TN Senate Preference

[MacGyver]

So, I don't like making this argument, and I don't have time to do it this morning (because I'm too busy actually running a small business.) But, as someone who has filtered practically every business decision they've made in the last decade through healthcare, it is where we are right now.

I'd be willing to make and support the argument that providing a basic medicare-type option for everyone would actually cost us less nationally - and be far outweighed by the economic benefit received than the system we have right now.

I run a small business.  I factor the decisions I make through insurance stuff. It weighs on every decision I make.

I'm pretty privileged.  I know folks push back against that word, but here's what I mean by it in this context.  I have the support structures in place in my family and community to allow me to pursue this business without going into persistent, potentially generational poverty if I get something wrong.  Everybody who has ever run a business knows you make some bad decisions every now and then.  Mine are unlikely to put my children and grandchildren in poverty.

I know a lot of us want to push back against this idea reflexively - because free stuff, socialism, whatever.  Frankly, I'm in that camp, too.  Or, at least I used to be.

Here's the question I would ask you consider.  How many people do you know who would love to start their own business - or would maybe like to change careers - or would like to leave that toxic workplace where they feel stuck - but don't because they need insurance?

What economic opportunity are we missing out on because people with dreams stay somewhere making $14/hour instead of going out and pursuing their dreams, creating jobs, and making the economic pie much larger?

Empire is hard, and late stage capitalism pretty much demands that companies take all the money off the table they can.

Our broken system is running as it's intended.

The problems are architectural in nature - even if you forget the ethical piece.

This is a case where market solutions can maybe slow the bleeding, but they're not going to fix the problem. The empire is simply too big, and the companies in the space don't have our interests at heart - they have their shareholders to report to every 12 weeks.

Like I say, I don't necessarily like making the argument, but it's squarely where I am now.

[gregintenn]

The answer is to go back to catastrophic medical care insurance and pay for the rest out of one's pocket.

We are always on the cusp of one major healthcare breakthrough after another. Among the many other unintended consequences of government healthcare is that these studies and medical advancements will instantly cease. Who wants that?

[gregintenn]

30 minutes ago, MacGyver said:

So, I don't like making this argument, and I don't have time to do it this morning (because I'm too busy actually running a small business.) But, as someone who has filtered practically every business decision they've made in the last decade through healthcare, it is where we are right now.

I'd be willing to make and support the argument that providing a basic medicare-type option for everyone would actually cost us less nationally - and be far outweighed by the economic benefit received than the system we have right now.

I run a small business.  I factor the decisions I make through insurance stuff. It weighs on every decision I make.

I'm pretty privileged.  I know folks push back against that word, but here's what I mean by it in this context.  I have the support structures in place in my family and community to allow me to pursue this business without going into persistent, potentially generational poverty if I get something wrong.  Everybody who has ever run a business knows you make some bad decisions every now and then.  Mine are unlikely to put my children and grandchildren in poverty.

I know a lot of us want to push back against this idea reflexively - because free stuff, socialism, whatever.  Frankly, I'm in that camp, too.  Or, at least I used to be.

Here's the question I would ask you consider.  How many people do you know who would love to start their own business - or would maybe like to change careers - or would like to leave that toxic workplace where they feel stuck - but don't because they need insurance?

What economic opportunity are we missing out on because people with dreams stay somewhere making $14/hour instead of going out and pursuing their dreams, creating jobs, and making the economic pie much larger?

Empire is hard, and late stage capitalism pretty much demands that companies take all the money off the table they can.

Our broken system is running as it's intended.

The problems are architectural in nature - even if you forget the ethical piece.

This is a case where market solutions can maybe slow the bleeding, but they're not going to fix the problem. The empire is simply too big, and the companies in the space don't have our interests at heart - they have their shareholders to report to every 12 weeks.

Like I say, I don't necessarily like making the argument, but it's squarely where I am now.

Et Tu, Brute'?

[n0rlf]

Where does it state in the constitution that the gov owes anyone health care? Why are we relying on it? What happened to personal responsibility? Yes it ccan be conusing and difficult to navigate as mentioned and that is mainly due to the government involvement! Fraud is rampant in any government system. Raises costs for everyone. Corruption follows and of course the usual I am just here for a paycheck people.

I refuse to let the government make decisions for me! I have to follow the laws bit I will be damned if I become a "Subject"! Seems we as a country had a little skirmish over that a few years back!

Personally I am for abolishing insurance all together. Everyone pays set amounts for visits. catastrophic issues can be handled on a per case basis. (Fell off a mountain, that is on you!, Rare disorder or something else unforseen then it is on everyone!) Over simplified but it should get the point across.

I am still of the less government is better no matter the issue. Government hasa NEVER fixed anything!

Don't get me started on medicines and Big pharm! That is an entire different discussion. A long and painful one!

[Erik88]

2 hours ago, gregintenn said:

the answer is to go back to catastrophic medical care insurance and pay for the rest out of one's pocket.

I'm just not sure that's possible Greg. I knew a guy in college who broke his arm without having insurance. That's a moderate injury, but not what I would call catastrophic. The bill he got from the hospital was around $13,000. For most Americans, a bill like that would be catastrophic. My wife went to the ER in 2017. They ran a few tests, told her what they thought was wrong and sent her on her way. Just for being there 2 hours and running some tests they billed insurance several thousand dollars. It would have really hurt us financially. I can understand your reasoning on this but it seems to me that the hospitals and doctors office are completely raping both insurance and non-insured.

Health care and health insurance is probably one of the biggest challenges we face. My wife is currently stuck an a horrible job that she hates. Part of the reason she hasn't left yet is because her company offers really good benefits, at least in this area. The health insurance for my company is insanely expensive and it's horrible coverage so we use hers. It's sad that health insurance has even become part of the discussion when searching for a better job. 

Edited July 20, 2018 by Erik88

[MacGyver]

16 minutes ago, gregintenn said:

Et Tu, Brute'?

Like I said, I don't like it. 

I would prefer market solutions - by far.  But the reality is that we no longer really have a market economy. The government - somewhat dependent on what side is in power - picks winners and losers.  It's gone on long enough now that enough people in both parties are sufficiently in corporate pockets that anything is unlikely to change.

I'm a pragmatist. And, I'd love to believe my ethics have compassion in a way that scales. You know I believe that the church has ceded way too much to the government - but charitable organizations aren't going to pick up the slack that happens with 325 million people.

All my argument above is saying is that you could probably make an economic argument for getting everyone a baseline of healthcare.

How many people do you know in your own life who've delayed making medical decisions until they were eligible for Medicare? I know a bunch.

The thing about poverty is that it charges interest.  

Someone putting off seeing a doctor about blood sugar issues, or hypertension, or other stuff that can be treated easily early on - become giant costly problems when they're delayed.

Up until this year, I've paid more for my insurance for my healthy family of five than I have for my mortgage. I know the cost of people putting off healthcare - and think I probably pay for a chunk of it as I write that check each month.

I don't like it.  All I'm saying is that if you could get past the optics, you could probably make a compelling economic case for it.

But don't worry - our political system is so bankrupt that i can't see us actually having a conversation like that at a national level.

 

[gregintenn]

3 minutes ago, Erik88 said:

I'm just not sure that's possible Greg. I knew a guy in college who broke his arm without having insurance. That's an moderate injury, but not what I would call catastrophic. The bill he got from the hospital was around $13,000. For most Americans, a bill like that would be catastrophic. My wife went to the ER in 2017. They ran a few tests, told her what they thought was wrong and sent her on her way. Just for being there 2 hours and running some tests they billed insurance several thousand dollars. It would have really hurt us financially. I can understand your reasoning on this but it seems to me that the hospitals and doctors office are completely raping both insurance and non-insured.

Health care and health insurance is probably one of the biggest challenges we face. My wife is currently stuck an a horrible job that she hates. Part of the reason she hasn't left yet is because her company offers really good benefits, at least in this area. The health insurance for my company is insanely expensive and it's horrible coverage so we use hers. It's sad that health insurance has even become part of the discussion when searching for a better job. 

That would all change with some competition.  Call your doctor's office and ask how much it would cost to have a wart removed. They'll have no idea.

 

If the food industry worked like the medical industry, a cheeseburger would cost several thousand dollars.

 

If the customer actually had to pay for services, they'd shop around and prices would begin to be competitive and affordable.

 

My wife is a medical coder for a hospital. She, and the dozens of her coworkers make a LOT of money doing something that isn't necessary, and seems counterproductive to me. Many costs like this would go away with cash services.

[MacGyver]

28 minutes ago, gregintenn said:

That would all change with some competition.  Call your doctor's office and ask how much it would cost to have a wart removed. They'll have no idea.

 

If the food industry worked like the medical industry, a cheeseburger would cost several thousand dollars.

 

If the customer actually had to pay for services, they'd shop around and prices would begin to be competitive and affordable.

 

My wife is a medical coder for a hospital. She, and the dozens of her coworkers make a LOT of money doing something that isn't necessary, and seems counterproductive to me. Many costs like this would go away with cash services.

I often tell people that I can fix healthcare in America by lunchtime.  Just tell me what something costs - and mark it up - say 20%.

The system is structurally broken.  The "competition" is rigged.  Currently, the doctors, the hospital groups, and the insurance companies sort of play a game of round robin.  Somebody gets to be the bad guy and take a haircut "this time" - but in the long run all of them still increase prices and make more money.

I'd be all for menu based services.  But, that in itself is going to require massive government intervention.  Someone has to set those prices.  Someone has to tell the companies, no you can't charge $5,000 for this injection that cost .$0.17 to manufacture.  That is going to be a lot of government "meddling".  

How is this different than the other?

I should say in my argument above, I'm not saying everyone gets it for free.  I'm all for employee contributions and figuring out ways for the citizen to pay for it.

 

[gregintenn]

7 minutes ago, MacGyver said:

I often tell people that I can fix healthcare in America by lunchtime.  Just tell me what something costs - and mark it up - say 20%.

The system is structurally broken.  The "competition" is rigged.  Currently, the doctors, the hospital groups, and the insurance companies sort of play a game of round robin.  Somebody gets to be the bad guy and take a haircut "this time" - but in the long run all of them still increase prices and make more money.

I'd be all for menu based services.  But, that in itself is going to require massive government intervention.  Someone has to set those prices.  Someone has to tell the companies, no you can't charge $5,000 for this injection that cost .$0.17 to manufacture.  That is going to be a lot of government "meddling".  

How is this different than the other?

I should say in my argument above, I'm not saying everyone gets it for free.  I'm all for employee contributions and figuring out ways for the citizen to pay for it.

 

One wouldn't charge $5000 for an injection if the clinic down the street charged $10. We definitely don't need government setting prices. Just the opposite. Get government out of it and let the free market work. Most of today's healthcare costs ARE incurred due to government regulations.

Edited July 20, 2018 by gregintenn

[MacGyver]

You and I believe in the same economic theory in principle.

The problem is the system that we have in practice - and where we've got the political capital to go. 

For all their free market talk, if you look at the healthcare lobby's spending - the GOP takes the bulk of the payoffs/campaign contributions from the industry.  They're the ones benefiting the most from keeping the current system broken.

All of this is fun to talk about.  The sad part is that the system is still broken and likely to remain that way.

[Erik88]

1 hour ago, gregintenn said:

That would all change with some competition.  Call your doctor's office and ask how much it would cost to have a wart removed. They'll have no idea.

I guess I'm not following. What is going to create the competition? 

[gregintenn]

32 minutes ago, Erik88 said:

I guess I'm not following. What is going to create the competition? 

People who would have to actually open their wallet and pay for what today they take for granted is free, or at least available with a set copay.

 

If I could get a new truck for free, I'd go to a lot, pick out the nicest one, and drive off. I don't give a crap what it costs.

Since I have to pay for my own truck, I'm going to price shop

as well as consider other options; even if I really need a new truck at all. This causes dealerships to be competitive in price without government regulating truck prices. This is something not seen in today's medical industry.

Edited July 20, 2018 by gregintenn

[Chucktshoes]

26 minutes ago, Erik88 said:

I guess I'm not following. What is going to create the competition? 

The healthcare market has been severely distorted by the dual controlling interests and government regulation. Right now there are very few actual healthcare consumers. There are a lot of healthcare users, but no consumers. The user has been divorced from the payer in the market. This creates an excessive demand on providers and no reason to acts as competitors and striving to increase service while decreasing prices. It’s not so much a marketplace as a model for wealth extraction. 

If you want to bring health back to the healthcare market, you have to make users into consumers. 

[Oh Shoot]

2 hours ago, MacGyver said:

....

How many people do you know in your own life who've delayed making medical decisions until they were eligible for Medicare? I know a bunch.

Yep, perfect example here.

When I lost my UTK gig in 97, I had to seek my own policy for 18 years, which was in short an expensive nightmare. Just before I became an Official Geezer, was paying about 7 K a year for what amounted to essentially a "catastrophic policy". About all it did was get me the "insurance price" on services as opposed to "street price". Total out of pocket NOT including premiums was around 10K.

That means that most anything of any significance would cost me 10 thousand bux, and I'd better get it all done in the same calendar year or it could be that much more again if treatment spanned to the next.

So my example, had a bum left elbow. Broke and dislocated it when I was a kid, did same again in my late 40's (and just before I lost the primo insurance). Then when 63 or 64, really bad dislocation while on an urban trek after a pratfall on a muddy sidewalk.

So it just bugged the hell out of me through those years, would pop out of joint doing the oddest things, etc. Worse, had to compensate for it in golf, so basically became a bogey golfer instead of single digit handicap. Heck, through all the years even a MIR would have cost me well over a grand, with operation in the 25 grand range or more. (needed the Tommy Johns surgery)

So finally on Medicare, had MRI done, 75 whole bucks! And the operation would have been around 300 bux!

But ya know what, the surgeon talked me out of it. Said would be happy to do it and could tighten it up good as new, but the odds were that it would cause chronic pain, as arthritis had set in to the point that things would rub and stay somewhat inflamed and whatever. Fact that it was "loose" was reason that even though unstable, it didn't hurt. Said basically I had waited too long to have it fixed.

I know there are a ton of examples like this, where folks forgo quality of life on non life threatening issues just due to high cost of the insurance, high deductible, and high out of pocket.  And ducking some potentially life saving tests, like colonoscopies and whatnot.

- OS

 

[Erik88]

44 minutes ago, Chucktshoes said:

The healthcare market has been severely distorted by the dual controlling interests and government regulation. Right now there are very few actual healthcare consumers. There are a lot of healthcare users, but no consumers. The user has been divorced from the payer in the market. This creates an excessive demand on providers and no reason to acts as competitors and striving to increase service while decreasing prices. It’s not so much a marketplace as a model for wealth extraction. 

If you want to bring health back to the healthcare market, you have to make users into consumers. 

 How could that be done? 

[chances R]

and so with all that said.....still voting for Blackburn.  Best choice.  Sitting out is a terrible option.  As mentioned the 'other' side buses people, vote 2 or 3 times, uses dead people, etc.  And to be honest, that's a bunch of crap, 'I don't care who you vote for, just vote'.  If you are going to vote for a Dem. then please sit it out.

[Erik88]

1 minute ago, chances R said:

'I don't care who you vote for, just vote'. 

If you are going to vote for a Dem. then please sit it out.

That's quite the contradiction there Donald.

 

 

[Raoul]

4 minutes ago, chances R said:

and so with all that said.....still voting for Blackburn.  Best choice.  Sitting out is a terrible option.  As mentioned the 'other' side buses people, vote 2 or 3 times, uses dead people, etc.  And to be honest, that's a bunch of crap, 'I don't care who you vote for, just vote'.  If you are going to vote for a Dem. then please sit it out.

I'm sure there's probably places where that happens, but I worked the polls for 12 years and in that time both parties had control at one time or another. It was always my pleasure to work with honest hardworking folks at every election.

[Omega]

1 minute ago, Raoul said:

I'm sure there's probably places where that happens, but I worked the polls for 12 years and in that time both parties had control at one time or another. It was always my pleasure to work with honest hardworking folks at every election.

There is a reason many places don't want a voter ID law, and it isn't because they can't afford a free ID, or can't get a ride to get one (they go everywhere else).

[mikegideon]

8 minutes ago, Erik88 said:

That's quite the contradiction there Donald.

 

 

LOL. I agree with the last part

Edited July 20, 2018 by mikegideon

[Erik88]

7 minutes ago, mikegideon said:

LOL. I agree with the last part

I'm writing in my vote for Basil.

 

 

[Garufa]

38 minutes ago, Erik88 said:

I'm writing in my vote for Basil.

 

 

He is on the ballot for Governor again this year.  I tried navigating his website the other day and it is as bizarre as ever.  

https://www.republicaninarepublic.com/

He’s on Twitter too.  Good stuff.

https://mobile.twitter.com/marceaux2018?lang=en

I saw him sitting in a raggedy old Explorer in front of the downtown post office a couple of weeks ago and thought about saying hey.  Then I remembered my policy of never engaging mentals in conversation and just kept walking.

[MacGyver]

Here’s your regular reminder that at least up through 2012, there’s no evidence that points to voter fraud being either statistically or electorally relevant...

The risk/reward scenario is lopsided. 

 

[Erik88]

9 minutes ago, MacGyver said:

Here’s your regular reminder that at least up through 2012, there’s no evidence that points to voter fraud being either statistically or electorally relevant...

The risk/reward scenario is lopsided. 

 

Trump's own commission couldn't even scrounge up any evidence of voter fraud. The commission was quietly disbanded earlier this year.

 

[gregintenn]

1 hour ago, Erik88 said:

 How could that be done? 

By you and I reaching into our wallets and paying for the services we use, not unlike most any other product or service we enjoy.

Edited July 20, 2018 by gregintenn