patrick.net

Be careful, Troy:
You're disagreeing with Adhom, meaning that you're hurting his feelings. Next, you'll be accused of attacking and misquoting.

I know that I have deep emotional scars requiring years of therapy from the accusations. Thank god there'll be universal healthcare available, partially subsidized by adhom, to treat my PTSD from this experience. I'm assuming that Nomo is doing okay, but he's been strangely silent on the effects adhominem has had on his fragile psyche.

Nomograph says

Government run businesses are bad. Government run public works are good.

Sounds like a knee jerk response to me.

Have we ever allowed private business to run parks, roads etc...? Actually roads yes, and it works quite well. Bridges too. You have heard of a toll bridge right? They are a godsend in many places.

Perhaps you should stop worshiping the collective and drinking the koolade. Your credibility is no greater than Ed Schultz. For entertainment purposes only.

Nomograph says

The US government is FAR more efficient than the private sector

Is this a joke?

Troy says

Does it ever bother you that you are always factually wrong about everything?

I often ask that of my liberal friends. It is funny to mention Medicare and Efficiency in the same sentence. But, then again you probably don't work on the front lines in a medical field do you? Talking out the wrong end of the food pipe.

Nomograph says

Providing the best possible health care to the greatest number of Americans in the most efficient possible way.

Like the department of education provides the best possible education to the youth of America with the least amount of waste, putting them in the highest percentiles amongst their international peers. You really should lay off the koolade.

AdHominem says

Troy says

Does it ever bother you that you are always factually wrong about everything?

I often ask that of my liberal friends. It is funny to mention Medicare and Efficiency in the same sentence. But, then again you probably don’t work on the front lines in a medical field do you? Talking out the wrong end of the food pipe.

So Troy's question stands, does it ever concern you to be factually wrong? Medicare was probably the worst example you could have picked. Administrative costs of 3% for medicare vs well over 25% for health insurance companies. I would call that more efficient, what say you? Oh, sorry, I forgot you don't deal in numbers just anecdotes. There are plenty of places where you could find far better examples. I guess you better check which end of your food pipe says "This end up". Yes, I worked on the front lines of medical for 5 years. My wife still does.

What I completely fail to understand is why the current bill bothers you. It's manna for the insurance carriers. Everyone will be required to buy health insurance without the government option to compete with. Health insurance company stocks are already going up fast. An open market health exchange for insurers to offer their policies. Wow, just what you wanted. The new medicare rates will result in lots of doctors dropping medicare, so medicare will be reduced sharply as per your wishes. More private industry, less medicare. Exactly what you have been asking for. Be careful what you wish for, you may get it.

bob2356 says

What I completely fail to understand is why the current bill bothers you.

Bob are you mentally challenged or just high? Do you have some made up picture in your mind that I work for AETNA or something?

I don't care if it is IRS, or Aetna through IRS coercing people to "buy insurance" or pay taxes. Taking one persons money by force and giving it to someone else has a word it is called theft. When the government does it, you can call it tyranny.

Wait, this is just another straw man. Trying to get me to argue about whether or not I am for big insurance. Clearly I am not so clearly you are just a straw man placer. Perhaps YOU work for Aetna and are trying to distract us from the latest boondogle, which as you accurately depict is what this bill is. We don't have a free market in health care because of the powerful lobby of government by the elites and smart guys like you who support it all.

Administrative costs of 3% for medicare vs well over 25% for health insurance companies

So govt programs which have been notoriously inefficient and wasteful suddenly become the model of efficiency when it comes to healthcare?? Actually, administrative costs average 12% for private industry insurance providers, not 25% as claimed. And there are sleight-of-hand statistical reasons for the reported differences in adminstrative costs between medicare and private providers, none of which have anything to do with government "efficiency". Since medicare focuses on the elderly and medical treatment costs for the elderly are on average far, far higher than the non-elderly, the higher spending artificially skews the Medicare administrative cost average downward. If you went by a more honest per-patient administrative cost, Medicare administrative costs jump to a massive 25%, not 3%. Oh, and did anyone mention the matter of Medicare keeping its future obligations off the books? No?

Then there's the massive wasteful fraud and abuse, $68 billion each year, which doesn't "count" as administrative cost. Govt bureacrats have little incentive to control waste and fraud, whereas a private insurer would go broke letting that kind of fraud run rampant. More here http://ur.lc/euz.

The myth of govt. Medicare 'efficiency' is an ugly lie which shameless zealots are perpetuating.

Grandma goes into an extended hospital stay for a variety of ailments related to old age. Total medical expenses for the stay are $50,000 with $1,000 to administrate. 2% admin costs. Young guy goes into hospital for arthroscopic knee surgery he injured while playing tennis. Total medical expense are $6,000 with $800 to administrate. Admin percentage is 13%. See how easy it is to fool some people?

ZippyDDoodah says

So govt programs which have been notoriously inefficient and wasteful suddenly become the model of efficiency when it comes to healthcare?

The general theory is that government can in fact compete with, or at least highly regulate, private industry where industry has pricing power over the consumer, and where the general welfare of the nation demands a more universal degree of access.

Historically, this has been police protection, firefighting, turnpikes, railroads, public utilities, primary, secondary, and higher education.

Nobody wants government manufacturing our toothpaste for us, but the general theory (driven by experience) is that private industry is great at delivering what we *want* efficiently, but not so much what we *need*. Being needs, industry has historically done its level best to drive out competition and establish high quasi-rents and barriers to entry.

@Troy. I couldn't disagree more with your assertion that private industry is somehow inferior to govt in delivering what we "need". We need food to survive, yet we get along fine without govt run grocery stores and farms, right?

And I don't see any evidence that insurance providers have any more "pricing power" than say, airlines or autos. If an insurance company gets a reputation for not paying legit claims, their customers, at least most them, have the choice to go to another carrier. In other words, insurance providers who don't satify the needs, pay a steep financial price. There is no such carrot-stick system with govt, which is why govt has so much waste and fraud.

ZippyDDoodah says

We need food to survive, yet we get along fine without govt run grocery stores and farms, right?

Grocery stores are an interesting case. Millions of people do not get along fine with the current free-market provisioning. Either out in the sticks where the density is too low to support anything other than one super walmart per county, or in medium-density urban blight areas where the wage-base is on subsistence levels. In both case if you take out gov't transfer payments (SS, AFDC, food stamps) grocery stores wouldn't have the turnover to maintain their overheads for anything other than communist-level store stocking of beer, wine, and packaged food with high shelf-lives.

For the current FY, gummint is spending $26B on farm supports. At $50K per job that's a half-million jobs, out of around three million total producer jobs.

But the larger point is that some markets have very high barriers to entry (railroads, utilities, cable TV), or that the general welfare is better served by universal public access (roads, schools, police services).

This is not controversial and most of the rest of the developed world has figured out that a mixed economy results in the best outcomes.

Part of the reason this is that any area with good social infrastructure -- good roads, good schools, well-policed -- is going to have VERY high ground rents, a taxable surplus that is either going to be siphoned off and privatized by parasitical landowners or the gummint. AFAICT things work better with the gummint doing the siphoning.

And I don’t see any evidence that insurance providers have any more “pricing power” than say, airlines or autos.

Pre-existing conditions. Recission. I'm happy with my personal coverage with Blue Shield, but it took two tries for them to take my money ($200/mo w/ $1700/yr deductible). The first time back in 2003 they weren't happy that I saw an ortho surgeon for a knee xray in late 2002 and declined to take me on.

After one year they jacked my rates 15%. The competition is KP, but they nearly killed my mom and I really don't want to go HMO.

Nomograph says

Who is Ed Schultz?

He gets paid to act a fool. Fortunately you do it for free. Thanks for the gift. And many happy returns.

Nomograph says

I doubt you ever know where the term comes from

I prefer the electric koolade acid test. A nice read when you are in liberal arts class.

But if you want some of the other koolade.... its a free cult, i mean country.

ZippyDDoodah says

See how easy it is to fool some people?

Please don't rile the animals, they haven't had their dose of other peoples money yet today.

Nomograph says

AdHominem says

electric koolade acid test

Sigh. You are incorrect. The term “drinking the Kool Aid” comes from something else. Shouldn’t you understand what the terms you are using mean?
HINT: it’s far more morbid than an old 60’s Tom Wolfe novel.

SIGH. Not everyone sees the world, or drinks the koolade like you.

and yes I know of the other koolade reference, you may have noticed I made reference too in my last post, it is a free CULT, I mean country.

PLEASE GO ON BELIEVING IN YOUR OWN SUPERIORITY. I am sure you will.

Would you like some more koolade?

It's already got the other 50% calling it unconstitutional. It'll fail before it is ever enacted, it's a damn token to the insurance industry and does nothing to improve on our current system. Only to impose hardship on every small business owner, middle class worker and rich person.

Tenouncetrout says

Only to impose hardship on every small business owner, middle class worker and rich person.

I think we all lose with this bill. Oh the insurance scumbags might make a little more money for a while and a few more people might get to live off someone else's dollar for a while, but in the end, the federal bureaucracy will have more control over medicine. We are on a march toward complete government control of the basic human needs. We might as well let the feds have control of food production, housing, employment etc.. and make our descent in to full Central planning and socialism complete.

AdHominem says

We might as well let the feds have control of food production, housing, employment etc.. and make our descent in to full Central planning and socialism complete.

So, in your mind it's impossible to have a single payer health care system without descending entirely into socialism? So, how does every other civilized country pull it off? Are they all socialists?

ZippyDDoodah says

So govt programs which have been notoriously inefficient and wasteful suddenly become the model of efficiency when it comes to healthcare?? Actually, administrative costs average 12% for private industry insurance providers, not 25% as claimed. And there are sleight-of-hand statistical reasons for the reported differences in adminstrative costs between medicare and private providers, none of which have anything to do with government “efficiency”. Since medicare focuses on the elderly and medical treatment costs for the elderly are on average far, far higher than the non-elderly, the higher spending artificially skews the Medicare administrative cost average downward. If you went by a more honest per-patient administrative cost, Medicare administrative costs jump to a massive 25%, not 3%. Oh, and did anyone mention the matter of Medicare keeping its future obligations off the books? No?

No, I agree government programs are far from a model of efficiency. Private health insurance isn't either. Future obligations have no bearing on administrative costs by the way, why bring it up? Yes the numbers can be read different ways. I've read the Heritage Foundation (far from an objective organization) article before and found it to be very light on supporting facts and methodology. There is a lot of juggling of definitions to come up the Books's numbers also. For example the 12% number only applies to large insurers covering large companies. Individual policy coverage is more like 30%. Yes medicare pays larger bills, but these kinds of treatments create a literal blizzard of claims from dozens of sources with hundreds of separate items to be paid, NOT a single big bill so this is a bogus argument. You screwed up on the 25% vs 3%, the article claims medicare is 25% higher not 25%.

Anyway my point was that if you wanted to pick an example of government inefficiency there are lots better choices than Medicare, which does a decent job. Adequately fund fraud prevention efforts and you could probably move that up to pretty good job.

tatupu70 says

So, how does every other civilized country pull it off? Are they all socialists?

LOL, AdHom doesn't want civilization, he wants the libertarian minarchy, ie how things were around 2000BC, but with guns.

Troy says

tatupu70 says

So, how does every other civilized country pull it off? Are they all socialists?

LOL, AdHom doesn’t want civilization, he wants the libertarian minarchy, ie how things were around 2000BC, but with guns.

actually not at all. And you are the first people who should be disarmed.

AdHominem says

actually not at all

So, you've realized that it is possible to have a single payer system in a capitalist system?

staynumz says

Only a step? Why didnt you guys get the whole thing done?

Because corporate interests have enough Republicans on the payroll to make sure they railroad any changes that might adversely affect them...

staynumz says

Why didnt you guys get the whole thing done?

The House version is pretty good, but the Senate, for numerous rather dubious Constitutional and historical reasons, gives dickholes like Lieberman disproportionate sway in the legislative process, and in our bicameral system both houses have to reach agreement before the bill proceeds to the executive for approval.

It doesn't help matters that 30% of this country are outright anti-gummint retards. And another 30% is de-facto helpless (ie with zero discretionary income) with little political power or organization. Plus one out of six who are elderly and basically have Got Theirs already and are resistant to change. Plus the 10-20% who are wealthy enough to not have to worry about access to the medical system.

That leaves ~10% of the population that have their heads on straight and are reform's primary beneficiaries. Not much of a popular constituency!

tatupu70 says

staynumz says

Only a step? Why didnt you guys get the whole thing done?

Because corporate interests have enough Republicans on the payroll to make sure they railroad any changes that might adversely affect them…

You can't possibly think that the Dem's are immune to this, do you?

The lobbyists pay the out-of-power party to subtract actual beneficiary regulations from a bill, while using the in-power party to get government mandated oligopoly powers and create extra barriers to entry for future competitors (i.e. small businesses).

The insurance companies' stocks all popped after this bill was passed. Seems to me that whatever the Dems are doing, it is great for big business at the direct cost of the taxpayer.

Tat and all dem supporters, I find your mindset to be DANGEROUS. This time, YOU ARE THE ENABLERS. The looting of the US taxpayer/economy has increased many fold over the last years, and will continue to get worse as long as dem supporters allow it. The Republitards definitely started this job, but the dems will be in power when the death knell sounds.

tatupu70 says

staynumz says

Only a step? Why didnt you guys get the whole thing done?

Because corporate interests have enough Republicans on the payroll to make sure they railroad any changes that might adversely affect them…

So you are freaking smart enough to realize the dilemma that presented.
Now pray tell, why did the Democrats fall into the Republicans clever little trap?

So you do admit that this batch of Democrats were ill equipped to toy with the forces they screwed up beyond FUBAR.

CBOEtrader says

tatupu70 says

staynumz says

Only a step? Why didnt you guys get the whole thing done?

Because corporate interests have enough Republicans on the payroll to make sure they railroad any changes that might adversely affect them…

You can’t possibly think that the Dem’s are immune to this, do you?
The lobbyists pay the out-of-power party to subtract actual beneficiary regulations from a bill, while using the in-power party to get government mandated oligopoly powers and create extra barriers to entry for future competitors (i.e. small businesses).
The insurance companies’ stocks all popped after this bill was passed. Seems to me that whatever the Dems are doing, it is great for big business at the direct cost of the taxpayer.
Tat and all dem supporters, I find your mindset to be DANGEROUS. This time, YOU ARE THE ENABLERS. The looting of the US taxpayer/economy has increased many fold over the last years, and will continue to get worse as long as dem supporters allow it. The Republitards definitely started this job, but the dems will be in power when the death knell sounds.

Yeah, unless I am mistaken it was 100% Democrats and 0% Republicans who voted to pass this bill (at least in the Senate).

Insurance companies know what Americans don't want to admit. You get what you pay for. Insurance lobby bought and paid for a bunch of congressmen and women in BOTH parties. And they got what they paid for, a bill that will help them and almost no one else.

Howard Dean summed it up very well: " This is going to benefit the insurance companies and not much more. We should kill this bill and start over." The government always does a great job running things. Obama admitted Medicare & Medicade have over $500 BILLIION per year in fraud .... uhhhh , and what exactly did the government ever do to stop that much fraud?

RayAmerica says

The government always does a great job running things. Obama admitted Medicare & Medicade have over $500 BILLIION per year in fraud …. uhhhh , and what exactly did the government ever do to stop that much fraud?

You need to check your figures there Ray. Your decimal point is off by one place.. And Obama just signed an executive order to fight Medicare fraud--that's what our Government is doing..

http://www.healthleadersmedia.com/content/FIN-242319/Obama-Plans-to-Sign-Executive-Order-to-Target-Medicare-Waste-Fraud.html

RayAmerica says

Obama admitted Medicare & Medicade have over $500 BILLIION per year in fraud

do you read what you type? $500B is just about their entire annual budget to the first approximation.

this batch of Democrats were ill equipped to toy with the forces they screwed up beyond FUBAR

The government always does a great job running things

we get the government we deserve. Maybe if the Republicans and teabaggers weren't so committed to obstructionism we'd have a better program.

and the Independents aye?

you know there's a word for the government you would like.

and if this Turd bill was so greatly crafted by the Republicans, then why didn't one single Republican vote for it, and why did so many Democrats vote for it?

Geesh you guys are denser than a mudderfugger.

If I have a medical emergency and have to go to the emergency room, will this bill benefit me?

Troy .... Medicare/Medicade annual budget is over $800 Billion. And yes, I do READ what I post.

As for you, do some research before flying off the handle ....

Why do Democrats support $500 billion in Medicare Waste/Fraud/Abuse?
MSNBC's First Read wonders why, if the President can so easily identify over $500 billion in Medicare waste, he hasn't done anything?:

Speaking of health care, how has Obama gone from touting $300 billion in Medicare waste/fraud/abuse savings in June as part of his plan to pay for health care to now claiming the White House has found $500-$600 billion in these savings. The fact is the president still hasn't release a detailed plan in general, let alone gotten into the "how to pay for" weeds when it comes to exactly how they found yet another $200 billion in cuts. This actually gets at the nut of the president's potential credibility problem: If there is so much money in waste/fraud/abuse in the Medicare system, then why do we continue to let it happen? Why are we waiting so long to deal with it? The average cynical voter is thinking, “Well, the president may be well meaning, but the bureaucracy that is the American government let this waste/fraud/abuse happen once, who is to say they won't let it happen again?”

RayAmerica says

Why do Democrats support $500 billion in Medicare Waste/Fraud/Abuse?
MSNBC’s First Read wonders why, if the President can so easily identify over $500 billion in Medicare waste, he hasn’t done anything?:

Ray-- could you link yto that article? Here's the only one I could find there

Law enforcement officials said it's just one of the many widespread, organized and lucrative schemes to bilk Medicare out of an estimated $60 billion dollars a year

http://www.msnbc.msn.com/id/22184921/

You're off by an order of magnitude...

Tenouncetrout says

then why didn’t one single Republican vote for it, and why did so many Democrats vote for it?

The situation is a bit more complex than this. The Republicans are going to run against this in November. Democratic Senators at all vulnerable needed a watered-down bill that didn't completely alienate the two-thirds of this country who are total fuck-heads.

That and what many Dems are today would really be somewhat conservative, Eisenhower Republicans of 50 years ago.

None of you have even read the bills in congress or the house, more speculation on what it will and will not do.

RayAmerica says

If there is so much money in waste/fraud/abuse in the Medicare system, then why do we continue to let it happen? Why are we waiting so long to deal with it?

Common Scams:
Equipment companies: they get a list of Medicare recipients (or cold call people) and send them equipment they didn't order. It's sent in the mail, can't reasonably be returned, and the companies change their addresses frequently so they're hard to catch.

Diabetic supplies - commercials like Wilford Brimley's classic offer "free" supplies, mail them to the patient and charge Medicare the max amount. They are on an automatic system where the supplies are sent every month, whether the patient needs them or not. IMHO supplies should be obtained from the local pharmacy so that the patient's supplies & meds are monitored.

Skilled Nursing Facilities, Therapy providers, home health companies charging for patients who probably don't need the care. Notes are "fudged" and/or doctored to make patients look sicker than they are.

Medical care provided that the patient doesn't need - extra tests, labs, treatments, etc.

Hospices signing on anyone they can, rather than discharging the patient if he/she doesn't appear to get better they keep them on service for several months. One nationwide hospice paid millions in fines for this practice, as well as refusing to allow patients to transfer to other hospices and refusing to allow them to "fire" the hospice.

The problem is that there are millions of providers and audits are conducted on a percentage basis. As quickly as one company is caught, others spring up. With the recession, there are cutbacks in the state-run programs the provide oversight. These providers give others a bad reputation, and also take advantage of seniors who don't understand the system.