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skarekrow13

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#3401
I highly doubt it Fex. The problem doesn't seem to be primarily one of competition for insurance providers. I have several companies that I can choose to purchase from already, but the only way to decrease cost is to get ****ty coverage. For instance, the closest to affordable plan for an individual comes in at around $70 a week with every possible benefit we can wrangle into that price. It comes out to be about $3,700 per year for insurance. Again, this is for ONE person. This plan also has a deductible of $3,000. Which means in addition to paying your premium you're responsible for the first $3k of expenses. Or in other words, you're close to $7,000 in the hole PER YEAR before your health insurance does anything to help you.

Coming back to the concept of interstate purchasing, a company from another state would somehow have to undercut that price or actually provide reasonable coverage for the same. In order to do that they need to find a way to profit somehow and medical costs from what the providers charge make that impossible as is.

I'll use the medication Naloxone to underscore the medical service delivery model in the USA. Naloxone for those unaware, is a drug that counteracts an opioid overdose. This medication has no demonstrated harm to someone who is not experiencing an overdose. In other words, if used at the wrong time, it has no negative impact. It's safe to deliver using either a nasal spray or auto-injector like an epi-pen. It's been around since the 60s primarily with EMTs and police and has a long history of saving lives for low cost.

Point 1: Despite it's excellent track record for DECADES and high level of safety, this medication has basically been a shadow in the country. We just started talking about it in CPR/First Aid classes (I'm an instructor) last year and many people are like "I've never heard of that." The reason they've never heard of it is because it's been behind a pharmacy wall for almost it's entire existence. It's safe, effective and easy to use. But no one was allowed to have it without extensive training. The point is this, we have a very weird thing where everything is behind closed doors and we place insane limitations on access. In the last few years (remember, it's been around for about 50) states have finally started adopting laws that extend its use into good samaritan laws which basically make it so you're not legally liable for trying your best with the drug. In my state, pharmacies need a doctor to sign off and say "we're fine with you distributing without a prescription." So for something that's about as harmful and as easy to use as a band aid, there's a ton of hoops to jump through to access it. Why is that?

Point 2: Money is everything. When Naloxone was a niche drug only found in the hands of EMTs and police officers it was relatively cheap. Essentially, there was no market so the company focused on other products for a profit. Now that the laws are loosening up and distribution should be wider, the cost has more than doubled in the last few years. There has also been increased focus on opioid deaths in the last few years and the company can capitalize off the fear. Why should you balk at $40 a dose to save a loved one's life? Well you shouldn't, because that's still a good cost/benefit ration. But it used to be about $20 and that extra cost might mean the difference between having it or not for a cash strapped addict or friend of addict.

So in short, interstate competition won't impact the cost of the care itself which is necessary to lower premiums (or government subsidy but that's a whole other topic)
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Fexelea

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#3402
Indeed, it was my impression as well that the real problem behind the absurd healthcare costs in the us are big pharma and the limitations such an industry produces.

It's a very complicated problem, because it is understandable that research is very expensive and people ought to profit from their work, but at the same time similar level of care in other countries is nowhere near as expensive. Switzerland has mandated insurance too, but I found their hospitalisation policies and costs much more cost effective.

Japan and Asia in general have national hospitals and private clinics, which means you can get free or subsidised care for most small ailments, and an ambulance ride costs you 10 usd. You can opt for extra insurance to cover the big scary issues like cancer or a private room for surgery etc, but if you twist your ankle you will likely just pay your local doctor ten to fifty bucks for all you needed.

I'm not sure if this is achieved by getting the drugs cheaper, but I do know that the state providing the hospital infrastructure meant the running costs are already significantly less. They are still very crowded, so people are encouraged to use small private clinics, but the availability of free care keeps prices somewhat low in my experience.

I'll look up the drug issue, I know in some regards the us gets shafted and charged more than other places.
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Rakuyo

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#3403
Fexelea wrote:Indeed, it was my impression as well that the real problem behind the absurd healthcare costs in the us are big pharma and the limitations such an industry produces.

It's a very complicated problem, because it is understandable that research is very expensive and people ought to profit from their work, but at the same time similar level of care in other countries is nowhere near as expensive. Switzerland has mandated insurance too, but I found their hospitalisation policies and costs much more cost effective.


Isn't that like admitting that over that the USA's over hyped economic liberalism just ends up squeezing everything out of its people?

People who work in the medical industry have told me that big pharma just can't fail to make buckets of money, and taxing it hardly changes a thing.
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Lich180

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#3404
The way I've seen insurance companies work is this:

You need a medication. You pay your insurance company 100$ a month. Insurance pays for your medication from the company fund you and every other customer of theirs pays into. The cost for you, out of pocket at the pharmacy is 0. Insurance pays 20$ to the pharmaceutical company.

Well, the pharmacy company realizes that insurance will pay for the drug no matter what, and decided to hike the price up to 200$. Insurance company goes "crap, charge more for policies". You now have to pay 500$ a month to cover the increased costs for one drug.

Everyone gets mad at prices, and goes to their representatives. Representatives pull in the CEO is the pharmacy and insurance company, and get bribed with profits from drug. Price drops to 150$, your monthly payment starts the same.

See the problems? There are no controls on how much a pharm company can charge for a drug (remember the epi-pen thing) and will lobby politicians for favors (money in politics, IE no controls on lobbyists spending on politicians) and no limit on how much your insurance can suck out of you.

Oh by the way, if you choose not to have insurance, you'll have to pay a few thousand dollars this year when you file your taxes. You have to pay whether you can afford insurance or not.

The ACA is anything BUT affordable . I'm lucky enough to have a job that has a decent health plan for my wife and I (350$/month for health, vision, dental, covers most prescriptions and tests). Not everyone is that lucky, though. The system needs to be reworked, and I don't see anyone currently in office trying to do anything.
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githcheater

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#3405
The high cost of healthcare in the US is more than just big pharma ...

High administrative costs, use of defensive medicine to avoid lawsuits, laws discouraging provider expansion, and the consumer being disconnected from price tag ...

https://www.cbsnews.com/news/why-is-hea ... rst-place/
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Lich180

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#3406
That's what I was trying to think of while typing my previous post out.

Another factor is the way American healthcare treats symptoms, not the cause of disease. Rather than eat healthy, exercise, and take care of ourselves we eat unhealthy food, sit around all day, and don't do anything proactive for our health. This makes us want fixes for the symptoms of obesity, diabetes, heart disease and other diseases caused by bad diets and unhealthy living.

Just like when you get the flu. The best thing is (if you are already healthy) to simply sit it out and suffer the symptoms. Not take Tamiflu and feel kinda better while still sick and get others I'll as well.
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githcheater

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#3407
Not this year ... otherwise healty people are dying due to the flu.

A few months ago, I waited out the flu 5 days and got pneumonia. Fortunately the pneumnia was caught early and the anti-biotics helped me get better and return to work.

My boss was wiped out with the flu and left work early a few weeks ago. He took Tamiflu and only missed one day of work.

Last week my my dad got norovirus and went to the emergency room. Tamiflu helped him a lot. He is feeling better now, but he still feels weak.

Next time I get the flu I won't wait ... I will see the doctor and get Tamiflu.
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Lich180

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#3408
I'll admit Tamiflu really helps, especially this year with such a bad flu virus going around.

But there's still a lot of snake oil / folk remedies / drug can that doctors will prescribe, simply because we feel the need to treat symptoms, not the disease itself.
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Lich180

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#3409
Well this whole situation with the information breach involving Facebook and Cambridge Analytica is fascinating. Please read the sources linked here, do not just dismiss this. Social media is being used to break apart people and weaken government's worldwide.

First, you have to understand:

-TRUMP CAMPAIGN hired CAMBRIDGE ANALYTICA in 2016.

-CAMBRIDGE ANALYTICA had the facebook info of 500 million users.

-The RUSSIANS had the hacked US voters rolls in their possession.

-SPECTRUM HEALTH had everyone's email address/actual addresses on the national health care database.

During the 2016 campaign A TRUMP CO server was connecting to a RUSSIAN BANK server which was connecting to a SPECTRUM HEALTH server.

https://www.cnn.com/2017/03/09/politics/fbi-investigation-continues-into-odd-computer-link-between-russian-bank-and-trump-organization/index.html

The TRUMP CO server was actually based outside PHILLY hosted by a company named Listrak. I imagine that the CAMBRIDGE ANALYTICA // FACEBOOK user data was here.

http://lancasteronline.com/news/local/fbi-gets-lititz-firm-s-help-in-probe-of-russian/article_ef5d5ed0-05ae-11e7-a003-471e5543b26a.html

The RUSSIAN BANK server was hosted by ALFA BANK had the hacked US voter rolls.

https://www.vox.com/2018/2/27/17060132/intelligence-russia-hacking-us-elections

SPECTRUM HEALTH, owned by **** Devos (husband of Betsy Devos) had access to everyone's email address/actual addresses from the national healthcare database.

https://www.axios.com/fbi-still-investigating-trump-server-link-to-russian-bank-1513300861-138e5453-4274-4e4b-b828-343b6550327b.html

With the info on all three servers... the US voter rolls could be associated with the FaceBook accounts by connecting where users live to their email address.

So if you wanted to target Republicans in Michigan who voted in the last 4 elections you'd know exactly how to get at them with Facebook ads.

With this information the trump campaign was able to use facebook's advertising to pump a steady stream of precision propaganda into swing voters' feeds.

That is how they were able to so aggressively and effectively micro target their ads.

There's more. But it complicates this further.

But Lukoil initially requested the app Cambridge Analytica developed for facebook that harvested all the personal user data. AND A Russian university developed the programing.

https://www.theguardian.com/news/2018/mar/17/cambridge-academic-trawling-facebook-had-links-to-russian-university

Lukoil is financed by Alfa Bank.

https://www.reuters.com/article/russia-lukoil-loans/russias-lukoil-raises-250-mln-of-financing-from-alfa-bank-idUSFWN12402420151005

Alfa Bank reps the Rosneft oil sale money that was tied up by US sanctions against Russia.

https://www.ft.com/content/c784f61a-0dc3-11e4-85ab-00144feabdc0

The Rosneft sale was an attempt to get around sanctions as Wilbur Ross (now trumps commerce sec) had done in 2015 while he was at Cyprus Bank.

https://www.theguardian.com/us-news/2017/mar/23/wilbur-ross-russian-deal-bank-of-cyprus-donald-trump-commerce-secretary

The details of the sale were worked out in the seychelles meeting organized by convicted child molester George Nader between Russian banker Kirill Dmitriev and Erik Prince (Betsy Devos' brother).

https://www.washingtonpost.com/world/national-security/mueller-gathers-evidence-that-2016-seychelles-meeting-was-effort-to-establish-back-channel-to-kremlin/2018/03/07/b6a5fb8c-224b-11e8-94da-ebf9d112159c_story.html?utm_term=.bad9c7106cb6

Rex Tillerson, the former exxon ceo, was tapped to be the Secretary of State to help loosen the sanctions so that after the shady Roseneft sale Exxon's proprietary tech could be used to dig up oil in Russia's arctic region. But when the sanctions couldn't be removed and the info started to leak the deal fell through and recently Exxon walked away from the deal.

https://www.reuters.com/article/us-exxon-mobil-russia-rosneft-oil/exxon-quits-some-russian-joint-ventures-citing-sanctions-idUSKCN1GC39B

Without that oil money Putin's power is weakened.

https://www.theguardian.com/world/2014/dec/21/vladimir-putin-russia-oil-prices-power-oligarchs


CA whistleblower stated they tested out the slogans and catch phrases back in 2014/15 depending on the news article

"And in 2014, "we were testing all kinds of messages and all kinds of imagery — that included images of walls, people scaling walls, we tested 'drain the swamp,' testing ideas of the 'deep state,'" he added. - http://theweek.com/speedreads/761935/cambridge-analytica-testing-trump-campaign-themes-2014-whistleblower-says

http://thehill.com/policy/technology/379090-whistleblower-cambridge-analytica-met-with-lewandowski-before-trump

Oh, and anyone who talks about this data breach on Facebook gets banned and their posts deleted.
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eremHaNeoN

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#3410
Ouch, that post at the top of the last post was TSMP's last here. Feb. 28, and hasn't posted since. I hope he hasn't decided to leave for good over a squabble with Fex herself over... I honestly was not following what the argument was over. But I hate to come back here and see users I and probably a number of others value highly go away and not come back because of politics or whatever else. The forum discussions here are often pretty slow-going as it is, and Discord... well, it's Discord. Good for small talk, in-depth discussions, less so. I dunno, **** like this is just depressing especially considering the current state of so many other forums out there. :/
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