ACA case dismissed for no standing.

On Sunday, June 20, 2021 at 3:11:20 AM UTC+10, Fred Bloggs wrote:
> On Friday, June 18, 2021 at 8:23:40 PM UTC-4, gnuarm.del...@gmail.com wrote: 
> > On Friday, June 18, 2021 at 7:42:21 PM UTC-4, amdx wrote: 
> > > On 6/18/2021 4:24 PM, Rick C wrote: 
> > > > On Friday, June 18, 2021 at 11:37:26 AM UTC-4, amdx wrote: 
> > > >> On 6/18/2021 10:16 AM, Fred Bloggs wrote: 
> > > >>> On Thursday, June 17, 2021 at 5:54:53 PM UTC-4, amdx wrote: 

<snip>
 
> > > This is like college loans, the government gets involved and all the 
> > > easy money drives up costs. 
> >
> > You did not understand a single word I wrote. Universal healthcare would do the opposite because it would be paid for by the government, not the patients and like Medicare, the payments would be controlled. Most likely a workable system would result in most healthcare professionals working for a universal healthcare system like the NHS in Britain.
>
> Public insurance is not working very well in US right now, as measured by treatment outcomes.

When the bulk of the US population is obese, the teir treatment out comes are never going to be great.

> It's significantly worse, as in way worse. Going universal is the fastest way to destroy health care in America.

Really? All the doctors are going to emigrate somewhere where they can get just as extravagantly over-paid?

> All these stories you hear about wonderful public health care in more socialist countries is total fantasy. 

https://www.worldometers.info/demographics/life-expectancy/

The United States of America sits at 46th in the life expectancy ranking - about four years short of places like Australia (which is 8th).

> Public employment and regulation of the work environment turns people into apathetic and incompetent loiterers.

Every rabid right-winger believes this, but there's no objective evidence supporting the idea.

> Everyone raves about Sweden, but if you're over 70 and become seriously ill with COVID there, they put you on the drug induced euthanasia program- whether you want it or not.

This sounds like something culled from the lying propaganda spread in a effort to block Obamacare.

> You and your family have no say in the matter. Most Americans wouldn't put up with these other national systems for 5 minutes. 

More anti-Obamacare propaganda. Which is to say, implausible nonsense.

> Universally available public insurance works, but Americans better avoid universal health care if they know what's good for them.

Ask any American private medical insurance company.

> > > Same with healthcare. Subsides are not the fix, lower costs and the rate of increases is. 
> >
> > I'm not talking about subsidies. I'm talking about drop kicking the existing system, getting rid of insurance (which IS subsidized) replacing it with a single payer system. Most politicians say "Medicare for all", but I think Medicare is a mess. WAY TOO COMPLICATED. In most countries you might want to live in health care is just paid for. No fuss, no muss. Can't get much more simple. 

It certainly worked that way in the Netherlands. The Australian system is appreciably more complicated, and doesn't seem to work as well, but if you do get sick, you always get treated and you won't end up bankrupted by having to pay for the treatment. Australians typically live about four year longer than Americans, so it works for us.

The Netherlands doesn't do quite as well - by about six months - but it is colder and more crowded.

-- 
Bill Sloman, Sydney

On Friday, June 25, 2021 at 10:55:41 PM UTC-4, Bill Sloman wrote:
> On Saturday, June 19, 2021 at 10:23:40 AM UTC+10, gnuarm.del...@gmail.com wrote: 
> > On Friday, June 18, 2021 at 7:42:21 PM UTC-4, amdx wrote: 
> > > On 6/18/2021 4:24 PM, Rick C wrote: 
> > > > On Friday, June 18, 2021 at 11:37:26 AM UTC-4, amdx wrote: 
> > > >> Ah, not really. My main point was that people with a net worth in the 
> > > >> top 10% are structuring 
> > > >> 
> > > >> their income to take advantage of subsidies on their healthcare 
> > > >> insurance. Paid for by people that 
> > > >> 
> > > >> have much less and earn a middle class income. 
> > > >> 
> > > >> I'll freely admit, I'm probably the dumb one, I have probably paid 
> > > >> over $70k in extra insurance premiums, 
> > > >> 
> > > >> since 2012, because I avoided the ACA and kept a private plan the whole 
> > > >> time. I could have got a large subsidy. 
> > > > It's always easy peasy to point out problems. It's also easy peasy to come up with lame, knee jerk solutions like Larkin tends to do. But you don't even try. 
> > > > 
> > > > My solution is universal health care like they have in most civilized countries. Then everyone gets all the treatment they need and it is back to paying according to your ability... well, as much as the tax system is structured for that. 
> > > > 
> > > > It would not require much extra taxes, at least beyond what is paid out today. Those who are currently covered under employers' plans would essentially be covered by the employer paying into funding universal health care just as they today pay for insurance. Those who are covered by Medicare or Medicaid would not change. That covers the lion's share of medical costs. The remainder of uninsured would need to be covered by some extra taxes collected. Or, maybe the savings of eliminating the medical insurance industry would cover that. 
> > > > 
> > > > There are many details to figure out for sure, but it's not an intractable problem. That would completely remove the minimum income goal for the retired, well, from the medical insurance aspect at least. They still want to minimize their taxes in general. 
> > > > 
> > > This is like college loans, the government gets involved and all the easy money drives up costs. 
> > 
> > You did not understand a single word I wrote.
> He doesn't want to.

I think it is a more fundamental issue of not making an effort to understand.   For some people it's just too hard to try to grasp what is really going on and simply let the reflexes kick in, "Government bad" and thinking it is the care providers who are the problem!  


> > Universal healthcare would do the opposite because it would be paid for by the government, not the patients and like Medicare, the payments would be controlled. Most likely a workable system would result in most healthcare professionals working for a universal healthcare system like the NHS in Britain.
> The NHS in the UK allows health-care professionals who mostly work for the NHS to moonlight in the private sector, charging a lot more to do pretty much what the patients wants. 
> 
> Even the doctors who do it are aware that the quality of care the patient gets isn't up to much - the private sector doesn't get enough work to keep the doctors involved at the top of their game. 

if they mostly work for the NHS, why would they not be working fully and at the top of their game? 


> > > Same with healthcare. Subsides are not the fix, lower costs and the rate of increases is. 
> > 
> > I'm not talking about subsidies. I'm talking about drop kicking the existing system, getting rid of insurance (which IS subsidized) replacing it with a single payer system. Most politicians say "Medicare for all", but I think Medicare is a mess. WAY TOO COMPLICATED. In most countries you might want to live in health care is just paid for. No fuss, no muss. Can't get much more simple.
> That was the way it worked in the Netherlands. Canadian economist who have looked at why the US health care system is as expensive as it is - half again more per patient than the most generous universal systems - say that most of the extra money is spent on accountants who have to spend time to make sure that every payment comes from the right source, and has the right justification. 

It's not exactly accountants.  They are expensive, so relatively few of them are analyzing the numbers from the 10,000 foot view.  But every bill submitted for payment has to be processed twice for the billing codes.  The doctor's written description is analyzed by people working for the doctors to assign billing codes to obtain the maximum compensation.  Then it is reviewed again by people working for the insurance companies to justify the minimum compensation.  In some cases this goes back and forth a few times.  VERY inefficient and adding nothing to the quality of care and in many cases reducing it since it presents a barrier to the care paid for and therefore provided.  

The major concern of people is that the government will be involved in setting the limits on what care will be justified and paid for in a single payer system.  That may be a real concern, but is it different from the same sort of limitations imposed by what insurance will pay for?  At least with the government you can vote out the politicians who cause significant quality of care impacts.  How much choice do you have with your insurance company?  I guess you can ditch the one your employer partly pays for and go it alone... if you can even figure out in advance what they will and won't  pay for.  I could never crack that code. 

-- 

Rick C.

-+- Get 1,000 miles of free Supercharging
-+- Tesla referral code - https://ts.la/richard11209

On Saturday, June 26, 2021 at 9:57:15 PM UTC+10, gnuarm.del...@gmail.com wrote:
> On Friday, June 25, 2021 at 10:55:41 PM UTC-4, Bill Sloman wrote: 
> > On Saturday, June 19, 2021 at 10:23:40 AM UTC+10, gnuarm.del...@gmail.com wrote: 
> > > On Friday, June 18, 2021 at 7:42:21 PM UTC-4, amdx wrote: 
> > > > On 6/18/2021 4:24 PM, Rick C wrote: 
> > > > > On Friday, June 18, 2021 at 11:37:26 AM UTC-4, amdx wrote: 
> > > > >> Ah, not really. My main point was that people with a net worth in the 
> > > > >> top 10% are structuring 
> > > > >> 
> > > > >> their income to take advantage of subsidies on their healthcare 
> > > > >> insurance. Paid for by people that 
> > > > >> 
> > > > >> have much less and earn a middle class income. 
> > > > >> 
> > > > >> I'll freely admit, I'm probably the dumb one, I have probably paid 
> > > > >> over $70k in extra insurance premiums, 
> > > > >> 
> > > > >> since 2012, because I avoided the ACA and kept a private plan the whole 
> > > > >> time. I could have got a large subsidy. 
> > > > > It's always easy peasy to point out problems. It's also easy peasy to come up with lame, knee jerk solutions like Larkin tends to do. But you don't even try. 
> > > > > 
> > > > > My solution is universal health care like they have in most civilized countries. Then everyone gets all the treatment they need and it is back to paying according to your ability... well, as much as the tax system is structured for that. 
> > > > > 
> > > > > It would not require much extra taxes, at least beyond what is paid out today. Those who are currently covered under employers' plans would essentially be covered by the employer paying into funding universal health care just as they today pay for insurance. Those who are covered by Medicare or Medicaid would not change. That covers the lion's share of medical costs. The remainder of uninsured would need to be covered by some extra taxes collected. Or, maybe the savings of eliminating the medical insurance industry would cover that. 
> > > > > 
> > > > > There are many details to figure out for sure, but it's not an intractable problem. That would completely remove the minimum income goal for the retired, well, from the medical insurance aspect at least. They still want to minimize their taxes in general. 
> > > > > 
> > > > This is like college loans, the government gets involved and all the easy money drives up costs. 
> > > 
> > > You did not understand a single word I wrote. 
> > He doesn't want to.
> I think it is a more fundamental issue of not making an effort to understand. For some people it's just too hard to try to grasp what is really going on and simply let the reflexes kick in, "Government bad" and thinking it is the care providers who are the problem!
> > > Universal healthcare would do the opposite because it would be paid for by the government, not the patients and like Medicare, the payments would be controlled. Most likely a workable system would result in most healthcare professionals working for a universal healthcare system like the NHS in Britain. 
> > The NHS in the UK allows health-care professionals who mostly work for the NHS to moonlight in the private sector, charging a lot more to do pretty much what the patients wants. 
> > 
> > Even the doctors who do it are aware that the quality of care the patient gets isn't up to much - the private sector doesn't get enough work to keep the doctors involved at the top of their game.
>
> if they mostly work for the NHS, why would they not be working fully and at the top of their game?

They are more or less okay. But in the NHS the teamwork is well-practised on lots of similar patients, and the private health care teams are quite a bit more ad hoc, and less practised on any specific procedure. It's a well-known effect. In the Netherlands when I was there smaller hospital got banned from dealing with low frequency complaints simply because the didn't see enough of them to keep in practice.

> > > > Same with healthcare. Subsides are not the fix, lower costs and the rate of increases is. 
> > > 
> > > I'm not talking about subsidies. I'm talking about drop kicking the existing system, getting rid of insurance (which IS subsidized) replacing it with a single payer system. Most politicians say "Medicare for all", but I think Medicare is a mess. WAY TOO COMPLICATED. In most countries you might want to live in health care is just paid for. No fuss, no muss. Can't get much more simple. 
> >
> > That was the way it worked in the Netherlands. Canadian economist who have looked at why the US health care system is as expensive as it is - half again more per patient than the most generous universal systems - say that most of the extra money is spent on accountants who have to spend time to make sure that every payment comes from the right source, and has the right justification.
>
> It's not exactly accountants. They are expensive, so relatively few of them are analyzing the numbers from the 10,000 foot view. But every bill submitted for payment has to be processed twice for the billing codes. The doctor's written description is analyzed by people working for the doctors to assign billing codes to obtain the maximum compensation. Then it is reviewed again by people working for the insurance companies to justify the minimum compensation. In some cases this goes back and forth a few times. VERY inefficient and adding nothing to the quality of care and in many cases reducing it since it presents a barrier to the care paid for and therefore provided. 
> 
> The major concern of people is that the government will be involved in setting the limits on what care will be justified and paid for in a single payer system. That may be a real concern, but is it different from the same sort of limitations imposed by what insurance will pay for? At least with the government you can vote out the politicians who cause significant quality of care impacts. How much choice do you have with your insurance company? I guess you can ditch the one your employer partly pays for and go it alone... if you can even figure out in advance what they will and won't pay for. I could never crack that code. 

The British NHS does assess new treatments for cost-effectiveness. Very new stuff is taken up medical people who like the idea and wrangle research money for a bunch of experimental patients, which is a bit informal but does seem to work. 

-- 
Bill Sloman, Sydney