patrick.net

CL says

How did they work exactly? Who paid for the "winners", and what happened to the losers? Were the people selected at random?

We've had at least one thread on Oregon's lottery.

"with no discernible improvement in [purported beneficiaries'] health."

"Researchers found no measurable health benefits in the Medicaid group for several chronic conditions, including hypertension, high cholesterol and diabetes."

All taxpayers paid, a few "winners" were selected at random, though they were "winning" like Charlie Sheen, i.e. the purported beneficiaries did not benefit. But, spending (including emergency hospitalizations) increased, which is to say the lobbyists' revenues increased, so from their POV it was a huge success.

Sounds like the Hunger Games

Dan8267 says

Sounds like the Hunger Games

In SF, we have housing lotteries also. At least in those, a few lucky winners get a roof over their heads at a reasonable cost. It doesn't excuse the policies that make housing unaffordable for almost everyone else, but the formula is very similar: artificially raise prices beyond the point of pain, then give a break to a few lucky winners. The difference is, lottery housing tends to be structurally sound; to make it more like the OP question, you'd need leaky roofs and toxic mold and rotten stairs that people can fall through, and of course the retail prices would need to be much higher.

curious2 says

All taxpayers paid, a few "winners" were selected at random, though they were "winning" like Charlie Sheen, i.e. the purported beneficiaries did not benefit. But, spending (including emergency hospitalizations) increased, which is to say the lobbyists' revenues increased, so from their POV it was a huge success.

I have a friend who was in Indiana's Lottery and 'won". I am under the impression that those were all closed and likely went to PCIP under ACA.

My questions are about how they used to work.

He says he paid BCBS for his premiums and that it was cheap, even though he has a chronic illness and high income.

If that is the case (and it might not be), then were the plans subsidized?

Was it Indiana using Medicaid dollars to achieve this?

Any other comments or outrages?

CL says

he has a chronic illness

Was he cured?

BCBS is a brand name owned by Wellpoint. If they gave him a discount or subsidy, but did not cure him, who do you think paid for the chronic treatments?

If they converted his chronic illness into an infinite revenue model ("no lifetime caps"), who won?

curious2 says

CL says

he has a chronic illness

Was he cured?

BCBS is a brand name owned by Wellpoint. If they gave him a discount or subsidy, but did not cure him, who do you think paid for the chronic treatments?

If they converted his chronic illness into an infinite revenue model ("no lifetime caps"), who won?

This was prior to ACA. They did not cure him (He has MS, so I don't think there are cures for that). His management is expensive, and he found them affordable through the lottery.

I assume the State paid for his care via a subsidy that he is unaware of. I would also assume that the State was allowed to implement their Medicaid policies with some latitude, which the lottery was part of.

Is that correct?

CL says

I don't think there are cures for that). His management is expensive....

At what point do you consider those two facts might be related? How many reports do you need to see that (a) Obamneycare increases funding for "management" of chronic conditions (with "no lifetime caps") while (b) sequestration cuts funding for research that might lead to cures and disrupt the expensive (read: lucrative) "management"? The two deals were brought to you by the same people, and maximize revenue and power for those same people; do you imagine them to be entirely coincidental? Do you consider the opposite policy choice (more research funding to find cures and less funding for chronic "management") might produce different results? With STEM graduates unemployed or underemployed, and research funding cut, is your "friend" happily investing in PhRMA stocks and saying gee what a wonderful policy environment we have here?

BTW, have I learned your language of endless rhetorical questions? Can you hear me now?

curious2 says

CL says

I don't think there are cures for that). His management is expensive....

At what point do you consider those two facts might be related? How many reports do you need to see that (a) Obamacare increases funding for "management" (with "no lifetime caps") while (b) sequestration cuts funding for research that might lead to cures and disrupt the expensive (read: lucrative) "management"? The two deals were brought to you by the same people, and maximize revenue and power for those same people; do you imagine them to be entirely coincidental?

Isn't communicating with endless question marks fun? Especially with no links to any sources of information? Gosh we must be having gangs of fun by now.

Sorry. What exactly does that have to do with State Lotteries???
??
??
??
??
??

CL says

What exactly does that have to do with State Lotteries?

Well, I provided the only links to information about state lotteries in this thread, then you asked, "Any other comments or outrages?" Were you going off topic in your own thread, and then surprised someone answered your later question too? Do I need more practice to realize all of your questions are rhetorical?

curious2 says

Dan8267 says

Sounds like the Hunger Games

In SF, we have housing lotteries also. At least in those, a few lucky winners get a roof over their heads at a reasonable cost. It doesn't excuse the policies that make housing unaffordable for almost everyone else, but the formula is very similar: artificially raise prices beyond the point of pain, then give a break to a few lucky winners.

They should make children fight to the death for housing and health care. Sell tickets to the rich and we'll balance the budget. You could also sell other things like rounds of ammunition the rich can shoot at the children who are battling in the Thunderdome. Why does San Francisco hate innovation?

curious2 says

CL says

What exactly does that have to do with State Lotteries?

Well, I provided the only links to information about state lotteries in this thread, then you asked, "Any other comments or outrages?" Were you going off topic in your own thread, and then surprised someone answered your later question too? Do I need more practice to realize all of your questions are rhetorical?

Got it. Nice work! And thank you for your diligence.

I asked re: outrages because normally some overly bitchy commenter would be able to slip in their complaints about the system in question, like lotteries.

http://www.in.gov/sba/files/BC_Hearing_2012_ICHIA_Program_Overview.pdf

Found that PDF.

"Funding:
ICHIA is funded by three entities. The participants
pay a premium that is approximately 50% of the total
cost of the program. The remaining cost, referred to as Net Losses, are shared by the health insurance companies operating in Indiana, and the State. The carriers’ share of the Net Losses is 25%, and the
State pays the remaining 75%. Tax credits previously granted to carriers have been eliminated for assessments paid after January 1, 2005. "

Does that mean that even the 25% that was paid into the program was offset by tax credits?

Maryland wasted 300Million on a state healthcare website that doesn't work. I figure it's the contractors who won. The losers are the taxpayers here, but of course the Democrats here don't care about taxpayers.

zzyzzx says

Maryland wasted 300Million on a state healthcare website that doesn't work. I figure it's the contractors who won. The losers are the taxpayers here, but of course the Democrats here don't care about taxpayers.

The Indiana one goes back to 1981. Looks like a healthy dose of taxpayer cash provided care for the uninsurable. I'd say the free-market fails from time to time, even when Ronnie Raygun was President.

CL says

Looks like a healthy dose of taxpayer cash provided care for the uninsurable.

I'd say it looks like an unhealthy dose of taxpayer cash enabled prices to continue climbing higher than anywhere else on earth.

CL says

I'd say the free-market fails from time to time, even when Ronnie Raygun was President.

Since we haven't had a free market in most healthcare for several decades at least, Reagan's presidency can't really tell us whether a free market would succeed or fail.

We have had a relatively free market in one sector of healthcare though: OTC drugs. In that sector, the American market has delivered the lowest prices in the world, and wide consumer choice. In the sectors where government and insurance colluded to "help," i.e. where they imposed mandates and subsidies captured by providers, we've seen the highest prices in the world. Some people might say those facts are related.

In medicine as in housing, when supply is restricted, subsidies without price controls are captured by the sellers. When the price is driven higher than anywhere else on earth, the purported beneficiaries are mainly conduits by which subsidies are transferred to providers.

Blaming Reagan is less specious than claiming the Dems or the Government "caused" the problem. It's not like the free market delivered care to everyone prior TR, FDR, Truman or LBJ.

Old people lived worse prior to Medicare, right?

CL says

Old people lived worse prior to Medicare, right?

They lived about as long. To the extent quality of life may have improved, most of that is probably due to increasing Social Security and SSI payments, plus improvements in technology outside the Medicare sector. Most people on Medicare report that they are happy with the program, but many of them are getting useless surgeries that confer no benefit to anyone other than the providers, and many are getting hospitalized due to their drug "benefits", and many are getting killed by their hospital "benefits". I don't doubt that you can point to some genuine beneficiaries, but the forest is more complicated than the subset of anecdotal trees you can point to. In the aggregate, the actual benefit per dollar of spending is much lower in the medical sector than in almost any other, and a strong argument can be made that excessive spending is actually killing people.

Insurance is access, and many were uninsured prior to Medicare.

Life expectancy has increased, and countless don't die in or because of poverty. It would seem as though the "free-market" would price out the elderly, because care has gone up in price, and they would be facing higher premiums as their incomes dropped.

If access to whatever current offerings we have doesn't improve quality of life, where is the parallel universe we can go to the care we do want?

Even if it's some crappy drugs to mitigate pain, it's what we produced and are entitled to. You can argue we deserve better, or cheaper but it doesn't change a thing.

CL says

Insurance is access....

No, insurance is a contract. Read yours.

CL says

many were uninsured prior to Medicare.

Medicare exists, as does Medicaid, but whether they are insurance depends on what definition you use. Some people refer to Medicare as insurance, but does Medicare describe itself that way?

CL says

Life expectancy has increased...

surprisingly little in the Medicare population, less than 10 years in the 50 year history of the program, and most of that is due to other factors like fewer smokers.

CL says

countless don't die in or because of poverty.

Oh please, spare us. First of all, you're ignoring Medicaid. Second, most people who go bankrupt with medical bills they can't afford actually had insurance at the time of their last injury or illness.

CL says

It would seem as though the "free-market" would price out the elderly....

How on earth do you know that without even seeing one? You're substituting talking points for data. To the extent that we do have a free market, it's in OTC drugs, where you can't seriously argue anybody has been priced out - we have the lowest OTC drug prices of any country on earth.

CL says

because care has gone up in price

The price has gone up in large measure because of the American insurance and subsidy system, which has raised prices higher than anywhere else in the world. Nobody else, anywhere, has ever seen the price increases America has seen since government started "helping" with insurance. At what point do you consider that the "help" might actually be not for the purported beneficiaries, but rather for the revenue recipients who actually receive it? Do you ever consider that?

CL says

where is the parallel universe we can go to the care we do want?

LOL - sarcasm really helps.

CL says

Even if it's some crappy drugs to mitigate pain...

Since you mention analgesics, consider Vioxx (Rx), Bextra (Rx), and ibuprofen (OTC) and naproxen sodium (OTC). Nobody ever showed the Rx analgesics to be more effective than the OTC drugs, but the Rx drugs cost 100x more, plus the cost of the required Rx itself, with the money being shared out to lobbyists, PhRMA executives, pharmacists counting out pills, doctors' incentives, etc. The patients did not benefit, in fact many suffered serious cardiovascular events including strokes, but the revenue recipients made a killing - literally.

CL says

You can argue we deserve better, or cheaper but it doesn't change a thing.

And you can argue that we don't, and that doesn't change a thing either.

CL says

it's what we produced and are entitled to.

In a democracy, you get the government that you deserve. When it's the Deluded Spendthrift Party vs the Deluded Ranting Hateful Lunatic Spendthrift Party, you end up with deluded spendthrift policy, or worse, and you are entitled to the consequences. You may be required to swallow their crap, but that doesn't mean you have to like it with a crap-eating grin on your face and expect everyone to agree with you that it smells like a rose when everyone with a functioning nose can smell that crap stinks.

BTW, I love the CNN headline, "Support for Obamacare slightly edges up," i.e. to 39% (still within the margin of error, which they didn't mention), while opposition remains near 60%. It takes real devotion to sum up 60-40 opposition with a headline saying "support edges up."

curious2 says

CL says

Insurance is access....

No, insurance is a contract. Read yours.

Semantics. If you are not in a life-threatening position, hospitals can refuse you if you don't have insurance, right?

curious2 says

Medicare exists, as does Medicaid, but whether they are insurance depends on what definition you use. Some people refer to Medicare as insurance, but does Medicare describe itself that way?

Yes. http://www.cms.gov/Medicare/Medicare-General-Information/MedicareGenInfo/index.html

"Medicare is a health insurance program for:

people age 65 or older,
people under age 65 with certain disabilities, and
people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)."

curious2 says

surprisingly little in the Medicare population, less than 10 years in the 50 year history of the program, and most of that is due to other factors like fewer smokers

Is that comparing Seniors to Seniors in the same time frame? What was the rate of increase prior to Medicare? 10 years out of 70 or so is an awful lot in any case.

curious2 says

Oh please, spare us. First of all, you're ignoring Medicaid. Second, most people who go bankrupt with medical bills they can't afford actually had insurance at the time of their last injury or illness.

Don't most of the elderly who have assets hide them so as to benefit even more from Medicare? Did people die in poverty prior to Medicare?

curious2 says

How on earth do you know that without even seeing one?

What kind of risk premium would YOU or anyone have to get in order to take the other side of that insurance bet? Old people cost a lot of money, if they want medicine and doctor attention.

curious2 says

Do you ever consider that?

Considered, but you are conflating Social safety nets and our unbridled greed. The safety nets were created due to the failure of the free-market to provide for the old, sick and dying. That's like saying the EPA caused dirty air and water, or food wasn't tainted prior to FDA. The people were revolting at the turn of the century, even voting for Socialists. What was their motivation, and was the market less free then?
curious2 says

LOL - sarcasm really helps.

I was serious. You may hate the whole system, but insofar as there are good, life saving measures out there, the people are entitled to them. What is your answer? Get sick and don't avail yourselves to the system we DO have? It makes no sense.

curious2 says

in fact many suffered serious cardiovascular events including strokes, but the revenue recipients made a killing - literally.

Okay. So......? Big Pharma sucks? We need more FDA regs and trials?

curious2 says

You can argue we deserve better, or cheaper but it doesn't change a thing.

And you can argue that we don't, and that doesn't change a thing either.

I'm not arguing we don't. I'm saying it's the system we have and there are good things and bad things. If you are ill, in pain, or dying, good luck with finding care in the libertopia that does not exist. So what is a patient to do?

curious2 says

i.e. to 39% (still within the margin of error, which they didn't mention), while opposition remains near 60%. It takes real devotion to sum up 60-40 opposition with a headline saying "support edges up."

You'll never go broke if you bet on Americans being fickle or stupid.