Comments by "Xyz Same" (@xyzsame4081) on "Vox" channel.

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  5. No, ACA was a weak proposal right from the beginning, and THEN one or a few of the Blue Dogs killed the public option- Big Donors !! (public option means people chose between a non-profit public insurance agency - likely Medicare - and the private agencies. Less than ideal - but a start). And then they tried to appease the Republicans and weakened it further. And it was never a question that they would touch the profits of the for-profit industry. - THAT is why the U.S. system is so much more expensive. the profit has to be financed - and the desire to maximize profit is toxic for a product like healthcare and cause excessive red tape, the attempt to cash in on patients who can pay (many do no pay their bills) they have to chase the money. The ininsured end up in emergency rooms - which is very expensive and also has worse outcomes (too late often, no prevention, and if they cannot pay no consisent and constant treatment, the hospital must stabilize such patients - and then they try to get rid of them). The free market works only when all partners have about equal power. The patients are much, much weaker. And worse - the service decides over the future ability to work, care for your family, quality of life, often over life and death. Complexity favours the big players. And they are always 4 steps ahead of the patients and 2 steps ahead of the regulators (if they would do their job). And it can get excessively expensive (even if the service is delivered cost-efficient). That is a very bad combination for the consumers/patients.
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  6. +laingalion your explanation - from the status quo point of view - seems reasonable. BUT: things can - and they MUST change. - It cost a lot to establish the electric grid (and the start of it was with public money for public lighting - the cities took up the tab for the infrastructure , so that for-profit energy providers would have a business model). The change of paradigm will also cost - this however is a) unavaoidable and b) we will have other and increasing costs the longer we wait *. Regulators have NOW the task to make electricity "as affordable as possible". Which btw negates the "free market" - it means that they externalize a lot of future costs. The producers and in turn the consumers do not pay for the full costs associated with the product. Their task can be REDEFINED- for instance to use more renewable energy and help with the integration. Of course that must be a systemic change - the providers cannot solve that alone. Not even if they had any intention. Future and rising costs The Pentagon plans for the consequences of climate change - war is excessively expensive. the average temperature predictions for the US are grim. Many large cities are nearby the ocean. they will have to relocate, the occasional catastrophic storm will force them long before the normal rise of the water level. Hurricanes might form less often - but when they start forming they will on average be stronger - and last longer. Harvey lasted for 60 hours, it was circling stationary over Texas, it should have spent itself after 28 hours (that's the usual time once a hurricane hits land, it is cut off the "energy supply" and the system weakens. But the water and atmospheric temperatures were much higher than usual. So an unusual amount of water vapor - the fuel for a hurricane system - kept Harvey going - and raining off over the same area for 60 hours instead only 24 hours. The weakening of the current of cold air around the Arctic means more stable weather fronts. It will either be longer warm and dry - or raining. Erratic weather patterns will mess with agriculture, like spring frosts, hail storms. Bugs have longer seasons, more spraying needed (both effect already show). New tropical diseases where they did not occur, .... Draughts ? Wildfires ? ask the people in Texas who used to work in the meat industry. Or folks in California.
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  12. + Shannon - yes things that are NOT essential / life saving / very costly - expenses where the consumers DO have a choice if they buy at all - those things can cost more in Europe. Like serving tap water - it means the restaurant may sell less other beverages and they have to take care of your glass. The waitresses have much better benefits (sick leave, maternity leave, healthcare, 5 week paid vacation, a reasonble not too fragmented work schedule, and knowing shifts in advance. It is not left to the discretion of the employer - they MUST grant that resp. must pay into the funds. McDonalds pays for those benefits in Europe - not out of the goodness of their heart, but because it is legally mandated. The only way to avoid that is to shut down operation and leave the niche to other businesses. They still make good profits, so they comply. Minimum wage - in the U.S. there are states where they have "tipping minimum wages" - that can be as little as 3 USD per hour + tips. Only when the income with the tips still below the federal minimum wage of 7,25 for the worked hours the employer has to increase it to to that level. Good luck with enforcing that on an individual level. That is why the softdrinks and coffee etc. cost more in the restaurants and bars in wealthy European countries - they make more of their profits with them (often more than with food - which is more of a hassle, needs more and better qualified workforce). For the same reason the supermarkets do not have greeters. Consumers have to pack up their groceries w/o help of staff (eldery or disabled persons might get friendly help from the cashier or polite other shoppers) but apart from that you are expected to do the work yourself. Which is fine - it takes the same amount of time. So Walmart offers an additional (if irrelevant) service - but the European chains have higher costs for their staff which translates to much better benfits for those workers. So businesses tend to eliminate costs that would require a very poorly paid workforce.
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  19. The negotiations were about a weak plan and dragged out, and Obama did not keep in contact with the base - of course not - they were trying to square the interests of the Big Donors with that of the insured/patients. - no exciting news for the base. The midterms in 2006 were strong (the Democrats wisely packed the races with Wallstreet Democrats, I think some insiders expected the bubble to burst at some time), progressives were sidelined to the best of their ability. In 2010 the enthusiasm of 2008 was gone - and Obama did not want to keep that level high, he did not try to keep in contact like FDR did when he pushed the New Deal. Obama had no intentions to be a president with populist economic measures (he had campaigned as such) - he was a centrist neoliberal sellout (like many others). So he certainly did not want the base engaged and on alert and ready to take it to the streets or townhalls. The 2010 midterms reflected that, and it cost them the majorities to pass something (and saved them from the embarrassment of having a majority - no more excuses why they do not work for the people). ACA despite the Republican tantrums passed in a window of time of 60 days in spring 2010. Then they could have passed EVERYTHING - incl. of course Single payer, or gun reform. In 2009 when they started with the issue Senate had a hearing regarding healthcare reform, they did not even invite experts on Single Payer (European style systems, with a public non-profit insurance agency, usually also many or all hospitals are public non-profits. Those systems are much more cost-efficient). Good thing the industries were invited and could present THEIR case to the Senators and the public. The Obama admin also let millions of homes be forclosed (they could have prevented that - but Obama sold out to Big Finance already in 2008. Remember Tim Geithners appointment ? The wolf in charge of the henhouse, that was the first red flag. The leaked Podesta emails approx. 8 years later confirmed it: citibank had sent an email about cabinet proposals - their candidates were appointed. So the banks werere first bailed out, later they were showered ! with TRILLIONS in form of QE for the banks in order to "improve" their balance sheets. That form of money creation could have been used to rescue the homeowners, too. Needless to say Big Finance does not want the unwashed masses to understand such concepts or that they could be (selectively and wisely) used for the good of the common people. (Which would be a revolution also for partially financing goverment budgets and big projects) - if interested see QE for the People or Dr. Richard Werner Debt and Interest Free Money or Dr. Stephanie Kelton MMT or the videos of positivemoney(dot)org, they call the concept Sovereign Money. Anyway: Wallstreet knew they would be safe with Clinton or McCain, they decided to buy the newcomer in 2008 as well - just in case - and they saw that he would be a much needed good distraction. That distraction (Hope and Change) was very much needed, the voters were furious about the GFC. So Obama got the campaign contributions, he talked a good game - even about Single Payer and Wallstreet regulation. And mainstream media got the green light that they could report regularily and positively about Obama (not Fox of course).
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  32. You should not "NEED" to find out these prices in the first place. Healthcare is a TERRIBLE FIT for the "free market" and the incentives of capitalism: the patients have much, much less information, and expertise and can easily be duped. As soon as one needs more than standard procedures (meaning often complications ) - they can demand whatever they want. She just cannot stop giving birth because they now introduce new procedures - which may or may not be necessary. The service (healthcare) most of the time cannot even be delayed - even a harmless uncomplicated broken arm needs to be treated right away - or it will become a major problem (risking your quality of life, ability to work, even life). And then there are the immediate life and death scenarios. with "nice to have can do without" products the consumers do have power. even if they do not have specific expertise - if something seems to be overpriced, or they cannot afford it - they JUST DO NOT BUY. Repair (unpleansant but necessary expenses) can often be delayed, alternatives found (like car sharing) - and the costs are NEVER as high as they can easily get with healthcare. Car breaks down at an untimely moment - if the repair would cost USD 4,000 or 10k or 100k - you would reconsider repairing it at all. Shop around - 10k is a LOT - many cars would not warrant those costs. 100k repair ? non existent. for all those reasons most wealthy countries have a system with many non-profit elements, mandatoy insurance - every must be in the system and IS ALLOWED in the system. Contributions in advance (only), affordable, income based, the rest of the costs of the system comes from government funding. And it is a good idea to have the same facilities for everyone. (One size fits all is good in healthcare - only the doctors when they decide WHAT is medically necessary should have a choice and differentiate). The bill is sent by the hospitals directly to the non-profit public agency that has the task to work for the common good - and to play a supportive role in the system. Hospitals: non-profits run by the ELECTED local government or for-profit but heavily regulated, usually run by religious organizations - that has historic reasons.
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  33. The bill is sent by the hospitals directly to the non-profit public agency that has the task to work for the common good - and to play a supportive role in the system. Hospitals: non-profits run by the ELECTED local government or for-profit but heavily regulated, usually run by religious organizations - that has historic reasons. There are price lists for the hospitals (and general practicioners or specialists, they all have a practice) they have general elements (compensation per day per patient) and elements for special treatments (like let's say mammographie). The picture is sufficiently complex so that it would be very hard for the hospital to game the system. (even non-profits have an incentive, for instance to help their muncipality when they extract more money out of the insurance agency). So that keeps "playing the system" at bay. There will be some inefficiencies but it is not too bad. Of course there is benchmarking possibe between the church run hospitals and those who a run by a city w/o a profit motive. The hospitals must offer good services any attempt to extract extra pay from patients (beyond cable TV) would not sit well with the locals and is illegal anyway. (They often have cafes to go with the visitors. Cafe and something to drink is free (even outside meals). Visitors will often bring flowers, treats, chocolate, fruit juice, but the snacks are not really necessary. Muncipalities took pride in getting "their" hospital serving the region in the post WW2 era. The mayor looks good when they can offer the jobs and short distances for the locals. So they function in an orderly fashion, like clockworks and there are no attempts to dupe patients. There are quotas for how many doctor practices and hospitals with a CONTRACT are in every region (per 1000 or 10,000 people). The non-profit insurance agency offers only a limited number of contracts - so that those who get a well bargained compensation only have enough patients to make it economically viable. They are evenly spread out over the country, so even rural areas are served and the transport distances are not too long. Private hospitals w/o contract are possible (but very rare) - a few more private doctors are around (maybe 20 %) they just have to find the patients. Usually they have a speciality, the general medical care is delivered by the public service and they cannot compete with those priced.
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  34. 8:30 The subsidies ** prop up a too expensive system - they finance dysfunction, red tape, the profits of the shareholders and the bribes aka donations for politicians. Per capita healthcare expenditures in Europe 5,000 - 6000 USD (in most of the wealthy nations). In the U.S. 9,200 (data World Bank 2014, the U.S. is meanwhile around 10,000). ** Obama is not honest - more subidies do not solve the basic problem ! So even cost efficient care in a system with a non-profit public insurance agency and many (or all) non-profit public hospitals would amound to average expenditures of 20k per year for a family of four. expenditures means: ALL that is spent on healthcare in the country no matter how it is paid for or WHO pays for it per capita: divided by ALL people (so from the healthy baby to the old person on life support). Even in Europe a good chunk of the the budgets for the non-profit agency must come from the government. But these subsidies fund the delivery of care to the patients and avery streamlined administration. A part of the funding comes from mandatory wage deductions, which are matched by employers. These are very affordable - the costs are usually a percentage of wage . Health status does not matter, everyone with a job over 600 USD per month must be insured * - and has then automatically full coverage. And healthcare insurance is not only mandatory - on the other hand it is also a right - incl. the right to the same insurance coverage and the same services in the same facilities like a person with a higher income (who has more wage deductions although there is a cap so that is always very reasonable - and more importantly they pay more taxes that indirectly fund the system). * in the systems that I know in Germany or Austria - every country developped their own system (based on some principles) since end of WW2 - so there are differences. But almost all have non-profit insurance agencies.
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