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(07-18-2018, 06:43 PM)MalabarJag Wrote: [ -> ]
(07-18-2018, 11:14 AM)HURRICANE!!! Wrote: [ -> ]They didn't have too.  Trump does so many screwed up things that everyone one of his actions needs to be monitored (by the reps of both parties) at the micro level.

What screwed up action has Trump done? You may disagree with some of his policy, but his policy decisions have been pretty much mainstream. For example, he has yet to facilitate a government take over of 20% of the US economy.


OTOH, I can think of at least two cases where Obama sent US taxpayer's money to foreign leaders (Iran, UN Climate Commission) without congressional approval.

That line always got to me.
For a party that always loved to say "let's not discuss how the pie is divided but try to make the pie larger," why did none of them ever ask "how can we maybe spend less than 1/5 or 1/6 of our economy on Healthcare?"
(07-18-2018, 08:34 PM)rollerjag Wrote: [ -> ]
(07-18-2018, 08:20 PM)MalabarJag Wrote: [ -> ]
I was referring to the $400M Obama shipped to Iran not for hostages.

That $400 million was an advance payment from the Shah's government for aircraft and other military supplies. When the embassy employees were taken hostage, we barred shipment of the equipment and kept the money in a trust. The repayment was made according to law. I know it doesn't fit your narrative, but facts are facts.

The $400M was separate from the money we held in trust. It was also sneaked out of the US by the Obama administration, so even Obama knew that it was illegal.

In any case, even if you discount the $400M (and I know the Left does) the $2B shipped to the UN Climate Commission was not approved by congress. I hear they used most of it to build a really nice headquarters.

(07-18-2018, 08:49 PM)mikesez Wrote: [ -> ]
(07-18-2018, 06:43 PM)MalabarJag Wrote: [ -> ]
What screwed up action has Trump done? You may disagree with some of his policy, but his policy decisions have been pretty much mainstream. For example, he has yet to facilitate a government take over of 20% of the US economy.


OTOH, I can think of at least two cases where Obama sent US taxpayer's money to foreign leaders (Iran, UN Climate Commission) without congressional approval.

That line always got to me.
For a party that always loved to say "let's not discuss how the pie is divided but try to make the pie larger," why did none of them ever ask "how can we maybe spend less than 1/5 or 1/6 of our economy on Healthcare?"

Neither party supports cheaper healthcare. When Clinton was president with a Pub congress they approved a bill to pay medical schools to cut down on their number of graduates. That's exactly the opposite of cutting healthcare costs.
(07-18-2018, 09:13 PM)MalabarJag Wrote: [ -> ]
(07-18-2018, 08:34 PM)rollerjag Wrote: [ -> ]That $400 million was an advance payment from the Shah's government for aircraft and other military supplies. When the embassy employees were taken hostage, we barred shipment of the equipment and kept the money in a trust. The repayment was made according to law. I know it doesn't fit your narrative, but facts are facts.

The $400M was separate from the money we held in trust. It was also sneaked out of the US by the Obama administration, so even Obama knew that it was illegal.

In any case, even if you discount the $400M (and I know the Left does) the $2B shipped to the UN Climate Commission was not approved by congress. I hear they used most of it to build a really nice headquarters.

(07-18-2018, 08:49 PM)mikesez Wrote: [ -> ]That line always got to me.
For a party that always loved to say "let's not discuss how the pie is divided but try to make the pie larger," why did none of them ever ask "how can we maybe spend less than 1/5 or 1/6 of our economy on Healthcare?"

Neither party supports cheaper healthcare. When Clinton was president with a Pub congress they approved a bill to pay medical schools to cut down on their number of graduates. That's exactly the opposite of cutting healthcare costs.

Exactly.
Like most bloated costs, most can be attributed to inefficiency and over regulation. Many of the mandates in 0bamacare demanded changes that were financially burdensome to providers. On a side note, the electronic requirements re: documentation have lead to massive identity theft and fraud, exact opposite of what was intended. That's a topic that deserves a thread of its own, it's been so bad. Another unintended consequence of having non-expert politicians dictate policy for an industry they don't understand.

Providers should always be profitable. Without it, not only can they not survive, but we cannot continue to be leaders of healthcare innovation.

That's the balance that needs to be struck. But by no means are providers taking too much profit. They are being saddled with too high costs before they cut in to profit.

Coupled with the fixed pricing reimbursement, and you have a system that is ripe for fraud. You can get about anything covered as long as it's "coded right" on the form. And, doctors can (and routinely do) encourage unnecessary care because they will be reimbursed, or... they feel it necessary so they aren't sued for lack of care. Much to clean up in that arena as well.

As most take their myopic look at healthcare, spinning incessantly on about enigmatic buzzwords like so-called "access," they miss the larger influencer of healthcare in our country - health itself.

Simply put... we're very unhealthy, which requires more care. Our diet is horrible, filled with foods that are inflammatory and diabetes-causing processed oils, grains, and sugars, and other unhealthy processed foods. In this sense, the health debate converges with the climate debate in that most engaging in the issue completely miss the forest for the trees. Our healthcare issue is driven by our poor health, just as the climate non-issue is driven by the activity of the sun. For both topics, we're addressing the wrong things and ignoring the causes. There's no policy that could possibly address either when most don't even recognize the drivers of those topics.

That's why both get mostly lip service, and the "solutions" that are implemented generally cause more problems and solve nothing at all.
(07-20-2018, 11:11 AM)pirkster Wrote: [ -> ]Like most bloated costs, most can be attributed to inefficiency and over regulation.  Many of the mandates in 0bamacare demanded changes that were financially burdensome to providers.  On a side note, the electronic requirements re: documentation have lead to massive identity theft and fraud, exact opposite of what was intended.  That's a topic that deserves a thread of its own, it's been so bad.  Another unintended consequence of having non-expert politicians dictate policy for an industry they don't understand.

Providers should always be profitable.  Without it, not only can they not survive, but we cannot continue to be leaders of healthcare innovation.

That's the balance that needs to be struck.  But by no means are providers taking too much profit.  They are being saddled with too high costs before they cut in to profit.

Coupled with the fixed pricing reimbursement, and you have a system that is ripe for fraud.  You can get about anything covered as long as it's "coded right" on the form.  And, doctors can (and routinely do) encourage unnecessary care because they will be reimbursed, or... they feel it necessary so they aren't sued for lack of care.  Much to clean up in that arena as well.

As most take their myopic look at healthcare, spinning incessantly on about enigmatic buzzwords like so-called "access," they miss the larger influencer of healthcare in our country - health itself.

Simply put... we're very unhealthy, which requires more care.  Our diet is horrible, filled with foods that are inflammatory and diabetes-causing processed oils, grains, and sugars, and other unhealthy processed foods.  In this sense, the health debate converges with the climate debate in that most engaging in the issue completely miss the forest for the trees.  Our healthcare issue is driven by our poor health, just as the climate non-issue is driven by the activity of the sun.  For both topics, we're addressing the wrong things and ignoring the causes.  There's no policy that could possibly address either when most don't even recognize the drivers of those topics.

That's why both get mostly lip service, and the "solutions" that are implemented generally cause more problems and solve nothing at all.

I've been to Europe and Canada.
They eat worse than us and they smoke more.  I witnessed it.  And you don't have to take my word for it, the statistics also say so.
You're just wrong.
Nope
(07-20-2018, 01:14 PM)mikesez Wrote: [ -> ]
(07-20-2018, 11:11 AM)pirkster Wrote: [ -> ]Like most bloated costs, most can be attributed to inefficiency and over regulation.  Many of the mandates in 0bamacare demanded changes that were financially burdensome to providers.  On a side note, the electronic requirements re: documentation have lead to massive identity theft and fraud, exact opposite of what was intended.  That's a topic that deserves a thread of its own, it's been so bad.  Another unintended consequence of having non-expert politicians dictate policy for an industry they don't understand.

Providers should always be profitable.  Without it, not only can they not survive, but we cannot continue to be leaders of healthcare innovation.

That's the balance that needs to be struck.  But by no means are providers taking too much profit.  They are being saddled with too high costs before they cut in to profit.

Coupled with the fixed pricing reimbursement, and you have a system that is ripe for fraud.  You can get about anything covered as long as it's "coded right" on the form.  And, doctors can (and routinely do) encourage unnecessary care because they will be reimbursed, or... they feel it necessary so they aren't sued for lack of care.  Much to clean up in that arena as well.

As most take their myopic look at healthcare, spinning incessantly on about enigmatic buzzwords like so-called "access," they miss the larger influencer of healthcare in our country - health itself.

Simply put... we're very unhealthy, which requires more care.  Our diet is horrible, filled with foods that are inflammatory and diabetes-causing processed oils, grains, and sugars, and other unhealthy processed foods.  In this sense, the health debate converges with the climate debate in that most engaging in the issue completely miss the forest for the trees.  Our healthcare issue is driven by our poor health, just as the climate non-issue is driven by the activity of the sun.  For both topics, we're addressing the wrong things and ignoring the causes.  There's no policy that could possibly address either when most don't even recognize the drivers of those topics.

That's why both get mostly lip service, and the "solutions" that are implemented generally cause more problems and solve nothing at all.

I've been to Europe and Canada.
They eat worse than us and they smoke more.  I witnessed it.  And you don't have to take my word for it, the statistics also say so.
You're just wrong.

You are correct in that most European nations have higher smoking rates than the US, although I don't see where pirkster referenced smoking. However, the smoking rate in Canada is significantly lower than in the US. As far as food consumption, I would agree with pirkster that the US has some of the unhealthiest eating habits in the West, and the statistics do back him up. The US has the 4th highest caloric intake per capita in the world, and the proportion of caloric intake from sugars and fats in the US is significantly greater than other Western nations.
(07-20-2018, 04:55 PM)Gettin\ Jaggy with it Wrote: [ -> ]
(07-20-2018, 01:14 PM)mikesez Wrote: [ -> ]I've been to Europe and Canada.
They eat worse than us and they smoke more.  I witnessed it.  And you don't have to take my word for it, the statistics also say so.
You're just wrong.

You are correct in that most European nations have higher smoking rates than the US, although I don't see where pirkster referenced smoking. However, the smoking rate in Canada is significantly lower than in the US. As far as food consumption, I would agree with pirkster that the US has some of the unhealthiest eating habits in the West, and the statistics do back him up. The US has the 4th highest caloric intake per capita in the world, and the proportion of caloric intake from sugars and fats in the US is significantly greater than other Western nations.

Well at least someone here is looking things up. 
I was going off of experience and what I remembered from looking at statistics years ago. Do you have any links so I can refresh my memory?

In any case, these lifestyle questions are only the first step in determining if Pirkster's story is true. If diet is really making us spend more on health care, you first have to prove (1) our diet is significantly worse, and (2) we spend more days in the hospital and have more specialist visits and take more prescription drugs for reasons tied to diet and lifestyle.
(1) might be true, you might have the data, but
(2) is not true. Western Europeans generally get more care than us.  More doctors visits and more days in hospitals. But they spend less money.
Something else is going on.
(07-20-2018, 11:11 AM)pirkster Wrote: [ -> ]Like most bloated costs, most can be attributed to inefficiency and over regulation.  Many of the mandates in 0bamacare demanded changes that were financially burdensome to providers.  On a side note, the electronic requirements re: documentation have lead to massive identity theft and fraud, exact opposite of what was intended.  That's a topic that deserves a thread of its own, it's been so bad.  Another unintended consequence of having non-expert politicians dictate policy for an industry they don't understand.

Providers should always be profitable.  Without it, not only can they not survive, but we cannot continue to be leaders of healthcare innovation.

That's the balance that needs to be struck.  But by no means are providers taking too much profit.  They are being saddled with too high costs before they cut in to profit.

Coupled with the fixed pricing reimbursement, and you have a system that is ripe for fraud.  You can get about anything covered as long as it's "coded right" on the form.  And, doctors can (and routinely do) encourage unnecessary care because they will be reimbursed, or... they feel it necessary so they aren't sued for lack of care.  Much to clean up in that arena as well.

As most take their myopic look at healthcare, spinning incessantly on about enigmatic buzzwords like so-called "access," they miss the larger influencer of healthcare in our country - health itself.

Simply put... we're very unhealthy, which requires more care.  Our diet is horrible, filled with foods that are inflammatory and diabetes-causing processed oils, grains, and sugars, and other unhealthy processed foods.  In this sense, the health debate converges with the climate debate in that most engaging in the issue completely miss the forest for the trees.  Our healthcare issue is driven by our poor health, just as the climate non-issue is driven by the activity of the sun.  For both topics, we're addressing the wrong things and ignoring the causes.  There's no policy that could possibly address either when most don't even recognize the drivers of those topics.

That's why both get mostly lip service, and the "solutions" that are implemented generally cause more problems and solve nothing at all.

I was a little too harsh on you. at the beginning of your post you mentioned over-regulation. 
that actually is a big part of the problem but, probably not the regulations are thinking of.
In the early nineties the American Medical Association launched a two prong assault on the American Healthcare System. 
First they persuaded Congress to reform Medicare such that a smaller number of residency positions would be subsidized through Medicare. Then they persuaded all of the teaching hospitals that none of them should take on more residents than that. then they persuaded the medical schools that they should reduce the number of students that are being let in so that none of them and up without a residency position at the end.
so next time you go to urgent care and wonder why you have an hour-long late even though you had an appointment, and why there are so few doctors even though doctors make so much money, maybe the truth will come to you.
(07-20-2018, 08:29 PM)mikesez Wrote: [ -> ]
(07-20-2018, 04:55 PM)Gettin\ Jaggy with it Wrote: [ -> ]You are correct in that most European nations have higher smoking rates than the US, although I don't see where pirkster referenced smoking. However, the smoking rate in Canada is significantly lower than in the US. As far as food consumption, I would agree with pirkster that the US has some of the unhealthiest eating habits in the West, and the statistics do back him up. The US has the 4th highest caloric intake per capita in the world, and the proportion of caloric intake from sugars and fats in the US is significantly greater than other Western nations.

Well at least someone here is looking things up. 
I was going off of experience and what I remembered from looking at statistics years ago. Do you have any links so I can refresh my memory?

In any case, these lifestyle questions are only the first step in determining if Pirkster's story is true. If diet is really making us spend more on health care, you first have to prove (1) our diet is significantly worse, and (2) we spend more days in the hospital and have more specialist visits and take more prescription drugs for reasons tied to diet and lifestyle.
(1) might be true, you might have the data, but
(2) is not true. Western Europeans generally get more care than us.  More doctors visits and more days in hospitals. But they spend less money.
Something else is going on.


There are some nice graphics at this Nat Geo link illustrating the diets of several nations. The underlying data source can be clunky but has more information if you wish to spend the time.

Health care in the US is undeniably more expensive, and there are many reasons. And quality health care isn't nearly as accessible for poor Americans as it is for many poor Europeans. However, the biggest reason why the US leads the world in medical innovation is due to the profits the companies can make in the US versus the rest of the world. The amount of money Americans spend on health care helps subsidize the quality of health care in Europe. See this link regarding pharmaceutical profits.
Iirc trump talked about truncating the approval time for FDA approval and also introducing right to try. This could significantly decrease the R&D costs to bring a product to market.
(07-22-2018, 05:51 PM)jj82284 Wrote: [ -> ]Iirc trump talked about truncating the approval time for FDA approval and also introducing right to try.  This could significantly decrease the R&D costs to bring a product to market.

Trump's idea would help, but getting the Medicare trustees to play hardball with the pharma companies on prices would help more.
They do spend a lot of money on research, but lately they have spent more on stock buybacks.  Meanwhile, their dividend yield is much higher than other sectors that are heavy in R and D, like defense or computers.
(07-22-2018, 06:12 PM)mikesez Wrote: [ -> ]
(07-22-2018, 05:51 PM)jj82284 Wrote: [ -> ]Iirc trump talked about truncating the approval time for FDA approval and also introducing right to try.  This could significantly decrease the R&D costs to bring a product to market.

Trump's idea would help, but getting the Medicare trustees to play hardball with the pharma companies on prices would help more.
They do spend a lot of money on research, but lately they have spent more on stock buybacks.  Meanwhile, their dividend yield is much higher than other sectors that are heavy in R and D, like defense or computers.
Medicare already negotiates prices. It is also a Trump agenda to start squeezing big pharma. He has met with two big pharma giants in the last week for this very thing.
(07-22-2018, 06:20 PM)B2hibry Wrote: [ -> ]
(07-22-2018, 06:12 PM)mikesez Wrote: [ -> ]Trump's idea would help, but getting the Medicare trustees to play hardball with the pharma companies on prices would help more.
They do spend a lot of money on research, but lately they have spent more on stock buybacks.  Meanwhile, their dividend yield is much higher than other sectors that are heavy in R and D, like defense or computers.
Medicare already negotiates prices. It is also a Trump agenda to start squeezing big pharma. He has met with two big pharma giants in the last week for this very thing.

They negotiate, yes, but they don't negotiate well.
The kind of discounts that the British other western europeans, and Canadians have been negotiating for themselves for years would surprise you.
There's only so much negotiating u can do when it takes 10 years to approve a drug. That's bureaucratic cost in addition to the actual development of the drug. Computer development doesn't have to deal with that kind of regulatory infrastructure. That's a big reason why so much analytical talent heads to programming instead of organic chemistry.

(07-22-2018, 06:54 PM)mikesez Wrote: [ -> ]
(07-22-2018, 06:20 PM)B2hibry Wrote: [ -> ]Medicare already negotiates prices. It is also a Trump agenda to start squeezing big pharma. He has met with two big pharma giants in the last week for this very thing.

They negotiate, yes, but they don't negotiate well.
The kind of discounts that the British other western europeans, and Canadians have been negotiating for themselves for years would surprise you.

They can only afford to go that low BECAUSE their model is based on recouping their r&d in the domestic market and essentially the other countries free ride for pennies over cost of production.  

Just focusing on reducing price and not th e actual COST to come to market will only lead to shortages and chasing away capital.
(07-22-2018, 06:56 PM)jj82284 Wrote: [ -> ]There's only so much negotiating u can do when it takes 10 years to approve a drug.  That's bureaucratic cost in addition to the actual development of the drug.  Computer development doesn't have to deal with that kind of regulatory infrastructure.  That's a big reason why so much analytical talent heads to programming instead of organic chemistry.

(07-22-2018, 06:54 PM)mikesez Wrote: [ -> ]They negotiate, yes, but they don't negotiate well.
The kind of discounts that the British other western europeans, and Canadians have been negotiating for themselves for years would surprise you.

They can only afford to go that low BECAUSE their model is based on recouping their r&d in the domestic market and essentially the other countries free ride for pennies over cost of production.  

Just focusing on reducing price and not th e actual COST to come to market will only lead to shortages and chasing away capital.

It's tough when you run out of other people's money.
(07-22-2018, 06:56 PM)jj82284 Wrote: [ -> ]There's only so much negotiating u can do when it takes 10 years to approve a drug.  That's bureaucratic cost in addition to the actual development of the drug.  Computer development doesn't have to deal with that kind of regulatory infrastructure.  That's a big reason why so much analytical talent heads to programming instead of organic chemistry.

(07-22-2018, 06:54 PM)mikesez Wrote: [ -> ]They negotiate, yes, but they don't negotiate well.
The kind of discounts that the British other western europeans, and Canadians have been negotiating for themselves for years would surprise you.

They can only afford to go that low BECAUSE their model is based on recouping their r&d in the domestic market and essentially the other countries free ride for pennies over cost of production.  

Just focusing on reducing price and not th e actual COST to come to market will only lead to shortages and chasing away capital.

See above. 
Just look at how much they have been spending on stock buybacks.
The "US funds R&D for the world" thing might have been true at one time but it hasn't been true for a while.  We are just marks for big stock holders now.
(07-22-2018, 07:19 PM)mikesez Wrote: [ -> ]
(07-22-2018, 06:56 PM)jj82284 Wrote: [ -> ]There's only so much negotiating u can do when it takes 10 years to approve a drug.  That's bureaucratic cost in addition to the actual development of the drug.  Computer development doesn't have to deal with that kind of regulatory infrastructure.  That's a big reason why so much analytical talent heads to programming instead of organic chemistry.


They can only afford to go that low BECAUSE their model is based on recouping their r&d in the domestic market and essentially the other countries free ride for pennies over cost of production.  

Just focusing on reducing price and not th e actual COST to come to market will only lead to shortages and chasing away capital.

See above. 
Just look at how much they have been spending on stock buybacks.
The "US funds R&D for the world" thing might have been true at one time but it hasn't been true for a while.  We are just marks for big stock holders now.

The FDA approved the second most new drugs ever in 2017. Clearly Mean Old Big Pharma isn't doing their job.  Rolleyes
(07-22-2018, 07:32 PM)flsprtsgod Wrote: [ -> ]
(07-22-2018, 07:19 PM)mikesez Wrote: [ -> ]See above. 
Just look at how much they have been spending on stock buybacks.
The "US funds R&D for the world" thing might have been true at one time but it hasn't been true for a while.  We are just marks for big stock holders now.

The FDA approved the second most new drugs ever in 2017. Clearly Mean Old Big Pharma isn't doing their job.  Rolleyes

That sounds true, but what does it have to do with my point.  Sure, they are spending a lot on R&D! They are spending more on buybacks.  They're just temporarily boosting their stock price.
(07-22-2018, 07:37 PM)mikesez Wrote: [ -> ]
(07-22-2018, 07:32 PM)flsprtsgod Wrote: [ -> ]The FDA approved the second most new drugs ever in 2017. Clearly Mean Old Big Pharma isn't doing their job.  Rolleyes

That sounds true, but what does it have to do with my point.  Sure, they are spending a lot on R&D! They are spending more on buybacks.  They're just temporarily boosting their stock price.


So your point is that a Corporation isn't supposed to make money? Or that they are doing a good job of both bringing new products to the market AND earning profits for their shareholders? What exactly is your point, that we in America are still shouldering the majority of the costs for all the incredible drugs that are saving and improving lives all around the globe, and, just like with NATO, everyone else is shirking their "fair share"? Because if that last one is your point it's really the only one that makes any kind of sense.
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