Jwheel86

rip Flip Arizona for Colorado and it's still a win.

Voted early today, as I came out an elderly couple was still trying to figure out who to vote for but said "No one with a lick of age on them will vote for Bernie, if he wins we're done." Sigh.

Can we just forget Florida and go for a state where Democrats win statewide? Something like this-

He hasn't been sentenced yet but it's a 5 year minimum, maximum 25. Plus he's got the case in LA pending. He's 67 years old so he very well may die in in a New York or California prison. According to CNN he walked out of court in cuffs and no walker.

The moderate pivot, without actually pivoting, needs to be the economic benefits of M4A. Removing market barriers for small businesses, the back bone of the American economy. Reducing the size of government by eliminating the health division of each State's Department of Insurance, massively downsizing Medicaid (under M4A Medicaid would be simply to fund institutional long term care), and opening the door to a complete restructure of the VA.

Just turned on MSNBC, is the Kornacki guy on cam actually working or pretending to work?

DNC donors readying a white flag?

Bloomberg isn't immune to the money pressure, Yang on CNN said Bloomberg is calling DNC donors and asking them to starve the other candidates saying "he's got this" . He doesn't got this and they'll keep funding Biden and Buttigieg.

Is tonight the night Bloomberg realized professional political operatives are bad at this and just in it for the money?

If this is the result Bernie could be the only one qualifying for any of California's 400+ delegates.

I did a quick read through, didn't see anything on Long Term Care.

35% + 16% = 51% progressive! Do we get to pull that meme if this is the result?

Hospital marks up the drug 6x and gets paid 3x. $243k profit for a nurses admin to send a fax every 4 months per patient.

What percentage of that care is hospital expenses vs hospital profit and drugs? Let's say you've got a case deemed hopeless by the Medicare manual, that's a lost sale to the drug company. At that point there is no reason why you can't compel the drug company to deliver treatment for free, which they already do voluntarily in high profile rare disease treatments. I'd rather screw over the drug company than try to write a government policy for who is worth treating. That million in profit in my case is simply the result of an admin sending a fax. A lot of these costs have no basis in reality.

And if we go down that path, rare disease treatment, which aren't that rare and new one gets approved almost every week, will be targeted for cost savings. Getting Spinraza outside the US is a nightmare because their a lot of national health systems make those exact same cost calculations. Only reason Biogen has a free drug program in the US is because they fear Congress, other countries don't have it because they have no leverage with Biogen. Canada's national system recommended that the provinces deny because the cost of drug exceeded cost of a wheelchair and other pallivative care, including for kids. Ireland's 20 kids are being denied because costs. There are videos on YouTube of pissed off MPs questioning Theresa May about Spinraza

What I'm arguing is that cost of treatment is nowhere near that expensive. Complications that require hospitalization, sure but not treating the base condition in many cases. These 9 boxes represent $2.156 million in treatment starting in April 2018. That's a lot of money, but let's break it down. Retail price from Biogen $125,000 per dose. Doses 1 - 5 reimbursed by Medicaid for at $135,000 per dose. Dose 6 - 9 reimbursed by BCBS for $368,000 per dose. ~$900 reimbursed for labs, procedure, recovery per dose. BCBS and Medicaid all in cost: $2.156m. That's $1.022m in pure profit for the hospital, $1.125m in drug costs, and $8,100 in hospital costs. But if I had Aetna, I would be denied. After 2 denials, Biogen gives you the drug for free. ~$900 reimbursed for labs, procedure, recovery per dose. Aetna all in costs: $8,100 Biogen remains highly profitable despite giving half their inventory away for free, and the hospital gets paid for services delivered plus $243k in profit from patients deemed worth it (like me under BCBS but not Aetna).

Obviously depends on what we're talking about but if treating the condition is an outpatient procedure or a drug vs if not treating involves hospice care we're talking 24/7 staff until the patient dies. Treating is cheaper. What about cancer treatment makes it a million dollar expense?

And what we need to ask is instead of ending care by force, is if the entities receiving the other side of those costs can afford to give the treatment for free or reduced cost. What pisses me off is this conversation Bloomberg had is identical to the debate over Spinraza in a lot of countries. Many public health systems took opinions from doctors that Spinraza wasn't worth it in adults to justify restrictions based on cost. A lot of insurance companies also have the same opinion in the US but those patients were instead given the drug for free, making the only real cost of treatment the doctor giving the injection. Remove drug cost and possibly surgeon fee and I'd bet palliative care is more expense.

That's a morality and cultural issue and we agree, the issue with Bloomberg is he's turning it into a cost issue. That's the sick part, the fact that he's blaming 95 year olds with cancer for increased healthcare costs and that denying care is the best solution. He's prioritizing keeping the current price structure over lives.

Where is the line? I agree this is and the 95 year old is a stupid example but this is going to become a huge issue as more rare disease treatments get approved. Who should be able to receive it? The bigger issue is why do these treatments cost what they cost. Biogen's stock is way up despite them giving half the patients Spinraza for free.

Fuck this guy.

Bernie needs to keep his eye on the long term. Anti Bernieism isn't just going to go away and she'd undermine him for her own gain, maybe even Primary Challenge in '24.

Counting on moderates to support a moderate is foolish. Fox News is going to have at least four months to turn that moderate into a socialist. We've already got ads running saying M4A and the Public Option are the same thing.