Kamala’s take on the Economy

[crazed_hoosier2]

That model absolutely works with car mechanics. I've got a mechanic that I go to for 80% of my needs. But I get tires from someone else, as well as oil changes. I do some stuff myself. When my maintenance interval service comes up, he does it, gives everything the once over and does anything he's found that makes sense for him to do. If it's transmission related he sends me to the transmission specialist.

I've had a 20+ year relationship with my mechanic.

Not only this...your mechanic/doctor will be in a competitive marketplace just as much as all of the other mechanics/doctors. It's not like he's going to be the lone holdout.

Of course you'd still be able to keep the Docs you wanted to keep. The idea is making healthcare more competitive. That doesn't necessarily mean you have to bounce around. How much do we bounce around with things we buy in competitive marketplaces? Do you travel across town to the other supermarket every other week? Or do you unwittingly benefit from the fact that your supermarket has to have competitive prices?

Moreover, the biggest problem isn't primary care. It's with specialty care.

 

[crazed_hoosier2]

None of this accounts for the new coverage that 20M people now have, who would have been without before the ACA.

I'm not really sure what point you're making here -- viz the point I'm making.

That chart simply looks at the percentage of healthcare goods/services that are paid for out of pocket. And it includes deductibles, co-payments, coinsurance, and just goods/services that don't involve insurers at all.

 

[DANC]

Eliminate the PBMs….the brand name padded their pockets to stay preferred on the formulary. This is an easy fix….but, alas we suck

Sorry for my ignorance on the matter, but what does PBM stand for?

 

[crazed_hoosier2]

Will she say colleges are price gouging because education costs have sky rocketed? No, because the Dems need educational contributions.

Somebody asked Mitch Daniels about the similarities between higher education and healthcare as it relates to cost increases over the past decades. His answer was something that intimated that he didn't think it was a coincidence. I also don't think it's a coincidence.

One thing that needs to happen in higher ed funding is establishing some kind of relationship between the cost to acquire a particular degree and the expected value of having the degree -- and the amount of subsidy and/or student lending needs to be tethered to that value.

I don't think a medical degree costing $250K is really too big of a deal. It's rational to what an MD can expect to earn.

But the idea of a Bachelor's degree in criminology costing the same to acquire as a Bachelor's degree in chemical engineering simply makes no sense -- if not from the standpoint of the universities, then at least from the standpoint of lenders and borrowers.

 

[mcmurtry66]

Sorry for my ignorance on the matter, but what does PBM stand for?

Pharmacy benefits management

 

[DANC]

Pharmacy benefits management

Thanks. Not familiar with that term.

 

[TDHoosier]

Craze, share your concerns about our "insurance model" as it relates to paying for health care.

The bottom line for me when it comes to health care is simply why is our care so expensive and why does such a high percentage of our total GDP go to health care.

Finally, what can be done to lower costs.

Healthcare costs are crazy. My wife approved two nurses on one of her units to pick up extra time at $122.00/hour just on Saturday alone. This happens all the time, why because nurses are vastly overpaid and call in regularly because they have a cash cushion. The "no amount of cash is enough" crew reaps the benefits.

PCA's (Medical assistants) run upwards to 25-27.00/hour, but in defense they do a lot of the work.

Reading this tread has made me appreciate my medical coverage. I pay $200.00 in premiums a month and if I practice preventive measures my visits and labs are free. I'm on 3 medication and pay about $40.00 a month total. If I joined my wife's plan I would only pay $120.00/month in premiums but I'm comfortable in my existing plan.

 

[mcmurtry66]

Thanks. Not familiar with that term.

Third party outfit that acts like an intermediary amongst pharmacies insurance cos and manufacturers. They negotiate drug prices help create formularies etc. spartan knows more.

 

[crazed_hoosier2]

None of this accounts for the new coverage that 20M people now have, who would have been without before the ACA.

Speaking of Obamacare, apropos of nothing, I have an anecdote. I'm not sure how representative it is of the broader landscape. And this anecdote is going to fly right in the face (or at least seem to) of the point I'm making about relying less on insurance and more on OOP in healthcare.

Earlier this year, we interviewed a young mother for a clerical job -- she'd be working every day at a jobsite trailer at an industrial facility not far from her home. Her husband worked for a small construction company in their small town. And she had been working part time, doing things similar to what we were hiring for. Neither of them had access to employer-sponsored health insurance. So they had an ACA plan, for which they paid a couple hundred bucks a month.

We were talking about our health insurance (which is a Cadillac plan, through one of our unions) and how much better it would be for her. She'd have 1/3 of the premium withheld from her check. And that amount would be more than what she was paying now. But it would be much better coverage. Our deductibles are $600 individual/$1800 family.

She had her daughter scheduled for a tonsillectomy in a couple weeks. It was going to cost them $8k out of pocket. I was pretty sure we wanted to hire her. So I asked her if she could push that procedure back until our coverage kicked in. She was able to, and it saved that family quite a lot of money.

 

[crazed_hoosier2]

Third party outfit that acts like an intermediary amongst pharmacies insurance cos and manufacturers. They negotiate drug prices help create formularies etc. spartan knows more.

Yeah, a couple of the bigger ones are CVS Caremark and Express Scripts.

 

[mcmurtry66]

Yeah, a couple of the bigger ones are CVS Caremark and Express Scripts.

Yup. I know a bunch of people at express scripts

 

[mcmurtry66]

Yeah, a couple of the bigger ones are CVS Caremark and Express Scripts.

You talk about gov healthcare etc and people don’t realize the magnitude. Something like 15 percent of all US workers are in healthcare

 

[crazed_hoosier2]

Healthcare costs are crazy. My wife approved two nurses on one of her units to pick up extra time at $122.00/hour just on Saturday alone. This happens all the time, why because nurses are vastly overpaid and call in regularly because they have a cash cushion. The "no amount of cash is enough" crew reaps the benefits.

PCA's (Medical assistants) run upwards to 25-27.00/hour, but in defense they do a lot of the work.

Reading this tread has made me appreciate my medical coverage. I pay $200.00 in premiums a month and if I practice preventive measures my visits and labs are free. I'm on 3 medication and pay about $40.00 a month total. If I joined my wife's plan I would only pay $120.00/month in premiums but I'm comfortable in my existing plan.

I sit on a hospital board. Our CEO basically summed this up that nursing costs were hit by a huge shortage -- and a lot of that had to do with COVID. Caused a lot of retirements earlier than expected, etc. So nursing has been a problem on top of a problem.

He did say at our last meeting that it's relaxed a fair bit. But I'm sure it's different in different parts of the country.

 

[Spartans9312]

Sorry for my ignorance on the matter, but what does PBM stand for?

Pharmacy Benefit Manager…Caremark, Express Scripts….yada yada yada

 

[hoot1]

Healthcare costs are crazy. My wife approved two nurses on one of her units to pick up extra time at $122.00/hour just on Saturday alone. This happens all the time, why because nurses are vastly overpaid and call in regularly because they have a cash cushion. The "no amount of cash is enough" crew reaps the benefits.

PCA's (Medical assistants) run upwards to 25-27.00/hour, but in defense they do a lot of the work.

Reading this tread has made me appreciate my medical coverage. I pay $200.00 in premiums a month and if I practice preventive measures my visits and labs are free. I'm on 3 medication and pay about $40.00 a month total. If I joined my wife's plan I would only pay $120.00/month in premiums but I'm comfortable in my existing plan.

TDH, sounds as if you are fairly young and in good health.

My case is entirely different. The wife and I have been healthy for most of our lives. Our out of pocket and life time health insurance costs have to be in the bottom 10% of those still kicking at 85 plus years of age.

What we face is the inevitable last few months of life which costs 10% of the total U.S. health care each year. Medicare pays out 40% of its budget each year for end of life care.

The wife and I could be facing expenditures of at least $25,000 to $50,000 for each of us for the final 1 to 3 months of our lives.

Don't know what the cost of final life care is in other countries and how they deal with it, but there has to be a better way.

 

[crazed_hoosier2]

TDH, sounds as if you are fairly young and in good health.

My case is entirely different. The wife and I have been healthy for most of our lives. Our out of pocket and life time health insurance costs have to be in the bottom 10% of those still kicking at 85 plus years of age.

What we face is the inevitable last few months of life which costs 10% of the total U.S. health care each year. Medicare pays out 40% of its budget each year for end of life care.

The wife and I could be facing expenditures of at least $25,000 to $50,000 for each of us for the final 1 to 3 months of our lives.

Don't know what the costs of final life care is in other countries and how they deal with it, but there has to be a better way.

God Bless ya, hoot. In case I haven't told you lately, you're a good egg.

And, you're right, end-of-life care is a huge, huge deal financially. And it's a very difficult one for everybody to approach.

 

[MyTeamIsOnTheFloor]

Robin Hood was fiction. Still is. Still must be.

 

[DANC]

Third party outfit that acts like an intermediary amongst pharmacies insurance cos and manufacturers. They negotiate drug prices help create formularies etc. spartan knows more.

So, basically, just an added cost. Bastards.

 

[TDHoosier]

TDH, sounds as if you are fairly young and in good health.

My case is entirely different. The wife and I have been healthy for most of our lives. Our out of pocket and life time health insurance costs have to be in the bottom 10% of those still kicking at 85 plus years of age.

What we face is the inevitable last few months of life which costs 10% of the total U.S. health care each year. Medicare pays out 40% of its budget each year for end of life care.

The wife and I could be facing expenditures of at least $25,000 to $50,000 for each of us for the final 1 to 3 months of our lives.

Don't know what the costs of final life care is in other countries and how they deal with it, but there has to be a better way.

I'm 52 with HBP and Cholesterol problems. I hate it when families face end of life care, usually a liquidation of all assets and then Medicaid takes over or at least from what I have seen. I've been in banking for over 25 years and the amount of elderly people who have seen their wealth dwindle to nothing due to medical expense is staggering. Many have turned to elder attorney's to help with this, which generally leads to setting up a trust of some sort.

I have a friend who's wife recently was diagnosed with early dementia, he is starting to spend money on tangible assets (river home and other things) and putting them in his daughters name to avoid most of this. Working their entire lives they have amassed a decent amount of wealth and it could all go to her care. He won't put her in a home, but he was once the most active guy I knew (motorcycled across the US several times) to now he can't stray to far from home.

 

[TDHoosier]

I sit on a hospital board. Our CEO basically summed this up that nursing costs were hit by a huge shortage -- and a lot of that had to do with COVID. Caused a lot of retirements earlier than expected, etc. So nursing has been a problem on top of a problem.

He did say at our last meeting that it's relaxed a fair bit. But I'm sure it's different in different parts of the country.

I'm sure there is a shortage, however I do not see how? An individual can get a 2 year degree, pass the nursing boards and come out making 80k (probably higher) a year. Typically this comes with zero to little college debt and you are staring a career at 21, I have two daughters one who followed her Mother into nursing the other who followed me into banking. One told me they chose the wrong field the other day, I let you guess which one.

 

[crazed_hoosier2]

I'm sure there is a shortage, however I do not see how? An individual can get a 2 year degree, pass the nursing boards and come out making 80k (probably higher) a year. Typically this comes with zero to little college debt and you are staring a career at 21, I have two daughters one who followed her Mother into nursing the other who followed me into banking. One told me they chose the wrong field the other day, I let you guess which one.

If I had to guess, I'd say that demand spiked and supply either contracted or simply didn't keep pace when Covid hit. And the turnaround time to get new ones hired and trained just lags that. We offer scholarships up to $8K for employees wanting to seek nursing educations -- they have to apply and meet certain criteria (and sign an employment contract). But it just doesn't happen overnight.

In any event, spiraling healthcare cost problems predated this -- but it did add fuel to the fire.

 

[hoot1]

I'm 52 with HBP and Cholesterol problems. I hate it when families face end of life care, usually a liquidation of all assets and then Medicaid takes over or at least from what I have seen. I've been in banking for over 25 years and the amount of elderly people who have seen their wealth dwindle to nothing due to medical expense is staggering. Many have turned to elder attorney's to help with this, which generally leads to setting up a trust of some sort.

I have a friend who's wife recently was diagnosed with early dementia, he is starting to spend money on tangible assets (river home and other things) and putting them in his daughters name to avoid most of this. Working their entire lives they have amassed a decent amount of wealth and it could all go to her care. He won't put her in a home, but he was once the most active guy I knew (motorcycled across the US several times) to now he can't stray to far from home.

TD, appreciate your comments and insight to problems facing our growing elder population.

Notice the number of attorneys becoming elder attorneys is increasing along with fees. Isn't more competition supposed to lower costs ?

On the other hand, there is that supply and demand thing.

 

[UncleMark]

She must be doing something right. Gas is 35 cents cheaper today than last week. Thanks Kamala!

 

[hookyIU1990]

She must be doing something right. Gas is 35 cents cheaper today than last week. Thanks Kamala!

She's waiving the federal requirement to sell low Reid Vapor Pressure gas, which in turn is contributing to an increase in greenhouse gasses in exchange for buying votes with lower gas prices.

😁

 

[hookyIU1990]

By the way, gas prices are down out here in California too

 

[IU_Hickory]

She talked about the rising costs of food and housing in the clip. The cost of both of those increased drastically while she has been office because of inflation from printing money. It has shit to do with price gouging or big corporations. Harris is the one who inferred the increase in costs was from price gouging and she was going to take them on and fix it. Not me. Save me the disingenuous talk. Point Break is awesome

yet corporations made record profits during and after the pandemic..


but definitely not price gouging.

 

[ChicagoFineForNow]

yet corporations made record profits during and after the pandemic..


but definitely not price gouging.

Which corporations? All of them? Record margins? When about did that start? I see a pretty precipitous dip in 2020. Is it a possibility that favorable policy geared toward corporations at the expense of small business is partly to blame for that? Which party is more responsible for Covid precautions that harmed SMB’s at the expense of Corporations?

 

[ChicagoFineForNow]

yet corporations made record profits during and after the pandemic..


but definitely not price gouging.

Does illegal immigration undercut labor costs? Has there been any illegal immigration under Biden? What effect does lower labor costs have on profit margin?

 

[TDHoosier]

If I had to guess, I'd say that demand spiked and supply either contracted or simply didn't keep pace when Covid hit. And the turnaround time to get new ones hired and trained just lags that. We offer scholarships up to $8K for employees wanting to seek nursing educations -- they have to apply and meet certain criteria (and sign an employment contract). But it just doesn't happen overnight.

In any event, spiraling healthcare cost problems predated this -- but it did add fuel to the fire.

Possibly I do think a ton has to do with work ethic as well. My wife's units are always full of nursing students shadowing, when I ask her why is there a shortage she always says most are lazy and don't want to do the work. Now I do have to keep in mind this is coming from a woman who puts in 50-60 minimum weekly, not including the phone calls up until 10pm nightly.

I know at UofL if you start to work there and want to go into nursing they will pay the tuition. Also at Norton's they use to have a scholarship that payed it all if you qualified (my wife benefited from this).

 

[hookyIU1990]

yet corporations made record profits during and after the pandemic..


but definitely not price gouging.

Record Net Profit Percentage or Record Net Profit Dollars?

 

[TDHoosier]

TD, appreciate your comments and insight to problems facing our growing elder population.

Notice the number of attorneys becoming elder attorneys is increasing along with fees. Isn't more competition supposed to lower costs ?

On the other hand, there is that supply and demand thing.

I hope it all works out for you. Having two parents in their late 70's it weighs on my mind what to do. Thankfully my Dad is 77 and still maintains his home and land (12 acres all cut and maintained) by himself. I don't try to take it for granted as I know it can all change quickly.

 

[twenty02]

I'm sure there is a shortage, however I do not see how? An individual can get a 2 year degree, pass the nursing boards and come out making 80k (probably higher) a year. Typically this comes with zero to little college debt and you are staring a career at 21, I have two daughters one who followed her Mother into nursing the other who followed me into banking. One told me they chose the wrong field the other day, I let you guess which one.

Not everyone is cut out to be a nurse.

 

[ChicagoFineForNow]

Not everyone is cut out to be a nurse.

That’s true. You have to be a female with mediocre grades in search of a husband that can allow you to retire from the workforce.

 

[hookyIU1990]

TD, appreciate your comments and insight to problems facing our growing elder population.

Notice the number of attorneys becoming elder attorneys is increasing along with fees. Isn't more competition supposed to lower costs ?

On the other hand, there is that supply and demand thing.

hoot, I'm out west with my wife at her Dad's house. He's 86 and has put all the safeguards in place that he can. Health is still reasonably good for a guy his age, but he commented how he hope's quick so the state and federal gov't gets as little as possible.

My parents have put all their land, machinery, and other assets in LLCs. Both of them were worried that if something happened with their health, they'll have to basically lose everything to qualify for anything they've paid into all of their lives.

 

[BradStevens]

Not only this...your mechanic/doctor will be in a competitive marketplace just as much as all of the other mechanics/doctors. It's not like he's going to be the lone holdout.

Of course you'd still be able to keep the Docs you wanted to keep. The idea is making healthcare more competitive. That doesn't necessarily mean you have to bounce around. How much do we bounce around with things we buy in competitive marketplaces? Do you travel across town to the other supermarket every other week? Or do you unwittingly benefit from the fact that your supermarket has to have competitive prices?

Moreover, the biggest problem isn't primary care. It's with specialty care.

I'm going to play devil's advocate for awhile here, to see how this plays out: heart surgeons aren't cereal boxes. Judging quality of each is difficult to impossible to do and doctor's abilities in specialty care aren't usually fungible.

Attorneys "compete" for PI cases all the time. Yet the price for PI attorneys has not changed in 30-40 years (maybe longer now?). I think one reason must be that the lay person cannot hope to know enough to compare prices and abilities of lawyers.

 

[hoot1]

Not everyone is cut out to be a nurse.

Think of all those care givers who get into the field to help people only to find out how difficult it is.

They then stay on the job rather than having to live with the thought they aren't really a caring person.

They keep reminding themselves they are both good at nursing and badly needed.

 

[hoot1]

I'm going to play devil's advocate for awhile here, to see how this plays out: heart surgeons aren't cereal boxes. Judging quality of each is difficult to impossible to do and doctor's abilities in specialty care aren't usually fungible.

Attorneys "compete" for PI cases all the time. Yet the price for PI attorneys has not changed in 30-40 years (maybe longer now?). I think one reason must be that the lay person cannot hope to know enough to compare prices and abilities of lawyers.

Brad, how many PI attorneys have never actually been in a courtroom ?

 

[mcmurtry66]

Brad, how many PI attorneys have never actually been in a courtroom ?

that my friend is a very loaded question and dependent upon many factors and states. the biggest change in that world is advertising. so now you have the morgan and morgan firms where they sign up thousands and thousands of cases and it's certainly true that they have lawyers who do nothing but send out demands and negotiate settlements. but outside of that most pi lawyers go to court. insurance adjusters @larsIU and defense whether captive or outside know whether you've tried cases and that impacts the value. what's more it depends on laws. in some states it used to be that the jury didn't get to hear that the P had medical insurance. so you could have a guy with an ER bill and chiro bill totaling $5k. settle it for $15k on a letter and make five grand in a few hours. No need for court. that law changed in places and now that offer from the insurance company might be $5k. better to file and do a quick and dirty trial. Med mal you almost always have to go to court and fight like an animal

some states have no fault where up to a certain threshold you pursue your own carrier via pip. that won't make much of a living. better go to court.

so i will say most pi lawyers have not only been in a courtroom but spent considerable time in a courtroom if they're actual pi lawyers. now @BradStevens swings for the fences with the class action shit. trial lawyers but difft breed

 

[TDHoosier]

That’s true. You have to be a female with mediocre grades in search of a husband that can allow you to retire from the workforce.

In my case it is the opposite. I'm 52 and daily I ask my wife if I retire at 55. I think it may be working.

 

[TDHoosier]

Not everyone is cut out to be a nurse.

This is true, but as I tell my wife the movies and TV make it seem like a much harder job. lol

Seems I see more and more people in general that aren't cut out to be anything in the workforce. It has to be difficult to have zero direction.