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Militarized American Healthcare

America Healthcare constitution socialism

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#21 Ivanhoe

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Posted 14 June 2017 - 1255 PM

When we were running up to Obamacare several of the likely outcomes were observed and we were told we were lying. One of them was the change in policies and how polices would be canceled. We were told this was false. Most of the predictions have happened or are starting to happen.


The vast majority of commentary on health care is done in the context of spherical cows. Laws of supply and demand don't exist, providers, insurers, and investors are dupes that can be squeezed without response, etc.
 


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#22 Ivanhoe

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Posted 14 June 2017 - 1258 PM

 

5. Allow every dollar related to your health care be deducted from all taxes.

 

 

Even better, have the same rules for individual income taxes as for businesses. And not just for health care.


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#23 JWB

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Posted 14 June 2017 - 1310 PM

Defense must be run by government for a variety of reasons that are not comparable with health care. The former is inherently collective because there is no such thing as an army of one. The latter is individualistc because every patient is different.

 

I would create a public option by funding  the public hospitals and clinics  with revenues from alcohol and tobacco taxes. Any citizen or legal resident could receive treatment after paying a means tested age adjusted co-pay. The administration of the facilities and systems would be at the state/county level.


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#24 TTK Ciar

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Posted 14 June 2017 - 1440 PM

We may be finding out soon whether single-payer is practical in America. California's "Healthy California Act" (SB562) https://leginfo.legi...=201720180SB562 is sailing through the state legislature. The governor has spoken against it, so we'll see if he vetoes it or not.

The act would pay for some set of medical goods and services for all Californians' health care needs, and illegalize private insurance covering any good or service covered by the HCA (so that health care providers could not simply refuse to treat anyone covered by the HCA; providers would have to be paid via the HCA or not at all).

It would pay for this via a combination of re-purposing existing federal and state health care spending and new taxes. The theory is that these new taxes would be less than what Californians are paying for premiums now, and that the state could negotiate lower prices for goods and services on citizens' behalf.

Maybe this would work out, maybe not. Some problems I see with it:
  • There is already a shortage of doctors in California, with long waiting periods for new appointments. Increasing their patient load by 8% (or more, since treatment would be "free") would exacerbate this problem. (8% of Californians are uninsured now.)
  • If doctors see their income decrease as a result of this state price negotiation, they might leave California, making the shortage worse. It might also discourage doctors from coming to California.
  • The bill text mentions that not all services would be covered, which implies that some citizens might get stuck paying for both, the HCA taxes and private insurance, if they need such services (my wife's special care requirements might put us in such a category, but it's impossible to tell for now).
  • The benefits are theoretical, contingent on competent implementation; in practice the government might fuck it all up, either through incompetence or political foolery. If any state can pull it off, though, it's California. It managed to implement the ACA policies fairly well.
  • If citizens drop their private insurance to use HCA, and HCA later proves unsustainable and gets dropped, it creates a set of citizens with gaps in coverage, which means all of their conditions become "pre-existing conditions" not covered by private health insurance.
Or maybe everything will be candy and rainbows. We'll see.

Edited by TTK Ciar, 14 June 2017 - 1445 PM.

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#25 rmgill

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Posted 14 June 2017 - 1454 PM

If that's in keeping with the State of California's constitution and the voters want to do that then that's their purview. 

We've already seen how TennCare worked out and we're seeing how RomneyCare works. 


Edited by rmgill, 14 June 2017 - 1454 PM.

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#26 Ivanhoe

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Posted 15 June 2017 - 0401 AM

  • There is already a shortage of doctors in California, with long waiting periods for new appointments. Increasing their patient load by 8% (or more, since treatment would be "free") would exacerbate this problem. (8% of Californians are uninsured now.)
  • If doctors see their income decrease as a result of this state price negotiation, they might leave California, making the shortage worse. It might also discourage doctors from coming to California.

 

Or just plain retire, in the case of older docs. Resulting in an unintentional supply deficit, driving prices higher rather than lower.


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#27 rmgill

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Posted 15 June 2017 - 0950 AM

How Government Regulations Made Healthcare So Expensive

 

 

Since the early 1900s, medical special interests have been lobbying politicians to reduce competition. By the 1980s, the U.S. was restricting the supply of physicians, hospitals, insurance and pharmaceuticals, while subsidizing demand. Since then, the U.S. has been trying to control high costs by moving toward something perhaps best described by the House Budget Committee: “In too many areas of the economy — especially energy, housing, finance, and health care — free enterprise has given way to government control in “partnership” with a few large or politically well-connected companies” (Ryan 2012). The following are past major laws and other policies implemented by the Federal and state governments that have interfered with the health care marketplace (HHS 2013):

  • In 1910, the physician oligopoly was started during the Republican administration of William Taft after the American Medical Association lobbied the states to strengthen the regulation of medical licensure and allow their state AMA offices to oversee the closure or merger of nearly half of medical schools and also the reduction of class sizes. The states have been subsidizing the education of the number of doctors recommended by the AMA.
  • In 1925, prescription drug monopolies begun after the federal government led by Republican President Calvin Coolidge started allowing the patenting of drugs. (Drug monopolies have also been promoted by government research and development subsidies targeted to favored pharmaceutical companies.)
  • In 1945, buyer monopolization begun after the McCarran-Ferguson Act led by the Roosevelt Administration exempted the business of medical insurance from most federal regulation, including antitrust laws. (States have also more recently contributed to the monopolization by requiring health care plans to meet standards for coverage.)
  • In 1946, institutional provider monopolization begun after favored hospitals received federal subsidies (matching grants and loans) provided under the Hospital Survey and Construction Act passed during the Truman Administration. (States have also been exempting non-profit hospitals from antitrust laws.)
  • In 1951, employers started to become the dominant third-party insurance buyer during the Truman Administration after the Internal Revenue Service declared group premiums tax-deductible.
  • In 1965, nationalization was started with a government buyer monopoly after the Johnson Administration led passage of Medicare and Medicaid which provided health insurance for the elderly and poor, respectively.
  • In 1972, institutional provider monopolization was strengthened after the Nixon Administration started restricting the supply of hospitals by requiring federal certificate-of-need for the construction of medical facilities.
  • In 1974, buyer monopolization was strengthened during the Nixon Administration after the Employee Retirement Income Security Act exempted employee health benefit plans offered by large employers (e.g., HMOs) from state regulations and lawsuits (e.g., brought by people denied coverage).
  • In 1984, prescription drug monopolies were strengthened during the Reagan Administration after the Drug Price Competition and Patent Term Restoration Act permitted the extension of patents beyond 20 years. (The government has also allowed pharmaceuticals companies to bribe physicians to prescribe more expensive drugs.)
  • In 2003, prescription drug monopolies were strengthened during the Bush Administration after the Medicare Prescription Drug, Improvement, and Modernization Act provided subsidies to the elderly for drugs.
  • In 2014, nationalization will be strengthened after the Patient Protection and Affordable Care Act of 2010 (“Obamacare”) provided mandates, subsidies and insurance exchanges, and the expansion of Medicaid.

    The history of medical cost inflation and government interference in health care markets appears to support the hypothesis that prices were set by the laws of supply and demand before 1980 and perhaps 1990. Even the degree of monopolization and nationalization promoted by politicians before 1965 was not enough to cause significant cost inflation and spending increases (Figure 2) until demands created by Medicare and Medicaid outstripped the restricted supply of physicians and hospitals.
     
     

Want medial costs in the US to go down? Dial back on the regulatory fabric. 


More at the link. 


Edited by rmgill, 15 June 2017 - 0950 AM.

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#28 Ken Estes

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Posted 16 June 2017 - 2319 PM

IOW screw the poor, the elderly pensioners and others less fortunate than you are. Nobody will care if they expire, although there may be charities interested. That's the Republican way and that's why I abandoned the party c.1986.

 

Gag a Maggot! You trust Mises.com for this junk. Economics a la Ayn Rand. Medicare a 'nationalization' of medicine and so forth. Sheer pap.


Edited by Ken Estes, 16 June 2017 - 2324 PM.

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#29 Rick

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Posted 17 June 2017 - 0028 AM

IOW screw the poor, the elderly pensioners and others less fortunate than you are. Nobody will care if they expire, although there may be charities interested. That's the Republican way and that's why I abandoned the party c.1986.

 

Gag a Maggot! You trust Mises.com for this junk. Economics a la Ayn Rand. Medicare a 'nationalization' of medicine and so forth. Sheer pap.

The first sentence is answered via Medicare and Medicaid. Bellow all you want, but it does come down to who will pay for it. An honest realization that led me vote straight Republican beginning in 1986.


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#30 JWB

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Posted 17 June 2017 - 1130 AM

Any one here thinks this was a good idea?


 

 


  • In 1972, institutional provider monopolization was strengthened after the Nixon Administration started restricting the supply of hospitals by requiring federal certificate-of-need for the construction of medical facilities.

 


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#31 Ken Estes

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Posted 17 June 2017 - 1347 PM

The sentence by itself offers little to assess. The method of execution and results might be more helpful. Nixon also initiated revenue sharing.

 

Nowhere have we seen 'nationalization' of a US economic sector.


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#32 sunday

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Posted 17 June 2017 - 1412 PM

The sentence by itself offers little to assess. The method of execution and results might be more helpful. Nixon also initiated revenue sharing.

 

Nowhere have we seen 'nationalization' of a US economic sector.

 

Amtrak could be thought as some kind of nationalization, perhaps.


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#33 Brian Kennedy

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Posted 17 June 2017 - 1540 PM

Every other industrialized country spends less on health care and delivers it to a larger percent of the population. So the question to me is, are we (the US) being too liberal, and not taking the gloves off and letting the cards fall where they may and saying if you can't afford health care, its because the feds have limited the market? Or is it because this is an industry, like fire fighting, police, and defense, that is better handled by the government? I tend to believe the latter. But it doesn't matter, I'm well off and I'll always have health care and I never want children. So this debate is academic to me. Is there anyone on this board from the US who DOESN'T have health care who wants to ring in?

I didn't have health care for several years at a time in my mis-spent 20s-early 30s, but that was just a stupid decision on my part (I was making a reasonable living as a freelancer but spending several hundred bucks a month would have been an issue, I was a pretty healthy guy, thought I was invincible, was too busy partying in Greenpoint -- shout-out to Josh -- etc.). It worked out ok in retrospect. If I had gotten hit by a truck or got cancer, I probably would have had a different opinion about that.

I think it basically boils down to whether you think health care is a basic human right or not. Most countries believe that it is, again on par with (even more important than) primary education. I guess we don't, because Socialism or something.

Edited by Brian Kennedy, 17 June 2017 - 1542 PM.

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#34 Brian Kennedy

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Posted 17 June 2017 - 1555 PM

In a feeble attempt to get back to what I think? Was the main point of the subject thread, I don't actually think that our shit health care is actually a military issue. If you want to tie it to some "our new recruits are too fat" bs, getting into shape is pretty fun and easy. People have been complaining about recruits being too fat for the past 75 years or so, it's worked out ok.
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#35 rmgill

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Posted 18 June 2017 - 0014 AM

 

The sentence by itself offers little to assess. The method of execution and results might be more helpful. Nixon also initiated revenue sharing.

 

Nowhere have we seen 'nationalization' of a US economic sector.

 

Amtrak could be thought as some kind of nationalization, perhaps.

 

When speaking of AMTRAK be sure to ALSO speak of CONRAIL and bear in mind that the federal government had a hand in manifesting the bankruptcy of Penn Central which is what AMTRAK and CONRAIL were created to replace. 


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#36 EchoFiveMike

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Posted 18 June 2017 - 0826 AM

Single source healthcare could work in a largely mono-ethnic, cohesive environment like Scandinavia, with the caveat that you cut off people who manifest deliberate, antisocial deviant behavior.  Taking care of the deliberately self destructive, ie druggies, homos, obscene fatties, criminals etc is what breaks the system.  S/F....Ken M   


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#37 Brian Kennedy

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Posted 18 June 2017 - 1811 PM

A lot of it is also 94-year-olds with dementia who get kept alive for a coupe more weeks even though they don't want to. (our elder care is great!) I'm firmly in the camp of settling up all your affairs and walking up a hill with a good book and a bottle of excellent bourbon and a shotgun, but it seems like most people don't actually do that when it comes down to it.
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#38 Ken Estes

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Posted 19 June 2017 - 1317 PM

Few 94 year-olds have dementia, and there are more than a few families that would like to have their elders hang around for a bit, while that is still possible.

 

I used to find it utterly hilarious that the right wing touted the ills of Canadian and UK health care  as symbolic of the ills of natl health care. Nobody pays any attention to the programs of Scandinavia, Germany, France, The Netherlands, Spain, where no private health insurance has been outlawed.... I wonder why that is. Goebbels would have been proud. I no longer find this humorous. 

 

The RW cried Socialism when Medicare was passed, but could not stop its inevitable improvements such that today, no RW politico dares argue against it, even though Paul Ryan schemes against it in his budgetary alchemy.

 

The current imbroglio in the US is clearly stated here:

 

https://www.nytimes....ef=opinion&_r=0

 

 

BTW, AMTRAK hardly represents nationalization of passenger rail, since not all was taken over and the company itself is a private-public hybrid.


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#39 rmgill

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Posted 19 June 2017 - 1437 PM

Pointing to scandanavia as a template blithely ignores the fact that it is a different and far more heterogeneous culture.

Why the social theory constructionist can't note gross differences in culture that stare them in the face is beyond me. They are also tiny. Again, if you want to make the case, fix the VA system and the run your little social welfare programs at the state level. Thats where they belong.
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#40 Ken Estes

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Posted 20 June 2017 - 0009 AM

VA is working fine. I know the bad apples in Arizona screwed things up and soiled VAs rep, but my experiences with the VA in Washington State have been superb, ditto for pals of mine in Virginia and N Carolina. 

 

The dumping of 'medical retirements' by the armed forces on to an underfunded VA, as well as numerous untreated and discharged military personnel placed the VA instantly into an instant six/twelve-month backlog, that has been exaggerated beyond reason [vets die while awaiting appointments? No, vets just die sometimes, and so on]. The lack of automated records interfacing DOD and VA has not helped a bit and accounts for severe delays. Congress was of little assistance over the years, and GW Bush and Co. tried to cut VA just as it was trumpeting 'Mission Accomplished' in 2003. That's two blunders for the price of one. We now have new VA cuts proposed by the Clown in Chief.

 

"Culture" may account for the US being the only rich and great power unable to create national health care, but not in the sense that Gill puts it. There is no compelling reason to copy UK and Canadian systems. State governments? They are too busy sending junketing parties to Hawaii to study fire departments and still trying to figure out how to fund education.


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