What does a TRUMP presidency look like?

[CountDeMoney]

Health care, even with all the maintenance drugs my wife and I are on, wasn't the most expensive item in our household budget before Obamacare (housing was).  I've posted this before, but pre-Obamacare, we didn't have health insurance at all (by our own choice) and we paid about $2400 a year for our healthcare.  Last year, we paid about $3000 a year in insurance premiums (that's going up this year, though less than what I feared it would), but in order to keep our premiums that low, we had to choose a plan that has such a high deductible that it doesn't end up actually paying for anything.  So now we're paying about $5400 ($3000 in premiums plus $2400 in out-of-pocket costs) for the same health care we were paying $2400 for.  And from talking to co-workers and other people who have similar incomes to us, this isn't an uncommon situation.

And yes, I do think that health care costs would come down if everyone paid out-of-pocket.  I can't prove it, but I have plenty of anecdotal evidence that doctors would charge their patients a lot less if they didn't expect insurance to cover the bulk of their charges.

You know what, you and your wife should really get into a catastrophic automobile accident. No really, just so you can prove your own point.

[sbr]

http://www.cnbc.com/2017/01/07/us-ethics-office-struggled-to-gain-access-to-trump-team-emails-show.html

US ethics office struggled to gain access to Trump Team, emails show

The office tasked with overseeing ethics and conflicts in the federal government struggled to gain access to leaders of the Trump transition team, and warned Trump aides about making decisions on nominees or blind trusts without ethics guidance, according to new emails obtained by MSNBC.

Office of Government Ethics Director Walter Shaub emailed Trump aides in November to lament that despite his office's repeated outreach, "we seem to have lost contact with the Trump-Pence transition since the election."

Trump aides may also be risking "embarrassment for the President-elect," Shaub warned, by "announcing cabinet picks" without letting the ethics office review their financial information in advance.

The perils for White House staff were even more severe, Shaub argued, because they might begin their jobs without crucial ethics guidance, raising a risk of inadvertently breaking federal rules.

"They run the risk of having inadvertently violated the criminal conflicts of interest restriction at 18 USC 208," Shaub wrote, citing a federal conflicts law in an email to Trump Transition aide Sean Doocey.

"If we don't get involved early to prevent problems," he added, "we won't be able to help them after the fact."

Shaub also warned that if Trump tried to create his own "blind trust" without the ethics office, the effort could be dead on arrival.

The government might decide potential trustees were not independent, he cautioned, if Trump aides talked to them "before consulting" with the ethics office.

In contrast to most proposals floated by the Trump transition team, Shraub added that the ethics office only considers a trust blind if its underlying assets have "been sold off."

In his public remarks, Trump has mostly focused on who would manage the Trump Organization. He has not suggested he would divest, or sell off its assets.

The emails were obtained through a Freedom of Information Request from MSNBC and The James Madison Project, and represented by the law office of Mark S. Zaid.

Richard Painter, former ethics lawyer for President George W. Bush, says the email exchanges suggest the ethics office is "trying to touch base so they can take these issues seriously," while the Trump transition team evinces less "desire to sit down and work through the issues."
Norm Eisen, a former ethics lawyer for President Obama, offered ethics advice to Trump aides before the election, and has criticized Trump's approach to business conflicts since his victory.

"My view is that Office of Government Ethics and Director Shaub have been strong and outspoken in advocating ethics to the new administration, and this confirms it," Eisen said.

The ethics office provided hundreds of pages of material, including correspondence with and about the Trump transition team.

Much of the material reflects routine transition preparation, including ethics guidance, trainings and tutorials on how to file financial disclosures required by federal law.

The correspondence shows Trump transition officials provided financial information and email responses to the ethics office, reflecting a cooperative approach on many issues, while ethics office staff also sought more detailed and frequent interaction.

After some lapses in responses, there are government emails asking Trump officials if they "are still with the transition team," and a reference to the struggle to "pin" down Trump lawyer Don McGahn for a call. In one email, a Trump official acknowledges the "difficulty in getting touch with counsel's office," an apparent reference to reaching McGahn, who Trump has since appointed as his White House counsel.

While the Freedom of Information Act (FOIA) request sought materials about Trump's potential divestment from his company, that topic rarely arose in the materials, which included some redacted email.

Bradley Moss, a federal employment lawyer who oversaw the FOIA request, said that absence was concerning.

"Conspicuously absent is any evidence of the preparations allegedly being undertaken by President-Elect Trump to resolve potential conflicts of interest through some manner of divestment," Moss said.

"If the President-Elect's lawyers and compliance officers are not coordinating with OGE, who, if anyone, within the government are they coordinating on these matters?" he asked.

It is also possible that other correspondence on conflicts between Trump officials and the ethics office exists, but was withheld as privileged under federal law.
Trump announced and rescheduled a press conference to unveil more detailed plans for his business, now slated for next week.

While the email correspondence mostly shows behind-the-scenes preparations for a new administration, the apparent frustration of the ethics office with Trump spilled into public view in late November.

That is when the normally staid office posted several dramatic tweets about Trump's business plans, citing its past advice for Trump to divest.
The tone was so unusual, some asked whether the office's account had been hacked — including a government relations staffer for Twitter, who contacted the office.

The newly released emails add more context, showing those tweets came after Director Walter Shaub's concerned and frustrated emails to Trump aides. As another batch of emails obtained by NPR showed, it was Shaub who personally ordered the tweet-storm, telling an aide, "post them all at once."

[mongers]

Health care, even with all the maintenance drugs my wife and I are on, wasn't the most expensive item in our household budget before Obamacare (housing was).  I've posted this before, but pre-Obamacare, we didn't have health insurance at all (by our own choice) and we paid about $2400 a year for our healthcare.  Last year, we paid about $3000 a year in insurance premiums (that's going up this year, though less than what I feared it would), but in order to keep our premiums that low, we had to choose a plan that has such a high deductible that it doesn't end up actually paying for anything.  So now we're paying about $5400 ($3000 in premiums plus $2400 in out-of-pocket costs) for the same health care we were paying $2400 for.  And from talking to co-workers and other people who have similar incomes to us, this isn't an uncommon situation.

And yes, I do think that health care costs would come down if everyone paid out-of-pocket.  I can't prove it, but I have plenty of anecdotal evidence that doctors would charge their patients a lot less if they didn't expect insurance to cover the bulk of their charges.

You know what, you and your wife should really get into a catastrophic automobile accident. No really, just so you can prove your own point.

They have a system for that in India.

http://www.bbc.co.uk/news/magazine-36446652

If no-one helps you after a car crash in India, this is why

When a road accident occurs, bystanders will usually try to help the injured, or at least call for help. In India it's different. In a country with some of the world's most dangerous roads, victims are all too often left to fend for themselves.

Kanhaiya Lal desperately cries for help but motorists swerve straight past him. His young son and the splayed bodies of his wife and infant daughter lie next to the mangled motorbike on which they had all been travelling seconds earlier.

The widely broadcast CCTV footage of this scene - showing the suffering of a family of hit-and-run victims in northern India in 2013 and the apparent indifference of passers-by - troubled many Indians.

Some motorcyclists and police eventually came to the family's aid but it was too late for Lal's wife and daughter. Their deaths sparked a nationwide debate over the role of bystanders - the media hailed it as a "new low in public apathy" and worse, "the day humanity died".

But what safety campaigner Piyush Tewari saw wasn't a lack of compassion but an entire system stacked against helping road victims.
Image caption
Piyush Tewari's own loss spurred him into action

His work to change this began nearly 10 years ago, when his 17-year-old cousin was knocked down on the way home from school.

"A lot of people stopped but nobody came forward to help," Tewari says. "He bled to death on the side of the road."

....

Shrijith Ravindran, the chief executive of a restaurant chain, is one person for whom this legislation cannot be introduced soon enough.

In January he came across an elderly man bleeding by the roadside in the western Indian city of Pune. A gathering crowd of people was still deliberating what to do when Ravindran put the man in his car and drove him to hospital.

The closest hospital gave him a bunch of papers to fill in before turning him away.

The next one swamped him with more paperwork before tending to the patient.

In total, he says, he spent three hours filling in these forms.

"They ask, 'Are you a relative?' The moment you say 'No', they don't do anything," says Ravindran.

"They wait for somebody to give them assurance that they will pay the bill. Valuable time is lost."

The elderly man finally received treatment once the paperwork was completed, but it was too late. He died of his injuries.

....

[grumbler]

Health care, even with all the maintenance drugs my wife and I are on, wasn't the most expensive item in our household budget before Obamacare (housing was).  I've posted this before, but pre-Obamacare, we didn't have health insurance at all (by our own choice) and we paid about $2400 a year for our healthcare.  Last year, we paid about $3000 a year in insurance premiums (that's going up this year, though less than what I feared it would), but in order to keep our premiums that low, we had to choose a plan that has such a high deductible that it doesn't end up actually paying for anything.  So now we're paying about $5400 ($3000 in premiums plus $2400 in out-of-pocket costs) for the same health care we were paying $2400 for.  And from talking to co-workers and other people who have similar incomes to us, this isn't an uncommon situation.

And yes, I do think that health care costs would come down if everyone paid out-of-pocket.  I can't prove it, but I have plenty of anecdotal evidence that doctors would charge their patients a lot less if they didn't expect insurance to cover the bulk of their charges.

I'm gonna call bullshit on your numbers, and note that you don't understand the concept of insurance, nor understand the risk you were running of permanently destroying your financial viability by just trusting that you would never get seriously ill nor suffer an accident.

You are like the people who insist that they are good drivers and therefore don't need liability insurance.

[PDH]

I don't have life insurance because I plan on being immortal.

[garbon]

And yes, I do think that health care costs would come down if everyone paid out-of-pocket.  I can't prove it, but I have plenty of anecdotal evidence that doctors would charge their patients a lot less if they didn't expect insurance to cover the bulk of their charges.

Or they'd only treat patients who can actually afford medical care.

[11B4V]

And yes, I do think that health care costs would come down if everyone paid out-of-pocket.  I can't prove it, but I have plenty of anecdotal evidence that doctors would charge their patients a lot less if they didn't expect insurance to cover the bulk of their charges.

Or they'd only treat patients who can actually afford medical care.

I don't understand the bolded.

[garbon]

And yes, I do think that health care costs would come down if everyone paid out-of-pocket.  I can't prove it, but I have plenty of anecdotal evidence that doctors would charge their patients a lot less if they didn't expect insurance to cover the bulk of their charges.

Or they'd only treat patients who can actually afford medical care.

I don't understand the bolded.

He's suggesting doctors wouldn't charge as much if they had to rely simply on what people could pay out of pocket.

[MadImmortalMan]

Well, people would pay more attention to their bills and try to shop for better prices is usually the argument for that. I think it has a place, but only up to a limit per year. Once you get over a certain amount, shopping around loses it's appeal. Not much difference between a 50k bill and a 51k bill for the average person.

[garbon]

Well, people would pay more attention to their bills and try to shop for better prices is usually the argument for that. I think it has a place, but only up to a limit per year. Once you get over a certain amount, shopping around loses it's appeal. Not much difference between a 50k bill and a 51k bill for the average person.

Why would medical practices be rushing to lower their prices - such that one could hunt around for a deal?

[11B4V]

Well, people would pay more attention to their bills and try to shop for better prices is usually the argument for that. I think it has a place, but only up to a limit per year. Once you get over a certain amount, shopping around loses it's appeal. Not much difference between a 50k bill and a 51k bill for the average person.

So you would visit/call several ER's to shop around for the best price for treatment. All the while what...while your bleeding out.

Stupidest thing I ever heard.

[DGuller]

Health care, even with all the maintenance drugs my wife and I are on, wasn't the most expensive item in our household budget before Obamacare (housing was).  I've posted this before, but pre-Obamacare, we didn't have health insurance at all (by our own choice) and we paid about $2400 a year for our healthcare.  Last year, we paid about $3000 a year in insurance premiums (that's going up this year, though less than what I feared it would), but in order to keep our premiums that low, we had to choose a plan that has such a high deductible that it doesn't end up actually paying for anything.  So now we're paying about $5400 ($3000 in premiums plus $2400 in out-of-pocket costs) for the same health care we were paying $2400 for.  And from talking to co-workers and other people who have similar incomes to us, this isn't an uncommon situation.

Imagine that, some people in a given year pay more for insurance than they get back for it.  That's actually how insurance works, most people lose in a given year, because when you win (get cancer, heart attack, serious car accident, house fire), you win really big.

[11B4V]

 

[Berkut]

Well, people would pay more attention to their bills and try to shop for better prices is usually the argument for that. I think it has a place, but only up to a limit per year. Once you get over a certain amount, shopping around loses it's appeal. Not much difference between a 50k bill and a 51k bill for the average person.

Why would medical practices be rushing to lower their prices - such that one could hunt around for a deal?

Beacause that is how markets work, of course.

The problem with dps idiocy has nothing to do with his observation that an actual free health care market would see reduced costs on a per-procedure basis.

[Admiral Yi]

It's not just the shopping around effect.  There's also reduced demand for trivial stuff, the same thing copays are attempting to curtail now.  Also read an article waaaay back about some doctor who had decided to accept only cash, *no* insurance of any kind, and because of the resulting decline in overhead he was able to cut the prices he charged by 40%.  Doesn't seem like a whole lot of the medical industry has followed suit however.