"Universal Access"

[Nbadan]

Wow, sounds catchy....watch out!

G.O.P. Plans to Replace Health Care Law With Universal Access
Source: MSN/NY Times


WASHINGTON House Republicans, responding to criticism that repealing the Affordable Care Act would leave millions without health insurance, said on Thursday that their goal in replacing President Obamas health law was to guarantee universal access to health care and coverage, not necessarily to ensure that everyone actually has insurance.

In defending the Affordable Care Act, the Obama administration, congressional Democrats and advocacy groups have focused on the 20 million people covered by the law, which has pushed the percentage of Americans without health insurance to record lows. The American Medical Association recently said that any new reform proposal should not cause individuals currently covered to become uninsured.

But House Republicans, preparing for a rapid legislative strike on the law next month, emphasize a different measure of success.

Our goal here is to make sure that everybody can buy coverage or find coverage if they choose to, a House leadership aide told journalists on the condition of anonymity at a health care briefing organized by Republican leaders.


Read more: http://www.msn.com/en-us/news/politics/gop-plans-to-replace-health-care-law-with-%e2%80%98universal-access%e2%80%99/ar-AAlCyvr

..so the GOP's plan is to replace universal access to health care for 20 million people with universal access to health insurance...

[rmt]

Wow, sounds catchy....watch out!

G.O.P. Plans to Replace Health Care Law With Universal Access
Source: MSN/NY Times




Read more: http://www.msn.com/en-us/news/politics/gop-plans-to-replace-health-care-law-with-%e2%80%98universal-access%e2%80%99/ar-AAlCyvr

..so the GOP's plan is to replace universal access to health care for 20 million people with universal access to health insurance...


GOP plan is to allow you to buy what you want if you want it. Obamacare is: you must have health insurance (or pay a fine), and it must have these 10 essential benefits (that they have determined).

[boutons_deux]

GOP plan is to allow you to buy what you want if you want it. Obamacare was: you must have health insurance (or pay a fine), and it must have these 10 essential benefits (that they have determined).

goddam, your're fucking stupid.

Who wants to pay auto insurance? That's how insurance works. Some insurance, like ACA, auto, life insurance for a mortgagee, are legally mandatory.

goddam, your're fucking stupid.

[rmt]

goddam, your're fucking stupid.

Who wants to pay auto insurance? That's how insurance works. Some insurance, like ACA, auto, life insurance for a mortgagee, are legally mandatory.

goddam, your're fucking stupid.

If I'm young, healthy or have no assets, I can think of lots of more pressing needs than EXPENSIVE ACA health insurance. A cheap, catastrophic policy, $59 on a Comprehensive Wellness Check* (no need to even see the doctor) to check that everything's in range and I'm good to go. Even if I'm old or have assets, that sounds good. Only if I'm sick does ACA sound good - hence the very high rates.

*https://www.directlabs.com/?tabid=2492

[boutons_deux]

If I'm young, healthy or have no assets, I can think of lots of more pressing needs than EXPENSIVE ACA health insurance. A cheap, catastrophic policy, $59 on a Comprehensive Wellness Check* (no need to even see the doctor) to check that everything's in range and I'm good to go. Even if I'm old or have assets, that sounds good. Only if I'm sick does ACA sound good - hence the very high rates.

*https://www.directlabs.com/?tabid=2492

goddam, your're fucking stupid.

Ms of people drive cars and never make claim. But they have to buy MANDATORY auto insurance.

Ever heard of a bad break? Keep your fingers crossed.

[rmt]

goddam, your're fucking stupid.

Ms of people drive cars and never make claim. But they have to buy MANDATORY auto insurance.

Ever heard of a bad break? Keep your fingers crossed.

And auto insurance doesn't cover oil/tire changes or routine maintenance - we pay for those ourselves. Catastrophic insurance is cheap - that will cover bad breaks - people will buy it. Comparison shop for routine doctor's visits and non-emergency procedures - pay out of pocket (like you do for oil changes) or HSA. ACA insurance mandates 10 essential benefits and drives up the cost making it more expensive for EVERYBODY.

[SnakeBoy]

goddam, your're fucking stupid.

Ms of people drive cars and never make claim. But they have to buy MANDATORY auto insurance.

Ever heard of a bad break? Keep your fingers crossed.

Mandatory Liability Auto Insurance

[baseline bum]

GOP plan is to allow you to buy what you want if you want it.

People with pre-existing conditions will be allowed to buy insurance in the same way people are allowed to buy Lamborghinis?

[DMC]

Mandatory Liability Auto Insurance

Yep, huge difference. Liability is a very different responsibility/protection concept than self coverage options. Being required to protect yourself isn't the same as being required to protect others, else the child seat laws are too invasive.

[DMC]

The problem with heath insurance is it doesn't insure anyone's health. You don't have a lot of health related events, you have health trends. People age, they develop conditions and unlike autos, they aren't repairable. They instead are treated with maintenance routines and medications. That snowballs as people age and a lot of it is due to lifestyle when young.

I don't know that people are entitled to healthcare. It seems like they should be, if it was just an aspect of living like freedom, joy, happiness and such, but it's brought on by the labor of other people. Who is entitled to receive your labor for free? Since it's never going to be free because doctors and researchers won't work for free (because the rest of the world isn't free to use), there would have to be a system that has a surplus to an extent where healthcare is made free for everyone, not just for those who cannot pay for it.

On federal lands where minerals exist including petroleum, those minerals could be sold and all of the profit used to pay for things that affect the entire country instead of being rolled into the pockets of the few. Or not. I don't give a shit. I'm just rambling on like it matters. We all die eventually so why spend your life as a slave to the system that has 100% failure rate eventually?

[rmt]

People with pre-existing conditions will be allowed to buy insurance in the same way people are allowed to buy Lamborghinis?

They would be treated the same way that employer sponsored or COBRA people are treated - no different rating as long as continuous coverage is maintained. No being without coverage and sign up when something happens the way it is now with ACA (without your rates being jacked up).

[baseline bum]

They would be treated the same way that employer sponsored or COBRA people are treated - no different rating as long as continuous coverage is maintained. No being without coverage and sign up when something happens the way it is now with ACA (without your rates being jacked up).

Meh without the subsidies that Ryan intends to remove for 2018 or 2019 the lower middle class and below aren't going to be able to afford insurance and many will have to drop coverage. Price's $1200 tax credit is laughable as hell. I know republicans like to act like insurance only got wildly expensive in 2014 with the ######'s plan, but ultimately Trump's plan will just pick people off insurance and bring things back to the glory days of medical bankruptcies. Even that plan is probably going to be hard to get through a teabagger congress scared of being primaried and where Trump likely won't get any democrat votes. The GOP acts like they have this big mandate but the senate numbers are close and if Ted Cruz and two other right wing senators think this plan is too much government interference it ain't even passing with reconciliation.

[ElNono]

They would be treated the same way that employer sponsored or COBRA people are treated - no different rating as long as continuous coverage is maintained. No being without coverage and sign up when something happens the way it is now with ACA (without your rates being jacked up).

COBRA is time-limited though... after a while, you're shit out of luck. I would argue that one of the major problems with healthcare in the US is it being tied to employment. Things like COBRA are the problem. When you need something like COBRA it's because you lost, even temporarily, employment and thus income, and those COBRA premiums, while perhaps smaller than out of pocket, are no slouch. Even people that eventually move to Medicare due to disability, it takes two full years before they can actually get Medicare. When they're the most vulnerable and need the most help, is when everything disappears. I don't like ACA at all, but the previous system was perverse as hell, and arguably just as bad.

Then again, as long as the discussion centers around who's going to pay for the bloated, inflated cost, instead of actually discussing why we have a bloated, inflated cost, there's not going to be a solution to this problem.

[baseline bum]

Then again, as long as the discussion centers around who's going to pay for the bloated, inflated cost, instead of actually discussing why we have a bloated, inflated cost, there's not going to be a solution to this problem.

Cost is such a complicated thing though. We eat like crap, we get diabetes, we get heart disease, and our healthcare bills shoot through the roof. But then people go nuts when San Francisco tells McDonalds they can't put toys in their Happy Meals to try to bribe kids into eating this kind of diet that's going to give them these exact expensive health problems. Germany slashed the money doctors get paid. But German doctors aren't raped by an insanely expensive educational system for 8 years like American docs are. The thought of hey take a pay cut when they have a mountain of student debt and thus took great risk for that MD degree sounds horrible.

[rmt]

Today I went for my mammogram and ultrasound and asked the insurance lady what the cash price vs insurance price was. Cash price $80. My co-pay with insurance is 10% which is $15 - so total insurance price is $150. The difference between cash price and insurance price is $70 - almost the real price of the procedure itself. Everyone complains about COST and how ACA didn't address it. The GOP plan (with its HSAs) allows for people to comparison shop for non-emergency procedures and routine physicals/labs and cut out the middleman (insurance companies). Of course, we can't comparison shop if we meet in a major car accident and are in an ambulance on the way to the ER, but that's when catastrophic insurance kicks in (this is really when insurance companies should be involved - not for the minor/routine stuff). People will never care about what something costs when the real cost is hidden by layers of insurance/copays, etc. Only when we are paying with "real" (HSA) dollars will we comparison shop the way we do for our phones, electronics, etc.

Regarding ElNono's COBRA post, the idea is that if people lose their job, they could convert to a cheap, catastrophic policy with same "rating" which would be much cheaper than a full-blown employer sponsored policy. Hopefully, HSA money has built up in previous years or if we could give/receive HSA $ from others (family, friends, charities), to cover the deductible if a catastrophe happens.

If we switch to a European model and force healthcare professionals to accept much less, then you have to practically guarantee low-cost education (because they would not be able to repay debt on low salary). The best and brightest will avoid the healthcare field. Similarly, with drug price control - no incentive for new drugs. If people want that trade-off, they have to accept low/no innovation too. And what do you do with the people caught between the 2 systems (between the switch) - forgive the debt?

At some point, we have to take responsibility for keeping healthy - we can't keep eating terribly, not exercising, etc and not expect disease to set in.

[Wild Cobra]

Today I went for my mammogram and ultrasound and asked the insurance lady what the cash price vs insurance price was. Cash price $80. My co-pay with insurance is 10% which is $15 - so total insurance price is $150.

<snip>

I've had times between good jobs when I had no insurance. Years ago, I went Dr. shopping. My youngest has hypothyroidism. I found a private clinic that could do the appointment, lab work, etc. for something like $170. When I had a good job again, and insurance choices, I asked the same clinic which insurance was best for us and for them to dealing with. She is now 28, and we both use the same clinic still.

You can find places that will give dramatically reduced places if you pay on the spot, and they don't have to deal with insurance companies.

[rmt]

I've had times between good jobs when I had no insurance. Years ago, I went Dr. shopping. My youngest has hypothyroidism. I found a private clinic that could do the appointment, lab work, etc. for something like $170. When I had a good job again, and insurance choices, I asked the same clinic which insurance was best for us and for them to dealing with. She is now 28, and we both use the same clinic still.

You can find places that will give dramatically reduced places if you pay on the spot, and they don't have to deal with insurance companies.

Same thing happened to us when dh was out of work for 5 months. We went on Christian Healthcare Ministries (basically catastrophic coverage) and paid the routine stuff. I was amazed at the prices - $80 mammograms/ultrasounds, $59 CWP labs. And now that we have insurance from dh's employer, I still go and support that place (granted - it's not swanky and the building's old but the equipment is up to date).

[rmt]

This is not a plug for CHM, but I'd like to put out their cost.

There are 3 levels (includes $9/month for Brother Keepers):

Gold - approx. $159 per month/unit - $500 deductible/incident - unlimited financial assistance
Silver - $94 per month/unit - $1000 deductible/incident - $225k financial assistance (accruing up to $1million)
Bronze - $54 per month/unit - $5000 deductible/incident - same as Silver

each adult counts as a unit, all dependent children up to age 26 count as 1 unit (even if you have 10 kids) so 3 units cover a family
CHM has been in existence since 1981 and self-sustaining. Granted - abortions, non-Christian behavior (e.g. drunk driving accident, STDs) aren't covered.

http://www.chministries.org/programs.aspx

[Wild Cobra]

This is not a plug for CHM, but I'd like to put out their cost.

There are 3 levels (includes $9/month for Brother Keepers):

Gold - approx. $159 per month/unit - $500 deductible/incident - unlimited financial assistance
Silver - $94 per month/unit - $1000 deductible/incident - $225k financial assistance (accruing up to $1million)
Bronze - $54 per month/unit - $5000 deductible/incident - same as Silver

each adult counts as a unit, all dependent children up to age 26 count as 1 unit (even if you have 10 kids) so 3 units cover a family
CHM has been in existence since 1981 and self-sustaining. Granted - abortions, non-Christian behavior (e.g. drunk driving accident, STDs) aren't covered.

http://www.chministries.org/programs.aspx

You just opened the door for libTARD attacks...

[rmt]

You just opened the door for libTARD attacks...

It's just an example of the cost - have to add a little more to cover for those. Everybody complains about the cost - well, here's a way. Cheap, catastrophic insurance and shop like we do for everything else. When we have no stake in the game, people don't care about the costs and health providers/companies continue to build their swanky buildings and charge us through the nose for them. Make them post their prices and people will gravitate toward the lower price.

[Will Hunting]

This is not a plug for CHM, but I'd like to put out their cost.

There are 3 levels (includes $9/month for Brother Keepers):

Gold - approx. $159 per month/unit - $500 deductible/incident - unlimited financial assistance
Silver - $94 per month/unit - $1000 deductible/incident - $225k financial assistance (accruing up to $1million)
Bronze - $54 per month/unit - $5000 deductible/incident - same as Silver

each adult counts as a unit, all dependent children up to age 26 count as 1 unit (even if you have 10 kids) so 3 units cover a family
CHM has been in existence since 1981 and self-sustaining. Granted - abortions, non-Christian behavior (e.g. drunk driving accident, STDs) aren't covered.

http://www.chministries.org/programs.aspx
:lmao $500 deductible per incident. Is that supposed to be good?

[Wild Cobra]

:lmao $500 deductible per incident. Is that supposed to be good?

That's how the costs are kept down, to be able to afford insurance.

Just don't have any incidents!

[rmt]

:lmao $500 deductible per incident. Is that supposed to be good?

Compared to the $6k deductibles we have now? You'd have to have 12 such incidents before you hit $6k.

[Will Hunting]

That's how the costs are kept down, to be able to afford insurance.

Just don't have any incidents!
Really, so that's how Canada keeps costs down? With super high deductibles that don't cover anything?

[rmt]

Really, so that's how Canada keeps costs down? With super high deductibles that don't cover anything?

I have a lot of relatives in Canada - recently went to a funeral there. It irks me no end when they say something to the effect that they don't have to spend hardly anything on defense cause the US will defend anybody who messes with Canada (because we are so close geographically). Same with drugs, medical devices, virtually any innovation - let US spend on research and development and we'll just copy what they discover. And their vaunted system is having problems too - no matter how much they spend.

http://www.forbes.com/sites/theapothecary/2014/06/13/if-universal-health-care-is-the-goal-dont-copy-canada/#24612819290d

http://www.huffingtonpost.ca/natasha-macdonalddupuis/the-future-of-canadian-healthcare_b_4429892.html

http://www.huffingtonpost.ca/bacchus-barua-/canada-health-care_b_9646872.html

[CosmicCowboy]

I wouldn't be opposed to a single payer clinic system that basically replaced the General Practicioner. Give the med students the option of free med school in exchange for X number of years working for the clinic at a reasonable salary for a reasonable amount of time (ten years??) meanwhile they could pursue a specialty if they chose to for their after clinic years. Have HSA's and catastrophic insurance for stuff exceeding clinic care. We still need to address drug costs. I have no problem with the drug companies recovering R&D costs plus profit but the exclusive price gouging period before generics become available is way too long for most drugs.

[clambake]

People with pre-existing conditions will be allowed to buy insurance in the same way people are allowed to buy Lamborghinis?

funny shit right here.

[rmt]

Last time I went to FP doc, they wanted to run an EKG on me. I asked why and how much would it cost. They said I qualify (based on age) and it would cost me nothing - I guess it's part of the routine labs ACA allows them to run. There is nothing wrong with my heart, no history of it in my family, all my heart/cholesterol/bp #s are excellent - complete waste of money - just because they can run it and get paid - all it does is drive up the cost for next year's premiums. This is the kind of thing that single payor would encourage. Conversely, with the catastrophic insurance/HSA - no way would that EKG even be considered - prefer to save my HSA $ for long-term care premiums.

[ElNono]

Cost is such a complicated thing though. We eat like crap, we get diabetes, we get heart disease, and our healthcare bills shoot through the roof. But then people go nuts when San Francisco tells McDonalds they can't put toys in their Happy Meals to try to bribe kids into eating this kind of diet that's going to give them these exact expensive health problems. Germany slashed the money doctors get paid. But German doctors aren't raped by an insanely expensive educational system for 8 years like American docs are. The thought of hey take a pay cut when they have a mountain of student debt and thus took great risk for that MD degree sounds horrible.

That's only partially true. Even in countries where obesity is not an epidemic like here, most people still die of heart disease, etc. Then you have things like cancer, that, except for rare episodes like smoking, they're largely out of a person's control. There's no country that has a life expectancy 15+ years better than another strictly due to "personal decisions". That's why it's kind that line of thinking is flawed, IMO. The real complication of talking about cost in the US is the notion of capitalism over everything else. It's way more about that mentality like rmt where "it's all about me, I don't want to pay for anybody else", even though he/she is undeniably going to be old, eventually will be dumped to the government to take care of the medical bills and at the current rate of price gouging in that industry, it's going to probably burn the life savings (if you're that fortunate to have at least some) to keep the person alive.

[rmt]

That's only partially true. Even in countries where obesity is not an epidemic like here, most people still die of heart disease, etc. Then you have things like cancer, that, except for rare episodes like smoking, they're largely out of a person's control. There's no country that has a life expectancy 15+ years better than another strictly due to "personal decisions". That's why it's kind that line of thinking is flawed, IMO. The real complication of talking about cost in the US is the notion of capitalism over everything else. It's way more about that mentality like rmt where "it's all about me, I don't want to pay for anybody else", even though he/she is undeniably going to be old, eventually will be dumped to the government to take care of the medical bills and at the current rate of price gouging in that industry, it's going to probably burn the life savings (if you're that fortunate to have at least some) to keep the person alive.

Except, as you say for cancer, a lot of our health problems are due to "lifestyle." My point is that we should be given a choice in how to spend our health care $ to target each individual person - not have it forced on us with one-size-fits-all policy (like ACA). Maternity benefits, birth control pills, pediatric dental and vision, EKGs - are all a waste of money for me - yet this is what ACA mandates and we pay through our nose through for. Except for some major car accident or cancer, (God willing) I plan to control my diabetes through diet/exercise and save HSA $s for what I think I'll need - long term care for when my body eventually breaks down so I hopefully won't be a burden to my kids, you or society.

[DMC]

That's only partially true. Even in countries where obesity is not an epidemic like here, most people still die of heart disease, etc. Then you have things like cancer, that, except for rare episodes like smoking, they're largely out of a person's control. There's no country that has a life expectancy 15+ years better than another strictly due to "personal decisions". That's why it's kind that line of thinking is flawed, IMO. The real complication of talking about cost in the US is the notion of capitalism over everything else. It's way more about that mentality like rmt where "it's all about me, I don't want to pay for anybody else", even though he/she is undeniably going to be old, eventually will be dumped to the government to take care of the medical bills and at the current rate of price gouging in that industry, it's going to probably burn the life savings (if you're that fortunate to have at least some) to keep the person alive.

People are going to have these diseases regardless, the difference is you don't pay for 40 years of treatment because the onset was at age 35 due to obesity and such.

[CosmicCowboy]

Speaking of cancer, There is a lot of incredible medical stupidity in "fighting" cancer. Hey, if it's caught early and curable, then great. I'm all for it. But late term terminal is just that...terminal. it blows me away that people spend hundreds of thousands if not millions of Insurance/Medicare money "fighting" terminal cancer just to have an awful, totally shitty quality of life for a few more months. Just realize you got handed a shitty deal and die with some fucking dignity. It's the only time you can do really great drugs legally.

[Th'Pusher]

Speaking of cancer, There is a lot of incredible medical stupidity in "fighting" cancer. Hey, if it's caught early and curable, then great. I'm all for it. But late term terminal is just that...terminal. it blows me away that people spend hundreds of thousands if not millions of Insurance/Medicare money "fighting" terminal cancer just to have an awful, totally shitty quality of life for a few more months. Just realize you got handed a shitty deal and die with some fucking dignity. It's the only time you can do really great drugs legally.

Agreed. Death panels are the way to go, tbh.

[ElNono]

Except, as you say for cancer, a lot of our health problems are due to "lifestyle." My point is that we should be given a choice in how to spend our health care $ to target each individual person - not have it forced on us with one-size-fits-all policy (like ACA). Maternity benefits, birth control pills, pediatric dental and vision, EKGs - are all a waste of money for me - yet this is what ACA mandates and we pay through our nose through for. Except for some major car accident or cancer, (God willing) I plan to control my diabetes through diet/exercise and save HSA $s for what I think I'll need - long term care for when my body eventually breaks down so I hopefully won't be a burden to my kids, you or society.

This is what I'm talking about. I think it's a very dumb position, but I also have to respect it because there's a number of people that think alike and never really experienced anything else, so it's difficult.
One day you'll realize that when it comes to health is not all about you or your dollars. Health is one of those things that end in death and that we all go through. As DMC said, it's a system with 100% failure rate. God forbid you don't have enough to pay your healthcare bills and your kids spend their life savings because they want mama to live a little longer, and don't have to live with the "we could've done a little more". There really is more to this than you and your money.

Notice that doesn't make ACA a good law, that's not what I'm arguing. We all are already aware the vast majority of countries spend a fraction of what we spend for the same thing, be it treatment or medication. So either they're living off of us, or somebody is pocketing a lot of money. Either case is wrong (or you could argue the latter isn't, it's just capitalism at work, but then again, it'll be hard to make an argument we're not the suckers in that system), and I think it makes way more sense to address that first, before we address who pays for what.


People are going to have these diseases regardless, the difference is you don't pay for 40 years of treatment because the onset was at age 35 due to obesity and such.

Then healthcare in America is only for those that can afford it. A valid opinion, but then we go back to another point which is again at the center of this conundrum: profit motive vs citizen well being, and what America wants to be in regards to that. Notice that was the status quo about 50 years ago, and for some reason we decided to move in a different direction (although, I think it's always good to review these kind of decisions, albeit it's more difficult to unwind them for obvious reasons).


Speaking of cancer, There is a lot of incredible medical stupidity in "fighting" cancer. Hey, if it's caught early and curable, then great. I'm all for it. But late term terminal is just that...terminal. it blows me away that people spend hundreds of thousands if not millions of Insurance/Medicare money "fighting" terminal cancer just to have an awful, totally shitty quality of life for a few more months. Just realize you got handed a shitty deal and die with some fucking dignity. It's the only time you can do really great drugs legally.

There's some truth to this, but as I was telling rmt, it's not always necessarily your choice, and there's emotional implications too. The topic can be more complicated than what it looks on the surface. I also wanted to agree with you on your earlier post that something needs to be done about the price of medications. R&D and what not makes sense, but when half your budget goes to free lunches for doctors to push your pill and other marketing, hmmm...

[Pelicans78]

Speaking of cancer, There is a lot of incredible medical stupidity in "fighting" cancer. Hey, if it's caught early and curable, then great. I'm all for it. But late term terminal is just that...terminal. it blows me away that people spend hundreds of thousands if not millions of Insurance/Medicare money "fighting" terminal cancer just to have an awful, totally shitty quality of life for a few more months. Just realize you got handed a shitty deal and die with some fucking dignity. It's the only time you can do really great drugs legally.

Thats not really the case. It's never that black or white. Usually when a cancer is considered terminal, people go on hospice and get comfort/palliative care. Otherwise most people try to treat the cancer if it isn't terminal or even early stage.

[Pelicans78]

It's always interesting seeing non-medical people whether it's in the government or here talk about how to fix healthcare.

[CosmicCowboy]

I had the blessing of walking my 55 year old sister through the last month or so of terminal breast cancer. I was fortunate that I hadn't bought my business partner out yet and could take off for a month plus to be with her. She had gone though the radiation etc. when she originally was diagnosed and had been cancer free for 5 years plus but it was a nasty one and metastasized. She chose not to fight a futile battle with chemo/radiation and all the disgusting side effects that go along with it just to prolong the inevitable. It was an interesting time. We drank wine, smoked a little pot, she had good hospice drugs and we just took the time for all her friends to visit and celebrate being with her. Part of the metastasisis was in her brain and she got goofy as shit...she loved to shop and we would go to Target in the wheelchair with her pushing a shopping cart and throwing shit in for all her friends...stack it up with a couple of grand of stuff and put it on the credit card...she would forget and we would take it all back the next day...go back three days later and buy all the same shit again LOL. She had a blast right up until the day she stopped breathing.

[rmt]

I had the blessing of walking my 55 year old sister through the last month or so of terminal breast cancer. I was fortunate that I hadn't bought my business partner out yet and could take off for a month plus to be with her. She had gone though the radiation etc. when she originally was diagnosed and had been cancer free for 5 years plus but it was a nasty one and metastasized. She chose not to fight a futile battle with chemo/radiation and all the disgusting side effects that go along with it just to prolong the inevitable. It was an interesting time. We drank wine, smoked a little pot, she had good hospice drugs and we just took the time for all her friends to visit and celebrate being with her. Part of the metastasisis was in her brain and she got goofy as shit...she loved to shop and we would go to Target in the wheelchair with her pushing a shopping cart and throwing shit in for all her friends...stack it up with a couple of grand of stuff and put it on the credit card...she would forget and we would take it all back the next day...go back three days later and buy all the same shit again LOL. She had a blast right up until the day she stopped breathing.

Sorry to hear about your sister, CC.

[ElNono]

I had the blessing of walking my 55 year old sister through the last month or so of terminal breast cancer. I was fortunate that I hadn't bought my business partner out yet and could take off for a month plus to be with her. She had gone though the radiation etc. when she originally was diagnosed and had been cancer free for 5 years plus but it was a nasty one and metastasized. She chose not to fight a futile battle with chemo/radiation and all the disgusting side effects that go along with it just to prolong the inevitable. It was an interesting time. We drank wine, smoked a little pot, she had good hospice drugs and we just took the time for all her friends to visit and celebrate being with her. Part of the metastasisis was in her brain and she got goofy as shit...she loved to shop and we would go to Target in the wheelchair with her pushing a shopping cart and throwing shit in for all her friends...stack it up with a couple of grand of stuff and put it on the credit card...she would forget and we would take it all back the next day...go back three days later and buy all the same shit again LOL. She had a blast right up until the day she stopped breathing.

Sorry about your loss. It's always difficult, tbh. I saw my uncle get devoured by leukemia in 8 months flat. This was a guy that had polio as a kid, had all sorts of motor problems, and still became a lawyer, eventually a judge, was a father and raised a family. An incredibly generous guy and a fighter through and through. There was just nothing to be done about his disease.

[DMC]

Then healthcare in America is only for those that can afford it. A valid opinion, but then we go back to another point which is again at the center of this conundrum: profit motive vs citizen well being, and what America wants to be in regards to that. Notice that was the status quo about 50 years ago, and for some reason we decided to move in a different direction (although, I think it's always good to review these kind of decisions, albeit it's more difficult to unwind them for obvious reasons).

I don't think the two need to be bifurcated. Were it not for profit motive, R&D would slow to a crawl. Imagine the federal government doing all the R&D and approving of their own findings through the FDA, then the caregivers who are also at some GS level administering the care. Profit drives innovation so unless you expect people to suddenly change and be as philanthropic as their blogs make them out to be, we have to work with the current mindset of profit first. Even the billionaires got rich before delving into philanthropy.

Citizen well being is first and foremost up to the citizen. If we could be fixed for free regardless the ailment, why would we ever alter our lifestyles? That's a reductionist argument against the current ACA, because we cannot be fixed of all ailments but we can live sloppy and still have the effects buffered by medical care.

It makes no difference whether "we" decide one way or the other, the profit motive drives the train and we are passengers.

[DMC]

It's always interesting seeing non-medical people whether it's in the government or here talk about how to fix healthcare.

You don't talk to mechanics or bodyshop folks about fixing car insurance issues. Doctors aren't experts at managing healthcare from a financial standpoint, that's what administrators are for.

[Th'Pusher]

I don't think the two need to be bifurcated. Were it not for profit motive, R&D would slow to a crawl. Imagine the federal government doing all the R&D and approving of their own findings through the FDA, then the caregivers who are also at some GS level administering the care. Profit drives innovation so unless you expect people to suddenly change and be as philanthropic as their blogs make them out to be, we have to work with the current mindset of profit first. Even the billionaires got rich before delving into philanthropy.

Citizen well being is first and foremost up to the citizen. If we could be fixed for free regardless the ailment, why would we ever alter our lifestyles? That's a reductionist argument against the current ACA, because we cannot be fixed of all ailments but we can live sloppy and still have the effects buffered by medical care.

It makes no difference whether "we" decide one way or the other, the profit motive drives the train and we are passengers.

There hasn't been much innovation going on in the pharmaceutical industry in the last few decades. They've mainly delivered slight variances on existing drugs to make them marginally better. Much of the money they spend on R&D goes to paying doctors to validate the effectiveness of a product and paying to keep exclusive rights and evergreening the few cash cows they have left.

[DMC]

There hasn't been much innovation going on in the pharmaceutical industry in the last few decades. They've mainly delivered slight variances on existing drugs to make them marginally better. Much of the money they spend on R&D goes to paying doctors to validate the effectiveness of a product and paying to keep exclusive rights and evergreening the few cash cows they have left.
:lmao

[Th'Pusher]

:lmao

Not sure what's funny about that. You threw out an Econ 101 take, the profit motive drives innovation, when it's clear you don't have much understanding of what's been going on in the industry the last 20 years.

[DMC]

Not sure what's funny about that. You threw out an Econ 101 take, the profit motive drives innovation, when it's clear you don't have much understanding of what's been going on in the industry the last 20 years.

You must be a tweener. You throw out a term like "past few decades" as if it means back to 2006. This is just another topic you know nothing about and just want to interject. Let's cut to the chase already and say you aren't that interested in it and I care too much and you exposed me.

[Th'Pusher]

You must be a tweener. You throw out a term like "past few decades" as if it means back to 2006. This is just another topic you know nothing about and just want to interject. Let's cut to the chase already and say you aren't that interested in it and I care too much and you exposed me.

I know that the industry has become extremely risk averse over the last 20 years or so and pharmaceutical companies spend much of their R&D budget on tweaking existing formulations to get slight better drugs and evergreening existing patented drugs. Feel free to refute my claim by naming all of the innovative wonder drugs the industry has produced.

[SnakeBoy]

I know that the industry has become extremely risk averse over the last 20 years or so and pharmaceutical companies spend much of their R&D budget on tweaking existing formulations to get slight better drugs and evergreening existing patented drugs. Feel free to refute my claim by naming all of the innovative wonder drugs the industry has produced.

How about just the ones that have received FDA Breakthrough Therapy designation just in 2016

GRAZOPREVIR
ELBASVIR
PALBOCICLIB
CRIZOTINIB
VENETOCLAX
CABOZANTINIB
PIMAVANSERIN
LENVATINIB MESYLATEL
NIVOLUMAB
ATEZOLIZUMAB
SOFOSBUVIR
VELPATASVIR
CANAKINUMAB
LUMACAFTOR
IVACAFTOR

[Th'Pusher]

How about just the ones that have received FDA Breakthrough Therapy designation just in 2016

GRAZOPREVIR
ELBASVIR
PALBOCICLIB
CRIZOTINIB
VENETOCLAX
CABOZANTINIB
PIMAVANSERIN
LENVATINIB MESYLATEL
NIVOLUMAB
ATEZOLIZUMAB
SOFOSBUVIR
VELPATASVIR
CANAKINUMAB
LUMACAFTOR
IVACAFTOR

Almost all examples of variations of existing medications. The reality is new innovation is expensive and risky. And with regard to the breakthrough therapy designation:



Four years into the US Food and Drug Administration’s (FDA) breakthrough therapy designation program and at least one prominent agency official is raising some questions about the transparency of the program and whether the drugs and biologics approved under it are as transformational as the “breakthrough” tag might suggest.

http://www.raps.org/Regulatory-Focus/News/2016/06/30/25250/Breakthrough-Therapies-FDA-Official-Calls-for-More-Transparency-on-Designation-Requests-Denials/

[DMC]

I know that the industry has become extremely risk averse over the last 20 years or so and pharmaceutical companies spend much of their R&D budget on tweaking existing formulations to get slight better drugs and evergreening existing patented drugs. Feel free to refute my claim by naming all of the innovative wonder drugs the industry has produced.


Almost all examples of variations of existing medications. The reality is new innovation is expensive and risky. And with regard to the breakthrough therapy designation:

.

http://www.raps.org/Regulatory-Focus/News/2016/06/30/25250/Breakthrough-Therapies-FDA-Official-Calls-for-More-Transparency-on-Designation-Requests-Denials/





That's quite a shift from saying "there hasn't been much innovation going on in the pharmaceutical industry in the last few decades" to saying "where are the wonder drugs?". It's the FDA that's become more risk averse. Drug companies waste billions trying to push through that red tape even for products that have no negative consequences considering the alternative is death for users.

The concept of low hanging fruit seems to escape you as well. I suppose there has been no automotive innovation since the automobile was invented, since it's just modifying the existing auto from year to year.

[Th'Pusher]

That's quite a shift from saying "there hasn't been much innovation going on in the pharmaceutical industry in the last few decades" to saying "where are the wonder drugs?".

Not really. I qualified my comment on innovation with "They've mainly delivered slight variances on existing drugs to make them marginally better."


It's the FDA that's become more risk averse. Drug companies waste billions trying to push through that red tape even for products that have no negative consequences considering the alternative is death for users.

So has R&D slowed to a crawl? Your initial claim was that R&D would slow to a crawl absent the profit motive. My argument is that we are not getting good ROI on pharmaceutical companies' R&D because the profit motive discourages innovation of new ideas as they are risky and expensive. Instead, they're protecting profits by raising prices on patented drugs while delaying the expiration of drug exclusivity wherever possible and even paying generic drug makers to not develop generic versions.


The concept of low hanging fruit seems to escape you as well. I suppose there has been no automotive innovation since the automobile was invented, since it's just modifying the existing auto from year to year.

Not lost on me at all. It's fine, but it's pretty much all pharmaceutical companies are doing which is my point.

[rmt]

That's quite a shift from saying "there hasn't been much innovation going on in the pharmaceutical industry in the last few decades" to saying "where are the wonder drugs?". It's the FDA that's become more risk averse. Drug companies waste billions trying to push through that red tape even for products that have no negative consequences considering the alternative is death for users.

The concept of low hanging fruit seems to escape you as well. I suppose there has been no automotive innovation since the automobile was invented, since it's just modifying the existing auto from year to year.

Gotta say that I love that backup camera. Dh despaired every time I used to hit something backing up in the minivan :-)

[Th'Pusher]

Gotta say that I love that backup camera. Dh despaired every time I used to hit something backing up in the minivan :-)
Let me guess, you don't like the fact the NHTSA issued a rule effectively requiring them on all new vehicles?

[rmt]

Let me guess, you don't like the fact the NHTSA issued a rule effectively requiring them on all new vehicles?

What is with you? Do you have to be snarky about everything I post? It was just an innocent comment. But you asked for it.

I love the backup camera - I love innovation and I love that competition forces innovation at still decent prices. Car prices have not gone up anywhere near house prices.

[Th'Pusher]

What is with you? Do you have to be snarky about everything I post? It was just an innocent comment. But you asked for it.

I love the backup camera - I love innovation and I love that competition forces innovation at still decent prices. Car prices have not gone up anywhere near house prices.

I read and don't respond to most of your posts rmt.

[rmt]

Can't pick up Timmy's jersey retirement. Would someone PLEASE record and post?

[rmt]

Can't pick up Timmy's jersey retirement. Would someone PLEASE record and post?

It's okay. Seems like it'll be on NBATV.

[DMC]

Can't pick up Timmy's jersey retirement. Would someone PLEASE record and post?

I'll summarize:

It was cool, Th'Pusher is a faggot. I'm out. Peace.

[DMC]

Not really. I qualified my comment on innovation with "They've mainly delivered slight variances on existing drugs to make them marginally better."



So has R&D slowed to a crawl? Your initial claim was that R&D would slow to a crawl absent the profit motive. My argument is that we are not getting good ROI on pharmaceutical companies' R&D because the profit motive discourages innovation of new ideas as they are risky and expensive. Instead, they're protecting profits by raising prices on patented drugs while delaying the expiration of drug exclusivity wherever possible and even paying generic drug makers to not develop generic versions.



Not lost on me at all. It's fine, but it's pretty much all pharmaceutical companies are doing which is my point.

A: Look up "innovation"
B: Which socialist country develops all the "wonder drugs"? List the top 10.

http://www.xconomy.com/wordpress/wp-content/images/2014/09/Table.png

btw, those other countries... that's "slowing to a crawl". It's not some nebulous concept you can glean from a quick trip to Google results page.


C: Talk to Magic Johnson

[Th'Pusher]

A: Look up "innovation"
B: Which socialist country develops all the "wonder drugs"? List the top 10.

http://www.xconomy.com/wordpress/wp-content/images/2014/09/Table.png

btw, those other countries... that's "slowing to a crawl". It's not some nebulous concept you can glean from a quick trip to Google results page.


C: Talk to Magic Johnson

You're making my point for me. Show me a trend line of number of NCEs developed by decade.

[ElNono]

I don't think the two need to be bifurcated. Were it not for profit motive, R&D would slow to a crawl. Imagine the federal government doing all the R&D and approving of their own findings through the FDA, then the caregivers who are also at some GS level administering the care. Profit drives innovation so unless you expect people to suddenly change and be as philanthropic as their blogs make them out to be, we have to work with the current mindset of profit first. Even the billionaires got rich before delving into philanthropy.

Citizen well being is first and foremost up to the citizen. If we could be fixed for free regardless the ailment, why would we ever alter our lifestyles? That's a reductionist argument against the current ACA, because we cannot be fixed of all ailments but we can live sloppy and still have the effects buffered by medical care.

It makes no difference whether "we" decide one way or the other, the profit motive drives the train and we are passengers.

It doesn't have to be all government either, and plenty of innovation coming from countries where healthcare isn't driven solely by profit motive. Heck, there's a shitload of government funded research (and that's not just on healthcare).

And yes there's an instrinsic bifurcation because they're intrinsically competing interests: what's good for a company and its fiduciary duty to its shareholders doesn't necessarily aligns (at least all the time) with the state interest in the citizenship well-being.

Now that doesn't mean that the solution has to be one or the other, and as a matter of fact it's actually not in most every country not named the US: there's an ample gamut of gray, where neither side will get all they want but they'll find something they both can live with. The US is probably the last bastion where this largely does not happen, but I personally think it has a lot more to do with ideology than practicality.

Anyhow, I would have liked to expand more but it will have to wait until after the holidays :toast

[DMC]

You're making my point for me. Show me a trend line of number of NCEs developed by decade.

Really? Making your point? Which country is developing more than the US? None. Where's your "empirical evidence" that socialist agenda healthcare would churn out more or better cures/treatments? I realize you're always going to look to cherry pick an aspect of an argument where you think you can find refuge, however I'm throwing this empirical evidence thing right back in your face. Which of the countries in the list are social agenda driven vs profit driven?

Also, you said there's been almost none in a few decades. Care to explain how that chart illustrates "almost none"? Or did you mean that a few decades is actually only about 11 years?

[boutons_deux]

BigPharma spends twice as much on marketing (esp corrupting docs) as it does on research. yearS ago that was $60B vs $30B

Most of the "new" drugs are old drugs tweaked to extend the patent, and they don't really work better. And lots of drugs of fucking marginally effective, useless, or harmful. Repug FDA will maim and kill Ms of people by waiving through untested BigPharma shit even quicker than now.

And of course, BigPharma charges more USA for the drugs 2x to 100x more in USA than in all industrial countries that regulate drug prices.

Defending BigPharma? G M A F B.

As corrupt and shitty and wealth-sucking as BigFinance.

btw, did y'all see Wells Fargo got caught yet again selling insurance policies secretly to clients, collecting the sales commission, then the policies lapse because the in-the-dark clients don't pay the first premium.

[Th'Pusher]

Really? Making your point? Which country is developing more than the US? None. Where's your "empirical evidence" that socialist agenda healthcare would churn out more or better cures/treatments? I realize you're always going to look to cherry pick an aspect of an argument where you think you can find refuge, however I'm throwing this empirical evidence thing right back in your face. Which of the countries in the list are social agenda driven vs profit driven?

Also, you said there's been almost none in a few decades. Care to explain how that chart illustrates "almost none"? Or did you mean that a few decades is actually only about 11 years?

I don't know what point you think you're refuting. I never said any country developed more than the US.

We were discussing profit motive and R&D. But, do you honestly think companies like Novartis, Roche, GlaxoSmithKline or Bayer are not looking to make a profit because they're based in more socially democratic countries than the US?

You're unraveling. Maybe you should go practice your arguments in the NBA forum :lol

[DMC]

I don't know what point you think you're refuting. I never said any country developed more than the US.

We were discussing profit motive and R&D. But, do you honestly think companies like Novartis, Roche, GlaxoSmithKline or Bayer are not looking to make a profit because they're based in more socially democratic countries than the US?

You're unraveling. Maybe you should go practice your arguments in the NBA forum :lol

You state that innovation is basically nil in the past few decades, I showed you different. Then you moved the goalpost to a decline, but its a global decline not in innovation but in products approved for sale. How does that go against my statement that removing the profit motive would slow R&D to a crawl?

Once again you interject with nothing to offer.

[Th'Pusher]

You state that innovation is basically nil in the past few decades, I showed you different. Then you moved the goalpost to a decline, but its a global decline not in innovation but in products approved for sale. How does that go against my statement that removing the profit motive would slow R&D to a crawl?

Once again you interject with nothing to offer.

I have already explained how the profit motive actually disincentivises innovation of new ideas because they're both expensive and risky. My initial comment on innovation was couched in the context of pharmaceutical companies' R&D budget primarily going to marginally improving existing drugs. No goal post move.

[DMC]

I have already explained how the profit motive actually disincentivises innovation of new ideas because they're both expensive and risky. My initial comment on innovation was couched in the context of pharmaceutical companies' R&D budget primarily going to marginally improving existing drugs. No goal post move.

lol.. OK Chumpdumper, let's go 12 pages of you denying your original statement and deflecting with baseless opinion poorly disguised as scientific conclusion..

[spurraider21]

It's always interesting seeing non-medical people whether it's in the government or here talk about how to fix healthcare.its always interesting to see us non-coaches talk about sports strategy

[Th'Pusher]

lol.. OK Chumpdumper, let's go 12 pages of you denying your original statement and deflecting with baseless opinion poorly disguised as scientific conclusion..


There hasn't been much innovation going on in the pharmaceutical industry in the last few decades. They've mainly delivered slight variances on existing drugs to make them marginally better. Much of the money they spend on R&D goes to paying doctors to validate the effectiveness of a product and paying to keep exclusive rights and evergreening the few cash cows they have left.

No need. My initial comment is right there ^ for all the world to read.

[TeyshaBlue]

I have already explained how the profit motive actually disincentivises innovation of new ideas because they're both expensive and risky. My initial comment on innovation was couched in the context of pharmaceutical companies' R&D budget primarily going to marginally improving existing drugs. No goal post move.

And artificially creating a market/need through a meticulously crafted ad campain for bogus conditions. EPI? What utter bullshit.

[DMC]

No need. My initial comment is right there ^ for all the world to read.

Yes, and so is the fact you ignored that the US is far and away the largest innovator in the world. Show me a system of non profit that has anything close to the innovation that the US has, in any field.

You committed a fallacy by suggesting that, because wonder drug creation as a whole has decreased, it wouldn't be that much worse with a non-profit motive.

If drug creation was 1000 in 1950's and dropped to 500 in the 1960's, you could say that it slowed to a crawl then even though you haven't defined what it even means. What you couldn't honestly do is what you did, which is to say there has been almost no innovation even if you try to qualify it with a disclaimer. You cannot simply disclaim a contradiction like that as if it's a caveat.

There has been no innovation in the automotive industry, only small changes in shape, design, powerplant, brakes, safety features and accessories of the vehicle.

[Adam Lambert]

its true, we do have the best boner meds

[DMC]

There hasn't been much innovation going on in the pharmaceutical industry in the last few decades. They've mainly delivered slight variances on existing drugs to make them marginally better. Much of the money they spend on R&D goes to paying doctors to validate the effectiveness of a product and paying to keep exclusive rights and evergreening the few cash cows they have left.

Few = 3 or more. It doesn't equal 2 decades. Otherwise it would be "a couple".

Much, many, few, marginally, mainly... these are some of your crutches in your arguments. They allow you to slop around and dodge any corners you've painted yourself into. That kind of tactic reeks of just laziness. I expect to see these now and again, however you rely too heavily on them. It tells me you don't know anything.

[Th'Pusher]

Yes, and so is the fact you ignored that the US is far and away the largest innovator in the world. Show me a system of non profit that has anything close to the innovation that the US has, in any field.

Countries don't create new drugs. Companies do. The first point, which I already made, was that non-US companies are also operating under the profit motive when it comes to investing in R&D. The second point, did you take into account the number of pharmaceutical companies headquartered in in each country when using the number of new chemical entities invented as a measure of innovation?


You committed a fallacy by suggesting that, because wonder drug creation as a whole has decreased, it wouldn't be that much worse with a non-profit motive.

If drug creation was 1000 in 1950's and dropped to 500 in the 1960's, you could say that it slowed to a crawl then even though you haven't defined what it even means. What you couldn't honestly do is what you did, which is to say there has been almost no innovation even if you try to qualify it with a disclaimer. You cannot simply disclaim a contradiction like that as if it's a caveat.

There has been no innovation in the automotive industry, only small changes in shape, design, powerplant, brakes, safety features and accessories of the vehicle.

Incorrect. I explained why the profit motive is a disincentive to new ideas because they are expensive and risky. Instead, companies prefer to spend their R&D marginally improving existing drugs while evergreening drugs still under patent.

[Th'Pusher]

Few = 3 or more. It doesn't equal 2 decades. Otherwise it would be "a couple".

Much, many, few, marginally, mainly... these are some of your crutches in your arguments. They allow you to slop around and dodge any corners you've painted yourself into. That kind of tactic reeks of just laziness. I expect to see these now and again, however you rely too heavily on them. It tells me you don't know anything.

I use these words as qualifiers because I am recalling information I have read and I do not have the time, nor the desire to go look up specifics. You can call it lazy. That's fine. Still, you have posted zero evidence to convince anyone (other than maybe WC) that the profit motive drives innovation in the current pharmaceutical industry. Your new chemical entity chart by country was pathetic.