such optimism!Oldsouljer said:hokiewolf said:Werewolf said:Here we goooo…
— MJTruthUltra (@MJTruthUltra) October 17, 2025
B-52 BOMBERS were just DEPLOYED and are now Flying off the coast of Venezuela and 10% of US Naval Power is now in the Region — “Trump’s not Bluffing”
- 10,000 US Soldiers are in the Caribbean and on ships on Puerto Rico
- Special Operations Helo’s were spotted… pic.twitter.com/mI9veEeOrJ
Thought we were against forever wars.
This may not be anymore "forever" than Grenada or Panama was. Besides, Venezuela's beautiful women must be liberated!
TRUMP 2024
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Last: 6 min ago by Civilized
caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
We live in two different Americas. Today millions of us will head to college football tailgates, where we will spend all day with friends & family. On the other side millions of losers will waste a perfect fall Saturday protesting Trump. Choose your life path wisely, kids.
— Clay Travis (@ClayTravis) October 18, 2025
packgrad said:We live in two different Americas. Today millions of us will head to college football tailgates, where we will spend all day with friends & family. On the other side millions of losers will waste a perfect fall Saturday protesting Trump. Choose your life path wisely, kids.
— Clay Travis (@ClayTravis) October 18, 2025
Liberals protest for a hobby. Just look at these people. Weak beta males and angry women upset with the way their lives have turned out.
hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Dunno. Often hard to tell why something hasn't been done yet.
It's the health care corollary to the same often-unknowable question when you're evaluating deals.
"Are we recognizing opportunity that others haven't, or did other people already figure out it's a ****ty deal, and we're just too dumb to see it?"
hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
id love to hear your examplesSmaptyWolf said:hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
hokiewolf said:id love to hear your examplesSmaptyWolf said:hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
Sure, give me an example of a heavy handed regulation and I'll be happy to look up why it came to be.
Certificate of NeedSmaptyWolf said:hokiewolf said:id love to hear your examplesSmaptyWolf said:hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
Sure, give me an example of a heavy handed regulation and I'll be happy to look up why it came to be.
In other news, Trump just pardoned f'Ing George Santos! Crooks of a feather flock together.
SmaptyWolf said:
In other news, Trump just pardoned f'Ing George Santos! Crooks of a feather flock together.
Once again, you are factually incorrect. He commuted the sentence, not pardoned.
And here's the future mayor of NYC and darling of the left happily posing with a WTC bombing co-conspirator and terrorist supporter.
https://nypost.com/2025/10/18/us-news/mamdani-appears-smiling-arm-in-arm-with-imam-siraj-wahhaj-93-wtc-bombing-co-conspirator/
https://nypost.com/2025/10/18/us-news/mamdani-appears-smiling-arm-in-arm-with-imam-siraj-wahhaj-93-wtc-bombing-co-conspirator/
jkpackfan said:
And here's the future mayor of NYC and darling of the left happily posing with a WTC bombing co-conspirator and terrorist supporter.
https://nypost.com/2025/10/18/us-news/mamdani-appears-smiling-arm-in-arm-with-imam-siraj-wahhaj-93-wtc-bombing-co-conspirator/
Awful. Yet liberal white women will still vote this guy into office.
hokiewolf said:Certificate of NeedSmaptyWolf said:hokiewolf said:id love to hear your examplesSmaptyWolf said:hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
Sure, give me an example of a heavy handed regulation and I'll be happy to look up why it came to be.
Lol, Certificate of Need regulations are a perfect encapsulation of why "free market" healthcare is so broken.
So back in the good ol' days they would build more hospital capacity than they needed in wealthier areas. In a functioning market you would think this would lower health care costs, but that's not what happens. Because nobody shops around with an axe stuck in their head, hospitals would deal with diluting their patient pools by just jacking up prices to pay for all the extra beds. Costs soared.
So along came CON regulations to "deal" with that. Of course that reduces capacity and creates monopolies, which is also a great excuse to raise prices!
Heads I win, tails you lose.
South Carolina recently changed their CON laws and it has led to a boom of rural healthcare facilities.SmaptyWolf said:hokiewolf said:Certificate of NeedSmaptyWolf said:hokiewolf said:id love to hear your examplesSmaptyWolf said:hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
Sure, give me an example of a heavy handed regulation and I'll be happy to look up why it came to be.
Lol, Certificate of Need regulations are a perfect encapsulation of why "free market" healthcare is so broken.
So back in the good ol' days they would build more hospital capacity than they needed in wealthier areas. In a functioning market you would think this would lower health care costs, but that's not what happens. Because nobody shops around with an axe stuck in their head, hospitals would deal with diluting their patient pools by just jacking up prices to pay for all the extra beds. Costs soared.
So along came CON regulations to "deal" with that. Of course that reduces capacity and creates monopolies, which is also a great excuse to raise prices!
Heads I win, tails you lose.
I'm NC, the CON process unnecessarily delays critical bed counts and other renovation work by 3-5 years.
Gulfstream4 said:jkpackfan said:
And here's the future mayor of NYC and darling of the left happily posing with a WTC bombing co-conspirator and terrorist supporter.
https://nypost.com/2025/10/18/us-news/mamdani-appears-smiling-arm-in-arm-with-imam-siraj-wahhaj-93-wtc-bombing-co-conspirator/
Awful. Yet liberal white women will still vote this guy into office.
Absolutely insane
hokiewolf said:South Carolina recently changed their CON laws and it has led to a boom of rural healthcare facilities.SmaptyWolf said:hokiewolf said:Certificate of NeedSmaptyWolf said:hokiewolf said:id love to hear your examplesSmaptyWolf said:hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
Sure, give me an example of a heavy handed regulation and I'll be happy to look up why it came to be.
Lol, Certificate of Need regulations are a perfect encapsulation of why "free market" healthcare is so broken.
So back in the good ol' days they would build more hospital capacity than they needed in wealthier areas. In a functioning market you would think this would lower health care costs, but that's not what happens. Because nobody shops around with an axe stuck in their head, hospitals would deal with diluting their patient pools by just jacking up prices to pay for all the extra beds. Costs soared.
So along came CON regulations to "deal" with that. Of course that reduces capacity and creates monopolies, which is also a great excuse to raise prices!
Heads I win, tails you lose.
I'm NC, the CON process unnecessarily delays critical bed counts and other renovation work by 3-5 years.
Good for them, assuming that's still true now that they're trashing Medicaid. I doubt they''ll build them if no one has insurance.
Now stay tuned while it magically defies market orthodoxy and doesn't lower health care costs at all, and possibly makes things worse.
you're welcome to continue to lose this argument, but they are being built now, I am building one currently.SmaptyWolf said:hokiewolf said:South Carolina recently changed their CON laws and it has led to a boom of rural healthcare facilities.SmaptyWolf said:hokiewolf said:Certificate of NeedSmaptyWolf said:hokiewolf said:id love to hear your examplesSmaptyWolf said:hokiewolf said:Has it been tried without heavy handed regulations?Civilized said:caryking said:SmaptyWolf said:caryking said:SmaptyWolf said:wolf howl said:FlossyDFlynt said:wolf howl said:Civilized said:wolf howl said:Civilized said:caryking said:Civilized said:Oldsouljer said:Civilized said:hokiewolf said:
No kidding. It's this hyperbole that solves nothing with respect to healthcare. Saying that is saying "I don't want to fix it"
Really?
Because it sure seems like what solves nothing is Republicans wanting to Monday Morning QB and delete Obamacare without ever doing the hard work of coming up with a more affordable, more accessible, more inclusive plan.
If someone in my family doesn't like the dinner spot that gets thrown out to the group, they have to come up with something better or else we just stick with what we have.
If one of my staff points out a problem on a job without also suggesting a solution, I remind them that announcing problems is the easy, low-value part of ultimately addressing an issue.
Like Smapty said, you may think Obamacare is now too expensive (but not without acknowledging the since-deleted mandate helped address the affordability piece).
But you can't with any level of serioiusness say that the Republicans have put forth anything that's better because they haven't put forth anything at all. They've just done the easy part without adding any value.
Aside from care for prisoners and veterans, I've never been clear on why medicine and medical insurance is any Constitutional business of the federal government.
Because it's ridiculous to take a strict constructionist stance on issues like this. The Constitution was written in 1787, decades or centuries before industrialization, the Internet, global markets, or nationwide healthcare systems existed.
National or global issues can't be managed effectively by 50 separate states.
And private industry and the market has shown it's incapable of providing adequate coverage and care for Americans, absent incentives and/or participation by the government.
Which first-world countries enjoy the best health outcomes and highest ROI on per-capita spending? How do they administer care? Which countries rank lowest on that same scale (I'll give you three guesses but you'll only need one).
And they probably rely on the US for all their defense..
No they "probably" do not. That is obviously and demonstrably false.
And regardless, again, their per-capita spending on health care is far LESS than ours. It's not like they're just spending more per-capita than us, throwing more money at the problem than we are, and getting better results that way. They have systems that are far more efficient than ours and they spend less per-person than we do.
We spend more, and get less for those dollars, than any developed nation in the world.
If someone comes to you and says "we have a system that will cover more Americans, provide more adequate coverage, and we'll spend less per-person than with the old system," what would your response be?
Of course everyone would want that but you're either raising taxes or cutting services/budget somewhere else to achieve it the way healthcare is setup in the US today.
The US spends grossly more on healthcare for a worse product/outcome. That needs to be fixed. Hospitals being profit centers is absolutely driving a significant portion of that problem. That model needs to change first, IMO. Unfortunately, the more government gets involved, the worse everything seems to get for citizens so I'm not sure how to do this effectively, and certainly not in today's political climate.
Fair post, and agreed. It's a real challenge with no easy, obvious, solutions. It's going to be a slog.
One of the things I feel strongest about though is we can't in good conscience repeal-and-not-replace.
It is totally unnecessary and counterproductive and speaks horribly of us as a nation to have a spike in cancelled insurance coverage for the ill, deferred and deficient care, medical bankruptcies, and an overall decline in quality of life just because we're in a hurry to score political points.
If you want to repeal Obamacare, perfectly fine, but we've got to figure out what to replace it with that's an improvement first, and "improvement" doesn't simply mean "a cheaper solution for the federal government and a much more expensive, less effective solution for tax-paying Americans."
Agreed, you can't just pull the rug without some alternative solution that's ideally an improvement over a currently broken option, IMO.
The brokenness of the US healthcare system is so deep it'll be nearly impossible to fix without a lot of pain somewhere. Was talking to a guy today that lived in the Netherlands for 10 years (wife is from there) and he loved their healthcare. Of course they spend a ton less on defense but I don't believe that's the majority of the US problem (we already spend way more per patient then they do). He mentioned doctors over there aren't paid extravagantly like in the US and administration is much less as well not to mention hospitals aren't for profit. His background is managing healthcare for Fortune 50 companies so I value his opinion.
I really do not believe any plan will be much better than what we currently have without overhauling for profit health care in America. No clue how to do that at this point.
Yep. My hottest take is that the current version of healthcare in this country cannot be solved. There are way too many cooks in the kitchen at this point.
It would take a total system overhaul that would include reorganizing many part of the government to "fix it". I just dont see it as a feasible outcome.
Same. I think it's a decades long project if it can even be done. Most likely what you could do in the short term is leverage the government to put pressure on big pharma to lower drug prices. If it's a $2 pill in every other country it should not be a $1500 pill in the US. That's probably the quickest way to lower one aspect of the problem. Hospitals and care facilities being profit centers will be much harder to unravel, same with cost of care as they're tied together.
I'll take a stab at it.
We just need to be honest that health care isn't really a functioning market. People don't shop around for the cheapest cancer treatment. Our only real cost controls are private insurance companies' payouts, and Medicare/etc payouts. More often than not, though, private insurance controls costs by shafting patients, or excluding them entirely if they can, because that's better than the insurance company getting dropped by a provider for underpayment.
Once you accept that, there's an obvious solution. Eliminate the private health insurance industry entirely (they literally add nothing to the system), and replace it with one, government run insurance company. The money you would have paid to your employer for health insurance just becomes a payroll tax. Unemployed people don't lose their insurance, they get subsidized just like now. The alphabet soup of government health becomes one simple insurance system.
So how does that fix the problem? The government now has full control of payouts. They could start by essentially paying what private insurance is paying now. Then over the course of 50 years or whatever they could slowly tighten the payment spigot, giving hospitals, doctors, and pharmaceutical companies time to adjust to lower payments from the "single payer" without major disruption.
Bottom line: We'd benefit from way more efficient administration in the short term, and over the long term would tackle the real cost drivers, while leaving the rest of the system private and letting them figure it out.
That's exactly what we need…
Your whole premise of shopping can be solved by divorcing health Insurance from a company benefit, that's really part of your compensation. People are relaxed in the life and want others to do it for them. Your suggestion is that Government do it. My suggestion is for individuals do it. People can join a pool if they want to spread the risk. We have many insurance companies doing this now, like Medi-share https://www.medical-share.com
Now, we already have Government run health insurance providers that some can get on. I'm sure you will think this is completely efficient, right?
Smapty, you're only get traction with your ideas with like-minded people. So, at some point, will you get your idea mandates to people that don't agree with you? I certainly hope not.
BTW, one of the most desired thing, for people that have the means to do so, is paying for their primary care physician as an access.
You're basically suggesting that we don't change anything. The problem now is that we have so many different payers, pools, etc. Even the ACA right now is severely limited by the fact that some providers simply choose not to accept those plans. Cost controls are limited when the providers are in the driver's seat to pick and choose who pays them.
The magic of "single payer" is that it eliminates that payment shell game, while creating the largest possible risk pool to further lower everyone's costs. And by definition every provider would accept your insurance, because there's only one choice.
Anyway, obviously the devil is in the details, but at least it's a "concept of a plan".
I guess you just skipped right by me wanting to divorce Health Insurance from employers…
That would change the system dramatically!!! People would be selecting their provider, thus creating their own competition.
Also, this single payer system will go broke like every other government program. What happens when we start talking about its insolvency? Tax more or cut services. Sorry, I'm not a fan of the government involved.
It surprises me that you do…. As a person that has managed people's money and been an executive in a company, the value of turning a profit is important, right?
Does any country in the world have effective health care administered the way you describe?
Since "heavy handed" regulations usually come about in response to something, I imagine you could stroll down memory lane in our country and find a time when our free market health care was largely unregulated and probably awful.
Sure, give me an example of a heavy handed regulation and I'll be happy to look up why it came to be.
Lol, Certificate of Need regulations are a perfect encapsulation of why "free market" healthcare is so broken.
So back in the good ol' days they would build more hospital capacity than they needed in wealthier areas. In a functioning market you would think this would lower health care costs, but that's not what happens. Because nobody shops around with an axe stuck in their head, hospitals would deal with diluting their patient pools by just jacking up prices to pay for all the extra beds. Costs soared.
So along came CON regulations to "deal" with that. Of course that reduces capacity and creates monopolies, which is also a great excuse to raise prices!
Heads I win, tails you lose.
I'm NC, the CON process unnecessarily delays critical bed counts and other renovation work by 3-5 years.
Good for them, assuming that's still true now that they're trashing Medicaid. I doubt they''ll build them if no one has insurance.
Now stay tuned while it magically defies market orthodoxy and doesn't lower health care costs at all, and possibly makes things worse.
You can also look at Florida as an example of healthcare costs not increasing because the CON was eliminated. It's produced competition amongst the different hospital systems.
El Lobo Loco said:SmaptyWolf said:
In other news, Trump just pardoned f'Ing George Santos! Crooks of a feather flock together.
Once again, you are factually incorrect. He commuted the sentence, not pardoned.
Now we're being pedants about commutations vs. pardons?
This crowd would have positively died if Biden or Obama pardoned or commuted a crooked and fraudulent Dem politician and gleefully explained "He always voted Democrat!""
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