patrick.net

I just visited DailyKos for a few minutes.

All the problems with Obamneycare apparently began late January, 2017. They alternately bash "Trumpcare", while laughing it didn't pass, while blaming the huge premium and deductible increases (yet again, year after year with Obamneycare) on Ryan's plan that didn't pass.

The compounding failures of Obamacare are now laid at Trump's feet.

Alternate Reality.

jazz music says

Straw Man says

What do you mean "now"?

Now, after the republican failure to repeal or replace, is not the time to gloat but the time to put forward a popular health care improvement.

With what army?

YesYNot says

IMO, people want every chance that they can get, so they will go for it even when it's not worth it.

I've seen multiple studies showing people make cheaper decisions when allowed to decide for themselves. It's mainly the hospital executives and other institutional pressures that drive the big ticket over-utilization, while entrepreneurial doctors (including kickbacks from diagnostic labs and other services) drive the routine over-utilization. Religious hospital corporations refuse to follow advance healthcare directives, saying their religion commands them to keep the patient "alive" as long as possible; some hospitals even involve the local police, removing patients involuntarily from their homes and inflicting treatments that the patients had specifically refused. It's a dynamic of cognitive dissonance and conflicts of interest: given a choice among many imperfect options, the natural and institutional tendency is to resolve uncertainty and ambiguity in the direction of self-interest. Institutions that maximize ROI get rewarded, and institutions that fail to maximize ROI get taken over as part of industry consolidation. Reducing hospital infections, for example, can end up costing medical staff their jobs, because the hospital's revenue falls and staff get laid off. Self-interested hospital executives make sure to focus on bringing in the business (I get constant direct mail brochures touting local hospitals), and maximizing the revenue from each sucker that walks in the door.

If you like books, I recommend The Good Nurse. It reports in depth the story of a serial killer who was convicted of murdering dozens of patients. He had probably murdered hundreds, and injured thousands. Hospital executives lied to police in order to cover up his crimes, and enabled him to move on to other hospitals and murder more people. The pattern echoed the Vatican covering up priests who molest children, moving them on to another parish to molest more children. Every single hospital executive who figured out they had a serial killer murdering patients chose to enable him to continue rather than stopping him, and zero hospital executives were ever punished for that. The book notes other, similar stories of serial killers working in hospitals, with murders eventually proved beyond a reasonable doubt. These were not "mercy killings," but actual malicious murders, including patients who had recovered and were about to be discharged to go home to normal lives. I've mentioned this book before, and some defenders of Obamneycare try to fight the example rather than considering the pattern. I don't know what percentage of iatrogenic fatalities result from intentional murder, but the point is the mentality: these instutitions are run by people who would (and did) literally enable a serial killer, even lying to police, for the purpose of protecting and maximizing institutional revenues and thus their own salaries.

curious2 says

From that link: "UPDATE: Chart deemed bogus. See comments. Rest of post altered to reflect that fact, including a big red “X” through the chart." So, commenters on that particular site deemed that chart bogus. It remains at Forbes and elsewhere without retraction.

What facts about the problems of the two studies are wrong? Nice shuffle and jive. What happened to

curious2 says

It says annual per capita costs, not merely one or two federal components of those costs.

It says per capita costs because Fischbeck skipped putting the word government in his study anywhere. And cherry picked his countries. and came up with numbers that aren't even close to what is in the public record. The real question is who paid for Fischbeck 's study and what were the results they wanted to see. This is the part where you say I fucked up. The chart really is only the government costs.

I never saw a retraction for the fake moon landing stories.

I added the address from the original post as my first item on https://whatdidyoubid.com:

https://whatdidyoubid.com/address/4/383-60th-street-piedmont-ca-94618

Site needs a ton of work and more features, but it's alive!

curious2 says

You can do the math if you want to challenge the Carnegie-Mellon chart. Medicare spends over $10k/yr per enrollee, and Medicaid spends another $2k/yr per person over 65, so that's $12k/yr just for those two programs. Medi-gap, long term care insurance, and "personal resources" add a lot more.

Meaning you can't begin to come up with anything that supports your claims. You are really saying that the two sources of over 2/3's of the health care spending for over 65's come up to 12k a year and the other third manages to triple that? You really want to try and sell that? Nursing home care last year was 150 billion out of 3.2 trillion. Hell of a big tail wagging that dog. You really do need ironbrain to help you with math.

It's not the Carnegie-Mellon chart. It's a Carnigie-Melllon professor of social sciences chart. He freely admits he did it totally on his own with his own database. It's not like it's some kind of official peer reviewed Carnegie-Mellon research no matter how many times you meaninglessly throw around the school name.

I am not familiar with the first five states but I am with Hawaii and California. You think housing prices are crazy here relative to incomes go try Hawaii. Biggest industry is tourism and there's no way a valet attendant and a front desk worker are able to afford $600k + homes.

I'm willing to bet Hawaii should be above California on this list. I know so many people there living with parents or in multi generation homes it's crazy. I always wondered how people can afford new cars/trucks on hourly wages then I realized they aren't paying shit for rent or living expenses, in fact many don't even buy food for the house and expect mom to still cook for them.

It's a societal norm over there so lots of people don't look down on it.

YesYNot says

Agreed that the primary purpose was to get more people covered by health insurance. A secondary goal, which was taken on in an effort to help finance the first goal was to make health care more efficient. Because there was a huge annual inflation of health care costs prior to Obamacare, you should judge the results by seeing how the annual increases changed under Obamacare. I cannot easily find charts to show this. If you have them, I'd be interested in seeing them.

Insurance companies are a big part of the cost of health care. Adding more people to the system doesn't make it cheaper. That's like adding water to drain the swamp.

@Patrick , good candidate property to start. Although the link isn't working for me.

BayArea says

$1.5M in Palo Alto? Where?

The couple isn't looking in Palo Alto; the Brother of the wife has a Hurdy Gurdy Warehouse in Palo Alto. Right next to Spatula City.

BayArea says

Patrick , good candidate property to start. Although the link isn't working for me.

How about now? Please hit https://whatdidyoubid.com/address/4/383-60th-street-piedmont-ca-94618 and let me know if that works.

Thanks!

APOCALYPSEFUCK_is_ADORABLE says

How about Charles Manson?

Today he'd qualify as a mainstream Republican, virtually indistinguishable from O'Reilly.

No good. He's not as prone to violent outbreaks as O'Reilly.

APOCALYPSEFUCK_is_ADORABLE says

Who Will Replace Obscene Phone Caller Bill O'Reilly on Fox?  

What about Shia LaBeouf? No wait, he looks too much like a Muslim with the beard. Fox News audience will never accept him with that foreign sounding name anyway.

Ironman says

Yes, you normally do... Now how do you explain this chart?

Our system is the most privately run, most non-transparent, and shittiest in the world. It has all of the problems of capitalism and few of the benefits.

www.youtube.com/embed/LQdObqEWscU

Sign in to make your opinion count. Sign in 14 Loading... Loading... Loading... Rating is available when the video has been rented. This feature is not available right now. Please try again later. Published on May 30, 2015Really the most intense ever Category Comedy License Standard YouTube License Suggested by DHX Media Shopkins Taco Terrie Easter Egg Hunt Shopkins Videos BEST Easter Play Adventure RaInBoW PoP 7 Show more Show less Loading... Autoplay When autoplay is enabled, a suggested video will automatically play next. Up next

bob2356 says

It says per capita costs because Fischbeck skipped putting the word government in his study anywhere.

According to YOUR LINK, he "used total medical expenditures for each country using OECD data."

As for cherry-picking, YOUR LINK says he omitted some of the countries where spending was "in between", meaning they were irrelevant to demonstrating the range of costs. If you can recall math, you might remember that the high and low extremes define the range. Whatever is "in between" does not change the range.

Some of the commenters in YOUR LINK defended the chart, including one who posted anecdotal observation similar to what I've seen among my own neighbors: people becoming eligible for Medicare and then getting surgery that makes them worse off, when their original complaints had been minor. Nobody at your link produced a better chart or better comprehensive data, and meanwhile we see an abundance of reports documenting entrepreneurial over-utilization that makes patients worse off.

Bob, you might feel better simply arguing with yourself. Create a second User account, and switch between accounts each day. You can harangue yourself all day long. At least you would have a better chance of winning. Meanwhile, you're fighting against a chart, without presenting a better one. American per capita spending remains the highest in the world, and at least a third of it (I'd say most) goes to waste, fraud, and abuse, including widely documented entrepreneurial over-utilization to maximize revenue. In California, we see Medicare HMO corporations suing each other like cattle ranchers fighting about poaching cattle, and the battles between them give a glimpse of the enormous revenues at stake. If you don't like the chart that Forbes and others published, then produce a better chart, but remember to use "total medical expenditures for each country" as YOUR LINK says Fischbeck did.

curious2 says

I don't know what percentage of iatrogenic fatalities result

I read the linked study in full, and can appreciate most of the points. I think that like unwinding Social Security, unwinding Medicare would be very difficult for the same reason. People have paid into the system and are owed huge benefits. To cut off medicare for them would require buying them out in some way, which is essentially paying for the 'unfunded liabilities' today rather than when the bill comes due. I also think that where the rubber meets the road (defining what is catastrophic rather than a predictable expense) is the hard part. Nevertheless, I agree that lack of cost transparency and responsibility takes away any incentive of the customer for reducing costs. This is the major problem with the system. I gave Trump credit for making comments about cost transparency during the election. But, this is an obvious problem without an easy solution. I'll give him or anyone else credit if they can get that implemented.

APOCALYPSEFUCK_is_ADORABLE says

Really? I can't remember the events, but why do you think that is?

I believe that he is a Eunuch. Even if he tries to harass women, they can just piss in his face and call it a day. What's he going to do about it? I read that his show keeps getting bumped up to take the place of various people who left or got the boot.

I hope that was good therapy for the snowflake that made it. I'm sure Donald got a good chuckle out of it, I know I did.

YesYNot says

People have paid into the system and are owed huge benefits

A big theoretical difference is the actual benefits don't need to cost nearly so much. With already more than a third going to waste, fraud, and abuse (I still say more than 50%), a more efficient system should deliver better results at lower cost.

The problem in the medical sector is not the people who have paid in and are owed benefits. The problem is the pigs at the trough who maximize the cost, including unnecessary and injurious "benefits," and lobby for more of the same. To the extent the two problems are related, it's because patients have become like hostages with Stockholm Syndrome, taking on the perspective of their captors. Patients demand more subsidies rather than lower costs, because that's what their captors/providers tell them is best.

I love that new wife smell.

curious2 says

Patients demand more subsidies rather than lower costs, because that's what their captors/providers tell them is best.

This.

This is not a violent meme.

I am going to miss mean old O'Reilly beating liberals to a pulp with his Jesus statue.

It's going to be hard to find somebody with the same aura of grandiose, prickish self righteousness. Many are called, but few can pull it off.

It's a revolt of the fading beauty leg-crossers!

jazz music says

Straw Man says

With what army?

Heheh the army of people that have their eyes opened to looking at no access to health care they can afford because the system is all about maximizing speculator passive gains for doing nothing, ohhh yeaaaaahhhhh.

You don't have said army at your disposal judging from the results of the last election. So there is nothing to "push" with. Try again after winning. Want me to remind you when the next election is? Hint: it's not "now". Your timing is waaay off.

curious2 says

According to YOUR LINK, he "used total medical expenditures for each country using OECD data."

Go lower for the comment by the author of the study itself that says it only captures government spending. You are still claiming the study covers all health care spending? How is that? You don't believe the person who wrote the study?

Leaving out private insurance in the US is absurd when comparing to other countries that have only government health care spending. It makes the chart meaningless.

curious2 says

American per capita spending remains the highest in the world,

That's not what the chart is meant to show. It shows American per capiita spending equal to other countries then exploding at 60-65. Put private insurance into the under 65 numbers and pull the bogus numbers out of over 65 it will be a very different chart with very different conclusions.

US health care spending is far higher than other countries at every age. It doesn't just explode at 60 and it doesn't go anywhere near $45,000 a year per capita for 70 year olds. You and Ironbrain screaming the chart shows it's all medicare's fault is absurd. Medicare is a problem but there are plenty of other equally big problems driving up health care spending.

Ironman says

Yes, you normally do... Now how do you explain this chart??

This is great, this chart actually shows how stupid the other chart is. Thanks for posting it.

I'd like to see Jesse Watters--I always enjoy his interviews with people on the street.

Is scraping a lob out of your shorts and eating it live on national television an impeachable offense?

bob2356 says

curious2 says

According to YOUR LINK, he "used total medical expenditures for each country using OECD data."

Go lower for the comment by the author of the study itself that says it only captures government spending.

"From a quick perusal of the comments on this and other sites, I find that there is no agreement as to what is wrong with the graph, aside from the comment that it only captures government spending (which implies that it should be a lower bound). I have tracked several of the links that have been proposed to provide results and have found it difficult to extract a single common truth.

The medical expenditure panel survey has 2010 total expenses as being $1.26 trillion."

You seem to have omitted "the comment that", and the conclusion "difficult to extract a single common truth" from your selective quotation. Paul Fischbeck and Dan Munro defended the chart while offering to improve it if others could provide better data. I have likewise invited you to produce a better chart. So far, you presented only partial data, which is what you accuse Fischbeck of doing, and he does not appear to concede that point. Even if, as you contend, his chart shows only government data, then that would not explain the huge disparity between the US and other countries in that age cohort.

This is much ado about very little, as you attack (as usual) without posting a more accurate total. You attack one graph while ignoring the many text links that support the same overall conclusion regarding entrepreneurial over-utilization driving higher costs. The McAllen vs El Paso article reported on a 2:1 disparity attributed to doctors' entrepreneurial over-utilization of Medicare. You seem to react defensively perhaps because your own income depends on your wife's medical practice, and you keep saying the cost problem doesn't result from doctors' salaries. You seem to ignore capital gains from shares in diagnostic lab corporations, in addition to illegal kickbacks from diagnostic labs, for example, in order to say it's all someone else's fault. Maybe you feel guilty because billing is your job and maybe you haven't figured out how to cash in the way many others do. I have tried to be as even-handed as possible, faulting primarily the hospital corporations (the biggest and most lethal revenue recipients, taking 40% of total medical spending for the whole population, and much of that from Medicare), the insurance companies, the drug companies, and doctors. You seem unable to handle the fact that doctors have a role in entrepreneurial over-utilization of Medicare, and so you keep fighting a chart while ignoring the tsunami of information on this point. The bottom line, from your linked source, is that nobody produced a better chart clearly contradicting the first; they debated some few trees, as you do, but not the overall forest.

At they very top of the list:

curious2 says

It's mainly the hospital executives and other institutional pressures that drive the big ticket over-utilization,

Thanks for your post.

Another one: The revolving door of Nursing Home to C Diff Hospitalization. Contract C Diff, kept in Hospital only a few days, back in Nursing Home. C Diff comes back again, back to Hospital. And then back to the nursing home before the C DIff is wiped out... ready to get it again and spread it to others.

Blurtman says

It's a revolt of the fading beauty leg-crossers!

Bitches finally decided they needed to cash in their sexual harassment chits while somebody would still believe they were worth harassing.

The Fox News beaver criss crossings have gone into lockdown!

"Just because I flash beaver for career advancement doesn't mean I am a bad person!"

theoakman says

I'll buy 5 oz the day it goes under $1000.

You'll likely have your chance... Not so sure you will have to wait 2 yrs. or more but perhaps.

You do have to give Kim credit, he does not limit his options.

A sprout of common sense, let's see if it blooms into something

Maher is right. Free speech is a really big deal and the left is taking very strong steps to put further limitations on it. Its sad and I'm glad Maher spoke out so strongly in favor of it.

Kim Jong Un is overdue a killing.

United should have Reaccommodated Dr Dao on a flight to North Korea and sacrificed the dope slinging deviant upon the alter of the almighty Kimfuck!