Life Altering Events

[🏀]

I will.

And outside of taking off my shoes at the airport, 9/11 isn't impacting my life very much right now. 

Precheck, man

[Lennys Tap]

I doubt it.  This is going to amplify the inequities that exist on our society on a number of levels.

Right now we live in a country where most have a lot and some have a lot more (too much?). Some of the people with a lot hate the people with a lot more. If enough of the people who have a lot and are already angry suddenly don’t have a lot anymore you’re right, things could get ugly.

[jesmu84]

Good stuff, eng.

I think you're correct on the end-game. But I think getting there is going to be brutal.

I also happen to believe that the recovery from this will be very good for the wealthy and not-so-good for the middle class. Similar to the recovery from 2008. THAT'S the part that worries me the most.

[The Hippie Satan of Hyperbole]

Right now we live in a country where most have a lot and some have a lot more (too much?). Some of the people with a lot hate the people with a lot more. If enough of the people who have a lot and are already angry suddenly don’t have a lot anymore you’re right, things could get ugly.

I had to read this a few times...but yeah.

[MU82]

I don't mean this in a pejorative sense, but if you are in the "government should save us" crowd, I can see why you are panicked. Governments generally and our government specifically is not designed to solve problems fast or efficiently. Regardless of the orange dope in office, a federal response was going to be slow. Companies, individuals, local governments are all going to be faster and more agile than federal government bureaucracy.

I work in the manufacturing sector, starting the week before and really ramping up this past week, manufacturing pivoted. Medical suppliers went into 24x7 operation (GEHC is going to make 6000 ventilators in the next 4 weeks at one plant alone),  PPE production capacity has tripled in a week, and other necessary supplies and capacity is expanding. The food supply chain is stable as is the public infrastructure, so any shortages are only because of panic hoarding that is unnecessary. We are going to flatten the curve(perhaps not as fast as we'd like) but we will also double our critical healthcare capacity in 4-6 weeks(Italy definitely can't do that). Further jobs will be evolving, Amazon is expanding as are critical manufacturing, there will be hardships no doubt but all is not lost in the short term.

Long term, this event will turn over political leadership....national leaders too long in the tooth with fail, others will step into the breach and work the problem. The working class will recognize its power to control it's own fate. Manufacturing will recognize the need to shorten and diversify the supply chain meaning some manufacturing jobs will come back. There will be the destruction of small businesses and lost eateries, etc but others will rise to replace them. There will be consolidation in business but there will be expansion as new business models replace old. Some will lose in the change, some will tread water, some will win....but we will survive. Anti-Virals will be developed as will vaccines. Treatment protocols will be available within 6 months that will save people otherwise lost now. Additionally we will very likely choice to(or have to) withdraw from our imperial adventures abroad....we will step back from Afghanistan and Iraq amongst others, reducing our military expenditure at a critical moment when we need to focus at home, largely because we can.

Yes income inequality and the "unfairness" of the system will evolve but huge paradigm shifting events like this have a way of repressing the balance.

The next 6 to 18 months will be difficult at times but I have zero doubt we'll come out better than we went in.

I like your optimism and I hope you are correct.

Not so sure about it bringing us closer together or about it leading to something better for most of those who are not already economically secure, but I hope you're right.

[mu03eng]

I like your optimism and I hope you are correct.

Not so sure about it bringing us closer together or about it leading to something better for most of those who are not already economically secure, but I hope you're right.

I actually think this event will drive the case for universal income (inversely I think you'll see universal healthcare be pushed further away). Somewhere Andrew Yang is smiling a little.

[MU82]

I actually think this event will drive the case for universal income (inversely I think you'll see universal healthcare be pushed further away). Somewhere Andrew Yang is smiling a little.

Interesting.

I don't see how, politically, either of those things would happen. Even if Dems win the presidency, the Senate and the House, they saw what happened after they pushed through the watered-down version of Obamacare in 2010. And if Republicans control any of those three branches, universal income will be a non-starter. But hey ... maybe I'm wrong.

[Hards Alumni]

Interesting.

I don't see how, politically, either of those things would happen. Even if Dems win the presidency, the Senate and the House, they saw what happened after they pushed through the watered-down version of Obamacare in 2010. And if Republicans control any of those three branches, universal income will be a non-starter. But hey ... maybe I'm wrong.

Who will foot the bill for the medical care for the thousands of Americans who don't have insurance?

[MU82]

Who will foot the bill for the medical care for the thousands of Americans who don't have insurance?

Who indeed.

[Hards Alumni]

Who indeed.

Everyone, of course.  Universal health care that we pay for, but we will still bankrupt people.

Interesting to think about.

[MU82]

Everyone, of course.  Universal health care that we pay for, but we will still bankrupt people.

You're preaching to the choir.

I am a big fan of (at the very least) the option for folks 50+ being able to buy into Medicare. It would strengthen Medicare (more $$$ coming in from younger, presumably healthier people), make the country more healthy overall, prevent some healthcare-related insolvencies, be a good next step up the healthcare-is-a-right ladder, etc.

Something like it was supposed to be part of the ACA but it did not receive quite enough support. I haven't heard a single viable argument against it.

[mu03eng]

You're preaching to the choir.

I am a big fan of (at the very least) the option for folks 50+ being able to buy into Medicare. It would strengthen Medicare (more $$$ coming in from younger, presumably healthier people), make the country more healthy overall, prevent some healthcare-related insolvencies, be a good next step up the healthcare-is-a-right ladder, etc.

Something like it was supposed to be part of the ACA but it did not receive quite enough support. I haven't heard a single viable argument against it.

Medicare is kind of a sham....private insurance is so expensive in part because medicare artificially sets rates under that of the market and providers then "overcharge" the private insurance to make up the difference. If health insurance were truly marketized (open market for insurance and employers were not allowed to provide health insurance) with a government provider option as well as for profit provider options we'd see health care costs decrease significantly.

If you went to a UBI and eliminated nearly all other entitlements there would be significant cost efficiency as well. Maybe we'll start thinking about these things when the dust settles.

[forgetful]

Everyone, of course.  Universal health care that we pay for, but we will still bankrupt people.

Interesting to think about.

I never really thought about the latter aspect you post above. Each and everyone of us foot the bill for people who ultimately can't pay for medical emergencies that befall them. So the hospitals win. Yet, you are right, despite this, we pile on the burden of bankruptcy on the person who did nothing wrong but get ill. Just a terrible though.

Also, if you think about inheritance. For the middle class, the idea of an inheritance is gone. Medical care and nursing homes will take every last penny they had worked so hard to save their entire life, the only people getting an inheritance is the super rich.

Our system is entirely broken.

[mu_hilltopper]

I think your pessimism is way over the top. But if you’re right the long run most humane strategy is perhaps isolating the old folks (like me) as much as is humanly possible and getting the rest of the country back to work as soon as possible.

Or .. my pessimism isn't even deep enough:

https://www.bloomberg.com/news/articles/2020-03-22/fed-s-bullard-says-u-s-jobless-rate-may-soar-to-30-in-2q

Federal Reserve Bank of St. Louis President James Bullard predicted the U.S. unemployment rate may hit 30% in the second quarter because of shutdowns to combat the coronavirus, with an unprecedented 50% drop in gross domestic product.

[GooooMarquette]

I never really thought about the latter aspect you post above. Each and everyone of us foot the bill for people who ultimately can't pay for medical emergencies that befall them. So the hospitals win. Yet, you are right, despite this, we pile on the burden of bankruptcy on the person who did nothing wrong but get ill. Just a terrible though.

Also, if you think about inheritance. For the middle class, the idea of an inheritance is gone. Medical care and nursing homes will take every last penny they had worked so hard to save their entire life, the only people getting an inheritance is the super rich.

Our system is entirely broken.

I don't disagree with the premise that the system is broken. But "the hospitals win?" Most hospitals are barely (if at all)  staying in the black, and it's getting harder as the population ages and Medicare doesn't cover the full cost of care.

IMHO, if you want to find the HUGE profits in healthcare, look to the drug and device companies, not the hospitals.

[Hards Alumni]

I don't disagree with the premise that the system is broken. But "the hospitals win?" Most hospitals are barely (if at all)  staying in the black, and it's getting harder as the population ages and Medicare doesn't cover the full cost of care.

IMHO, if you want to find the HUGE profits in healthcare, look to the drug and device companies, not the hospitals.

Well, and the insurance companies, but yes.

[jesmu84]

I don't disagree with the premise that the system is broken. But "the hospitals win?" Most hospitals are barely (if at all)  staying in the black, and it's getting harder as the population ages and Medicare doesn't cover the full cost of care.

IMHO, if you want to find the HUGE profits in healthcare, look to the drug and device companies, not the hospitals.

Yes and no. Hospitals are doing about as well as they always have. However, administrators and administration costs have skyrocketed since healthcare became a corporate venture.

[GooooMarquette]

Yes and no. Hospitals are doing about as well as they always have. However, administrators and administration costs have skyrocketed since healthcare became a corporate venture.

Administrators and administration costs have risen as Medicare and Medicaid rules have become increasingly byzantine.

And FWIW...some people try to blame the complexities on "the insurance companies," but that's a red herring. Figuring out the Medicare billing and coding requirements is infinitely more time-consuming than doing the same for commercial insurers.

[MU82]

Medicare is kind of a sham....private insurance is so expensive in part because medicare artificially sets rates under that of the market and providers then "overcharge" the private insurance to make up the difference. If health insurance were truly marketized (open market for insurance and employers were not allowed to provide health insurance) with a government provider option as well as for profit provider options we'd see health care costs decrease significantly.

If you went to a UBI and eliminated nearly all other entitlements there would be significant cost efficiency as well. Maybe we'll start thinking about these things when the dust settles.

Hmmm.

Most hospitals are barely (if at all)  staying in the black

I don't know about "most," and I'm far to lazy to look it up.

However, I will say that the large "health care systems," many of which began as hospitals (or groups of them) and have morphed into, well, "health care systems," seem to be doing A-OK.

Here in NC, the largest employer is Atrium Health, a ginormous, "not-for-profit" health care system anchored by one huge hospital and numerous satellite hospitals. Over the last couple decades, they swallowed up clinics and small hospitals, used their clout to lure physicians out of private practice, etc.

They are "not for profit" because they put all of what would be profits back into the system. They build ever more hospitals, clinics, cancer centers, pay their administrators ever more money (I believe they now have 2 dozen executives each making $1 million or more), etc, etc, etc.

Many states have at least one such entity, some have several. Chicago alone has a few.

I do know that lots of rural hospitals can't make ends meet and end up folding ... or getting usurped by the likes of Atrium.

[jesmu84]

Here in NC, the largest employer is Atrium Health, a ginormous, "not-for-profit" health care system anchored by one huge hospital and numerous satellite hospitals. Over the last couple decades, they swallowed up clinics and small hospitals, used their clout to lure physicians out of private practice, etc.

They are "not for profit" because they put all of what would be profits back into the system. They build ever more hospitals, clinics, cancer centers, pay their administrators ever more money (I believe they now have 2 dozen executives each making $1 million or more), etc, etc, etc.

Many states have at least one such entity, some have several. Chicago alone has a few.

I do know that lots of rural hospitals can't make ends meet and end up folding ... or getting usurped by the likes of Atrium.

This is what I'm talking about.

Corporate takeover of healthcare.

It hurts the providers and the patients.

And helps ..? C-suite salaries?

[GooooMarquette]

Hmmm.

I don't know about "most," and I'm far to lazy to look it up.

However, I will say that the large "health care systems," many of which began as hospitals (or groups of them) and have morphed into, well, "health care systems," seem to be doing A-OK.

Here in NC, the largest employer is Atrium Health, a ginormous, "not-for-profit" health care system anchored by one huge hospital and numerous satellite hospitals. Over the last couple decades, they swallowed up clinics and small hospitals, used their clout to lure physicians out of private practice, etc.

They are "not for profit" because they put all of what would be profits back into the system. They build ever more hospitals, clinics, cancer centers, pay their administrators ever more money (I believe they now have 2 dozen executives each making $1 million or more), etc, etc, etc.

Many states have at least one such entity, some have several. Chicago alone has a few.

I do know that lots of rural hospitals can't make ends meet and end up folding ... or getting usurped by the likes of Atrium.

"Seem to be doing A-OK" is pretty vague. Do you have numbers on which you base this, or are you assuming it based on expansion? Because getting bigger is not the same as getting more profitable.

[WellsstreetWanderer]

Medicare is kind of a sham....private insurance is so expensive in part because medicare artificially sets rates under that of the market and providers then "overcharge" the private insurance to make up the difference. If health insurance were truly marketized (open market for insurance and employers were not allowed to provide health insurance) with a government provider option as well as for profit provider options we'd see health care costs decrease significantly.

If you went to a UBI and eliminated nearly all other entitlements there would be significant cost efficiency as well. Maybe we'll start thinking about these things when the dust settles.

Someone who knows of which he speaks. Correct analysis. 

[WarriorDad]

But none of those patients will need to declare bankruptcy due to their treatments.

Universal healthcare isn't a solution to a pandemic.

It's about lowering costs and saving lives - mostly by removing a middle-man whose sole purpose is to make money.

I am mostly for UHC and bankruptcy protection is a reason.  The downside is it trains a society to overuse the system and generally over rely on it.  In a case like a pandemic that is not good news.  Lower probability of success doctors tend to not pursue.  This is happening in Italy now.

A website I find to do an excellent job of presenting th3 pros and cons of issues

https://www.thebalance.com/universal-health-care-4156211

[muwarrior69]

Medicare is kind of a sham....private insurance is so expensive in part because medicare artificially sets rates under that of the market and providers then "overcharge" the private insurance to make up the difference. If health insurance were truly marketized (open market for insurance and employers were not allowed to provide health insurance) with a government provider option as well as for profit provider options we'd see health care costs decrease significantly.

If you went to a UBI and eliminated nearly all other entitlements there would be significant cost efficiency as well. Maybe we'll start thinking about these things when the dust settles.

So the government would be the only employer to provide health insurance.

[mu03eng]

So the government would be the only employer to provide health insurance.

Depends on how you look at it, they would be two different parts of the government.....but in this utopia government employment would be significantly lower across all levels of government