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I maintain that Trump has achieved zero in health care. His only achievement is undermining Obamacare (“repeal and then having no idea what to do”). So far I ha

I maintain that Trump has achieved zero in health care. His only achievement is undermining Obamacare (“repeal and then having no idea what to do”). So far I haven’t seen any real effort to make health insurance any better (where is the “wonderful” plan he promised coming in?) other than bringing us back to the glory days before 2008 when people with preconditions couldn’t get insurance and plans would dump you whenever you got actually sick. He also didn’t “jumpstart” the economy as claimed on the site. I have no problem with you voting for Trump. Go ahead.

robomartin 7y ago
You can maintain that view if you'd like, but understand it does not align with reality at all. BTW, this isn't a discussion about who I might vote for, please don't get defensive. This is a good conversation so far, no need to go there. Let me add something about healthcare. I'd like to suggest you are focusing on the wrong thing (as are millions others). The US healthcare problem is NOT an issue of insurance. Not even close. That's the biggest fallacy and lie told by politicians for decades now. Put in very simple terms: You cannot fix the US healthcare system with insurance. Period. It is NOT an insurance problem. I don't care if we pass Medicare for All, None or the Pink Unicon Plan. Insurance is not the problem. What's the problem? Costs. Well, it's layers of issues really. In no particular order at all: The cost of medical education is ridiculous. The government needs to get out of the student loan game and allow the free market to drive education costs down. Today a doctor graduates with $300K or more in student debt. This means, in no uncertain terms, that this person cannot work for a salary lower than what's require in order to have a hope of paying back that loan and, on top of that, having a life, raising a family, owning a home, etc. BTW, my wife is a physician, so I have first-hand data on some of the internals of the business side of medicine. The next problem --and this affects everyone, not just doctors-- is that our education system loads-up degrees with a bunch of unnecessary pork clearly designed to add another year, if not more, to the process of obtaining a degree. In other countries, if you study, say, electrical engineering, you are treated to science and engineering courses, you don't have to burn months taking myriad unnecessary general education, sociology or other non-engineering courses. When a university is charging you $50K a year to keep you within their walls it is quite profitable to require you to take a bunch of other stuff with the excuse of these things being degree requirements. This adds at least $50K, if not more, to the cost of getting a degree. Moving on from there, the cost of malpractice insurance is ridiculous. Of course, there's variance from specialty to specialty. The range is from $5K to $50K per year and it also depends on where the physician might be practicing (which State). These costs are an important element of the equation that ultimately determines how much we have to pay to have a dozen people attend to us during a surgery or half a dozen people involved in emergency care, etc. Then there's tort reform. Yes, things have been getting better, with some States doing better than others. However, the consequences of our litigious society is that doctors are forced to cover their behind by sometimes ordering all kinds of unnecessary tests and medicine. This costs money and that cost is passed on to the patient one way or the other. Now you start looking at medicine at the hospital level and things get worse. The hospital employs a bunch of people with huge student loans and varying degrees of malpractice insurance and office expenses to cover. The hospital itself has to cover itself through expensive insurance. And then there's the regulatory burden of actually running a hospital. Costs pile-up and, once again, they are passed on to the patient. Then we move on to drug companies. The cost of developing drugs and obtaining regulatory approval is massive. Some drugs cost in the region of $5 billion. The FDA mandates testing that costs in the range of $300 million. Drug companies have non-trivial costs associated with dealing with the regulatory burden. In addition to this they have to worry about lawsuits as well, which means they have expensive insurance, people to manage this (entire legal teams) and the cost of occasional settlements reached in litigation. Once again, costs pile-up and patients end-up paying for them. Medical device manufacturers are subject to the same equation. I once tried to develop a relatively simple medical device that would help millions of people. The regulatory burden and FDA costs were so high I dropped the idea entirely. The reason the same drugs and devices cost less outside the US is that drug companies charge US patients for the cost of doing business in the US. This makes sense, why would a company charge the US burden in nations where they have a far lower cost existence? There's more, but I'll stop here. For example, we could talk about the truly horrific medical patient data system that adds untold cost to our healthcare system. The bottom line is that one could pass the most wonderful sounding insurance scheme and it would do absolutely nothing towards dealing with any of the above problems. Not one thing. These are basic business problems. When things cost you too much you go back and analyze the cost structure that leads to high prices. Our cost structure is horribly high. Which means our costs to deliver care are equally horrific. Insurance will not fix this at all. It's like saying that changing auto insurance policies is going to reduce the cost of buying a Tesla. No, the cost of buy a Tesla is associated with the cost of making a Tesla and not with the insurance the owner will pay to drive one.
- Ididntdothis 7y ago
  You are making some good points. everybody agrees the the US system is f...ed. But don't forget how this discussion started. You stated that Trump is addressing things and I am saying he has done nothing and will do nothing other than talking tough. That point still stands.
  - robomartin 7y ago
    No, sorry, your point is vacuous. It is based on a lack of information and an obvious refusal to read the material I posted. You are not informed. OK, here, I'll post the list here. This list is not exhaustive. You can google each and every one of these and find further details. This is far, very far, massively far, from your idea that Trump has not achieved anything in healthcare. The exact opposite is actually true, what this administration has been able to achieve in this domain while being under absolutely brutal attack 24/7 on the part of the Democrats and almost the entire media is, well, nothing less than remarkable. He still has at least a year to go, some think he has five. I can only imagine what he would have been able to accomplish under more favorable circumstances. This political war has cost this country dearly. He has lists like this one in almost every domain affected by Federal policy. It's simply amazing. People don't know about it because the media are so incredibly biased and one-sided that they hide it all, they don't talk about it, they only focus on the hatred. And so it isn't a surprise that someone can actually believe that he has done nothing, despite all the evidence and documentation that shows otherwise. I mean, you can literally go dig-up the executive orders and read them. This is real. I hope you re-evaluate your belief system, because you are 100% wrong on this. You don't have to believe me, go dig-up the executive orders and read them. Everything below can be corroborated. No lies. You can still, as I, dislike his public persona, yet you can and should be honest enough to accept the fact that the results he is delivering are likely without parallel in modern US history. It's amazing. - The Department of Agriculture provided more than $1 billion in FY2017 to be used to improve access to health care services for 2.5 million people in rural communities. - The Trump administration expanded access to Association Health Plans (AHPs) allowing small business to pool risk across states. - The Trump Administration allows for Short-Term Limited Duration plans to be extended up to 12 months. - President Trump signed a six-year extension of the Children’s Health Insurance Program to fund healthcare for 9 million. Keeping CHIP is expected to save the Federal government about $6 billion dollars. - President Trump has mobilized his entire administration to address drug addiction and opioid abuse by declaring the opioid crisis a nationwide public health emergency - Trump created a bipartisan opioid commission that issued 56 recommendations to help defeat the opioid crisis - In October 2017, President Trump directed The Department of Health and Human Services to declare the opioid crisis a public health emergency, allowing grant money to be used to combat abuse - President Trump signed the International Narcotics Trafficking Emergency Response by Detecting Incoming Contraband with Technology (INTERDICT Act) that would give customs agents $9 million for screening tools on the border - In FY2017, HHS invested nearly $900 million in opioid-specific funding - Trump successfully pressured China to close dangerous loopholes that allowed Chines fentanyl manufacturers to legally ship the compound worldwide, much of which ended up in the U.S. - Under President Trump, The FDA has approved the largest number of generic drugs in history. - Generics increase competition in the marketplace and lower the cost of prescription drugs for all Americans. - In December 2018, year-end drug prices fell for the first time in nearly 50 years. - The Trump Administration issued guidance expanding options for individuals with chronic conditions. High deductible plans can now cover products such as insulin, inhalers and statins pre-deductible - President Trump signed an executive order to modernize flu vaccines and help protect more Americans by promoting new technologies to improve vaccine manufacturing and effectiveness. - Took executive action to strengthen Medicare and reform the Medicare program to stop hospitals from overcharging seniors on their drugs. - The Departments of Labor, Treasury, and HHS issued a final regulation expanding the use of health reimbursement arrangements (HRAs) which will benefit more than 11 million people. - Created new insurance options though association health plans, short-term plans, and health reimbursement arrangements: some are up to 60% less expensive - HHS finalized a rule aimed at increasing transparency in the pharmaceutical industry that requires drug companies to disclose the price of medication in direct-to-consumer television advertisements. - Launched initiative to end HIV/AIDS in America. - Ensured Great Healthcare with initiatives to SAVE AMERICAN LIVES: $6 billion funded to fight the opioid, fentanyl, and drug addiction epidemic. - HHS Awarded $125 Million In Grants to 1,352 Community Health Centers Across All U.S. States, Territories And The District Of Columbia. - HHS Released A Tool For Medicare Consumers That Would Allow Them To Participate In Negotiating Lower Prescription Drug Prices. - Under urging by the Trump Administration, Pfizer and Novartis have agreed to voluntarily drop their prescription drug prices. - Passed Right-To-Try to give critically ill patients access to life-saving cures.

robomartin 7y ago

You can maintain that view if you'd like, but understand it does not align with reality at all. BTW, this isn't a discussion about who I might vote for, please don't get defensive. This is a good conversation so far, no need to go there. Let me add something about healthcare. I'd like to suggest you are focusing on the wrong thing (as are millions others). The US healthcare problem is NOT an issue of insurance. Not even close. That's the biggest fallacy and lie told by politicians for decades now. Put in very simple terms: You cannot fix the US healthcare system with insurance. Period. It is NOT an insurance problem. I don't care if we pass Medicare for All, None or the Pink Unicon Plan. Insurance is not the problem. What's the problem? Costs. Well, it's layers of issues really. In no particular order at all: The cost of medical education is ridiculous. The government needs to get out of the student loan game and allow the free market to drive education costs down. Today a doctor graduates with $300K or more in student debt. This means, in no uncertain terms, that this person cannot work for a salary lower than what's require in order to have a hope of paying back that loan and, on top of that, having a life, raising a family, owning a home, etc. BTW, my wife is a physician, so I have first-hand data on some of the internals of the business side of medicine. The next problem --and this affects everyone, not just doctors-- is that our education system loads-up degrees with a bunch of unnecessary pork clearly designed to add another year, if not more, to the process of obtaining a degree. In other countries, if you study, say, electrical engineering, you are treated to science and engineering courses, you don't have to burn months taking myriad unnecessary general education, sociology or other non-engineering courses. When a university is charging you $50K a year to keep you within their walls it is quite profitable to require you to take a bunch of other stuff with the excuse of these things being degree requirements. This adds at least $50K, if not more, to the cost of getting a degree. Moving on from there, the cost of malpractice insurance is ridiculous. Of course, there's variance from specialty to specialty. The range is from $5K to $50K per year and it also depends on where the physician might be practicing (which State). These costs are an important element of the equation that ultimately determines how much we have to pay to have a dozen people attend to us during a surgery or half a dozen people involved in emergency care, etc. Then there's tort reform. Yes, things have been getting better, with some States doing better than others. However, the consequences of our litigious society is that doctors are forced to cover their behind by sometimes ordering all kinds of unnecessary tests and medicine. This costs money and that cost is passed on to the patient one way or the other. Now you start looking at medicine at the hospital level and things get worse. The hospital employs a bunch of people with huge student loans and varying degrees of malpractice insurance and office expenses to cover. The hospital itself has to cover itself through expensive insurance. And then there's the regulatory burden of actually running a hospital. Costs pile-up and, once again, they are passed on to the patient. Then we move on to drug companies. The cost of developing drugs and obtaining regulatory approval is massive. Some drugs cost in the region of $5 billion. The FDA mandates testing that costs in the range of $300 million. Drug companies have non-trivial costs associated with dealing with the regulatory burden. In addition to this they have to worry about lawsuits as well, which means they have expensive insurance, people to manage this (entire legal teams) and the cost of occasional settlements reached in litigation. Once again, costs pile-up and patients end-up paying for them. Medical device manufacturers are subject to the same equation. I once tried to develop a relatively simple medical device that would help millions of people. The regulatory burden and FDA costs were so high I dropped the idea entirely. The reason the same drugs and devices cost less outside the US is that drug companies charge US patients for the cost of doing business in the US. This makes sense, why would a company charge the US burden in nations where they have a far lower cost existence? There's more, but I'll stop here. For example, we could talk about the truly horrific medical patient data system that adds untold cost to our healthcare system. The bottom line is that one could pass the most wonderful sounding insurance scheme and it would do absolutely nothing towards dealing with any of the above problems. Not one thing. These are basic business problems. When things cost you too much you go back and analyze the cost structure that leads to high prices. Our cost structure is horribly high. Which means our costs to deliver care are equally horrific. Insurance will not fix this at all. It's like saying that changing auto insurance policies is going to reduce the cost of buying a Tesla. No, the cost of buy a Tesla is associated with the cost of making a Tesla and not with the insurance the owner will pay to drive one.

Ididntdothis 7y ago
You are making some good points. everybody agrees the the US system is f...ed. But don't forget how this discussion started. You stated that Trump is addressing things and I am saying he has done nothing and will do nothing other than talking tough. That point still stands.
- robomartin 7y ago
  No, sorry, your point is vacuous. It is based on a lack of information and an obvious refusal to read the material I posted. You are not informed. OK, here, I'll post the list here. This list is not exhaustive. You can google each and every one of these and find further details. This is far, very far, massively far, from your idea that Trump has not achieved anything in healthcare. The exact opposite is actually true, what this administration has been able to achieve in this domain while being under absolutely brutal attack 24/7 on the part of the Democrats and almost the entire media is, well, nothing less than remarkable. He still has at least a year to go, some think he has five. I can only imagine what he would have been able to accomplish under more favorable circumstances. This political war has cost this country dearly. He has lists like this one in almost every domain affected by Federal policy. It's simply amazing. People don't know about it because the media are so incredibly biased and one-sided that they hide it all, they don't talk about it, they only focus on the hatred. And so it isn't a surprise that someone can actually believe that he has done nothing, despite all the evidence and documentation that shows otherwise. I mean, you can literally go dig-up the executive orders and read them. This is real. I hope you re-evaluate your belief system, because you are 100% wrong on this. You don't have to believe me, go dig-up the executive orders and read them. Everything below can be corroborated. No lies. You can still, as I, dislike his public persona, yet you can and should be honest enough to accept the fact that the results he is delivering are likely without parallel in modern US history. It's amazing. - The Department of Agriculture provided more than $1 billion in FY2017 to be used to improve access to health care services for 2.5 million people in rural communities. - The Trump administration expanded access to Association Health Plans (AHPs) allowing small business to pool risk across states. - The Trump Administration allows for Short-Term Limited Duration plans to be extended up to 12 months. - President Trump signed a six-year extension of the Children’s Health Insurance Program to fund healthcare for 9 million. Keeping CHIP is expected to save the Federal government about $6 billion dollars. - President Trump has mobilized his entire administration to address drug addiction and opioid abuse by declaring the opioid crisis a nationwide public health emergency - Trump created a bipartisan opioid commission that issued 56 recommendations to help defeat the opioid crisis - In October 2017, President Trump directed The Department of Health and Human Services to declare the opioid crisis a public health emergency, allowing grant money to be used to combat abuse - President Trump signed the International Narcotics Trafficking Emergency Response by Detecting Incoming Contraband with Technology (INTERDICT Act) that would give customs agents $9 million for screening tools on the border - In FY2017, HHS invested nearly $900 million in opioid-specific funding - Trump successfully pressured China to close dangerous loopholes that allowed Chines fentanyl manufacturers to legally ship the compound worldwide, much of which ended up in the U.S. - Under President Trump, The FDA has approved the largest number of generic drugs in history. - Generics increase competition in the marketplace and lower the cost of prescription drugs for all Americans. - In December 2018, year-end drug prices fell for the first time in nearly 50 years. - The Trump Administration issued guidance expanding options for individuals with chronic conditions. High deductible plans can now cover products such as insulin, inhalers and statins pre-deductible - President Trump signed an executive order to modernize flu vaccines and help protect more Americans by promoting new technologies to improve vaccine manufacturing and effectiveness. - Took executive action to strengthen Medicare and reform the Medicare program to stop hospitals from overcharging seniors on their drugs. - The Departments of Labor, Treasury, and HHS issued a final regulation expanding the use of health reimbursement arrangements (HRAs) which will benefit more than 11 million people. - Created new insurance options though association health plans, short-term plans, and health reimbursement arrangements: some are up to 60% less expensive - HHS finalized a rule aimed at increasing transparency in the pharmaceutical industry that requires drug companies to disclose the price of medication in direct-to-consumer television advertisements. - Launched initiative to end HIV/AIDS in America. - Ensured Great Healthcare with initiatives to SAVE AMERICAN LIVES: $6 billion funded to fight the opioid, fentanyl, and drug addiction epidemic. - HHS Awarded $125 Million In Grants to 1,352 Community Health Centers Across All U.S. States, Territories And The District Of Columbia. - HHS Released A Tool For Medicare Consumers That Would Allow Them To Participate In Negotiating Lower Prescription Drug Prices. - Under urging by the Trump Administration, Pfizer and Novartis have agreed to voluntarily drop their prescription drug prices. - Passed Right-To-Try to give critically ill patients access to life-saving cures.