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Old 02-16-2017, 11:26 AM   #3931
Greedy,Greedy,Greedy
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Re: I used to be disgusted, and now I try to be amused.

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Originally Posted by sebastian_dangerfield View Post
No one's ever had cheap preventative care to credibly test that theory. And a theory is all that is.

A true market price has never existed for preventative care since the 40s, when a TPA system was introduced and warped the market.

If what I'm proposing were introduced, all costs, including preventative care, would fall radically. And insurers acting as TPAs would infect the marketplace 1/10th as much as they do now.

You don't trust average Joe to take care of himself if he saved 50-60% on premiums and a similar percentage on preventative care?

The argument you offer is one used by half shrewd minds to disguise "we need insurers and govt. to manage people's health care" as economically wise policy.* (And really, is a guy who doesn't use TPA administered preventative care somehow going to use it less when it's cheaper and easier to buy directly? How's that even possible?) If we make health care truly cheap and people choose to spend elsewhere, that's their foolish choice. At least the cost of the catastrophic care they'll inevitably require will also be cheap, so the burden to those of us carrying them will still be less than it is now.
_____
* I don't think you're using it that way. I think you believe it economically refutes my proposal. For a lot of others, however, it's dressing up nanny state aims as math-supported policy.
My god this is stupid silly word salad. (Insert exasperated emoji).

We have cheap preventive care now. Every payor consciously keeps it below what a market price would be. So the first statement is just patently wrong and unthought out, and it just keeps going further off the skids from there.

And preventive care is going to be a few cents out of every healthcare dollar you spend. Do we need to type slower for you? Cutting the cost of preventive care in HC is like cutting the cost of the paper your big mac is wrapped in.

I understand your motive behind the word salad is to scream "free markets solve everything". But if you aren't going to even attempt to do a cogent analysis based on actual facts, why should anyone pay attention? Free markets clearly haven't solved your analytical problems.
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Old 02-16-2017, 11:32 AM   #3932
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Re: I used to be disgusted, and now I try to be amused.

Quote:
Originally Posted by sebastian_dangerfield View Post
I think you're all "in the box" on this one.* Envision a situation in which costs for preventative care, premiums, and catastrophic and chronic condition care are all decreased by greater than 50%. How in the hell could any TPA system beat that?

It's doable, and it would involve removing all TPA structures (except for catastrophic and chronic condition care). Think of the savings if insurers only provided actual insurance, and a market for affordable preventative care existed.

You're seeing it already, and you're going to see it a lot more as people move into concierge arrangements. It works, it provides value, and it creates a better direct doc to patient relationship.

* Hi Flower!
Hi! Being inside the box is the new thinking outside the box. It was scary outside the box and that made it hard to think straight and we started making crazy predictions about what would happen in the future. Crazy predictions that we insisted were absolutely certain to come true even though they were based not on facts or information, but rather on nothing more than our scared and muddled outside-the-box thinking. Then everything got completely fucked. So I'll be thinking inside the box, thank you very much.
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Old 02-16-2017, 11:34 AM   #3933
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Re: I used to be disgusted, and now I try to be amused.

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Originally Posted by Greedy,Greedy,Greedy View Post
My god this is stupid silly word salad.

We have cheap preventive care now. Every payor consciously keeps it below what a market price would be. So the first statement is just patently wrong and unthought out, and it just keeps going further off the skids from there.

And preventive care is going to be a few cents out of every healthcare dollar you spend. Do we need to type slower for you? Cutting the cost of preventive care in HC is like cutting the cost of the paper your big mac is wrapped in.

I understand your motive behind the word salad is to scream "free markets solve everything". But if you aren't going to even attempt to do a cogent analysis based on actual facts, why should anyone pay attention? Free markets clearly haven't solved your analytical problems.
Done
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Old 02-16-2017, 11:37 AM   #3934
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Re: I used to be disgusted, and now I try to be amused.

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Envision a situation in which costs for preventative care, premiums, and catastrophic and chronic condition care are all decreased by greater than 50%.

I'm now envisioning Canada. It's very cold and snowy. Someone has put the Tragically Hip on. When I go in the bar they have 80 kinds of beer but no Bud or Miller. They have the hockey game on with the sound turned down, there's a fire in the fireplace, and Justin Trudeau is pulled up in an easy chair with his shirt off, surrounded by a multi-cultural cabinet.

This is great. Thanks.
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Old 02-16-2017, 11:38 AM   #3935
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Re: I used to be disgusted, and now I try to be amused.

Wonking.

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I neither wanted, nor didn't want, either of these people to be President. But he is a lunatic
These two thoughts cause you no cognitive dissonence?

Quote:
so it is only logical to infer voters were really fucking angry if they took the step of voting for someone like him.
Or they didn't think he was a lunatic.

Securing the border, keeping the Muslims out and blowing up trade deals are reasonable positions to a whole lot of people. Casually racist and xenophobic people.

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I assumed she'd win, but I'm not sure I wouldn't have have voted third party no matter how close it was.
Sure, what's empowering a lunatic when you can make a meaningless gesture? Especially when you agree with the person you otherwise could have voted for something like 65% of the time.

Quote:
I was considering voting for her out of fear the market would get crushed, but another part of my brain was saying, "the Fed can fight whatever may come - even Trumpocalypse."
"Falsely propping up asset prices to benefit the banks!"

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And none who believe your argument that we're at fault.
Taking personal responsibility is really hard.

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1. Where do they get off blaming us for their own candidate's failure?
You just said there was literally nothing that would have made you vote for her. That's your failure, not her's.
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Old 02-16-2017, 11:39 AM   #3936
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Re: I used to be disgusted, and now I try to be amused.

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Done
Thanks.
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Old 02-16-2017, 11:40 AM   #3937
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Re: I used to be disgusted, and now I try to be amused.

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I figured Trump risk was low, as he was a closet centrist.
You are not allowed to express a judgment on anything ever again. God damn.

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Old 02-16-2017, 12:16 PM   #3938
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I wish that I could be there right now, just passin' time.

Quote:
Originally Posted by Greedy,Greedy,Greedy View Post
I'm now envisioning Canada. It's very cold and snowy. Someone has put the Tragically Hip on. When I go in the bar they have 80 kinds of beer but no Bud or Miller. They have the hockey game on with the sound turned down, there's a fire in the fireplace, and Justin Trudeau is pulled up in an easy chair with his shirt off, surrounded by a multi-cultural cabinet.

This is great. Thanks.
Ok, Not Bad. It's the Leafs playing the Habs, and I'm the only Not Francophone pulling for Montreal.

While I prefer his mother in her Studio 54 days:



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Old 02-16-2017, 12:33 PM   #3939
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Re: I wish that I could be there right now, just passin' time.

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Ok, Not Bad. It's the Leafs playing the Habs, and I'm the only Not Francophone pulling for Montreal.

I'm Not Judgy. You do you, man. Know that You're Not Alone:
I'm more into the multi-cultural cabinet, myself.



But, it's important to get the full image.
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Old 02-16-2017, 12:46 PM   #3940
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Re: I used to be disgusted, and now I try to be amused.

Quote:
Originally Posted by sebastian_dangerfield View Post
I think you're all "in the box" on this one.* Envision a situation in which costs for preventative care, premiums, and catastrophic and chronic condition care are all decreased by greater than 50%. How in the hell could any TPA system beat that?

It's doable, and it would involve removing all TPA structures (except for catastrophic and chronic condition care). Think of the savings if insurers only provided actual insurance, and a market for affordable preventative care existed.

You're seeing it already, and you're going to see it a lot more as people move into concierge arrangements. It works, it provides value, and it creates a better direct doc to patient relationship.

* Hi Flower!
I can't figure out why you think that having consumers negotiate what preventative care they want and how much they'll pay for it is going to lead to better outcomes and lower prices than having coverage providers do it. Most people I know -- you may be the exception here -- really would prefer not to have to negotiate these things, both because of information asymmetries and because it's a pain in the ass.
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Old 02-16-2017, 02:02 PM   #3941
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Re: I used to be disgusted, and now I try to be amused.

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I can't figure out why you think that having consumers negotiate what preventative care they want and how much they'll pay for it is going to lead to better outcomes and lower prices than having coverage providers do it. Most people I know -- you may be the exception here -- really would prefer not to have to negotiate these things, both because of information asymmetries and because it's a pain in the ass.
The times you need to negotiate are also a bit of a problem.

"This man just had a heart attack!"

"OK, surgery is $20,000. Will that be cash or check?"

"I'd like a discount."

"Discount department is out to lunch. They can talk to you in an hour. Please, have a seat."
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Old 02-16-2017, 02:27 PM   #3942
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Re: I used to be disgusted, and now I try to be amused.

That was quite the Trump press conference. I truly cannot stand to hear that man talk.

Maybe it's just thing on Twitter, but I have seen several calls from the Resistance to go all Tea Party and start running progressives in primaries against Dems who vote for Trump nominees. I know I do not have a vested interest in the success of such an endeavor, but it doesn't seem to me that primary challenging red state Democrats is a winning strategy. I do not believe that the proponents of such a plan grasp the fact that an Elizabeth Warren candidate probably won't run well in West Virginia, or other states that went for Trump. With a few exceptions, most Tea Party challenges were in pretty safely red states.
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Old 02-16-2017, 02:52 PM   #3943
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Re: I used to be disgusted, and now I try to be amused.

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That was quite the Trump press conference. I truly cannot stand to hear that man talk.

Maybe it's just thing on Twitter, but I have seen several calls from the Resistance to go all Tea Party and start running progressives in primaries against Dems who vote for Trump nominees. I know I do not have a vested interest in the success of such an endeavor, but it doesn't seem to me that primary challenging red state Democrats is a winning strategy. I do not believe that the proponents of such a plan grasp the fact that an Elizabeth Warren candidate probably won't run well in West Virginia, or other states that went for Trump. With a few exceptions, most Tea Party challenges were in pretty safely red states.
Agreed completely. The Democratic Party will do best on a big tent strategy. I'd even welcome the likes of you to the party.

Does it mean we will have Democrats agree with each other 100% of the time, the way the Rs generally do right now? Probably, but perhaps that's a good thing.
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Old 02-16-2017, 03:23 PM   #3944
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Re: I used to be disgusted, and now I try to be amused.

Quote:
Originally Posted by sebastian_dangerfield View Post
I think you're all "in the box" on this one.* Envision a situation in which costs for preventative care, premiums, and catastrophic and chronic condition care are all decreased by greater than 50%. How in the hell could any TPA system beat that?

It's doable, and it would involve removing all TPA structures (except for catastrophic and chronic condition care). Think of the savings if insurers only provided actual insurance, and a market for affordable preventative care existed.

You're seeing it already, and you're going to see it a lot more as people move into concierge arrangements. It works, it provides value, and it creates a better direct doc to patient relationship.

* Hi Flower!
I'm sorry that I don't think about the health care system, preventative care, or providers as much as you do.
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Old 02-16-2017, 03:41 PM   #3945
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Re: I used to be disgusted, and now I try to be amused.

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I'm sorry that I don't think about the health care system, preventative care, or providers as much as you do.
ouch
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