Random Thoughts (Political Edition)

Our presidency has a two-term limitation. The chancellorship not...

But Merkel is on her last term (the fourth), however this CSU revolt will play out.
 
DanRoM;n3550866 said:
[...]
But Merkel is on her last term (the fourth), however this CSU revolt will play out.

Did she say she will not run again? I must have missed that. I was hoping she would say it after the last election, but I didn't read or hear it ...

prizrak - she could run forever, in theory. Germanys chancellor that has stayed in office the longest was H. Kohl (16 years then voted out), if Merkel stays her whole term, she would have been in office for 16 years too. There has been speculations that she may step aside after half her term, but that's just speculations right now.

And let me add that I am for a term limit of the chancellor in Germany. 3 terms or 12 years should be enough. 16 years (or theoretically longer) is too long IMO. I don't think a 2 term limit (8 years) like the Us- president is long enough for long term stability (2 terms of 5 years, like in France - I could get behind that) - but 16 years is definetly too long.

And update: Germany still has a running government. They muddelt through (that's how the Brits say it?). I am dissapointed. In the End it was all just hot air.
 
prizrak;n3550913 said:
Interesting. I'm all for term limits on everyone, our Congress needs that too

Hear Hear!
 
[No message]
 
Why are we not doing this again?
 
Crypto, did you read the actual story?
The highly critical report found that even doubling all federal individual and corporate income taxes would not cover the costs of Sanders’ Medicare for All plan.

GR/Calvin,
These types of studies can often be misleading in their conclusions simply due to how the system works. The thing to remember is that all insurance plans, no matter whether it's government backed or private negotiates rates with providers. Medicaid/medicare being a government backed plan basically sets the prices at whatever they want and physicians can either accept it or not. The other thing to keep in mind is that due to the way the system works there are massive differences in pricing. Two hospitals in the same zip code could have wildly different pricing for the same type of procedure, those "prices" have only been put in place so that insurance companies can get "discounts", for example when my daughter was born the bill (free for me) was twice what the insurance company actually paid, the rest was a "discount". However if you were to come in for cash the original undiscounted price would be the one you pay.

So it's kind of hard to do a proper cost analysis without having to average things out, which does not give you a complete picture.

The other thing these studies don't look at is how it would impact availability of care, we already have a shortage of doctors, lowering what they can make isn't going to help.

This is anecdotal but my wife's previous employer, a urologist, opted out of all the insurances and went cash only. He also essentially shuttered the urology practice and went into cosmetic medicine, simply because he was making enough money as it is very expensive to run a practice. Mind you this is a busy practice where they would have a jam packed schedule of patients.
 
I came into contact with those inflated prices for treatment only once, suffice to say that I was very happy to have travel health insurance. It was something like $1100 for one relatively simple visit to an American ER... not what you'd call a bargain. As for medication prices, IIRC the German statutory health insurers all negotiate them jointly with the pharmaceutical companies. When the news still reported on that sort of thing (i.e. before Germany's "OMG ALL THOSE BROWN PEOPLE!!!" phase), it sounded like a complicated, but worthwhile effort to me. It's not quite "single-payer" or whatever one chooses to call it, but the combined purchasing power can still be leveraged. That the usual neoliberal suspects would, of course, rather we had no statutory health insurance at all, but at least scrapping it altogether is pretty much unthinkable. It also gives us quite reliable numbers on the amount of money the statutory health insurers spend on medication, which is be helpful if they're interpreted wisely.

As for shortages of doctors, the problem exists all over the world. Small wonder if you consider that studying medicine is extremely difficult, more time-consuming than most other subjects, often very expensive and once you're finished, you tend to work insane hours without making insane amounts of money. That only changes after a long time and if you're lucky. Years ago, I quit medical school at an early stage and am glad that I did because the friends with whom I'm still in contact all encountered difficult working conditions and poor pay. The finance and HR people in healthcare know that the medical and nursing staff are motivated not just by money, but also by altruism, so they exploit that as much as possible. In Germany, med school graduates are also known to work very hard for very limited rewards and complain very little (if at all) because German medical schools are designed to weed out everyone who isn't like that. Combine all those factors and the product can only be a shortage of doctors and nurses.
 
The Government already has it's own bargaining unit within the Medicare system, so I don't see why it would not have it for whatever the new, or expanded system would be.
 
calvinhobbes;n3551934 said:
I came into contact with those inflated prices for treatment only once, suffice to say that I was very happy to have travel health insurance. It was something like $1100 for one relatively simple visit to an American ER... not what you'd call a bargain.
That was pretty cheap then, my daughter busted her eye brow open and the ER bill for sitting there for like 2 hours waiting for 4 stitches was something like 6 grand. Only had to pay the 125 co-pay but still that's an insane amount of money.

As for medication prices, IIRC the German statutory health insurers all negotiate them jointly with the pharmaceutical companies. When the news still reported on that sort of thing (i.e. before Germany's "OMG ALL THOSE BROWN PEOPLE!!!" phase), it sounded like a complicated, but worthwhile effort to me. It's not quite "single-payer" or whatever one chooses to call it, but the combined purchasing power can still be leveraged. That the usual neoliberal suspects would, of course, rather we had no statutory health insurance at all, but at least scrapping it altogether is pretty much unthinkable. It also gives us quite reliable numbers on the amount of money the statutory health insurers spend on medication, which is be helpful if they're interpreted wisely.
As I understand (and I could be entirely wrong) the way the German system works is that you essentially have Obamacare on steroids where the insurance companies are private but everyone has to have insurance, so they do end up having to negotiate prices.

As for shortages of doctors, the problem exists all over the world. Small wonder if you consider that studying medicine is extremely difficult, more time-consuming than most other subjects, often very expensive and once you're finished, you tend to work insane hours without making insane amounts of money. That only changes after a long time and if you're lucky. Years ago, I quit medical school at an early stage and am glad that I did because the friends with whom I'm still in contact all encountered difficult working conditions and poor pay. The finance and HR people in healthcare know that the medical
and nursing staff are motivated not just by money, but also by altruism, so they exploit that as much as possible. In Germany, med school graduates are also known to work very hard for very limited rewards and complain very little (if at all) because German medical schools are designed to weed out everyone who isn't like that. Combine all those factors and the product can only be a shortage of doctors and nurses.
I don't see how that's a good thing, after all does it matter that you have health insurance when you can't see a doctor when you need to?

GRtak;n3551937 said:
The Government already has it's own bargaining unit within the Medicare system, so I don't see why it would not have it for whatever the new, or expanded system would be.
It doesn't have a bargaining unit, it sets prices, with no regard for regional differences I might add. Why would one expect an expanded system to be any different.

Healthcare is an extremely complex issue and the idea that there is some sort of a simple solution like expanding medicare to everyone would fix everything is at best overly optimistic.

A little more on prices of prescription drugs, there is an idea, and I haven't looked into it enough to be 100% sure, that US basically carries all the pharmaceutical RnD because we don't regulate prices like other countries. So sure Germans and Canadians pay much less for prescription drugs, but it's the US prices that make development of those drugs actually possibly. Now like I said I haven't done any concrete research into this, it's just something that sounds logical.
 
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Healthcare is complex, and yet we lag behind with getting basic care to the most vulnerable and seem to act as if that does not matter.

If you want to talk about pharmaceutical RnD, the US government pays for most of it, with the big pharma companies paying a small portion and keeping all the profits.
 
GRtak;n3551955 said:
Healthcare is complex, and yet we lag behind with getting basic care to the most vulnerable and seem to act as if that does not matter.
That's wildly inaccurate, plenty of people propose all kinds of solutions, Obamacare being one of those. However one of the biggest factors in price inflation that is pricing so many people out of health care is the fact that someone else is paying for it.

Adam Ruins Everything covers it better than I could:

I'm not saying that current system is good in any way, but the suggestion that "let's have government pay for everything" is far from a proper solution.

If you want to talk about pharmaceutical RnD, the US government pays for most of it, with the big pharma companies paying a small portion and keeping all the profits.
Source?
 
Why does all of Europe have healthcare when we don't? How has Canada figured it out, yet we have not?
 
GRtak;n3551959 said:
Why does all of Europe have healthcare when we don't? How has Canada figured it out, yet we have not?

Have they figured it out though? Jim can chime in on Canada but the doctors I know who worked in Europe (different countries) say that there are massive wait lists and that people have a hard time getting care. Hell just look at calivinandhobbes's post above about Germany. UK's system seems to be pretty fucked from what I remember reading of it. Having "insurance" is not helpful if you can't get care when you need it, I know this first hand when I couldn't get an appointment with an ortho for a fucked up knee any sooner than a month out.

P.S. My wife works in the medical field, so I have a bit more exposure to the other side of healthcare.
 
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