dagblog - Comments for "Hey Andrew Cuomo! Feel the Bern, (don't fuck the poor)"

States rights to be pooh and

artappraiser — Mon, 17 Feb 2020 03:05:54 +0000

In reply to Hey Andrew Cuomo! Feel the Bern, (don't fuck the poor)

States rights to be pooh and have zero access

Rural hospitals in states that have not expanded Medicaid recorded a -0.3% median operating margin, compared to 0.8% for rural facilities in expansion stateshttps://t.co/mUkhIGSnb8 via @modrnhealthcr HT @rshawnm
— Farzad Mostashari (@Farzad_MD) February 16, 2020

I am reminded of George Bush Sr. talking bout 1,000 points of light all the wunnerful people just come together and do things out of the goodness of their hearts. I think many may draw the line at going into debt to help, though? Like say, a rural hospital in a non-expansion state. Kind of like: exercise in futiliy?

I used to wonder why medicaid

jollyroger — Sat, 15 Feb 2020 21:43:21 +0000

In reply to Excellent point: They print

I used to wonder why medicaid is a shared burdened/state administrated program anyway, being as how the number of illnesses that sort geographically from state to state is limited (to the diseases of obesity...) and I figured it had to do with abortion, but the Hyde Amendment solved that and of course, it's race.

One may note in passing how much misery the white ruling class in the states of the former confederacy inflicted on themselves in foregone medical care so that they could revel in the orgasm of spitenfreude as they contemplate the pleasure of inflicting loss on the undeserving.

One may further note with schadenfreude, (see what I did there?) that those states with the diseases of obesity...

Excellent point: They print

artappraiser — Sat, 15 Feb 2020 20:57:42 +0000

In reply to As you have often pointed out

Excellent point: They print not, neither may they borrow when most vital to do so.

As you have often pointed out

jollyroger — Sat, 15 Feb 2020 20:52:42 +0000

In reply to ok good, then it's more

As you have often pointed out, "single payer" is a cost containment measure only to the extent that enhanced price discovery is a necessary but not sufficient step. Single provider, of course, is the way to go (cf VA, Britain, kaiser)

Either way, making states bear any burden whatsoever is lunacy. They print not, neither may they borrow when most vital to do so.

ok good, then it's more

artappraiser — Sat, 15 Feb 2020 20:45:51 +0000

In reply to Forgive me for cherishing

ok good, then it's more realistic get the real total costs of all health care in this counry out in the open. I wasn't sure about that. Sooner or later, all the hidden ways to pay for everything gotta come out. Has to as it continues to grow as a huge part of the economy....

What a piece o monumental

jollyroger — Sat, 15 Feb 2020 20:44:00 +0000

In reply to Forgive me for cherishing

What a piece o monumental stupidity? Why have a "maintenance of effort" standard, which only penalizes the fisc of previously humane states, and the people of previously stingy?

yeah, the insurance is

artappraiser — Sat, 15 Feb 2020 20:42:46 +0000

In reply to These days shopping for any

yeah, the insurance is basically a huge high risk gamble now! buying a pig in a poke. not buying peace of mind. you have no idea what you're going to get, it might be worse misery one way or another

it's popular to go for "home care" now if at all possible and Medicare does sometimes cover depending on diagnosis/conditions? I know states even use Medicaid funds for things like transport to providers. Keep them out of the expensive nursing home. But that has it's own downsides, as nobody can hear the patient's screams should there be a caretaker fed up with their own life. Like with babysitting, cameras monitored by cell phone are de rigeur now....

One has to think: like with babysitting. If the taxpayer doesn't like paying for other people's child care, they won't like paying to change other people's parents diapers, either. It really is a question of how socialist do you wanna be?

In any case, we've gotten used to hiding the expense of nursing homes for all classes being born by Medicaid and blaming the poor for Medicaid's high expense. That hasn't been done as much for child care before school age. I learned recently that some states are starting to come up with clawing back the expense. Operating on the presumption that primary residence is safe and sound is now faulty, sure, while the person is alive, as there could always be a miracle and they need their home back. Or they want to die at home and take hospice services. But after they are dead, kids can't presume any longer that they will get the home.

Forgive me for cherishing

jollyroger — Sat, 15 Feb 2020 20:41:15 +0000

In reply to There is major major delusion

Forgive me for cherishing this rare opportunity to correct you DoubleA.

Bernie will fix your teeth, your vision, your hearing and pay the attendant to wipe your....um...ease your senior years.

M4A covers all forms of long term care currently breaking the back of Medicaid.

How do ya like him now?

Edit to Add. SHUT MY MOUTH

Bernie will NOT pay the attendant--Jayapral will! Evidently one of the siginficant differences between the Sanders M4A plan and Pramila Jayapal's is that hers is the one (I was conflating with his) that eliminates Medicaid entirely.

under the Jayapal proposal, states could see significant savings relative to current Medicaid spending because Medicaid would be eliminated, and there would be no state financing requirements. However, under other proposals, states would remain responsible through a maintenance of effort (MOE) requirement for all or part of current state spending on Medicaid. The Sanders Medicare-for-all program would require states to maintain their existing Medicaid eligibility standards and spending on institutional long-term care services and would continue to provide states with federal matching payments for these services, locking in variation in eligibility standards and financing across states. Long-term care accounts for more than one in five dollars of Medicaid spending and in 2016, community based long-term care services accounted for 57% of all Medicaid spending on long-term care nationally, although this varies by state. The level of state savings under the Sanders proposal will vary based on current state spending on institutional long-term care services.

https://www.kff.org/medicaid/issue-brief/how-will-medicare-for-all-propo...

These days shopping for any

jollyroger — Sat, 15 Feb 2020 20:26:56 +0000

In reply to I got super lucky,got both my

These days shopping for any sort of long term care insurance in the marketplace is the proverbial "cold shot".

Assisted Living policies have to be priced to reflect that 7-8k monthly drawdown, and none that I have ever heard of covers more than three years of assisted living (I suppose the implicit assumtiion is that you will "graduate" before the end of that period...

Medicaid, per contra, of course, does not run out in three years.

The horror that the times article unfolds, (which is an artifact of the shift to managed care in Medicaid administration itself) raises a whole new level of nightmare, viz the interposition of a "gatekeeper" telling the family that Pops is still "street legal" notwithstanding the florid behaviors cited.

I got super lucky,got both my

PeraclesPlease — Sat, 15 Feb 2020 06:08:26 +0000

In reply to There is major major delusion

I got super lucky,got both my parents into assisted living insurance plan back in the short period before insurance companies realized it was a bad deal. One used the hell out of it, the other not, but yeah, $7k-$8k per month adds up over the years, and I'm sure it'll be much worse by my time unless miraculously robots bring the costs down.