How does this happen?
Post Reply
 
Thread Rating:
  • 0 Votes - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
12-09-2017, 03:46 PM
RE: How does this happen?
I've never understood why people think that insurance companies "are here to help".

That's simplistic twaddle, peddled by the industries marketing people.

Insurance companies want one thing - to take as much of your money as they can, and keep, if at all possible, every penny.

If you don't believe that - you've been lucky - and never made a claim that the insurance company couldn't weasel out of paying.

.......................................

The difference between prayer and masturbation - is when a guy is through masturbating - he has something to show for his efforts.
Find all posts by this user
Like Post Quote this message in a reply
[+] 2 users Like onlinebiker's post
12-09-2017, 04:37 PM
RE: How does this happen?
(12-09-2017 02:13 PM)BikerDude Wrote:  Almost make one believe in the "reptile people" stuff.
I mean you wonder how people can get this fucking evil.
It's X Files shit.
The black oil.
Human beings just aren't this callous.
It takes gene splicing to achieve this level of reptile mind

(The bolding belongs to me.)



Um... what planet do we live on?

Don't let those gnomes and their illusions get you down. They're just gnomes and illusions.

--Jake the Dog, Adventure Time

Alouette, je te plumerai.
Find all posts by this user
Like Post Quote this message in a reply
12-09-2017, 08:05 PM
RE: How does this happen?
(12-09-2017 03:46 PM)onlinebiker Wrote:  I've never understood why people think that insurance companies "are here to help".

Because they would make even less money if they didn't help. That's the nature of all businesses, and all human interactions for that matter. Complete selfishness does not equal optimal profit.

However, I certainly agree that the government should be able to provide healthcare more economically than the private sector. Contrary to libertarian ideas, there really are certain things governments do better than businesses.
Find all posts by this user
Like Post Quote this message in a reply
12-09-2017, 11:23 PM
RE: How does this happen?
(12-09-2017 08:05 PM)Thoreauvian Wrote:  Contrary to libertarian ideas, there really are certain things governments do better than businesses.
I don't disagree that government is better at certain things but I think after 50+ years of abysmal cost-to-benefit of Medicare and Medicaid I don't see how Government has demonstrated that Healthcare is one of those certain things. Personally, I think the toxic financial and regulatory partnership between government and the Insurence industry has been nothing but harmful overall and that both are to blame.

In the defence of the Libertarians, the US hasn't exactly had 50 years of free market healthcare. I know, I know, I sound like a broken record these days but some of the best and most efficient healthcare in the world comes from countries with dramatically lower government involvement in the industry.

When valour preys on reason, it eats the sword it fights with.
Find all posts by this user
Like Post Quote this message in a reply
[+] 2 users Like WhiskeyDebates's post
12-09-2017, 11:41 PM
RE: How does this happen?
(12-09-2017 11:23 PM)WhiskeyDebates Wrote:  ...
I know, I know, I sound like a broken record these days but some of the best and most efficient healthcare in the world comes from countries with dramatically lower government involvement in the industry.

Efficient, yes. That's Bloomberg's metric that puts SG snd HK up there at the top.

But I question whether 'efficiency' should be the decisive metric if one considers healthcare as an enabler.

Or to put it another way... how would you measure 'best'?

Consider

Find all posts by this user
Like Post Quote this message in a reply
[+] 1 user Likes DLJ's post
13-09-2017, 05:51 AM (This post was last modified: 13-09-2017 06:00 AM by BikerDude.)
RE: How does this happen?
(12-09-2017 08:05 PM)Thoreauvian Wrote:  
(12-09-2017 03:46 PM)onlinebiker Wrote:  I've never understood why people think that insurance companies "are here to help".

Because they would make even less money if they didn't help. That's the nature of all businesses, and all human interactions for that matter. Complete selfishness does not equal optimal profit.

However, I certainly agree that the government should be able to provide healthcare more economically than the private sector. Contrary to libertarian ideas, there really are certain things governments do better than businesses.

Those "laws" of the market have disappeared with the horse and Carriage.
People really don't have legitimate choices in health insurance. The exchange was meant to do that but it's a crock. You have a choice of at best a handful of plans that are mostly priced beyond people means and are managed by a handful of companies. All of them equally shitty.
The last 3 places I worked each had 3 insurance plans and all of them were managed by the same company. And if you went out onto the exchange to buy, it was way more expensive because it didn't have any company buy in. And I consider myself one of the lucky ones to have good insurance offered by a very big company.
But even there you have to choose between a high deductible and low payments or visa versa. Then you get one of the health contribution thingies where you put money in a fund to use toward the deductible. Bottom line is it sucks.
For most of my career I paid a very manageable amount of money out of my paycheck and at best had something like a $20 copay. I don't think anything has really changed except that the insurance and pharma companies have gone farther and farther in bleeding us dry.
This nonsense idea that somehow you get a competitive market place by having a choice between at best a very small handful of insurance companies is a crock.
Same thing with other things like gasoline, electricity, telephone. The government has usually worked to fight against monopolies (think the telephone industry) but it has had pretty minimal impact. It's sort of swimming against the tide.
And today they don't even fight against monopoly.
I'm no Marxist but his idea that capitalism would eventually "turn inward" and eat it's self alive seems very resonant to me.
All of the biggest companies have gotten in on the health care industry.
It's easy money. And yet we all talk about a "health care crisis".
It's all just a matter of which side of the line you are on.
One man's crisis is apparently another's windfall.
Big companies have entire divisions that are in health care.
Today's CEO of GE started out as the head of that and the profits were so high he rose to be CEO.

[Image: anigif_enhanced-26851-1450298712-2.gif]
Find all posts by this user
Like Post Quote this message in a reply
[+] 1 user Likes BikerDude's post
13-09-2017, 04:57 PM
RE: How does this happen?
(12-09-2017 11:41 PM)DLJ Wrote:  
(12-09-2017 11:23 PM)WhiskeyDebates Wrote:  ...
I know, I know, I sound like a broken record these days but some of the best and most efficient healthcare in the world comes from countries with dramatically lower government involvement in the industry.

Efficient, yes. That's Bloomberg's metric that puts SG snd HK up there at the top.

But I question whether 'efficiency' should be the decisive metric if one considers healthcare as an enabler.

Or to put it another way... how would you measure 'best'?

Consider
Just like on any other subject I wouldn't want to use a single metric when evaluating the merits of a system. I'd want to take into account as many relevant and prescient metrics as possible. It's also important when discussing things like this to not fall into the nirvana fallacy, every system is gonna have problems it's about finding a system that works better not perfectly. I only bring that up cause I see it a lot these days. Anyway, the metrics I use when talking about things of this nature are as follows.

1.) Cost. Fairly straight forward really, how much does something year over year cost.
2.) Efficiency. Again fairly straight forward.
3.) Sustainability. Can the system be maintained for long periods of time at similar costs, or at least at a cost that matches reasonable revenue increases?
4.) Financing. How will you pay for it? Will it have to be debt-financed and for how long? Is it voluntarily or coercively funded?
5.) Coverage. How broad is the coverage or how narrow? Will it have to be dramatically expanded and how will that affect the cost and other factors?
6.) Morality. How moral is the system? Does it require policies or programs to sustain it that would be considered immoral in other areas of society?
7.) Value. How much bang for your buck are you getting? What % of the dollar is being spent on the good/service and how much would be considered "wasted"?
8.) Tools. What tools are available to the system to check faulty behaviour, to incentivise efficiency and punish waste and mismanagement.
9.) Social impact. How is this likely to change the behaviour of individuals in society? Will it foster dependency or self-reliance? Will it promote personal responsibility, social cohesion, and other positive ideals or will it be a breeding ground for harmful and costly ideologies?

While some are easier to quantify than others it's my opinion that in every single one of these metrics the current American Healthcare system receives a failing grade. Attempting to make adjustments and revamping the current system would help bring some of the metrics up I have no doubt about that. However, their are elements of the system that intrinsically fail to produce good results in several of those metrics namely 3, 6, 8, and 9. I can elaborate if requested haha.

While the SG and HK models are not perfect they hit all of those metrics far better than just about any other system of Healthcare on Earth. I think it's the model, far more than the Nordic model, that should be looked at for some form of replication in other countries or at least as a sign that maybe the notion I see regularly of "more government = better results" is not necessarily accurate. I think it's a success story, it's not perfect, but compared to the alternative I think it's the "best" we have right now.

When valour preys on reason, it eats the sword it fights with.
Find all posts by this user
Like Post Quote this message in a reply
13-09-2017, 05:39 PM
RE: How does this happen?
(13-09-2017 04:57 PM)WhiskeyDebates Wrote:  
(12-09-2017 11:41 PM)DLJ Wrote:  Efficient, yes. That's Bloomberg's metric that puts SG snd HK up there at the top.

But I question whether 'efficiency' should be the decisive metric if one considers healthcare as an enabler.

Or to put it another way... how would you measure 'best'?

Consider
Just like on any other subject I wouldn't want to use a single metric when evaluating the merits of a system. I'd want to take into account as many relevant and prescient metrics as possible. It's also important when discussing things like this to not fall into the nirvana fallacy, every system is gonna have problems it's about finding a system that works better not perfectly. I only bring that up cause I see it a lot these days. Anyway, the metrics I use when talking about things of this nature are as follows.

1.) Cost. Fairly straight forward really, how much does something year over year cost.
2.) Efficiency. Again fairly straight forward.
3.) Sustainability. Can the system be maintained for long periods of time at similar costs, or at least at a cost that matches reasonable revenue increases?
4.) Financing. How will you pay for it? Will it have to be debt-financed and for how long? Is it voluntarily or coercively funded?
5.) Coverage. How broad is the coverage or how narrow? Will it have to be dramatically expanded and how will that affect the cost and other factors?
6.) Morality. How moral is the system? Does it require policies or programs to sustain it that would be considered immoral in other areas of society?
7.) Value. How much bang for your buck are you getting? What % of the dollar is being spent on the good/service and how much would be considered "wasted"?
8.) Tools. What tools are available to the system to check faulty behaviour, to incentivise efficiency and punish waste and mismanagement.
9.) Social impact. How is this likely to change the behaviour of individuals in society? Will it foster dependency or self-reliance? Will it promote personal responsibility, social cohesion, and other positive ideals or will it be a breeding ground for harmful and costly ideologies?

While some are easier to quantify than others it's my opinion that in every single one of these metrics the current American Healthcare system receives a failing grade. Attempting to make adjustments and revamping the current system would help bring some of the metrics up I have no doubt about that. However, their are elements of the system that intrinsically fail to produce good results in several of those metrics namely 3, 6, 8, and 9. I can elaborate if requested haha.

While the SG and HK models are not perfect they hit all of those metrics far better than just about any other system of Healthcare on Earth. I think it's the model, far more than the Nordic model, that should be looked at for some form of replication in other countries or at least as a sign that maybe the notion I see regularly of "more government = better results" is not necessarily accurate. I think it's a success story, it's not perfect, but compared to the alternative I think it's the "best" we have right now.

Thanks. Good list.

If I may tweak it a little:
1, 2 and 7 are all financial ... overkill. But the distinction between 'cost' vs. 'price' is valid.
6. I'd drop 'morality' as a 'service' metric but add some stuff about data security and use 'breaches of ethics' as a 'component' (i.e. care giver) metric
7 - 'value', has three components: outcomes (expected and actual), perceptions and preferences. Better to measure those independently.

So I'd add a bunch of qualitative (subjective) metrics e.g. quality of care (customer satisfaction / wait times (compared to expectation) / long stay comfort etc.)

Also to be taken into account regarding #9 - specifically relating to a predominantly public service, which would be by far the easiest (and therefore cheapest (capex)) for the US to implement simply by extending Medicare ... (think of the social impact of NASA) - leading the world, creating innovation, creating jobs, underpinning society etc.
Government spending shouldn't necessarily have the same efficiency targets as the private sector i.e. it's government investment in its people as capabilities (intangible) rather than its people as resources (tangible).

This is fun. Given your expertise in the subject (and mine) shall we do the same exercise for brothels? I'd wager the metrics would be pretty much the same.

Big Grin

Find all posts by this user
Like Post Quote this message in a reply
14-09-2017, 06:21 AM
RE: How does this happen?
(13-09-2017 04:57 PM)WhiskeyDebates Wrote:  Just like on any other subject I wouldn't want to use a single metric when evaluating the merits of a system. I'd want to take into account as many relevant and prescient metrics as possible. It's also important when discussing things like this to not fall into the nirvana fallacy, every system is gonna have problems it's about finding a system that works better not perfectly. I only bring that up cause I see it a lot these days. Anyway, the metrics I use when talking about things of this nature are as follows.

1.) Cost. Fairly straight forward really, how much does something year over year cost.
2.) Efficiency. Again fairly straight forward.
3.) Sustainability. Can the system be maintained for long periods of time at similar costs, or at least at a cost that matches reasonable revenue increases?
4.) Financing. How will you pay for it? Will it have to be debt-financed and for how long? Is it voluntarily or coercively funded?
5.) Coverage. How broad is the coverage or how narrow? Will it have to be dramatically expanded and how will that affect the cost and other factors?
6.) Morality. How moral is the system? Does it require policies or programs to sustain it that would be considered immoral in other areas of society?
7.) Value. How much bang for your buck are you getting? What % of the dollar is being spent on the good/service and how much would be considered "wasted"?
8.) Tools. What tools are available to the system to check faulty behaviour, to incentivise efficiency and punish waste and mismanagement.
9.) Social impact. How is this likely to change the behaviour of individuals in society? Will it foster dependency or self-reliance? Will it promote personal responsibility, social cohesion, and other positive ideals or will it be a breeding ground for harmful and costly ideologies?

While some are easier to quantify than others it's my opinion that in every single one of these metrics the current American Healthcare system receives a failing grade. Attempting to make adjustments and revamping the current system would help bring some of the metrics up I have no doubt about that. However, their are elements of the system that intrinsically fail to produce good results in several of those metrics namely 3, 6, 8, and 9. I can elaborate if requested haha.

While the SG and HK models are not perfect they hit all of those metrics far better than just about any other system of Healthcare on Earth. I think it's the model, far more than the Nordic model, that should be looked at for some form of replication in other countries or at least as a sign that maybe the notion I see regularly of "more government = better results" is not necessarily accurate. I think it's a success story, it's not perfect, but compared to the alternative I think it's the "best" we have right now.

What is it that makes the US different from all the other countries who manage to have Government run health care?
Why in all those other cases does it end up lowering costs and producing better outcomes but in the US somehow we contend that it won't do the same?
I really can only explain the resistance as the effect of misinformation by interested parties. Just like pretty much everything else.
Manufacturing consent.

Usually I find Richard Wolff very condescending and annoying but IMO he hits it on the head.



[Image: anigif_enhanced-26851-1450298712-2.gif]
Find all posts by this user
Like Post Quote this message in a reply
[+] 2 users Like BikerDude's post
14-09-2017, 06:30 AM (This post was last modified: 14-09-2017 07:38 AM by BikerDude.)
RE: How does this happen?
1.) Cost. Fairly straight forward really, how much does something year over year cost.
Why would it cost more than it doesn now? And I contend it should cost less.

2.) Efficiency. Again fairly straight forward.
Why would it be less efficient than it is now? And I contend it should be more efficient since "inefficiency" is a cash cow to the insurance industry.

3.) Sustainability. Can the system be maintained for long periods of time at similar costs, or at least at a cost that matches reasonable revenue increases?
Why would it be any less sustainable than the system we have now?

4.) Financing. How will you pay for it? Will it have to be debt-financed and for how long? Is it voluntarily or coercively funded?
The same way people pay for insurance now. You have a dollar amount taken from your paycheck that is for medical insurance.
It would have a different label. I'm for coercively funded but I guess it could be an option to start with. Remember the insurance industry fought tooth and nail to eliminate the "public option" from Obama care.
Because it would actually compete with them and force them to lower their prices.

5.) Coverage. How broad is the coverage or how narrow? Will it have to be dramatically expanded and how will that affect the cost and other factors?
Why would it be any different than coverage now? I suspect it would be better. Like it is in other countries with single payer systems.

6.) Morality. How moral is the system? Does it require policies or programs to sustain it that would be considered immoral in other areas of society?
I have no idea what you are asking.

7.) Value. How much bang for your buck are you getting? What % of the dollar is being spent on the good/service and how much would be considered "wasted"?
The percent cost of insurance run programs run around 20%. Medicaid runs around 2%. Translate "wasted" into the term "profit" and you have the crux of the issue.

8.) Tools. What tools are available to the system to check faulty behaviour, to incentivise efficiency and punish waste and mismanagement.
I have no idea. But why would the US be the one instance where people abuse the system?

9.) Social impact. How is this likely to change the behaviour of individuals in society? Will it foster dependency or self-reliance? Will it promote personal responsibility, social cohesion, and other positive ideals or will it be a breeding ground for harmful and costly ideologies?
Unless there is something uniquely shitty about Americans it won't any more than it does in Canada or Great Britain or France etc.

For me the one thing that gives me pause comes more from the "left". The proponents of single payer health care. I call them the "political class".
The people that make their bacon off bloated Government and have no interest in efficiency in that realm.
The thing we need to watch out for is in the way it gets implemented.
If the health care system is kept separate from the "general fund" or whatever you want to call it then it will work fine.
But if the left sees it as a windfall for implementing a wish list and it goes into a giant slush fund it will not lower costs and it will be a government run cash cow.
This is really what has happened to our social security.
It is not kept discreet from all the other funds.
And it's been raided over and over to pay for wars and whatever else is the issue of the day.
Remember Al Bore with his "lock box".
But in the end there is no reason why the same economics (at least) can't work in a single payer system.
And in reality it SHOULD improve the economics.
Even just by getting everyone under the same tent. It's a basic fact of how insurance works that the bigger the pool the more costs are spread out.
That's what insurance is.
But the main issue is that things now are run by corporations who don't have the goal of lowering costs or providing any better services than they absolutely have to.
In fact they are legally prohibited from doing either of those things.
If they either price below the absolute highest price that the market will bear or provide a higher level of service than necessary to maintain profits they can be sued by shareholders.
And it has happened.
Famously in the case of Henry Ford.
http://www.professorbainbridge.com/profe...lders.html

Bottom line is that the "rules" that govern business and make it efficient don't apply to things like health care.
There is a different outcome that is the metric for success than shareholder profits.
Removing shareholder profits is essential to have the most efficient system possible.
Every bit of what constitutes profit in the a health care system can rightly be seen as inefficiency where the goal socially is to provide the most service for the lowest cost.
That is NOT the goal of any business. The goal IS profit. And it is legally required to act and implement policy as such.
So the "problems" with our current corporate run system are not actually problems for those companies. They are a huge success.
That's why things are so fucked up. It's not an accident.
And the pay that they give to their fucking CEO's is a testament to it.
They are raping us the same as the big banks have. Obama care was just TARP for the health care industry.

[Image: anigif_enhanced-26851-1450298712-2.gif]
Find all posts by this user
Like Post Quote this message in a reply
[+] 1 user Likes BikerDude's post
Post Reply
Forum Jump: