Hillary Clinton says 'many, many, many people' want her to join 2020 Democratic primary

[Burnt Reynolds 5,058]

13 hours ago, ALFKAD said:

The same reason Canadians and Brits come here and pay out of pocket,  perhaps?

The vast majority of those are actually because they want to play doctor and get elective surgeries that their healthcare system won't cover without a medical reason, which requires a process itself to clear. 

 

Those "cancer" situations are not only extremely rare, but often times have an explanation that is not an indictment on the healthcare system of their home country.

 

In the overwhelming normality of these systems, they function well. Canadians and Brits aren't afraid to seek preventative care, thus, particularly in the case of Canadians, taxpayers spend insanely less on acute and emergency care. Whether in a business sense or government sense, efficiency is met by delivering the best quality at the lowest cost. The US is failing this badly, resulting in many Americans either not seeking preventative care, inefficiently adding cost by seeking acute and emergent care disproportionately, or going bankrupt due to not being able to afford insurance, or having some caveat of coverage their existing insurance still cause them to go bankrupt.

 

So something will give. If Republicans are serious about the issue and want to keep things market driven rather than universal, they will take the hit (PR and losing insurance campaign $$), and gut cost-driving inefficiencies starting with the worst elements, like the insurance industry. But we already know these people are cowards. They're going to continue doing nothing useful, while playing defense for when Democrats pass the ridiculous Elizabeth Warren type of universal they want, which is an awful result.

[Steeleballz 7,550]

4 hours ago, Bill & Katya said:

 

So the headlines of the linked stories are misleading.  They implied that healthcare in the US is the worst among the first world countries they used for comparison.  However, people of means seem to choose the US for healthcare even though they could get it much cheaper in a socialized system.

 

  No, the best treatment available does not represent the system as a whole. It has been said for years that the US health care system is the best in the world for those whom cost is no object. That cannot be extrapolated to everyone. We can not all pay to check in to Cedars Sinai tomorrow to have a procedure done.

 

   For the millions who avoid even going in for a preventative physical exam because they are worried about the potential cost of care, it’s not the best system.

[Burnt Reynolds 5,058]

Democrats aren't the only people that do focus groups, studying each voting demographic and psychographics are something done substantially by both parties particularly because that's how they facilitate the vast majority of people pointlessly voting "D or R".

 

The point is, I guarantee you the Republicans and Democrats seeing these focus groups are sharing with their insurance lobby buddies data that points to what I can tell you I already know, and that is universal is only gaining more and more support, even in reddest states, because it is increasingly seen as the only alternative to the useless insurance industry. The last decade basically saw Obama kick the can down the road, while shilling for his industry buddies implementing Obamacare, because their focus groups said this would be good PR, but the point is, the cost is destroying the lives of many Americans, and the tolerance for it is wearing thin, everywhere. 

 

Some of us actually do believe that a market healthcare system can still function, we saw it for the vast majority of this country's history, but that requires people actually motivated to see a market driven system work and doing something to facilitate making it work. Where is this effort coming from? Nowhere. Republicans, the only party that broadly has the only stated intent for "market" options, wind up either passing Obamacare-type mandates (mandates are NOT "markets", they are cost-driving corporatism masquerading as a market option), or passing laws ("reform", "coverage mandates", etc.) that make market possibilities that much more difficult. With this many laws governing healthcare, what people can and can't do, who's legally responsible for what, hundreds of millions of Americans already covered by federal/state/local government options (Medicare, VA, Medi-Cal, county medical, and so on), etc., it's basically government run already. You're seeing red states even toying with the idea of universal, taking this seriously to get it done their way rather than the Democrats' way, which is an awful federally run universal, which is the worst case scenario.

 

In the end, I wonder how long people on the right can keep playing into this facade.. this doesn't even help you and your family. You're repeating the talking points invented by the insurance lobby itself, broadly mainstreamed by the Republicans (and Democrats) through these connections done to facilitate 1) power, and 2) money, amongst themselves. Think for yourselves guys, and stop repeating the things other people taking advantage of you, and other Americans, contrive for you.

Edited November 20, 2019 by Burnt Reynolds

[Dashinka 24,747]

35 minutes ago, Steeleballz said:

 

  No, the best treatment available does not represent the system as a whole. It has been said for years that the US health care system is the best in the world for those whom cost is no object. That cannot be extrapolated to everyone. We can not all pay to check in to Cedars Sinai tomorrow to have a procedure done.

 

   For the millions who avoid even going in for a preventative physical exam because they are worried about the potential cost of care, it’s not the best system.

I understand that being in the healthcare field, your view would be more comprehensive, but when I (and I imagine a lot of others) see a headline that says the US has the worst healthcare in the world, the first thought is the quality of care, medical technologies, innovation, etc., and not thoughts about insurance, or payment methods.

[90DayFinancier 910]

1 hour ago, Burnt Reynolds said:

 

 

So something will give. If Republicans are serious 

So something will give. If Republicans are serious about the issue and want to keep things market driven rather than universal, they will take the hit (PR and losing insurance campaign $$), and gut cost-driving inefficiencies starting with the insurance industry

 

How can you have a market driven solution without insurance? What drives pricing and value?

 

[Burnt Reynolds 5,058]

8 minutes ago, 90DayFinancier said:

How can you have a market driven solution without insurance? What drives pricing and value?

 

You're kidding right? The two parties involved (customer, provider of care) negotiate the price. It operates the very way a market does. This is how it worked up until a few decades into the 20th century where they decided to concoct the insurance industry and tie it to your employer. It's also how it works when you don't have insurance. I'll save you the long spiel about how this was also an era of intense psychological experimentation, era of Freud, Keynes, MKUltra, etc.

[yuna628 9,700]

5 hours ago, Bill & Katya said:

 

So the headlines of the linked stories are misleading.  They implied that healthcare in the US is the worst among the first world countries they used for comparison.  However, people of means seem to choose the US for healthcare even though they could get it much cheaper in a socialized system.

No. If you look at healthcare as various hospitals and doctors around the country and our system of insurance, it is easy to see why it would be ranked as it is. Healthcare in countries that utilize an NHS system or some sort of hybrid system can often find themselves receiving care that is what I'd term 'perfectly adequate'. Yes there are problems and horror stories, but the people that live in those countries hear our own horror stories, of a person going bankrupt or never being able to afford care in the first place. It is unlikely they've heard the horror stories in America of bad doctors and hospitals that will kill you and then bankrupt you for the pleasure but that certainly wouldn't help their outlook on the system.

 

When I think of articles like this I think of the totality of the whole. Yes, we have great innovations and tech, but we do lack competency, standards, money (especially in rural hospitals), and a flood of the elder generation of expert doctors going out while new not necessarily expert moving in. We fob off care to PAs and CNAs and RNs at overworked practices. Employees are paid dismally to function. I have been very sick lately and I have yet to see an actual doctor in lieu of the RN. Granted she is very good and has been doing extensive testing and we're getting close to finding out what is wrong... but still for once I'd like to see the actual doctor?

 

The rich come here for a reason, not because they could get it cheaper, but because there are very specialized places and we still have pockets of some of the best elder generation of experts in the world. But they are typically only giving care to people that can afford it, not your average person that might be dying away in a rural hospital due to incompetent care. What good is cheaper care if that care may only provide them adequate care and you are dying of something that doesn't require merely adequate and money is not your concern?

 

My father almost died several times this year. I still remember getting off the phone and having to hold my mom's hand and telling her devastating news.... that my dad at the local hospital, had no doctors present there that could do anything for him, no surgeons who could treat this, no ICU facility that could handle it. They delayed many hours on a tarmac in the driving rain before they gave up and drove him two hours to our finest trauma center (and imo one of the finest in the world). If you are shot, go there. If you have a brain injury, go there. If you are going to die, go there. Because there are men and women there who can work miracles that other hospitals simply could not. My dad's eventual surgeon after being sedated in the ICU for many weeks, was an expert in his field, world renowned, and an immigrant that has been here since a young man. He has operated on the rich, the poor, the famous, and the infamous. He is an old man now, and dad was one of his very last surgeries.

 

After he recovered, they sent him home. There he quickly spiraled again, due to the incompetence of his local newbie doctor (we didn't know what we know now and afterwards we fired him). I called his surgeon on the phone and described his symptoms - he told me to not wait, not even bother going to the local hospital, to get him back to the trauma center any way I could. He collapsed in my husband's arms, while I was on the phone with 911. The paramedics brought him back to life and medivac'd him. The surgeon was so angry at that doctor and a whole team worked on him once again. Still my dad needed to rehab at the local hospital, but while there he contracted two very dangerous infections. It took weeks of incompetence with that local hospital to get my dad proper treatment - and eventually I had to go above the newbie doctor treating him and demand my mom's very competent doctor review his case. That doctor was floored and finally my dad got the right treatment he needed. In total now for five months of care, Medicare has somewhere fielded close to over a half million.

 

Medicare paying for this gave us a great deal peace of mind. If my dad hadn't been retired and still working on his health insurance? No way. Absolutely no way. He'd be dead right now and we'd be broke.

 

I do not know if the NHS could have handled such a situation with my father. My husband says unlikely at his local hospital. Perhaps in London, but there is now extreme shortages.

 

I know that it is easy to tell ourselves that America is the best at everything. And in some things we are. When it comes to healthcare I'm confident that we are best at it only in *some areas*, in *some states*, and in *some locations* by *some people*. It is no longer a countrywide thing, if it ever were. The NHS will give a person peace of mind that hey will get care *eventually* and they will not go broke for it. They are willing to wait for their care and endure a lot of what this American gal thinks is a lot of stupidity and some really bad instances of deaths to get it, because they believe the alternative is worse. I believe if the UK had a system like ours and many economic factors continued as they are, things would be very much worse. He agrees with me. He has marveled at our hospitals and how things are done but the prospect that without insurance a person could die or even with it they could go bankrupt makes him wary.

Edited November 20, 2019 by yuna628

[yuna628 9,700]

I also wanted to add (can't edit now). That our local hospital is very bad. When I didn't have insurance they nearly killed me and stuck me with a big bill I dutifully paid. They can barely cope over there. It's dirty, it's incompetent.. it's nowhere you want to be. It gets bad ratings even with all the constant 'buyouts'. When I started getting sick in spring and needed surgery, I went to a different but 'average' hospital. They did the job, screwed up the surgery, but still by the grace of one good doctor, he fixed me, and I left there without any infections. But they did not tell me, what I now know.. that my bloodwork is a mess and something is still wrong.

 

My dad's best friend was diagnosed with very aggressive cancer when he was still youngish, around the same time my mom was also diagnosed. My dad had a little bit better insurance at the time, and my mom was able to get really good care and they got the cancer out. My dad's friend was not so lucky. They stuck with that local deathtrap hospital where they dithered around with his care, suggested a whole host of nonsense things... and eventually when things were so desperate, his wife was seeking out for-profit hospitals like CTCOA for help. It was all too late by then. Instead of getting him hospice care they just fed her false hope for $s.. and the cancer took him soon after.

Edited November 20, 2019 by yuna628

[90DayFinancier 910]

40 minutes ago, Burnt Reynolds said:

You're kidding right? The two parties involved (customer, provider of care) negotiate the price. It operates the very way a market does. This is how it worked up until a few decades into the 20th century where they decided to concoct the insurance industry and tie it to your employer. It's also how it works when you don't have insurance. I'll save you the long spiel about how this was also an era of intense psychological experimentation, era of Freud, Keynes, MKUltra, etc.

No, I am not kidding. It was a dead serious question.

If one is incapacitated say under the influence of anesthesia, what will drive decisions about what treatments can be applied and at what cost? At that point you would need a proxy to determine whether the treatment and the risk reward is worth it to you and your interest.

 

What about trauma treatment? You will not be in any position to negotiate as you bleed to death. How will the providers of that trauma service rely on payment?

 

Who decides capacity? Portland may have too many dialysis machines while Atlanta has too many Catscan devices. Can the market sort all of gaps? 

 

Some mechanism will need to ensure that the provider can remain viable and that the consumer has a cohesive system of care, all within ethical bounds.

 

We have to freely recognize that insurance companies and others have forced inefficient pricing into the system and probably other factors have providers over providing.

 

In terms of regular care, there is nothing that prevents one from striking a deal with your physician. But care is complex with many specialities and asset ROI issues and providers will group to create efficiency and profit. Consumers will want to manage the risk and the imbalance of power and sign a contract with the provider. When the consumer feels they are not getting a good deal in those contacts, they will combine into a consumers union via fraternity or maybe your employer which will balance the playing field. It won't be long before you have insurance companies calling the shots.

 

 

 

Edited November 20, 2019 by 90DayFinancier

[yuna628 9,700]

6 minutes ago, 90DayFinancier said:

No, I am not kidding. It was a dead serious question.

If one is incapacitated say under the influence of anesthesia, what will drive decisions about what treatments can be applied and at what cost? At that point you would need a proxy to determine whether the treatment and the risk reward is worth it to you and your interest.

 

What about trauma treatment? You will not be in any position to negotiate as you bleed to death. How will the providers of that trauma service rely on payment?

 

Who decides capacity? Portland may have too many dialysis machines while Atlanta has too many Catscan devices. Can the market sort all of gaps? 

 

Some mechanism will need to ensure that the provider can remain viable and that the consumer has a cohesive system of care, all within ethical bounds.

 

We have to freely recognize that insurance companies and others have forced inefficient pricing into the system and probably other factors have providers 

 

In terms of regular care, there is nothing that prevents one from striking a deal with your physician. But care is complex with many specialities and asset ROI issues and providers will group to create efficiency and profit. Consumers will want to manage the risk and the imbalance of power and sign a contract with the provider. When the consumer feels they are not getting a good deal in those contacts, they will combine into a consumers union via fraternity or maybe your employer which will balance the playing field. It won't be long before you have insurance companies calling the shots.

 

 

 

I think if we're going to look back to ''ye olden days'' when employers didn't offer insurance, and we didn't have much of an insurance system at all and you could negotiate your care with the local country doctor with a bottle of whisky and some chickens and hope you stayed alive. We'd find some amazing things...

 

That was then..

 

This is now. Things have been invented since then. Medical technology has exploded. People aren't dying from stupid things (well..sort of). We have cures or treatments for things that didn't exist. Whenever I hear about 'negotiating' in emergency situations I want to laugh and cry at the same time.... healthcare and paying for it back then? Well i'm sure the paying system worked okay, not so sure about the actual care though. Nowadays that outdated notion isn't going to cut it. The system needs an intensive overhaul.

Edited November 20, 2019 by yuna628

[Dashinka 24,747]

21 minutes ago, yuna628 said:

I also wanted to add (can't edit now). That our local hospital is very bad. When I didn't have insurance they nearly killed me and stuck me with a big bill I dutifully paid. They can barely cope over there. It's dirty, it's incompetent.. it's nowhere you want to be. It gets bad ratings even with all the constant 'buyouts'. When I started getting sick in spring and needed surgery, I went to a different but 'average' hospital. They did the job, screwed up the surgery, but still by the grace of one good doctor, he fixed me, and I left there without any infections. But they did not tell me, what I now know.. that my bloodwork is a mess and something is still wrong.

 

My dad's best friend was diagnosed with very aggressive cancer when he was still youngish, around the same time my mom was also diagnosed. My dad had a little bit better insurance at the time, and my mom was able to get really good care and they got the cancer out. My dad's friend was not so lucky. They stuck with that local deathtrap hospital where they dithered around with his care, suggested a whole host of nonsense things... and eventually when things were so desperate, his wife was seeking out for-profit hospitals like CTCOA for help. It was all too late by then. Instead of getting him hospice care they just fed her false hope for $s.. and the cancer took him soon after.

Just curious, a lot of folks choose where to live based on school systems, why not based on quality of hospitals.

[yuna628 9,700]

1 minute ago, Bill & Katya said:

Just curious, a lot of folks choose where to live based on school systems, why not based on quality of hospitals.

You try telling a giant swath of the US to move to Baltimore.  

[Boiler 45,981]

Florida is full of people who move because of old age, I was told that the reason we do not have a pharmacy where I live is no Care Homes here.

[Steeleballz 7,550]

1 hour ago, Boiler said:

Florida is full of people who move because of old age, I was told that the reason we do not have a pharmacy where I live is no Care Homes here.

 

  It's 'cause you live out in the boonies. 

[yuna628 9,700]

3 minutes ago, Steeleballz said:

 

  It's 'cause you live out in the boonies. 

I live in the boonies and there are still plenty of pharmacies, that are constantly getting broken into for the oxy. It's a scary place in the boonies these days...