Seniors lounge (over 50) come on in.

movdqa

Talk Tennis Guru
Don’t really understand, what you are asking. My post was in relation to the Novartis case in India.

Anyway, it seems that the charity part of a meds company is not approved by someone. I think it is wonderfull, considering the market and supply in that market.

I was only conserned, of the charity part. Some seemed to get pissed off, by the idea of a med lab company giving their products to charity, which is really controvercy to, what I am seeing in CBS Golf Chanel and other proadcastings from US, where celebs shine in the spotlight organizing an event to support schools for special kids and childrens hospitals.


——————————
No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
I'm not sure who kept complaining about med labs but I get annoyed when people point fingers without specifics.

Shouldn't need charity to buy drugs.
 

movdqa

Talk Tennis Guru
The Pharmas lobbied to make that illegal.
I don't see what could be done about it.

WRT to expensive dentistry - my understanding is that people just do medical tourism. Mexico seems to be a destination for inexpensive dental work. Some go to India or Taiwan. The market at work.
 

Curiosity

Professional
The Pharma executive may have a lot of stuff already in place but he reports to the BoD and the BoD and shareholders demand profits from management. If an executive doesn't understand that and produce profits, he's fired.

The uninsured rate in MA is 2.8%. Figure out how they did that and expand it to the rest of the country. Maybe ask Mitt Romney to work on it.

Crowns? My guy charged $250 to $1,000 for crowns depending on difficulty. Do you charge based on value to the customer or based on lower cost?

I had a bunch of amalgam fillings replaced with porcelain. If we want a cheap solution, go with amalgam.
If you received a porcelain crown for less that $900, you were the extremely rare exception. For a temporary crown, $260 is normal.

MA laws and tax rates explain their coverage rates: "Massachusetts has the highest rate of insured residents of any state in the country - 95 percent of adults 18 to 65 years old and 98 percent of children - largely thanks to the state's health care reform law passed a decade ago. The law required all adults to have health insurance and all companies with more than 10 full-time employees to offer it." Force them to by one of the offered plans on penalty of large fines, and they'll buy it. Surprise! Annual Deductibles have doubled over the last ten years. The main reason MA residents pay less of their income for healthcare is that MA salaries are, on average, higher than most of the nation.

Let me guess: You work in a field adjuct to medicine (physical therapy or similar) covered by Medicare and most insurers?
Many in medicine and medicine related fields "start a business." I've created a number of LLCs for them. The risk is typically zero, though margins may vary short-term. These are typically started in order to raise income, not lower it. Did I mention how many physicians sold their practices to HMOs in the 1990s, then, a few years later, bought them back for a much lower price? Have I mentioned that the for-profit practices of physicians are, more often than not, housed in un-taxed non-profit hospitals? Have I mentioned that almost every physician I know hates the insurance companies, and considers them leeches? Our medical consumers been thoroughly ***** by the fact that the medical consumer has no organization with sufficient money to counter the lobbies of Pharma and the practitioners. It's that simple. It got this way because of the massive "tax-expenditure" provisions initiated during WWII, initiated for nothing having to do with commercial or consumer rationality. For the first forty years thereafter those with insurance (every prosperous person) had good reason to shut up and smile.
 

movdqa

Talk Tennis Guru
I actually doubt most people are happy with their health insurance ... particularly those who can't afford it. I think there is a big difference between being afraid of the replacement, and being happy with their current health insurance. Yes ... if you have access to good policies ... and you make enough ... you can weather the $2000-$4000 yearly caps. But my guess is the vast majority live in fear of having to go to the hospital and waiting for the copay bill. What else in our free market do we buy and not really know how much it costs until you are told what it costs.

But I think the main point here is many of us think 1) there be a lot of bad pricing behavior going on that would should questiond/fixed ... 2) and you thinking it's all about right, fair and expected. That's all this comes down to.

I really don't think most people are happy with insurance companies. If they are ... just wait. 8-B

Good discussion ... I always learn a lot from you. I don't like it when it ends up like piling on ... hope you just enjoy a good debate also. (y)

Edit: you want to know who isn't usually happy with the insurance companies ... doctors and pharmacist that have to deal with them every single day. Go talk to a few of them.
Doctors, pharmacists and hospitals have been made villains in this thread.

What you have happening is that doctors groups are joining hospital groups to leverage EMR, billing and coverage.

The Gallop Poll has Americans reporting as being happy with their healthcare. That poll has influenced the Presidential candidates.
 

Pete Player

Hall of Fame
I'm not sure who kept complaining about med labs but I get annoyed when people point fingers without specifics.

Shouldn't need charity to buy drugs.
Yes, the drugs. Different from medicine. But the words used the same anyway sometimes.

Did not mean any of the illegal stuff, but meds (not meths) for cancer.


——————————
No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
 

movdqa

Talk Tennis Guru
Doctors, pharmacists and hospitals have been made villains in this thread.

What you have happening is that doctors groups are joining hospital groups to leverage EMR, billing and coverage.

The Gallop Poll has Americans reporting as being happy with their healthcare. That poll has influenced the Presidential candidates.
This is why you have "Medicare For All [who want it]" understanding that most are happy with what they have now.
 

movdqa

Talk Tennis Guru
"Good discussion ... I always learn a lot from you. I don't like it when it ends up like piling on ... hope you just enjoy a good debate also."

I have experience debating forums (as in everyone in the forum).
 

ByeByePoly

G.O.A.T.
Doctors, pharmacists and hospitals have been made villains in this thread.

What you have happening is that doctors groups are joining hospital groups to leverage EMR, billing and coverage.

The Gallop Poll has Americans reporting as being happy with their healthcare. That poll has influenced the Presidential candidates.
Absolutely not ... no people are villains ... good people in bad systems. My wife works at an insurance company ... she is no villain ... usually. 8-B
 

movdqa

Talk Tennis Guru
If you received a porcelain crown for less that $900, you were the extremely rare exception. For a temporary crown, $260 is normal.

MA laws and tax rates explain their coverage rates: "Massachusetts has the highest rate of insured residents of any state in the country - 95 percent of adults 18 to 65 years old and 98 percent of children - largely thanks to the state's health care reform law passed a decade ago. The law required all adults to have health insurance and all companies with more than 10 full-time employees to offer it." Force them to by one of the offered plans on penalty of large fines, and they'll buy it. Surprise! Annual Deductibles have doubled over the last ten years. The main reason MA residents pay less of their income for healthcare is that MA salaries are, on average, higher than most of the nation.

Let me guess: You work in a field adjuct to medicine (physical therapy or similar) covered by Medicare and most insurers?
Many in medicine and medicine related fields "start a business." I've created a number of LLCs for them. The risk is typically zero, though margins may vary short-term. These are typically started in order to raise income, not lower it. Did I mention how many physicians sold their practices to HMOs in the 1990s, then, a few years later, bought them back for a much lower price? Have I mentioned that the for-profit practices of physicians are, more often than not, housed in un-taxed non-profit hospitals? Have I mentioned that almost every physician I know hates the insurance companies, and considers them leeches? Our medical consumers been thoroughly ***** by the fact that the medical consumer has no organization with sufficient money to counter the lobbies of Pharma and the practitioners. It's that simple. It got this way because of the massive "tax-expenditure" provisions initiated during WWII, initiated for nothing having to do with commercial or consumer rationality. For the first forty years thereafter those with insurance (every prosperous person) had good reason to shut up and smile.
I replaced a ton of stuff over a period of ten years. But a lot of things in my state are inexpensive. My dentist had a Cerac machine in the 1990s. He told me that he was one of two dentists in the state with the technology. He has always been a rapid adopter of technology. Insurance didn't really cover the procedures so I paid it out of pocket over ten years - a few at a time. Unfortunately he retired and the dentist that took over the business doesn't do Cerac any longer - she sends the work out. One thing about the porcelain though - the performance is far, far better than Amalgam. The new dentist does have 3-d imaging technology to match upper teeth with lower teeth. We'll see how well that technology works out in the future. Though I hope that I don't need any of it. I've found that the porcelain stuff just about lasts forever.
 

Curiosity

Professional
I don't see what could be done about it.

WRT to expensive dentistry - my understanding is that people just do medical tourism. Mexico seems to be a destination for inexpensive dental work. Some go to India or Taiwan. The market at work.
My PCP's parents go back to South Korea for dental work. Why should that be necessary? Are too few Americans willing to become dentists? Has the industry systematically sought to prevent new dental schools from opening? (The answer is "yes.") Does the dental industry cheer when a dental school closes, as Georgetown Univ.'s did thirty years ago...because the building was sought at a high lease price by an Italian Pharma company? Has the dental industry vigorously fought attempts to allow dental hygienists to practice independently? Yes. Have they fought (with political contributions) the legalizing of "denturists"? Yes. And who doesn't care about all this low-end-dentistry blocking. Why, the prosperous, who likely had good dental hygiene and care as children and adolescents. We don't need the cheaper services. The poor surely do.
 

Curiosity

Professional
I replaced a ton of stuff over a period of ten years. But a lot of things in my state are inexpensive. My dentist had a Cerac machine in the 1990s. He told me that he was one of two dentists in the state with the technology. He has always been a rapid adopter of technology. Insurance didn't really cover the procedures so I paid it out of pocket over ten years - a few at a time. Unfortunately he retired and the dentist that took over the business doesn't do Cerac any longer - she sends the work out. One thing about the porcelain though - the performance is far, far better than Amalgam. The new dentist does have 3-d imaging technology to match upper teeth with lower teeth. We'll see how well that technology works out in the future. Though I hope that I don't need any of it. I've found that the porcelain stuff just about lasts forever.
Agree that the Siemens-built machines were excellent. My dentist bought one ($50,000) but discontinued its use because of maintenance issues. He also found too many clients (!) were unwilling to pay for porcelain once polymer white filling material became available.
 

movdqa

Talk Tennis Guru
Oh ... just think how inefficient they could be and still be cheaper than what we pay big pharma. I think the same thing about oil production when the price per barrel gets high enough. We were sold a bill of goods {pun intended} when they told us everything in our life/society had to be outsourced and priced by the private sector. Cars ... of course, healthcare and insurance ... of course not. Now ... that is different than not using the efficiency of the private market to your advantage. Just plug it in where you can ... where it offers advantage, but the market should be treated as the tool ... not us.
There's a saying in commodities markets: the solution to high prices is high prices.

High prices made shale economic. So we're now making 12.4 million barrels per day and even exporting some of it. We're making so much of it that ROPEC has cut back production so that prices don't collapse. And the market dictates that the shale companies further drive down costs. The oil market does actually work really well despite a cartel designed to maximize prices. Nothing like good old government controls to raise prices and crowd out the competition.
 

Curiosity

Professional
If it were that big a problem, I'd just go to another country and buy the stuff. And then you'd have arbitrage and the prices would come down.
Such arbitrage is generally in violation of US law. People have begun to flout the law, especially regarding car trips to Canada. Nonetheless, the spirit of American Pharma is to fight that sort of activity tooth-and-claw. I always bring back a variety of OTC things such as Ibuprophene (not Ibuprophen) when I return from Spain each year. Not legal for sale here, but approved in Europe, faster-acting and very cheap.
 

Curiosity

Professional
I don't see what could be done about it.

WRT to expensive dentistry - my understanding is that people just do medical tourism. Mexico seems to be a destination for inexpensive dental work. Some go to India or Taiwan. The market at work.
That is not "the market at work." That is US residents having to pursue extreme measures because the market in the US is heavily rigged by industry-purchased statutes and congressional (tax-payer) coverage of many large industry costs.
 

movdqa

Talk Tennis Guru
And they have done it for other substances.
——————————
No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
It's done for textbooks too. I was in Singapore a long time ago and walked into a college bookstore and recognized the US textbooks there and bought one or two at one-third the price in US college bookstores or on Amazon. I immediately thought that it would be a great arbitrage opportunity but I wasn't going to fit a dozen of them in my luggage. The books also had some words to the effect that they couldn't be sold in the US. But they were anyways as other enterprising people figured this out. Sometimes you could get the books through Amazon even though they weren't supposed to. I imagine that there were back channels that worked.

I would just hop on a bus or drive to Montreal if I had to buy something there that was unreasonable here.
 

movdqa

Talk Tennis Guru
My PCP's parents go back to South Korea for dental work. Why should that be necessary? Are too few Americans willing to become dentists? Has the industry systematically sought to prevent new dental schools from opening? (The answer is "yes.") Does the dental industry cheer when a dental school closes, as Georgetown Univ.'s did thirty years ago...because the building was sought at a high lease price by an Italian Pharma company? Has the dental industry vigorously fought attempts to allow dental hygienists to practice independently? Yes. Have they fought (with political contributions) the legalizing of "denturists"? Yes. And who doesn't care about all this low-end-dentistry blocking. Why, the prosperous, who likely had good dental hygiene and care as children and adolescents. We don't need the cheaper services. The poor surely do.
Probably something for the FTC to look at.

There are cheaper services for the poor. To the point of Medicaid Fraud.
 

movdqa

Talk Tennis Guru
Agree that the Siemens-built machines were excellent. My dentist bought one ($50,000) but discontinued its use because of maintenance issues. He also found too many clients (!) were unwilling to pay for porcelain once polymer white filling material became available.
The polymer stuff doesn't perform as well but it is fast and easy. It also doesn't work in a lot of cases where the material has to be supportive. I think that most people use the cheaper solutions and would doubt that Medicaid covers porcelain.
 

movdqa

Talk Tennis Guru
That is not "the market at work." That is US residents having to pursue extreme measures because the market in the US is heavily rigged by industry-purchased statutes and congressional (tax-payer) coverage of many large industry costs.
That's what the FTC is for - to smash monopolies. It's harder to do, of course, when monopolies have political support.

But you have things like this in every country and society.
 

movdqa

Talk Tennis Guru
Yes, the drugs. Different from medicine. But the words used the same anyway sometimes.

Did not mean any of the illegal stuff, but meds (not meths) for cancer.


——————————
No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
So you mean pharmas?

Med labs could be anything. Could be pathology, labs that do blood work, etc.
 

movdqa

Talk Tennis Guru
If you received a porcelain crown for less that $900, you were the extremely rare exception. For a temporary crown, $260 is normal.

MA laws and tax rates explain their coverage rates: "Massachusetts has the highest rate of insured residents of any state in the country - 95 percent of adults 18 to 65 years old and 98 percent of children - largely thanks to the state's health care reform law passed a decade ago. The law required all adults to have health insurance and all companies with more than 10 full-time employees to offer it." Force them to by one of the offered plans on penalty of large fines, and they'll buy it. Surprise! Annual Deductibles have doubled over the last ten years. The main reason MA residents pay less of their income for healthcare is that MA salaries are, on average, higher than most of the nation.

Let me guess: You work in a field adjuct to medicine (physical therapy or similar) covered by Medicare and most insurers?
Many in medicine and medicine related fields "start a business." I've created a number of LLCs for them. The risk is typically zero, though margins may vary short-term. These are typically started in order to raise income, not lower it. Did I mention how many physicians sold their practices to HMOs in the 1990s, then, a few years later, bought them back for a much lower price? Have I mentioned that the for-profit practices of physicians are, more often than not, housed in un-taxed non-profit hospitals? Have I mentioned that almost every physician I know hates the insurance companies, and considers them leeches? Our medical consumers been thoroughly ***** by the fact that the medical consumer has no organization with sufficient money to counter the lobbies of Pharma and the practitioners. It's that simple. It got this way because of the massive "tax-expenditure" provisions initiated during WWII, initiated for nothing having to do with commercial or consumer rationality. For the first forty years thereafter those with insurance (every prosperous person) had good reason to shut up and smile.
I'm a software engineer working in big-cap tech company that makes infrastructure software.

I generally don't try to infer or impute work as a potential pejorative. People often have interests and expertise in areas outside their work domain.

I do appreciate the high quality of care in Massachusetts.

I am aware of the HMO situation in the 1990s as I saw how people worked with them. I had an HMO for several years and recall arguing with them over a coverage issue and I had to escalate up several levels of management to get a resolution. It's the ultimate in narrow networks.

I haven't seen complaints by doctors about their hospitals or insurance companies. I sometimes ask sensitive questions on what they think of the healthcare system and where it is going. They are generally concerned. I'd have to say that I have been treated well by my insurance company, doctors, hospitals, nurses and others through my major illness and illnesses by my relatives.
 

Pete Player

Hall of Fame
Absolutely not ... no people are villains ... good people in bad systems. My wife works at an insurance company ... she is no villain ... usually. 8-B
A viper anyway?


——————————
No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
 

Curiosity

Professional
I'm a software engineer working in big-cap tech company that makes infrastructure software.

I generally don't try to infer or impute work as a potential pejorative. People often have interests and expertise in areas outside their work domain.

I do appreciate the high quality of care in Massachusetts.

I am aware of the HMO situation in the 1990s as I saw how people worked with them. I had an HMO for several years and recall arguing with them over a coverage issue and I had to escalate up several levels of management to get a resolution. It's the ultimate in narrow networks.

I haven't seen complaints by doctors about their hospitals or insurance companies. I sometimes ask sensitive questions on what they think of the healthcare system and where it is going. They are generally concerned. I'd have to say that I have been treated well by my insurance company, doctors, hospitals, nurses and others through my major illness and illnesses by my relatives.
Didn't think of the "pejorative" aspect, though I see it now. I primarily was simply seeking an explanation for so many supportive comments for the financial arrangements of the US healthcare system, which is unjust compared to any other developed nation. It is true, though, that both the people who work for large companies and government employees (of all types) seem loathe to see change. Understandable. Perhaps half of my local friends are physicians, and they all seem to feel the insurers take more than twice the value they deliver. I personally do not know the facts of that complicated assessment. The system as-is continues because slightly more than 50% of families are covered by the two happy groups.

IBM retirees were very happy with their IBM retirement health insurance...right up until IBM realized they could abrogate their agreements and dump the lot of them onto the ACA "Marketplace," together with a 5k payment. It represents a huge loss to the retirees. The concept is catching on. Expect to see many companies show ongoing (if quiet) support for the ACA.

I do know that my "gold plated" privately-purchased family health policy was nixed by the ACA. I also know that my start-to-finish C treatments, including surgery, didn't cost (to my current insurer) more than three times the annual premiums I'd been paying for more than twenty-eight years.

I noticed that President Trump today advocated legalizing US resident purchases of meds from Canada, at Canadian prices. That's a start. The Big Pharma industry was up in arms by 5 p.m. EST.

I don't have all the answers, but do not expect the current arrangements to last. I pay school taxes and tuitions with after-tax money. There is no reason health insurance policy payments by either employer or employee should be untaxed income.
 
Last edited:

movdqa

Talk Tennis Guru
"Didn't think of the "pejorative" aspect, though I see it now. I primarily was simply seeking an explanation for so many supportive comments for the financial arrangements of the US healthcare system, which is unjust compared to any other developed nation. It is true, though, that both the people who work for large companies and government employees (of all types) seem loathe to see change. Understandable. Perhaps half of my local friends are physicians, and they all seem to feel the insurers take more than twice the value they deliver. I personally do not know the facts of that complicated assessment. The system as-is continues because slightly more than 50% of families are covered by the two happy groups."

It's a very common ad hominem approach to a debate. But let's look at the operating margins of a few companies since it's always a better approach to look at actual data than just randomly declare someone else as the villain:

United Healthcare: 7.91%
Microsoft: 34%
Apple Computer: 25%
Facebook: 34%
McDonalds: 42%
WalMart: 4%
Target: 6%
Starbucks: 15%
Comcast: 19%
Disney: 23%
Visa: 66%
Verizon: 24%
IBM: 15%
Home Depot: 15%
Goldman Sachs: 12%
Valero Energy: 3.49%
Taco Bell, Kentucky Fried Chicken, Pizza Hut, Long John Silvers: 32%

So we're all quite content to pay large margins for fast food, cable television, smartphone service, computer hardware, credit card processors, banks and home maintenance companies than we are for healthcare because they are evil and some doctors think that they make too much money. Perhaps you could ask your doctor friends as to what their margins are.

If you or someone else thinks that some company or group is making too much money, put up the facts. Or you're just making an unfounded accusation thereby damaging reputation without cause. And contributing false evidence to a debate.

And let's use the facts from the Gallop Poll; not a misrepresentation: Majorities rate quality (80%) and coverage (69%) as excellent or good (https://news.gallup.com/poll/245195/americans-rate-healthcare-quite-positively.aspx).

Your claim is that only people working for large companies and government employees are happy with their healthcare.

Boston, MA – Enrollees in Medicaid reported in a nationwide survey that they’re largely satisfied with the health care they receive under the program, according to researchers at Harvard T.H. Chan School of Public Health. Most Medicaid enrollees said that they have good access to physicians, while few reported any barriers to accessing care due to their Medicaid insurance. https://www.hsph.harvard.edu/news/press-releases/survey-finds-medicaid-enrollees-satisfied-with-coverage-physician-access/



"IBM retirees were very happy with their IBM retirement health insurance...right up until IBM realized they could abrogate their agreements and dump the lot of them onto the ACA "Marketplace," together with a 5k payment. It represents a huge loss to the retirees. The concept is catching on. Expect to see many companies show ongoing (if quiet) support for the ACA."

I personally don't understand how anyone looking at retirement or in retirement isn't aware of the pressures to reduce retiree costs, whether in private, non-profit or government pensions. Pensions were popular when we had shorter life-expectancies and medical care cost less (part of the reason for lower life-expectancies). IBM hasn't been exactly employee friendly since the 1990s. But that's IBM. But, as with many things, some organizations are funding their pensions properly while some aren't. Most states aren't. They use fictional accounting so that they don't have to raise taxes to reach responsible funding levels.

I'm doing the early retirement thing and will eventually be on an ACA plan. I've checked the plans in my state and they are quite good - considerably better than they were a few years ago.

"I do know that my "gold plated" privately-purchased family health policy was nixed by the ACA. I also know that my start-to-finish C treatments, including surgery, didn't cost (to my current insurer) more than three times the annual premiums I'd been paying for more than twenty-eight years."

I'm similar. I never used medical services and then got hit with Cancer. But payment and benefits are year-to-year. So that is inconsequential.

"I noticed that President Trump today advocated legalizing US resident purchases of meds from Canada, at Canadian prices. That's a start. The Big Pharma industry was up in arm by 5 p.m. EST. "

Big Pharma has been under political attack from both parties. It's been an area to keep away from as far as investing goes as one tweet or press conference or debate can tank your stock in an instant.

"I don't have all the answers, but do not expect the current arrangements to last. I pay school taxes and tuitions with after-tax money. There is no reason health insurance policy payments by either employer or employee should be untaxed income."

I'd have to think about the accounting on that one. If it were a larger expense to employers, then they could simply write it off as an expense. I don't really think that it's in danger politically. You saw the level of protest against the removal of SALT deductability but it got passed anyways. The reasoning is that it benefited the wealthy. If you go after government employees healthcare, you're going to have the unions up in arms - basically both parties up in arms over it. And voting constituencies that traditionally turn out to vote.
 

Curiosity

Professional
Why isn't food, drink, shelter, clothing and clean toilets part of health insurance?

Must as well through in college, and grad school too.
It is curious to note that hearing aids are not covered by health insurance and the ACA, but that Viagra is. So it's less important that you can hear than that you can, well, you know...
 

Curiosity

Professional
It is curious to note that hearing aids are not covered by health insurance and the ACA, but that Viagra is. So it's less important that you can hear than that you can, well, you know...
OK, it took me a minute, but now I get it: The theory must be that if a husband can't hear but can, well, do that, then more marriages might last longer? (NPI)
 

movdqa

Talk Tennis Guru
It is curious to note that hearing aids are not covered by health insurance and the ACA, but that Viagra is. So it's less important that you can hear than that you can, well, you know...
It goes to show the ridiculousness of wanting others to cover your costs for subjectively necessary things.

Insurance is supposed to cover losses.
 

ByeByePoly

G.O.A.T.
OK, it took me a minute, but now I get it: The theory must be that if a husband can't hear but can, well, do that, then more marriages might last longer? (NPI)
Yeah ... after a lot of years of marriage, both would benefit from periods of “sorry ... I didn’t hear what you said”.

A silent horny wife ... that’s living the dream man ... assuming she also can’t read (ttw posts).

:-D
 

ByeByePoly

G.O.A.T.
"Didn't think of the "pejorative" aspect, though I see it now. I primarily was simply seeking an explanation for so many supportive comments for the financial arrangements of the US healthcare system, which is unjust compared to any other developed nation. It is true, though, that both the people who work for large companies and government employees (of all types) seem loathe to see change. Understandable. Perhaps half of my local friends are physicians, and they all seem to feel the insurers take more than twice the value they deliver. I personally do not know the facts of that complicated assessment. The system as-is continues because slightly more than 50% of families are covered by the two happy groups."

It's a very common ad hominem approach to a debate. But let's look at the operating margins of a few companies since it's always a better approach to look at actual data than just randomly declare someone else as the villain:

United Healthcare: 7.91%
Microsoft: 34%
Apple Computer: 25%
Facebook: 34%
McDonalds: 42%
WalMart: 4%
Target: 6%
Starbucks: 15%
Comcast: 19%
Disney: 23%
Visa: 66%
Verizon: 24%
IBM: 15%
Home Depot: 15%
Goldman Sachs: 12%
Valero Energy: 3.49%
Taco Bell, Kentucky Fried Chicken, Pizza Hut, Long John Silvers: 32%

So we're all quite content to pay large margins for fast food, cable television, smartphone service, computer hardware, credit card processors, banks and home maintenance companies than we are for healthcare because they are evil and some doctors think that they make too much money. Perhaps you could ask your doctor friends as to what their margins are.

If you or someone else thinks that some company or group is making too much money, put up the facts. Or you're just making an unfounded accusation thereby damaging reputation without cause. And contributing false evidence to a debate.

And let's use the facts from the Gallop Poll; not a misrepresentation: Majorities rate quality (80%) and coverage (69%) as excellent or good (https://news.gallup.com/poll/245195/americans-rate-healthcare-quite-positively.aspx).

Your claim is that only people working for large companies and government employees are happy with their healthcare.

Boston, MA – Enrollees in Medicaid reported in a nationwide survey that they’re largely satisfied with the health care they receive under the program, according to researchers at Harvard T.H. Chan School of Public Health. Most Medicaid enrollees said that they have good access to physicians, while few reported any barriers to accessing care due to their Medicaid insurance. https://www.hsph.harvard.edu/news/press-releases/survey-finds-medicaid-enrollees-satisfied-with-coverage-physician-access/



"IBM retirees were very happy with their IBM retirement health insurance...right up until IBM realized they could abrogate their agreements and dump the lot of them onto the ACA "Marketplace," together with a 5k payment. It represents a huge loss to the retirees. The concept is catching on. Expect to see many companies show ongoing (if quiet) support for the ACA."

I personally don't understand how anyone looking at retirement or in retirement isn't aware of the pressures to reduce retiree costs, whether in private, non-profit or government pensions. Pensions were popular when we had shorter life-expectancies and medical care cost less (part of the reason for lower life-expectancies). IBM hasn't been exactly employee friendly since the 1990s. But that's IBM. But, as with many things, some organizations are funding their pensions properly while some aren't. Most states aren't. They use fictional accounting so that they don't have to raise taxes to reach responsible funding levels.

I'm doing the early retirement thing and will eventually be on an ACA plan. I've checked the plans in my state and they are quite good - considerably better than they were a few years ago.

"I do know that my "gold plated" privately-purchased family health policy was nixed by the ACA. I also know that my start-to-finish C treatments, including surgery, didn't cost (to my current insurer) more than three times the annual premiums I'd been paying for more than twenty-eight years."

I'm similar. I never used medical services and then got hit with Cancer. But payment and benefits are year-to-year. So that is inconsequential.

"I noticed that President Trump today advocated legalizing US resident purchases of meds from Canada, at Canadian prices. That's a start. The Big Pharma industry was up in arm by 5 p.m. EST. "

Big Pharma has been under political attack from both parties. It's been an area to keep away from as far as investing goes as one tweet or press conference or debate can tank your stock in an instant.

"I don't have all the answers, but do not expect the current arrangements to last. I pay school taxes and tuitions with after-tax money. There is no reason health insurance policy payments by either employer or employee should be untaxed income."

I'd have to think about the accounting on that one. If it were a larger expense to employers, then they could simply write it off as an expense. I don't really think that it's in danger politically. You saw the level of protest against the removal of SALT deductability but it got passed anyways. The reasoning is that it benefited the wealthy. If you go after government employees healthcare, you're going to have the unions up in arms - basically both parties up in arms over it. And voting constituencies that traditionally turn out to vote.
Does margins show us how much it costs?
 

movdqa

Talk Tennis Guru
Does margins show us how much it costs?
I took several accounting and finance courses in undergrad. I recommend that traders and investors and others who want to do analysis on companies, government and non-profits, to take at least Accounting 101 and Finance 101 so that you can read accounting statements and reports and make judgements about companies, organizations and governments and do comparisons between systems.
 

ChaelAZ

Legend
Last few seasons I've been asked to jump back in various league, including the 4.0 group, but honestly I felt physically I wasn't up to it (so of course mentally I didn't think I was back up to level). Many fof my past teammates started a new 18's 4.0 team, and they finally dragged me out on court last night for a match.

I think sometimes I just get stuck in my own head thinking if I am not playing my best tennis that I am bad, so it was nice to be able to hang with them and I was surprised at how good the tennis was all around. I've played the 4.0 Flex leagues the last year and I call that the "Whose Line is it Anyway" of leauge play, where rating seem made up on the results really don't matter. That is, of all the 4.0 play I had I would say less than half were truly a 4.0 level of competitiveness. Not the biggest confidence builder. Last night though...this was a solid, match.

1st set everyone was a bit rusty so it was round and round of everyone holding serves and very little point action. I was playing with my old partner (he has still been playing 4.0 so was much sharper than me) and we clicked fairly well. We took the first set 6/4 or 7/5 (don't recall). Second set everyone started getting the groundy and net play groove back so a lot of solid points and we lost the second set 3/6. We blocked 2 hours out so decided to play the third set, even with the 90+ degrees and 40% humidty. We took the thrid set 6/2 but everyone was a little weary. We just served spots well.

For me, I was really happy with things overall. Oddly, I am usually spot on and banging return of serve and I swear I was only like 60% in, so not sure what was up with that. Actually everyone was a bit off overall, so I didn't feel too bad about it. Also, having not played a ton of higher level doubles lately, I was a bit crazy Ivan about crashing the net....a bit TOO much. I knew I needed to get to the net more often to fnish points, but being rusty my mid court volley approach wasn't strong enough, or I was just outright coming in when I should have setup one more shot before approaching. My partner was laughing because he kept fading back too much, so we were whack on positioning and having to compensate a lot.

I was really happy with my net work and volleys though, including a good 5 or 6 touch volley/drop shots that were oh-so-sweet. That was countered by our oppoents with a few of their own, but some amazing angled dipping cross court winners. Nothing worse than feeling like you've got the winning position in a point, only to have someone rip it in front of you for a winner while you are grunting and bending down to the best of your ability. lol.

Serve was excellent for placement and variety and I was winning more points on a kicking 70mph serve, and never really hit anything lfat over maybe hgigher 80's. Again, normally all of us would be tee'ing off on slower balls, but I just played it like it was, and everyone was struggling a bit. Saved the shoulder and neck too.

Ground strokes felt good and I had everyone comment on how much more spin and depth I was getting on both sides.

Having not played with the guys for years, it was nice to hear I had noticeabley improved. Back to the thought that if I am not playing my best I am somehow bad, it goes to show how I am, we are, our own worst emnemies sometimes. I am certainly my hardest critic and I need to improve there and learn to celebrate my accomplishments and not be stuck in a I-am-not-good-enough, need to improve mindset. Hell, we all can and want to improve, but should not lose sight of things we have improved.

It was just a positive, good tennis kinda night.
 

movdqa

Talk Tennis Guru
Last few seasons I've been asked to jump back in various league, including the 4.0 group, but honestly I felt physically I wasn't up to it (so of course mentally I didn't think I was back up to level). Many fof my past teammates started a new 18's 4.0 team, and they finally dragged me out on court last night for a match.

I think sometimes I just get stuck in my own head thinking if I am not playing my best tennis that I am bad, so it was nice to be able to hang with them and I was surprised at how good the tennis was all around. I've played the 4.0 Flex leagues the last year and I call that the "Whose Line is it Anyway" of leauge play, where rating seem made up on the results really don't matter. That is, of all the 4.0 play I had I would say less than half were truly a 4.0 level of competitiveness. Not the biggest confidence builder. Last night though...this was a solid, match.

1st set everyone was a bit rusty so it was round and round of everyone holding serves and very little point action. I was playing with my old partner (he has still been playing 4.0 so was much sharper than me) and we clicked fairly well. We took the first set 6/4 or 7/5 (don't recall). Second set everyone started getting the groundy and net play groove back so a lot of solid points and we lost the second set 3/6. We blocked 2 hours out so decided to play the third set, even with the 90+ degrees and 40% humidty. We took the thrid set 6/2 but everyone was a little weary. We just served spots well.

For me, I was really happy with things overall. Oddly, I am usually spot on and banging return of serve and I swear I was only like 60% in, so not sure what was up with that. Actually everyone was a bit off overall, so I didn't feel too bad about it. Also, having not played a ton of higher level doubles lately, I was a bit crazy Ivan about crashing the net....a bit TOO much. I knew I needed to get to the net more often to fnish points, but being rusty my mid court volley approach wasn't strong enough, or I was just outright coming in when I should have setup one more shot before approaching. My partner was laughing because he kept fading back too much, so we were whack on positioning and having to compensate a lot.

I was really happy with my net work and volleys though, including a good 5 or 6 touch volley/drop shots that were oh-so-sweet. That was countered by our oppoents with a few of their own, but some amazing angled dipping cross court winners. Nothing worse than feeling like you've got the winning position in a point, only to have someone rip it in front of you for a winner while you are grunting and bending down to the best of your ability. lol.

Serve was excellent for placement and variety and I was winning more points on a kicking 70mph serve, and never really hit anything lfat over maybe hgigher 80's. Again, normally all of us would be tee'ing off on slower balls, but I just played it like it was, and everyone was struggling a bit. Saved the shoulder and neck too.

Ground strokes felt good and I had everyone comment on how much more spin and depth I was getting on both sides.

Having not played with the guys for years, it was nice to hear I had noticeabley improved. Back to the thought that if I am not playing my best I am somehow bad, it goes to show how I am, we are, our own worst emnemies sometimes. I am certainly my hardest critic and I need to improve there and learn to celebrate my accomplishments and not be stuck in a I-am-not-good-enough, need to improve mindset. Hell, we all can and want to improve, but should not lose sight of things we have improved.

It was just a positive, good tennis kinda night.
That sounds wonderful.

I think that one of the big impediments (after raising kids) is work. I'm juggling three projects and got a bunch of other things dumped on me today and have a bunch of compliance courses to do. I'm trying to clean things up before I retire but sometimes I ask why I should bother. Life shouldn't be all about work.
 

ChaelAZ

Legend
That sounds wonderful.

I think that one of the big impediments (after raising kids) is work. I'm juggling three projects and got a bunch of other things dumped on me today and have a bunch of compliance courses to do. I'm trying to clean things up before I retire but sometimes I ask why I should bother. Life shouldn't be all about work.

I hear ya. One of the biggest reasons I haven't done leagues is, I am up at 4am and working by 6am. I don't get out until 5p, so the idea of driving an hour to some court to play another few hours of tennis is honestly exauhsting before I even hit the first ball. Even last night we started our match at 7p and I was home at 5:30p and thinking I would rather grab a beer and chill than go play. Then with leauges, it is every week. With all the work/family commitments it is tough to keep it up. For me at least. And hell, I am only 50.
 

ByeByePoly

G.O.A.T.
I took several accounting and finance courses in undergrad. I recommend that traders and investors and others who want to do analysis on companies, government and non-profits, to take at least Accounting 101 and Finance 101 so that you can read accounting statements and reports and make judgements about companies, organizations and governments and do comparisons between systems.
Nah ... I know if the hospital gives me an obscene bill ... I could care less what their margins are. The answer to my question was no.
 

ByeByePoly

G.O.A.T.
I hear ya. One of the biggest reasons I haven't done leagues is, I am up at 4am and working by 6am. I don't get out until 5p, so the idea of driving an hour to some court to play another few hours of tennis is honestly exauhsting before I even hit the first ball. Even last night we started our match at 7p and I was home at 5:30p and thinking I would rather grab a beer and chill than go play. Then with leauges, it is every week. With all the work/family commitments it is tough to keep it up. For me at least. And hell, I am only 50.
Yes ... tennis here ... other crap to odds and ends so they can delete it. I would not want to lose this thread. (y)
 

ByeByePoly

G.O.A.T.
One never knows.
I think some decent discussion broke out in a couple of odds and ends threads, particularly the AI one. You just have to be careful and not bring it over to "tennis talk", although in this thread "medical" is definitely not far OT. 8-B
 

movdqa

Talk Tennis Guru
Nah ... I know if the hospital gives me an obscene bill ... I could care less what their margins are. The answer to my question was no.
Yes, but you want to talk about policy.

There are lots of reasons why individual bills are large or small. And you can complain about those or applaud them.

But when you want to make vast policy changes, then you should understand what you're talking about.

I had an expert trader ask me why Kirkland Lake, a mining company, traded like a software company. That is the stock price was going up exponentially. I just went to Yahoo Finance and looked over their earnings reports for the past three years along with their operating margins and growth rate. That expert trader only used technical analysis. I use technical analysis and fundamental analysis which shows you the other side of analysis. I just posted a picture of their earnings for the past three years and he understood why the price is rising exponentially. But he would never have thought to look at their earnings reports because he doesn't know how to read accounting statements.

When someone asks me to look at a company, I do a technical scan (takes one to ten seconds) and a fundamental scan. The fundamental scan can take a few seconds to half-a-minute depending on what I find. So I can analyze companies pretty quickly as targets on taking a position. The technician doesn't know what he doesn't know. He can't argue coherently on fundamentals because he chooses not to. In like manner, I see lots and lots of people arguing about what companies do or don't do or how much they make and how unfair it is and I just think that they don't know what they are talking about. That goes for politicians too.
 

ByeByePoly

G.O.A.T.
Yes, but you want to talk about policy.

There are lots of reasons why individual bills are large or small. And you can complain about those or applaud them.

But when you want to make vast policy changes, then you should understand what you're talking about.

I had an expert trader ask me why Kirkland Lake, a mining company, traded like a software company. That is the stock price was going up exponentially. I just went to Yahoo Finance and looked over their earnings reports for the past three years along with their operating margins and growth rate. That expert trader only used technical analysis. I use technical analysis and fundamental analysis which shows you the other side of analysis. I just posted a picture of their earnings for the past three years and he understood why the price is rising exponentially. But he would never have thought to look at their earnings reports because he doesn't know how to read accounting statements.

When someone asks me to look at a company, I do a technical scan (takes one to ten seconds) and a fundamental scan. The fundamental scan can take a few seconds to half-a-minute depending on what I find. So I can analyze companies pretty quickly as targets on taking a position. The technician doesn't know what he doesn't know. He can't argue coherently on fundamentals because he chooses not to. In like manner, I see lots and lots of people arguing about what companies do or don't do or how much they make and how unfair it is and I just think that they don't know what they are talking about. That goes for politicians too.
I'm going to stop talking about this in this thread ... after this post. 8-B

"But when you want to make vast policy changes, then you should understand what you're talking about."

I think there is two aspects/levels of this. I do not think you need to be an expert as a voter to vote for universal healthcare. That is more a matter of the heart ... the nation continues on with it or without it.

On the 2nd level ... needing to understand in order to change healthcare to a different system, I could not agree more. But that is complicated ... think tank level stuff, not reading a balance sheet stuff, not what is a good investment stuff.

It's beyond the senators. The idea that a senator ... or a president ... a presidential candidate can whip up their own plan is the stuff of Comedy Central. The healthcare topic is complicated enough to have it's own moon shot version of NASA. The public should be presented with the facts, choices, tradeoffs before one senator utters a word about "freedom" ... or from the other side "human right" .. or one citizen votes. And no ... the Obamacare debate on the senate floor wasn't even close ... I watched it all. I view us (citizens) voting on healthcare pretty much like UK voting on Brexit ... no one "knows even close to enough".

One of the huge problems is ecnomics is closer to religion than science ... it can be whatever an economist wants it to be. Just listen to two top renown economist argue with each other ... they agree on almost nothing. I have no idea how you filter that out from a Healthcare NASA level think tank trying to present the facts and options to the public. I know I came to the conclusion the economy and globalization is so complex ... no one really understands it.

On investing ... I think Jim Cramer got it right ... paraphrasing:

"The only way you can make money in the stock market is buy the stocks the big guys are about to buy".

Meet you in odds and ends later for continued discussion on this topic. (y)
 

movdqa

Talk Tennis Guru
I'm going to stop talking about this in this thread ... after this post. 8-B

"But when you want to make vast policy changes, then you should understand what you're talking about."

I think there is two aspects/levels of this. I do not think you need to be an expert as a voter to vote for universal healthcare. That is more a matter of the heart ... the nation continues on with it or without it.

On the 2nd level ... needing to understand in order to change healthcare to a different system, I could not agree more. But that is complicated ... think tank level stuff, not reading a balance sheet stuff, not what is a good investment stuff.

It's beyond the senators. The idea that a senator ... or a president ... a presidential candidate can whip up their own plan is the stuff of Comedy Central. The healthcare topic is complicated enough to have it's own moon shot version of NASA. The public should be presented with the facts, choices, tradeoffs before one senator utters a word about "freedom" ... or from the other side "human right" .. or one citizen votes. And no ... the Obamacare debate on the senate floor wasn't even close ... I watched it all. I view us (citizens) voting on healthcare pretty much like UK voting on Brexit ... no one "knows even close to enough".

One of the huge problems is ecnomics is closer to religion than science ... it can be whatever an economist wants it to be. Just listen to two top renown economist argue with each other ... they agree on almost nothing. I have no idea how you filter that out from a Healthcare NASA level think tank trying to present the facts and options to the public. I know I came to the conclusion the economy and globalization is so complex ... no one really understands it.

On investing ... I think Jim Cramer got it right ... paraphrasing:

"The only way you can make money in the stock market is buy the stocks the big guys are about to buy".

Meet you in odds and ends later for continued discussion on this topic. (y)
I subscribe to Hedgeye which is a hedge fund advisory service. They had a long recommendation on XLU and VNQ. I did some analysis on the two ETFs and their components looked expensive. So I submitted a comment that they have been doing really well but I felt that they were overvalued. This comment was read over the air in a live video stream. The response is that they're about mathematics and that they have a process that takes feelings out of the equation. One of the first books that they recommend you read is on Fractal Geometry. They recently suggested Infinite Powers, a book on calculus. They use the power of the second derivative so that you know where you are in the cycle - not based on where you feel you are. They are data driven. One of their services gives you 160 pages of data every morning - it's an institutional product that costs $16,000 per quarter.

I'm glad that we didn't take a trip to the moon based on matters of the heart. Real math and science work a lot better.

The public doesn't have knowledge to decide. They just get pushed around by slogans.

That economists disagree is no reason to dismiss their analysis. You're just making ad hominem arguments.

If you want a seat at the table, get the prerequisite education.

Jim Cramer is a showman. His job is to get people to watch him. It works really well in the ten year bull market that we've been in because you could just be long and do fine.
 

Dartagnan64

Legend
Most people are happy with their healthcare and insurance.
Most people are healthy and need little from the system. Ask unhealthy people if they are satisfied.
Fast is, US spends almost 3x as much as other nations on healthcare without any evidence of superiority in outcomes and low satisfaction ratings compared to most European nations.

I don't think Canada has a particularly good healthcare system either but if I was going to fix it, I certainly wouldn't look South but rather across the pond to places like Switzerland, Scandinavia, Netherlands, Germany, etc. Most of those healthcare systems show great metrics on outcome measure and high patient satisfaction scores and deliver health care at half the cost of US.
 

movdqa

Talk Tennis Guru
Most people are healthy and need little from the system. Ask unhealthy people if they are satisfied.
Fast is, US spends almost 3x as much as other nations on healthcare without any evidence of superiority in outcomes and low satisfaction ratings compared to most European nations.
I was diagnosed with cancer two years ago and treated for about 18 months and am. Owning surveillance. Since then, I have been in the ER twice. Once for an intestinal blockage and once for a heart condition.

I am quite happy with how my insurance company handled payments and am happy with the hospitals that I used and think highly of the doctors and staff at these places.

You get to know the people with cancer and other diseases if you have it yourself. I have not heard any complaints about our company health insurance. Some complaints about billing here and there but it’s not hard to straightthings out.

My mother had a heart attack three years ago at 93 years of age. She was admitted to the Shapiro Cardiovascular Center at Brigham and Women’s Hospital where she received world class care. She was not expected to live but they found a combination of drugs to keep her alive and she is alive and lives independently at 96 years of age. Her insurance is Medicare.

There are a lot of sick people that are happy with their health insurance. They appreciate it even more than those that don’t need it.
 

ByeByePoly

G.O.A.T.
I was diagnosed with cancer two years ago and treated for about 18 months and am. Owning surveillance. Since then, I have been in the ER twice. Once for an intestinal blockage and once for a heart condition.

I am quite happy with how my insurance company handled payments and am happy with the hospitals that I used and think highly of the doctors and staff at these places.

You get to know the people with cancer and other diseases if you have it yourself. I have not heard any complaints about our company health insurance. Some complaints about billing here and there but it’s not hard to straightthings out.

My mother had a heart attack three years ago at 93 years of age. She was admitted to the Shapiro Cardiovascular Center at Brigham and Women’s Hospital where she received world class care. She was not expected to live but they found a combination of drugs to keep her alive and she is alive and lives independently at 96 years of age. Her insurance is Medicare.

There are a lot of sick people that are happy with their health insurance. They appreciate it even more than those that don’t need it.
I am wobbling all over the place with this yoga tree pose. Do you get better over time?
 

tonylg

Professional
Most people are healthy and need little from the system. Ask unhealthy people if they are satisfied.
Fast is, US spends almost 3x as much as other nations on healthcare without any evidence of superiority in outcomes and low satisfaction ratings compared to most European nations.

I don't think Canada has a particularly good healthcare system either but if I was going to fix it, I certainly wouldn't look South but rather across the pond to places like Switzerland, Scandinavia, Netherlands, Germany, etc. Most of those healthcare systems show great metrics on outcome measure and high patient satisfaction scores and deliver health care at half the cost of US.
I'm late to this discussion and haven't read all the background, but you've nailed it.

I'm Australian and we used to have a really good public health system, with the option to insure privately if you so wished. Over the past couple of decades, successive governments have moved us more to the US private system with lower level health welfare for those who don't take out private insurance. They even penalise us through the tax system for not having private health insurance.

Fact is, nowhere in the world has it been more efficient to let the market sort out health care. Quite the opposite. In Australia, we now pay a fortune (comparatively) for private health care full of gaps, or get to use a run down public system full of gaps. 30 years ago we had an excellent system that has been sabotaged.
 

norcal

Hall of Fame
Back to tennis...our league starts up in a month. Was hoping to be able to practice my serve this summer but alas my slow healing wrist/thumb has prevented that. However I have been serving each Sunday at our practice/drop in. In fact the last 3 Sundays I have gone 13-0 in sets! Of course a lot of that is luck but considering we mix up partners it means I have been playing consistently well. In league I will probably just be playing singles since we have lots of good dubs guys. My movement continues to improve and I hope to incorporate more net play into singles, my transition game is finally feeling 'somewhat' natural thanks to all the dubs I've been playing.
 
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