[SK in CV]

[quote=harvey]Lol, you guys are discussing healthcare implementation, tradeoffs, objectives like it’s an actual business endeavour run by people with management skills.

Of course it is, but this thread is about the “Health care vote.”

So far there’s no evidence that Trump even understands the basics of this domain. Or that he’s even trying.

There are probably more than a few Republicans in congress that get it, but their primary objective is only to undo anything that Obama did.

It will be a goddamn mess that will get far worse before it starts to get better. We are literally going to see unnecessary suffering and death for thousands of Americans.

All out of spite.[/quote]

I’m not positive that’s going to happen, (the “far worse before better” part) but you’re dead on with the motivation. Republicans (and others) spent 7 years complaining about Obamacare, but can’t come up with a plan to make it better. The problem they face is that way too many now know that it IS far better than nothing, so repealing without replacing is DOA.

Of course they can make it better. And it isn’t that complicated. 1st by restoring what they’ve already broken by defunding parts of the original law. 2nd by adding a public option, allowing those over 55 to buy into medicare everywhere at actuarially sound rates, and allowing a medicare buy in markets where there are fewer than 3 options on the state or federal exchanges. Simple. Infrastructure already in place.

But republicans in office will hate it. Not enough people will die.

[SK in CV]

[quote=no_such_reality]
It comes from UHG’s 10-K. It’s across all their business lines. The ACA law requires the 80% to be for health care claims and quality improvements.[/quote]

80% for individuals and small groups. 85% for large groups. Their overall MLR for all QHP is between the 2 since they sell in both markets. The 35% margin originally referenced included products other than qualified health plans.

[SK in CV]

[quote=no_such_reality]
For major health insurance companies like United Health Group cost of services is 65%. Profit, administration, marketing, etc is 35%. UH is a fairly good company.

[/quote]

Not sure where those numbers are coming from. By law, the medical loss ratio for qualified health plans must be at least 80% for individual and small group policies and 85% for large group policies. If MLR is lower than those numbers, premiums must be rebated.

Not an entirely fair comparison since Medicare spends almost nothing on premium collection or sales, but Medicare overhead is less than 2%

[SK in CV]

[quote=ocrenter]Kinda splitting hair here.

Single payer literally means there is only one payer and thus this one and only payer has the monopoly and thus the ability to dictate pricing.

Medicare for all would be single payer, but VA for all would be single payer and single provider.[/quote]

Not splitting at all. The VA is a single payer model.

It is also the only example of government controlled health care, similar to the UK NHS. Medicare isn’t. The Canadian version isn’t.

[SK in CV]

[quote=livinincali]
What are you talking about. A recession is a reduction of GDP by definition. Health care spending is included in the measurement of GDP. If GDP is 15 trillion and health care is 3 trillion of that then reducing health care spending by 1 trillion reduces GDP by 1 trillion. Therefore you have a recession by definition. Now that recession might be short lived once the economy reallocates itself but it most certainly will take some time for the economy to reallocate itself. [/quote]

You are assuming that single payer will reduce GDP. Any economic model (or any evidence at all) that this will happen? I think there is no evidence that insuring 20 million additional people will reduce GDP, even if healthcare spending per person declines. Other than profit made by private insurance companies, private hospitals and pharma companies, I doubt there will be any hit to the economy. To the contrary, it would be beneficial to much of the economy.

[SK in CV]

[quote=ocrenter][quote=FlyerInHi]I think that VA is the most efficient.

Service members, retirees and family could go to VA or private insurance/providers if they have other insurance.[/quote]

you are kidding right?

btw, single payer does not mean the VA.

single payer means more like multiple competing entities like Kaiser and Scripps and Sharp.[/quote]

Actually the VA is more like single payer. (though I too question whether it’s been a very successful model.) I think a more likely model would be medicare for all, where medicare is everyone’s primary insurance. Kaiser, Sharp, and Scripps are providers, so they don’t have anything to do with what defines single payer.

[SK in CV]

[quote=Harvey]The argument that we shouldn’t improve something that is obviously very broken because any improvements could theoretically cause a recession is a terrible way to approach policy.[/quote]

It can “theoretically cause a recession” only by using “theory” the way evolution deniers say “it’s only a theory”. There is no economic model that shows a recession is a possibility, much less a likelihood.

[SK in CV]

[quote=harvey][quote=SK in CV]I didn’t read the rest of the comment so I don’t know what the point was. History tells me there really wasn’t one. But this quote, containing a lot of fancy phrases, and important sounding words, makes no sense. There may be a transaction that the author was attempting to describe. This isn’t it. This is just words strung together. Bait, if you will, for conspiracy theorists, who don’t really understand shit about the subject.[/quote]

It’s not a “comment” – it’s an article from the WSJ.[/quote]

Right, which is kinda why I read that part and didn’t read the rest. It’s a shit article. Go figure.

[SK in CV]

[quote=phaster][quote]
Special-Purpose Entities Are Often A Clever Way to Raise Debt Levels

…hidden behind the financial tables, special-purpose entities have recently become the subject of sharper scrutiny. Much of the Enron accounting issues revolved around special-purpose entities…

…Think of the SPE as a trust…To establish this trust, the company must sell the SPE an asset — any of the ones listed on its balance sheet will do…The SPE pays the company for the receivables with the money it collects from these new investors and the company gets to beef up the cash section of its balance sheet.

…With only one asset on its books, investors won’t be hard to find. Even better, they’re willing to accept a lower interest rate because it appears that the repayment of their loan is a pretty sure thing since the SPE has no other debt.

Assuming the parent company has not offered a guarantee on the loan (we’ll get to that shortly), the company no longer has connections to the SPE. And in turn, the SPE’s creditors now only have claim to the assets of the SPE…

…Well don’t forget about the company’s creditors. They aren’t all that thrilled with the fact that the company sold off one of its assets, especially if it did so at a loss. Now how are they going to get paid?

…anyone who spends a second looking at financial statements may be a little perturbed by this arrangement as well. In many instances, we’d like to see that debt reported on the company’s balance sheet. But as long as the company is not liable for the SPE’s debt, FASB allows the transaction to be reported off-balance sheet…

…SPEs have been around for years, stuffed away in some footnote…

https://www.wsj.com/articles/SB1014329454674201960
[/quote]

[/quote]

I didn’t read the rest of the comment so I don’t know what the point was. History tells me there really wasn’t one. But this quote, containing a lot of fancy phrases, and important sounding words, makes no sense. There may be a transaction that the author was attempting to describe. This isn’t it. This is just words strung together. Bait, if you will, for conspiracy theorists, who don’t really understand shit about the subject.

[SK in CV]

Hire a civil engineer and come up with a plan, and then estimate based on that plan. There are dozens of ways to deal with active or expansive soil. If the existing improvements are actually on fill that has settled, there may be no reason to add caissons, just level and seal the existing foundation. If it is still active, the difference between doing it right and doing it wrong could be hundreds of thousands of dollars. The worst thing you could do is rely on some guy on a blog that doesn’t know what he’s talking about.

There is no reason that improvements should cost close to $300 to $400 a foot if you’re not doing anything too wild.

[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.

[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?

[SK in CV]

[quote=ocrenter]
True. Except he just called for complete repel first, another reversal of prior position, a reversal that would leave 32 million uninsured.

How many Americans heard that story today in the middle of his little cyber bullying stunt?[/quote]

Cable news covered it a bit. I was watching somebody this afternoon, and they had a GOP consultant on, who complained a bit that the media covered the wrong things. Then she was asked what the WH actually wanted in a health care bill. Her response? ¯_(ツ)_/¯ The WH has no policies. But whatever it is, it’s good. The best.

[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.

[SK in CV]

[quote=ocrenter]Interesting how with a couple of tweets no one is talking about the failed hugely unpopular senate health care bill any more.

The guy’s timing is impeccable.[/quote]

Except Trump. He tweeted about it this morning. McConnell had already sent the Senate home for recess Thursday morning.

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