Kamala Harris 2020

[Onboard 2.0 9083]

2 minutes ago, BradInATX said:

Sure. And we'll probably have 10x the support staff to administer the program, 10x the tax revenue, 10x the healthcare professionals, etc.

Obviously they won't be exactly that, but the things that drive wait times are going to be things like demographics, quality of our healthcare professionals vs. Canada, etc. I have no idea whether we'd be better or worse - just calling out that saying "well, we'll obviously be worse than Canada's percentage because we're bigger" is silly. We'd probably be worse because we're an unhealthier nation. Or because we're a country where half the population does things like demonize a president who wants to spend money on preventative care up front, in order to save money in the long run. And vote in politicians who make sure that doesn't happen.

As systems increase I size efficiency is not increased in gov't agencies, what's silly about that ?

And unless they also control the delivery system, then medicaid type fraud will only increase as well.  $30 billion last year I believe.

[Anastasis 23699]

3 hours ago, bad_teammate said:

He's here! WOO!

 

Lack of exchange feels more like this.

[bad_teammate 13479]

16 minutes ago, Anastasis said:

The reality is that the end of the distribution drives healthcare expenditures.  Top 1% about 1/4 of all healthcare expenditures.  Top 10% ~2/3 of all expenditures. Optimizing care for the most medically complex should be the focal point to turn the trend in our NHE.

Yes, the sickest people require the most care which costs the most money. Yep. We all know this. What's your point?

Are private health insurance mechanisms somehow superior for this care-optimization effort?

What do we look at? Cancer survival rates? Life expectancy?

Also... which systems work best for the 99%?

Is there an actual point you're trying to make or are you just stating the obvious (sick and old people are the most expensive)?

[Anastasis 23699]

 

8 minutes ago, bad_teammate said:

Yes, the sickest people require the most care which costs the most money. Yep. We all know this. What's your point?

Are private health insurance mechanisms somehow superior for this care-optimization effort?

I think that the point was made pretty clearly earlier. There is evidence that in the US Medicare context they in fact are. 

4 hours ago, Anastasis said:

The outcomes, both clinically and in terms of healthcare costs are better in MA compared to FFS Medicare for the most medically complex members. The reality is that Medicare is not what Bernie is really talking about at all when he talks about Medicare for all.  It is something totally different when you get down to the nuts and bolts. 

Two relatively recent analyses from Avalere. 

http://go.avalere.com/acton/attachment/12909/f-0571/1/-/-/-/-/BMA Report.pdf

https://go.avalere.com/acton/attachment/12909/f-69e32532-ce17-42c8-87bc-8b95e12e258a/1/-/-/-/-/BMA_Duals_ISPOR_2019.pdf?nc=0&ao_optin=1

 

[bad_teammate 13479]

Again, I'm happy to just accept these industry-produced studies. 

Let's just go 100% with the idea that Medicare Advantage is producing better results than FFS in those specific circumstances. WONDERFUL. I love it. What are we learning? What's the takeaway? What are the implications regarding the current healthcare proposals offered by the candidates?

What's your point?

[bad_teammate 13479]

Guy whose story was used in a Kamala ad (back when she supported Medicare for All) isn't too happy with her new plan.

Another Bernie Bro, right?

 

[Anastasis 23699]

Just now, bad_teammate said:

Again, I'm happy to just accept these industry-produced studies. 

 Let's just go 100% with the idea that Medicare Advantage is producing better results than FFS in those specific circumstances. WONDERFUL. I love it. What are we learning? What's the takeaway? What are the implications regarding the current healthcare proposals offered by the candidates?

 What's your point?

Are you really this dense?

 

Somebody else please chime in here if the dots are not connecting. 

[bad_teammate 13479]

3 minutes ago, Anastasis said:

Are you really this dense?

Apparently, yes, I am.

Seems like there are a bunch of different good things that exist and we should pull the most effective utilization strategies.

[ChiTownDoc 21323]

I refuse to argue w BT.  The dots never connect with him but not one time has he ever admit he was wrong.  

I do value based medicine for a living.  We have contracts with several top hospital groups in the country.  

But anything I say will get an eye roll from BT because he knows it all.  It’s a shame that somebody who knows so much does so little in life.  If you have healthcare figured out go get a job and save us. 

I, for one, would love to compete against you.  

[ChiTownDoc 21323]

6 hours ago, Hank Kingsley said:

Personally I'm not critical of her plan (I admittedly do not have enough knowledge of the healthcare system to argue details), but that's a snake move on her part. 

 

 

What?!  Knowing you don’t have the knowledge is stopping you from talking nonstop shit?  What a fucked up concept.  

Actually, you’re a decent guy.  Have a talk with BT please.  BT has turned into the Rocco of CR.  That’s nightmare fuel.  

[Anastasis 23699]

6 minutes ago, ChiTownDoc said:

I do value based medicine for a living.

The number of people on this forum who understand the concept of value-based/outcome-based contracting in healthcare, and what entities have been the driving factor behind that paradigm in the US, can be counted on one or two hands tops. 

[bad_teammate 13479]

Idiot: "Medicare for All is cool. It's like the free Medicare but it is expanded to cover, like, everything. And everyone is on it automatically, no matter what."

Genius: "That's not Medicare, though, because I want to argue that 'Medicare' is primarily defined by the right-wing reforms made to it -- accelerating in the 1980s/90s under successive right-wing governments -- with the very explicit purpose of making the program easier for private capital to profit from. It's uh... real important and stuff."

[Anastasis 23699]

[bad_teammate 13479]

3 minutes ago, Anastasis said:

The number of people on this forum who understand the concept of value-based/outcome-based contracting in healthcare, and what entities have been the driving factor behind that paradigm in the US, can be counted on one or two hands tops. 

The entities that have been the driving factors behind the paradigm (you should be pantsed for using that word, drone) of outcome-based contracting are the industries desperately trying to avoid regulation and nationalization of any aspect of their business.

And it doesn't seem to actually work.

---------------------
Pharmaceutical manufacturers and some private payers are increasingly interested in outcomes-based contracts for high-cost brand-name drugs. But the power of these contracts to curb spending is questionable, largely because their applicability is restricted to a small subset of drugs and meaningful metrics to evaluate their impact are limited. There is no evidence that these contracts have resulted in less spending or better quality.

---------------------

IT WOULD BE AN HONOR TO COMPETE AGAINST YOU ON THE FIELD OF BATTLE IN THE HEALTHCARE MARKET, SIR! *single tear courses cinematically down my cheek*

 

[bad_teammate 13479]

Guys these brilliant market-based reforms are going to start taking over ANY MINUTE NOW!

Just ANY second now...

[Anastasis 23699]

You are actually arguing against reimbursement approaches that align financial incentives with health outcomes, rather than fee for service? This is what your brand of socialism is going to promote as the solution to our upside down healthcare expenditures? Good luck man. 

[bad_teammate 13479]

You are actually arguing against reimbursement approaches that align financial incentives with health outcomes, rather than fee for service? 

If that's actually a more efficient way to do it, then I'm all for it handled within a single-payer universal system.

I just posted a study saying it doesn't really work, though, at least in the case of drugs. But if it does in other cases, awesome.

[Anastasis 23699]

10 hours ago, bad_teammate said:

Seems like there are a bunch of different good things that exist and we should pull the most effective utilization strategies.

What if what the current functioning of the Medicare program shows us is that a system where there are private plans competing against each other, and against a public option, on benefit design and premium package, results in a system where the principles of choice, value, and quality are well balanced.

I don't quite understand what it is exactly about Kamala's plan is causing you to light your hair on fire, other than the fact that it doesn't effect Bernie's socialist healthcare utopia.  The part of her plan that I am curious about for further details is how the "buy in" would actually work, how that buy in premium would be priced, and what Medicare options would be available to people that buy in.  I also think that a 10 year phase could be accelerated.  Kamala's plan is smart in that it largely leverages the Medicare system that is already in place.  I don't see a reason that you couldn't scale it more aggressively. 

[DigglerontheHoof 21516]

14 hours ago, Brisketexan said:

Let's presume that the data in there is correct (setting aside the arguments, let's just look at the data).

A certain percentage of their population had to wait on medical treatments.

A certain percentage of their GDP was lost in terms of lost wages because of that.

In a vacuum, those stats are meaningless, as what the piece would purport to do is COMPARE the Canadian and US systems.  So, how do they COMPARE?  Because if the argument is "single-payer ain't perfect," no shit, Sherlock.  The question is whether it's better than what we have here.

For example, EVERY Canadian has coverage, but 1 million Canadians had to wait for care.  Compare that to the US:

Translation:

2.7% of Canadians had to wait for medical care.

8.3% of Americans have no coverage at all.

These are relevant comparisons.  I'd rather wait for medical care than not get it at all, right?

I don't know what the answer is but I've worked w/ a lot of Canadians over the last 5 or so years.  I have heard dozens of nightmare stories about years-long waits for procedures, infants going undiagnosed because they had to wait 2 years to see a specialist, friends/family going years w/out treatment.  They're either all liars or there are serious fucking issues w/ their system. 

 

[Anastasis 23699]

 

9 hours ago, bad_teammate said:

The entities that have been the driving factors behind the paradigm (you should be pantsed for using that word, drone) of outcome-based contracting are the industries desperately trying to avoid regulation and nationalization of any aspect of their business.

CMS, provider groups (in some specialties in particular), payers.  I'd go with those three groups as driving factors, probably in that order. Outcomes based reimbursement for prescription drugs, which seems to be your particular focus, is relatively undeveloped compared to other forms of value based reimbursement.   

[Onboard 2.0 9083]

23 minutes ago, DigglerontheHoof said:

I don't know what the answer is but I've worked w/ a lot of Canadians over the last 5 or so years.  I have heard dozens of nightmare stories about years-long waits for procedures, infants going undiagnosed because they had to wait 2 years to see a specialist, friends/family going years w/out treatment.  They're either all liars or there are serious fucking issues w/ their system. 

 

I think this is closer to the truth. I haven't heard of 2 year waits, but I've heard accounts of a year, and several of many months.  It's just not a system that can be sustained in a country with a large population like the US.  We have north of $30B a year in Medicare and Medicaid fraud Currently.

Our plans have gotten worse since the ACA was introduced, namely a $5k deductible we now have that used to be $1,000 - $2,000, and that was a plan for a family of four, not just the 2 adult plan we currently have.  The ACA was simply a license to raise rates, and deductibles as insurance companies saw fit.

[Js1 86939]

Hey monkeys, take it here. 

 

[David Dennison 19441]

14 hours ago, Onboard 2.0 said:

As systems increase I size efficiency is not increased in gov't agencies, what's silly about that ?

And unless they also control the delivery system, then medicaid type fraud will only increase as well.  $30 billion last year I believe.

That's it?

[bad_teammate 13479]

Hey monkeys, take it here. 
 

Kamala fans trying to doxx critics.

[Js1 86939]

Bernie people criticizing another candidate's twitter supporters?

 

[Hank Kingsley 21598]

 

[Js1 86939]

 

[BradInATX 9208]

It's time to start calling the statement "the majority of Americans want Medicare for All" out for what it actually is. It's fake news.

 

 

 

[Js1 86939]

 

[Anastasis 23699]

The political beauty of the term "Medicare for all" is that it can mean vastly different things to different people, ranging anywhere from a single payer, national healthcare system to an ACA like market place where private insurers compete and consumers have a public option if they so choose. I understand Bernie's frustration, given that he originated the term, but the reality is that he originated the term to describe something that isn't even representative of Medicare.  It is something totally different. His Medicare for all plan isn't even Medicare, for all. 

 

Edited July 30, 2019 by Anastasis

[bad_teammate 13479]

Expanding Medicare Advantage is a giveaway to private insurance companies and anyone proposing it is not serious about controlling costs because they are promoting expansion of a wasteful, overly-expensive system.

---------------------------------------

- Risk score errors triggered nearly $70 billion in “improper” payments to Medicare Advantage plans from 2008 through 2013 — mostly overbillings, according to government estimates. Federal officials refused to identify health plans suspected of overcharging Medicare, citing agency policy that keeps many business records confidential. The Center is suing to make these records public.

- Risk scores of Medicare Advantage patients rose sharply in plans in at least 1,000 counties nationwide between 2007 and 2011, boosting taxpayer costs by more than $36 billion over estimated costs for caring for patients in standard Medicare.

- In more than 200 of these counties, the cost of some Medicare Advantage plans was at least 25 percent higher than the cost of providing standard Medicare coverage. The wide swing in costs was most evident in five states: South Dakota, New Mexico, Colorado, Texas and Arkansas.

---------------------------------------

It's a scam. It's a fraud. It's a grift.

[bad_teammate 13479]

It's actually pretty impressive how deceptive she is.

 

[Js1 86939]

Again, spreading Bernie propaganda from his paid staff. Of course they aren’t complimentary 

[Js1 86939]

 

[bad_teammate 13479]

19 minutes ago, Js1 said:

Again, spreading Bernie propaganda from his paid staff. Of course they aren’t complimentary 

He's right. Kamala's campaign is trying to use make her garbage "Medicare for All" plan look like it's backed by 200 economists when those 200 economists were actually talking about Bernie's plan.

Look, bud, I'm sorry that you've decided to back a lying, untrustworthy horse. I know it's putting you in a tough spot. There's a better way, man. You can free yourself from that burden. You can't even honestly try to defend the plan itself. It's unfortunate.

And I'm way more eager to listen to a campaign spokesperson than listen to one of CAP's boys.

Center for American Progress - Our Supporters

A bunch of trust funds, insurers, and private equity firms fund this bullshit think-tank. Good job parroting its propaganda!

[Hank Scorpio 17924]

26 minutes ago, Js1 said:

Again, spreading Bernie propaganda from his paid staff. Of course they aren’t complimentary 

I mean, that's true, but I think the bigger point is that he's right and what Harris is claiming is not true. My crazy old racist grandpa has terrible opinions, but when he says OU sucks he's not wrong. 

[Hugo Stiglitz 23367]

Kamala’s strength isn’t defending her policy ideas.  It’s pretty clear her policy “ideas” are just a means to an end.  She’s a great politician and reminds me a lot of Obama with a little more backbone but wading into the policy waters should not be her schtick for this campaign.  She should stick to cutting motherfuckers, she’s good at that.

[Mojo Hand 4580]

I don't really have a problem with Kamala staking a claim to her own version of Medicare for All, as long as it's open and honest, but if she's claiming support for her version based on supporters of Bernie's version, that's total horseshit. 

[Hank Scorpio 17924]

7 minutes ago, Hugo Stiglitz said:

 reminds me a lot of Obama 

So racist

[bad_teammate 13479]

11 minutes ago, Hugo Stiglitz said:

Kamala’s strength isn’t defending her policy ideas.  It’s pretty clear her policy “ideas” are just a means to an end.  She’s a great politician and reminds me a lot of Obama with a little more backbone but wading into the policy waters should not be her schtick for this campaign.  She should stick to cutting motherfuckers, she’s good at that.

[Mojo Hand 4580]

C'mon guys, he just means that she's clean and articulate. 

[Hugo Stiglitz 23367]

Well, she is following the first term Senator straight to the presidency Obama roadmap.  Her political trajectory reminds of Obama the most.  

[immortal13 4059]

54 minutes ago, Mojo Hand said:

C'mon guys, he just means that she's clean and articulate. 

Well spoken, even

[TwiceHorn 31987]

Lmao @ "clean."

 

[Js1 86939]

And that was said 12 years ago. JFC

[Dbeasy 15526]

I refuse to argue w BT.  The dots never connect with him but not one time has he ever admit he was wrong.  
I do value based medicine for a living.  We have contracts with several top hospital groups in the country.  
But anything I say will get an eye roll from BT because he knows it all.  It’s a shame that somebody who knows so much does so little in life.  If you have healthcare figured out go get a job and save us. 
I, for one, would love to compete against you.  

People like BT is what causes a lot of people to vote republican.

[Js1 86939]

If an overzealous internet supporter causes someone to vote Republican, they didn’t even a nudge. 

[bad_teammate 13479]

43 minutes ago, Dbeasy said:

People like BT is what causes a lot of people to vote republican.

 

Be nice to me or I'm going to be a Nazi!!!!!!!!!!!!!!

[bad_teammate 13479]

Bernie and Liz were on stage with a bunch of Healthcare Republicans.

Tonight's stage is 90% Healthcare Republican, including Kamala whose plan seems somewhat lifted from Paul Ryan.

#sad

 

[bad_teammate 13479]

FANCY SPEECH ON A FANCY STAGE!
I HAD TO FACE THE REALITY OF HARDCORE MARIJUANA POSSESSORS!!!!!!!!!!!!!