Joe Biden beats Donald Trump, officially making Trump a one-term twice impeached, twice popular-vote losing president

[Scott]

16 minutes ago, CayceG said:

 

 

 

 

 

Y'all are fucking psychopaths. You should be ashamed. 

You need to visit an ICU.

[Jwheel86]

1 minute ago, CastlevaniaNut18 said:

There's no hard line, but after years of dealing with this stuff, I put quality of life as my top priority. If there's no meaningful chance for recovery and a decent life after that, then the treatment should stop. I've seen way too many people wanna keep 80 year old grandpa breathing, even if it means he's going to spend the rest of his "life" bedbound, with pressure ulcers getting worse, going septic, being fed through a tube, constantly shitting in those grotesque wounds on the backside.

 

Far too many times, I've felt like I was doing more harm, abiding my a family's naive wish to keep someone breathing than just peacefully letting them go.

 

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. 

[Commissar SFLUFAN]

Bloomberg essentially came up with a "solution" for something where there really is no pressing problem.

[CayceG]

16 minutes ago, SFLUFAN said:

You totally misinterpreted what @Remarkableriots said

 

Reading back, @Remarkableriots gets a pass. 

 

Also, there's a difference between providing palliative care and turning people away. 

[Guest]

6 minutes ago, Jwheel86 said:

 

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. 

How we spend money is itself a moral and cultural issue. 

[CastlevaniaNut18]

4 minutes ago, Jwheel86 said:

 

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. 

I don't really disagree, which is why I did say the quote was pretty callous.

 

I'm not well versed in healthcare costs, but I'd wager a significant portion goes to people being completely noncompliant. I might look for a new line of work if all my patients suddenly started taking their diseases seriously and becoming compliant with lifestyle and diet and taking their medications.

[CastlevaniaNut18]

4 minutes ago, CayceG said:

 

Reading back, @Remarkableriots gets a pass. 

 

Also, there's a difference between providing palliative care and turning people away. 

Last I checked, no one advocated for straight up turning people away. Though I have had patients kicked out of the hospital or had the hospital refuse to admit them, but that's an entirely different topic.

[Commissar SFLUFAN]

This all boils down to the fact that people in Western liberal cultures are simply afraid to die.

[Guest]

4 minutes ago, CayceG said:

 

Reading back, @Remarkableriots gets a pass. 

 

Also, there's a difference between providing palliative care and turning people away. 

Switching from life extending to palliative care on the elderly is clearly what Bloomberg was describing.

[Nokra]

13 minutes ago, SFLUFAN said:

This all boils down to the fact that people in Western liberal cultures are simply afraid to die.

To be fair, it is pretty fucking terrifying.  

 

Edit - In case the  didn't make it clear, I was mostly being facetious.  

[Jwheel86]

18 minutes ago, sblfilms said:

How we spend money is itself a moral and cultural issue. 

 

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.

 

25 minutes ago, sblfilms said:

Switching from life extending to palliative care on the elderly is clearly what Bloomberg was describing.

 

Remove drug cost and possibly surgeon fee and I'd bet palliative care is more expense. 

[Guest]

Just now, Jwheel86 said:

Remove drug cost and possibly surgeon fee and I'd bet palliative care is more expense. 

There is zero chance that managing pain and suffering is more expensive than managing pain and suffering while also trying to keep people living longer.

[CastlevaniaNut18]

58 minutes ago, Jwheel86 said:

 

Remove drug cost and possibly surgeon fee and I'd bet palliative care is more expense. 

I'm really curious as to how you came to that conclusion.

[Joe]

Bloomberg is probably right, but there is little chance voters (Democrat or otherwise) will agree with him on that issue. So keep it coming.

[Jwheel86]

5 minutes ago, CastlevaniaNut18 said:

I'm really curious as to how you came to that conclusion.

 

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? 

[CastlevaniaNut18]

1 minute ago, Jwheel86 said:

 

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? 

Why is everything more expensive regarding healthcare in the US?

 

But it seems weird to exclude drugs and surgical procedures in your comparison, as that's what treatment is. Typically, when you start palliative care, patients don't live long. You're simply making them comfortable with drugs like morphine and ativan until they die. Of course, chemo drugs and surgery are going to be loads more expensive.

[Guest]

59 minutes ago, Jwheel86 said:

 

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? 

People who get hundreds of thousands in life extending treatment also end up on hospice. I’m sorry, but your argument here makes no sense.

[CastlevaniaNut18]

Withdrawing grandpa's tube feeds and making him comfortable until he passes is a lot cheaper than repeat hospitalizations for sepsis, wound care, surgical debridements, etc. It's also more merciful.

[Jwheel86]

7 minutes ago, sblfilms said:

People who get hundreds of thousands in life extending treatment also end up on hospice. Im

sorry, but your argument here makes no sense.

 

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). 

[Jason]

1 hour ago, CastlevaniaNut18 said:

Withdrawing grandpa's tube feeds and making him comfortable until he passes is a lot cheaper than repeat hospitalizations for sepsis, wound care, surgical debridements, etc. It's also more merciful.

 

My grandfather died at 94 but he was pretty vocal about being done for several years prior to that. For him the problem was that his body was failing but his mind was still mostly there, and it was making him miserable that he couldn't do anything he enjoyed. He used to go on daily long walks but had to progressively cut down on that until he couldn't go on walks at all. He was a big reader, and for years he'd read with a magnifying glass but his eyes eventually got bad enough that even that didn't work, so he basically had to stop reading. I was sad when he died and I miss him but it was hard to be too torn up about it knowing how absolutely miserable he was at the end and that he'd been ready to die for a good long while before it happened.

[Guest]

2 minutes ago, Jwheel86 said:

 

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). 

You’re talking about rare genetic treatment regimens that affect a tiny number of people, we are talking about old people with cancers and other terminal conditions who continue to be treated to extend their lives in some cases only weeks when we could just try and make them comfortable...which we would do once the life extending treatments fail anyways.

 

Everybody is going to get palliative care in these scenarios, so the added cost is just the life extending stuff for terminally ill elderly people.

[Jwheel86]

7 minutes ago, sblfilms said:

You’re talking about rare genetic treatment regimens that affect a tiny number of people, we are talking about old people with cancers and other terminal conditions who continue to be treated to extend their lives in some cases only weeks when we could just try and make them comfortable...which we would do once the life extending treatments fail anyways.

 

Everybody is going to get palliative care in these scenarios, so the added cost is just the life extending stuff for terminally ill elderly people.

 

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 

[Guest]

24 minutes ago, Jwheel86 said:

 

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 

You’re still arguing something different than what Bloomberg is talking about. He is saying, and the data backs this up, that we spend too much on curative types of treatment for terminally ill old people when we should just be making them comfortable as they end life. That is different from the sort of expenditures we should consider making for younger folks who likely can live decades with these treatments.

 

Medicare for example spends more than 25% of its annual expenditures on life extending treatment for patients who will die that calendar year. 

Over 100 billion dollars annually just by Medicare to keep elderly people alive a few extra months. And it isn’t as though we aren’t also doing palliative care for those individuals. 
 

This doesn’t even factor in the R&D dollars we spend on developing treatments to keep old folks alive a little bit longer.

[Jwheel86]

19 minutes ago, sblfilms said:

Over 100 billion dollars annually just by Medicare to keep elderly people alive a few extra months

 

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. 

[Jason]

11 minutes ago, Jwheel86 said:

 

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. 

 

I always love getting my EOBs because they always emphasize "here's what your plan saved you" but there's never ANY basis provided for those numbers. The arithmetic they break out is worse than useless given the complete lack of transparency on how they're figuring the basis costs. 

[Guest]

27 minutes ago, Jwheel86 said:

 

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. 

On cost: Palliative care + curative care is > palliative care

 

Any cost saving policies you choose to implement would affect both palliative and curative care, and anyway you cut it the above remains true. Spendings 100s of billions to slightly extend the lives of the elderly in a world of limited resources is a failing of western

civilization. The Inuits of old knew how to handle old age.

[SaysWho?]

More than 18,000 Democrats turn out on first day of Nevada early voting

 

Quote

Nevada's Democratic Party leadership is hoping a strong early turnout for its caucuses signals a successful showing this weekend.

 

More than 18,000 Democrats turn out for first day of early voting in Nevada Democratic caucusgoers participated in the first day of early voting in Nevada Saturday, the state party announced, a considerable turnout that Democrats celebrated even as some voters voiced concerns over long wait times.

Approximately 84,000 people participated in Nevada's 2016 Democratic caucuses.

 

[SaysWho?]

Washington Post goes in-depth on allegations of sexism from Michael Bloomberg the past several decades

 

Quote

Garrison complaint
18. Upon information and belief, in 1989, when a male Company salesperson was getting married, Bloomberg said to the female salespeople, “All of you girls line up to give him [oral sex] as a wedding present.” He repeated like words on several occasions in each of the years plaintiff was employed at the Company.

 

Quote

Several lawsuits have been filed over the years alleging that women were discriminated against at Bloomberg’s business-information company, including a case brought by a federal agency and one filed by a former employee, who blamed Bloomberg for creating a culture of sexual harassment and degradation.

 

Quote

A number of the cases have either been settled, dismissed in Bloomberg’s favor or closed because of a failure of the plaintiff to meet filing deadlines. The cases do not involve accusations of inappropriate sexual conduct; the allegations have centered around what Bloomberg has said and about the workplace culture he fostered.

 

Quote

One of Bloomberg’s rivals for the Democratic nomination, Sen. Elizabeth Warren of Massachusetts, said in December at an Iowa campaign stop that nondisclosure agreements are “a way for people to hide bad things they’ve done.” She called on Bloomberg to release women from such agreements.

 

Asked while campaigning to respond, Bloomberg said: “Maybe the senator should worry about herself and I’ll focus on myself.” He acknowledged enforcing nondisclosure agreements by his former employees and said, “You can’t just walk away from it. They’re legal agreements, and for all I know the other side wouldn’t want to get out of it.”

 

Quote

Garrison alleged that Bloomberg berated female employees who got pregnant. “What the hell did you do a thing like that for?” Bloomberg allegedly told one pregnant employee. On another occasion, the lawsuit said, Bloomberg berated a female employee who had trouble finding a nanny. “It’s a f------ baby! . . . All you need is some black who doesn’t have to speak English to rescue it from a burning building.”

 

[SaysWho?]

Bernie Sanders Draws More Than 11,000 To Denver Rally

 

Quote

The campaign had already moved the event from a 5,000-seat auditorium to accommodate demand. According to the Denver fire marshall, more than 11,000 people ended up filling the convention center halls Sunday evening.

 

 

[Jwheel86]

7 hours ago, Jason said:

 

I always love getting my EOBs because they always emphasize "here's what your plan saved you" but there's never ANY basis provided for those numbers. The arithmetic they break out is worse than useless given the complete lack of transparency on how they're figuring the basis costs. 

 

 

 

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.

[Dodger]

4 hours ago, SaysWho? said:

More than 18,000 Democrats turn out on first day of Nevada early voting

 

 

 

Before I left Vegas I did see a Steyer commercial and billboard! I'd have no idea who he was if it wasn't for this thread. Apparently he isn't on the Bloomberg plan of trying to buy the election. 

[Alpha1Cowboy]

15 hours ago, sblfilms said:

I wouldn’t let my family spend that kind of money on me if I were an old man. 34 year old me, that has young kids at home? Sure. But we need to move beyond our western fears of death. We literally talk about 90 year old people dying like it’s a tragedy. It’s not, that’s an exceptional life lived in the history of human civilization. That doesn’t mean those close to that person can’t be sad about it.
 

 

Homelessness is itself a policy failure that further burdens society. Fixing it is a net benefit to society. And there are societies where the elderly understand they shouldn’t burden the younger generations with their unproductive selves  

 

 

If that's the thinking then its an easy jump to kill of drug abusers and murderers.  They contribute nothing to society...except wasting tax payer dollars that could go to education and healthcare.  If you want to deny a 93 year old life saving treatment but are ok with supporting a 35 year old who raped and murdered a 7 year old to the tune of 38 thousand a year for 20 years....who will eventually get out and has a high chance of getting out and continuing to be a drag on society.....then it seems to be counter productive to each other.

 

Edit: I am in favor of neither...but rather working harder to find a better solution.

 

 

Shit...if thats the choice probably to give the 93 year old a gun at least and drop them off on Republcan Politicians lawns so they can at least take a couple of them down on their way out.

 

 

Thats what Clint Eastwood would do..

[GeneticBlueprint]

2 minutes ago, Alpha1Cowboy said:

If that's the thinking then its an easy jump to kill of drug abusers and murderers.  They contribute nothing to society...except wasting tax payer dollars that could go to education and healthcare.  If you want to deny a 93 year old life saving treatment but are ok with supporting a 35 year old who raped and murdered a 7 year old to the tune of 38 thousand a year for 20 years....who will eventually get out and has a high chance of getting out and continuing to be a drag on society.  

 

Are you serious with this nonsense? Letting a fragile life pass away is not equivalent in form, function, or consequence to execution. Try again.

[Alpha1Cowboy]

7 minutes ago, GeneticBlueprint said:

 

Are you serious with this nonsense? Letting a fragile life pass away is not equivalent in form, function, or consequence to execution. Try again.

 

 

What the fuck is a fragile life?  There's a lot of children with major health issues where life expectancy is lower than normal..are they next beacuse their life is fragile?

 

Age should not be a sole defining  factor in treatment availability.   Shit...most cancers are more treatable in elderly people just because it doesn't advance as fast.  

 

We've gone to the mother fucking moon.....we can figure out  universal healthcare

 

 

 

[GeneticBlueprint]

3 minutes ago, Alpha1Cowboy said:

 

 

What the fuck is a fragile life?  There's a lot of children with major health issues where life expectancy is lower than normal..are they next beacuse their life is fragile?

 

Age should not be a sole defining  factor in treatment availability.   Shit...most cancers are more treatable in elderly people just because it doesn't advance as fast.  

 

 

 

 

Are you serious with this nonsense? Stop with the disingenuous slippery slope bullshit. It's not a good look.