Trumpcare

[MooNiNite]

Excellent point in that the neoliberals only care about deregulation and not about the potential harm ensued. It is an erroneous belief that corporations are somehow benevolent entities that care deeply for their consumers. Nothing can be further from the truth.

except corporations lose customers if they lose quality. So they are held to a standard or else face consequences.

 

When the government messes up, only the people suffer, because they have no other choices. 

[MooNiNite]

A few improvements to the story. While trying to make a profit you notice that using poor water and chemicals bad for health make for more profits so you use them. OF course you issue a study from your scientists about how great those items really are for you...........etc.

 

When people get sick from a product it becomes a great press story. Then they stop buying. Chipotle had to do some major efforts. Jack-in-the-box i think just diminished.  

[Brian]

Excellent point in that the neoliberals only care about deregulation and not about the potential harm ensued. It is an erroneous belief that corporations are somehow benevolent entities that care deeply for their consumers. Nothing can be further from the truth.

Corporations are composed of individuals. Individuals have individual personalities and make decisions based on their own criteria. Some people make decisions which align with our own individual criteria and some don't. That is true for those individuals who are part of the leadership of an organization as well as for those who are not.

 

<shrug>

[ralis]

except corporations lose customers if they lose quality. So they are held to a standard or else face consequences.

 

When the government messes up, only the people suffer, because they have no other choices. 

 

 

Really? How much business are the pharmaceutical companies losing due to drug interactions, side effects and deaths? They have a captive audience.

[MooNiNite]

It's humorous how the democrats think they are fighting against the one percent and the upper class, but then they play right into their hands. They don't quite grasp what people will be in charge of these giant programs that organize mass amounts of people. (CEO's of major corporations..) And then they lock themselves in legally and bind themselves, only watch as the monopolistic greed continually increases their premiums and crumbles their lives.

 

It is actually very similar to an HOA.....  

[MooNiNite]

Really? How much business are the pharmaceutical companies losing due to drug interactions, side effects and deaths? They have a captive audience.

 

Well now you're getting into a whole new cookie jar. 

[MooNiNite]

The pharmaceutical monopoly has tight grips on "medical standards."

[Brian]

I will read your post later. In what capacity were you employed?

Several. Strategic international IT infrastructure, primarily, towards the end. We had operations in more than a dozen ​countries on five continents.

[Brian]

Really? How much business are the pharmaceutical companies losing due to drug interactions, side effects and deaths? They have a captive audience.

Quite a bit, actually. Adverse events are a big deal. One of the more disturbing trends in recent years, though, has been the practice of governments collecting enormous fines from corporations (including but not limited to pharmaceutical companies) -- it is like a mafia "protection" racket (and the previous Administration took this in a new direction by redirecting such funds to politically oriented organizations rather than using them to either offset taxpayer expenditure or compensate those directly impacted by corporate misdoing).

[blackstar212]

When people get sick from a product it becomes a great press story. Then they stop buying. Chipotle had to do some major efforts. Jack-in-the-box i think just diminished.

LOL yeah right. Keep eating that antibiotic beef etc.

[blackstar212]

It's humorous how the democrats think they are fighting against the one percent and the upper class, but then they play right into their hands. They don't quite grasp what people will be in charge of these giant programs that organize mass amounts of people. (CEO's of major corporations..) And then they lock themselves in legally and bind themselves, only watch as the monopolistic greed continually increases their premiums and crumbles their lives.

 

It is actually very similar to an HOA.....

It is not funny, the democrats are no better. Remember there is one party in the USA the property party and it has two right wings the Republicans and the Democrats.

[MooNiNite]

LOL yeah right. Keep eating that antibiotic beef etc.

 

Well some people prefer to pay less for lower quality food. That is another choice that is available. 

[MooNiNite]

Republicans

Freedom over equality

 

Democrats 

Equality over freedom

[ralis]

Republicans

Freedom over equality

 

Democrats 

Equality over freedom

 

 

This kind of freedom? Trump-loving former congressman hauled off in handcuffs for allegedly looting his own charity

 

Edited March 17, 2017 by ralis

[MooNiNite]

This kind of freedom? Trump-loving former congressman hauled off in handcuffs for allegedly looting his own charity

 

 

 

See im thinking Hillary's charities are shutting down because she doesnt have as much political influence.

 

http://www.dailywire.com/news/12435/clinton-foundation-shuts-down-global-initiative-michael-qazvini#exit-modal

[Brian]

Imagine you and I both produce & sell snow cones.

 

We are in competition with each other to produce snow cones the public wishes to buy and to do so at a cost, and price them such that, we find it worthwhile to continue this venture. We both have to make judgement calls regarding the ingredients we use, the vendors we choose, the flavors we offer, the equipment we purchase, where to set price-points to maximize revenues, whether/when to hire employees and what to pay them. We have to make choices about marketing strategies and sales strategies -- where do we advertise? Do we use a "food truck" or a push cart or a brick-and-mortar store front? Do we lease or buy? We've got production questions to answer, including things like how much product we can reasonably expect to sell, which products seem most attractive, what market fluctuations we should anticipate, etc.

 

Through all this, we are watching the market and the economy, the weather, the competition (both direct (like other snow cone vendors) and indirect (like those dreaded FroYo vendors!)), the supply-chain, the news, the government, etc. And we are constantly looking for opportunities to produce a better product, or produce it more cost-effectively or more efficiently or more quickly, or to tweak our product line, or any of several dozen other variables which impact our business models and therefore our businesses.

 

After all, people don't have to buy snow cones and even those who want to buy snow cones don't have to buy them from us -- and even those who want to buy them from us have to make complex decisions about their own buying patterns so these aren't​ guaranteed sales, either.

 

Don't forget, of course, that our livelihoods -- and the well-beings of our families -- depend on our success.

 

Now let's suppose that the leaders of local government decide they know how the frozen snack/dessert industry should operate, or they feel that the public is being taken advantage of by unscrupulous marketers or whatever, and they establish a City Department of Frozen Snacks & Desserts to inspect, regulate and subsidize the private industry "for the good of the people." At first, it seems like some "common sense" requirements -- using quality ingredients, not "price gouging" and stuff like that. Soon, however, the intrusions grow more onerous and less reasonable -- including things like mandatory "preferred suppliers" selected by "the Department" and standardized menus with required production levels. Create a level playing field, protect the consumer, etc., etc.

 

Good thing you have the option to pick up and move your business to another city just a few miles down the road, right? I mean, the same sorts of competition between snow cone vendors, and between different specialists in the frozen snacks & desserts family of business, and between all discretionary spending options, also plays out between competing cities, too. This helps to promote innovation and improve products and foster market efficiencies and the entire economy gains as a result.

 

Except one day the central government decides it needs to insert itself in the frozen snacks & desserts industry...

 

As on the local level, the insertion starts painlessly and fairly innocuously. The newly formed Agency for Frozen Dessert & Snack Consumer Protection and Affordability Assurance (henceforth called AFDSCPAA, for convenience) begins to grow larger and more assertive. Fixed product offerings, standardized supply-chains, AFDSCPAA-mandated labor & production requirements, and industrywide pricing specifications are only the beginning. Soon, the government begins a "fairness program" intended to ensure everyone is treated equally by the industry. A subsidy program is implemented to provide free snow cones to the indigent and a stiff tax is imposed upon those who can afford to do their fair share.

 

The producers notice, however that the burdens imposed by AFDSCPAA mandates have not only cut into their profit margins but have made it impossible to break even given the mandatory pricing levels and some start to go out of business. Additionally, many of those citizens who can afford all the snow cones they want realize they are paying for other people's snow cones, too, and they stop coming by so often. The government responds by declaring a universal right to frozen snacks and desserts, establishing a public-private partnership program to oversee the FDS industry, and forming a family of NGO agencies to protect the consumer from the predatory snow cone corporations (like you...)

 

Since the consumer is no longer directly purchasing FDS products (we all have FDS purchasing allotments assigned to us according to AFDSCPAA guidelines and managed by the NGOs), the American Snack & Dessert Alliance for Responsible Enjoyment (the ASDARE being the now rich & powerful public-private partnership which oversees the black-hearted profiteers like you and makes recommendations for new regulations to the unelected bureaucrats in the AFDSCPAA) can increase the price points on the mandatory product offerings guidelines. This allows the vendors to increase their prices, generates additional revenues for the percentage-based-funding ASDARE, and drives more money into the annual budget of the AFDSCPAA (which uses part of that budget for universal snow cone entitlement programs, part of it for staffing a new FDS monitoring & enforcement sub-agency, and part of it for community enrichment programs which provide fact-based information to schools and the media about the merits of government-controlled snack & dessert programs as well as the nutritional value of daily consumption by school-age children of standardized FDS products).

 

Now that the consumer is no longer the primary payer, and the manufacturers no longer respond to dynamic market forces, AND an entire governmentally linked corporate structure has emerged surrounding the marketplace, prices are decoupled from the market itself. $3 for a snow cone? $100 for a snow cone? $1000 for a snow cone? Who cares?!? You aren't actually paying for it! The government is!

 

Obviously, this isn't intended to be a corollary to the healthcare industry or the education industry but I think the savvy reader will see some recognizable themes here...

 

As to the point you make about how "...the medical market has been doing that to itself for 50 years..." Indeed. It is perhaps worth recognizing, however, that the Federal government really injected itself into the private health insurance industry during WWII and into private healthcare delivery in the 1960s. On a non-insurance-related/regulatory note, the FDA was formed in 1906 but really didn't grow teeth until FDR signed the Food, Drug & Cosmetic Act in 1938. The "prescription drug" industry was born out of the Durham-Humphrey Amendment in 1951. The modern pharmaceutical development model grew out of the thalidomide crisis in the late '50s ("never let a crisis go to waste," right?) which resulted in the FDA being given tremendously expanded authority in 1962. The FDA is only one Federal agency having significant impact on the private healthcare industry and I mention it only as an example, but it is worth pointing out that it has over 14,000 employees and an annual budget of over $4B. Did I mention that they have armed agents and their own SWAT-team capabilities?

 

(I worked in the pharmaceutical industry for 13 years...)

Instead of snow cones, imagine you and I baked bread:

http://www.miamiherald.com/news/nation-world/world/americas/venezuela/article138964428.html

[dawei]

As to the point you make about how "...the medical market has been doing that to itself for 50 years..." Indeed. It is perhaps worth recognizing, however, that the Federal government really injected itself into the private health insurance industry during WWII and into private healthcare delivery in the 1960s. On a non-insurance-related/regulatory note, the FDA was formed in 1906 but really didn't grow teeth until FDR signed the Food, Drug & Cosmetic Act in 1938. The "prescription drug" industry was born out of the Durham-Humphrey Amendment in 1951. The modern pharmaceutical development model grew out of the thalidomide crisis in the late '50s ("never let a crisis go to waste," right?) which resulted in the FDA being given tremendously expanded authority in 1962. The FDA is only one Federal agency having significant impact on the private healthcare industry and I mention it only as an example, but it is worth pointing out that it has over 14,000 employees and an annual budget of over $4B. Did I mention that they have armed agents and their own SWAT-team capabilities?

 

(I worked in the pharmaceutical industry for 13 years...)

 

thanks for the comments.

 

I think the problem I see is that this industry is well known for having high costs from many angles.  Malpractice, data systems & software, equipment, salaries, and big Pharm... and insurance companies complaining they are losing money.

 

I started with an accounting perspective:  If you're losing money, you are simply paying out more than you are taking in.  

 

Q1:  Is that a result of rising costs from these various angles or simply because insurance was capped in some ways and forced to take on patients who need care?   they may represent outliers of needing care.  I don't have any proof but my gut says it is the patient care influx exceeds the money influx:  Claims exceed Policy payments.

 

Here is what I see as another big problem that started with ACA but seeing something getting worse with AHCA, and it ties back to my point of Q1.   ACA mandated care even for people who don't really need it nor want it.   They were forced to pay for something that they never received.   The AHCA now removes the mandate.

 

Q2: Who is more likely to continue their healthcare coverage, those that need it and are running up claims or those who didn't want it in the first place?

 

If the former, what ACHA is doing (I know it is an EO), then the spectrum of people with insurance vs who really uses it, is now skewed ever worse towards the ones submitting so many claims that insurance companies are screaming they bleeding money.  Mean, removing the mandate actually makes the insurance company's ability to make money even harder. 

 

Another problem.   If some areas are willing to reduce costs, the insurance companies may not be willing to pass along those savings so they can get back to their profit margins and shareholder happiness.

 

Q3:  What are the top 3-5 expenses that cause the health industry to be so incredibly high in costs ?

 

 

BTW:   A little irony is that my employer based health insurance actually went down !!!  But they still get the last laugh... it is now down to $850 a month   .   But they claim they lost $475 million in 2015 and $650 million in 2016... so they pulled out of many state exchanges (down from 34 to 8).

[windwalker]

 

brings a different perspective to the conversation 

Edited March 18, 2017 by windwalker

[Enishi]

Good post Brian.

I find that people here and elsewhere constantly misunderstand the libertarian/minimal government approach to healthcare and safety nets. Accusations of favoring Social Darwinism and not wanting to take care of people fly all over the place. Where there's certainly some libertarians who might have that mentality (you'll find selfish people hiding under every ideological umbrella), the understanding I have of it is that it's more about allowing organic, self-organizing phenomena to do it's work.

 

I'd add that it can't be claimed that the results of said organic evolution are always going to be pretty, but the main point is that attempts at state control are never going to be as robust and adaptable as self-organization.  

Edited March 18, 2017 by Enishi

[MooNiNite]

Can anyone find a website that lists the cost of medical education by country?

[Brian]

Can anyone find a website that lists the cost of medical education by country?

"List price" or what people actually pay directly? Government involvement in US education has made that sector bizarro-world, too. Edited March 18, 2017 by Brian

[MooNiNite]

"List price" or what people actually pay directly? Government involvement in US education has made that sector bizarro-world, too.

List Price

[Brian]

Danger, Will Robinson!

 

https://www.theguardian.com/society/2017/mar/19/nhs-impossible-budget-crisis-health-trusts

 

Not "Trumpcare" but perhaps a new chapter in a cautionary tale...

[MooNiNite]

I bet USA has the most expensive schooling costs when it comes to being a doctor

[Brian]

I bet USA has the most expensive schooling costs when it comes to being a doctor

Costs are really hard to compare because it isn't apples to apples, because it isn't a level playing field, and because of government involvement (almost across the board but in different ways). Here's an interesting comparison, though:

 

http://www.shanghairanking.com/FieldMED2012.html