AuthorTopic: Knarf's Knewz Channel  (Read 956636 times)

Offline Eddie

  • Administrator
  • Master Chef
  • *****
  • Posts: 12824
    • View Profile
Re: Trump: Dangerous because he is effective
« Reply #10590 on: January 18, 2018, 05:48:31 AM »
The political establishment in the US has classified him as an aberration, a coincidence of unfortunate circumstances, and a political phenomenon, certainly a nuisance and maybe even a scary, unpredictable man.

They do so because Donald Trump is not and does not want to be "one of them".

In fact, he campaigned on the elite's failure to understand the depth of frustration among ordinary people hit by globalisation. He plays by his own rule book, is in his own way consistent, knows what he is doing, what he wants, and how to get there.

To succeed, he needs friends outside the establishment. And he got them. American politics have been taken over by the big oil companies and corporations. The big ambition is to engineer a swing from the US, being the third-largest global net importer of fossil fuels, to a net exporter, mainly through export of Liquefied Natural Gas (LNG). The larger goal is to create protections for big business, both domestically and internationally.

To pursue these ends, Trump has mobilised the whole state apparatus.

Roadblocks put up by previous administrations are phased out and the green light is given for drilling, including off-shore.

The main activity of the Environmental Protection Agency (EPA) today is not to "protect the environment"; instead, it is busy revoking a long list of regulations and rules introduced to improve environmental quality and protect citizens against toxic substances.

    He has even been able to exploit the animosity of the establishment media to serve his agenda.

     

Deregulation normally linked to the 1980s almost dwarfs, compared with the sweeping dismantling of regulatory frameworks that has been happening over the past year. Restrictions on financial institutions introduced after the global financial crisis are disappearing, and the door is opening for financial institutions to repeat the reckless behaviour that provoked the 2008-2009 crisis.

Congress approved a tax reform at the end of 2017. It introduced lower corporate taxes, benefitting large oil and financial institutions, and lower taxes for higher income brackets. Basically, it is Republican policy sold to the electorate as a measure to stimulate the economy, without mentioning the medium-term negative effects for the middle class and public debt.

Foreign policy, too, has been submitted to the pursuit of these goals. The Chinese market for LNG, expected to be the biggest one in the future, must be conquered. That explains foreign policy vis-a-vis China, North Korea, and oil and gas exporting countries in the Middle East.

According to the rumours going around in diplomatic circles, a more aggressive trade policy is in the pipeline. This may involve not only castrating the World Trade Organization (WTO) and leaving the North American Free Trade Area (NAFTA), but specific cases of temporary import restrictions.

Meanwhile, on the domestic front, to ensure the support of his base, Trump has been keeping true to his campaign promises.

A string of measures introduced to make it more difficult for foreigners to enter the US is presented as a step to protect Americans from terrorism. A superb use of declaratory policy, it sounds good and appeals to the xenophobia among Trump's supporters.

The wall at the Mexican border is moving from being talked about to reality. In early January, Congress was asked for $18bn to build more than 700 miles of barriers.

Obamacare was not abrogated, but turning off financial flows through executive orders turns it into a shadow of what it was intended to be.

To push through all these policies, Trump has had to control or sideline, in one way or another, all three pillars of the state - executive, legislative, and judicial. He cares neither for the constitution, nor for political traditions and etiquette.

The executive branch is facing drastic cuts in financing and staff, and is focused on dismantling the regulatory system.

Trump likes to operate through executive orders, circumventing the legislative branch. Congress has been pushed aside and almost no time has been set aside for building coalitions. Trump's partnership with the Republican congressmen has mainly been focused on removing Obama-era regulations.

Trump's administration has also challenged the judiciary, which has tried to block some of his executive orders. Almost surreptitiously, he has taken advantage of a high number of judicial vacancies to appoint more federal judges, in his first year as president, than any of his predecessors.

He has even been able to exploit the animosity of the establishment media to serve his agenda. Accusing cable networks and newspapers of deceiving the public and publishing "fake news", he has encouraged his supporters to reject mainstream media outlets. But, more importantly, he has used the media obsession with his persona to drive attention away from major policies he is pushing for.

Much of what he does flies under the radar because the media and general public pay attention to the controversial tweets he posts on a regular basis.

In short, Trump has proven to be quite effective at achieving what he wants. And that makes him quite dangerous.

Over the past year, he has demonstrated that the checks and balances supposedly set in place in the US political system, to prevent a president from pursuing rash and ill-considered decisions, do not really function properly. By the time he is done with his presidential term, he might have done irreparable damage to the US political system and US foreign relations.

http://www.aljazeera.com/indepth/opinion/trump-dangerous-effective-180118095302716.html

On the money, for sure.
What makes the desert beautiful is that somewhere it hides a well.

Offline Eddie

  • Administrator
  • Master Chef
  • *****
  • Posts: 12824
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10591 on: January 18, 2018, 06:55:43 AM »
The US is the most expensive nation in the world in which to have a baby – and it may factor into thousands of bankruptcies each year



Stella Apo Osae-Twum and her husband did everything by the book. They went to a hospital covered by insurance, saw an obstetrician in their plan, but when her three sons – triplets – were born prematurely, bills started rolling in.

The hospital charged her family $877,000 in total.

“When the bills started coming, to be very honest, I was an emotional wreck,” said Apo Osae-Twum. “And this is in the midst of trying to take care of three babies who were premature.”

America is the most expensive nation in the world to give birth. When things go wrong – from pre-eclampsia to premature birth – costs can quickly spiral into the hundreds of thousands of dollars. While the data is limited, experts in medical debt say the costs of childbirth factor into thousands of family bankruptcies in America each year.

It’s nearly impossible to put a price tag on giving birth in America, since costs vary dramatically by state and hospital. But one 2013 study by the the advocacy group Childbirth Connection found that, on average, hospitals charged $32,093 for an uncomplicated vaginal birth and newborn care, and $51,125 for a standard caesarean section and newborn care. Insurance typically covers a large chunk of those costs, but families are still often on the hook for thousands of dollars.

Another estimate from the International Federation of Health Plans put the average amount insurers paid for a vaginal birth in the US at $10,808 in 2015. That is quintuple the IFHP estimate for another industrialized nation, Spain, where it costs $1,950 to deliver a child. The amount insurers pay for births in America is lower than the amount billed by hospitals because insurers negotiate lower prices.

Even the luxurious accommodations provided to the Duchess of Cambridge for the birth of the royal family’s daughter Princess Charlotte – believed to have cost up to $18,000 – were cheaper than many births in America.

Despite these high costs, the US consistently ranks poorly in health outcomes for mothers and infants. The US rate of infant mortality is 6.1 for every 1,000 live births, higher than Slovakia and Hungary, and nearly three times the rate of Japan and Finland. The US also has the worst rate of maternal mortality in the developed world. That means America is simultaneously the most expensive and one of the riskiest industrialized nations in which to have children.

American families rarely shoulder the full costs of childbirth on their own – but still pay far more than in other industrialized nations. Nearly half of American mothers are covered by Medicaid, a program available to low income households that covers nearly all birth costs. But people with private insurance still regularly pay thousands of dollars in co-pays, deductibles and partially reimbursed services when they give birth. Childbirth Connection put the average out of pocket childbirth costs for mothers with insurance at $3,400 in 2013.

In Apo Osae-Twum’s case, private insurance covered most of the $877,000 bill, but her family was responsible for $51,000.

Apo Osae-Twum was the victim of what is called “surprise billing”. In these cases, patients have no way of knowing whether an ambulance company, emergency room physician, anesthesiologist – or, in her case, a half-dozen neonatologists – are members of the patient’s insurance plan.

Even though Apo Osae-Twum went to a hospital covered by her insurance, none of the neonatologists who attended to her sons were “in-network”. Therefore the insurance reimbursed far less of their bills.
Q&A
Did you receive an unexpected or unmanageable bill after giving birth?

There are few studies that estimate the number of families who go bankrupt from this type of unexpected expense. One of the best estimates is now outdated – conducted 10 years ago. But one of the authors of that research, Dr Steffie Woolhandler, estimates as many as 56,000 families each year still go bankrupt from adding a new family member through birth or adoption.

“Why any society should let anyone be bankrupted by medical bills is beyond me, frankly,” said Woolhandler. “It just doesn’t happen in other western democracies.”

Since Woolhandler conducted that research in 2007, 20 million Americans gained health insurance through the Affordable Care Act health reform law, and consumer protections were added for pregnant women. But Republicans and the Trump administration have pledged to repeal these consumer protections.

“People face a double whammy when they’re faced with a medical condition,” said Woolhandler. Bankruptcy is often “the combined effect of medical bills and the need to take time off work”.

There is no nationwide law that provides paid family leave in the US, meaning most families forgo income to have a child.

And although childbirth is one of the most common hospital procedures in the nation, prices are completely opaque. That means Americans don’t know how much a birth will cost in advance.

Dr Renee Hsia, an emergency department physician at the University of California San Francisco and a health policy expert likened the experience to buying a car, but not knowing whether the dealership sells Fords or Lamborghinis. “You don’t know, are you going to have a complication that is a lot more expensive? And is it going to be financially ruinous?”

According to Hsia’s 2013 study, a “California woman could be charged as little as $3,296 or as much as $37,227 for a vaginal delivery, and $8,312 to $70,908 for a caesarean section, depending on which hospital she was admitted to.”

Apo Osae-Twum and her family only found relief after a professional medical billing advocate agreed to take their case. Medical Cost Advocate in New Jersey, where Derek Fitteron is CEO, negotiated with doctors to lower the charges to $1,300.

“This is why people are scared to go to the doctor, why they go bankrupt, and why they forgo other things to get care from their kids,” said Hsia. “I find it heartbreaking when patients say … ‘How much does this cost?’”

Did you receive an unexpected or unmanageable bill after giving birth? Share your story using our encrypted form.

https://www.theguardian.com/us-news/2018/jan/16/why-does-it-cost-32093-just-to-give-birth-in-america

Not a fair article at all. Three premature triplets is not just "giving birth".

In most countries other than perhaps western Europe, they would have just died. All three of these kids were probably on life support, perhaps for weeks.

My daughter got a bill for nearly this much over a broken ankle that required multiple trips to  the OR and two weeks in ICU....and that was 7 years ago now.

Giving birth is expensive, but not nearly that expensive for normal deliveries, which don't even rate an overnight hospital stay these days in most US hospitals.
What makes the desert beautiful is that somewhere it hides a well.

Offline knarf

  • Global Moderator
  • Master Chef
  • *****
  • Posts: 10295
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10592 on: January 18, 2018, 08:30:13 AM »

Not a fair article at all. Three premature triplets is not just "giving birth".

In most countries other than perhaps western Europe, they would have just died. All three of these kids were probably on life support, perhaps for weeks.

My daughter got a bill for nearly this much over a broken ankle that required multiple trips to  the OR and two weeks in ICU....and that was 7 years ago now.

Giving birth is expensive, but not nearly that expensive for normal deliveries, which don't even rate an overnight hospital stay these days in most US hospitals.

I agree that they used a sensational example to amplify their point, but....there are many other examples in the article that illustrate how and why the FSoA is gouging the daylights of those who have to have medical care. It is way to complicated for me to know the reasons, so I just chalk it up to  "get as much as you can to fill the coffers". It seems built into the the systemic way capitalism works these days in America, and we have the perfect President to continue to widen the inequality gap. You are WAY more knowledgeable about this being in the business, but as you say "the article isn't fair", so i see that medical costs are not fair. 

Here is an article I just found that might shed some light....he even acknowledges the whole thing is to complex to get the root of the problem.

Why is health care so damn expensive?

Never has there been more talk of innovation and yet more disappointment in the future than in the health care industry. AngelList shows almost a thousand startups just in the digital health space alone, and VCs invested $3.5 billion in digital health startups in just the first half of 2017 according to Rock Health’s industry analysis. There are dozens of health innovation conferences hosted in the United States every year, with participants chattering, chattering, chattering about this or that “innovation.”

All of that innovation has done practically nothing though to fix the single worst problem of modern American health care: it’s cost. Health care in the United States has never been more expensive. The United States is spending about $3.5 trillion a year on health care expenses, an increase of 12,300% since 1960. In that timeframe, health care spending increased from 5% of U.S. GDP to about 17.5% of GDP.

Despite all of that spending, the age-adjusted mortality rate for Americans has only slowly declined every year since 1980. Even worse, life expectancy for Americans — among the most typical metrics for measuring broad health and wellness outcomes for a country — declined for the second year in a row in 2017.

It’s Juicero innovation at its finest. We’re paying more, way more, than we used to, and yet our outcomes have never been worse.

This is the problem known as “cost disease” — the rapidly escalating costs of basic human services like health care, housing, education, construction, and infrastructure. It’s a problem that plagues the developed world, but none more so than in the United States. Scott Alexander, who blogs at Slate Star Codex, wrote a masterful summary of the problem a year ago that’s worth reading for how this pattern seems to emerge across all of these industries.

It is one thing though to identify the pattern, and it’s another to start to tease out the reasons why costs have spiraled 123x in just a few decades. The pithy answer is that there is no pithy answer: industries like construction and healthcare are simply too complicated to have a simple response to the question of cost disease. It’s literally all the answers and none of them at the same time.

There is a slowly growing understanding in policy circles that cost is the fundamental challenge to improving America’s human services and infrastructure. The tradeoffs required in American medicine — offering better care or offering more care to more people would simply be moot if the overall cost of health care was 9% of GDP instead of 17.5% — the median percentage in the OECD group of industrialized countries.

Call me cynical, but having talked with dozens of digital health startups over the past few years, this basic fact so rarely seems to register with founders. Entrepreneurs are trying to digitalize medical records, or improve operating room efficiency through better analytics, or create a new (and expensive!) robotic medical device. These innovations are important, but they are a bit like rearranging the deck chairs on the Titanic to try to right-size the ship: actions far too small to make a difference.

This problem is thankfully starting to be addressed by startups head on. One startup is Avant-garde Health, which publicly announced a $4 million seed round led by General Catalyst, Tectonic Ventures, and Founders Collective this week (the round was closed mid-last year).

I chatted with Derek Haas, who is the founder and CEO of the company and who has spent the last few years completely immersed in the challenges of controlling the rampant cost disease in American hospitals.

If you are wondering what one of the main drivers of cost disease in health care is, it likely starts with the fact that few hospitals and providers actually know what their costs are except for aggregated numbers. We can cue a facepalm emoji, but the reality is that it is really hard to do this sort of analysis with existing management systems.

The company’s solution is to use a technique called “activity-based costing” and apply it to the health industry. The idea is to try to accurately assign every expense of an organization to the exact activity that created that cost. In the healthcare context, Avant-garde uses “time-driven” costing to assign expenses to treatment. The goal, Haas explained, is “to understand for each patient what care is delivered, who delivered that care, and how much time did it take to deliver that care.”

So, for instance, every health professional that sees a surgery patient needs to assign exactly their time to that patient so that the true cost of that surgery can be calculated and analyzed. A nurse who spends 20 minutes in the room needs to assign one third of their hourly rate to the patient.

Now, this sort of costing can sound like an MBA’s godsend or a patient’s worst nightmare (let alone the providers who need to input their timecards). However, Haas’ data from the last few years though shows that the tradeoff between quality of care and cost often doesn’t have to be made. “What we frequently observe is that the biggest drivers of cost and delivery of care is the volume of care,” he explained. In other words, surgeons who conduct more surgeries both have more experience — improving outcomes — while also cutting the cost of each surgery by amortizing their income across more patients.

In addition to volume, standardized treatment is also key. “When you look at organizations with more standardization in how care is delivered, those organizations are getting better outcomes and are often more cost-effective” to boot Haas said.

For example, Avant-garde worked with the Penn State Hershey Medical Center to improve the efficiency of Total Hip Arthroplasty surgery (i.e. a hip replacement). What the hospital found is that different surgeons were using different hip components at different rates, increasing the total supply cost of the surgery. With improved analytics and physician education, the hospital was able to save $842 per surgery with minimal change to outcomes.

Today, Avant-garde is focused on just collecting and analyzing cost data. Its long-term goal though is to attach those costs to actual patient outcomes so that administrators can understand when additional spending is helping patients, and when it doesn’t. “People are often making decisions based on perceived quality, rather than actual outcomes,” Haas said. By getting better outcomes data, hospitals can start to help consumers get better treatment at lower expense.

Avant-garde is not a panacea to our healthcare cost disease. But it is a step in the right direction. By quantifying aspects of the healthcare business that are today opaque, management is being given the tools to actually make the right decisions on behalf of patients and payers.

That in many ways is the story of cost disease in every industry. What looks like a tradeoff can often be recast as a win-win situation. Lowering infrastructure costs can suddenly mean not choosing between three subway routes, but doing all of them. We suddenly don’t have to choose between new technology in classrooms and lower class sizes. And we don’t need to choose between limiting treatment and offering insurance to more people. For founders thinking about making an impact, there’s a trillion dollar idea right here.

https://techcrunch.com/2018/01/13/why-is-health-care-so-damn-expensive/?ncid=mobilenavtrend
HUMANS ARE STILL EVOLVING! Our communities blog is at https://openmind693.wordpress.com

Offline Eddie

  • Administrator
  • Master Chef
  • *****
  • Posts: 12824
    • View Profile
Re: Why Is Healthcare So Expensive?
« Reply #10593 on: January 18, 2018, 09:34:44 AM »
It's really easy to understand if you understand the drivers.

1. Everyone wants their aged parents (and themselves) to get the equivalent of heroic care in their futile struggle against old age. Even if Dad was a smoker. He needs a heart bypass? Does Medicare cover it? Yes? Then go for it.

2. Doctors and hospitals get paid to perform treatment, not counsel people to avoid treatment. CPR on a 90 year old?  Go for it. Hook up the ventilator and hope they start breathing again. That'll be 100K per day please.

3. Sorry, but your baby was born with a congenital defect. With proper treatment, he/she might live to age 30. If we don't operate today and then put your baby on life support for 3 months, he/she will not make it.  Go for it!

4. Insurance  companies make money by taking in more money in premiums than they pay out in benefits. And they own almost all the hospitals now, and the doctors mostly work for them as employees. So by ripping off both doctors and patients they do GREAT! CEO Bonus!

5. Patients who have no insurance are at the mercy of hospitals.  Nowadays fees are negotiated between large groups of providers and giant corporations. Sometime the negotiated fees are so low the providers make very little. So....they can up make some of that shortfall up by overcharging uninsured individuals, who have absolutely no leverage to negotiate anything.

The solutions are obvious,but not at all politically expedient.

We need to spend a lot less on dying people who are going to die anyway. We need to spend less saving defective babies.. We need to get the greedy corporate middle men (corporate insurance giants) out of healthcare. We need to put less money  into fighter jets and foreign occupations, and more into Medicare/Medicaid. We need to offer universal free health care, with reasonable but not unlimited benefits. We need to legislate tobacco use out of existence, as best we can.
« Last Edit: January 18, 2018, 10:23:27 AM by Eddie »
What makes the desert beautiful is that somewhere it hides a well.

Online RE

  • Administrator
  • Chief Cook & Bottlewasher
  • *****
  • Posts: 29944
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10594 on: January 18, 2018, 09:50:19 AM »

Not a fair article at all. Three premature triplets is not just "giving birth".

In most countries other than perhaps western Europe, they would have just died. All three of these kids were probably on life support, perhaps for weeks.

My daughter got a bill for nearly this much over a broken ankle that required multiple trips to  the OR and two weeks in ICU....and that was 7 years ago now.

Giving birth is expensive, but not nearly that expensive for normal deliveries, which don't even rate an overnight hospital stay these days in most US hospitals.

I agree that they used a sensational example to amplify their point, but....there are many other examples in the article that illustrate how and why the FSoA is gouging the daylights of those who have to have medical care. It is way to complicated for me to know the reasons, so I just chalk it up to  "get as much as you can to fill the coffers".

The entire health care industry is a Criminal Racket.  They start with a gated profession to keep the number of practitioners low.  Said practitioners will charge whatever the market will bear, and there is no incentive to keep costs down.  The patients are a captive market, they have no choice when sick but to go to these thieves.  The medical professionals get rich, the patients are impoverished with every illness.  Then of course you have the Insurance Industry, which has to take their cut of the pie also, driving costs up still more.  Then there are no limitation on the type of care, they'll do heart transplants on 80 year olds if they figure they can get paid for it by somebody, including the taxpayer there of course.  You can never get a straight answer on what a big procedure will cost, but you have to sign an open ended contract that you will pay any difference between what your insurance company pays and what they charge.  You can't find out in advance what the Insurance company will reimburse either.  This is all a violation of Tort law, and if push ever came to shove I would litigate it.  However, I have been relatively successful negotiating the minefield and getting my medical bills paid either by insurance or Da Goobermint, so I got no complaints in this area.  My complaints currently stem from the complete incompetence of many if not most of these practitioners.  They charge a fortune for every visit, but they do NOTHING.

RE
SAVE AS MANY AS YOU CAN

Offline Eddie

  • Administrator
  • Master Chef
  • *****
  • Posts: 12824
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10595 on: January 18, 2018, 10:21:28 AM »

Not a fair article at all. Three premature triplets is not just "giving birth".

In most countries other than perhaps western Europe, they would have just died. All three of these kids were probably on life support, perhaps for weeks.

My daughter got a bill for nearly this much over a broken ankle that required multiple trips to  the OR and two weeks in ICU....and that was 7 years ago now.

Giving birth is expensive, but not nearly that expensive for normal deliveries, which don't even rate an overnight hospital stay these days in most US hospitals.

I agree that they used a sensational example to amplify their point, but....there are many other examples in the article that illustrate how and why the FSoA is gouging the daylights of those who have to have medical care. It is way to complicated for me to know the reasons, so I just chalk it up to  "get as much as you can to fill the coffers".

The entire health care industry is a Criminal Racket.  They start with a gated profession to keep the number of practitioners low.  Said practitioners will charge whatever the market will bear, and there is no incentive to keep costs down.  The patients are a captive market, they have no choice when sick but to go to these thieves.  The medical professionals get rich, the patients are impoverished with every illness.  Then of course you have the Insurance Industry, which has to take their cut of the pie also, driving costs up still more.  Then there are no limitation on the type of care, they'll do heart transplants on 80 year olds if they figure they can get paid for it by somebody, including the taxpayer there of course.  You can never get a straight answer on what a big procedure will cost, but you have to sign an open ended contract that you will pay any difference between what your insurance company pays and what they charge.  You can't find out in advance what the Insurance company will reimburse either.  This is all a violation of Tort law, and if push ever came to shove I would litigate it.  However, I have been relatively successful negotiating the minefield and getting my medical bills paid either by insurance or Da Goobermint, so I got no complaints in this area.  My complaints currently stem from the complete incompetence of many if not most of these practitioners.  They charge a fortune for every visit, but they do NOTHING.

RE

I think the gist of this might have been true when you and I were young, but it's changed a lot. The average primary care provider is lucky to net $200K these days.



The corporate takeover of medicine has radically changed everything, which is why so many doctors have been retiring and taking disability and just flat getting out.

The good job now is being an insurance company CEO. Is that a gate kept profession?

Cigna CEO David Cordani: $17.3 million

Cordani's total compensation rose considerably compared to 2014, when he pulled in $14.5 million. His 2015 total includes $1.2 million in base salary, $12.9 million in stock and option awards, $2.9 million in non-equity incentive plan compensation and $352,952 in other compensation.

Aetna CEO Mark Bertolini: $17.3 million

Bertolini's base salary in 2015 was $1.03 million, and he earned $14.1 million in stock and option awards, $1.8 million in non-equity incentive plan compensation and $271,908 in all other compensation. In 2014, Bertolini's overall compensation totaled $15 million--though that figure was down from the $30 million he earned in 2013.

UnitedHealth CEO Stephen Hemsley: $14.5 million

Hemsley's total compensation decreased from the $14.9 million he earned in 2014. His 2015 base salary was $1.4 million, and he received $9.4 million in stock and option awards in addition to $3.7 million in non-equity incentive plan compensation and $145,679 in other compensation.\

How do the Big Five CEOs stack up? Check out 2014's highest health insurance CEO earners.

Anthem CEO Joseph Swedish: $13.6 million

Swedish earned a base salary of $1.3 million, in addition to stock and option awards totaling $10.4 million. He also netted $1.7 million in non-equity incentive plan compensation and $237,896 in all other compensation. Swedish earned $13.5 million in total compensation in 2014.

Humana CEO Bruce Broussard: $10.3 million

Broussard's total compensation has gone up only marginally from 2014, when it was $10.1 million. It includes a base salary of $1.2 million, $8.8 million in stock and option awards, and $331,774 in all other compensation. He did not receive any non-equity incentive plan compensation.


What makes the desert beautiful is that somewhere it hides a well.

Offline knarf

  • Global Moderator
  • Master Chef
  • *****
  • Posts: 10295
    • View Profile
Re: Why Is Healthcare So Expensive?
« Reply #10596 on: January 18, 2018, 10:55:46 AM »
It's really easy to understand if you understand the drivers.

1. Everyone wants their aged parents (and themselves) to get the equivalent of heroic care in their futile struggle against old age. Even if Dad was a smoker. He needs a heart bypass? Does Medicare cover it? Yes? Then go for it.

2. Doctors and hospitals get paid to perform treatment, not counsel people to avoid treatment. CPR on a 90 year old?  Go for it. Hook up the ventilator and hope they start breathing again. That'll be 100K per day please.

3. Sorry, but your baby was born with a congenital defect. With proper treatment, he/she might live to age 30. If we don't operate today and then put your baby on life support for 3 months, he/she will not make it.  Go for it!

4. Insurance  companies make money by taking in more money in premiums than they pay out in benefits. And they own almost all the hospitals now, and the doctors mostly work for them as employees. So by ripping off both doctors and patients they do GREAT! CEO Bonus!

5. Patients who have no insurance are at the mercy of hospitals.  Nowadays fees are negotiated between large groups of providers and giant corporations. Sometime the negotiated fees are so low the providers make very little. So....they can up make some of that shortfall up by overcharging uninsured individuals, who have absolutely no leverage to negotiate anything.

The solutions are obvious,but not at all politically expedient.

We need to spend a lot less on dying people who are going to die anyway. We need to spend less saving defective babies.. We need to get the greedy corporate middle men (corporate insurance giants) out of healthcare. We need to put less money  into fighter jets and foreign occupations, and more into Medicare/Medicaid. We need to offer universal free health care, with reasonable but not unlimited benefits. We need to legislate tobacco use out of existence, as best we can.

Yea, i get the overall picture. I really like your summation! I just found a pod cast hosted by Ralph Nader about the single payer health system like Canada. There are alot of "facts" in it. It was just 5 days ago.  This struggle reminds me of the David vs. Goliath fight. In this case David has no "weapon.

Medicare For All/UnKoch My Campus

The first 40 minutes is the Medicare issue, the second 20 minutes is about the Koch roaches.

https://ralphnaderradiohour.com/category/single-payer-healthcare/
« Last Edit: January 18, 2018, 11:03:16 AM by knarf »
HUMANS ARE STILL EVOLVING! Our communities blog is at https://openmind693.wordpress.com

Online RE

  • Administrator
  • Chief Cook & Bottlewasher
  • *****
  • Posts: 29944
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10597 on: January 18, 2018, 11:39:43 AM »
I think the gist of this might have been true when you and I were young, but it's changed a lot. The average primary care provider is lucky to net $200K these days.

Primary Care providers aren't doctors.  They are Nurse Practitioners and Physicians Assistants and even more incompetent than the MDs and DOs.  Every one of my doctors makes minimum $300K net.  Same with the Dentist I used up here before I went to Mejico.  All in the Top .5% bracket, aka RICH.  All CRIMINALS.

RE
« Last Edit: January 18, 2018, 11:41:48 AM by RE »
SAVE AS MANY AS YOU CAN

Offline Eddie

  • Administrator
  • Master Chef
  • *****
  • Posts: 12824
    • View Profile
Re: Knarf's Knewz Channel
« Reply #10598 on: January 18, 2018, 12:09:07 PM »
Petty criminals in this case, compared to insurance execs. By a factor of 100X.
What makes the desert beautiful is that somewhere it hides a well.

Online RE

  • Administrator
  • Chief Cook & Bottlewasher
  • *****
  • Posts: 29944
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10599 on: January 18, 2018, 12:28:28 PM »
The good job now is being an insurance company CEO. Is that a gate kept profession?

There are MANY gates on the way to becoming a CEO of an Insurance Company, at least if you are not born rich into the class of people who get those jobs.

These folks are like Drug Kingpins, EXTREMELY successful Criminals.  But there aren't that many of them, maybe a few dozen.  There are 1000s of Doctors & Dentists though.  They are like the Street Level Dealers.  They begin the process of extraction of money from the poor directly. They aren't AS successful Criminals as the CEOs, but they are still part of the same Criminal Racket.  Your local Meth Dealer drives a Mercedes, while the addicts live in tents.  Your local Neurosurgeon lives in a Mansion, while the broken neck victim lives in a 1 bedroom unit in government subsidized housing.  Precisely the same model, just one is "legal" and the other is not.


RE
SAVE AS MANY AS YOU CAN

Offline monsta666

  • Administrator
  • Sous Chef
  • *****
  • Posts: 1356
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10600 on: January 18, 2018, 01:33:41 PM »
There are 1000s of Doctors & Dentists though.  They are like the Street Level Dealers.  They begin the process of extraction of money from the poor directly. They aren't AS successful Criminals as the CEOs, but they are still part of the same Criminal Racket.  Your local Meth Dealer drives a Mercedes, while the addicts live in tents.  Your local Neurosurgeon lives in a Mansion, while the broken neck victim lives in a 1 bedroom unit in government subsidized housing.  Precisely the same model, just one is "legal" and the other is not.

Interesting you should say that. After the Gulf war our family need to emigrate. My dad wanted to settle in the United States America while my mum thought England was the better choice. Her reasoning? She didn't think the medical system is the US was a just one and things were fairer in England. My dad talked about the extra money that could be earned living in the US but ultimately her decision prevailed.

Online RE

  • Administrator
  • Chief Cook & Bottlewasher
  • *****
  • Posts: 29944
    • View Profile
Re: Why does it cost $32,093 just to give birth in America?
« Reply #10601 on: January 18, 2018, 01:58:00 PM »
There are 1000s of Doctors & Dentists though.  They are like the Street Level Dealers.  They begin the process of extraction of money from the poor directly. They aren't AS successful Criminals as the CEOs, but they are still part of the same Criminal Racket.  Your local Meth Dealer drives a Mercedes, while the addicts live in tents.  Your local Neurosurgeon lives in a Mansion, while the broken neck victim lives in a 1 bedroom unit in government subsidized housing.  Precisely the same model, just one is "legal" and the other is not.

Interesting you should say that. After the Gulf war our family need to emigrate. My dad wanted to settle in the United States America while my mum thought England was the better choice. Her reasoning? She didn't think the medical system is the US was a just one and things were fairer in England. My dad talked about the extra money that could be earned living in the US but ultimately her decision prevailed.

Good choice.  Both mom & dad likely would have had a much harder time getting licensed to practice here than in Jolly Old England.   I worked with one fellow in the lab who was a Cuban Doctor who couldn't get licensed to practice here.  The gate keepers make it fairly difficult for foreign trained doctors to get their license in the FSoA.

Health Care is a Conduit Scheme which funnels money from the patients through the practitioners then on up to the top of the pyramid of CEOs.  It's typical Capitalism, controling and monopolizing a necessary item the whole population needs, be it food, energy, communication, health care etc.

RE
« Last Edit: January 18, 2018, 02:01:00 PM by RE »
SAVE AS MANY AS YOU CAN

Offline Eddie

  • Administrator
  • Master Chef
  • *****
  • Posts: 12824
    • View Profile
Re: Knarf's Knewz Channel
« Reply #10602 on: January 18, 2018, 02:12:19 PM »
Medicine predated capitalism by several centuries, and it will no doubt remain after capitalism, as we know it, has played out.

I doubt it's easier to get a license in the UK than it is here. I've know Cuban doctors who got their license here. My wife used to work for a building full of Spanish speaking docs in San Antonio and most of them were foreign trained.

For a criminal, I sure do have to work hard. Crime should be easier than this.

Next time I want to be a politician, where the real money gets passed under the table.
What makes the desert beautiful is that somewhere it hides a well.

Online RE

  • Administrator
  • Chief Cook & Bottlewasher
  • *****
  • Posts: 29944
    • View Profile
Re: Knarf's Knewz Channel
« Reply #10603 on: January 18, 2018, 02:17:48 PM »
Medicine predated capitalism by several centuries

In those days, they got payed in Chickens.  The local doctor didn't live much better than his patients.

RE
SAVE AS MANY AS YOU CAN

Offline knarf

  • Global Moderator
  • Master Chef
  • *****
  • Posts: 10295
    • View Profile
U.S. immigration officials have begun preparing for a major sweep in San Francisco and other Northern California cities in which federal officers would look to arrest more than 1,500 undocumented people while sending a message that immigration policy will be enforced in the sanctuary state, according to a source familiar with the operation.

Officials at Immigration and Customs Enforcement, known as ICE, declined to comment Tuesday on plans for the operation.

The campaign, centered in the Bay Area, could happen within weeks, and is expected to become the biggest enforcement action of its kind under President Trump, said the source, who requested anonymity because the plans have not been made public.

Trump has expressed frustration that sanctuary laws — which seek to protect immigrants and persuade them not to live in the shadows by restricting cooperation between local and federal authorities — get in the way of his goal of tightening immigration.

The operation would go after people who have been identified as targets for deportation, including those who have been served with final deportation orders and those with criminal histories, the source said. The number could tick up if officers come across other undocumented immigrants in the course of their actions and make what are known as collateral arrests.

The sweep would represent the first large-scale effort to target the region since Gov. Jerry Brown in October signed legislation enacting a statewide sanctuary law. Supporters say the law allows undocumented immigrants to cooperate with local police and seek education, health care and other public services without worrying they will expose themselves to possible deportation.

Acting ICE Director Thomas Homan slammed Brown for signing SB54, which he said undermined public safety, and signaled he was prepared to take action.

He said at the time that the federal government would not allow California to be “a sanctuary state for illegal aliens,” and would have no choice but to “conduct at-large arrests in local neighborhoods and at worksites, which will inevitably result in additional collateral arrests, instead of focusing on arrests at jails and prisons where transfers are safer for ICE officers and the community.”

Early this month, Homan told Fox News that “California better hold on tight.” He said that if local politicians “don’t want to protect their communities, then ICE will.”

Told of the planned sweep, California Sen. Dianne Feinstein expressed outrage Tuesday, saying immigrants “must not be targeted in raids solely because they are Californians.” She said a large-scale operation would show that “the administration is carrying out its enforcement actions to make a political point and not based on the security of the country.”

The source who spoke to The Chronicle said the plan calls for immigration officers to be flown in from other parts of the country to help carry out the operation. The sweep could span more than one day and will include enforcement of work sites suspected of illegally employing undocumented immigrants, the source said.



    Border arrests plunge, deportation arrests soar
    ICE sweep targeting sanctuary cities snares 27 in Bay Area
    ICE chief threatens ‘at-large arrests’ in California

An ICE spokesman in San Francisco, James Schwab, said in an email Tuesday that the agency “doesn’t comment on future or current operations.”

Liberal-leaning lawmakers in the Bay Area and across California have sparred for years with federal officials over the role local agencies play in immigration enforcement.

The tension intensified after the July 2015 killing of Kate Steinle on a San Francisco Bay pier, when it was revealed that the undocumented immigrant shooter, Jose Ines Garcia Zarate, had been released from San Francisco Jail under the city’s sanctuary ordinance, even though immigration officers had asked that he be turned over for a sixth deportation.

After Garcia Zarate was acquitted of murder charges in November, Homan blamed San Francisco for Steinle’s death, saying the shooting “could have been prevented if San Francisco had simply turned the alien over to ICE, as we requested, instead of releasing him back onto the streets.”

The statewide legislation signed by Brown limits the circumstances under which jails turn over undocumented inmates to the federal government. It also forbids police officers from arresting people on civil immigration warrants and from joining federal agents in task forces intended to enforce immigration laws.

Under the Trump administration, ICE has repeatedly warned that if the agency can’t detain people from local jails, it will be forced to arrest them in the communities that hold such policies.

Last week, a group of politicians, including Reps. Barbara Lee, D-Oakland, and Zoe Lofgren, D-San Jose, sent a letter to Department of Homeland Security Secretary Kirstjen Nielsen requesting a meeting with her and Homan to clarify the remarks he made on Fox News about stepping up enforcement in California.

“The statements are a direct threat to Californians,” the letter read. “These statements are reprehensible and the department’s change in policy will instill fear in our communities. ... Acting Director Homan’s attack on sanctuary cities is not only an infringement of state rights but a direct assault on communities of color.”

In recent years, ICE has not made a practice of conducting major immigration sweeps in cities like San Francisco and Oakland. In September, 27 people were arrested in Santa Clara County as part of an operation targeting sanctuary cities across the country that led to 500 arrests. In June, federal officers arrested 54 people in Central California.

Pratheepan Gulasekaram, a professor at Santa Clara University School of Law and an immigration expert, said that a major sweep in Northern California would echo tactics seen under the George W. Bush administration.

“This is a bluff since California continues to resist,” he said. “This is more show than anything else. They want to make it seem like they are carrying through on this threat. ... I highly doubt that ICE, in the way that it is currently funded, has the ability and resources to maintain something like this on a sustained basis.”

Gulasekaram said the raid would “tear up a lot of lives” but have “little meaningful outcome on public safety.”

http://www.sfgate.com/bayarea/article/Feds-planning-massive-Northern-California-12502689.php
HUMANS ARE STILL EVOLVING! Our communities blog is at https://openmind693.wordpress.com