re: Lying Ted vs Crazy Bernie - ObamaCare Debate Night on CNN

You retards are still on this "Lyin' Ted" bullshite? You do know Trump made that shite up to play you, right?

Of course you don't.

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The market is too fragmented

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Yet leftists still want to prevent interstate insurance. Apparently, economies of scale only apply to government. It's an odd view of economics.

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If the evidence suggested to me that interstate insurance was the key to success, I would be all for it.

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I can't say I'd expect it to be the boon many think it would be. But I wasn't really arguing for it. Merely pointing out leftists have a very inconsistent view of the concept of purchasing leverage on pricing.

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the barriers to entry are not really regulatory, they are financial and network based.

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Hmmm... one cannot really separate the financial and network acquisition (and maintenance) climate from the regulatory climate. They are tightly coupled and intertwined.

As for your point about geographic separation...I'd expect a shite-ton of M&A activity if interstate ops were allowed. Much cheaper to buy that than build it yourself from scratch.

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the model does not take into account varying degrees of obesity, which are likely to affect lifetime health-care costs, nor indirect costs of obesity such as reduced productivity.

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Oh so the people that are so fat they get their legs cut off from diabetes, go blind, need countless surgeries, are in and out of the ED with heart failure. Oh and can't work so they are on medicaid, disability, food stamps, and need transportation. I see these people every damn day.

But yea thats probably not an important part of the equation

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It wasn't to really attempt to separate them, only to point out that even when those state barriers have been lifted, it hasn't produced the theorized results proponents have suggested.

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Gotcha.

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And honestly, at its core there is still looming the larger question of whether forcing states to give up their autonomy to dictate their own regulations is actually ideal for consumers?

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That was my point. Leftists seem to think forcing them to give up their automomy is a benefit... if government does it.

The broader point is their agenda isn't really pro-patient. It's pro-governemnt/anti-private industry.

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The simple answer is that broadening your risk pool, is, well, risky.

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Worse. It's futile. Broadening the "risk pool" doesn't lower payout. IF cancer is 1:1000 incidents... going from 10,000 to 20,000 patients doesn't lower your payout ratio. The only thing that helps is IMPROVING your "risk pool" by taking on lower-risk patients. That doesn't happen with a general population expansion. (nor forced acceptance of pre-existing conditions).

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Because such a system naturally incentivizes companies to locate in the laxest and most favorable regulatory state. Is that ideal from a consumer perspective? I tend to think it wouldn't be.

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Ok. But the same would apply government under single payer, with the payer dictating it's own laws, regulations, and treatment standards. (I realize you weren't arguing for that)

As for laxest regulations... one could consider that a feature, not a flaw, as those regulations are a significant cost driver. As always it's a cost/benefit calculation. Some seem to believe that healthcare is immune from such considerations.

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Worse. It's futile. Broadening the "risk pool" doesn't lower payout. IF cancer is 1:1000 incidents... going from 10,000 to 20,000 patients doesn't lower your payout ratio. The only thing that helps is IMPROVING your "risk pool" by taking on lower-risk patients. That doesn't happen with a general population expansion. (nor forced acceptance of pre-existing conditions).

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And I think you are kinda hitting on the head part of the inherent conflict with the idea. Insurers want to keep risk minimal. Not to mention keep costs low. Entering a new market is tricky both from a risk perspective and the likely higher costs negotiated due to lack of presence.

If you go to a hospital trying to expand your network into a new state. The hospital will want to know what your bringing to the table for them. Maybe you have a robust list of clients in Connecticut, but that won't mean much in Georgia to the hospital. The Georgia hospital will see you with your puny list and your in-state competitor with his enormous network and will naturally favor him. So that expanding insurer will be stuck trying to raise rates on his people in Connecticut to establish business in Georgia. Which can be self defeating unless the company is willing to take loses.

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Ok. But the same would apply government under single payer, with the payer dictating it's own laws, regulations, and treatment standards. (I realize you weren't arguing for that)

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No its a fair point to bring up. Single-payer, or any solution has its drawbacks. One of the legitimate issues with single-payer as I understand it is it could mean too much power in the sense it would harm the system around it due to government leverage. Shifting wages too low and disincentivizing innovation and/or employment. It can also go the opposite direction and set up a rent-seeking situation where societal goals may be met optimally, but the taxpayer is on the hook for unnecessary extra high costs propping up inflated prices in the healthcare sector. The truth seems to be what you make of it politically. Looking at international examples that range in measures of efficacy, quality, cost, and supply, Single-payer does manage to cover everyone at a lower cost then our system, and when done well provide as good of quality of care and access. However, I also don't think it is realistic to implement that in this country due to a number of reasons.

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As for laxest regulations... one could consider that a feature, not a flaw, as those regulations are a significant cost driver. As always it's a cost/benefit calculation. Some seem to believe that healthcare is immune from such considerations.

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One could. But like the current shifting sentiments on free trade, is it in the best interest of the American people as a whole to be beholden to the state with the worst consumer protection laws, laxest regulations and least punitive legal protections? If the argument is America has a better baseline of standards then China, that would be true. But it would also suggest that that baseline should be examined and maintained.

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Fear the Reaper - Cowbell

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One of the biggest takeaways from this debate is that Bernie doesn't understand that insurance is based on risk stratification.

It's like he's angry about that.

Unbelievable.

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true dat

I enjoyed the hell out of this debate - the first actual debate on anything, anywhere that I have seen in decades. It was fantastic. It harkens back to when politics was not a blood sport.

I wish these two could debate weekly - name the topic. A committed socialist vs a committed constitutionalist. It doesn't get any more fundamental than that. Let the two side battle it out on an intelligent intellectual level.

ahhhhhh - nostalgia. This is the kind of thing millennials are totally ignorant of.

Sanders is so out of touch with small business owners. "Well by you not having insurance for your employees, you have an unfair advantage over the hair salon who does. Because you can offfer lower prices".

After seeing the highlights this morning, I completely understand why Progs use the tactics they use today.

They can't win any logical argument. Has to be emotion, shouting down, using some "ism" to demean the opponent, or their favorite, violence.