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  • I've worked as a provider within and received care from the VA. It's not terrible but the scope of inefficiency is broad. Facilities are modern, all over the place regardless of where you might live and seek medical services from and generally of equal quality to commercially provided medical services. The system is complex. You have to know how to work it to your advantage and that can be difficult for most of the population it serves - that seems to be the source of complaints that show up in the press.

    It is inappropriate to try to suggest the VA HC System is a a good or a bad model for universal health care. It's neither. The reason is that the mechanics of how care is paid for and delivered is starkly different than any practical suggestions for managing costs and delivery of commercial medical care.

    Let me be clear. Medicare for all sounds great but for a number of very good reasons, it's impractical. There really is a narrow segment of folks who get boxed out of the current US HC system and I think AA has shed some light on that segment. Medicaid covers the poor and while not all providers will accept it, there are plenty who will. Medicare covers the elderly (with appropriate limitations already in place, IMO). Employer based medical coverage remains the functional alternative for the rest. None of these mechanisms are perfect but I'm inclined to believe the best approach to making all these systems work better is to tweak them not to shit can them and start over.

    Waste, fraud and abuse are present in all three segments of the US HC Delivery model. It's not that hard to wring, or at least improve, the waste, fraud and abuse out of these systems. That's where I'd start and I actually think the Trump administration is on the right track, notwithstanding DJT should just STFU when he tries to talk about how great he's doing in this area. Cost management should be another key target to improve in the current HC system - that's a tough nut to crack because powerful people within the system who have a vested interest in maintaining the status quo are obstacles. I've posted here about one of them - Pharmacy Benefit Managers or PBMs. That's another place I'd target for cost control and there are a lot of good ways to do that through federal regulation. This is one place in a free HC market economy I'd be all for better regualtions.
    Last edited by Jeff Buchanan; August 3rd, 2018, 09:51 AM.
    On Harbaugh's expectations for M football in 2015 (NFL NETWORK): �We'd rather be about it than talk about it."

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        If it becomes unacceptable when changing the race, it was never acceptable to begin with.

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        • Originally posted by iam416 View Post
          Those two things aren't at all causally connected, IMO, Froot. The Medicare-For-All movement was one of Bernie's central planks in 2016 with the ACA still well in force and upheld by the Supreme Court. The Ds, over the past 2 years, have adopted more and more of Bernie's platform. It's a natural progression as the Ds become the Democrat [Socialists]. The idea that a sabotaged ACA is driving this is buffoonery; nothing but a way to get a snarky shot in at the Rs and their efforts to undo the ACA through non-legislative means.

          Incidentally, I'm with you on the Rs. Either pass a law or don't. That's the proper process. But they could restore the ACA to it's grand glory tomorrow and the Ds that have called for Medicare-For-All wouldn't change their position one iota. And you know it.
          I'm not sure on that talent, the congress did everything they could to sabotage it prior to 2016. it kind of rendered it ineffective, it was always a good faith effort on the Obama administration to make it bipartisan. At the end they got a bunch of amendments and then no votes and starve the funding. The bipartisan negotiations were absolutely foolish in retrospect, it was a conservative think tank proposal, there isn't going to be a second conservative proposal if the Democrats get back in power. That's the causal connection in my mind. You may not think there is a causal connection but I do. So I don't know it.

          There is no sense in actually trying to redo the ACA or improve on it knowing the ongoing opposition.
          Last edited by froot loops; August 3rd, 2018, 10:50 AM.

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          • I'm not sure that there is, literally, ANY healthcare bill that could pass now. Or in 2020 when the Ds have control of the House and Executive. I think it's a toxic issue that no one wants to own.
            Dan Patrick: What was your reaction to [Urban Meyer being hired]?
            Brady Hoke: You know.....not....good.

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                • most vets--90% when given a choice of using the VA or going to non VA healthcare would rather stay in the VA


                  specialty care can be difficult with most specialists hard to afford for the VA whenthey genrally make a lot more outside VA

                  but fact of mat4ter is govt never has been economic in it big agencies and the VA is no different.

                  21 million vets alive today maybe 6 million getting treated at the VAeache year-medical budget alone was 160 billion--about 24K a year for each vet just for the medical care let alone compensation and education which accounts for another 100 billion a year

                  I think we could do better

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                  • Originally posted by iam416 View Post
                    You're going to have to link that Koch Brothers-funded study. But, really, I admire the approach of saying moving to Medicare for All will allow us to pay for so much more. That's some real motherfucking chutzpah.
                    https://www.mercatus.org/system/file...paper-v1_1.pdf

                    Table 2 I believe is the what you will find interesting.

                    The change in administrative costs and health care spending would save 2.154 Trillion over the next decade as opposed to doing nothing. I suspect that it could be more a lot more than that because people with insurance are more likely to go to the doctor for preventive care which catches things before it is huge thing that requires an ER visit (or worse).

                    2012 Detroit Lions Draft: 1) Cordy Glenn G , 2) Brandon Taylor S, 3) Sean Spence olb, 4) Joe Adams WR/KR, 5) Matt McCants OT, 7a) B.J. Coleman QB 7b) Kewshan Martin WR

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                    • Originally posted by Whitley View Post

                      https://www.mercatus.org/system/file...paper-v1_1.pdf

                      Table 2 I believe is the what you will find interesting.

                      The change in administrative costs and health care spending would save 2.154 Trillion over the next decade as opposed to doing nothing. I suspect that it could be more a lot more than that because people with insurance are more likely to go to the doctor for preventive care which catches things before it is huge thing that requires an ER visit (or worse).
                      I personally don't find it interesting. Jesus, the dems sound like my wife that will spend 100 bucks because an item is 20% off acting like she saved me money. I have to kindly remind her that she cost me 100 dollars, she didn't actually save me anything.

                      I'm still waiting for you to square how we spend 32 Trillion over the next 10 years on healthcare for all.

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                      • Screw any other noise that is going on in here right now. THIS is of utmost importance!

                        https://www.fathomevents.com/events/...th-anniversary

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                        In Columbus, of course, the fanbase holds the University accountable for doing the wrong thing. -Talent, Esq-

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                        • The greatest ending in film history, if you've never seen it

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                            • Originally posted by Kapture1 View Post

                              I personally don't find it interesting. Jesus, the dems sound like my wife that will spend 100 bucks because an item is 20% off acting like she saved me money. I have to kindly remind her that she cost me 100 dollars, she didn't actually save me anything.

                              I'm still waiting for you to square how we spend 32 Trillion over the next 10 years on healthcare for all.
                              You prefer the current system which costs 34 Trillion over the next 10 years and doesn't cover everyone?
                              2012 Detroit Lions Draft: 1) Cordy Glenn G , 2) Brandon Taylor S, 3) Sean Spence olb, 4) Joe Adams WR/KR, 5) Matt McCants OT, 7a) B.J. Coleman QB 7b) Kewshan Martin WR

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                              • Don't quote that jackass.
                                In Columbus, of course, the fanbase holds the University accountable for doing the wrong thing. -Talent, Esq-

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