And They're Off! The Democratic Candidates for 2020

Started by JBS, June 26, 2019, 05:40:42 PM

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drogulus



    My Medicare Advantage provider just mailed me a notice of benefit improvements for 2020.

    I will keep my plan, I think. I'm trading off no networking for a slightly richer benefit package. I can keep my hypothetical doctor if he doesn't run away to join the circus.
     
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71 dB

Swiss healthcare system is the closest of all developped countries to the US healthcare system, but it works somewhat reasonably because it's so heavily regulated. It's the second most expensive system after the US.
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drogulus

Quote from: 71 dB on October 15, 2019, 08:18:21 AM
Swiss healthcare system is the closest of all developped countries to the US healthcare system, but it works somewhat reasonably because it's so heavily regulated. It's the second most expensive system after the US.

     If you look at the plans and ways costs are paid it comes out like this:

     

     We have high costs and poor outcomes. I prefer high costs and good outcomes, though the world and I agree that good outcomes should come first.
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71 dB

Quote from: drogulus on October 15, 2019, 08:46:13 AM
     We have high costs and poor outcomes.

Exactly. That's why you need Bernie Sanders to become the next oval office occupant.
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Crossfeeders reduce spatial distortion and make the sound more natural
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JBS

Quote from: North Star on October 14, 2019, 10:27:17 PM
It should be pointed out that in Finland, the occupational health care is significant too - mandatory to provide even if you just have one employee, the costs are compensated by the government. The employer may acquire occupational health care services from occupational health care units at public health centres, municipal enterprises and companies providing occupational health care, occupational health care centres jointly operated by several employers (occupational health care associations), or occupational health care units at private medical centres - or provide it in-house. And there's also a separate student healthcare system founded by the Finnish university students' union in 1954 that recently expanded to cover students in universities of applied sciences too, not just university students. (you pay something like 80 dollars for it at the start of the school year to be covered).

The occupational health care sounds like what we in the US call workmen's compensation, but much more robust and much more proactive than our version (which kicks in only after the injury occurs or the illness starts, and it's usually up to the employee to prove it's work related if there's any doubt).

Hollywood Beach Broadwalk

JBS

Quote from: 71 dB on October 15, 2019, 09:58:25 AM
Exactly. That's why you need Bernie Sanders to become the next oval office occupant.

So we can have high costs and poor outcomes under a Democratic president?

Hollywood Beach Broadwalk

JBS

Quote from: milk on October 15, 2019, 04:30:34 AM
I should be able to answer this with 100% confidence but I sometimes get confused by this kind of thing. I think companies over a certain size, and that employ you on a regular full-time contract, have to enroll you. It used to be that Japan offered most people lifetime full-time careers. Over the last decade or so, this has been eroded and more temporary contracts have been used. Recently, the government passed new labor provisions like requiring companies to make contracts permanent after a certain number of years. Unlike the U.S., there is not effective enforcement and litigation does not lead to quick and punitive results. Some companies have taken to skirting the law by deception, asserting some kinds of exceptions or have just tried ignoring it. Unions have taken it to court but that process is slow. In the end, the unions are basically prevailing but companies not yet sued are still dragging it out without the kind of fear of punishment you see in the States. Even some big private universities have acted duplicitously and lost court cases.
I think this system basically works and I think the government will end up forcing companies to cover people. Either way, there are premiums, but much less than the U.S. I think. Other problems in Japan come up tangentially like the sharply aging population contributing to Japan having the largest debt in the developed world (relative to GDP) and old people abusing the system by hanging out in hospitals as if it were a social club. Japan delivers pretty good quality medicine relatively efficiently although everything in Japan has aspects that are inefficient due to institutional "culture."
Just as an anecdote: I see a neurologist once every few months for migraines; He prescribes medicine I take daily; the visit costs about 4-5 dollars and the medicine for 3 months costs about 15-20$ total. I could change doctors if I wanted by just making an appointment somewhere else. We also are having our second baby in February and that's another thing I could describe but we can go to any hospital we want and it's relatively easy. As for premiums I'm not sure what they cost because my job deducts it and contributes but for my 3-person family I'm thinking it's maybe 2 or 3 hundred dollars a month. Something like that.
The only thing that worries me is I float between the two systems due to the nature of my contract. Knock on wood I can stay in the company system. I believe if I get kicked onto the independent worker system I wold see premiums double, perhaps. I don't like how the poorer you are the more you pay. That part leads me to think the European single-payer systems are better but, on the other hand, this system works pretty well and it's probably more palatable in the U.S. perhaps. You do pay for it individually.

Thanks. You'd probably pay about the same premium as an employee in a US employer provided plan.
I would amend you "unlike the US". Companies kicking employees off health plans has been a trend for almost 30 years now, and there's been no government attempt to stop it. In fact, Obamacare actually encouraged it, since employers could claim employees had an alternative.

Hollywood Beach Broadwalk

drogulus

Quote from: JBS on October 15, 2019, 10:10:23 AM
So we can have high costs and poor outcomes under a Democratic president?

     Poor outcomes are choices, mostly inconsistent with Medicare. The collapse of private insurance will help pave the way for Medicare phase in.

     I'll take a tax over a premium, even a super subsidized one like the Swiss use for low incomes. But really the cost argument is a McGuffin in this drama, it's about covering everyone and improving outcomes, especially for those getting the worst outcomes presently.

     You can ask me what the odds are that Medicare will be degraded by expanding it. Certainly I'd worry if it was likely. It's not likely.
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JBS

Quote from: drogulus on October 15, 2019, 10:44:57 AM
     Poor outcomes are choices, mostly inconsistent with Medicare. The collapse of private insurance will help pave the way for Medicare phase in.

     I'll take a tax over a premium, even a super subsidized one like the Swiss use for low incomes. But really the cost argument is a McGuffin in this drama, it's about covering everyone and improving outcomes, especially for those getting the worst outcomes presently.

     You can ask me what the odds are that Medicare will be degraded by expanding it. Certainly I'd worry if it was likely. It's not likely.

Medicare is not in such great shape to begin with.

Medicare for All would improve outcomes for those now getting bad outcomes, but it  lead to somewhat worse outcomes for the rest.

Hollywood Beach Broadwalk

drogulus

Quote from: JBS on October 15, 2019, 10:50:19 AM
Medicare is not in such great shape to begin with.

Medicare for All would improve outcomes for those now getting bad outcomes, but it  lead to somewhat worse outcomes for the rest.

     I think both are false. Trust funds are a sham. There is no program that's universal that will make my Medicare worse. It doesn't matter how many are added to it. We are using available resources, not dividing up dollars.
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JBS

Quote from: drogulus on October 15, 2019, 11:05:20 AM
     I think both are false. Trust funds are a sham. There is no program that's universal that will make my Medicare worse. It doesn't matter how many are added to it. We are using available resources, not dividing up dollars.

Dollars are bookkeeping shorthand for resources. Dividing up dollars is allocating resources.
You are right, trust funds are a sham. And there are not enough dollars/available resources to stretch Medicare to cover everyone at the current levels it now offers to Medicarees. But by worse outcomes I was referring to those under 65 now covered by company plans or private plans.  They will almost all pay more and get less.

Hollywood Beach Broadwalk

drogulus

Quote from: JBS on October 15, 2019, 11:29:30 AM
Dollars are bookkeeping shorthand for resources. Dividing up dollars is allocating resources.
You are right, trust funds are a sham. And there are not enough dollars/available resources to stretch Medicare to cover everyone at the current levels it now offers to Medicarees. But by worse outcomes I was referring to those under 65 now covered by company plans or private plans.  They will almost all pay more and get less.

     Dollar run outs are policy, they don't "run out" on their own, there's no such thing. The difference between resource run outs and dollar run outs that leave resources idle is stark and unmistakable. 

     It's always a choice what we wish to run out of dollars for and how much idleness we impose upon the economy to "save dollars" in Nowheresville instead of bank accounts.

     Dollars are shorthand for resources we are using and not for resources we don't want to use for whatever shrinky dinky reason.

     For reasons only the gods could possibly understand somebody decided that there was a "too much" level for health care spending, without much in the way of guidance about what the right level should be. It's a riddle encased in a dilemma surrounded by total bullshit.

     We don't spend 50% of GDP on defense any more, it's a small fraction of that. Are we supposed to believe that a much higher percentage of the budget going to improving the lives of everyone is a poor use of dollars? Poor compared to what? Who says?
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greg

Quote from: drogulus on October 14, 2019, 10:06:08 AM
    There is a view that people like their employer health care. Very few who have it do. I didn't. It was only better than having no insurance.
Mine is much better than having no insurance but the problem is what exactly do I compare it to? I don't even know what constitutes "good."
Wagie wagie get back in the cagie

71 dB

Bernie Sanders' medicare for all plan is better than any current private insurance plan. It covers more. So, you get more. Not only that, but for about 95 % of people it is effectively a tax cut, because healthcare private taxes (premiums and copays) are gone and the tax raise to compensate it is less so there is net savings. 
Spatial distortion is a serious problem deteriorating headphone listening.
Crossfeeders reduce spatial distortion and make the sound more natural
and less tiresome in headphone listening.

My Sound Cloud page <-- NEW Jan. 2024 "Harpeggiator"

drogulus

Quote from: greg on October 15, 2019, 01:15:05 PM
Mine is much better than having no insurance but the problem is what exactly do I compare it to? I don't even know what constitutes "good."

    Good is you're fired and you still have it. Good is it follows you wherever you go. Good is you aren't lucky to have it because everyone does.

Quote from: 71 dB on October 15, 2019, 01:41:09 PM
Bernie Sanders' medicare for all plan is better than any current private insurance plan. It covers more. So, you get more. Not only that, but for about 95 % of people it is effectively a tax cut, because healthcare private taxes (premiums and copays) are gone and the tax raise to compensate it is less so there is net savings. 

     That's a bit optimistic on what a plan would be like at the outset. It would make sense for taxation to be as progressive as income tax, and better yet to use no separate tax at all. We don't tax for aircraft carriers and then subject ourselves to threats that starting in 2025 they will be 20% smaller. It seems dollars we fictionally don't have are good for almost everything, while only dollars we fictionally do have are good for others.
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Karl Henning

Quote from: drogulus on October 15, 2019, 02:17:36 PM
    Good is you're fired and you still have it. Good is it follows you wherever you go. Good is you aren't lucky to have it because everyone does.

     That's a bit optimistic on what a plan would be like at the outset. It would make sense for taxation to be as progressive as income tax, and better yet to use no separate tax at all. We don't tax for aircraft carriers and then subject ourselves to threats that starting in 2025 they will be 20% smaller. It seems dollars we fictionally don't have are good for almost everything, while only dollars we fictionally do have are good for others.

Good luck trying to talk sense to him!
Karl Henning, Ph.D.
Composer & Clarinetist
Boston MA
http://www.karlhenning.com/
[Matisse] was interested neither in fending off opposition,
nor in competing for the favor of wayward friends.
His only competition was with himself. — Françoise Gilot

milk

Quote from: JBS on October 15, 2019, 10:17:43 AM
Thanks. You'd probably pay about the same premium as an employee in a US employer provided plan.
I would amend you "unlike the US". Companies kicking employees off health plans has been a trend for almost 30 years now, and there's been no government attempt to stop it. In fact, Obamacare actually encouraged it, since employers could claim employees had an alternative.
Yes, my only point is that there is often an option to sue in the U.S. - for anything people think is illegal. The risk of losing is high. In Japan, whatever happens, people don't win frighteningly big payouts. Take the university in Japan that systematically and secretly lowered women's scores, for years, on medical school entrance exams. I think in the U.S., women would have sued that university out of existence since they basically stole women's entire lives. But in Japan, they just bow deeply, shuffle some people around, and carry on.

JBS

Quote from: drogulus on October 15, 2019, 11:57:50 AM
     Dollar run outs are policy, they don't "run out" on their own, there's no such thing. The difference between resource run outs and dollar run outs that leave resources idle is stark and unmistakable. 

     It's always a choice what we wish to run out of dollars for and how much idleness we impose upon the economy to "save dollars" in Nowheresville instead of bank accounts.

     Dollars are shorthand for resources we are using and not for resources we don't want to use for whatever shrinky dinky reason.

     For reasons only the gods could possibly understand somebody decided that there was a "too much" level for health care spending, without much in the way of guidance about what the right level should be. It's a riddle encased in a dilemma surrounded by total bullshit.

     We don't spend 50% of GDP on defense any more, it's a small fraction of that. Are we supposed to believe that a much higher percentage of the budget going to improving the lives of everyone is a poor use of dollars? Poor compared to what? Who says?

To be blunt, your economic ideas are based on a rubbish theory that is based on an idea that works out to the proposition that "money has no value".

Given that, there's no response to be made to the above other than to note that it is based on nonsense.

Hollywood Beach Broadwalk

drogulus

#878
Quote from: JBS on October 15, 2019, 03:53:46 PM
To be blunt, your economic ideas are based on a rubbish theory that is based on an idea that works out to the proposition that "money has no value".



    The value it has is what it buys, the whole GDP. I think what you mean is what the cost is to produce dollars, which is zero. Dollars have price, not cost.
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drogulus

#879
A prince, who should enact that a certain proportion of his taxes should be paid in
a paper money of a certain kind, might thereby give a certain value to this paper
money. (Smith, 1776, p. 312)


     A tax driven currency has negligible inherent cost. That is not the same as a loan cost.

     The Natural Rate of Interest is Zero
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