hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
wolf howl 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".
So going to a system similar to what Canada has today? No one is Canada is cheering for their healthcare system today so how would we improve upon that and not just bring typical single payer issues (long wait times, limited options, private insurance still often needed, low R&D, much higher taxes, less choices, etc.)?
That providers can not accept specific insurances today is a problem that could/should be fixed immediately, that's ridiculous IMO but I know it happens as it's happened to me before.
hokiewolf 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?
you're spot on. Let competition solve the risk pool instead of the government dictating one plan.
I have two insurance options in my plan. What if I had 15? That competition drives the cost down.
And get rid of CON rules and allow for better competition for services.
SmaptyWolf said:wolf howl 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".
So going to a system similar to what Canada has today? No one is Canada is cheering for their healthcare system today so how would we improve upon that and not just bring typical single payer issues (long wait times, limited options, private insurance still often needed, low R&D, much higher taxes, less choices, etc.)?
That providers can not accept specific insurances today is a problem that could/should be fixed immediately, that's ridiculous IMO but I know it happens as it's happened to me before.
There's a cottage industry funded by our health care industry cranking out propaganda about how awful everyone else is. Don't believe the hype. More people in Canada love their system than don't, and our system has many of the same problems (it just took me a couple months to see my dermatologist) even though we actually pay much more (which we don't call taxes for some reason). And most medical R&D is funded separately by taxpayers, anyway, as DOGE loves to tell us.
There certainly are lots of variations of single payer around the world, so I'm sure a uniquely American version is something we could figure out. The alternative appears to be throwing our hands up and continuing to watch the implosion, and I guess just deciding that only a subset of Americans will get health care.
El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
SmaptyWolf said:hokiewolf 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?
you're spot on. Let competition solve the risk pool instead of the government dictating one plan.
I have two insurance options in my plan. What if I had 15? That competition drives the cost down.
And get rid of CON rules and allow for better competition for services.
You sound like you're reading the ObamaCare brochure. "In the ACA marketplace, which is separate from your employer, every health insurance company will compete for your business, which will drive costs down!".
Except it doesn't drive costs down very much, because the real cost drivers have nothing to do with insurance competing... and have everything to do with the reimbursement rates that our hospitals, doctors, and drug companies are demanding. Insurance "competing" ends up just meaning lower premiums in exchange for crappier coverage and higher deductibles. Year after year.
Gulfstream4 said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
Running drugs is a dangerous business
Now I know what you're asking yourself.
— Brian Cates - Political Columnist & Pundit (@drawandstrike) October 16, 2025
What's the value of having a hidden, super-duper-top-secret-off-the-books email addy where you've been writing DRAFT EMAILS to yourself or other people?
**gigglesnort!**
Keep watching! This is gonna GIT GUD. pic.twitter.com/NoFQspJv7s
They can see your vote through the envelope. pic.twitter.com/xY0hblD6jE
— ⚡️THOR⚡️ the Deplorable 🇺🇸 (@ThorDeplorable) August 20, 2021
Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
hokiewolf said:Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
remind me what country we are at war withcaryking said:hokiewolf said:Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
Perhaps the goal was to destroy the packages and not the people. The people were just casualties of war…
You are 100% spot on about the result, but I think you are missing the why. Healthcare is essentially rent control. The few who qualify for affordability receive the benefit at the cost of those who aren't anointed that privilege. Concurrently, the government sets the price, controls the amount of healthcare that can be provided, and discourages competition. NYC sets rent control prices, they limit and regulate the ability for developers to build new housing stock, and those who do not qualify for rent control are left to pay higher cost.SmaptyWolf said:hokiewolf 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?
you're spot on. Let competition solve the risk pool instead of the government dictating one plan.
I have two insurance options in my plan. What if I had 15? That competition drives the cost down.
And get rid of CON rules and allow for better competition for services.
You sound like you're reading the ObamaCare brochure. "In the ACA marketplace, which is separate from your employer, every health insurance company will compete for your business, which will drive costs down!".
Except it doesn't drive costs down very much, because the real cost drivers have nothing to do with insurance competing... and have everything to do with the reimbursement rates that our hospitals, doctors, and drug companies are demanding. Insurance "competing" ends up just meaning lower premiums in exchange for crappier coverage and higher deductibles. Year after year.
hokiewolf said:remind me what country we are at war withcaryking said:hokiewolf said:Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
Perhaps the goal was to destroy the packages and not the people. The people were just casualties of war…
hokiewolf said:caryking said:hokiewolf said:El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.
Perhaps the goal was to destroy the packages and not the people. The people were just casualties of war…
remind me what country we are at war with
Not an actual war. But hey, we did do a good thing and help the Colombians get rid of cartel leaders. Then we took the eye off the ball when the whole thing moved to Mexico.caryking said:hokiewolf said:remind me what country we are at war withcaryking said:hokiewolf said:Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
Perhaps the goal was to destroy the packages and not the people. The people were just casualties of war…
Did we ever finish the war on drugs from the 80's?
RussiaOldsouljer said:hokiewolf said:caryking said:hokiewolf said:El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.
Perhaps the goal was to destroy the packages and not the people. The people were just casualties of war…
remind me what country we are at war with
Better question is what countries are at war with us?
caryking said:SmaptyWolf said:wolf howl 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".
So going to a system similar to what Canada has today? No one is Canada is cheering for their healthcare system today so how would we improve upon that and not just bring typical single payer issues (long wait times, limited options, private insurance still often needed, low R&D, much higher taxes, less choices, etc.)?
That providers can not accept specific insurances today is a problem that could/should be fixed immediately, that's ridiculous IMO but I know it happens as it's happened to me before.
There's a cottage industry funded by our health care industry cranking out propaganda about how awful everyone else is. Don't believe the hype. More people in Canada love their system than don't, and our system has many of the same problems (it just took me a couple months to see my dermatologist) even though we actually pay much more (which we don't call taxes for some reason). And most medical R&D is funded separately by taxpayers, anyway, as DOGE loves to tell us.
There certainly are lots of variations of single payer around the world, so I'm sure a uniquely American version is something we could figure out. The alternative appears to be throwing our hands up and continuing to watch the implosion, and I guess just deciding that only a subset of Americans will get health care.
Smapty, first.. I want to thank you for having a reasonable back and forth with me. No name calling; rather, just sharing our thoughts on the subject.
I think we start from two different premises.. it sounds as if you at comfortable with the government running things. I'm not! I can't think of a single department/program that's run properly, within the Federal Government.
Ultimately, I think you and I have the same results we would like to see. It's the getting there where we differ. Nonetheless, I'm not so confident things will ever change as the system is so big that tearing it down will not happen in my lifetime…
Also, the DOGE platform was very supportive by me. Now, I think it's clear that they never had anything or they would have been part of the Big Beautiful Bill. They weren't! Well, perhaps Pubs had more sacred cows in there and they couldn't get passed. I don't know…
caryking said:SmaptyWolf said:hokiewolf 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?
you're spot on. Let competition solve the risk pool instead of the government dictating one plan.
I have two insurance options in my plan. What if I had 15? That competition drives the cost down.
And get rid of CON rules and allow for better competition for services.
You sound like you're reading the ObamaCare brochure. "In the ACA marketplace, which is separate from your employer, every health insurance company will compete for your business, which will drive costs down!".
Except it doesn't drive costs down very much, because the real cost drivers have nothing to do with insurance competing... and have everything to do with the reimbursement rates that our hospitals, doctors, and drug companies are demanding. Insurance "competing" ends up just meaning lower premiums in exchange for crappier coverage and higher deductibles. Year after year.
I know the ACA program stated those things; however; the Insurance Companies had all kinds of subsidies in the ACA…
🚨BREAKING: In a bombshell announcement, the Trump administration declared the 'National Farm Security Action Plan' which bans future Chinese Communist Party-linked farmland purchases, aims to reclaim existing land with executive actions and imposes fines up to 25% of land value. pic.twitter.com/hg1J4uDWCm
— MAGA ARMY (@MAGAARMY_) October 17, 2025
The Bolton case has been assigned to Obama-appointed activist Judge Theodore Chuang.
— Bad Hombre (@joma_gc) October 16, 2025
Chuang is the same judge who issued a preliminary injunction blocking President Trump and DOGE from dismantling USAID — he was overturned on appeal.
Chuang also blocked Trump’s travel ban… pic.twitter.com/6Jx7lmgafx
hokiewolf said:SmaptyWolf said:hokiewolf 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?
you're spot on. Let competition solve the risk pool instead of the government dictating one plan.
I have two insurance options in my plan. What if I had 15? That competition drives the cost down.
And get rid of CON rules and allow for better competition for services.
You sound like you're reading the ObamaCare brochure. "In the ACA marketplace, which is separate from your employer, every health insurance company will compete for your business, which will drive costs down!".
Except it doesn't drive costs down very much, because the real cost drivers have nothing to do with insurance competing... and have everything to do with the reimbursement rates that our hospitals, doctors, and drug companies are demanding. Insurance "competing" ends up just meaning lower premiums in exchange for crappier coverage and higher deductibles. Year after year.
You are 100% spot on about the result, but I think you are missing the why. Healthcare is essentially rent control. The few who qualify for affordability receive the benefit at the cost of those who aren't anointed that privilege. Concurrently, the government sets the price, controls the amount of healthcare that can be provided, and discourages competition. NYC sets rent control prices, they limit and regulate the ability for developers to build new housing stock, and those who do not qualify for rent control are left to pay higher cost.
Centralized Government planning does not work. Free markets work. Let the markets do what they do and increase the competition for services. The ones who provide the best service, get to charge the premium price.
There is a shortage of healthcare in this country because politicians continue to believe that t they know better than the professionals who work day in and day out in these service industries.
I would be much more interested in creating a subsidized safety net for healthcare if we didn't artificially limit the size of the pie.
SmaptyWolf said:hokiewolf said:SmaptyWolf said:hokiewolf 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?
you're spot on. Let competition solve the risk pool instead of the government dictating one plan.
I have two insurance options in my plan. What if I had 15? That competition drives the cost down.
And get rid of CON rules and allow for better competition for services.
You sound like you're reading the ObamaCare brochure. "In the ACA marketplace, which is separate from your employer, every health insurance company will compete for your business, which will drive costs down!".
Except it doesn't drive costs down very much, because the real cost drivers have nothing to do with insurance competing... and have everything to do with the reimbursement rates that our hospitals, doctors, and drug companies are demanding. Insurance "competing" ends up just meaning lower premiums in exchange for crappier coverage and higher deductibles. Year after year.
You are 100% spot on about the result, but I think you are missing the why. Healthcare is essentially rent control. The few who qualify for affordability receive the benefit at the cost of those who aren't anointed that privilege. Concurrently, the government sets the price, controls the amount of healthcare that can be provided, and discourages competition. NYC sets rent control prices, they limit and regulate the ability for developers to build new housing stock, and those who do not qualify for rent control are left to pay higher cost.
Centralized Government planning does not work. Free markets work. Let the markets do what they do and increase the competition for services. The ones who provide the best service, get to charge the premium price.
There is a shortage of healthcare in this country because politicians continue to believe that t they know better than the professionals who work day in and day out in these service industries.
I would be much more interested in creating a subsidized safety net for healthcare if we didn't artificially limit the size of the pie.
Leaving aside Medicaid, etc, and just focusing on employee health insurance, the hospitals, doctors, and drug companies... aren't they all private already, and largely protected by the Centralized Government from having to bear the costs of covering 80 year olds, etc? What's been holding them back from unleashing their incredible cost savings all these years?
hokiewolf said:Oldsouljer said:hokiewolf said:caryking said:hokiewolf said:El Lobo Loco said:hokiewolf said:
Now what? We should just shoot the survivors now right?The US carried out a strike on a boat in the Caribbean on Thursday that did not kill everyone on board, two US officials told @NatashaBertrand & @kylieatwood.
— Zachary Cohen (@ZcohenCNN) October 16, 2025
There are believed to be survivors among the crew, but status is unclear.
Confirms Reuters. https://t.co/UGuSs6l6vy
We should take them into custody and interrogate them. Then let them go back to their home country as we publicly praise their cooperation.
Why is it ok to live now as opposed to when we shot up their boat? This ain't a gotcha question, btw. I don't know the right answer either.
Perhaps the goal was to destroy the packages and not the people. The people were just casualties of war…
remind me what country we are at war with
Better question is what countries are at war with us?
Russia
From the Soviet JFK docs released by @RepLuna: Kennedy–Khrushchev World Peace Bridge “could and should be built between Alaska and Russia at once.”
— Kirill Dmitriev (@kadmitriev) October 16, 2025
With modern @boringcompany technology this can become a Putin-Trump tunnel connecting the Eurasia and Americas for < $8 billion pic.twitter.com/c84VK75rh5
Federal and State governmentsSmaptyWolf said:hokiewolf said:SmaptyWolf said:hokiewolf 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?
you're spot on. Let competition solve the risk pool instead of the government dictating one plan.
I have two insurance options in my plan. What if I had 15? That competition drives the cost down.
And get rid of CON rules and allow for better competition for services.
You sound like you're reading the ObamaCare brochure. "In the ACA marketplace, which is separate from your employer, every health insurance company will compete for your business, which will drive costs down!".
Except it doesn't drive costs down very much, because the real cost drivers have nothing to do with insurance competing... and have everything to do with the reimbursement rates that our hospitals, doctors, and drug companies are demanding. Insurance "competing" ends up just meaning lower premiums in exchange for crappier coverage and higher deductibles. Year after year.
You are 100% spot on about the result, but I think you are missing the why. Healthcare is essentially rent control. The few who qualify for affordability receive the benefit at the cost of those who aren't anointed that privilege. Concurrently, the government sets the price, controls the amount of healthcare that can be provided, and discourages competition. NYC sets rent control prices, they limit and regulate the ability for developers to build new housing stock, and those who do not qualify for rent control are left to pay higher cost.
Centralized Government planning does not work. Free markets work. Let the markets do what they do and increase the competition for services. The ones who provide the best service, get to charge the premium price.
There is a shortage of healthcare in this country because politicians continue to believe that t they know better than the professionals who work day in and day out in these service industries.
I would be much more interested in creating a subsidized safety net for healthcare if we didn't artificially limit the size of the pie.
Leaving aside Medicaid, etc, and just focusing on employee health insurance, the hospitals, doctors, and drug companies... aren't they all private already, and largely protected by the Centralized Government from having to bear the costs of covering 80 year olds, etc? What's been holding them back from unleashing their incredible cost savings all these years?
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
packgrad said:
I voted for this. Alphas are back.— Karoline Leavitt (@PressSec) October 17, 2025
Zohran Mamdani is a Trojan horse for Obama and the Islamic takeover of America
— Wall Street Apes (@WallStreetApes) October 16, 2025
“Great GPS tracking information — Zohran Mamdani — appears to have been at Barack Obama's place in Washington, D.C. twice in just 6 weeks. Who else was there? Leaders of the Muslim Brotherhood”
“And… pic.twitter.com/WtkFBJSlh8
Thought we were against forever wars.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
Tiptoe faster. pic.twitter.com/CLs2uxGDeY
— Scott Lincicome (@scottlincicome) October 18, 2025
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.
lol, great pivot. Proud of you.Werewolf 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.
I doubt this one is forever; I believe Maduro may be trying to bribe Trump/America with promises of oil & minerals.......he knows it is just a matter of time and his a$$ fries.
Allow our children and grandchildren to be preyed up .........or idly stand by?
hokiewolf said:Werewolf said:Here we goooo…
— MJTruthUltra (@MJTruthUltra) October 17, 2025
B-52 BOMBERS were just DEPLOYED and are now Flying off the coast of Venezuela and 10% of US Naval Power is now in the Region — “Trump’s not Bluffing”
- 10,000 US Soldiers are in the Caribbean and on ships on Puerto Rico
- Special Operations Helo’s were spotted… pic.twitter.com/mI9veEeOrJ
Thought we were against forever wars.
hokiewolf said:Werewolf said:hokiewolf said:Werewolf said:Here we goooo…
— MJTruthUltra (@MJTruthUltra) October 17, 2025
B-52 BOMBERS were just DEPLOYED and are now Flying off the coast of Venezuela and 10% of US Naval Power is now in the Region — “Trump’s not Bluffing”
- 10,000 US Soldiers are in the Caribbean and on ships on Puerto Rico
- Special Operations Helo’s were spotted… pic.twitter.com/mI9veEeOrJ
Thought we were against forever wars.
I doubt this one is forever; I believe Maduro may be trying to bribe Trump/America with promises of oil & minerals.......he knows it is just a matter of time and his a$$ fries.
Allow our children and grandchildren to be preyed up .........or idly stand by?
lol, great pivot. Proud of you.
