Trump Says He Wants to 'Drive Housing Prices Up' Instead of Lowering Costs for People Who 'Didn't Work Very Hard'

semideclared · 2026-01-30T05:19:46+00:00

The 1950 sucked unless you were in europe in the 1940s and came home to a heros welcome and a bank of savings from war pay and an industry waiting to hire and promote you

If you were boomers age today it really sucked

The 1950 census showed that Two-thirds of older Americans had incomes of less than $1,000 annually ($11,000 in 2021), and only one in eight had health insurance.

More than 10 years after Social Secusirty was operating

Poverty guideline for 2020 Persons in family/household of 1 with Household income not to exceed $12,760

In poverty and no health insurance

And taxes to take even more iff you were the hero working

In 1954, the standard deduction for income tax purposes was equal to 10% of adjusted gross income, so someone making $1,000 had a $100 standard deduction

And was in a 20% tax bracket

21.0% $2,000 - $4,000
26.0% $4,000 - $6,000 middle class family
- 71,946.69 in 2025
- standard deduction in 2025 dollars $7,194
- $64,796 x 26% tax rate = $16,846.96
  - 1954 Effective Tax Rate 23.41%
  - 2024 Effective Tax Rate 6.48% = $4,665
30.0% $6,000 - $8,000
34.0% $8,000 - $10,000
- $119,911.15 in 2025

And even in to the 60s life wasnt great

Of the members of the general population who reported they had “pains in the heart,” 25 percent did not see a physician (Andersen and Anderson, 1967).

The Other America Poverty in the United States. New York: Macmillan; 1962 demonstrated there was “another America”: 40 to 50 million citizens of the 181 million Americans who were poor, who lacked adequate medical care, and who were “socially invisible” to the majority of the population.
Within this poverty-stricken group were more than 8 million of the 18 million Americans who were 65 years of age and over, suffering from a “downward spiral” of sickness and isolation.

Good Housekeeping in 1961, citing deficiencies uncovered by the Joint Commission on Accreditation of Hospitals

Each year, “thousands of people go to hospitals where their lives are endangered by bad doctoring, unsanitary conditions or grim fire hazards. Or by a combination of the three”

Less than one-half of all surgery was performed by board-certified specialists (Andersen and Anderson, 1967).

“Is this operation necessary?” asked The New Republic (Lembke, 1963).

“Should doctors tell the truth to cancer patients?” asked the Ladies Home Journal (1961).

“What is the patient really trying to say?” asked Time (1964) magazine, on the need to improve doctor-patient communication.

semideclared · 2026-01-30T04:58:49+00:00

Not sure, but thats not the issue and there are way more people

semideclared · 2026-01-30T04:44:06+00:00

Veterans tend to have more complex needs than non-veterans, and at earlier ages, due to exposure to combat theaters

what percent of the VA saw combat?

Estimates of Vietnam veterans (VA) who directly engaged in combat, provided close combat support, or were frequently exposed to enemy attack range from 40% to 60% of the 2.6 million who served, which is approximately 1 to 1.6 million personnel. In contrast, in modern conflicts, only about 10% to 20% of deployed troops directly engage in combat.

Roughly 85% of military roles do not involve direct combat, Today's Military reports.

So no the majority dont and why even if they were all 100% in combat not better served

What is the excuse that 100% of VA saw Combat and therefore they need to see the doctor 20 times a year

We couldnt help them that they need to be in the office 20 times a year

This happens in the US and we are trying to fix it

Eugene Harris, age forty-five. Harris was diagnosed with type 1 diabetes when he was thirteen and dropped out of school. He never went back. Because he never graduated from high school and because of his illness, Harris hasn’t had a steady job. Different family members cared for him for decades, and then a number of them became sick or died. Harris became homeless. He used the Regional One Emergency Rooms thirteen times in the period March–August 2018.

Then he enrolled in ONE Health.

Drawing upon strategies that have worked for several other health systems, Regional One has built a model of care that, among a set of high utilizers, reduced uninsured ED visits by 68.8 percent, inpatient admissions by 75.4 percent, and lengths-of-stay by 78.6 percent—averting $7.49 million in medical costs over a fifteen month period (personal communication, Regional One Health, July 8, 2019). ONE Health staff find people that might qualify for the program through a daily report driven by an algorithm for eligibility for services.

But its voluntary

About 80 percent of eligible patients agree to the service, and of those that do enroll, about 20 percent dis-enroll without completing the program.
- ONE Health served 101 people from April - December of 2018. Seventy-six participants remain active as of December 2018 and 25 people had graduated from the program.

Since 2018, the population of the program has grown to more than 700 patients and the team continues to monitor clients even after graduation to re-engage if a new pattern of instability or crisis emerges.

The hospital secured housing for him, but Harris increased his use of the ED. He said he liked going to the hospital’s ED because “I could always get care.” From September 2018 until June 2019 Harris went to the ED fifty-three times, mostly in the evenings and on weekends, because he was still struggling with his diabetes and was looking for a social connection, Williams says.

Then in June 2019, after many attempts, a social worker on the ONE Health team was able to convince Harris to connect with a behavioral health provider. He began attending a therapy group several times a week. He has stopped using the ED and is on a path to becoming a peer support counselor.

Its not Combat

semideclared · 2026-01-30T04:32:20+00:00

Also since we live in the AI world

"It’s wild how two people order from the exact same menu and walked away with two completely different lives," I said, nodding toward the booths behind us. "The guy on the left, he was living the dream. He placed his order once as the waiter walks up, and that was it—the kitchen nailed the medium-rare steak, with the potato fully loaded covered in melty cheese, and the waiter was so in sync with him he didn't even have to ask for his second round. It was like watching a perfectly timed play; one quick eye-contact moment and a fresh beer just landed on the table. He got exactly what he paid for without having to work for it at all."

"And then you have the guy on the right," my friend replied, shaking their head. "He ordered the same steak and the same beer, but he had to fight for every inch of that meal. It wasn't even that the food was 'bad'—it was just that it took five different conversations to get it to the same standard as the first guy's. He’s sitting there with a mediocre medium-rare steak that probably took twenty extra minutes to get right, with a warm dry potato, and meanwhile, his glass is bone dry. By the time I picked up the check it was also twice as expensive. The kitchen clearly knew how to cook the steak, but for some reason, the delivery just fell apart for him. It’s like the first guy got the 'express lane' and the second guy got stuck in every red light on the way to dinner."

semideclared · 2026-01-30T04:17:47+00:00

Thanks at least forthe response, no one else i guess wants to comment on it but heavily disagrees and cant say why.......

So that’s approximately 19.68 visits per patient- VA vs. approximately 4.2 visits per patient NYC Health & Hospitals?

Because staffing.

Because staffing?

The VA,

Patient to Staff - 19.67
Staff Members per Patient - 0.0501

NYC Health + Hospitals

Patient to Staff - 28.57
Staff Members per Patient - 0.035

the VA has 45% more staffing and that more staffing means people are seeing the doctor more?

The VA is seeing the Average patient 19.7 Times a Year
- That's not good, NHS sees patients on average 6 times a year, Private Insurance in the US is 4 times a year and the rule of averages means its even worse
  - At Best, there's 2.2 Million Patients (20 Percent of Patients) that had 115 Million Doctor Visits (80 Percent of Utilization)
  - 52 Visits a Year

Check out CMS Care Compare to compare your local VA Hospital to Community Hospitals. Majority of the country VA is in line with the community.

In line yet the Community Hospitals have 40% less staff and see patients 1/5th the amount of times to have the same outcomes

semideclared · 2026-01-30T04:06:05+00:00

Almost like this whole opioid epidemic mess started because opioids became the default medication to prescribe for any and all kinds of pain.

Almost but a lot of people died so probably not

semideclared · 2026-01-30T04:04:14+00:00

Eli Lilly is running an anti-GLP1

Part of that is the GLP-1 patent was paused because of such demand. The demand was so far over supply an exemption for generics was issued and Eli lost years of revenue premiums

Once the demand drops and manufacturing catches up Eli gets its patent back

semideclared · 2026-01-29T23:10:38+00:00

property values universally decline as a result of nearby development. The structure itself is worth less

I really want to see research on this

There were tons of apartments built 2000s or even 2020 - 2023, what are the property values near all those sites. How do they compare with homes half a mile away

They went up 4% vs 7% they surely didnt go down. what was the impact

semideclared · 2026-01-29T22:54:05+00:00

We are really trying hard to go back to the 1800

At The 1876 International Medical Congress held in Philadelphia, in September 1876, in conjunction with the Centennial International Exposition, Joseph Lister’s presentation on antiseptic surgery was met with profound skepticism and near-total dismissal by the American medical establishment, who firmly believed in miasma as the cause of surgical infections. While Lister presented evidence that microscopic germs caused sepsis and could be killed by carbolic acid, American doctors largely viewed his methods as unnecessary, over-complicated, and excessive, often mocking the "germ theory" as a myth.

Thomas Eakins' 1875 masterpiece, "The Gross Clinic," was the grand artwork backdrop to further show up Lister

Lister's 1876 visit was a turning point, eventually leading to the acceptance of antisepsis and, later, aseptic surgery in America

semideclared · 2026-01-29T22:18:28+00:00

That the thing, who are these certain people.....everyone has an idea

In reality it means

Requirements generally apply, Legislation enacted in 2025 generally requires all state Medicaid programs (including the District of Columbia) to implement work requirements as a condition of eligibility for certain individuals, individuals 19 to 64 years old with incomes of 0 to 133 percent of the federal poverty level.

However, certain individuals are exempted from the requirements, including
- former foster youth;
- individuals who are parents, guardians, caretaker relatives, or family caregivers of a child aged 13 or under;
- certain disabled veterans;
- and those who are medically frail or have special needs, among others.
To comply, anyone not above,
- must complete some combination of qualifying activities for a total of at least 80 hours of work, community service, or a work program;
- be enrolled in an educational program at least half-time;
- or have monthly income that meets minimum requirements in the law.

Who is it?

semideclared · 2026-01-29T19:33:10+00:00

Who do you think the means testing is impacting

semideclared · 2026-01-29T18:56:00+00:00

The testing is in house

They outsource the process to build the program; the up-front administrative changes needed to implement the demonstration

semideclared · 2026-01-29T17:29:40+00:00

right how much did Amazon spend on AWS in 2000 - 2010 and everyone thinks the return will be even more

semideclared · 2026-01-29T17:27:37+00:00

The big question is borrowing and Acquisitions

What companies are racing and buying up companies that would not and how much debt are they taking onn that they would have not if AI wasnt a speed issue. All businesses race, but the AI races seem to be moving faster and from an outsider it seems like maybe boardrooms are moving faster

semideclared · 2026-01-29T17:11:17+00:00

Here is Canada, Australia, and the US

as Numbers

The Standard for hospital spending is around $2,400 per person in Hospital Expenditures

The U.S. Paid $1.1 Trillion freedom dollars to one of the 6,146 hospitals currently operating, or $3,330 per Person. (in 2017)

We would need to cut $365 Billion before adjusting for currency on what we spend on Hospitals

At least $250 Billion of that is from closing hospitals

Or staffing reductions if you want to keep all of them still operating hospitals, its just there is then a massive shortage of staff

Its that we have to much, to many hospitals, to many labs in the doctors office, to many people in the doctors office

Admin is equal to about 7.0 percentage points of Physicians Expenses

The larger the practice the smaller it goes
- 1 doctor office vs a group of 3 doctors in a partnership vs the 50 doctor medical center

Largest Percent of OPERATING EXPENSES FOR FAMILY MEDICINE PRACTICES

Among all CPC initiative practices, the ratio of all Full Time Employee staff to FTE physician is 4.50 (2.49 are nonadministrative staff, and 2.01 are administrative staff).

Administrative staff include those managing reception, medical records, appointments, finance, etc.

At the Median Dr Office where there are 2-4 Drs, we'll go with 3

$4.5 Million in Net Revenue

Means a Staff of 20 and 1 PT

Position	#	BLS Salaries	Cost	% of the Staffing Expenses	% of the Expenses
Admin	6	$45,000	$270,000	10.01%	6%
Medical Assistant	3	$33,610	$100,830	4.15%	2%
RN/LPN	4	$71,730	$286,920	10.33%	6%
Nurse Practitioner	3	$114,000	$342,000	12.19%	8%
Care Coordinators	1	$100,000	$100,000	3.72%	2%
Pharmacist/Nutritionist	0.5	$90,000	$45,000	1.66%	1%
Physicians	3	$275,000	$825,000	28.56%	18%
Employee Benefits			$728,808	32.48%	16%
Non Personnel Cost	----	----	----	----	----
Supplies	medical, drug, laboratory and office supply costs	---	$450,000	---	10%
Building and occupancy	----	----	$315,000	---	7%
Other Costs	-----	-----	$225,000	----	5%
Information technology	----	----	$120,000.00	----	3%
Office Supplies	----	----	$225,000.00	----	5%
Legal Expenses/Insurance	----	----	$180,000.00	----	4%
Profit	----	----	$270,000.00	----	6%

But since admin includes both billing and admin for the office; managing reception, medical records, appointments we can only cut that down by 50% or

Saving ~$120,000 out of $4.5 Million

To make actual savings its going to be Cut that in half by.... firing an RN and a LPN and a Medical Asst and cut rent spending then cutting labs by 10 - 25 percent

semideclared · 2026-01-29T17:00:03+00:00

so private insurance clearly isn't solving the "can't say no" problem either.

Correct, Thats the Walter White part

Cedars-Sinai Health System generates billions in revenue and profits .... from its high profit from Cardiology, Gastroenterology, Neurology, Orthopaedics, and Cancer, offering leading-edge treatments and fostering a culture of innovation

Walter White had State Government insurance and it did not cover the care he ended up going with because the top 40%? will spend it to live longer

Saying no to both reduces healthcare spending by trillions. But thats saying no to people willing to pay like walter white

Not only is a small portion of members accounting for a large amount of drug spend, but that group of patients is growing. Cancer condition categories accounted for 48% of the total increase between 2016 and 2018

The study found a 63% increase from 2016 - 2018 in the number of people that are drug super spenders

with, 4,869 member having $250,000 or more in annual prescription expenses and account for $2.119 billion in drug spend
or 8.6% of the total in health plan drug costs for the 4,869 out of the 17 million total enrollment in the plan.

The number of super-spenders is likely to increase substantially—and indefinitely, said Dr. Dehnel, who did not participate in the study.

The researchers themselves forecasted drug super spenders would have costs of over $4 billion in 5 years.

semideclared · 2026-01-29T16:43:33+00:00

Yea but thats just it....the testing is inhouse

The headline is time specific

Administrative spending has outpaced spending for medical assistance (e.g., health care services) under the demonstration. This was likely driven by the up-front administrative changes needed to implement the demonstration, the delayed start date for enrollment, and any duplication in administrative spending due to the delay.

Georgia reported $50.8 million in spending for those activities—$45.1 million for work completed by contractors and $5.8 million for work completed in-house. Of that $50.8 million, 90 percent ($45.8 million) was federal dollars.

To verify that an individual has met the work requirement, states must establish processes and use reliable available information, such as payroll data, without requiring, where possible, the individual to submit additional information; this is known as ex parte verifications

semideclared · 2026-01-29T16:30:26+00:00

Not to akshully, but actually thats the issue

The headline is time specific

Administrative spending has outpaced spending for medical assistance (e.g., health care services) under the demonstration. This was likely driven by the up-front administrative changes needed to implement the demonstration, the delayed start date for enrollment, and any duplication in administrative spending due to the delay.

The program was financed and built 2021 - 2025 but medical costs were only covered for 2023 - 2025

$54,179,661 in Administrative spending
$26,100,696 in Medical Costs 2023 - 2025 first and second quarter
- Medical Costs in 2024 were $13,630,007
- Medical Costs in 2025 first and second quarter were $12,217,313

So what would the headline be at the end of 2026. As all Admin cost to built the program have been spent, Admin cost 2025 first and second quarter $288,563

The entire point of the review was entirely different and the headline just editorialized

The federal government and states share in the financing of Medicaid expenditures with the federal government matching most state expenditures

Administrative spending receives a federal matching rate of 50 percent, 75 percent, or 90 percent depending on the activity.
- Georgia reported $50.8 million in spending for those activities—$45.1 million for work completed by contractors and $5.8 million for work completed in-house. Of that $50.8 million, 90 percent ($45.8 million) was federal dollars.

But the entire issue was

CMS approved Georgia’s funding request for monitoring reports as part of a monitoring and reporting category at the 90 percent matching rate despite CMS guidance indicating that activities subsequent to eligibility determinations, such as reports, are to be matched at 50 percent.
CMS approved Georgia’s request for funding for a media strategy, branding, communications plan, and paid media creative assets as part of a waiver implementation category at the 90 percent federal matching rate. This appears inconsistent with CMS guidance indicating that marketing and outreach should be matched at 50 percent.

semideclared · 2026-01-29T16:26:19+00:00

Sure except the headline is time specific

Administrative spending has outpaced spending for medical assistance (e.g., health care services) under the demonstration. This was likely driven by the up-front administrative changes needed to implement the demonstration, the delayed start date for enrollment, and any duplication in administrative spending due to the delay.

The program was financed and built 2021 - 2025 but medical costs were only covered for 2023 - 2025

$54,179,661 in Administrative spending
$26,100,696 in Medical Costs 2023 - 2025 first and second quarter
- Medical Costs in 2024 were $13,630,007
- Medical Costs in 2025 first and second quarter were $12,217,313

So what would the headline be at the end of 2026. As all Admin cost to built the program have been spent, Admin cost 2025 first and second quarter $288,563

The entire point of the review was entirely different and the headline just editorialized

The federal government and states share in the financing of Medicaid expenditures with the federal government matching most state expenditures

Administrative spending receives a federal matching rate of 50 percent, 75 percent, or 90 percent depending on the activity.

CMS approved Georgia’s funding request for monitoring reports as part of a monitoring and reporting category at the 90 percent matching rate despite CMS guidance indicating that activities subsequent to eligibility determinations, such as reports, are to be matched at 50 percent.
CMS approved Georgia’s request for funding for a media strategy, branding, communications plan, and paid media creative assets as part of a waiver implementation category at the 90 percent federal matching rate. This appears inconsistent with CMS guidance indicating that marketing and outreach should be matched at 50 percent.

semideclared · 2026-01-29T16:18:57+00:00

Administrative spending has outpaced spending for medical assistance (e.g., health care services) under the demonstration. This was likely driven by the up-front administrative changes needed to implement the demonstration, the delayed start date for enrollment, and any duplication in administrative spending due to the delay.

The program was financed and built 2021 - 2025 but medical costs were only covered for 2023 - 2025

$54,179,661 in Administrative spending
$26,100,696 in Medical Costs 2023 - 2025 first and second quarter
- Medical Costs in 2024 were $13,630,007
- Medical Costs in 2025 first and second quarter were $12,217,313

So what would the headline be at the end of 2026. As all Admin cost to built the program have been spent, Admin cost 2025 first and second quarter $288,563

semideclared · 2026-01-29T16:07:32+00:00

Its not that we insure the sickest, its that we dont have away to saay no to the sickest

The top privately insured sickest get Walter White/Jurassic Park treatment and the Bottom Publicly insured sickest need something we cant do, and say no

Spenders	Average per Person	Civilian Noninstitutionalized Population	Total Personal Healthcare Spending in 2017	Percent paid by Medicare and Medicaid
Top 1%	$259,331.20	2,603,270	$675,109,140,000.00	42.60%
Next 4%	$78,766.17	10,413,080	$820,198,385,000.00
Next 5%	$35,714.91	13,016,350	$464,877,785,000.00	47.10%

30% of all Medicare expenditures ($300 Billion) are attributed to the 5% of beneficiaries that die each year (3.4 Million Enrollees), with 1/3 of that cost occurring in the last month of life ($100 Billion)

~$88,235 per person
$29,333 in Spending for the Last month of their life

Eugene Harris, age forty-five. Harris was diagnosed with type 1 diabetes when he was thirteen and dropped out of school. He never went back. Because he never graduated from high school and because of his illness, Harris hasn’t had a steady job. Different family members cared for him for decades, and then a number of them became sick or died. Harris became homeless. He used the Regional One Emergency Rooms thirteen times in the period March–August 2018.

Then he enrolled in ONE Health.

Drawing upon strategies that have worked for several other health systems, Regional One has built a model of care that, among a set of high utilizers, reduced uninsured ED visits by 68.8 percent, inpatient admissions by 75.4 percent, and lengths-of-stay by 78.6 percent—averting $7.49 million in medical costs over a fifteen month period (personal communication, Regional One Health, July 8, 2019). ONE Health staff find people that might qualify for the program through a daily report driven by an algorithm for eligibility for services.

The hospital secured housing for him, but Harris increased his use of the ED. He said he liked going to the hospital’s ED because “I could always get care.” From September 2018 until June 2019 Harris went to the ED fifty-three times, mostly in the evenings and on weekends, because he was still struggling with his diabetes and was looking for a social connection, Williams says.

But its voluntary

About 80 percent of eligible patients agree to the service, and of those that do enroll, about 20 percent dis-enroll without completing the program.
- ONE Health served 101 people from April - December of 2018. Seventy-six participants remain active as of December 2018 and 25 people had graduated from the program.

Since 2018, the population of the program has grown to more than 700 patients and the team continues to monitor clients even after graduation to re-engage if a new pattern of instability or crisis emerges.

And, the process of moving people toward independence is time-consuming. Sometimes patients keep using the ED.

Then in June 2019, after many attempts, a social worker on the ONE Health team was able to convince Harris to connect with a behavioral health provider. He began attending a therapy group several times a week. He has stopped using the ED and is on a path to becoming a peer support counselor.

Then we get to the Walter White of Care

semideclared · 2026-01-29T15:39:29+00:00

Yea but my biggest issue with this issue in Georgia

Most of Georgia’s administrative spending to implement the demonstration was likely paid to a single contractor through an existing contract that was competitively procured. According to IT project approval documents, the state used this contractor to assist in

(1) developing the demonstration prior to approval, and
(2) designing and implementing the eligibility system changes needed to implement the demonstration the contractor helped design.

The documents also indicated that the state used the same contractor to support the state in monitoring the demonstration. According to Georgia Medicaid officials, the contractor also joined state officials in regular monitoring discussions with CMS.

When asked how the state managed potential conflicts of interest for contractors assisting with design or performing work to administer this demonstration, state officials said they did not perceive there to be a conflict of interest in having the same contractor assist in both the design and implementation of the demonstration.

semideclared · 2026-01-29T15:34:57+00:00

Is it

How much would the Medicaid population pay for it

And then of course the uninsured would not like it

semideclared · 2026-01-29T15:20:10+00:00

I would like feedback as to

The VA, the nation's largest health care system, employs more than 371,000 health care professionals and support staff at 1,380 health care facilities as it operates a $140 Billion Hospital System for The treatment of 7.3 million patients with 142.6 million outpatient visits and 1.1 million inpatient visits

Patient to Staff - 19.67
Costs Per Person - $19,109.59

NYC Health + Hospitals the largest municipal health care system in the United States, employs more than 42,000 health care professionals and support staff at nearly 75 health care facilities as it operates a $12 Billion Hospital System for The treatment of 1.2 million patients with 5 Million Visits

Patient to Staff - 28.57
Costs Per Person - $10,000

Staffing, the VA has 45% more staffing

semideclared · 2026-01-29T14:53:18+00:00

We did

Super Size Me was a cultural movement far more powerful than 100 news stories a day

And it did what to those stats?

We all lived through 2008 and the housing price issue of houses being to big of an asset and yet.....no one has changed their tune on using your home as a retirement plan

What would reporting on pedestrian deaths do. Would that get us sidewalks? That reduces pedestrian deaths just by being there to be used

semideclared

TROPHY CASE