[PassedOut]

kenberg, on Sep 26 2010, 09:24 PM, said:

I really don't think that the age of the patient should be a prominent feature in the financial, as opposed to the medical, aspects of the decision.

I think that the person's condition should be the driving factor, not age.

[cloa513]

There is no real health system in virtually all countries. Its just a hotch potch of health subsystems. Preventative health care has proven to be financial advantageous yet not substantially and widespread pushed in any country. People pay for the risks that they can't really control such as genetic diseases but don't really pay for the risks that they can control such as lifestyle diseases, crime, accidents. Insurance companies have proven to be not good managers of risk such as that they can't think of non-medication solutions as being better than pills.

People who say smoking costs less because people die earlier and don't have age related diseases forget that smoking brings those diseases to earlier in life.

[kenberg]

There can be general principles, hard enough to get agreement on, and then there can be troubles with interpretation and implementation.

Here are a couple of general principles:
1. Just as a family cannot afford all possible interventions, a country also cannot.
2. It's OK if rich people get more, as long as your basic citizen gets a reasonable shake.



For example, consider the Mayo/UCLA dichotomy mentioned earlier. If the Average Joe could get the Mayo treatment and Bill Gates gets to avail himself of UCLA super treatments, this would be a very great improvement for Average Joe. Perhaps/probably Mayo for everyone is beyond what we can do, at least in part because there are only so many great doctors and there are a lot of sick people. But I come back to the thought that there well may be kids with pneumonia who today cannot get the care I got in 944. This is embarrassing and we need to do something.


And we do need to address administrative costs and unneeded treatment. I was stunned to find that my three minute removal of skin tags (there was one I wanted off and another I was unaware was even there) came to 700 plus bucks. Even more, I cannot for the life of me see why the expense should not be largely or wholly mine. But that's not how we do things, so fine, I take the money and run. But it's nuts. And I repeat, Obama did not create this mess.

[luke warm]

possible trouble brewing?

http://www.msnbc.msn.com/id/39548132/ns/he..._new_york_times

i like this quote, "“I don’t think my job as a commissioner is to make sure every company is viable forever,” Ms. Voss (Iowa state regulator) said.

[hrothgar]

luke warm, on Oct 7 2010, 05:36 PM, said:

possible trouble brewing?

http://www.msnbc.msn.com/id/39548132/ns/he..._new_york_times

i like this quote, "“I don’t think my job as a commissioner is to make sure every company is viable forever,” Ms. Voss (Iowa state regulator) said.

Just to clarify, here's a slightly longer quote from Ms Voss:

Quote

And even some state regulators, like Ms. Voss, whose state has formally requested a federal waiver to allow Iowa to decide case by case what considerations to give individual carriers, acknowledges that some plans should be allowed to leave the market. “I don’t think my job as a commissioner is to make sure every company is viable forever,” Ms. Voss said.

If you were just reading Jimmy's original excerpt, one might easily think that the word "company" was referring to the companies that were purchasing said health care plans rather than inefficient health care providers.

[sharon j]

I knew a young man (33) who was self employed. His income did not allow him to purchase health insurance. He noticed a lump in his abdomine. He never saw anyone about it because of the cost. He is dead.

I'm not sure if getting medical help would have saved him or even prolonged his life. But I think it is a shame and so sad he didn't think he had any options.

[luke warm]

hrothgar, on Oct 7 2010, 10:00 AM, said:

luke warm, on Oct 7 2010, 05:36 PM, said:

possible trouble brewing?

http://www.msnbc.msn.com/id/39548132/ns/he..._new_york_times

i like this quote, "“I don’t think my job as a commissioner is to make sure every company is viable forever,” Ms. Voss (Iowa state regulator) said.

Just to clarify, here's a slightly longer quote from Ms Voss:

Quote

And even some state regulators, like Ms. Voss, whose state has formally requested a federal waiver to allow Iowa to decide case by case what considerations to give individual carriers, acknowledges that some plans should be allowed to leave the market. “I don’t think my job as a commissioner is to make sure every company is viable forever,” Ms. Voss said.

If you were just reading Jimmy's original excerpt, one might easily think that the word "company" was referring to the companies that were purchasing said health care plans rather than inefficient health care providers.

yes, i should have provided a link... but what are your thoughts re: waivers?

[hrothgar]

[quote name='luke warm' date='Oct 7 2010, 08:35 PM'] [QUOTE]And even some state regulators, like Ms. Voss, whose state has formally requested a federal waiver to allow Iowa to decide case by case what considerations to give individual carriers, acknowledges that some plans should be allowed to leave the market. “I don’t think my job as a commissioner is to make sure every company is viable forever,” Ms. Voss said. [/QUOTE]

If you were just reading Jimmy's original excerpt, one might easily think that the word "company" was referring to the companies that were purchasing said health care plans rather than inefficient health care providers. [/QUOTE]
yes, i should have provided a link [/quote]
No, you should have provided a quote that accurately reflected the author's point...

[hrothgar]

luke warm, on Oct 7 2010, 08:35 PM, said:

but what are your thoughts re: waivers?

Personally, I think that draconian transitions from one state to another are highly problematic.

As a practical example, I don't believe that driving an insurance carrier out of business overnight is in anyone's interest. Consequently, I see nothing wrong with granting short term waivers to companies that made an effort to comply with the regulations in question but fell short.

However, I have strong objections to the use of waivers as a mechanism to circumvent / ignore regulations either in the short term or the long term.

[luke warm]

hrothgar, on Oct 7 2010, 12:57 PM, said:

luke warm, on Oct 7 2010, 08:35 PM, said:

yes, i should have provided a link

No, you should have provided a quote that accurately reflected the author's point...

i did... your interpretation of it notwithstanding

hrothgar, on Oct 7 2010, 02:06 PM, said:

However, I have strong objections to the use of waivers as a mechanism to circumvent / ignore regulations either in the short term or the long term.

well the trouble is, someone has to determine whether that is the aim or not... this will get much worse before it gets better (assuming it ever does)... single payer system was the only way to have universal healthcare... what we now have is an abomination and that's even before the new congress starts ripping it apart

[y66]

Wonkbook: Some very good news for Obamacare by Ezra Klein and Evan Soltas, Published: May 24, 2013 at 8:32 am

[Winstonm]

Quote

"This is a home run for consumers in every region of California," Peter Lee, the executive director of Covered California, said in a press release. 'Our active negotiating will not only benefit potential enrollees to Covered California, but will benefit all Californians by making health care affordable.' California is one of just six states that will use their negotiating leverage to force lower premiums under Obamacare.

This news makes the resisting governors look petty, more interested in upholding their misguided ideological viewpoints than doing what is right for their constituency.

[kenberg]

y66, on 2013-May-24, 07:38, said:

Wonkbook: Some very good news for Obamacare by Ezra Klein and Evan Soltas, Published: May 24, 2013 at 8:32 am

Very interesting, and I hope it continues to work.


Perhaps easy to overlook: If you scroll down the link a bit you find a link entitled repose en paix, Georges.
Or you can go directly via



A link to the NYT obit
http://www.nytimes.c...at-79.html?_r=0

I did not know of Georges Moustaki. My loss, most obviously.

[PassedOut]

Medicare trust fund to last to 2026 as health costs drop

Quote

The new projection, released Friday by the Social Security and Medicare Board of Trustees, is an improvement of nine years in the forecast since passage of President Obama’s Affordable Care Act. The trustees’ report credits the act with part of the cost slowdown, particularly by placing new limits on Medicare Advantage, a form of Medicare run by private insurers.

However, the trustees also credit lower costs and use rates in “most … service categories – especially skilled nursing facilities” – a development that most economists believe is in part due to the recent recession but also to more fundamental efforts to reduce costs throughout the health care industry.

Obviously a lot more must be done to cut the massive waste in the US healthcare system, but at least we have begun.

[Winstonm]

Meanwhile, back on the (Texas) ranch, there is no state-run program such as in California, and therefore those in need in that state continue to be held hostage to the haves.

[PassedOut]

From a business perspective, medical expenses in the US are beyond fat, they are obese: PAYING TILL IT HURTS: A Case Study in High Costs

Quote

Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories — and often by a huge margin.

Americans pay, on average, about four times as much for a hip replacement as patients in Switzerland or France and more than three times as much for a Caesarean section as those in New Zealand or Britain. The average price for Nasonex, a common nasal spray for allergies, is $108 in the United States compared with $21 in Spain. The costs of hospital stays here are about triple those in other developed countries, even though they last no longer, according to a recent report by the Commonwealth Fund, a foundation that studies health policy.

With these costs, you'd expect better outcomes. Alas, the outcomes here are worse than elsewhere...

[y66]

Health Plan Cost for New Yorkers Set to Fall 50% by Roni Caryn and Reed Abelson via Krugman:

Quote

Individuals buying health insurance on their own will see their premiums tumble next year in New York State as changes under the federal health care law take effect, Gov. Andrew M. Cuomo announced on Wednesday.

State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.

Supporters of the new health care law, the Affordable Care Act, credited the drop in rates to the online purchasing exchanges the law created, which they say are spurring competition among insurers that are anticipating an influx of new customers. The law requires that an exchange be started in every state.

“Health insurance has suddenly become affordable in New York,” said Elisabeth Benjamin, vice president for health initiatives with the Community Service Society of New York. “It’s not bargain-basement prices, but we’re going from Bergdorf’s to Filene’s here.”

“The extraordinary decline in New York’s insurance rates for individual consumers demonstrates the profound promise of the Affordable Care Act,” she added.

Administration officials, long confronted by Republicans and other critics of President Obama’s signature law, were quick to add New York to the list of states that appear to be successfully carrying out the law and setting up exchanges.

“We’re seeing in New York what we’ve seen in other states like California and Oregon — that competition and transparency in the marketplaces are leading to affordable and new choices for families,” said Joanne Peters, a spokeswoman for the Department of Health and Human Services.

Matt Yglesias July 16, 2013:

Quote

Conservatives think the law is unraveling. But implementing the Affordable Care Act is going to be a huge success.

[mike777]

y66, on 2013-July-17, 19:46, said:

Health Plan Cost for New Yorkers Set to Fall 50% by Roni Caryn and Reed Abelson via Krugman:



Matt Yglesias July 16, 2013:

ok just for the record you are in favor of open competition and capital markets in healthcare.....got it and you are on record.

[Winstonm]

y66, on 2013-July-17, 19:46, said:

Health Plan Cost for New Yorkers Set to Fall 50% by Roni Caryn and Reed Abelson via Krugman:



Matt Yglesias July 16, 2013:

Meanwhile, the House of Representatives for the 38th time passed a measure to repeal the ACA. Who do they represent?

[y66]

Winstonm, on 2013-July-18, 07:59, said:

Meanwhile, the House of Representatives for the 38th time passed a measure to repeal the ACA. Who do they represent?

Themselves?