Author Topic: The Politics of Health Care  (Read 586038 times)

ccp

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Leftist medical academics
« Reply #1750 on: December 15, 2019, 08:08:32 AM »
https://townhall.com/columnists/janerobbins/2019/12/15/medical-associations-embrace-propaganda-not-science-n2557967

"Under AAP policy, any position statement is drafted by a small committee (usually 10-12 members, and maybe as few as seven) and then voted on by the roughly 12-member board of directors. The broader membership has no direct input into the statement and would generally learn of it only after it’s issued. So the only thing the AAP policy tells us is that less than 0.05 percent of the pediatricians who are still members of AAP believe in experimenting medically on gender-confused children."

This is what I see in the adult medical organizations

A bunch of academic libs direct the their positions and declarations

I have never had any one of them reach out and ask for my opinion.
or take a survey etc

It is the academic self appointed elites - again .

Crafty_Dog

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WSJ on the Fifth Circuit decision
« Reply #1751 on: December 21, 2019, 11:22:43 AM »
An ObamaCare Judicial Morass
Democrats get new ammunition as an ill-fated lawsuit drags on.
By The Editorial Board
Dec. 20, 2019 7:10 pm ET
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A sign on an insurance store advertises Obamacare in San Diego, October 2017. PHOTO: MIKE BLAKE/REUTERS
Even as Democratic presidential candidacies implode over Medicare for All, Republican state attorneys general and the Trump Administration are handing the left a political lifeline with an overbroad attack on ObamaCare in the courts. On Wednesday the Fifth Circuit Court of Appeals ensured this will drag on as it struck down the individual mandate and asked a district-court judge to determine if other parts of the law have to go too.

The finding that the mandate is unconstitutional is straightforward though it should have little impact. Chief Justice John Roberts in 2012 upheld the Affordable Care Act’s (ACA) command that everyone purchase insurance on grounds that it was a “tax” on failing to buy insurance. In 2017 the GOP Congress set the penalty for failing to buy insurance at $0. If it doesn’t collect revenue, the Fifth Circuit now says, it can’t be a tax.

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That’s a clever legal twist, but states and the Trump Administration want to go further. They say the mandate’s illegality means that much or all of the rest of ObamaCare’s regulations and subsidies must also be dismantled. A district court judge agreed.

The Fifth Circuit panel didn’t affirm this view but also didn’t repudiate it. The judges appear open to the idea that big parts of the law need to fall with the mandate. Most vulnerable would be ObamaCare’s “community rating” and “guaranteed issue” provisions that regulate insurance prices and require companies to cover pre-existing conditions.

The legal issue is called “severability.” The test is whether removing the unconstitutional part would blow up the functioning of rest of the law, as well as the thornier question of whether “Congress would have preferred no ACA at all to an ACA without the mandate.” We’ve opposed ObamaCare’s baleful effects as much as anyone, but there’s little doubt the mandate is severable.

The confusion comes from the misjudgment of the law’s drafters. They said the mandate would cause healthy people to buy insurance and create a thriving individual health-insurance market. If that had happened, then the mandate may have been difficult to sever.

Yet the mandate turned out not to be much of an inducement for people to buy health insurance they couldn’t afford. Congress’s elimination of the penalty in 2017 hasn’t resulted in higher insurance premiums. And the same Congress kept the rest of the law in place. The Fifth Circuit judges seem to want an open-ended inquiry into the “intent” of two different Congresses making complex policy decisions in light of different facts. The simpler solution is to defer to the most recent Congress.

ObamaCare created an entitlement through subsidies and Medicaid; the mandate was mostly superfluous in practice. If conservatives declare that the mandate is an inextricable part of ObamaCare, they would ironically vastly overstate the law’s success in an attempt to sink it.

Millions of people now rely on the law, and “reliance interests” will also doom this challenge if it ever reaches Chief Justice Roberts. He’s unlikely to be amused that other judges are using his saving construction for the law to overturn it today. Yet the GOP will be battered politically in the interim.

Speaker Nancy Pelosi said in response to the ruling that “Republicans have taken every opportunity to dismantle” coverage for Americans with pre-existing conditions. The GOP would do better to develop a health agenda that candidates can defend politically rather than use the judiciary as a legislature of last resort.


ccp

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Trump kept "pre existing conditions"
« Reply #1753 on: January 20, 2020, 05:01:06 PM »


Trump kept "pre existing conditions"

https://www.newsmax.com/t/newsmax/article/950533/1

my opinion - one of 7 billion - is whoever works health care wins 2020.

 :-)

DougMacG

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Re: Trump kept "pre existing conditions"
« Reply #1754 on: January 21, 2020, 09:11:08 AM »
"whoever works health care wins 2020."

Trump should partner up right now with House Republicans and all the best minds of conservative think tanks and hold real policy talks (alongside the impeachment hearings) and propose more moves toward market solutions that they can run on in the fall.  More consumer choices, more deregulation, more details on disclosures of prices, and so on. 

How about a 10 point (conservative) Contract with America on Health Care that will pass the House if the nation elects them?  Build it, perfect it and put it on the ballot.

ccp is right.  Silence on health care will cost them (another) election.  They better have a plan and it better be a good one.

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1755 on: January 21, 2020, 09:55:53 AM »
Call in Dr. Ben Carson!  Sen and Doctor Rand Paul too!

ccp

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Re: The Politics of Health Care
« Reply #1756 on: January 21, 2020, 11:16:57 AM »
"How about a 10 point (conservative) Contract with America on Health Care that will pass the House if the nation elects them? "

Now that is a good idea!

put that up against "free Medicare for All"  that would bankrupt this country and make everyone debt poor for the next 100 yrs!

DougMacG

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Imagine Health Care Deregulation
« Reply #1757 on: February 03, 2020, 09:08:51 AM »
I miss the posts from Venezuela and have wondered where Denny has gone.  I see he is still active at Motley Fool discussion board:
https://boards.fool.com/LastPosts.asp?limit=10&uid=95826397

Here is a comment I like, with apologies to our own fully certified MD:

"I have read that part of AMA's unspoken mission is to restrict the number of doctors which is typically the function of all professional and artisan guilds. It's a form of restraint of trade to benefit the current guild members. Then, of course, the blame is placed on the "free" market which is not free from manipulation by the guilds (a. k. a. labor unions -- AMA being the US medical labor union).

Imagine deregulating medicine! ;)   
"

    - (our) Denny S  ?

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1758 on: February 03, 2020, 10:33:25 AM »
Sounds like how he sees things :-)

ccp

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BMI discriminates
« Reply #1759 on: February 07, 2020, 05:52:24 AM »

"  body mass index (BMI) is discriminatory to gender nonbinary students."  WHAT??????????


https://www.foxnews.com/health/california-gavin-newsom-moves-pause-student-fitness-tests-citing-bullying-concerns

 :-o :-(

DougMacG

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Re: BMI discriminates
« Reply #1760 on: February 07, 2020, 06:28:59 AM »
"  body mass index (BMI) is discriminatory to gender nonbinary students."  WHAT??????????

https://www.foxnews.com/health/california-gavin-newsom-moves-pause-student-fitness-tests-citing-bullying-concerns

 :-o :-(

Forget about discrimination, what is a "gender nonbinary" student?  The ones who don't know which bathroom to use? 

"Hey Joe (Biden), How many genders are there?" "I know there are at least two.  Wait, is that a trick question?"

Back to BMI, did anyone think there was a perfect number for everyone?  We can't even judge by credit score or criminal background anymore.
« Last Edit: February 07, 2020, 06:48:42 AM by DougMacG »

ccp

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American College of ACP (Liberals)
« Reply #1761 on: February 11, 2020, 11:41:03 AM »
https://thehill.com/policy/healthcare/482437-doctors-group-breaks-from-health-care-industry-with-support-for-medicare

Well I cancelled my membership 1 to 2 yrs ago

I don't recall ever being surveyed as to my opinion


They take all these political positions always siding  with the political correct crowd .

and then suggest we all agree with it.

From climate change, to abortion, to me too, to trans gay, to anti Republican anything , and on and on and on

Doherty was never elected.  He is just there for many years pretending he speaks for me .

Well since i am no longer a member, he doesn't.

I was not from my memory politically activist until the last maybe 10 yrs........?




ccp

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high costs of insulin
« Reply #1762 on: February 18, 2020, 06:37:40 AM »
and how we foot the bill for the rest of the world
where insulin sells for 10 times less

and despite insulin being around since 1921
the cost keeps going endlessly higher even for basic insulins

and how the pharmacy benefits managers , drug companies are ripping off the patients and their insurances:

https://www.mayoclinicproceedings.org/article/S0025-6196(19)31008-0/fulltext

There is no possibility there is not some form of collusion and price fixing .

Even if not a direct agreement it is an unsaid fact that all the drug companies are keeping their prices high in tandem.

DougMacG

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Re: high costs of insulin
« Reply #1763 on: February 18, 2020, 08:23:07 AM »
and how we foot the bill for the rest of the world
where insulin sells for 10 times less

and despite insulin being around since 1921
the cost keeps going endlessly higher even for basic insulins

and how the pharmacy benefits managers , drug companies are ripping off the patients and their insurances:

https://www.mayoclinicproceedings.org/article/S0025-6196(19)31008-0/fulltext

There is no possibility there is not some form of collusion and price fixing .

Even if not a direct agreement it is an unsaid fact that all the drug companies are keeping their prices high in tandem.

I remember after Katrina oil prices spiked with the closing of refineries and shipping lanes and a Dem leaning friend commented on the greed of the oil companies.  But in fact, oil company greed was the only factor that held constant during that supply interruption and price spike up and back down. 

The economics of insulin is simple, same as every other commodity or manufactured good or service - UNLESS something is standing in the way of market forces working.

When the price and profits go up, the incentive to produce more goes up and the new supply and competition brings down the price.  I can only guess why that isn't happening, government interference in the market, probably at every step and every level.

I know nothing about insulin but one crazy idea would be to legalize it.
-------------------
From the Mayo Clinic article:
Reasons for the High Cost of Insulin
"The number 1 reason for the high cost of insulin is the presence of a vulnerable population that needs insulin to survive (Table 1). This population, which numbers in the millions,14 is willing to pay anything to have access to a lifesaving drug. The desperate need for a lifesaving product allows insulin to be priced at high levels because it is not a luxury item that one can forego. The manufacturers of insulin know that patients who need it will spend whatever it takes to acquire it, regardless of price. It is a matter of life and death."

    - No, that isn't the reason insulin isn't a plentiful, affordable medicine in the year 2020.

Back to Mayo reason list:
1 • Vulnerable population who is willing to pay high costs to have access to a lifesaving drug
2 • Virtual monopoly/oligopoly
3 • Patent abuse and evergreening
4 • Barriers to biosimilar entry
5 • Pharmacy benefit managers and other middlemen who benefit from a high list price
6 • Lobbying power of insulin manufacturers


Note the 2nd, 4th and 6th reasons. Virtual monopoly.  Why?  Barriers to entry.  Why?  Lobbying power?  No, it's not the "lobbyists", it's the government they are lobbying.

If the government is failing you, why not get them out of the business, turn the quality certification over to something non-government such as the American Diabetes Assn, diabetes.org.

The only barrier to entry should be you need to have a safe, pure, effective product.

I'm not diabetic but I would be happy to have a Mayo Clinic certification on a med if the government is too slow, too stupid or too corrupt to do the job.  Why is the answer to bungled government always more government or complete government takeover?  It makes no sense to me.
« Last Edit: February 18, 2020, 08:31:57 AM by DougMacG »

ccp

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Re: The Politics of Health Care
« Reply #1764 on: February 18, 2020, 09:12:26 AM »
Very good points Doug

If we take the position that the companies will go ahead and "abuse the system "

because they can,  and this is consistent will human behavior in general
then

the problem must be the system is broken (like at the Copyright Office)
this the system needs to fixed. so the greedy cannot manipulate the system to their benefit

removing barriers of entry seems like it would help.

however I am not sure it is just this.

Even the biosimilars still seem to charge a lot .
only somewhat less then the ibg monopoly players according to this article.

one interesting thing is Walmart has availability of one type of insulin at low cost
 because of their purchasing power.

the pharmacy benefits managers are supposed. to have the same effect
but while they may save some insurers money NONE of that saves patients money.

I thinks some wholesale prescription plans have tried to break the strangle hold but I am not sure if any really successful

I don't think I can say it is due to regulations.

I think price collusion is clearly a factor

Just like market forces have not really been able to break the stranglehold of the big tech companies that control most of the market in on line ads and data etc.

DougMacG

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Re: The Politics of Health Care
« Reply #1765 on: February 18, 2020, 09:47:46 AM »
Thanks ccp.

"I think price collusion is clearly a factor"

Yes, price collusion between near monopoly players is broken only with new supplies entering the market.  They don't have to talk to each other to collude.  They just do market price studies like everyone does.

"Just like market forces have not really been able to break the stranglehold of the big tech companies that control most of the market in on line ads and data etc."

Ever since the rise of Microsoft, these big companies can't be beat because of their low price and high functionality.  Google and Facebook are mostly "free" to the user with massive functionality.  There are no barriers to entry to sell (most) products on the internet without a middleman for less, just the challenge of getting costs down and getting the word out.

Back to Insulin, something or somebody is stopping more supplies and new suppliers from entering the market.  Mayo Clinic pointing the finger at "Lobbying power of insulin manufacturers" makes me wonder...  Lobby whom?  To do what?  Government.  To block new supplies and suppliers, I presume.
« Last Edit: February 18, 2020, 09:52:15 AM by DougMacG »