evilgenius wrote:Ibon wrote:Cog wrote:Unless you address costs, TrumpCare will end up exactly where ObamaCare did.
That's correct. The costs of medical procedures, drugs and insurance is at the end controlled by the industries that lobby to defend their profits. There is a giant cartel at play here that are shafting the American consumer. Anyone who has lived in foreign countries and has compared the costs knows this is the result of artificially inflated prices engineered by the industries who have an army of lobbyists in DC.
Trump will confront this same brick wall Obama did in trying to dismantle this cartel.
Trump would have to feel a rising tide of outrage from the public that would rival the force that lobbyists currently have. This requires an educated electorate.
All you really need to do, for employer based care, is get rid of pre-tax contributions by employees and employers. Employers are incentivized under that scheme to give employees a "raise" in the form of more money contributed to the healthcare plan. Employees also consider a tacit raise that is swallowed up by higher premiums as a raise, again an easy and desirable way for employers to manage their plans in lieu of actual raises for which they have to pay matching taxes. It's the unreasonable fear of taxes, the rejection of (by ease of substitution) any pay increase should it involve them, that is the real bogeyman in this argument. The avoidance of taxes is at the root of high healthcare costs. Obviously, this also contributes to employee's lack of increase in real income over time as well. You cannot discount the micro-economic part of the equation. Personal and corporate greed are both involved in high healthcare costs. They both contribute to the outsized amount of money available to the system which causes an over statement of demand in dollar terms.
Newfie wrote:You DO have price discovery, EU posted it.
If enough folks take their medical dollars elsewhere it WILL change.
Although I suspect you will first see legislation to outlaw overseas treatment.
Cog wrote:Because people don't want to face the fact that insurance companies, big pharma, hospitals, and doctors are going to take a severe economic hit should price discovery be the law.
We have price discovery in nearly every commodity and service in our capitalist system. But not in health care. That has to change and right quick.
Cog wrote:I am skeptical as well. What would Trump's reward for crashing the stock price of every pharmaceutical company and health insurance company? It sure wouldn't be reelection even if it were in the long term benefit of everyone involved. Now maybe Trump doesn't care about reelection but there are 535 people in Washington DC who think about it day and night. We can't continue to have 7-9% yearly increases in health care costs. Already people are being priced out of the market.
It goes against my philosophy of small government, but we may have to go down the road of some type of government ran health care if we don't get a handle on the pricing. The thought depresses me though since I don't trust government to do anything well.
evilgenius wrote:What you are saying looks as if it could come with a high probability of undesirable unintended consequences. Imagine, for instance, some bacterial development that required us to kick antibiotic research up a few notches, but we couldn't meet the challenge because of the financial condition of pharmaceutical companies after a Trump industry shakeup? Imagine the wars within those companies for control, in the wake of the opportunity to seize power manifesting itself due to extreme volatility of stock prices? Those wars would be certain to come with obstruction of both vision and long term decision making. People within an organization act differently when they can't be certain a governing regime will retain power more than a short time. They don't necessarily change everything they do to match the new vision, wondering if they oughtn't to stay ready for a change of plans when the next CEO comes in.
Ibon wrote:evilgenius wrote:What you are saying looks as if it could come with a high probability of undesirable unintended consequences. Imagine, for instance, some bacterial development that required us to kick antibiotic research up a few notches, but we couldn't meet the challenge because of the financial condition of pharmaceutical companies after a Trump industry shakeup? Imagine the wars within those companies for control, in the wake of the opportunity to seize power manifesting itself due to extreme volatility of stock prices? Those wars would be certain to come with obstruction of both vision and long term decision making. People within an organization act differently when they can't be certain a governing regime will retain power more than a short time. They don't necessarily change everything they do to match the new vision, wondering if they oughtn't to stay ready for a change of plans when the next CEO comes in.
You are sounding like a corporate lobbyist for the pharmaceutical industry who is basically saying that state of the art drugs are only possible if Uncle Sam subsidizes our industry which is what is actually happening with the price protections in place that cause US citizens to pay sometimes 10 - 20 times the prices for drugs than you see in other countries.
And your hypothetical example of an urgently needed anti-biotic actually is good to point out another strategic marketing decision that pharmaceutical companies took years ago when they failed to develop new antibiotics because these drugs actually cure you of disease. That makes their research and development a low priority for drug companies because you can only sell a single dose. Much better to develop anti-statins and spend hundreds of millions on marketing and creating incentives for doctors to prescribe them because these are pills that you take for decades. Chronic medication is the principal area of R&D for drug companies, not actually curing you of illness. It is only after 3 decades of drugs like Zocor and Lipitor that suddenly the truth comes out that these anti-statins where marginal in as a control of cholestrol and heart disease in most cases.
How about cancer drugs and the billions of dollars that the industry makes in prescribing chemo-therapies long past their effectiveness in terminal patients. How the industry plays on the desperate hope of loved ones who spend billions and billions when these patients should be given morphine and made comfortable instead of milked for the last dollar.
It is a deeply cynical industry, sick to the core in the way profits drive R&D and the way procedures and drugs are prescribed. Most folks still see the doctor in the white coat or watch the advertisements and actually believing that there still exists this hippocratic oath that drives the health care industry. That is long gone. It is a money game, cynical and driven by greed and profit. It's a sick industry. I was in it for 25 years and know what I am talking about.
Nobody wants to open this can of worms.
It is a metaphor actually for much of what we discuss here. To cure the problem requires a short term correction and financial hit. Long term solutions require this to happen but you wont find a politician with the integrity to confront this.
Same applies to energy, climate change, our deeply indebted financial system... Everyone is afraid of the short term pain required to reform sick industries.
Kristen wrote:Mandatory euthanasia at 75 would solve our health care crisis. The baby boomers were lucky enough to live in the age of prosperity while the declining youth survive off of its rotting corpse. I haven't had health insurance in five years and at age 30, I've been lucky enough to remain healthy by preventative measures. If I did get struck down with some medical emergency I'd likely refuse care to be honest. I'd hate to be a freeloader on the system and inconvenience the fictional middle class.
I hate to break it to you, but chances are you're just not prepared for what’s coming. Not even close. Don't take it personally. I'm simply playing the odds. After spending more than a decade warning people all over the world about the futility of pursuing infinite exponential economic growth on a finite planet, I can tell you this: very few are even aware of the nature of our predicament. An even smaller subset is either physically or financially ready for the sort of future barreling down on us. Even fewer are mentally prepared for it. And make no mistake: it's the mental and emotional preparation that matters the most. If you can't cope with adversity and uncertainty, you're going to be toast in the coming years. Those of us intending to persevere need to start by looking unflinchingly at the data, and then allowing
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