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Study: More than a third of healthcare costs go to bureaucracy:
U.S. insurers and providers spent more than $800 billion in 2017 on administration, or nearly $2,500 per person – more than four times the per-capita administrative costs in Canada’s single-payer system, a new study finds.
Over one third of all healthcare costs in the U.S. were due to insurance company overhead and provider time spent on billing, versus about 17% spent on administration in Canada, researchers reported in Annals of Internal Medicine.
Cutting U.S. administrative costs to the $550 per capita (in 2017 U.S. dollars) level in Canada could save more than $600 billion, the researchers say.
“The average American is paying more than $2,000 a year for useless bureaucracy,” said lead author Dr. David Himmelstein, a distinguished professor of public health at the City University of New York at Hunter College in New York City and a lecturer at Harvard Medical School in Boston.
“That money could be spent for care if we had a ‘Medicare for all program’,” Himmelstein said.
To calculate the difference in administrative costs between the U.S. and Canadian systems, Himmelstein and colleagues examined Medicare filings made by hospitals and nursing homes. For physicians, the researchers used information from surveys and census data on employment and wages to estimate costs. The Canadian data came from the Canadian Institute for Health Information and an insurance trade association.
When the researchers broke down the 2017 per-capita health administration costs in both countries, they found that insurer overhead accounted for $844 in the U.S. versus $146 in Canada; hospital administration was $933 versus $196; nursing home, home care and hospice administration was $255 versus $123; and physicians’ insurance-related costs were $465 versus $87
They also found there had been a 3.2% increase in U.S. administrative costs since 1999, most of which was ascribed to the expansion of Medicare and Medicaid managed-care plans. Overhead of private Medicare Advantage plans, which now cover about a third of Medicare enrollees, is six-fold higher than traditional Medicare (12.3% versus 2%), they report. That 2% is comparable to the overhead in the Canadian system.
(Score: 3, Interesting) by JoeMerchant on Thursday January 09 2020, @02:46PM (40 children)
Utterly obtuse, but... sure, that's one way to look at the scale of things. If we didn't increase taxes ANYWHERE at all and suddenly took over payments of ALL healthcare costs from the current insurance system. My company and myself combined currently pay approximately $20,000 in insurance costs for a family of 4, and our insurance doesn't seem to be overly lavish.
Now, if you're bitching and moaning about having to increase taxes by $5K per person to cover healthcare for the uninsured, consider that we are already providing healthcare to the uninsured - inefficiently. Rather than putting them through lower cost preventative measures, we wait until they blow up into life and death charity cases and spend more on them. Even if their lives have no value that's not good economy, then consider that: were they healthy, they would be less of a drag on the welfare portion of that $11,009 in taxes that we pay and they might actually pay some taxes themselves - effectively lowering the tax bill for those who do currently pay - and this 1/3 cost reduction in TFA doesn't consider reduced cost for those paying into insurance covering the cost of the uninsured.
What I will point out is the physical layout of Mount Sinai Hospital in Miami Beach. The building is split 60/40 by a long hallway - on the 60 side are patient waiting rooms, examination and treatment rooms, M.D. offices, scheduling, etc. with a nice view of Biscayne Bay. On the 40 side are 100% administrative offices - non patient facing recordkeeping, and mainly: billing, coding, insurance interfacing, and collections, a notorious weak spot for MSMCMB, they actually went insolvent due to unpaid bills that they never tried to collect in the 1990s. Those administrative offices were smaller than the patient facing side, but they had more employees per square foot over there- boiler room telephone jockeys making (or at least attempting to make) the money flow.
If we could reduce that $5000 per head insurance cost 1/3 by moving the insurance costs off of the employers and individuals onto a tax bill, I'd be up for that $6500 per year net raise in my family income. Would suck for all those billers and coders and insurance cogs that got put out of work, but that's the price of capitalism and efficiency. Maybe 1/3 of them could transfer into the government administration of the new system, and the other 2/3 can find something actually useful to do with their lives - maybe starting with staffing some birth control / family planning offices, oh, but Roe v Wade is on the way out, the way that coal fired power is on the way in, isn't it?
🌻🌻 [google.com]
(Score: -1, Flamebait) by Anonymous Coward on Thursday January 09 2020, @02:58PM (8 children)
What is this "we" stuff? You are making the choice to go away your money to insurance companies. You could have been putting that $20k in stocks instead and you would have millions of dollars for health expenses by now (that would cost at least half of what insurance charges your too!). Just because you act like an idiot why do the rest of us have to pay?
(Score: 2) by JoeMerchant on Thursday January 09 2020, @03:58PM (7 children)
No, I couldn't, because I work for a company that pays $16K to the insurance companies, my elective portion is only $4K - most large companies are like this.
Now, when we were younger, and insurance was cheaper, and I worked for a small company and had to get private pay, IIRC my wife and I paid something like $6K per year for both our insurance combined. The Ob/Gyn mismanaged our first pregnancy and my wife ended up taking a 6 day $30K tour through ICU - which private pay insurance responded to by raising her rates from $3K per year to over $12K per year due to "pre-existing conditions" which happened during our continuous coverage, apparently that was legal within in the rules at the time. We did respond by dropping her insurance and banking the $12K/yr for the next two years. Now, it just so happens that after two years I ended up working for a larger company with group insurance, so we just kept the $24K and had company coverage for birth #2 which went without complications. Fifteen years later, a friend of mine had a similar complication during pregnancy - the 2015 bill for it was over $80K, it's probably over $100K today. During those two years while we were private pay, we discovered that just about everything is 10x more expensive for private pay than it is while you are covered by insurance. You can ask for consideration and maybe get 10% off, but otherwise, a Dr. visit that would have been $60, patient portion $25 with insurance is billed at $590 and if you ask nicely they'll reduce that to $530, since you're private pay. Still, paying these inflated rates we came nowhere near even $3K per year in normal healthcare costs.
But, if we had banked that $3K per year per person and invested in the boom/bust cycles of the market, as long as we didn't hit any big bills during a bust cycle, we'd be ahead today- but not by millions, maybe $100K, maybe less - but our healthcare events have been minimal. Hit one of those $100K hospital stays - oh, that's insured cost, private pay is going to run closer to $1M, and you're done - the hospital now owns your house, cars, and anything else not protected from them by law.
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(Score: 0) by Anonymous Coward on Thursday January 09 2020, @04:20PM (6 children)
The opposite is true. $100k chargemaster insurance price equates to $1k-50k cash price (depends on the exact stuff done). But keep shilling for the insurance companies.
https://en.wikipedia.org/wiki/Chargemaster [wikipedia.org]
(Score: 2) by JoeMerchant on Thursday January 09 2020, @05:22PM (1 child)
No argument that the actual cost of services is far lower than what they bill.
Our experience in the 2001-2003 timeframe was that we were presented with outrageous bills for any medical treatment my wife did receive, literally the $500 office visit, and she did have a $6K cancer removal procedure during those years - same procedure "allowed charges" would have been far lower with insurance, actual cost lower still. As an individual presented with these bills our options were: pay, ask for reduced rate because we are private pay and get a 90% bill, or let it go to collections.
Nobody anywhere (other than one AC on the internet) has told me it's any better today. The insurance companies and service providers continue to play the "billed amount: 10-20x, allowed by insurance: 1x, patient responsibility: 0.2x" game. You try going uninsured into an oncology department and see what kind of bill you receive, if they'll even treat you in the first place - you're going to have to demonstrate ability to pay before seeing the M.D. in most practices.
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(Score: 0) by Anonymous Coward on Thursday January 09 2020, @09:36PM
Vision services are different than medical for sure, but I just went to the optometrist and paid 90$ in cash for a full exam and glasses prescription. Insurance price would have been ~60$ and premium about a dollar a month. I probably did get overcharged, but I haven't had an eye exam for 5 years, and the difference was made up by the premia I saved.
(Score: 0) by Anonymous Coward on Thursday January 09 2020, @08:02PM
The wikipedia link you provided states exactly the opposite. Insurer get a huge discount. Cash payers end up with the full charge master price.
(Score: 0) by Anonymous Coward on Thursday January 09 2020, @09:48PM (2 children)
It may be what they are willing to accept in compromise if they knew they couldn't collect more. But if you have built up any assets in your life at all, why would they negotiate with you after you consumed the services? It would be like buying the market price lobster in a restaurant and trying to negotiate the price down when you found out they charged $200. Good luck with that.
(Score: 0) by Anonymous Coward on Friday January 10 2020, @03:32AM (1 child)
Because dealing with the insurance company is that much worse... and that is usually what they get in the end anyway. The price *you* see is just the start of negotiations between the hospital and insurance company. Do people just give away tens of thousands of dollars each year without looking into where it goes at all?
(Score: 0) by Anonymous Coward on Friday January 10 2020, @04:36AM
You're not getting the point. The inflated chargemaster pricing is what hits you if you do not have applicable insurance (or better put "membership in a discount plan the provider accepts"). The insurance companies will negotiate flat rates per code that 1) they will pay and 2) can be passed to the end user. With "Obamacare", you have some say in what insurance company you pick for the next year.
I still have traditional insurance through a major employer. I pay a token amount a month for decent health insurance, and my membership is good at most local facilities. One of my friends foolishly had a blood test done at a provider that (he didn't know) was out of network, and he got billed for $5k and the insurance company would only cover a couple of hundred for Usual and Customary pricing. He still had to come up with the rest the provider demanded.
With the insurance companies, yes, because the affordable care act forces people to buy insurance through these providers or get penalized on taxes.
With providers - ignorance of what they charge, or whether you are covered with them, is at your own peril. Like walking into a random restaurant and ordering stuff. The "cash is king" people that pop up around these conversations may have a point if they negotiate before getting services, supposing the provider even cares to get into this kind of discussion.
(Score: 1, Disagree) by The Mighty Buzzard on Thursday January 09 2020, @03:41PM (30 children)
Ahh, so you're looking to get rid of insurance and raise taxes on a truly massive scale then. I expect you'll still be excluding poor folks from paying income taxes at all (most of them don't right now) and effectively giving them free healthcare at the expense of everyone else? Good to know where you stand.
My rights don't end where your fear begins.
(Score: 4, Insightful) by JoeMerchant on Thursday January 09 2020, @04:07PM (22 children)
Define "poor folks" - you're all fuckin' peasants as far as I can see.
What you seem to be missing is: we're paying for healthcare today through insurance and taxes, if we provide the same healthcare tomorrow that we provide today, the cost for care will be the same. If we can drop the administrative costs and lose 33% of the total bill, that's "free money" to anyone who doesn't benefit from those costs right now. I don't really care if that money comes out of me in insurance payments, reduced salary because my company pays for insurance, or taxes - it comes out regardless.
If you're willing to pay an extra $6500 per year into "the system" just to keep the status quo of wealth distribution, you must be better off than 99% of the people I know.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Thursday January 16 2020, @04:31PM (21 children)
And I'm saying stop paying for healthcare through insurance or taxes. If medical providers and drug companies don't have someone with bottomless pockets to bill, I guarantee you prices will become far more sane.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Thursday January 16 2020, @06:44PM (20 children)
I do not believe in your KoolAid and I will not be drinking it.
However, private pay is an option already today in the U.S. - we did it with my wife for 2 years including one cancer treatment, and it was STILL cheaper than non-big-pool insurance (our only option at the time) would have been. Hell, on average no insurance is guaranteed to be cheaper than insurance simply because you don't have to pay for the insurance processing: people, people who have to have cars to drive to work, houses to live in, kids to put through college AND pay health insurance themselves - Ouroboros ain't cheap to feed.
If you want to paint a Yoko Ono fantasy landscape where everything instantly changes to match the picture in your mind, sure, you've got some valid points. Now: stop bitching about it on an obscure internet chat board that nobody reads and go try to do something about it. You've got time, look at Bernie: 70 what years old and about to make a difference, maybe.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Friday January 17 2020, @05:10PM (19 children)
You don't believe it because you don't want to. If you wanted the truth you have only to look back before everyone had insurance and government assistance.
You have your hobbies, I have mine.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Friday January 17 2020, @05:48PM (18 children)
My grandparents' generation. Both of my great grandfathers died around age 30, cardiac issues, although one managed to father 9 children before checking out. Of those 9 children, one was blind from birth - probably complications that a trip in from the farm to the hospital would have prevented (though, God only knows what other diseases you might catch while in town...) The woman who bore those 9 children chewed tobacco until she was 96, and lived to 98.
We can't all go back and live on the farm, with 9 kids, 30 grandkids, etc. those 400 acres just aren't enough to go around anyway.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Friday January 17 2020, @10:23PM (17 children)
We certainly can go back to not giving healthcare providers and drug companies a blank check to nearly bottomless pockets, which is precisely what insurance and government assistance do. Hell, even just removing all non-crucial, routine care and medication from medicare/insurance coverage would do an enormous amount to lower costs.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Friday January 17 2020, @11:19PM (15 children)
My work insurance policy (named BIND - sounds like handcuffs to me) is taking baby steps in that direction. They've pulled out some of the high ticket items like joint replacement, etc. and basically make you private-pay for those with a payment plan - but still with their negotiated prices which is extremely important in today's medical billing landscape (aka minefield).
I've been totally in favor of this kind of approach to national healthcare from the start. National healthcare shouldn't cover high dollar options. If your choice is between a $5K round of chemo, or a $50K round of LINAC radiotherapy, or a $250K round of proton therapy, even if proton therapy has a better outcome ratio, I'm fine with the national insurance paying you $5K that you can either use toward chemo for your 95% cure chance, or to help pay for whatever super-therapy you think you want to get that 97% cure chance. Is that cold, heartless? I don't think so when it means that millions of people who currently get NO care until they present at an ER literally on death's door would have affordable access to more cost-efficient preventative care.
To plug an old Michael Moore piece: what healthcare they have in Cuba for free, we should have in the U.S. for basically free. Not super state of the art everything, but M.D.s and HCPs with eyes on the patients making informed diagnoses, basic antibiotics and low cost preventative care - that's what's stupid about the U.S. system right now, locking people out of that.
You want to lock the doors on the "supercare" wing and require a gold card for access - I'm fine with that.
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(Score: 2) by The Mighty Buzzard on Monday January 20 2020, @01:47PM (14 children)
That's the exact opposite of what I suggested though. Insurance should be only for the costly, emergency care. Covering routine care and medication saves nobody anything but does add an extremely high bureaucracy tax on top of what you should be paying.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Monday January 20 2020, @02:28PM (13 children)
And, I guess what I am saying is: private insurance is for the costly stuff, single payer for the routine.
The AMA needs to be kicked to the curb and we need to start training M.D.s who are willing to work for something like 50% above the median household income - that would be ~$95K/yr today. That has to start back with med school, you can't saddle the M.D.s with $600K in debt if they're only going to make $95K/yr. There are plenty of highly competent people who would be willing to be an M.D. for lower pay, if they could get licensed.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Monday January 20 2020, @02:50PM (7 children)
Single-payer is deeper pockets even than the largest insurance company on the planet. It would do the exact opposite of its stated goal: saving the people money.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Monday January 20 2020, @04:22PM (6 children)
And it works for over 500M citizens in countries arguably more advanced than the U.S. without cost control problems, but, hey, think different - right? It worked for our great-great grandparents back before we had clean drinking water in the cities, why not try it again today?
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Monday January 20 2020, @04:31PM (5 children)
Without cost control problems because they have told US drug companies "sell it to us for $this or we will ignore your patents". So US drug companies are forced to sell to them for that or risk a competitor selling drugs they hold a patent on at a loss to the entire world. Fear not though, they pass the costs of those extortionate discounts on to the folks here in the US.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Monday January 20 2020, @04:48PM (4 children)
Listen to the sound of my tiny violin, not giving a single fuck.
I've given you the perspective in the past of what it costs to produce and sell a medical device (my personal career and experience), right? Drugs are much the same. You know how drug reps are recruited, right? Straight out of school based 100% on ability to influence, whether that influence is based on physical attractiveness, willingness to give lap dances, or literally whatever it takes to move the product. That's fine, but it's fucking expensive. Drug reps come into medical offices catering lunch on an unbelievable regular basis - some places literally get a really nice free lunch EVERY SINGLE DAY for every single employee in the building catered by the various drug reps. The M.D.s who have related these stories to me are generally of the position: I can buy my own lunch, but for the rest of the staff they really value it... that gets them access, expensive access, but access nonetheless to push their product.
The true astronomical costs of R&D aren't sunk into any particular drug or device, it's because of the 19 failures that make zero return for the one commercial success. Then the costs of selling those successful devices/drugs outstrip this cost of R&D by more than an order of magnitude. Then there are the smaller, but still significant, costly efforts put in for national legislation lobbying to support the whole fiasco. This is how you sell a pill that costs less than $0.40 each to make by hand for $20.00 each when it's sold through the pharma/sales rep/insurance channels. How you sell a device that costs less than $600 to make for over $30K per implantation.
The EU and ROW don't get that kind of bullshit extreme high cost hard sell treatment, even with their discounts and costs of entry to the countries, the profit margins are higher per unit overseas due to the lack of the hard-sell costs.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Monday January 20 2020, @05:02PM (3 children)
You should give a fuck. If they don't stand to make money by developing new drugs, they won't develop new drugs. And since the US develops the majority of the new drugs for the world...
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Tuesday January 21 2020, @01:49AM (2 children)
The system has developed itself into a shitty shitty way of making new drugs, and when you break down what's really spent on R&D vs what's spent on sales, you're going to find 20 sales twats out there, 9 of whom are pulling down $300K+ per year in commissions, mostly because they're breaking policies and laws and getting away with it - short term, while the other 11 are going to be cycled through the company in less than a year hoping to find fresh meat with new ideas about how to skirt or outright break the law - that's 20 sales schmucks for every actual R&D worker, in the successful drug companies. And, as a drug company, if you don't do the hard sell on all fronts, you are not competitive in the marketplace, your funding dries up, and you die - unless maybe you're lucky enough to sell out to a big marketing company that is willing to play the game.
As for innovation - what got innovated in the insulin field in the last 10 years, besides innovative new ways to jack up the price? And, it's not just insulin, not by a longshot.
The sad part of this equation is that most major drug and device development companies are giant multi-national operations, so there's not really an opportunity for big players in other countries to prove their ability to compete.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Tuesday January 21 2020, @05:30PM (1 child)
What's your point? Sales douches are apparently necessary to keep the money flowing in at a profit level high enough to warrant the R&D expenditures or even continued existence of the companies. What levels that requires of each is irrelevant. It wouldn't make a "should we do it" difference if it were a 99% to 1% split.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Tuesday January 21 2020, @06:54PM
Then I guess you really don't care about innovation. As a race, we've got limited resources on this planet, if we spend 99% of those resources in each others' faces trying to convince each other to buy our shit not theirs, that leaves precious little left over to actually improve the shit with.
First, we had to quit bashing each other over the head with rocks long enough to get a decent farm going. I think we're > 99% there, globally today.
Then, we had to quit burning each other's crops long enough to get some kind of civilization going. Probably closer to 95% achieved.
Then, we had to quit spending 50%+ of our GDP on weapons and troop deployments (and actual wars) to get some actual quality of life for the majority of people. This one I'm going to rate around 50% done today - depending on your thresholds and definitions I'd say it's clearly in the 20-80% range somewhere.
I'll agree that all of that is more important than worrying about whether we spin our wheels in inefficient lawsuits, god-awful sales practices, fradulent televangelist schemes, etc. but, what really concerns me is that the "good companies" like AT&T Bell Labs used to put 20-25% of their gross proceeds into R&D, but today you're lucky to get 10%, and the trends out of Wall Street continue to squeeze on the long term investments like R&D and encourage the short term gains like sales-push. At some point, the wheels are going to fall off the bus and we will have forgotten completely how to innovate.
When drug prices are inflated 50-100x over the cost of manufacture, and 90%+ of that margin is being plowed into S&M instead of R&D, I'd say we jumped the shark some time ago.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Monday January 20 2020, @02:58PM (4 children)
Man, I need more caffeine. Premature Submit due to lack of cognition.
There's a reason doctors command the wages they do. They spend unbelievable amounts of effort, hardships, and capital to attain their skills. They deserve to be compensated for the scarcity and difficulty of attainment of said skills. That and they're expected to pay insane malpractice insurance premiums so that people can sue them for gazillions of dollars when they're not absolutely perfect at all times.
Also, setting government wages for citizens ain't just socialism, it's flat out communism.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Monday January 20 2020, @04:29PM (3 children)
Supply and demand, like anything else. The AMA keeps a stranglehold on supply, putting M.D.s not only in high demand, but also with overinflated opinions of their own worth and importance leading to some seriously dysfunctional relationships in the medical profession.
Normal practicing M.D.s in the UK and EU, for example, do only make about €90K/yr, and they are providing a better overall quality of care to their populations as measured by health outcomes, life expectancy, infant mortality, etc.
Artificial scarcity created by the AMA's med school and residency requirements - requirements which are un-necessary to ensure quality care by the program graduates.
FTFY.
🌻🌻 [google.com]
(Score: 2) by JoeMerchant on Monday January 20 2020, @04:37PM
Creating artificial scarcity in markets is one of the worst aspects of monopolistic behavior - the evil head of capitalism that, like Hydra, needs constant vigilance because as soon as you cut one off two grow back in it's place.
How many competing AMAs do we have in our "free market"? Just the one, last I checked - absolute monopoly, worse than socialism or communism, both of which get a bad rap due to examples of them being implemented with corrupt central control.
And we're not talking about entertainment, or communication, or food, or transportation, or construction, or energy, we're talking about healthcare.
🌻🌻 [google.com]
(Score: 2) by The Mighty Buzzard on Monday January 20 2020, @04:43PM (1 child)
If that were true you wouldn't have every doctor who practices being sued every single year, likely multiple times. You can't have it both ways. Either doctors are competent and suing them for unrealistic expectations should be done away with or they aren't competent and the standards need to be raised even higher.
The scarcity and difficulty of attainment factor in to the value, so *shurg*.
As for doctors' wages? Those are trivial as a percentage of your healthcare costs. Removing their ability to work for whoever pays them the best like everyone else isn't just vile and contemptible, it's also unwarranted.
My rights don't end where your fear begins.
(Score: 2) by JoeMerchant on Monday January 20 2020, @04:55PM
Tort reform is a whole other area that's out of control, but maybe not quite as far out of control as healthcare costs.
You can't draw any rational conclusions based on frequency and payouts of lawsuits and settlements. The legal system is like a fucking casino, rigged, but with some big random payouts based on arbitrary lucky breaks.
Raising standards does not raise competence. Addressing how care is delivered improves outcomes. Giving M.D.s more time to spend on each individual case has direct measurable improvements in outcomes, flunking out prospective M.D.s in Chem 101 with arbitrarily hard exams does nothing - except to reduce the number of practicing M.D.s which does give them less time to spend on individual cases.
Specialist doctors' incomes ($1M+ per year) are, indeed trivial in the bigger picture of healthcare costs, but they are symptomatic of a shortage of M.D.s which is one of the root problems in the system.
🌻🌻 [google.com]
(Score: 2) by JoeMerchant on Friday January 17 2020, @11:44PM
Vaguely related insanity: https://gritpost.com/retiree-holiday-inn-senior-home/ [gritpost.com]
Over the course of a year, Robison would pay approximately $21,900 to stay at a Holiday Inn at the senior discount rate for 365 days. The retirement home he looked at would cost $68,620. And that’s typically the price for a senior home, according to Forbes.
“It takes months to get into decent nursing homes. Holiday Inn will take your reservation today,” he added. “And you’re not stuck in one place forever — you can move from Inn to Inn, or even from city to city.”
“The Inn has a night security person and daily room service. The maid checks to see if you are ok. If not, they’ll call an ambulance… or the undertaker,” Robison continued. “If you fall and break a hip, Medicare will pay for the hip, and Holiday Inn will upgrade you to a suite for the rest of your life.”
🌻🌻 [google.com]
(Score: 3, Insightful) by fustakrakich on Thursday January 09 2020, @07:37PM (6 children)
Yeah, yeah, we know, fuck the poor...
La politica e i criminali sono la stessa cosa..
(Score: 2) by The Mighty Buzzard on Thursday January 16 2020, @04:32PM (5 children)
Saying get your thieving hand out of my pocket is not the same as saying fuck the poor. I got nothing against charity but if you have pry the money from its rightful owner's wallet first under threat of imprisonment or death, it is not charity.
My rights don't end where your fear begins.
(Score: 1) by fustakrakich on Thursday January 16 2020, @04:59PM
Sorry, you want the bennies, you gotta pay the dues.
La politica e i criminali sono la stessa cosa..
(Score: 1) by fustakrakich on Thursday January 16 2020, @05:09PM (3 children)
:-) Such is life in the collective
La politica e i criminali sono la stessa cosa..
(Score: 2) by The Mighty Buzzard on Friday January 17 2020, @05:12PM (2 children)
"We are the Democrats. Existence as you know it is over. We will add your financial distinctiveness to our own. Resistance is futile."
My rights don't end where your fear begins.
(Score: 1) by fustakrakich on Friday January 17 2020, @07:18PM (1 child)
*sigh* So hopelessly biased
La politica e i criminali sono la stessa cosa..
(Score: 2) by The Mighty Buzzard on Friday January 17 2020, @10:27PM
That's not bias, that's their stated platform. Just paraphrased.
My rights don't end where your fear begins.