New ICE Vehicles Banned in California by 2035

[Dadhawk]

We're a long way from ICE bans at this point, but what the heck.

Originally Posted by ZDan

...M4A is the way to go.

I'm all for universal healthcare but having seen the finances behind hospitals with a large Medicare payer mix I can tell you the healthcare system will not survive on a strict M4A plan. The nonprofit hospital I work for is one of the few that manages to run in the black, but it's not because of Medicare reimbursements. That is strictly a red proposition with commercial and self-pay moving it slightly into the black area each year.

Originally Posted by ZDan

Yeah, and if you have 10 employees and pay 9 of them $1 and 1 of them $100, the *average* pay is $10/hr. The *minimum wage* should be a living wage, everywhere in the country.
...
Long/short, I don't believe this "estimate" is arrived at legitimately...
Here's a study for you: [I] Why Does the Minimum Wage Have
No Discernible Effect on Employment?

I can only speak from my family's personal experience, but I have 3 sons that have worked low end jobs in high school at grocers and other retail jobs. At no point were they paid minimum wage even as 16 year olds. In fact, the Bureau of Labor Statistics says that in 2017 less than 2.3% of all hourly workers made minimum wage or less.

My sons all made, starting out, a minimum of $10 per hour (38% higher than minimum wage) as far back as 12 years ago.

I've also not seen anything that convinces me that $31,200 a year ($15x2080) is a "living wage". Maybe if you're single, and you don't live in NYC or Los Angeles.

According to MIT, the living wage in the county where I live in Georgia (which is a relatively affluent county) is $13.66 but that changes to $35.79 ($74,443) if you have 3 kids and a single parent. So, then, does the Federal minimum wage need to float based on your family circumstances?

Also, their estimate for LA County in California is $14.83 for a single person. Based on what I know about price differences in Georgia and CA I find it hard to believe that $46.80 difference per week ($2,434 per year) is enough to give you the same lifestyle between the two areas.

I don't know what the real "answer" is, but I don't think it's one that can be legislated.

[Tomm]

Originally Posted by Dadhawk

I don't know what the real "answer" is, but I don't think it's one that can be legislated.

This.

[AnalogMan]

Originally Posted by Dadhawk

We're a long way from ICE bans at this point, but what the heck.

I don't know what the real "answer" is, but I don't think it's one that can be legislated.

There are many potential 'solutions'. We can try to learn from the examples of the 192 other countries on Earth and see what works and what doesn't. If you look at cost and quality as the most important factors in assessing healthcare (seems reasonable, how good is it and how much does it cost?), so many measures show that the U.S. has, by far, the most expensive healthcare in the world, but far from the best. In cost we're always #1 by a wide margin, but in quality, depending in the metrics, we're usually somewhere between 20th and 40th. The World Population Review rates us 37, down there with Cuba and Slovenia -

https://worldpopulationreview.com/co...e-in-the-world

For most countries around the world, and certainly for all the countries in the top 20, healthcare is a legislated solution. It was a conscious decision by the elected leaders that healthcare is a right that should be given to all people, not just to those who can afford it. The U.S. is the only major country on Earth that takes the position that healthcare is not a right for all its people.

It's not that top-quality healthcare isn't available in the U.S. It certainly is. This country has some of the best physicians, some of the best facilities, and some of the best treatments available anywhere on Earth. It's just that they're far from universally available to everyone. If you want the best, it's only available to those who can afford to pay for it. Even though the ACA reduced the number of people without health coverage by about 20 million, there are still almost 30 million people today who don't have any health insurance because they can't afford it (or don't have jobs that provide it). That brings the average quality of healthcare in this country way down.

France often is considered to have the highest quality healthcare in the world (compared to our 37th). Yet the cost of healthcare in France is less than half of what it is in the U.S. Likewise Italy, with the second best care has a cost about 1/3 that of the U.S.

https://www.healthsystemtracker.org/...untries___2018

All those countries with better quality healthcare than we have legislated it into being. They took profit out of the picture and instead used the money for salaries for physicians and nurses, hospital equipment and staff, and medicines.

Our costs are so high because of how much must go to pay for the profits of all the for-profit companies involved in delivering our healthcare. Every dollar that goes to corporate profits is a dollar that doesn't go for physicians, nurses, or anything else that actually provides healthcare to people.

For any public company in the U.S. (and most of the insurance and other companies involved in healthcare are publicly held), it has been codified into law that the highest priority of any corporation is to maximize shareholder value. Always. At all times. Above any and all other obligations or activities. That means squeezing every last possible penny possible in profits (plus 30%), and doing anything and everything to pump (hype) up the stock price right now, immediately, today, short term.

Any CEO that dares incur the wrath of hedge funds and other institutional shareholders by not charging usurious prices for drugs, by not paying employees the bare minimum you can get away with, by not borrowing money and leveraging the company to the hilt, or by being so foolish as to actually try to invest in R&D for new drugs, invariably gets quickly and viciously sued and then has to defend himself before a judge and rapacious plaintiff's attorneys asking 'why didn't you do this to increase profits and share price?'. Ask me how I know.

The goals are mutually exclusive: as a society, is our priority to maximize corporate profits, or to maximize the quality of healthcare and how many people have it?

Pick one.

[Dadhawk]

Originally Posted by AnalogMan

There are many potential 'solutions'.

My last statement you quoted was more about minimum wage and wage equity than healthcare.

I agree that healthcare needs to be affordable, portable and universal. I just don't think M4A or single payer of any sort is the answer.

Open up insurance across state lines, and lets see what the free market with a government backup does first. Provide subsidies like AHA does for those that can't afford it outright based on income and mandate all insurance companies accept it against their policies. Maybe that's a start.

[ZDan]

Originally Posted by Dadhawk

I don't know what the real "answer" is, but I don't think it's one that can be legislated.

Real answer is to outlaw bribery and reform campaign financing. Absolutely *is* legislatable, but our legislators are bought and paid for by corporate $$$$$$$

[ZDan]

Originally Posted by AnalogMan

The goals are mutually exclusive: as a society, is our priority to maximize corporate profits, or to maximize the quality of healthcare and how many people have it?

Pick one.

I pick 2nd one, extended such that we *all* have healthcare.

[Dadhawk]

Originally Posted by ZDan

Real answer is to outlaw bribery and reform campaign financing. Absolutely *is* legislatable, but our legislators are bought and paid for by corporate $$$$$$$

One in the same to me since its unlikely either will happen.

[Dadhawk]

Originally Posted by AnalogMan

..They took profit out of the picture and instead used the money for salaries for physicians and nurses, hospital equipment and staff, and medicines.

Our costs are so high because of how much must go to pay for the profits of all the for-profit companies involved in delivering our healthcare. Every dollar that goes to corporate profits is a dollar that doesn't go for physicians, nurses, or anything else that actually provides healthcare to people.

I'm sorry but personnel costs are a big part of the issue with healthcare in the US. Have you seen what physicians make? It's so high that the Bureau of Labor Statistics I quoted earlier doesn't even list an average, only that it's "over $208,000 per year". Along with everything else, that will have to be reigned in to make healthcare "affordable".

Here's a comparison from a UK website, notice the differences:

[AnalogMan]

Originally Posted by Dadhawk

I'm sorry but personnel costs are a big part of the issue with healthcare in the US.

Of course! This opens up a whole 'nother can of worms about why personnel costs are so high in the U.S. A part of the reason is malpractice. Malpractice insurance isn't cheap. If you had tort reform so that anyone couldn't easily sue anyone else for anything and everything under the sun, with the possibility of 8- and 9-figure settlements, and brought litigation costs down to a level comparable with other countries, physicians wouldn't have to make as much money because they wouldn't be paying out so much for malpractice insurance.

It's also partly a function of the top end of the market driving demand. Wealthy consumers who can afford to pay for their own healthcare demand, and can pay for, the best cardiologists, neurologists, cosmetic surgeons, etc., especially in major cities like New York, Boston, etc. I imagine primary care physicians or pediatricians in poor rural areas aren't raking in 7-figure salaries (but their malpractice insurance still needs to be paid for).

Then there's yet another can of worms with costs of schooling. Medical school in the U.S. isn't cheap. In France, if you get in, medical training is virtually free. Having a national healthcare system, combined with nationally-paid medical training, seems to make costs a lot more reasonable than in the U.S.

[Irace86.2.0]

Originally Posted by Dadhawk

I'm sorry but personnel costs are a big part of the issue with healthcare in the US. Have you seen what physicians make? It's so high that the Bureau of Labor Statistics I quoted earlier doesn't even list an average, only that it's "over $208,000 per year". Along with everything else, that will have to be reigned in to make healthcare "affordable".

Here's a comparison from a UK website, notice the differences:

We have some nurses making more than doctors, TBH.

Doctors in this country also need to pay $200k for med school on top of their undergraduate. They are saddled with debt and don't start making money until their early thirties. A nurse finishing college at 22 is better off than a doctor finishing residency at 30-33 until age 54 or something, when the higher salary of the doctor finally crosses his net worth over the nurse's net worth. Why? The nurse had a head start on income with less school debt. In other countries, college is free. Getting in is a matter of going to college prep schools and merit. That is why the comparison doesn't make sense.

France and Germany have free college. England use to have free college, but they went away with that, and it is yet to be seen if there will be long term consequences for short term gains. Pretty sure Spain is free or tuition is about as bad as community college here.

https://www.investopedia.com/article...ge-tuition.asp

I should add, if you think $200k is bad then you should see the salaries of the top execs. My hospital's execs are making half a mill, and they aren't even CEOs for big, big companies.

[ZDan]

Originally Posted by Dadhawk

I'm sorry but personnel costs are a big part of the issue with healthcare in the US. Have you seen what physicians make? It's so high that the Bureau of Labor Statistics I quoted earlier doesn't even list an average, only that it's "over $208,000 per year". Along with everything else, that will have to be reigned in to make healthcare "affordable".

Doctors deserve $208k/year way way WAY more than health insurance CEOs deserve $20M/year. Their jobs are non-essential. So let's start with eliminating the need for people to buy insurance from profit-driven corporations who by god are going to charge the MAXIMUM and give you the MINIMUM in return. And of course drop you if you get sick enough to lose your job and are unable to afford the jacked-up rates to keep them...

[Irace86.2.0]

Originally Posted by Dadhawk

My last statement you quoted was more about minimum wage and wage equity than healthcare.

I agree that healthcare needs to be affordable, portable and universal. I just don't think M4A or single payer of any sort is the answer.

Open up insurance across state lines, and lets see what the free market with a government backup does first. Provide subsidies like AHA does for those that can't afford it outright based on income and mandate all insurance companies accept it against their policies. Maybe that's a start.

It isn't about minimum wage for me or determining what a living wage means. It is about corporations and CEOs making millions and billions and not sharing the profit with their employees to the tune that their employees struggle to live to such an extent that I have to pay via my tax dollars, so these employees can have food stamps or whatever. Walmart and the Waltons are one of the richest companies and families in the world, but they can't afford to pay their employees enough, so their employees don't qualify for government assistance and can make ends meet. That is insane to me that I am supplementing the income of one of the richest families in the world.

With healthcare, there is no need to hold onto a system that is broken. As long as people can't be turned away from ERs private insurance will forever be paying for non-payers and non-payers will gamble going into bankruptcy if a large event happens. There is no other fix for this except universal healthcare where everyone has to contribute something. Universal healthcare removes profits and high executive salaries from insurance, and it simplifies the billing department for hospitals and doctor's offices. We don't have to wonder. It has been overwhelming demonstrated to be the case in other countries and with bipartisan studies. Cheaper with better outcomes. There would be losers. No doubt.

[Dadhawk]

Originally Posted by Irace86.2.0

There is no other fix for this except universal healthcare where everyone has to contribute something. Universal healthcare removes profits and high executive salaries from insurance, and it simplifies the billing department for hospitals and doctor's offices. We don't have to wonder. It has been overwhelming demonstrated to be the case in other countries and with bipartisan studies. Cheaper with better outcomes. There would be losers. No doubt.

I've already said it's broke and it needs to be fixed but we already have an example of Uncle Sam lead healthcare (VA anyone?) and having personally had relatives with experience in that system, no thanks.

[Dadhawk]

Originally Posted by ZDan

Doctors deserve $208k/year way way WAY more than health insurance CEOs deserve $20M/year.

A private company can pay its employees (at both end of the spectrum) what the market will bear, and that's what happens. People underestimate the impact the members of the c-suite have on how a company runs and survives. Are there abuses, sure, just like with everything else. Folks are just smoking some good stuff though if they think letting the Feds run healthcare is somehow going to magically make it better.

Remember this is the same people that just passed as "COVID recovery bill" that was over 5,000 pages long and were able to completely understand it with just 2 hours before they voted on it.