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my platform as presidential candidate - what's yours?

POSTED BY: RUE
UPDATED: Sunday, December 19, 2021 17:42
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Monday, July 8, 2019 11:25 AM

SIGNYM

I believe in solving problems, not sharing them.


CC: I finished my response to your post, in depth, and corrected the formatting.

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

"The messy American environment, where most people don't agree, is perfect for people like me. I CAN DO AS I PLEASE." - SECOND

America is an oligarchy http://www.fireflyfans.net/mthread.aspx?tid=57876 .

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Monday, July 8, 2019 12:03 PM

SIGNYM

I believe in solving problems, not sharing them.


Anyway, I think I have a decent set of prposals to handle immigration.

Now, IF those proposals are successful we should see a significant decrease in the number of illegal aliens living and working in the USA over tne years ... maybe a 25% reduction. One effect is that the Federal government will be paying out proportionately less welfare than before. Another effect is that there will be less demand for housing and less pressure on infrastructure. Another effect is that farms, construction, and personal services, meatpacking, janitorial services will have fewer cheap labor employees to draw from.

Jobs could open up again for young folk.

I used to make money as a babysitter. Others mowed lawns or delivered the newspaper (od those flyers that get stuck to your doorknob). Housekeeping. (We had to clean the house and do laundry and cook dinner from a young age, that was our contribution to the household.) Kids might have to mow their parent's lawn and wash the family car, as I did. They might know what it's like to have a paintbrush in-hand. To get a summer job on construction, or on farm, or in light assembly. TRULY skilled labor, or labor in dangerous conditions, will have to pay more.

So wages will go up for some things, and some prices will go up accordingly.

Isn't that the same effect as raising the minimum wage?

Anyway, unless someone has somehing on point to offer, I think this topic has been beaten to death. On to the next topic.

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

"The messy American environment, where most people don't agree, is perfect for people like me. I CAN DO AS I PLEASE." - SECOND

America is an oligarchy http://www.fireflyfans.net/mthread.aspx?tid=57876 .

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Monday, July 8, 2019 8:18 PM

JEWELSTAITEFAN


Quote:

Originally posted by SIGNYM:
Anyway, I think I have a decent set of prposals to handle immigration.

Now, IF those proposals are successful we should see a significant decrease in the number of illegal aliens living and working in the USA over tne years ... maybe a 25% reduction. One effect is that the Federal government will be paying out proportionately less welfare than before. Another effect is that there will be less demand for housing and less pressure on infrastructure. Another effect is that farms, construction, and personal services, meatpacking, janitorial services will have fewer cheap labor employees to draw from.

Jobs could open up again for young folk.

I used to make money as a babysitter. Others mowed lawns or delivered the newspaper (od those flyers that get stuck to your doorknob). Housekeeping. (We had to clean the house and do laundry and cook dinner from a young age, that was our contribution to the household.) Kids might have to mow their parent's lawn and wash the family car, as I did. They might know what it's like to have a paintbrush in-hand. To get a summer job on construction, or on farm, or in light assembly. TRULY skilled labor, or labor in dangerous conditions, will have to pay more.

So wages will go up for some things, and some prices will go up accordingly.

Isn't that the same effect as raising the minimum wage?

NO.
The primary purpose Libtards want to rise the minimum Wage is to overinflate Union Wage Rates and Pay Scales, thereby overinflating Inflation, to give the wealthy a greater portion of wealth.
Increasing Wages via Market Forces while Leaving Minimum Wage or lowering it decreases the portion of the pie that the wealthy can vacuum up.
Quote:

Anyway, unless someone has somehing on point to offer, I think this topic has been beaten to death. On to the next topic.


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Monday, July 8, 2019 8:27 PM

JEWELSTAITEFAN


Quote:

Originally posted by 6ixStringJack:
Quote:

Originally posted by second:
Quote:

Originally posted by 6ixStringJack:
And now I'm getting bored and I really have shit to do today. Maybe I'll come back to this later... assuming of course Microsoft doesn't force a restart of windows and the article is still open. Otherwise I won't be able to even read the article without paying the NYT to read their trash rag.

Do Right, Be Right. :)

The NYT labels articles as "opinion" when it happened sometime other than yesterday, since it is not "new" or "news".

I'd LOVE to see where they actually say that is their definition of OPINION. Needless to say, that is not the ACTUAL definition of opinion, and they are purposefully misusing the word if this is how they define it.

Quote:

At a June 2016 campaign rally, Trump pointed to one attendee and said: “Oh, look at my African-American over here. Look at him.”
(Youtube link removed from quote since it messes up the page formatting. Look to Second's original post above.)

This actually gave me a chuckle. I'm surprised I'd never seen this before and that it wasn't played every single night on CNN for 3 months straight.

That wasn't racism. Obviously he meant "his african american supporter" that he was pointing to, but it could easily be taken out of context to sound like he had "ownership" of the person, since he phrased it as a possessive.

It was just a pretty cringe moment, to be sure. The type of stuff that is almost unavoidable for white male politicians in 2019, yanno, being forced to essentially say things like "I have black friends", and then being roasted afterward for saying it, even though they would have been equally roasted for never having said it. It's just a lose/lose world for white males right now. Especially politicians, or anybody with high profile careers.

Quote:

If you open the NYT link in private window, you don't need worry about their limit of 10 "free" articles per month. Try it:
www.nytimes.com/interactive/2018/01/15/opinion/leonhardt-trump-racist.
html

This is actually a great tip that EVERYBODY HERE SHOULD TAKE ADVANTAGE OF. Thanks, Second.

I can't believe that works. My first thought is, how did the NYT overlook this? My second thought is wanting to know what is different in the coding of how private windows are handled as opposed to non-private windows and how this could be exploited elsewhere. Ad blockers today have been neutered because they are being forced to slowly not block ads anymore by more and more sites. I'm looking forward to the day that a new hacker group that doesn't give a shit comes around and brings us a new one that works right. (You can actually set up a raspberry pi box attached to your router that will do a really good job of this, but it's not for the novice and it does come with its own pitfalls).

In any case, I will always at least try this when I'm being blocked by a paywall at one of these papers in the future. NYT is hardly the only website that does it.

Do Right, Be Right. :)

I wondered what the heck a private window was. But I found it.
I should remember to post this in the Writer's Resource Package thread.

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Tuesday, July 9, 2019 7:54 AM

SIGNYM

I believe in solving problems, not sharing them.


So, my platform as Presidential candidate, on immigration:

Stop intervening in other nations' internal affairs. (No destabilization campaigns, military assistance and military/security "aid", no invasions, proxy wars, hybrid wars etc)
Withdraw from "free trade" agreements which have ruined the economic livelihoods of small farmers outside of the USA
Build a wall; secure the border
Revert to the original definition of asylum as POLITICAL asylum
Accept only asylees as immigrants for settlement;
Require all asylees to present themselves at an official border crossing,
Immediately deport without hearing (after fingerprinting, photographing, and taking DNA samples of) anyone found to have crossed the border illegally
Hire more immigration judges, streamline the asylum process using a standardized questions and definitions
Fund detention adequately to house and care for detainees, including instituting a program of DNA-testing "family members" to ensure that child-trafficking is not taking place. House children with parents: parents are held involuntarily; children are releaseable and thus not "detained" altho in the same facility
Continue with deportation of illegal immigrants including fining employers who hired employees without the necessary paperwork (Name and Social Security number verified with e-verify. Which, btw, I have used. It's very easy)
Make English the official language of the United States (Constitutional amendment)
Eliminate birthright citizenship from the 14th amendment (Constitutional amendment)
REQUIRE all long-term (25 year) and (otherwise) non-criminal residents to obtain citizenship on pain of deportation

Unless something else comes up that requires a reconsideration, this is my list of proposed policies

*****

Like I said, on to another topic: HEALTHCARE

I start with the idea of MEDICARE FOR ALL, and the following figures

The United States colletively spent an estimated $3.67 trillion dollars on health care in 2018, including Medicare expenditure
https://hctadvisor.com/2018/01/3-67-trillion-2018-us-healthcare-spendi
ng-category
/

The total Medicare budget for that same year was $704.6 billion, or about 19% of total health care expenditures
https://www.hhs.gov/about/budget/fy2018/budget-in-brief/cms/medicare/i
ndex.html


Medicare currently covers approximately 15% of the total population
https://assets.aarp.org/rgcenter/health/fs149_medicare.pdf

So Medicare expenditures are somewhat higher, as a percent of total spending over percent of people covered. However, consiering that Medicare covers the oldest (65+ yers old) and sickest (survivors benefits to Social Security-covered disabled dependents) portion of the population, I'm going on the broad assumption that IF ALL OF THE MONEY CURRENTLY SPENT ON HEALTHCARE WERE TO BE TURNED OVER TO MEDICARE, IT WOULD ADEQUATELY FUND HEALTHCARE FOR ALL

This includes premiums spent by businesses to cover their employees, state and county tax revenues which fund state and county hospitals, miscellaneous local clinics, money currently spent on individual and state-sponsored private insurance premiums, Medicaid etc.

However, although the overall funding would probably by adequate, getting that funding would be uneven. For example, you couldn't just require that companies turn over their premiums to the USA government - it would put the burden on those businesses which were responsible for covering their employees but leave other, less reponsible busineses, untouched.

So there would have to be a "tax" of some sort, possibly simply raising the Medicare tax on wages by a factor of (approximately) five while eliminating the premium payments that (some) employers pay for their employees. The current Medicare tax rate is 2.9%, the proposed Medicare tax rate would be about 15%, which is split between employer and employee.

However, it is a truism that the more you tax a specific activity the more you inhibit it. Taxing wages - while easy - might make employment less attractive. It would (in essence) raise the minimum wage by about 7%, and incentivitze automation and the creation of a "gray" economy, so I think I would be looking for an alternate source of funding instead of- or in addition to - an increased medicare tax. After all, there's no logical link between employers and healthcare. It's not as if employers CAUSE poor health, so why should they pay for it? Why not tax tobacco (including vaping), alcohol, air and water polluters, GMO-crop growers, sugar growers, anything-with-a-screen-makers, vehicle-makers, and fill-in-the-blank-with-your-cause-of-ill-health-maker-here?

Another possible source of funding (my persoanl favorite) would be to tax the capital gains of any transaction with less than six months of holding at full income tax rates, and eliminate the tax dodges that allow these transactions not to be taxds at all. That would eliminate (or certainly slow down) high-frequency trading and arbitrage. True, it doesn't cause poor health, but it's an activity that I'd certainly like to curtail, and there's a lot of money there which isn't doing anything productive!





-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

"The messy American environment, where most people don't agree, is perfect for people like me. I CAN DO AS I PLEASE." - SECOND

America is an oligarchy http://www.fireflyfans.net/mthread.aspx?tid=57876 .

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Tuesday, July 9, 2019 8:02 AM

6IXSTRINGJACK


I agree with your immigration policies.


It's not that I don't agree on your medicare policies, but I just don't feel that I have anything worthwhile to say on it. I view it as an unfixable problem in 2019. Just like I do the wage issue.

Half of me agrees with JSF about raising minimum wage. Half of me agrees with Second.

I don't think raising minimum wage would improve anybody's life, but at the same time, far too many people are being abused for minimum wage rates and can't even get by in America. Raising the minimum wage would likely just make everything cost more, put small companies who can't afford it out of business almost overnight, and would really screw the people who were making $16/hr vs. a $7.25 minimum wage and are now only making $16/hr vs. a $15 minimum wage.

The whole system is broke. I don't know if that was done intentionally behind the scenes for the last 100 years or if that's just the aftermath of all of the bubbles bursting, but I don't think there is any way of fixing it now.

Do Right, Be Right. :)

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Tuesday, July 9, 2019 8:07 AM

6IXSTRINGJACK


Quote:

Originally posted by JEWELSTAITEFAN:
I wondered what the heck a private window was. But I found it.
I should remember to post this in the Writer's Resource Package thread.



I've always had a vague idea of what it is, but I rarely used it because it actually breaks quite a few sites that rely on whatever it blocks.

I've got to assume that cookies from the NYT that count how many articles you've viewed in the month are stored in your browser, and turning the window private allows you to view the NYT without the check for going over 10 articles being tripped. A lot of sites would either tell you that you need cookies enabled to use them, or just wouldn't work properly in the private window. I'm surprised that NYT lets you do it.

I'm going to do a little experiment and post more when I'm done...

Do Right, Be Right. :)

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Tuesday, July 9, 2019 8:25 AM

6IXSTRINGJACK


A few things...

1. I read it wrong. You don't get 10 free articles unless you sign up with your email address first. I'm not exactly sure how many you can view before being blocked before signing up.

It's $2 per week to view unlimited articles. $3.13 if you want NYT Cooking and the crossword puzzle.

2. Yeah. I was right about the cookies...


I opened up the article that Second linked to try out the private window thing with normally and wasn't blocked. (Although I did get the invite to subscribe with my email for 10 free articles per month).

Inside that article, I right clicked a link to a different article and was completely blocked from reading it without subscribing for the free stuff or paying for a real subscription. (article here: https://www.nytimes.com/2018/01/14/us/politics/trump-im-not-a-racist.h
tml?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region®ion=top-news&WT.nav=top-news
)

I know you don't use Firefox, but the following process is probably the same in your browser...

1. I copied the link of the new article and closed any instances of the times that were opened.
2. I went into Options, Privacy & Security, Cookies & Site Data.
3. I clicked on Manage Data.
4. In the search bar I typed NYT
5. A bunch of hits came up for the Times. I deleted all of them and hit save changes.
6. I then put the link I copied for the new article into the search bar and I was no longer blocked from seeing it.
7. But once that new article was up, when I right clicked onto another article in a new tab, I was blocked again.


This is what I figured was going on since the Private Window thing worked. It only works here because the NYT isn't being very invasive in its tech to make sure people are paying to read. They could just as easily do the same thing without you being able to get around it by logging IP addresses and checking them against a subscriber base.

I wonder why they don't? It's kind of cool that they don't.


Since the Private Window thing works without any hassle, there would be no reason for you to go in and delete your NYT cookies every time you read an article there.

But that gave me another idea...

1. I went into the same security options above, but this time I clicked on "Manage Permissions".
2. In the "Address of Website" bar I put the link https://nytimes.com.
3. I clicked the "Block" button under the bar, and then clicked "Save Changes".

Now I can view NYT articles without being blocked or without even remembering to open them in a Private Window.

I'm going to try the same with a few other news sites and see what happens.

Do Right, Be Right. :)

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Tuesday, July 9, 2019 8:43 AM

6IXSTRINGJACK


Washington Post...

You can't view articles in Private Mode. It says the following and blocks your ability to read the article:

Quote:


We noticed you’re browsing in private mode.
Private browsing is permitted exclusively for our subscribers. Turn off private browsing to keep reading this story, or subscribe to use this feature, plus get unlimited digital access.





But...

Unlike with the NYT which doesn't require you to delete existing cookies after blocking their website from using cookies, you have to go in and delete all washingtonpost cookies for this to take effect or it will still know that you've read too many articles.

After blocking https://www.washingtonpost.com AND deleting any cookies I found by typing in just "wash" in the the search bar for deleting individual cookies, it seems that I can now browse as many articles as I want without being blocked.



Enjoy this while it lasts. I'm sure they'll change the tech on their end sooner or later.

I think I'm going to make a thread about this, and you guys can try it out on other sites and I'll add it to the OP.

Also, those using browsers other than Firefox can test it out and put instructions how to do it in your browser as well. It's all generally the same, but let's write up a guide so easy a 2 year old could do it.

Do Right, Be Right. :)

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Tuesday, July 9, 2019 5:54 PM

JEWELSTAITEFAN


Quote:

Originally posted by 6ixStringJack:
Washington Post...

You can't view articles in Private Mode. It says the following and blocks your ability to read the article:

Quote:


We noticed you’re browsing in private mode.
Private browsing is permitted exclusively for our subscribers. Turn off private browsing to keep reading this story, or subscribe to use this feature, plus get unlimited digital access.





But...

Unlike with the NYT which doesn't require you to delete existing cookies after blocking their website from using cookies, you have to go in and delete all washingtonpost cookies for this to take effect or it will still know that you've read too many articles.

After blocking https://www.washingtonpost.com AND deleting any cookies I found by typing in just "wash" in the the search bar for deleting individual cookies, it seems that I can now browse as many articles as I want without being blocked.



Enjoy this while it lasts. I'm sure they'll change the tech on their end sooner or later.

I think I'm going to make a thread about this, and you guys can try it out on other sites and I'll add it to the OP.

Also, those using browsers other than Firefox can test it out and put instructions how to do it in your browser as well. It's all generally the same, but let's write up a guide so easy a 2 year old could do it.

Do Right, Be Right. :)

Opera browser is free. Thge high-Speed Browser on a Diet. Fast. Minimal RAM and CPU. And difficult to crash.

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Wednesday, July 10, 2019 12:00 PM

SIGNYM

I believe in solving problems, not sharing them.


SIX, thanks for the tip on paywalls, I haven't tried it yet but will the next time I run into a paywalled article. If I understand it correctly, in order to view paywalled articles on most sites (probably) you need to delete the previous cookes associated with that site, and block cookies from that site before you open an article. Correct?

JSF: Hubby loaded BRAVE on the tablet, but I haven't tried THAT yet either. Some time this week I'll give it a try, just been real busy. Tom Luongo (one vlogger that I listen to semi-regularly, along wth The Duran) has been pushing the Brave browser as a better alternative to anything anything Android/Google associated, since they scrape your data wherever you go. (I have NoScript also loaded with Firefox, it's amazing how many google apps pop up with each site. googletagmanager and google-analytics are everywhere; I have them blocked but most people don't even know that they're running in the background.)


-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

"The messy American environment, where most people don't agree, is perfect for people like me. I CAN DO AS I PLEASE." - SECOND

America is an oligarchy http://www.fireflyfans.net/mthread.aspx?tid=57876 .

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Wednesday, July 10, 2019 12:06 PM

SIGNYM

I believe in solving problems, not sharing them.


So, while I noodle on exactly WHERE to get the money for Medicare For All (in total, we spend enough on healthcare to fund healthcare for everyone) I'm going to appeal for help on how to improve Medicare and do some research.

KIKI once posted that the current system of paying for only one proximate diagnosis was wrong, since it failed to address complex causes (paying for the amputation without addressing the underling diabetes and drug addiction which caused homelessness is stupid).

But as I mentioned, as a first thought negotiating better drug prices would be a terrific first step. I'll do some research and pencil=whip the potential savings on that.

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

"The messy American environment, where most people don't agree, is perfect for people like me. I CAN DO AS I PLEASE." - SECOND

America is an oligarchy http://www.fireflyfans.net/mthread.aspx?tid=57876 .

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Wednesday, July 10, 2019 9:19 PM

6IXSTRINGJACK


Quote:

Originally posted by SIGNYM:
SIX, thanks for the tip on paywalls, I haven't tried it yet but will the next time I run into a paywalled article. If I understand it correctly, in order to view paywalled articles on most sites (probably) you need to delete the previous cookes associated with that site, and block cookies from that site before you open an article. Correct?




Yeah. That's right.

Second's tip for the Private Window works fine for NYT, but it won't work for WaPo. They know you're using it and their site doesn't allow you to use private windows unless you're already paying them.

If you set up your cookies for any offending sites, you don't have to worry about it at all. At least until they change that.

Do Right, Be Right. :)

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Wednesday, July 17, 2019 2:14 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


Quote:

Originally posted by SIGNYM:
So, while I noodle on exactly WHERE to get the money for Medicare For All (in total, we spend enough on healthcare to fund healthcare for everyone) I'm going to appeal for help on how to improve Medicare and do some research.

KIKI once posted that the current system of paying for only one proximate diagnosis was wrong, since it failed to address complex causes (paying for the amputation without addressing the underling diabetes and drug addiction which caused homelessness is stupid).

But as I mentioned, as a first thought negotiating better drug prices would be a terrific first step. I'll do some research and pencil=whip the potential savings on that.

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

"The messy American environment, where most people don't agree, is perfect for people like me. I CAN DO AS I PLEASE." - SECOND

America is an oligarchy http://www.fireflyfans.net/mthread.aspx?tid=57876 .

So, I put this here as an indicator of which topic I'm addressing.

Yes, the Medicare system has these things called DRG's (diagnosis related group) introduced in the 1980's. And they, along with Medicare reimbursement rates, have been problematic ever since.

DRG's were introduced to fix the problem of 'for service' charges. Doctors would perform services and get reimbursed for whatever they did (or said they did). There was no check on what doctors might do to run up the tab and get more money. An easy case could be milked for a long, long time.

So the government created these DRGs to reimburse doctors and hospitals according to what they *should* spend for each patient with a diagnosis.

The shortcomings were immediately obvious. Patients couldn't have more than 1 DRG because no one knew how to do the calculation if one or both conditions aggravated each other. So a patient who came with with uncontrolled diabetes AND heart failure would only be reimbursed for treatment for one of them. Or, you could have a patient with a vastly more serious and complicated case, and their treatment would only be reimbursed at the average rate. This would especially discriminate against public hospitals, since they typically had more indigent, and thus untreated, unmanaged and complicated, medical cases.

The whole DRG concept has been tinkered with ever since to try and repair a faulty plan.

But on top of that DRG reimbursement rates are too low. And that leads to health care providers 'upcoding' - listing a patient in a more serious category than they actually are. And what that does, among other things, is scramble the MEDICAL record as to what the patient actually suffers from, poisoning it as a source of accurate medical information.

All this to solve a problem that has a better solution as in Canada.


Canada avoids the entire complicated cluster& in the US by paying doctors a normal, negotiated, income. (The doctors' union negotiates with the government. Also, afaik public medical school costs are on par with other graduate degrees, so doctors aren't trying to pay off huge education loans.) Hospitals are reimbursed for incurred costs. And especially important these days, the government negotiates drug prices. Medical practice in Canada and its associated businesses are unlike the US. In the US they're one giant mutual rip-off morass ... with all the accumulated mutual overcharging eventually falling on the consumer.

As a result of the rather pragmatic Canadian system, everyone is medically covered for life, including long-term nursing home care, at about half the per capita costs as the US.

I think a certain amount of good will is also important; and as well, anyone could intentionally game the system, so there's probably some back end checking.



Moving on to 'people who like their insurance should be able to keep it'.

There now are rumblings in the ordinary-insured world about co-pays, deductibles, caps, undisclosed out-of-plan contracted services and doctors, drug availability, and the like.
https://www.latimes.com/politics/la-na-pol-health-insurance-angry-pati
ents-20190628-story.html

Rising health insurance deductibles fuel middle-class anger and resentment
Middle-class Americans are bearing the brunt of the rise in health insurance deductibles and medical bills. That’s helped widen the country’s political divisions.

But still
https://news.gallup.com/poll/226607/news-americans-satisfaction-health
care.aspx

77% rate their personal healthcare as "excellent" or "good"
even if only
61% of overall Americans (who) say they are satisfied with their care costs

Now, this is just my observation, but that satisfied 77% is awfully close to that number of 80% of sick people who get better no matter what the doctors do, or don't do.


The REAL test of medical care comes when you REALLY need a doctor. And then you find out that that new immune treatment for your kind of incurable cancer isn't covered. Or that that surgery for disabling normal pressure hydrocephalus (that looks like Parkinson's but isn't, and that can be cured with shunt surgery) isn't covered. The common finding is that people WITH insurance are UNDER-COVERED, and they're exposed to being financially wiped out by a serious medical illness.

And that's why Obamacare FAILED to reduce death rates, and FAILED to reduce medical bankruptcies in the slightest - because even if people with pre-existing illnesses could get coverage, and even though 85% of premiums had to go to patient care, and even if common diagnostic tests were free (though treatment was not) - the whole system from medical schools through wheelchair vendors is broken. And mere private insurance reform a la Obamacare, which is extremely limited in scope, is an obvious failure by the numbers that tabulate the results. And obviously something different needs to be done.


The issues I haven't pondered are
- Should people be allowed to keep their insurance if - statistically - it leads to bankruptcy? Because if we're looking to improve medical care delivery, this will leave a lot of people (who like their medical care until they need it) at risk.
- And, the problem with two competing systems means that private insurers will be able to skim the cream off the top, taking money out of the system without providing care to the people who need it. That makes the government system bear the burden of the most expensive patients with reduced resources.





And if democrats don't do anything different, how are they any better?
tic tac

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Wednesday, July 24, 2019 3:06 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61954&mid=1
079564#1079564


Quote:

https://www.vox.com/policy-and-politics/2019/7/23/20699958/medicare-ex
tra-center-american-progress-single-payer-health-reform


According to an analysis CAP commissioned from the independent health care consulting firm Avalere and provided exclusively to Vox, Medicare Extra would achieve universal coverage — adding 35 million people to the insurance rolls — while cutting national health expenditures by more than $300 billion annually.

Avalere, which uses a methodology meant to mimic the Congressional Budget Office’s approach, also estimates that Medicare Extra would cost the government between $2.8 trillion and $4.5 trillion more than it’s spending now over the first 10 years, depending on how you structure the cost sharing. CAP is quick to note that at the lower range, the plan could be financed entirely through wealth taxes and other levies on richer Americans.

That said, the true costs of the plan would be somewhat higher. Because Medicare Extra takes about four years to phase in, a 10-year cost estimate underplays the actual running costs; once the program is up and running, it will spend about $400 billion to $500 billion per year. (Or, as I understand it, while the government will spend more on Medicare Extra, overall expenses will go down by reduced spending elsewhere - perhaps on private insurance and copays.)





I'm always curious about comparisons. In this case, I'm curious how the proposed "Medicare Extra" compares to the Canadian system, which I think is a proven achievable system. The Canadian system covers everyone for life, including unlimited nursing home care, with no 'cost sharing' (ie premiums, copays, and deductibles).

The Medicare Extra plan estimates that: "Medicare Extra would achieve universal coverage — adding 35 million people to the insurance rolls — while cutting national health expenditures by more than $300 billion annually. ... once the program is up and running, it will spend about $400 billion to $500 billion per year." I presume this means that while the particular "Medicare Extra" program would spend $400 - $500 billion annually, overall, other costs would go down such that, in total, it would cut overall national health expenditures by more than $300 billion annually.

If it's going to save $300B we should compare it to today's total expenditures to see if it comparatively saves a lot, a little, or in between. So, what do we pay now?

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Tr
ends-and-Reports/NationalHealthExpendData/Downloads/NHE2017.zip

2017 Total National Health Expenditures 3,492,077 (million, or 3.5 trillion)

So Medicare Extra would save an estimated 300B out of the current 3.5T in medical expenses. A savings of 300B out of 3.5T is slightly less than a 9% annual savings over current expenditures. NOT AT ALL IMPRESSIVE compared to the Canadian system which would save us roughly 50%, is universal, birth-through-death, has no 'cost sharing'.

As I noted in my post above, mere insurance reform can't solve our medical system issues: from exorbitant medical school tuitions, through exorbitant prices charged by medical products vendors (MRI machines through medications through band-aids), through hospital and medical care corporations, and on down through private profit and administrative overhead. Insurance reform merely partially addresses the insurance issues, but also fails to address the private insurance 'overhead' of administrative costs and profit that get tacked onto every consumer. As long as the government is paying private businesses at every step, the 'overhead' of administrative costs and profit, as well as overcharging, will continue to drive up overall expenses in every directly and indirectly related arena, beyond the mere cost of providing the service.

And the article agrees in a limited way. As it notes: "Gaffney had two main criticisms of the plan. The first was that it continues using premiums, copays, and deductibles to pay for insurance ... The other argument Gaffney makes is that in preserving a significant role for private insurance, Medicare Extra keeps insurer profits and administrative waste that could otherwise go toward reducing premiums or expanding coverage. ... I tend to think the single-payer advocates have the better of this one: Administrative costs are about twice as high in America as in Canada, and there’s little evidence that Canada is suffering under a crisis of insufficient billing bureaucracy." Not to mention profit and administrative costs in the entire related industry ...


As above, my other criticism is that most people who go medically bankrupt have insurance. Most people are happy with their insurance BECAUSE roughly 80% of medical issues are minor, and will go away on their own no matter what the doctor does or doesn't do. People become unhappy - and financially damaged - when they have something major that requires significant medical care to get better, or just to survive. That's when they find treatments aren't covered, doctors aren't covered, equipment and supplies aren't covered, deductibles run into the thousands, lifetime caps come into play, they're billed multiple times for the same things, or billed for things that weren't done, (or both), ... and so on.

Medicare Extra would do very little to reduce medical bankruptcy if those currently 'happy people' happily elect to keep their under insured coverage, and run into major illnesses and bills - which a certain percentage are sure to do.

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Monday, July 29, 2019 2:59 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


This is a marker. In discussing the economic drain of US military bases around the globe (for ahem! 'national defense') I've been using old information of appx 800 US military bases around the globe. That underreports them by appx 25%. The correct figure is appx 1000 according to the most recent publication available at Amazon

Directory of U.S. Military Bases Worldwide: Third Edition (Directory of U.S. Military Bases Worldwide)

and confirmed in 2017 by a separate publication also available at Amazon

Base Nation: How U.S. Military Bases Abroad Harm America and the World Paperback – Download: Adobe Reader, October 3, 2017





And if democrats don't do anything different, how are they any better?

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Saturday, September 7, 2019 10:07 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


I've been focused on thermonuclear holocaust for a few years. It's been simmering away quite nicely on the back burner for, probably, decades. Hillary was all on board (being the democrat's globalist/neo-liberal official rep). With Trump, we're getting a glimpse into the hidden facts. And he seems on-board too.

https://www.paulcraigroberts.org/2019/08/23/the-irresponsibility-of-sm
all-nations
/

The Irresponsibility of Small Nations

After falsely accusing Russia of violating the Intermediate-Range Nuclear Forces Treaty (INF), Washington unilaterally repudiated the treaty. Thus did the US military/security complex rid itself of the landmark agreement achieved by Ronald Reagan and Mikhail Gorbachev that defused the Cold War.

The INF Treaty was perhaps the most important of all of the arms control agreements achieved by American 20th century presidents and now abandoned in the 21st century by US neoconservative governments. The treaty removed the threat of Russian missiles against Europe and the threat of European-based US missiles to Russia. The importance of the treaty is due to its reduction of the chance of accidental nuclear war. Warning systems have a history of false alarms. The problem of US missiles on Russia’s border is that they leave no time for reflection or contact with Washington when Moscow receives a false alarm. Considering the extreme irresponsibility of US governments since the Clinton regime in elevating tensions with Russia, missiles on Russia’s border leaves Russia’s leadership with little choice but to push the button when an alarm sounds.

That Washington intends to put missiles on Russia’s border and pulled out of the INF Treaty for this sole purpose is now obvious. Only two weeks after Washington pulled out of the treaty, Washington tested a missile whose research and development, not merely deployment, were banned under the treaty. If you think Washington designed and produced a new missile in two weeks you are not intelligent enough to be reading this column. While Washington was accusing Russia, it was Washington who was violating the treaty. Perhaps this additional act of betrayal will teach the Russian leadership that it is stupid and self-destructive to trust Washington about anything. Every country must know by now that agreements with Washington are meaningless.

Surely the Russian government understands that there are only two reasons for Washington to put missiles on Russia’s border: (1) to enable Washington to launch a pre-emptive nuclear strike that leaves Russia no response time, or (2) to enable Washington to threaten such a strike, thus coercing Russia to Washington’s will. Clearly, one or the other of these reasons is of sufficient importance to Washington for Washington to risk a false alarm setting off a nuclear war.

Military analysts can talk all they want about “rational players,” but if a demonized and threatened country with hostile missiles on its border receives a warning with near zero response time, counting on it to be a false alarm is no longer rational.

The 1988 treaty achieved by Reagan and Gorbachev eliminated this threat. What purpose is served by resurrecting such a threat? Why is Congress silent? Why is Europe silent? Why is the US and European media silent? Why do Romania and Poland enable this threat by permitting US missiles to be stationed on their territory?

Little doubt the Romanian and Polish governments have been given bagfulls of money by the US military/security complex, which wants the multi-billion dollar contracts to produce the new missiles. Here we see the extreme irresponsibility of small countries. Without the corrupt and idiotic governments of Romania and Poland, Washington could not resurrect a threat that was buried 31 years ago by Reagan and Gorbachev.

Even the American puppet state of occupied Germany has refused to host the missiles. But two insignificant states of no importance in the world are subjecting the entire world to the risk of nuclear war so that a few Romanian and Polish politicians can pocket a few million dollars.

Missiles on Russia’s borders that provide no response time are a serious problem for Russia. I keep waiting for Moscow to announce publicly that on the first sign of a missile launching from Romania or Poland, the countries will immediately cease to exist. That might wake up the Romanian and Polish populations to the danger that their corrupt governments are bringing to them.

Why aren’t the Romanian and Polish provocations sufficient justification for Russia to pre-emptively occupy both countries? Is it more provocative for Russia to occupy the two countries than it is for the two countries to host US missiles against Russia? Why only consider the former provocative and not the latter?

No one is capable of coming to Romania and Poland’s aid even if anyone was so inclined. NATO is a joke. It wouldn’t last one day in a battle with Russia. Does anyone think the United States is going to commit suicide for Romania and Poland?

Where are the UN resolutions condemning Romania and Poland for resurrecting the specter of nuclear war by hosting the deployment of US missiles on their borders with Russia? Is the entire world so insouciant that the likely consequences of this act of insanity are not comprehended?

It does seem that human intelligence is not up to the requirements of human survival.

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Sunday, September 8, 2019 5:33 AM

JO753

rezident owtsidr


Quote:

Originally posted by 1kiki: Washington unilaterally repudiated the treaty.


You mean Trump did.
https://www.armscontrol.org/act/2018-11/news/trump-withdraw-us-inf-tre
aty


You know, this guy:


So the move iz clearly to make it look like America iz the bad guy wile freeing Putin from the pesky treaty.

----------------------------
DUZ XaT SEM RiT TQ YQ? - Jubal Early

http://www.7532020.com .

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Sunday, September 8, 2019 8:28 AM

CAPTAINCRUNCH

... stay crunchy...


Quote:

Originally posted by JO753:
Quote:

Originally posted by 1kiki: Washington unilaterally repudiated the treaty.


You mean Trump did.
https://www.armscontrol.org/act/2018-11/news/trump-withdraw-us-inf-tre
aty


So the move iz clearly to make it look like America iz the bad guy wile freeing Putin from the pesky treaty.



I noticed that too, Jo. Not once did the author say “Trump” instead he said “Washington.” Although he did use Reagan and Clinton... almost like was trying to absolve Russia’s favorite puppy.

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Sunday, September 8, 2019 8:55 AM

THG


Quote:

Originally posted by REAVERFAN:

If you lived in the US, I'd suggest you vote for Bernie in the primary.

Since you don't, fuck off.



The thing is reaver, that what rue (kiki) says is her presidential platform, is the opposite of what Trump is doing.

military
severely reduce military overseas
abandon our policy by which we allow ourselves the 'first strike' nuclear option
maintain reduced nuclear capability that's still sufficient to assure destruction of nuclear opponent

Trump tore up the treaty and is creating new, more controversial nukes.

environment
commit to significant greenhouse gas reductions; stump the country for it to create popular pressure in Congress so Congress will pass the Paris Accord

Not only is Trump a climate change denier, he is removing all our environmental protections so polluters can pollute with impunity.

economy
stump for a 'fair deal' economy where everyone has the opportunity to earn a living wage

Right, tax cuts for the rich and fuck the little guy is what Trumps about. You know, exploit the average guy.

And sig in the next post says that's the dream when it comes to kiki's post. Yet, they are two of Trumps staunchest supporters. Bullshit, Russian trolls. No substance, just bullshit.

T



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Sunday, September 8, 2019 9:33 AM

6IXSTRINGJACK


Why don't you chucklefucks take a look at the list of things that Trump has done against Russian interests since he's been in office?

That question is rhetorical, of course. I'm speaking to conspiracy theorists.


You boys make Alex Jones proud.

Do Right, Be Right. :)

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Sunday, September 8, 2019 10:08 AM

CAPTAINCRUNCH

... stay crunchy...


Quote:

Originally posted by 6IXSTRINGJACK:
Why don't you chucklefucks take a look at the list of things that Trump has done against Russian interests since he's been in office?

That question is rhetorical, of course. I'm speaking to conspiracy theorists.


You boys make Alex Jones proud.

Do Right, Be Right. :)



You ever notice how Trump fans never post a single thread about what great things he’s doing? I don’t even see posts about the great ideas/things he’s come up with (other than how to keep out “others”)? It’s pretty much all focused on Dem hate.

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Sunday, September 8, 2019 10:49 AM

6IXSTRINGJACK


Quote:

Originally posted by captaincrunch:
Quote:

Originally posted by 6IXSTRINGJACK:
Why don't you chucklefucks take a look at the list of things that Trump has done against Russian interests since he's been in office?

That question is rhetorical, of course. I'm speaking to conspiracy theorists.


You boys make Alex Jones proud.

Do Right, Be Right. :)



You ever notice how Trump fans never post a single thread about what great things he’s doing? I don’t even see posts about the great ideas/things he’s come up with (other than how to keep out “others”)? It’s pretty much all focused on Dem hate.




lol

I'm not a Trump fan other than a good laugh I get from his occasional tweets. Let's just say you'd never find me dead wearing a MAGA hat.

Democrats in 2019 are just gross though. They have been for well over 10 years now.

I used to post shit about GWB every day here with the Democrats on this board. I haven't changed. You have.

Do Right, Be Right. :)

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Sunday, September 8, 2019 11:32 AM

SIGNYM

I believe in solving problems, not sharing them.


Quote:


Why don't you chucklefucks take a look at the list of things that Trump has done against Russian interests since he's been in office?
That question is rhetorical, of course. I'm speaking to conspiracy theorists.
You boys make Alex Jones proud.
Do Right, Be Right. :)- SIX

You ever notice how Trump fans never post a single thread about what great things he’s doing? I don’t even see posts about the great ideas/things he’s come up with (other than how to keep out “others”)? It’s pretty much all focused on Dem hate.= CC



Oh baloney! "Dem hate"? Like ... who? WHO is being hated on? Nancy Pelosi barely gets a mention. Same with Adam Schiff. The thread on "who's running in 2020" regularly sinks to the bottom of the page and beyond.

Do you know what the mainstay of the conversation has been for the past three years?

RUSSIA!

RUSSIA!RUSSIA!RUSSIA!RUSSIA!RUSSIA!RUSSIA!RUSSIA!


Endlessly repeated ad nauseum. It's insane. You people are delusional. And just because someone criticizes you for falling for this deep state-engendered hoax doesn't mean it's a defense of Trump.

Oh, and BTW ... I started a Trump: Good, bad, ugly" thread http://www.fireflyfans.net/mthread.aspx?tid=61325 to discuss what Trump ws doing (not what he was tweeting, and not your delusions about RUSSIA!!) It died an inglorious death because nobody wanted to discuss what was REALLY going on. All anyone wanted to post about was RUSSIA! If you can get past this RUSSIA! fixation and (oh btw) manage to NOT call me a "Russian troll" for the umpteenth time, then .. let's revisit that thread and have a real discussion. 'Cause, yanno, I've got a lot to say about him, and not all of it is nice.

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY

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Sunday, September 8, 2019 12:06 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


While I certainly appreciate you trolls keeping this up near the top - do you have anything to say on-topic? Anything at all?

Yanno, you could tackle some of the easiest questions first. Here's one - do you think a nuclear war is winnable?

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Sunday, September 8, 2019 2:02 PM

SIGNYM

I believe in solving problems, not sharing them.


Quote:

Originally posted by 1kiki:
While I certainly appreciate you trolls keeping this up near the top - do you have anything to say on-topic? Anything at all?

Yanno, you could tackle some of the easiest questions first. Here's one - do you think a nuclear war is winnable?

Oh pshaw! KIKI! Who wants to discuss the insanity of nuclear armageddon when it's so much juicier to go on and on about RUSSIA!!! ?

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY

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Sunday, September 8, 2019 2:22 PM

6IXSTRINGJACK


There's no end of the world coming. There's no nuclear war coming. The environment isn't going to self destruct in 12 years. There is no impending Civil War.

These are bored people. "Russia!" fills a hole for them.

Do Right, Be Right. :)

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Sunday, September 8, 2019 3:26 PM

THG


Quote:

Originally posted by captaincrunch:
Quote:

Originally posted by 6IXSTRINGJACK:
Why don't you chucklefucks take a look at the list of things that Trump has done against Russian interests since he's been in office?

That question is rhetorical, of course. I'm speaking to conspiracy theorists.


You boys make Alex Jones proud.

Do Right, Be Right. :)



You ever notice how Trump fans never post a single thread about what great things he’s doing? I don’t even see posts about the great ideas/things he’s come up with (other than how to keep out “others”)? It’s pretty much all focused on Dem hate.



Absolutely G, dead on. All they do is deflect and deny when Trump does 100 fold what they've always complained about others doing. It's obvious why too. It's about trolling with them. It always has been.

T



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Sunday, September 8, 2019 4:10 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


Anything 'on topic' - or just more of your endless trolling?

Here's a starter question - do you think a nuclear war is winnable?

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Monday, September 9, 2019 2:42 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


--- healthcare ---

The m$m is starting to frame the anti-Bernie debate. Most people will literally never get beyond the headlines - that's why the NYTimes was so frantic about a headline that they had to call the entire newsroom staff together to 'discuss' Trump's 'racism' (and their shift from 'Russia'.)

This is what the NYTimes headlined about Bernie:


Sanders Went to Canada, and a ‘Medicare for All’ Dream Flourished Wow. You went to Canada and saw the light, eh Bernie? Yanno, I went to Canada and all I got was this T-shirt.
It's called being dismissive. Damning with faint praise.
Anybody who lives even remotely close to the Canadian/ Canadien border knows a lot about its healthcare system. Sanders didn't just accidentally stumble across the border and notice something different, et voilà!, now it's part of his campaign.

Senator Bernie Sanders has staked his presidential campaign on transforming U.S. health care. A trip he made to study the Canadian system helps explain why. 7m ago
I studied for an exam once, too.
And those intrepid enough to read the subhead were treated to more of the same. Again, it sounds like Sanders did one thing once - he made a trip - and suddenly he's proposing national healthcare policy with a tourist's knowledge.

I've pointed out the mind-reading and suppositions in the text below, and highlighted the facts, along with relevant quotes from named sources with first-hand knowledge. I've also interpolated clearly delineated comments.

https://www.nytimes.com/2019/09/09/us/politics/bernie-sanders-health-c
are.html


BURLINGTON, Vt. — In July 1987, Bernie Sanders, then the mayor of Burlington, Vt., arrived in Ottawa convinced (mindreading) he was about to see the future of health care.

Years earlier, as his mother’s health declined, and his family struggled to pay for medical treatment, he was spending more time attending to her than in classes at Brooklyn College, suffering through what his brother called “a wrecked year’’ leading to her death. Over time, he had come to believe that the American health care system was flawed and inherently unfair. In Canada, he wanted to observe firsthand the government-backed, universal model that he strongly suspected was better. (This is clearly editorialization, or at best unsupported 'mindreading' claims: 'he believed', 'he wanted', 'he strongly suspected'.)

Amid
tours of community centers and meetings with health care providers, Mr. Sanders, then 45 , more than liked what he saw. “He was thrilled,” recalled Beth Mintz, a professor of sociology at the University of Vermont and a member of a task force that accompanied Mr. Sanders. “It gave him much more confidence in the possibility of the single-payer system as a solution.” (I can find no stories about his visit to Canada, except quotes from 1987 where he said single payer would bankrupt the US. Here's one link from a pageful of links https://freebeacon.com/politics/sanders-1987-astronomical-cost-single-
payer-bankrupt-nation
/)


Decades before “Medicare for all” would propel his presidential campaigns, Mr. Sanders’s expedition to Ottawa helped forge his determination to transform the American health care system. His views burst onto the national political scene
during his 2016 presidential run, when he championed a single-payer program alongside many of his other liberal policy ideas. Now, as he seeks the Democratic presidential nomination for a second time, he has made “Medicare for all” the single most important issue of his campaign and in turn set the agenda for the ideological discussion in the Democratic primary.

Health care dominated the first two Democratic debates this summer and will most likely be a prominent issue again during the third debate on Thursday in Houston. Other candidates support “Medicare for all,” but it is Mr. Sanders who has become singularly identified with it — “I wrote the damn bill!’’ he proclaimed in July’s debate.

A review of hundreds of pages of documents from the first chapters of his political career — including speeches, correspondences and newspaper clippings — as well as interviews with those who have known him throughout his life, show that while his democratic socialist worldview underpins his “Medicare for all” pitch, he was also guided by other factors. Chief among them were his mother’s illness and death, which instilled in him a deeply personal urge to ensure everyone had access to medical care, (These are more 'mindreading' claims: 'democratic socialist worldview underpins his “Medicare for all”', 'he was also guided', 'Chief among them', 'instilled in him'.) and
the adjacency of Vermont to Canada, which afforded him a blueprint to enact the kind of universal health care system he had envisioned for years.

Together, they help explain why he has staked not only his campaign, but also much of his political legacy, on promoting “Medicare for all.’’

“You can’t overstate the impact that Vermont’s proximity to Canada had on Bernie’s thinking about how to approach reforming the American health care system,” said Jeff Weaver, who has worked with Mr. Sanders since the 1980s and remains one of his closest advisers. The pull of Canada remains strong: In July, Mr. Sanders took a bus trip from Detroit to Windsor, Ontario, with diabetes patients to highlight lower drug prices in Canada.

In an interview on Sunday, Mr. Sanders vividly described how seeing the Canadian system up close (ie over the entire course of his life in Vermont) significantly shaped his own views on health care.

“It was kind of mind blowing to realize that the country 50 miles away from where I live — that people could go to the doctor whenever they wanted and not have to take out their wallet,” he said. “That was just a profound lesson that I learned,” he said.

He also criticized the American system as “barbaric.” And he vowed — as he often does in his stump speeches — “to take on the greed and the corruption of the health care industry.” “This is a fight I will not shy away from,” he said.

Mr. Sanders’s health care proposal has attracted legions of supporters who are fed up with the rising costs of the current system, and it sets him apart from more centrist candidates like Joseph R. Biden Jr. But his uncompromising position also threatens to alienate voters who are pleased with the Affordable Care Act, or who do not want to give up their private insurance. His own state of Vermont so far does not have a single-payer program.

Despite skepticism about his views, however, Mr. Sanders has consistently resolved to reform the health care system, even before being elected to public office.
In 1972, when he was running for Senate as a candidate from Vermont’s left-wing Liberty Union Party, The Bennington Banner, a local newspaper, reported him taking an uncompromising stance: “There is absolutely no rational reason, in the United States of America today, we could not have full and total free medical care for all.”

The challenge of paying medical bills

The first seeds of Mr. Sanders’s concern were sown in Brooklyn. (unevidenced mindreading)

A high-school track and cross country star with an emerging political streak, Mr. Sanders had wanted to go to Harvard, friends said. But by his senior year, his mother, Dorothy Sanders, had become sick, her heart damaged from having rheumatic fever as a child.

As her health declined, her illness consumed him. He stopped going to track practice.
To be closer to her, he began his freshman year at Brooklyn College.

Mr. Sanders describes his family as lower middle class. His father, an immigrant from Poland, was a paint salesman. He has said his parents frequently argued about money.

When his mother fell ill, his family moved her into a charity hospital in New Jersey. After a failed heart surgery, she died in March 1960, when she was in her mid-40s. “Bernard actually spent much more time with her than he did in class,’’ his brother, Larry, recalled in an interview in February. “It was really a kind of wrecked year and a very unhappy year.”

Then, as now, Mr. Sanders avoided speaking of his mother’s death. On Sunday, he declined to discuss his personal life, but said that his family had “struggled economically, and that’s it.”

In a 2006 interview with Vermont PBS, he offered a rare glimpse into how her illness shaped his thinking.

“When you talk about money and family, how do you get the money for the medical treatment that my mother needed?” he said. “I won’t go into the whole long song and dance of it. But trust me, it was something that I also have not forgotten about — the right of people to have health care, which was a little bit difficult in our family situation.”

It would still be some years, though, before health care became his political hallmark.

Mr. Sanders transferred to the University of Chicago, where he spent hours in the library reading progressive publications that would influence his political views and turned his energy toward civil rights.

“We didn’t talk about health care,” said one of his roommates, Ivan Light. “It was not on the political agenda at that time. Civil rights was on the agenda.”

After moving to Vermont, he became active in politics. A perennial candidate with the Liberty Union Party
in the 1970s, he focused on issues like the tax structure. (So the 1972 quote from the Burlington Banner “There is absolutely no rational reason, in the United States of America today, we could not have full and total free medical care for all.” was a one-off?)

But he also began to study health care seriously. Included in a collection of papers from those days are pamphlets, articles and other material related to medical care. One publication he saved from March 1972 was titled, “Health Rights News;” its slogan was “Health care is a human right.”

That research soon began to take hold: In October 1976, when he was the Liberty Union candidate for governor, he told The Burlington Free Press that the delivery of medical care was “basically a national problem” and that he supported “public ownership of the drug companies and placing doctors on salaries.”

“I believe in socialized medicine,” he said.

As mayor of Burlington, Mr. Sanders became somewhat fixated on Canada’s health care system. (Here we have more mind reading - but now it's new and improved! with even MORE! NEGATIVE connotations! Sanders wasn't interested, or even focused - nope. He was 'fixated'.)

John Bloch, who has known Mr. Sanders since the 1970s, said he thought Mr. Sanders’s views were influenced in part by the people he lived near in the rural town of Stannard, Vt., many of whom were in desperate need of health care. “He didn’t just come to this as Johnny-come-lately,” Mr. Bloch said.

In the interview Sunday, Mr. Sanders said he was particularly affected at the time by a young boy who lived across the road whose teeth, he said, were rotting in his mouth.

Deb Richter, a Vermont physician and longtime advocate for single-payer health care, who has worked with Mr. Sanders on the issue for 20 years (That would be since about 2000.), said Mr. Sanders had always felt that health care should be a human right. “You ask Vermonters, ‘How long has Bernie been talking about single-payer health care for all?’ and nobody can remember a time he wasn’t talking about it,’’ she said. ('Always' = since about 2000, according the Richer's personal knowledge. The paragraph appears to be hyperbole.)

Turning his sights toward Canada

After Mr. Sanders was elected mayor of Burlington in 1981, he largely emphasized local issues, like property taxes and affordable housing. (Since the article claims that as mayor of Burlington 1981 - 1989, Sanders was 'fixated on healthcare, this article contradicts its own timeline.) He also aimed to execute his own foreign policy, going further than many Democrats in supporting socialist leaders.

“I was the mayor of a city of 40,000 people,” Mr. Sanders said in the interview. “Talking about national health care is not exactly what you talk to the board of aldermen about.”

By then, he had also become somewhat fixated (ie: not interested, or even focused - 'fixated' - in case you didn't get that the first time) on Canada, just 50 miles from his office in city hall. In September 1981, he invited the director of the Quebec Insurance Board to deliver a presentation on the province’s health insurance plan. Later, he demanded more accountability from the state’s health insurance company and encouraged a review of hospital budgets.

But as he pondered broader electoral ambitions, his priorities began to shift. Even before he announced
his 1986 campaign for governor, he said he planned to run in part on controlling the cost of health care, according to an article in the Vermont newspaper The Times Argus.

He lost that race but gathered valuable information in the process: During his campaign, his team had polled Vermont residents on issues. “To my surprise,” Mr. Sanders said in 1987, “the issue that Vermonters felt most strongly about was the rapidly rising costs of health care.”

That finding served to galvanize his actions on health care. He quickly set up a task force and charged it with studying how to make the system more affordable.

Soon Mr. Sanders and the task force — which included an expert on the Cuban health care system, professors and a minister — were traveling to Ottawa, which had implemented a government-supported, single-payer system.

Jed Lowy, who went on the trip, recalled touring a public hospital, visiting a neighborhood community health center and speaking with physicians. “It was interesting to see another way that health care was provided,” Mr. Lowy said.

That trip, and a later one to Montreal, reinforced Mr. Sanders’s idea that Vermont’s northern neighbor had effectively put into practice the kind of accessible, affordable system he had long sought.

At a news conference after the Ottawa visit, the task force suggested Burlington could model its health care system after Canada’s. And in unequivocal tones, Mr. Sanders said it would be “absolutely negligent” not to examine at least some aspects of the Canadian model.

In March 1988, the task force released a report recommending the creation of a national health care system.

Mr. Sanders’ focus on health care policy met some resistance at home from city employees reluctant to give up benefits they had earned.

Mr. Sanders forcefully rebutted the criticism.

“You may regard this as ‘propaganda’,” he wrote tersely in response to a letter from an angry constituent in December 1982. (1982? Didn't this happen after 1987?) “I expect that you may not have talked to citizens who are taking their food money to pay for medical care.”

By the time Mr. Sanders was mounting his 1988 congressional run, he was speaking about health care in the kind of dogmatic (not pragmatic, not humane, not progressive - DOGMATIC) terms he uses today, and he was broadening his vision beyond Vermont. He praised the National League of Cities for adopting a resolution to establish a national health system.

Soon after formally announcing his congressional campaign, he set forth his premier agenda item, one that he had imagined since his mother’s death some three decades earlier. (mindreading) “I want to make it emphatically clear,” he said in April 1988, “that I will make health care reform a top priority as a United States congressman from the state of Vermont.”

Alexander Burns contributed reporting. Kitty Bennett and Alain Delaquérière contributed research.

Sydney Ember is a political reporter based in New York. She was previously a business reporter covering print and digital media. @melbournecoal






First of all, the article focuses on 'what does Bernie really want', rather than doing an analysis of facts (which I suspect would make Canadian healthcare look pretty good). And then it engages in egregious 'mindreading' claims that it fails to back with even one quote from the "hundreds of pages of documents" they claimed to have reviewed. It makes claims unsupported by - or even CONTRADICTED by - available information (for example saying that Sanders was addressing affordable housing which claiming he was 'fixated' on Canada's healthcare) It plays fast and loose with the timelines, mixing up various parts of the past. And it makes blatantly editorializing descriptions.

And let me repeat - not one fact about whether or not Canda's healthcare system works better than ours.









‘UVA has ruined us’: Health system sues thousands of patients, seizing paychecks and putting liens on homes
Over six years, the University of Virginia Health System took people to court more than 36,000 times, an analysis has found. Heather Waldron, an insurance agent and former nurse, is losing her home after UVA sued to recoup $164,000 in charges for her emergency surgery in 2017.

By Jay Hancock and Elizabeth Lucas

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Monday, September 9, 2019 9:27 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


The original article in the NYTimes (above) was a hatchet job on Sanders. While not as obvious as the one done on Tulsi Gabbard, it was aimed at derailing Sanders, and more specifically, his medical plan. The medical plan that's favored? The #notmedicareforall one.

Here is the NYTimes article, restated, with unreferenced opinions removed, a straightforward timeline, and egregious misstatements of fact corrected.







Mr. Sanders describes his family as lower middle class. His father, an immigrant from Poland, was a paint salesman. He has said his parents frequently argued about money.

When his mother fell ill during Sanders' high school years, his family moved her into a charity hospital in New Jersey about 2 hours away. After a failed heart surgery, she died in March 1960, when she was in her mid-40s, shortly after Sanders graduated from high school.

Then, as now, Mr. Sanders avoided speaking of his mother’s death. On Sunday, he declined to discuss his personal life, but said that his family had “struggled economically, and that’s it.”

But in a 2006 interview with Vermont PBS, he offered a rare glimpse into how her illness shaped his thinking. “When you talk about money and family, how do you get the money for the medical treatment that my mother needed?” he said. “I won’t go into the whole long song and dance of it. But trust me, it was something that I also have not forgotten about — the right of people to have health care, which was a little bit difficult in our family situation.”

Years earlier, as his mother’s health declined, and his family struggled to pay for medical treatment, he was spending more time attending to her than in classes at Brooklyn College, suffering through what his brother called “a wrecked year’’ leading to her death. Over time, he had come to believe that the American health care system was flawed and inherently unfair. In Canada, he wanted to observe firsthand the government-backed, universal model that he strongly suspected was better.
he was also guided by other factors. Chief among them were his mother’s illness and death, which instilled in him a deeply personal urge to ensure everyone had access to medical care
The first seeds of Mr. Sanders’s concern were sown in Brooklyn.
A high-school track and cross country star with an emerging political streak, Mr. Sanders had wanted to go to Harvard, friends said. But by his senior year, his mother, Dorothy Sanders, had become sick, her heart damaged from having rheumatic fever as a child.
Soon after formally announcing his congressional campaign, he set forth his premier agenda item, one that he had imagined since his mother’s death some three decades earlier.


During his college years, Sanders was focused on civil rights and took part in the Civil Rights Movement activities, but over the years and past college, extending his involvement to the peace movement. He graduated with a BA in political science from the University of Chicago in 1964.

After initially buying a property in Vermont with his first wife in 1964, traveling through Europe, and later divorcing and selling the property in 1966; Sanders permanently settling in Vermont in 1968.

Sanders ran unsuccessful third-party political campaigns in the early to mid-1970s. He ran as the Liberty Union candidate for governor of Vermont in 1972 and 1976 and as a candidate for U.S. senator in 1972 and 1974. As a candidate, he focused on issues like the tax structure. But one publication he saved from March 1972 was titled, “Health Rights News;” its slogan was “Health care is a human right.” And in 1972, when he was running for Senate as a candidate from Vermont’s left-wing Liberty Union Party, The Bennington Banner, a local newspaper, reported one quote: “There is absolutely no rational reason, in the United States of America today, we could not have full and total free medical care for all.” In October 1976, when he was the Liberty Union candidate for governor, he told The Burlington Free Press that the delivery of medical care was “basically a national problem” and that he supported “public ownership of the drug companies and placing doctors on salaries.” “I believe in socialized medicine,” he said.

In 1980 Sanders was elected mayor of Burlington, Vermont. He was mayor for eight years, from April 6, 1981, to April 4, 1989.

As mayor, Sanders largely emphasized local issues, like property taxes and affordable housing.

But he became acquainted with both the medical-care struggles of his constituents, and with the alternative Canadian system just 50 miles away, as many people who live near the Canadian border do.

John Bloch, who has known Mr. Sanders since the 1970s, said he thought Mr. Sanders’s views were influenced in part by the people he lived near in the rural town of Stannard, Vt., many of whom were in desperate need of health care. “He didn’t just come to this as Johnny-come-lately,” Mr. Bloch said.

A December 1982(?) letter indicates his thinking on healthcare. “You may regard this as ‘propaganda’,” he wrote tersely in response to a letter from an angry constituent. “I expect that you may not have talked to citizens who are taking their food money to pay for medical care.”

In an interview on Sunday, Sanders said he was particularly affected at the time by a young boy who lived across the road whose teeth, he said, were rotting in his mouth. And he vividly described how seeing the Canadian system during his lifetime in Vermont significantly shaped his own views on health care. “It was kind of mind blowing to realize that the country 50 miles away from where I live — that people could go to the doctor whenever they wanted and not have to take out their wallet,” he said. “That was just a profound lesson that I learned,” he said.

“You can’t overstate the impact that Vermont’s proximity to Canada had on Bernie’s thinking about how to approach reforming the American health care system,” said Jeff Weaver, who has worked with Mr. Sanders since the 1980s and remains one of his closest advisers.

Even before he announced his 1986 campaign for governor, he said he planned to run in part on controlling the cost of health care, according to an article in the Vermont newspaper The Times Argus.

He lost that race but gathered valuable information in the process: During his campaign, his team had polled Vermont residents on issues. “To my surprise,” Mr. Sanders said in 1987, “the issue that Vermonters felt most strongly about was the rapidly rising costs of health care.”

As mayor of Burlington, Vermont, Bernie interviewed experts about Canada’s medicare system on his regular TV program, exploring how it delivered high quality universal care, at lower cost.

And as a result of his election bid, Sanders quickly set up a task force and charged it with studying how to make medical care more affordable. The task force included Sanders, an expert on the Cuban health care system, professors and a minister. Since Ottawa had implemented a government-supported, single-payer system, in July 1987 the task force arrived there to tour community centers and meet with health care providers.

Decades before “Medicare for all” would propel his presidential campaigns, Mr. Sanders’s expedition to Ottawa helped forge his determination to transform the American health care system.
convinced he was about to see the future of health care.
Amid tours of community centers and meetings with health care providers, Mr. Sanders, then 45 , more than liked what he saw. “He was thrilled,” recalled Beth Mintz, a professor of sociology at the University of Vermont and a member of a task force that accompanied Mr. Sanders. “It gave him much more confidence in the possibility of the single-payer system as a solution.”


At the time, Sanders said that if Medicaid was expanded to all (with existing structures, price controls, and reimbursements still in place) it could "bankrupt the nation". At the time he was wasn't addressing socialized medicine, or even the Canadian system, but simply an expansion of the existing US Medicaid program. And instead, in March 1988, the task force released a report recommending the creation of a national health care system.

By the time Mr. Sanders was mounting his 1988 congressional run, he was speaking about health care in the terms he uses today, and he was broadening his vision beyond Vermont.


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Tuesday, September 10, 2019 3:45 AM

SIGNYM

I believe in solving problems, not sharing them.


The M$M is doing a hatchet job on Sanders the same as the hatchet job on Gabbard, and the rest of the candidates appear to be virtue-signalling ninnies or establishment hacks ... NOT a group I'd vote for!

But aside from coverage of the 2020 campaign, what's YOUR take on the solution to our healthcare problem?

I did "run the numbers", and by adding up ALL the money spent on premiums (either individual or employer benefits), out of pocket costs, and all of the tax money spent on Medicare, Medicaid, and the various county hospitals, clinics etc we could easily extend Medicare to cover everyone and not spend an additional penny.

But I think we could achieve cost savings and even more effective healthcare, so I have a few ideas and some ??

Of course we could save a lot of money by having the Federal government use its bargaining power to lower drug prices. Medicare Part D totalled up to $95 billion in 2018; if the RXprescriptions in the USA were brought to average developed world prices, costs would be reduced by about 50%, resulting in a savings of approximately $45 billion per year.

https://www.kff.org/medicare/issue-brief/the-facts-on-medicare-spendin
g-and-financing
/
https://www.drugwatch.com/featured/us-drug-prices-higher-vs-world/?Pag
eSpeed=noscript


And by eliminating the bean-counters and insurance executives we could save at least 15% of "administrative costs" in Medicare and Medicaid, so we could potentially provide Medicare for all and spend LESS money than we're currently spending now.

But Medicare seems to encourage inefficiency because it pays "per procedure" and not for treating the whole person. It seems lead to a system of disconnected specialists where patients are shuttled from doctor to doctor, often not getting a correct diagnosis or effective treatment. The approach which seems to work best is when a TEAM of involved doctors and nurses discuss a particular patient.

Also, my experience with HMOs has been less-than-stellar ... if you have what 85% of patients have you'll do well with their standard treatments but if you have something unusual ... heaven help you! And altho plans like Kaiser are "technically" non-profit, the doctors are incentivized to skimp on patient care because the doctors get to pocket the unexpended premiums at the end of the year. So I would not advocate an HMO-style system.

How would you reform Medicare reimbursements, KIKI, assuming that you thought it needed reform?



-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY

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Tuesday, September 10, 2019 9:43 AM

6IXSTRINGJACK


At the end of the day, insurance ponzi schemes are what have made medical care completely unaffordable. If doctors were only able to charge reasonable prices that people could actually afford to pay since the beginning, then the prices wouldn't be where they are right now.

Just look at the dental industry as an example. Most insurance, even the best private insurance people can pay for while working good jobs, don't cover much dental costs at all outside of 2 checkups and x-rays. Even when it does, it's usually not more than 20 percent of any procedures beyond a tooth pulling or capping.

Dentures for $3500 with all the teeth pulled out though?

Doesn't sound like a bad deal compared to a 5 minute ball massage with KY jelly in the early 2000's that cost me over $3000 out of pocket when I had a lump and was worried that I might have had testicular cancer. Wouldn't even want to know what that would cost in 2019.

Do Right, Be Right. :)

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Tuesday, September 10, 2019 11:32 AM

SIGNYM

I believe in solving problems, not sharing them.


Quote:

Originally posted by 6IXSTRINGJACK:
At the end of the day, insurance ponzi schemes are what have made medical care completely unaffordable. If doctors were only able to charge reasonable prices that people could actually afford to pay since the beginning, then the prices wouldn't be where they are right now.

Just look at the dental industry as an example. Most insurance, even the best private insurance people can pay for while working good jobs, don't cover much dental costs at all outside of 2 checkups and x-rays. Even when it does, it's usually not more than 20 percent of any procedures beyond a tooth pulling or capping.

Dentures for $3500 with all the teeth pulled out though?

Doesn't sound like a bad deal compared to a 5 minute ball massage with KY jelly in the early 2000's that cost me over $3000 out of pocket when I had a lump and was worried that I might have had testicular cancer. Wouldn't even want to know what that would cost in 2019.

Do Right, Be Right. :)

For whatever reason dentists still remain largely small practices which compete effectively with each other, not giant monopoly-style hospital-chain corporations.

Maybe the difference is that hospitals require so much more equipment: imaging equipment and laboratories and surgical suites and a phamacy that carries everything?

I dunno. Around here, most hospitals are giant complexes that sprawl thru multiple many-story buildings. The only one that I know is reasonable is (was?) a charity-based hospital started by the Catholic Church, it's still only one building and seems very well-run. But once you get past a certain size, then you need multiple layers of management to coordinate the multiple moving parts ... you need a director of pathology and a director of surgical services and the head of maintenance and the IT director and director of nursing services etc and THEY all report to the next layer up (chief officers?) which reports to the layer over that (hospital board, quality control...) and THEY report to corporate HQ... Seems like all I ever see nurses do is "charting". You can't have all of those moving parts w/o CYA paperwork!

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY

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Tuesday, September 10, 2019 11:56 AM

SIGNYM

I believe in solving problems, not sharing them.


Seems like the best way to reduce the amount of red tape is to have standard prices posted, and published hospital reviews. This business of hospitals billing different insurances, and different PLANS in each insraunce, different rates is insane.

It's hard to judge "performance" because some hospitals (in poorer areas) get patients who're sicker that other hospitals which leads to poorer outcomes, but there are some things directly under hospital control like hospital-acquired infections, patient comfort, and ER wait-times. Also, there should be a log of complaints against hospitals or against specific staff working there - missed diagnoses, etc. Maybe that would provide people with real-time info on where to get a procedure done.


-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY

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Tuesday, September 10, 2019 2:55 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


just assembling some facts



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Tuesday, September 10, 2019 2:58 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.



Canada/ medical school tuition
https://afmc.ca/node/256

The highest annual tuition (citizen and resident) in Canada was at McMaster University - $27,241 (Canadian dollars)

The lowest annual tuition (citizen and resident) in Canada was at Université de Montréal - $3,507 (Canadian dollars)



US/ medical school tuition
https://www.usnews.com/education/best-graduate-schools/the-short-list-
grad-school/articles/most-expensive-private-medical-schools

https://www.usnews.com/education/best-graduate-schools/the-short-list-
grad-school/articles/public-medical-schools-with-the-lowest-in-state-tuition-and-fees


The highest annual tuition plus fees (citizen and resident) in the US was at Columbia University - $67,810

The lowest annual tuition plus fees (citizen and resident) in the US was at Texas Tech University Health Sciences Center - $18,808


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Tuesday, September 10, 2019 3:14 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


https://www.politico.com/agenda/story/2017/10/25/doctors-salaries-pay-
disparities-000557


In the United States, the supply of doctors is tightly controlled by the number of medical school slots, and more importantly, the number of medical residencies. Those are both set by the Accreditation Council for Graduate Medical Education, a body dominated by physicians’ organizations. The United States, unlike other countries, requires physicians to complete a U.S. residency program to practice.

In recent years, the number of medical residents has become so restricted that even the American Medical Association is pushing to have the number of slots increased. The major obstacle at this point is funding. It costs a teaching hospital roughly $150,000 a year for a residency slot. Most of the money comes from Medicare, with a lesser amount from Medicaid and other government sources. The number of slots supported by Medicare has been frozen for two decades after Congress lowered it in 1997 at the request of the American Medical Association and other doctors’ organizations.


There are two parts to the high pay received by our doctors relative to doctors elsewhere, both connected to the same cause. The first is that our doctors get higher pay in every category of medical practice, including general practitioner.

The other reason that our physicians earn so much more is that roughly two-thirds are specialists. This contrasts with the situation in other countries, where roughly two-thirds of doctors are general practitioners. This means we are paying specialists’ wages for many tasks that elsewhere are performed by general practitioners.

And Medicare exerts little control over the fields of specialization in the residency slots it supports, largely leaving this up to the teaching hospitals, which have an incentive to offer residencies in specialties from which they can get the most revenue per resident. This means they are more likely to train someone in neurology or cardiology than as a family practitioner.



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Tuesday, September 10, 2019 3:26 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


Canada -
some doctors are hired directly by government, most are reimbursed by a fee-for-service schedule negotiated between doctors organizations and the government.



US -
https://www.ama-assn.org/about/research/employed-physicians-now-exceed
-those-who-own-their-practices

In 2018, 47.4% of practicing physicians were employed, while 45.9% owned their practices, according to a new entry in the AMA Policy Research Perspectives (PRP) series.

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Wednesday, September 11, 2019 1:07 AM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


http://www.canadaqbank.com/blog/2019/02/11/how-much-do-canadian-doctor
s-earn-in-a-year
/
as of 2018, Canadian doctors earned an average of $307,482 a year (Canadian dollars)


https://www.medscape.com/slideshow/2018-compensation-overview-6009667
Separate data from Medscape's 8th Physician Compensation Report for 2018 states that the average U.S. primary care physician earns $223,000 annually. Meanwhile, medical specialists earn an average of $329,000, as of 2018.


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Wednesday, September 11, 2019 1:14 AM

6IXSTRINGJACK


Quote:

Originally posted by SIGNYM:
Quote:

Originally posted by 6IXSTRINGJACK:
At the end of the day, insurance ponzi schemes are what have made medical care completely unaffordable. If doctors were only able to charge reasonable prices that people could actually afford to pay since the beginning, then the prices wouldn't be where they are right now.

Just look at the dental industry as an example. Most insurance, even the best private insurance people can pay for while working good jobs, don't cover much dental costs at all outside of 2 checkups and x-rays. Even when it does, it's usually not more than 20 percent of any procedures beyond a tooth pulling or capping.

Dentures for $3500 with all the teeth pulled out though?

Doesn't sound like a bad deal compared to a 5 minute ball massage with KY jelly in the early 2000's that cost me over $3000 out of pocket when I had a lump and was worried that I might have had testicular cancer. Wouldn't even want to know what that would cost in 2019.

Do Right, Be Right. :)

For whatever reason dentists still remain largely small practices which compete effectively with each other, not giant monopoly-style hospital-chain corporations.

Maybe the difference is that hospitals require so much more equipment: imaging equipment and laboratories and surgical suites and a phamacy that carries everything?

I dunno. Around here, most hospitals are giant complexes that sprawl thru multiple many-story buildings. The only one that I know is reasonable is (was?) a charity-based hospital started by the Catholic Church, it's still only one building and seems very well-run. But once you get past a certain size, then you need multiple layers of management to coordinate the multiple moving parts ... you need a director of pathology and a director of surgical services and the head of maintenance and the IT director and director of nursing services etc and THEY all report to the next layer up (chief officers?) which reports to the layer over that (hospital board, quality control...) and THEY report to corporate HQ... Seems like all I ever see nurses do is "charting". You can't have all of those moving parts w/o CYA paperwork!

-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY



I think the biggest reason is that when medicaid started the Government explicitly denied coverage for all things "oral". Insurance companies since then have hardly covered any dental, even in emergency cases and issues such as mine that will greatly impact overall health and longevity if the people can't afford to pay for it without insurance.

It's still expensive, but dental work is a downright bargain compared to health issues that are covered by insurance companies, medicaid and medicare. Dentists weren't able to raise the prices at magnitudes larger per year over inflation like doctors and hospitals were because they'd all go out of business with no customers that could afford their help.

Do Right, Be Right. :)

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Wednesday, September 11, 2019 1:33 AM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


2009 McAllen, Texas, the second highest per capita cost for medical care in the entire country

https://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum


McAllen is in Hidalgo County, which has the lowest household income in the country ... McAllen ... is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care.

One afternoon in McAllen, I rode down McColl Road with Lester Dyke, the cardiac surgeon, and we passed a series of office plazas that seemed to be nothing but home-health agencies, imaging centers, and medical-equipment stores. “Medicine has become a pig trough here,” he muttered. Dyke is among the few vocal critics of what’s happened in McAllen. “We took a wrong turn when doctors stopped being doctors and became businessmen,” he said.

When you look across the spectrum from Grand Junction to McAllen—and the almost threefold difference in the costs of care—you come to realize that we are witnessing a battle for the soul of American medicine. Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough is seeing a doctor. And the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue.

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Wednesday, September 11, 2019 1:39 AM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.



2015 McAllen, Texas, an average per capita cost for medical care in the entire country

https://www.vox.com/2015/5/6/8560365/health-care-gawande-mcallen


This is partly a story about McAllen, and what happens to a city that becomes synonymous with bad health care. Doctors there, as Gawande writes, began to reevaluate the type of care they provided.

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Wednesday, September 11, 2019 1:39 AM

SIGNYM

I believe in solving problems, not sharing them.


This is about the UVA story

https://www.washingtonpost.com/health/uva-has-ruined-us-health-system-
sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/2019/09/09/5eb23306-c807-11e9-be05-f76ac4ec618c_story.html?utm_source=pocket-newtab


-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY

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Wednesday, September 11, 2019 11:16 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.



So, I've been posting about healthcare and health for a long time (a small sampling is found below). And I've made the point a few times that the problem with US healthcare goes far deeper than who's paying for it.

It starts with medical schools and doctors, and goes up through for-profit hospitals and insurance companies and rapacious drug companies, and all the way down to disposable bedpan and non-sterile gauze vendors.

I've described it as a pool of cutthroats trying to take advantage of each other (for example, where the wheelmaker rips-off the wheelchair vendor, and the wheelchair vendor rips-off the clinic, and the clinic rips-off Medicare), but ultimately passing the costs on to the consumers/ taxpayers who get stuck for all of it.

I started profiling the differences between Canada and the US regarding medical schools, tuitions, per capita number of doctors, percentage of specialists, how doctors are compensated, and even 'what motivates doctors'.

And I don't think our problems are entirely structural and fixable by structural changes (even though many changes would deeply improve the situation, I can't think of any that are beyond gaming.)

And I think it's a legitimate ethics difference. In the US profit is king. Anything that makes a profit = good, anything that doesn't make a profit = bad, anything provided as a service = evil communism. It equates social value (even necessity) with money, when it's anything but. And in the US there's still a cachet associated with the title (rich) doctor. (As opposed to say a veterinarian or dentist.) Many people go to med school to GET RICH, and they're willing to put up with financial and personal hardship just to get there.

On top of that medical schools severely limit the number of students, and medical associations severely limit the number of residencies; AND both the residency programs AND the residents-to-be trend away from primary care and toward far more lucrative specialties. And that leads to a shortage of doctors society needs most, which are general practitioners; and an excess of specialists looking to make money off of their skills ... which is why the US has roughly 2x more knee replacements per capita than other industrialized countries. ( https://www.sciencedirect.com/science/article/pii/S1063458415011656) (And unnecessary, ineffective, and even dangerous surgeries follow trends - hysterectomies, tonsillectomies, gall bladder removals, ear tubes, back surgeries, arthroscopies ... and so on.)

The argument's been made that to change society we need to change what gets rewarded. And that would be an interesting experiment (though I'm at a loss as to how to configure that and implement it).

But I look at most doctors, and they're just - yanno - running the maze on their way to the cheese, preferably the biggest piece possible. Then you see some doctors like those at the Mayo clinic or the collective in Grand Junction - and they've made a deliberate decision to step out of the routine, to not focus on profit, and to get together as a group to get the patient truly well. (BTW - that was the original and is apparently the still-surviving MO of Dr. Mayo's very first practice.) And then you see the doctors of McAllen, TX pushing the profit motive to the max, and pushing the patients' welfares right out of the picture - not doing anything ILLEGAL, mind you. Just unethical. Charging literally the second most per capita in the entire US for medical care - 300% the national average for patients no sicker, not getting better care, and in an area not more expensive to operate in - in the poorest county in the country.

So, when it comes to those particular individual doctors in McAllen - if anyone wanted to - they could have been individually and specifically named and shamed. And after the article came out, I'm sure they experienced some collective embarrassment which is why they (apparently) changed their ways.

But the point is they felt no apparent shame ahead of time, or during those years where they carried on raking in the dough with both hands.

So, you can set all different kinds of reward systems.* And I think they would be helpful for the majority of doctors if a new ethic of doctoring became the norm. But until the motivations change, doctors could also just end up gaming the system to get what they feel THEY DESERVE, despite whatever limits the system tries to impose on them.

* This is an interesting discussion of the positives and negatives of different reimbursement schemes and how they apply in the Canadian single-payer system. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.524.3764&
rep=rep1&type=pdf


and a breakdown of the gross salary of Canadian doctors (before overhead such as office, staff, and supplies) https://www.theglobeandmail.com/life/health-and-fitness/health/how-muc
h-are-canadian-doctors-paid/article7750697
/ . And this article explains how doctors' salaries in the US are double those in other western countries. https://www.politico.com/agenda/story/2017/10/25/doctors-salaries-pay-
disparities-000557





INSURANCE!
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=60258&p=1

Obamacare
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=60961&p=1

An Olive Branch to the Hillary Supporters
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=60977&p=1

What ever happened to Impeach the President & Repeal Obamacare?
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=60126&p=3

Aetna to pull out of ObamaCare ENTIRELY by 2018
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61654&p=1

Ocasio-Cortez' wish-list
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=62808&p=1

Identifying and treating “super-utilizers”
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61341&p=1

ACA
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61413&p=1

Waiting Lists for Single Payer Health Care
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61833&p=1




More Examples of the Crisis of Antibiotic Resistance
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=60421&p=1

Malaria Vaccine Trials Appear Successful, Study Reports
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61277&p=1

New Tuberculosis Therapy Could Be More Potent Than Current Treatments
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61340&p=1

Scripps Team Awarded $1.8M Grant to Develop Drugs for Heart Disease, RA (topic: public money, private profit)
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61345&p=1

Scientists Prove New Approach to Polio Vaccines Work (topic: synthetic, non-living vaccine)
http://www.fireflyfans.net/mthread.aspx?bid=18&tid=61350&p=1



“It was kind of mind blowing to realize that the country 50 miles away from where I live — that people could go to the doctor whenever they wanted and not have to take out their wallet.” B. Sanders And at half the per capita cost, too.

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Thursday, September 12, 2019 1:51 AM

6IXSTRINGJACK


Quote:

Originally posted by SIGNYM:
This is about the UVA story

https://www.washingtonpost.com/health/uva-has-ruined-us-health-system-
sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/2019/09/09/5eb23306-c807-11e9-be05-f76ac4ec618c_story.html?utm_source=pocket-newtab


-----------
Pity would be no more,
If we did not MAKE men poor - William Blake

You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY



I was under the mistaken impression that you couldn't lose your house for medical bills, nor had your wages garnished.

If that ever happens to me, I'll quit my job. I'd rather starve to death.

Fuck them.

Do Right, Be Right. :)

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Thursday, September 12, 2019 2:25 AM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


On to differences in hospitals between Canada, and the US.

http://www.cwhn.ca/en/node/39754
Although almost all Canadians believe hospitals are publicly owned and accountable institutions, under provincial legislation 95% operate on a non-profit basis. Most of Canada's approximately 850 hospitals are owned and operated by non-profit, voluntary organizations.
(Though de-listing services and departments, and outsourcing have allowed aggressive for-profit acquisitions. -1kiki)

https://www.beckershospitalreview.com/hospital-management-administrati
on/50-things-to-know-about-the-hospital-industry-2017.html

4. Out of total registered hospitals, about 20.2 percent are state-owned, 58.5 percent are nonprofit and 21.3 percent are for-profit.


FWIW I've worked in the VA, an extremely large county hospital, an extremely large for-profit private hospital, an extremely large non-profit private hospital, a private medical group, and a religious-owned community hospital.

And I have never seen such shenanigans as those at the extremely large for-profit private hospital.

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Thursday, September 12, 2019 2:48 AM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


I hope to continue with medical insurance companies.

“It was kind of mind blowing to realize that the country 50 miles away from where I live — that people could go to the doctor whenever they wanted and not have to take out their wallet.” B. Sanders And at half the per capita cost as in the US.

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Friday, September 13, 2019 1:19 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


I just wanted to point out this one example of the totality of our medical care's systemic rip-off: Lazarus: When a hospital sling costs 900% more than Amazon’s price, something is very wrong https://www.latimes.com/business/story/2019-09-12/medical-equipment-pr
icing


It's not just medical insurance companies that need reform.

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Friday, September 13, 2019 3:18 PM

1KIKI

Goodbye, kind world (George Monbiot) - In common with all those generations which have contemplated catastrophe, we appear to be incapable of understanding what confronts us.


Medical Debt is Crushing Many Americans. Is the Health Care System on the Verge of Collapse?

As I've posted before, Obamacare is a failure when it comes to two statistics: death rates from chronic diseases which have edged up slightly under its full implementaton, and medical bankruptcy rates which haven't gone down. https://www.eurekalert.org/pub_releases/2019-02/pfan-6ob020719.php

Roughly 80% of people will get better whether they see a doctor or not, and whether that the doctor does anything or not - and that's because most doctors' visits are due to self-limiting conditions.

When you really need medical care is when you're managing a chronic condition, and when you're suffering from a serious accident or illness.

Obamacare - no it doesn't cover that. Obamacare makes sure you have insurance despite pre-existing conditions. And it mandates free screening for things like hypertension, diabetes, or breast cancer.

But getting treatment for those pre-existing conditions? Or for illnesses that might be discovered by your free screening? Or for anything else that might come up? And its cost?

That's between you and your insurance company.







https://www.theorganicprepper.com/medical-debt-is-crushing-many-americ
ans-is-the-health-care-system-on-the-verge-of-collapse
/

Medical Debt is Crushing Many Americans. Is the Health Care System on the Verge of Collapse?

By Dagny Taggart

Health care expenses are a massive burden for many Americans, and for some, they can be financially devastating.

A new report from Kaiser Health News revealed some shocking examples of just how bad things can get for some people.

‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes covers the cases of individuals who are dealing with serious financial hardship due to the University of Virginia Health System’s aggressive collection practices.

The article begins with the story of Heather Waldron, who required emergency surgery in 2017. She believed she had insurance at the time – it wasn’t until after her hospitalization that she learned a computer error involving the HealthCare.gov website caused a lapse in her coverage.

The UVA health system slapped Waldron with a lawsuit and a lien on her home to recoup the $164,000 in charges, leading to serious financial hardship for her family:

She is now on food stamps and talking to bankruptcy lawyers. A bank began foreclosure proceedings in August on the Blacksburg house she shared with her family. The home will be sold to pay off the mortgage.

She expects UVA to take whatever is left.

The $164,000 billed to Heather Waldron for intestinal surgery was more than twice what a commercial insurer would have paid for her care, according to benefits firm WellRithms, which analyzed bills for Kaiser Health News using cost reports UVA files with the government. Charges on her bill included $2,000 for a $20 feeding tube. (source)

Waldron is not alone. There are many stories similar to hers – and some are much worse.
The UVA Health System aggressively pursued patients for medical bills for years.

The Kaiser Health News (KHN) analysis found that during a six-year period ending in June 2018, “the UVA health system and its doctors filed 36,000 lawsuits against patients seeking a total of more than $106 million, seizing wages and bank accounts, putting liens on property and homes and forcing families into bankruptcy.”

People who have received treatment in the UVA system are facing a particularly formidable opponent. “UVA stands out for the scope of its collection efforts and how persistently it seeks payment, pursuing poor as well as middle-class patients for almost all they’re worth,” the KHN report explains. Court records, documents, and interviews with hospital officials and dozens of patients revealed that UVA has sued people for as much as $1 million and as little as $13.91.

The system has garnished thousands of paychecks, seized $22 million over six years in state tax refunds owed to people with outstanding bills, sued about 100 patients every year who were their own system’s employees, filed thousands of property liens, and hit some patients with legal fees and interest that added up to more than the original bill. UVA has the most restrictive eligibility guidelines for financial assistance of any hospital system in Virginia. “Savings of only $4,000 in a retirement account can disqualify a family from aid, even if its income is barely above the poverty level,” KHN reports.

UVA Health System spokesman Eric Swensen told KHN that UVA gave $322 million in financial assistance and charity care in fiscal 2018. But legal and finance experts said that’s not a reliable estimate:

The $322 million “merely indicates the amount they would have charged arbitrarily” before negotiated insurer discounts, said Ge Bai, an accounting and health policy associate professor at the Johns Hopkins Carey Business School.

The figure is “based on customary reporting standards used by hospitals across the U.S.,” Swensen said.

Insurers would have paid UVA only $88 million for that care, according to an accounting of unpaid bills presented in September 2018 to the UVA Health board. Even that unpaid figure did not come out of UVA’s purse since federal and state governments provided “funding earmarked to cover indigent care” for almost all of it — $83.7 million, according to Bai.

The real, “unfunded” cost of UVA indigent care: $4.3 million, or 1.3% of what it claims, according to the document.

“That’s nothing,” given how much money UVA makes, Bai said. “Nonprofit hospitals advance their charitable mission primarily through providing indigent care.” (source)

Perhaps the most surprising detail about the UVA Health System is that it is not a for-profit system and does not have shareholders making demands. It is funded with taxpayer and state money (also taxpayer money, of course):

Like other nonprofit hospitals, it pays no federal, state or local taxes on the presumption it offers charity care and other community benefits worth at least as much as those breaks. Democratic Gov. Ralph Northam, a pediatric neurologist, oversees its board.

UVA Medical Center, the flagship of UVA Health System, earned $554 million in profit over the six years ending in June 2018 and holds stocks, bonds and other investments worth $1 billion, according to financial statements. CEO Sutton-Wallace earns a salary of $750,000, with bonus incentives that could push her annual pay close to $1 million, according to a copy of her employment contract, obtained under public information law. (source)

Other hospitals in the US are suing patients too.

Recently, journalists and academics have exposed hospital collections practices in Baltimore, Memphis, New Mexico, North Carolina, Nebraska, and Ohio. In 2014, NPR and ProPublica published stories about a hospital in Missouri that sued 6,000 patients over a four-year period.

NPR recently reported on collection practices at Mary Washington, another Virginia hospital. According to their report, Mary Washington sues so many patients that the court reserves a morning every month for its cases.

Since KHN and NPR exposed the collection practices at the two Virginia hospitals, both have stated they are going to change their ways.

“Gov. Ralph Northam and the president of the University of Virginia committed to changing UVA Health System’s collections practices a day after Kaiser Health News detailed its aggressive and widespread pursuit of former patients for unpaid medical bills,” KHN reported.

NPR added an Editor’s note to its June 25 article about Mary Washington that states:

The day after this story published, Mary Washington Healthcare announced it will suspend its practice of suing patients for unpaid bills, stating: “We are committed to a complete re-evaluation of our entire payment process to ensure that all patients know they have access to care.” When asked what they will do about any patient whose wages are currently being garnished, Eric Fletcher, Mary Washington’s senior vice president, said in a statement to NPR: “We are happy to try to work with that patient and the courts and their employer to try to eliminate the garnishment.” (source)

According to a study published in the American Medical Association’s journal, JAMA in June, an estimated 20% of US consumers had medical debt in collections in 2014. Medical debt has been increasing with direct patient billing, rising insurance deductibles, and more out-of-network care being delivered, even at in-network facilities.

For the JAMA study, researchers looked at Virginia court records from 2017 and found that in the state, 36% of hospitals sued patients and garnished their wages in 2017. They identified 20,054 warrant-in-debt lawsuits and 9232 garnishment cases. Garnishments were MORE common in non-profit hospitals (71%).

“If you’re a nonprofit hospital and you have this mission to serve your community, [lawsuits] should really be an absolute last resort,” says Jenifer Bosco, staff attorney at the National Consumer Law Center, told NPR:

Bosco explains that IRS rules require nonprofit hospitals to have financial assistance programs and prohibit them from taking “extraordinary collection actions” on unpaid medical bills without first attempting to determine patients’ eligibility for financial assistance.

Nonprofit hospitals, Bosco says, “have to provide some sort of financial help for lower-income people, but the federal rules don’t say how much help, and they don’t say how poor you have to be to qualify [or] if you have to be insured or uninsured.” (source)

“Hospitals were built — mostly by churches — to be a safe haven for people regardless of one’s race, creed or ability to pay. Hospitals have a nonprofit status — most of them — for a reason. They’re supposed to be community institutions,” Dr. Martin Makary, one of the JAMA study’s authors and a surgeon and researcher at Johns Hopkins Medicine, told NPR.
Unpaid hospital bills are a leading cause of personal debt and bankruptcy in the US.

According to a study published in the American Journal of Public Health earlier this year, 66.5 percent of all bankruptcies in the US are tied to medical issues, either because of high costs for care or time out of work. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills, the researchers found.

The study, titled Medical Bankruptcy: Still Common Despite the Affordable Care Act, states, “Despite gains in coverage and access to care from the ACA, our findings suggest that it did not change the proportion of bankruptcies with medical causes.”

Prior to the ACA’s implementation in 2014, 65.5 percent of debtors reported medical reasons for filing bankruptcy. After the Act was implemented, 67.5 percent cited medical expenses as their reason. In 2007, an estimated 62.1 percent cited medical bills as contributors to their bankruptcy, and 40.3% cited income loss due to illness.

Other studies have found that at least 25 percent and as many as 50 percent of bankruptcies include significant medical debt, according to a recent report from The Balance.

One study found that the insured were a bit more likely to declare bankruptcy (3 percent) than the uninsured (1 percent), The Balance reports:

Most probably thought their insurance protected them from medical costs. They weren’t prepared to pay for unexpected deductible and coinsurance costs. Almost a third weren’t aware that a particular hospital or service wasn’t part of their plan. One-in-four found that the insurance denied their claims.

How did those with insurance wind up with so many bills? After high deductibles, co-insurance payments, and annual/lifetime limits, the insurance ran out. Other companies denied claims or just canceled the insurance. (source)

According to GoFundMe CEO Rob Solomon, one-third of the donations made through the site help people pay for medical care. Roughly 250,000 campaigns for assistance with medical bills and healthcare costs are set up on the crowdfunding site annually, raising total contributions of $650 million per year.
Millions of Americans are struggling to pay healthcare-related costs.

Even Americans who have insurance coverage are struggling to afford medical bills. As the research shows, health insurance won’t completely protect you. Many people have been bankrupted by high deductibles and other out-of-pocket expenses. This is why you should try to have at least the amount of your deductible in savings.

Rising healthcare costs have serious implications for many Americans. According to a recent report from The Balance, many people cannot afford groceries, rent, and clothing due to medical costs. Many have burned through their savings, and others have taken on extra work to pay medical bills. Some cut back on or skip prescription medications and follow-up care, and many rack up credit card debt and use loans to pay for healthcare expenses.

Here are some more troubling facts from The Balance report:

In 2015, the Kaiser Family Foundation found that there were 1 million adults who declared medical bankruptcy. That is more than those going bankrupt for unpaid credit card debt or mortgage defaults. A 2013 Nerdwallet study found that almost 30 percent maxed out their credit cards, while 8 percent were forced into bankruptcy because the illness cost them their jobs.

Even more disturbing was that 78 percent of them had health insurance that failed to cover all their bills. Sixty percent were let down by private insurance, not Medicare or Medicaid. Ten million of them will incur medical costs they can’t pay off each year, thanks to high-deductible plans.

How did those with insurance wind up with so many bills? Before the ACA, many were sunk by annual and lifetime limits. Others were stuck when insurance companies denied claims or just canceled the policy once they got sick.

But even after Obamacare, many weren’t prepared for high deductibles and co-insurance payments. In 2017, 31 percent of the insured found it difficult to afford copays. That’s up from 24 percent in 2015, according to a Kaiser Family Foundation study. Similarly, 43 percent found deductibles too high, compared to 34 percent in 2015. (source)

What are the causes of rising health care costs?

A recent report from The Balance answered this question. Here are some shocking statistics from that report:

In 2017, U.S. health care costs were $3.5 trillion. That makes health care one of the country’s largest industries. It equals 17.9 percent of gross domestic product. In comparison, health care cost $27.2 billion in 1960, just 5 percent of GDP. That translates to an annual health care cost of $10,739 per person in 2017 versus just $146 per person in 1960. Health care costs have risen faster than the average annual income. (source)

There are two causes of this massive increase – government policy and lifestyle changes, the report goes on to explain:

First, the United States relies on company-sponsored private health insurance. The government created programs like Medicare and Medicaid to help those without insurance. These programs spurred demand for health care services. That gave providers the ability to raise prices. A Princeton University study found that Americans use the same amount of health care as residents of other nations. They just pay more for them. For example, U.S. hospital prices are 60 percent higher than those in Europe. Government efforts to reform health care and cut costs raised them instead.

Second, chronic illnesses, such as diabetes and heart disease, have increased. They are responsible for 85 percent of health care costs. Almost half of all Americans have at least one of them. They are expensive and difficult to treat. As a result, the sickest 5 percent of the population consume 50 percent of total health care costs. The healthiest 50 percent only consume 3 percent of the nation’s health care costs. Most of these patients are Medicare patients. The U.S. medical profession does a heroic job of saving lives. But it comes at a cost. Medicare spending for patients in the last year of life is six times greater than the average. Care for these patients costs one-fourth of the Medicare budget. In their last six months of life, these patients go to the doctor’s office 29 times on average. In their last month of life, half go to the emergency room. One-third wind up in the intensive care unit. One fifth undergo surgery. (source)

The best way to avoid medical debt is by taking care of yourself.

Accidents are often not preventable, and neither are some health conditions.

But many of the health issues that lead to massive medical debt are preventable, including obesity, Type 2 diabetes, and heart disease.

A 2014 study published in The Lancet revealed that

… chronic diseases are the main causes of poor health, disability, and death, and account for most of health-care expenditures. The chronic disease burden in the USA largely results from a short list of risk factors—including tobacco use, poor diet and physical inactivity (both strongly associated with obesity), excessive alcohol consumption, uncontrolled high blood pressure, and hyperlipidaemia—that can be effectively addressed for individuals and populations. (source)


“It was kind of mind blowing to realize that the country 50 miles away from where I live — that people could go to the doctor whenever they wanted and not have to take out their wallet.” B. Sanders
And at half the per-capita cost as the US.

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