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Alexandria Ocasio-Cortez


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47 minutes ago, sheeeit said:

As for your examples, I would assume the same people would apply and work those police jobs that are working them now?  What possible difference would it make if they were being paid by a private company or the govt.  You seem to assume that bribery can only exist in the private sector which is curious.  

What government constraints and oversight would limit the power and whimsy of your private police force? Who might be attracted to a job where they wear a gun and have near plenary power over anyone they apprehend? I'm surprised you don't see the difference between a band of mercenaries and a band of government lawmen.

I assume that bribery only exists in the private security? That's just an oddball interpretation of my position which actually seems to reflect your own binary view of private vs public sector efforts.

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38 minutes ago, Bat Guano said:

Medicare and Medicaid may have distorted the private market, but the undeniable fact is, they work, and they work much more efficiently than their private counterparts.

I agree with most of your post but this part I strongly disagree with.  This is not a perfect example but it is quite interesting to consider.  We need to remember that the private insurers had no problem covering people currently getting medicaid, they just were not going to do it without getting paid.

In 2017 there were roughly 28 M (lots of kids) people that lacked private health insurance.  The vast majority were medicaid recipients.  Now before people go crazy, I fully support medicaid to those that need it.  It is a very good use of govt funds.  

But in 2017 total spend on medicaid for these 28M people totaled about $560B between state and federal.  medicaid provides, essentially, the same benefits that ACA compliant health insurance plans provide.  If we take the most basic ACA compliant plan that is equivalent to the benefits provided by Medicaid, the premium for coverage is approximately $400/per month per person (it is actually less for kids but we will use the higher figure).  So that is about $4,800 annually.  So the private insurance world will insure every uninsured american for $135B.  Lets be really generous and say every single person, all 28M, will use their entire $1,000 deductible in the year.  That is another $28B.  So the private insurance world will insure everyone to an ACA compliant level and we can pay all of their deductibles for somewhere in the range of $163B yet we spend $560B annually on medicaid.  Throw in about $20B annually for dental and vision.  

So the US could simply pay the premium for every single uninsured person, and pay their annual deductible and provide dental and vision care for less than $200B and as a country we save $360B.   

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6 minutes ago, jimmyjazz said:

However you want to couch it, you are saying the US has no hope of solving problems that have been solved many times over, with great satisfaction among their electorates, by smaller countries with far lower GDP.

I'm not ready to throw up my hands.

It would take an educated public demanding far more of our elected officials, which is of course absurd at face value, but in the end, a vote is a vote (until it isn't).

 

Designing a functional system that would address healthcare access, delivery and financing is really not that hard. Four or five posters here could probably outline a pretty good model over a few beers. Now implementing that model in our dysfunctional political environment is quite another thing. That’s where it breaks down. But hey, prove me wrong. Democrats should have total control in 2020 (just like they did in 2008) and will have their chance. 

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5 minutes ago, RomaVicta said:

What government constraints and oversight would limit the power and whimsy of your private police force? Who might be attracted to a job where they wear a gun and have near plenary power over anyone they apprehend? I'm surprised you don't see the difference between a band of mercenaries and a band of government lawmen.

I assume that bribery only exists in the private security? That's just an oddball interpretation of my position which actually seems to reflect your own binary view of private vs public sector efforts.

You clearly can not grasp what I am saying.  Whatever oversight we currently have on the police we would have on a private police force.  I am suggesting that if Austin currently spends $200M on its police force, that if we bid out the exact same services to private companies, that the bids to perform the same work would be less than $200M.  I am saying we have no idea if the police force is run efficiently or not because we have nothing to compare it to.  

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2 minutes ago, jimmyjazz said:

So your approach is to accept the dysfunctional political environment and resulting outcomes, as opposed to treating the disease.  That makes a lot of sense.

No. I don’t accept that. Our politics need to fundamentally change. Sure, let’s talk about treating the disease. All for it. I think there is a thread in that. But I also happen to think that the disease is terminal. Id love to be wrong. 

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18 minutes ago, sheeeit said:

I agree with most of your post but this part I strongly disagree with.  This is not a perfect example but it is quite interesting to consider.  We need to remember that the private insurers had no problem covering people currently getting medicaid, they just were not going to do it without getting paid.

In 2017 there were roughly 28 M (lots of kids) people that lacked private health insurance.  The vast majority were medicaid recipients.  Now before people go crazy, I fully support medicaid to those that need it.  It is a very good use of govt funds.  

But in 2017 total spend on medicaid for these 28M people totaled about $560B between state and federal.  medicaid provides, essentially, the same benefits that ACA compliant health insurance plans provide.  If we take the most basic ACA compliant plan that is equivalent to the benefits provided by Medicaid, the premium for coverage is approximately $400/per month per person (it is actually less for kids but we will use the higher figure).  So that is about $4,800 annually.  So the private insurance world will insure every uninsured american for $135B.  Lets be really generous and say every single person, all 28M, will use their entire $1,000 deductible in the year.  That is another $28B.  So the private insurance world will insure everyone to an ACA compliant level and we can pay all of their deductibles for somewhere in the range of $163B yet we spend $560B annually on medicaid.  Throw in about $20B annually for dental and vision.  

So the US could simply pay the premium for every single uninsured person, and pay their annual deductible and provide dental and vision care for less than $200B and as a country we save $360B.   

What do 28 million uninsured people have to do with Medicaid?  Do you always just make shit up and hope nobody bothers to look up the real numbers?

66.5 million people are enrolled in Medicaid right now.  Doubtful that there were 40 million sign ups between your made up 2017 stat and now.

"73,156,236 individuals were enrolled in Medicaid and CHIP in the 51 states reporting August 2018 data. 66,637,193 individuals were enrolled in Medicaid and 6,519,043 individuals were enrolled in CHIP (please see contextual information below regarding CHIP enrollment)."

https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html

*DC is the 51st state in this quote.

Edited by FondrenRoad
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20 minutes ago, sheeeit said:

I agree with most of your post but this part I strongly disagree with.  This is not a perfect example but it is quite interesting to consider.  We need to remember that the private insurers had no problem covering people currently getting medicaid, they just were not going to do it without getting paid.

In 2017 there were roughly 28 M (lots of kids) people that lacked private health insurance.  The vast majority were medicaid recipients.  Now before people go crazy, I fully support medicaid to those that need it.  It is a very good use of govt funds.  

But in 2017 total spend on medicaid for these 28M people totaled about $560B between state and federal.  medicaid provides, essentially, the same benefits that ACA compliant health insurance plans provide.  If we take the most basic ACA compliant plan that is equivalent to the benefits provided by Medicaid, the premium for coverage is approximately $400/per month per person (it is actually less for kids but we will use the higher figure).  So that is about $4,800 annually.  So the private insurance world will insure every uninsured american for $135B.  Lets be really generous and say every single person, all 28M, will use their entire $1,000 deductible in the year.  That is another $28B.  So the private insurance world will insure everyone to an ACA compliant level and we can pay all of their deductibles for somewhere in the range of $163B yet we spend $560B annually on medicaid.  Throw in about $20B annually for dental and vision.  

So the US could simply pay the premium for every single uninsured person, and pay their annual deductible and provide dental and vision care for less than $200B and as a country we save $360B.   

Where are you getting those numbers?

Medicare admin costs are around 2%, Medicaid around 7%. Private insurers' admin costs are 12 -18%, depending on group sizes.

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51 minutes ago, sheeeit said:

I am suggesting that if Austin currently spends $200M on its police force, that if we bid out the exact same services to private companies, that the bids to perform the same work would be less than $200M.  I am saying we have no idea if the police force is run efficiently or not because we have nothing to compare it to.  

And I am suggesting that there are concerns that are much greater than the bottom line when it comes to a great many public functions.

I don't want Officer Jones to be answerable to shareholders, because shareholders have significantly divergent interests compared to mine as a member of the general public that is to be protected and served.  I don't want Officer Jones to be cutting corners because of profit-increasing directives from corporate HQ.  I don't want Officer Jones to be focusing more on traffic tickets than real crime because CopCorp. gets a cut of all revenue (shit, this is already a problem with the police as a public entity -- imagine how much worse it would be if it was a for-profit private entity).

I don't want to replace the US Army with Blackwater.  I want an Army that serves the Commander in Chief and Congress absolutely, with no competing loyalties.  I don't want my Army to get an order and say "well, that's not in our contract."

The inherent value of having certain functions answerable ONLY to "we the people," and being inherently public service entities, is often equal to or greater than any financial considerations.

Shit, people hold up the Post Office as an example.  A Post Office has, for centuries, all over the world, been something that EVERY government maintains.  It's not because they love sweet cushy gov't jobs.  It's because having a reliable service by which written communications, transactions, and goods can travel is necessary for a functioning economy.  Governments build and maintain airports, and ports, and highways, and postal services, because those are force-multipliers for commerce.  Which is a net good for the public as a whole.  We shouldn't care if government function X (the USPS, the airport, etc.) makes a profit, or if it requires taxes to cover its bills, if that function is serving a greater public good.  

Shit, the military is the PERFECT example to this.  Since the days of looting enemy cities ended, an army doesn't MAKE money.  It protects it.  It secures our safety and commercial viability.  The navy protects the sea lanes so that commerce flows.  We put money in, we get NO money out.  But we get great benefit.

The public good is a real thing.  Not everything can and should translate to a P&L analysis.

Edited by Brisketexan
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3 hours ago, Hugo Stiglitz said:

What? It was Romney’s blueprint 

The Commonwealth of Massachusetts passed a health care reform law in 2006 with the aim of providing health insurance to nearly all of its residents. The law mandated that nearly every resident of Massachusetts obtain a minimum level of insurance coverage, provided free health care insurance for residents earning less than 150% of the federal poverty level (FPL)[1] and mandated employers with more than 10 "full-time" employees to provide healthcare insurance. The law was amended significantly in 2008 and twice in 2010 to make it consistent with the federal Affordable Care Act. Major revisions related to health care industry price controls were passed in August 2012, and the employer mandate was repealed in 2013 in favor of the federal mandate (even though enforcement of the federal mandate was delayed until January 2015).[2]Because Mitt Romney was the governor of Massachusetts at the time, the law has colloquially been called Romneycare, a reference to the nicknaming of the Patient Protection and Affordable Care Act as "Obamacare".[3]

"Romneycare" was created by Super majority D Massachusetts House and Senate,  it was signed by a R, with 8 sections veto'd that were all overidden by said Super majority D.

 

But other than that, totally a Republican creation.

 

In Fall 2005, the House and Senate each passed health care insurance reform bills. The legislature made a number of changes to Governor Romney's original proposal, including expanding MassHealth (Medicaid and SCHIP) coverage to low-income children and restoring funding for public health programs. The most controversial change was the addition of a provision which requires firms with 11 or more workers that do not provide "fair and reasonable" health coverage to their workers to pay an annual penalty. This contribution, initially $295 annually per worker, is intended to equalize the free care pool charges imposed on employers who do and do not cover their workers.

On April 12, 2006, Governor Romney signed the health legislation.[21] He vetoed eight sections of the health care legislation, including the controversial employer assessment.[22] He vetoed provisions providing dental benefits to poor residents on the Medicaid program, and providing health coverage to senior and disabled legal immigrants not eligible for federal Medicaid.[23] The legislature promptly overrode six of the eight gubernatorial section vetoes, on May 4, 2006, and by mid-June 2006 had overridden the remaining two.[24]

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19 minutes ago, bad_teammate said:

We're capitalists, that's just how it is.

#Pelosi

A farmer’s horse runs away.

All the neighbors say, “How unfortunate!”

“We’ll see,” replies the farmer.

The horse returns along with three wild horses.

“That’s amazing!” say all the neighbors.

“We’ll see,” replies the farmer.

Next day, his son tries to ride one of the wild horses, gets bucked off, and breaks a leg.

“What bad luck!” say the neighbors.

“We’ll see,” replies the farmer.

The following week military officials come to the village to draft all the young men into the army. But because the son’s leg is broken, they leave him.

“That’s great!” say the neighbors. “We’ll see,” replies the farmer. 

 

 

I hate to be both sides guy, but there is a benefit to seeing both sides in everything, this included.

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1 hour ago, jimmyjazz said:

How does this not put a ribbon on the entire argument?

The bigger issue for me is that we cannot have the cost of healthcare roughly doubling every 10 years. We need to get costs under control and keep increases in line with inflation.

Private corporations do not like their growth capped at the rate of inflation. 

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7 minutes ago, Continental Op said:

How can you guys spend so much time talking about healthcare policy when one time Ocasio-Cortez wore some expensive clothes someone loaned her for a photo shoot?

Remember when the GOP spent thousands to clothe that hillbilly from Alaska 10 years ago?

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Just now, Iconoclast Texan said:

The answer is in no way socialized medicine. There has to be a concerted effort to fight against it by the GOP. Preventing the disaster of a British or Canadian style NHS is one of the main reasons I’m a Republican and always will be.

 

Whew.    You should get that put on a tailored jersey or some such.

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Just now, Francisco 2.0 said:

Whew.    You should get that put on a tailored jersey or some such.

They have my vote. That’s all that matters. The WSJ had sa great opinion piece about how awful socialized medicine compared to ours. There is healthcare available to every social strata in this country. If you’re poor and don’t have a job it’s not as good as someone who does. There is nothing wrong with that.

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2 minutes ago, Iconoclast Texan said:

They have my vote. That’s all that matters. The WSJ had sa great opinion piece about how awful socialized medicine compared to ours. There is healthcare available to every social strata in this country. If you’re poor and don’t have a job it’s not as good as someone who does. There is nothing wrong with that.

And if you're middle class, it bankrupts you.

Medical%20bills%20and%20bankruptcy.jpg

medbankruptcyoverview.jpg

CR-Inline-ACA-Bankruptcy-chart3-final-06

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6 minutes ago, Iconoclast Texan said:

There is healthcare available to every social strata in this country. If you’re poor and don’t have a job it’s not as good as someone who does. There is nothing wrong with that.

I’m guessing we won’t be seeing any Bible verses from you any longer.

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5 minutes ago, Brisketexan said:

And if you're middle class, it bankrupts you.

See, that's a feature, not a bug.

It's everyone's responsibility to make as much money as necessary for their medical care.  If it requires you making $1.2 million per year, so be it.  If you can't afford to do that, well, that's your fault for not making enough to take care of you or your loved ones.  

 

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18 minutes ago, Iconoclast Texan said:

The answer is in no way socialized medicine. There has to be a concerted effort to fight against it by the GOP. Preventing the disaster of a British or Canadian style NHS is one of the main reasons I’m a Republican and always will be.

 

https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-group/revenue

i wish i could screencap the chart at this link.

revenue growth and profit are the engine behind shareholder success in this country. i'm not sure that is in line with positive medical outcomes.

all these companies are doing extremely well by pinching everyone's costs. look at the costs chart posted above. 

somehow they are getting away with it.

why?

 

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29 minutes ago, Iconoclast Texan said:

The answer is in no way socialized medicine. There has to be a concerted effort to fight against it by the GOP. Preventing the disaster of a British or Canadian style NHS is one of the main reasons I’m a Republican and always will be.

 

You do know that the US ranjs behind both the UK and Canada in terms of healthcare efficiency, right?  So if their systems are "disasters", what does that make ours?

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1 minute ago, hayden_horn said:

https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-group/revenue

i wish i could screencap the chart at this link.

revenue growth and profit are the engine behind shareholder success in this country. i'm not sure that is in line with positive medical outcomes.

all these companies are doing extremely well by pinching everyone's costs. look at the costs chart posted above. 

somehow they are getting away with it.

why?

 

As much as CIGNA, Humana and the rest of the bloodsucking health insurance companies suck ass, I can still make an appointment and be seen by a specialist with my PPO tomorrow depending on their availability. Do you have family in either Canada or the UK? I do and have had family members come here to the US to get treated for things that would have taken months to be treated back in their homes. Nationalized health care sounds good to some Americans because they think they will get the same access they do now without the middleman. That’s not reality.

“Single-payer programs usually impose long waiting lists and delays unheard of in the U.S. Last year, a record 4.2 million patients were on England’s NHS waiting lists; 362,600 patients waited longer than four months for hospital treatment as of that March, and 95,252 waited longer than six months. By this July, 4,300 people had been on the wait list more than a year—all after receiving their diagnosis and referral—according to NHS England’s “Referral to Treatment” waiting-times data. 

In Canada last year, the median wait time between seeing a general practitioner and following up with a specialist was 10.2 weeks, while the wait between seeing a doctor and beginning treatment was about five months. According to a Fraser Institute study, the average Canadian waits three months to see an ophthalmologist, four months for an orthopedist and five months for a neurosurgeon.”

https://www.wsj.com/articles/the-false-promise-of-medicare-for-all-1542066511?mod=article_inline

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3 minutes ago, DixonHur said:

You do know that the US ranjs behind both the UK and Canada in terms of healthcare efficiency, right?  So if their systems are "disasters", what does that make ours?

Degrading the health care system and choices for the middle and upper classes in this country to marginally improve the health outcomes of the poor who usually compound their health problems with poor nutrition, lack of exercise and other poor lifestyle choices seems like a bad trade off. 

Edited by Iconoclast Texan
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How do the average wait times compare between the US and the NHS?  Given that the US spends more than twice per capita than the UK on healthcare, I would assume wait times would be better, especially considering the limited access to healthcare in the US.  

Edited by Fozzz
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6 minutes ago, Iconoclast Texan said:

Degrading the health care system and choices for the middle and upper classes in this country to marginally improve the health outcomes of the poor who usually compound their health problems with poor nutrition, lack of exercise and other poor lifestyle choices seems like a bad trade off. 

So Canadians spend half as much for healthcare, have a longer average life span, and half the maternal mortality of the US, but somehow in your mind that equates to a "degrading" in healthcare?

Interesting.

 

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Degrading the health care system and choices for the middle and upper classes in this country to marginally improve the health outcomes of the poor who usually compound their health problems with poor nutrition, lack of exercise and other poor lifestyle choices seems like a bad trade off. 

EXCEPT OUR MIDDLE AND UPPER CLASS OUTCOMES AREN’T BETTER, EITHER.
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As much as CIGNA, Humana and the rest of the bloodsucking health insurance companies suck ass, I can still make an appointment and be seen by a specialist with my PPO tomorrow depending on their availability. Do you have family in either Canada or the UK? I do and have had family members come here to the US to get treated for things that would have taken months to be treated back in their homes. Nationalized health care sounds good to some Americans because they think they will get the same access they do now without the middleman. That’s not reality.

“Single-payer programs usually impose long waiting lists and delays unheard of in the U.S. Last year, a record 4.2 million patients were on England’s NHS waiting lists; 362,600 patients waited longer than four months for hospital treatment as of that March, and 95,252 waited longer than six months. By this July, 4,300 people had been on the wait list more than a year—all after receiving their diagnosis and referral—according to NHS England’s “Referral to Treatment” waiting-times data. 

In Canada last year, the median wait time between seeing a general practitioner and following up with a specialist was 10.2 weeks, while the wait between seeing a doctor and beginning treatment was about five months. According to a Fraser Institute study, the average Canadian waits three months to see an ophthalmologist, four months for an orthopedist and five months for a neurosurgeon.”

https://www.wsj.com/articles/the-false-promise-of-medicare-for-all-1542066511?mod=article_inline


AMERICANS ARE SEVERAL TIMES MORE LIKELY TO TRAVEL TO ANOTHER COUNTRY FOR CARE AS A CANADIAN IS TO TRAVEL TO THE UNITED STATES FOR CARE.
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1 hour ago, Bozo_Casanova said:


AMERICANS ARE SEVERAL TIMES MORE LIKELY TO TRAVEL TO ANOTHER COUNTRY FOR CARE AS A CANADIAN IS TO TRAVEL TO THE UNITED STATES FOR CARE.

Anybody that lives within a few hours of the mexican border knows people that cross for medical or dental care.   From primary care to plastic surgery, people travel across borders. 

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2 hours ago, Iconoclast Texan said:

As much as CIGNA, Humana and the rest of the bloodsucking health insurance companies suck ass, I can still make an appointment and be seen by a specialist with my PPO tomorrow depending on their availability. Do you have family in either Canada or the UK? I do and have had family members come here to the US to get treated for things that would have taken months to be treated back in their homes. Nationalized health care sounds good to some Americans because they think they will get the same access they do now without the middleman. That’s not reality.

“Single-payer programs usually impose long waiting lists and delays unheard of in the U.S. Last year, a record 4.2 million patients were on England’s NHS waiting lists; 362,600 patients waited longer than four months for hospital treatment as of that March, and 95,252 waited longer than six months. By this July, 4,300 people had been on the wait list more than a year—all after receiving their diagnosis and referral—according to NHS England’s “Referral to Treatment” waiting-times data. 

In Canada last year, the median wait time between seeing a general practitioner and following up with a specialist was 10.2 weeks, while the wait between seeing a doctor and beginning treatment was about five months. According to a Fraser Institute study, the average Canadian waits three months to see an ophthalmologist, four months for an orthopedist and five months for a neurosurgeon.”

https://www.wsj.com/articles/the-false-promise-of-medicare-for-all-1542066511?mod=article_inline

And that's why many Americans have long waits, too.

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Going to India and Costa Rica for cheaper surgeries?  Is that the statistic you are using?

No, but that’s an OK start. According to most widely cited estimates about 2M Americans go abroad for medical procedures, or about .6% of the US population, and that number is growing by ~15-20% year as US costs increase and care quality declines. Around 50k Canadians come to the US, or around .15% of the Canadian population.

 

Now if you counted the very large number of people who access the Mexican and Canadian markets for prescription drugs, dental work and outpatient care you are probably talking about several times that 2M number.

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  • hayden_horn changed the title to Alexandria Ocasio-Cortez


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