OT: Hopefully these smart guys can figure something out
Papi_Chulo
Miami, FL (or the nearest big-booty club)
Warren Buffett says US health care must be revamped or it will be left to the government -- which will probably make it worse
Complacency will make fixing the nation's health-care system a daunting task, according to Warren Buffett, whose Berkshire Hathaway recently joined with J.P. Morgan Chase and Amazon to develop a new model for their 1 million employees.
Buffett along with Amazon's Jeff Bezos and J.P. Morgan's Jamie Dimon recently formed the health-care joint venture Haven to figure out how to deliver better health care at a lower cost. One of the problems with the current system, Buffett said in an interview for Yahoo Finance, is that health-care providers and others entrenched in the current model don't have any incentive to change things.
"We have a $3.4 trillion industry, which is as much as the federal government raises every year, that basically feels pretty good about the system," Buffett said. "There's enormous resistance to change while a similar acknowledgement that change will be needed. And of course if the private sector doesn't supply that over a period of time, people will say 'we give up, we've got to turn this over to the government,' which will probably be even worse."
Health spending rose 3.9 percent in 2017 and now makes up nearly 18 percent of American economic output. Last month in his State of the Union address, President Donald Trump called for legislation to cut drug prices. He has also outlined a plan to end the "rigged system" in which people in other countries pay far less for drugs like insulin than Americans spend at home.
"We've got this incredible economic machine but we shouldn't be spending 18 percent when other countries are doing something pretty comparable in terms of doctors per capita and hospital beds per capita," Buffett told Yahoo Finance. "We're paying a price."
Haven CEO Atul Gawande, who is a surgeon, is tasked with figuring out how to build the new model. Buffett said the goal isn't to make money but to find a way to deliver better care and stop the "march upward" of costs.
"We've got a wonderful partnership in the sense that it's large and in the sense that it has reasonable market muscle with more than 1 million employees," Buffett said. "We've got a unity of commitment and an ability to execute on the commitment."
https://www.cnbc.com/2019/03/18/warren-b…
Complacency will make fixing the nation's health-care system a daunting task, according to Warren Buffett, whose Berkshire Hathaway recently joined with J.P. Morgan Chase and Amazon to develop a new model for their 1 million employees.
Buffett along with Amazon's Jeff Bezos and J.P. Morgan's Jamie Dimon recently formed the health-care joint venture Haven to figure out how to deliver better health care at a lower cost. One of the problems with the current system, Buffett said in an interview for Yahoo Finance, is that health-care providers and others entrenched in the current model don't have any incentive to change things.
"We have a $3.4 trillion industry, which is as much as the federal government raises every year, that basically feels pretty good about the system," Buffett said. "There's enormous resistance to change while a similar acknowledgement that change will be needed. And of course if the private sector doesn't supply that over a period of time, people will say 'we give up, we've got to turn this over to the government,' which will probably be even worse."
Health spending rose 3.9 percent in 2017 and now makes up nearly 18 percent of American economic output. Last month in his State of the Union address, President Donald Trump called for legislation to cut drug prices. He has also outlined a plan to end the "rigged system" in which people in other countries pay far less for drugs like insulin than Americans spend at home.
"We've got this incredible economic machine but we shouldn't be spending 18 percent when other countries are doing something pretty comparable in terms of doctors per capita and hospital beds per capita," Buffett told Yahoo Finance. "We're paying a price."
Haven CEO Atul Gawande, who is a surgeon, is tasked with figuring out how to build the new model. Buffett said the goal isn't to make money but to find a way to deliver better care and stop the "march upward" of costs.
"We've got a wonderful partnership in the sense that it's large and in the sense that it has reasonable market muscle with more than 1 million employees," Buffett said. "We've got a unity of commitment and an ability to execute on the commitment."
https://www.cnbc.com/2019/03/18/warren-b…
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39 comments
SJG
SJG
Look at the Senate and Congress, their gov't run health care.
SJG
But in lieu of a fair (not rigged) private healthcare system, the solution will become the government solution.
Kudos to these guys for seeing the writing on the wall and wanting to do something about it.
The issue is who had access and who makes money off of it.
Warren Buffet is doing everything he can to privatize public schools.
Bezos and those others, fuck them all.
https://www.solobrushes.com/Products/160…
SJG
:)
SJG
SJG
Medicaid is another huge cost. The fraud and misuse is staggering. Put in a work requirement for Medicaid coverage, and deny coverage to non citizens, and the cost will be cut in half. And, as an added benefit, more people will enter the workplace.
The use of nurse practitioners also has huge potential. Much of what MDs do could be done more efficiently and effectively with nurse practitioners. Colds, flus, chronic diseases,etc.
The bigger problem is what will happen to the private companies when ( not if) Medicare for all becomes a reality. First they have over a million employees. Secondly every public retirement program has huge holdings of the stock and/bonds of the insurance companies. What if that value is lost? How about individual retirement programs? Too many issues to be resolved for me to see it in my lifetime, but it’ll happen.
The VA doesn't work because its underfunded and our vets come back from all our wars with a lot of health issues.
The truth is that Obamacare has morphed into another social welfare program since the only people who are buying it anymore are people who are subsidized. So now poor people who do not qualify for Medicaid can still get insurance. I'm ok with it in this form now that the individual mandate is gone. The one remaining problem is those who do not qualify for subsidies are largely being priced out of the individual market, so millions have actually LOST coverage that they used to receive in the individual market.
What I think is missing is guaranteed issue options for un-subsidized participants that do not include all of the so-called Essential Health Benefits. It's the mandates that are driving up the cost for the un-subsidized and many do not need pregnancy coverage, mental health benefits or all of the other bloat that is stuffed into each one of these policies. This would solve the one serious coverage gap remaining in this country.
In terms of cost controls, there is no easy answer. Those controls in other countries are the reason that the U.S. is home to most medical innovation now. Other countries have been getting a free ride off of our medical system by obtaining new drugs paid for by R&D costs borne by U.S. consumers. Also, in many countries, rationing has started, with the government deciding who qualifies for certain medical treatments and, ultimately, who lives and dies. So I don't think I will ever be on board for universal government run healthcare.
Look at the areas of medicine where procedures are elective.....breast augmentation and vision correction. Their costs have gone down while other areas have risen at astronomical rates. Why....because it's all on the consumer to choose to have the procedure at all and who to have it done by. Shopping around and having options is what keeps prices down and quality up. I swear that this idea that health care is a RIGHT is also part of the issue. No it isn't. It's a service and if you can afford it, you can buy it......if not, I'm sorry, you may have to suffer. The same goes for food and housing. If you are lazy as fuck and don't do anything to earn an income, you think someone deserves to have a nice apartment and be able to buy nice organic food at 3 times the cost from some place like Whole Foods? I'm guessing you don't. Maybe there should be some McDonald's level clinics and a range of care available up to private top level doctors and hospitals who have all the latest equipment, techniques and meds. You buy what you can afford. I bet you wouldn't be going to the doc for every sniffle if you knew you had to pay for it. Get the docs and the clinics competing and watch prices come down. Make people pay for their shit and watch how much NEED for a doc goes down. Suddenly, knowing what it will cost to be seen by a doc, maybe people stop doing so much stupid shit. Maybe, instead of banning smoking, people choose to quit because they know what it will cost them if they do get cancer....and if they can't afford the treatments, they'll know they'll have an unhappy ending.
Oh....but the rich will be able to get everything and the poor won't get good care. You think that doesn't happen now? Do you think Bezos and those guys are worried about using their HMO.....or do they just pay to see their private doctor and pay for treatments when they need it? Don't like it....feel free to pool your money together with others of the same mindset to open free clinics and such. You can be as charitable with your money as you want.....you should have no say in how charitable others have to be. You want to go to the best steak house in town and buy a meal for a homeless person....go for it. Should everyone have to do the same thing? Is it less helpful if a person goes instead to some middle of the road place and buys meals for a few homeless? What if they go cheap and feed hundreds by going to a fast food joint? And what if they themselves are just scraping by and can't afford to share at the time....are they evil?
Every time there is an issue, people seem to feel that it has to be solved by government. What ever happened to pulling yourself up by the bootstraps and taking care of your own shit? The government has done nothing but grow over the decades and become more expensive. I don't think that's what makes things better in general. After all, look at countries where government runs everything....the USSR, China, Cuba, Venezuela......yeah....that's what you get. A ruling class that is just like our rich (though it's probably much harder to become a top communist party member than a wealthy american) having whatever they want and hoarding millions and unlike the US, have everyone else be poor as shit. Oh...but they have great education systems and health systems. Bullshit. When Castro was sick, he went to Spanish doctors, not his own healthcare system. Want to talk about the hungry.....how many did the USSR and China allow to die from starvation? Was it 10 million or 100 million....I always forget the exact number. We can watch live what happens when a government takes over everything in Venezuela.....they were a rich country before they went down the road of socialism and now people are picking out of the garbage to eat while their Equality for All leadership transports millions in gold out of the country and denies foreign aid from crossing the border to help feed the people.
I would think that a bunch of guys who resent the goody goody people from trying to shut down SCs would stop to think that being the goody goody guys and trying to tell others how to live their lives would repulsive. Have principles. Do you think people should be free to live their lives and live with the consequences of their choices or do you think we need a nanny state to tell us all how to be good little boys and girls, how to stay healthy and safe, and to for sure do only things that will be morally good for the masses. Come the fuck on!
It's time to separate the two. Insurance ≠ healthcare.
I would not mind government sponsored health insurance, but I really don't want to go to any government run medical facility.
As someone who is a Republican with libertarian leanings, I agree 100% from a pure theoretical standpoint. If insurance carriers disappeared altogether and we went to a pure cash and carry model, then I am sure that medical costs would drop dramatically.
But the "facts on the ground" are what we have to deal with. The simple reality is that we live in a country in which the vast majority of voters, myself included, do not believe that someone should have to die simply for lack of ability to pay for healthcare. A majority of voters also believe that one should not have to go bankrupt in order to receive life saving medical treatments or other care.
For decades, Republicans have been making the free market case, advocating for policies like "price transparency" as a means to spur competition. Where it has fallen short is that most doctors do not rely upon cash customers for the bulk of their earnings, but instead earn their livings off of insurance companies and, to a lesser degree, government programs. Until that changes, most doctors are not going to be motivated to compete for cash customers or accept payments lower than those offered by insurance companies. Indeed, right now most doctors, hospitals and pharmacies tend to gouge cash customers because they don't have the negotiating power of insurance companies or the federal government.
So with all of these facts established, the complete absence of action simply leads to more endless sob stories that the Dems can trot out to sympathetic voters during elections. This has been happening for many years and it is how we got saddled with this Obamacare monstrosity in the first place. If Republicans don't take the lead and come up with better answers than the [likely ineffective] "price transparency" proposals bandied about during the GW years, then it's only going to get worse.
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I barely skimmed the rest of your rant. The answer is that in the pre-Obamacare era, a hard-working, successful, person could get sick, become uninsurable, and go bankrupt through no fault of their own. I've brought up that point countless times on TUSCL. Those of you who support a family don't seem to understand how vulnerable you are to an illness that's no fault of your own. With a serious, chronic, illness, you're better off dead to your family(under the old system).
John McCain was a hero in voting down the repeal of Obamacare and he saved 10s of millions from losing their healthcare. Obamacare was spared in Congress, but it's being challenged in the courts with a lawsuit that people on the left and the right think is idiotic. Might go the Supreme Court for the third time.
Just today, the Trump justice department is supporting a full-out repeal of Obamacre with NOTHING to replace it. Which means 10s of millions of people would lose their healthcare and we go back to the days where you can be uninsurable of your medical history. Dems control the house because of the healthcare debate, and politically this is a gift to the Dems in 2020. If the Dems want to win in 2020, they need to consolidate on a plan that extends healthcare incrementally without throwing 150M off employer-sponsored plans and completely disrupting the insurance market (see @Gawker's excellent post).
But he's not wrong about the whole cycle of chronic or life threatening illnesses leading to bankruptcy, often when those same people become too sick to work and/or could not find coverage in the individual market. And these are the sob stories that Dems are going to start trotting out, once again, if Obamacare is scrapped completely. Remember, the vast bulk of the population never had to deal with Obamacare in practice, so they have no idea how utterly atrocious and ineffective it is for anyone who is not being subsidized.
Most hospitals are government owned and run, or they run by staying within the government's laws.
The old 80-20 health insurance does not exist anymore. Everyone is in managed health care, and that means that you only get the bare minimum which the attorneys for the HMO can squeeze by the governments laws.
We pay much more than other countries, and we get shittier care. It is run by the government, its just that some other parties are still in there, sucking out money and screwing things up.
SJG
The US was at the forefront, up through the mid-60's.
But since the Right has made a comeback, via Racism, prejudice against minorities and immigrants, and then via the I AM A CHRISTIAN movement.
So now we have some catching up to do.
SJG
So even if health care is transferred completely to the government....what's going to happen? Will they bring the costs down by just telling providers that they'll only get $X for a procedure that cost $XX? Will they go ahead and pay what the procedures cost and then run out of cash to pay for the next people's care? Will they just run up trillions of dollars of debt to pay for everyone to get the top level care (oops....what's another $20 trillion). Will they eventually start telling people that they don't get to have that top grade care and will be reduced to level 2, level 3,....level 100 care? Will they eventually tell people that they don't get care because some younger, older, healthier person should have it instead....because it's better for the masses? Don't think it can happen....look at the long delays that Canadians have to wait for appointments. They end up crossing the border to come to the states to be seen quickly and pay for it out of their own pockets. Look at England which had basically kidnapped a couple of kids, refusing to let them out of the hospitals even though other organizations were willing to take over the healthcare of the kids.
You make healthcare a government agency and who's going to work there? Are the top doctors going to work for scaled government wages? How many would retire or select to go into other fields? They don't spend hundreds of thousands of dollars and more than a decade training to become doctors just so they can get by on government salaries. What's going to happen to the quality of care if the best docs leave the business and go on to something else? Nurses are already overworked and underpaid...I don't think the government is going to help that. Just picture the DMV employees working to make sure your cancer is getting the right treatments.
I can't claim that I have the perfect solution...I'm not in the field at all. It just seems like there are plenty of examples out there that show that socialized medicine comes at a price. Longer waits, denial of care, less overall quality. And as someone said above, who's going to innovate if they know they won't get their investment back. Drugs costs billions to develop....if the company is only allowed to make back what it invested, why would they bother. Remember, not every drug makes it to the market....so they also have to worry about covering those costs on top of the ones that do make it. Think it will be better under the government....how much do government projects usually go over budget....whether they work or not? We'll just end up with less development of new drugs and techniques.
Government is not the solution, it's the problem. People like to blame the high cost insurance and health care on the private sector. But who makes it cost so much really? If anything goes wrong, at all, during someone's treatment, what happens? Some court will find for the patient and give them millions of dollars for their emotional distress. I'm not saying that you don't punish those who are negligent, but we've become this population that thinks that doctors and hospitals have to be perfect. Things go wrong and people make mistakes....and money isn't going to bring back whatever went wrong. How much is malpractice insurance for individual doctors and hospitals? How much do they have to charge to make up for that because one wrong move and wooooosh.....there goes every dime you have. In cases of deliberate or obvious negligence, make them suffer but they can't be held to this idea that they can save every life and fix every ill perfectly! Government kills innovation too. How many hoops do they put in front of pharmaceutical companies and researchers who are trying to develop new ways to save lives and improve care? How much do those hoops cost and how can you expect those costs not to be passed on to the patients? Again, how can they afford to pay millions do develop a treatment and then only get thousands back ,by comparison, in return. They cannot afford to operate at a loss. Want more government subsidies or do you want fewer innovators....cause it's going to probably be one of those.
Short version of my ramblings. You can look at the world and history to see what happens when government takes over healthcare (or any other part of the economy). Heath care slows and eventual is rationed. Free markets lead to more general prosperity so that even the lowest of the population have the opportunity to get some health care. The idea of equality in socialist countries is that everyone will receive the same equal care.....shitty care...eventually. Meanwhile, the ruling class of those countries of equality take their amassed fortunes and fly to the states or other countries to get better care for themselves.
That’s what happens when health care is free.
I agree with most of what you said in theory. Government controlled healthcare leads to shortages, rationing, lack of innovation and a laundry list of ills. The only reason the Medicare recipients still enjoy such great healthcare now is because the medical system is heavily subsidized by everyone else, with drug companies and doctors making up for less revenue from Medicare by charging more to privately insured folks and cash customers.
But Ivory Tower theories alone won't address the real problem now, which is voter sentiment. As I pointed out above, the vast majority of voters do not believe that someone should have to die simply for lack of ability to pay for healthcare. Also, a majority of voters also believe that one should not have to go bankrupt in order to receive life saving medical treatments or other care. Further, as healthcare costs continue to rise and deductibles/co-pays along with them, which has impacted employer based healthcare plans as well as individual plans, sentiment continues to trend ever more in favor of some form of active legislation.
If the Republicans continue to do nothing more than float fluffy notions, like price transparency, and theoretical ivory tower objections that most voters don't really understand, then sooner or later the Dems are going to do something far worse. They've already made two runs at it in the modern era and the second attempt fucked the individual marketplace, which is only a tiny piece of the whole pie, with a rhino dick. Do we really want to sit on our hands and wait for them to permanently fuck up our whole healthcare system?
SJG
How many voting idiots still believe that the Polar Bears are all dying.....though their populations have quadrupled?
How many voting idiots still believe that OJ was innocent?
How many voting idiots still believe that socialism leads to prosperity for all?
And unfortunately, the number of those idiots is growing....some through a crappy and biased education system. Some by illegally crossing the border and getting the go ahead to vote by leftist politicians. If there was some kind of test of basic general knowledge or common sense before giving suffrage, the political spectrum would look much different.
When they feel the pain a bit that will do a tremendous amount to level the playing field.
SJG