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lostnfound

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Member since: Sat Sep 6, 2003, 04:28 AM
Number of posts: 11,268

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This whole healthcare fiasco very telling: Discussion CAN'T focus on excess profits driving cost

The country spends almost DOUBLE per capita what other countries spend.
💰We have $10,000 injectable opioid antidotes that used to cost $65.
💰We have $70,000 per year MS drugs that cost $7,000 in the U.K.
💰We have kickbacks to doctors, who themselves are in deep debt due to unfunded universities and medical schools.
💰We have trumped-up dieseases wherein the limits for saying you have high blood pressure or high cholesterol were artificially lowered due to lobbying from drug companies that simply wanted to expand their market.
💰We have direct-to-consumer drug advertising every 5 minutes on TV.
💰We have very well-paid executives, like the United Healthcare CEO who received annual compensation between $30 M and $100 M per year -- whose MAIN job is to increase profits, increase revenue, and increase value back to shareholders.
💰We have at least $100 Billion dollars in dividends going back to stockholders in the for-profit healthcare industry.

Even on MSNBC, the debate isn't -- and CAN'T be -- seriously focused on why medical costs are so high, because, well, there is direct-to-consumer drug advertising every 5 minutes .

How much of the $4.5 trillion health care cost in the US is turning into profit for the top 1%? How much of it is unnecessary treatment driven by a desire to increase revenues to for-profit companies?
The Powell memo has been so successful that the only argument allowed is "some people want free stuff and they want ME to pay for it through higher taxes". do they teach the
Powell memo in school now? Ha. I doubt it -- and if they did, any person in the state of Florida has the legal right to challenge it, even non-parents.

Russian oligarchs and American Liberty

I was curious which Russian born spy turned "lobbyist" might have been present at the Kushner-Manafort-Trumplet meeting, and googled. Didn't find an answer, but I did find a couple of interesting articles. One was an article in the Weekly Standard (ugh, I know) from April 2012 saying that one of the oligarchs, Bidzina Ivanishvili, "one of the world's richest men with an estimated $6.5 billion fortune, hired a small army of PR consultants and lobbyists in Washington, including at least 7 of Washington’s most prominent firms". It says that he is "the single largest private investor in Russia’s state-owned gas giant Gazprom. He also holds a major stake in the Russian oil company Lukoil" and praises Putin. April 2012, an election year.
http://www.weeklystandard.com/russian-oligarch-hires-army-of-d.c.-lobbyists/article/636936

I also ran across this: http://www.therussianoligarchs.com Which has an interesting graphic or article or two. The 24 year old daughter of Rybolovlev is the new owner of the Cyprus island that Jackie Onassis once lived on -- maybe a birthday present, because fourteen months earlier she was also given a Central Park penthouse.

There's a graphic showing that the world's second biggest collection of billionaires is in Russia.


One of the oligarchs with political ambitions lists Renaissance Capital as one of his major holdings ($460 M). Is that the Mercer firm? Maybe not. Appears to be a separate Russian company with a similar name.

There's an article about how Miami is becoming the "Russian Riviera". Which again makes me think about Berenton Whisenant, the federal prosecutor found dead on the beach near Miami ("head wound by possible gunshot or other trauma", who'd been "handling several visa and passport cases". http://www.miamiherald.com/news/local/obituaries/article152981139.html and
http://www.cbsnews.com/news/beranton-whisenant-jr-federal-prosecutor-found-dead-on-florida-beach/

Outside of google, in real life, I meet a freshly minted Russian immigre, a young man with an unusually hard or aggressive edge about him, who picks me ups in an Uber, in a suburb not so far from the place where Peter Smith, the GOP conspiracy true believer who committed suicide ten days after disclosing his own Russia-Trump connections to the Wall Street Journal, lived. There's a Russian-born banker whose son is no longer friends with my own, after his dad freaked out that that I'd let them take an Uber together. (What a great database Uber must be compiling, all the addresses that people go to. Which we know they USE, at least, to avoid picking up anti-Uber politicians.) I laugh at my own "lighthearted paranoia"; it amuses me to mention to a close friend that I noticed a group of Russians meeting up and high-fiving back in an obscure restaurant not long after the election. Celebrating. I'm a fan of a kind of dark humor, when things get bleak. Abramovich had the world's largest yacht parked by the Statue of Liberty for a while - is it still there, blocking the view? (Nope. It finally moved. http://nypost.com/2017/06/19/statue-of-liberty-finally-free-of-oil-tycoons-mega-yacht/)

My city is one of three cities mentioned as a hotbed concentration for Russian spies, per James Clapper, if I recall. Mr. Clapper says there's been a sharp increase in Russian spies and visa applications after election. He says they are laying the groundwork for the 2018 elections. http://www.cnn.com/2017/07/06/politics/russia-steps-up-spying-efforts-after-election/index.html Maybe there are many more, people who get jobs here to support themselves in mundane roles, so they blend in. Maybe at various levels in society. It feels like the "Red Scare", but I don't feel any animosity toward the individuals; that's just the system they were born into. They are humans first, potential spies second. Up until the point where they get involved in pushing people out of windows. It's America, right? We let anyone in, if you are loyal to America. (Except Latinos coming across the border, for some reason I can't understand, but that's another story.)

The locusts are coming. What do they do when they take over a country? Maybe Russian style oligarchy is coming. Are they collecting bank account numbers too, in their hacks? Can they strip the stock market, try to trigger a collapse, make the electronic records of your money disappear?

Most of us see wealth inequality as a problem, but to some, wealth inequality is the goal. Enrich yourself like Putin and the oligarchs and the Kochs and the Mercers to become powerful, then use the power to enrich yourself further. Putin mastered this. Maybe our own oligarchs are jealous. All the oligarchs are created by greed and corrupt systems, but in Russia, they are also routinely created through fear. In Russia, Putin is the all-powerful terrifying rich guy at the top of the heap. Do our oligarchs feel less powerful in comparison? Did they feel less powerful when President Obama was in office? The oligarchs of the world are in a race to corner the private Greek islands and the private oil and the biggest yachts, and maybe 3% taxes to pay for the little people's healthcare lowers their standing on Fortune's Richest Lists.

The world's largest yacht was anchored last month in a place where it blocks the view of the Statue of Liberty, but I wouldn't feel any better if it was owned by an American, instead of a Russian. Public treasures are not anathema to freedom; they are the flowering of it, no matter what the Ayn Randians tell you. But we do like our bright illusions of freedom, and all these Russians teaming with the useful idiot in the White House are making it pretty dark. Are we going to let America turn into the kind of oligarchy that pushes people out of fourth story apartment windows, or weakens a banister and watches them fall, or poisons them or sprays them with bullets on a public sidewalk in broad daylight, for opposing a political leader or expressing dissent or being a journalist exposing corrupt financial connections? If we let that happen, well, we might as well send that Statue all the way back to France.

Damn it,we need a fact-based debate...WHERE the money GOES, not just who to KICK OUT of lifeboat?

In this stupid debate about who should or shouldn't be thrown out of the lifeboat, about who pays for the bloated bureaucratic behemoth we call the "US Healthcare System", can we talk about health care costs?

Pharma Revenues by Market
http://www.worldatlas.com/articles/countries-with-the-biggest-global-pharmaceutical-markets-in-the-world.html

US $339 B
Japan $94 B
China. $87 B
Germany $46 B
France. $37 B
Italy. $27 B
Britain. $24 B

Partly driven by excess marketing, absurd "what the market will bear" pricing, markets for prescriptions expanded by lobbying the AMA or NIH to drop targets for blood pressure or diabetes etc., and kickbacks to doctors.
https://img.washingtonpost.com/wp-apps/imrs.php?src=


That's just pharma. So, what happens if we focus on where the money is going? Might pharmaceutical revenues be under threat? Could it be that our public discussion is restricted to "Single Payer vs. ACA vs. Tax Credits vs. Cutting Medicaid" because focus on underlying costs would create downward pressure on revenue for major health related corporations?

One minor difference between the U.S. And other countries is gunshot wounds -- likely exceeding $3.7 billion per year. ($1.4 / 42% + $180 + $224)
https://www.usatoday.com/story/news/nation/2013/03/04/gunshot-wounds-medicaid-insurance-costs/1956445/

From Blue Cross Website, 39% hospitals; 22% physician/clinic, 21% pharma, 10% administration.


Or this, broken down by disease.
https://qph.ec.quoracdn.net/main-qimg-9426b4bab14e3d2555e63fb390c96b8b

Breakdown of hospital stays: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb148.jsp
Interesting collection of public health references: http://www.bettycjung.net/Phdata2.htm

Here's a hypothesis: The RANGE of DEBATE on this topic has been ARTIFICIALLY and intentionally NARROWED to prevent real debate. Real debate might cause us to take steps like: banning direct-to-consumer ads, outlawing price differentials based on who pays for a procedure or drug, identifying the most wasteful and ineffective drugs, prohibiting price gouging. What we humans see as "savings" is seen by WallStreet (and its most important owners) as drops in revenue. The impact on market cap is the bitter pill that the Owners refuse to swallow.

They'd rather kill Medicaid and eventually Medicare, and force old or sick people to use their life savings and reverse mortgages to cope with inflated costs, than accept a present decline in Pfizer or Untied HealthCare or Merck or Aetna stock. That's a big part of the reason that common sense is swimming upstream in American politics. Protecting the Dow.

Cutting health care expenses: two approaches

1) the GOP APPROACH. Cut expenses by putting the burden on those who cannot pay: sick, old and poor people. I wonder if they have underestimated how much they will save with their approach, because dead poor people don't need expensive medical treatments, and wealthy living people tend to be a little healthier, so overall eventually you'll save a lot by killing off the sick poor ones. There's lots of hidden financial goodness in the Senate bill. Like, the absence of maternity care might lead some women to end their pregnancies, rather than having expensive births in the hospital. Not sure what the going rate was for DIY in the 60s, but with Pence's influence the country will probably find that out.

2) the COMMON SENSE APPROACH. Focus on "LESS EXPENSE AT MORE VALUE" such as

A) PRICE GOUGING. After a hurricane or other emergency, there are certain laws against jacking up the price of water, food, gas or hotels -- against "price gouging". But if a person has a life threatening illness and needs a little pill to save or prolong their life, the sky is the limit. *Pharmaceutical companies charge what the market will bear.* in some cases, a single medicine can run $60,000 or $80,000 per year. Drug prices are based on patient desperation, monopolies, deceptive advertising, and pricing that depends on who is paying for it.

B) MULTI-LAYER PROTECTION RACKET. Insurance companies make profits by promising to protect you from illness and by delivering the minimum required to avoid damage to their reputation or prosecution. They may pay $8,000 for a hospital bill with a sticker price of $16,000; while walking in to the ER as an uninsured patient will cost you the full $16,000. If you only pay $10,000 of it, the rest of your debt will get turned over to a collection agency who may hound you into bankruptcy. And the collection agency may "buy" your $8,000 debt from the hospital for $100 or $200. Protect me from disease, protect me from out of control hospital bills... and to protect my credit rating, is better pay those deductibles and 20% coinsurance. Unless, of course, I've bought a more expensive policy, to protect me from THOSE.

C) COMPLICATED RULES AND BUREAUCRATIC INEFFICIENCIES. Did your doctor fill in the right "insurance codes"? The lump that he removed from your arm may be billed at a different price based on whether it was less than 2.5 mm, between 2.5 mm and 5.0 mm, or greater than 5.0 mm. When you first get the hospital bill and the separate doctor bill and the separate lab bill (and hopefully not an ambulance bill), the insurance company hasn't processed the claim yet. Month later, you get a new bill, and you may have to file an appeal to get it right. To recover $19 coinsurance on some lab tests, there might be 6 people touching it. Even worse, the doctors may know you need an MRI to diagnose the limp in your knee, but they're going to do an X-ray first, because the insurance rules don't like the MRI. Extra tests get done for the sake of checking the boxes of how to "troubleshoot the symptoms".

D) FRAUD, BRIBES, AND KICKBACKS. Some doctors get CHECKS in the mail from pharmaceutical companies for prescribing their medicines. Some clinics or doctors' offices file claims on services never rendered. Referrrals go to doctors at an affiliated business. Organizations like the FDA or the AMA are not immune to bribes or political pressure. The level at which a person will be labeled as having "high blood pressure" or "high cholesterol" have been lowered, under the influence of pharmaceutical companies that profit from the resultant dramatically expanded market.

E) ROOT CAUSES OF ILLNESS, INJURY, AND DISEASE. Exercise, healthy eating: Trump destroys Michelle Obama's program to encourage healthy eating in the schools, and Congress says nothing. Gunshot victims: how much money is spent on trauma wards, multiple surgeries, rehabilitations, or lifetime care of shooting victims? Stress: life/work balance is promised to some college graduates in demand, but inever to low-wage employees. Stress contributes to the absurd gap in life expectancy of rich versus poor. So do environmental factors, like lead in the water of Flint Michigan, or breathing in toxic Chinese drywall installed in lower-end housing. Lack of prenatal care, self-medicating with alcohol, sedentary lifestyles are all costly. Do green spaces actually make a difference in the health costs of a community?

**********
If our congress wasn't half-bought by pharmaceuticals and insurance company CEOs, AND HALF-BOUGHT BY THE OWNERS OF STOCK IN THESE COMPANIES, the issues above are what they'd be tackling.

Many of these things START with the idea of a "COMMUNITY". Investing public money in green space makes no sense to a person whose worldview is libertarian, because why use perfectly good land that could otherwise become someone's Gunsmoke ranch, or luxurious seaside villa, and turn it into a public park or walking trail? In "you're-on-your-own-istan", survival of the fittest will take care of these old sick poor people, or else the private charity of "rugged individualists" will "save" them, after they differentiate "worthy" recipients of charity from "unworthy" ones.

To which I say, let every libertarian billionaire have an MRI machine in his own basement, and a staff of doctors; let them be followed by a perpetual privately funded ambulance, and let them pay the full expense of the initial development of that pharmaceutical that they consume, all on their own. While they are at it, be sure to have them pay for a good portion of each doctor's and nurse's medical education, too, and for the education of dentists and specialists and lab workers. Let them each be their own little billionaire "island". Because it's the VOLUME of humanity that has enabled the development of modern medical miracles and the proliferation of facilities and capabilities. Developing a medicine to treat every ailment, or the techniques to most effectively treat burn victims, or the imaging and surgical machinery to do brain surgery wasn't a cost that was eaten wholly by 100 rich people. It was a century of technology, medical trials, scientific study by tens of thousands of individuals, successes and failures.

But the "Medical Monopoly" properties have mostly all been sold, and the board is mostly in the hands of just a few, and when we land on their property we'd better be prepared to pay $16,000 or $160,000 or whatever they want to charge us, because otherwise we will be out of the game. The rules are pretty complicated, and the big owners might do some little trades to keep us afloat, to keep us in the game a little longer, hoping we are lucky enough to survive another lap and collect a measly $200. The important thing to them though is that their built-up properties don't get devalued. If you start talking about price controls on pharmaceuticals, their stock will plummet. Any move toward single payer is going to destroy the insurance companies or transform them into mere "utilities" -- low grade administrators. Kickback schemes will be screaming as they go.

But if you open up the Wild West for new insurance plans that discriminate and don't have to cover EHB's, well, you've just opened up a whole new monopoly board for all the same players to exploit. Add in a database of DNA, with which your likelihood of having certain diseases can be much more accurately predicted, and the schemes can include insurance policies that protect you from a lot of diseases you aren't likely to get but maybe not the one disease you are predisposed to develop. Get an illness that's a precursor or marker for some more expensive illness, and find yourself dropped.

If you think these things can't happen, we can point to a list of evidence of what CAN and HAS happened.

Axelrod hypnosis meme, over and over, "Bernie is not gonna be president"

Axelrod is including this comment over and over and over like a magic spell or a way to hypnotize his listeners... "Sleepy..sleepy..you will feel very sleeeepppy". In every speech, and he's giving them three or four a day now.

Yeah, so Axelrod, a guy like you participated when a freshman senator became president in spite of all the naysayers who thought "there's no WAY this country's gonna elect him". He had a name that was one letter away from the world's most infamous terrorist, for heaven's sake.

Is Axelrod spinning tales or he is bailing water as fast as he can out of the leaky boat? I don't know. But I do believe that as a multimillionaire, he's counting on favorable tax rates for him and his pals, and maintaining that special place for corporatist democrats that's carved out to keep corporate money flowing while giving We The People an alternative to the dinosaur mouth-breathing mostly-insane right wing. Thank you for your service, David. Thank God for Obama. And Hillary. And Bill. You DO beat THAT dinosaur alternative.

Still.. My working class brethren are kind of sick of living on nothing but fumes from the party up above. I'm sick of watching hardworking people that I grew up with struggle to cope with minor unexpected bills, at an age when they should have resources to ease their pain. I'm actually sick of the cynicism being passed on to the young, that says there's no good politicians. My own dad was a politician, about a million years ago, and he was a good hearted honest man. None of his kids would dream of going into politics, though. Too dirty.

The price we all pay for electing corporatists of one color or another (blue or red) is that we are being tacked like a sailboat upwind, in a direction of greater wealth inequality and more plutocracy.. The plutocracy part is nearly total, already.

Obama is an awesome president, the most awesome president that he's allowed to be, given the constraints of the U.S. plutocracy. Bill was a great president too, and if Hillary gets elected, I'll be celebrating the defeat of Marcobushcruderump & Company Inc. Celebrating the first woman president and expecting that her nominees to the Supreme Court would be excellent. She would do what she can to soften the impact of pro-corporate policies on the poor and on the environment. There'd be much to be grateful for.

But then there's Bernie. I want to get a bumper sticker that says, "Bernie: The Real Deal". Just because he's been consistent, straightforward, dependable and NOT bought. Electing him would start a shift from the Plutocracy back toward democracy.

David Axelrod says Bernie is never going to be president, and we know why. It's because people like David Axelrod are out there telling us what to think, and money equals speech according to the Supreme Court, and there's a lot of money-bought speech that will be flying at us on the airwaves. They will try to make up scandals, paint Bernie as strange and unelectable, and if that doesn't work, they'll distort the images and the sound until we have another "Dean Scream" moment. David and his allies have stock portfolios and future gigs to protect. Populism must be stopped at all costs -- or channelled into Economically Approved paths.

But...How to make Americans learn to think for themselves again, to recognize their own interests!?!? In spite of what talking heads on TV will tell them? It seems improbable. I don't have so much confidence in the clear thought processes of the American public.

But electing a freshman senator with a name just one letter away from the world's most infamous terrorist seemed improbable too. We didn't all think the country was ready for Obama, but enough of the country WAS in fact ready for Obama... Enough to get him elected twice.

What if the country is ready now for something new again? Maybe instead of being repeatedly tacked upwind by corporate money that pulls us in the direction of greater wealth inequality and more corporate influence, we could turn it around and let the sail out. Catch a favorable wind from the banking meltdown and decades of low wages and massive student loan debt and an unwelcoming job market.

Maybe now the country would be ready for the voice of Bernie.

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