Miscellaneous And Off Topic Subjects

[entropy]

I'd be interested in knowing when health care insurance became a common benefit provided by employers (thanks to being a deductible expense vs. you paying tax on it as income). You can probably trace the spiraling-out-of-control costs back to that point

I'll see if I still have some timelines on the evolution of healthcare insurance.. but basically during and after WWII businesses used insurance benefits as a way to attract the best potential employees. Over time the benefit perks kept increasing. Today we are at a point where insurance is no longer used as initially intended (meaning for emergencies or critical care) but for cold medications and to fix lifestyle choices.

[Hannibal]

I feel like it is only in my life that health insurance has become a standard expectation. Like when I was a kid the phenomenon of getting a doctor bill in the mail and just paying it still existed. At some point people in the past probably were legitimately better off getting insured by their employer because of the tax implications, but this has led to a royally fucked up system where the usual forces of supply and demand are kept apart.

[froot loops]

The outcome of the Affordable Care Act may indeed be some incremental change that leads to single payer but it certainly wasn't part of some grand scheme. The idea was borne out of a conservative think tank and was backed by Republicans as an alternative to the Clinton plan back I the 90s. This was an effort at bipartisanship on the Obama administration, it didn't work as the GOP made it their game plan to oppose anything Obama was for even if it meant doing a 180 from their previous stance.

The theory is the American public thinks the President has more power than the position actually does. So if Congress stays in gridlock, the President gets the blame.

[entropy]

No one makes sure something happens now.

As far as incentive: concern, care, reputation, avoidance of lawsuits, and keeping a regular patient on your roster, paying you (i.e., alive and not seeking a new doc) were all incentives. The thought that the nominal reimbursement that docs get for preventative now are great motivators has been shown to be greatly overstated.

all your incentives mean is doing enough to get by... I'm not suggesting doctors don't care. I think they do. But they have to see so many patients per day to make the $$'s work. And as I said, they have little participation from the patient. The model will not reduce costs. You can only reduce costs by limiting supply (long term).. imo

and many organizations are going at risk with populations and starting the process. I'm glad they are starting. I don't know if they will end up working, but it's better than saying keep managing health the way we do today. I do think they have a lot of potential.

[froot loops]

Getting the medical bill in the mail and paying it still exists even with medical insurance.

[AlabamAlum]

The outcome of the Affordable Care Act may indeed be some incremental change that leads to single payer but it certainly wasn't part of some grand scheme. The idea was borne out of a conservative think tank and was backed by Republicans as an alternative to the Clinton plan back I the 90s. This was an effort at bipartisanship on the Obama administration, it didn't work as the GOP made it their game plan to oppose anything Obama was for even if it meant doing a 180 from their previous stance.

The theory is the American public thinks the President has more power than the position actually does. So if Congress stays in gridlock, the President gets the blame.

I think many in certain power circles wanted a single payer and saw it as the ultimate evolution of universal healthcare. And at the very least, when there is a low cost government mandated health plan option the incentive for businesses to offer an employer supported plan diminishes. Further, the more requirements given to private insurance combined with lessened reimbursement pulls many of the private companies from participation. When a universal mandate for coverage exists but third party or private companies are unwilling or unable to participate in sufficient numbers, a federal single payer is the de facto result. Perhaps not mandated by law, but by necessity.

[AlabamAlum]

all your incentives mean is doing enough to get by... I'm not suggesting doctors don't care. I think they do. But they have to see so many patients per day to make the $$'s work. And as I said, they have little participation from the patient. The model will not reduce costs. You can only reduce costs by limiting supply (long term).. imo

and many organizations are going at risk with populations and starting the process. I'm glad they are starting. I don't know if they will end up working, but it's better than saying keep managing health the way we do today. I do think they have a lot of potential.

The reimbursement for managing preventative has not been shown to be a great motivator. I'll see if I can dig up the articles on a non-subscription based server outsude of Cinahl or PubMed.

[entropy]

reimbursement for managing preventative care barely exists.. it's still a FFS world. Doesn't mean the model shouldn't change.

[AlabamAlum]

Okay. What do I know? NOTHING. That's what. I stand corrected. I concede. I resign. I quit. Also, Roll Tide, you jabroni.

[froot loops]

I think many in certain power circles wanted a single payer and saw it as the ultimate evolution of universal healthcare. And at the very least, when there is a low cost government mandated health plan option the incentive for businesses to offer an employer supported plan diminishes. Further, the more requirements given to private insurance combined with lessened reimbursement pulls many of the private companies from participation. With a universal mandate for coverage but third party or private companies unwilling or unable to participate in sufficient numbers, a federal single payer is the de facto result. Perhaps not mandated by law, but by necessity.

That might be true for some people in various circles, they maybe justified their support for this because they talked themselves into the evolution argument. The truth is it was the best they could get after a historic wave election that gave the Democratic party control of Congress with 60 votes. They could have gotten a little more if Obama had realized the GOP wasn't going to participate at all but not much more.

[Dr. Strangelove]

Manafort is gone.

Every time the Trump campaign has a good night they throw up all over themselves the next morning. Moderation is key!!!

[entropy]

I just had an example of the waste in our healthcare system..

Earlier this week I had my blood work done for my first 6 month checkup. Today, my primary physician did blood work for my annual exam (which also helps lower my deductible). Two labs taken in one week.

[entropy]

oh.. and in 3 weeks, I get to have a CT scan and that doctor ordered blood work as well..

[entropy]

Okay. What do I know? NOTHING. That's what. I stand corrected. I concede. I resign. I quit. Also, Roll Tide, you jabroni.

LOL..

I just have a different view on how to fix they system. That is all.

But I think we'd both agree that a if Americans walked more and eat a little bit better, it would benefit us all in the long run.

[Da Geezer]

Hack said:

Suggests a central-banker rethink is in the cards. http://www.garp.org/#!/risk-intellig...0000003CebWEAS. Also some red meat for the charter schools debate lower down.

Good post and good article. Concise.

The US has had a growth rate of just under 4% historically. It still amazes me that elites are willing to accept 1.5%.