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America's health extortion racket is not extending our lives at all


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2018 Feb 21, 1:04pm   13,390 views  55 comments

by Patrick   ➕follow (55)   💰tip   ignore  

We spend the most of any country by a long shot, and yet have worse outcomes than most other industrialized countries.

It's almost as if handing cash to medical administrators, health insurance companies, and stockholders in private medical companies is, like, not actually a good treatment for any disease at all.

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1   Bd6r   2018 Feb 21, 1:21pm  

The same type graph probably can be generated for educational outcomes.
2   Patrick   2018 Feb 21, 1:25pm  

drB6 says
The same type graph probably can be generated for educational outcomes.


Absolutely.

What we have are dependencies on blood-sucking providers of these services which, like ticks, burrow into the flesh of the nation and don't think they're doing anything wrong at all. The tick just thinks "Gotta eat, right?"

They get away with it because of the extreme corruption of American politics, which, going by that graph, is apparently worse than in all other countries. We could in theory make laws and policies to handle education and health care by spending less, with better results, like other countries do, but hey, that would cut into profits, and that in turn would cut into campaign donations for Congressmen.

One fix would be publicly funded Congressional campaigns, but everyone currently in Congress got there with private funding of their campaign by the very same ticks that we need to dig out of our flesh, so are Congressmen ever going to vote to change that?

Maybe it's time for direct democracy and the end to a Congress that fails us over and over.
3   Heraclitusstudent   2018 Feb 21, 1:54pm  

It's doing what capitalism does: optimize life time profits on customers. In this case without much competition.
4   Bd6r   2018 Feb 21, 2:01pm  

Patrick says
One fix would be publicly funded Congressional campaigns

Another would be to stop gerrymandering election districts and have some computer program draw the new district lines to get shortest district borders possible or have the borders go as much along county lines as possible. Now the elections are not competitive in most districts, so the representatives can set themselves upon admirable goal of personal enrichment and screwing the constituents who will vote them in anyway as "the alternative is worse".
5   Patrick   2018 Feb 21, 2:18pm  

Heraclitusstudent says
It's doing what capitalism does: optimize life time profits on customers. In this case without much competition.


Government regulation to ensure free-market competition is supposed to get the benefits of capitalism without the harm of monopolies and oligopolies.

But our government has failed us. They let the foxes run the henhouse, over and over.

drB6 says
the borders go as much along county lines as possible


I like that idea. Why not require all districts to be contiguous blocks of counties?

I know why though. Everyone in Congress got elected under the current gerrymandering system and so they have no desire to change it. How can we get around that problem?
6   bob2356   2018 Feb 21, 3:10pm  

Patrick says
But our government has failed us. They let the foxes run the henhouse, over and over.


Democracy american style. Oligarchs rule.
8   Malcolm   2018 Feb 21, 4:09pm  

It's a fucking disgrace and I want it fixed.

1. HSAs for out of pocket and incidentals, as well as elective procedures.
2. An end to private health insurance, move to an HMO model like Kaiser.
3. One million dollar lifetime limit, then you go to Medicare.
4. Medicare should kick in at 55.
5. Government picks up the tab for low/no income patients.

End of story!
9   mell   2018 Feb 21, 4:11pm  

Malcolm says
2. An end to private health insurance, move to an HMO model like Kaiser.


Private insurance has no bearing on the rest. Let those who want to have private insurance have it. The real problem is that HMOs and/or the government are not necessarily cheaper, often more expensive wrt the care they deliver. Kaiser is relatively well run though so they can work. No reason to ban PPOs and private insurances for those who can afford and want it.
10   Patrick   2018 Feb 21, 4:21pm  

mell says
Kaiser is relatively well run though so they can work.


I was talking to a Kaiser administrator last weekend (I just happen to know the guy) and he said that Kaiser's advantage is mostly that they are both:

1. a private insurer
2. the sole provider for that insurer

So the insurance part of Kaiser never has to negotiate with the provider part of Kaiser. I had not considered that advantage to Kaiser.

I do think we fail to have a true market for health care because prices are well hidden from the public, and variable depending on who you are. To have a real market to drive down prices, we need all providers to publish their prices, to present non-emergency bills in advance of treatment, and to charge the same prices no matter who you are or what insurance you may or may not have. Not sure how Kaiser would fit into that plan though.
11   Malcolm   2018 Feb 21, 4:29pm  

All I know is that I am sick of a model where people buy an insurance policy that they never get a benefit from. I have never had a problem, because I am very healthy, but when I watched Sicko, I saw some patterns that started hitting close to home, and frankly scared the living shit out of me.

The reason I use Kaiser as an example is that is the only HMO that I know of. I like the model, where the administration is part of the medical operation, not some third party cluster fuck that ends up bankrupting people who have paid premiums all of their lives.

I have a real problem with the concept of a for profit company making approval decisions for people. That is not a healthcare system, it is a scam. I was for Obamacare, it was an interesting experiment, but I consider it a failure. Obama tried to do exactly what a conservative approach would do, trust that the free market will provide the lowest cost and the best quality. The insurance companies basically realized that they had a captive market who had to buy their service. That was the flaw.
12   Malcolm   2018 Feb 21, 4:42pm  

Patrick says
Not sure how Kaiser would fit into that plan though.


The important thing is that it is not for profit. I am all for a gatekeeper to prosecute fraud and to decline truly unnecessary services, but not for a private intermediary who seeks to maximize profit by minimizing covered expenses. That is not health care. I am wired to understand systems and processes. Since profits and real comprehensive coverage are apparently mutually exclusive, the concept is flawed. There is no better system that to have multiple HMOs competing on quality and value.
13   Patrick   2018 Feb 21, 4:45pm  

I agree that Obamacare was interesting, but a failure. It was really a giveaway to insurance companies, forcing a captive market to pay by law whatever the hell private insurance companies demanded. That's about as far from a free market as you can get.

We should just wholesale copy the system from some other country. Actually any other country provides better results than ours per dollar spent. Much much better results.

Looks like Japan has really excellent longevity and spends only $3K per person on healthcare per year, as opposed to our $8.5K.

But then again, Japan can do a lot of things that we cannot, because Japan does not have excessive diversity weakening their national identity like we do. The Japanese probably actually give a shit about each other because of their shared history and culture, and so are willing to cooperate on big issues like healthcare for everyone. Diversity is our weakness, and we should be honest about that. We need to get our culture back into melting-pot mode. E pluribus unum!
14   Patrick   2018 Feb 21, 4:46pm  

Malcolm says
There is no better system that to have multiple HMOs competing on quality and value.


Yes, maybe that is it.

I would add that those HMOs need to be decoupled from employment as well, so that changing jobs does not force a change in insurance.
15   Malcolm   2018 Feb 21, 4:47pm  

Patrick says
But then again, Japan can do a lot of things that we cannot, because Japan does not have excessive diversity weakening their national identity like we do. The Japanese probably actually give a shit about each other because of their shared history and culture. Diversity is our weakness, and we should be honest about that. We need to get our culture back into melting-pot mode. E pluribus unum!


OK, whoever hijacked Patrick's account better stop it!!!!!!!!!!!!! LOL
16   Bd6r   2018 Feb 21, 5:11pm  

Patrick says
But then again, Japan can do a lot of things that we cannot, because Japan does not have excessive diversity weakening their national identity like we do. The Japanese probably actually give a shit about each other because of their shared history and culture, and so are willing to cooperate on big issues like healthcare for everyone.

Japanese are also not morbidly obese and act with some degree of rationality.
Diversity as such is neither good or bad, in my opinion. Compare Singapore which is pretty diverse but acts rationally (e.i. everyone has to abide by rules and there is no allowance for PC bullshit, and you will not get preferential treatment because your ancestor 1000 years ago was oppressed) with US/Western Europe which act completely irrationally with illegal immigration, special treatment for everyone who is not productive etc.
17   Patrick   2018 Feb 21, 5:28pm  

The levels of obesity in America are pretty interesting though. Why?

It may not be entirely eating too much, but partly the contamination of our foods with livestock antibiotics, livestock fatteners, and pesticides:

https://www.salon.com/2014/03/13/5_shocking_reasons_why_americans_are_getting_fatter_partner/

I had bad acne in high school, but it went away entirely during the summer I spent in Germany on an exchange program. Conversely, the German kids who came to our high school arrived unblemished, but left looking like a pizza. I'm pretty sure it was something in the food. I've read that dioxins in the milk supply may be responsible.
18   Bd6r   2018 Feb 21, 5:48pm  

Patrick says
meritocracy and good governance

This is the key, I think.

I have looked at these diversity studies, and they seem convincing. On the other hand, if we do not go by today's BS diversity definition, then US was pretty diverse in late 1800's - German immigrants were quite different culturally from English, both were different from French or Irish, and somehow they managed to build a prosperous country together.
19   Bd6r   2018 Feb 21, 5:52pm  

Patrick says
The levels of obesity in America are pretty interesting though.

We have a huge amount of 1st, 2nd, and 3rd generation Asian Americans here. First generation is never fat, even after living in US for 20 yrs, second is usually not fat, 3rd can be quite fat. Perhaps what/how they eat is the key - 1st and even 2nd generation still live on food they ate in home countries.
20   anonymous   2018 Feb 21, 5:56pm  

drB6 says
Diversity as such is neither good or bad, in my opinion. Compare Singapore which is pretty diverse but acts rationally (e.i. everyone has to abide by rules and there is no allowance for PC bullshit, and you will not get preferential treatment because your ancestor 1000 years ago was oppressed) with US/Western Europe which act completely irrationally with illegal immigration, special treatment for everyone who is not productive etc.


What the hell does all that mean?

You are aware that pretty much everyone in singapore lives in public housing with state mandated ethnic quotas for each neighborhood aren't you? That should work well in the US.
21   bob2356   2018 Feb 21, 6:35pm  

drB6 says
I have looked at these diversity studies, and they seem convincing. On the other hand, if we do not go by today's BS diversity definition, then US was pretty diverse in late 1800's - German immigrants were quite different culturally from English, both were different from French or Irish, and somehow they managed to build a prosperous country together.


You have your history mixed up. German/Irish migration was mostly mid to late 1800's. The first wave wasn't even German since Germany didn't exist until 1871. There was serious prejudice and anti immigration backlash. The American Party (also called the Know Nothing Party) was formed to promote anti immigrant anti catholic agenda. They did quite well and worked to get anti immigrant/german laws passed. There was a considerable amount of violence including "bloody monday" in Louisville KY . Irish need not apply was common. It wasn't until the turn of the century both groups worked up out of the lowest rungs of society and started gaining social respect and political power. At which point they started persecuting the Chinese. Workingmen’s Party leader Denis Kearney, for example, closed his speeches to American laborers with “Whatever happens, the Chinese must go.”

The Italian migration was from the turn of the century until the 1920's. Same anti immigrant anti catholic backlash. Most people don't know the KKK was pretty much non existent by 1915. Membership went from almost nothing to over 4 million between 1915 and 1920 as an anti Catholic organization.

It was far from groups living nicely together and building a prosperous nation.
22   bob2356   2018 Feb 21, 6:48pm  

Patrick says
I do think we fail to have a true market for health care because prices are well hidden from the public, and variable depending on who you are. To have a real market to drive down prices, we need all providers to publish their prices, to present non-emergency bills in advance of treatment, and to charge the same prices no matter who you are or what insurance you may or may not have. Not sure how Kaiser would fit into that plan though.


You keep chanting this time and time again like it came down from the mount as the 11th commandment. . My question still stands with you dodging it time after time. How on a nuts and bolts level is posting prices going to make anything more than a token impact on the system as it exists now?

Curiosity totally overwhelms me as to how someone can present a bill until you determine what is wrong and what needs to be done to fix it. Do you go to a garage and say present me with a bill then check what's wrong with my brakes?
23   Strategist   2018 Feb 21, 7:02pm  

Patrick says
America's health extortion racket is not extending our lives at all


How can it? We go through life saving medical procedures, and when the bill comes, we die of a heart attack.
24   Strategist   2018 Feb 21, 7:13pm  

Patrick says
The levels of obesity in America are pretty interesting though. Why?

It may not be entirely eating too much, but partly the contamination of our foods with livestock antibiotics, livestock fatteners, and pesticides:

https://www.salon.com/2014/03/13/5_shocking_reasons_why_americans_are_getting_fatter_partner/

I had bad acne in high school, but it went away entirely during the summer I spent in Germany on an exchange program. Conversely, the German kids who came to our high school arrived unblemished, but left looking like a pizza. I'm pretty sure it was something in the food. I've read that dioxins in the milk supply may be responsible.


We don't eat natural foods our bodies were designed for anymore. The problems we face today, which were not a problem for our ancestors, is due to man made additives, preservatives, and excessive use of sugar and fat.
I remember reading an article many years ago about the high levels of obesity and diabetes among Native Americans in the reservations. Their ancestors ate what they could grow and hunt like corn. Today, they eat burgers, fries, and sodas. The side effect of this man made junk can never be good.
25   anonymous   2018 Feb 21, 7:57pm  

anon_e144f says
What the hell does all that mean?

You are aware that pretty much everyone in singapore lives in public housing with state mandated ethnic quotas for each neighborhood aren't you? That should work well in the US.

First, I am not aware that everyone in Singapore lives in public housing. Most (about 3/4) do. Second, my point is that Singapore has rational policies, is diveres, and diversity does not handicap them. US is not rational and hence diversity here comes off negative. Singapore has specific rules for hiring which say that "Employers are advised to follow a system of meritocracy while selecting and recruiting candidates for employment. Skills, experience and ability to perform the job should take precedence over age, race, gender, religion, family status or disability". How does it compare with the situation in US? Which country is more rational? Third, I am not suggesting quotas for housing in US which you imply. I am suggesting, however, that rational attitude prevail.

Hope that next time you can comprehend a little better.

drB6
26   anonymous   2018 Feb 21, 7:57pm  

bob2356 says
You have your history mixed up. German/Irish migration was mostly mid to late 1800's. The first wave wasn't even German since Germany didn't exist until 1871.

I am aware of all of that, and I am not sure where you get that I am mixed up. At the end of 19th century, which is what I am talking about, all groups that I mentioned were in US in reasonably large amounts. Even if they did not get along very well initially (beer riots in Milwaukee, for example), the result of their immigration was probably overall positive. And what is the point of the well-known fact that Germany did not exist until 1871? It was called German confederation or something like that since early 19th century, which is irrelevant to discussion here. There are some ethnic groups which can not learn English for three generations, do not integrate, and demand special treatment nowadays.

drB6
27   MisdemeanorRebel   2018 Feb 21, 7:59pm  

Singapore has problems with the Malays. In fact, the reason Chinese-majority Singapore left Malaysia and became an independent city state is anti-Kuffar sentiment and racism from the Malays.


I have to speak candidly to be of value, but I do not want to offend the Muslim community... I think we were progressing very nicely until the surge of Islam came, and if you asked me for my observations, the other communities have easier integration – friends, inter-marriages and so on – than Muslims... I would say, today, we can integrate all religions and races, except Islam.
from his book 'Lee Kuan Yew: Hard Truths to Keep Singapore Going' (Asia One, March 08 2011 [28])
28   CBOEtrader   2018 Feb 21, 8:06pm  

Patrick says
yet have worse outcomes


Try being a doctor, and extend a 250 lb ghetto queen' s life as she eats her Cheetos and little Debbie donuts. Life expectancy is far more about life choices than health coverage.

Obama care was a huge step backwards, but we do still have the best doctors and most accessible healthcare in the world.
29   CBOEtrader   2018 Feb 21, 8:10pm  

bob2356 says
How on a nuts and bolts level is posting prices going to make anything more than a token impact on the system as it exists now?


I sell medical/life/supplemental insurance. People ask about prices ALL THE TIME. It would help A TON to know how much a doctor would charge for a procedure. Most clients w preexisting conditions know exactly what they need done. A large portion even know the medical code for the procedure they need.
30   Strategist   2018 Feb 21, 8:14pm  

TwoScoopsPlissken says
Singapore has problems with the Malays. In fact, the reason Chinese-majority Singapore left Malaysia and became an independent city state is anti-Kuffar sentiment and racism from the Malays.


Best thing that ever happened to them.
31   CBOEtrader   2018 Feb 21, 8:14pm  

HEYYOU says
Cash or DIE!
No free market entity should have to deal with the added cost of your insurance paperwork because you are a failure.
If one wants to use insurance,the price should immediately increase 10 fold.


Almost all doctors do this. Most Hospitals do as well.

They will both pick and choose which type of insurance they accept based largely on how difficult it is to get paid from that insurance. It's one of the reasons why they hate Obama care.

Also try this next time you are at a doctors office... tell them you have insurance but would like to instead pay in cash, then ask them how much they could discount the bill. Watch as 40% of the bill evaporates before your eyes. This also works with dentists.
32   CBOEtrader   2018 Feb 21, 8:21pm  

Patrick says
The levels of obesity in America are pretty interesting though. Why?


The sad reality is, obesity and diet is a cultural issue. We are fatter than Europe mostly because we have more blacks. Same answer for lower life expectancy, gun violence, etc.... our black communities arent doing so hot. Unfortunately us racist crackers aren't allowed to point out statistics.

Do you remember freakonomics wherein that black economist named PC culture in universities as the single biggest impediment to studying and helping black communities?
33   anonymous   2018 Feb 21, 8:22pm  

Malcolm says
Patrick says
But then again, Japan can do a lot of things that we cannot, because Japan does not have excessive diversity weakening their national identity like we do. The Japanese probably actually give a shit about each other because of their shared history and culture. Diversity is our weakness, and we should be honest about that. We need to get our culture back into melting-pot mode. E pluribus unum!


OK, whoever hijacked Patrick's account better stop it!!!!!!!!!!!!! LOL


Our host has changed a lot in the years since you were last active. It's been a fascinating metamorphosis to observe...
34   Strategist   2018 Feb 21, 8:24pm  

CBOEtrader says
HEYYOU says
Cash or DIE!
No free market entity should have to deal with the added cost of your insurance paperwork because you are a failure.
If one wants to use insurance,the price should immediately increase 10 fold.


Almost all doctors do this. Most Hospitals do as well.

They will both pick and choose which type of insurance they accept based largely on how difficult it is to get paid from that insurance. It's one of the reasons why they hate Obama care.

Also try this next time you are at a doctors office... tell them you have insurance but would like to instead pay in cash, then ask them how much they could discount the bill. Watch as 40% of the bill evaporates before your eyes. This also works with dentists.


So pay cash, get a 40% discount, and then make a claim with the insurance, eliminating copays and deductibles? Please advise.
35   Patrick   2018 Feb 21, 8:27pm  

bob2356 says
Do you go to a garage and say present me with a bill then check what's wrong with my brakes?


Do you go to a garage and say "Charge me whatever you want" or do you get an estimate after the initial diagnosis?
36   Patrick   2018 Feb 21, 8:35pm  

bob2356 says
The Italian migration was from the turn of the century until the 1920's. Same anti immigrant anti catholic backlash. Most people don't know the KKK was pretty much non existent by 1915. Membership went from almost nothing to over 4 million between 1915 and 1920 as an anti Catholic organization.

It was far from groups living nicely together and building a prosperous nation.


And yet, the dominant ethos was that we should all assimilate into a common culture - the melting pot. And it worked damn well. Immigrants tried hard to be "American" and that meant learning English, playing baseball, eating American food (at least in public). They were rewarded with acceptance and we all benefitted from the feeling of unity as Americans.

Now we have divisiveness driven by "diversity". I suspect that the near-religious worship of diversity is a deliberate strategy by the billionaire elite to weaken national unity and thus make it easier to outsource jobs and insource illegal aliens, because this creates power and profit for themselves.
37   CBOEtrader   2018 Feb 21, 9:58pm  

Patrick says

Now we have divisiveness driven by "diversity". I suspect that the near-religious worship of diversity is a deliberate strategy by the billionaire elite to weaken national unity and thus make it easier to outsource jobs and insource illegal aliens, because this creates power and profit for themselves.


Ofc it is.

Globalisation solidifies power into the hands of whoever is currently winning the power game. When people no longer have localized autonomy, but rather defer to a centralized power. Become that centralized power and you control the world while pulling up the rope ladder of competition.

Bim. Bam. Boom. GS, KSA, and Amazon.com run the world. End of story.

#maga is about the individual over the collective. Localized power over centralized power. This is why the #fakenews controlled by billionaire wanna-be tyrants hate Trump so much.
38   bob2356   2018 Feb 22, 6:19am  

anon_e401a says
Skills, experience and ability to perform the job should take precedence over age, race, gender, religion, family status or disability". How does it compare with the situation in US? Which country is more rational? Third, I am not suggesting quotas for housing in US which you imply. I am suggesting, however, that rational attitude prevail.

Hope that next time you can comprehend a little better.


I comprehend just fine. Singapore's rationalism is the result of an all pervasive nanny state government. Housing quotas are just one part. It works but there is a heavy cost of living under one of the more authoritarian governments. Which at the moment is relatively benevolent, but could radically change very quickly. Let the economy really tank in Singapore and race based conflicts will explode no matter what the government says or does.

Comparing a small island of 5 million people to a vast country of 330 million people isn't very realistic. A country that is 60 years old filled with people who were already living side by side more or less socially equal isn't a a very valid comparison with a country of ongoing waves of immigrants that had 100 years of slavery followed by 100 years of legal state sponsored racism and then another 50 years of not at all subtle racism that wasn't state sponsored that is still going on.

Affirmative action is to level the playing field to provide equal opportunity to pursue positions, not to provide preferences. The laws are specific about that. Under Title VII of the Civil Rights Act, you cannot base a hiring decision, in whole or in part, on a person's race or gender. It is illegal and can be prosecuted if someone feels they are more qualified but passed over for race reasons. There is nothing irrational about that.

Does it all work perfectly, of course not. Does Singapore work perfectly, of course not.
39   bob2356   2018 Feb 22, 6:29am  

anon_e401a says
There are some ethnic groups which can not learn English for three generations, do not integrate, and demand special treatment nowadays.


What groups are those? I lived in the RIo Grande Valley for years. The parents speak Spanish and the kids answer back in English. I know a bunch of third generation that don't speak Spanish at all. The whole not learn English for 3 generations is pure race baiting bullshit.
40   bob2356   2018 Feb 22, 6:50am  

CBOEtrader says

I sell medical/life/supplemental insurance. People ask about prices ALL THE TIME. It would help A TON to know how much a doctor would charge for a procedure. Most clients w preexisting conditions know exactly what they need done. A large portion even know the medical code for the procedure they need.


CBOEtrader says
Also try this next time you are at a doctors office... tell them you have insurance but would like to instead pay in cash, then ask them how much they could discount the bill. Watch as 40% of the bill evaporates before your eyes. This also works with dentists.


You can't have it both ways. Either doctors offices can tell you how much or they can't. Of course they can tell you how much. So why would I put my cash out of pocket, do all the work of submitting a superbill to the insurance company and then struggle to get paid for it when I can just let the doctor bill the insurance company? How much becomes the insurance companies problem not mine. Does it affect my deductible, not at all. Will it be less than my copay. No way. So why do it? That's the whole problem.

You guys keep saying post prices, post prices. But why is anyone going to ;bother to look at them if the insurance company pays anyway? Crickets chirping every time I ask that.

Patrick says

Do you go to a garage and say "Charge me whatever you want" or do you get an estimate after the initial diagnosis?


See above. If an insurance company was paying for it no way I would ask anything. I'd just say do it. Ever wreck a car? You go to a body shop your friends recommend and let the shop haggle it out with insurance, you don't shop around for the best deal for the insurance company. That's the whole problem with this idea that posting prices will matter. You keep saying it will. How? Crickets chirping.

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