When Bain owns your hospital, rest assured of highest care

Oh, and GFY.:lol

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Originally Posted by coyotes_geek

So what's more important here boutons? Quality of care improving, or just making sure that no one makes a buck along the way?

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OBVIOUSLY, if you had been listening, the NATIONAL HEALTH BILL of $8000/person with 40M+ uninsured is the problem.

"making a buck" :lol

We're talking about $100Bs/year in corporate/investor profits.

I do not think it's ethical for a Corporate-Americans, esp not (foreign) equity investors, to be sucking downs $100Bs in profits from sick care.

The Federal govt MUST get into creating a non-profit health care system with its own GOVT EMPLOYEES. There's no other entity big enough to take on the job. I don't GAF, obviously, if that causes the for-profit health care to shrink dramatically. That would be a huge and 100% positive side-effect.

Some things in life should not be for profit. Healthcare being the most obvious example.

I know its a philosophical quandary, but ultimately, it divides those amongst us who believe in hardcore capitalism to their very greedy core with those of us who realize the difference between healthcare being nonprofit in this country and socialism as the boogeyman of modern conservative America.

Off the top of my head, industries that should be nonprofit:

1. Healthcare
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.
.
.
.
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2. Insurance (all kinds, health, property, etc)
3. Education
4. Banking

Not necessarily in that order, except for #1.

insurance?

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Originally Posted by TeyshaBlue

Effectiveness should be the ultimate metric with costs being weighted, but, subservient to effectiveness. If we achieved enhanced effectiveness, as measured by outcomes, and even came close to current costs, it's a total win. Current spend is the target I would use. Price reduction is fool's gold.

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Current costs are unsustainable. There's no arguing that. If we're not happy with whatever outcomes we're measuring now we're certainly not going to like them any more as the medicare trust fund runs out and costs for unfunded programs like medicare D do nothing but escalate. The only way we can combat that is through focusing on price.

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Variability is the enemy of process efficiency. Period. I agree that a bureaucracy does not fear the reaper in the same way a for profit model would. There has to be an accountability factor in this. I'm not smart enough to get there.:p:

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I'm not sure anyone is. The bureaucracy is always going to be accountable to elected leaders who are always going to be accountable to voters who are always going to pick their elected leaders based on promises of being provided goodies.

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I do think the hybrid model I've been pitching is a good step forward as it combines the best of both models. Have a single payer handle routine HMO-type functions. Have for profit insurers provide, well, insurance (gasp!) as they were designed to do for issues outside of the (I know, heretofore undefined) "routine". Freed from the costs of HMO functions, insurance companies could produce reasonable premiums. Using the ACA administrative cost sledgehammer is a good tool to make sure these premiums are priced appropriately.

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The cost sledgehammer doesn't reduce costs, it just shifts who has to absorb them.

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Originally Posted by boutons_deux

OBVIOUSLY, if you had been listening, the NATIONAL HEALTH BILL of $8000/person with 40M+ uninsured is the problem.

"making a buck" :lol

We're talking about $100Bs/year in corporate/investor profits.

I do not think it's ethical for a Corporate-Americans, esp not (foreign) equity investors, to be sucking downs $100Bs in profits from sick care.

The Federal govt MUST get into creating a non-profit health care system with its own GOVT EMPLOYEES. There's no other entity big enough to take on the job. I don't GAF, obviously, if that causes the for-profit health care to shrink dramatically. That would be a huge and 100% positive side-effect.

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Finally an answer.

Making sure no one profits from the healthcare system = more important.
Quality of care being provided = less important.

I respectfully disagree, but to each their own.

"The bureaucracy is always going to be accountable to elected leaders"

not true.

We want the civil service to do it's job, no matter what the politicians happen to be in office. iow, civil service isn't to be politicized.

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Originally Posted by coyotes_geek

Finally an answer.

Making sure no one profits from the healthcare system = more important.
Quality of care being provided = less important.

I respectfully disagree, but to each their own.

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goddammit, your dense

Where did I say quality of care was less important?

Quality of care can be maintained without $100Bs/year going to mgmt and investors.

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Originally Posted by boutons_deux

goddammit, your dense

Where did I say quality of care was less important?

Quality of care can be maintained without $100Bs/year going to mgmt and investors.

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:lol

boutons is mad.

Answer the question bot.

As long as quality of care improves, why should it bother anyone if someone made a profit?

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Originally Posted by coyotes_geek

Current costs are unsustainable. There's no arguing that. If we're not happy with whatever outcomes we're measuring now we're certainly not going to like them any more as the medicare trust fund runs out and costs for unfunded programs like medicare D do nothing but escalate. The only way we can combat that is through focusing on price.

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Focus on process efficiency. Internal costs (price) takes care of itself. External cost is an issue. But if a market is subject to a population that will pay only at a particular price point, so too goes the market.

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Originally Posted by CG

I'm not sure anyone is. The bureaucracy is always going to be accountable to elected leaders who are always going to be accountable to voters who are always going to pick their elected leaders based on promises of being provided goodies.
The cost sledgehammer doesn't reduce costs, it just shifts who has to absorb them.

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The absorber is the insurer. I'm getting some kind of rebate for my health insurance (I'll believe it when I see it) because my provider didn't meet the ACA 85/15% admin barrier. This can't be recouped through an increase in premiums...at least not in the current policy period.

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Originally Posted by boutons_deux

"The bureaucracy is always going to be accountable to elected leaders"

not true.

We want the civil service to do it's job, no matter what the politicians happen to be in office. iow, civil service isn't to be politicized.

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You think civil service isn't politicized? :lmao

Yeah, I got a giggle outta that too.:lol

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Originally Posted by TeyshaBlue

The absorber is the insurer. I'm getting some kind of rebate for my health insurance (I'll believe it when I see it) because my provider didn't meet the ACA 85/15% admin barrier. This can't be recouped through an increase in premiums...at least not in the current policy period.

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Just to clarify, I promise I'm not trying to go Yoni/WC here by advocating that there's no role whatsoever for government in the healthcare industry. There is. Hell, I'm the one who wants the government to start taxing junk food and passing out money via HSA accounts (but that's not today's discussion :bang). Just wanted to mention that before I take another swing at the above. :)

The 85/15 rule may sound good, but it's not going to reduce costs. In fact it's probably going to increase them. But CG, how can it be a bad thing to cap administration costs and oh by the way, GFY? All that 85/15 rule did was create a situation where an insurer has to increase premiums in order to increase profits. The higher the premiums, the more $$$ that 15% of it equals.

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Originally Posted by coyotes_geek

Just to clarify, I promise I'm not trying to go Yoni/WC here by advocating that there's no role whatsoever for government in the healthcare industry. There is. Hell, I'm the one who wants the government to start taxing junk food and passing out money via HSA accounts (but that's not today's discussion :bang). Just wanted to mention that before I take another swing at the above. :)

The 85/15 rule may sound good, but it's not going to reduce costs. In fact it's probably going to increase them. But CG, how can it be a bad thing to cap administration costs and oh by the way, GFY?(:lol:lol) All that 85/15 rule did was create a situation where an insurer has to increase premiums in order to increase profits. The higher the premiums, the more $$$ that 15% of it equals.

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If you increase profits, you make it that much harder to meet the 85/15 rule. It's counter-cyclic, no?

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Originally Posted by TeyshaBlue

If you increase profits, you make it that much harder to meet the 85/15 rule. It's counter-cyclic, no?

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I maybe running that backward in my noggin. Lemme cogitate on that a minute. :wakeup

Feel free to wake me the fuck up.:lol

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Originally Posted by coyotes_geek

:lol

boutons is mad.

Answer the question bot.

As long as quality of care improves, why should it bother anyone if someone made a profit?

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because those $100Bs profits come out patients' pockets. Why should they finance profits on top of paying for care?

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Originally Posted by TeyshaBlue

If you increase profits, you make it that much harder to meet the 85/15 rule. It's counter-cyclic, no?

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Looks to me like you're just giving incentive to create higher costs through the whole system. Feel free to shoot holes in this.

Insurance company charges you $1.00 in premium, pays $0.85 to whoever provided you whatever healthcare service and gets to keep $0.15 for themselves. If they want to make $0.165 instead of $0.15, the only way for them to do it is to start charging you $1.10 and paying your provider $0.935. Insurance company = happy, your provider = happy, you = not so much.

This health care debate reminds me of rednecks I know (including me) bitching about the cost of new pickups. The first new truck I bought out of college cost $6300. It was a truck (even ordered the optional air conditioner) that hauled shit from point a to point b. It got 10 miles to the gallon, needed points plugs and condensor every 15,000 miles, brake pads every 30,000 etc.) It's expected life expectancy was 100,000 miles before an engine/trans rebuild. I looked at a truck last week that cost $55,000. Yeah, it still hauls shit from point a to point b but there is a hell of a difference between my first truck and this one...maybe not $48,000, but enough that there is no comparison. Trucks are that much better and health care is that much better.

really weak analogy, since 40M+ have been priced out of your pickup truck health care market.

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Originally Posted by boutons_deux

really weak analogy, since 40M+ have been priced out of your pickup truck health care market.

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That doesn't make sense. If you can't afford a new truck with all the bells and whistles then buy a used one. It's not an inalienable right that everyone should have a new crew cab 4X4 King Ranch F350.

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Originally Posted by boutons_deux

because those $100Bs profits come out patients' pockets. Why should they finance profits on top of paying for care?

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Because that motive for profit is what created the situation for them to receive better care than they were before.

Quote:

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Originally Posted by coyotes_geek

Looks to me like you're just giving incentive to create higher costs through the whole system. Feel free to shoot holes in this.

Insurance company charges you $1.00 in premium, pays $0.85 to whoever provided you whatever healthcare service and gets to keep $0.15 for themselves. If they want to make $0.165 instead of $0.15, the only way for them to do it is to start charging you $1.10 and paying your provider $0.935. Insurance company = happy, your provider = happy, you = not so much.

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http://i3.photobucket.com/albums/y64...e/fillion1.gif

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Originally Posted by clambake

insurance?

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Absolutely insurance. Why is betting on the likelihood of you being hurt or your property being damaged an industry of profit?

When I say "non-profit", I mean it as a generic term. I do not mean government takeover, either. But healthcare should be under the government's strict purview, imo. That way politicians can lose their job when they vote against the public welfare, in the interest of corporations.

Which is why none of those items I listed would ever be legislated against to oblivion as for-profit. Politicians do not want their careers tied to policy-making that important to every American. They'll fight the good fight against unimportant moral issues like abortion. That'll divide and conquer those filthy plebs!

Here is a bonus for legislators, 3 of the 4 industries listed, I guarantee, are the single largest private donors to their campaigns. Nothing wrong with self-interest except when youre a public official of any capacity.

But who am I kidding, really? I stopped voting two years ago and never plan to again in my life. Such an utter waste of time, to debate any of this, at any point.

Yes, I had time to waste.

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Originally Posted by DarkReign

Absolutely insurance. Why is betting on the likelihood of you being hurt or your property being damaged an industry of profit?

When I say "non-profit", I mean it as a generic term. I do not mean government takeover, either. But healthcare should be under the government's strict purview, imo. That way politicians can lose their job when they vote against the public welfare, in the interest of corporations.

Which is why none of those items I listed would ever be legislated against to oblivion as for-profit. Politicians do not want their careers tied to policy-making that important to every American. They'll fight the good fight against unimportant moral issues like abortion. That'll divide and conquer those filthy plebs!

Here is a bonus for legislators, 3 of the 4 industries listed, I guarantee, are the single largest private donors to their campaigns. Nothing wrong with self-interest except when youre a public official of any capacity.

But who am I kidding, really? I stopped voting two years ago and never plan to again in my life. Such an utter waste of time, to debate any of this, at any point.

Yes, I had time to waste.

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well, i know you're a business owner. i have all the business insurance to protect me against anything, including an umbrella policy to cover anything else.

they are assuming the risk.