Health care vote

[livinincali]

[quote=FlyerInHi][quote=livinincali]Nobody wants to fix health care because it will be bad politically. You need to address the cost side of the equation. If you do you instantly create a recession or possibly worse a depression. Health care represents about 20% of GDP right now. If you cut in half you probably put 2 to 3 million people out of a job in the short term. It would be good in the long run as those people would find other jobs that were more productive but it wouldn’t be good in the short term. The problem is you face reelection in the short term. The one hope you might have from somebody like Trump is maybe he doesn’t really care about reelection and might do something politically bad in the short term to fix the long term.[/quote]

Haha, nobody is even proposing such.

that’s like hoping Repuclicans would cut spending and pay down the debt from the savings.[/quote]

That’s exactly the point and why I don’t see the government ever fixing the health care issue in this country. We’re never going to get to single payer because it would create a massive recession in the short term. A president could indeed choose to enforce Sherman and Clayton acts laws against health care providers that make it illegal to charge different people for the same services. That would help as you could probably force health care providers to adopt the approved medicare rates for all patients. It would simplify the billing procedure and they’d likely respond by laying off hundreds of thousands of administrator jobs related to billing and dealing with insurance rate negotiation. It would definitely help with the cost side of the equation but it would also probably put us in a recession.

So instead we get this nonsense that the republicans are working on right now. I.e. were going to act like were doing something without actually doing anything.

[FlyerInHi]

Livin’, i woulld be happy with basic universal coverage and capping the growth of health care as the economy grows in the years ahead. Same with military spending.

[SK in CV]

[quote=livinincali]
That’s exactly the point and why I don’t see the government ever fixing the health care issue in this country. We’re never going to get to single payer because it would create a massive recession in the short term. [/quote]

I don’t buy the recession thing. Wouldn’t happen. Health care jobs won’t disappear. Health care admin jobs won’t disappear. Both will increase. Dramatically.

[spdrun]

If the government can provide health care less expensively than the private mish-mosh we have, people would have more money in their pockets. Hardly recessionary.

[Reality]

[quote=SK in CV][quote=livinincali]
That’s exactly the point and why I don’t see the government ever fixing the health care issue in this country. We’re never going to get to single payer because it would create a massive recession in the short term. [/quote]

I don’t buy the recession thing. Wouldn’t happen. Health care jobs won’t disappear. Health care admin jobs won’t disappear. Both will increase. Dramatically.[/quote]

Health systems and doctors make their money off private insurance. They are doing good to break even treating members of government payers (Medicare and Medicaid). Many doctors won’t see these patients because they lose money on them.

Health systems would be put on a serious diet with single payer. Loss of jobs would be unavoidable.

[SK in CV]

[quote=Reality]
Health systems and doctors make their money off private insurance. They are doing good to break even treating members of government payers (Medicare and Medicaid). Many doctors won’t see these patients because they lose money on them.

Health systems would be put on a serious diet with single payer. Loss of jobs would be unavoidable.[/quote]

True with regards to Medicaid for Doctors. Not for non-profit hospitals. They will trade uninsured for Medicaid patients in a heart beat. Check the financial status of non-profit hospitals in states that expanded Medicaid v. those that did not for evidence to support my claim.

Complete fallacy with regards to Medicare for docs in most specialties. Fallacy with regards to all hospitals and virtually all other allied health professions with regards to Medicare.

There is no way that adding 20 million to the insured ranks will decrease the number of health care providers or their income. Not. A. Chance. From the emergence of health insurance 100 years ago, it’s rapid expansion to union workers in the 40’s, to Medicare in 1963 and Medicaid in 1965, to the ACA a few years ago, every single change that increased the number of insured, has also increased the number of workers and their income in all medical fields. Every damn time. A move to single payer can’t possibly be any different.

[FlyerInHi]

What was this Muslim doctor thinking, moving to Trump country? He should have known that people raised on certain values are irredeemable.

https://www.washingtonpost.com/national/in-a-midwestern-town-that-went-for-trump-a-muslim-doctor-tries-to-understand-his-neighbors/2017/07/01/0ada50c4-5c48-11e7-9fc6-c7ef4bc58d13_story.html?hpid=hp_hp-top-table-main_minnesotamuslim-640pm%3Ahomepage%2Fstory&utm_term=.d02185f03787

[Reality]

[quote=SK in CV]

True with regards to Medicaid for Doctors. Not for non-profit hospitals. They will trade uninsured for Medicaid patients in a heart beat. Check the financial status of non-profit hospitals in states that expanded Medicaid v. those that did not for evidence to support my claim.
[/quote]

It doesn’t support your claim. Trading uninsured for government insured is one thing. Trading rich private insurance for government insurance is another. Providers would take a big hit.

[SK in CV]

[quote=Reality][quote=SK in CV]

True with regards to Medicaid for Doctors. Not for non-profit hospitals. They will trade uninsured for Medicaid patients in a heart beat. Check the financial status of non-profit hospitals in states that expanded Medicaid v. those that did not for evidence to support my claim.
[/quote]

It doesn’t support your claim. Trading uninsured for government insured is one thing. Trading rich private insurance for government insurance is another. Providers would take a big hit.[/quote]

What claim did I make that it does not support?

[spdrun]

It doesn’t support your claim. Trading uninsured for government insured is one thing. Trading rich private insurance for government insurance is another. Providers would take a big hit.

Under any system that would pass in the US, private/supplemental insurance (think “Medigap”) would also exist.

[SK in CV]

[quote=spdrun]

It doesn’t support your claim. Trading uninsured for government insured is one thing. Trading rich private insurance for government insurance is another. Providers would take a big hit.

Under any system that would pass in the US, private/supplemental insurance (think “Medigap”) would also exist.[/quote]

Absolutely. And with only insignificant exceptions, Medicare is NOT a losing proposition for health care providers.

[livinincali]

[quote=SK in CV][quote=livinincali]
That’s exactly the point and why I don’t see the government ever fixing the health care issue in this country. We’re never going to get to single payer because it would create a massive recession in the short term. [/quote]

I don’t buy the recession thing. Wouldn’t happen. Health care jobs won’t disappear. Health care admin jobs won’t disappear. Both will increase. Dramatically.[/quote]

Well then you didn’t fix the cost side of the equation. Why is health care so expensive in this country. Most of the money spent is going into somebody’s pocket somewhere. If we’re spending 3 trillion per year on health care and change that number to 2 trillion via single payer or whatever mechanism you can come up with, that’s 1 trillion less dollars going into some person’s pocket. Yeah the economy will reallocate the jobs and spending over time but it won’t happen immediately. Health care spending is included in GDP. If I reduce health care spending dramatically via some solution or change then I’ve reduced GDP as well.

If what you say comes to pass and we increase the number of jobs in the medical sector how exactly will health care costs come down.

[ocrenter]

[quote=livinincali][quote=SK in CV][quote=livinincali]
That’s exactly the point and why I don’t see the government ever fixing the health care issue in this country. We’re never going to get to single payer because it would create a massive recession in the short term. [/quote]

I don’t buy the recession thing. Wouldn’t happen. Health care jobs won’t disappear. Health care admin jobs won’t disappear. Both will increase. Dramatically.[/quote]

Well then you didn’t fix the cost side of the equation. Why is health care so expensive in this country. Most of the money spent is going into somebody’s pocket somewhere. If we’re spending 3 trillion per year on health care and change that number to 2 trillion via single payer or whatever mechanism you can come up with, that’s 1 trillion less dollars going into some person’s pocket. Yeah the economy will reallocate the jobs and spending over time but it won’t happen immediately. Health care spending is included in GDP. If I reduce health care spending dramatically via some solution or change then I’ve reduced GDP as well.

If what you say comes to pass and we increase the number of jobs in the medical sector how exactly will health care costs come down.[/quote]

Huge % of cost is in pharmaceutical and specialty cost.

Let’s say right now 5/10 patients with knee pain goes to the orthopedic surgeon directly. And orthopedic surgeon is charging $100 per visit instead of the $50 per visit at the generalist. If you force the 10 patients to all see the generalist, and only the one needing surgery is referred to the specialist, that would be a difference of $600 vs $750.

Now let’s say instead of 5/10 of these patients all getting an MRI, which is say $1000 (you got to pay the radiologist), only 2 of the 10 got the MRI, now the difference is $2600 vs $5750.

Next, let’s say 5 of the patients got a steroid injection at $30 each, vs the Synvisc injection at $300 each, the difference is now $2750 vs $7250.

FYI, Synvisc injections are not proven to help any more than steroid injections. Further more, most MRIs are done as therapeutic treatment of patient’s anxiety about their particular joint pain.

I can go on and on about the potential savings. Does changes like the above reduce income for the local orthopedic surgeon and radiologist, you bet, but they are not going to be in the poorhouse, that I can guarantee. But true impact on jobs would be minimal, except the drug company pusher that provides the free lunch and luxury box seat to the local sporting event, he or she will certainly get the axe.

[Anonymous]

If efficiencies and cost savings led to recessions then most of economic history would have been a recession.

[ocrenter]

[quote=harvey]If efficiencies and cost savings led to recessions then most of economic history would have been a recession.[/quote]

Health care doesn’t lend itself to unbridled free market forces. It is beyond easy to scare the client into doing a whole bunch of expensive and worthless treatments and procedures. In fact, client expectation is the expensive stuff. Efficiency can only come about from single payer forcing discipline in cost control.

[Author]

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