It's High Crimes and Misdemeanours Time! Trump thread no. 95

[Roussette]

I thought it was about time I started a thread so here it is! Mueller time tomorrow...

www.theguardian.com/us-news/2019/jul/21/mueller-report-trump-nadler-impeachment

Thanks guys!

Jilly I don't think it would (or could) be a wholesale 'wham bam thank you ma'am now we have the US NHS' kind of thing.

It would require a massive overhaul of our tax system to fund it to start with. Then you'd have to have the procedures to set up & staff facilities, then procedures to start transferring people from private to State. It would have to be 'walked in' in stages. I think the 'one system' proponents know that. Now, it's good to know what side of the debate they're on, but let's hear about 'how', not just 'what'. I have no intention of buying a 'pig in a poke'.

One of my duties in my former career was effectuating new legislation. There were often months to a year and many, many layers of lawyers and the sharp pencil brigade between something being signed into law until it finally got to us, the people who 'made it work'. And that was just changes to existing legislation! Something like changing to an NHS would (or should) take years.

That's before you get to the charges made by hospitals, practitioners, and pharmaceutical companies.

And as a counterpoint because I just posted a Bernie thing, here is Warren:

www.newsweek.com/elizabeth-warren-wins-over-college-students-during-democratic-debate-1451890?utm_campaign=NewsweekTwitter&utm_medium=Social&utm_source=Twitter

Woah.

cathedral.org/have-we-no-decency-a-response-to-president-trump.html

'As faith leaders who serve at Washington National Cathedral ¬– the sacred space where America gathers at moments of national significance – we feel compelled to ask: After two years of President Trump’s words and actions, when will Americans have enough?'

Interesting questions Across... most of which have been answered but on the private versus NHS...

Does the NHS pay for part of private care then private insurance picks up the rest? If not, does private insurance pay 100%? How expensive is 'good' private insurance? And I assume having private insurance doesn't allow you to 'opt out' of paying NHS contributions?

Private insurance is a luxury that basically allows you to queue jump AFAIC. Depending on the level you have, you can rest easy that there is no waiting. However, you have to be referred by the NHS and that can be clunky to deal with. We had private insurance for a number of years (via DHs job, then when he retired we paid for it ourselves before it got horrendously expensive because of our ages so we had no choice but to give it up).

No you can't opt out of NHS contributions.
It did mean my DH, who had a heart condition, could have a procedure within a week instead of a worried wait.

I've had eye surgery and paid for it myself and I'm due a dental implant shortly which might involve bone grafts, that will cost me a minimum of £3,000 probably more, as Asking said... dental and eyes cost a lot. I feel sorry for elderly patients needing cataract operations, they have to wait in a queue to have it done on the NHS.

However, I cannot praise the NHS highly enough in an emergency. I've recently experienced this with my DH and encephelitis, he could not have been looked after better with 4 GP appointments in a 5 day period followed by a 2 weeks stay in hospital, all for free.

So there is good and bad basically. The NHS is horrendously overstretched but at the sharp end they are wonderful.

Thanks for the info Roussette. I didn't realize that the private insurance was basically 'queue jumping', still NHS but faster. I thought it was more like I can see Dr X at the NHS clinic, or I can use my private insurance and see Dr Y at the private clinic across the street.

Or skip the insurance and just pay directly to see Dr Y. (in which case the NHS is out of the equation).

I’ve reported Braindead above - apparently almost every active thread has been targeted.

Me too! They’ve been mighty busy.

I didn't realize that the private insurance was basically 'queue jumping', still NHS but faster. I thought it was more like I can see Dr X at the NHS clinic, or I can use my private insurance and see Dr Y at the private clinic across the street

I suppose it's skip the queue hypothetically speaking. If you need a knee op or hip replacement or whatever, you have to wait and be in pain. If you have private insce, you just get on with it! And there is more choice as to who you see or where you go. But you might end up seeing the same specialist if it's NHS or private depending on what the specialist does. You'll just be seeing him or her sooner!

From today's press, this is worrying isn't it... 'Trump won'

www.politico.com/magazine/story/2019/08/01/dem-debate-gop-strategists-roundup-2-227496

Re NHS vs private, in the UK private doesn't touch 'pre-existing' and anything serious private dumps you back into the NHS anyway - it is basically queue jumping but for non life-threatening.

I understand the US system makes pregnancy much more of a financial cost / risk - not an issue with the NHS

Pregnancy/being a woman in the USA is clearly fraught with danger anyway, what with not being allowed an abortion in some states even if carrying the baby to term will kill you both, or you are fourteen and it is the product of incestuous rape. And miscarrying may get you charged with murder. And so on. (Not as bad as in some of Latin America, even so.)

I cannot praise the NHS highly enough in an emergency.

This is true. It’s truly amazing how they come through in these situations.

My experience with a chronic condition is that once you’re in the system (which took months) the treatment is very good. That said I’m a straightforward case and only see the consultant a couple of times a year.

The geriatric care for both my parents at the end of their lives earlier this year was distressingly, shockingly bad. That wasn’t so much seeing the cracks in the system as falling down a massive great big cavern in the middle of it.

If you need a knee op or hip replacement or whatever, you have to wait and be in pain. If you have private insce, you just get on with it!

That sums it up well! My experience of going private with a Tonsillectomy was that I got in pretty much immediately and had a nice night in my own room in a private hospital on the top floor of an NHS hospital, Surgeon also worked in NHS, and I probably jumped the queue to see him by about a year.

See, I really like the freedom of choice that I have now and don't mind paying for it. I don't think I want a totally State run system with all private healthcare abolished, like Bernie wants. But I wouldn't mind an NHS with a private 'option' as it were, like the UK has.

But honestly, the ACA is working really well. It definitely needs 'tweaking', but that could be done through more regulation of the healthcare industry. It's low cost for low income and your premiums rise as your income does as it's an income based subsidy. And no pre-existing conditions clauses. My son's bacon was saved by the ACA when he lost his job. He paid $80/month for great insurance (govt paid the rest) and was able to continue his care and get the meds he needed. My cousin is on the ACA with subsidy, no private insurance will touch her, or she'd pay $1000 per month, because of pre-existing conditions.

The main issue with the current US system, even with ACA, I think, is the cost-benefit relationship.
The US has one of the highest (if not the highest) costs for medical care but some of the lowest health indicators in the West.

This is a major concern for me in Portugal, and in the UK, as far as I can understand it, as the public services are being degraded through lack of investment and the private sector is blooming.

In the US, the system is primarily geared towards profit and I understand why insurance companies, hospitals and pharmaceuticals, as well as doctors, are not particularly happy about a change.

Just to point out as well that both in the UK and Portugal there is some degree of choice within their NHS systems. At least in recent years it has become possible to choose hospitals and doctors in surgeries or medical centres.
The issue of waiting lists remains, though. But it is possible to have medical insurance for a fraction of the cost in the US.
I have, in Portugal, a sort of additional health insurance for public servants that costs me 3.5% of my salary and covers children. Because it's not private health insurance, I have no issues with previous illnesses, and I can access private health care (either at a heavily discounted price, or with a % refund).

Worth checking:
Cost in US vs western countries
www.consumerreports.org/cro/magazine/2014/11/it-is-time-to-get-mad-about-the-outrageous-cost-of-health-care/index.htm

Quality in US vs western countries
www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-dalys-rate-per-100000-2017

But I think the costs, etc can start to be addressed through legislation and regulatory changes.

When I was younger hospitals were usually owned by communities, religious groups, or by groups of doctors. They were all run as non-profits. But once 'for profit' corporations came in that's when costs started skyrocketing. Starting with regulations capping profits and perhaps saying that medical facilities must be private, not public corporations (as in wholly owned, no stockholders) we should be able to start bringing costs down. At least any 'profits' would be plowed back into facilities instead of being paid in dividends.

But whatever the 'cure', something has to change. DH and I are fine. We're both retired civil servants with excellent insurance and we'll soon be on Medicare which will lower our costs even further. And (and this is the main thing) we don't mind paying extra in taxes to see that everyone has the same level of care that we do. This is the main roadblock, that so many people don't want to do a little belt tightening to create equality of care.

Maximum costs for procedures and drugs can be capped, but it will be difficult to address the number of consults and medical procedures.

That's something I've noticed when going private here. Doctors tend to push for surgical interventions or for medical exams that I'm not sure are necessary.
The last time I ended up going for a breast MRI because it was recommended by the Imagiologist and even though my doctor didn't actually think it was necessary.
DS escaped ear drum surgery because I'm a "let's wait" type of person rather than going for asap surgery at "his hospital" as recommended by the doctor we saw.

thehill.com/homenews/administration/455620-graham-threat-to-bust-panel-rules-roils-senate-tensions

www.vanityfair.com/news/2019/07/federal-reserve-interest-rates-donald-trump?utm_source=twitter&utm_medium=social&utm_campaign=onsite-share&utm_brand=vanity-fair&utm_social-type=earned

'Despite a humming economy, the central bank announced that it would cut interest rates for the first time in over a decade, lowering the target range for the benchmark rate a quarter point to between 2% and 2.25%, and signaling that more cuts may (or may not) be in the offing. The move, while widely expected, was seen as largely unnecessary, given that unemployment is low, consumers are still spending, and the stock market is doing well.'

Quite.

The big question was ......WHY.?

https://edition.cnn.com/2019/08/01/investing/federal-reserve-jerome-powell-rate-cuts/index.html

Sorry. Regular posters and lurkers will know the answer to that. The Fed caved,

Sen. Patrick Leahy
@SenatorLeahy

'Chairman Graham just broke Judiciary Committee rules to advance Trump bill to indefinitely detain immigrant children. Senator Leahy will be speaking on this momentarily.'