Politics debate

[Chrish]

Health care is in shambles. And pharmacy more than anything will be affected by it due to factors such as saturation.

From job safety perspective, which party winning will benefit us the most?

Socialist medicine ie. Medicare for all, or Trump removing Obama care altogether?

Or either way, we are - - - -ed ???

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[Pharmacy is a Scam]

Even if Medicare For All passes, it will be several years before the impact will be felt.

So basically, either way, we are - - -ed.

 

[3boooda]

Pool party.

 

[VictorOfHungerGames]

Health care is in shambles. And pharmacy more than anything will be affected by it due to factors such as saturation.

From job safety perspective, which party winning will benefit us the most?

Socialist medicine ie. Medicare for all, or Trump removing Obama care altogether?

Or either way, we are - - - -ed ???

I havent voted since the first time i ever voted which was back in 2000. Since then I realized every single politician is the same. Big talk, no substance. Probably due to the satanic world we live in...

Recently though ive heard Andrew Yang speak. I think im going to maybe possibly likely vote for him if he makes it to the top.

 

[JustFillIt]

Look - Roseanne Barr had some good ideas.

 

[WVUPharm2007]

Yang or nothing.

 

[VictorOfHungerGames]

Yang or nothing.

#yanggangbang

 

[AM77]

Our country is $22 trillion in debt. How are we going to afford $30 trillion for Medicare for All? By raising taxes on corporations? They’ll just pack up their bags and leave.
I don’t know why people are so crazy about socialism these days. It wasn’t even the thing 20 years ago. Just take a look at Venezuela.

 

[lane one]

All of the people pushing Medicare for All have absolutely no idea how healthcare currently works. They act like medicare is a blank check that pays for each and every therapy prescribed by your Doctor, regardless of how ludicrous. Medicare actually blows. If the government takes over and reimburses at medicare rate for every man, woman and child we treat then we are doomed.

During the second democratic debate, Warren told some made up story about an MS patient who was constantly being denied HER meds because some GREEDY insurance company was trying to save a penny. In reality, the patient would never get that drug with Medicare of All either. In reality, the drug being prescribed has probably never shown any benefit in that particular patient population, and therefore is not being approved for that patient. Medicare of All would not change this, it would likely make it worse as cost-cutting measures would become more and more extreme in order to fund the plan.

They are basically selling a lie that they can sign a bill that will make healthcare delivery free of cost. I hope american voters see through it before it's too late.

 

[wagrxm2000]

All of the people pushing Medicare for All have absolutely no idea how healthcare currently works. They act like medicare is a blank check that pays for each and every therapy prescribed by your Doctor, regardless of how ludicrous. Medicare actually blows. If the government takes over and reimburses at medicare rate for every man, woman and child we treat then we are doomed.

During the second democratic debate, Warren told some made up story about an MS patient who was constantly being denied HER meds because some GREEDY insurance company was trying to save a penny. In reality, the patient would never get that drug with Medicare of All either. In reality, the drug being prescribed has probably never shown any benefit in that particular patient population, and therefore is not being approved for that patient. Medicare of All would not change this, it would likely make it worse as cost-cutting measures would become more and more extreme in order to fund the plan.

They are basically selling a lie that they can sign a bill that will make healthcare delivery free of cost. I hope american voters see through it before it's too late.

But it's free.

I loved how no one wanted to say taxes would be raised and if they did they had to go into this huge explanation.

What they don't realize is most people enjoy their insurance and either don't have to use it so the deductible doesn't hurt them or have Medicaid. All these people will have their taxes raised for no reason.

Also whenever hospitals going broke got brought up, they quickly changed the subject.

 

[Sine Cura]

"Enjoy their insurance"
"have Medicaid"

LOL

 

[Chrish]

I am democratic in political ideology but Medicare for all is little ridiculous.

PS I find it amusing how people are uncomfortable talking about politics even on anonymous forum!

 

[wagrxm2000]

"Enjoy their insurance"
"have Medicaid"

LOL

This is a sad post coming from a pharmacist who sees insurance claims all the time. Yes some people have high deductible but why should we punish the majority for the minority?

 

[PharFromNormal]

Bernie is an animated character but I would love to see him try to establish a formulary and covered standard benefits that everyone will get for free (no deductible or copay) while staying in the already sky high price tag. Ideologically they probably don’t want to refuse or reject coverage for anyone for anything. Private insurance companies make big bucks but they have to also be the public enemy as they have the responsibility to say “no” to protect limited (although sometimes seemingly large quantities) of resources. There is absolutely no way that a single national plan would include the best coverage of all the best private insurance plans out there. Somewhere, someone will take a step back in certain dimensions of coverage. I think it’s totally fine if that were to happen but to bluntly refuse it won’t and/or state people won’t generally experience changes in quality/access is laughable. Yes some would now be covered that weren’t and some would also see a regression to the mean. Is brand name livalo the same tier as generic pravastatin? Of course no copays and no managed care tactics those evil insurers use. Arthritis pain? Take this free vimovo. Oh it’s not covered? Who is this evil government that restricts access to medications my doctor prescribed that I clearly need!!!!! The universal plan better cover my daily revatio and not ask any questions about what it’s for. They only ask questions to find excuses not to pay! No copays!

Has anyone mentioned yet that the NHS only provides a free healthcheck to patients 40-74 once every 5 years?

I guess we all take those free annual visits for granted...

 

[Sine Cura]

This is a sad post coming from a pharmacist who sees insurance claims all the time. Yes some people have high deductible but why should we punish the majority for the minority?

Because people want to go to poorly run/inadequately staffed FQHCs because no one else takes Medicaid and pharmacists control whether providers at these clinics get burnt out

 

[Chrish]

So, just listened to part of Yang podcast to see what the fuss is all about..

First impression: I kinda like him from what I see Seems like an intelligent fella with problem-solving skills. Of course, I need to see more of him during debates and listen to the whole pod-casts.

 

[BenJammin]

M4A will never happen.

 

[Chrish]

That doesn't mean current healthcare system isn't broken. It SUCKS !!!!

I am receiving $500 - $600 invoices from the Labcorp for the tests that were performed in January and now they aren't covered by the insurance. May be Medicare for all isn't the answer but that doesn't mean current system doesn't require any reform. It's a complete joke tbh..

 

[VA77]

That doesn't mean current healthcare system isn't broken. It SUCKS !!!!

I am receiving $500 - $600 invoices from the Labcorp for the tests that were performed in January and now they aren't covered by the insurance. May be Medicare for all isn't the answer but that doesn't mean current system doesn't require any reform. It's a complete joke tbh..

Yeah I think Wags relationship with Labcorp will cost them. Guess they didn't learn from Theranos.

 

[greenteapanacea]

Maybe cost caps for both healthcare and education would be helpful?

 

[zelman]

Our country is $22 trillion in debt. How are we going to afford $30 trillion for Medicare for All? By raising taxes on corporations? They’ll just pack up their bags and leave.

Bernie has suggested taxing stock transactions at a <1% rate. Seems pretty reasonable.

 

[zelman]

I havent voted since the first time i ever voted which was back in 2000. Since then I realized every single politician is the same.

It has been suggested that this point of view is propaganda spread by the GOP as a means of voter suppression. Low voter turnout may increase republican success, but the data isn’t totally clear cut: Sanders' Shaky Turnout Claim - FactCheck.org

 

[deleted480308]

Maybe cost caps for both healthcare and education would be helpful?

Why? Things cost money. Shop around and pay the price charged. And stop making hospitals give free care if you want the price on actual payors to decrease

 

[deleted480308]

Bernie has suggested taxing stock transactions at a <1% rate. Seems pretty reasonable.

Anchor every transaction with taxes? It’s a really burdensome and disastrous policy.

 

[zelman]

Anchor every transaction with taxes? It’s a really burdensome and disastrous policy.

Can something be preemptively disastrous?

 

[deleted480308]

Can something be preemptively disastrous?

As in can we preemptively know an idea is horrible? Yes.

 

[northeast-southwest]

The current system is such a mess. I have yet to hear a reasonable way to fix it.

 

[zelman]

As in can we preemptively know an idea is horrible? Yes.

dis·as·trous
/dəˈzastrəs/
adjective
adjective: disastrous

1. causing great damage.
   "a disastrous fire swept through the museum"
   

I contend that the idea alone cannot be disastrous without causing damage.

 

[spacecowgirl]

The whole narrative around Medicare for All or whatever you want to call it is incorrect. The people pushing it are framing it wrong, thus it is no wonder detractors have plenty to criticize. We have to stop looking at it like we (the 99%) just take money out and put nothing in. Or that it will just be some unlimited resource that pays for every drug and procedure. It is creating a much bigger risk pool which spreads the risk and cost.

Who has cheaper premiums? A small business with 100 employees or a big corp with 5000? Why is it different? Are people in the bigger corp just getting "free" or reduced price care? Who has better leverage with wholesalers - a small company or a big one? When you remove middlemen and rent-seekers who eat up almost 1/3 of healthcare dollars can you pay providers more or less? Will it cost consumers more or less? Do we pay for other people's decisions now under our current plans? Is it more or less expensive to move people from one plan to another on Jan 1 because their employer got a better deal with BCBS vs UHC? Do any of us really have a choice in insurance through our employer? We might have PPO vs HDHP or maybe 3 different coverage plans but do we have any actual choice?

Healthcare never has been and never will be a free market. We have some sort of bastard hybrid of all the negatives and none of the benefits of both free market and subsidized industry with our healthcare. It is easy to see why people are afraid of all of the worst of Medicare for All - because they assume we will continue to have all of the dysfunction of our current commercial and Medicare systems. And that will happen/has happened with a half-assed approach. There will be downsides for sure - workers in the insurance, billing and PBM space will be displaced. We'll still need some of those people to maintain the administrative aspects of Medicare for All but that will be a negative impact. People will be unhappy that they have the illusion of less choice in insurance plans.

Medicare for all would actually be great for businesses large and small and entrepreneurs. Workers would have the ability to move more freely without being tied to a job that may not be what is best for their family but has good insurance. Unions would be able to focus on bargaining for higher wages or better conditions vs keeping high-cost insurance plans.

 

[Reirrac]

Let's be realistic. Socialist programs will ruin the economy. If there's no business and money to be made there's no jobs for pharmacists either.

Spare the emotional speech, capitalism is what made the medical profession as good as it gets.

 

[spacecowgirl]

I am generally crotchety and don't like people as a whole but I realize that I live in a society, whether I like it or not. I cannot take the good of society without accepting the bad. I cannot have paved roads and good schools without paying for another kid's school lunch or appendectomy. I cannot have pizza delivered to my house without paying for a bridge wrecked by a hurricane 2000 miles away.

I am completely dependent on everyone else just like every Bunkerville prepper who wears clothes they did not weave from cotton they did not grow stockpiling food they did not grow in cans of metal they did not mine,

 

[spacecowgirl]

Let's be realistic. Socialist programs will ruin the economy. If there's no business and money to be made there's no jobs for pharmacists either.

Spare the emotional speech, capitalism is what made the medical profession as good as it gets.

Emotional?

 

[Sine Cura]

The correct order of what drives what is fossil fuel consumption => human "progress." No economic system does diddly squat without fossil fuels

 

[Reirrac]

Emotional?

"If we don't do this Bob will suffer and die!" "If we don't do that you're an uncaring person!" line of talk, for example.

 

[PharFromNormal]

Who has cheaper premiums? A small business with 100 employees or a big corp with 5000? Why is it different? Are people in the bigger corp just getting "free" or reduced price care?

I would say this actually largely depends on what the companies are, and mix of demographics of the employees. A small business that has a large skew of young healthy male adults employeed at a health/fitness company probably has a lower risk profile (thus lower premiums) than a large manufacturing company that has pretty grueling working conditions where the average worker age is ~55+.

Scale can be easily offset by risk profile of beneficiaries. It’s not that simple. While moving to a bigger risk pool can benefit some through risk dilution it’s not a sure thing for everyone. If you are in a small relatively low risk pool to begin with you may move to a bigger risk pool with more overall risk. There will be winners and losers. The number winners may outnumber the losers but don’t diminish that it is possible to be a loser in this scenario.

(And I say males because young healthy females are at higher “risk” of having a baby which would drive utilization)

 

[lord999]

Why? Things cost money. Shop around and pay the price charged. And stop making hospitals give free care if you want the price on actual payors to decrease

Hill-Burton Free and Reduced-Cost Health Care | HRSA

Disclaimer: the information in this website does not bind the public, except as authorized by law or as incorporated into a contract. In 1946, Congress passed a law that gave hospitals, nursing homes and other health facilities grants and loans for construction and modernization. In return, they...

www.hrsa.gov

Not possible, the way that the Hill-Burton Act works, patients do not have the ability to negotiate prices in advance due to how charges are made. We gave that ability up when we first got Medicare 1968 and recently EMTALA.

And not possible to withdraw either, otherwise, you wouldn't be trained nor have a residency as even military medicine's training is funded by CMS through the Executive Office interchange.

Why I say this is that there is no simple disentanglement of one part without getting the whole operation to collapse like a screwed up Jenga pile due to the interdependencies. The real reform in the medical market only can happen when we address who the biggest payer is, us as in the US Government. It's very pernicious to the extent that the USG penetrates even routine transactions, but without it, there's no modern medical establishment. Social Transformation of Medicine still applies.

 

[deleted480308]

dis·as·trous
/dəˈzastrəs/
adjective
adjective: disastrous

1. causing great damage.
   "a disastrous fire swept through the museum"

I contend that the idea alone cannot be disastrous without causing damage.

a tax on every transaction would cause great damage

The whole narrative around Medicare for All or whatever you want to call it is incorrect. The people pushing it are framing it wrong, thus it is no wonder detractors have plenty to criticize. We have to stop looking at it like we (the 99%) just take money out and put nothing in. Or that it will just be some unlimited resource that pays for every drug and procedure. It is creating a much bigger risk pool which spreads the risk and cost.

Who has cheaper premiums? A small business with 100 employees or a big corp with 5000? Why is it different? Are people in the bigger corp just getting "free" or reduced price care? Who has better leverage with wholesalers - a small company or a big one? When you remove middlemen and rent-seekers who eat up almost 1/3 of healthcare dollars can you pay providers more or less? Will it cost consumers more or less? Do we pay for other people's decisions now under our current plans? Is it more or less expensive to move people from one plan to another on Jan 1 because their employer got a better deal with BCBS vs UHC? Do any of us really have a choice in insurance through our employer? We might have PPO vs HDHP or maybe 3 different coverage plans but do we have any actual choice?

Healthcare never has been and never will be a free market. We have some sort of bastard hybrid of all the negatives and none of the benefits of both free market and subsidized industry with our healthcare. It is easy to see why people are afraid of all of the worst of Medicare for All - because they assume we will continue to have all of the dysfunction of our current commercial and Medicare systems. And that will happen/has happened with a half-assed approach. There will be downsides for sure - workers in the insurance, billing and PBM space will be displaced. We'll still need some of those people to maintain the administrative aspects of Medicare for All but that will be a negative impact. People will be unhappy that they have the illusion of less choice in insurance plans.

Medicare for all would actually be great for businesses large and small and entrepreneurs. Workers would have the ability to move more freely without being tied to a job that may not be what is best for their family but has good insurance. Unions would be able to focus on bargaining for higher wages or better conditions vs keeping high-cost insurance plans.

no one ever talks about the taxes when pitching this idea
No one brags about the unilateral power the govt will have to stop paying for a treatment
No one talks about govt driving docs out of business with draconian price cuts

I am generally crotchety and don't like people as a whole but I realize that I live in a society, whether I like it or not. I cannot take the good of society without accepting the bad. I cannot have paved roads and good schools without paying for another kid's school lunch or appendectomy. I cannot have pizza delivered to my house without paying for a bridge wrecked by a hurricane 2000 miles away.

I am completely dependent on everyone else just like every Bunkerville prepper who wears clothes they did not weave from cotton they did not grow stockpiling food they did not grow in cans of metal they did not mine,

You are bad at economics. There is a difference between the voluntary interdependence of specialization and some rando who didn’t do anything for you saying you owe them a surgery.....you don’t

 

[deleted480308]

Hill-Burton Free and Reduced-Cost Health Care | HRSA

Disclaimer: the information in this website does not bind the public, except as authorized by law or as incorporated into a contract. In 1946, Congress passed a law that gave hospitals, nursing homes and other health facilities grants and loans for construction and modernization. In return, they...

www.hrsa.gov

Not possible, the way that the Hill-Burton Act works, patients do not have the ability to negotiate prices in advance due to how charges are made. We gave that ability up when we first got Medicare 1968 and recently EMTALA.

And not possible to withdraw either, otherwise, you wouldn't be trained nor have a residency as even military medicine's training is funded by CMS through the Executive Office interchange.

Why I say this is that there is no simple disentanglement of one part without getting the whole operation to collapse like a screwed up Jenga pile due to the interdependencies. The real reform in the medical market only can happen when we address who the biggest payer is, us as in the US Government. It's very pernicious to the extent that the USG penetrates even routine transactions, but without it, there's no modern medical establishment. Social Transformation of Medicine still applies.

Remove the biggest middle man. Doctors should pay for their training just like everyone should pay for their care

 

[spacecowgirl]

You are bad at economics. There is a difference between the voluntary interdependence of specialization and some rando who didn’t do anything for you saying you owe them a surgery.....you don’t

Lots of randos "pitched in" to cover my 84K in medical expenses when I was a young, presumably healthy person with cancer.

 

[deleted480308]

Lots of randos "pitched in" to cover my 84K in medical expenses when I was a young, presumably healthy person with cancer.

And the govt should not have made them, that’s a role for voluntary charity

 

[lord999]

Remove the biggest middle man. Doctors should pay for their training just like everyone should pay for their care

You're being contrary at this point as that's something where you wouldn't have been able to afford it on a private basis, unless you happen to have $300k around (even at the private level, programs are subsidized by CMS). That lack of human capital utilization is actually not in the interest of the USG, they have private actor responsibilities as well to ensure that you are not compromised to any other entity than the USG due to the amount of public trust invested in you when you take your office. The entire reason for the program, we found out the hard way (and with enough dead bodies) in the Korean War that we did not have enough medical personnel in the right places that we had excess deaths attributed to it. And due to the issues of private training versus sales in our logistics system as we found out the hard way in WWII (don't buy critical supplies from Nazis didn't occur until we were at war with them), we have always taken an internal interest in training personnel who we own their time for a period. That is the cheapest and least difficult way to have the personnel we need do the jobs we want.

 

[wucool33]

And due to the issues of private training versus sales in our logistics system as we found out the hard way in WWII (don't buy critical supplies from Nazis didn't occur until we were at war with them)

And this is why I think trump is unintentionally helping China accelerate its development. China hasn’t really seriously considered developing its own chips/processor and other techs until the US stopped selling them to China.

 

[lord999]

And this is why I think trump is unintentionally helping China accelerate its development. China hasn’t really seriously considered developing its own chips/processor and other techs until the US stopped selling them to China.

The one entertaining thing to note that the best semiconductors are actually Taiwanese (that's also true for most computer electronics OEMs as well), but the materials all come from the mainland. That hasn't escaped the tech industry's notice, and I agree with you that I could see this really backfiring on us as it comes down to who hurts worse from an embargo, us with consumer good or China with food. I'm thinking a double KO.

 

[deleted480308]

You're being contrary at this point as that's something where you wouldn't have been able to afford it on a private basis, unless you happen to have $300k around (even at the private level, programs are subsidized by CMS). That lack of human capital utilization is actually not in the interest of the USG, they have private actor responsibilities as well to ensure that you are not compromised to any other entity than the USG due to the amount of public trust invested in you when you take your office. The entire reason for the program, we found out the hard way (and with enough dead bodies) in the Korean War that we did not have enough medical personnel in the right places that we had excess deaths attributed to it. And due to the issues of private training versus sales in our logistics system as we found out the hard way in WWII (don't buy critical supplies from Nazis didn't occur until we were at war with them), we have always taken an internal interest in training personnel who we own their time for a period. That is the cheapest and least difficult way to have the personnel we need do the jobs we want.

With the low rate of default, an american doctor could absolutely get private financing for training

 

[PharFromNormal]

Hill-Burton Free and Reduced-Cost Health Care | HRSA

Disclaimer: the information in this website does not bind the public, except as authorized by law or as incorporated into a contract. In 1946, Congress passed a law that gave hospitals, nursing homes and other health facilities grants and loans for construction and modernization. In return, they...

www.hrsa.gov

Not possible, the way that the Hill-Burton Act works, patients do not have the ability to negotiate prices in advance due to how charges are made. We gave that ability up when we first got Medicare 1968 and recently EMTALA.

And not possible to withdraw either, otherwise, you wouldn't be trained nor have a residency as even military medicine's training is funded by CMS through the Executive Office interchange.

Why I say this is that there is no simple disentanglement of one part without getting the whole operation to collapse like a screwed up Jenga pile due to the interdependencies. The real reform in the medical market only can happen when we address who the biggest payer is, us as in the US Government. It's very pernicious to the extent that the USG penetrates even routine transactions, but without it, there's no modern medical establishment. Social Transformation of Medicine still applies.

Thank you.

I think many, if not all, agree that our system is a mess from the outside looking in. Hell even from the inside looking in.

What I think many don’t begin to understand is the massive massive undertaking it would be to unwind and rebuild the entire system in which has tentacles intertwined every which way and growing deeper and more twisted as we go.

“Healthcare” funds trickle out to extreme parts of our economy. There are entangled regulations (how the hell are we going to import meds and satisfy track and trace) and competing societal expectations (hate big pharma and insurance but don’t want government to have total control).

We can certainly change and evolve to something else but there will for sure be a sizable portion of people that reside in the US that won’t be happy in any scenario. There isn’t a magic bullet. There are losers now and there will be losers in the future. Damned if we do, damned if we don’t. Just figure out how to make whatever it is best for you.

 

[lord999]

With the low rate of default, an american doctor could absolutely get private financing for training

No they wouldn't, we've done that approach too. See Flexner Commission for details for how that era was an abysmal failure in medical education. And remember, what are American physician's salaries based on, oh that's right, the government.

I'm not unsympathetic toward libertarian viewpoints, I hold them myself. But if you are going the free market route here, there are consequences to that as well. The problem is finding a regulatory structure that permits as much freedom to for people to receive good care while allowing for specialization and infrastructure maintenance necessary to have that good care. Pure free market is as much a failure as a complete government solution. That is why even in the market area, the Church had an advantage, and one of the key drivers for the modern healthcare bureaucracy were the low church denominations, because they could not organize the funding or infrastructure for hospitals and medical personnel that the established bureaucratic episcopal churches (Catholic, Anglican/Episcopal, Lutheran) had done in most metropolitan areas (Congregationalists being the one exception in the East). The original push for Medicare explicitly wanted to break up the monopoly power of the high church medical establishment, and partly why you actually have the ability to get an education without having to join a specific denomination's hospital to practice.

 

[deleted480308]

No they wouldn't, we've done that approach too. See Flexner Commission for details for how that era was an abysmal failure in medical education. And remember, what are American physician's salaries based on, oh that's right, the government.

I'm not unsympathetic toward libertarian viewpoints, I hold them myself. But if you are going the free market route here, there are consequences to that as well. The problem is finding a regulatory structure that permits as much freedom to for people to receive good care while allowing for specialization and infrastructure maintenance necessary to have that good care. Pure free market is as much a failure as a complete government solution. That is why even in the market area, the Church had an advantage, and one of the key drivers for the modern healthcare bureaucracy were the low church denominations, because they could not organize the funding or infrastructure for hospitals and medical personnel that the established bureaucratic episcopal churches (Catholic, Anglican/Episcopal, Lutheran) had done in most metropolitan areas (Congregationalists being the one exception in the East). The original push for Medicare explicitly wanted to break up the monopoly power of the high church medical establishment, and partly why you actually have the ability to get an education without having to join a specific denomination's hospital to practice.

Your conflating two things. A requirement by govt (we can that utility elsewhere) to be educated to a certain standard to do a task does not at all mean that the govt has to take over as the payor for residents

 

[PharmDminus]

what are my fellow conservatives thoughts on public option, assuming it is unsubsidized?

 

[deleted480308]

what are my fellow conservatives thoughts on public option, assuming it is unsubsidized?

An unsubsidized public option would never work math wise because the people who “need” it could never afford to pay the premiums required to keep it solvent

 

[PharFromNormal]

what are my fellow conservatives thoughts on public option, assuming it is unsubsidized?

Very hard question to answer without getting into the critical details. When you say “unsubsidized” would the entire budget for the government run admin and oversight also be funded off of premiums? Where’s the funding for the start up come from? Debt that they are required to pay down? I’d be very interested to see what the risk profile is for those that opt into a public option. My guess would be high, making it not a practical option for those that need it when they need it. From there they’d death spiral and we’d be back to square one.

I’m not opposed to a public option, again curious on the details of a specific proposal. It would certainly be doing “something” but don’t know if that “something” would really work all that long without forcing people into the risk pool.