[kenberg]

On a different set of recent posts, in my experience emergency room care is a very very mixed bag. Very.

[mike777]

I found comments from renown British cardiac surgeon Stephen Westaby informative in this whole discussion regarding socialized medicine, minimum health care coverage and Medicaid budgets.

Britain's National Health Care service values saving money over saving lives.
NHS is reluctant to cover the costs of advanced interventions.
He discusses treatment delays and poor attention to best practices by the NHS
Medical Directors are intent on ensuring that "no one does anything new or interesting" (lets call that innovation or lack thereof)

[Winstonm]

kenberg, on 2017-July-14, 05:54, said:

On a different set of recent posts, in my experience emergency room care is a very very mixed bag. Very.

It is interesting that your experience and my experience is at odds with the poster who is selling ER as the best answer for healthcare.

[barmar]

rmnka447, on 2017-July-13, 14:02, said:

Simply providing insurance isn't a panacea. It has to be accompanied by a concomitant serious look at how to expand healthcare capacity. But that's not how the discussion is being framed.

The ACA is clearly not a panacea, it's full of compromises that were necessary to get it passed. But it was a step in the right direction, with plans to implement other improvements like cost containment. The GOP is trying to go backwards, without replacing it with a better solution.

[RedSpawn]

barmar, on 2017-July-14, 07:52, said:

The ACA is clearly not a panacea, it's full of compromises that were necessary to get it passed. But it was a step in the right direction, with plans to implement other improvements like cost containment. The GOP is trying to go backwards, without replacing it with a better solution.

The GOP is trying to rollback ACA so it can give tax breaks to the wealthy constituents before the 2018 midterm elections. There is a method to the madness.

[mike777]

RedSpawn, on 2017-July-16, 15:28, said:

The GOP is trying to rollback ACA so it can give tax breaks to the wealthy constituents before the 2018 midterm elections. There is a method to the madness.

Negative income tax or Universal Income anyone?


as for health care some version or form of medicare or Medicaid for everyone seems the pathway, We can deal with paying for it, fixing it, stopping fraud and waste and some form of tort reform for later.

As long as there are tests to perform to stop a lawsuit, patients refuse to ask the cost, we only ask if it hurts, docs will order it.

[ldrews]

Recent study/report on how US Health Care compares to other developed countries: http://www.commonwea.../mirror-mirror/

[Winstonm]

ldrews, on 2017-July-17, 19:15, said:

Recent study/report on how US Health Care compares to other developed countries: http://www.commonwea.../mirror-mirror/

This is good. Thanks for the post.

[ldrews]

So it appears that the Republican Senate couldn't get its act together, even to just repeal Obamacare. Just another indication of the lack of social consensus.

Obamacare will continue to be the law of the land for the foreseeable future. And it appears to be imploding. All of those people who now have individual/family coverage and can't afford the premiums, copays or deductibles. And all of those people who are eligible but cannot even get coverage because there are no insurers left in their area. Let us hope that not too many people get hurt.

[cherdano]

ldrews, on 2017-July-18, 15:00, said:

So it appears that the Republican Senate couldn't get its act together, even to just repeal Obamacare. Just another indication of the lack of social consensus.

To the contrary, it is a sign of a majority social consensus that the government should help its citizens to get healthcare.

Quote

Obamacare will continue to be the law of the land for the foreseeable future. And it appears to be imploding. All of those people who now have individual/family coverage and can't afford the premiums, copays or deductibles. And all of those people who are eligible but cannot even get coverage because there are no insurers left in their area. Let us hope that not too many people get hurt.

How, exactly, would they have been better off if one of the GOP repeal/replace/rexxxx bills had passed?

[Winstonm]

ldrews, on 2017-July-18, 15:00, said:

So it appears that the Republican Senate couldn't get its act together, even to just repeal Obamacare. Just another indication of the lack of social consensus.

Obamacare will continue to be the law of the land for the foreseeable future. And it appears to be imploding. All of those people who now have individual/family coverage and can't afford the premiums, copays or deductibles. And all of those people who are eligible but cannot even get coverage because there are no insurers left in their area. Let us hope that not too many people get hurt.

Weird. You have shown you are capable of providing reasonable information - but when you talk about the ACA all you do is repeat Trump's BS talking points. The ACA is not collapsing; however, there are areas of it that need improvements. Rising deductibles is only one part.

The reality is that prior to the ACA many states only had 1 or 2 insurers. With the ACA, many states added insurers but now those added insurers are backing out of the states they entered for a variety of reasons. Here in Oklahoma, a Kansas insurer offered coverage the first year of the ACA then withdrew the next year.

That the number of insurers in states is reverting to the norm doesn't mean that the ACA is losing insurers.

Here's a fact check:
http://www.politifac...out-soaring-ob/

[kenberg]

Wasn't there some woman back maybe 25 years ago who tried to get a healthcare plan going? Hillary something or other I think she was called. Maybe Donny and Hillary could go out for a drink and console each other.

[Zelandakh]

Winstonm, on 2017-July-18, 15:28, said:

Weird. You have shown you are capable of providing reasonable information - but when you talk about the ACA all you do is repeat Trump's BS talking points.

Remember when ldrews used to tell everyone to ignore everything DT says? He appears to have become a victim of his own argument.

[helene_t]

rmnka447, on 2017-July-09, 14:13, said:

There's a 900 lb. gorilla that no one advocating universal healthcare has addressed as yet. How do you expand the availability of healthcare to make healthcare receivable in a timely fashion by all the millions of additional people to be covered under the system? Right now, our healthcare delivery systems have a finite capacity and adding millions more individuals vying for that care will cause cost increases and scarcity resulting in rationing. Inevitably, that rationing will result in increased fatalities resulting from inability to receive timely care. How do we prevent that?

You are right that expanding access to healthcare will, in itself, increase the demand for healthcare. And the demand for healthcare in the US is already high and will, regardless of political (non)solutions, grow even bigger for demographic and technological reasons.

However, there are some reasons to hope that expanding access to healthcare will not increase the demand as much as a quick back-of-the envelope calculation suggests:
- Some health services are provided to uninsured anyway, for example through ER. This is not necessarily the most efficient way of providing healthcare so in some cases, the pressure on resources could actually drop.
- Providing care for patients before the disease progress to a stage that require more drastic interventions (removing an appendix before the patient needs to be sent to the ICU etc) could in some cases save resources.

That said, I think that at some point Americans need to get used to the idea that they have to do something about health care that is provided for purely commercial reasons. Somehow doctors need to be motivated to avoid procedures that are not cost-efficient, regardless of who will be paying for it.

[ldrews]

helene_t, on 2017-July-18, 16:26, said:

You are right that expanding access to healthcare will, in itself, increase the demand for healthcare. And the demand for healthcare in the US is already high and will, regardless of political (non)solutions, grow even bigger for demographic and technological reasons.

However, there are some reasons to hope that expanding access to healthcare will not increase the demand as much as a quick back-of-the envelope calculation suggests:
- Some health services are provided to uninsured anyway, for example through ER. This is not necessarily the most efficient way of providing healthcare so in some cases, the pressure on resources could actually drop.
- Providing care for patients before the disease progress to a stage that require more drastic interventions (removing an appendix before the patient needs to be sent to the ICU etc) could in some cases save resources.

That said, I think that at some point Americans need to get used to the idea that they have to do something about health care that is provided for purely commercial reasons. Somehow doctors need to be motivated to avoid procedures that are not cost-efficient, regardless of who will be paying for it.

I believe that California has pending legislation to provide universal healthcare to the residents of California. The only problem seems to be that the estimated budget to fund it is 3 times the current total state budget.

Is everyone prepared to pay the bill for universal health care?

[ldrews]

cherdano, on 2017-July-18, 15:25, said:

To the contrary, it is a sign of a majority social consensus that the government should help its citizens to get healthcare.



How, exactly, would they have been better off if one of the GOP repeal/replace/rexxxx bills had passed?

Well, the Democrats and Republicans certainly do not have a consensus, and the Republicans, among themselves do not have a consensus, as is evidenced by the recent elections and legislative failure. Exactly how do you infer a majority social consensus from this?

I have no idea how the public would be better off under the Republican plans. I think the Republicans are just as screwed up as the Democrats on this issue. But I continue to read about insurance companies pulling out of the market leaving many areas with no insurers available for the private plans, or only 1 insurer available (can you say "no competition" to hold prices?), I also read about premiums going up rapidly, 76% in Oklahoma just this last year. And deductibles also going up. A study showed that 50% of Obamacare hospital copay bills for 2016 are still unpaid, higher % for larger bills.

My take on this is that even if one qualifies for Obamacare, one cannot afford it. This does not seem to me to be signs of a functioning system.

[ldrews]

Zelandakh, on 2017-July-18, 15:50, said:

Remember when ldrews used to tell everyone to ignore everything DT says? He appears to have become a victim of his own argument.

And I still say to watch what Trump does, not what he says. Of course the media doesn't seem to spend much time on reporting what he does, only what he says and RussiaGate.

[Winstonm]

ldrews, on 2017-July-18, 17:44, said:

I believe that California has pending legislation to provide universal healthcare to the residents of California. The only problem seems to be that the estimated budget to fund it is 3 times the current total state budget.

Is everyone prepared to pay the bill for universal health care?

What you fail to mention is that if California adopts a single payer then none of the individuals or corporations would have to pay insurance premiums - that amount could be collected as taxes and eliminate the high administrative costs inherent in the current private payer system.

[Winstonm]

ldrews, on 2017-July-18, 18:03, said:

And I still say to watch what Trump does, not what he says. Of course the media doesn't seem to spend much time on reporting what he does, only what he says and RussiaGate.

What he does? Like this?

Quote

When President Trump’s meeting with Russian President Vladimir Putin went for more than two hours, well past the scheduled half-hour, it was a major news event. But it turns out that wasn’t even the end of the conversation between the two men.

Ian Bremmer, president of the Eurasia Group, first reported the second meeting Tuesday. Other outlets also reported the news, and the White House confirmed it to Reuters. (BuzzFeed journalist Alberto Nardelli had previously reported about a meeting.) Trump reportedly met with the Russian leader for an additional hour of informal chats after a dinner of G20 leaders—though the White House in a statement reported late Tuesday by NBC’s Hallie Jackson called the encounter “brief” and denied it constituted a second meeting. While the first meeting was small—the only attendees were Trump, Putin, the Russian foreign minister, Secretary of State Rex Tillerson, and one interpreter from each country—this was even smaller: just Trump, Putin, and a Russian interpreter. Trump did not have his own interpreter.

[ldrews]

Winstonm, on 2017-July-18, 18:12, said:

What he does? Like this?

Exactly. Trump seems to be establishing better relations with Russia. As the major nuclear weapon power in the world today, I think that is probably a good idea. Or would you prefer to have a confrontational relationship with Russia?