Post: #101

(11-24-2014 02:11 PM)MidWest Wrote:  The reason why many people outside the U.S thinks our system sucks is because of this guy:







^^^^^ They see that movie and think "Good God those Americans I feel so sorry for them"


Quite honestly though I haven't really been affected by this Obamacare thing. I mean I still have my same health insurance before the law came about. I also have a separate package I get in college. I'll admit though that health care costs in the U.S. are very high and something needs to be done about that.

There is something wrong with the insurance cost and billing process. Its partially because it takes them so long to pay and partially for reasons I don't understand. If you take a hospital bill and ask to pay cash they will knock 60% without batting an eyelash. That is some insane markup.

My kid was in the hospital for a long time and there were some bills that were paid by medicare, some by insurance and some small stuff by me. Medicare paid %100 of the bill as printed, insurance usually had some sort of rate limit that was 60-80% of the full bill and then I was paying 20-40% of my bills.

Post: #102

Against. The US spends more on healthcare per capita than any other country. No "solution" should have been considered that didn't have as one of its primary goals reducing costs to levels comparable to other developed countries. Instead, the priority seems to have been centralized control and further socializing medicine with possible costs saving only mentioned as a way to market the product (and my own experience was that costs were much higher).

Post: #103

Support because more people can now see the doctor.

Post: #104

(11-24-2014 04:45 PM)Sonsowey Wrote:  Support because more people can now see the doctor.

Actually this isn't even remotely true, in 2015 if Obamacare isn't repealed thousands of Doctors are going to quit or start practices that refuse Obamacare patients. 2015 is when significant parts of the Obamacare bill start to affect billing.

I know this because I speak to doctors (there's ton of them in Boston) and they all hate Obamacare.

http://www.reportingonhealth.org/2014/03...ealth-care

Quote:Apparently not. Deloitte’s 2013 survey of over 20,000 physicians notes 62% say that “it is likely that many physicians will retire earlier than planned in the next one to three years. This perception is fairly uniform among all physicians, irrespective of age, gender, or medical specialty.”

And if they’re not retiring outright, doctors say they believe physicians will “scale back practice hours (55 percent) based on how the future of medicine is changing.” None of this is surprising when Deloitte reports that “[s]ix in 10 physicians (57 percent) say that the practice of medicine is in jeopardy.”

Enjoy your "free" healthcare for the next one or two years, then it's going to be massive lines and shit care until you die. Good job voting for socialism in a country full of leeches, great idea guys. Too bad the doctors won't work for slave wages to treat a bunch of welfare druggies.

Post: #105

(11-24-2014 05:53 PM)Samseau Wrote:  

(11-24-2014 04:45 PM)Sonsowey Wrote:  Support because more people can now see the doctor.

Actually this isn't even remotely true, in 2015 if Obamacare isn't repealed thousands of Doctors are going to quit or start practices that refuse Obamacare patients. 2015 is when significant parts of the Obamacare bill start to affect billing.

I know this because I speak to doctors (there's ton of them in Boston) and they all hate Obamacare.

http://www.reportingonhealth.org/2014/03...ealth-care

Quote:Apparently not. Deloitte’s 2013 survey of over 20,000 physicians notes 62% say that “it is likely that many physicians will retire earlier than planned in the next one to three years. This perception is fairly uniform among all physicians, irrespective of age, gender, or medical specialty.”

And if they’re not retiring outright, doctors say they believe physicians will “scale back practice hours (55 percent) based on how the future of medicine is changing.” None of this is surprising when Deloitte reports that “[s]ix in 10 physicians (57 percent) say that the practice of medicine is in jeopardy.”

Enjoy your "free" healthcare for the next one or two years, then it's going to be massive lines and shit care until you die. Good job voting for socialism in a country full of leeches, great idea guys. Too bad the doctors won't work for slave wages to treat a bunch of welfare druggies.

Just blows my mind that the guy who was the main architect behind the whole Obamacare plan said himself that it would only be approved based on the "stupidity" of the American voter.

Not a Republican. Not a pundit. The guy who designed the original version for Mass and then was called in by Obama to design it for nation wide. A professor at MIT, who has no political ties or anything to gain has said himself what a disaster this would be. That the only reason it even worked in Mass to start with was because the state got $400,000,000 a year from the Fed govt. to pay for it.

And yet there are people who still support it.

Post: #106

(05-24-2014 04:50 AM)Sp5 Wrote:  The healthcare system in the USA is so fucked up and expensive, it will probably take a fiscal collapse to sort it out.

Unless you're a Social Darwinist, you probably agree that people should get health care, even if they are too old, retarded, crazy or crippled to work. It would seem to be a step backwards in human development to have people dying of appendicitis because they could not pay for the surgery. On the other hand, why pay $500,000 for a heart transplant for an 85 year old guy?

Since Obama is a tool of special interests of many types, he promoted a system where the hogs will keep skimming and feeding out of the trough. Of course the Congress demanded the same thing.

While Europeans and Americans both pay a lot of taxes, it seems that Europeans get more for their money in the way of health care and infrastructure.

Most of the developed world, excluding Canada, has a 2 tier health care system where one tier is nationalized and everyone can access healthcare and then another tier is privately based and accessible to people who want to pay more for quicker access, etc. The underlying assumption in most of those countries however, is that healthcare is a fundamental right and not a luxury, like basic services, universal education, etc. The US seems the only place that doesn't view healthcare in that way.

Other posters made great points re the pharmaceutical industry, and its death grip on the govt, specifically the agency that is supposed to regulate it, the FDA. Most of Big Pharma's costs are allocated to sales and marketing and not to R&D. This includes the ridiculous ads on television (most countries do not permit pharma advertising on television and the US had the same prohibition until the 1990s), the whole armies of pharma drug reps, the conventions for doctors held in tropical locations and cruise ships, etc...

Actual basic scientific research is done in academia and the tax-payer funded National Institute of Health, and not by Big Pharma. So the costs of pharmaceutical research is socialized by taxpayers but of course, obscene pharma profits are privatized by Big Pharma.

Speakeasy mentioned price controls that other nations impose on the cost of drugs so that someone in New Zealand or Canada pays $6 for a medication that an American would pay $100 for...this is why:

"Finally, while other nations set wholesale drug prices, the law prohibits the US government from using its considerable bargaining power under Medicare and Medicaid to negotiate lower drug prices. This was part of the deal Big Pharma extracted for its support of the Affordable Care Act of 2010." - http://billmoyers.com/2014/10/06/allow-b...ma-rip-us/

And honestly, what pharmaceutical drug discovered in the past 30 years has been truly ground-breaking? Due to the profit based system, it seems to me that so many of the drugs "developed" by pharmaceutical are designed to "manage" illnesses and not actually cure anything. Managing a disease is a very good profit generator; curing diseases is just bad for business.

For example, a blockbuster drug like statins (Lipitor) used to treat high cholesterol has been discovered to cause musko-skeletal pain, to the point that 50 years olds walk like 80 year olds, and actual cognitive dysfunction in the form of memory loss that is not reversible.

The pharmaceutical companies knew about these long term side effects and downplayed or outright denied their ill effects until the evidence became overwhelming, thanks to the Internet. Not only that but statins are only effective on a very small segment of the populations, but marketed to everybody, and at one point, in order to increase revenue, pharma executives were proposing expanding the market to children!

Imagine the long term side effects of other popular medications like pills for ADHD, anti-depressants, heart issues (Vioxx, which got pulled off the market), etc...I predict we're going to see class action lawsuits in the coming years as the side effects of so many drugs will prove to be worse than the actual conditions.

One of my uncles got tagged with high total cholesterol and opted not to take statins. His doctor was adamant that he take it and he explained that doctors MUST prescribe statins or else they will be in violation of their board’s standard of care, leading to malpractice suits and a whole world of pain. My uncle acquiesced but just threw the pills in the garbage. He changed his diet to the Paleo diet, based on my recommendations, and managed to dramatically increase his HDL (good cholesterol) levels while reducing his LDL and Trig levels. He did all this without medication that would have had adverse effects on his body and mind.

The power of healthcare business interests is reflected in the lack of independence doctors have in applying ethical care to their patients, perverting their oath of "doing no harm".

Post: #107

(11-24-2014 06:01 PM)It_is_my_time Wrote:  Just blows my mind that the guy who was the main architect behind the whole Obamacare plan said himself that it would only be approved based on the "stupidity" of the American voter.

Not a Republican. Not a pundit. The guy who designed the original version for Mass and then was called in by Obama to design it for nation wide. A professor at MIT, who has no political ties or anything to gain has said himself what a disaster this would be. That the only reason it even worked in Mass to start with was because the state got $400,000,000 a year from the Fed govt. to pay for it.

And yet there are people who still support it.

He said nothing about the ACA being "a disaster". You are placing words in his mouth to suit your own agenda.

Quote:"Lack of transparency is a huge political advantage," Gruber said in the video. "Call it the stupidity of the American voter, or whatever. But basically, that was really, really critical to get the thing to pass. I wish we could make it all transparent. But I'd rather have this law than not."

He was referring to deliberate obfuscation so the Congressional Budget Office wouldn't score the mandate to buy health insurance as a tax. Since taxes are unpopular to the public, stating it as such would've caused more resistance. His criticisms about how that were done may be valid, but he wasn't criticizing the entire notion of having the ACA.

Criticizing the way it was passed and saying the results of the health care system itself are a disaster are two entirely separate things.

(11-24-2014 06:54 PM)Vronsky Wrote:  

(05-24-2014 04:50 AM)Sp5 Wrote:  The healthcare system in the USA is so fucked up and expensive, it will probably take a fiscal collapse to sort it out.

Unless you're a Social Darwinist, you probably agree that people should get health care, even if they are too old, retarded, crazy or crippled to work. It would seem to be a step backwards in human development to have people dying of appendicitis because they could not pay for the surgery. On the other hand, why pay $500,000 for a heart transplant for an 85 year old guy?

Since Obama is a tool of special interests of many types, he promoted a system where the hogs will keep skimming and feeding out of the trough. Of course the Congress demanded the same thing.

While Europeans and Americans both pay a lot of taxes, it seems that Europeans get more for their money in the way of health care and infrastructure.

Most of the developed world, excluding Canada, has a 2 tier health care system where one tier is nationalized and everyone can access healthcare and then another tier is privately based and accessible to people who want to pay more for quicker access, etc. The underlying assumption in most of those countries however, is that healthcare is a fundamental right and not a luxury, like basic services, universal education, etc. The US seems the only place that doesn't view healthcare in that way.

The reason for this I think boils down to rugged individualism paired with the protestant ethic. Class struggle and social stratification is denied under this system. Even though America doesn't even lead the world in upward mobility. If you are poor, it's because you're lazy. If you are rich, it's because you're industrious(of course I'm not saying this is never the case, but it's assumed to be from the outset). And work for Americans in and of itself is considered a virtue, not a means to an end. Americans are the only people that take pride in never taking vacation time from work. Which is the sign of an unhealthy society, not something to be lauded.


Kudos on bringing down your dads cholesterol by natural means.

Post: #108

Against.

Getting the government into the healthcare biz was the most suicidal thing Congress have ever done. How have they managed other things? Amtrak? Postal service? Veteran's Admin? Medicaid? Social Security?

If you really believe that Social Security will be there for you when you turn 65, I've got some great real estate to sell you in the swamps of Louisiana.

Boomers are like this Old Testament fucking PLAGUE of locusts that came and just devoured everything and LEFT. They are the most selfish generation the planet has ever seen. And as long as Grandma (who likely never paid into the system to begin with) can VOTE, she will always vote for the one politician who promises to give (i.e. STEAL) her a check every month.

Parasites. All of them.

If we can somehow roll back a woman's right to vote (and thus, destroy), then maybe we can talk about some kind of plan. But it should NEVER come at the expense of the most productive, who most likely don't need it.

Post: #109

People says that Canada has the same system and it works

How delusional

Post: #110

(11-28-2014 03:33 AM)Soberane Wrote:  People says that Canada has the same system and it works

How delusional

This video is the truth. When I lived in Canada I waited 5 years to get a 'family doctor' which I had to book appointments 6 months out to see and the guy was a total asshole. I had a kidney stone, had to go to the emergency room for it, where I was for 28 hours...until i eventually saw the Urologist, which they fly in from minneapolis once every 2 weeks...he sent my tests for follow up to my family doctor, who called me 8 months later to see if it had been resolved.

Post: #111

What a complete and utter disaster Obamacare will be. More feminism, more govt. stealing from men to give to women so they can sit on their asses and do nothing but talk shit on men. Just a complete disaster. Here is the weakling dumbass being grilled about admitting you have to be stupid to think this will work...

https://www.youtube.com/watch?v=d46iFb7C4Yo

Post: #112

It's obvious to most of you already that Obamacare wasn't intended to accomplish what the politicians promised it would from the very start.

- It didn't lower health insurance premiums
- It didn't let you keep your existing healthcare plan
- It didn't let you keep your doctor
- It raised taxes
- It created forced spending

And so on.

All of the promises were lies in order to drum up enough popular support to get it passed into law. This begs the question, what was it's true purpose?

I have a working theory on why, but to understand this, we have to go back a few years.

In the 2008 financial crisis, major financial institutions were experiencing losses on their reckless bets. Instead of being forced to eat their losses, like every other person in the country would (corporations are legally considered people, though not when they're bankrupt or found guilty of felonies), the government loaded them up with free money forcefully taken from taxpayers.

In addition to these bailouts, the Federal reserve kept interest rates at essentially 0%, which eviscerated savers, but kept the assets of the financial corporations at artificially high prices while forcing higher payments on renters.

Cutting rates to 0% meant that financial companies didn't have to take high losses on their over-inflated assets, could sell off inventory at higher prices, and could accept higher rental fees. In short, it was a win for the rent seeking top 0.01% FIRE economy, and a loss for everyone else.

Additionally, it was a boon for big government, as lower interest rates meant that they could increase government spending, since the payments on our national debt would be lower. Politicians always kick the can down the road rather than face the pain during their administration.

However, this created a crisis for a very large and powerful sector of the economy. Insurance companies and pension funds are based on a financial structure where those first coming into the system pay a monthly fee, and will receive a higher pay out should they face a statistically low emergency or decide to retire.

A large part of insurance companies remaining solvent is that the pool of money coming in from the payees will be invested in assets which generate interest over time. This ensures that the insurance company can generate further income over time, allowing them to keep the insurance premiums low enough to attract payees and keep the system running.

As interest rates are near 0%, this financial structure is no longer feasible. Insurance companies are being forced to take on much riskier stock investments, risking a loss of their funds entire capital pool, or drastically raise premiums to compensate. Raising premiums would scare away payees, and the funds would shortly become bankrupt as new claims came in.

Medical insurance companies have lobbied to make sure Americans pay exorbitant premiums for sub par service compared to nearly every other country on the planet. These elevated medical insurance premiums have pushed up the cost of healthcare, and created an artificial subsidy for expensive medications which otherwise wouldn't be feasible in a free market.

As interest rates were pushed to 0% during a time where millions of Americans were struggling financially, and certainly wouldn't be able to afford drastic health insurance premiums, nearly everyone would have opted to go without. This would have had a knock on effect in the American healthcare, insurance and pharmaceutical industries. It would have forced healthcare companies to restructure, and operate in a way that would have been much more affordable for the American consumer.

But the megalithic health and pharmaceutical companies are much more politically powerful than the American electorate, so rather than restructure, they opted to increase their campaign contributions and create an effective marketing strategy to push their plan through. In addition to campaign finance, they may have also convinced politicians that healthcare is a major part of the US GDP (over 20%), so a restructuring of the healthcare industry would mean a drop in GDP, and lower tax revenues.

So they passed through ACA to save the asses of the healthcare monopolies at the expense of everyone else. We now have precedent where the government has the legal authority to force citizens to pay for private services they don't want.

TLDR;

• Fed sets interest rates to 0% to prevents financial companies taking a loss on bad asset investments, and to allow higher government spending
• Low interest rate environment forces insurance and pension funds into eventual bankrupcy, as their investment models are based on the assumption of much higher guaranteed interest rates.
• Insurance companies that raise premiums to cover lower investment returns would face a loss of insurance payees, and eventual bankrupcy
• Rather than restructure, medical insurance companies lobbied politicians to force the populace to buy their product and stave off bankrupcy
  

The zero interest rate environment has created a situation where rather than restructure, as a healthy free market capitalist economy would have done, politicians have opted to kick the can down the road. All this has done is bought time, as greater economic dislocations will begin to pop up that threaten to implode the entire economy.

My bet is that the next major domino to fall will be the large state pension funds, perhaps Illinois or California.

Post: #113

(07-19-2016 10:19 AM)thoughtgypsy Wrote:  My bet is that the next major domino to fall will be the large state pension funds, perhaps Illinois or California.

Nice summary. You are not incorrect, as they always new it was not healthcare reform at all, just insurance reform (as you state, actually just subsidy).

What's your guess on the over/under for a pension system debacle?

5 years? 10? More?

Post: #114

(07-19-2016 02:29 PM)Kid Twist Wrote:  Nice summary. You are not incorrect, as they always new it was not healthcare reform at all, just insurance reform (as you state, actually just subsidy).

What's your guess on the over/under for a pension system debacle?

5 years? 10? More?

It's only a guess, but what I think the pension funds have been doing is piling their funds into riskier assets in order to paper over their unfunded liabilities. So likely they've been putting everything into stocks to chase the yields they desire.

That would mean that the next time the stock market crashes, they'll be facing losses they can't eat, and you'll start seeing a lot of funds go under. If I had to give a timeline, I'd say within the next 5 years, though I would have expected a crash to happen a long time ago by now.

Post: #115

(07-19-2016 02:29 PM)Kid Twist Wrote:  

(07-19-2016 10:19 AM)thoughtgypsy Wrote:  My bet is that the next major domino to fall will be the large state pension funds, perhaps Illinois or California.

Nice summary. You are not incorrect, as they always new it was not healthcare reform at all, just insurance reform (as you state, actually just subsidy).

What's your guess on the over/under for a pension system debacle?

5 years? 10? More?

Agreed. Public pensions like the state employees of Wisconsin or province of Ontario teachers pension plans are juicy money buckets. They won't be immune forever...its just too tempting

Post: #116

Quote:And honestly, what pharmaceutical drug discovered in the past 30 years has been truly ground-breaking? Due to the profit based system, it seems to me that so many of the drugs "developed" by pharmaceutical are designed to "manage" illnesses and not actually cure anything. Managing a disease is a very good profit generator; curing diseases is just bad for business.

For example, a blockbuster drug like statins (Lipitor) used to treat high cholesterol has been discovered to cause musko-skeletal pain, to the point that 50 years olds walk like 80 year olds, and actual cognitive dysfunction in the form of memory loss that is not reversible.

You make many good points. But I also blame the doctors. Apparently they come out of medical school ignorant of pharmacy science and just prescribe the "brand names" that get promoted in their office .But there are countless older generics that do the same thing. Even Lipitor wasn't necessary for most people. There were 4 dollar generics but the companies promoted it and doctors prescribed them.


I have learned that when i go to a doctor I have to basically ask for the cheapest generic that works or they will do some fancy brand name.

Post: #117

My current girlfriend writes large contracts for AETNA, and has twice recently turned down national contract negotiation positions for them. Regardless, she did hold a national position once, and she'll be the first to tell you how fucked it all is.

This isn't a case of embracing change, it's a case of senseless change with an excuse driver.

Moreover, the turbulent volatility in most private sectors of business since 2000 have driven many, many schlebs into higher medical positions due to the stability and high pay, providing security from baby boom trail off, etc. There are more immoral hacks as surgeons, doctors, nurses, specialists than ever before, which is why she left nursing.

In short, anything that becomes overly institutionalized is fucked. Government in general, medicine, education, massive large sector business. Operational efficacy flushed down the toilet, bloated overhead driving up the costs of everything, group think, lowest common denominator knee jerk thinking - i.e. 15% of the population w/o healthcare means the other 85% takes it in the ass. Bullshit. That 15% in make-up cost could have been handled in operational efficiency savings alone.

Obamacare is a fucking scam pyramid, rooted in another entitlement. As a significant portion of the national debt Dems drove up resulted in what we have thus far, and everyone's bitching except those who hedged the market, rebounded and reinvested.. which represent very few without millions in the bank already.

The quality in care has dropped across the nation, most people have experienced this if in need of healthcare. It's the same thing as the General Motors bail out. Chevy's are still pieces of shit, now they just cost more and are made entirely, not partially, by "protected" class workers who don't give a fuck...

Post: #118

I'm against it, I believe there is a better way for sustainable healthcare in America.

(07-19-2016 01:12 PM)TheOllam Wrote:  Seriously Leftys. You want to Unify Healthcare Nationally? But your followers all want to remain fatties? How about instead of using my taxes to treat all the baby boomer sickos with DiBeetus, Obesity, Lung Cancer and Liver Cirossis from preventable, diet induced ailments, we just provide healthy school lunches and real gym classes for kids. BUT NOOOOOO, Leftys want their CAKE and want to EAT Yours Too!

Post: #119

(05-23-2014 03:43 PM)Cr33pin Wrote:  Fuck Obama Care

This country needs something done about the money making racket they call health care, but Obama Care aint it. The number one money making business in America is the healthcare system. They don't give a fuck about curing whatevers wrong with you they just wanna sell you some pills to mask your symptoms. Americans are sick, fat and fucked up an its only getting worse.

I'm doing something about it--making a good, but not fantastic living. My car mechanic makes about twice what I do per hour.

And most of the dozens of health care people I work with do care if patients get better. Even if they're very narcissistic and not emotional, they want treatment to work due to professional pride.We get a little callous and sometimes burnt out, but I would argue people who really want to make money without helping anyone are skimming on Wall St.

Health care is the result of thousands of years of people thinking and working, and your life would probably be vastly worse if a lot of the practices of sanitation and public health weren't followed.

"They don't give a fuck" is the kind of lazy, gross generalization that doesn't really lend itself to productive policy discussion.

Post: #120

(07-19-2016 11:09 PM)iknowexactly Wrote:  

(05-23-2014 03:43 PM)Cr33pin Wrote:  Fuck Obama Care

This country needs something done about the money making racket they call health care, but Obama Care aint it. The number one money making business in America is the healthcare system. They don't give a fuck about curing whatevers wrong with you they just wanna sell you some pills to mask your symptoms. Americans are sick, fat and fucked up an its only getting worse.

I'm doing something about it--making a good, but not fantastic living. My car mechanic makes about twice what I do per hour.

And most of the dozens of health care people I work with do care if patients get better. Even if they're very narcissistic and not emotional, they want treatment to work due to professional pride.We get a little callous and sometimes burnt out, but I would argue people who really want to make money without helping anyone are skimming on Wall St.

Health care is the result of thousands of years of people thinking and working, and your life would probably be vastly worse if a lot of the practices of sanitation and public health weren't followed.

"They don't give a fuck" is the kind of lazy, gross generalization that doesn't really lend itself to productive policy discussion.

I don't presume to speak for others, but my impression was Cr33pin was referring more to the Health Insurance CEO/Regulatory Bureaucrat class, and not the local nurse or healthcare technician.

I have family members who've pursued nursing careers, and I know their biggest motivation is helping others. At the same time, I have no illusions that many pharmaceutical CEOs and FDA administrators are motivated by nothing more than sociopathic greed.

Post: #121

A few thoughts on US healthcare as of 2016:

1. Medical school is too expensive and is one of the few educational areas where the government should be doing everything possible to lower cost for students who want to work in medicine but are daunted by the financial risk. Be it lowering cost of programs, paying for school, better loan repayment programs, or whatever. I'm all for helping bright people who want to do a necessary hard job that benefits society.

I partially didn't pursue medical school because I had grave concerns about taking out the massive student loan debt, something going sideways (fucked up in school, false association killing my ability to practice, etc), and not being able to get the debt forgiven in some capacity.

2. I think people with shitty lifestyle choices should pay more. Best measure would probably be a body fat index rating tied to cost of premium since generally being a fat fuck = higher cost down the line or at the time.

The overall rating would account for age and maybe some other factors but someone who eats like garbage and sits on their ass all day SHOULD pay more. We charge people more for driving like dumb asses as well as charge men high payments solely based on gender; we should charge more for people who abuse their bodies.

It really is complete crock of shit that a fat fuck pays the same as someone who exercises and eats right; unhealthy people are rewarded at the expense of healthy people. I understand shit happens to everyone but eating right/exercising is one of the few areas people have control over in their lives. And being a fat fuck universally pretty much is proven to lead to having an assortment of medical issues down the line that cost money.

3. Deductibles are way too high and the target should be $1500-2000/year for TOTAL out of pocket expenses for an individual. Cost sharing should occur the entire time period. The aforementioned limit is a reasonable amount for any working individual.

4. VA medical services should be shut down. Give veterans some modified version of Medicare and be done with it.

5. Medical insurance companies should operate like non-profits with strict rules on profit. They offer virtually no value. The money should be going to the providers.

6. Reform malpractice laws so doctors can be decentralized again and work their own practices and manage legal cost. Many doctors join groups/hospitals not out desire but fear; due to malpractice cost risk and the potential insane cost of legal services/bullshit lawsuits.

7. Make uniform rules that make competition between state lines easy and straightforward.

Do the aforementioned and cost will come down tremendously.

As for state pension funds (should start a thread on this):

No doubt they are done. Next major crash will probably do them in. I avoided getting a state government gig in large part because I have NO confidence the pension system will pay out as intended, if at all, when I'm eligible to collect. Social Security as of today can only pay 75% of liabilities for guys who are ready to collect in the 2030s (A LOT of us here). So you planned on getting $10,000 in SS when you got older? Well fuck you: you are getting $7,500 and you will like it. And that's the BEST estimate without bullshit things that libtards have tried to float like "means testing" in the mix (i.e. legalizing not paying people who have paid into the system but said you would or STEALING their money). Some other estimates are far more dire.

If I recall correctly, California was issuing out IOUs after the last crash.

If you look at every pension system in the country, all have curtailed payouts and benefits while demanding more contributions for years. Some are on the verge or have filed for bankruptcy (Detroit - essentially a failed US city; which filed for bankruptcy in 2013 is a warning of what's to come). The Federal government a few years ago started making employees pay an additional 3-4% (can't remember the exact amount) of their paychecks; which is an enormous sudden increase. This is the trend and has been for quite some time across the board; higher contributions and less benefits and less security. Everyone is trying to keep propped up a mismanaged and broken system that is on borrowed time.

Once the next market crash occurs, a ton of paper wealth is going to be wiped out forever since there is no safe spot to park money with 0% or negative interest rates being the standard now WORLDWIDE. Can't lower rates further as well to drive business/economic growth to grow your way out of the problem. Combined with the cost of everything rising and pension fund managers will have no way to pay off liabilities. Since pension funds pretty much live and die on paper wealth as opposed to real assets, you do the math on what the outcome will be like. The federal government can at least print more money (for now) but state/city/county governments can't do that.

There is going to be riots in the streets of teachers, cops, firemen, and other government employees during the next crash. Basically Occupy Wall Street except older people who have done their time, know how to organize, and have a legit reason to be pissed. I feel sorry for them; they have no idea what's coming their way and how fragile their so called "secured" government pension really is.

There MIGHT be a way or two to soft-land out of this impending disaster but it's more likely it will end as a hard-landing for most. I suggest everyone prepare and plan accordingly.

Post: #122

Quote:No doubt they are done. Next major crash will probably do them in. I avoided getting a state government gig in large part because I have NO confidence the pension system will pay out as intended, if at all,

Th

Quote:ere is going to be riots in the streets of teachers, cops, firemen, and other government employees during the next crash. Basically Occupy Wall Street except older people who have done their time, know how to organize, and have a legit reason to be pissed. I feel sorry for them; they have no idea what's coming their way and how fragile their so called "secured" government pension really is.

I don't really agree with the above. It really depends on the state and /or structure of the pension system . Take NYS for example, Unlike Detroit, Chicago, and many other cities.. gov't employers are ACTUALLY obligated to put money into the pension system. The money is already there when someone is retired, that is needed to fund them. The gov't has no access to the money, since the fund is controlled by the pension funds of different jobs. unfortunately, the funds have been known to lend money to the gov't in crisis's.. but certainly not close to the balance.

The problem is they are reducing benefits for those NEW coming on. Others are grandfathered. Detroit is a bad example, a city that has been insolvent for decades. The money..simply wasn't there, and they refused to put the money promised into the pension fund.

As for cops rioting, well ..that says it all. Since they have the guns the country gov't has NO DESIRE to allow that to ever happen. In such a situation the gov't would fall apart. Most high level officers in the National Guard are gov't employees.Many are cops! So the Feds wouldn't even be able to count on the National Guard.

Post: #123

Any doctors on RVF want to chime in?

As a Canadian I still prefer my single player system, and as much as we complain about the wait times here, very few people I come across here who would want to get rid of our current system, including doctors.

Having the ability to go to the clinic at any time under any circumstance without getting asked about insurance, or payment options if anything happens to me, from a drug overdose to being hit by a car is a privilege that most people out here hold dear. My doctor thinks the system works, I wonder how many American doctors would prefer single payer versus not?

Post: #124

(07-20-2016 05:55 PM)jimukr104 Wrote:  

The Black Knight Wrote:There is going to be riots in the streets of teachers, cops, firemen, and other government employees during the next crash. Basically Occupy Wall Street except older people who have done their time, know how to organize, and have a legit reason to be pissed. I feel sorry for them; they have no idea what's coming their way and how fragile their so called "secured" government pension really is.

I don't really agree with the above. It really depends on the state and /or structure of the pension system . Take NYS for example, Unlike Detroit, Chicago, and many other cities.. gov't employers are ACTUALLY obligated to put money into the pension system. The money is already there when someone is retired, that is needed to fund them. The gov't has no access to the money, since the fund is controlled by the pension funds of different jobs. unfortunately, the funds have been known to lend money to the gov't in crisis's.. but certainly not close to the balance.

Of course as you say, it depends on the state. From 2015 article:

Quote:ALBANY—State lawmakers are moving ahead with a plan to defer more than $1 billion in pension payments over the next five years, arguing it will help them hold the line on spending increases even as critics warn of long-term risks.

[...]

“It's a bad idea,” she said. “Anything we do to postpone payment, to defer payment, puts those funds in jeopardy. New York is a bright spot—we're pretty well funded—and we don't want to start down the slippery slope to a situation like New Jersey or Illinois where we don't have the funds to meet our obligations.”

(I know Illinois does not = Chicago but they are interwoven to certain degrees).

Source: http://www.politico.com/states/new-york/...nts-020625

From another 2015 article:

Quote:Nov 24 - New York state's employees' retirement fund, one of the largest public pension funds in the United States, lost $11 billion as markets swooned earlier this year, according to a state financial watchdog on Tuesday.

Although some of those losses will have been recuperated as markets recovered from their steep losses earlier this year, the declines highlight how volatility in financial markets can affect the U.S. public pension sector. Under current funding arrangements public pension funds need lofty annual returns of 7 to 8 percent to stay solvent over the long run.

[...]

U.S. public pensions have been trying to rebuild their assets after the 2008 financial crisis left the $4 trillion sector seriously underfunded. Although relatively well funded plans such as New York's are better able to withstand market losses there is concern over the outlook for weaker funds.

Source: http://www.reuters.com/article/new-york-...ME20151124

Anyhow, I still think the whole pension system is a giant house of cards. Even if one state is a bit better protected, they are ALL still dependent on growth and returns based around paper money and assets AND they are all still interconnected with each other in some way. 7-8% safe returns consistently to meet obligations? Not a chance in hell with economic growth slowing, the population exponentially growing, the baby boomers beginning to retire in droves AND with 0% and negative interest rates worldwide being the standard. Where is the money going to come from? Current and future pension folks expecting their rightful pay day. It's the ONLY source available to work with.

People are going to have to settle for reductions in pension payouts AT BEST in the not so distance future. Be in no more cost of living adjustments, excessive inflation in the currency, or just a blunt direct: "We can only pay you 80% what we promised. Deal with it. Be glad you are not in that other state where they are only getting 50%"

And people are gonna be VERY upset when that reality suddenly hits them in the face after putting their time in or when they still working towards a pension expecting a certain income down the line. People are gonna flip out. Rioting is gonna happen.

When the house of cards come down (the next crash - which we are due for any day now since it has been about 7-8 years since the last one), it's going to be bad unless something is done ASAP to make for a soft-landing.

Post: #125

Anyone know the last time health care costs decreased under any president?