Union support

[Marvin the Martian]

One of the largest unions in Nevada just trashed Medicare for All. This was going to be a problem for MFA candidates, union workers often have merch better and cheaper health care than the rest of us.

They did not endorse in the 2016 caucus, and have not here. So who knows how much this flyer will impact the race. But I doubt this will be the only union worried about their health care benefit.

https://electoral-vote.com/#item-4

 

[Sope Creek]

One of the largest unions in Nevada just trashed Medicare for All. This was going to be a problem for MFA candidates, union workers often have merch better and cheaper health care than the rest of us.

They did not endorse in the 2016 caucus, and have not here. So who knows how much this flyer will impact the race. But I doubt this will be the only union worried about their health care benefit.

https://electoral-vote.com/#item-4

The import of this news isn't that progress isn't possible, but rather that it needs to be done incrementally, to allow people to adjust to the change a little bit at a time.

MFA would be revolutionary for the delivery of health care. It's not illogical . . . it's just that there would be too much change too quickly for the public generally to accept readily.

 

[Lucy01]

The import of this news isn't that progress isn't possible, but rather that it needs to be done incrementally, to allow people to adjust to the change a little bit at a time.

MFA would be revolutionary for the delivery of health care. It's not illogical . . . it's just that there would be too much change too quickly for the public generally to accept readily.

Your post doesn’t address anything about how a Labor Union reacts to MFA! Health insurance Is a very big organizing tool for a Union. Take Health insurance away and unions will disappear!

 

[Sope Creek]

Your post doesn’t address anything about how a Labor Union reacts to MFA!

I didn't intend for it to.

Health insurance Is a very big organizing tool for a Union.

That's a good point, but that's because there is no overarching system that makes it easy for individuals to get health care coverage, making negotiated contracts between large health insurance providers and large organizations like corporations, churches, unions, etc. necessary. Fix the overarching health care system and you can eliminate the need for unions, etc. to focus on health care as part of their contracts.

Take Health insurance away and unions will disappear!

Silly Lucy . . . unions would be free to negotiate other compensation and work conditions issues on behalf of their membership . . . and there'd be more money to negotiate for.

 

[Marvin the Martian]

The import of this news isn't that progress isn't possible, but rather that it needs to be done incrementally, to allow people to adjust to the change a little bit at a time.

MFA would be revolutionary for the delivery of health care. It's not illogical . . . it's just that there would be too much change too quickly for the public generally to accept readily.

I agree with this. The sad thing is, we aren't good at doing things incrementally. If we had decided in 1860 to incrementally end slavery, the committee drafting the proposal on how to end slavery would still be writing its first report.

 

[Sope Creek]

I agree with this. The sad thing is, we aren't good at doing things incrementally. If we had decided in 1860 to incrementally end slavery, the committee drafting the proposal on how to end slavery would still be writing its first report.

Interesting . . . is healthcare an issue that is on par with slavery? If so, what are the two primary sides in the discussion? Consumers vs. providers? Consumers vs. insurers? Insurers vs. providers? Government vs. insurers? Government vs. providers? Government vs. consumers?

Regarding health care, don't we have an initial report . . . in the form of the ACA? Or is it your position that the ACA has been a worthless exercise because it's incremental and not MFA?

[on edit] Did we learn anything from the Civil War? If so, could what we learned is that resolving our issues without bloodshed is important, too, even if it means doing so incrementally?

 

[CO. Hoosier]

I didn't intend for it to.

That's a good point, but that's because there is no overarching system that makes it easy for individuals to get health care coverage, making negotiated contracts between large health insurance providers and large organizations like corporations, churches, unions, etc. necessary. Fix the overarching health care system and you can eliminate the need for unions, etc. to focus on health care as part of their contracts.



Silly Lucy . . . unions would be free to negotiate other compensation and work conditions issues on behalf of their membership . . . and there'd be more money to negotiate for.

Medicare is probably not as good as coverage as is most union plans. Most of those who advocate MFA misrepresent Medicare.

 

[Marvin the Martian]

Regarding health care, don't we have an initial report . . . in the form of the ACA? Or is it your position that the ACA has been a worthless exercise because it's incremental and not MFA?

ACA is again being overturned in lower courts. I'm not confident ACA is permanent. I don't think congress will get the votes to roll it back, but looking at the Supremes, I am not at all betting on ACA.

Interesting . . . is healthcare an issue that is on par with slavery? If so, what are the two primary sides in the discussion? Consumers vs. providers? Consumers vs. insurers? Insurers vs. providers? Government vs. insurers? Government vs. providers? Government vs. consumers?

Americans by nature despise change. The primary sides are those without coverage (or without affordable coverage) and those that want America to exist as it did in their youth. And yes, I suspect insurance companies, pharma, and big medical groups side with the latter. But in voting, the cannot change block is the key demographic.

Did we learn anything from the Civil War? If so, could what we learned is that resolving our issues without bloodshed is important, too, even if it means doing so incrementally?

The Civil War faced that same "no change" block. Most southerners had no investment in slavery, yet fully supported it because slavery existed when they were young and things that existed when they were young is how God intended things to be. In America maybe more than most countries, that "its how its always been" is a powerful group. Jim Crow benefited from that as well. So did the anti-gay marriage movement.

But unlike those movements, courts just are not going to decide that separate but unequal health care is unconstitutional. So it has to come from other means. Most people realize health care is a mess. It is after ACA (though less so) and it was before ACA. But we can't get anything moved through the slowness caused by the "we didn't need government in my youth so we don't need it now" morass.

 

[mcmurtry66]

Medicare is probably not as good as coverage as is most union plans. Most of those who advocate MFA misrepresent Medicare.

Last I read private sector union membership was down to about 5 or 6% of the workforce.

 

[twenty02]

One of the largest unions in Nevada just trashed Medicare for All. This was going to be a problem for MFA candidates, union workers often have merch better and cheaper health care than the rest of us.

They did not endorse in the 2016 caucus, and have not here. So who knows how much this flyer will impact the race. But I doubt this will be the only union worried about their health care benefit.

https://electoral-vote.com/#item-4

Unions traded wages for better benefits..... this was actually a wise choice as benefits aren't taxable, where wages obviously are.

Of course they are going to oppose something like MFA..... just like the dupes who paid for their own college (or student loan payoff) will oppose the idea of loan forgiveness and free college.

 

[Sope Creek]

Medicare is probably not as good as coverage as is most union plans.

Some see that as a bug, I see that as a feature . . . it can be controlled in a variety of ways, including supplemental insurance programs to start, or changing the coverage to suit the needs of a majority of Americans . . . or some combination of that . . . .

 

[El Drado]

Unions traded wages for better benefits..... this was actually a wise choice as benefits aren't taxable, where wages obviously are.

Of course they are going to oppose something like MFA..... just like the dupes who paid for their own college (or student loan payoff) will oppose the idea of loan forgiveness and free college.

MFA and free college, IMO, does not fix the issue. The issue is the cost of healthcare and college. The costs are not in line and the markets have gone rogue. We pay whatever the hell the bill says, and we don't know what the bill will say until we receive it (mainly talking healthcare). What other market can operate like this....would you get a car not knowing the cost, or put groceries in your cart without any clue of what the price tag was? The conversation needs to be about correcting the cost issue and making it transparent

 

[CO. Hoosier]

Some see that as a bug, I see that as a feature . . . it can be controlled in a variety of ways, including supplemental insurance programs to start, or changing the coverage to suit the needs of a majority of Americans . . . or some combination of that . . . .

Supplemtal plans don’t change coverages. They simply help with copay and deductibles. Medicare advantage plans do expand coverages, but those are capitation plans with strict rules about networks.

MFA will be expensive enough. Expanding coverages too would be a significant issue. That said, using Medicare to pay for neo natal and pediatrics will present enough coverage issues to last a while.

 

[CO. Hoosier]

MFA and free college, IMO, does not fix the issue. The issue is the cost of healthcare and college. The costs are not in line and the markets have gone rogue. We pay whatever the hell the bill says, and we don't know what the bill will say until we receive it (mainly talking healthcare). What other market can operate like this....would you get a car not knowing the cost, or put groceries in your cart without any clue of what the price tag was? The conversation needs to be about correcting the cost issue and making it transparent

Excellent point. There is no meaningful market for health care. Trump has already signed an EO about transparency. I don’t know when it takes effect. To your larger point, you can’t control costs by limiting reimbursement rates.

 

[mcmurtry66]

MFA and free college, IMO, does not fix the issue. The issue is the cost of healthcare and college. The costs are not in line and the markets have gone rogue. We pay whatever the hell the bill says, and we don't know what the bill will say until we receive it (mainly talking healthcare). What other market can operate like this....would you get a car not knowing the cost, or put groceries in your cart without any clue of what the price tag was? The conversation needs to be about correcting the cost issue and making it transparent

This is spot on. What's more not only do you not know what the bill is going to be in advance, the bill is tethered in many respects to what the patient has: medicare/medicaid, private insurance, self-pay, no insurance at all.

 

[Sope Creek]

MFA and free college, IMO, does not fix the issue. The issue is the cost of healthcare and college. The costs are not in line and the markets have gone rogue. We pay whatever the hell the bill says, and we don't know what the bill will say until we receive it (mainly talking healthcare). What other market can operate like this....would you get a car not knowing the cost, or put groceries in your cart without any clue of what the price tag was? The conversation needs to be about correcting the cost issue and making it transparent

I agree. I would add that we should consider enacting a law that no provider can charge any patient more than a limited percentage of its lowest contracted price for the same service - say 110%. That would be designed to cut out the socialism from the right where individual consumers subsidize heavily negotiated corporate health care costs as part of an insurance program.

 

[Sope Creek]

Supplemtal plans don’t change coverages. They simply help with copay and deductibles. Medicare advantage plans do expand coverages, but those are capitation plans with strict rules about networks.

MFA will be expensive enough. Expanding coverages too would be a significant issue. That said, using Medicare to pay for neo natal and pediatrics will present enough coverage issues to last a while.

That may be the way they currently work . . . there's nothing that says they have to work that way in response to MFA.

 

[Marvin the Martian]

MFA and free college, IMO, does not fix the issue. The issue is the cost of healthcare and college. The costs are not in line and the markets have gone rogue. We pay whatever the hell the bill says, and we don't know what the bill will say until we receive it (mainly talking healthcare). What other market can operate like this....would you get a car not knowing the cost, or put groceries in your cart without any clue of what the price tag was? The conversation needs to be about correcting the cost issue and making it transparent

How do you control costs in health care? I have many times linked a story that spoke of the impact competition has on costs. Chattanooga has low health care costs, and it has several competing medical organizations. There is one organization in southwest Georgia, it monopolizes the market. SW Georgia has some of the highest costs in the land. I don't know what alternative the people have. If their kid breaks their arm, pack them up and drive to Atlanta?

Even with transparency, there is a math that comes into play. If I can find a procedure slightly cheaper out of network, I can choose that (and I have). But it goes into a different pool for reaching my deductible. I am almost never going to get that back. If I pay a little bit more but stay in network, I reach my 20% copay sooner (and maybe even the 100% OOP sooner). So there is a certain calculus one has to do especially early in a year. Am I really saving money by putting that money into an OOP pool?

 

[CO. Hoosier]

That may be the way they currently work . . . there's nothing that says they have to work that way in response to MFA.

Sure that’s how supplements have to work. If supplements expand coverages then you don’t have MFA. You government AND private coverage.

 

[mcmurtry66]

I agree. I would add that we should consider enacting a law that no provider can charge any patient more than a limited percentage of its lowest contracted price for the same service - say 110%. That would be designed to cut out the socialism from the right where individual consumers subsidize heavily negotiated corporate health care costs as part of an insurance program.

Lowest contracted price by private insurers or the government? Medicare/medicaid is drastically lower in terms of reimbursements than any private carrier I've ever experienced.

 

[Sope Creek]

Sure that’s how supplements have to work. If supplements expand coverages then you don’t have MFA. You government AND private coverage.

That's distinction without a difference. You would still have MFA . . .

. . . if you wanted something more than that, say, a lasik surgery, you could either obtain private insurance or pay for it out of pocket.

 

[Sope Creek]

Lowest contracted price by private insurers or the government? Medicare/medicaid is drastically lower in terms of reimbursements than any private carrier I've ever experienced.

You're in the weeds, Mc. Them's just details . . . .

 

[Aloha Hoosier]

ACA is again being overturned in lower courts. I'm not confident ACA is permanent. I don't think congress will get the votes to roll it back, but looking at the Supremes, I am not at all betting on ACA.



Americans by nature despise change. The primary sides are those without coverage (or without affordable coverage) and those that want America to exist as it did in their youth. And yes, I suspect insurance companies, pharma, and big medical groups side with the latter. But in voting, the cannot change block is the key demographic.



The Civil War faced that same "no change" block. Most southerners had no investment in slavery, yet fully supported it because slavery existed when they were young and things that existed when they were young is how God intended things to be. In America maybe more than most countries, that "its how its always been" is a powerful group. Jim Crow benefited from that as well. So did the anti-gay marriage movement.

But unlike those movements, courts just are not going to decide that separate but unequal health care is unconstitutional. So it has to come from other means. Most people realize health care is a mess. It is after ACA (though less so) and it was before ACA. But we can't get anything moved through the slowness caused by the "we didn't need government in my youth so we don't need it now" morass.

Misused movement. Those supporting the status quo aren’t the movement, those supporting change are the movement. There was an anti-slavery movement, the suffrage movement, and the same sex marriage movement. They all were movements for change.

 

[CO. Hoosier]

That's distinction without a difference. You would still have MFA . . .

. . . if you wanted something more than that, say, a lasik surgery, you could either obtain private insurance or pay for it out of pocket.

How is that a distinction without a difference? MFA is advertised in the basis of you don’t need private insurance. This isn’t about elective care like lasik or nose jobs. Medicare doesn’t cover, or it restricts, some care and procedures that are often covered by private insurance.

 

[Marvin the Martian]

Misused movement. Those supporting the status quo aren’t the movement, those supporting change are the movement. There was an anti-slavery movement, the suffrage movement, and the same sex marriage movement. They all were movements for change.

I am confused, we have had movements for health care reform for over 100 years https://pnhp.org/a-brief-history-universal-health-care-efforts-in-the-us/

Supporting status quo is the inertia, and inertia is hard to overcome. Sometimes too hard.

 

[Sope Creek]

How is that a distinction without a difference? MFA is advertised in the basis of you don’t need private insurance. This isn’t about elective care like lasik or nose jobs. Medicare doesn’t cover, or it restricts, some care and procedures that are often covered by private insurance.

You're saying that MFA has to cover everything (other than elective care) or it's not really MFA . . . are you intending to say that?

 

[Aloha Hoosier]

I am confused, we have had movements for health care reform for over 100 years https://pnhp.org/a-brief-history-universal-health-care-efforts-in-the-us/

Supporting status quo is the inertia, and inertia is hard to overcome. Sometimes too hard.

I’m confused as to why you say you’re confused. Seems like you understand that the efforts to bring about change are the movements.

 

[Marvin the Martian]

I’m confused as to why you say you’re confused. Seems like you understand that the efforts to bring about change are the movements.

I used movements in terms of courts deciding for gay marriage and against Him Crow. I did not think courts would ever decide in favor of universal coverage. So I am confused where the movement point is coming from.

 

[El Drado]

How do you control costs in health care? I have many times linked a story that spoke of the impact competition has on costs. Chattanooga has low health care costs, and it has several competing medical organizations. There is one organization in southwest Georgia, it monopolizes the market. SW Georgia has some of the highest costs in the land. I don't know what alternative the people have. If their kid breaks their arm, pack them up and drive to Atlanta?

Even with transparency, there is a math that comes into play. If I can find a procedure slightly cheaper out of network, I can choose that (and I have). But it goes into a different pool for reaching my deductible. I am almost never going to get that back. If I pay a little bit more but stay in network, I reach my 20% copay sooner (and maybe even the 100% OOP sooner). So there is a certain calculus one has to do especially early in a year. Am I really saving money by putting that money into an OOP pool?

Have you ever taken out a huge ball of christmas lights or electrical cord and said, "what the hell is that mess?"?
You have to start somewhere, and imo the US gov needs to intervene and start the untangling.
You are correct, consumers don't have options and don't have transparency, but we need to start somewhere (i would start with medication costs and duplicate other countries mandates)......we all know people that have delayed retirement so they can have good coverage or sadly bankruptcies. The healthcare private sector will never correct this, but none of us want the government to have complete control either.....so that leaves them correcting the market. There is no silver bullet......

 

[CO. Hoosier]

You're saying that MFA has to cover everything (other than elective care) or it's not really MFA . . . are you intending to say that?

No. I’m saying Medicare, as now existing, doesn’t cover everything while the advocates clearly imply that it does. That is either ignorance or dishonesty. Even money on which.

 

[Marvin the Martian]

Have you ever taken out a huge ball of christmas lights or electrical cord and said, "what the hell is that mess?"?
You have to start somewhere, and imo the US gov needs to intervene and start the untangling.
You are correct, consumers don't have options and don't have transparency, but we need to start somewhere (i would start with medication costs and duplicate other countries mandates)......we all know people that have delayed retirement so they can have good coverage or sadly bankruptcies. The healthcare private sector will never correct this, but none of us want the government to have complete control either.....so that leaves them correcting the market. There is no silver bullet......

I agree with you, I just fear the wording I am hearing from,some that transparency is the final step.

I read a story years ago about a doctor whose wife was expecting. They went to the local hospital in advance of the delivery to confirm the costs. They left happy. Unknown to anyone, the anesthesiologist working delivery day was not in network and hit them with a huge bill.

Transparency is a step, not a destination. I am just concerned too many people see it as the destination.

 

[Aloha Hoosier]

I used movements in terms of courts deciding for gay marriage and against Him Crow. I did not think courts would ever decide in favor of universal coverage. So I am confused where the movement point is coming from.

Did you read all my posts? If you did, I don’t understand how you could possibly confused. It started with Sope calling the opposition to legalizing same sex marriage, and other resistance to change, a movement. That wasn’t the movement, efforts to change the status quo are movements. Examples are the Civil Rights movement and the same sex marriage movement. I don’t know how I could make this clearer or less confusing.

 

[mcmurtry66]

I agree with you, I just fear the wording I am hearing from,some that transparency is the final step.

I read a story years ago about a doctor whose wife was expecting. They went to the local hospital in advance of the delivery to confirm the costs. They left happy. Unknown to anyone, the anesthesiologist working delivery day was not in network and hit them with a huge bill.

Transparency is a step, not a destination. I am just concerned too many people see it as the destination.

Exactly! That's the other nonsense. Insurance and coverage is part of the problem - but so too is the rising cost of care that seems to be just arbitrarily set by providers, and that includes prescription costs. Then to compound matters Joe Blow presents to the ER complaining of whatever and gets hit with an ER bill, and a month later out of no where a separate physicians' group bill because the doctors treating him have their own entity/llc that they bill from. One trip to the ER you can have an ambulance bill, ER bill, and two physicians' groups bills at least three of which bills come as a surprise that only exacerbate the surprise of the cost of service, depending of course on what kind of coverage you had - if any....

 

[iuwclurker]

MFA and free college, IMO, does not fix the issue. The issue is the cost of healthcare and college. The costs are not in line and the markets have gone rogue. We pay whatever the hell the bill says, and we don't know what the bill will say until we receive it (mainly talking healthcare). What other market can operate like this....would you get a car not knowing the cost, or put groceries in your cart without any clue of what the price tag was? The conversation needs to be about correcting the cost issue and making it transparent

Health care under a curative paradigm will never behave like a "normal" market -- in normal markets, the goal is more customers, according to Hippocrates, in medicine the goal is fewer customers.

So the primary opposing economic forces are those wanting more sick people versus those wanting fewer sick people.

Medical science understandably has long focused on curing medical problems. Now there are even two forces there, those attempting to create healthy people and those wanting to prolong sickness (e.g., pharmaceutical research, for which cures are anathema, lifelong medication, the holy grail).

Interestingly, health insurance providers are supporters of the healthy paradigm shift. Who'da thunk it? So the question is, just who's against? Doctors have to have patients to have work, but most signed on in good faith. Hospitals are being taken over by CEOs and turning doctors into pawns, so there's one culprit for certain. We all know pharma has become corrupt as sin. Medical schools have been loath to change their curriculum.

That's where I'd look, who's against people being healthy?

 

[Marvin the Martian]

Did you read all my posts? If you did, I don’t understand how you could possibly confused. It started with Sope calling the opposition to legalizing same sex marriage, and other resistance to change, a movement. That wasn’t the movement, efforts to change the status quo are movements. Examples are the Civil Rights movement and the same sex marriage movement. I don’t know how I could make this clearer or less confusing.

Ah, you quoted me which led to the confusion on my end as I wasn't sure how I misused it.

 

[mcmurtry66]

Yep

Health care under a curative paradigm will never behave like a "normal" market -- in normal markets, the goal is more customers, according to Hippocrates, in medicine the goal is fewer customers.

So the primary opposing economic forces are those wanting more sick people versus those wanting fewer sick people.

Medical science understandably has long focused on curing medical problems. Now there are even two forces there, those attempting to create healthy people and those wanting to prolong sickness (e.g., pharmaceutical research, for which cures are anathema, lifelong medication, the holy grail).

Interestingly, health insurance providers are supporters of the healthy paradigm shift. Who'da thunk it? So the question is, just who's against? Doctors have to have patients to have work, but most signed on in good faith. Hospitals are being taken over by CEOs and turning doctors into pawns, so there's one culprit for certain. We all know pharma has become corrupt as sin. Medical schools have been loath to change their curriculum.

That's where I'd look, who's against people being healthy?

It really has changed from care to a hard business. I've had numerous clients over the years get in car crashes and present to the hospital. The intake nurse/clerk would take my client's health insurance information and then ascertain how he was injured. If he was in a car crash the hospital would then refuse to use/run his health insurance. Instead the hospital would put a lien on the personal injury case and try and recover the bill from the PI case settlement because their reimbursement rate from the health insurance provider was so low. So you have a guy who has ostensibly paid for health insurance but the hospital won't take it because they want his settlement money. Sope mentioned getting into the weeds but healthcare is nothing but the weeds.

 

[iuwclurker]

I agree with this. The sad thing is, we aren't good at doing things incrementally. If we had decided in 1860 to incrementally end slavery, the committee drafting the proposal on how to end slavery would still be writing its first report.

A major incremental factor is health care providers. Rural and poor areas already have scarcity problems and successful doctors, who like their money, have been retiring early because of the added bureaucracy of Obamacare and other changes. Meanwhile, medical schools have long limited enrollment to keep the supply of doctors low for financial reasons.

Suddenly changing the system isn't going to address a scarcity problem when it takes a minimum of 4-12 years to create doctors (depending on how far back into K-16 you want to go to start creating the larger numbers of doctors).

 

[Aloha Hoosier]

Ah, you quoted me which led to the confusion on my end as I wasn't sure how I misused it.

Darn it. I thought I had quoted Sope. Now I know that I’m the source of the confusion. Sorry about that.

 

[Aloha Hoosier]

Yep

It really has changed from care to a hard business. I've had numerous clients over the years get in car crashes and present to the hospital. The intake nurse/clerk would take my client's health insurance information and then ascertain how he was injured. If he was in a car crash the hospital would then refuse to use/run his health insurance. Instead the hospital would put a lien on the personal injury case and try and recover the bill from the PI case settlement because their reimbursement rate from the health insurance provider was so low. So you have a guy who has ostensibly paid for health insurance but the hospital won't take it because they want his settlement money. Sope mentioned getting into the weeds but healthcare is nothing but the weeds.

That ought to be a crime.

 

[hoot1]

Health care under a curative paradigm will never behave like a "normal" market -- in normal markets, the goal is more customers, according to Hippocrates, in medicine the goal is fewer customers.

So the primary opposing economic forces are those wanting more sick people versus those wanting fewer sick people.

Medical science understandably has long focused on curing medical problems. Now there are even two forces there, those attempting to create healthy people and those wanting to prolong sickness (e.g., pharmaceutical research, for which cures are anathema, lifelong medication, the holy grail).

Interestingly, health insurance providers are supporters of the healthy paradigm shift. Who'da thunk it? So the question is, just who's against? Doctors have to have patients to have work, but most signed on in good faith. Hospitals are being taken over by CEOs and turning doctors into pawns, so there's one culprit for certain. We all know pharma has become corrupt as sin. Medical schools have been loath to change their curriculum.

That's where I'd look, who's against people being healthy?

Staying healthy longer can mean more of us facing Alzheimer's which I see as becoming a more prevalent and expensive problem in the years ahead.

So you save money in the short run by staying healthy only to run up huge costs in the final years of a long life.

Seems like we cannot win.