Petition to expand Medicare to be the Single Payer Healthcare System for the USA

[vertical_doug]

Fun with numbers...the average person uses 600k of Medicare benefits (I've read that in an investment trade rag, I wish I had the source). At a 2.9% tax rate that is about 20 million in career earnings it would take to pay for what you use. A married person with a non working spouse would need 40mil in earnings to pay for what they use. How many people today who consider themselves pretty well off (even the top 1%) will hit that? Not many.

This onion has a lot of layers. End of life care, tort reform, educational costs etc all need to be addressed. It's all part of where we are at. It's why the term "single payer" is a buzz word that functionally means nothing.

The Lifetime Distribution of Health Care Costs
This is a dated study on Lifetime Distribution of Healthcare. The authors have a somewhat lower number $316,000 (268k Men, 361k women mainly driven by longer life expectancy)

The question is whether your $600k number was billed rate or the reimbursement rate. If the $600K is at a billed rate, the medicare reimbursed rate will be closer to the $300k number and not that far off. But this highlights the real problem, reimbursements rates, non-transparent pricing etc. You can never be sure if you are comparing apples to oranges. Until this is addressed, you really get nowhere and this is precisely what the hospitals don't want to address and lobby against. It leaves the door wide open for abuse.

We keep arguing about who should pay and not about why it costs so much.

[jclay]

Obviously the problems with our healthcare system involve more than our idiotic choice of Balkenized financial mechanisms that rescale the term, but changing to a national single payer system would provide a good framework from which to base other reforms. If you want to know what the term means the I suggest utilizing the links in the first post. And for historical context: We largely ended up with our current system as a result of wage freezes during WWII. Offering HC was a way to increase effective compensation without violating wage laws at the time. And it fed into our Frontier Mentality and fantasy of fierce individuality; still does.

If you were a NASCAR team owner and your team was consistently getting beaten by the same half dozen teams, and the other guys were doing it with smaller budgets which would you do:
A) study how they manage to do it and make changes accordingly or
B) keep listening to your team members tell you why you're really number one, change won't work and then continue doing what you've been doing?

Most other western countries supply world class, cradle to grave health care to their entire populations for approximately 70% of what we pay. In the USA our single payer systems operate with lower administrative costs than commercial insurance companies. One can only imagine the further reduction to costs if we adopted a uniform national HC financial system and rid the HC industry of the Medusa's head of different and opaque reimbursement schedules and differing administrative procedures. Having a system whereby individuals aren't periodically separated from their contributions, where those lifetime contributions remain in tact, would obviously be beneficial.

[Jonathan]

John, you had me before you mentioned NASCAR. I think you're asking all the right questions. I think I mentioned above we will need to get over ourselves to really peel the onion. Was it Winston Churchill who said, "the americans always do what's right when there is no other choice"? Or something like that.

[vertical_doug]

America’s Most Admired Lawbreaker - The Huffington Post

58,000 words on J&J . weekend reading

[ericpmoss]

I'm a believer in letting people who *like* doing economic projections do their thing based on a concrete plan rather than have me guessing about a plan that's not written down.

UMass economist Gerald Friedman did an analysis of Bernie Sanders' single payer health plan. The WSJ said it would cost $18trillion over 10 years, and that was awful. Here's Friedman's response to the WSJ, with links to the WSJ article if you are subscribed, which presumably has links to the original work.

An Open Letter to the Wall Street Journal on Its Bernie Sanders Hit Piece | Gerald Friedman

Based on this (and experience with Mom's end-of-life insurance fiasco), I'd be game.

[ericpmoss]

From the "special place in hell for pasty-faced entitled narcissist douchebag hedge fund manager 'job creator'" file:

http://www.nytimes.com/2015/09/21/bu...smtyp=cur&_r=0

Takes a 62 year old drug (should be no patent at this point) and raises the price from $13.50 a pill to $750. His excuse is that it won't affect many people and it will fund research. Research into tax havens.

He's only one example, but to add to why I fucking hate these kinds of assholes, he lobbied the FDA to not approve the drugs from makers whose stock he was shorting.

[vertical_doug]

From the "special place in hell for pasty-faced entitled narcissist douchebag hedge fund manager 'job creator'" file:

http://www.nytimes.com/2015/09/21/bu...smtyp=cur&_r=0

Takes a 62 year old drug (should be no patent at this point) and raises the price from $13.50 a pill to $750. His excuse is that it won't affect many people and it will fund research. Research into tax havens.

He's only one example, but to add to why I fucking hate these kinds of assholes, he lobbied the FDA to not approve the drugs from makers whose stock he was shorting.

He violated rule number one about making money: be invisible.

Now that he gloated in the NYTIMES, this guy is getting run over by a truck. Hillary picked up on it, and tweeted something needs to be done. It was just timely as she was releasing her healthcare agenda.

Needless to say, the Hillary tweet caused a panic in biotech which sold off 5%. Now healthcare and pharma are selling off in Europe on the back of this.

On the other hand, maybe the guy did the same trade he tried last time. He shorted the industry as he was about to interview and be an asshat. Although in his Bloomberg interview he just appeared to be too stupid and smug to really get it.

[jclay]

From the "special place in hell for pasty-faced entitled narcissist douchebag hedge fund manager 'job creator'" file:

http://www.nytimes.com/2015/09/21/bu...smtyp=cur&_r=0

Takes a 62 year old drug (should be no patent at this point) and raises the price from $13.50 a pill to $750. His excuse is that it won't affect many people and it will fund research. Research into tax havens.

He's only one example, but to add to why I fucking hate these kinds of assholes, he lobbied the FDA to not approve the drugs from makers whose stock he was shorting.

Next time someone bitches to you about the government paying $500 for toilet seats or government inefficiency, trot this ass-wipe out. He deserves to contract some awful, incurable but not fatal diseases. Funding research? How about for starters we cut our military/CIA type foreign adventurism budget in half and plow the savings into medical research? Novel idea. And start voting for folks like Dennis Kucinich, Bernie Sanders and others who aren't corporate shills or warmongers.

Tomdispatch.com

[Christian Fox]

He violated rule number one about making money: be invisible.

Now that he gloated in the NYTIMES, this guy is getting run over by a truck. Hillary picked up on it, and tweeted something needs to be done. It was just timely as she was releasing her healthcare agenda.

Needless to say, the Hillary tweet caused a panic in biotech which sold off 5%. Now healthcare and pharma are selling off in Europe on the back of this.

On the other hand, maybe the guy did the same trade he tried last time. He shorted the industry as he was about to interview and be an asshat. Although in his Bloomberg interview he just appeared to be too stupid and smug to really get it.

Exactly. This stupid douche owns a non-patented drug. Any big pharma company can make a generic in about 10 minutes, sell it for $13.50/pill, have a massive PR goodwill gesture and put this turd out of business at the same time. If that happens, I bet he comes out and says the whole thing was a stunt to highlight the broken system.

[Christian Fox]

Next time someone bitches to you about the government paying $500 for toilet seats or government inefficiency, trot this ass-wipe out. He deserves to contract some awful, incurable but not fatal diseases. Funding research? How about for starters we cut our military/CIA type foreign adventurism budget in half and plow the savings into medical research? Novel idea. And start voting for folks like Dennis Kucinich, Bernie Sanders and others who aren't corporate shills or warmongers.

Tomdispatch.com

I know you're not a market guy, but watch it work it's magic on this turd. He won't last long. On the other hand, we'll always have $500 toilet seats; it's near impossible to root out inefficiency from a system where it's someone else's money being spent and there is no consequence to overspending.

[monadnocky]

From the "special place in hell for pasty-faced entitled narcissist douchebag hedge fund manager 'job creator'" file:

http://www.nytimes.com/2015/09/21/bu...smtyp=cur&_r=0

Takes a 62 year old drug (should be no patent at this point) and raises the price from $13.50 a pill to $750. His excuse is that it won't affect many people and it will fund research. Research into tax havens.

He's only one example, but to add to why I fucking hate these kinds of assholes, he lobbied the FDA to not approve the drugs from makers whose stock he was shorting.

What an unfettered, complete, though-and-through asshole.
Like comic-book level of evil and greed.

[jclay]

I know you're not a market guy, but watch it work it's magic on this turd. He won't last long. On the other hand, we'll always have $500 toilet seats; it's near impossible to root out inefficiency from a system where it's someone else's money being spent and there is no consequence to overspending.

But I AM a market guy, where its the best goods and services mechanism/compromise for people and biz. A nations healthcare simply isn't one of them and there is far too much direct evidence to support the superiority of national health services if cost efficiencies, universal care and high quality are the goal.

And successful private companies I've worked for have done far worse for their clients/customers than $500 toilet seats; like 3 orders of magnitude on a project in low 7-figures in one notable instance. Healthcare ain't like purchasing crackers, or tires.

[vertical_doug]

Why New Drugs Are So Expensive | MIT Technology Review


MIT Technology Review magazine
November/December 2013


WHY IT MATTERS

New drugs can cost hundreds of thousands of dollars a year.

In January 2012, the U.S. Food and Drug Administration approved Kalydeco, the first drug to treat the underlying cause of cystic fibrosis, after just three months of review. It was one of the fastest approvals of a new medicine in the agency’s history. Vertex Pharmaceuticals, which discovered and developed the drug, priced Kalydeco at $294,000 a year, which made it one of the world’s most expensive medicines. The company also pledged to provide it free to any patient in the United States who is uninsured or whose insurance won’t cover it. Doctors and patients enthusiastically welcomed the drug because it offers life-saving health benefits and there is no other treatment. Insurers and governments readily paid the cost.

Several months later, Zaltrap was approved to treat colorectal cancer. The drug was discovered by Regeneron, an emerging biopharmaceutical company like Vertex, but sold by the French drug maker Sanofi. Though it worked no better in clinical trials than Roche’s cancer drug Avastin, which itself adds only 1.4 months to life expectancy for patients with advanced colorectal cancer, Sanofi priced Zaltrap at $11,000 a month, or twice Avastin’s price. Unexpectedly, there was resistance. Doctors at Memorial Sloan-Kettering in New York, one of the world’s leading cancer centers, decided Zaltrap wasn’t worth prescribing. They announced their decision—the first time prominent physicians anywhere had said “Enough” to the introduction of a high-priced cancer drug—on the op-ed page of the New York Times. Three weeks later Sanofi effectively dropped its price by half through rebates to doctors and hospitals. Even so, British health authorities said they would not pay for the treatment.....

[jclay]

I know you're not a market guy, but watch it work it's magic on this turd. He won't last long. On the other hand, we'll always have $500 toilet seats; it's near impossible to root out inefficiency from a system where it's someone else's money being spent and there is no consequence to overspending.

There's something else here, hidden in plain sight; we know about $500 toilet seats and Medicare fraud because of governmental oversight, transparency and prosecution. You don't hear about fraud from your private insurer because they apparently aren't required to disclose such problems, and which one would want be the first to let the investing public know about its problems with same. In my personal example, the consultancy that spent a half million client dollars (net difference re the alternative) on a completely unnecessary sub-system of a 2 million project was spending someone else's money, and the client thought it was a job well done; it works after all, it was just a damn expensive way to move some water. The consultancy certainly won't tell them otherwise. Hell, they think it was a fine approach, too.

Tomdispatch.com

[dogrange]

There's something else here, hidden in plain sight; we know about $500 toilet seats and Medicare fraud because of governmental oversight, transparency and prosecution. You don't hear about fraud from your private insurer because they apparently aren't required to disclose such problems, and which one would want be the first to let the investing public know about its problems with same. In my personal example, the consultancy that spent a half million client dollars (net difference re the alternative) on a completely unnecessary sub-system of a 2 million project was spending someone else's money, and the client thought it was a job well done; it works after all, it was just a damn expensive way to move some water. The consultancy certainly won't tell them otherwise. Hell, they think it was a fine approach, too.

Tomdispatch.com

You don't need to hear about private health industy fraud, we all get to experience it regularly with totally opaque pricing and bills that we get from our insurers with no real recourse to challenge or even find out if the billing was done correctly.

[jclay]

This is just too funny, in a theater of the moronic sort of way, and maddening at the same time.

A colleague recently opined that if allowed free reign to run on its own, market forces would reduce the cost of health care and HC insurance. His key point was the need to create a system that would enhance the individual's incentive to dicker over price with the medical establishment in advance of medical procedures! This is a college grad mind you, someone who has had an education which should have improved his analytical and abstract thinking skills. It reminded me that my previous US representative, an undertaker ironically enough, who proposed similar ideas. Ignoring the economics related to oligopolies and long term, non-commodity services vs. commodity products like crackers and tires, how might that work in a day to day sort of way?

Scenairio 1) Your child needs a nail removed from her eye and you think you're going to negotiate the price, on the spot, with the doctor, ER, pharmaceutical company, etc. You're going to comparison shop between doctors, too.

Scenairio 2) You get peritonitis and you or your wife will have the luxury and knowledge to dicker on price with the ER room, ER doctor, hospital where you get admitted for emergency surgery, surgeon, anesthetist, the lab work and whatever else is involved.

Not surprisingly, I woke up a little dizzy the next morning.

Bernie Sanders has my vote. He gets it and I think has the strength of character to go to the mat on this issue, not cave in to the medical establishment as Obama did.

[Christian Fox]

From the "special place in hell for pasty-faced entitled narcissist douchebag hedge fund manager 'job creator'" file:

http://www.nytimes.com/2015/09/21/bu...smtyp=cur&_r=0

Takes a 62 year old drug (should be no patent at this point) and raises the price from $13.50 a pill to $750. His excuse is that it won't affect many people and it will fund research. Research into tax havens.

He's only one example, but to add to why I fucking hate these kinds of assholes, he lobbied the FDA to not approve the drugs from makers whose stock he was shorting.

Oh, and shock...this piece of shit got hisself arrested for being a fraudulent scumbag.

Martin Shkreli Arrested on Securities Fraud Charges

[Dallas Tex]

What an unfettered, complete, though-and-through asshole.
Like comic-book level of evil and greed.

Nothing of substance to add to the discussion. I'm just shocked that no one told this guy that he doesn't want to be the face of this company. Dude seriously looks like he's from central casting for a despicable dude in a made for TV movie. When I saw the first news clips of this guy, I sincerely thought it was an SNL skit. I wonder how much of this would have happened if he didn't look so evil?

[vertical_doug]

KBIO is the company he orchestrated a short squeeze in last month.
He bought the one-off WuTang Clan album then said he'd let Taylor Swift listen in exchange for sex.
You can steal drug money from Widows and Orphans, but don't diss TaySway. Apple found out the hard way too. No wonder he was arrested.

[roseyscot]

KBIO is the company he orchestrated a short squeeze in last month.
He bought the one-off WuTang Clan album then said he'd let Taylor Swift listen in exchange for sex.
You can steal drug money from Widows and Orphans, but don't diss TaySway. Apple found out the hard way too. No wonder he was arrested.

I suspect he will be in a "federal, pound me in the ass prison" soon enough. Or, dead from suicide.