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PostPosted: January 28 17, 10:03 am 
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AWvsCBsteeeerike3 wrote:
ghostrunner wrote:
Whoa. The Washington Post received leaked audio from the GOP meeting in Philly.

https://www.washingtonpost.com/politics ... 2354dc576b



Where's the audio?


Not released. I suppose to try and protect sources.


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PostPosted: January 28 17, 10:45 am 
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vinsanity wrote:
AWvsCBsteeeerike3 wrote:
So, yeah, let's blame the insurance companies. But, obviously insurance companies are going to do [expletive] like this. It's how they make money. The value they provide is completely nothing.

Wait; are you on board with single payer health care?

I'm much more for single payer than obamacare, and I'm not much confident the republican band of goons is capable of improving it.

In my ideal world, and I'm sure there's probably a decent enough reason this isn't being done (more), but the Federal Government would initiate its own healthcare plan. That would entail no insurance required, no payment required, and care provided at locations across the US. I'm sure an algorithm could calculate where to put clinics and pharmacies based on X people per physician and no more than X miles to a doctor. In the cities it would likely be the lower income areas that would get clinics and hospitals (if needed). In the rural areas, the clinics would likely be very rural centered between to smaller towns..but that's down in the weeds. Regardless, get a base care of service provided for all of americans that is free and provided by the feds.

As of right now, they partially do this. There are programs where the govt will pay tuition reimbursement and stipends for 4th year med students that agree to a 2-3 year deal to work where the govt asks them to which is underserved areas. Sometimes it's BFE and sometimes it's LA. But, this is just a start.

If they're going to go single payer route, they should form their own closed system that relies on no one for anything. Agree to pay for students tuition up front (doctors, nurses, techs, etc). Negotiate a deal with universities where they get a discount (say $25k/year) or start up their own university. Train med students for 4 years. Then, at the end of those 4 years, like mlb teams that control the rights of their drafted players, the govt could dispense the docs around the country as needed for 6 (or whatever) years. After those 6 years, they can go to the private side or stay on the public side if they qualify.

There can still be insurance. People can still choose their own doctors. They just have to pay to do that. How they do it, I don't much care, that's not a concern. Maybe the wealthy would have quicker access to medical professionals and maybe they would have access to better professionals. But, at least there would be a base level of care for everyone in america that doesn't involve going to the ER and getting a $5k bill for the trouble. And, if you have insurance, they are forced to keep you and pay for illnesses. In other words, an insurance company can't drop a kid that gets cancer to avoid paying the costs and kicking the kid into the government provided healthcare. Not only that, but if an illness is discovered when a person is on an insurance, that insurance is forced to cover costs as agreed to in the policy for the remainder of the patients life. The govt can provide medicine for a fee.

Regarding pharmaceuticals, it's kind of tricky, I think. On the one hand, there are a ton of patents that have run out on medicines and generic versions are available. So, the govt could either contract to buy these and provide them free of charge or make them itself and provide them. The issue is with new drugs that are still under patent. Obviously the govt can't just steal the recipe and maek their own. But, they shouldn't have to pay $10k for a hep c treatment either unless there is a legit cost associated with the drug.... I don't have a good answer for how to control pharmaceutical costs. BUT, they are a huge pita and problem in the system, imho. Huge margins. Monopolies. Etc.

Some very prelim costs are:

Assume 50% on government healthcare at first and 50% stay private. 320M people in America so 160M on let's call is AWcare. 1 doctor per 500 people. 320k doctors. 320 nurses. 320 techs. 100k admin. Salaries of 50k 35k 25k 20k. That's $35B in salaries. Add in 25% for benefits and we're at $45B, call it $50B. Add in the cost of schooling (say 1.2M to account for dropouts) and we're at another $30B. Of course, that's not really an accurate number. You'd really need to multiply it by 4 or 2 depending on the profession and then divide that out by the # of years worked to get the true number, but this way is close enough for this purpose. So far we're at about $80B to provide doctors, nurses, techs and admin available to half the country.

Let's say there's 100 clinics set up in each state. 5000 clinics total. Let's say average rent is 10k/month so 120k per year. That's another 600M. Quadruple that cost to account for equipment costs and we're at $3B total for equipment and leases. This seems woefully low, but it's the best I got.

Now there's all the specialties. The number of doctors in America is right around 2.5 per 1k. I only calculated 2 per 1k. So, there's some room to bump up the doc costs.

But, I think I'll just stop there for now and let people criticize before I waste anymore time. But, there's how I'd go about solving the healthcare issue. It's obviously not a short term solution as the very earliest it could start would be 4 years as docs would have to agree to do it then go through 4 years of school. And, starting up a med school would be a huge undertaking in itself. But, looking at the numbers, it really seems like there is room to make it work.


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PostPosted: January 28 17, 11:27 am 
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AW: sounds a hell of a lot better than what we have now. Let's do it. AW for President!


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PostPosted: January 28 17, 12:57 pm 
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Another thing about doing it this way...You could then after a decade or 5 years or whatever say this is definitively say this is what it costs us to cover 100℅ of a person's healthcare costs. Then provide business with an appropriate deduction based on what percent of coverage a business provides it's employees.


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PostPosted: September 24 18, 11:34 am 
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The story of the new University of Iowa Children's Hospital (yes, the one Iowa football fans wave at every home game) is still unfolding. I've talked about it before but it keeps getting worse and worse. The whole story is not out yet. When they greenlighted the project roughly 5 years ago, the budget was $260 million. It has ended up costing $380 million. Only $50 million of that or so was paid for with donations from private donors. The other $330 million is going to be paid for with "patient revenue".

They are now refusing to pay a contractor that they owe $21.5 million. That's a tactic Trump used to use. This is how you see Trump reflected in our larger culture every so often, and you can kind of see where he came from. That article also speculates that one of the reasons they installed Bruce Herreld as chancellor to the U of Iowa was to do PR to sell this terrible project to the public.

It also sounds now like the University itself is on the hook for some of these costs, as a judge ordered the university to pay that contractor from their general fund. Projects like this is how college and health care end up costing so much.

So why would a nonprofit like a Children's hospital want to spend $380 million on a building, instead of....helping sick children, which is actually their mission? Nonprofits do not have the profit motive to grow like for-profit companies. But I believe that they still have a very strong incentive to grow. The bigger they become, the easier it is to maintain funding, and exert political influence over local and state governments. If Iowans suddenly had $380 million to spend on health care, I do not think we would decide to spend 100% of it on a new building in 1 city. Just a hunch.


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PostPosted: September 24 18, 11:39 am 
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From that article about the contractor, there are others:

Quote:
UI officials recently reported commitments at $370 million, with contractors demanding more — as Modern Piping isn’t the only one in litigation over its treatment on the Board of Regents’ biggest-ever project. Merit Construction also is locked in a legal battle with the university over four bid packages it says are worth $64.1 million — not including attorneys fees, back charges and other costs — although much of that is in dispute.

That case is scheduled for arbitration this fall.

UI executives have said the children’s hospital was covered entirely with gifts, patient revenue and bonds — which the Board of Regents have had to increase to keep up with the project’s rising cost. The university — not the state — however is on the hook for the litigation payouts, even as it struggles with persistent legislative cuts that have it increasing tuition, freezing faculty pay, halting campus construction and closing some centers.


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PostPosted: September 24 18, 11:54 am 
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All non-profits are not created equal. I haven’t dug deep but it’s clear that huge institutions like hospital systems and unis do have a profit motive of a sort. They do nothing to keep costs down, they build and build and obviously need sick people to fill their beds and get their MRIs and on and on.


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PostPosted: November 16 18, 7:10 pm 
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PostPosted: January 7 19, 8:23 am 
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A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills
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On April 3, Nina Dang, 24, found herself in a position like so many San Francisco bike riders — on the pavement with a broken arm.

A bystander saw her fall and called an ambulance. She was semi-lucid for that ride, awake but unable to answer basic questions about where she lived. Paramedics took her to the emergency room at Zuckerberg San Francisco General Hospital, where doctors X-rayed her arm and took a CT scan of her brain and spine. She left with her arm in a splint, on pain medication, and with a recommendation to follow up with an orthopedist.

A few months later, Dang got a bill for $24,074.50. Premera Blue Cross, her health insurer, would only cover $3,830.79 of that — an amount that it thought was fair for the services provided. That left Dang with $20,243.71 to pay, which the hospital threatened to send to collections in mid-December.

“Eight months after my bike accident, I’m still thinking about [the bill], which is crazy to me,” Dang says.

Dang’s experience with Zuckerberg San Francisco General is not unique. Vox reviewed five patient bills from the hospital’s emergency room, in consultation with medical billing experts, and found that the hospital’s billing can cost privately insured patients tens of thousands of dollars for care that would likely cost them significantly less at other hospitals.

The bills were all submitted by patients to Vox’s Emergency Room Billing Database, which served as the basis for a year-long investigation into ER billing practices.

Zuckerberg San Francisco General (ZSFG), recently renamed for the Facebook founder after he donated $75 million, is the largest public hospital in San Francisco and the city’s only top-tier trauma center. But it doesn’t participate in the networks of any private health insurers — a surprise patients like Dang learn after assuming their coverage includes a trip to a large public ER.


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PostPosted: January 14 19, 10:42 pm 
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Putting this here because the big increases are health care related, but it's pretty fascinating what's gone up and what's gone down over the years.

Spoiler: show
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