Dangers of a Trump Presidency--Part 7

[bardtoob]

In the U.S., access to health care often times means access to health insurance since that's the only most people can obtain health services practically-speaking unless they qualify for a state-sponsored program.

Clearly you have done your research and are correct.

I was just playing with ideas.

(I don't know if you are trying to inform me, but I am pretty familiar with the situation as I have worked for a medical group, health plan, and hospital system at various stages in my career.)

 

[VGThuy]

Clearly you have done your research and are correct.

I was just playing with ideas.

(I don't know if you are trying to inform me, but I am pretty familiar with the situation as I have worked for a medical group, health plan, and hospital system at various stages in my career.)

Oh no, I wasn't trying to inform you. I'm the last person to do that, . I was just trying to clarify my point, but I think I ended up confusing myself. I wanted to say I agree that the right to health care (if there is one) and the right to health insurance are very different things. I just wanted to say that if we were to make health insurance illegal, then I can see new constitutional challenges coming up which ironically would be based on the right to access health care...something that has been argued doesn't exist in the U.S. Of course, I'm sure the more conservative challengers will avoid using that argument as much as they can and frame it as the right to contract and some other business-related right.

Also, because I'm born and raised in the U.S., it's really hard for me to separate health care coverage and health insurance. That's how much I've been indoctrinated to the American way of looking at things.

 

[once_upon]

I'm watching SNL and still in disbelief that despite all the shite Trump did and said during the campaign, he is the president.

How is it this alternative universe is real?

 

[Louis]

The option of making all (or most) health insurance illegal is not entirely crazy, provided there was legislation in place to prevent price gouging. I don't think the vast majority of people would pay the prices their insurance pays, and it would make them more attentive to bills. Medicine would have to operate like any other industry, and keep prices in line with what mass market consumers can afford. (There would need to be regulation to keep this in check, I realize.) In some ways, it would be bringing back the family doctor (or village shaman ) model, and it's not entirely different from how some national insurance operates -- e.g., I must go to a local GP whose catchment area I live in. I know various consumer-directed healthcare plans have failed, but I don't think they've been set up to succeed. Consumers have never had real choice uninfluenced by large insurance companies.

The other thought I've had is healthcare loans, payable on death. I would never want to see anyone bankrupted because of healthcare, but really... if the taxpayers are paying millions of dollars for someone's coverage, why do their assets get passed along to their heirs? That type of model with socialized losses, but privatized gains, hurts those most in need. I'd be fine with people signing over their 401(k), IRA, or even their house to the government in exchange for their care. They can take certain distributions while they're alive, but whatever is left (if anything) when they and their spouse die goes to the government healthcare fund. This already happens with nursing home care.

 

[snoopy]

I don't think price gouging would be a threat with no insurance. What are are the medical providers going to do if only 5% of the population could afford to pay for care? Most would have no income. Rather, I think prices would drop. The quickest way to bring down the cost of healthcare is to get rid of insurance. My two preferred solutions to the healthcare crisis are single payer or no payer (insurer). Insurance screws up the market.

If big money insurance dropped out of healthcare, the thing that would be impacted is innovation and investment. If no one was paying $600 a month for their diabetes shots, there'd be a lot less private reasearch.

 

[PRlady]

I don't think price gouging would be a threat with no insurance. What are are the medical providers going to do if only 5% of the population could afford to pay for care? Most would have no income. Rather, I think prices would drop. The quickest way to bring down the cost of healthcare is to get rid of insurance. My two preferred solutions to the healthcare crisis are single payer or no payer (insurer). Insurance screws up the market.

If big money insurance dropped out of healthcare, the thing that would be impacted is innovation and investment. If no one was paying $600 a month for their diabetes shots, there'd be a lot less private reasearch.

I've seen studies demonstrating that a huge amount of that money that Big Pharma is solemnly pledging to spend on research actually gets spent on marketing their prescription drugs. I would personally love to go back to the days when it was illegal to market those drugs directly to consumers.

 

[Louis]

I've seen studies demonstrating that a huge amount of that money that Big Pharma is solemnly pledging to spend on research actually gets spent on marketing their prescription drugs. I would personally love to go back to the days when it was illegal to market those drugs directly to consumers.

I'm with you, but only if there are restrictions on marketing to medical professionals, too, and limits (preferably $0) on what any medical professional can take from a pharmaceutical rep.

I don't like marketing drugs directly to consumers, but I like even less the influence big pharma has over doctors, leaving consumers to blindly accept the drug whose rep has visited the doctor most often, given the doctor the best deal, etc.

 

[allezfred]

I've seen studies demonstrating that a huge amount of that money that Big Pharma is solemnly pledging to spend on research actually gets spent on marketing their prescription drugs. I would personally love to go back to the days when it was illegal to market those drugs directly to consumers.

Isn't the U.S. the only developed that allows direct marketing of prescription drugs* to consumers? There seems to be a pattern here.

*May cause vomiting, diarrhea, heart failure, death and/or mild discomfort

 

[MacMadame]

To be fair to her, I bet a lot of people didn't realize how far the deep-end people they thought they really knew would go until Trump.

This isn't the only relationship what has been sunk by Trump. All-in-all, it's been a crazy 1.5 years.

Giuliani is being floated as DHS replacement.

Damn, that man's name gets floated for EVERY position. Honestly, if he wanted a position in the cabinet and Trump wanted him in the cabinet, don't people think it would have happened by now.

Just remember this—Sen. Murkowski chairs the Sub-committee on Appropriations which has oversight of monies allotted to departments—including Interior.

And she's already used it to say FU to him.

I do think basic maternity cover should be a requirement for all policies.

It really has to be for the system to work. Otherwise, the only people who would opt-in to it would be women who are or want to get pregnant. And that's not how insurance works. The risk and cost has to be spread around.

Prancer mentioned she takes out way more than she pays in when it comes to health insurance. I'm in the same position with auto insurance (though if I live past 80, I may finally have caught up). But auto insurance pays the real costs (or close enough) for accidents. Health insurance and our pay for service system has caused the billed amounts for health services to become insane.

For example, when I had my WLS, I paid cash: $17500. Friends who had it covered by insurance found their insurance companies billing anywhere from $23000 to $90000 for the same service. But the amount the insurance companies actually paid out was more like $7000-20000. Because what is paid doesn't always cover the costs (there is a lot of post-op hand-holding that is not necessary for other kinds of surgery), many surgeons end up charging extra fees to people on insurance to make up the difference between what insurance pays for and how much and what it actually costs them to provide that service. So you think you are only going to pay a co-pay or 10% of the cost but you have to pay another $3000-7000 on top of that.

Does this make sense to anyone?

 

[Susan1]

Big, fat, hairy DUH

http://washingtonjournal.com/2017/07/30/top-congresswoman-just-revealed-pence-putting-trumps-lunacy/

"just" revealed? good grief

 

[Prancer]

I've seen studies demonstrating that a huge amount of that money that Big Pharma is solemnly pledging to spend on research actually gets spent on marketing their prescription drugs. I would personally love to go back to the days when it was illegal to market those drugs directly to consumers.

I believe that pharmaceutical companies spend about 10-20% of their budgets on R&D and do indeed spend a great deal more on marketing and distribution.

But as with most things, it's not that simple. US pharmaceutical companies produce more new drugs in any given year than any other country, and by a pretty big margin. R&D doesn't cost them much because a lot of drugs are developed in government-funded labs; getting the drugs from development to market is incredibly expensive, however, even without advertising costs. New drugs, even those developed by non-US companies, tend to be introduced in the US before they are introduced in other countries because the market is less regulated, meaning that new drugs still under patent are more common here than elsewhere, and Americans just flat-out take a lot more drugs than do people elsewhere, which means we spend more on drugs overall. Also, while prescription drug prices have gone up quite a bit, out-of-pocket expenses actually haven't: "list prices for drugs rose about 12 percent in 2015, net prices — what insurers and employers actually paid — grew only about 2.8 percent." Some studies have shown that regulating prices in the US will decrease development of new drugs and the production of drugs used to treat rare conditions.

Marketing is effective, certainly, but maybe not as effective as people think: The vast majority of drugs dispensed in the United States — more than 80 percent — are generics, which are low-cost alternatives to brand-name drugs. If your doctor writes you a prescription, there is a very good chance it will cost you $10 or less.

I am not a fan of Big Pharma by any means, but there are reasons that what appears to be a relatively simple problem is still a problem and it's not all because Big Pharma is evil (although some of it certainly is).

 

[LilJen]

Yes, but the implication is that Trump is no longer connected to the Republican Party establishment.

I think it is the firing of Preibus that will have a more profound impact on Trump than firing Sessions or Mueller. Preibus is going to get on the phone and sink Trump from a dark corner.

And then all the die-hards will see that as validation that Washington is corrupt and can't handle a real revolutionary who wants to drain the swamp. It's going to get really ugly in this country, even more so than it is now.

Yeah, I can see some people REALLY excited about Trump NOT having ties with the GOP. After all, that was one of the big reasons for his appeal--he was 'independent'; nobody could 'buy' him because he funded his campaigning himself; he was 'different' and not beholden to the party.

It is possible to have universal healthcare AND private health insurance. Might not be as profitable for the insurance and pharmaceutical companies, but they still do business in countries that have universal healthcare.

Yep. Switzerland is one prime example.

I've seen studies demonstrating that a huge amount of that money that Big Pharma is solemnly pledging to spend on research actually gets spent on marketing their prescription drugs. I would personally love to go back to the days when it was illegal to market those drugs directly to consumers.

Isn't the U.S. the only developed that allows direct marketing of prescription drugs* to consumers? There seems to be a pattern here.

*May cause vomiting, diarrhea, heart failure, death and/or mild discomfort

Yep, I absolutely HATE having TV commercials for all this stuff. Nor do I appreciate all the sales folks coming to doctors' offices with free samples, free lunch, free baseball tickets (yeah, my sister & her hubby, both internists, got this once), free lots of stuff in attempts to influence their behavior on ANY other basis than safety and effectiveness.

 

[bardtoob]

Yeah, I can see some people REALLY excited about Trump NOT having ties with the GOP. After all, that was one of the big reasons for his appeal--he was 'independent'; nobody could 'buy' him because he funded his campaigning himself; he was 'different' and not beholden to the party.

I agree . . . However, those excited are not the one's with the fat checkbooks or the degrees that get office jobs in Washington.

 

[MacMadame]

This article lays out some ways the Trump-Russia connection could proceed from here. The most interesting part of the article for me was the chart showing what stories on it are being reported on in the media. There is a lot more coverage now than their was earlier in the year in spite of some people claiming there is less.

https://fivethirtyeight.com/features/trump-and-congress-are-probably-on-a-collision-course-over-russia/?ex_cid=newsletter-top-stories

 

[tracylynn]

I have been watching a program called America in Color on the Smithsonian Channel. It's an interesting program as each episode focuses on a decade and takes black and white videos and pictures and puts them in color. The program tackles the most important events for each decade.

Anyhoo, the episode on the 50's was interesting because it talk about Joseph McCarthy and McCarthyism. While they were talking about McCarthy, I couldn't help but think of Trump and how it sounded like they were talking about him because of the behavior. For example, making accusations with little or no evidence. Eventually, the Republican Party turned on Joe and censured him. I just wish the today's Republican Party would have some balls and do something about some members of their party and agent red.

BTW...The Civil Rights movement that they have discussed was powerful. Right now they are talking about The Beatles

 

[once_upon]

My doctor was speechless last week when I told her she was one of the well meaning but useless democrats who thought a no vote on repeal was a win. And she is one whose income will be impacted. She keeps telling me things will be ok, and 2018 will be a game changer. I told her to go to talk with her office business manager. July 1st was the magic day.

Despite my telling my husband over and over and over and over again, the issues with insurance, it was this afternoon when it finally dawned on him. Probably after the one millionth time of me saying it. He said, well we will determine in November - if there is no ACA insurers on the open market, I'll just go on (contractor's) crappy insurance for a short time. I said, it will not be enough. Not because it is crappy insurance and really only would be helpful for major medical things, but because we CANNOT pay out of pocket the $250 because she will not see me without insurance that she is a provider with.

"NOT EVEN OUT OF NETWORK rates?" no, that's what I have been trying to tell you.

Taking away the 0.001% of those who abuse the system, destroys the rest of us.

 

[Prancer]

This article lays out some ways the Trump-Russia connection could proceed from here. The most interesting part of the article for me was the chart showing what stories on it are being reported on in the media. There is a lot more coverage now than their was earlier in the year in spite of some people claiming there is less.

https://fivethirtyeight.com/features/trump-and-congress-are-probably-on-a-collision-course-over-russia/?ex_cid=newsletter-top-stories

@snowbird should probably see this.

 

[MacMadame]

Does snowbird love data? I love data.

 

[Prancer]

Does snowbird love data? I love data.

I don't know if snowbird loves data or not. That's not really the point.

 

[Reuven]

I've seen studies demonstrating that a huge amount of that money that Big Pharma is solemnly pledging to spend on research actually gets spent on marketing their prescription drugs. I would personally love to go back to the days when it was illegal to market those drugs directly to consumers.

However, I find it darkly amusing that half of a drug commercial time is spent telling us how the side effects could kill us, but "YOU NEED THIS DRUG!"

 

[misskarne]

Isn't the U.S. the only developed that allows direct marketing of prescription drugs* to consumers? There seems to be a pattern here.

*May cause vomiting, diarrhea, heart failure, death and/or mild discomfort

However, I find it darkly amusing that half of a drug commercial time is spent telling us how the side effects could kill us, but "YOU NEED THIS DRUG!"

I wish someone had been there to take a picture of my face the first time I turned on my hotel room's TV when I was in America and got to the first commercial break. My jaw hit the carpet. I mean, we have some advertising here, but for stuff like Codral, Zyrtec, you know, minor cold-and-flu, Nurofen, hayfever relief stuff. Not fcuking medication for serious heart problems! (I will never forget that commercial, nor my horror). Between that, the life insurance policy advertising, and the lawyer advertising, I messaged my parents that night and told them American advertising was genuinely frightening and they were never to complain to me about our commercials ever again.

 

[skatesindreams]

A presidential historian looks at Trump:
http://www.cnn.com/videos/tv/2017/07/30/rs-douglas-brinkley-trump-is-unfit-for-command.cnn/video/playlists/reliable-sources-highlights/

 

[Buzz]

Nashville's mayor Megan Barry has lost her son Max form an apparent drug overdose. He was only 22 years old and an only child. Terrible thing to lose a child especially in such a way.
http://www.bbc.com/news/world-us-canada-40779317

 

[ballettmaus]

Not entirely sure where to put it because it's not specifically Trump related but I don't want to start a new thread about US politics. Anyway, hackers managed to hack voting machines at a security conference in Las Vegas. http://www.politico.com/story/2017/07/30/hackers-voting-machines-las-vegas-241130

http://thehill.com/policy/cybersecurity/344488-hackers-break-into-voting-machines-in-minutes-at-hacking-competition

 

[Mozart]

Wow the Mooch is gone. That was quick

 

[snoopy]

Wut? So Kelly wanted him out and he is gone. Scaramucchi should have been nicer to Preibus. Trump never listened to him.

 

[Mozart]

He just resigned.

 

[Mozart]

http://www.nydailynews.com/news/politics/anthony-scaramucci-resigns-communications-director-article-1.3371914?cid=bitly

 

[ballettmaus]

I wonder when Giuliani will get floated as the new communications director

 

[susan6]

The Mooch is out. This administration is SUCH a tire fire. And the majority of American voters knew this craziness was going to happen. Trump was a joke, his candidacy was a publicity stunt, and sensible people knew it. He did NOT actually want to be president. He wanted to lose and then rake in a sh*t-ton of money from the publicity and a series of post-election protest rallies. The look on his face on election night when the rust belt states turned red was a priceless image of shock and panic. "Low energy Jeb" was right....he was a chaos candidate, and now he's a chaos president.

This would be hilarious if it were a movie or a TV show, but since it's reality....not so funny. The only silver lining is the high likelihood that Trump HATES his life right now.