RL Anger

Shebakoby

@Shebakoby said:

@surreality said:

@Shebakoby said:

Oh. Interesting. So, if Canada wasn't having price controls, would Americans be as badly gouged in drug prices, then?

All signs point to yes. If you look at gas prices for an example it becomes fairly clear: if they could get away with it yesterday, they will try to get away with it today and tomorrow.

Gas prices in Canada are mostly gas tax from various levels of government.

...I'm not talking about gas prices in Canada.

Don't American gas prices have a huge chunk of it in tax, too? Maybe not as much as Canada, but still?

surreality

I have to ask, because I'm not reading through this thread to dig for it: @Shebakoby , are you talking about an issue that personally affected you or people you personally know offline, or fringe outlier cases you've heard about having happened?

Because I would run out of fingers and toes counting the people I know personally, offline, who have been screwed up in some permanent and sometimes life-threatening fashion by the old version of US healthcare or their lack of access to it, myself included.

So if you're talking outlier strangers, please have at least a frail iota of respect for those people who are living with the consequences of the nightmare you're idealizing.

@Shebakoby said:

Don't American gas prices have a huge chunk of it in tax, too? Maybe not as much as Canada, but still?

Everything here has a pile of taxes in it; that doesn't impact the behavior of companies that, once they have established that they can acquire a certain level of profit, will continue to do precisely that. Do not think for a second the companies screaming, "Oh, gov't! Bail us out! We are in trouble even though we already raised our prices!" didn't make record profits: they absolutely did. And they kept making them even when their cost dropped substantially, because it had been proven that the market would bear the new price point, which was not 'oh the gov't just added a pile of taxes', ffs. Rare is the corporation that is going to lower their price point from a level that's proven to be sustainable even if their cost drops; they will just repeat the whole process later and cry about how their 'new normal' is being threatened and we get to go through the whole rigamarole again.

Ganymede

@Shebakoby said:

Don't American gas prices have a huge chunk of it in tax, too? Maybe not as much as Canada, but still?

Isn't that kind of irrelevant?

In the United States, gas prices are mostly based on federal, state, and local taxes. Those taxes are generally ear-marked for transportation-related projects and funds. The same can be said about cigarettes, with such funds going to public-health projects.

Most people know this, and accept it. Fewer people seem to understand how corrupt, inefficient, and generally-awful the American health care system is. They are afraid of non-existent crises in other countries. They should be afraid of the crises that actually exist in the United States.

mietze

One of the reasons that the governor of Oregon might not have ever experienced a health care wait is because he is of significant wealth/employment class to have never been without good health insurance accepted by all the doctors of his choice/in his area, so it was never an issue with him. The people with no insurance/shitty insurance experienced something very different.

Until about 3 years before Obamacare, my family was paying $1000/mo for shitty ass $5000 deductable catastrophic care only "health insurance". Then we joined an extremely expensive HMO but at least preventative stuff was covered. So I spent the first decade of my children's lives being given That Look in the doctor's office that would have denied us care until I said the magic words of "how much is your cash discount if I pay you in full today?" The vast majority of people who are not on good insurance plans do not have the means to do that. And doctors were not required to accept medicaid (the indigent person medical plan).

Wonder what the wait time was for a family who did not qualify for medicaid/find a provider for it who didn't have $300 to drop per visit for a pediatric visit + immunizations + medication? Would they have bothered to try to get in at all? That is why there wasn't really a wait there, as say there was when I was growing up in the military (socialized medicine that all could access, so yes, more demand, and there was indeed triage in a way that regular care visits elsewhere didn't need) because you'd already cleared a bunch of hurdles even being able to know you could call to make an appointment in the first place.

In any place perfect, no. But it is pretty icky that the reason why there was so little of that in some tiers of the medical system the US is because so many people were /denied any kind of access/ period. Look at public health/indigent clinics though and the story is way different.

Shebakoby

@surreality said:

I have to ask, because I'm not reading through this thread to dig for it: @Shebakoby , are you talking about an issue that personally affected you or people you personally know offline, or fringe outlier cases you've heard about having happened?

Because I would run out of fingers and toes counting the people I know personally, offline, who have been screwed up in some permanent and sometimes life-threatening fashion by the old version of US healthcare or their lack of access to it, myself included.

So if you're talking outlier strangers, please have at least a frail iota of respect for those people who are living with the consequences of the nightmare you're idealizing.

@Shebakoby said:

Don't American gas prices have a huge chunk of it in tax, too? Maybe not as much as Canada, but still?

Everything here has a pile of taxes in it; that doesn't impact the behavior of companies that, once they have established that they can acquire a certain level of profit, will continue to do precisely that. Do not think for a second the companies screaming, "Oh, gov't! Bail us out! We are in trouble even though we already raised our prices!" didn't make record profits: they absolutely did. And they kept making them even when their cost dropped substantially, because it had been proven that the market would bear the new price point, which was not 'oh the gov't just added a pile of taxes', ffs. Rare is the corporation that is going to lower their price point from a level that's proven to be sustainable even if their cost drops; they will just repeat the whole process later and cry about how their 'new normal' is being threatened and we get to go through the whole rigamarole again.

why do you think I'm "idealizing" it? I'm not. And no, I'm not talking about "stranger outliers" (interestingly enough, many of the horror stories I've heard re: USA health care WOULD be considered "stranger outliers"). US healthcare needed fixing and badly.

The point i was making about the taxes is it's probably every bit as "gouging" as the companies' prices.

Shebakoby

@mietze said:

One of the reasons that the governor of Oregon might not have ever experienced a health care wait is because he is of significant wealth/employment class to have never been without good health insurance accepted by all the doctors of his choice/in his area, so it was never an issue with him. The people with no insurance/shitty insurance experienced something very different.

Until about 3 years before Obamacare, my family was paying $1000/mo for shitty ass $5000 deductable catastrophic care only "health insurance". Then we joined an extremely expensive HMO but at least preventative stuff was covered. So I spent the first decade of my children's lives being given That Look in the doctor's office that would have denied us care until I said the magic words of "how much is your cash discount if I pay you in full today?" The vast majority of people who are not on good insurance plans do not have the means to do that. And doctors were not required to accept medicaid (the indigent person medical plan).

Wonder what the wait time was for a family who did not qualify for medicaid/find a provider for it who didn't have $300 to drop per visit for a pediatric visit + immunizations + medication? Would they have bothered to try to get in at all? That is why there wasn't really a wait there, as say there was when I was growing up in the military (socialized medicine that all could access, so yes, more demand, and there was indeed triage in a way that regular care visits elsewhere didn't need) because you'd already cleared a bunch of hurdles even being able to know you could call to make an appointment in the first place.

In any place perfect, no. But it is pretty icky that the reason why there was so little of that in some tiers of the medical system the US is because so many people were /denied any kind of access/ period. Look at public health/indigent clinics though and the story is way different.

I'm curious. If there were a significant portion of the Oregon population that had any sort of health care wait, wouldn't they contact the governor or their state representative and thus make him aware of the issue?

The only thing I've heard that's negative about Obamacare from people I know (not stranger outliers) is that it significantly increased the cost of a state offered health insurance plan so that they can no longer afford the premiums.

Three-Eyed Crow

@Shebakoby said:

I'm curious. If there were a significant portion of the Oregon population that had any sort of health care wait, wouldn't they contact the governor or their state representative and thus make him aware of the issue?

BWAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA.

Ahem. Sorry. Maybe for someone who isn't American this isn't a laughable idea. Which is all I have to say about our health care system compared to the rest of the civilized world, really.

Ganymede

@Shebakoby said:

The only thing I've heard that's negative about Obamacare from people I know (not stranger outliers) is that it significantly increased the cost of a state offered health insurance plan so that they can no longer afford the premiums.

Obamacare does not address the systematic problems; it rides along with it. The system essentially does three things: (1) forces insurers to carry applicants; (2) coughs up a subsidy payable to insurers on behalf of applicants based on their income; and (3) penalizes people for not being insured. This is mostly a win-situation for insurers.

Shebakoby

@Three-Eyed-Crow said:

@Shebakoby said:

I'm curious. If there were a significant portion of the Oregon population that had any sort of health care wait, wouldn't they contact the governor or their state representative and thus make him aware of the issue?

BWAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA.

Ahem. Sorry. Maybe for someone who isn't American this isn't a laughable idea. Which is all I have to say about our health care system compared to the rest of the civilized world, really.

don't Americans run to their representatives if they have a problem?

Shebakoby

@Ganymede said:

@Shebakoby said:

The only thing I've heard that's negative about Obamacare from people I know (not stranger outliers) is that it significantly increased the cost of a state offered health insurance plan so that they can no longer afford the premiums.

Obamacare does not address the systematic problems; it rides along with it. The system essentially does three things: (1) forces insurers to carry applicants; (2) coughs up a subsidy payable to insurers on behalf of applicants based on their income; and (3) penalizes people for not being insured. This is mostly a win-situation for insurers.

Good grief, the more i learn about it, the more it looks like a sop to the insurance companies. Although I guess there's a change where it's easier for people on social assistance or minimum wage to get coverage via subsidies now?

Miss Demeanor

@Shebakoby said:

@Three-Eyed-Crow said:

@Shebakoby said:

I'm curious. If there were a significant portion of the Oregon population that had any sort of health care wait, wouldn't they contact the governor or their state representative and thus make him aware of the issue?

BWAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA.

Ahem. Sorry. Maybe for someone who isn't American this isn't a laughable idea. Which is all I have to say about our health care system compared to the rest of the civilized world, really.

don't Americans run to their representatives if they have a problem?

AHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAno. The representatives we have have their campaigns largely funded by the same corporations we would complain to them about. The chance of them risking their funding to do anything about the problem is.. slim to none.

Shebakoby

@Miss-Demeanor all the funding in the world doesn't mean a thing if the people vote for someone else, right?

You guys need an NDP and a Liberal party to keep the other two parties on their toes. (the NDP prides itself on not taking corporate donations)

Miss Demeanor

All the voting in the world don't mean a thing if both sides are being funded by large corporations. And good luck trying to institute that!

Silver

@Shebakoby said:

don't Americans run to their representatives if they have a problem?

Yes. And then habitually they fail to listen, and then they get voted out of office once they blow off enough of their constituents, and then the party opposite them crows about how CLEARLY the electorate must be coming around to their way of thinking, when really both major parties in the US are essentially the same people who have different masters, none of whose masters are the actual voters that put them in office.

It's why Congress went more Republican back in 2014. It doesn't mean that Americans were going "hey let's give the Republicans more of a shot". It's because they were going "my incumbent representative doesn't give a damn about me, so let's fire them".

It will be the same in 2016 and 2018, etc. A slough of Congressmen get fired every cycle not so much out of affirmative support for the party of the winner but out of spite for the incumbent.

TNP

And speaking of which...

I HATE election years. Especially since it's almost two years long.

I also HATE the media for giving the shit bag Republican candidates a forum. Donald Trump is not a serious candidate. Ted Cruz is not a serious candidate. Mike Huckabee is not a serious candidate.

I HATE Republican voters for potentially making shit bags serious candidates.

surreality

@Shebakoby said:

The point i was making about the taxes is it's probably every bit as "gouging" as the companies' prices.

That you think this somehow addresses corporate profit behaviors in any capacity just boggles the mind. It does not. Not even in the slightest way. There is no parity here, it is not a parallel, it isn't even apples and oranges, it's apples and dump trucks.

ThatGuyThere

@Shebakoby
The job of every corporation is to maximize profits. In fact in the US they are legally required to or can be sued by their own shareholders. So yes if Canada had no price controls US consumers would be charged the same, just likely that Canadians would be getting the higher prices as well.

Ganymede

@Shebakoby said:

The point i was making about the taxes is it's probably every bit as "gouging" as the companies' prices.

I somehow missed this. You're not even close.

Taxes aren't great, especially in Canada. Those ad valorem taxes really slam the lower and middle classes. However, those people can still get quality care with little problem.

When I say "price-gouging," consider the following:

Let Service be a given procedure.

Health care providers that accept Public insureds (on Medicare or Medicaid) are paid $A by the government for Service.
Health care providers that accept Insurer J's insureds are paid $B for Service.
Health care providers that accept Insurer K's insureds are paid $C for Service.
Health care providers that provide Service to uninsured charge $D.
Insurer K is bigger than Insurer J, and can leverage a better price for Service. Therefore, $C < $B.
The government tamps down prices artificially. Therefore, $A < $C.

So, what's the price for Service? Presuming that there is an equal number of all insureds and the uninsured, then it's reasonable to presume that P = (A + B + C + D) / 4. And, since A < C < B < D, the uninsured will always pay above the "actual" price of service.

This is different than your tax scenario; this shows that the health care providers are forced to price-gouge the uninsured. Which inures to the benefit of the health insurance companies.

TNP

Plus, when it comes to prescription drugs, unless it's changed in the last couple years, it's illegal for the government to try to get better drug prices from the pharmaceutical companies for Medicare. And who pays for Medicare? The taxpayers! So we get screwed that way too.

Shebakoby

@Ganymede said:

@Shebakoby said:

The point i was making about the taxes is it's probably every bit as "gouging" as the companies' prices.

I somehow missed this. You're not even close.

Taxes aren't great, especially in Canada. Those ad valorem taxes really slam the lower and middle classes. However, those people can still get quality care with little problem.

When I say "price-gouging," consider the following:

Let Service be a given procedure.

Health care providers that accept Public insureds (on Medicare or Medicaid) are paid $A by the government for Service.

Health care providers that accept Insurer J's insureds are paid $B for Service.

Health care providers that accept Insurer K's insureds are paid $C for Service.

Health care providers that provide Service to uninsured charge $D.

Insurer K is bigger than Insurer J, and can leverage a better price for Service. Therefore, $C < $B.

The government tamps down prices artificially. Therefore, $A < $C.

So, what's the price for Service? Presuming that there is an equal number of all insureds and the uninsured, then it's reasonable to presume that P = (A + B + C + D) / 4. And, since A < C < B < D, the uninsured will always pay above the "actual" price of service.

This is different than your tax scenario; this shows that the health care providers are forced to price-gouge the uninsured. Which inures to the benefit of the health insurance companies.

The crazy part about all this, is how health insurance has evolved so that people end up using it to pay for a doctor's visit. This would be akin to getting your car insurance to pay for a tune-up. I learned in economics in school that Insurance was intended to shield people from the "true" cost of a catastrophe (and in doing so, pools money to pay for said catastrophes, and the risk of going bankrupt or into serious debt is spread around). Car insurance is for accidents. Health insurance was originally intended to cover catastrophic health events (major illnesses such as those requiring hospital stays, or serious injuries). But I also learned in economics, that insurance also distorts the true costs, so that people end up paying more in the long run.

Could you imagine how much more it would cost to get tires replaced if car insurance was invoked to cover the bill?