Sunday, May 7, 2017

Trump back on message


Price of  "premiums and deductibles" again.




66 comments:

Noah Way said...

And tRump is going to fix that ... LOL

A lot of interesting stuff is posted here. Unfortunately none of it by Matt.

Matt Franko said...

If he puts $4k bid in everyone <65 pocket and price offered come down to meet it he is going to look like a genius...

I think this is what he thinks is going to happen...

Matt Franko said...

If the left was smart, they would argue that the only thing wrong with it is that the credit is not generous enough....

Instead they are sticking with defending ACA or on some left fringes "single payer!"...

Six said...

Matt, I think if Trump sends everybody $4000 a month to buy health insurance, we would have "single payer!" with lots of money exchangers to write checks to providers while skimming off a chunk for themselves. You and Trump are "leftists!" with a thin "free market!" patina.

Matt Franko said...

Its 4k annual... looking like not enough via static type analysis... he should be challenged on this...

Only skim will be the bank fees to operate the MSAs IF, and I repeat IF, the providers will grow a pair and man up and bypass the insurers to make their own public offers...

Penguin pop said...

Matt, what would be an adequate amount when it comes to the tax credit?

Matt Franko said...

Maybe look at Warren's amounts?

http://moslereconomics.com/2009/03/02/mosler-health-care-proposal/


... idk... there are a lot of people who show up for care who are currently unaccounted for , illegals etc... we need to get them legal and get them the 4K too or otherwise get them out...

Also Trump may be assuming too much that providers are like the business people he is used to dealing with...

Six said...

Rough numbers off the top of my head: 17% of 17 trillion economy divided by 323 million people is about $8900 a year per person. $5000 or $6000 would make us more like a normal country. I'm pretty sure Trump! will accommodate the insurance companies.

Matt Franko said...

Don't forget Medicare is not included... iow you have to take out the > 65 cohort... then it would be a fraction of 17%...

Matt Franko said...

Medicare 20%

https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html

Noah Way said...

You can always count on Americans to do the right thing - after they've tried everything else.

-- Winston Churchill



I don't think so.

Matt Franko said...

Solar compnies have people going door to door trying to sign people up for maybe a ONE TIME 4K credit...

Trump's is a 4K guaranteed ANNUITY.... will the medical industry respond in excess of what the solar people are doing ?

Tom Hickey said...

Matt, you are assuming that this is Trump's plan. As I understand it, this is Ryan's plan. From what I am reading DJT understands about nothing about the intricacies of health care and probably has not even read the plan. If that is the case you are reading a whole lot into this that is not there.

Six said...

Many of the >65 cohort pay additional premiums and co-pays ...

Unknown said...

The very first item of Mosler's plan for 2009 belies what you are saying Matt.

Mosler healthcare plan.

1. Government funding for a full time, $8 per hour job that includes full federal health care coverage for the worker and dependents.

So doesn't work without a job guarantee.

2. Government should fund at least 90% of health care costs paid for by businesses.

Only then does the third part come in

3. a) Everyone gets a ‘medical debit card’ with perhaps $5000 in it to be used for qualifying medical expenses (including dental) for the year.
b) Expenses beyond that are covered by catastrophic insurance.
c) At the end of the year, the debit card holder gets a check for the unused balance on the card, up to $4,000, with the $1,000 to be spent on preventative measures not refundable.
d) The next year, the cards are renewed for an additional $5,000.

According to Kaiser, in 2008 (when Mosler's plan was devised - annual healthcare insurance premium cost $12,700 per family. In 2016, the cost was $18,200 ($6500 for singles) - this does not include deductibles and copays. See Premiums stable but workers' out-of-pocket health costs are rising, Kaiser report says

So Warren's program (that Matt is talking about) is only to pay for deductibles and co-pays - all else is covered by government and employer paid insurance.

Matt Franko said...

He's never going to tell you what he is really thinking... this is how you have to deal with people like him...

Every time he opens his mouth he is trying to manipulate you...

"DJT understands about nothing about the intricacies"

He never operates on the level of "intricacies" he's establishing about a 40M people x 4k = $160B initial pot of tax credits to go after to provide people healthcare...

Might be a little short... but providers could just go to Wash DC next year and lobby for a bit more...

Matt Franko said...

Warren hasnt gotten anywhere in 20 years.... hello...

Its too complicated a sale... people's eyes glaze over...

Keep it simple, get the credit established... once the credit is established, then it should be up to providers to go to Congress and get it increased if they can substantiate their needs...

Matt Franko said...

"In 2016, the cost was $18,200"

so Trump's $14k max credit per household is again looking a bit short... this is the only issue...

MRW said...

Should just be Medicare for all. Then people who want to add additional cadillac coverage are free to do it.

Matt Franko said...

" annual healthcare insurance premium cost $12,700 per family. In 2016, the cost was $18,200 "

Ok so what you are saying is that if a family can come up with the extra $4200 above Trumps 14k credit then they should be able to get their own insurance... Is this a big deal?

OR if Trump is correct and premiums and deductibles are going to come down, then he might hit it on the nose and they wouldnt have to put anything else in...

Matt Franko said...

"Should just be Medicare for all."

Translation: "we're too stupid to figure it out so just pay the providers anything they want..."

Penguin pop said...

"He's never going to tell you what he is really thinking... this is how you have to deal with people like him...

Every time he opens his mouth he is trying to manipulate you... "

That part is pretty obvious then. He says a bunch of shit to appeal to hardcore conservatives and then backpedals on it, and tries to assist in proposing the most outrageous stuff that even he has to know would never pass to supposedly get some kind of better deal on it later.

Six said...

This thread reminds me of the story about several blind people describing an elephant ...

Penguin pop said...

In other words, he's has a big mouth and says things or exaggerates most of the time. Isn't that the definition of a P.T. Barnum type character here?

Six said...

"Warren hasnt gotten anywhere in 20 years.... hello..."

Translation: "we're too stupid to figure it out so just pay the insurers anything they want..."

Penguin pop said...

The whole Johnson Amendment issue was one of those "much ado about nothing" kind of manipulation you'd expect from a guy like Trump for example. The hardcore conservative evangelicals were still pissed anyway.

Matt Franko said...

"we're too stupid to figure it out"

Trump has probably looked at the Kaiser data at $18k and figured he would establish a guarantee at 25% below that list price and then with the scale of enrollments of millions of people he will get them to come down to hit his bid at $14k....

ie he's "figured it out" to him...

Matt Franko said...

Trump is not an academic economist... he's a business guy...

Matt Franko said...

Or maybe he pulled the $14k number out of his ass....

Unknown said...

Matt,

You are only looking at a part of Warren's program - the one that tries to help with co-pays and deductibles.

First - Job guarantee with complete healthcare

Second - Government takes care of at least 90% of healthcare costs.


Only then does his $5,000 tax credit comes in - it is there to take care of the incidental expenses that come with illness. If a person has no illness, then it is like a Basic Income Guarantee.

You cannot take only a portion of Warren's program. You have to look at the entire program.

Warren's proposal is nowhere like the Rebuplican/DJT proposed Healthcare.

Matt Franko said...

"Warren's proposal is nowhere like the Rebuplican/DJT proposed Healthcare."

Not saying it is... Warren's seems to be more generous... this is the issue...

Why dont you get on Warren's case for not proposing "single payer!" ?

Unknown said...
This comment has been removed by the author.
Unknown said...

Warren's program belongs in the "Single Payer Helathcare)" category

First - Job guarantee with complete healthcare (paid totally by the Federal Government)

Second - Government takes care of at least 90% of healthcare costs. (Paid for by the Federal Government)

Third - $5,000 (more in 2017 $) tax credit (Paid totally by the Federal Government)

Matt Franko said...

Unk,

He is not saying "govt takes care of 90% of healthcare costs..."

Read it again.

He is saying "Government should fund at least 90% of health care costs paid for by businesses."

ie if businesses dont pay anything, then govt doesnt pay anything... he is trying to remove healthcare as a marginal cost of production FOR BUSINESSES with this... good idea to do that too but not relevant...

Trump provides the tax credit to ALL US persons without insurance/healthcare... anyone with a valid Federal ID Number...

Matt Franko said...

Think of it like a $14k household BIG but only the USD balances are conditional and can only be used for healthcare or a healthcare insurance scheme if the household doesnt have either....

Unknown said...

Matt, you have it wrong. He intends to shift the burden off business on to the Government, and not on to the common person. You are reading it incorrectly. He definitely does not mean shift the burden from business on to the ultimate consumer of healthcare, which is what you and the Republicans/DJT are taking it to mean.

There is a very good 1999 article on the issue of healthcare - Universal Health Care in the US

Also good reading is A Brief History: Universal Health Care Efforts in the US again from 1999. and Timeline: History of Health Reform in the U.S.

The employer covered health insurance really took off after the passage of the 1954 - Revenue Act of 1954 which excluded employers' contributions to employee's health plans from taxable income.

I believe that this was an attempt to weaken the demands for a publicly funded health plan for the US.

Ben Johannson said...

MRW,

Patterning after Canada's Medicare system doesn't appear a good fit for the U.S. Americans tend to want more choice and aren't likely to tolerate bottlenecks in access to doctors as happens in Canada due to chronic underfunding. A system resembling Germany's, with hundreds of health insurwnce programs to choose feom and high competition would seem a much better choice.

Unknown said...

Ben,

"Americans tend to want more choice"

That is not the case, except for a small but elite minority. Most just want healthcare when they need it.

Also, all my Canadian friends say "what bottlenecks?" only for elective things. Also, the underfunding springs from the Harper era, and continued by the Liberals. And just like the US, individual provinces sometimes do strange funding things.

Ben Johannson said...

Canada suffers significantly longer wait times than the U.S. and many patients may not agree that their problems are just elective. Germany designed a system with better wait times and more consumer choice; it's the better option.

Unknown said...

Ben,

Are you from Canada?

Noah Way said...

@Ben

My wife just signed up for an annual health women's appointment, the first available slot was September. In case you haven't noticed It's the first week of May. We both had checkups with a new doctor that we had to wait 10 weeks for.

So don't tell me how lousy things are in Canada. You don't have a fucking clue.

lastgreek said...

Also, all my Canadian friends say "what bottlenecks?" only for elective things

Exactly!

OK, really fast here so please excuse the writing:

Last year, vacationing in Greece, I had a terrible accident (shit happens) -- I fell (let's leave out the how ad why) and smashed the upper side of my handsome Greek face (really, just like those ancient Greek busts ...lol). We were in a small town so the only medical facility was a very small hospital that happened to have, lucky me, an old CT-scan machine. The diagnosis was 3 fractures and maybe even the orbital floor fractured and thus the fear of collapse. I immediately returned home for three reasons: 1) We were in small town, to go to a city many miles away that had a major hospital was logistically impossible for me; 2)didn't know what kind of care or costs to expect; 3) I knew without a doubt that in Canada I would receive the best care possible and on par, if not higher, than some of the best hospital facilities in the world.... On my return, went straight to the hospital. That same day, I saw two specialists. One was a plastic surgeon specialising in facial reconstruction and the other a trauma specialist from the oral maxillofacial department: two top doctors. Long story short ... I got excellent treatment ... immediately ... it cost me zero, nada, nothing, zilch! ... and I still have my handsome Greek looks ;)

So, Americans, don't believe the nonsense you hear in the mainstream press or from your politicians regarding Canada's healthcare system. Sure, if you go to emergency because you saw a pimple on your wiener then, yeah, you're probably going to wait a bit in the emergency room to see a doctor -- maybe even a 4-to-5 hour wait depending on how many real sick people are waiting. Is our medical system perfect? Of course not. But next to your barbaric and inhuman system you guys have, yeah, you're damn right it is!

Sometimes I wish Trump would jus change his mind and build the damn wall on the northern border :(

Matt Franko said...

Don't tell me: Ouzo??? Huh? Huh?...

Matt Franko said...

Opponents of Trumpcare probably don't want the illegals to get carded if they have a medical issue...

If they come in for treatment and they don't have credentials ICE comes out and puts them on the next Air National Guard C-130 training flight back to Guatemala.... there are many political reasons to oppose Trumpcare...

With "single payer!" the providers just submit a claim under the phony FID number they're given and govt probably pays it...

Six said...

In February we made an appointment for my daughter to see an endocrinologist in August (earliest available). Freedom!

lastgreek said...

No, not ouzo -- German beer!

Lol ... no, Matt. It was nothing like that. I had climbed up the fig tree in our back yard because the only ripe figs were at least a good 10 feet or so up ... and while standing on a branch I slipped, careless me, when I reached out to grab one. I was "lucky" enough to hit (my face, that is) on a big branch on the way down. Had I not and hit the ground instead, I'd probably be flirting with Marilyn Monroe in heaven right now ... or some other pretty blond ;)

Steve D said...

'This thread reminds me of the story about several blind people describing an elephant ...' sans TH, 100% correct, sir.

Ben Johannson said...

I suggest dropping the bad attitudes, anecdotal provincialism and tendency to comment before you think, and instead use your brains. Canada has one of, if not the, worst single-payer systems in the developed world. Is it overall an improvement over the U.S. system? Yes, but that's a pretty low bar.


"The report, part of a survey of residents in 11 countries sponsored by the U.S.-based Commonwealth Fund, shows 29 per cent of Canadians had to wait four hours or longer before being seen by a practitioner during their most recent emergency department visit.

That’s almost three times the international average of 11 per cent of patients who had to wait that long. Patients in France, Germany and the Netherlands fared the best, with one to four per cent reporting a four-hour-plus wait time.

Canada also topped the list for having the highest proportion of patients with long delays to see specialists, with 56 per cent waiting longer than four weeks, compared with the international average of 36 per cent, CIHI said."



http://www.nationalpost.com/m/wp/news/canada/blog.html?b=news.nationalpost.com/news/canada/canada-ranks-low-in-international-comparison-of-patient-wait-times-repor


The U.S. has better examples to learn from than that set by Canadians.

Tom Hickey said...

Comes down to increasing supply to both bring costs down and also provide more efficient service.

What's the problem? Artificial scarcity.

lastgreek said...

I suggest dropping the bad attitudes, anecdotal provincialism and tendency to comment before you think, and instead use your brains. Canada has one of, if not the, worst single-payer systems in the developed world. Is it overall an improvement over the U.S. system? Yes, but that's a pretty low bar.

Oh please. My wife has practiced nursing here and in Germany, her half-sister in France. Ask them and they'll you -- Never, ever, would they seek treatment in France/Germany if they had the choice between those two countries and Canada.

Please allow me another anecdote:

My mother diagnosed with a brain tumor 10 years ago. IMMEDIATE MECIAL CARE ... from one of the top neurosurgeons in the world: Dr. Rolando Del Maestro. Google the damn name!

MRW said...

Ben Johannson, which province are you referring to? Each province has a different system. Your comments are misinformed. You dont gave a clue what you're talking about.

MRW said...

lastgeek is right.

MRW said...

lastgreek, what province are you in?

MRW said...

Ben Johannson, baloney on the wait-time. I had a critical mass. Took me 10 days to get MRI appt at diagnostic lab close by. The mass doubled in those 10 days. Good 'ole USA.

lastgreek said...
This comment has been removed by the author.
lastgreek said...

Montreal, Quebec.

As for the big English hospitals (the ones I'm familiar with), we have ...

The Montreal General Hospital (where I sought treatment last summer after my terrible accident)

The Royal Victoria Hospital (where I was born),

The Montreal Jewish General Hospital (where I was last week when my fingernail was treated after it got infected and swelled when a day earlier I had stuck my hand in our dog's mouth to retrieve a bone),

The Montreal Children's Hospital (where I take the little one).

The Montreal Neurological Institure (Of Doctor Penfield fame (Tom, you remember him?) and where my mother's tumor was successfully treated).

Btw ... not saying are system here is perfect; things could be better. If we limit supply, it's because the "we're out of money" nonsense creeps in; we got the resources. When you hear that Canadians doctors are flocking to the states, that is an outright lie. But I will say that American recruiting agents are here in Canada, on mass, trying to snatch our nurses.

Tom Hickey said...

I know of Wilder Penfield more as a researcher into consciousness than as a doctor. He was one of the early people in what came to be called consciousness studies.

Bob said...

It is difficult to get a family doctor in Nova Scotia (and in several provinces), therefore if you need to see a doctor you have to go through the emergency intake. It is a slow process but that is how it is. Politicians have been making excuses for failing to fix the problem for decades now.

MRW said...

"When you hear that Canadians doctors are flocking to the states, that is an outright lie." Especially true of young Canadian doctors I've spoken to. They hold the American system in disdain and as a violation of the Hippocratic Oath.

MRW said...

It is difficult to get a family doctor in Nova Scotia (and in several provinces). Impossible where I live in the US.

MRW said...

The nice thing you Canadians have is the price of drugs. 1/8th AT THE VERY LEAST what we pay.

lastgreek said...

It is difficult to get a family doctor in Nova Scotia (and in several provinces), therefore if you need to see a doctor you have to go through the emergency intake.

I sympathize with you. We have the same problem in some rural areas in Quebec -- doctors want to work in the big cities :(

Same problem in other fields. A Montreal acquaintance of mine just finished his RCMP training; he's 36. They want him to do 10 years in northern Manitoba before he can request a transfer to Montreal. They had originally told him 3 years. So now the guy is freaking out.

Matt Franko said...

It takes a village...

Ben Johannson said...

Oh please. My wife has practiced nursing here and in Germany, her half-sister in France. Ask them and they'll you -- Never, ever, would they seek treatment in France/Germany if they had the choice between those two countries and Canada.

Prove it. Show me the data. Oh, you don't do empirical evidence, you say?

Please allow me another anecdote

Making the same error again always corrects the original.

My mother diagnosed with a brain tumor 10 years ago. IMMEDIATE MECIAL CARE ... from one of the top neurosurgeons in the world: Dr. Rolando Del Maestro. Google the damn name!

Your mother and whatever travails and perils you choosd to claim for her are of no concern whatsoever. I can get sentiment anywhere; if you can't argue logically and rationally then stop wasting others' time.

lastgreek said...

Your mother and whatever travails and perils you choosd to claim for her are of no concern whatsoever. I can get sentiment anywhere; if you can't argue logically and rationally then stop wasting others' time.


"Claim"? That was reality, buddy.

"Can't argue logically"? Lol... Buddy, I have EXPREIRIENCED it all my life! I don't need you to find some selective stats, then come here and tell me this is how it is. You look hard enough online, you'll find the bogus stats you want to support your case.

As I said, the Canadian system is not perfect; it could be better. You go to the emergency room with a pimple on your wiener, you are going to wait. Yes, for some non emergency procedures/tests there are waits, but the waits are not much different than in other countries with a national health care system. In some specialties there are shortages because graduates are preferring more lucrative specialties; that needs to be addressed. But I'll take the Canadian system, with it's Canadian doctors and nurses anytime over any other European medical system.

Hey! I got more real-life experiences -- oops, I mean anecdotes -- regarding Canada's healthcare system. Like that time my father snuck out of the hospital. He couldn't take it anymore; enough was enough; the man was good to go. Had my father known they were going to keep him in the hospital for days over a dizzy spell he had felt, to run a million tests and have a half dozen doctors prove him, he would not have gone. The bastards at the Canadian hospital (the Montreal Jewish General) were too meticulous, caring and professional. Too much! Bastards!

Damn I am lucky to live in a great country like Canada ... the winter months of January and February not withstanding :(

Matt Franko said...

I like the Canadian National Anthem when they play it at the NHL games....