Florida State Seminoles

[bluetick]

Healthcare in the U.S. costs about twice as much as it does in any other developed country. If the $3 trillion U.S. healthcare sector were ranked as a country, it would be the world’s fifth largest economy according to “Consumer Reports." The cost of this huge financial burden to every household because of lost wages, higher premiums and taxes plus additional out-of-pocket expenses is more than $8,000.

Even with all this money being spent on healthcare, the World Health Organization ranked the U.S. thirty-seventh in healthcare systems, and The Commonwealth Fund placed the U.S. last among the top 11 industrialized countries in overall healthcare.

Why is the U.S. paying so much more for care and not appearing at the top of the rankings? Here’s a look at six key reasons the U.S. is failing to provide adequate healthcare at reasonable prices.

1. Administrative Costs

The number one reason our healthcare costs are so high, says Harvard economist David Cutler, is that “the administrative costs of running our healthcare system are astronomical. About one quarter of healthcare cost is associated with administration, which is far higher than in any other country.”

One example Cutler brought up in a discussion on this topic with National Public Radio was the 1,300 billing clerks at Duke University Hospital, which has only 900 beds. Those billing specialists are needed to determine how to bill to meet the varying requirements of multiple insurers. Canada and other countries that have a single-payer system don’t require this level of staffing to administer healthcare.

2. Drug Costs

Another major difference in health costs between the U.S. and every other developed nation is the cost of drugs. The public definitely believes drug costs are unreasonable; now politicians are starting to believe that too. In most countries the government negotiates drug prices with the drug makers, but when Congress created Medicare Part D, it specifically denied Medicare the right to use its power to negotiate drug prices. The Veteran's Administration and Medicaid, which can negotiate drug prices, pay the lowest drug prices. The Congressional Budget Office has found that just by giving the low-income beneficiaries of Medicare Part D the same discount Medicaid recipients get, the federal government would save $116 billion over 10 years. Think of what the savings might be if all Medicare recipients could benefit from Medicaid-negotiated drug prices!

3. Defensive Medicine

Yet another big driver of the higher U.S. health insurance bill is the practice of defensive medicine. Doctors are afraid that they will get sued, so they order multiple tests even when they are certain they know what the diagnosis is. A Gallup survey estimated that $650 billion annually could be attributed to defensive medicine. Everyone pays the bill on this with higher insurance premiums, co-pays and out-of-pocket costs, as well as taxes that go toward paying for governmental healthcare programs.

4. Expensive Mix of Treatments

U.S. medical practitioners also tend to use a more expensive mix of treatments. When compared with other developed countries, for example, the U.S. uses three times as many mammograms, two-and-a-half times the number of MRIs and 31% more Caesarean sections. This results in more being spent on technology in more locations. Another key part of the mix is that more people in the U.S. are treated by specialists, whose fees are higher than primary-care doctors, when the same types of treatments are done at the primary-care level in other countries. Specialists command higher pay, which drives the costs up in the U.S. for everyone.

5. Wages and Work Rules

Wages and staffing drive costs up in healthcare. Specialists are commanding high reimbursements and the overutilization of specialists through the current process of referral decision-making drives health costs even higher. The National Commission on Physician Payment Reform was the first step in fixing the problem; based on its 2013 report, the commission adopted 12 recommendations for changes to get control over physician pay. Now it is working with Congress to find a way to implement some of these recommendations.

6. Branding

“There is no such thing as a legitimate price for anything in healthcare,” says George Halvorson, the former chairman of health maintenance organization Kaiser Permanente. “Prices are made up depending on who the payer is.”

Providers who can demand the highest prices are the ones that create a brand everyone wants. “In some markets the prestigious medical institutions can name their price,” says Andrea Cabarello, program director at Catalyst for Payment Reform, a nonprofit that works with large employers to get some control on health costs.

The Affordable Care Act (ACA) has pushed back to some degree against the high costs created by branding. In central Florida, for example, one of the top brands is Florida Hospital. This year ACA policies offered by Humana did not include services provided by this brand. Similar types of contract negotiations knocked out top hospitals in other locations. It remains to be seen whether this will cause those hospitals to reduce prices to get those patients back.

The Bottom Line

Most other developed countries control costs, in part, by having the government play a stronger role in negotiating prices for healthcare. Their healthcare systems don’t require the high administrative costs that drive up pricing in the U.S. As the global overseers of their country's systems, these governments have the ability to negotiate lower drug, medical equipment and hospital costs. They can influence the mix of treatments used and patients’ ability to go to specialists or seek more expensive treatments.

So far in the U.S., there has been a lack of political support for the government taking a larger role in controlling healthcare costs. The most recent legislation, the Affordable Care Act, focused on ensuring access to healthcare, but maintained the status quo to encourage competition among insurers and healthcare providers. This means there will be multiple payers for the services and less powerful control over negotiated pricing from providers of healthcare services


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[Professor Tiger]

Scaramucci comes in , next day says Priebus is the leaker, 2 days later, Priebus is out the door.

Heh. Trump sends Scaramooch into the West Wing to find the leaker and encourage him to stop:

[youtube]Ywnn0jNmDIw[/youtube]

[Tree]

So Trump picks the guy who destroyed Kansas with right wing policies to be some religious ambassador to the world. Could this administration get any stranger?

https://www.nytimes.com/2017/07/26/us/p ... eedom.html

[Professor Tiger]

Healthcare in the U.S. costs about twice as much as it does in any other developed country. If the $3 trillion U.S. healthcare sector were ranked as a country, it would be the world’s fifth largest economy according to “Consumer Reports." The cost of this huge financial burden to every household because of lost wages, higher premiums and taxes plus additional out-of-pocket expenses is more than $8,000.

Even with all this money being spent on healthcare, the World Health Organization ranked the U.S. thirty-seventh in healthcare systems, and The Commonwealth Fund placed the U.S. last among the top 11 industrialized countries in overall healthcare.

Why is the U.S. paying so much more for care and not appearing at the top of the rankings? Here’s a look at six key reasons the U.S. is failing to provide adequate healthcare at reasonable prices....

etc etc etc

That all sounds well and good, but can you point to anything the federal government does cheaper and more efficiently than private industry? Has anybody ever said, "Let's let the US Postal Service take over UPS or FedEx, and it will run much better"? If the goal of single payer is compassion for the poor, have you ever gone to the DMV and felt the love? Instead of waiting in line for 3 hours to get your drivers license renewed, imagine waiting in line for 3 hours with severe chest pain or numbness on one side of your body. That's the federal government's version of "health care customer service," already on tragic display in the VA, and there is nothing compassionate about that.

[bluetick]

Before Obamacare, the US healthcare system was broken because premiums and deductibles were always skyrocketing and lower income people couldn't afford it.

Under Obamacare, the US healthcare system has been broken because premiums and deductibles have been skyrocketing and lower income people can't afford it.

If the Republicans repeal and replace Obamacare, the US healthcare system will be broken because premiums and deductibles will continue skyrocketing and lower income people won't be able to afford it.

If the Republicans fail to repeal and replace Obamacare, the US healthcare system will continue to be broken because premiums and deductibles will continue to skyrocket and lower income people won't be able to afford it.

The Professor Tiger Healthcare Plan: no plan - we're fucked, everything is broken, American Exceptionalism means we own the mess we got, by God; let's move on to a bathroom bill.

[Cletus]

Here's one of the bad hombres Trump is desperate to kick of the country. Not sure how this makes America great (let me know when that gets going).

https://amp.cnn.com/cnn/2017/07/27/poli ... index.html

[Professor Tiger]

Here's one of the bad hombres Trump is desperate to kick of the country. Not sure how this makes America great (let me know when that gets going).

https://amp.cnn.com/cnn/2017/07/27/poli ... index.html

Here are some more bad hombres that Trump is trying to kick out of the country. They are called MS 13:





The way this Makes America Great Again is there is finally a serious attempt to keep them from coming and going in and out of America at will, aided and abetted by sanctuary cities.

And this is how it has been going: according to Politifact...

Illegal immigration the lowest in 17 years

http://www.politifact.com/truth-o-meter ... rump-said/

MAGA

[crashcourse]

VA is not a good example of single payer for a lot of reasons

You have 8 million vets the VA serves. Of those 8 million 4 million are considered "disabled" of those 4 million "disabled" 3.5 million are related to non combat--like orthopedic wear and tear--depression anxiety bipolar. hell even diabetes, hypertension and sleep apnea are service connected for many. Point being less then a 10 % are actually wounded vets. The other 90 % are guys that you will never get well. If you get them well potentially could lose their disability payment which run up to 3K a month. Throw in the fact many of these guys are filling up slots better used by other vets in need. why do you ask? because they mneed a paperwork trail to file their next bogus claim to try to get more and more disability. My personal estimate of this as I have been associated with medical care for active duty and vets since 1990 is 1-2 million vets everyyear are defrauding the system 25%. Nothing worse then seeing someone you know is a hundred percent sevice connected for 25 different things earnin 3K a month theough disability--earning another 3K a month being govt employed since they get preference and hearing how their golf game is and watching them seeuin not one bit of evidence they are 100% disabled

the other big issue is the constant battle between admin nursing and the medical staff. the medical staff is the docs and we see less and less every year. their are less and less medical grads and when you have more money offered being a civilian then the government could hope to lure you with you lose good young doctors to be replaced by doctors who have a black mark or three for malpractice or just plain lazy or too incompetent --well welcome to the VA. I imagine the VA is down 50-% from what they need to be which leads to waiting lists. enter the nurses who have established a program call nurse practitioner to fill the worid. I know a few good NP's but they know their limits. the vast majority cannot handle a panel of 1200 vets but the entire nursing profession seems hell bent on replacing the medical staff with as many nurse pracs as they can. they are not trained by physicans they are trained by nurses. they do 500 horus of clinicals before they are set loose. by contrast PAs do 2000 hours and doctors do about 6000-7000. but they get their degree --are labeled independent byt the medical world and go out and are inept especially the first 3-4 years in delivering quality medical care--but like tribblles they are multiplying at an alarming rate and soon will be at a location near you

last are the administrators. the snot nosed little interns that also seek to put a stamp on their ideas and move up in the world. they also have multipleied into a force that consumes office space in VA's with such titles as quality this and assistant this and performance this and generally don't mean anything because theuy are always in meetings at conferences or plotting and planning to reinvent the wheel.

anyhoo off my soapbox --that's the VA

soon to be the entire medical system as tic documented so well

[Jungle Rat]

Stop posting these long ass posts. I keep having seizures.

[Professor Tiger]

Rat, those aren't seizures. Those are LSD flashbacks.

Crash, all good points. Yes, I agree that the average VA patient is not the same as the average civilian patient. But the other negative aspects of VA care you mentioned - chronic understaffing, taking a large part of the case load that should be handled by MD's instead dumped on NP's, and, as you correctly described them, "the administrators. the snot nosed little interns that also seek to put a stamp on their ideas and move up in the world." All those will abound and clog up single payer just as they abound and clog up the VA today.

PS, from what I've heard, the Indian Health Service makes the VA look like the Mayo clinic.

[hedge]

You make Simple Jack from Tropic Thunder look like Einstein...

[bluetick]

Rat, those aren't seizures. Those are LSD flashbacks.

Crash, all good points. Yes, I agree that the average VA patient is not the same as the average civilian patient. But the other negative aspects of VA care you mentioned - chronic understaffing, taking a large part of the case load that should be handled by MD's instead dumped on NP's, and, as you correctly described them, "the administrators. the snot nosed little interns that also seek to put a stamp on their ideas and move up in the world." All those will abound and clog up single payer just as they abound and clog up the VA today.

PS, from what I've heard, the Indian Health Service makes the VA look like the Mayo clinic.

What is your plan? C'mon, let's hear it, tough guy.

[Professor Tiger]

I'm not optimistic about any liberal health care schemes. Look at what is happening to the mother of all liberal health care schemes - Obamacare - before our eyes.

I'm not optimistic about purely capitalistic health care schemes either. They will wind up making trillions for insurance companies and screw the little guy.

To me, the best option is keeping Medicare for the elderly and Medicaid for the poor, and a no frills public option for everybody else. Keep the public option voluntary and subsidize it just enough so that lower income people can afford it. Maybe that would work, but it might not. Premiums and copays have been soaring so much for so long I've almost come to think of them like gravity. It just is. I'm not sure what can change it.

[bluetick]

To me, the best option is keeping Medicare for the elderly and Medicaid for the poor, and a no frills public option for everybody else. Keep the public option voluntary and subsidize it just enough so that lower income people can afford it. Maybe that would work, but it might not. Premiums and copays have been soaring so much for so long I've almost come to think of them like gravity. It just is. I'm not sure what can change it.

Ummm. Gubmint care for the poor... gubmint care for the elderly... and a no frills public option, partially subsidized, for everybody else? Hate to break it to you, professor pinko commie, but if you add all that up, you've got universal healthcare.

I'll have what you're having.

[bluetick]

Anthony Scaramucci‘s ouster from Trump Administration might have been a messy affair for the White House, based on a report from CNN’s Jeff Zelany about the now-former Communications Director’s was led away from the president’s mansion.

Zeleny was on with Brooke Baldwin to discuss the reports saying Chief of Staff John Kelly removed Scaramucci from his post over his lack of “discipline.” During his report, Zeleny said Scaramucci was “essentially escorted off the White House property earlier this afternoon.” Zeleny's reporting was corroborated by CBS's Jackie Alemany


That's fucking awesome.

[Professor Tiger]

During his report, Zeleny said Scaramucci was “essentially escorted off the White House property earlier this afternoon.” Zeleny's reporting was corroborated by CBS's Jackie Alemany

Scaramucci's confrontation of Kelly, and his resulting removal from the premises, probably looked a lot like this (start at :18):

[youtube]SbgKYhX8_gs[/youtube]

[Professor Tiger]

Hate to break it to you, professor pinko commie, but if you add all that up, you've got universal healthcare.

Yeah... nobody's perfect...

[crashcourse]

"What is your plan? C'mon, let's hear it, tough guy."

100 million working age between 18-65 seek the entitlement route. same with disabled vets
there's a lot of good soldiers out there who truly deserve what they get if not more. majority however play the game however to increase their disability to 100%

if you are truly 100% disabled you shouldn't be triple dipping. bunchaguys out there work for the govt, retired from military and draw a 100% medical pension check. whistleblowing from the public on those individuals who are out waterskiing on days off yet claim multiple condition yielding that 100%

ever see how many help wanted signs there are out there. you'd think part of that 100million would be able to fill some of those positions.

government cant run social security cant run medicare obamacare failing miserably time to get out of health care and leave it to the capitalist --that said your insurance companies cant have the biggest buildings in the city --sporting venues and events named after them and continue to turn profits that allow them to get into financial markets outside of medical

in essence get America working again instead of keeping America spoiled again

[eCat]

Trump decides to withhold funding from the insurance companies on Obamacare to cover the difference in subsidies and premiums

ok, I like that - which he believes will result in the demise of Obamacare

the problem is that RINOs are just going to fund the difference directly to the people by increasing their subsidies to the tune of about $9 billion

so once again, the people that pay for insurance out of their own pocket are the ones who will feel the pain of rising health care costs.

Obamacare is a disaster.

The Federal Government is incapable of running a enterprise wide system effectively. The first step to correcting this is to mandate a balanced budget every year, regardless of whether we are in times of war, national crisis or otherwise. When Americans have to choose what the priorities limited money is spent on, only then will they, and the government see how ineffective our process is.

As long as they have the ability to print money, only a fool and the willfully ignorant see this as a logical and sound approach to managed care.

[Professor Tiger]

Trump decides to withhold funding from the insurance companies on Obamacare to cover the difference in subsidies and premiums

I wouldn't do that for one reason. Obamacare is currently in a death spiral. I say, don't interfere with the death spiral. Let it crash just as the Democrats designed it to do. And when it does, Trump and the Republicans point to the wreckage and say, "Look at what the Democrats did to you. We tried to stop this, but the Democrats would have none of it." That will be a powerful argument. But if Trump accelerates the crash, the Dem's will blame the crash on him and the Republicans with a small shred of justification. Don't give them that justification. Keep the blame for the crash of Obamacare on THEIR necks, where it belongs.

The Federal Government is incapable of running a enterprise wide system effectively. The first step to correcting this is to mandate a balanced budget every year, regardless of whether we are in times of war, national crisis or otherwise. When Americans have to choose what the priorities limited money is spent on, only then will they, and the government see how ineffective our process is.

Amen to that. Only I would keep a provision to deficit spend in times of a DECLARED BY CONGRESS (per the Constitution) and national economic crisis (e.g. 1929 Crash and Depression). And that exception would have to be renewed annually.

Too bad that law will never be enacted. Asking politicians of both parties to give up deficit spending is like asking a crack addict to give up crack. And even if they did pass such a law, they would just ignore it, like Illinois just did for two years.