidence consists of comparing a country where 80% of coverage is employer or government based to one where virtually none of it is?

Should we disband Medicare/aid? Let's get on this Swiss Model.

The Swiss model does offer government subsidies.

The government subsidizes health care for the poor on a graduated basis, with the goal of preventing individuals from spending more than 10 percent of their income on insurance.

http://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/

And once again, employer-based insurance doesn't appear to be an essential part of the PPACA. If we need to abandon that requirement it can be done and the evidence suggests that the PPACA will function just fine without it.

So yes, if need be the PPACA can be more closely modeled after Swisscare through reform.

The Lone Bolt
11-14-2013, 05:17 PM
But the government administrator doesn't take a profit. I've worked in a hospital for years, so I see Medicare and Medicaid work on the ground every day. I don't buy any of the hysteria about the government boogie man running health care. It works good enough.

There is no such thing as a perfect health care system. People die. People also get very sick, or old, and still hang on for a long time. It's a fact of life. For the best for the most, I still go with single payer. It's still the best solution for the big flaw in the ACA concept: There are millions of people living below the poverty line who are not going to be able to afford it and will still come to the ERs. Not only that, it will significantly lower the cost of drugs with volume buying.

Government assistance is an essential part of the PPACA. The goal as I see it is to privatize and properly regulate as much as possible in order to reap the benefits of the free market with the same guarantees, and without the shortcomings, of government programs.

DenverBrit
11-14-2013, 05:20 PM
I thought USA had better cure and survival rates for cancer then the EU did?

I think we can argue what country has best care till we are blue in the face but it matter little.

That selective bi polar condition can now be covered.....I think. :P

peacepipe
11-14-2013, 05:25 PM
Government assistance is an essential part of the PPACA. The goal as I see it is to privatize and properly regulate as much as possible in order to reap the benefits of the free market with the same guarantees, and without the shortcomings, of government programs.

there are quite a bit more shortcomings with the private sector vs government. you got to remember profit always comes first in the private sector,which isn't very healthcare friendly.

Rohirrim
11-14-2013, 05:40 PM
Government assistance is an essential part of the PPACA. The goal as I see it is to privatize and properly regulate as much as possible in order to reap the benefits of the free market with the same guarantees, and without the shortcomings, of government programs.

That's our fundamental difference: I don't believe that healthcare should be a profit making endeavor, beyond the practitioners themselves earning a fair wage for their services.

pricejj
11-14-2013, 05:54 PM
Ro the Swiss have had a system just like the PPACA in place for the last 20 years and Massachusetts for the last 10. The PPACA will work too if given a chance.

LOL You have no clue.

Massachussetts has the HIGHEST health care costs in the entire world, with the FASTEST INCREASING healthcare costs anywhere in the entire world. Massachussetts is going in debt FASTER (as a % of GDP) than any state in the US.

The problem with people like you, is you literally have NO IDEA how economics work.

pricejj
11-14-2013, 05:57 PM
Singapore is where all sustainable health care is headed.

Fortunately, with minor changes (away from Obamacare) US healthcare costs can be diminished rapidly.

cutthemdown
11-14-2013, 07:11 PM
That selective bi polar condition can now be covered.....I think. :P

It can be covered but i have to pay 250 a month and the first 5000 myself before obamacare does anything about it. Hey but poor people can get some fo free.

BroncoBeavis
11-14-2013, 08:11 PM
According t Bloomberg, the US is ranked 46th, just ahead of Serbia, but just below Iran. :)
http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries

Dude, that's a cost benefit analysis.

"When life comes to death, we're not as thrifty as Serbia!!!" LOL

pricejj
11-14-2013, 08:24 PM
This Socialist Progressive administration is disgusting.


1. Millions of law-breakers and illegals go to the ER and don't pay for expensive medical service, not because they have an emergent situation...but because they know they will be treated.
2. Rather than FIX the problem, the administration forces everyone to purchase unnecessary insurance.

Instead of holding the non-paying lawbreakers and illegals accountable, Obama demands payment in full from people who aren't even receiving the care to begin with, while offering illegals amnesty, and patting the non-paying lawbreakers on the back.

Absolutely disgusting.

pricejj
11-14-2013, 08:36 PM
It's a lawless regime.

Refuses to enforce immigration laws. But will pursue American taxpayers relentlessly BAMN in order to pay for those illegals.


You will NOT find any other country in the world, where this is happening.

pricejj
11-14-2013, 08:42 PM
Have you seen these putrid ads?

https://pbs.twimg.com/media/BY5Cw-EIMAA6AqQ.jpg

This is the Socialist Progressives. Absolutely horrifying.

All of you Democrats who voted for, and continue to defend this filth should be ashamed.

DenverBrit
11-14-2013, 08:46 PM
Dude, that's a cost benefit analysis.

"When life comes to death, we're not as thrifty as Serbia!!!" LOL


the U.S. spends the most on health care on a relative cost basis with the worst outcome

I've cut and pasted the sub headline for you, try again.

Better yet, go find data that puts US health care at the top of the rankings.

Or even......top ten?....top twenty?? Top thirty??

Seriously, why are you attempting to debate a topic you don't understand??

DenverBrit
11-14-2013, 09:06 PM
Have you seen these putrid ads?


This is the Socialist Progressives. Absolutely horrifying. This is your tax dollars at work America.

All of you Democrats who voted for, and continue to defend this filth should be ashamed.

LOL Filth?? :rofl:

Singapore is where all sustainable health care is headed.

Fortunately, with minor changes (away from Obamacare) US healthcare costs can be diminished rapidly.

What we need is government mandated healthcare costs like the system you have championed, Singapore.

From the WHO 2010 report on MSA's.


3.1 Singapore
The impact of MSAs in Singapore is difficult to assess due to concurrent reforms in the health sector and lack of information (Hsiao 1995).
What is available indicates that while MSAs were effective in reducing consumption, they were ineffective in containing costs or extending coverage (Barr 2001).
In fact, an initial increase in health expenditure followed the introduction of MSAs, likely due to simultaneous infrastructural upgrades (Hsiao 1995).
Furthermore, MSAs were not successful in introducing price competition as the Singaporean system operates on quality, e.g. physical amenities,
rather than on price or technical measures (Dixon 2002).
As such, high-cost not cost-effective care is provided, with service intensity and costs inflated. Reductions were not seen until the government recognised
supply-side forces and intervened with regulations (Hanvoravongchai 2002). Cost reductions, therefore, cannot be attributed to MSAs but rather
to direct government control (Barr 2001, Hsiao 2001, Dixon 2002). MSAs also failed to fill coverage gaps in Singapore. Despite their
compulsory nature and a 95% subscription rate in 1992 (Hsaio 1995), MSAs have played a small role in total spending, representing only 8% in 1999,
due to restrictions on their use (Hanvoravongchai 2002). Important population segments remained without adequate coverage, and in
recognition, the government created other forms of risk-pooling and safety
nets for the poor and elderly. Coverage was extended because of these schemes, not MSAs (Barr 2001, Dixon 2002)
http://www.who.int/healthsystems/topics/financing/healthreport/MSAsNo17FINAL.pdf

Rohirrim
11-14-2013, 10:26 PM
I see Price has gone full nutso.

BroncoBeavis
11-14-2013, 10:53 PM
I've cut and pasted the sub headline for you, try again.

Better yet, go find data that puts US health care at the top of the rankings.

Or even......top ten?....top twenty?? Top thirty??

Seriously, why are you attempting to debate a topic you don't understand??

Says the guy touting a list that puts Libya ahead of Canada or the UK LOL :rofl:

pricejj
11-14-2013, 10:59 PM
For Lone Bolt, who LOVES Obamacare, because it's just like Massachussetts and Switzerland. PLEASE do us all a favor, and take ECON 101 before you vote next time. Government spending in a private industry (like healthcare, real estate, and education) creates MASSIVE INFLATION.

The U.S. ranks second in health care cost per capita ($8,608), only to be outspent by Switzerland ($9,121).

U.S. Socialist Democrats certainly don't want to be outdone by the Swiss.

pricejj
11-14-2013, 11:02 PM
I see Price has gone full nutso.

Shouldn't you be working on your manifesto comrade?

The Lone Bolt
11-14-2013, 11:16 PM
For Lone Bolt, who LOVES Obamacare, because it's just like Massachussetts and Switzerland. PLEASE do us all a favor, and take ECON 101 before you vote next time. Government spending in a private industry (like healthcare, real estate, and education) creates MASSIVE INFLATION.

The U.S. ranks second in health care cost per capita ($8,608), only to be outspent by Switzerland ($9,121).

U.S. Socialist Democrats certainly don't want to be outdone by the Swiss.

Hmm. So why do Massachusetts citizens surveyed overwhelmingly support the law?

http://thehill.com/blogs/healthwatch/state-issues/315505-mass-poll-finds-high-satisfaction-under-romneycare

http://thehill.com/blogs/healthwatch/state-issues/315505-mass-poll-finds-high-satisfaction-under-romneycare

I think that the most important measure of a law's success is the support of those who actually live under it, wouldn't you agree? hmmm...

The Mass law has been in place for ten years now and there's no support for overturning it (in fact just the opposite). The Swiss law has been in place for twenty years now and there's no support for overturning it. What does that tell you?

The Lone Bolt
11-14-2013, 11:20 PM
I see Price has gone full nutso.

I agree. I'm actually enjoying the major freak-out by the repubs on this board.

pricejj
11-14-2013, 11:28 PM
LOL Filth?? :rofl:


You lie like your President.

Brit has no clue about Singapore's healthcare, while quoting 20 year old sources (1995), just as Singapore's HSA's began to have a MAJOR impact.

Please come into the 21st century.

That's what I don't get about the Socialists. They refuse to look at sustainable solutions (like Singapore), and continue to look at a century-old broken European model, which doesn't work.

http://www.expatmedicare.com/healthcare-singapore-expats-guide

1. Singapore’s healthcare system is funded by both the government and by individuals and their employers. Government expenditure on healthcare is only 3.5% of its GDP, of which 68.1% comes from private sources.
2. Employees save 20% total of their salary (pre-tax), and Employers contribute 15% towards a fund which can be used for retirement, real estate, education, and health (5% towards health, MEDISAVE).
3. To pay for personal medical expenses, the Government implemented the ‘4M’ framework of Medisave, Medishield, Medifund and Medication Assistance Fund. Implemented in 1984, Medisave can be used to pay for hospital expenses incurred by the individual or his dependent(s). Limits are set and adjustments are made every now and then to ensure sufficient savings to last for a lifetime.
4. 80% of the primary healthcare is made up of some 2,000 private medical and dental clinics (the other 20% taxpayer subsidized polyclinics).
5. The Hospital system consists of 15 public hospitals (where Singaporeans enjoy 80% subsidy), and 21 private hospitals. Singapore's public hospitals are much better, cheaper, and efficient than "government hospitals" in other countries.

pricejj
11-14-2013, 11:33 PM
Hmm. So why do Massachusetts citizens surveyed overwhelmingly support the law?
What does that tell you?

Massachussetts is overwhelmingly Liberal, and enjoys paying much more for their healthcare than anyone else in the world?

I'd much rather pay 3.5% of GDP than 17% of GDP towards highly efficient healthcare wouldn't you?

pricejj
11-14-2013, 11:36 PM
I agree. I'm actually enjoying the major freak-out by the repubs on this board.

The only ones freaking out are Democrat lawmakers. I have been showing you the best solution (by far), Singapore, ever since President PantsOnFire was elected.

It doesn't matter if you choose to ignore it or not. The entire world is moving that direction, as it's the only sustainable way to both keep costs low for the general populace, and provide a safety net for the poor.

The U.S. is remarkably close to the Singapore model:
1. The first step is to change the 'individual insurance mandate' into an 'individual HSA mandate'. Eliminate 'bronze plans', replace them with 'catasrophic' plans that people can CHOOSE to purchase if they want.
2. Step two is to separate Medicare/Medicaid hospital's and doctor's from the private sector (which may already be happening).
3. Step three: eliminate Obama's ridiculous 'free' procedures for a chosen few, and implement fee-for-service for EVERY procedure (even if it's a small fee). No more hidden costs that are shifted onto other people.
4. Regulate costs in the public (Medicare/Medicaid) hospitals to limit taxpayer liability (like Tricare).
5. Allow drug-reimportation (Democrats have repeatedly voted this down over the last decade).
6. Allow to purchase 'catastrophic' plans (all insurance plans) across state lines.


All the healthcare problems would be solved. Efficiency would be high. Quality would be high. And costs would instantly drop to less than 10% of GDP within 5 years (I guarantee it).

BroncoBeavis
11-14-2013, 11:37 PM
Hmm. So why do Massachusetts citizens surveyed overwhelmingly support the law?

http://thehill.com/blogs/healthwatch/state-issues/315505-mass-poll-finds-high-satisfaction-under-romneycare

http://thehill.com/blogs/healthwatch/state-issues/315505-mass-poll-finds-high-satisfaction-under-romneycare

I think that the most important measure of a law's success is the support of those who actually live under it, wouldn't you agree? hmmm...

The Mass law has been in place for ten years now and there's no support for overturning it (in fact just the opposite). The Swiss law has been in place for twenty years now and there's no support for overturning it. What does that tell you?

Funny, I've been told you can't gauge quality by self-satisfaction surveys. Sad thing is, those poll numbers look very similar to these numbers

http://www.cnn.com/2009/POLITICS/03/19/health.care.poll/

From long before the "If I Like it, You can Keep It" Care Act was finally passed.

"When Americans say they support health care reform, that doesn't mean they want to lose their own coverage or give up their own doctor," said Keating Holland, CNN's polling director. "That's something that the Clinton White House didn't realize in 1993."

Whoops. LOL

The Lone Bolt
11-14-2013, 11:43 PM
Massachussetts is overwhelmingly Liberal, and enjoys paying much more for their healthcare than anyone else in the world?

I'd much rather pay 3.5% of GDP than 17% of GDP towards highly efficient healthcare wouldn't you?

I see. So the "overwhelmingly liberal" Mass voters are embracing in overwhelming numbers a system based on, not single payer, but the free market.

And you have declared yourself the better judge of the system that they live under and you don't.

Excuse me while I roll on the floor laughing...


BWAAAAAAAAHAHAHAHAHAHAHAHAHAHAHAHAHA


HEHEHEHEHEHEHEHE


SNARF SNARF HAHAHAHAHAHAHA


Giggle.... giggle... snarf...







OK I'm done now. :D

pricejj
11-14-2013, 11:48 PM
I see. So the "overwhelmingly liberal" Mass voters are embracing in overwhelming numbers a system based on, not single payer, but the free market.


The U.S. system is not free-market. Government spending (Medicare, Medicaid) in the private system has INFLATED healthcare costs through the roof.

...just like in housing....just like in college tuition.

pricejj
11-14-2013, 11:58 PM
Whoever voted for Obama, is an absolute moron. That fact can't be denied. The guy lies through his teeth with every word he says. It's obvious he thinks he's a dictator, and has ZERO CLUE about economics, or how to do his job.

Let's make everything more expensive, make everyone more miserable, break a bunch of laws, circumvent the constitution, and rack up more debt than ALL the other Presidents combined! YAY!!!

Obama, Harry Reid, Pelosi, et al. will be remembered as some of the biggest criminals in U.S. history.

pricejj
11-15-2013, 12:04 AM
The U.S. Democrat Socialists try to copy European Socialism.


Yeah, really working bozos!

Even with MASSIVE quantitative easing, the EU is still contracting, and unemployment is still going up.

What is it in your brains that refuses to recognize how economics work? Maybe you just LIKE being slaves to government control? Wake the **** up.

The Lone Bolt
11-15-2013, 12:06 AM
The U.S. Democrat Socialists try to copy European Socialism.


Yeah, really working bozos!

Even with MASSIVE quantitative easing, the EU is still contracting, and unemployment is still going up.

What is it in your brains that refuses to recognize how economics work? Maybe you just LIKE being slaves to government control? Wake the **** up.

Ahh the freak-out continues. Music to my eyes. ;D

pricejj
11-15-2013, 12:46 AM
Also a special message to Blart, who is rarely seen these days.

Remember when I was telling you printing money was a bad idea...and you said 'what inflation'?

I told you that the gap between those who have assets, and those who don't have assets would become insurmountable?

Looks like I'm right again (just like on everything else).

barryr
11-15-2013, 03:40 AM
Obama thinks after insurance companies have dropped millions with more to come that he can tell them to change and give back people's insurance is comical and lies at the same time. The insurance companies love this: higher premiums and higher deductibles. Obama knows they won't go back now, and that is the plan. Force people off their individual insurances and into Obamacare with those higher costs that they can't afford and/or having their insurances dropped.

UltimateHoboW/Shotgun
11-15-2013, 07:06 AM
http://d1ovi2g6vebctw.cloudfront.net/wp-content/uploads/2013/11/o-RACHEL-MADDOW-facebook-700x392.jpg


Now they are fixing the problem.......on purpose!

DenverBrit
11-15-2013, 09:30 AM
Brit has no clue about Singapore's healthcare, while quoting 20 year old sources (1995), just as Singapore's HSA's began to have a MAJOR impact.



LOL

OMG, you can't even read a dumbed down paper without getting confused. Hilarious!

The 2010 WHO report quote merely sourced the original papers on the introduction of the MSA's and reports on the outcome.

WHO 2010 Report.
Reductions were not seen until the government recognised
supply-side forces and intervened with regulations (Hanvoravongchai 2002). Cost reductions, therefore, cannot be attributed to MSAs but rather
to direct government control (Barr 2001, Hsiao 2001, Dixon 2002)


"Cost reductions attributed to Direct government control" Got it yet?? Ha!

No? ok, here's the abstact from Barr's report on MSA's in Singapore.

Abstract

With the United States currently experimenting with medical savings accounts (MSAs), it is appropriate to revisit the Singapore experience, where the practice has been in place for a decade and half. Singapore runs a modern, effective health system at a fraction of the cost of most systems operating in the developed West. Although MSAs contribute to the framework of a cultural rhetoric of personal responsibility for health care, this article argues that the heart of the Singapore system of health funding, with its financial discipline, is government control of inputs and outputs and strict rationing of health services according to wealth.

B-Large
11-15-2013, 09:41 AM
Everybody here knows my own ideas on that. I just think universal, single payer is inevitable. I don't even bother with the political argument over it anymore. I think it's just inescapably practical. Eventually, we will have no other option. I guess some people thought the ACA was some kind of sneaky stepping stone to that, but I never agreed with that take. I think the ACA was a last ditch effort by the insurance companies to avoid it. After all, ACA delivers everybody to the doorstep of the insurance companies. How anybody can think that's a stepping stone to single payer is beyond me, except maybe by the circuitous route that it will fail and then single payer will be inevitable. Me? I think it's inevitable either way. People on the single payer side of the equation are just waiting for common sense to lead everybody else to that same conclusion. ;D

Single Payor
Individual Dedcutibles for Every Person based on income, no exceptions
Providers and Hospital can be public or private

Its very simple, it would be much cleaner and still ahev incentives for people to use their dollars wisely.

Lets abort this current TPA mess, and get on with it...

DenverBrit
11-15-2013, 09:42 AM
Says the guy touting a list that puts Libya ahead of Canada or the UK LOL :rofl:

Nope, I linked to Bloomberg's list and challenged you to find a list where US healthcare is indexed in the top thirty or better.

You can't, so you make another of your dumabass statements.

You, Price and Barry are typical of the current right wingnut philosophy.

"Ignorance is bliss"

B-Large
11-15-2013, 09:46 AM
Again, there's no logic behind thinking it will work, because it does nothing to address the American system's real flaw.

Too many consumers are removed from the real cost of their healthcare. On one level, because of overinsurance. And that is multiplied by the fact that many (probably most) consumers don't even pay (much) out of pocket for the insurance itself.

Americans need to know and care more about what health services and insurance really cost them. The ACA does what most past reforms have done... it tries to further mask the true cost.

So it won't work. It can't work.

that why you do a system of single payor, with every person having a deductible to cover before the risk pool releases a dime of payment. Youget the efficiencies of a streamlined payment system witht the incentives for people to make better choices...

BroncoBeavis
11-15-2013, 10:00 AM
Nope, I linked to Bloomberg's list and challenged you to find a list where US healthcare is indexed in the top thirty or better.

You can't, so you make another of your dumabass statements.

You, Price and Barry are typical of the current right wingnut philosophy.

"Ignorance is bliss"

Did you look at the methodology. It's basically life expectancy over cost. Laughable.

The fact that you'd even link to it says everything.

I've already linked studies that show superior cancer outcomes in the US. That's not a product of luck. You tend to cite studies that lean on life expectancy (demographic) or cost efficiency (should we let Papa die, or sell our only Mule?), or how much government pays vs personal out of pocket (because government has magical money trees)

Pony Boy
11-15-2013, 10:05 AM
Single Payor
Individual Dedcutibles for Every Person based on income, no exceptions
Providers and Hospital can be public or private

Its very simple, it would be much cleaner and still ahev incentives for people to use their dollars wisely.Lets abort this current TPA mess, and get on with it...

With Single Payer everything is paid for with taxes and has the government making decisions for private citizens. Many citizens will hate the idea that their money will be paying and supporting the unhealthy decisions of others.

Write it down, it will never happen. No one wants to be told they have to pay to swim in a public pool where half of the people are pissing in it for free.

BroncoBeavis
11-15-2013, 10:05 AM
that why you do a system of single payor, with every person having a deductible to cover before the risk pool releases a dime of payment. Youget the efficiencies of a streamlined payment system witht the incentives for people to make better choices...

That all works up until the people with less money start skipping treatments because they can't afford the deductible and appeal to the news at 11. While the millionaires instantly see their private providers that don't accept the single-payer rabble.

In short, we wouldn't be much further along than we are today. As I've said, I'm not theoretically opposed to a backstop safety-net public program in the right circumstances. But in entitlement America, what it'll end up translating to is "I deserve the same service Bill Gates Gets!"

Which is high comedy. But it passes for critical thinking in some circles.

DenverBrit
11-15-2013, 10:16 AM
Did you look at the methodology. It's basically life expectancy over cost. Laughable.


LOL

Right, life expectancy has nothing to do with healthcare.

DenverBrit
11-15-2013, 10:20 AM
Did you look at the methodology. It's basically life expectancy over cost. Laughable.

The fact that you'd even link to it says everything.

I've already linked studies that show superior cancer outcomes in the US. That's not a product of luck. You tend to cite studies that lean on life expectancy (demographic) or cost efficiency (should we let Papa die, or sell our only Mule?), or how much government pays vs personal out of pocket (because government has magical money trees)

Some cancers, yes, that is not in dispute.

Study Of 31 Countries Finds Wide Variations In Cancer Survival Rates
In the international comparison, the researchers saw the highest survival rates for breast and prostate cancer in the USA. They also noted Japan as having the highest survival for colon and rectal cancers in men and France as having the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers, while Algeria clearly claimed the lowest survival for all cancers in both men and women.http://www.medicalnewstoday.com/articles/115086.php

BroncoBeavis
11-15-2013, 10:24 AM
LOL

Right, life expectancy has nothing to do with healthcare.

I've posted this before.

http://www.slate.com/blogs/moneybox/2013/08/28/life_expectency_health_care.html

It's basically your Comrade Yglesias dismantling the very "study" you posted.

BroncoBeavis
11-15-2013, 10:27 AM
Some cancers, yes, that is not in dispute.

For all cancers, Europe had a much lower survival than the US. Survival for prostate cancer in the US is 91.9% compared to 57.1% in Europe - a 34% difference. The difference for breast cancer survival, however, is 10%. In Europe, the western countries generally had higher cancer survival rates: France led survival for rectum and colon cancers, Sweden led for breast cancer (82%), and Austria led for prostate cancer. Eastern Europe, on the other hand, did not perform as well. Slovakia had the lowest survival rates for rectal cancer in men and breast cancer, and Poland had the lowest survival rates for the other studied cancers.

Our Health Care is duh Worst! LOL

DenverBrit
11-15-2013, 10:35 AM
I've posted this before.

http://www.slate.com/blogs/moneybox/2013/08/28/life_expectency_health_care.html

It's basically your Comrade Yglesias dismantling the very "study" you posted.

Good for him. So post a different ranking instead of deflecting and avoiding the subject.

My comrade?? WTF does that mean?

Are you implying I'm a communist because I disagree with your opinions??

BroncoBeavis
11-15-2013, 11:07 AM
Good for him. So post a different ranking instead of deflecting and avoiding the subject.

My comrade?? WTF does that mean?

Are you implying I'm a communist because I disagree with your opinions??

Your own article shows we show very good Apples-to-Apples outcomes.

And I'm implying that Yglesias agrees with you in many ways on the Health Care front. But even he can't take the "study" you posted seriously.

W*GS
11-15-2013, 11:21 AM
LOL

Right, life expectancy has nothing to do with healthcare.

Interesting visualization:

http://www.healthmetricsandevaluation.org/tools/data-visualization/us-health-map

BroncoBeavis
11-15-2013, 11:34 AM
Interesting visualization:

http://www.healthmetricsandevaluation.org/tools/data-visualization/us-health-map

Hey, sweet. You can almost tell where all the reservations are. We better talk to whoever's in charge of their Health Care system. LOL

B-Large
11-15-2013, 12:04 PM
With Single Payer everything is paid for with taxes and has the government making decisions for private citizens. Many citizens will hate the idea that their money will be paying and supporting the unhealthy decisions of others.

Write it down, it will never happen. No one wants to be told they have to pay to swim in a public pool where half of the people are pissing in it for free.

At the end of the day, insurers and CMS pay for testing and procedures based on evidence based recommendations from expert panels.. does it really matter if the State of Colorado's Risk Pool Pays, or Cigna Colorado Risk Pool pays? If Government were to run it, at least Voters can change the HHS secretary if they didn't like the the expenditures on healthcare.. what recourse do you have with Cigna, litigation?

To your other point, we already pay for people who make bad decisions, thats risk pooling... and we also pay for people who go to cross fit every AM, have 5% fat and get pancreatic cancer... it all gets paid for on way or another, nobody is uimmune to healthcare costs, they WILL catch up with you at some point.. so why not implement the most efficient system possible?

B-Large
11-15-2013, 12:09 PM
That all works up until the people with less money start skipping treatments because they can't afford the deductible and appeal to the news at 11. While the millionaires instantly see their private providers that don't accept the single-payer rabble.

In short, we wouldn't be much further along than we are today. As I've said, I'm not theoretically opposed to a backstop safety-net public program in the right circumstances. But in entitlement America, what it'll end up translating to is "I deserve the same service Bill Gates Gets!"

Which is high comedy. But it passes for critical thinking in some circles.

The deductible would be income based, so really outside of some peripheral financial hardship people don't really have an excuse.... Rich people already have conceige docs, but thatis for primary care- they will still have to work in the same system to see specialists just liek the rest of us...

Its probably one of the best proposed solutions out there, common risk pooling with a flavor of pay your own way..... hybrid if you will

pricejj
11-15-2013, 01:00 PM
...


Life expectancy in Colorado (80 years) is the same as the U.K. (80). Yet you want the U.S. to go to single payer for life expectancy reasons?



Life expectancy in Hawaii (82.7 years) is better than in any single payer country.

BroncoBeavis
11-15-2013, 01:08 PM
The deductible would be income based, so really outside of some peripheral financial hardship people don't really have an excuse.... Rich people already have conceige docs, but thatis for primary care- they will still have to work in the same system to see specialists just liek the rest of us...

That's where you're missing something. Once the single-payer price fix sets in, a whole second market begins. The best providers take cash (or private coverage) and get paid what the market will pay. The lower-tier providers stay behind and manage the squeeze chute for the 'rest of us'

So long as everyone's ok with that, it works ok. Problem is, these same Progressives will never be ok with that once the rubber meets the road.

B-Large
11-15-2013, 01:16 PM
That's where you're missing something. Once the single-payer price fix sets in, a whole second market begins. The best providers take cash (or private coverage) and get paid what the market will pay. The lower-tier providers stay behind and manage the squeeze chute for the 'rest of us'

So long as everyone's ok with that, it works ok. Problem is, these same Progressives will never be ok with that once the rubber meets the road.

I think that is a bit simplistic. Specialty providers will still take pateints with insurance, because it pays better than primary care. Also, what some of these MD in primary care find out is, by the time they have a panel of 500 cash paying pateints, they work 80 hours a week, spend tons of time on call, and its costs them a fortune to run a stand alone practice... most INternists will navigate to Kaiser or an Academic Medical Center, where they can still make a good salary, see 20-30 patients a day and don't have to worry about all the BS of a concierge medicine practice- plus they tend to get primary care support agreements in those places where the specilties support primacy care wish is always a money loser.

BroncoBeavis
11-15-2013, 01:24 PM
I think that is a bit simplistic. Specialty providers will still take pateints with insurance, because it pays better than primary care. Also, what some of these MD in primary care find out is, by the time they have a panel of 500 cash paying pateints, they work 80 hours a week, spend tons of time on call, and its costs them a fortune to run a stand alone practice... most INternists will navigate to Kaiser or an Academic Medical Center, where they can still make a good salary, see 20-30 patients a day and don't have to worry about all the BS of a concierge medicine practice- plus they tend to get primary care support agreements in those places where the specilties support primacy care wish is always a money loser.

It won't look much like concierge medicine. That's a whole different animal, and a product of today's market. Under single payer, you'll have whole separate health channels. Especially in decent-sized markets where there's enough market that doesn't need any public coverage.

That is unless some sort of economic incentive (like queue hopping) is introduced. But that brings about a whole other set of problems.

DenverBrit
11-15-2013, 02:03 PM
Life expectancy in Colorado (80 years) is the same as the U.K. (80). Yet you want the U.S. to go to single payer for life expectancy reasons?



Life expectancy in Hawaii (82.7 years) is better than in any single payer country.

Yeah, that's what I posted, a rational for adopting a single payer system so we could all live to the same age. :rofl:

Actually, for half the cost of the US system with everyone covered and free market supplemental insurance, not a bad idea. Well done.

I actually would prefer to head towards the Singapore model. But the right wing, at the same time, want the Singapore system, but reject or deny its mandates and government controls. Sound familiar?

An excellent Healthcare blog sums it up nicely.

That’s how you get conservatives advocating for Singapore’s health care system without any real understanding of it.
Singapore’s system has massive subsidies for nursing homes, rehabilitation care, and home-based care. It requires mandatory savings – 36% of wages spread over various accounts.
The government also provides a basic level of care that’s heavily, heavily subsidized. And here’s the kicker – it relies on tons of government intervention in the market to keep costs down.
They use centrally planned and fixed budgets, they control the acquisition of new technology, they regulate the number of students and physicians,
they use purchasing power to buy drugs more cheaply, they have an employer mandate for foreign workers,and they have a national EHR. They’re also not the most open society in the world.

Here’s the thing. I bet you could find lots of liberal wonks, and lots of Democrats, who would be fine with much of the above.
You want Swisscare? Great. You want Singapore? OK. The problem is that’s not what’s offered. It’s Swisscare, but without a mandate.
Guess what? That’s doesn’t work – that’s why Swisscare has a mandate!

They suggest Singapore, but without the mandatory savings, public hospitals, and government management. That doesn’t work – that’s why Singapore has those aspects.


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TonyR
11-15-2013, 05:14 PM
Whoever voted for Obama, is an absolute moron.

So, then, you were a Sarah Palin guy?

Pony Boy
11-15-2013, 05:25 PM
At the end of the day, insurers and CMS pay for testing and procedures based on evidence based recommendations from expert panels.

So depending on the age of the patient and the advancement of their illness an expert panel will determine if the patient can pull money from the pool they have paid into. In other words government run death panels.

pricejj
11-15-2013, 08:25 PM
Actually, for half the cost of the US system with everyone covered and free market supplemental insurance, not a bad idea. Well done.



How about we go quarter the cost and live longer with the Singapore approach? Much better.

So, then, you were a Sarah Palin guy?

In 2008 I was the only person in Boulder County to vote for Gene Amondson (to see if my vote would actually be counted), because I was disgusted with Obama and McCain.

L.A. BRONCOS FAN
11-18-2013, 12:36 AM
So let me get this straight:

The republi-cons had eight years to fix the problem, did absolutely nothing, and now they actually think they're credible when they talk about health care reform?

L0L! :laugh:

http://www.bartcop.com/palin-scrabble.jpg