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2019-11-08 10:31 by Karl Denninger
in Podcasts , 215 references Ignore this thread
Bloomberg, Impeachment and Health (Podcast)
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Health care reform link: https://market-ticker.org/akcs-www?post=231949

Implementation: https://market-ticker.org/akcs-www?post=231959

Note this (which is linked from the above article) -- in which I point out that if the US Government will not cut the crap, and the people won't insist that it stop then I am forced to advocate for full nationalization of the entire health system because it is the only means of exposing the cost and forcing it to eventually come under control.  Yes, this means I will forcefully advocate for a Democrat that intends to impose exactly that, because losing in 2020 beats Civil War in 2024.

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Naomi_cas
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I have not read Warren's proposal yet. However, it is worth noting that medicare charges (with a PARTICIPATING physician who accepts medicare patients AND has agreed to charge medicare approved fees) are substantially lower than those in the marketplace (as much as 80% or more lower) depending on services (I still have to find the complete list of codes and prices that medicare approves, presumably it is available info).

For example, people on medicare who have opted for an MSA (medical savings account) as a type of Advantage plan are supposed to make sure they are receiving care from a participating institution-physician, as the insurance company (see Lasso Healthcare for example) will NOT pay more than the medicare approved fees. Of course, same applies when using your deductible, only the medicare approved fees will be considered towards the deductible. Said deductible is upwards from $7 000.00, with medicare approved fees hardly anyone spends over $1,000.00 especially since we are considering a low risk patient population. So you can see how Lasso likely works as a catastrophic insurance and forces people to "shop" for their care. Side note, the MSA includes a yearly "allowance" of about $3000, which is used to pay for medical expenses, medicare approved or not, ie you can order your own blood work if you know what you want to look at and pay cash for it.

So if everybody is on medicare, either you seek services from medicare approved institutions and the fees indeed drop by a huge percentage as compared to the marketplace, or you would be yourself responsible for the balance likely as much as 80%+ of the bill. Possibly you could seek a supplemental insurance. So what happens to the non participating outfits? and how many people get on very long waiting lists? yes there will be "a bit" of "realignment" but a lot of physicians will be forced into the medicare framework.

For one thing, you would think there would be to start with a HUGE campaign to finally make public the role of lifestyle =food and activity on disease prevention, and the reversibility of such as diabetes to start with.

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Tickerguy
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@Naomi_cas - There is the leftist and doctor-sponsored line of bull****, and then there is the truth.

The truth is that Medicare and Medicaid spent $1.576 trillion last fiscal year. I assure you that was not 80% less than any privately-negotiated anything.

 


The means by which this alleged "underpayment" is ginned, gamed and gypped are legend. First there's services billed and not performed (at all.) Then there is upcoding, where yes, they're paid for a "service" that is actually 3-4-5x as expensive as what was performed, but for which they can code "aggressively" to get paid more. And then there is just flat-out bull****, which is that the physician payment is nowhere near a significant percentage of the whole spend.

IF you're on Medicare you're at least protected from balance billing, which is an even more-pernicious scam. But make no mistake -- out of $4+ trillion spent on health care in total, and given the fact that older people do indeed tend to need more medical care than younger people on a statistical basis, if you think Medicare is somehow "economizing" compared against private health care you're flat-out nuts.

The "pessimistic" $56 trillion (or Warren's "optimistic" added $20 trillion) in federal health spending is nothing more than a cost-shift. Medicare-for-all does nothing more or less than take what is now a premium paid by the employer into some plan and turn it into a tax. Warren has explicitly said this.

If you take the ~$2.5 trillion a year that private firms and individuals spend on health care (total $4.1 trillion which is MOL correct against GDP) and shift it from private to government, multiply by 10 what do you get? $25 trillion dollars. If you then inflate that by the current Medicare/Medicaid trend rate, which I remind you has a THIRTY YEAR HISTORY of being on-trend, you get somewhere around SIX AND A HALF TRILLION A YEAR 10 years from now. Take the arithmetic average over 10 years and you're right near that $53 trillion, aren't you?

None of what is being discussed will change a thing trajectory wise, which is the problem. If Medicare and Medicaid were in fact an answer to this then they'd be experiencing deflation in spending, since that's what technology and productivity DO -- they reduce price in constant dollars. If PRIVATE insurance as we currently have it (differential pricing, hidden pricing, surprise bills, monopolist "concentration" and similar) were the answer then PRIVATE cost would be going down in constant dollars but it is not; it TOO is rising at about the same rate as Medicare and Medicaid!

Medicare and Medicaid are rising in spend at 8% or thereabouts EVERY YEAR and has been on a 30 year trajectory. The PPACA produced a couple of years of below-trend growth numbers in Medicare and Medicaid, almost all of it by forcing employers to provide coverage where they weren't before and thus shifting OFF some of the federal spend into the private sector. HOWEVER, OVERALL SPEND DID NOT GO DOWN AT ALL AND IN FACT DID NOT MATERIALLY COME OFF TREND, SO THE CLAIM THAT IT MADE CARE MORE AFFORDABLE OR WOULD IMPROVE COST EFFICIENCY WAS A LIE. SHIFTING WHICH POCKET THE $20 COMES OUT OF DOESN'T CHANGE A ****ING THING. IT WAS AND IS A SCAM.

The ONLY way to fix this is to get the ******ned socialist and communist dickheads in the middle of it OUT. It would be NICE if the existing, applicable law (confirmed TWICE by the Supreme Court in the late 1970s and early 1980s) was enforced as that would be peaceful with said dickheads either choosing to cut it out or go to prison. While there are many people who claim there are "exemptions" there is nothing in 15 USC Chapter 1 exempting any medically-related firm and the claims that medically-related insurance firms and collectives of drug stores, pharmaceutical firms, doctors or similar providers are exempt has twice been to the USSC and tossed.

But if that law is NOT going to be enforced then the only options remaining for America are to (1) hang them all, with or without trial first, (2) shoot them all, with or without trial first or (3) the nation will fiscally collapse, and the tipping point is likely to be hit by 2024 or even earlier if there is a recession at which point the option to fix this by enforcing the law will have expired as there will be no law, no government funding, the markets will have crashed and there will be no civil order either.

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Winding it down.

Mannfm11
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Bankruptcy, here we come. There are too many groups with their hands in the till to ever expect DC to fix this. Warren's plan merely institutionalizes the **** you we are getting. Costs will be managed by denial of care, just like any other socialist medical system.

All one has to do is take one look at a hospital bill and realize that no reasonable retailer or consumer would present or agree to the bull**** they put on the bill. I liken a hospital room to a hotel room and a lousy one at that. For $200 or $300 a day, you can stay in a really nice hotel, complete with pools and other facilities. No one in a hotel would pay $25 for a box of tissue or a roll of toilet paper. Nor would they pay 10 times the rate for room service. The little stores in hotels are expensive, but aspirin can be had at a reasonable rate. You can have your own around the clock servant for probably less than $500 a day, instead of begging someone to show up when you need them. And, the hotel doesn't have 300 bureaucrats you never see.

What does a hospital have? Profit centers. Operating rooms, testing facilities. Most businesses that have profit centers would make concessions to have you at their facilities. Not a hospital, which charges you and additional $500 to $2000 a day to be there. The ER is even worse. Prepare for maximum screwing.

I went to the ER once in recent years. Buzzards all over the place. I ended up paying a bill around $2200 plus doctors. I call the ER doctors buzzards, as they scavenge for billings and they don't charge normal prices. I suspect a buzzard can expect to bill maybe $1000 a hour in a busy ER. A few years later, my mother slammed the door on her thumb and I had to take her in. An advanced nurse sewed it up and presto, the same buzzard that looked at me tried to get in the room. Medicare paid the bill and I don't know if the buzzard got in a lick. The guy doing the sewing tried to keep him out.

Why is everything cheap in the US, but health care? That is despite the fact that health care costs have to be included in the price of everything we buy. This blows a hole in the socialist story that there is a such thing as free. There is no free health care, no free taxes, no free regulations, no free education. Someone pays and it is always the middle class, the producer. The consumer pays the producer. If the producer isn't paid a sufficient amount, the good or service isn't available. Only health care and taxes do we often not have a choice. Even heat or air conditioning are voluntary up to a certain level.

I will probably just fall over dead one day, but in general I have been lucky. I spend a sizable amount of money managing disk problems in my back that go down my legs. Maybe I'm just putting off the inevitable, but I haven't heard good reports about getting surgery. Even at OK Surgical, it would probably cost $25,000, after rehab. Crap shoot.

As I said yesterday, health costs have been institutionalized. Drugs get billing because people have to pay for them. Almost no one pays a hospital bill, either because they can't or insurance pays it. We have no clue what it should really cost, because almost no one pays, directly. We often have to pay a doctor, so we know. I understand the hospital bureaucracy might cost as much as $800 billion a year. This was a figure I read on Twitter, posted by a non management hospital employee group. That is a $5000 bill, if have a job. $200,000 out of your life to pay a bunch of blood suckers. That is a reasonable house for most people. And you haven't received 1 minute of care. If this figure is true, you have a lobby of maybe 6 to 8 million people. The figure sounds absurd, but if it isn't, nothing is fixed until these people are massively reduced or eliminated. Getting rid of half would shave 10% off total costs and they would go in a competitive system. We could probably do with 20% of them, to be honest, saving $640 billion a year and $4000 per job.

Then we have the unions, protected by DC as sacred cows. I have been around and I will say, at least in most of America, there are a lot of **** jobs in hospitals. There is also a staffing requirement around the clock. Service sucks, as my mother always had someone stay with whomever was in the hospital around the clock, because you don't get help. Most of the time you see someone, it is to cram their drugs down your throat, something they charge dear rates to do. Why does a $50 a day Day's Inn room cost as much as it does, if you don't get service, but instead get screwed?

How much excess is in hospitals? Vacant rooms? Extra help? Too many bureaucrats? Billing departments for insurance charges? What else is producing the 50% to 75% extra our system costs? Addressing the bureaucrats might achieve as much as 30% of the trip from the present costs to cutting them in half.

I don't know about 80% Karl, but I think we could cut it in half, if we could break the political log jam. We have to recognize that 20% of the total is probably consumed by billing practices. Under a single payer, that wouldn't go away. So, that is 20% for billing, 20% for bureaucrats. Billing includes the insurance end as well as the provider end. 75% reduction of the 2, wipes out 30% of the current costs and puts a lot of people out of work. That tallies $7500 per job, based on 160 million employed. Throw in your enforced solution to type II and we are on our way to getting near 50%.

This brings us to the problem, politics. 20% of the economy equates to 32 million jobs. If we reduce this to a conservative figure, then I would suggest 20 million to 25 million people have their living tied up in the health care system. Throw in the education system and we have a big **** you in politics. Can any politician dare to face down that big a group (s). Look what happened to the governor of KY, who merely suggested fixing the pension system. The only way to face these people down is to go to a strict interpretation of the Constitution and get the government out of health and education. Only a massive uniting of the 120 million or so people getting ****ed by this system would change things. We are being billed to build political clout against us.

On the other subject, impeachment, we are watching a conspiracy. I suspect a good number of the witnesses being called are actually involved or have knowledge of crimes committed between the US and Ukraine. Schiff, Ciaramello and Zaid are guilty of sedition or treason. I suspect the much of the media is guilty of being an accomplice The CIA and State department are bordering on being enemies of the people of the US, instead of allies. The story that the CIA controls the media, once a left field conspiracy theory, has legitimate plausibility. Impeaching a President for asking that potential crimes be looked into is a criminal coverup, not an impeachable offense. That is, unless one wants to institutionalize crime openly in DC. I think the entire charade we have seen since the election is a massive criminal coverup done by the people making he charges, something I have believed from the start. This includes keeping people out of the Clinton Foundation, one of the great money laundering operations in history.

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Mannfm11
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Karl, you point out one fact. Something that can't go on forever won't. 8% annual will, in not so many years, produce a figure larger than the GDP, even though theoretically it will be included in the GDP, thus making the GDP a false figure.

The question is, what are we getting out of health care? 3 of 4 of my grandparents outlived my parents, my mother and my paternal grandmother living about the exact same time, Mom outliving her father by a year and my Dad dying at age 69. Grandparents were all born in the 1890's. Are we being sold a bunch of bull****? I look at old grave stones. It appears to me that if a few things like accidents, alcohol and drugs, TB or something an anti-biotic will treat don't get someone, they generally lived a full life.

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The only function of economic forecasting is to make astrology look respectable.---John Kenneth Galbraith
Lemonaid
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Post the damn prices publicly and you can't charge more for that procedure, service, etc than the public post.

You can't provide the service unless you've posted it publicly.

That solves the medical cost issue. That exposes the insurance companies immediately and fatally.


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"There is no means of avoiding the final collapse of a boom brought about by credit expansion. The alternative is only whether the crisis should come sooner as the result of a voluntary abandonment of further credit expansion, or later as a final and total catastrophe of the currency system involved." Ludwig von Mises
Amused
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Well, for the more entertaining side of things...on the impeachment front, we've reached the point where Trump says he hardly knows, Gordon Sondland...he was just a coffee boy ;)

I wish had that kind of **** you money, to be able to buy an ambassadorship, or have even more **** you money, to not even know the guy that gave me the million dollars for the job.

Regardless of how one feels about impeachment, or the impending doom of the medical system exploding, I think this whole situation is a nice microcosm of where we are as a nation.
Aztrader
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Think about all those employees that get medical coverage given to them and are not taxed on it. What happens when they impose this government BS that nationalizes everything. Betting that if corporations are allowed to keep their own plans, the value of the insurance will become part of the employee's taxable income.
Tickerguy
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@Aztrader -- They won't -- Warren's plan and any other that can actually pass without instantly detonating the federal budget will force the formerly-paid premiums to turn into a tax remitted to the Federal Government.

If they were to NOT impose that tax it would instantly add roughly $2.5 trillion a year to the deficit. There is not a snowball's chance in Hell that would pass even a heavily-socialist House or Senate and if it was attempted there would likely be an immediate and very strong warning from the TBAC that such a law, were it to be signed, would result in the detonation of the entire Federal Treasury Market (because it would cause exactly that.)

There's plenty of insanity out there but nothing THAT crazy is being proposed.

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Tinman
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"the value of the insurance will become part of the employee's taxable income"

It's already on the 1040... wonder why?

I don't think Corps would keep private plans for anyone but the officers. They would dump everyone off and pocket the savings. Your salary wound not rise. That is if you still had a job at that point.
Tickerguy
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There will be no savings; you will get dumped off but the corporation will get taxed equal to what they used to spend on the insurance premiums.

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Winding it down.
Tritumi
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Here in Japan we have a mixed system. The base is a single payer scheme. Your monthly payment is tied to your income from the previous year and there is a 20% charge against a government controlled price for ALL services, or nearly all, be it medical, dental, pharmaceutical, mental, etc. At the age of 60, you start paying an additional much smaller monthly rate for long term care insurance, also based upon your income. You are free to take on additional insurance, even for specifics such as cancer or heart disease and these payments are rather small as it is a private, co-operative, non-profit. You are free to go to whatever doctor or medical facility you choose, there is no such thing as out of network. There are of course doctors who are completely private and most take the national insurance, very few do not and these are, as you would expect, at the ultra rich end. Your medical expenses become a tax deductable factor when you surpass 100,000 (about $970) in expenses.

Here in Tokyo, my closest neighborhood clinic is two minutes away - and that counts the elevator ride down from my home to ground floor. Literally, around the corner. Dental as well. It is where I received my age discounted flu shot a couple of weeks ago. There are lots of small local neighborhood clinics run as single GP offices where the GP is associated with a hospital. The facilities are not cadillac for the most part. The effort is not to produce fashionable image.

Last week I had the set of bi-annual tests at my cardiac guy's place. 24 hour halter monitor, blood work-up, X-ray, EKG, and bicycle stress test (that also uses a mask to analyze flow and gas - something buddies in US who have stress tests tell me is not part of their "comprehensive"), and five week renewal of the two mild drugs regularly prescribed for BP. My cost: $214 at a fairly high-end private clinic that does take the basic national insurance.

There are also programs administered through one's company or employment, but I was self employed for the better part of 25 years, so my need for them way back then was pretty minimal.

In short, relative to Karl's point, if I understand him, the American health care system is such a threat to national security as currently configured that failure to reform will require basically arresting and taking it into custody.

Doing so will at least normalize the custodial modality which most American inmates are already experiencing as the core of citizenship.

Naomi_cas
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I have a bio-med background and I am somewhat familiar with a lot of the scams of the medical field (there is a reason why I quit med school and went into basic research). Also I have avoided MDs as "providers" like the plague all my life-just like my father did. For me it is like dealing with the mafia...or a drug cartel. So my experience as a patient is VERY limited.
I can see how for the average patient, even not in an emergency, it is quite hard to control what care you are actually getting and getting billed for. You do have to know the billing codes for specific services and make sure you do not authorize anything you do not need (and not approved my medicare). But you can ask, and refuse services you deem unnecessary...worse case scenario you are asked to go seek care elsewhere...which is fine. That goes for dentists as well. Yes there can be the famous argument "this is the standard of care for our office" but if the medical literature shows there is no evidence that the so called care is effective than I WILL refuse to have it, period. Again I can see that not everyone is going to spend hours on pub med before they have even the most minimal intervention. Not to mention the providers' degree of expertise-excellence.

There is NO one around me who has not dealt with the medical industry. Many do on a regular basis. I have stayed away from MDs unless mandatory med visit usually work related. I have never taken any drugs, except some aspirin a couple times a year. I do not see the pleasure in eating-drinking crap mindlessly, in stressing over what my friends are doing, it does not enrich my life, especially if I have to reverse the destruction with "healthcare". People in my family have lived in their 90s before healthcare was so available, so I figure it would be a shame to screw up one's body with a toxic lifestyle. Most people do not see that though.

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Reason: typo
Naomi_cas
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Tritumi:

what about the mandatory physical that people take in Japan when they reach age 30 ?

I can just see the results in the US population... (Europe as well).

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Tickerguy
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@Naomi_cas -
Quote:
I can see how for the average patient, even not in an emergency, it is quite hard to control what care you are actually getting and getting billed for.

It's actually nearly impossible. In a hospital it is effectively impossible.

Further, the latest scam is that PE firms are coming in, "buying" practice groups and then "reworking" their front office. This is most-annoyingly happening in dental offices, but it's also happening everywhere else too, and it has exactly one purpose -- to crank coding and billing, along with "treatment plans" at, of course, crazy prices.

Simply forcing all providers of all stripes (including pharmacies) to post prices and charge everyone the same price for the same thing, obtaining a signature on what amounts to a work order with the price on it before starting, would stop 95% of the bull**** and prices would fall like a STONE. In the event you CAN'T sign (you're flat on your back, collapsed) again, enforcing level pricing for everyone for the same thing resolves 95% of the problem.

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Amused
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Tritumi:
that is what I don't get it about most of the arguments from anyone who says that they are against reform of our Healthcare System.

Just pick another other First World nations model. Japan, Australia, whoever, and say: 'if that model works, let's just do that'

But it is going to require jailing many people here and destroying many 'industries' in as Tickerguy hass pointed out, or is at least going to cause a economic recession while we correct the imbalances in the existing industry.
Tritumi
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@Naomi_cas the health check system shows up throughout one's life here as there are also mandatory physicals for children. These form part of the statistical awareness regarding trending issues in health care.

To your more specific concern, a quick search gives this informative commentary:
https://www.city-cost.com/blogs/Tomuu/zD....
The notes and references look pretty good as explaining things, pro and con.

As I understand your desire to avoid the whole system, a fair component of your awareness is the intent or motivation defining those trying to trap you into a profit scam.

My experience here is rather different. When I worked for companies and we had the annual check up, the goal was essentially to catch medical issues before they blossom into illness that require expensive correction or maintenance. For the same reason, I paid for such comprehensive checks when I was on my own.

The old saying applies: an ounce of prevention is worth a pound of cure.

Hope this somewhat addresses your "what about".
Tritumi
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@Amused: Karl is absolutely right that dislocation in the "industry" is inevitable one way or another. Whether jailing directly or through impoverishment and chaos may well be the spectrum solely available.

However, one cannot disregard the simple fact that ALL first world nations are quite simply dependent on economic arrangements and policies, be they fiscal or monetary or both, that believe the future value will be created there to service the massive debt already sinking them today.

Disregarding the factors involved is, as our host has long maintained, the LEVERAGE which empowers the bezzle.
Naomi_cas
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Tritumi:

Prevention has been first and mostly in lifestyle ie DIET, activity level, SLEEP, environment (exposure to outdoors, stress...).

Awareness, I have a bio-med background and I do keep track of medical literature (MDs usually do not have time to read studies and even less analyze them). I would not be qualified to carry out most procedures, but I am able to determine whether I need such or not, or whether a "detection" test introduces more risk than I take by not running it.
I can definitely get any blood work done, in fact exceeding the panels that MDs would recommend, enabling me to adjust diet or possible supplements (insulin level-just monitoring glucose you are 10 years behind the curve).

In the absence of any physical sign, you can at least monitor regularly blood pressure, glucose levels, speed of heart rate drop after intense exercise. Heart rate variability is a number I would like to have.

Generally, I like to improve a bit month after month: resistance, recovery time, muscle mass. Basically I want to make sure I can hike up and down the Grand Canyon without being a risk to my hiker buddies. I mostly monitor my health by the activities I do routinely, I want to see a lot better than "stagnation". I am not sure it is enough to keep walking/running the same 10 miles.

BTW I started needing glasses as a teen as I became short sighted. I did eliminate ALL processed food, and sugar 2 years ago, and "somehow" I no longer need glasses, not to drive and most importantly not while hiking!!

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Tritumi
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@Naomi: Funny you should mention the Canyon as I have about 200 miles worth of blister memory down, across, and up a few Canyon trails - though not, sadly, since late 80s. Used to be a yearly ritual, big deal for a Marylander. Anyway, Ive no dispute on any of your observations. When I take my brisk daily morning hour plus loop around the area at 530 most others out are at least as old.

Lucky here in Japan as Diet is indeed biggest life style contributor to healthy life style as well the quality of the food. Lots of popular culture reinforcement regarding food appropriate to season, and simply how cuisine is intertwined with definition of being Japanese.

Here, you simply have to be more active because the private car is secondary for most people. I do not own a car here. Imagine the freedom that provides though most Americans would feel less free without one. As for sleep, well, addiction to CSpan is a personal problem...
Goldguy
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Naomi_cas Yes, the food that most people eat over the years ends up destroying ones ability to digest said food. Eating a typical American diet will over time destroy your ability to digest, hence, the lack of mineral, vitamin uptake, including the problems of gerd, acid reflux, constipation. And once you are older, the doctors want to prescribe drugs that reduce the acid in your stomach. Huge mistake, just making matters worse. I think most doctors don't have a clue how bad nutrition in this country really is. Years ago when I reached 60 I started having problems digesting...finally found enzymes and betaine Hydrochloride and now digest like a kid again. The doctors don't have any answers, I stay away and doctor myself.
Stee_man
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My understanding is medicare pays about 15% less than the typical private insurance rates. Figure the insurance companies are adding 30% more for profit and overhead. At 8% growth, single payer would buy us about 5 more years.

I'm switching parties just because balance billing must be fixed, and the republicans did nothing for 2 years with both houses of congress and Trump in power. **** them.

Problem is, the democrats won't do anything either. Once they get elected the lobbyists will take over and Warren care will look like another Obamacare.
Idiom
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Why aren't states just building their own hospitals? Is there a constitutional reason California isn't just building its own?

Also, more tellingly, why is medicare for all being promoted instead of VA care for all?

Nearly everywhere else the public option is a government owned hospital, with a private option, not government insurance paying for fancy ass private care.
Tickerguy
Posts: 159974
Incept: 2007-06-26
A True American Patriot!
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@Idiom -- Because the politicians ALL know that 20% of GDP is both unsustainable and must be sustained. If it goes back to where it was before this crap, which is about 4% of GDP, the market crashes immediately.

But if it doesn't go back to 4% of GDP the government crashes within the next 5 years. Perhaps with all sorts of bull**** they'll get a few more (and you can bet they'll try) but it won't matter in terms of outcome.

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Winding it down.
Whitehat
Posts: 1358
Incept: 2017-06-27

Gone West
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not giving the bitch credit for thinking this far ahead, perhaps whoever behind the scenes produced the idea for her deserves the credit. it is a centralization plan which would allow for the government to centrally control and ration healthcare making the current crop of admin their field agents.

could this be their ****ed up idea of an exit strategy? many who understand the gravity of the situation as you describe it wonder if there is some sort of plan for mitigating the consequences or worse opportunistically use the coming crisis.

the politicos must know what we know.

either way, those of us who keep our own health outside of the system have massively better chances.

perhaps the great slob-moron reduction will occur. it lifts the spirits knowing that one day i will be sitting somewhere hearing how some fat-slob or other type of irresponsible, worthless individual will be lamenting that his drug or procedure is denied and he is being tracked to palliative care after the appeal was denied by the regional directorate. one can hope.

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There are two ways to be rich: One is by acquiring much, and the other is by desiring little.
snow, seasons, distance and dirt roads: SSDD
"Be not deceived; G-d is not mocked; for whatsoever a man soweth, that shall he also reap" (Gal. 6:7)
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