A realignment in American politics underway

And Kari its not for me to offer free advice. Its for those high 6 figure types to do their work.  If they don't then they ought to get rid of them.

What every honest person, including Hillary knows, is that if Obamacare isn't fixed it will collapse. And that will be as soon as the next recession, which surely isn't that far off.

caribny posted:
ba$eman posted:
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It's funny how you oppose what I say, then you agree with much of my position.  Caribj is a fake and liar.  And isn't it the position of Trump to open up the marketplace to cross-border competition?  .

Listen baseman you know even less about this than Kari.  How will it be competition if Empire Blue Iowa is competing with Empireblue NY.

There has been massive consolidation in health insurance so there is no competition to get.

And this doesn't address the fact that the reason why premiums are uncreasing is because healthcare costs are increasing?

If prescription drugs and hospital costs are high how does competition help?  In fact there will be no competition beyond what we already have.

And here is your nonsense. The GOP are against any public support to compensate insurance companies for having to ensure unhealthy people. They are against the public option which would allow the state to assume risks for people too difficult to ensure.

Baseman do you suggest that sick people be left to die on the streets? Because this is what the GOP want to do.

No, you are a fool to think that's what I'm saying.  But you have no solution that it viable except the Govt take over, which is also fine.  You are coming from a welfare mindset where people do not take responsibility then someone has to pay up when the shit hits the fan.  This does NOT how it works in a risk-based insurance model.

You think you know everything and if one does not agree with your model, then they don't know anything.  I know very well how it works. I also know the impact on people and small businesses, which have been stunted due to this.

Listen Caribj, the ONLY beneficiaries of Obamacare are the don and out welfare class, not anyone making 400% of poverty, that's approx $60k/pa, a hardly livable wage when you have to fork over 1,200 per month in premiums and 2,500 deductible.  You have no clue of what you speak, you spout hot air and sheer nonsense.

Listen again Caribj, your conceptual position is flawed, so you speak from a flawed position from the inception.  So you are wrong, regardless how much you write and how you try to frame the issue.

The uninsurable needs to be put in a separate pool (State/Fed Medicaid), people/kids who have serious lifelong chronic conditions, etc.  They should not be dumped on the insurance Companies as the premiums are unaffordable for the families.  The poor people with high costs should also be part of the Govt Medicaid pool and not for the market insurance.  People who chose not to take out insurance and then falls ill, stick them with the bill.  You cannot force the insurance companies to take on a known certainly and pass it on to everyone.

Caribj, you are stuck in the social engineering mindset that is Obama so you don't see it, you just don't.  Obamacare is a big disaster.

And look at you, cussing the doctors and Pharma companies.  Don't blame the Pharma companies, clear up the frigging generic backlog and get the prices down for non-exclusive drugs.  For exclusive drugs, yes ensure fair pricing for everyone, they need to have a return and the population needs access.  However, don't make stupid political statements, it solves nothing.

ba$eman posted:
 

No, you are a fool to think that's what I'm saying.  But you have no solution that it viable except the Govt take over, which is also fine.  You are coming from a welfare mindset where people do not take responsibility then someone has to pay up when the shit hits the fan.  This does NOT how it works in a risk-based insurance model.

You think you know everything and if one does not agree with your model, then they don't know anything.  I know very well how it works. I also know the impact on people and small businesses, which have been stunted due to this.

Listen Caribj, the ONLY beneficiaries of Obamacare are the don and out welfare class, not anyone making 400% of poverty, that's approx $60k/pa, a hardly livable wage when you have to fork over 1,200 per month in premiums and 2,500 deductible.  You have no clue of what you speak, you spout hot air and sheer nonsense.

Listen again Caribj, your conceptual position is flawed, so you speak from a flawed position from the inception.  So you are wrong, regardless how much you write and how you try to frame the issue.

The uninsurable needs to be put in a separate pool (State/Fed Medicaid), people/kids who have serious lifelong chronic conditions, etc.  They should not be dumped on the insurance Companies as the premiums are unaffordable for the families.  The poor people with high costs should also be part of the Govt Medicaid pool and not for the market insurance.  People who chose not to take out insurance and then falls ill, stick them with the bill.  You cannot force the insurance companies to take on a known certainly and pass it on to everyone.

Caribj, you are stuck in the social engineering mindset that is Obama so you don't see it, you just don't.  Obamacare is a big disaster.

And look at you, cussing the doctors and Pharma companies.  Don't blame the Pharma companies, clear up the frigging generic backlog and get the prices down for non-exclusive drugs.  For exclusive drugs, yes ensure fair pricing for everyone, they need to have a return and the population needs access.  However, don't make stupid political statements, it solves nothing.

If you put the uninsurable into a pool, where they aren't diluted by healthy low utilizers of healthcare then they will be extremely expensive to insure. Are you going to allow your income taxes to be increased, because surely you cannot expect those people to afford this coverage?  The only way that government can pay for this is if they tax you more.

I suspect you want the pre Obamacare days when INDIVIDUAL health insurance used to cost $1600/month because only sick people bought it. Note to you. In NYS this coverage now costs around $650.

And what of WORKING people, whose employers cannot afford to provide them with health insurance, and who don't earn enough to buy insurance to cover their families ($2,000/month).

I will make it easy as you are a racist. All of these underpaid Guyanese Indians working in those small Guyanese owned businesses.  If they earn enough not to get Medicaid, but don't have $2,000 to buy health insurance for their families then what are they expected to do?

As it is Guyanese Indians have legions of health problems, diabetes being but one. Very expensive diseases to treat if one doesn't get ongoing primary care from a doctor. Uninsured people only access healthcare when they get very sick. Usually in the ER.  I had a severe injury once and had to go to ER. I was amazed as to how many people were there to deal with diabetes and blood pressure issues.  From the minute that you walk into ER a $1,000 bill is triggered.

 

caribny posted:
Kari posted:

Caribny, when will you offer an analysis of the ills of Obamacare and suggest solutions? .

My solution is that they have to focus on containing cost increases.  It is for those involved in healthcare delivery to figure out what exactly they ought to do.  It is they and not a bunch of lawyers and politicians who should be leading this effort.

No, you have no clue of what you speak.  You parrot Obama's and his surrogate line.  You have no solution because you start from a flawed position.  You have no solution that balances out everyone's imperatives.

On the demand side you have varied risk (old plus healthy young).....that reminds me of CDOs and tranches of bundled-up blue chip stocks with high risk junk. Okay so let's look at this model to spread risks. So staying on the demand side, if you have a monopolist (say the US government on behalf of this) then there is your power in the market where the supply side has oligopolists - big pharma, fro-profit hospitals and doctors, etc.

So two big forces meet in the marketplace and negotiate from strength. You must get some equitable position. the supply side will contain costs and the demand side will get just what's needed and not more. And you know what it does not stifle innovation or the profit motive. Win-Win

Kari posted:

On the demand side you have varied risk (old plus healthy young).....that reminds me of CDOs and tranches of bundled-up blue chip stocks with high risk junk. Okay so let's look at this model to spread risks. So staying on the demand side, if you have a monopolist (say the US government on behalf of this) then there is your power in the market where the supply side has oligopolists - big pharma, fro-profit hospitals and doctors, etc.

So two big forces meet in the marketplace and negotiate from strength. You must get some equitable position. the supply side will contain costs and the demand side will get just what's needed and not more. And you know what it does not stifle innovation or the profit motive. Win-Win

So we go to single payer.  I have no issue, but we are in a hybrid model that will fail!  We can always ask the Canadians for help on this!  Their system works!

ba$eman posted:
 

No, you have no clue of what you speak.  You parrot Obama's and his surrogate line.  You have no solution because you start from a flawed position.  You have no solution that balances out everyone's imperatives.

I assume that you are talking to Kari because I am telling of the faults of Obamacare.

In any case it is clear that you know even less than does Kari on this topic.

I am also telling you that the GOP plan is WORSE.

1. Putting all sick people in one pool is very expensive as there is no dilution of this pool of high cost people with others who are lower cost. Do you know the principle of any form of insurance? You spread risk by mixing high risk with low risk.

BEFORE Obamacare states did have these high risk pools. They FAILED!

2. There has been massive concentration of health insurers.  These are already have operations across states? There will NOT be any competition. The GOP is pretending as if all 50 states have unique and separate companies.  They know fully well that this isn't the case, but they know that dummies like you don't know this.

3.  The GOP want to prevent employers from deducting the health insurance premiums that they pay on behalf of their employees, or to make such payments taxable to the employees.  This will result in most people having to pay income tax on about $24k of additional income, this out of cash that they didn't receive in hand. Or they will have to go buy their own insurance when their employees cease to provide this.

Why do you think, when asked about what will replace Obamacare Trump's response is the "best plan ever" and refuses to disclose the features of this "best plan".

Kari posted:

On the demand side you have varied risk (old plus healthy young).....that reminds me of CDOs and tranches of bundled-up blue chip stocks with high risk junk. Okay so let's look at this model to spread risks. So staying on the demand side, if you have a monopolist (say the US government on behalf of this) then there is your power in the market where the supply side has oligopolists - big pharma, fro-profit hospitals and doctors, etc.

So two big forces meet in the marketplace and negotiate from strength. You must get some equitable position. the supply side will contain costs and the demand side will get just what's needed and not more. And you know what it does not stifle innovation or the profit motive. Win-Win

 

Medicare is going broke, and you suggest single payer. Yes if Medicare cannot afford to cover the costs of 15% of the population, then expand it to cover 100%. Brilliant thinking.

What folks like you never understand is that delivering healthcare costs, and you haven't addressed who is going to pay for this.

In fact increasingly doctors are forcing patients to be responsible for paying the difference between what Medicare pays them, and what they bill.  Many others are simply refusing to accept additional patients.

This piecemeal approach to the problem means that various groups are pitted against each other, and those with the strong lobbying groups (high end specialists, large hospital networks, medical devices suppliers and Big Pharma) protect their turf.

So it is the primary care physician and the small ambulatory care facilities that bear the burden.  I know several PCs and hear their complaints.  They regard going into this as a huge mistake. PCs are the focus of how healthcare is delivered, bear huge costs of delivering service, and yet see declining pay rates in exchange.

We will soon have no PCs or OB/GYNs, side from the few trained at those offshore med schools in the Caribbean or 3rd world imports from Nigeria and India.

There needs to be an all embracing discussion on how healthcare is provided in the USA, its economics and the roles that the stakeholders will play in modifying this. It is NOT a quick fix.

This is what I had with the whole process. Obama tried to ram through Obamacare quickly when his focus ought to have been on recovering the economy, which was still in dire shape in 2010. In fact Obama lost the House in 2010 because of his Obamacare fixation.

For this to have worked it should have been phased in more slowly. Yes putting in place the plans to have adult kids be included, removing lifetime maximums, placing minimal standards that health insurance policies had to meet, and preventing companies for using pre existing conditions to refuse coverage.

But the focus should have been on modifying costs rather than pretending as if our problems are solely a health insurance issue.

Had Obama focused on the economy, including starting that Infrastructure Bank that he spoke of in 2008. The Feds would have bought bonds issued by this entity instead of wasting money buying treasuries.  The result was that by the time the economy did in fact fully recover it had already been baked into most people's heads, as this was in fact the slowest recovery for a long time.

If Obama was focusing on the economy in 2010, instead of trying to rush through a sloppily built Obamacare he would have kept the House, and seen less of a backlash in the state legislatures.  He would then have had the clout to fully implement Obamacare once it was ready.

But his rushing caused the huge embarrassment when the exchanges didn't work.  He also didn't have the time to educate the public, so that there was pushback when people saw their insurance replaced by more expensive and comprehensive plans, and also saw their doctors dropped as the HMO plans excluded them.

ba$eman posted:
!  We can always ask the Canadians for help on this!  Their system works!

The Canadians took decades to build their system. Obama wanted to totally transform health insurance in one year, without doing one thing to change how healthcare is delivered.

The USA has the world's most expensive form of healthcare delivery on this planet and no way a single payer system will work, unless there is massive rationing of care. Americans will NOT stand for massive rationing.

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