Trump: Biden DISINFORMATES AND MISINFORMATES

What was needed was a multi faceted approach to lowering the cost of healthcare, not just more insurance.

Direct subsidies for lower incomes and pre-existing conditions in the short run.

Longer term, healthcare, while never cheap, has seen ridiculous cost growth for decades. ACA did little to nothing to increase or even more efficiently provide healthcare. To resolve this we basically need more doctors, requirements on disposing of perfectly good but not state of the art equipment, and less ambulance chasers.

The needs are:
More doctors, more medical school capacity. Lower requirements for residency. Almost all non-primary care services are decided by committee with the provider group anyway. The cost of medical education is prohibitive to supply. This basically goes for nurses as well.

More options in healthcare insurance for tiered coverage, to borrow from a cheesy commercial; “only pay for what you need”.

Standards for designating diagnostic equipment as “obsolete”.

This will not happen but something has to be done about ambulance chasers. They have already raped the public through healthcare, auto insurance, and most recently homeowners insurance through roofing scams.

Lastly, our hospital and clinic system is in desperate need of some good old fashioned Industrial Engineering analyses. My father went through treatment for lung cancer several years ago and to say that it was painful to watch the inefficiency is an insult to painful. I have a full and clear understanding of why nurses burn out.

Now I would ask you, respectfully to provide 3-5 cost reduction ideas of your own before going into defensive posture that the system we have cannot be operated with better efficiency and lower cost.

 

I think the healthcare system could be improved. However, none of those seem likely to do it. Subsidizing is something that we already do. The size of the subsidy to make an unhealthy person attractive enough for an insurance company to overlook a pre-existing condition would be substantial. It would also create an incentive to get diagnosed with pre-existing conditions, leading to massive fraud, likely. And, if that subsidy is differentiated, it would require a massive bureaucracy to determine the right subsidy. Seems like it is better to subsidize pre-existing conditions overall as a group and eliminate pre-existing conditions as a means by which the insurance company can deny.

The issue with focusing on cost is that it assumes that costs and inefficiencies are what drives prices up. That isn't really true. Pricing is based on customer value, not cost. Cost simply serves as a lower bound. What is driving price up is the lack of competition at the hospital system level and the lack of an outside option to healthcare in certain, high probability of death situations (death is not an attractive outside option). The lack of competition at the hospital level is really the only place that we see cost as a deterrent, although this is mostly due to the cost of imaging equipment, and other high cost, relatively low usage features.

If we want to lower cost, we need to convince providers that we will accept the outside option. While creating more hospital systems could help as well, the nature of emergency care makes that effect somewhat limited (somebody isn't going to price shop in the middle of their heart attack).

The problem is that this just feels wrong and unethical to us as people. Nobody wants to hear the person negotiating on their behalf say "Sure, for that price, I suggest we just let him die" and then get up and try to walk away. But the more credible that threat is, the more likely prices will come down. The more that we can bargain as consumers, which we currently do through insurance, the better off we are. It is why I think we need some kind of single payer, as that makes the threat more dangerous (and, possibly more credible due to the expense across more people).

 

I see you’ve chosen to go to the extremes of situations to not honestly talk about the solutions. That’s fine, I wasn’t expecting much.

People only want to hear about the magic potion or bullet that will “fix it all once and forever”. There is no single solution, there is no magic potion. This is an issue that will have to be worked hard to chip away problems.

Most people just aren’t up for rolling up their sleeves and getting to work.

 

That is quite the shift. Here is your initial claim:

So now we have moved from "much simpler and far cheaper ways" to "no magic potion."

I have not gone to any extreme on the issue. I am analyzing the issue from a perspective of incentives and economics. And I notice that you didn't dispute anything that I said on a substantive level.

 

Your comment about shopping for a better price to treat a heart attack was nonsense. I don’t think that anyone is proposing that. Emergencies can and should be separated and dealt with on their own within an overall framework. That was a typical deflection from people who are not serious about resolving a serious problem.

 

I never said anybody was proposing that. I simply gave that as a reason that increasing hospital systems would only partially solve the problem.

What does that mean? That is a lot of words but not much in the way of real substance. How does one "deal with" emergencies?

 

Let me know whenever you want to get serious. I’m not going to be holding my breath.

 

I have been dealing with issues at a substantive level. You are not. You are just alluding to "simple" solutions but then backtracking.

 

I have not backtracked, and if you think you are being substantive you need to rethink your position on that.

You want single payer. I get that. You will contort logic as much as necessary to convince people that that is the only way. You are not a problem solver, you seek opportunity to have your way by dividing. In other words; you are a true leftist.

 

Meh. Cost of med school isnt an issue. They have twice the applicants every year to med school than they can accept and the graduation rate is astronomically high because of the quality of students they accept. I wonder if graduating more and reducing the quality is all that great an idea? PA's are a good bridge for that shortfall though, and lots of programs are sprouting up. Nursing is in bad shape though. Pay increases will help attract more maybe.

We are too 'merica free to really address the problem though and that is through massive investments in preventative care and really step up the personal invasiveness of health training and care in public schooling. In my opinion.

 

I already showed how you did. You started with "simple solutions" and then backtracked to "no magic potion."

I actually only want partial single payer. The problem is that you are not a problem solver. You aren't interested in solving the actual problems. You are interested in doing "something." Not solving problems. There is an important distinction between those, which requires the diagnosis of the problem before solving it. You started with the wrong diagnosis, which is that this is driven by cost and inefficiency. I pointed out that pricing is not a result of cost, but rather a function of customer value and the challenges in confronting that issue.

And, when confronted with this, you start turning debates into personal attacks instantly.

 

HTF is that backtracking? I said simple solutions. That’s with an “s” at the end. There is no magic solution. It will require multiple solutions to individual aspects of the problem. Tell me again how that is a backtrack?

 

Impact of Trump Disinformation:

Lancaster man accused of sending death threats to New York AG, judge in Trump civil case | News 4 Buffalo.
BUFFALO, N.Y. (WIVB) — A Lancaster man who was arraigned last Monday allegedly sent threats to New York Attorney General Letitia James and a Supreme Court judge presiding over the civil case against former President Donald Trump, multiple sources confirmed to News 4 WIVB.

The Erie County District Attorney’s Office said Tyler Vogel, 26, allegedly sent the text messages on March 24, which threatened “physical harm or death” to the victims if they did not comply with his request to cease action in a “high-profile civil case.”

It is alleged that Vogel used a paid background website to get Judge Arthur Engoron and James’ phone numbers, officials said. A temporary order of protection was issued on behalf of the victims.

Vogel was charged with two counts of making a terroristic threat and two counts of second-degree aggravated harassment. He will return to court on April 9 for a felony hearing after a Thursday appearance was pushed back, officials said.

 

Okay, if you want to play the semantic game, let's play it. Here is your claim:

"there were many much simpler and far cheaper ways to go about doing so." Then, when asked about it, you handwaved at direct subsidies and tried to suggest that we could lower cost, as if pricing was a function of costs and not just due to issues of pricing healthcare with a person who has a metaphorical gun to their head. Finally, when it is pointed out that these aren't really solutions, suddenly, here is your response:

From "many simple solutions" to "no single solution," "no magic potion," "worked hard to chip away at problems."

If you don't see how that is a pretty substantial backtrack, I don't know what to tell you. But it is.