Effect on 2018 elections of Trumpf purposely leaving Obamacare in place?

[Jhhnn]

The graph was more to indicate that dropping wages are compensated by increased non-wage compensation. Real median household income has generally increased.

Yeh, we made it back to where we were 20 years ago. Meanwhile, incomes of the financial elite have increased by leaps & bounds.

So, where's that magical trickle down goodness, anyway?

 

[agent00f]

Property ownership is pretty fundamental to most economic systems. Idea ownership, limited at most.

Examples? If anything I'd argue tech people are lucky they aren't exposed to even more competition from H1Bs and such.

The point is the rules are entirely arbitrary as rulemaking sees fit.

The graph was more to indicate that dropping wages are compensated by increased non-wage compensation. Real median household income has generally increased.

Household income increases with greater female participation in the workforce.

 

[agent00f]

Nope. Europe's (underlying) HC costs are rising at approx the same rate as ours.

Government can limit the price charged to consumers, but it can't limit cost of the product or service. Venezuela has tried and we've seen what happens: Cheap prices but no product/service available. Elsewhere, as in the USA, attempts to limit the price charged are accompanied by "back door" subsidies with cute names like "risk corridor" or tax credits to obscure the fact.

We must find another way.

Fern

Europe/Asia's HC costs are substantially lower than ours due to price limits, in proportion to the degree of limit as entirely expected by anyone who can understand numbers and ratios. Eg higher for swiss/germany with more private insurance and less state fiat.

Conservatives are easily identified by denial of empirical reality, same here as for climate or evolution or anything such matters.

 

[zinfamous]

I have no "Republican betters". Stand by the implosion is coming. And just to be clear that train wreck of a health care bill that was tabled last week was also an abortion. They are working the wrong end of the problem. They need to fix the healthcare cost not the insurance industry.

OK, I'll be waiting with arm-in-arm for when this "implosion" occurs. ...fwiw, I assure you that only of us will be underwhelmed.

 

[fskimospy]

Thats just not true with healthcare. It might be true for a lot of other things and I'll concede that if healthcare costs weren't so completely out of whack with what they should be it might be true. Take a simple MRI, the price can vary from $500 to over $13,000, there is absolutely zero reason for a price disparity that big and we have the same disparities with every medical procedure even in the same city. For reference, the average cost of a MRI in Japan is a little over $100 and there are even a few places in the US that you can pay $300ish cash for an MRI yet we have places billing $13,000 for the same exact thing. Even worse is that like just about everything else healthcare related they aren't required to, and never do, tell you the costs upfront. A mechanic can't work on your car and then tell you that he's charging you $15,000 after he has already completed the work yet that is exactly what happens in the healthcare industry. I understand that in certain emergency situations it wouldn't matter and that unforeseen things can happen but that doesn't mean they shouldn't be held to the same standards that every other industry is. This is just one of the problems but it's a big one. We are told, and I am sure it's true, that billing has added significant cost to medical procedures yet if I walk into a hospital and want to pay cash upfront I am charged an insanely higher rate than they would charge an insurance company despite having reduced costs and they don't have to wait to get paid! This is also illegal in most other sectors, you shouldn't be able to charge people getting the exact same treatment vastly different prices (often as much as 10X more) based only on how they pay. Imagine if the cost of buying a TV was 10X more if you paid cash versus financing it with XYZ company, that's basically what we are talking about.

Regardless, the Federal governments healthcare costs have been rising at roughly 8% a year for quite some time and there is absolutely zero reason to think that will slow down. In 2016 we spent $1.1 trillion at the Federal level on all of the healthcare related programs. Put it into your own calculator, 1.1 * 1.08 and hit enter and see what the number says after 4 times and then after 8 times. Then tell me how we can afford to pay it in 8 years under ANY tax plan.

So again, the bottom line is that we must address healthcare costs in this country and we don't have long to do it. When we do that insurance costs will follow suite.

There's a very good reason to think it will slow down, just not in the immediate future. Actual health care cost inflation has been very low for the past 10 years or so, meaning that addressing costs is exactly what has been happening. What we can't stop from happening is that the population of 65+ in our country will be increasing for the next decade or so.

You REALLY want to address health care costs though? Institute something like NICE from the U.K. Chemo drug is super expensive and only extends life by three months? Not paying for it. The ACA tried this in a limited way but what did we get for it? Conservatives screeching about death panels. You want affordable health care? Start looking at the problem like adults.

 

[IronWing]

Institute something like NICE from the U.K.

National Institute of Coordinated Experiments?

 

[dullard]

Government can limit the price charged to consumers, but it can't limit cost of the product or service. Venezuela has tried and we've seen what happens: Cheap prices but no product/service available...We must find another way.

In Venezuela, the few doctors they have can leave for other countries with better wages. Price controls tend to have that problem. It limits new supply, drives away existing supply, and in general leaves you with shortages and/or low quality (look at slum lords for example in price controlled apartments).

There is another way though. We can produce more doctors. With more doctors, the amount they can charge naturally declines with simple supply and demand. With more doctors, lack of supply isn't a problem (what are they going to do, leave the US for Venezuela?).

Rural America often has one specialist to choose from. That specialist has a complete and total monopoly in the area and charges accordingly (think income reaching upwards of $1M/year in some specialties in rural areas where the cost of living is miniscule). If we doubled the supply of doctors, they'd only make say $300k/year and each patient would get double the face time with their specialists leading to better care.

We need more medical schools, more residencies, lower entrance requirements (eliminate the useless bachelor's degree before medical school which often adds $20k to $200k to the doctor's debt and many times in a useless degree like history). As it is, a person with a 3.8 GPA could make a great doctor but probably won't even get a spot in medical school. No, we don't need to lower the standards so much that we lower the quality of care. But there are certainly ways we can lower the entry barrier to becoming a doctor without harming quality of the doctors.

But this requires that we break the stranglehold of the AMA.

 

[cliftonite]

In Venezuela, the few doctors they have can leave for other countries with better wages. Price controls tend to have that problem. It limits new supply, drives away existing supply, and in general leaves you with shortages and/or low quality (look at slum lords for example in price controlled apartments).

There is another way though. We can produce more doctors. With more doctors, the amount they can charge naturally declines with simple supply and demand. With more doctors, lack of supply isn't a problem (what are they going to do, leave the US for Venezuela?).

Rural America often has one specialist to choose from. That specialist has a complete and total monopoly in the area and charges accordingly (think income reaching upwards of $1M/year in some specialties in rural areas where the cost of living is miniscule). If we doubled the supply of doctors, they'd only make say $300k/year and each patient would get double the face time with their specialists leading to better care.

We need more medical schools, more residencies, lower entrance requirements (eliminate the useless bachelor's degree before medical school which often adds $20k to $200k to the doctor's debt and many times in a useless degree like history). As it is, a person with a 3.8 GPA could make a great doctor but probably won't even get a spot in medical school. No, we don't need to lower the standards so much that we lower the quality of care. But there are certainly ways we can lower the entry barrier to becoming a doctor without harming quality of the doctors.

But this requires that we break the stranglehold of the AMA.

I have cousins who are specialists (GI/cardiology) and they are making close to the 1M figure living in the middle of no where. So there is definitely truth to this.

 

[Darwin333]

There's a very good reason to think it will slow down, just not in the immediate future. Actual health care cost inflation has been very low for the past 10 years or so, meaning that addressing costs is exactly what has been happening. What we can't stop from happening is that the population of 65+ in our country will be increasing for the next decade or so.

Except for a few year pause/slow down, not for the Federal government it hasn't and that has been what I have been solely talking about.

You REALLY want to address health care costs though? Institute something like NICE from the U.K. Chemo drug is super expensive and only extends life by three months? Not paying for it. The ACA tried this in a limited way but what did we get for it? Conservatives screeching about death panels. You want affordable health care? Start looking at the problem like adults.

I couldn't agree more but you didn't address any of my points. Why do we pay so much more for something like an MRI than say Japan? If a person can pay $300ish cash for an MRI how in the hell can any entity legally get away with billing $13,000 for the same exact procedure? Maybe it's just me but being charged $13,000 for something that should cost hundreds of dollars seems like it would seriously effect the cost of healthcare...

 

[fskimospy]

Except for a few year pause/slow down, not for the Federal government it hasn't and that has been what I have been solely talking about.

I couldn't agree more but you didn't address any of my points. Why do we pay so much more for something like an MRI than say Japan? If a person can pay $300ish cash for an MRI how in the hell can any entity legally get away with billing $13,000 for the same exact procedure? Maybe it's just me but being charged $13,000 for something that should cost hundreds of dollars seems like it would seriously effect the cost of healthcare...

The actual paid amount for that MRI is nowhere near $13k.

 

[Londo_Jowo]

I couldn't agree more but you didn't address any of my points. Why do we pay so much more for something like an MRI than say Japan? If a person can pay $300ish cash for an MRI how in the hell can any entity legally get away with billing $13,000 for the same exact procedure? Maybe it's just me but being charged $13,000 for something that should cost hundreds of dollars seems like it would seriously effect the cost of healthcare...

I had a MRI done on my shoulder in 2014, the facility charged my insurance $600, and my 20% copay for the MRI was $120.