Manual for right wingers (http://www.talkingpointsmemo.com/documents/2009/08/memo-details-co-ordinated-anti-reform-harrassment-strategy.php?page=1)
Pretty scary. It's a long read but worth it. This is just crazy, deceitful, and it seems counterintuitive to the whole idea of having a forum to discuss it.
Have you hugged your healthcare conglomerate today?
Quote from: rowjimmy on August 06, 2009, 09:49:11 AM
Have you hugged your healthcare conglomerate today?
no. I actually want the public option.
Quote from: Sophist on August 06, 2009, 10:05:34 AM
Quote from: rowjimmy on August 06, 2009, 09:49:11 AM
Have you hugged your healthcare conglomerate today?
no. I actually want the public option.
Me too. I'm a
HUGE socialist.
Quote from: rowjimmy on August 06, 2009, 10:14:43 AM
Quote from: Sophist on August 06, 2009, 10:05:34 AM
Quote from: rowjimmy on August 06, 2009, 09:49:11 AM
Have you hugged your healthcare conglomerate today?
no. I actually want the public option.
Me too. I'm a HUGE socialist.
comrade, let us flood the streets with Marxist doctrine then!
The right wing tactics are crazy. I want healthcare for everyone, but I think that the original and the watered down plans don't get us there. Even the original proposal left 20 million people out.
I want to see this one not get passed, but rather modified.
At this point, the ball-less dems have allowed themselves to be bullied so badly that there won't be a public option.
Why the hell do you seek to achieve a majority and celebrate it when you get there if you're just going to pander to the minority members of the chamber and squander your power?
The Republitards never did that.
Of course they were busy squeezing the soul out of our nation...
wouldn't it be really cool if the GOP leaders got together with the Dems and come up with some kind of compromise instead of making this some kind of attempted power grab?
don't these guys work for us?
oh - I foget - power is more important than actually governing and doing something good for the country.
Just two things of note: First, the woman you see all over your TV set who is a Canadian speaking out about how she got screwed by the Canadian system is full of shit and our health minister was livid over her claims (a TV program here did an investigation into her case as well and proved it was bunk). What she needed done was not an emergency and was bearing no immediate impact on her life and as such she was asked to wait a brief period. Had it been threatening, she would of been taken care of right away, that is how our system works, the most in need first. And yes, sometimes you have to wait an inordinate amount of time in a waiting room......but its free.....for everyone. She is being paid huge cash for these ads and has admitted such on another program here in Canada.
Second, the other set of ads that have been running feature a bald headed lobbyist spewing about government health care, I am sure you have seen him. Well he ran a massive health conglomerate.........that was eventually charged with the biggest fine ever levied in American history. The company had to pay 1.7 billion for having defrauded the U.S. government over the period of ten years (I think). And he is currently running a large part of the right's lobbying campaign. Sadly, the right have a lot of good arguments, it's just they are being drowned out by the lunatic fringe and the over-zealous lobbyists who fuel them. Here is the interview CNN's Rick Sanchez had where he questions him about the fine; artful dodger.
http://videocafe.crooksandliars.com/heather/rick-sanchez-takes-conservatives-patients (http://videocafe.crooksandliars.com/heather/rick-sanchez-takes-conservatives-patients)
I think I'm going to move to France.
Quote from: Superfreakie on August 08, 2009, 03:11:27 AM
Just two things of note: First, the woman you see all over your TV set who is a Canadian speaking out about how she got screwed by the Canadian system is full of shit and our health minister was livid over her claims (a TV program here did an investigation into her case as well and proved it was bunk). What she needed done was not an emergency and was bearing no immediate impact on her life and as such she was asked to wait a brief period. Had it been threatening, she would of been taken care of right away, that is how our system works, the most in need first. And yes, sometimes you have to wait an inordinate amount of time in a waiting room......but its free.....for everyone. She is being paid huge cash for these ads and has admitted such on another program here in Canada.
Second, the other set of ads that have been running feature a bald headed lobbyist spewing about government health care, I am sure you have seen him. Well he ran a massive health conglomerate.........that was eventually charged with the biggest fine ever levied in American history. The company had to pay 1.7 billion for having defrauded the U.S. government over the period of ten years (I think). And he is currently running a large part of the right's lobbying campaign. Sadly, the right have a lot of good arguments, it's just they are being drowned out by the lunatic fringe and the over-zealous lobbyists who fuel them. Here is the interview CNN's Rick Sanchez had where he questions him about the fine; artful dodger.
http://videocafe.crooksandliars.com/heather/rick-sanchez-takes-conservatives-patients (http://videocafe.crooksandliars.com/heather/rick-sanchez-takes-conservatives-patients)
thanks - not only did he run a health care conglomerate that was fined for fraud, it was a
for profit company.
Question for Daren, or Matt, or any Canadian pauger. I understand there's a private insurance system in Canada as well. How many people use it? Why? who are they?
And finally, a couple comments about the current system from someone who has seen both sides. I realize in a way I'm preaching to the choir cause most of us are leftist hippies, but still...
If you're worried about a govt or insurance company getting between you and your doctor, it is ALREADY HAPPENING. Private companies put up more hoops and roadblocks than Medicare. I'm no fan of Medicare either. The Pres uses Mayo Clinic as an example of a high quality, cost efficient system. According to Time mag, Mayo is losing money on their Medicare patients. Something is wrong.
The system is too expensive. People with insurance, in general, get too much testing and care. That's why all those roadblocks are there. To some degree, they are necessary.
Why is too much stuff being done? Several reasons, imo. some generalizations, in no order
-many patients want everything done. some have "unreal" expectations
-doctors and patients embrace new (expensive) technology marketed as the latest and greatest thing, before it is adequately tested
-doctors want to do anything they can to help their patients and order extra tests 'just to be safe". patients like that. An unwanted consequence is too much information and false positive tests, that lead to more testing and more money spent. Any time more stuff is done, there also is a small but real chance something can go wrong. There are potential complications to everything, even cat scans (long term effects of radiation, etc).
-doctors want to do anything they can to avoid getting sued. THERE NEEDS TO BE TORT REFORM
-Most overutilization by doctors is not merely to get paid more. Most tests (x rays, stress tests) are ordered by doctors who get NOTHING for ordering the test. Cutting the reimbursement for these tests won't decrease the amount of tests ordered, cause the docs ordered don't get anything now - they don't care what the reimbursement is. they just want the test result (or think they do)
-hospitals and doctors get paid fee for service. While it is sadly true that some docs order things to pad their income (this is regrettable), from my observations in New England, this is the vast minority.
-medicine is expensive. it is labor intensive, delivered by highly trained people. (who do you want taking care of you during and emergencey at 2 AM?) drugs are expensive. medical equipment is expensive. for all the bitching about drug companies, much of it justified, right now it takes about $100 million to launch a new drug. For every 100 drugs tested, less than 5 actually make it to market.
-I wish I knew how to fix it
end of rant.
I lied. not the end.
I forgot to mention (sorry)
the millions of people without insurance
the people with insurance, but the deductables are so high they can't afford care
the people who can't afford their prescription drugs
the people who are losing their job and their insurance, so they stop going to doctors. If they don't pay for COBRA (which they can't afford), they will have a hard time getting re-insured because of pre-existing conditions.
these people need to be covered.
again, the question is how will we all pay for it, I don't know.
and finally, somehow, there needs to be incentive for us to stop eating ourselves to death as a nation. the growing cost of obesity>diabetes>hypertension>heart disease, stroke etc is large, on a financial and human scale.
National healthcare will also relieve the impending burden on the existing Medicare program. As people age into Medicare that have not had proper healthcare during the so-called prime of their lives, they bring forward many undiagnosed and untreated conditions that are then even more expensive to treat. SLS is dead on about Americans eating themselves to death. Not just in quantity but quality. How and what we eat is a a large part of our current disfunction.
I've seen a lot of things lately that suggest that there's more like 9 million people who can't afford healthcare that whatever 40-50 million our money hungry congress people would have us believe. That number comes from the oh so accurate census, being out of healthcare for a month puts you as a statistic on that list, people who can afford healthcare and choose not to have it (some high percentage of people in their 20s), and people who qualify for care but are uninformed.
So 9 million people should be simple to work with, but it begs the question of if we even need something other than a simple reform to what we have.
Quote from: jephrey on August 11, 2009, 03:35:53 AM
I've seen a lot of things lately that suggest that there's more like 9 million people who can't afford healthcare that whatever 40-50 million our money hungry congress people would have us believe. That number comes from the oh so accurate census, being out of healthcare for a month puts you as a statistic on that list, people who can afford healthcare and choose not to have it (some high percentage of people in their 20s), and people who qualify for care but are uninformed.
So 9 million people should be simple to work with, but it begs the question of if we even need something other than a simple reform to what we have.
Check your sources.
http://factcheck.org/2009/06/the-real-uninsured/
Its a crazy time that we live in when the President of the United States of America is about to take the stage in New Hampshire and theres a dude on private church property w/ a gun strapped to his side, and the NH police say its completely legal for him to be standing there w/ his pistol as long as its not concealed.
Why do people think they need to bring a gun to a Town Hall Meeting about Health Insurance Reform?
Where were this guy and his pistol and his sign about "Watering the Tree of Liberty" when President Bush was trampling all over our civil rights and constitution?
Because caring for people is unamerican.
http://media.mtvnservices.com/mgid:cms:item:comedycentral.com:240655
http://media.mtvnservices.com/mgid:cms:item:comedycentral.com:240656
:-D
love the daydream sequence
Quote from: rowjimmy on August 11, 2009, 08:30:48 AM
Quote from: jephrey on August 11, 2009, 03:35:53 AM
I've seen a lot of things lately that suggest that there's more like 9 million people who can't afford healthcare that whatever 40-50 million our money hungry congress people would have us believe. That number comes from the oh so accurate census, being out of healthcare for a month puts you as a statistic on that list, people who can afford healthcare and choose not to have it (some high percentage of people in their 20s), and people who qualify for care but are uninformed.
So 9 million people should be simple to work with, but it begs the question of if we even need something other than a simple reform to what we have.
Check your sources.
http://factcheck.org/2009/06/the-real-uninsured/
Yeah, factcheck does give more information on it but doesn't say that yes, the number is exactly that -nor does it say what it actually is - or even give an estimate (unless they're agreeing to the 45.7M). The real bottom line is getting insurance to people who "really" cannot afford it, or who it's not available to. As fact-check points out, there are many reasons why people don't have insurance... Money is one of them, and it might be the biggest reason, but how can you lump everyone who is out of insurance into that group? The 9M figure I threw out (what I heard on the radio - not a conservative station) may be way off, but so may the 45.7M figure. Maybe it's more like 25M. Unfortunately, nobody has a number with a good degree of accuracy and I'm not about to be all gung ho about higher taxes for something so vague.
Finally, I'm not adamant about the exact figure, but It'd be nice if fact-check or someone else could come up with an estimate that at least takes all of this into account.
Here's fact-check's last paragraph:
In short, it's true that many of the 45.7 million "uninsured" could find coverage through existing government programs or pay for their own coverage if they chose. Some, perhaps 6 million, are illegal immigrants who would not receive coverage under any proposal now being considered. Do these amount to half the total, as former Sen. Thompson implied? That's possible, but we judge that the available evidence doesn't support that conclusion.
So it IS possible.
Fred Thompson, for the record, is dumb and thinks Americans are dumber.
When campaigning for the presidency, he'd roll into town in a limousine, then jump into a pickup truck to drive a block over to his rally. "Because he's just like regular people."
Fact of the matter is, you already pay for the health care of the uninsured; illegal immigrants or no.
Hospitals cannot, legally, turn away sick patients and they pass the cost of their rising overhead to the patients that actually pay. that's one of many reasons that health insurance premiums continue to skyrocket.
Fred Thompson is an idiot.
Sadly, Congressional Democrats are being bigger idiots currently. The House insists on the public option, the Senate cant support it, and the White House is currently acting like a Waffle House. And Im not talking about the Belgian kind, or the diner chain.
Quote from: rowjimmy on August 18, 2009, 08:46:13 AM
Fact of the matter is, you already pay for the health care of the uninsured; illegal immigrants or no.
Hospitals cannot, legally, turn away sick patients and they pass the cost of their rising overhead to the patients that actually pay. that's one of many reasons that health insurance premiums continue to skyrocket.
To elaborate on RJ's comment; because the only way for an illegal immigrant to see a doctor is by passing through an emergency room, as they cannot be refused, not only do they increase costs but in addition, they contribute to the extended wait times suffered by those with real emergencies. Reform might possibly find a way to alleviate these incidences, as well as find a way to charge them, for many obviously do not return to pay the bills incurred from these ER visits for fear they may be deported through a paper trail.
Second, assuming that you can not keep track of undocumented workers nor plug the holes that allow them to continue working in the States (ie. employers looking for cheap labor to smugglers who will find a way), somehow government needs to create a voluntarily program whereby they may be loosely monitored in case, god forbid, there is ever a true epidemic (I am looking at you media hyped swine flu). Having some sort of health statistics might aid in prevention or at least containment of a possible disaster.
Quote from: Superfreakie on August 18, 2009, 09:27:50 PM
Quote from: rowjimmy on August 18, 2009, 08:46:13 AM
Fact of the matter is, you already pay for the health care of the uninsured; illegal immigrants or no.
Hospitals cannot, legally, turn away sick patients and they pass the cost of their rising overhead to the patients that actually pay. that's one of many reasons that health insurance premiums continue to skyrocket.
To elaborate on RJ's comment; because the only way for an illegal immigrant to see a doctor is by passing through an emergency room, as they cannot be refused, not only do they increase costs but in addition, they contribute to the extended wait times suffered by those with real emergencies. Reform might possibly find a way to alleviate these incidences, as well as find a way to charge them, for many obviously do not return to pay the bills incurred from these ER visits for fear they may be deported through a paper trail.
Second, assuming that you can not keep track of undocumented workers nor plug the holes that allow them to continue working in the States (ie. employers looking for cheap labor to smugglers who will find a way), somehow government needs to create a voluntarily program whereby they may be loosely monitored in case, god forbid, there is ever a true epidemic (I am looking at you media hyped swine flu). Having some sort of health statistics might aid in prevention or at least containment of a possible disaster.
Let me paraphrase for republicans:
1. You're already paying for illegal immigrants and non-insured people to receive health care, via your huge insurance premiums.
2. They only go to the most expensive places (ER's), with conditions that are comparatively expensive (Because they haven't been previously treated)
3. If you paid for their PREVENTATIVE healthcare (read: the cheapest form) via commie red socialist big gov't medicine, you'd save money.
4. The best thing to do is to go to town hall meetings wearing unconcealed weapons.
Quote from: kellerb on August 18, 2009, 09:52:54 PM
Quote from: Superfreakie on August 18, 2009, 09:27:50 PM
Quote from: rowjimmy on August 18, 2009, 08:46:13 AM
Fact of the matter is, you already pay for the health care of the uninsured; illegal immigrants or no.
Hospitals cannot, legally, turn away sick patients and they pass the cost of their rising overhead to the patients that actually pay. that's one of many reasons that health insurance premiums continue to skyrocket.
To elaborate on RJ's comment; because the only way for an illegal immigrant to see a doctor is by passing through an emergency room, as they cannot be refused, not only do they increase costs but in addition, they contribute to the extended wait times suffered by those with real emergencies. Reform might possibly find a way to alleviate these incidences, as well as find a way to charge them, for many obviously do not return to pay the bills incurred from these ER visits for fear they may be deported through a paper trail.
Second, assuming that you can not keep track of undocumented workers nor plug the holes that allow them to continue working in the States (ie. employers looking for cheap labor to smugglers who will find a way), somehow government needs to create a voluntarily program whereby they may be loosely monitored in case, god forbid, there is ever a true epidemic (I am looking at you media hyped swine flu). Having some sort of health statistics might aid in prevention or at least containment of a possible disaster.
Let me paraphrase for republicans:
1. You're already paying for illegal immigrants and non-insured people to receive health care, via your huge insurance premiums.
2. They only go to the most expensive places (ER's), with conditions that are comparatively expensive (Because they haven't been previously treated)
3. If you paid for their PREVENTATIVE healthcare (read: the cheapest form) via commie red socialist big gov't medicine, you'd save money.
4. The best thing to do is to go to town hall meetings wearing unconcealed weapons.
Absolutely brilliant; Kellerb, master of the paraphrase. ROFLMAO. I can't wait to drink with you someday. Actually, I can't wait to have drinks with many people on this board :beers:
But its not the R's that are holding this ship up at this point, even if the House and Obama wanted to force this thing through, the Senate is douching up the whole thing.
The R's have a simple strategy - water this thing down enough that it doesnt work, and then claim that it doesnt work because its government run. This way they can continue to operate under the false pretense that theyre really against large Government, and blame the Democratic government for the failure of health insurance / care reform.
The real kick in the pants is that they dont even have to enact this strategy to its full extent, because the moron Dems are going to do a fine enough job watering it down and taking any true "reform" out of the bill.
Quite frankly, Obama is the most prolific and influential Dem for many years, its about time he enacts some of the strategies and tactics that he used to dispel the myths during the campaign and get tough on these Senatorial Dems who want to work against the platform that got him elected and got them their huge majorities on both sides of the congress.
If youre not calling your Senators, youre not helping. We need a ground movement like we had in the election, but too many Americans only get semi-motivated politically every 4 years, and figure they can just sit back and let the bureaucrats run the government.
among the problems is that the scare tactics are working.
the people against it are riled up, the people for it are not. many of the people I have spoken to that are against it are quoting the lies they here on TV.
once again, if you say something loud enough and often enough, it becomes true
Have a look here:
http://www.huffingtonpost.com/katharine-zaleski/inside-the-mob-outside-th_b_260465.html
Quote from: slslbs on August 18, 2009, 10:41:17 PM
once again, if you say something loud enough and often enough, it becomes true
So I'm really not hung like a race horse?
kucinich on
olbermann schultz tonight talking healthcare....
oh and
Quote from: Superfreakie on August 18, 2009, 10:16:45 PM
Absolutely brilliant; Kellerb, master of the paraphrase. ROFLMAO. I can't wait to drink with you someday.
it delivers
Quote from: mirthbeatenworker on August 19, 2009, 08:03:24 PM
kucinich on olbermann tonight talking healthcare....
oh and
Quote from: Superfreakie on August 18, 2009, 10:16:45 PM
Absolutely brilliant; Kellerb, master of the paraphrase. ROFLMAO. I can't wait to drink with you someday.
it delivers
I'm just like this, but out loud.
Quote from: kellerb on August 19, 2009, 08:14:28 PM
Quote from: mirthbeatenworker on August 19, 2009, 08:03:24 PM
kucinich on olbermann tonight talking healthcare....
oh and
Quote from: Superfreakie on August 18, 2009, 10:16:45 PM
Absolutely brilliant; Kellerb, master of the paraphrase. ROFLMAO. I can't wait to drink with you someday.
it delivers
I'm just like this, but out loud.
So let me get this straight; you are more like this :wtu: than this :tte: ?
the cover story this week from the onion......great stuff
-------------------------------------------------------------------------------------
Congress Deadlocked Over How To Not Provide Health Care
August 18, 2009 | Issue 45•34
(http://www.theonion.com/content/files/images/congress_article_large.article_large.jpg)
Leaders on both sides of the aisle try to hammer out an agreement on fucking over Americans.
WASHINGTON—After months of committee meetings and hundreds of hours of heated debate, the United States Congress remained deadlocked this week over the best possible way to deny Americans health care.
"Both parties understand that the current system is broken," House Speaker Nancy Pelosi told reporters Monday. "But what we can't seem to agree upon is how to best keep it broken, while still ensuring that no elected official takes any political risk whatsoever. It's a very complicated issue."
"Ultimately, though, it's our responsibility as lawmakers to put these differences aside and focus on refusing Americans the health care they deserve," Pelosi added.
The legislative stalemate largely stems from competing ideologies deeply rooted along party lines. Democrats want to create a government-run system for not providing health care, while Republicans say coverage is best denied by allowing private insurers to make it unaffordable for as many citizens as possible.
"We have over 40 million people without insurance in this country today, and that is unacceptable," Sen. Orrin Hatch (R-UT) said. "If we would just quit squabbling so much, we could get that number up to 50 or even 100 million. Why, there's no reason we can't work together to deny health care to everyone but the richest 1 percent of the population."
"That's what America is all about," he added.
House Minority Leader John Boehner (R-OH) said on Meet The Press that Republicans would never agree to a plan that doesn't allow citizens the choice to be denied medical care in the private sector.
"Americans don't need some government official telling them they don't have the proper coverage to receive treatment," Boehner said. "What they need is massive insurance companies to become even more rich and powerful by withholding from average citizens the care they so desperately require. We're talking about people's health and the obscene profits associated with that, after all."
Though there remain irreconcilable points, both parties have reached some common ground in recent weeks. Senate leaders Harry Reid (D-NV) and Mitch McConnell (R-KY) point to Congress' failure to pass legislation before a July 31 deadline as proof of just how serious lawmakers are about stringing along the American people and never actually reforming the health care industry in any meaningful way.
"People should know that every day we are working without their best interests in mind," Reid said. "But the goal here is not to push through some watered-down bill that only denies health care to a few Americans here and a few Americans there. The goal is to recognize that all Americans have a God-given right to proper medical attention and then make sure there's no chance in hell that ever happens."
"No matter what we come up with," Reid continued, "rest assured that millions of citizens will remain dangerously uninsured, and the inflated health care industry will continue to bankrupt the country for decades."
Other lawmakers stressed that, while there has been some progress, the window of cooperation was closing.
"When you get into the nuts and bolts of how best not to provide people with care essential to their survival, there are many things to take into consideration," Rep. Michele Bachmann (R-MN) said. "I believe we can create a plan for Americans that allows them to not be able to go to the hospital, not get the treatment they need, and ultimately whither away and die. But we've got to act fast."
For his part, President Barack Obama claimed to be optimistic, even saying he believes that a health care denial bill will pass in both houses of Congress by the end of the year.
"We have an opportunity to do something truly historic in 2009," Obama said to a mostly silent crowd during a town hall meeting in Virginia yesterday. "I promise I will only sign a clear and comprehensive health care bill that fully denies coverage to you, your sick mother, her husband, middle-class Americans, single-parent households, the unemployed, and most importantly, anyone in need of emergency medical attention."
"This administration is committed to not providing health care," Obama added. "Not just for this generation of Americans, but for many generations to come."
It seems like we could easily pay for a nationwide health care plan with all of the money we are wasting on a bullshit war that we had no business starting. That being said, we must find a way to insure the uninsured. Making money on health care (drug companies) is borderline treason.
Everything I'm hearing is bad news for any sort of change on the healthcare front, but I still remain optimistic.
Quote from: aphineday on August 22, 2009, 03:58:31 PM
It seems like we could easily pay for a nationwide health care plan with all of the money we are wasting on a bullshit war that we had no business starting. That being said, we must find a way to insure the uninsured. Making money on health care (drug companies) is borderline treason.
I don't know about that. We're a capitalist society. Health insurance and pharmaceutical companies aren't meant to be nonprofit organizations. That being said, it's the abuses within healthcare that is contributing to the rising costs. Along with the uninsured being unable to pay for their own healthcare, so a lot of time that can be written off as charity with the actual cost being passed onto insurance companies, who then pass it on to those insured under them.
Quote from: antelope19 on August 24, 2009, 02:26:27 PM
Everything I'm hearing is bad news for any sort of change on the healthcare front, but I still remain optimistic.
Yeah, but what we have going now isn't going to work either. :-(
Quote from: goodabouthood on August 24, 2009, 04:56:47 PM
Quote from: aphineday on August 22, 2009, 03:58:31 PM
It seems like we could easily pay for a nationwide health care plan with all of the money we are wasting on a bullshit war that we had no business starting. That being said, we must find a way to insure the uninsured. Making money on health care (drug companies) is borderline treason.
I don't know about that. We're a capitalist society. Health insurance and pharmaceutical companies aren't meant to be nonprofit organizations. That being said, it's the abuses within healthcare that is contributing to the rising costs. Along with the uninsured being unable to pay for their own healthcare, so a lot of time that can be written off as charity with the actual cost being passed onto insurance companies, who then pass it on to those insured under them.
Quote from: antelope19 on August 24, 2009, 02:26:27 PM
Everything I'm hearing is bad news for any sort of change on the healthcare front, but I still remain optimistic.
Yeah, but what we have going now isn't going to work either. :-(
Yes, I remain optimistic that there will be some sort of change for the better but it's really not looking good at this point.
Taking care of people is evil. How dare anyone suggest it?
/sarchasm
fucking despicable
and this asshole is a doctor, or was
in a way, he's right, because everyone should be paying for their neighbors' health care.
http://www.youtube.com/v/e3jwhLcW_c8&hl=en&fs=1&
where the puking emoticon?
i hate to turn the TV on anymore...
it just frustrates me.
I recommend reading the article by Matt Taibbi in the new Rolling Stone with the Beatles on the cover.
Once again he hits the nail on the head and exposes our leaders as the frauds they truly are and how big of a cluster-f this whole process of healthcare "reform" has become.
The worst part about this, is there are no thoughts about the actual mechanisms that work to bring us healthcare.
In order for everyone to have adequate healthcare, we need a serious increase in the availability of all resources required to provide health care. This means we need twice as many doctors, probably 4 times as much health equipment, at least twice as many nurses, a larger supply of pharmacists, etc to provide all the services that would be required with a hugely increased healthcare client base.
None of the legislation has addressed this problem. The debate over healthcare has actually disuaded some from the profession, there are many in Medical school who are contemplating different careers because of their fears that Med school won't be worth it financially when they exit.
Before Obama, and his team of experts had made this their priority issue, they should have thought of all of the logistics inherent to the problem before they opened their fat mouths and said they were going to "fix a broken system".
It's kind of like if the Government mandated that McDonalds provide free hamburgers for everyone, but when you show up at McDonald's, none are available. You can't mandate that they give you what they do not possess.
there is a shortage of docs, primarily primary care.
there is too much equipment and over-utilization of the system by those who have the means.
it will take years to get more docs, but many of the problems theoretically can, and should, be addressed now.
criticize his methods or his plan, but give him (and Clinton) credit for the balls to attempt to fix it. Many people in recent memory didn't even try. 40% of the US Senate and a larger minority of the House is also unwilling to try. Rather than throw daggers, they should face the problem and try and work it out.
I recently read that (GOP) Senator Chaffee had a very good alternative plan to Clinton in the early 90s - many thought it was not only better, but workable. It was squashed by the GOP establishment because they didn't want to "help the Clintons"
Yeah, I agree. It's just that something like this takes at least 2-4 years for a panel of experts to figure out BEFORE you introduce steps to try and fix it.
One of the things that I think sucks about this previous election is that regardless on how you feel about John Edwards personal life, he had a stupendously wonderful platform that he had invested in the research and time to make it work.
Read:(http://images.barnesandnoble.com/images/14550000/14555325.JPG)
For an example of how someone who wanted to be our executive took the time and money to organize a panel of experts to research the problems in a system and what we can do to fix them ON HIS OWN before he ran for President the second time.
It really frustrates me that more people haven't taken the time to read this book.
If we were to eliminate Poverty here, the symptomatic problem of Healthcare inadequacy would be eliminated as well.
In my opinion our Healthcare inadequacy is a symptom of the rampant Poverty problem we have here in the U.S.A.
Quote from: fauxpaxfauxreal on August 26, 2009, 08:35:39 PM
One of the things that I think sucks about this previous election is that regardless on how you feel about John Edwards personal life, he had a stupendously wonderful platform
I think America is the only western country that still expects their legislators to be saints, possibly Canada runs second. In Europe, especially England, it has come to be abnormal if you are not cheating on your wife, or being caught in nazi drag while getting pegged by a meth'd out prostitute. It is sad how many great politicians America has railroaded because of personal failings.
Now to derail the thread on this topic:
You guys recently tossed out Elliot Spitzer (well he resigned but). I was really saddened by this because, and you may or may not know this, he was the only fucking guy who had figured out what Wall Street was doing and was about to introduce a ton of legislation trying to rectify the problem. He was a real financial genius and on our side, the good side. And this is really rare because these individuals are normally swooned away with huge salaries and perks offered by multi-nationals, big banks and insurance companies etc.... Long before the crisis started he had warned and wrote about the bad swaps, the poor insurance requirements that were allowing sub-prime mortgages to be bundled and sold to banks in Europe and Asia. He was the relatively new sheriff on Wall Street and those in power were ready to do anything to get rid of him. He loved going after the wealthy bastards ripping off the normal folk, took great pride in it. To be honest, with the investigations he was running and the legislation they were going to be introducing, I for sure thought he was going to have an "accident". In the world of business and law, he was fucking crazy......as in crazy good.
Now ask yourself, with all the prostitute business that goes down in New York, and all the politicians and business men involved, why is it that only Spitzer got nailed? None of that was by accident. Don't fuck with the big boys. When I read the news that day, I knew immediately who was behind it. Fuckers. The new legislation he was writing was going to run them all up the flag pole. Oh well, the economy tanked and now they are writing new legislation but there will still be loop holes in it everywhere, as those writing the legislation are a bunch of dodgy bastards themselves. At least Paulson is gone but he screwed you guys so hard before the left but that is another story, you guys really got fucked with the first tarp and which companies got bailouts and which ones were allowed to fail.....look it up some time, it's scary...............too bad they don't sell lube for the fucking you guys have gotten recently. :-o
I pretty much agree.
I don't care who you fuck, what drugs you do or how much you gamble...
What I care about is the quality of what you bring to the table. I completely agree that personal issues are often used when politicians are going to eff big business.
true, sort of.
but Spitzer was prosecuting prosecution rings and going after hi profile johns.
wtf was he thinking, that nobody would find out he was doing the same thing as the bad guys he was chasing?
I don't expect politicians to be perfect, I do expect them to pass the stupid test.
I know healthcare reform is a serious subject and it needs to be addressed but.... this is actually really close to being part of our problem.
(http://pix.motivatedphotos.com/2009/8/17/633861216943850165-healthcarereform.jpg)
Quote from: slslbs on August 28, 2009, 10:01:12 AM
true, sort of.
but Spitzer was prosecuting prosecution rings and going after hi profile johns.
wtf was he thinking, that nobody would find out he was doing the same thing as the bad guys he was chasing?
I don't expect politicians to be perfect, I do expect them to pass the stupid test.
True, I have not read much about his ativities against other crime. I have spent my time mostly reading his regulatory proposals and his actions against white collar crime. It's hard to pass the stupid test when johnson keeps getting in the way.
well, you know what they say about
a stiff one having no conscience
LMAO @ that picture of the burger. :lol:
Interesting study by Forbes released today: Most medicated (determined by the rate of prescription drug use) states per capita:
10) Iowa
09) Mississippi
08) Louisiana
07) Kentucky
06) Missouri
05) Arkansas
04) Tennessee
03) South Carolina
02) Alabama
01)
West VirginiaQuote
Dr. Jane Barlow, vice president of medical strategy and clinical quality for Medco Health Solutions ( MHS - news - people ), one of the nation's largest pharmacy benefit manager, says there's a reason these states use more medication: Their rates of heart disease, obesity and diabetes are higher than the national average, particularly in West Virginia.
:|
thats a pretty disturbing statistic. wv is the 3rd most overweight state, down from first and second in years passed, but not because we got any healthier, but because mississippi and whoever else got heavier.
if you come to wv, its noticeable how many people are overweight. when we were in colorado we were all like "wheres the fat people?"
poverty, lack of education, distrust of authority, etc, etc, all play a large role. its really disturbing when you see 3 and 5 year olds w/ candy bars and mountain dew walking out of wal-mart. its also part of our culture, though the food habits have stuck around, the nature of work and even the work ethic has changed.
my restaurant doesnt have a deep fryer and we never use butter. no wonder why we're not raking in the $$$$$'s.
There's nothing wrong with butter.
butter rules.
i love some butter, too, nothing against it. i am a southerner, after all. however, in the context of many commercial kitchens it is hugely overused, and not just for saute, either.
Quote from: Hicks on August 31, 2009, 12:10:12 PM
butter rules.
Butter and/or Olive oil.... the only way to go. Gotta go with the "anything in moderation" mentality.
when you make a sauce that starts w/ a pound or two of butter (as many do), then dunk all of the steaks in butter before they hit the plate (which tons of places do, its an old trick for poor cooks), then hit it w/ some of that sauce, and then put a potato (something else we dont do, potatoes) on the plate w/ butter and sour cream, and then some saute some veggies in butter...
you can see how it gets out of hand. i do love some butter, but its widely overused in many commercial applications.
granted, i cook primarily latin cuisine, which is lighter on the butter than more traditional (french) style cuisine.
Quote from: guyforget on August 31, 2009, 12:14:55 PM
when you make a sauce that starts w/ a pound or two of butter (as many do), then dunk all of the steaks in butter before they hit the plate (which tons of places do, its an old trick for poor cooks), then hit it w/ some of that sauce, and then put a potato (something else we dont do, potatoes) on the plate w/ butter and sour cream, and then some saute some veggies in butter...
I could feel my arteries clogging while I read that... yeah, one reason I buy steaks and cook them myself (with the excpetion of special occasions where we go to Churasco's or Fogo de Chao). Went to Outback steakhouse once. ugh - hollandaise all over everything! Now I'm hungry.... Thai food today!
Quote from: antelope19 on August 31, 2009, 11:56:02 AM
Interesting study by Forbes released today: Most medicated (determined by the rate of prescription drug use) states per capita:
10) Iowa
09) Mississippi
08) Louisiana
07) Kentucky
06) Missouri
05) Arkansas
04) Tennessee
03) South Carolina
02) Alabama
01) West Virginia
Quote
Dr. Jane Barlow, vice president of medical strategy and clinical quality for Medco Health Solutions ( MHS - news - people ), one of the nation's largest pharmacy benefit manager, says there's a reason these states use more medication: Their rates of heart disease, obesity and diabetes are higher than the national average, particularly in West Virginia.
:|
Every State except Iowa and Missouri are southern states... How strange...
Quote from: Hicks on August 26, 2009, 12:56:06 PM
I recommend reading the article by Matt Taibbi in the new Rolling Stone with the Beatles on the cover.
Once again he hits the nail on the head and exposes our leaders as the frauds they truly are and how big of a cluster-f this whole process of healthcare "reform" has become.
just read that.
good article - maddening stuff
the only way something worthwhile can happen is if Obama goes to the Hill and kicks some ass. don't think that will happen, and even if it does...
:|
why the f*ck do they keep having these town hall meetings and giving these as*holes a venue to scream and yell and make the news. the majority of the country wants reform and we just voted overwhelmingly as a country for 'change.' the public doesnt need the convincing.
Quote from: mirthbeatenworker on September 02, 2009, 07:43:09 PM
why the f*ck do they keep having these town hall meetings and giving these as*holes a venue to scream and yell and make the news. the majority of the country wants reform and we just voted overwhelmingly as a country for 'change.' the public doesnt need the convincing.
Exactly.
Quote from: slslbs on September 01, 2009, 11:17:13 PM
the only way something worthwhile can happen is if Obama goes to the Hill and kicks some ass. don't think that will happen, and even if it does...
:|
http://www.youtube.com/watch?v=fsP5dkNF38w
more of the classiest people in the country heckling disabled people
edited because i found it on youtube instead of that other site, which was pretty comical in itself...
Fried Butter. Now available w/ a side of angioplasty at the Texas State Fair. :shakehead: This could go in the other thread too...
(http://www.foxnews.com/images/559166/1_21_450_Butter.jpg)
Yes it's from moveon.org, but that doesn't mean it isn't funny. . .
or true.
http://pol.moveon.org/insurance_execs/?id=17291-3993370-Xq8uH.x&t=1
That was freaking hilarious. Good find.
insurance companies need to make big profits so they can afford to get their employees health insurance
that shits expensive
:-)
(http://images.huffingtonpost.com/gadgets/slideshows/2780/slide_2780_38633_large.jpg)
if anyone is interested in reading relatively apolitical discussions on health care reform written by people in the field, I believe these are availble w/o a subscription.
http://content.nejm.org/cgi/search?excludeflag=TWEEK_element&search_tab=collections&hits=20&fulltext=&COLLECTION_NUM=18
http://search.nejm.org/search?w=health+care+reform
a comment on the Baucus bill is here
http://healthcarereform.nejm.org/?p=1893&query=TOC
Quote from: slslbs on September 24, 2009, 08:46:32 AM
if anyone is interested in reading relatively apolitical discussions on health care reform written by people in the field, I believe these are availble w/o a subscription.
http://content.nejm.org/cgi/search?excludeflag=TWEEK_element&search_tab=collections&hits=20&fulltext=&COLLECTION_NUM=18
Thanks for the link, I'll check it out.
So Grassley who, earlier in the summer was in favor of the individual mandate is now against it.
ConservaDem Kent Conrad has just gone off a cliff.
QuoteLet me just conclude for my progressive friends who believe that the only answer to getting costs under control and having universal coverage is by a government-run program. I urge my colleagues to read the book by T.R. Reid, "The Healing of America."
I had the chance to read it this weekend. He looks at the health-care systems around the world. And what he found is in many countries they have universal coverage. They contain costs effectively. They have high-quality outcomes, in fact higher than ours. They're not government-run systems in Germany, in Japan, in Switzerland, in France, in Belgium -- all of them contain costs, have universal coverage, have very high quality care and yet are not government-run systems.
Ezra Klein @ the WashingtonPost comments on this :
QuoteGermany, Japan, Switzerland, France and Belgium have a level of government intrusion in their systems that would make the average tea partier retch. In France, for instance, the government provides all basic insurance coverage directly. In Germany, insurers aren't permitted to make a profit. In Japan, health insurance is publicly provided, and private insurance is available only to ease co-payments or cover services that the government leaves out. This stuff makes the shackled public plan look downright objectivist.
That said, I think France, Germany, and Japan offer excellent models, and their low costs, universal coverage, and impressive outcomes back up that contention. But they're not a rebuke to the progressives in this debate. They are confirmation of the argument that systems with more government-intervention offer lower costs and better outcomes. And either way, my sense is that Kent Conrad stands more firmly between this country and the French health-care system than does Barbara Boxer, but I'd certainly be glad to learn I was wrong on that.
jeez...
seems to me like these guys are probably responding to what they hear from their constituents at home (they want to get re-elected), and their constituents are responding to the propoganda they have heard from the opposition.
I just find it amazing and frustrating what people will do to see someone they don't agree with go down.
Is Rachel Maddow's show the most watchable thing on cable news? I think it might be.
(At least that's where I heard about Conrad's latest bout with blatant hypocrisy/ignorance...)
Quote from: rowjimmy on September 24, 2009, 11:05:49 AM
So Grassley who, earlier in the summer was in favor of the individual mandate is now against it.
ConservaDem Kent Conrad has just gone off a cliff.
QuoteLet me just conclude for my progressive friends who believe that the only answer to getting costs under control and having universal coverage is by a government-run program. I urge my colleagues to read the book by T.R. Reid, "The Healing of America."
I had the chance to read it this weekend. He looks at the health-care systems around the world. And what he found is in many countries they have universal coverage. They contain costs effectively. They have high-quality outcomes, in fact higher than ours. They're not government-run systems in Germany, in Japan, in Switzerland, in France, in Belgium -- all of them contain costs, have universal coverage, have very high quality care and yet are not government-run systems.
Ezra Klein @ the WashingtonPost comments on this :
QuoteGermany, Japan, Switzerland, France and Belgium have a level of government intrusion in their systems that would make the average tea partier retch. In France, for instance, the government provides all basic insurance coverage directly. In Germany, insurers aren't permitted to make a profit. In Japan, health insurance is publicly provided, and private insurance is available only to ease co-payments or cover services that the government leaves out. This stuff makes the shackled public plan look downright objectivist.
That said, I think France, Germany, and Japan offer excellent models, and their low costs, universal coverage, and impressive outcomes back up that contention. But they're not a rebuke to the progressives in this debate. They are confirmation of the argument that systems with more government-intervention offer lower costs and better outcomes. And either way, my sense is that Kent Conrad stands more firmly between this country and the French health-care system than does Barbara Boxer, but I'd certainly be glad to learn I was wrong on that.
jeez...
my guess is that nobody saw this, cause nobody watched the CBS evening news. anyway, they did a segment on the overuse of CT and MRI scans, how much it is costing the system, and the potential damage of excess radiation (from ct). I work with one of the guys interviewed (SB) - he told us that during the interview, he blamed fear of malpractice suits as part of the reason for overutilization of imaging and that malpractice reform is necessary. Guess how many times they mentioned the malpractice issue in the piece?
regardless, it's a decent spot.
http://www.cbsnews.com/video/watch/?id=5337981n&tag=related;photovideo
(if you guessed a number greater than zero, you would be wrong)
John Edwards probably doesn't like the sound of that!
then maybe he had something to do with the way CBS edited the interview.
Ha. He made his money on torts against Healthcare providers. All of his mullah is from malpractice suits.
Quote from: fauxpaxfauxreal on October 06, 2009, 10:28:22 AM
Ha. He made his money on torts against Healthcare providers. All of his mullah is from malpractice suits.
yup
"ambulance chaser in chief"
Quote from: slslbs on October 06, 2009, 10:40:22 AM
Quote from: fauxpaxfauxreal on October 06, 2009, 10:28:22 AM
Ha. He made his money on torts against Healthcare providers. All of his mullah is from malpractice suits.
yup
"ambulance chaser in chief"
Heh. Glad we have the cocaine snorter in chief instead.
Quote from: slslbs on October 06, 2009, 09:49:37 AM
my guess is that nobody saw this, cause nobody watched the CBS evening news. anyway, they did a segment on the overuse of CT and MRI scans, how much it is costing the system, and the potential damage of excess radiation (from ct). I work with one of the guys interviewed (SB) - he told us that during the interview, he blamed fear of malpractice suits as part of the reason for overutilization of imaging and that malpractice reform is necessary. Guess how many times they mentioned the malpractice issue in the piece?
regardless, it's a decent spot.
http://www.cbsnews.com/video/watch/?id=5337981n&tag=related;photovideo
(if you guessed a number greater than zero, you would be wrong)
I think the fear of malpractice is the main reason for a lot of unnecessary testing, not just imaging. Too many doctors, out of necessity, practice with the CYA (cover your ass) mentality. And it's not out of their own need to do so, but out of fear of malpractice suits, and the litigious society we live in.
Quote from: goodabouthood on October 06, 2009, 11:26:37 AM
Quote from: slslbs on October 06, 2009, 09:49:37 AM
my guess is that nobody saw this, cause nobody watched the CBS evening news. anyway, they did a segment on the overuse of CT and MRI scans, how much it is costing the system, and the potential damage of excess radiation (from ct). I work with one of the guys interviewed (SB) - he told us that during the interview, he blamed fear of malpractice suits as part of the reason for overutilization of imaging and that malpractice reform is necessary. Guess how many times they mentioned the malpractice issue in the piece?
regardless, it's a decent spot.
http://www.cbsnews.com/video/watch/?id=5337981n&tag=related;photovideo
(if you guessed a number greater than zero, you would be wrong)
I think the fear of malpractice is the main reason for a lot of unnecessary testing, not just imaging. Too many doctors, out of necessity, practice with the CYA (cover your ass) mentality. And it's not out of their own need to do so, but out of fear of malpractice suits, and the litigious society we live in.
The downside of limiting malpractice suit payouts, is that when and if a psychotic doctor does something truly fucked to one of his patients after the reform, then the recourse formerly afforded by the patient becomes unusable... leaving the patient high and dry and allowing the doctor to literally "get away with murder".
Perhaps the reform that is needed isn't by law or decree, but in a change of our own personal moral compasses.
Quote from: fauxpaxfauxreal on October 06, 2009, 11:28:47 AM
Quote from: goodabouthood on October 06, 2009, 11:26:37 AM
Quote from: slslbs on October 06, 2009, 09:49:37 AM
my guess is that nobody saw this, cause nobody watched the CBS evening news. anyway, they did a segment on the overuse of CT and MRI scans, how much it is costing the system, and the potential damage of excess radiation (from ct). I work with one of the guys interviewed (SB) - he told us that during the interview, he blamed fear of malpractice suits as part of the reason for overutilization of imaging and that malpractice reform is necessary. Guess how many times they mentioned the malpractice issue in the piece?
regardless, it's a decent spot.
http://www.cbsnews.com/video/watch/?id=5337981n&tag=related;photovideo
(if you guessed a number greater than zero, you would be wrong)
I think the fear of malpractice is the main reason for a lot of unnecessary testing, not just imaging. Too many doctors, out of necessity, practice with the CYA (cover your ass) mentality. And it's not out of their own need to do so, but out of fear of malpractice suits, and the litigious society we live in.
The downside of limiting malpractice suit payouts, is that when and if a psychotic doctor does something truly fucked to one of his patients after the reform, then the recourse formerly afforded by the patient becomes unusable... leaving the patient high and dry and allowing the doctor to literally "get away with murder".
Perhaps the reform that is needed isn't by law or decree, but in a change of our own personal moral compasses.
Certainly the last sentence is true.
Personally, I disagree with a proposed cap on payouts, because there are some unfortunate, major f-ups. If someone is truly negligent, then a suit is fair game.
That is not what's driving the system, imo. There are a TON of "nuisance" law suits that never see the light of day. I read that over 90% of malpractice suits get thrown out or won by the doc (including settlements) - unfortunately I can't find the reference. Even when there is no payout, a lawsuit costs the system a ton of money in legal fees, not to mention the human cost.
Short of changing a large portion of the populaton's mentality, having sort of a pre-trial board to decide if something has any merit would go a long way, imo.
also, in Michigan, there has been a "trial" of doctors "apologizing" for errors, coming up with some sort of equitable settlement up front, cutting off the whole trial process from the start. it seems to be working.
Quote from: slslbs on October 06, 2009, 12:11:55 PM
Quote from: fauxpaxfauxreal on October 06, 2009, 11:28:47 AM
Perhaps the reform that is needed isn't by law or decree, but in a change of our own personal moral compasses.
Certainly the last sentence is true.
Personally, I disagree with a proposed cap on payouts, because there are some unfortunate, major f-ups. If someone is truly negligent, then a suit is fair game.
That is not what's driving the system, imo. There are a TON of "nuisance" law suits that never see the light of day. I read that over 90% of malpractice suits get thrown out or won by the doc (including settlements) - unfortunately I can't find the reference. Even when there is no payout, a lawsuit costs the system a ton of money in legal fees, not to mention the human cost.
Short of changing a large portion of the populaton's mentality, having sort of a pre-trial board to decide if something has any merit would go a long way, imo.
also, in Michigan, there has been a "trial" of doctors "apologizing" for errors, coming up with some sort of equitable settlement up front, cutting off the whole trial process from the start. it seems to be working.
Yeah, fauxpas is right on with his last sentence, but as discussed elsewhere, and again mentioned in the highlighted portion of sls's response, changing a large portion of society's mentality simply isn't going to happen. The idea of pre-trial boards sounds like a damn good one and not one I had heard before. That would save time, money, and keep the threat of multimillion dollar lawsuits out of doc's minds thereby allowing them to practice a little more freely.
Quote from: slslbs on October 06, 2009, 12:11:55 PM
Quote from: fauxpaxfauxreal on October 06, 2009, 11:28:47 AM
Quote from: goodabouthood on October 06, 2009, 11:26:37 AM
Quote from: slslbs on October 06, 2009, 09:49:37 AM
my guess is that nobody saw this, cause nobody watched the CBS evening news. anyway, they did a segment on the overuse of CT and MRI scans, how much it is costing the system, and the potential damage of excess radiation (from ct). I work with one of the guys interviewed (SB) - he told us that during the interview, he blamed fear of malpractice suits as part of the reason for overutilization of imaging and that malpractice reform is necessary. Guess how many times they mentioned the malpractice issue in the piece?
regardless, it's a decent spot.
http://www.cbsnews.com/video/watch/?id=5337981n&tag=related;photovideo
(if you guessed a number greater than zero, you would be wrong)
I think the fear of malpractice is the main reason for a lot of unnecessary testing, not just imaging. Too many doctors, out of necessity, practice with the CYA (cover your ass) mentality. And it's not out of their own need to do so, but out of fear of malpractice suits, and the litigious society we live in.
The downside of limiting malpractice suit payouts, is that when and if a psychotic doctor does something truly fucked to one of his patients after the reform, then the recourse formerly afforded by the patient becomes unusable... leaving the patient high and dry and allowing the doctor to literally "get away with murder".
Perhaps the reform that is needed isn't by law or decree, but in a change of our own personal moral compasses.
Certainly the last sentence is true.
Personally, I disagree with a proposed cap on payouts, because there are some unfortunate, major f-ups. If someone is truly negligent, then a suit is fair game.
That is not what's driving the system, imo. There are a TON of "nuisance" law suits that never see the light of day. I read that over 90% of malpractice suits get thrown out or won by the doc (including settlements) - unfortunately I can't find the reference. Even when there is no payout, a lawsuit costs the system a ton of money in legal fees, not to mention the human cost.
Short of changing a large portion of the populaton's mentality, having sort of a pre-trial board to decide if something has any merit would go a long way, imo.
also, in Michigan, there has been a "trial" of doctors "apologizing" for errors, coming up with some sort of equitable settlement up front, cutting off the whole trial process from the start. it seems to be working.
"Most (73%) settled malpractice claims involve medical error. A 2006 study published in the New England Journal of Medicine concluded that claims without evidence of error "are not uncommon, but most [72%] are denied compensation. The vast majority of expenditures [54%] go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant." Physicians examined the records of 1452 closed malpractice claims. Ninety-seven percent were associated with injury; of them, 73% got compensation. Three percent of the claims were not associated with injuries; of them, 16% got compensation. 63% were associated with errors; of them, 73% got compensation (average $521,560). Thirty-seven percent were not associated with errors; of them, 28% got compensation (average $313,205). Claims not associated with errors accounted for 13 to 16% percent of the total costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including lawyers, experts, and courts). Claims involving errors accounted for 78 percent of administrative costs.
A 2006 follow-up to the 1999 Institute of Medicine study found that medication errors are among the most common medical mistakes, harming at least 1.5 million people every year. According to the study, 400,000 preventable drug-related injuries occur each year in hospitals, 800,000 in long-term care settings, and roughly 530,000 among Medicare recipients in outpatient clinics. The report stated that these are likely to be conservative estimates. In 2000 alone, the extra medical costs incurred by preventable drug related injuries approximated $887 million – and the study looked only at injuries sustained by Medicare recipients, a subset of clinic visitors. None of these figures take into account lost wages and productivity or other costs.
About 10 percent of the cost of medical services is linked to malpractice lawsuits and more intensive diagnostic testing due to defensive medicine, according to a January 2006 report prepared by Price Waterhouse Coopers LLP for the insurers' group America's Health Insurance Plans...The figures were taken from a March 2003 study by the U.S. Department of Health and Human Services that estimated the direct cost of medical malpractice was 2 percent of the nation's health-care spending and said defensive medical practices accounted for 5 percent to 9 percent of the overall expense."
I need to find a reference for the article I was referring to.
from the NEJM article cited above:
QuoteConclusions Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant.
even claims that are denied cost the system $
10 years ago, expert witnesses got paid $450 per hour, I'm sure they were billed out for more.
Edit - the number quoted above is for defense. my guess is plaintiff was much more lucrative. some people make their living off of it.
Obviously, ths is a 2 sided issue. if there were no errors, there would be fewer complaints. Health care would be better (and less expensive).
There has been a huge push the past several years to reduce them, in a number of ways. Checks and double checks have been instituted, a lot of energy has been spent and more is needed.
Other things that have been worked on the past several years by the professional societies are overall improvements in quality (which may increase or decrease cost, depending on what is being done, but will improve health care) and also improve efficiency and decrease overutilization.
Punishing legitimate claims because of the abuses of illegitimate claims is not how the system should work.
A cap on payouts could cause this result.
Therefore, I'm anit-caps.
If someone can show me a better way to ferret out illegitimate claims, I'd like you to tell me please.
Again, this is another problem that would most likely be solved with the elimination of poverty (in my opinion, of course).
Elimination of poverty does not eliminate greed.
Quote from: guyforget on October 07, 2009, 11:17:07 AM
Elimination of poverty does not eliminate greed.
No, but greed would hopefully follow shortly thereafter. As poverty is eliminated, societies tolerance for greed would also be diminished. You would have a lot less sympathetic juries willing to award money from big corps to "innocent victims" when the evidence is almost blaring that whoever is being sued is not at fault. You'd be surprised as to how many jurors sympathetic to faux "victims" are just people who feel jilted by the system.
A.) Im not buying that.
B.) A lot of sls's point is that once these matters make it into the system, its already money lost. So whether or not juries award the money is only part of the problem, once a frivolous suit makes it to a jury its already cost too much.
Quote from: guyforget on October 07, 2009, 11:32:35 AM
A.) Im not buying that.
B.) A lot of sls's point is that once these matters make it into the system, its already money lost. So whether or not juries award the money is only part of the problem, once a frivolous suit makes it to a jury its already cost too much.
There could be a law added that plaintiff's in malpractice suits who fail to substantiate their claims would be liable for the defendants legal fees.
I'd feel this addresses your B concern.
Agree to disagree on A...I don't have time to argue it with you. I think you are underestimating the effect the existance of poverty in our current system causes throughout our entire society, as I'm sure you feel that I am overestimating the effect.
The most greedy people are often the most wealthy.
I dont see how ending poverty will end greed, they are mutually exclusive. IMHO.
Quote from: guyforget on October 07, 2009, 12:00:21 PM
The most greedy people are often the most wealthy.
I dont see how ending poverty will end greed, they are mutually exclusive. IMHO.
I disagree with the first statement. I think the said could be said about the impoverished as well.
I've met plenty from both sides of the coin in my day, and I think when all is said and done, people are people... they have the same emotions, trappings and shortcomings regardless of what your economic status is. I've met some nasty greedy homeless people, and I've met people with obscene amounts of money who were absolute Saints. I totally can relate to your perspective on that, however, because I have totally often felt the same way. I believe differently, however.
That might be one of the most naive things Ive ever read.
I guess your faith in humanity might be noble...
But I think its incredibly naive.
If you think that the most greedy people in this country are not also those with the most wealth and power, have you been paying attention for the past 2 years through this financial meltdown? Have you been paying attention to the basis of this entire healthcare debate?
Hell, have you been paying attention to the history of nearly every society ever instilled upon this earth?
Im not talking about your rich neighbor, the guy who may donate a significant portion of his extra income to his church or whatever. Im talking about the people who hold the keys to the economy of the country, and the world. The people who keep the rich getting rich and the poor getting poor.
Its not even worth the debate because what you said above is entirely nonsensical.
I disagree. I've seen the homeless act entirely greedy and selfish when dealing with others. Perhaps they don't have the mechanism or ability to fully activate that greed, but they do possess the greed itself. Just because you are greedy, doesn't mean you actually possess much materially, it just means you are a greedy, selfish person.
Also, Guy, the nobility can be just as Philanthropic as they are Greedy. Just because someone is in control of resources, does not automatically make them corrupt.
It takes as much Faith in humanity to believe someone to be inherently bad as it does to believe them to be inherently good. I think that assuming one extreme is as naive as assuming the other extreme. I don't believe all impoverished people are greedy, just like I hope you don't believe all of those in control of large corporations are either.
I never put all of my eggs in one basket.
Quote from: guyforget on October 07, 2009, 12:00:21 PM
The most greedy people are often the most wealthy.
OFTENYoure missing my point. I never said that impoverished people cant also be "greedy."
What I said was: Ending poverty will not end greed. Plain and simple. To argue otherwise is not only baseless, but its also naive.
Quote from: guyforget on October 07, 2009, 12:00:21 PM
The most greedy people are often the most wealthy.
I really dont see how, or even why, anyone would dispute that, besides that maybe they just like to be contrary in certain discussions.
Quote from: guyforget on October 07, 2009, 06:41:08 PM
I never put all of my eggs in one basket.
Quote from: guyforget on October 07, 2009, 12:00:21 PM
The most greedy people are often the most wealthy.
OFTEN
Youre missing my point. I never said that impoverished people cant also be "greedy."
What I said was: Ending poverty will not end greed. Plain and simple. To argue otherwise is not only baseless, but its also naive.
Quote from: guyforget on October 07, 2009, 12:00:21 PM
The most greedy people are often the most wealthy.
I really dont see how, or even why, anyone would dispute that, besides that maybe they just like to be contrary in certain discussions.
I stand corrected, I thought you meant 'The majority of greedy people are the most wealthy" I misread. That statement is what I was disagreeing with. The way I read what you wrote was that "Out of all of the people who are greedy in the world, most of them are wealthy".
Keith Olbermann last night dedicated his entire program to a special comment on Health Care.
It's pretty impressive.
Here is the audio podcast:
http://www.sendspace.com/file/b1nluw
video, here:
http://www.msnbc.msn.com/id/3036677/vp/33217642#33217642
thanks
Infant denied coverage due to pre-existing condition.
http://www.nbc11news.com/localnews/headlines/63813127.html
Say wha?
edit:
I guess it's not technically a pre-existing condition. But what else do you call a baby that's growing too big too fast? Just stupid.
What is most shocking is how they insurance guy lies and says that the industry is leaning towards reform.
Well they are leaning toward reform.
The type of "reform" where everyone is required to buy a piece of shit policy.
Quote from: rowjimmy on October 12, 2009, 08:32:45 PM
What is most shocking is how they insurance guy lies and says that the industry is leaning towards reform.
shocking?
not really
other adjectives apply
Yeah. I guess I'm not shocked by the spin...
Disgusted?
Yep.
As a coda to that story I linked, apparently the CEO of Rocky Mtn Health made a press release stating that they were changing their underwriting rules to cover all healthy infants, regardless of statistical black magic re: size/weight/age charts.
It took a viral "Rocky Mtn Baby Killerz" internet campaign to get their attention, so I'm not sure they get full credit for it. But I suppose that even "CYA" change is better than callous indifference.
Latest development, per Politico:
Snowe (R-ME) announces support for some version or other of Baucus Bill. MEaning the Senate Finance Cmmte, finally, will belch out something health related and the whole sorry process will move on to the Senate floor.
In all seriousness, this is probably good news for everyone except progressives who want single-payer or nothing and their unlikely hard-right allies, who just want nothing.
that is good news.'
I have a lot of respect for Olympia Snow - not just 'cause of this.
the Baucus bill is clearly flawed, but is a good starting point, imo
the big challenge is how to realistically reduce costs, or at least prevent them from rising as fast as they are.
I'd prefer Single-payer but I feel a public option is a must.
These "exchanges" are bullshit and have not worked on the state level in the past.
For folks with 11:00 to spare, and don't feel like listening to a 3.0 Possum, may I suggest John Stewart's utter evisceration :samurai: of CNN. Of course, it's healthcare related:
http://www.thedailyshow.com/watch/mon-october-12-2009/cnn-leaves-it-there
Awesome. As usual.
thanks - will check it out at home
Quote from: rowjimmy on October 13, 2009, 02:18:36 PM
I'd prefer Single-payer but I feel a public option is a must.
These "exchanges" are bullshit and have not worked on the state level in the past.
QFT
Quote from: Alumni on October 13, 2009, 02:26:26 PM
For folks with 11:00 to spare, and don't feel like listening to a 3.0 Possum, may I suggest John Stewart's utter evisceration :samurai: of CNN. Of course, it's healthcare related:
http://www.thedailyshow.com/watch/mon-october-12-2009/cnn-leaves-it-there
that was awesome
Quote from: slslbs on October 13, 2009, 09:17:48 PM
Quote from: Alumni on October 13, 2009, 02:26:26 PM
For folks with 11:00 to spare, and don't feel like listening to a 3.0 Possum, may I suggest John Stewart's utter evisceration :samurai: of CNN. Of course, it's healthcare related:
http://www.thedailyshow.com/watch/mon-october-12-2009/cnn-leaves-it-there
that was awesome
Yes!! absolute quality stuff... and now in more important matters... Just how many woman did David Letterman sleep with?? fact check please...
Quote from: slslbs on October 13, 2009, 09:17:48 PM
Quote from: Alumni on October 13, 2009, 02:26:26 PM
For folks with 11:00 to spare, and don't feel like listening to a 3.0 Possum, may I suggest John Stewart's utter evisceration :samurai: of CNN. Of course, it's healthcare related:
http://www.thedailyshow.com/watch/mon-october-12-2009/cnn-leaves-it-there
that was awesome
Finally watched this. Good work as usual.
I just wanted to let Sophist know that the other day there was a doctor talking about the supply of doctors and how it differs in rural and urban areas and how that effects the economics of the different health care systems in those areas...and I thought it was enlightening.
Apparently Supply only truly effects the health care economy when it is in short supply, however when supply outweighs demand...the doctors just order more tests and procedures to make up for it. I found that take interesting.
Quote from: fauxpaxfauxreal on October 15, 2009, 07:55:51 PM
I just wanted to let Sophist know that the other day there was a doctor talking about the supply of doctors and how it differs in rural and urban areas and how that effects the economics of the different health care systems in those areas...and I thought it was enlightening.
Apparently Supply only truly effects the health care economy when it is in short supply, however when supply outweighs demand...the doctors just order more tests and procedures to make up for it. I found that take interesting.
Thanks. That is interesting.
Quote from: Sophist on October 16, 2009, 08:15:07 AM
Quote from: fauxpaxfauxreal on October 15, 2009, 07:55:51 PM
I just wanted to let Sophist know that the other day there was a doctor talking about the supply of doctors and how it differs in rural and urban areas and how that effects the economics of the different health care systems in those areas...and I thought it was enlightening.
Apparently Supply only truly effects the health care economy when it is in short supply, however when supply outweighs demand...the doctors just order more tests and procedures to make up for it. I found that take interesting.
Thanks. That is interesting.
This American Life'd (http://www.thisamericanlife.org/Radio_Episode.aspx?episode=391)
Quote from: fauxpaxfauxreal on October 15, 2009, 07:55:51 PM
I just wanted to let Sophist know that the other day there was a doctor talking about the supply of doctors and how it differs in rural and urban areas and how that effects the economics of the different health care systems in those areas...and I thought it was enlightening.
Apparently Supply only truly effects the health care economy when it is in short supply, however when supply outweighs demand...the doctors just order more tests and procedures to make up for it. I found that take interesting.
that is probably true for some, but to paint all doctors with that brush is unfair and inappropriate.
I have no doubt that there is over-utilization done in the name of billing. Much of the over-utilization that I see is done by well meaning doctors who don't profit at all from the unnecessary tests that they order, for example a primary care doc ordering unnecessary CAT scans or stress tests. He / she doesn't profit at all from those tests.
regardless of motive, we need to decrease over-utilization. reducing reimbursement rates won't do it, and, in many circumstances, is penalizing the wrong party. we need to educate docs about when and what to order (efforts have been underway for several years - it's a long process). Part of insurance companies asking for prior approval is aimed at this. It's a pain in the ass, but the efforts are, in many cases, not inappropriate. And, we need to stop the abuses that faux mentioned.
Some approaches to fix it are innapropriate, imo. For instance, CMS (the gov't agency that runs Medicare) and the Baucus committee looked at the 2 most costly areas - oncology and cardiology. They decided that we need to reduce spending in those areas and chopped reimbursement. The 2 most common causes of death in the US are -
you guessed it- cancer and heart disease. There is a reason those are the 2 most costly areas of health care. Doesn't make much sense to me, or the WSJ editorial, to make blanket cuts there. What they're doing is kinda like what a HS student does to fudge chem lab - it knows the answer it wants and does something simple and mindless to get there.
(disclaimer - conflict of interest)
Quote from: rowjimmy on October 16, 2009, 08:43:17 AM
Quote from: Sophist on October 16, 2009, 08:15:07 AM
Quote from: fauxpaxfauxreal on October 15, 2009, 07:55:51 PM
I just wanted to let Sophist know that the other day there was a doctor talking about the supply of doctors and how it differs in rural and urban areas and how that effects the economics of the different health care systems in those areas...and I thought it was enlightening.
Apparently Supply only truly effects the health care economy when it is in short supply, however when supply outweighs demand...the doctors just order more tests and procedures to make up for it. I found that take interesting.
Thanks. That is interesting.
This American Life'd (http://www.thisamericanlife.org/Radio_Episode.aspx?episode=391)
Thanks RJ. That is exactly where I heard it. I knew it was on NPR, and I didn't properly cite it in my poorly worded post.
I think this is the single best thing I've read about realistically fixing the health care system. Patients get good care, people get well paid, and the incentives are in the right place.
http://www.time.com/time/magazine/article/0,9171,1930501,00.html
New ABC poll, Support for Public Option, sampling error +/- 3%.
August
52% Favor
46% Oppose
Now
57% Favor
40% Oppose
IMO, this is really good news. Without the public option, you essentially derive impotent policy from a bill that solves very little, exactly what the Republican leadership and insurance lobby are after. For, without the public option, the inevitable failures that would ensue would only serve as canon fodder come 2012.
Have any of you seen the figures pertaining to the amount spent by the insurance lobby since the fighting over this overhaul began? Last figure I saw bandied about was somewhere around 275 million. So who do you think is really going to lose if health care overhaul passes, the people or the insurance companies? :lol:
interesting.
Dave Axelrod was on GS Sunday AM talk show. He claims that in the mid 90s, 95% of premiums went into health care. Now, only about 80 - 85% of premiums go into health care. Guess where that extra 10 -15% (of a larger pie) is going?
sounds like a little old fashion competition is in order. These guys are exempt from anti - trust. McCain's idea about being able to buy insurance across state lines could also potentially increase competition as well.
to me, the interesting thing is how big a deal is being made by the public option - it will either save health care or ruin it, depending on who is speaking. My understanding is that the only people who would be eligible are those with incomes below a certain level who don't have employer provided insurance. Estimates are this is somewhere about 4% of the population.
All I know is that each year, after my annual review, I am presented with the figures for my salary and "other compensation". Factored into the "other compensation" is the cost of my health and other benefits.
Guess which row has seen the most growth in the past five years?
The Health Benefit line, of course.
If they weren't paying so much (and more each year) for my health benefits, I might could see a bit of that money come home to my family.
Plus the firm could more likely afford to add staff where needed which equals more jobs.
Which equals economic growth.
Which leads to fewer people on welfare & such.
/just sayin'
Quote from: slslbs on October 20, 2009, 09:39:35 AM
interesting.
Dave Axelrod was on GS Sunday AM talk show. He claims that in the mid 90s, 95% of premiums went into health care. Now, only about 80 - 85% of premiums go into health care. Guess where that extra 10 -15% (of a larger pie) is going?
sounds like a little old fashion competition is in order. These guys are exempt from anti - trust. McCain's idea about being able to buy insurance across state lines could also potentially increase competition as well.
to me, the interesting thing is how big a deal is being made by the public option - it will either save health care or ruin it, depending on who is speaking. My understanding is that the only people who would be eligible are those with incomes below a certain level who don't have employer provided insurance. Estimates are this is somewhere about 4% of the population.
Here is my Coles notes reason, please don't take me to task on it as I have to get some real work done today and can not get caught in a paug debate :lol:
A public option is so incredibly important because it will finally establish a national price scale. The greatest problem with the US system is that the prices are not set according to true market forces for reasons such as one insurance company having a monopoly over an entire state, or a couple insurance companies setting prices in collusion (yes, this is illegal but do you really think this is not what is happening right now, why would premiums be increasing four times faster than the annual rate of inflation. Keep in mind, what McCain proposed about doing away with state lines, while increasing competition would not solve anything if the collusion I just mentioned was in play). By having a private option, all of a sudden you create a national pricing index against which private companies can push and the public can balance. In a roundabout way, by providing coverage for the poor, it will prevent gross insurance surcharges for everyone. This is why the insurance companies are spending millions to prevent this, their huge profit margins will be exposed and vanish. This is why these poor and middle class people who argue against it at town halls don't have a fucking clue what they are doing. Unless you are wealthy, you should be jumping up and down for a public option, regardless of whether you directly benefit. Is it fair the insurance companies should be setting prices according to the government competition? Not necessarily, but as I said, true market forces are not being allowed influence in the present system, so there is no other option but government intervention to create fairness for the consumer.
Not sure if this makes sense. I'm busy but maybe I will return later to clarify some things.
Quote from: rowjimmy on October 20, 2009, 09:55:00 AM
All I know is that each year, after my annual review, I am presented with the figures for my salary and "other compensation". Factored into the "other compensation" is the cost of my health and other benefits.
Guess which row has seen the most growth in the past five years?
The Health Benefit line, of course.
If they weren't paying so much (and more each year) for my health benefits, I might could see a bit of that money come home to my family.
Plus the firm could more likely afford to add staff where needed which equals more jobs.
Which equals economic growth.
Which leads to fewer people on welfare & such.
/just sayin'
exactly
Quote from: Superfreakie on October 20, 2009, 10:22:13 AM
Here is my Coles notes reason, please don't take me to task on it as I have to get some real work done today and can not get caught in a paug debate :lol:
A public option is so incredibly important because it will finally establish a national price scale. The greatest problem with the US system is that the prices are not set according to true market forces for reasons such as one insurance company having a monopoly over an entire state, or a couple insurance companies setting prices in collusion (yes, this is illegal but do you really think this is not what is happening right now, why would premiums be increasing four times faster than the annual rate of inflation. Keep in mind, what McCain proposed about doing away with state lines, while increasing competition would not solve anything if the collusion I just mentioned was in play). By having a private option, all of a sudden you create a national pricing index against which private companies can push and the public can balance. In a roundabout way, by providing coverage for the poor, it will prevent gross insurance surcharges for everyone. This is why the insurance companies are spending millions to prevent this, their huge profit margins will be exposed and vanish. This is why these poor and middle class people who argue against it at town halls don't have a fucking clue what they are doing. Unless you are wealthy, you should be jumping up and down for a public option, regardless of whether you directly benefit. Is it fair the insurance companies should be setting prices according to the government competition? Not necessarily, but as I said, true market forces are not being allowed influence in the present system, so there is no other option but government intervention to create fairness for the consumer.
Not sure if this makes sense. I'm busy but maybe I will return later to clarify some things.
makes sense. the insurance system, while competitive in parts of the country (like New England) is not competitive at all in much of the country. It is my impression that most of the abuses take place where the insurance is least competitive, but I have no data to back that up.
so - we need more competition. honest competition, without collusion.
I agree, it seems like the people screaming the loudest against the public option are the people who will benefit most (not counting Congressmen in that).
My issues regarding the public option is that
1)as I understand it, very few people will be affected by it. It will impact those people who don't have insurance (positively I suspect) but I don't see it as the cure-all or wrecking ball to the system, as people will argue
2) the govt has a track record for underfunding some things, like Medicare, and paying waaaay too much for other things, like defense contracts. The Medicare reimbursement system is flawed on many levels. Forgive me if I'm repeating myself, but Mayo clinic, reportedly one of the most efficient (economically) and high quality systems in the US, also is reportedly losing money on their Medicare patients. With or without a public option, the reimbursement system needs to be fixed - paying appropriately for required services and discouraging (or not paying for) unnecessary / redundant services. The drug and equipment companies and the liability system all need to be put in line with reality, too.
Quote from: slslbs on October 20, 2009, 10:54:11 AM
My issues regarding the public option is that
1)as I understand it, very few people will be affected by it. It will impact those people who don't have insurance (positively I suspect) but I don't see it as the cure-all or wrecking ball to the system, as people will argue
2) the govt has a track record for underfunding some things, like Medicare, and paying waaaay too much for other things, like defense contracts.
Answers
1) Here is the best way to explain public option. The government comes in and says that, after much research (not funded by insurance companies), a heart by-pass will cost 1000$. Then there is an insurance company somewhere that is trying to put together a plan for middle class clients and on it they decide to write that, after their research, the cost of a by-pass is 10,000$. Well, then the middle class clients go "how is that possible, the govt says it can do it for a 1000$". Then the insurance company goes ooops our bad, we will charge 2000$, a thousand more but you get some bells and whistles.
2) Govt like business requires proper oversight. Each fails without it as they suffer the same problems, save one being slightly more concerned about profit margin.
right - but the gov't has gotten it wrong so many times. The way CMS decides on what to pay for something is they see what they are paying the most money for and decide it's too much, then say it should be less. It seems as if they know the answer they want and find a way to get it (see my post from a few days ago or the WSJ editorial here http://online.wsj.com/article/SB10001424052748704471504574443472658898710.html)
I'm not against the concept of a public option, and I don't inherently mistrust the gov't, but I don't inherently trust them either. If they get it wrong, it literally takes an act of Congress to fix it.
Other things have to change as well for this to work - the CER they are proposing is a good idea. It's just more complex, imo than public option or not.
Even with single payer systems, Canada and W Europe are wrestling with containing health care costs
Quote from: slslbs on October 20, 2009, 12:08:07 PM
Even with single payer systems, Canada and W Europe are wrestling with containing health care costs
IMO this is what health care should be. Personally, I favor the single payer with a possible private option, a hybrid like in France but, as you mention, there are troubles containing costs. However, this burden must be shouldered by all if you believe in some permutation of social morality. It is harder to sell this in a country such as the United States which is founded on the bastion of individualism. In Europe, health care is an inherent cost that society must bear because it is a moral duty. For relinquishing some of your individual rights to join society, your participation is rewarded with health care and other protections such as the rule of law. And yes, maybe you pay more taxes, but you know what, you are better off than most other societies on earth, be satisfied.
Lollerz. American morality.
Quote from: Superfreakie on October 20, 2009, 12:57:41 PM
Quote from: slslbs on October 20, 2009, 12:08:07 PM
Even with single payer systems, Canada and W Europe are wrestling with containing health care costs
IMO this is what health care should be. Personally, I favor the single payer with a possible private option, a hybrid like in France but, as you mention, there are troubles containing costs. However, this burden must be shouldered by all if you believe in some permutation of social morality. It is harder to sell this in a country such as the United States which is founded on the bastion of individualism. In Europe, health care is an inherent cost that society must bear because it is a moral duty. For relinquishing some of your individual rights to join society, your participation is rewarded with health care and other protections such as the rule of law.
once again, no problem with that, either. I suspect you and I are on the same side of the argument, just to different degrees.
To clarify, I think everyone has the right to coverage.
A true "free market" system won't / can't / hasn't worked imo.
I guess the point I'm trying to make is that we need to keep our eyes open, there is more than one thing that needs to be fixed, a "public option" or single payer system doesn't make all the other problems go away, and if done improperly, could make it worse.
Also, the public option covers a failure of the measure by those who would not be able to afford health care, but would be required (by law) to purchase it. I thought it was shady that they were mandating that everyone in the nation buy healthcare, which in turn mandates that everyone in the nation possess money without actually mandating that everyone in the nation has access to money.
yes, true.
the same could be accomplished by subsidized pvt insurance or by expanding Medicaid, which already exists.
not disagreeing with you, just playing :evil: advocate
Oh, yeah, totally. The way the Baucus bill sounds is that you buy insurance or you pay a fine. If you don't have money for insurance, do you have money to pay the fine? Probably not. "Who cares for those people", you ask? "We all should", is my answer.
Quote from: slslbs on October 20, 2009, 01:06:22 PM
Quote from: Superfreakie on October 20, 2009, 12:57:41 PM
Quote from: slslbs on October 20, 2009, 12:08:07 PM
Even with single payer systems, Canada and W Europe are wrestling with containing health care costs
IMO this is what health care should be. Personally, I favor the single payer with a possible private option, a hybrid like in France but, as you mention, there are troubles containing costs. However, this burden must be shouldered by all if you believe in some permutation of social morality. It is harder to sell this in a country such as the United States which is founded on the bastion of individualism. In Europe, health care is an inherent cost that society must bear because it is a moral duty. For relinquishing some of your individual rights to join society, your participation is rewarded with health care and other protections such as the rule of law.
once again, no problem with that, either. I suspect you and I are on the same side of the argument, just to different degrees.
To clarify, I think everyone has the right to coverage.
A true "free market" system won't / can't / hasn't worked imo.
I guess the point I'm trying to make is that we need to keep our eyes open, there is more than one thing that needs to be fixed, a "public option" or single payer system doesn't make all the other problems go away, and if done improperly, could make it worse.
Tax the rich and get them to pay for it. But that's socialism :wink:
Quote from: fauxpaxfauxreal on October 20, 2009, 01:25:57 PM
Oh, yeah, totally. The way the Baucus bill sounds is that you buy insurance or you pay a fine. If you don't have money for insurance, do you have money to pay the fine? Probably not. "Who cares for those people", you ask? "We all should", is my answer.
in theory, anyone who can't afford insurance will have some or all of it covered by gov't funds.
in practice, the question is where you draw the lines
and, yes, we all should care
I agree a hundred and ten percent. Of course lines should never have had to be drawn. If people got into business for moralistic reasons as opposed to antimoralistic greedy reasons, I think the free market would work, and thusly, the private health care system would work. I'd have to say that while termed a "free market", our current marketplace is more like corporate piracy than a truly "free market".
No comments on the house bill that passed this weekend? Anyone think it'll get through the senate? From what I am reading, it doesn't look like it will.
Quote from: antelope19 on November 09, 2009, 01:08:27 PM
No comments on the house bill that passed this weekend? Anyone think it'll get through the senate? From what I am reading, it doesn't look like it will.
I'm getting the same feeling from what I've read in today's paper... It looks like they will water it down more to the point it will be nearly pointless and the bill will fail miserably because it will not contain enough teeth to bite through major insurance companies grip and health insurance costs will continue to increase and so will the costs of hospital visits and so will the cost of pharmaceuticals...
Quote from: antelope19 on November 09, 2009, 01:08:27 PM
No comments on the house bill that passed this weekend? Anyone think it'll get through the senate? From what I am reading, it doesn't look like it will.
I don't like the fact that they killed abortion funding for those most likely to use abortions (the lower classes).
Also: There is little chance this will pass the three votes to come. It passed with a TINY margin in the House, which has a sizable democratic majority. If it does pass the Senate, I think the compromise bill will definitely not repass in the House. Also, the fact that they had the final debate and vote on a Saturday probably had a great deal to do with it passing. There is always a higher chance of getting a vote to go through when you are in a "special session".
by no means a perfect bill, but, considering what we have now, not bad.
I doubt the Senate will pass a bill with a public option.
Frankly, I don't get it. Only 4% of the population would even qualify for a public option, the way it is written now. Hardly seems like it is "a road to government takeover of health care".
Lieberman (who I respect, in general) is getting on my nerves more and more over time.
Quote from: slslbs on November 09, 2009, 06:10:53 PM
by no means a perfect bill, but, considering what we have now, not bad.
I doubt the Senate will pass a bill with a public option.
Frankly, I don't get it. Only 4% of the population would even qualify for a public option, the way it is written now. Hardly seems like it is "a road to government takeover of health care".
Lieberman (who I respect, in general) is getting on my nerves more and more over time.
It's the lobby system. These dooders are getting PIZZAID (and maybe even intimidated physically) to not pass real health care reform. This is the way the system we have works. Especially because most of us have the attitude that this is "just the way it works". We are all to blame for our collective laziness and inability to tackle tough issues head on.
Quote from: slslbs on November 09, 2009, 06:10:53 PM
Lieberman (who I respect, in general) is getting on my nerves more and more over time.
Wow, I am surprised you had an affinity towards him. I have found him to be the slimiest of the slimy snakes. So transparently self-serving, at times it makes me sick....then again most politicians do :-P
Quote from: fauxpaxfauxreal on November 09, 2009, 06:15:05 PM
Quote from: slslbs on November 09, 2009, 06:10:53 PM
by no means a perfect bill, but, considering what we have now, not bad.
I doubt the Senate will pass a bill with a public option.
Frankly, I don't get it. Only 4% of the population would even qualify for a public option, the way it is written now. Hardly seems like it is "a road to government takeover of health care".
Lieberman (who I respect, in general) is getting on my nerves more and more over time.
It's the lobby system. These dooders are getting PIZZAID (and maybe even intimidated physically) to not pass real health care reform. This is the way the system we have works. Especially because most of us have the attitude that this is "just the way it works". We are all to blame for our collective laziness and inability to tackle tough issues head on.
The United States is suffering from a severe democratic deficit that stems from those lobbying moneys needed to fund electoral campaigns. Take a quick glance at last week's mayoral, governor and district elections, and the incomprehensible amount of money spent on the campaigns. And the solution is simple extremely simple; the US should have publicly funded elections. It would immediately cut a tremendous amount of corruption and return a significant portion of the US back to the people.......
Wait, SF...
Are you saying it *shouldn't* cost one hundred million dollars to win the NYC mayoral election? :crazy:
Quote from: Superfreakie on November 10, 2009, 04:23:59 PM
Quote from: slslbs on November 09, 2009, 06:10:53 PM
Lieberman (who I respect, in general) is getting on my nerves more and more over time.
Wow, I am surprised you had an affinity towards him. I have found him to be the slimiest of the slimy snakes. So transparently self-serving, at times it makes me sick....
Agreed, what a slimeball.
Quote from: Hicks on November 10, 2009, 05:45:08 PM
Quote from: Superfreakie on November 10, 2009, 04:23:59 PM
Quote from: slslbs on November 09, 2009, 06:10:53 PM
Lieberman (who I respect, in general) is getting on my nerves more and more over time.
Wow, I am surprised you had an affinity towards him. I have found him to be the slimiest of the slimy snakes. So transparently self-serving, at times it makes me sick....
Agreed, what a slimeball.
Third'd
Dude is on my folding chair list.
I guess my liking him dates back to the campaign of 2000.
The past 2 years or so, it's an entirely different story.
I'm of the opinion that Gore may have picked up a Southern state or two without Lieberman on the ticket.
"If every Deadhead in Florida voted in 2000, the world would be a different place now"
Bob Weir, October, 2008
Quote from: slslbs on November 10, 2009, 09:24:28 PM
"If every Deadhead in Florida voted in 2000, the world would be a different place now"
Bob Weir, October, 2008
I hear ya, no sense in wishing the past had been different.
Quote from: Superfreakie on November 10, 2009, 04:32:47 PM
Quote from: fauxpaxfauxreal on November 09, 2009, 06:15:05 PM
Quote from: slslbs on November 09, 2009, 06:10:53 PM
by no means a perfect bill, but, considering what we have now, not bad.
I doubt the Senate will pass a bill with a public option.
Frankly, I don't get it. Only 4% of the population would even qualify for a public option, the way it is written now. Hardly seems like it is "a road to government takeover of health care".
Lieberman (who I respect, in general) is getting on my nerves more and more over time.
It's the lobby system. These dooders are getting PIZZAID (and maybe even intimidated physically) to not pass real health care reform. This is the way the system we have works. Especially because most of us have the attitude that this is "just the way it works". We are all to blame for our collective laziness and inability to tackle tough issues head on.
The United States is suffering from a severe democratic deficit that stems from those lobbying moneys needed to fund electoral campaigns. Take a quick glance at last week's mayoral, governor and district elections, and the incomprehensible amount of money spent on the campaigns. And the solution is simple extremely simple; the US should have publicly funded elections. It would immediately cut a tremendous amount of corruption and return a significant portion of the US back to the people.......
Remember when Barack Obama vowed to only take public funding for the Presidential election, and then McCain agreed?
Oh yeah, thank you Mr. President.
More Jon Stewart awesomeness.
Health care link: exposing the congenital exaggerators liars involved in Faux News' coverage of health care protests.
http://www.thedailyshow.com/watch/tue-november-10-2009/sean-hannity-uses-glenn-beck-s-protest-footage
this will never pass the senate, its really too bad, our system is beyond fucked up
i had a kydney stone around a month ago which lasted around 10 brutal days. i have pretty good individual plan with $1000 ded., 20% C.P, that my employer pays $200 for. i had one E.R visit with plenty of Dilaudid :-D, an xray, a bunch of percocet :-P, a few doc visits, some tests, blood work, a strainer and thats about it.
i just got over $2000 in bills that I have to pay....after my insurance has paid and with adjustments. wtf? a kydney stone is worth that much, man i got had, they are laughin all the way to the bank, but shiiiiiiiiit, next time fuck the doc, i will just get my neighbor to write me another percocet and call it good. how can anyone afford a bill like that, right before MSG, i mean, right before Christmas?
Quote from: whatapiper on November 13, 2009, 01:41:35 AM
how can anyone afford a bill like that, right before MSG, i mean, right before Christmas?
I can see Whatapiper calling the collections dept. at the hospital right now.
Voice: Hello, county medical collection, how may I help you?
Whatapiper: Yes, I have a bill here for 2,000 dollars from your hospital.
Voice: Ok, sir, what can I help you with?
Whatapiper: You do understand that Phish's three night stand at Madison Square Garden is rapidly approaching, don't you?
Voice: Wow, you are right. We will defer your bill for at least 6 months, we apologize for the inconvenience.
Whatapiper: Damn right.
Quote from: fauxpaxfauxreal on November 13, 2009, 02:15:04 PM
Quote from: whatapiper on November 13, 2009, 01:41:35 AM
how can anyone afford a bill like that, right before MSG, i mean, right before Christmas?
I can see Whatapiper calling the collections dept. at the hospital right now.
Voice: Hello, county medical collection, how may I help you?
Whatapiper: Yes, I have a bill here for 2,000 dollars from your hospital.
Voice: Ok, sir, what can I help you with?
Whatapiper: You do understand that Phish's three night stand at Madison Square Garden is rapidly approaching, don't you?
Voice: Wow, you are right. We will defer your bill for at least 6 months, we apologize for the inconvenience.
Whatapiper: Damn right.
Voice: and sir, given the events that have transpired, and will be occuring, do you need any more percocet?[/quote]
fyp
http://www.youtube.com/v/8vS6kIbJu64&color1=0xb1b1b1&color2=0xcfcfcf&hl=en_US&feature=player_embedded&fs=1
Lieberman is just a patsy.
He's the guy that the dems get to blame when they fail to do their jobs.
Quote from: fauxpaxfauxreal on December 19, 2009, 02:35:20 PM
Lieberman is just a patsy.
He's the guy that the dems get to blame when they fail to do their jobs.
Sure, that
sounds good, but you should elaborate. Plenty of Dem's pushed hard for the public option, then compromised w/ the trigger, then compromised yet again w/ medicare buy-in. And Leiberman but the kibosh on all of them.
Quote from: guyforget on December 19, 2009, 02:38:09 PM
Quote from: fauxpaxfauxreal on December 19, 2009, 02:35:20 PM
Lieberman is just a patsy.
He's the guy that the dems get to blame when they fail to do their jobs.
Sure, that sounds good, but you should elaborate. Plenty of Dem's pushed hard for the public option, then compromised w/ the trigger, then compromised yet again w/ medicare buy-in. And Leiberman but the kibosh on all of them.
Just remember, the Dems dumped Lieberman before Lieberman dumped the Dems. The level of "Theatre" in the Senate and the House has reached an all time high. You want Lieberman to stop being a douche now? Go back in time and support him throughout the 2000's.
To add: Until the democratic party takes responsibility for turning Lieberman into a monster, I don't think they have any fucking right to bitch about him or paint him negatively.
Pretty sure the voters dumped Lieberman from the Democratic party when he lost the primary.
Quote from: fauxpaxfauxreal on December 19, 2009, 02:41:08 PM
To add: Until the democratic party takes responsibility for turning Lieberman into a monster, I don't think they have any fucking right to bitch about him or paint him negatively.
He paints himself as a vigilante, vengeful asshole all on his own in my eyes...
edit: oops, forgot self serving...
Quote from: Hicks on December 19, 2009, 02:44:43 PM
Pretty sure the voters dumped Lieberman from the Democratic party when he lost the primary.
Which was caused by a lack of funding from the Democratic party and a lack of internal support from the Dems. You don't lose a primary unless your party is trying to kick you in the face. The Democrat Party done fucked up and fails to take responsibility for it.
Quote from: fauxpaxfauxreal on December 19, 2009, 02:46:30 PM
Which was caused by a lack of funding from the Democratic party and a lack of internal support from the Dems. You don't lose a primary unless your party is trying to kick you in the face. The Democrat Party done fucked up and fails to take responsibility for it.
Seriously?
I also seem to remember him being a couple of voter frauds away from being the Vice President...
Quote from: guyforget on December 19, 2009, 02:48:47 PM
Quote from: fauxpaxfauxreal on December 19, 2009, 02:46:30 PM
Which was caused by a lack of funding from the Democratic party and a lack of internal support from the Dems. You don't lose a primary unless your party is trying to kick you in the face. The Democrat Party done fucked up and fails to take responsibility for it.
Seriously?
I also seem to remember him being a couple of voter frauds away from being the Vice President...
Which makes the entire thing so egregious.
First of all, the Conneticut Dems should never have tried to take away his seat if he never wanted to give it up. It's a respect type of thing. The Dems gambled and lost-bigtime. Second of all, after that happened, the Dems should have apologized profusely and licked the hell out of his butthole. They didn't, and tried to paint him as some kind of Francis Bacon when really he's more like a guy that got fired from his job, ended up buying the company just to get his job back and was pissed when it was all done.
You guys arguing against this to me is symptomatic of the problem, you don't recognize that dOOder has good reason to be a thorn in the Dem's side.
By that logic he should have never won the general election since he was going up against the same Democratic funding once again.
In any case dude has been a Republican masquerading as a Dem or an independent since Bush's inauguration.
Tried is a lot different than did. Its bullshit political grudges, and not supporting your constituents, that make the Senate such a theatrical joke these days.
Its asinine either way, to think that him not getting the nomination in 2004 is somehow good reason to turn his back on the party, not to mention his constituents in a state that did support the public option according to the polls. Those constituents are who keep him at his post in the U.S. Senate.
If I lived in CT, Id vote for a 3-legged donkey before I voted for him again in the Senate.
Quote from: Hicks on December 19, 2009, 02:50:49 PM
By that logic he should have never won the general election since he was going up against the same Democratic funding once again.
In any case dude has been a Republican masquerading as a Dem or an independent since Bush's inauguration.
He's always been a centrist. That was part of his appeal as a Vice Presidential candidate. The Democratic party naturally assumed that he would steal votes away from Bush. This didn't happen, and the Democrats kind of blamed him for losing the 2000 presidential race. As time went on, the Democrats did not like that he continued to be a centrist. For some reason they felt as though putting him on the ballot was a favor to Lieberman, and opposed to being a favor for the Democratic party. Lieberman had felt all along that he was doing the party a favor by accepting the nomination. The rift begins until the Democratic Party as a whole and more specifically in Connecticut decide that they are not going to nominate him as their parties candidate for office. The party controls the nomination process. If the party does not want you to be nominated, they will not nominate you. It's a fact. The percentage of people who vote in Congressional nomination primaries is minute compared to the amount of people who vote in the actual election. Parties have way less control over the regular election than they do during the primary, especially since many Conn. Repubs seized the opportunity and increased their funding and support for Lieberman. I don't know how you can't realize that the Democrats fucked up in their handling of Lieberman, but they totally have. We totally have.
I fault us for trying to make the guy look like a shit head without owning our place in creating the monster.
Quote from: guyforget on December 19, 2009, 02:54:52 PM
Tried is a lot different than did. Its bullshit political grudges, and not supporting your constituents, that make the Senate such a theatrical joke these days.
Its asinine either way, to think that him not getting the nomination in 2004 is somehow good reason to turn his back on the party, not to mention his constituents in a state that did support the public option according to the polls. Those constituents are who keep him at his post in the U.S. Senate.
If I lived in CT, Id vote for a 3-legged donkey before I voted for him again in the Senate.
I agree 110 percent. The thing is Lieberman holds a lot of cards in Washington. Like him or not, the man is a crucial component of the senate. He's done a lot of good things for Connecticut and the amount of political capital that he possesses among his constituents is actually high. You might not support him, but many will, and that's a part of the conundrum we're in now. I personally don't like him, but I can't blame him. The thing about you first statement that you have to remember is that Lieberman is now doing to the party what he felt was done to him. That is how I feel we created this monster and now its just our own political karma come to bite us on the ass.
Quote from: Hicks on September 04, 2008, 11:52:30 AM
:roll: No Bush/McCain supporter is a democrat in my book. There's a reason that the democratic party didn't support that fraud last time around, he consistently votes to support the republican agenda.
Quote from: Hicks on December 19, 2009, 03:07:24 PM
Quote from: Hicks on September 04, 2008, 11:52:30 AM
:roll: No Bush/McCain supporter is a democrat in my book. There's a reason that the democratic party didn't support that fraud last time around, he consistently votes to support the republican agenda.
He never endorsed Bush. He campaigned for Kerry/Edwards. The reason he supported McCain in 2008 was because he was not supported in 2006 by the Democratic party.
How you can't see this is beyond me.
i just cant find a way to justify how a grown man who holds such an important position, could act with spite and vengeance. its not a mature reaction, despite whatever grudges he may hold. a senator is elected to represent the best interests of his constituents. his constituents in connecticut showed through polls that they supported the progressive health reform agenda, including a public option. he let them down, and regardless of how he may feel that he has been spited, by the senate, his state, or whomever, its an immature reaction that has a profound effect on all americans, including those whom have never spited him in the past.
I never said he endorsed Bush. He supported him by voting for every piece of shit legislation that the Republicans introduced between 2000-2006.
It's how politics works, sadly, Guy.
I agree, and I think it is time for the Democratic Party to "man up" and explain everything succinctly and rationally to those they serve.
Explain that "well, we got upset with Lieberman for being a part of the "Gang of 14" and stopping us from Filibustering Samuel Alito's supreme court nomination", and "we didn't like that he was Hawkish in the senate". "Our response in making it seem like Lieberman was upset for not getting the Presidential nomination in 2004 was totally wrong, and we acted childish when we tried to make it seem like Lieberman was upset over something so trivial, because he never was". "We should have endorsed Lieberman in 2006". Then they should explain how Harry Reid was wrong in 2006 to not strip Lieberman of his committee chairmanships and how Lieberman acted childish in 2008 and is acting childish now. The party should also explain that they are responsible for creating the monster in the same way that Lieberman is responsible for acting like one. Then they should go onto say publically that they want to bury the hatchet and are willing to do what it takes.
If Lieberman still acts like a dick after this, then I blame Lieberman.
Until the Dems own up to their part, I split the blame 50/50....
Quote from: Hicks on December 19, 2009, 03:18:09 PM
I never said he endorsed Bush. He supported him by voting for every piece of shit legislation that the Republicans introduced between 2000-2006.
This is simply not true. For example, take stem cell research...and Pro-Choice issues. Lieberman has a 100 percent approval rating from pro-choice groups for a reason.
It is true he is Hawkish. However, as a Jewish man who is heavily supported by the Jewish community, I think this might make some sense.
He did not act as though he was a member of the republican party between 2000-2006, that's just wrong. He did support "No Child Left Behind", but so did a lot of other Dems. The reason the Dems originally got pissed off is because he brokered a compromise with the right that stopped the Dems from Filibustering Samuel Alito's nomination. How this was such an important issue is beyond me? I think he pissed some people off behind closed doors and they acted as babyish as he's acting now in response.
don't forget that Lieberman spoke at the REPUBLICAN convention in favor of McCain.
If that's what he truly believed, that's fine. I can live with that. He had to know there would be political backlash because of it. Right or wrong, it was gonna come.
true - that was after the 06 election. but it signals a large break.
despite that, he didn't lose his seniority on Senate committees
edit (again)- that all said, I can't say I blame Lieberman, even though I disagree with him. This is how Washington works. The hold outs have extra power. Same with Nelson, the reps from NO. If Olympia Snow said she would support the bill, she would get some party favors too.
Quote from: slslbs on December 19, 2009, 07:31:36 PM
don't forget that Lieberman spoke at the REPUBLICAN convention in favor of McCain.
If that's what he truly believed, that's fine. I can live with that. He had to know there would be political backlash because of it. Right or wrong, it was gonna come.
true - that was after the 06 election. but it signals a large break.
That was a direct result of the 2006 election. Perhaps it was babyish, but the man had every right to be pissed, and if the Democratic party didn't think there would be a backlash from the lack of support Lieberman received in the 2006 swing election, they were out of their gourds. Lieberman had done absolutely nothing to receive the treatment that he received in the 2006 election. If you want to say it's because he was a hawk, remember Clinton, Biden, Kerry, et al. all supported the Iraq conflict from the beginnig. The man is the Democratic parties patsy, and has been for 3 years. If he isn't, then the Democratic party did a good job out of creating a monster and is reeping what it sowed.
Quote from: slslbs on December 19, 2009, 07:31:36 PM
despite that, he didn't lose his seniority on Senate committees
Blame this little Faux Pas on Harry Reid. This happened because in 2006, the party was in a broo-ha-ha over this election in Ct. The party quickly realized that Lieberman was going to run as a third party candidate and was going to win. They had assumed that if he didn't win the primary, he wouldln't run. They hadn't even considered the fact that he could run third party and win.
As soon as this happened, Senators on the left side of the aisle quickly threw their support behind Lieberman. The party had enough balls to not endorse him for the nomination, but didn't have enough balls to kick him out of the party.
Reid was one of the first to say "he'll retain his position and stature in the Democratic caucus if he wins". What Harry Reid should have said is "he's running against the Democratic candidate in Ct. Since he wants to fight the party, he is no longer in the party". The party was all bark and no bite. Lieberman saw no punishment from the Dems in power for fighting the party so hard in Ct. Since he wasn't punished and he looked like a scapegoat, he felt no qualms at all endorsing McCain for the presidency. Again, I feel as though this was all political theatre, because unlike 2000 and 2004, McCain no longer wanted to win. Do you think he honestly felt as though Sarah Palin was a good choice? Fuck no. McCain wanted Obama to win as much as the public did. He didn't have a chance in hell. Lieberman endorsing McCain was just a sideshow to make people remember that Lieberman exists and he's "a bad guy".
The whole thing was rather retarded in my book.
Again, when Lieberman speaks at the Republican convention, is he stripped of chairmanships? Nope. He gets no punishment. He is kicked out of the caucus, only to rejoin later on. Harry Reid has no testicles and is a failure for the Democratic party (and in more instances than this).
Instead of hating on the fall guy Lieberman, more dems should be placing the blame on "I can't do anything right" Reid.
actually, I think they did the right thing by not stripping him of his chairmanships. Obama campaigned on unity, he showed he was the bigger guy.
And the Dems are better off with Lieberman being a marginal #60 than #41 for the GOP.
Quote from: slslbs on December 19, 2009, 07:53:41 PM
actually, I think they did the right thing by not stripping him of his chairmanships. Obama campaigned on unity, he showed he was the bigger guy.
And the Dems are better off with Lieberman being a marginal #60 than #41 for the GOP.
They should have stripped him of his shit in 2006. That's where Harry Reid failed. He fought the party in 2006, he should have gotten stripped of party support.
ANYWAY....
Lieberman, schmeberman. I think that that in the end, Obama is the one who dropped the ball on the public option.
Quote from: guyforget on December 21, 2009, 01:06:14 PM
ANYWAY....
Lieberman, schmeberman. I think that that in the end, Obama is the one who dropped the ball on the public option.
Obama's only job right now is to give pretty speechs, take pictures with world leaders and other people of interest, don't die and look like he's in charge. Dude is for ser powerless, imo. Whether or not that is his fault, I don't know. I feel like that is the way it is.
I would blame Harry Reid before I blamed Obama. Reid is clearly unfit to be in the first chair of the left side of the aisle.
there are a few ways to look at this.
they will likely get a health care bill passed. after much debating, screaming at town meetings, tv, radio, interwebs, we will probably get something. I doubt we could have gotten more.
If this passes, 96% of all Americans will be covered. That's pretty damn big, imo. It is probably the biggest piece of social legislation since the 60s.
If it happens, Obama was the catalyst. Clinton couldn't get it done, Bush didn't try. Carter, Reagan, Bush 1 didn't try either. Obama deserves credit here for getting the process going, even though many people (self included) feel this falls short.
Single payer is not going to happen in this country in our lifetime. too many people are against anything that sounds like socialism.
The bill is not perfect, by a long shot. no bill is. there is definitely more work to do.
the process was ugly. This is Washington. There are always deals made and compromises. We just heard about all these because this is such a big bill. Enough people in the Senate were against the public option that it wouldn't fly. More deals would have had to be cut in order to try and get it. You do what you can do.
A friend of mine is a general in the marines, he has spent about half the last 10 years in DC (hates it in DC, going to Carolina soon). I asked him how frustrating it was when congress gives them weapons they don't want or need, but they get them because they are made in some powerful congressman's state or district.
He says 1)it happens all the time, and 2)this is a democracy, it's like making sausage.
all these congressman and Senators watch out for their self interest, to get something for their constituents, and to get re-elected.
the only realistic way around the deal making in Washington is to give the pres (or somebody) absolue, or near absolute power. I don't think we want that.
I think this whole "Clinton couldn't get it done, Obama could" argument is specious. Clinton improved the economic climate in the U.S. by leaps and bounds during the 90's. He did an awesome job of not only containing the contagions released by Reagan's disastorous policies, but also helping to cure the ills that existed before those contagions were spread.
Frankly, he might not have gotten Health Care legislation passed, but he set the ball rolling. It was a small setback in an administration that saw him constantly fighting for what was right.
I think this Healthcare Reform is all a red herring to do nothing but make it seem as though Obama fought for the good of the people while in actuality doing a bunch of nothing.
Obama hasn't been in office for a year.
If you want to compare him to Clinton, either wait a bit, or just look at Clinton's first 11 months.
things happen slowly in Washington.
both of them campaigned on health care reform. I give Clinton credit for trying, but he couldn't get it passed.
Quote from: slslbs on December 21, 2009, 02:25:14 PM
Obama hasn't been in office for a year.
If you want to compare him to Clinton, either wait a bit, or just look at Clinton's first 11 months.
things happen slowly in Washington.
both of them campaigned on health care reform. I give Clinton credit for trying, but he couldn't get it passed.
The thing with Clinton is, he never promised to work with the other side of the aisle. I think Obama painting himself in that manner is more of a liability than actual political capitol. I felt a lot better about Clinton's first 11 months, than I did about Obamas first 11, but then again I was 14 and more idealistic.
I think it just rubs me the wrong way that I think some put down Clinton to make Obama look better, and I think that is just rude, inconsiderate and wrong.
Quote from: fauxpaxfauxreal on December 21, 2009, 02:34:49 PM
Quote from: slslbs on December 21, 2009, 02:25:14 PM
Obama hasn't been in office for a year.
If you want to compare him to Clinton, either wait a bit, or just look at Clinton's first 11 months.
things happen slowly in Washington.
both of them campaigned on health care reform. I give Clinton credit for trying, but he couldn't get it passed.
The thing with Clinton is, he never promised to work with the other side of the aisle. I think Obama painting himself in that manner is more of a liability than actual political capitol. I felt a lot better about Clinton's first 11 months, than I did about Obamas first 11, but then again I was 14 and more idealistic.
I think it just rubs me the wrong way that I think some put down Clinton to make Obama look better, and I think that is just rude, inconsiderate and wrong.
Pot, meet Kettle. I think you'll find you have
lots in common.
Quote from: fauxpaxfauxreal on December 21, 2009, 02:34:49 PM
Quote from: slslbs on December 21, 2009, 02:25:14 PM
Obama hasn't been in office for a year.
If you want to compare him to Clinton, either wait a bit, or just look at Clinton's first 11 months.
things happen slowly in Washington.
both of them campaigned on health care reform. I give Clinton credit for trying, but he couldn't get it passed.
The thing with Clinton is, he never promised to work with the other side of the aisle. I think Obama painting himself in that manner is more of a liability than actual political capitol. I felt a lot better about Clinton's first 11 months, than I did about Obamas first 11, but then again I was 14 and more idealistic.
I think it just rubs me the wrong way that I think some put down Clinton to make Obama look better, and I think that is just rude, inconsiderate and wrong.
that was certainly not meant to be a put down of Clinton. It was stating a fact. Clinton had a huge effort on health care reform, had a huge committee, made a big effort, and the bill never got passed.
I think Clinton was a very good president and have defended him on other threads in this forum.
As far as working with the other side of the aisle, I think you can blame everyone, everywhere in Washington. Before health care reform ever started, the GOP said "we will make this his Waterloo". It's hard to work with someone who has that attitude.
Honestly, I think that when Obama started, he had full intentions of working with the GOP. Many of us (self included) thought that he could.
The fact is, that Washington is more divided than ever. You can only make a deal with someone who is willing to deal with you - based on the above quote, and other behaviour, it is very clear that the GOP does not want to deal. The dems just said, OK, we will try to get it done anyway, and they did.
Let me repeat, I blame everyone, even us (or me, anyway), for being transiently idealistic enough to believe that there would be cooperation. But the GOP has shown little sign that it wants to do anything except for get headlines criticizing the current admin.
Quote from: sunrisevt on December 21, 2009, 02:40:28 PM
Quote from: fauxpaxfauxreal on December 21, 2009, 02:34:49 PM
Quote from: slslbs on December 21, 2009, 02:25:14 PM
Obama hasn't been in office for a year.
If you want to compare him to Clinton, either wait a bit, or just look at Clinton's first 11 months.
things happen slowly in Washington.
both of them campaigned on health care reform. I give Clinton credit for trying, but he couldn't get it passed.
The thing with Clinton is, he never promised to work with the other side of the aisle. I think Obama painting himself in that manner is more of a liability than actual political capitol. I felt a lot better about Clinton's first 11 months, than I did about Obamas first 11, but then again I was 14 and more idealistic.
I think it just rubs me the wrong way that I think some put down Clinton to make Obama look better, and I think that is just rude, inconsiderate and wrong.
Pot, meet Kettle. I think you'll find you have lots in common.
Quote from: slslbs on December 21, 2009, 02:45:31 PM
that was certainly not meant to be a put down of Clinton. It was stating a fact. Clinton had a huge effort on health care reform, had a huge committee, made a big effort, and the bill never got passed.
I think Clinton was a very good president and have defended him on other threads in this forum.
As far as working with the other side of the aisle, I think you can blame everyone, everywhere in Washington. Before health care reform ever started, the GOP said "we will make this his Waterloo". It's hard to work with someone who has that attitude.
Honestly, I think that when Obama started, he had full intentions of working with the GOP. Many of us (self included) thought that he could.
The fact is, that Washington is more divided than ever. You can only make a deal with someone who is willing to deal with you - based on the above quote, and other behaviour, it is very clear that the GOP does not want to deal. The dems just said, OK, we will try to get it done anyway, and they did.
Let me repeat, I blame everyone, even us (or me, anyway), for being transiently idealistic enough to believe that there would be cooperation. But the GOP has shown little sign that it wants to do anything except for get headlines criticizing the current admin.
Oh I totally know what you are saying, and I agree. The comment about the putting Clinton down to boost Obama's administration up wasn't directed at you, but more was directed at the youngest generation of Obama-ites who receive much of their opinion about Clinton's administration from the mass media. I think when the idea that Clinton failed on Health Care is perpetuated, it somehow brings up the debate of Clinton versus Obama, a debate which I find to be rather counter-productive.
I totally agree about the right hand side of the aisle being complete and utter babies right now. However, I feel that this is a problem that is partially the creation of the left. In 2002, when America was at a turning point, the left basically said "whatever the administration proposes, we will agree to with minimal objection". The left was very careful to keep its critique of the right to a mininum in a move to preserve political capitol while basically providing the Cheney administration with a blank check. That was the time for the Left to act how the Right is acting now. The Right is at fault for acting like babies now, and totally not paying back the political capitol loan that they were provided by the left circa 2002, but I felt that in 2002 the left should not have provided that loan to begin with. I was very, very, very dissapointed with our party from 2002-2004. I am still dissapointed with our party, because we have failed to adequately explained how all of us fucked up post 911.
I would like to see the party I loved so much growing up, own up to it's personal faults in order to make a brighter future.
I haven't seen Obama truly do this yet. He seperates himself from the right, yet he doesn't own up to the part that the left played. Clinton does the same thing nowadays.
I really want everything to work out, I think the Democratic party is at a turning point, and I hope it all doesn't fall to shit.
Quote from: fauxpaxfauxreal on December 21, 2009, 02:55:29 PM
Quote from: slslbs on December 21, 2009, 02:45:31 PM
that was certainly not meant to be a put down of Clinton. It was stating a fact. Clinton had a huge effort on health care reform, had a huge committee, made a big effort, and the bill never got passed.
I think Clinton was a very good president and have defended him on other threads in this forum.
As far as working with the other side of the aisle, I think you can blame everyone, everywhere in Washington. Before health care reform ever started, the GOP said "we will make this his Waterloo". It's hard to work with someone who has that attitude.
Honestly, I think that when Obama started, he had full intentions of working with the GOP. Many of us (self included) thought that he could.
The fact is, that Washington is more divided than ever. You can only make a deal with someone who is willing to deal with you - based on the above quote, and other behaviour, it is very clear that the GOP does not want to deal. The dems just said, OK, we will try to get it done anyway, and they did.
Let me repeat, I blame everyone, even us (or me, anyway), for being transiently idealistic enough to believe that there would be cooperation. But the GOP has shown little sign that it wants to do anything except for get headlines criticizing the current admin.
Oh I totally know what you are saying, and I agree. The comment about the putting Clinton down to boost Obama's administration up wasn't directed at you, but more was directed at the youngest generation of Obama-ites who receive much of their opinion about Clinton's administration from the mass media. I think when the idea that Clinton failed on Health Care is perpetuated, it somehow brings up the debate of Clinton versus Obama, a debate which I find to be rather counter-productive.
I totally agree about the right hand side of the aisle being complete and utter babies right now. However, I feel that this is a problem that is partially the creation of the left. In 2002, when America was at a turning point, the left basically said "whatever the administration proposes, we will agree to with minimal objection". The left was very careful to keep its critique of the right to a mininum in a move to preserve political capitol while basically providing the Cheney administration with a blank check. That was the time for the Left to act how the Right is acting now. The Right is at fault for acting like babies now, and totally not paying back the political capitol loan that they were provided by the left circa 2002, but I felt that in 2002 the left should not have provided that loan to begin with. I was very, very, very dissapointed with our party from 2002-2004. I am still dissapointed with our party, because we have failed to adequately explained how all of us fucked up post 911.
I would like to see the party I loved so much growing up, own up to it's personal faults in order to make a brighter future.
I haven't seen Obama truly do this yet. He seperates himself from the right, yet he doesn't own up to the part that the left played. Clinton does the same thing nowadays.
I really want everything to work out, I think the Democratic party is at a turning point, and I hope it all doesn't fall to shit.
that kind of action started a long, long time ago.
the shame of it is, during the Reagan admin, Tip O'neil, his political adversary, would drink with him.
Unfortunately, that attitude is gone. It has changed from professional to personal. Both sides blame each other for starting it (I blame Lee Atwater during the Bush - Dukakis campaign), both sides do it. they all ought to grow up.
I think Obama would work with them if a) they would work with him, and / or b) he needed to.
The "ethics consults" - I forget the real name - Sarah Palin changed it to "death panel", which of course it is not, was a GOP idea. O'bama thought it was a good one, used it, and gave the originator credit. What else do they want him to do.
Oh, I know it has been getting worse. Shit used to be the political parties, for the most part, would play political theatre for their constituency, but at the end of the day, everyone was in it for the good of everyone and the good of the nation. I totally agree that the theatre has been becoming more important than the actual policy America needs a reconciliation of both sides. It's for the good of everyone. It's hard to do at this point, because the "average american" still feels that either A) Republicanism=good or B) Democratism=good. When the answer really is C)Americanism=good.
Drew Westen on Obama & leadership.
Quote
Like most Americans I talk to, when I see the president on television, I now change the channel the same way I did with Bush. With Bush, I couldn't stand his speeches because I knew he meant what he said. I knew he was going to follow through with one ignorant, dangerous, or misguided policy after another. With Obama, I can't stand them because I realize he doesn't mean what he says -- or if he does, he just doesn't have the fire in his belly to follow through. He can't seem to muster the passion to fight for any of what he believes in, whatever that is. He'd make a great queen -- his ceremonial addresses are magnificent -- but he prefers to fly Air Force One at 60,000 feet and "stay above the fray."
It's the job of the president to be in the fray. It's his job to lead us out of it, not to run from it. It's his job to make the tough decisions and draw lines in the sand. But Obama really doesn't seem to want to get involved in the contentious decisions. They're so, you know, contentious. He wants us all to get along. Better to leave the fights to the Democrats in Congress since they're so good at them. He's like an amateur boxer who got a coupon for a half day of training with Angelo Dundee after being inspired by the tapes of Mohammed Ali. He got "float like a butterfly" in the morning but never made it to "sting like a bee."
Do you think Americans ought to have one choice of health insurance plans the insurance companies don't control, or don't you? I don't want to hear that it would sort of, kind of, maybe be your preference, all other things being equal. Do you think we ought to use health care as a Trojan Horse for right-wing abortion policies? Say something, for God's sake.
He doesn't need a chief of staff. He needs someone to shake him until he feels something strongly enough not just to talk about it but to act. He's increasingly appearing to the public, and particularly to swing voters, like Dukakis without the administrative skill. And although he is likely to squeak by with a personal victory in 2012 if the economy improves by then, he may well do so with a Republican Congress. But then I suppose he'll get the bipartisanship he always wanted.
Full editorial
http://www.huffingtonpost.com/drew-westen/leadership-obama-style-an_b_398813.html
^
I disagree. Obama's fundamentally a pragmatist - that's what he campaigned on, and that's how he's governing. He's hung back on HCR largely because he thinks that it's the best way to get some kind of a decent bill passed. Making big speeches and being specific about exactly what he wants in a bill would only have come back to bite him if the bill got watered down (which it obviously did).
So...what has he actually accomplished, then?
Quote
Featured Legislation
Signed on October 30, 2009
Ryan White HIV/AIDS Treatment Extension Act of 2009
Signed on October 28, 2009
National Defense Authorization Act for Fiscal Year 2010
Signed on October 22, 2009
Veterans Health Care Budget Reform and Transparency Act
Signed on August 06, 2009
Cash For Clunkers Extension
Signed on June 22, 2009
Family Smoking Prevention and Tobacco Control Act
Signed on May 22, 2009
Credit Card Accountability, Responsibility, and Disclosure (CARD) Act of 2009
Signed on May 22, 2009
Weapons Systems Acquisition Reform Act
Signed on May 20, 2009
Helping Families Save Their Homes Act
Signed on May 20, 2009
Fraud Enforcement and Recovery Act
Signed on April 21, 2009
Edward M. Kennedy Serve America Act
Signed on March 30, 2009
Omnibus Public Lands Management Act
Signed on March 20, 2009
Small Business Act Temporary Extension
Signed on February 17, 2009
American Recovery and Reinvestment Act
Signed on February 11, 2009
DTV Delay Act
Signed on February 04, 2009
Children's Health Insurance Reauthorization Act
Signed on January 29, 2009
Lilly Ledbetter Fair Pay Act
Quote from: Alumni on December 22, 2009, 02:18:55 AM
So...what has he actually accomplished, then?
he named the family puppy, that's worthy of a vacation. :wink:
(I just wanted to post that joke, I don't actually hold that cynical an opinion of him)
Quote from: spaced on December 21, 2009, 09:50:05 PM
^
I disagree. Obama's fundamentally a pragmatist - that's what he campaigned on, and that's how he's governing. He's hung back on HCR largely because he thinks that it's the best way to get some kind of a decent bill passed. Making big speeches and being specific about exactly what he wants in a bill would only have come back to bite him if the bill got watered down (which it obviously did).
there was an editorial in the Sunday nyt applauding Obama for just that. Being pragmatic, not waiting for perfection, taking what he can get, and keeping the ball rolling.
things work slowly.
I do agree with some of Westen's points. I think Obama (and Clinton), worry a bit too much about trying to make everyone happy. I would like it if he got a bit ballsier
Some of the comparisons to FDR were interesting. I would argue that the stimulous plan is a (constitutional) modern day version of the WPA.
FDR asked for, and was given, inordinate amount of power by congress. Looking back on it, it probably would be deemed unconstitutional. Congress wouldn't give up that much power today, and frankly, no president should get it. GWB tried to get some more, and look where it got us.
Another difference is that today, everything is out there. We have way more information about the process than we did even 5 years ago. The process probably hasn't changed much, but our knowledge of it has. And, to a certain degree, the process sucks. But that's what we have, and one person isn't going to change it.
what can we do? write your reps, write the White House. Every time I've written, I've gotten a response, and I can tell by the letter that someone actually read the response. How much of that got to the actual rep or senator, I don't know, but if enough people saying similar things makes a difference, imo.
Quote from: slslbs on December 22, 2009, 09:07:22 AM
Quote from: spaced on December 21, 2009, 09:50:05 PM
^
I disagree. Obama's fundamentally a pragmatist - that's what he campaigned on, and that's how he's governing. He's hung back on HCR largely because he thinks that it's the best way to get some kind of a decent bill passed. Making big speeches and being specific about exactly what he wants in a bill would only have come back to bite him if the bill got watered down (which it obviously did).
there was an editorial in the Sunday nyt applauding Obama for just that. Being pragmatic, not waiting for perfection, taking what he can get, and keeping the ball rolling.
things work slowly.
I do agree with some of Westen's points. I think Obama (and Clinton), worry a bit too much about trying to make everyone happy. I would like it if he got a bit ballsier
Some of the comparisons to FDR were interesting. I would argue that the stimulous plan is a (constitutional) modern day version of the WPA.
FDR asked for, and was given, inordinate amount of power by congress. Looking back on it, it probably would be deemed unconstitutional. Congress wouldn't give up that much power today, and frankly, no president should get it. GWB tried to get some more, and look where it got us.
Another difference is that today, everything is out there. We have way more information about the process than we did even 5 years ago. The process probably hasn't changed much, but our knowledge of it has. And, to a certain degree, the process sucks. But that's what we have, and one person isn't going to change it.
what can we do? write your reps, write the White House. Every time I've written, I've gotten a response, and I can tell by the letter that someone actually read the response. How much of that got to the actual rep or senator, I don't know, but if enough people saying similar things makes a difference, imo.
Well said. :clap:
Quote from: slslbs on December 22, 2009, 07:12:43 AM
Quote
Featured Legislation
Signed on October 30, 2009
Ryan White HIV/AIDS Treatment Extension Act of 2009
Signed on October 28, 2009
National Defense Authorization Act for Fiscal Year 2010
Signed on October 22, 2009
Veterans Health Care Budget Reform and Transparency Act
Signed on August 06, 2009
Cash For Clunkers Extension
Signed on June 22, 2009
Family Smoking Prevention and Tobacco Control Act
Signed on May 22, 2009
Credit Card Accountability, Responsibility, and Disclosure (CARD) Act of 2009
Signed on May 22, 2009
Weapons Systems Acquisition Reform Act
Signed on May 20, 2009
Helping Families Save Their Homes Act
Signed on May 20, 2009
Fraud Enforcement and Recovery Act
Signed on April 21, 2009
Edward M. Kennedy Serve America Act
Signed on March 30, 2009
Omnibus Public Lands Management Act
Signed on March 20, 2009
Small Business Act Temporary Extension
Signed on February 17, 2009
American Recovery and Reinvestment Act
Signed on February 11, 2009
DTV Delay Act
Signed on February 04, 2009
Children's Health Insurance Reauthorization Act
Signed on January 29, 2009
Lilly Ledbetter Fair Pay Act
Obama runs the legislative branch, too? :-P
I'm thinking more along the lines of:
-Afghanistan
-Bailouts
-Abandoning Financial System Reform
-Not having an opinion on health care so as to maximize his chances of being able to take credit for whatever Congress does produce
Next up...I'm willing to wager that we see a complete lack of leadership on the environment. I'm not necessarily referring to Copenhagen.
I get that there are different leadership styles. Obama seems happy with being able to claim that he "was in office when..."
Quote from: slslbs on December 22, 2009, 09:07:22 AM
Quote from: spaced on December 21, 2009, 09:50:05 PM
^
I disagree. Obama's fundamentally a pragmatist - that's what he campaigned on, and that's how he's governing. He's hung back on HCR largely because he thinks that it's the best way to get some kind of a decent bill passed. Making big speeches and being specific about exactly what he wants in a bill would only have come back to bite him if the bill got watered down (which it obviously did).
there was an editorial in the Sunday nyt applauding Obama for just that. Being pragmatic, not waiting for perfection, taking what he can get, and keeping the ball rolling.
things work slowly.
The HC bill didn't just get watered down. It got positively bad in spots. The NYT also editorialized that
Quote
In another concession, the Senate bill would allow states to ban the coverage of abortions by health plans sold on the new exchanges. Those exchanges will allow people who buy health insurance to choose from an array of private plans, with subsidies provided to help low- and middle-income people pay the premiums.
This amounts to deplorable interference by state governments into decisions that should be made by a woman and her doctor — and abortion rights groups are right to object.
Change we can believe in.
If we're members of the religious right
Quote from: Alumni on December 22, 2009, 10:55:18 AM
Obama runs the legislative branch, too? :-P
I'm thinking more along the lines of:
-Afghanistan
-Bailouts
-Abandoning Financial System Reform
-Not having an opinion on health care so as to maximize his chances of being able to take credit for whatever Congress does produce
Next up...I'm willing to wager that we see a complete lack of leadership on the environment. I'm not necessarily referring to Copenhagen.
I get that there are different leadership styles. Obama seems happy with being able to claim that he "was in office when..."
wasn't sure what you meant.
as far as Afghanistan, I guess you missed his speech. I admit, I'm a bit perplexed by the 18 month thing. It seems like it's throwing a bone to the left. As far as expanding our commitment there - he stated during his campaign that we need to bolster our efforts in Afghanistan. doing so wasn't pandering to the right; he said he was gonna do that.
the House recently passed a decent bill on FS reform. I suppose it will go to the senate after NY, It got watered down, like they all do, but still seems like a decent bill.
as far as the bailouts go, there are many people on both sides of the aisle that think the bailouts prevented a depression with even higher unemployment. Personally, I think more strings should have been attached to the money before giving it away.
as far as "not having an opinion on HCR", I think he had an opinion on the public option. He gave it away, perhaps too early, but I personally don't think it was gonna fly no matter what. I also think that both the merits and evils of it were waaaay overstated.
Unless you give the pres the line item veto (unconstitutional), we're stuck with congress throwing all kinds of shit in there, and taking things out.
Part of it is me just trying to be provocative. Like the crack at giving Obama credit for signing into law legislation that was passed by a Democratic Congress that's been sitting on its hands since 1994. :)
But I am largely dissatisfied with Obama. I know he's an important symbol of racial progress. It's just that after a miserable few years with Bush in office and the GOP in control of Congress, I would have preferred someone with the courage of their convictions (a Democratic Reagan?) and then Obama.
I just don't think he's very effective.
I think Afghanistan is a mistake. I think he backed himself into it during the campaign when he wanted to be able to criticize Bush for Iraq and not seem like a liberal wimp. So he wasn't anti-war, he was "anti-the-wrong-war." I think Afghanistan will fail to accomplish much of anything, but I'm willing to be wrong, I guess.
I think the health care bill was handled poorly. It isn't completely without merit, I guess. But I have to wonder if the end result was worth it. I understand the need to spend political capital if you're going to achieve bold policy changes. But what we're getting is kind of milquetoast. Assuming the economy rebounds, regardless of Obama's actions one way or the other, he's going to get reelected. Was the health care bill worth the risk of 6 years of GOP control of Congress?
Maybe it will be, maybe it won't. I'm not up to speed on the latest draft, but previous drafts have seemed pretty fishy to me. They're advertised as a step forward because they prohibit things like excluding coverage for preexisting conditions. To which I say, "Prohibit preexisting condition exclusions or what?" One previous draft "prohibited" those exclusions by imposing something like a $10,000 fine for each case. Okay. You don't need to be a policy wonk on par with Bill Clinton to see what might go wrong with that approach.
If Obama doesn't have the spine to get upset when Wall Street types blow of scheduled meetings with the White House, why on Earth should I believe that Obama has the fortitude to push for real regulatory reform?
I'm not against countercyclical spending. I'm with Obama on the stimulus spending. Like you, I wish they'd been a bit more careful with the bailouts. I just brought it up because I see this more as a continuation of Bush's response than as an achievement in its own right.
Obama hasn't even really bothered with environmental/energy policy yet. Small wonder Copenhagen was a disaster. When other countries meet behind your back to get things done, that's a pretty clear sign that you are at best irrelevant and at worst counterproductive. I know, you can only do one thing at a time, and that thing was health care reform. I hope it ends up being worth it.
I can sum it up in one sentence. Obama strikes me as being just as cynical as GWB. I think he's more interested in being perceived as a transformational political figure than in actually being one. It's funny to read the editorials in international newspapers now that they're realizing that he's a business-as-usual president. Those folks really drank the Obama kool-aid. :)
To link back up to the nominal thread topic...maybe it was the right time for health care reform. I'm not sure it will bring about the level of change that's been promised. And I don't think we can judge whether or not it's a success without considering the whole range of effects it's had on Obama's first year.
I hear ya.
I think a "Democratic Reagan" is a great analogy. What I respect most about Reagan, is that he had a vision, and got people to go along - sort of. It's not hard to get congress to cut taxes, and he wound up raising taxes before the end of his admin, but he gave the perception that he was in control. I didn't agree with his vision, but he had one.
that was my biggest knock against clinton.
I think the jury is still out on Obama. We'll have to see over time what he does when words alone don't get the job done. I actually agree with the push in Afghanistan. I don't like war, but this was one that was worth starting. We should have finished it years ago, instead of going into Iraq. As much as I don't like war, sometimes we have to use our military. Part of the training vids for Al Quedah was some of our chickenshit moves in the past (Reagan pulling the marines out of Lebanon after the bombing - I guess he wasn't so much of a hawk). They have the feeling that they can do whatever they want without consequences. Regardless, his move isn't pandering to the right, he said he was going to do this from the beginning - if anything it's pandering to the left.
As far as health care goes, I think he saw what happened to Clinton. Clinton gave congress the bill. There was no effort at compromise, it just got shelved. Obama gave congress a barebones blueprint and told them to get on it. Should he have twisted more arms - maybe. Maybe he is saving that for the final push - something still can go wrong over the differences on abortion and public option.
He called in the head guys from Wall St last week. Unfortunately, there is nothing he can legally do to them, and they know it. It is up to congress to pass a law to get it done. Looking back on it, I kinda wish they took on Wall St before they took on health care. I think Obama was surprised at the resistance he got on Health care. Finally, they are starting to take those guys on. We'll have to wait and see if it has any teeth.
I'm anxious to see what he does with the environment, too. We'll have to see, but getting the economy going and getting people back to work are rightly his top priorities.
I don't think he is as cynical as GWB. to me, he is more thoughtful, and is trying to do the right thing. GWB had a lot of "I'm right, and if you disagree with me you're wrong". Black and white. BO is the exact opposite, sometimes to a fault. If I had to choose, I would pick the more thoughtful, nuanced leader. Sometimes you have to take the bull by the horns. I think he has done it to some degree, but probably needs to do it a little more.
sooo- back to Health care, I see the current bill, if it is passed, as a flawed, but necessary 1st step. Hopefully it will pass, and improvements will be made.
Quote from: spaced on December 21, 2009, 09:50:05 PM
^
I disagree. Obama's fundamentally a pragmatist - that's what he campaigned on, and that's how he's governing. He's hung back on HCR largely because he thinks that it's the best way to get some kind of a decent bill passed. Making big speeches and being specific about exactly what he wants in a bill would only have come back to bite him if the bill got watered down (which it obviously did).
He didn't campaign on pragmatism...I thought his campaign was based on an appeal for idealism. "Hope...Change...Yes We Can". His whole rhetorical style has been based on saying that "idealism is pragmatic".
I emailed my rep and Senators last week about a few issues; malpractice reform and prescription drugs. Got a response back from the rep today. Obviously, it's a partisan view, but interesting and informative, imo. It also tells more about the bill than you hear on the average nightly news
Quote
Thank you for contacting my office regarding health care reform. I appreciate your views and having the benefit of your opinion.
For much of this year, both the House and Senate have been working on health care reform legislation with the goal of providing health care coverage for all Americans and lowering the unsustainable costs in our health care system. This is an undertaking that has been decades in the making, and the passage of the Affordable Health Care for America Act on November 7th represents a historic moment that lends great momentum to finally fulfilling this most important need and our late Senator Ted Kennedy's lifelong dream.
At its core, this health care reform legislation is built on the principle of "shared responsibility." Individuals will be required to buy insurance, employers will be required to provide it for their employees, and the government will be required to help people find and pay for an affordable plan. In this regard, it is very similar to the universal health care system in Massachusetts that we already have.
As this health care bill was crafted over the last several months, I solicited input from Fifth District residents at town hall meetings, during telephone town hall meetings, via email, letters and phone calls, and through my Congress On Your Corner program. I also met extensively with doctors, nurses, hospital administrators, community health center professionals, insurance company representatives, pharmaceutical company representatives, nursing home administrators, patient advocacy groups, medical device company representatives, and other health care stakeholders in our district.
I heard over and over again that driving down the high cost of health care is our greatest challenge. I also heard from so many constituents who were worried about losing their health care coverage in this economic downturn and from employers who were finding it increasingly difficult to provide coverage to their employees.
The Affordable Health Care for America Act takes many steps to address our system's out-of-control costs. First, by requiring insurance companies to cover routine checkups and preventive care, like mammograms, colonoscopies, and routine vaccinations. This ensures that fewer people will need to rely on expensive emergency room care for potentially preventable illnesses.
But more importantly, this bill makes significant steps towards changing the way we pay for healthcare by moving towards a global payment system for doctors rather than a fee-for-service system. These types of payment structures have been extremely successful in reducing costs in places such as the Cleveland and Mayo Clinics, while maintaining outstanding levels of care.
It also encourages the formation of Accountable Care Organizations that allow hospitals and doctors to work together to manage and coordinate care in order to avoid duplicating tests and treatments, and allows doctors in the organization to get paid a salary rather than a fee for each service. It will also bring down costs by investing in electronic health records and by ensuring that patients get the best care possible, not the most expensive care available.
Our current fee-for-service system is part of the reason why health care premiums have doubled in 9 years, growing 3 times faster than wages. Without reform, the cost of health care for the average American family is expected to increase by $1,800 every year with no end in sight. There is simply no question that health care reform is central to our economic recovery.
This bill also allows people the freedom to choose the quality, affordable health care that is best for them, including the choice of a public option that competes on a level playing field against private insurance companies. This public option will also have to be self-sufficient, relying on the premiums it collects. The bill preserves what is best in the current system by allowing Americans who like their doctor and their health care plan to keep it, a top priority for the Obama administration. Additionally, it keeps the Massachusetts Connector intact.
This health care reform measure also gives families the peace of mind that they will have access to health care when they need it by preventing the denial of health care coverage due to pre-existing conditions and making it illegal for insurance companies to drop your coverage when you get sick.
Additionally, seniors will see their prescription drug costs go down. The approximately 6 million seniors, 7,400 of whom live in the Fifth District, who currently fall into the Medicare "donut hole", the gap in which prescription drugs are not covered, will see that gap in coverage completely closed over time.
While access to care is not a problem that we have in Massachusetts, tens of millions of Americans cannot afford health care coverage, and that number increases by 14,000 every day. The Affordable Healthcare for America Act takes significant steps towards covering all Americans, while enabling anyone happy with their current plan to keep it, facts which have earned it the endorsement of the American Medical Association, American Nurses Association, the AARP, and many other leading health care provider and patient advocacy groups.
Finally, this bill is fully paid for, not adding a dime to our deficits now or in the future. The non-partisan Congressional Budget Office estimates that the bill will reduce our nation's growing deficit over ten years by $104 billion.
As with any undertaking of this magnitude, the legislation is not perfect. I am very disappointed that the final bill included language that severely restricts access to reproductive health services for women. By effectively ensuring that plans offered on the health insurance exchange do not offer abortion services, the bill discriminates against low-income women and goes so far as to prevent those who want to buy a plan that covers abortion services with their own money from making that choice. I will be working with my colleagues in the House of Representatives to change this unreasonable and unwarranted language in conference.
But, overall, I strongly believe that this bill expands access to health care for nearly all of our citizens and begins to control the unsustainable cost of care. It is for these reasons that I was proud to support this historic bill.
Before this bill becomes law, it has to be voted on by the U.S. Senate. After that, the House and Senate bills will have to be combined, go to both chambers for another vote, and sent to the President's desk for his signature. I appreciate that you took the time to be in touch, and I will be sure to keep your thoughtful views in mind as Congress continues to work on this issue.
Please do not hesitate to contact my office in the future with questions or concerns. If you would like more information on the Affordable Healthcare for America Act, please visit my website at http://tsongas.house.gov and click on the blue "Quality Affordable Health Care" tab
Trivial side note:
I saw the URL at the end of the letter and did a doubletake. Tsongas, huh?
Wait...what?!? :-o
Ahh. Different Tsongas. :)
Quote from: fauxpaxfauxreal on December 22, 2009, 02:46:49 PM
Quote from: spaced on December 21, 2009, 09:50:05 PM
^
I disagree. Obama's fundamentally a pragmatist - that's what he campaigned on, and that's how he's governing. He's hung back on HCR largely because he thinks that it's the best way to get some kind of a decent bill passed. Making big speeches and being specific about exactly what he wants in a bill would only have come back to bite him if the bill got watered down (which it obviously did).
He didn't campaign on pragmatism...I thought his campaign was based on an appeal for idealism. "Hope...Change...Yes We Can". His whole rhetorical style has been based on saying that "idealism is pragmatic".
Well yes, that's sort of true as far as it goes, but two things. First, he always marketed himself as a level-headed consensus-broker, not a fire-breathing ideologue - sure, he had plenty of aspirational rhetoric, but it was always couched in terms of "bringing people together" rather than single-mindedly pushing his own agenda. He ran the kind of campaign that caused people to project their own beliefs onto him - if you were a moderate, you probably thought he was too; if you were a dyed-in-the-wool liberal, you thought he was too.
Second, and more importantly, he has to look at the reality of the situation now. With most policy areas, he's completely constrained by what Congress does; he can't pass legislation himself, he can only try to persuade legislators to do stuff. Sure, he can go on TV and make big, inspirational speeches, but he can persuade legislators just as well (maybe better in some situations) behind closed doors - plus this doesn't carry the downside of being perceived as a "failure" when Congress screws things up and doesn't do what he says.
Basically, there are plenty of things to criticize Obama for (his record on civil liberties is totally inconsistent with his campaign promises, for example), but (a) he's still way better than any conceivable Republican candidate, and (b) most of the things people have been complaining about in the last few posts are more attributable to our completely ineffectual Congress than to him.
good point.
I also think the Dems have done a pretty poor job getting out the message of the positive side of the bill.
The press has been covering this the way they cover elections - the horse race and not the meat. The GOP is also doing a much better job of getting their message out. Of course, it's easier to say "this sucks", than to give an intelligent argument, but the Dems, and the WH, need to get that argument out.
Desperately.
Quote from: spaced on December 22, 2009, 09:27:46 PM
Well yes, that's sort of true as far as it goes, but two things. First, he always marketed himself as a level-headed consensus-broker, not a fire-breathing ideologue - sure, he had plenty of aspirational rhetoric, but it was always couched in terms of "bringing people together" rather than single-mindedly pushing his own agenda. He ran the kind of campaign that caused people to project their own beliefs onto him - if you were a moderate, you probably thought he was too; if you were a dyed-in-the-wool liberal, you thought he was too.
If you're a dyed-in-the-wool liberal, you might remember pre-campaign Obama as one of you. :)
But I think it's a fair point
Quote
Second, and more importantly, he has to look at the reality of the situation now. With most policy areas, he's completely constrained by what Congress does; he can't pass legislation himself, he can only try to persuade legislators to do stuff. Sure, he can go on TV and make big, inspirational speeches, but he can persuade legislators just as well (maybe better in some situations) behind closed doors -
That's the exact basis for much of the criticism that I've heard. Obama hasn't worked with legislators behind the scenes. He's never spoken to Lieberman. He tries to make the best of a poor political situation without expending the energy to try and change it.
Quoteplus this doesn't carry the downside of being perceived as a "failure" when Congress screws things up and doesn't do what he says.
I don't think this is something the average president really needs to worry about - especially not Obama. Congress always has low approval ratings. There's nothing stopping you from articulating a clear vision and then expressing pragmatism in the end when/if Congress doesn't live up.
Quote(b) most of the things people have been complaining about in the last few posts are more attributable to our completely ineffectual Congress than to him.
Out of curiosity, which ones? My long-ish post was intentionally focused on Obama as president.
I agree he's better than any of the Republican alternatives in 2008. I'm not complaining that the country elected a Democrat. Whether we elected the right Democrat... :-)
eta
Of course, Obama was the right Democrat in the important sense of winning the election. Imagine that. The "black guy with a black name" (Chris Rock's phrase) was the electable one. Beltway politics aside, that's hard to complain about...
Quote from: Alumni on December 22, 2009, 11:12:31 PM
Quote(b) most of the things people have been complaining about in the last few posts are more attributable to our completely ineffectual Congress than to him.
Out of curiosity, which ones? My long-ish post was intentionally focused on Obama as president.
I wasn't really trying to respond to anything in particular, just the general feeling I got from the thread, but I think healthcare is a good example. There are probably things that Obama could have done better in terms of strategy (maybe you're right and he didn't do enough behind the scenes), but I think the way that Congress is set up right now makes large-scale political changes close to impossible, so the fact that
something is getting passed is a pretty big achievement.
For one thing, the way the filibuster or the threat of the filibuster has been used lately means that there's a de facto 60-vote requirement for everything, whereas the filibuster was used relatively sparingly up until very recently. Look at this chart:
(http://www.american.com/graphics/2008/march-april-magazine/Gumming%20Up%20the%20Works.jpg)
Even if the Senate still had all of the influence-buying problems, etc. that it has now, imagine what would have gotten passed if all we needed was 50 votes, which is the way the Senate is supposed to function, and usually did up until a few years ago. Can you imagine passing anything like Medicare or Social Security in today's Congress? It would be impossible.
I don't disagree with criticizing Obama, I just think that Congress is the main problem. It needs to be fixed in a lot of ways before we can expect to have a really well-functioning government again, no matter who's in the Executive Branch.
Oh, and as a general matter, I agree with everything Paul Krugman says here: http://krugman.blogs.nytimes.com/2009/12/20/the-wysiwyg-president/#more-6157 (http://krugman.blogs.nytimes.com/2009/12/20/the-wysiwyg-president/#more-6157).
Quote from: spaced on December 23, 2009, 02:18:41 AM
Quote from: Alumni on December 22, 2009, 11:12:31 PM
Quote(b) most of the things people have been complaining about in the last few posts are more attributable to our completely ineffectual Congress than to him.
Out of curiosity, which ones? My long-ish post was intentionally focused on Obama as president.
I wasn't really trying to respond to anything in particular, just the general feeling I got from the thread, but I think healthcare is a good example. There are probably things that Obama could have done better in terms of strategy (maybe you're right and he didn't do enough behind the scenes), but I think the way that Congress is set up right now makes large-scale political changes close to impossible, so the fact that something is getting passed is a pretty big achievement.
For one thing, the way the filibuster or the threat of the filibuster has been used lately means that there's a de facto 60-vote requirement for everything, whereas the filibuster was used relatively sparingly up until very recently. Look at this chart:
(http://www.american.com/graphics/2008/march-april-magazine/Gumming%20Up%20the%20Works.jpg)
Even if the Senate still had all of the influence-buying problems, etc. that it has now, imagine what would have gotten passed if all we needed was 50 votes, which is the way the Senate is supposed to function, and usually did up until a few years ago. Can you imagine passing anything like Medicare or Social Security in today's Congress? It would be impossible.
I don't disagree with criticizing Obama, I just think that Congress is the main problem. It needs to be fixed in a lot of ways before we can expect to have a really well-functioning government again, no matter who's in the Executive Branch.
Oh, and as a general matter, I agree with everything Paul Krugman says here: http://krugman.blogs.nytimes.com/2009/12/20/the-wysiwyg-president/#more-6157 (http://krugman.blogs.nytimes.com/2009/12/20/the-wysiwyg-president/#more-6157).
It's fair to note, also, that Social Security and the GI Bill and almost every other major piece of legislation passed with at least some support from both sides of the isle. One of the main reasons congress is so broken is the fierce partisanship that has taken over where politics used to be about true compromise. Imagine what would have passed if even 3 or 4 repubs were on board from the start... This situation where every single Dem in the senate has the power to veto the entire bill over whatever ruffles his feathers is a mess.
Obama shouldn't be speaking with Lieberman. Droopy looking son of a bitch is lucky they don't strip him of any power that he has. He's a traitor to his caucus and his only contribution to Obama's hopes of bipartisanship is that he's in both parties at the same time.
Quote from: spaced on December 23, 2009, 02:18:41 AM
Even if the Senate still had all of the influence-buying problems, etc. that it has now, imagine what would have gotten passed if all we needed was 50 votes, which is the way the Senate is supposed to function, and usually did up until a few years ago. Can you imagine passing anything like Medicare or Social Security in today's Congress? It would be impossible.
exactly. trying to get a "fillibuster proof" majority is nearly impossible, especially when one side going in vows not to cooperate.
Quote from: rowjimmy on December 23, 2009, 10:29:06 AM
Obama shouldn't be speaking with Lieberman. Droopy looking son of a bitch is lucky they don't strip him of any power that he has. He's a traitor to his caucus and his only contribution to Obama's hopes of bipartisanship is that he's in both parties at the same time.
LOL. When did he betray his party pre-2006 exactly? I'll allow everyone to paint Lieberman as the second coming of Francis Bacon when someone can show me how Lieberman acted as a traitor to his caucus before the Democratic party betrayed Lieberman in 2006.
Quote from: fauxpaxfauxreal on December 25, 2009, 01:01:06 AM
Quote from: rowjimmy on December 23, 2009, 10:29:06 AM
Obama shouldn't be speaking with Lieberman. Droopy looking son of a bitch is lucky they don't strip him of any power that he has. He's a traitor to his caucus and his only contribution to Obama's hopes of bipartisanship is that he's in both parties at the same time.
LOL. When did he betray his party pre-2006 exactly? I'll allow everyone to paint Lieberman as the second coming of Francis Bacon when someone can show me how Lieberman acted as a traitor to his caucus before the Democratic party betrayed Lieberman in 2006.
Just because He turned on his party out of revenge doesn't mean He didn't turn on his party... Not to mention when He was elected, He was elected as a Democrat... So he also turned on his electors, or the people... I don't see why we should defend his vengeful malicious actions... He just decided to put his own feelings above those of the people, and his party... He had an opportunity to get back into very good graces with his party or to stick it to them, and He chose the negative... Fuck him!!! He is a traitor...
Quote from: Poster Nutbag on December 25, 2009, 03:56:27 PM
Quote from: fauxpaxfauxreal on December 25, 2009, 01:01:06 AM
Quote from: rowjimmy on December 23, 2009, 10:29:06 AM
Obama shouldn't be speaking with Lieberman. Droopy looking son of a bitch is lucky they don't strip him of any power that he has. He's a traitor to his caucus and his only contribution to Obama's hopes of bipartisanship is that he's in both parties at the same time.
LOL. When did he betray his party pre-2006 exactly? I'll allow everyone to paint Lieberman as the second coming of Francis Bacon when someone can show me how Lieberman acted as a traitor to his caucus before the Democratic party betrayed Lieberman in 2006.
Just because He turned on his party out of revenge doesn't mean He didn't turn on his party... Not to mention when He was elected, He was elected as a Democrat... So he also turned on his electors, or the people... I don't see why we should defend his vengeful malicious actions... He just decided to put his own feelings above those of the people, and his party... He had an opportunity to get back into very good graces with his party or to stick it to them, and He chose the negative... Fuck him!!! He is a traitor...
In 2006, when he was elected, he was elected as an independent and not a Democrat.
I'm not defending him, I'm just pointing out that if the Democrats had wanted Joe Lieberman's obedience, they were idiots to attack his campaign in 2006. You can't complain about what you created.
Quote from: fauxpaxfauxreal on December 25, 2009, 04:04:28 PM
Quote from: Poster Nutbag on December 25, 2009, 03:56:27 PM
Quote from: fauxpaxfauxreal on December 25, 2009, 01:01:06 AM
Quote from: rowjimmy on December 23, 2009, 10:29:06 AM
Obama shouldn't be speaking with Lieberman. Droopy looking son of a bitch is lucky they don't strip him of any power that he has. He's a traitor to his caucus and his only contribution to Obama's hopes of bipartisanship is that he's in both parties at the same time.
LOL. When did he betray his party pre-2006 exactly? I'll allow everyone to paint Lieberman as the second coming of Francis Bacon when someone can show me how Lieberman acted as a traitor to his caucus before the Democratic party betrayed Lieberman in 2006.
Just because He turned on his party out of revenge doesn't mean He didn't turn on his party... Not to mention when He was elected, He was elected as a Democrat... So he also turned on his electors, or the people... I don't see why we should defend his vengeful malicious actions... He just decided to put his own feelings above those of the people, and his party... He had an opportunity to get back into very good graces with his party or to stick it to them, and He chose the negative... Fuck him!!! He is a traitor...
In 2006, when he was elected, he was elected as an independent and not a Democrat.
I'm not defending him, I'm just pointing out that if the Democrats had wanted Joe Lieberman's obedience, they were idiots to attack his campaign in 2006. You can't complain about what you created.
Your argument that Dems can't complain only makes sense based on two premises:
(1) The Democrats wrongly opposed Lieberman in the 2006 primary, and/or
(2) Lieberman's response to the primary challenge was and is justified.
Neither of those premises are correct. First, it made perfect sense for many Dems to support Lamont in the primary (although IIRC there were still a ton who stuck with Holy Joe until he lost). Lieberman was (and is) nothing but a mouthpiece for Bush and the Republicans on foreign policy. For example, in 2005 he said, ". . . in matters of war we undermine Presidential credibility at our nation's peril." I mean, WTF? Not only did he uncritically embrace the entire Republican foreign policy agenda, he actually said people couldn't even
disagree with Bush. You can't seriously think that they were somehow obligated to unanimously support the guy at that point.
Second, even if Lieberman was somehow wronged by the Dems (he wasn't), how does that give him the right to become the unprincipled hack that he is now? After supposedly being a supporter of "universal healthcare" for his entire career (and probably running on that platform to get reelected), he's suddenly going to the mat to keep it from even being voted on. Three months ago he thought the medicare buy-in was a great idea, but as soon as it got into the bill he suddenly opposed it - not only that, but he was willing to filibuster it to keep it from even coming up to a vote. I don't see how it's unreasonable for people to complain about that.
EDIT: just to make the last part of my logic explicit here - Lieberman was a douche, he's currently even more of a douche, and even if his current level of douchiness was somehow predictable back in 2006, that doesn't mean that people forfeit the right to complain about it.
How you don't see how this problem was exacerbated (if not created) by the lack of support Lieberman received in 2006 is beyond me.
Here is where I fault the Democratic Party. When they decided to support Lamont, Lieberman should have been seen as betraying his party when he announced his independent candidacy and summarily stripped of all of his Committee positions by Harry Reid. The Democrats should have fully supported Lamonts campaign and those who supported Lieberman during the election should have been outed as treasonists. If Lieberman still won, do not allow him to caucus, strip him of his Commitee positions, treat him as though he is a Freshman independent senator. This didn't happen. As soon as Lieberman announced his candidacy Hill-dawg immediately announced her support for Lieberman (do you not remember she was the first to break the threshold?) and Harry Reid quickly added that the Senatorial Democratic Caucus was fully behind Sen. Joe if he should win. This is where the Democrats fucked it. They were not prepared to punish Joe for anything. They gave Joe all the cards for nothing. They might as well have never run Lamont in the first place.
If this had occured and not the flip flopping perpetrated by Reid et. al. in between 2006 and now, then Lieberman would have quickly been silenced, he would have fallen in line and would have lost his credibility.
This isn't what happened. If the Democrats weren't entirely ready to completely lose control of Lieberman, than they shouldn't have supported Lamont AT ALL during the primary. It was an all or nothing race with Lieberman in 2006. The Democrats just didn't have enough balls and decided they wanted a win/win situation...however they were on the Lose/Lose side of that equation.
I am not saying we should have been easier on Lieberman. What I'm saying is that we should be more honest in where we've fucked up with respect to Lieberman.
Also, I think it showed a lot more balls for Lieberman to actively support our foreign policy during the Bush Administartion than for him to have supported it privately, but acted as though he was anti-Bush doctrine during the administration. A weird political dynamic that not all Democrats have been held accountable for. I think the Democrats right now are benefitting from being "the lesser of two necessary evils". I do not appreciate being sold idealism in a bottle with the fine print saying "really just the lesser of two necessary evils", that's unnacceptable to me personally.
OK, I guess I don't disagree with you as much as I thought - I thought you were saying that the primary challenge was unfair or that Lieberman was acting reasonably. I don't think there was anything objectionable about a primary challenge in the first place, given Lieberman's embrace of the other party's platform on the major issue of the election. But afterwards, you're definitely right from a strategic standpoint that they basically pissed him off without taking away any of his power or showing any spine, and that's a recipe for disaster (and it was obvious at the time).
But as I've said earlier in this thread, we wouldn't even have needed his 60th vote in the first place if our Senate weren't so fucked up.
Great piece from the New Yorker regarding the current bill...
QuoteWhy the health care bill is worth passing : The New Yorker
Reforming America's health-insurance system was never going to be an easy task, given people's natural aversion to change (not to mention Republicans' aversion to doing anything that might help Barack Obama). But what's made the task even more difficult is that American politicians—as well as American voters—have a confused, and often contradictory, set of beliefs about how health insurance should work. The wayward, patchwork plan that we seem likely to end up with is probably a good reflection of the wayward, patchwork opinions that most legislators have on the subject.
Consider the Genetic Information Nondiscrimination Act, which went into effect in November. The law prohibits health insurers from using genetic information to set rates or deny coverage. At the moment, genetic testing for disease is still relatively crude and uncommon. That will change in the future. People who know that they are much more likely to get sick, and therefore much more likely to run up huge medical bills, will be able to get insurance at the same price as those with less risky genetic profiles. Everyone, it turns out, supports this: the bill passed unanimously in the Senate, and nearly so in the House.
Politicians on both sides of the aisle overwhelmingly believe, likewise, that insurance companies should be prohibited from taking preëxisting conditions into account when setting prices or extending coverage. Both the House and the Senate reform bills include language banning this. Even Republicans have been vehement on the subject: Senator Tom Coburn, of Oklahoma, has said that "everyone agrees" that we need to eliminate the use of preëxisting conditions, while Senator Chuck Grassley, of Iowa, declared that insurers have to be barred from "charging higher premiums to people who are sick." The insurance companies themselves have accepted that the only factors they'll be allowed to take into account in setting prices will be age, region, and whether or not someone smokes. The general consensus, then, is that even if you're already sick, and guaranteed to run up huge medical bills in the future, you should be able to get health insurance at the same price as someone your age who's perfectly healthy. Economists have a name for this: "community rating." And the fact that it has such strong backing in Washington is heartening. Americans, and American politicians, have decided that people should have guaranteed access to insurance, and that they shouldn't have to worry about losing it just because they get laid off or fall ill.
So where's the contradiction? Well, Congress's support for community rating and universal access doesn't fit well with its insistence that health-care reform must rely on private insurance companies. After all, measuring risk, and setting prices accordingly, is the raison d'être of a health-insurance company. The way individual insurance works now, risk and price are linked. If you're a triathlete with no history of cancer in your family, you're a reasonably good risk, and so you can get an affordable policy that will protect you against unforeseen disaster; if you're overweight with high blood pressure and a history of heart problems, your risk of becoming seriously ill is substantial, and therefore private insurers will either charge you high premiums or not offer you coverage at all. This kind of risk evaluation—what's called "medical underwriting"—is fundamental to the insurance business. But it is precisely what all the new reform plans will ban. Congress is effectively making private insurers unnecessary, yet continuing to insist that we can't do without them.
The truth is that we could do just fine without them: an insurance system with community rating and universal access has no need of private insurers. In fact, the U.S. already has such a system: it's known as Medicare. In most areas, it's true, private companies do a better job of managing costs and providing services than the government does. But not when it comes to health care: over the past decade, Medicare's spending has risen more slowly than that of private insurers. A single-payer system also has the advantage of spreading risk across the biggest patient pool possible. So if you want to make health insurance available to everyone, regardless of risk, the most sensible solution would be to expand Medicare to everyone. That's not going to happen. The fear of government-run health care, the power of vested interests, and the difficulty of completely overhauling the system have made the single-payer solution a bridge too far for Washington, and for much of the public as well. (Support for a single-payer system hovers around fifty per cent.) That's why the current reform plans rely instead on a mishmash of regulations, national exchanges, and subsidies. Instead of replacing private insurance companies, the proposed reforms would, in theory, turn them into something like public utilities. That's how it works in the Netherlands and Switzerland, with reasonably good results.
One could recoil in disgust at the inefficiency and incoherence of the process—at the fact that private insurers will continue to make billions a year providing services the government has shown, via Medicare, that it can provide on its own. But, messy as the reform plans are, they can still dramatically transform the system for the good. Reform would guarantee that tens of millions of people who don't have insurance will get it, and that people who have insurance now won't have to worry about losing it. And, by writing community rating and universal access into law, Congress will effectively be committing itself to the idea that health care, regardless of risk, is a right. If a little incoherence is the price of that deal, it's worth paying. ♦
Read more: http://www.newyorker.com/talk/financial/2010/01/04/100104ta_talk_surowiecki#ixzz0bIXF4eZc (http://www.newyorker.com/talk/financial/2010/01/04/100104ta_talk_surowiecki#ixzz0bIXF4eZc)
Quote from: spaced on December 27, 2009, 05:05:09 PM
OK, I guess I don't disagree with you as much as I thought - I thought you were saying that the primary challenge was unfair or that Lieberman was acting reasonably. I don't think there was anything objectionable about a primary challenge in the first place, given Lieberman's embrace of the other party's platform on the major issue of the election. But afterwards, you're definitely right from a strategic standpoint that they basically pissed him off without taking away any of his power or showing any spine, and that's a recipe for disaster (and it was obvious at the time).
But as I've said earlier in this thread, we wouldn't even have needed his 60th vote in the first place if our Senate weren't so fucked up.
Yeah exactly. What I take issue with is the Democratic Parties current position of just saying "Fuck Joe Lieberman" when they are to blame for creating the monster... it's not all Joe's fault.
MASSIVE election today in Massachusetts.
Quote from: antelope19 on January 19, 2010, 09:14:33 AM
MASSIVE election today in Massachusetts.
yea - Coakley has run a
terrible campaign.
imo, of the candidates who ran in the dem primary, she was one of the weakest, if not the weakest, one in the debates. She has the best statewide organization and the support of the Clintons (who called their supporters before the primary).
It's gonna be close.
If Massachusetts votes Brown in, Ted Kennedy is going to turn over in his grave and I will be extremely :frustrated: Obviously Coakley has run a horrible campaign if the polls are so close in Massachusetts, a hugely Democratic State.
Brown has basically won with 52% of the vote.
Coakley ran the worst smear campaign I have ever witnessed. I am so sick of hearing how Scott Brown will ruin the world. Not once did Coakley say where she stood on any issues.
Hate to say it, but I voted for the third party candidate. I cant stand either of the others.
Well, looks like its official. This health care bill is officially fu**ed :|
healthcare bill was fucked before this, frankly.
this could have more far-reaching repercussions, but we'll have to wait and see.
im sure there are quite a few whacko people out there re-remembering the phrase "obama's waterloo" for their tea parties in coming months, as this is the best possible fuel for their fires.
On the http://www.cnn.com/ (http://www.cnn.com/) breaking news ticker!
House Democrats have 216 votes needed to pass health care reform, chairman of House Democratic Caucus tells CNN.
really hope this passes.
I've VERY dissapointed at the Dems for lots of things on this bill, mostly removing the malpractice reform the Pres said he was in favor of. Still we need universal coverage.
The fact that we have people in this countrly w/o medical coverage is a disgrace. I can go on about stories I see every day, but won't for now.
I don't understand what these people are against. There is no expansion of the federal program, so it's not a govt takeover (for better or worse, I don't think we'll ever have single payer in the US). I almost wish some of the ignorant protestors (and some GOP lawmakers) find out what it's like to get sick and have no medical coverage.
Will Rush really be moving to Costa Rica?
Quote from: slslbs on March 21, 2010, 12:27:52 PM
I've VERY dissapointed at the Dems for lots of things on this bill, mostly removing the malpractice reform the Pres said he was in favor of. Still we need universal coverage.
What seems lost on the majority of your public, is that very few large pieces of legislation ever pass to remain in their original draft. More often than not, legislation is a living entity. These pieces are continuously altered and tailored for contingencies that could not of been foreseen at their inception; social interests and civic understanding inevitably evolve and so must law. Nor is it possible for anyone to envision all the pitfalls without actually putting the concerned legislation to test. Eventually, one must abandon the computer models so that the car may be driven. The Civil Rights Act of '64 hardly looks like it did when it first came into being, with changes often stemming from court challenges, with the court expanding its parameters through interpretation. This health care bill is going to have huge problems and yes, there will be abuses. But as we do with most problems, they will be fixed. To believe that one can present perfection in its infancy is ludicrous, but it does make for a convincing argument. :wink:
I definitely agree with that, which is why I am strongly in favor of the bill.
One of the reasons I am dissapointed in the Dems (other than the malpractice issue) is the process. this could / should have been done months ago, and many of them were holding out based upon small parts of the bill rather than looking at the whole. For instance, those on the left, who want single payer, thought this wasn't far enough. Well, it's a hell of a lot better than what we have. They wanted something perfect, and couldn't see the forest from the trees.
One step at a time, and this is a very big step.
anyway, the health care bill process proves my impressions that-
1) to many (not all) of those in congress, political power is more important than the American people
2)the Dems, as a whole, are inept
3)the GOP, as a whole, is scary / dangerous
Quote from: slslbs on March 21, 2010, 02:19:44 PM
1) to many (not all) of those in congress, political power is more important than the American people
2)the Dems, as a whole, are inept
3)the GOP, as a whole, is scary / dangerous
Correct, correct and correct Steve. You receive a 100% on your Sunday civics quiz. :hereitisyousentimentalbastard
It passed
:-)
Quote from: slslbs on March 21, 2010, 02:19:44 PM
this could / should have been done months ago, and many of them were holding out based upon small parts of the bill rather than looking at the whole.
Due Process... While I favor passage of The Bill, the fact that the Dems went through the entire horse-beating process gave the passage that much more meaning. I think all voices should be heard, despite how absurd (*cough* tea baggers), before a final vote is tallied...
Quote from: slslbs on March 21, 2010, 02:19:44 PM
1) to many (not all) of those in congress, political power is more important than the American people
2)the Dems, as a whole, are inept
3)the GOP, as a whole, is scary / dangerous
1. But their Power is derived from the People. Come November, we may a shift (probably). Those that "held-out", did so because they had to look favorable to their constituencies...
2. Yeah, we've known that for along time... Its the one thing that makes the DNC displeasing to me... Come on! Have some balls! At least the GOP has big hairy ones!
3. Pretty much! If the TeaBaggers are the typical GOP, then we're F***ed when they get in power!
I'm glad it passed. This will be my only post concerning this...
Terry
Bill >
Law
(end set)
Quote from: rowjimmy on March 23, 2010, 11:56:59 AM
Bill >
Law
(end set)
(http://blog.beliefnet.com/moviemom/im-just-a-bill-opt.jpg)
Quote from: rowjimmy on March 23, 2010, 11:56:59 AM
Bill >
Law
(end set)
it's not that easy. (not that this was easy)
still a way to go on this
Quote from: slslbs on March 23, 2010, 03:22:14 PM
Quote from: rowjimmy on March 23, 2010, 11:56:59 AM
Bill >
Law
(end set)
it's not that easy. (not that this was easy)
still a way to go on this
I simply meant that the bill is now law.
understood.
and very psyched about that.
I'm just taking the long view, cause we still have lots of work to do.
Quote from: slslbs on March 23, 2010, 11:43:43 PM
understood.
and very psyched about that.
I'm just taking the long view, cause we still have lots of work to do.
agreed. Should be interesting to see how things play out over the next year or two.
hell, itll be interesting to see how things play out this week.
F BomB Biden
Big ... deal: Joe Biden drops F-Bomb at bill signing (http://www.youtube.com/watch?v=KRsUqUAqQXA#)
I guess it is time to present the minority point of view I was very much against this bill. Against this bill, not providing universal health care.
This bill is exceptionally poorly written. Far too many compromises in the wrong areas. The Cadillac plan tax they put in is going to harm many people trying to get health care. Companies with these plans are already investigating going to private funded plans which means 2 things. 1. No tax revenue they were expecting and 2. these higher plans are what help make the insurance companies profitable and disperse their costs as these higher incomes tend to live healthier lives, those costs are now going to get passed on to the small business and the people buying their own insurance.
Then for those making more than %133 and %400 of the poverty level they must buy insurance or pay a $695 fine. Even with the buying groups the insurance companies can't offer a plan they can afford. Most people making %400 will struggle with even some of the basic health care plans. It is going to offer health care to 32 million people, not provide. They are still going to have to figure out a way to pay for it themselves.
Where it did well was expanding medicaid to more people.
What this bill should have concentrated on was health care reform. Insurance companies have record profits every year and this did nothing to regulate the industry that has developed in a way to prevent affordable health care.
It does nothing to address the fact that costs are rising at such a rate that small businesses are having to drop coverage or not hire to maintain it. They are the heart of job growth in this country and by helping them you would have help the economy and provided coverage to more people.
Prescription drugs, seriously, what the F***. The U.S. pays more to buy drugs from the same companies than any other country. That is at the heart of our rising medical costs, why didn't it address that?
This bill passes costs on to people who can afford healthcare to pay for those who can't and will cause their coverage to decline in doing so. It doesn't actually provide healthcare to the 32 million, and it magically doesn't address industry reform for an industry with lobbiest with really deep pockets.
Can we stop with it will save money? Basic logic makes that impossible. 32 million people don't have a means to coverage today, but will. It saves money by increasing taxes and payments elsewhere, not by actually saving money.
Congressional asshats, had a chance to do something great and did something poor they are masking as great.
(http://www.lamebook.com/wp-content/uploads/2010/03/healthbeware31.png)
(http://www.lamebook.com/wp-content/uploads/2010/03/healthbeware41.png)
http://tpmmuckraker.talkingpointsmemo.com/2010/03/fbi_investigating_cut_gas_line_at_home_of_dem_reps.php (http://tpmmuckraker.talkingpointsmemo.com/2010/03/fbi_investigating_cut_gas_line_at_home_of_dem_reps.php)
apparently protest now entails posting addresses of family members of congresspeople and cutting gas lines at their houses
stay classy, tea party republicans
Quote from: guyforget on March 24, 2010, 02:08:14 PM
http://tpmmuckraker.talkingpointsmemo.com/2010/03/fbi_investigating_cut_gas_line_at_home_of_dem_reps.php (http://tpmmuckraker.talkingpointsmemo.com/2010/03/fbi_investigating_cut_gas_line_at_home_of_dem_reps.php)
apparently protest now entails posting addresses of family members of congresspeople and cutting gas lines at their houses
stay classy, tea party republicans
Sweet, right wing domestic terrorism! They really do love America.
yeah, like the scumbag militia leader Mike Vanderboegh in Alabama who recently took credit for inciting people to throw bricks though congresspeoples's windows and who also recently said that people were "cleaning their weapons." he's also under investigation for leaving messages on a ny congresswoman's voicemail threatening to kill all the children of congresspeople who vote for the bill.
the shocker?
.... he lives on a monthly social security check.
(http://i.imgur.com/590Ev.png) (http://i.imgur.com/590Ev.png)
(click to enlarge)
Quote from: rowjimmy on March 24, 2010, 02:33:55 PM
(http://i.imgur.com/590Ev.png) (http://i.imgur.com/590Ev.png)
FTW
:clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap: :clap:
Quote from: Guyute on March 24, 2010, 07:26:39 AM
I guess it is time to present the minority point of view I was very much against this bill. Against this bill, not providing universal health care.
This bill is exceptionally poorly written. Far too many compromises in the wrong areas. The Cadillac plan tax they put in is going to harm many people trying to get health care. Companies with these plans are already investigating going to private funded plans which means 2 things. 1. No tax revenue they were expecting and 2. these higher plans are what help make the insurance companies profitable and disperse their costs as these higher incomes tend to live healthier lives, those costs are now going to get passed on to the small business and the people buying their own insurance.
Then for those making more than %133 and %400 of the poverty level they must buy insurance or pay a $695 fine. Even with the buying groups the insurance companies can't offer a plan they can afford. Most people making %400 will struggle with even some of the basic health care plans. It is going to offer health care to 32 million people, not provide. They are still going to have to figure out a way to pay for it themselves.
Where it did well was expanding medicaid to more people.
What this bill should have concentrated on was health care reform. Insurance companies have record profits every year and this did nothing to regulate the industry that has developed in a way to prevent affordable health care.
It does nothing to address the fact that costs are rising at such a rate that small businesses are having to drop coverage or not hire to maintain it. They are the heart of job growth in this country and by helping them you would have help the economy and provided coverage to more people.
Prescription drugs, seriously, what the F***. The U.S. pays more to buy drugs from the same companies than any other country. That is at the heart of our rising medical costs, why didn't it address that?
This bill passes costs on to people who can afford healthcare to pay for those who can't and will cause their coverage to decline in doing so. It doesn't actually provide healthcare to the 32 million, and it magically doesn't address industry reform for an industry with lobbiest with really deep pockets.
Can we stop with it will save money? Basic logic makes that impossible. 32 million people don't have a means to coverage today, but will. It saves money by increasing taxes and payments elsewhere, not by actually saving money.
Congressional asshats, had a chance to do something great and did something poor they are masking as great.
I think you made some good points, which is why I earlier said that we still have a lot of work to do. I see this as an important first step, but what still has to be figured out is how to actually reduce costs. The 3rd party payers and the govt had addressed this by simply telling doctors and hospitals "we are going to pay you less", which doesn't make sense.
we could have had a good bill if the top minds in both parties sat down and discussed it with input from the medical community, and didn't worry about the politics. Being that this is the USA in the 21 century, an intelligent process in lawmaking is impossible, and this is what we got stuck with.
Quote from: slslbs on March 24, 2010, 04:57:57 PM
we could have had a good bill if the top minds in both parties sat down and discussed it with input from the medical community, and didn't worry about the politics. Being that this is the USA in the 21 century, an intelligent process in lawmaking is impossible, and this is what we got stuck with.
due to the way the government in your country is set up, a two party system that requires unwavering polarity for its populous support, this is how you must now advance legislation. First, get the ball rolling no matter how bad it looks on paper, as has just happened. And then, when the dust settles, both sides will come to the table, having dropped their polemical arguments so that they may hammer out something that will truly help the country. This is the only way that the legislative process can be steered away from a zero sum game and in this manner neither loses face (Japanese term not to be confused with melting face).
Quote from: Superfreakie on March 24, 2010, 05:22:23 PM
Quote from: slslbs on March 24, 2010, 04:57:57 PM
we could have had a good bill if the top minds in both parties sat down and discussed it with input from the medical community, and didn't worry about the politics. Being that this is the USA in the 21 century, an intelligent process in lawmaking is impossible, and this is what we got stuck with.
due to the way the government in your country is set up, a two party system that requires unwavering polarity for its populous support, this is how you must now advance legislation. First, get the ball rolling no matter how bad it looks on paper, as has just happened. And then, when the dust settles, both sides will come to the table, having dropped their polemical arguments so that they may hammer out something that will truly help the country. This is the only way that the legislative process can be steered away from a zero sum game and in this manner neither loses face (Japanese term not to be confused with melting face).
maybe if both sides melted face we could get something done
Here's a slide show of what is basically included in the reform bill...
http://www.salon.com/news/feature/2010/03/19/healthcare_facts_slideshow/slideshow.html# (http://www.salon.com/news/feature/2010/03/19/healthcare_facts_slideshow/slideshow.html#)
Quote from: rowjimmy on March 24, 2010, 02:33:55 PM
(http://i.imgur.com/590Ev.png) (http://i.imgur.com/590Ev.png)
(click to enlarge)
:clap: :clap: :clap:
Quote from: Superfreakie on March 24, 2010, 05:22:23 PM
Quote from: slslbs on March 24, 2010, 04:57:57 PM
we could have had a good bill if the top minds in both parties sat down and discussed it with input from the medical community, and didn't worry about the politics. Being that this is the USA in the 21 century, an intelligent process in lawmaking is impossible, and this is what we got stuck with.
due to the way the government in your country is set up, a two party system that requires unwavering polarity for its populous support, this is how you must now advance legislation. First, get the ball rolling no matter how bad it looks on paper, as has just happened. And then, when the dust settles, both sides will come to the table, having dropped their polemical arguments so that they may hammer out something that will truly help the country. This is the only way that the legislative process can be steered away from a zero sum game and in this manner neither loses face (Japanese term not to be confused with melting face).
(http://www.groovanauts.com/board/images/smilies/biggthumpup.gif)
+K to RJ and Superfreakie
(http://z.about.com/d/politicalhumor/1/0/B/J/3/obama-package-headline.jpg)
the bill's going back to the house
Quote from: yotta on March 25, 2010, 03:36:55 AM
anything you say in vwashington somebodys gonna bitch at you per se. so, end of the day, millions of people are now insured. in the words of a raggae tune, "if love were a king that money woulda buyed, the rich woulda lived, the poor woulda DIED"
probably the most cogent thing you've uttered yet on the paug...
(http://week4paug.net/tet/jokerclap.gif)
Quote from: guyforget on March 25, 2010, 03:09:53 AM
the bill's going back to the house
not "the BILL", the reconciliation.
correct, the reconciliation bill
it was late...
(http://www.salon.com/entertainment/comics/this_modern_world/2010/03/29/this_modern_world/story.jpg)
QuoteRepublicans, Leukemia Team Up To Repeal Health Care Law
April 8, 2010 | ISSUE 46•14
(http://media.theonion.com/images/articles/article/17215/Republicans_large.jpg)
Key Republicans and the blood cancer leukemia make a joint statement condemning the health care bill.
WASHINGTON—Citing a mutually shared vision of health care in America, congressional Republicans and the deadly bone-marrow cancer leukemia announced a joint effort Wednesday to repeal the Patient Protection and Affordable Care Act, the historic new bill that extends health benefits to 32 million Americans nationwide.
"Republicans have no greater ally in this fight than leukemia," said Sen. Jim DeMint (R-SC), who was flanked by Sen. Mitch McConnell (R-KY), House Minority Leader John Boehner (R-OH), and the abnormal increase in white blood cells. "Denying insurance to Americans with preexisting conditions and ensuring that low-income Americans stand no chance of receiving quality health care are just a few of the core beliefs that the GOP and leukemia share."
"And believe me, if anyone is angrier than the Republican Party that children can no longer be denied coverage for having preexisting conditions, it's leukemia." DeMint continued. "We're a match made in heaven."
continued @ http://www.theonion.com/articles/republicans-leukemia-team-up-to-repeal-health-care,17215/ (http://www.theonion.com/articles/republicans-leukemia-team-up-to-repeal-health-care,17215/)
Sue Lowden's plan to pay for health care? "Bring a chicken to the doctor" (http://www.youtube.com/watch?v=qZezfjWox5s#ws)
thought this was a good time to bump this one.
on the way to the Supreme Court
QuoteAppeals court strikes health insurance requirement
By Greg Bluestein
Associated Press / August 12, 2011
ATLANTA—A federal appeals panel struck down the centerpiece of President Barack Obama's sweeping health care overhaul Friday, moving the argument over whether Americans can be required to buy health insurance a step closer to the U.S. Supreme Court.
Tweet 3 people Tweeted this
ShareThis
The divided three-judge panel of the 11th Circuit Court of Appeals concluded Congress overstepped its authority when lawmakers passed the so-called individual mandate, the first such decision by a federal appeals court. It's a stinging blow to Obama's signature legislative achievement, as most experts agree the requirement that Americans carry health insurance -- or face tax penalties -- is the foundation for other parts of the law.
Chief Judge Joel Dubina and Circuit Judge Frank Hull found in a 207-page opinion that lawmakers cannot require residents to "enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die."
In a lengthy dissent, Circuit Judge Stanley Marcus accused the majority of ignoring the "undeniable fact that Congress' commerce power has grown exponentially over the past two centuries." He wrote that Congress generally has the constitutional authority to create rules regulating large areas of the national economy.
The White House argued the legislative branch was using a "quintessential" power -- its constitutional ability to regulate interstate commerce, including the health care industry -- when it passed the overhaul law. Administration officials said they are confident the ruling will not stand. The Justice Department can ask the full 11th Circuit to review the panel's ruling and will also likely appeal to the Supreme Court.
"Individuals who choose to go without health insurance are making an economic decision that affects all of us -- when people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab," said White House adviser Stephanie Cutter.
The 11th Circuit's ruling, which sided with 26 states that had sued to stop the law from taking effect, is the latest contradictory judicial opinion on the health care debate. The federal appeals court in Cincinnati upheld the individual mandate in June, and an appeals court in Richmond has heard similar challenges to the law. Several lower court judges have also issued differing opinions on the debate.
Legal observers long expected the case would ultimately land in the Supreme Court, but experts said Friday's ruling could finally force the justices to take the case.
"There needs to be a pronouncement that's nationwide," said Carl Tobias, a professor at the University of Richmond School of Law. "It would be almost impossible to implement it if we have splintered decisions from different geographic circuits. The Supreme Court may feel now it has to take it."
J. Peter Rich, a Los Angeles-based health care attorney, said the Supreme Court had never weighed in on an issue such as the provision requiring individuals to buy health insurance.
"They have never ruled on this specific issue," he said. "This really is a case of first impression, although the Obama administration may try to argue otherwise."
Rich said it's not unconstitutional for individual states to have such requirements, noting that Massachusetts has a similar law in place. However, the high court has yet to weigh in on whether a federal requirement passes muster.
It's the latest hit the president's taken in what's been a rough month that's included humiliating blows on both the economy and in Afghanistan, while polls show deteriorating public support for both him and Congress.
Obama has been criticized by his Democratic base for his failures, which include dropping his push for tax increases as part of last week's compromise to raise the government's debt ceiling and his inability to let the Bush tax cuts for the wealthy to expire at the end of last year.
The Atlanta-based court is considered by many observers to be the most pivotal legal battleground yet because it reviewed a sweeping ruling by U.S. District Judge Roger Vinson, who not only struck down the individual mandate but threw out other provisions ranging from Medicare discounts for some seniors to a change that allows adult children up to age 26 to remain on their parents' coverage.
His reasoning was that the insurance requirement was "inextricably bound together" with the rest of the law, but the 11th Circuit concluded Vinson went too far. The panel's ruling noted that the "lion's share of the act has nothing to do with private insurance, much less the mandate that individuals buy insurance."
The provision requiring all Americans to carry health insurance or face a tax penalty has been at the center of the legal debate. The law does not allow insurers to turn away the sick or charge them outrageous premiums. To cover their health care costs, others -- particularly the young and healthy -- will need to pay premiums to keep costs from skyrocketing. The potential tax penalties are meant to ensure they will do so.
The Obama Administration also has a little-known fallback if it loses the court battle. The government can borrow a strategy that Medicare uses to compel consumers to sign up for insurance.
Medicare's "Part B" coverage for doctor visits carries its own monthly premium. Yet more than nine in 10 seniors sign up. The reason: Those who opt out when they first become eligible face a lifelong tax penalty that escalates the longer they wait.
The key difference is that the Medicare law doesn't require that seniors buy the Part B coverage. Experts say Obama's overhaul could also be changed in a similar fashion.
The states had urged the 11th Circuit to uphold Vinson's ruling, saying in a court filing that letting the law stand would set a troubling precedent that "would imperil individual liberty, render Congress's other enumerated powers superfluous, and allow Congress to usurp the general police power reserved to the states."
The Justice Department countered that Congress had the power to require most people to buy health insurance or face tax penalties because Congress can regulate businesses that operate across state lines, including health care providers.
The reaction was swift and celebratory from the states that filed the lawsuit.
Michigan Attorney General Bill Schuette called the decision a "huge victory in the fight to protect the freedom of American citizens from the long arm of the federal government." Alabama Attorney General Luther Strange called it a "monumental case" for individual liberty. And Texas Attorney General Greg Abbott declared: "'Obamacare' is closer to an end."
A separate legal ruling Friday also buoyed critics of the law. The Ohio Supreme Court appeared to clear the way for voters there to decide whether to reject parts of the health care law in November with a unanimous ruling that rejected a liberal policy group's challenge of the so-called Health Care Freedom Amendment.
But the administration did get a small dose of good news Friday. The federal appeals court in San Francisco found that a former California lawmaker and a legal foundation could not file another challenge on the overhaul.
The 11th Circuit's ruling in Atlanta didn't come as a complete surprise. During oral arguments in June, each of the three judges repeatedly raised questions about the overhaul and expressed unease with the insurance requirement. And each judge worried aloud if upholding the landmark law could open the door to Congress adopting other sweeping economic mandates.
The arguments took place in what's considered one of the nation's most conservative appeals courts, but the randomly selected panel represents different judicial perspectives.
None of the three is considered either a stalwart conservative or an unfaltering liberal, but observers were quick to point out that the decisive vote came from a Democrat appointee. Hull, a former federal judge in Atlanta, was tapped by President Bill Clinton.
http://www.realclearpolitics.com/articles/2011/10/21/obamacares_broken_promises_111762.html
Quote
ObamaCare's Broken Promises
WASHINGTON -- Hard times continue for the Affordable Care Act (aka Obamacare). The administration has scrapped the law's long-term care insurance program, covering nursing homes and home health care. The program was deemed unrealistic. This is a harbinger. As the law is implemented -- assuming the Supreme Court doesn't declare it unconstitutional or Republicans don't repeal it -- disappointments will mount.
Nursing homes are expensive; typical costs can run up to $80,000 per patient annually. Home health care averages almost $22,000. The ACA mandated that the long-term insurance, called CLASS (for Community Living Assistance Services and Supports), be self-sustaining. Private insurance premiums would cover costs without government subsidies. Impossible, the administration found.
Premiums would be high, at least $235 and a month and perhaps as much as $3,000. People wouldn't sign up, and those who did would be very sick. Huge deficits would eventually emerge. Maybe CLASS supporters cynically hoped the administration would justify artificially low premiums. Government would then have to cover the ultimate shortfalls or throw thousands of elderly into the streets. The administration wisely rejected that path.
This setback heralds others. Controlling health spending was a major promise. After all, it's called the Affordable Care Act, and boosters argue that it will subdue runaway spending. It almost certainly won't. One prominent skeptic is Arnold Relman, the former editor of The New England Journal of Medicine.
Writing in The New York Review of Books, Relman says that "the law does very little or nothing to address some of the most important causes of the high cost of care and its rapid inflation." Note: Relman isn't a conservative crank. He's a critic of insurance companies and advocates a single-payer, government-run health-care system.
The ACA, Relman writes, doesn't alter fee-for-service reimbursement that gives "all physicians strong financial incentives to provide more services than needed." The resulting "fragmentation of medical care ... allows specialists to practice in isolation without restraints on cost, causes duplication and disorganization of services, and discourages the use of primary care physicians."
Relman is unimpressed with the ACA provisions intended to control costs: for example, the Independent Payment Advisory Board (IPAB). It's a group of 15 experts who would recommend changes if government health spending rose too rapidly.
"However, the law stipulates that the IPAB cannot reduce Medicare benefits or increase Medicare premiums, and it defers any proposed reductions in payments to hospitals for a few years," Relman writes. The IPAB would mainly cut physicians' Medicare reimbursement rates, he says. But doctors could "easily" offset these cuts "by providing more services, such as performing more diagnostic tests."
Relman also dismisses "accountable care organizations" (ACOs) that supposedly save money through coordinated care by doctors and hospitals. The regulations governing ACOs will be so complicated that there won't be many of them, he writes.
"Restructuring the delivery of medical care" is essential, Relman says. He takes hope in the growth of multi-specialty groups that include both primary doctors and specialists. Nearly 200,000 doctors, about a quarter of practicing physicians, now belong to these groups, he says. On paper, they can better control costs by limiting duplication, fostering cooperation and eliminating wasteful services. But this isn't likely as long as fee-for-service prevails.
Something needs to force change. Republicans have a strategy. Rep. Paul Ryan would convert Medicare -- the nation's largest insurance program -- into a voucher system. Medicare beneficiaries would receive a fixed amount and would shop for the most appealing health plan that their money would buy. Government spending would be limited by size of the vouchers. To attract patients, doctors and hospitals would be compelled -- so the theory goes -- to combine in ways that lowered costs and improved quality. Through tax credits, the same approach would apply to the under-65 population.
Relman's solution is not entirely dissimilar. He would replace fee-for-service with an annual per-patient payment to doctors who would be responsible for the patient's "comprehensive care." Both Ryan's voucher and Relman's lump sum are what health experts call "capitation" or "global payments." The big difference is that Relman would have government administer the payments directly, with attendant regulations. A single-payer system, he thinks, would extract savings from the overhead and profit of the insurance industry. In 2011, that's estimated at $152 billion, 5.6 percent of health spending.
Despite profound differences, both these radical proposals proceed from common premises: Limiting health-care spending requires explicit ceilings on the dollars put into the system; and changing incentives for doctors and hospitals will create a superior delivery system. We should be debating ideas like these, because overhauling the health-care system is important in its own right and for controlling federal spending. Instead, the ACA skews the agenda. Many of its promises rest, like CLASS, on unrealistic assumptions. Disappointments loom, and the needed debate is deferred.
QuoteAppeals court upholds Obama health care law
By Nedra Pickler
Associated Press / November 8, 2011
WASHINGTON—A conservative-leaning appeals court panel on Tuesday upheld the constitutionality of President Barack Obama's health care law, as the Supreme Court prepares to consider this week whether to resolve conflicting rulings over the law's requirement that all Americans buy health care insurance.
A panel of the U.S. Court of Appeals for the District of Columbia issued a split opinion upholding the lower court's ruling that found Congress did not overstep its authority in requiring people to have insurance or pay a penalty on their taxes, beginning in 2014. The requirement is the most controversial requirement of Obama's signature domestic legislative achievement and the focus of conflicting opinions from judges across the country. The Supreme Court could decide as early as Thursday during a closed meeting of the justices whether to accept appeals from some of those earlier rulings.
The suit in Washington was brought by the American Center for Law and Justice, a legal group founded by evangelist Pat Robertson. It claimed that the insurance mandate is unconstitutional because it forces Americans to buy a product for the rest of their lives and that it violates the religious freedom of those who choose not to have insurance because they rely on God to protect them from harm. But the court ruled that Congress had the power to pass the requirement to ensure that all Americans can have health care coverage, even if it infringes on individual liberty.
"That a direct requirement for most Americans to purchase any product or service seems an intrusive exercise of legislative power surely explains why Congress has not used this authority before -- but that seems to us a political judgment rather than a recognition of constitutional limitations," Judge Laurence Silberman, an appointee of President Ronald Reagan wrote in the court's opinion. Silberman was joined by Judge Harry Edwards, a Carter appointee. But, they added, "The right to be free from federal regulation is not absolute and yields to the imperative that Congress be free to forge national solutions to national problems."
Judge Brett Kavanaugh, a former aide to President George W. Bush who appointed him to the bench, disagreed with the conclusion without taking a position on the merits of the law. He wrote a lengthy opinion arguing the court doesn't have jurisdiction to review the health care mandate until after it takes effect in 2014.
The federal appeals court in Cincinnati also upheld the law. The federal appeals court in Atlanta struck down the core requirement that Americans buy health insurance or pay a penalty, while upholding the rest of the law.
And like Kavanaugh's dissenting opinion, an appeals court in Richmond, Va., ruled it was premature to decide the law's constitutionality. This aspect of the court challenges issue involves a federal law aimed at preventing lawsuits from tying up tax collection. Kavanaugh and the Richmond court held that taxpayers must begin paying the penalty for not purchasing insurance before they can challenge it in court.
Jay Sekulow, chief counsel for the American Center for Law and Justice, which filed the suit in Washington, said the group is considering whether to ask the full appeals court to hear the case or make a request directly to the Supreme Court. "We still remain confident that Obamacare and the individual mandate, which forces Americans to purchase health insurance, is the wrong prescription for America and ultimately will be struck down as unconstitutional by the U.S. Supreme Court," Sekulow said.
The liberal interest group Constitutional Accountability Center said the ruling from a solid conservative like Silberman, as the Supreme Court prepares to take up the issue, is a "devastating blow" to opponents of the law.
"With two prominent conservatives, this panel was thought to be a dream come true for conservative challengers of the act," said the center's president, Doug Kendall. "Today that dream became a nightmare, as the panel unanimously rejected the challenges to the act, disagreeing only about why those challenges failed."
didn't see your post until just now.
One of the valid criticisms of the ACA is that it does nothing directly to reduce costs. Indirectly, by encouraging cooperation among providers (ACOs, I think they are called), electronic health records (which will hopefully reduce duplication and errors) and other initiatives they are hoping costs will go down. Also, by making health care accessible, people can get into the system for preventative care or care in the early stage of disease as opposed to just going to ERs (expensive) or waiting until they are sick (also expensive).
Capitation was tried in the northeast in the mid to late 90s and was eventually discarded by the insurance companies. They didn't publicly state why - either it wasn't saving as much $ as they thought or there were pt complaints who felt their doctor's interests were to NOT give care, order tests, etc, as opposed to giving care.
I don't claim to know the real answer - if there was one someone would have come up with it by now
Drumroll, please. A SCOTUS decision in the middle of the campaign should make for some entertaining debates.
http://www.nytimes.com/2011/11/15/us/supreme-court-to-hear-case-challenging-health-law.html
Quote
Supreme Court to Hear Case Challenging Health Law
WASHINGTON — The Supreme Court on Monday agreed to hear a challenge to the 2010 health care overhaul law, President Obama's signature legislative achievement. The development set the stage for oral arguments by March and a decision in late June, in the midst of the 2012 presidential campaign.
The court's decision to step in had been expected, but Monday's order answered many questions about just how the case would proceed. Indeed, it offered a roadmap toward a ruling that will help define the legacy of the Supreme Court under Chief Justice John G. Roberts Jr.
Appeals from three courts had been vying for the justices' attention, presenting an array of issues beyond the central one of whether Congress has the constitutional power to require people to purchase health insurance or face a penalty through the so-called individual mandate.
The Supreme Court agreed to hear appeals from just one decision, from the United States Court of Appeals for the 11th Circuit, in Atlanta, the only one so far striking down the mandate. The decision, from a divided three-judge panel, said the mandate overstepped Congressional authority and could not be justified by the constitutional power "to regulate commerce" or "to lay and collect taxes."
The appeals court went no further, though, severing the mandate from the rest of the law.
On Monday, the justices agreed to decide not only whether the mandate is constitutional but also whether, if it is not, how much of the balance of the law, the Patient Protection and Affordable Care Act, must fall along with it.
Even the Obama administration, while arguing that the mandate is perfectly constitutional, has said that it is "absolutely intertwined" with two other provisions — one forbidding insurers to turn away applicants, the other barring them from taking account of pre-existing conditions.
The 11th Circuit ruled for the administration on another point, rejecting a challenge to the law's expansion of the Medicaid program. The Supreme Court also agreed to hear an appeal from that ruling.
The 26 states, represented by Paul D. Clement, a former United States solicitor general, had argued that Congress had exceeded its constitutional authority by expanding the eligibility and coverage thresholds that states must adopt to remain eligible to participate in Medicaid.
The problem, Mr. Clement wrote, was that "Congress did not tie its new conditions only to those additional federal funds made newly available under" the Affordable Care Act. "It instead made the new terms a condition of continued participation in Medicaid, thereby threatening each State with the loss of all federal Medicaid funds — on average, more than a billion dollars per year — unless it adopts the act's substantial expansions of state obligations."
On Monday, the justices agreed to consider that question. The justices also said they would consider an intriguing threshold issue.
In September, a divided three-judge panel of the United States Court of Appeals for the Fourth Circuit, in Richmond, Va., ruled that it was premature to decide the case in light of the Anti-Injunction Act, a federal law that bars suits "for the purpose of restraining the assessment or collection of any tax." The Supreme Court had interpreted the term "tax" very broadly for purposes of the law.
If the Fourth Circuit ruling is correct, individuals may not challenge the individual mandate until the first penalty is due in April 2015. On Tuesday, a dissenting judge on the United States Court of Appeals for the District of Columbia Circuit also endorsed that position.
The administration had initially pressed but later abandoned the argument. In the Supreme Court, the Justice Department suggested that the court consider the issue and perhaps appoint a lawyer to present arguments in favor of it, as the court occasionally does when the parties agree on a significant issue that could alter the outcome of the eventual decision.
I'm not a big fan of the mandate, on principle, so I wouldn't be heartbroken to see it struck down. As I understand it, the government's justification of this is based upon the interstate commerce clause, correct? There's something that has been invoked to no end in justifying all sorts of creeping federal gov't influence. I'd sure love to see it rolled back, but a part of me would think that finally doing so now, for the sake of checking ObamaCare, would be just as much a political statement by the court's conservatives as it would be an expression of their allegiance to the strict letter of the constitution.
Quote from: V00D00BR3W on November 14, 2011, 12:00:01 PM
I'm not a big fan of the mandate, on principle, so I wouldn't be heartbroken to see it struck down. As I understand it, the government's justification of this is based upon the interstate commerce clause, correct? There's something that has been invoked to no end in justifying all sorts of creeping federal gov't influence. I'd sure love to see it rolled back, but a part of me would think that finally doing so now, for the sake of checking ObamaCare, would be just as much a political statement by the court's conservatives as it would be an expression of their allegiance to the strict letter of the constitution.
Yes, the defense of the mandate (that Obama ridiculed Hillary for during the primary) revolves around the fact that Congress can regulate interstate commerce and that, since the decision to either buy or forego health insurance is an economic one, it can be legislated. The expanded interpretation of the Commerce Clause, along with the Necessary and Proper Clause, can be/have been used to legally justify pretty much anything Congress wants to do. But, setting aside personal feelings about the ACA, are people really comfortable with granting that kind of all encompassing power to a bunch of clowns who everyone admits have no clue what the hell they are doing? If the precedent is set that Congress can force every citizen to buy a product from a private for-profit company, where does that stop? Like you, I am just not comfortable with that kind of unrestrained gov't.
The practical reason why the administration needs the mandate is because it is the only way to appease the insurance companies. You cannot have the pre-existing condition ban and guaranteed issue (i.e., no one can be rejected for coverage for any reason) without the mandate. But give the health insurance industry access to 50M captive new customers and it suddenly becomes a lot more palatable.
But here's what I don't understand about your response, VB: you admit the mandate blows and that you believe there should be some limits on Congress' power, but then you question the motives of the conservative bloc. If you think you the mandate should be struck down, why does it matter how it comes to pass? Don't get me wrong, I'll take no great pleasure in watching the self-righteous GOP dooshes whacking each other off, but in the end I'll be able to celebrate a win for liberty while chastising the dildos doing drive-by moonings of the White House.
Quote from: runawayjimbo on November 14, 2011, 04:26:34 PM
Quote from: V00D00BR3W on November 14, 2011, 12:00:01 PM
I'm not a big fan of the mandate, on principle, so I wouldn't be heartbroken to see it struck down. As I understand it, the government's justification of this is based upon the interstate commerce clause, correct? There's something that has been invoked to no end in justifying all sorts of creeping federal gov't influence. I'd sure love to see it rolled back, but a part of me would think that finally doing so now, for the sake of checking ObamaCare, would be just as much a political statement by the court's conservatives as it would be an expression of their allegiance to the strict letter of the constitution.
Yes, the defense of the mandate (that Obama ridiculed Hillary for during the primary) revolves around the fact that Congress can regulate interstate commerce and that, since the decision to either buy or forego health insurance is an economic one, it can be legislated. The expanded interpretation of the Commerce Clause, along with the Necessary and Proper Clause, can be/have been used to legally justify pretty much anything Congress wants to do. But, setting aside personal feelings about the ACA, are people really comfortable with granting that kind of all encompassing power to a bunch of clowns who everyone admits have no clue what the hell they are doing? If the precedent is set that Congress can force every citizen to buy a product from a private for-profit company, where does that stop? Like you, I am just not comfortable with that kind of unrestrained gov't.
The practical reason why the administration needs the mandate is because it is the only way to appease the insurance companies. You cannot have the pre-existing condition ban and guaranteed issue (i.e., no one can be rejected for coverage for any reason) without the mandate. But give the health insurance industry access to 50M captive new customers and it suddenly becomes a lot more palatable.
But here's what I don't understand about your response, VB: you admit the mandate blows and that you believe there should be some limits on Congress' power, but then you question the motives of the conservative bloc. If you think you the mandate should be struck down, why does it matter how it comes to pass? Don't get me wrong, I'll take no great pleasure in watching the self-righteous GOP dooshes whacking each other off, but in the end I'll be able to celebrate a win for liberty while chastising the dildos doing drive-by moonings of the White House.
Precisely because of the abuses of the interstate commerce argument we've seen pile up over the years. I think mainstream conservatives are probably only slightly more interested than their liberal counterparts in enforcing a very narrow application of this concept, broadly speaking. But when it's being used to justify a liberal pet project, people tend to rediscover their ideological purity pretty fast.
Just a cynical side comment, really...
As someone who is a healthcare professional AND as someone who meets with 8-10 small business(2-250 employees) owners a week to consult with them about their employee benefits, I feel like I should weigh in on this.......
The VAST majority of them, both men and women, think it's a joke and are pretty tired of being told they have to do one thing one week and something different the next(see COBRA). The overwhelming response? "Does it even matter? Who knows what's going to happen or what we're going to be responsibloe for? There's a (good) chance the president won't even be re-elected"
Don't shoot the messenger! Just forwarding the sentiments of the small business owner in the MD, DC, and northern VA area. I know it's not the popular opinion around here, but there's alot of truth what I'm dealing with on a daily basis.
Quote from: V00D00BR3W on November 14, 2011, 05:36:47 PM
Precisely because of the abuses of the interstate commerce argument we've seen pile up over the years. I think mainstream conservatives are probably only slightly more interested than their liberal counterparts in enforcing a very narrow application of this concept, broadly speaking. But when it's being used to justify a liberal pet project, people tend to rediscover their ideological purity pretty fast.
Just a cynical side comment, really...
I hear you. I think both sides are pretty quick to abandon their principles when it benefits their prerogative. I was just pointing out that it doesn't make sense to let the partisan hacks and their inherent dickishness influence your opinion. Bad policy is bad policy regardless of who proposes it.
Quote from: antelope19 on November 14, 2011, 10:00:58 PM
The VAST majority of them, both men and women, think it's a joke and are pretty tired of being told they have to do one thing one week and something different the next(see COBRA). The overwhelming response? "Does it even matter? Who knows what's going to happen or what we're going to be responsibloe for? There's a (good) chance the president won't even be re-elected"
I know it's a stock GOP line, but the uncertainty created by burdensome regulation really is a major reason why employers are reluctant to hire.
It's also a MAJOR reason why companies AREN'T offering health insurance if they aren't already. Not only are they required to shoulder a huge expense from the premiums, they're having to pay extra for lawyers and CPAs for advice to make sure their going to be in compliance. Based on the penalties they would be subjected to if they weren't in compliance, I can't say I blame them. The fines alone would force many a small business to close its doors.
Quote from: antelope19 on November 14, 2011, 10:00:58 PM
The VAST majority of them, both men and women, think it's a joke
It
is a joke. Because the vast majority will retain their employer based insurance. And so it won't make a difference...
Now if you tell me that my rates will go up because of it, I'd rather say the rates would go up because the wind blows...
Terry
Quote from: runawayjimbo on November 14, 2011, 10:25:22 PM
Quote from: antelope19 on November 14, 2011, 10:00:58 PM
The VAST majority of them, both men and women, think it's a joke and are pretty tired of being told they have to do one thing one week and something different the next(see COBRA). The overwhelming response? "Does it even matter? Who knows what's going to happen or what we're going to be responsibloe for? There's a (good) chance the president won't even be re-elected"
I know it's a stock GOP line, but the uncertainty created by burdensome regulation really is a major reason why employers are reluctant to hire.
I call bullshit:
QuoteWASHINGTON -- With the economy in a slump for nearly four years, corporate executives and conservative politicians have repeatedly invoked "uncertainty" as a major barrier to American job-creation. The "uncertainty" jab is a go-to talking point for any congressional Republican looking to tag President Barack Obama as a tax-raising, regulation-obsessed foe of American businesses.
But according to banking data compiled by economic research firm Moebs Services, the uncertainty plaguing the American economy has nothing to do with government regulations or taxes on millionaires. It's an uncertainty driven squarely by consumers and small-businesses who are worried about their short-term financial prospects. And it's been going on since well before Obama took up residence in the White House.
Since the end of 2007, bank customers have pulled over $900 billion out of certificates of deposits at major U.S. banks, parking their money in checking accounts and money market deposit accounts. Banks pay customers interest to park their money in CDs, but pay out next-to-nothing for money market accounts, and still less -- usually nothing -- for checking accounts.
"These are enormous shifts," Moebs Services founder and Chairman Mike Moebs told HuffPost. "We haven't seen stuff like this since the 1930s."
Money market and checking accounts offer consumers the ability to withdraw their money quickly, while CDs require the funds to be locked up for years. And that heavy reliance on short-term cash indicates a tremendous amount of uncertainty among the American public about the future -- people with jobs are uncertain about whether they will have one in a year, people without jobs have to pay the bills and don't know how long their unemployment checks will keep coming in.
"People are beginning to realize that zero is a good number if the alternative is a negative number," said Ed Friedman, a director at Moody's Analytics.
The total balance of retail CDs -- interest-bearing accounts targeting ordinary consumers -- has fallen by about $350 billion since the end of 2007. Checking accounts, meanwhile, have climbed by an almost identical amount over the same time period -- jumping from $620 billion to $960 billion, an increase of over 50 percent, which has occurred despite repeated threats from big banks to charge new checking fees.
Another $570 billion has been pulled from "jumbo" CDs -- bigger CD accounts that are used by the wealthy or businesses -- while money market deposit account balances have jumped from $3.9 trillion to $5.7 trillion, suggesting an additional flow of money from other investments, like the stock market and mutual funds.
"People continue to be very pessimistic," said economist Dean Baker, co-Director of the Center for Economic Policy and Research, noting that economic conditions like the trouble in Europe could dramatically disrupt financial markets in the near future. "It wouldn't be irrational to stay out now."
This rush to easily accessed, low-paying accounts is a symptom of the recession itself. When people are out of work, they cannot afford the luxury of having their money tied up in longer-term investments. The bills have to be paid.
The shift in consumer banking behavior has also tracked an overall stagnation in the federal money supply, making the change all the more significant.
Moebs runs calculations that correspond to a measure of the total supply of money that the Federal Reserve ceased to cover during the Bush years, once known as the "M3" metric. The metric aggregates the currency in peoples' pocketbooks, checking accounts, CDs, money market accounts and other assets that were viewed as highly liquid prior to the current recession. And according to Moebs, that supply of money has gone from $10.6 trillion in 2007 to $11.3 trillion in the first quarter of 2011 -- an increase of less than 2 percent per year. That compares to an increase of more than 9 percent over the course of 2007 alone.
This kind of uncertainty -- a lack of consumer confidence -- can become a self-fulfilling prophecy. When consumers pull their money out of longer-term investments, banks are reluctant to make longer-term loans, which in turn can hamper businesses, which become reluctant to hire without access to credit. The government can, in fact, take steps to alleviate the kind of uncertainty by boosting demand in the economy -- essentially, spending government money. But with congressional Republicans vilifying government spending on a regular basis, this prospect has been unlikely for years.
"It's really a function of the liquidity trap," said Josh Bivens, an economist with the Economic Policy Institute, a liberal think-tank. "We have way too little spending in the economy, which is why we have low interest rates across the board. But then once you see interest rates piling up near the zero-bound, uncertainty is going to drive people to cash."
The Federal Reserve, however, has options. The Fed has kept interest rates low for years, and resorted to exotic maneuvers to encourage consumers and companies to spend money and boost the economy. But since 2008, the Fed has actually paid banks to park their excess reserves at the central bank, rather than lend them out into the economy. If the Fed wanted that money to make its way to consumers and businesses and stimulate job growth, it could simply reverse its policy -- instead of paying banks interest on excess reserves, it could charge them fees. At present, banks can actually make money by doing nothing with their money. If there were a penalty for doing nothing, banks would work harder to find good loan candidates.
"The money doesn't end up going out into the marketplace," Nomi Prins, former managing director for Goldman Sachs, said. "It would make sense to reverse the policy."
http://www.huffingtonpost.com/2011/11/13/gop-uncertain-economy-debunked_n_1088448.html
I called bullshit as soon as an insurance salesman referred to himself as a healthcare professional.
Quote from: mirthbeatenworker on November 15, 2011, 08:52:58 AM
I called bullshit as soon as an insurance salesman referred to himself as a healthcare professional.
This
Quote from: rowjimmy on November 15, 2011, 08:24:51 AM
Quote from: runawayjimbo on November 14, 2011, 10:25:22 PM
Quote from: antelope19 on November 14, 2011, 10:00:58 PM
The VAST majority of them, both men and women, think it's a joke and are pretty tired of being told they have to do one thing one week and something different the next(see COBRA). The overwhelming response? "Does it even matter? Who knows what's going to happen or what we're going to be responsibloe for? There's a (good) chance the president won't even be re-elected"
I know it's a stock GOP line, but the uncertainty created by burdensome regulation really is a major reason why employers are reluctant to hire.
I call bullshit:
http://www.huffingtonpost.com/2011/11/13/gop-uncertain-economy-debunked_n_1088448.html
Well if the HuffPo says it, it must be so. :roll: So what, in your mind, debunks the very real world example lope gave about the uncertainty small employers are facing with respect to healthcare costs and the lanside of regulatory hoop jumping that goes along with it?
Of course there are a multitude of reasons why we've lost millions of jobs since Obama took office. But to think consumer uncertainty as represented by an increase in checking accounts has more to do with staggering levels of long-term unemployment than an inability on the part of employers to budget for and hire more permanent workers is, IMO, completely missing the point. Consumers are uncertain because there's no jobs, not the other way around.
I almost thought the author was on to something at the end when he talked about the Fed paying interest on excess reserves but then, in true HuffPo fashion, he blows way past reasonable to WTF?! territory. Absolutely the Fed should not be paying interest on excess reserves and removing that would certainly increase lending. But to say there should be a fee imposed on banks holding excess reserves is absurd. Does this jackass really not remember what happened the last time we gave banks an incentive to undercapitalize?
I know this thread is about healthcare but...
QuoteAbsolutely the Fed should not be paying interest on excess reserves and removing that would certainly increase lending. But to say there should be a fee imposed on banks holding excess reserves is absurd. Does this jackass really not remember what happened the last time we gave banks an incentive to undercapitalize?
Imposing a fee would be stupid. Banks are holding excessive reserves because its safe money. That's not where the money is made anyhow, its in lending, but until all of the bad debt is out of the system, banks are going to remain tight. Once it settles out and they can better gauge their provisions for loan loss, I think you will see some more. It is going to take a long time. The amount of money tied up in bad debt is ridiculous and its long. Its not like these are automobiles.
do you think everyone in this country should have access to health care? (i do)
do you think someone should be excluded because of a prior illness? (I don't)
hospitals and physicians are required to give emergent care regardless of ability to pay - should they just eat that loss? (something that is otherwise unusual in a capitalistic society) - unless you think hospitals should be able to turn people away like some attendees at a recent republican debate.
do you think that rights come with responsibility (I do)
the only way this can reasonably be paid for is that everyone pays their share. If some people "opted out", it would likely affect the rates of everyone. if insurance companies were allowed to cherry pick, people with chronic illness may lose coverage.
it has been argued that if one has a health savings account, they should be able to opt out of insurance - they better have a huge account if they plan on ever getting sick.
imo the mandate for health insurance is analogous to statewide mandates on car insurance. yes, I realize we are comparing federal vs state, but I'm looking at this on "the right thing to do"
If a company declines to hire because of the cost of health insurance then they are stupid.
You can always hire on a contract basis if you don't want to provide benefits.
do you think everyone in this country should have access to health care?I do
do you think someone should be excluded because of a prior illness?No, but I don't think it is unreasonable to say people using the most should pay more than people using very little
hospitals and physicians are required to give emergent care regardless of ability to pay - should they just eat that loss?I do think there should be more charitable services, but that can only be possible if the cost of care comes down significantly
do you think that rights come with responsibilityIs that from Spider Man?
Quote from: slslbs on November 15, 2011, 10:51:54 AM
the only way this can reasonably be paid for is that everyone pays their share. If some people "opted out", it would likely affect the rates of everyone. if insurance companies were allowed to cherry pick, people with chronic illness may lose coverage.
it has been argued that if one has a health savings account, they should be able to opt out of insurance - they better have a huge account if they plan on ever getting sick.
As I've said (and you've agreed), the issue is that costs have unreasonably increased and the current law does absolutely nothing to change that. The "bending the cost curve" line he was so fond of is a great idea; the problem is that this law will not do that.
Quote from: slslbs on November 15, 2011, 10:51:54 AM
imo the mandate for health insurance is analogous to statewide mandates on car insurance. yes, I realize we are comparing federal vs state, but I'm looking at this on "the right thing to do"
Can't afford/choose not to buy car insurance? Take the bus. Can't afford/choose not to buy health insurance? Pay a tax. That's doesn't sit well with me.
Quote from: Hicks on November 15, 2011, 10:59:14 AM
If a company declines to hire because of the cost of health insurance then they are stupid.
You can always hire on a contract basis if you don't want to provide benefits.
How do you sustain a recovery with an influx of contract workers? How does that affect consumer sentiment knowing that their employment can be terminated at any time for any reason? Adding contract worker is like adding a people for the census or a dept store during the holidays. We need permanent jobs, not temporary ones.
C'mon dude either you are playing dumb or really are naive.
My wife started as a temp and has been at her job for four years. Same thing with tons of my friends.
If you do a good job it will lead to a permanent position the majority of the time.
That may be your experience. It depends on the industry. At my job, only 1 out of 10 contract workers is brought on as a full-time hire. I don't know the national stats, but I can't imagine more than 50% of all temporary workers are brought on full time (I'll do some digging).
Quote from: Hicks on November 15, 2011, 11:40:48 AM
If you do a good job it will lead to a permanent position the majority of the time.
I think we all know better of the American public than to expect them to do a good job. :wink:
Here's the first thing I found when I Googled "temporary workers to full time positions":
http://management.fortune.cnn.com/2011/05/05/the-rise-of-the-permanently-temporary-worker/
Quote
The rise of the permanently temporary worker
Temp jobs are in and permanent ones are out, for now. And it doesn't look like there's a surefire route to go from one to the other, posing serious risks to worker morale and corporate growth.
FORTUNE -- It's a glass half full/half empty situation. Well, maybe American employers just stole half a glass from their workers. The rise in temporary worker hires may be a smart business move, insulating employers in a volatile economy, or it could be creating a permanent wedge of cheaper, benefit-less workers that eventually supplants a big chunk of the full-time workforce.
It all depends on how you interpret a sliver of data on temporary hiring from the U.S. Department of Labor, which tracks job placements by temp agencies but not temp hiring by individual companies. The department also doesn't keep tabs on how often companies downgrade positions from permanent to temporary status.
The latest federal data show that 2.3 million people held temporary jobs in March, up from a low in mid-2009 of 1.7 million, as companies seek to satisfy customer demand without making long-term commitments to worker salary and benefits.
"Employers know that the economy could change at any time," says Jon Osborne, vice president for research at Staffing Industry Analysts, which follows temporary staffing agencies, "so by hiring somebody temporarily, companies have staffing for their peak needs but can let them go when they are no longer needed."
Companies stand to benefit from this flexibility, with the economy seesawing in the midst of a recovery that may take as long as five years. But it underscores the uncertainty for employees, with a huge number of workers -- 8.4 million -- reporting that they are involuntarily employed part-time, according to the latest federal statistics. Some of the underemployed are likely working for temporary agencies, while others are in informal settings.
Labor experts warn that these hire-and-fire positions can undermine company morale and long-term prospects.
"Temporary workers don't want to devote their lives and loyalty to an employer," observes Lauren Appelbaum, research director for the UCLA Institute for Labor and Employment.
Temporary workers are often paid less than full-time workers, and are not likely to receive any benefits. Such workers, according to a recent U.S. General Accountability Office report, are less likely to have health insurance or retirement benefits, or be protected by labor laws. Not providing health insurance means that ailing workers often rely on emergency room treatment or Medicaid, treatment scenarios in which the costs are largely covered by the public, adding to the taxpayer burden -- a charge, for example, that has been made against giant retailer Wal-Mart (WMT).
The disappearance of benefits and job security are part of a larger trend in which work has become increasingly informal in recent years, says Nik Theodore, director of the Center for Urban Economic Development at the University of Illinois.
"Temporary jobs are the tip of the iceberg of ways that work has become casual-ized," he says.
...
For now, temporary hiring still has the leading edge when it comes to job growth. Osborne, of Staffing Industry Analysts, says that a recent survey of client companies suggested tepid workforce growth over the next two years and an increase in the overall share that temporary workers make up in the American labor pool.
Experts caution against expecting temporary or contingent jobs to turn into full-time positions. "Temporary help is really cyclical, governed by business cycles," says Heidi Shierholz, an economic at the Economic Policy Institute, a research group.
"When unemployment is still high and continuing, there is not a lot of pressure to create or convert those jobs to permanent status."
Quote from: runawayjimbo on November 15, 2011, 11:25:44 AM
do you think that rights come with responsibility
Is that from Spider Man?
Quote from: slslbs on November 15, 2011, 10:51:54 AM
the only way this can reasonably be paid for is that everyone pays their share. If some people "opted out", it would likely affect the rates of everyone. if insurance companies were allowed to cherry pick, people with chronic illness may lose coverage.
it has been argued that if one has a health savings account, they should be able to opt out of insurance - they better have a huge account if they plan on ever getting sick.
As I've said (and you've agreed), the issue is that costs have unreasonably increased and the current law does absolutely nothing to change that. The "bending the cost curve" line he was so fond of is a great idea; the problem is that this law will not do that.
Quote from: slslbs on November 15, 2011, 10:51:54 AM
imo the mandate for health insurance is analogous to statewide mandates on car insurance. yes, I realize we are comparing federal vs state, but I'm looking at this on "the right thing to do"
Can't afford/choose not to buy car insurance? Take the bus. Can't afford/choose not to buy health insurance? Pay a tax. That's doesn't sit well with me.
spiderman, hmm.
no - the point was that if you expect someone to take care of you in an emergency, you need to pay your share if you could afford it.
can't afford insurance? that's what medicaid is supposedly for.
don't want to buy insurance? what should we do with you when you get sick? Have a heart attack?- take some aspirin and call me in the morning. Get cancer? Go to Tahiti and enjoy your last days. Or, go to the hospital, sell your house and go bankrupt to pay the bills.
I think there are (at least) 2 parts to health care reform. One is making sure everyone is covered. I think this bill did a reasonable job with that. The problem is that if you started your own country, and wanted to provide health insurance, I doubt anyone would decide an employer based model. I also think that doing away with an employer based model would be politically would be very, very difficult.
The other part is, like you and I agree, is somehow reducing costs. Part of the problem with the high cost of medicine is that it is, well, expensive. Labor intensive with highly trained individuals who have spent a great deal of time and $ on this training. New drugs are expensive (costs about 800 mill to get something to market). New technology is expensive. Yes, we need to somehow reform the payment model, but imo the reason why single payer systems in Europe are having difficulty paying the bills isn't because they are government run, but because health care is expensive.
This bill takes a shot at it with ACOs and other things to make health care more efficient which should bring down costs. They need to reform the payment system and the torte system. Pay for performance is being phased in (independent of this law). Hospitals will get paid more for good outcomes, less for poor outcomes (for certain conditions). This will only get bigger in time.
Personally, I think that figuring out ways to reduce cost will take time, I don't see this bill (or any bill) as the final answer, just a starting point to figure out what works.
That's just data from temp agencies which tend to be employee mills much more so than when companies hire contract workers on their own.
In any event, it's certainly not ideal but an increase of 600,000 temp workers is 600,000 more people working.
Quote from: Hicks on November 15, 2011, 10:59:14 AM
If a company declines to hire because of the cost of health insurance then they are stupid.
You can always hire on a contract basis if you don't want to provide benefits.
This is a REAL thing and it is not stupid. The cost of healthcare is ridiculous. I am involved to some degree on those financial numbers and they are staggering. The rates certainly do make a company rethink their ability to increase staff. Especially the smaller ones. We have approximately 250 employees which is not really small, but these things do get discussed. I just looked at my company's financials and during our Q1, our ratio of health insurance to salary is 8.58%. So our compensation expense is not just $1, but now $1.0858. Last year during the same period it was 7.04%. Although it sounds like a small increase of 1%, that is actually a 17.9% increase in healthcare expenses.
I know many of you are not privy to some of the realities that exist, but cost is astronomical. I am not advocating that the system is right, but to state that companies are stupid in factoring this in is not being very open minded.
These are only health care costs and do not include other insurances and benefits that also increase the level of expense. Payroll taxes, etc. also increase and continue to increase your compensation expenses. It is a very evil and twisted web of pick up sticks that are piled up when you dig into these issues.
Quote from: slslbs on November 15, 2011, 11:56:50 AM
no - the point was that if you expect someone to take care of you in an emergency, you need to pay your share if you could afford it.
I absolutely agree with this. But what I disagree is that "your share" is in the form of a mandate to buy insurance. If you make the decision to forego health insurance (an extremely foolish decision, IMO), you should be free to do so and should accept the consequences of that decision. That doesn't mean hospitals should turn people away, but it does mean that you better be prepared to pay for whatever services you use.
Quote from: slslbs on November 15, 2011, 11:56:50 AM
The problem is that if you started your own country, and wanted to provide health insurance, I doubt anyone would decide an employer based model. I also think that doing away with an employer based model would be politically would be very, very difficult.
Absolutely. It was a gimmick to get around the gov't imposed wage freeze during WWII and it should never have gotten to where it is now. Unfortunately, you are correct that changing this will be difficult/impossible, but IMO it should absolutely be on the table.
Quote from: slslbs on November 15, 2011, 11:56:50 AM
Personally, I think that figuring out ways to reduce cost will take time, I don't see this bill (or any bill) as the final answer, just a starting point to figure out what works.
Behaviors also need to be changed. I saw a headline the other day that said something like 1 in 10 will have Type II diabetes by 2030. Our processed food, no exercising lifestyle is going to massively increase health spending unless we can reverse course. Clearly there is much work to be done. And I certainly respect your opinion, especially as someone on the front lines of these issues, but I am just afraid that a massive complex law like this will end up only further exasperating the health care inflation problem by creating perverse incentives much the way Medicare and HMO legislation did.
Quote from: UncleEbinezer on November 15, 2011, 12:06:33 PM
Quote from: Hicks on November 15, 2011, 10:59:14 AM
If a company declines to hire because of the cost of health insurance then they are stupid.
You can always hire on a contract basis if you don't want to provide benefits.
This is a REAL thing and it is not stupid. The cost of healthcare is ridiculous. I am involved to some degree on those financial numbers and they are staggering. The rates certainly do make a company rethink their ability to increase staff. Especially the smaller ones. We have approximately 250 employees which is not really small, but these things do get discussed. I just looked at my company's financials and during our Q1, our ratio of health insurance to salary is 8.58%. So our compensation expense is not just $1, but now $1.0858. Last year during the same period it was 7.04%. Although it sounds like a small increase of 1%, that is actually a 17.9% increase in healthcare expenses.
I know many of you are not privy to some of the realities that exist, but cost is astronomical. I am not advocating that the system is right, but to state that companies are stupid in factoring this in is not being very open minded.
These are only health care costs and do not include other insurances and benefits that also increase the level of expense. Payroll taxes, etc. also increase and continue to increase your compensation expenses. It is a very evil and twisted web of pick up sticks that are piled up when you dig into these issues.
I would recommend reading my entire post and not just the first sentence.
Quote from: Hicks on November 15, 2011, 01:08:22 PM
Quote from: UncleEbinezer on November 15, 2011, 12:06:33 PM
Quote from: Hicks on November 15, 2011, 10:59:14 AM
If a company declines to hire because of the cost of health insurance then they are stupid.
You can always hire on a contract basis if you don't want to provide benefits.
This is a REAL thing and it is not stupid. The cost of healthcare is ridiculous. I am involved to some degree on those financial numbers and they are staggering. The rates certainly do make a company rethink their ability to increase staff. Especially the smaller ones. We have approximately 250 employees which is not really small, but these things do get discussed. I just looked at my company's financials and during our Q1, our ratio of health insurance to salary is 8.58%. So our compensation expense is not just $1, but now $1.0858. Last year during the same period it was 7.04%. Although it sounds like a small increase of 1%, that is actually a 17.9% increase in healthcare expenses.
I know many of you are not privy to some of the realities that exist, but cost is astronomical. I am not advocating that the system is right, but to state that companies are stupid in factoring this in is not being very open minded.
These are only health care costs and do not include other insurances and benefits that also increase the level of expense. Payroll taxes, etc. also increase and continue to increase your compensation expenses. It is a very evil and twisted web of pick up sticks that are piled up when you dig into these issues.
I would recommend reading my entire post and not just the first sentence.
Yeah, I understand your second comment. Hiring on a contract basis certainly is an option, but as an employer it is way more trouble than its worth for this situation. Temp workers in many cases are utilized for short term projects, acute needs for demand or for commodity positions. There are lots of upsides, however the downsides (in my opinion) outweigh the positives. Although you do present an option which would work, I am not sure that is really a viable option. Companies actually do want employees to be there long term because you gain knowledge and value that far surpasses monetary value. Simply from a monetary standpoint, it makes sense, but I am not so sure that's the answer. I certainly could not keep turning over my team. I would lose so much knowledge.
I hear what you are saying, I just think its a stretch to use contract hires as a means to fill jobs. Its easier to endure further hardship and be less efficient. It sounds crazy I know, but that's what how I see it.
is there a way to hide a topic permanently so I am not even tempted to post in it?
Quote from: runawayjimbo on November 15, 2011, 12:46:16 PM
Behaviors also need to be changed. I saw a headline the other day that said something like 1 in 10 will have Type II diabetes by 2030. Our processed food, no exercising lifestyle is going to massively increase health spending unless we can reverse course. Clearly there is much work to be done. And I certainly respect your opinion, especially as someone on the front lines of these issues, but I am just afraid that a massive complex law like this will end up only further exasperating the health care inflation problem by creating perverse incentives much the way Medicare and HMO legislation did.
-absolutely. as a nation we are eating ourselves to death. Much of this can be laid on the food industry and misguided regulation (written, of course, by and for the food industry). People making poor food choices aren't helping matters (familiar theme)
-yes, that is a potential problem. the free market has proven it can't solve this one. the problem somehow needs to be addressed. I think it will need to be done in multiple steps. it will take co-operation between all parties involved, and will be a combination of market and regulatory forces. anyone who thinks it can be done with one piece of legislation is kidding themselves. I certainly don't have the answer.
Quote from: bvaz on November 15, 2011, 01:42:58 PM
is there a way to hide a topic permanently so I am not even tempted to post in it?
C'mon, bvaz, get in the game! I'd love to hear the thoughts of a cranky old man like yourself.
I'll just keep bumping it until you can't resist the temptation. :wink:
You guys are funny. It's hard to be an insurance salesman when that's not what I do any more. But thanks for calling bullshit and making it personal. I'm just reporting what I hear every day from the small business owner. Can you say the same? I sell administrative software, fwiw. I couldn't care less what products their using.
Quote from: antelope19 on November 15, 2011, 02:13:28 PM
You guys are funny. It's hard to be an insurance salesman when that's not what I do any more. But thanks for calling bullshit and making it personal. I'm just reporting what I hear every day from the small business owner. Can you say the same? I sell administrative software, fwiw. I couldn't care less what products their using.
Oh its been personal since I met you! :hereitisyousentimentalbastard
I am not sure who all of our SMB owners are out here but I know there are a few.
To be clear, it is my job to know what is going on with healthcare reform. I sell adminstraive software to small businesses to help them stay ahead of the curve for the largest payroll provider in the country. If you all want to disagree with me, I don't have a problem with that.
But just because what I report isn't what you want to hear, it doesn't make it false. I'm just saying that all of this seems to be having the opposite affect on what was intended.
If you want to call me out, fine. But at the same time, I'll be just as happy to talk circles around you.
My firm's health care premiums for 2012 have gone down for the first time in more than a decade.
Enjoy.
Quote from: rowjimmy on November 15, 2011, 07:40:42 PM
My firm's health care premiums for 2012 have gone down for the first time in more than a decade.
Enjoy.
Congrats!
Do you know why?
It's because alot of the healthcare reform stuff has fallen off the table. There was SO MUCH uncertainty with healthcare reform a few years back that the carriers put major premium increases to make up for the possibility(what they thought was a sure thing) of major loss on their part. We have slowly seen a downward trend(at least in our area) in premiums over the last year with the biggest decreases seen this 3rd and fourth quarter. The rates are finally starting to check back to what they would have been all along.
That didn't just happen because they like you OR because of the legislation(well, technically it WAS because of the legislation, but that's only because you've been paying more than you probably should have over the last few years). YMMV based on the size of your company, health issues, average age and underwriting guidelines in your state.
Quote from: antelope19 on November 16, 2011, 07:43:50 AM
Quote from: rowjimmy on November 15, 2011, 07:40:42 PM
My firm's health care premiums for 2012 have gone down for the first time in more than a decade.
Enjoy.
Congrats!
Do you know why?
It's because alot of the healthcare reform stuff has fallen off the table. There was SO MUCH uncertainty with healthcare reform a few years back that the carriers put major premium increases to make up for the possibility(what they thought was a sure thing) of major loss on their part. We have slowly seen a downward trend(at least in our area) in premiums over the last year with the biggest decreases seen this 3rd and fourth quarter. The rates are finally starting to check back to what they would have been all along.
That didn't just happen because they like you OR because of the legislation(well, technically it WAS because of the legislation, but that's only because you've been paying more than you probably should have over the last few years). YMMV based on the size of your company, health issues, average age and underwriting guidelines in your state.
I actually think it's because several of the really old people (70+) finally got the hell off of our plan in the last year.
Bump'd for Supreme Court oral arguments starting tomorrow.
It should be an interesting case but lawyers suck (
sorry especially bvaz) so I'm sure they'll find a way to shit the bed. I'll take "they punt on ruling on the case until 2015 when the first person pays the tax" for $1000.
http://www.cbsnews.com/8301-280_162-57404212/historic-review-of-healthcare-law-at-high-court/
Quote
Historic review of healthcare law at High Court
(CBS News) The stage is set for the opening on Monday: three days of historic Supreme Court arguments over President Obama's health care law, the Affordable Care Act.
It is a case that has divided the American public, and lower courts.
CBS News correspondent Jan Crawford reports that the final word could now rest with the Supreme Court.
On Friday, people started lining for a coveted spot inside the courtroom, but the justices will start the massive case Monday morning not with the big constitutional issues but with a basic legal question: Is it too soon for the courts to take up this law?
This is an issue because the key part of the law-the requirement that all Americans buy health insurance or pay a penalty on their taxes-doesn't take effect until 2014.
One federal appeals court ruled the lawsuits should wait until that actually happens. But even if the Supreme Court agrees, the justices this week will go ahead and hear all the other arguments against the law.
Tuesday is the ballgame. That's when the justices will take up the so-called "individual mandate," the controversial requirement that Americans have to buy insurance.
The question: Can Congress force people to buy something?
The opponents, including 26 states, argue Congress has no power under the Constitution to order people to buy anything-and that if the law stands, Congress will have sweeping new authority to dictate our behavior.
On Wednesday, the justices will turn to more technical though equally important questions-including: If the individual mandate is unconstitutional, does that mean the entire law is struck down?
One lower court rejected the individual mandate but said the rest of the massive law could remain, including provisions that keep insurers from dropping people with pre-existing conditions or raising premiums based on medical history.
Also on Wednesday, the court will look at how Congress expanded health care law for the poor by imposing new requirements on the states, another huge question of Congressional power. This case really has it all. That's why some legal experts say it will be the most important set of rulings since the justices reviewed FDR's New Deal programs 70 years ago.
Well Jimbo, looks like they didn't punt. I think the semantic argument of "tax vs. penalty" is missing the point. Let's say, hypothetically, there's an unconstitutional law that someone wants to challenge in court. Why should some poor sap have to get tangled up in it before the court can step in and say, "Yup, that's unconstitutional, that guy never should have gotten tangled up in it." Seems pretty simple to me.
Interestingly, here's an economist opining (http://www.foxnews.com/opinion/2012/03/27/what-happens-if-obamacares-individual-mandate-is-thrown-out/) that the defeat of the law (win for conservatives) would precipitate a collapse of the private-insurance industry and ultimately push us into a single-payer system (win for liberals).
Sounds like it. I'm very happy to have been wrong about that. And yes, it was a ridiculously arcane law that really had no business in the discussion (except that the justices hired a guy to argue it for them to make sure they had an out). The individual mandate today is the ballgame.
Regarding the link, I don't think he's saying defeat of the law would force a single payer, he's saying if only the
mandate is unconstitutional the private industry is doomed (assuming they are required to continue offering guaranteed issue and community rating). That's why the severability question tomorrow is just as important as the mandate.
I did take issue when he said "pick up the tab through significantly higher health insurance premiums and government subsidies." The surcharge premium attributable to the uninsured is (I believe) around 5-10%. That's not nothing, but I don't know that "significant" would be the word that I'd use.
This caught my eye and it is something the law's defenders rarely admit:
Quote
The individual mandate in ObamaCare was just a political deal between the administration and insurance companies—the latter will get millions of new healthy policyholders and attendant profits.
Pharma's hands are all over it too. That's one of the reasons I just can't think of the law as reform.
Quote from: runawayjimbo on March 27, 2012, 10:49:10 AM
Quote
The individual mandate in ObamaCare was just a political deal between the administration and insurance companies—the latter will get millions of new healthy policyholders and attendant profits.
Pharma's hands are all over it too. That's one of the reasons I just can't think of the law as reform.
ITs been a couple of years and since Cody has been born, I really haven't been keeping up...
But I seem to recall the buy-in mandate being a compromise between the Admin's want of a single-payer, and the GOP's want of no gov't provider as competition to private insurers. The compromise was the private insurers would also be the gov't provider.
It was a crappy deal for OB, but one that was needed to get the broader deal passed...
Terry
Quote from: runawayjimbo on March 27, 2012, 10:49:10 AM
I did take issue when he said "pick up the tab through significantly higher health insurance premiums and government subsidies." The surcharge premium attributable to the uninsured is (I believe) around 5-10%. That's not nothing, but I don't know that "significant" would be the word that I'd use.
I'd say 5-10% of total healthcare spending would count as "significant." And, just based on the anecdotes I hear of what medivac trips and hospital stays and procedures cost for some people, I'd say that percentage is a significant sum for them as well. I don't know what the answer is, but somehow or another, the costs of caring for the uninsured have to be addressed. Ironically, the people who would be most against a government-run, taxpayer-funded system for caring for (everyone, or at least the poor) are also the most vocal critics of the current plan, which attempts to reduce the burden of subsidizing care for the uninsured by the insured. One way or another, we are all paying for it. Aside from the personal liberty issue, you'd think conservatives would be all about the individual mandate, since it aims to stop all those "freeloaders" from mooching off their premiums.*
Quote from: twatts likes ghoti on March 27, 2012, 10:54:22 AM
Quote from: runawayjimbo on March 27, 2012, 10:49:10 AM
Quote
The individual mandate in ObamaCare was just a political deal between the administration and insurance companies—the latter will get millions of new healthy policyholders and attendant profits.
Pharma's hands are all over it too. That's one of the reasons I just can't think of the law as reform.
ITs been a couple of years and since Cody has been born, I really haven't been keeping up...
But I seem to recall the buy-in mandate being a compromise between the Admin's want of a single-payer, and the GOP's want of no gov't provider as competition to private insurers. The compromise was the private insurers would also be the gov't provider.
It was a crappy deal for OB, but one that was needed to get the broader deal passed...
Terry
I could be wrong here but I would doubt this was a compromise with the GOP since they oppose the plan anyway and they were such a minority in congress at the time that their votes weren't needed to pass the legislation.
Obama probably figured he'd have less resistance working within the private-insurance system rather than blowing it up and going single payer. And yes, I'd assume pressure from the insurance industry itself had a role there.
* I forgot, they already have an answer for that (http://goo.gl/69zg3).
Quote from: twatts likes ghoti on March 27, 2012, 10:54:22 AM
Quote from: runawayjimbo on March 27, 2012, 10:49:10 AM
Quote
The individual mandate in ObamaCare was just a political deal between the administration and insurance companies—the latter will get millions of new healthy policyholders and attendant profits.
Pharma's hands are all over it too. That's one of the reasons I just can't think of the law as reform.
ITs been a couple of years and since Cody has been born, I really haven't been keeping up...
But I seem to recall the buy-in mandate being a compromise between the Admin's want of a single-payer, and the GOP's want of no gov't provider as competition to private insurers. The compromise was the private insurers would also be the gov't provider.
It was a crappy deal for OB, but one that was needed to get the broader deal passed...
I don't think Obama ever pushed for single payer (even during the Campaign of Promises). It was certainly never on the table during the healthcare discussions. There was the dustup about whether or not to include the public option, but not single payer.
During the debate they put in that insurers could not exclude for pre-existing conditions (or for any other reason) and that you can't underwrite your insureds and charge different prices for different risk factors. It's not to say that these aren't laudable goals that seem "fair", but the health insurers said (like VDB's link suggested) that forcing these regulations alone would lead to severe unprofitability and the marketplace would be very quickly crowded out by Medicare on steroids. So, in order to appease the health insurance companies, the administration had to deliver 50M new subscribers which are generally younger and healthier than the national average. Thus, the mandate was born (there were some clips floating around of Obama attacking Hillary and John Edwards (remember him?) for supporting a mandate which was pretty goddamned hilarious to watch now).
And to be clear, this wasn't a compromise brought about by the pesky GOP refusing to go along with everything Obama does. It was brought about by Obama's refusal to challenge the system and bring about the change he so believed in. Don't want to tackle employer based health care, fine. Then fight for single payer. I don't agree with it, but at least it is a substantive change. This whole process just became a big shady backroom deal that Obama was supposed to represent the end of (remember the Louisiana Purchase (http://www.huffingtonpost.com/2010/02/05/mary-landrieu-defends-lou_n_450476.html)? Cornhusker Kicback (http://thehill.com/blogs/blog-briefing-room/news/82621-obama-healthcare-plan-nixes-ben-nelsons-cornhusker-kickback-deal)?). Yes, I know that's idealistic. It just fucking sucks to expect so little of the people we elect to represent us.
still avoids posting in this thread.
:music:
Sounds like it was a bad day for the mandate.
http://youtu.be/n30uutD5OVM
Funny thing is, while there's a legitimate constitutional objection to the individual mandate, a single-payer national system would face no such challenge. (It would face other challenges, sure--but not that one.)
imo the debate over single payer would make this look like a birthday party.
None of the candidates in 08 were for single payer (maybe Edwards, but I doubt it)
I get the argument "the govt shouldn't be able to make me buy insurance" but you WILL get sick and require health care at some point in your life, unless you die suddenly. Health care providers are required by law (and ethics) to treat everyone, regardless of ability to pay. People who use the system but don't pay in raise the cost of health care for everyone. People who delay treatment because they can't afford it only wind up getting sicker and costing the system more money.
The "interstate commerce" argument may seem like a copout, but hospitals in MA side of the MA - NH border (MA has Romneycare, just about the same thing as Obamacare) are getting stuck with people from NH w/o insurance. We all travel across state lines and sometimes need to utilize the health care system. Some people are employed by a company in a different state.
to me, the individual mandate makes "common sense". If health insurers had to cover everyone and not exlude pts with pre existing conditions (they applied it to neonates with congenital disease), premiums would skyrocket unless everyone had to buy in. I don't care about the insurance companies, it would cost all of us a ton more $ in premiums if there wasn't a mandate.
ETA: regardless of whether we had employer based care, non employer based care, or single payer, the only way to make it affordable is for the requirement that everyone purchase insurance
As far as Obama's compromise, the main one he made was the public option. There were other compromises, but the bottom line here is that upwards of 96% of US citizens are covered by this, which is a substantial improvement over the situation as of 2009.
btw, if you ever were able to make a significant business deal w/o a compromise, you either were negotiating with a fool who gave you everything, you were a fool who gave everything, both of you had your interests almost perfectly aligned, or one of you had incredible power over the other.
Quote from: slslbs on March 27, 2012, 01:07:17 PM
imo the debate over single payer would make this look like a birthday party.
None of the candidates in 08 were for single payer (maybe Edwards, but I doubt it)
I get the argument "the govt shouldn't be able to make me buy insurance" but you WILL get sick and require health care at some point in your life, unless you die suddenly. Health care providers are required by law (and ethics) to treat everyone, regardless of ability to pay. People who use the system but don't pay in raise the cost of health care for everyone. People who delay treatment because they can't afford it only wind up getting sicker and costing the system more money.
The "interstate commerce" argument may seem like a copout, but hospitals in MA side of the MA - NH border (MA has Romneycare, just about the same thing as Obamacare) are getting stuck with people from NH w/o insurance. We all travel across state lines and sometimes need to utilize the health care system. Some people are employed by a company in a different state.
to me, the individual mandate makes "common sense". If health insurers had to cover everyone and not exlude pts with pre existing conditions (they applied it to neonates with congenital disease), premiums would skyrocket unless everyone had to buy in. I don't care about the insurance companies, it would cost all of us a ton more $ in premiums if there wasn't a mandate.
As far as Obama's compromise, the main one he made was the public option. There were other compromises, but the bottom line here is that upwards of 96% of US citizens are covered by this, which is a substantial improvement over the situation as of 2009.
btw, if you ever were able to make a significant business deal w/o a compromise, you either were negotiating with a fool who gave you everything, you were a fool who gave everything, both of you had your interests almost perfectly aligned, or one of you had incredible power over the other.
Well said. Exactly what I've been trying to figure out how to put into words. It helps that you live out that way, and have more first-hand experience, but thanks for finding a way to say what I was thinking!
Doesn't sound like it went much better for ObamaCare from this morning's arguments about whether or not the law can exist without the mandate.
Quote
Jeffrey Toobin @JeffreyToobin
At #scotus, still a train wreck, maybe also a plane wreck for @barackobama.
http://www.latimes.com/news/politics/la-pn-justices-poised-to-strike-down-entire-healthcare-law-20120328,0,2058481.story
Quote
Justices poised to strike down entire healthcare law
Reporting from Washington— The Supreme Court's conservative justices said Wednesday they are prepared to strike down President Obama's healthcare law entirely.
Picking up where they left off Tuesday, the conservatives said they thought a decision striking down the law's controversial individual mandate to purchase health insurance means the whole statute should fall with it.
The court's conservatives sounded as though they had determined for themselves that the 2,700-page measure must be declared unconstitutional.
"One way or another, Congress will have to revisit it in toto," said Justice Antonin Scalia.
Agreeing, Justice Anthony Kennedy said it would be an "extreme proposition" to allow the various insurance regulations to stand after the mandate was struck down.
Meanwhile, the court's liberal justices argued for restraint. Justice Ruth Bader Ginsburg said the court should do a "salvage job," not undertake a "wrecking operation." But she looked to be out-voted.
Chief Justice John G. Roberts Jr. and Justice Samuel A. Alito Jr. said they shared the view of Scalia and Kennedy that the law should stand or fall in total. Along with Justice Clarence Thomas, they would have a majority to strike down the entire statute as unconstitutional.
An Obama administration lawyer, urging caution, said it would be "extraordinary" for the court to throw out the entire law. About 2.5 million young people under age 26 are on their parents' insurance now because of the new law. If it were struck down entirely, "2.5 million of them would be thrown off the insurance rolls," said Edwin Kneedler.
The administration indicated it was prepared to accept a ruling that some of the insurance reforms should fall if the mandate were struck down. For example, insurers would not be required to sell coverage to people with preexisting conditions. But Kneedler, a deputy solicitor general, said the court should go no further.
But the court's conservatives said the law was passed as a package and must fall as a package.
The justices are scheduled to meet Wednesday afternoon to debate the law's Medicaid expansion.
Everyone who said GWB and Gore were basically the same in 2000, please KYS now.
I was hoping we'd get a blame Bush commentary on the constitutioniality of a bill.
Quote from: Hicks on March 28, 2012, 12:57:36 PM
Everyone who said GWB and Gore were basically the same in 2000, please KYS now.
So, does the court have line-item authority? The fact that they're arguing over it suggests it's unclear. How could that be?
Also, how about the fact that a total wipeout would take with it some very popular provisions: insurance up to age 26, no denial of coverage for pre-existing conditions. It's been pointed out that the mandate is part of what would help pay for some other popular, but expensive, reforms. That leaves us with some tough decisions. How to get what we actually want without getting things we don't want. Too bad Americans (and their reps) aren't very good at tough decisions.
Quote from: bvaz on March 28, 2012, 01:15:04 PM
I was hoping we'd get a blame Bush commentary on the constitutioniality of a bill.
Pretty sure he appointed 40% of the Justices that are striking it down.
it just gets old. That's all I'm saying. But it's the reason why I should stay out of these threads to begin with.
I haven't even voiced where I stand on the issue. It is something that impacts me greatly. The whole blame Bush banter is old though.
Quote from: bvaz on March 28, 2012, 02:06:57 PM
it just gets old. That's all I'm saying. But it's the reason why I should stay out of these threads to begin with.
I haven't even voiced where I stand on the issue. It is something that impacts me greatly. The whole blame Bush banter is old though.
I agree it does get old!
Unfortunately there are long reaching effects of the colossal fuck up that was the Bush Admin, and doubly unfortunate is that we will be feeling the after effects for quite some time.
Quote from: Hicks on March 28, 2012, 01:57:32 PM
Quote from: bvaz on March 28, 2012, 01:15:04 PM
I was hoping we'd get a blame Bush commentary on the constitutioniality of a bill.
Pretty sure he appointed 40% of the Justices that are striking it down.
Obama appointed 40% of the justices voting to uphold it (including the one who was actually arguing on behalf of the bumbling Solicitor General yesterday). Partisan politics goes both ways.
Quote from: bvaz on March 28, 2012, 01:15:04 PM
I was hoping we'd get a blame Bush commentary on the constitutioniality of a bill.
It would be incongruous if there was objective agreement around questions of constitutionality. But the fact that even among SCOTUS justices there's no agreement confirms that there isn't, and the ideological perspective of those justices can determine the outcome of cases. And given that presidents get to nominate justices whose ideologies they want reflected on the court, that means people may lament the selection of justices by the guy who nominated them.
Quote from: Hicks on March 28, 2012, 02:09:44 PM
Quote from: bvaz on March 28, 2012, 02:06:57 PM
it just gets old. That's all I'm saying. But it's the reason why I should stay out of these threads to begin with.
I haven't even voiced where I stand on the issue. It is something that impacts me greatly. The whole blame Bush banter is old though.
I agree it does get old!
Unfortunately there are long reaching effects of the colossal fuck up that was the Bush Admin, and doubly unfortunate is that we will be feeling the after effects for quite some time.
first, I'm not even convinced the bill will be overturned, but regardless.....
blaming Bush for Obama and a democratic Congress forcing a bill through so quickly before properly legislating it is pretty weak. if you don't want to get to the Supreme Court, they shouldn't have forced a bill through like they did. it's so freaking weak to blame Bush for a president who is so clearly in over hsi head and can't cash in on any promise he made. you blame Bush. I blame the people that actually believed Obama was going to accomplish what he promised.
but our political views will never agree. the funny thing is I think I am pretty much down the middle. I happen to live in a state very much to the left which can make me appear to be ultra conservative. if I lived in the south, people would probably consider me a liberal.
blame whomever you want to blame for this. bush isn't the one who forced this particular bill through congress. enjoy the rest of the discussion on the topic. I'll know better than to chime in anymore.
Quote from: runawayjimbo on March 28, 2012, 02:13:47 PM
Quote from: Hicks on March 28, 2012, 01:57:32 PM
Quote from: bvaz on March 28, 2012, 01:15:04 PM
I was hoping we'd get a blame Bush commentary on the constitutioniality of a bill.
Pretty sure he appointed 40% of the Justices that are striking it down.
Obama appointed 40% of the justices voting to uphold it (including the one who was actually arguing on behalf of the bumbling Solicitor General yesterday). Partisan politics goes both ways.
Can't argue with that I suppose, but at the same time I have to wonder if Obamacare is unconstitutional then what's the alternative?
Do we just continue with the status quo and by the time we are old no one but the megarich can afford decent healthcare?
Something's gotta give.
Quote from: Hicks on March 28, 2012, 02:30:48 PM
Quote from: runawayjimbo on March 28, 2012, 02:13:47 PM
Quote from: Hicks on March 28, 2012, 01:57:32 PM
Quote from: bvaz on March 28, 2012, 01:15:04 PM
I was hoping we'd get a blame Bush commentary on the constitutioniality of a bill.
Pretty sure he appointed 40% of the Justices that are striking it down.
Obama appointed 40% of the justices voting to uphold it (including the one who was actually arguing on behalf of the bumbling Solicitor General yesterday). Partisan politics goes both ways.
Can't argue with that I suppose, but at the same time I have to wonder if Obamacare is unconstitutional then what's the alternative?
Do we just continue with the status quo and by the time we are old no one but the megarich can afford decent healthcare?
Something's gotta give.
The alternatives are:
1. Single-payer
2. Get rich or die tryin'
Quote from: bvaz on March 28, 2012, 02:28:46 PM
Quote from: Hicks on March 28, 2012, 02:09:44 PM
Quote from: bvaz on March 28, 2012, 02:06:57 PM
it just gets old. That's all I'm saying. But it's the reason why I should stay out of these threads to begin with.
I haven't even voiced where I stand on the issue. It is something that impacts me greatly. The whole blame Bush banter is old though.
I agree it does get old!
Unfortunately there are long reaching effects of the colossal fuck up that was the Bush Admin, and doubly unfortunate is that we will be feeling the after effects for quite some time.
first, I'm not even convinced the bill will be overturned, but regardless.....
blaming Bush for Obama and a democratic Congress forcing a bill through so quickly before properly legislating it is pretty weak. if you don't want to get to the Supreme Court, they shouldn't have forced a bill through like they did. blame whomever you want to blame for this. bush isn't the one who forced this particular bill through congress. enjoy the rest of the discussion on the topic.
I'll know better than to chime in anymore.
agreed - the problem was the political environment was (is) so toxic there seemed to be no opportunity to compromise. The GOP has made it their strategy to do whatever it takes to not cooperate and make life difficult for OB so that one of their own will be elected.
Examples are "health care will be his waterloo", the death panel lies they promoted (even thought the ethics panel was proposed by a member of the GOP).
In fact, much of what was passed was first proposed by Dole in the mid 90s - including the individual mandate (and supported by Newt), and, we both live under this type of system in MA supported and signed by Mitt
The Dems could have done a much better job at this, but the GOP put them in a corner.
anyway, it looks like the US will remain the only "civilized" country that doesn't provide health care for all it's citizens.
Kind of strange when members of the GOP like to talk about "culture of life'.
Travesty
and, fwiw, I enjoy your posts here bvaz - hope you change your mind.
The law getting overturned would be bad for Obama politically, yes, in that it would allow the GOP to say "see, we told you so, this guy's outta control." But, to your points above, if he's smart Obama will have ample opportunity to neutralize a lot of the criticism by calling out Republicans who at one point supported, proposed or enacted very similar policies. If Obama were really shrewd he would try and turn this into a chance to paint Republicans as political opportunists who play games with people's healthcare by opposing things just for the sake of defeating him.
Besides, with Mitt as the nominee Obama will throw the Mass. model back in his face at every opportunity, and I think the ability to dodge and weave that comparison will be limited.
Mitt signed a bill in a democratic state. I think Mitt gets too much credit as an individual for the health care law.
second, I hate the GOP's politics as much as the Dems. It jsut plain sucks. Bush forced through more than Obama ever could think of tryign to force through.
It just irritates me that Obama prided himself on bipartisanship and then forced this through and his supporters decide to blame past adminstrations instead of calling him out for not doing what he said he would do.
and fwiw, I consider potential supreme court justice nominations for when I vote for a president. I'm not sure I can say that about most americans.
until we get true bipartisanship, this is what we can expect. no comprimising and bills being forced through when one party has control. I'm not even saying the republicans are right on this. what I am saying is this should have been expected from day 1 the way it was handled.
once again bvaz, I mostly agree. At the time, Mitt claims to have been the driving force. I wasn't in his office, so I don't know, but whether he was the driving force or just merely signed it, he clearly supported it.
Unfortunately, I don't think bipartisanship will be coming any time soon. Reagan and O'Neill drank together. That's not gonna happen now.
I personally consider the Dems inept and the GOP scary, but philosphically I'm kinda left center (ex - voted for Weld; in 1980 voted for Anderson)
Quote from: V00D00BR3W on March 28, 2012, 02:54:43 PM
The law getting overturned would be bad for Obama politically, yes, in that it would allow the GOP to say "see, we told you so, this guy's outta control." But, to your points above, if he's smart Obama will have ample opportunity to neutralize a lot of the criticism by calling out Republicans who at one point supported, proposed or enacted very similar policies. If Obama were really shrewd he would try and turn this into a chance to paint Republicans as political opportunists who play games with people's healthcare by opposing things just for the sake of defeating him.
Besides, with Mitt as the nominee Obama will throw the Mass. model back in his face at every opportunity, and I think the ability to dodge and weave that comparison will be limited.
yep - I don't think this is the death knell for Ob in November, too much can happen. My guess is he will be voted in or out based on how the economy is doing. He will continune trying to paint the GOP as for the 1% and Mitt as the ultimate flip flopper. I honestly don't want to try to predict who will be sworn in next Jan.
I do think it will be very, very hard to pass another bill that attempts to provide Universal health care in the near future if this bill gets put down.
as an aside, they had a Harvard Con Law prof discuss the proceedings in yesterdays Boston Globe. One of her points, which I agree with based upon what I have read, is that it seems like neither the attorneys arguing on either side or the USSC has a clue of how the health care market works (or doesn't)
I think Obama's willingness to bend over the bargaining table when forging the bill was a pretty strong slice of bipartisanship. Unfortunately it was not a two-way street.
that said, this thing was in trouble the minute he backed off the single-payer plan.
Obama is criticized from the left for not delivering on his promised agenda and then criticized from the right for being partisan.
Unfortunately the only way to accomplish anything in this political climate is to circle the wagons and torch the other side at every opportunity.
That may not be fair or right but it's the reality.
From my point of view Obama's main mistakes have come from his tendency to compromise too early in the negotiating process. I hope to see him take more of a hard line approach should he win a second term.
Quote from: slslbs on March 28, 2012, 03:10:06 PM
as an aside, they had a Harvard Con Law prof discuss the proceedings in yesterdays Boston Globe. One of her points, which I agree with based upon what I have read, is that it seems like neither the attorneys arguing on either side or the USSC has a clue of how the health care market works (or doesn't)
Government employees out of touch with the predicaments of the average joe with regards to benefits?
I'm shocked.
Quote from: Hicks on March 28, 2012, 03:13:00 PM
Obama is criticized from the left for not delivering on his promised agenda and then criticized from the right for being partisan.
Unfortunately the only way to accomplish anything in this political climate is to circle the wagons and torch the other side at every opportunity.
That may not be fair or right but it's the reality.
From my point of view Obama's main mistakes have come from his tendency to compromise too early in the negotiating process. I hope to see him take more of a hard line approach should he win a second term.
agreed.
Quote from: slslbs on March 28, 2012, 03:10:06 PM
as an aside, they had a Harvard Con Law prof discuss the proceedings in yesterdays Boston Globe. One of her points, which I agree with based upon what I have read, is that it seems like neither the attorneys arguing on either side or the USSC has a clue of how the health care market works (or doesn't)
agreed. it's complicated.
Quote from: rowjimmy on March 28, 2012, 03:11:24 PM
that said, this thing was in trouble the minute he backed off the single-payer plan.
agreed but single payer would have been a huge disaster imo. I'm not talking how you feel about it but how it would ahve actually worked (or not worked) in the actual healthcare field.
Quote from: rowjimmy on March 28, 2012, 03:11:24 PM
I think Obama's willingness to bend over the bargaining table when forging the bill was a pretty strong slice of bipartisanship. Unfortunately it was not a two-way street.
that said, this thing was in trouble the minute he backed off the single-payer plan.
Bipartanship only works when your opponents is will to work with you. When their only goal is to sabotage your aims, why even consider working with them...
If ACA had to be "forced", IMO it is just as indicative of the GOP's unwillingness to work to tackle one of the greatest issues facing Americans today...
I wonder, could we next argue about the Constitutionality of Medicare??? I'm tired of paying for old people that were too stupid to save money for their age-related medical issues...
Terry
Quote from: V00D00BR3W on March 28, 2012, 02:54:43 PM
The law getting overturned would be bad for Obama politically, yes, in that it would allow the GOP to say "see, we told you so, this guy's outta control." But, to your points above, if he's smart Obama will have ample opportunity to neutralize a lot of the criticism by calling out Republicans who at one point supported, proposed or enacted very similar policies. If Obama were really shrewd he would try and turn this into a chance to paint Republicans as political opportunists who play games with people's healthcare by opposing things just for the sake of defeating him.
On the contrary, I'm thinking throwing the whole law out might be the best for Obama's re-election prospects. I can think of three scenarios coming out of this decision and their impact on the election:
1.
Whole law overturned: This may in fact be the best case scenario for Obama. The 31% of people who are Ds will vote Obama and the 27% of Rs are voting against him. The 40% of independents is where it's at. By about 2-1 they dislike the law but most have a favorable opinion of Obama. A majority of independents might vote against Obama just to nullify ObamaCare, but could be more likely to vote for him if they don't have to vote for the GOP candidate who would try to repeal the law. Plus, independents already widely dislike Romney. Result: Obama ekes out a close win.
2.
Whole law stands: This would probably have minimal effect, as Romney would continue to attack Obama and Obama would continue to say "Dude, this was your idea." Some independents still vote against healthcare despite their obvious distaste for the very hateable Romney. Election very close barring some financial/political firestorm like Europe falling off the cliff or another debt ceiling vote in October (both very real possibilities).
3.
Mandate overturned, rest of law stands: This is really bad news for Obama. Not only is it stinging rebuke to his entire first term, the rest of the law is still in effect which gives independents a reason to hold their nose and pull the lever for Romney. Plus, it would have a devastating effect on the private health insurance industry and would give Romney plenty of ammo against Obama in the general ("You're a constitutional law professor and part of your signature legislation is unconstitutional? Maybe you better go back to law school yourself [applause break...oh I'm not supposed to read that part?]" "You're law...or what's left of it [smirky rich guy laugh]...will drive premiums significantly higher and eventually force people into a de facto single payer system. Mr. President, the American people don't want to be Canada!") If this is the outcome, I think Romney wins.
Quote from: slslbs on March 28, 2012, 03:10:06 PM
I do think it will be very, very hard to pass another bill that attempts to provide Universal health care in the near future if this bill gets put down.
Maybe, maybe not. Depends on how badly people are wanting to move away from the status quo and how much they can be convinced that things are only going to spiral more out of control if we do nothing. And if they can be made to understand that all that popular shit they want needs to be payed for somehow, e.g. by expanding the pool.
The pols could come back and just go for single-payer. Say, "Fine, if we can't force you to buy health coverage we'll just give it to everyone and pay for it out of taxes... do you want universal healthcare or not?" The counterpoint to this approach (which I don't dismiss) is the question: how badly do you want to be in a government-administered health plan?
even now the discussion leads to re-election. this is the problem. even, we the people can't discuss topics without making it political and about getting votes.
maybe obama's approach wasn't so bad after all.
Quote from: bvaz on March 28, 2012, 03:34:18 PM
even now the discussion leads to re-election. this is the problem. even, we the people can't discuss topics without making it political and about getting votes.
maybe obama's approach wasn't so bad after all.
Well, but it is political. That's what I was saying about how SCOTUS justices can't even agree on constitutionality most of the time, otherwise we'd always have unanimous decisions. And you know that as November approaches this issue is going to be discussed in terms of politics as often or more often than in terms of policy.
Besides, politicians pass laws and in doing so they play all sorts of political games. I hate it as much as you do. In a vacuum, yes, we can talk policy and policy only. But in discussing actual or proposed laws, it's realistic to also look at them in their political contexts.
Quote from: bvaz on March 28, 2012, 03:34:18 PM
even now the discussion leads to re-election. this is the problem. even, we the people can't discuss topics without making it political and about getting votes.
maybe obama's approach wasn't so bad after all.
On that we can definitely agree, whatever happened to what is good for the majority of the American people?
We are so fucked.
Quote from: Hicks on March 28, 2012, 03:40:36 PM
Quote from: bvaz on March 28, 2012, 03:34:18 PM
even now the discussion leads to re-election. this is the problem. even, we the people can't discuss topics without making it political and about getting votes.
maybe obama's approach wasn't so bad after all.
On that we can definitely agree, whatever happened to what is good for the majority of the American people?
We are so fucked.
I finally agree with you and now I disagree with voodoo. :frustrated: I hate this thread. :-D
Quote from: rowjimmy on March 28, 2012, 03:11:24 PM
that said, this thing was in trouble the minute he backed off the single-payer plan.
Never happened
Quote from: Hicks on March 28, 2012, 03:13:00 PM
From my point of view Obama's main mistakes have come from his tendency to compromise too early in the negotiating process. I hope to see him take more of a hard line approach should he win a second term.
That might be tough to do since GOP will likely hold the House and may even take the Senate (or at least will continue to filibuster at every turn).
Quote from: twatts likes ghoti on March 28, 2012, 03:19:55 PM
I wonder, could we next argue about the Constitutionality of Medicare???
I'm down :wink:
Quote from: V00D00BR3W on March 28, 2012, 03:40:23 PM
Quote from: bvaz on March 28, 2012, 03:34:18 PM
even now the discussion leads to re-election. this is the problem. even, we the people can't discuss topics without making it political and about getting votes.
maybe obama's approach wasn't so bad after all.
Well, but it is political. That's what I was saying about how SCOTUS justices can't even agree on constitutionality most of the time, otherwise we'd always have unanimous decisions. And you know that as November approaches this issue is going to be discussed in terms of politics as often or more often than in terms of policy.
Besides, politicians pass laws and in doing so they play all sorts of political games. I hate it as much as you do. In a vacuum, yes, we can talk policy and policy only. But in discussing actual or proposed laws, it's realistic to also look at them in their political contexts.
This'd
Back on topic, it sounds like Obama got his first clear win this afternoon on the issue of whether or not the Medicaid expansion unlawfully coerced states to complying with ObamaCare. Roberts reportedly said the states may have forfeited sovereignty by taking so much federal money since New Deal.
Quote from: bvaz on March 28, 2012, 03:45:46 PM
Quote from: Hicks on March 28, 2012, 03:40:36 PM
Quote from: bvaz on March 28, 2012, 03:34:18 PM
even now the discussion leads to re-election. this is the problem. even, we the people can't discuss topics without making it political and about getting votes.
maybe obama's approach wasn't so bad after all.
On that we can definitely agree, whatever happened to what is good for the majority of the American people?
We are so fucked.
I finally agree with you and now I disagree with voodoo. :frustrated: I hate this thread. :-D
Heh, I don't actually disagree on the fundamentals of how fucked up and disappointing our political and lawmaking systems are. Trust me, I find it endlessly aggravating.
Quote from: runawayjimbo on March 28, 2012, 03:49:31 PM
Back on topic, it sounds like Obama got his first clear win this afternoon on the issue of whether or not the Medicaid expansion unlawfully coerced states to complying with ObamaCare. Roberts reportedly said the states may have forfeited sovereignty by taking so much federal money since New Deal.
And what empowers Roberts to make that declaration? If we're talking constitutionality, is there anything in the constitution that attaches a "use it or lose it" condition to state sovereignty? That doesn't sound very "strict constructionist" to me.
Quote from: V00D00BR3W on March 28, 2012, 04:41:04 PM
Quote from: runawayjimbo on March 28, 2012, 03:49:31 PM
Back on topic, it sounds like Obama got his first clear win this afternoon on the issue of whether or not the Medicaid expansion unlawfully coerced states to complying with ObamaCare. Roberts reportedly said the states may have forfeited sovereignty by taking so much federal money since New Deal.
And what empowers Roberts to make that declaration? If we're talking constitutionality, is there anything in the constitution that attaches a "use it or lose it" condition to state sovereignty? That doesn't sound very "strict constructionist" to me.
I don't think he was making an argument for or against the constitutionality of it, he was simply saying that the petitioner's argument is kinda weak since they've been sucking at the federal teat for 80 yrs.
Besides, I don't think Roberts has ever tried to be Clarence Thomas. It's not completely outside the realm of possibility that he (and possibly Kennedy) could still go along with the expansive interpretation of the Commerce Clause and allow this thing to stand. As the saying goes, you don't win a case before the Supreme Court on oral arguments, but you can lose it.
The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.
Quote from: aphineday on March 28, 2012, 07:27:26 PM
The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.
please define your logic.
if a hospital lost money every year, how could it stay open? employees want their paychecks. vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too. they can't buy supplies and pay employees and have nothing leftover for themselves.
the profits are meant to be reinvested in new technology and benefit the community.
there is a growing trend for hospitals to be for profit entities. I have an opinion on that which I won't share at this time.
http://www.huffingtonpost.com/bill-maher/new-rule-not-everything-i_b_244050.html
here I go again :frustrated:
you can argue what an acceptable profit margin is but how can a hospital lose money and stay open?
I'm just talking accounting 101. forget policy.
if my expenses for the month are $100,000, how can I make $90,000 in revenue and pay those expenses. are the drug companies going to forgive the extra $10,000 and say the hospital doesn't owe it.
forget these articles that make no sense. let's just discuss simple accounting.
you can definitely argue that a hospital doesn't need to make a 15% contribution margin. but you can't lose money every year. it is fiscally impossible.
Probably in the same way that governments continue to function with deficits.
Which is why the single payer system with a taxpayer funded healthcare system is the only way out of this mess.
sorry, but a hospital can't be run like a government running at a deficit.
we have bank accounts. when philips delivers an MRI machine, we need to pay them for it or they come take it back. nurses will not come to work if they don't get paid the previous week. drug companies won't deliver drugs. american red cross won't deliver blood.
I hate to be mean about it but you can't run a hospital at a deficit. the bills are paid out of a bank account. if there is no money, the bills aren't paid.
Quote from: bvaz on March 28, 2012, 07:54:24 PM
Quote from: aphineday on March 28, 2012, 07:27:26 PM
The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.
please define your logic.
if a hospital lost money every year, how could it stay open? employees want their paychecks. vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too. they can't buy supplies and pay employees and have nothing leftover for themselves.
the profits are meant to be reinvested in new technology and benefit the community.
there is a growing trend for hospitals to be for profit entities. I have an opinion on that which I won't share at this time.
C'mon, bvaz, get in the game!
I wouldn't even say "meant to be reinvested". Clearly the profit motive provides the incentive to create new drugs and machines that ultimately lead to greater health outcomes.
Conversely, under a single payer system, the gov't will need to make difficult decisions about how to spend their limited healthcare dollars. Do you (aphineday) have a lot of faith in the gov't making a politically difficult decision or do you think it's more likely they'd continue to blow smoke up our ass and keep promising the moon even though we're broke as shit?
Quote from: runawayjimbo on March 28, 2012, 08:22:05 PM
Quote from: bvaz on March 28, 2012, 07:54:24 PM
Quote from: aphineday on March 28, 2012, 07:27:26 PM
The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.
please define your logic.
if a hospital lost money every year, how could it stay open? employees want their paychecks. vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too. they can't buy supplies and pay employees and have nothing leftover for themselves.
the profits are meant to be reinvested in new technology and benefit the community.
there is a growing trend for hospitals to be for profit entities. I have an opinion on that which I won't share at this time.
C'mon, bvaz, get in the game!
I wouldn't even say "meant to be reinvested". Clearly the profit motive provides the incentive to create new drugs and machines that ultimately lead to greater health outcomes.
Conversely, under a single payer system, the gov't will need to make difficult decisions about how to spend their limited healthcare dollars. Do you (aphineday) have a lot of faith in the gov't making a politically difficult decision or do you think it's more likely they'd continue to blow smoke up our ass and keep promising the moon even though we're broke as shit?
I don't even bother discussing a single payer system. it will never happen. trust me on that. I know enough about the industry to know it could never work here and will not work. it will not ever get to the point that it will happen.
the only thing I will argue on your point is new drugs are developed by drug companies and machines by manufacturers. they are of course regulated, but their prices are not based on reimbursement for services. I guess they are indirectly but it is indirect.
a hospital needs to make enough money to buy a new piece of equipment from a manufacturer or new drugs. it completely expands the whole discussion to a very wide discussion when adding drug companies and device manufacturers.
The government needs to stop spending all its money on guns and start spending it on medical technology.
See I just solved all our problems. :wink:
Quote from: bvaz on March 28, 2012, 07:54:24 PM
Quote from: aphineday on March 28, 2012, 07:27:26 PM
The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.
please define your logic.
if a hospital lost money every year, how could it stay open? employees want their paychecks. vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too. they can't buy supplies and pay employees and have nothing leftover for themselves.
the profits are meant to be reinvested in new technology and benefit the community.
there is a growing trend for hospitals to be for profit entities. I have an opinion on that which I won't share at this time.
Right, sorry. What I meant was the "for profit" trend to which you're referring. I understand that hospitals need to turn a profit for sure. I just hate the fattening of wallets based on healthcare.
Quote from: Hicks on March 28, 2012, 08:36:11 PM
The government needs to stop spending all its money on guns and start spending it on medical technology.
See I just solved all our problems. :wink:
joking aside, clearly you're right.
the one thing I will say is that medical coverage is one of the highest (if not the highest) percentage of the federal budget.
it's a huge problem with no easy answer.
the government is trying to create quality healthcare with concepts like value based purchasing, medical homes and accountable care organizations.
there is already a ton going on in healthcare before health care reform takes effect. but there is no doubt healthcare is expensive and cutting costs within healthcare is necessary. as much as I discuss it, the fewer answers I have.
Quote from: Hicks on March 28, 2012, 08:36:11 PM
The government needs to stop spending all its money on guns and start spending it on medical technology.
See I just solved all our problems. :wink:
Nice! Now can you get me a lower rate on my mortgage?
Quote from: aphineday on March 28, 2012, 08:38:06 PM
Quote from: bvaz on March 28, 2012, 07:54:24 PM
Quote from: aphineday on March 28, 2012, 07:27:26 PM
The absolutely disgusting thing about all of this for me is that health care is FOR PROFIT in this country.
please define your logic.
if a hospital lost money every year, how could it stay open? employees want their paychecks. vendors want to be paid for equipment and supplies.
please explain how you think it is possible to lose money every year.
as far as physicians, they need to pay themselves too. they can't buy supplies and pay employees and have nothing leftover for themselves.
the profits are meant to be reinvested in new technology and benefit the community.
there is a growing trend for hospitals to be for profit entities. I have an opinion on that which I won't share at this time.
Right, sorry. What I meant was the "for profit" trend to which you're referring. I understand that hospitals need to turn a profit for sure. I just hate the fattening of wallets based on healthcare.
What would be an acceptable level of profit for a hospital? How about an insurance company? Pharma? Having a group of people determining what is fair or reasonable (be it for a company, an industry, or personal income) generally leads to outcomes that are neither and nearly always come down on the backs of those with less rather than those with the most.
yea, there are a boatload of tough principles here
-hospitals need to make $. Even "not for profits" have to have a + margin. They need to be able to invest, expand, and borrow money. In order to get a good bond rating they need to have a good balance sheet
-Pharma and industry need to make $ to keep innovating. We're seeing a tragic shortage of important generic drugs (chemo for kids, "code blue" drugs, vaccines for example) because the producers aren't making enough $
-Health care is labor intensive, with highly trained professionals. training is expensive in both time and money.
Single payer sounds good in theory, I just don't see it working in the US, politics aside. The VA system is a mess. Govt programs (state and fed) move slowly and are somewhat tied to politics. A couple of weeks ago the "doc fix" was in the news. It's a long story, but it's a mess that started in the late 90s and Congress chooses to kick the can rather than fix it once and for all.
where we can cut $ (easier said than done)
we are all responsible for overutilization.
patients expect everything, and expect it now.
doc try to deliver to keep people happy - it's easier to order an expensive test or drug than to explain that a pt doesn't need it (or used judgement)
docs don't want to make a mistake and have a pt get sick or die. an extra test might be worth it. sometimes it's hard
docs don't want to get sued. if you do something extra, well you tried. if you didn't, you blew it. this is especially visible in the ED, which even without defensive medicine is the most expensive place to get routine medical care (except the icu and OR)
there's too much damn shit to know to be on top of everything
new technology and new drugs are expensive; they're often available before we fully know how to use them - or not use them
then, there's the fee for service system, which unfortunately is subject to abuse.
Well said, sls. +k
It's a number of extremely complex and interconnected issues and there is clearly no easy answer. But at least we all (ETA: except the politicians, obviously) recognize the status quo sucks and a change is drastically needed.
Quote from: slslbs on March 28, 2012, 09:20:44 PM
Single payer sounds good in theory, I just don't see it working in the US, politics aside. The VA system is a mess. Govt programs (state and fed) move slowly and are somewhat tied to politics.
Obviously the "death panel" rhetoric was bogus, but I just can't trust the gov't (who politicize what toilet paper they should have on Capitol Hill) to make the best decisions for me and my family's health, especially with something as personal and unique as healthcare.
Quote from: slslbs on March 28, 2012, 09:20:44 PM
A couple of weeks ago the "doc fix" was in the news. It's a long story, but it's a mess that started in the late 90s and Congress chooses to kick the can rather than fix it once and for all.
I meant to ask you how you felt about that. What was that about? Something about paying for the payroll tax cut?
Quote from: slslbs on March 28, 2012, 09:20:44 PM
-Health care is labor intensive, with highly trained professionals. training is expensive in both time and money.
You went to medical school, I wonder, what's your feeling on making it easier for people to become doctors? The AAMC accepts what, 1 out of every 10 applicants, many of whom will not finish medical school? Shortages raise prices in every market, even healthcare.
Quote from: slslbs on March 28, 2012, 09:20:44 PM
docs don't want to get sued. if you do something extra, well you tried. if you didn't, you blew it. this is especially visible in the ED, which even without defensive medicine is the most expensive place to get routine medical care (except the icu and OR)
Up yours, bvaz
Quote from: runawayjimbo on March 28, 2012, 08:53:45 PM
What would be an acceptable level of profit for .... an insurance company?
i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.
Quote from: mirthbeatenworker on March 28, 2012, 10:49:13 PM
Quote from: runawayjimbo on March 28, 2012, 08:53:45 PM
What would be an acceptable level of profit for .... an insurance company?
i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.
/thread.
TL ftmfw
Quote from: aphineday on March 29, 2012, 01:25:55 AM
Quote from: mirthbeatenworker on March 28, 2012, 10:49:13 PM
Quote from: runawayjimbo on March 28, 2012, 08:53:45 PM
What would be an acceptable level of profit for .... an insurance company?
/thread.
TL ftmfw
i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.
All but the most heartless would agree (do we need more evidence that they exist or pretend to exist?).
However, at least a number range is going to have to be garnered to change the pace.
This country already has a number of assumed rights built on platitudes (Life, Liberty, Pursuit of Happiness ring a bell?), and you see how well those are interpreted (anyone in power tells us what they mean).
If we're (and I mean all of us who aren't in the heartless lot bent on pure profit alone) serious about changing the healthcare system in this country, we need to be serious about the cost and our ability to pay that cost.
Then we have to convince people that the cost is worth their investment.
Quote from: runawayjimbo on March 28, 2012, 10:36:50 PM
Quote from: slslbs on March 28, 2012, 09:20:44 PM
docs don't want to get sued. if you do something extra, well you tried. if you didn't, you blew it. this is especially visible in the ED, which even without defensive medicine is the most expensive place to get routine medical care (except the icu and OR)
Up yours, bvaz
except that I'm a lawyer for a hospital you jackass. I've never been inside a courtroom except for a couple of minor things I had to deal with. and then funny thing, it is not the lawyers. it is the people who want to get "easy" money by bringing the suit. I love how lawyers get blamed. without greedy clients, there'd be even more unemployed lawyers.
but since you bring it up. yeah, lawyers suck but let's read some of the threads about people on here who have needed them and gone to them when they needed help.
Quote from: mirthbeatenworker on March 28, 2012, 10:49:13 PM
i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.
I don't even know what that means. people have no idea what it's like to work in a hospital. people have no idea what a day costs and that insurance companies want people out as soon as possible. yeah, you can say the hospital can keep them but read above. if a hospital loses money, it can't invest in new products and technology.
this shit is so much more complicated than "ending a thread" with one line that has absolutely no meaning.
people don't know what it's like to have to deal with insurance companies that create more overhead for hospitals by originally denying. people don't know what it's like how some payers try and skim 5% off all black and white contractually agreed fee schedules just to see how they can get away with it and hospitals have to dedicate staff to payment verification. how would you all feel if your employer paid you 5% less each week because it is a way they thought of trying to make more money.
you can think people in healthcare are padding their wallets. I am sure it happens some places but trust me, hospitals/doctors offices are far from fantasy land.
now I'm officially out of this thread. honestly, I don't have the time to keep up with it and chime in. it's one thing to read these articles. it's another thing to live in this world every day.
Quote from: runawayjimbo on March 28, 2012, 10:36:50 PM
Quote from: slslbs on March 28, 2012, 09:20:44 PM
A couple of weeks ago the "doc fix" was in the news. It's a long story, but it's a mess that started in the late 90s and Congress chooses to kick the can rather than fix it once and for all.
I meant to ask you how you felt about that. What was that about? Something about paying for the payroll tax cut?
Quote from: slslbs on March 28, 2012, 09:20:44 PM
-Health care is labor intensive, with highly trained professionals. training is expensive in both time and money.
You went to medical school, I wonder, what's your feeling on making it easier for people to become doctors? The AAMC accepts what, 1 out of every 10 applicants, many of whom will not finish medical school? Shortages raise prices in every market, even healthcare.
SGR was part of the Balanced Budget act of 97. The "doc fix" is what has turned into a yearly bill to counter it. Here are a couple of links (I purposely avoided medical publications which may be percieved as biased)
http://www.washingtonpost.com/national/health-science/medicares-sgr-formula-has-snowballed-to-budget-busting-juggernaut/2011/12/13/gIQAXaq3wO_story.html
http://en.wikipedia.org/wiki/Medicare_Sustainable_Growth_Rate
Basically, Congress thought that the way to reduce $ on health care is to just say they'll reduce it. They came up with a formula which has been attacked by all angles and even Medicare and Congress know its wrong. This formula would reduce medicare expenses by reducing payments every year in a progressive manner, basically between 3 - 5% per year each year. Every year there is a big debate over this, so Congress eventually leaves reimbursement flat. The next year, the same thing happens. But the cuts, by law, should have been progressive. By this year, if Congress didn't act, there would have been a 27% reduction to Medicare reimbursement. The results wouldn't have been pretty. There have been several bills to repeal the whole thing. The closest it got was 2 years ago when it passed the house and got fillibustered in the Senate by Jim Bunning (R-Kent). So, every year, Congress time and our $ is spent writing a bill that puts this off for between 6 months and 1 - 2 years, instead of just dealing with it.
If your wondering, the reimbursement that has actually been paid per service since this time has been relatively flat, depending on the service. In general, primary care gets small increases and specialty services of all kinds (office, imaging, operations) get cut. So, the global Medicare expenditures have increased based upon volume of procedures and new drugs / more drugs / new procedures as opposed to paying docs more per service. Essentially, more work for the same money.
As far as making it easier to become a doc, my own opinion is that it certainly shouldn't be easy. I wonder what the reason 1 in 10 people quit school is, based on my experience it's less. People find out once they're in med school they don't like it; making it easier won't help. In Europe, you go to MS for 6 years right after HS, instead of 4 years college and 4 years MS. I think 18 is too young to be picking who will go to med school, but you can argue that a full BA or BS might not be necessary. I liked undergrad, but the expense has grown astronomically, so maybe something to be considered.
Also, training is long. 3 years for internal medicince, fam practice, and peds, medical specialties are another 3 years on top of that. Surgery is 5 years +. The specialty societies have been trying to reduce the requirements from 3 years IM before specialty training to 2, but have met resistance from IM program directors. If that happens, which I think it should, then there will be a labor shortage in medical residency programs. As it is, all positions aren't filled. Increasing the # of MS grads per year would be reasonable, allow an increase in physician work force, and not lower the bar too much for medical training.
also, in the future you will nee more nurse practitioners and physician assistants do primary care. this will lower cost and improve access. the affect it will have on outcome remains to be seen, but a smart NP or PA, who knows their limitations is reasonable.
long winded answers to short questions.
just read your post - bvaz
my comment wasn't "anti-lawyer" but against the current system. I think we both know what the problems are. Of course, docs need to make fewer errors. IMO, people get sued for a bad outcome which may or may not be from a screw up. Sometimes, life sucks, medicine is inexact, diseases are bad, and shit happens. People shouldn't get sued for that, but they do.
I've been an expert witness for the defense 3 times over the past 15 years (one currently). The doc won the first, settled with the 2nd, and the 3rd is ongoing. Won't comment in any way on the current case. Both results were correct, imo, and both cases were reasonable. The issue is the unreasonable cases that get brought about. Anyway, topic for a different time.
before runawayjimbo took another shot at me being a lawyer, I thought he should at least be informed of the type of lawyer I am. not that I take it personally, but I thought I'd give him a better opportunity to take jabs at the actual work I do.
not to get into the malpractice issue too much, but without changing the malpractice system, more coverage just means more lawsuits, both frivilous and legitimate. that's just plain statistics. ignoring that issue is just going to cause more problems. but I agree, it is a whole different topic but just highlight how complicated the after effects of this legislation can be.
Quote from: bvaz on March 29, 2012, 06:45:05 AM
before runawayjimbo took another shot at me being a lawyer
Psst....it was a joke.
Quote from: bvaz on March 29, 2012, 06:08:54 AM
Quote from: mirthbeatenworker on March 28, 2012, 10:49:13 PM
i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.
I don't even know what that means.
of course you do. as whistleblowers like linda peeno and others have
made it clear that insurance companies like humana systemically reward 'adjusters'
who deny coverage. http://www.democracynow.org/2007/6/21/hmo_whisteblower_dr_linda_peeno_on
i'm not going to get into it because it is of course well known and you are just
pretending you have "no idea what i mean"
i never claimed that my statement was so profound that i was "ending a thread."
i just dont feel the need to talk in circles and spin arguments when right vs wrong is so very clear.
Meanwhile, over at foxnews.com:
(https://lh6.googleusercontent.com/---uZu2rqBY0/T3RnRvUXa0I/AAAAAAAACdQ/nq2UALQJdIU/s462/Screen%2520shot%25202012-03-29%2520at%25209.43.49%2520AM.png)
And here's an artist's rendering of who those 54.9% are:
(http://rtone.files.wordpress.com/2010/04/ostrich_cartoon.jpg)
"And let us never return to healthcare reform again"
:hereitisyousentimentalbastard
Quote from: mirthbeatenworker on March 29, 2012, 09:17:31 AM
Quote from: bvaz on March 29, 2012, 06:08:54 AM
Quote from: mirthbeatenworker on March 28, 2012, 10:49:13 PM
i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.
I don't even know what that means.
of course you do. as whistleblowers like linda peeno and others have
made it clear that insurance companies like humana systemically reward 'adjusters'
who deny coverage. http://www.democracynow.org/2007/6/21/hmo_whisteblower_dr_linda_peeno_on
i'm not going to get into it because it is of course well known and you are just
pretending you have "no idea what i mean"
i never claimed that my statement was so profound that i was "ending a thread."
i just dont feel the need to talk in circles and spin arguments when right vs wrong is so very clear.
Dude, does everything you reference have to come from a Michael Moore movie? (insert winkiface so you don't freak out on me like bvaz (just kidding, bvaz))
I honestly have no idea what you mean. While I don't doubt that insurers (like any business) try to reduce their costs, there is very little evidence to suggest that outright rejection of claims is a widespread and abusive practice in the industry. The stat floating around during the healthcare debate was that 1-in-5 claims are denied. You may say that's unacceptable, but the statistic was (some would say purposefully) misleading in that a denial is not the same as a rejection. A claim could be denied for administrative reasons (e.g., claim sent to the wrong insurer, which is not that uncommon in a complex interwoven healthcare system) only to be paid at a later point, usually unbeknownst to the insured. In fact, according to a 2008 AMA study (http://www.ama-assn.org/ama1/pub/upload/mm/368/reportcard.pdf), the denial rate for 8 of the largest insurers ranged from 2.68%-6.85% (p. 5). Is that fair? Maybe not, but it certainly doesn't suggest to me there is a rampant abuse of "letting sick people stay sick and die."
But I do agree with you (in one respect) that what is very clear is the system is broken. What is not as clear is the best way to fix it (while, as nab points out, being able to pay for it.) sls' discussion on the SGR is a great illustration of why I am so fearful of giving more control to the gov't: I just don't have faith that a politician will be able to focus on anything but their next election instead of making the difficult choices that would be required to control healthcare costs over the long run. Much easier to promise the moon to get elected today without worrying about the long-term effects (not to mention the market distorting forces introduced when a single payer is involved).
ETA: just found a more recent AMA Report Card showing that denials of private insurers range from 0.68%-3.62% while gov't run Medicare denies 2.73%, 60% higher than the average of the 7 private insurers.
(http://www.ama-assn.org/resources/images/psa/metric-11.jpg)
Quote from: runawayjimbo on March 29, 2012, 10:57:22 AM
Quote from: mirthbeatenworker on March 29, 2012, 09:17:31 AM
Quote from: bvaz on March 29, 2012, 06:08:54 AM
Quote from: mirthbeatenworker on March 28, 2012, 10:49:13 PM
i don't know the magic number, but one which wasn't accomplished by letting sick people stay sick and die.
I don't even know what that means.
of course you do. as whistleblowers like linda peeno and others have
made it clear that insurance companies like humana systemically reward 'adjusters'
who deny coverage. http://www.democracynow.org/2007/6/21/hmo_whisteblower_dr_linda_peeno_on
i'm not going to get into it because it is of course well known and you are just
pretending you have "no idea what i mean"
i never claimed that my statement was so profound that i was "ending a thread."
i just dont feel the need to talk in circles and spin arguments when right vs wrong is so very clear.
Dude, does everything you reference have to come from a Michael Moore movie? (insert winkiface so you don't freak out on me like bvaz (just kidding, bvaz))
I honestly have no idea what you mean. While I don't doubt that insurers (like any business) try to reduce their costs, there is very little evidence to suggest that outright rejection of claims is a widespread and abusive practice in the industry. The stat floating around during the healthcare debate was that 1-in-5 claims are denied. You may say that's unacceptable, but the statistic was (some would say purposefully) misleading in that a denial is not the same as a rejection. A claim could be denied for administrative reasons (e.g., claim sent to the wrong insurer, which is not that uncommon in a complex interwoven healthcare system) only to be paid at a later point, usually unbeknownst to the insured. In fact, according to a 2008 AMA study (http://www.ama-assn.org/ama1/pub/upload/mm/368/reportcard.pdf), the denial rate for 8 of the largest insurers ranged from 2.68%-6.85% (p. 5). Is that fair? Maybe not, but it certainly doesn't suggest to me there is a rampant abuse of "letting sick people stay sick and die."
But I do agree with you (in one respect) that what is very clear is the system is broken. What is not as clear is the best way to fix it (while, as nab points out, being able to pay for it.) sls' discussion on the SGR is a great illustration of why I am so fearful of giving more control to the gov't: I just don't have faith that a politician will be able to focus on anything but their next election instead of making the difficult choices that would be required to control healthcare costs over the long run. Much easier to promise the moon to get elected today without worrying about the long-term effects (not to mention the market distorting forces introduced when a single payer is involved).
ETA: just found a more recent AMA Report Card showing that denials of private insurers range from 0.68%-3.62% while gov't run Medicare denies 2.73%, 60% higher than the average of the 7 private insurers.
(http://www.ama-assn.org/resources/images/psa/metric-11.jpg)
ok, just gloss over congressional testimony of a phsycian and former humana employee with a chart.
what about the people who were denied coverage to begin with, either becase of age or a previous health issue? you say its a business protecting agaisnt a loss, i say its letting sick people stay sick and die.
the original question was how much is an acceptable level of profit. i say one, a still very 'healthy' one, where these people were able to be made well. if its such a small number, how much would it have cost to cover those? what were those procedures? what number of people does that percentage represent?
how many people died because of it? you see it in terms of $, i see it in terms of the actual people behind those numbers.
I'm just gonna chime in here and agree that corporate profit motives should be divorced from health care. There's too much perverse incentive in making money off of people being hurt and sick.
And I say this as the grandchild of a surgeon, child of a general internist, and husband of a family nurse practitioner.
I'm not going to pretend to know the actual costs involved but when I take my daughter in for a procedure that literally takes 10 minutes in the OR and it costs $6000 something is very, very wrong.
What can we do to get these costs under control?
Quote from: Hicks on March 29, 2012, 12:55:07 PM
I'm not going to pretend to know the actual costs involved but when I take my daughter in for a procedure that literally takes 10 minutes in the OR and it costs $6000 something is very, very wrong.
What can we do to get these costs under control?
Don't take her to the emergency room??? I mean, your complaint is the equivalent of bitching about having to buy a lamborghini in order to drive to the mall... (Yes that was the analogy I told my wife when we took our kid to the ER for a fever...)
If it was truly an emergency, the $6000 would be the least of your worries... Strike all that, I read "OR" as "ER"... And yeah, $6000??? Sounds pretty cheap to train doctors and nurses that are attempting to better (or SAVE) your kid's life through an invasive surgical procedure... But if you want to pay less for surgery, I have a butcher knife soaking in rubbing alcohol out in the garage... I'll only charge you half that amount...
Terry
Quote from: mirthbeatenworker on March 29, 2012, 12:22:58 PM
ok, just gloss over congressional testimony of a phsycian and former humana employee with a chart.
The point is that one person's experience is not indicative of the entire industry. I'm not disputing that there are some bad people in the industry following immoral business practices. There's bad cops too. And don't get me started on the 20-something yr old teachers who take advantage of those poor teenage boys by buying them booze and weed and having sex with them!! All I'm saying is that, when you look on the aggregate, 2% doesn't seem like unfounded denials are as commonplace in the private health insurance industry as Dr. Peeno would have us believe. Is 1 person too many to be denied a potentially life saving procedure? Of course. But that doesn't, IMO, invalidate the millions of people who have directly benefited from having relatively easy access to the (expensive) technological advances that have drastically improved people's quality of life.
Quote from: mirthbeatenworker on March 29, 2012, 12:22:58 PM
you see it in terms of $, i see it in terms of the actual people behind those numbers.
This is a very important point and one that makes it very difficult for many people to consider the healthcare market as they would any other. There is a human element that makes us identify with the horrific stories of people who have a serious condition and get dicked around by their insurance company or just give up because of the bureaucratic horseshit. I fully acknowledge that. But we also need to balance that desire to make things better for everyone with the ability to fund these procedures while still encouraging innovation or else we'll all be worse off. I don't think we should just let people die, I think we should try lower costs to make sure everyone can get the care they need.
Quote from: sunrisevt on March 29, 2012, 12:36:44 PM
I'm just gonna chime in here and agree that corporate profit motives should be divorced from health care. There's too much perverse incentive in making money off of people being hurt and sick.
Do you think there wouldn't be as many perverse incentives by interjecting the gov't into personal healthcare decisions? Look at the contraception issue. I just can't believe that both sides wouldn't continue to play political games with people's lives. And it's easy for you to say when the Ds control the policies, but what happens if there's a GOP administration in charge of your healthcare. I think I asked you this before, but would you really be comfortable with Pres. Rick Santorum setting the agenda of the single payer healthcare system? Cause that would scare the fuck out of me. We could just pray the sickness away.
Quote from: Hicks on March 29, 2012, 12:55:07 PM
I'm not going to pretend to know the actual costs involved but when I take my daughter in for a procedure that literally takes 10 minutes in the OR and it costs $6000 something is very, very wrong.
What can we do to get these costs under control?
As sls laid out above, it's a ridiculously complex problem. If you want to argue a single payer would be the best way to reduce administrative costs and provide the best outcomes, I can understand that argument (not that I subscribe to it). I would argue that more competition is critical to driving down costs and continuing to foster innovation that is obviously so important in the field. But to steer this back to the current issue, what I don't understand is how Obama can say we are going to keep the same system with some more gov'tal distortions and that things will get better. There is nothing in the law that would "bend the cost curve" as he was so fond of saying. Is it good that more people will have coverage? Of course, but if it doesn't address the root cause of rampant medical inflation across all segments of the industry, we'll just keep spending more and making it more complicated for people to get the care they need.
ETA:
Quote from: twatts likes ghoti on March 29, 2012, 01:20:32 PM
But if you want to pay less for surgery, I have a butcher knife soaking in rubbing alcohol out in the garage... I'll only charge you half that amount...
:hereitisyousentimentalbastard
See, we heartless libertarians can still have a sense of humor!
Quote from: twatts likes ghoti on March 29, 2012, 01:20:32 PM
Quote from: Hicks on March 29, 2012, 12:55:07 PM
I'm not going to pretend to know the actual costs involved but when I take my daughter in for a procedure that literally takes 10 minutes in the OR and it costs $6000 something is very, very wrong.
What can we do to get these costs under control?
Don't take her to the emergency room??? I mean, your complaint is the equivalent of bitching about having to buy a lamborghini in order to drive to the mall... (Yes that was the analogy I told my wife when we took our kid to the ER for a fever...)
If it was truly an emergency, the $6000 would be the least of your worries...
Strike all that, I read "OR" as "ER"... And yeah, $6000??? Sounds pretty cheap to train doctors and nurses that are attempting to better (or SAVE) your kid's life through an invasive surgical procedure... But if you want to pay less for surgery, I have a butcher knife soaking in rubbing alcohol out in the garage... I'll only charge you half that amount...
Terry
I asked the nurse and she said they can perform 80 such procedures in a single day, so now I'm on the hook for entire cost of training the doctor and nurses?
What about the other 79 people that had it done THAT SAME DAY?
Do the math, that's $480,000 for a single day's work for the staff.
And yes I realize there was some equipment and anesthetic involved, but still, it's fucking ridiculous.
Quote from: Hicks on March 29, 2012, 01:45:25 PM
Quote from: twatts likes ghoti on March 29, 2012, 01:20:32 PM
Quote from: Hicks on March 29, 2012, 12:55:07 PM
I'm not going to pretend to know the actual costs involved but when I take my daughter in for a procedure that literally takes 10 minutes in the OR and it costs $6000 something is very, very wrong.
What can we do to get these costs under control?
Don't take her to the emergency room??? I mean, your complaint is the equivalent of bitching about having to buy a lamborghini in order to drive to the mall... (Yes that was the analogy I told my wife when we took our kid to the ER for a fever...)
If it was truly an emergency, the $6000 would be the least of your worries...
Strike all that, I read "OR" as "ER"... And yeah, $6000??? Sounds pretty cheap to train doctors and nurses that are attempting to better (or SAVE) your kid's life through an invasive surgical procedure... But if you want to pay less for surgery, I have a butcher knife soaking in rubbing alcohol out in the garage... I'll only charge you half that amount...
Terry
I asked the nurse and she said they can perform 80 such procedures in a single day, so now I'm on the hook for entire cost of training the doctor and nurses?
What about the other 79 people that had it done THAT SAME DAY?
Do the math, that's $480,000 for a single day's work for the staff.
And yes I realize there was some equipment and anesthetic involved, but still, it's fucking ridiculous.
I'm not sure what kind of procedure your child had, but if it betters his/her life, wasn't it worth $6000??? And if not, why did you even do it???
Terry
Quote from: twatts likes ghoti on March 29, 2012, 01:59:03 PM
Quote from: Hicks on March 29, 2012, 01:45:25 PM
Quote from: twatts likes ghoti on March 29, 2012, 01:20:32 PM
Quote from: Hicks on March 29, 2012, 12:55:07 PM
I'm not going to pretend to know the actual costs involved but when I take my daughter in for a procedure that literally takes 10 minutes in the OR and it costs $6000 something is very, very wrong.
What can we do to get these costs under control?
Don't take her to the emergency room??? I mean, your complaint is the equivalent of bitching about having to buy a lamborghini in order to drive to the mall... (Yes that was the analogy I told my wife when we took our kid to the ER for a fever...)
If it was truly an emergency, the $6000 would be the least of your worries...
Strike all that, I read "OR" as "ER"... And yeah, $6000??? Sounds pretty cheap to train doctors and nurses that are attempting to better (or SAVE) your kid's life through an invasive surgical procedure... But if you want to pay less for surgery, I have a butcher knife soaking in rubbing alcohol out in the garage... I'll only charge you half that amount...
Terry
I asked the nurse and she said they can perform 80 such procedures in a single day, so now I'm on the hook for entire cost of training the doctor and nurses?
What about the other 79 people that had it done THAT SAME DAY?
Do the math, that's $480,000 for a single day's work for the staff.
And yes I realize there was some equipment and anesthetic involved, but still, it's fucking ridiculous.
I'm not sure what kind of procedure your child had, but if it betters his/her life, wasn't it worth $6000??? And if not, why did you even do it???
Terry
You are completely missing my point.
If some motherfucker took my daughter hostage and I had to shell out $6000 as ransom to get her back it would technically be "worth it".
That doesn't make it right.
Quote from: twatts likes ghoti on March 29, 2012, 01:59:03 PM
Quote from: Hicks on March 29, 2012, 01:45:25 PM
Quote from: twatts likes ghoti on March 29, 2012, 01:20:32 PM
Quote from: Hicks on March 29, 2012, 12:55:07 PM
I'm not going to pretend to know the actual costs involved but when I take my daughter in for a procedure that literally takes 10 minutes in the OR and it costs $6000 something is very, very wrong.
What can we do to get these costs under control?
Don't take her to the emergency room??? I mean, your complaint is the equivalent of bitching about having to buy a lamborghini in order to drive to the mall... (Yes that was the analogy I told my wife when we took our kid to the ER for a fever...)
If it was truly an emergency, the $6000 would be the least of your worries...
Strike all that, I read "OR" as "ER"... And yeah, $6000??? Sounds pretty cheap to train doctors and nurses that are attempting to better (or SAVE) your kid's life through an invasive surgical procedure... But if you want to pay less for surgery, I have a butcher knife soaking in rubbing alcohol out in the garage... I'll only charge you half that amount...
Terry
I asked the nurse and she said they can perform 80 such procedures in a single day, so now I'm on the hook for entire cost of training the doctor and nurses?
What about the other 79 people that had it done THAT SAME DAY?
Do the math, that's $480,000 for a single day's work for the staff.
And yes I realize there was some equipment and anesthetic involved, but still, it's fucking ridiculous.
I'm not sure what kind of procedure your child had, but if it betters his/her life, wasn't it worth $6000??? And if not, why did you even do it???
Terry
yeah hicks, if you question the cost you dont love your daughter!
now shut up and do as your told! :wink:
Quote from: runawayjimbo on March 29, 2012, 01:31:20 PM
Quote from: mirthbeatenworker on March 29, 2012, 12:22:58 PM
ok, just gloss over congressional testimony of a phsycian and former humana employee with a chart.
The point is that one person's experience is not indicative of the entire industry. I'm not disputing that there are some bad people in the industry following immoral business practices.
this is all moot anyway, because as you famously once declared:
Quote from: runawayjimbo on November 23, 2011, 10:55:32 PM
no one profits from other people's misery.
Quote from: mirthbeatenworker on March 29, 2012, 02:23:11 PM
Quote from: runawayjimbo on March 29, 2012, 01:31:20 PM
Quote from: mirthbeatenworker on March 29, 2012, 12:22:58 PM
ok, just gloss over congressional testimony of a phsycian and former humana employee with a chart.
The point is that one person's experience is not indicative of the entire industry. I'm not disputing that there are some bad people in the industry following immoral business practices.
this is all moot anyway, because as you famously once declared:
Quote from: runawayjimbo on November 23, 2011, 10:55:32 PM
no one profits from other people's misery.
That's not true? :|
::cancels order of dozen chinese slave labor kids::
::kicks can down road, thinking the 13th one was free too :x ::
Quote from: mirthbeatenworker on March 29, 2012, 02:23:11 PM
Quote from: runawayjimbo on March 29, 2012, 01:31:20 PM
Quote from: mirthbeatenworker on March 29, 2012, 12:22:58 PM
ok, just gloss over congressional testimony of a phsycian and former humana employee with a chart.
The point is that one person's experience is not indicative of the entire industry. I'm not disputing that there are some bad people in the industry following immoral business practices.
this is all moot anyway, because as you famously once declared:
Quote from: runawayjimbo on November 23, 2011, 10:55:32 PM
no one profits from other people's misery.
If you want to take my comments out of context go for it. I don't think that makes your case any stronger but hey, have at it. But it doesn't even make sense in this argument. People die in car accidents too; do the auto companies profit from people's misery? Alcohol is pretty goddamned dangerous, should we ask the gov't to step in and save us? The bottom line is that the overwhelming majority of people have unquestionably benefited from evil, greedy health insurers than have been harmed by them.
Quote from: runawayjimbo on March 29, 2012, 02:36:47 PM
Quote from: mirthbeatenworker on March 29, 2012, 02:23:11 PM
Quote from: runawayjimbo on March 29, 2012, 01:31:20 PM
Quote from: mirthbeatenworker on March 29, 2012, 12:22:58 PM
ok, just gloss over congressional testimony of a phsycian and former humana employee with a chart.
The point is that one person's experience is not indicative of the entire industry. I'm not disputing that there are some bad people in the industry following immoral business practices.
this is all moot anyway, because as you famously once declared:
Quote from: runawayjimbo on November 23, 2011, 10:55:32 PM
no one profits from other people's misery.
If you want to take my comments out of context go for it. I don't think that makes your case any stronger but hey, have at it. But it doesn't even make sense in this argument. People die in car accidents too; do the auto companies profit from people's misery? Alcohol is pretty goddamned dangerous, should we ask the gov't to step in and save us? The bottom line is that the overwhelming majority of people have unquestionably benefited from evil, greedy health insurers than have been harmed by them.
It's true. I include the health insurance companies in my prayers every night. If it wasn't for them, I don't know where I'd be. Probably a lot better off. God bless health insurance companies.
Quote from: runawayjimbo on March 29, 2012, 02:36:47 PM
Quote from: mirthbeatenworker on March 29, 2012, 02:23:11 PM
Quote from: runawayjimbo on March 29, 2012, 01:31:20 PM
Quote from: mirthbeatenworker on March 29, 2012, 12:22:58 PM
ok, just gloss over congressional testimony of a phsycian and former humana employee with a chart.
The point is that one person's experience is not indicative of the entire industry. I'm not disputing that there are some bad people in the industry following immoral business practices.
this is all moot anyway, because as you famously once declared:
Quote from: runawayjimbo on November 23, 2011, 10:55:32 PM
no one profits from other people's misery.
If you want to take my comments out of context go for it. I don't think that makes your case any stronger but hey, have at it. But it doesn't even make sense in this argument.
People die in car accidents too; do the auto companies profit from people's misery?
Alcohol is pretty goddamned dangerous, should we ask the gov't to step in and save us? The bottom line is that the overwhelming majority of people have unquestionably benefited from evil, greedy health insurers than have been harmed by them.
1. how is it out of context?
2. thats a shit analogy
3. alcohol is heavily regulated by the gov't
I'm hopping back in here with a couple of points.
1.) MBW never did proclaim his statement to be so profound as to end a thread, but I did; It's that simple to me.
2.) Hicks is spot on. I understand that it is a money game, and that leads me to point 3.
3.) All of this talk about regarding healthcare denying claims as a "business protecting itself from a loss" is exactly the mindset I'm opposed to. Before you call me out (medical procedures aren't free, training doctors isn't free etc..), I get it. I forgot that Docs don't pay anything out of their pockets or take loans. IF we are going to pay for their training, then that's a completely different ballgame. I'm a pilot, and I owe a lot of money in loans I took to make that a reality. Nobody bitches about how much it costs to train pilots, and that's why airfares are so high etc..
$6,000 for Hicks to take his child to the ER is absurd, and should not be how it's handled period. The argument of "isn't $6000 worth bettering your kid's life" is insane. He did it to help his child, but (as he said, but I just want to reiterate) OF COURSE IT'S "WORTH IT", but it's also inherently fucking wrong.
Quote from: runawayjimbo on March 29, 2012, 01:31:20 PM
Quote from: sunrisevt on March 29, 2012, 12:36:44 PM
I'm just gonna chime in here and agree that corporate profit motives should be divorced from health care. There's too much perverse incentive in making money off of people being hurt and sick.
Do you think there wouldn't be as many perverse incentives by interjecting the gov't into personal healthcare decisions? Look at the contraception issue. I just can't believe that both sides wouldn't continue to play political games with people's lives. And it's easy for you to say when the Ds control the policies, but what happens if there's a GOP administration in charge of your healthcare. I think I asked you this before, but would you really be comfortable with Pres. Rick Santorum setting the agenda of the single payer healthcare system? Cause that would scare the fuck out of me. We could just pray the sickness away.
First, Santorum's not a faith healer or Christian Scientist; he's a cafeteria Catholic. He's not even been consistent in his adult life on his application of Catholic principles. But no, that's not the point...
A
sane national health plan would definitely cover contraception and reproductive health care broadly and at low cost to consumers, because it's a guaranteed cost-cutting measure. Unplanned pregnancies are much, much more costly to society than lots of rubbers, pills, IUDs, Plan Bs, etc.
I agree with you that bringing the gov't futher into health care is scary. But the corporate state has proved itself a miserably poor steward of the common good--in fact is was always insane to expect legal entities whose only raison d'etre is profit for shareholders to voluntarily keep the public good in mind in their pursuit of profit. I'm willing to consider models based on those of the UK & Western Europe as viable, sane alternatives.
And no, I'm not saying corporations are evil. I'm saying they need to get the fuck out of the businesses of providing health care, running prisons, providing military services, etc. Certain vital social functions should
necessarily be the sole purview of the government, and I think health care has moved into that category over the last century.
Quote from: aphineday on March 29, 2012, 03:16:18 PM
$6,000 for Hicks to take his child to the ER is absurd, and should not be how it's handled period. The argument of "isn't $6000 worth bettering your kid's life" is insane. He did it to help his child, but (as he said, but I just want to reiterate) OF COURSE IT'S "WORTH IT", but it's also inherently fucking wrong.
1) He said OR, not ER. That was my mistake.
2) "Wrong" is relative. He never stated what the procedure was, so we make a lot of assumptions. If he said he paid a $6000 deductible to treat his child's cancer, it would totally be "right". If he paid $6000 to have a wart removed, then its "wrong"... But like I asked before, if paying $6000 wasn't worth it, why do it???
UNLIKE the hostage scenario he brought up before, taking your kid to the hospital is not involutary. They did not kidnap his kid, do the procedure, then demand payment. He walked in said here is my kid ready for surgery, where do I sign up???
Terry
Quote from: twatts likes ghoti on March 29, 2012, 03:33:38 PM
Quote from: aphineday on March 29, 2012, 03:16:18 PM
$6,000 for Hicks to take his child to the ER is absurd, and should not be how it's handled period. The argument of "isn't $6000 worth bettering your kid's life" is insane. He did it to help his child, but (as he said, but I just want to reiterate) OF COURSE IT'S "WORTH IT", but it's also inherently fucking wrong.
1) He said OR, not ER. That was my mistake.
2) "Wrong" is relative. He never stated what the procedure was, so we make a lot of assumptions. If he said he paid a $6000 deductible to treat his child's cancer, it would totally be "right". If he paid $6000 to have a wart removed, then its "wrong"... But like I asked before, if paying $6000 wasn't worth it, why do it???
UNLIKE the hostage scenario he brought up before, taking your kid to the hospital is not involutary. They did not kidnap his kid, do the procedure, then demand payment. He walked in said here is my kid ready for surgery, where do I sign up???
Terry
*sigh*
You know what the details don't really matter, but it was a procedure to put tubes in her ears after she had three ear infections.
To be honest I questioned whether she really needed it because her hearing seemed fine to me, she has always been very responsive to sounds and my voice.
But I'm not a doctor and was I going to take chances with her language development?
Of course not.
Do I feel like I sort of got scammed by the entire ordeal?
A little bit.
assuming you have health insurance, the hospital wasn't paid $6,000.
that opens up a whole new can of worms discussion.
single payer system "fixes" that but creates a lot more what I perceive as problems.
regardless of the cost Hicks, glad the procedure went well anyway.
Quote from: mirthbeatenworker on March 29, 2012, 03:14:33 PM
1. how is it out of context?
Because you chopped off several sentences of a coherent argument into a one liner that you took offense too. You're fucking O'Keef-ing me, and I think you're better than that.
Quote from: mirthbeatenworker on March 29, 2012, 03:14:33 PM
2. thats a shit analogy
Why? Your point was that health insurers profit from people's misery. Doesn't a flaming wreck due to, I don't know, shitty brake pads, also cause misery? And if so, are the producers of that product responsible for that? Maybe you'd have taken less offense to my statement if I had qualified it as "no one profits from
intentionally causing other's misery", but then you'd probably harp on the fact that health insurers willfully destroy people's live despite the evidence I provided above that, on the aggregate, completely blows that argument to shit.
Quote from: mirthbeatenworker on March 29, 2012, 03:14:33 PM
3. alcohol is heavily regulated by the gov't
So what, so's health care? I don't think there's any disputing that alcohol causes misery (probably much more than health insurers who deny a whopping 2-3% of claims for apparently no other reason than to wipe their asses with $100s). But, following your logic, if they are profitting from people's misery, aren't they inherently evil?
Quote from: aphineday on March 29, 2012, 03:16:18 PM
3.) All of this talk about regarding healthcare denying claims as a "business protecting itself from a loss" is exactly the mindset I'm opposed to. Before you call me out (medical procedures aren't free, training doctors isn't free etc..), I get it. I forgot that Docs don't pay anything out of their pockets or take loans. IF we are going to pay for their training, then that's a completely different ballgame.
Now you want to pay for medical school too?!? You seem like a good dued, aphineday, so please take this with the sarcasm it is intended, but can I please get a hit of what you're smoking because it must be some sweet shit.
Let's take a different approach, since I agree that it would be great to give everyone the greatest healthcare in the world. But here's a quick and dirty calculation to illustrate my skepticism with single payer: since 1950, tax revenues have averaged 18% of GDP regardless of tax rates. Coincidentally, healthcare spending runs around 15% (not since 1950, but that's what it currently is). So, if you want the gov't to take over all healthcare spending, what do we get rid of? Hicks made the very salient point yesterday that maybe we should stop blowing shit up all over the world and we could save a buck or two. So let's cut the defense budget by more than half to roughly $350B (I assume you recognize the need to have some level of defense spending). Now let's say the efficiencies of a gov't provided plan cuts healthcare spending by half (I can hardly type that with a straight face, but let's go for it), bringing total healthcare spending to around a trillion dollars. That brings healthcare and defense spending to about $1.35T or almost two-thirds of the entire budget (note if you are less generous with the cost reductions and assume only 1/4 reduction in healthcare spending, the two amount to 95% of current tax revenues). So you guys tell me: what do you want to start cutting in order to provide this glorious healthcare regime you're talking about? This is all assumes that having a monopoly in healthcare has no other adverse effects like stifiling innovation or the politicization of every individual's healthcare decisions (which I believe would have very severe outcomes on people's health). So while it's all good to talk in broad vagueries like our current presiednt likes to do, just do the math. This shit doesn't add up.
Quote from: Hicks on March 29, 2012, 03:38:23 PM
Quote from: twatts likes ghoti on March 29, 2012, 03:33:38 PM
Quote from: aphineday on March 29, 2012, 03:16:18 PM
$6,000 for Hicks to take his child to the ER is absurd, and should not be how it's handled period. The argument of "isn't $6000 worth bettering your kid's life" is insane. He did it to help his child, but (as he said, but I just want to reiterate) OF COURSE IT'S "WORTH IT", but it's also inherently fucking wrong.
1) He said OR, not ER. That was my mistake.
2) "Wrong" is relative. He never stated what the procedure was, so we make a lot of assumptions. If he said he paid a $6000 deductible to treat his child's cancer, it would totally be "right". If he paid $6000 to have a wart removed, then its "wrong"... But like I asked before, if paying $6000 wasn't worth it, why do it???
UNLIKE the hostage scenario he brought up before, taking your kid to the hospital is not involutary. They did not kidnap his kid, do the procedure, then demand payment. He walked in said here is my kid ready for surgery, where do I sign up???
Terry
*sigh*
You know what the details don't really matter, but it was a procedure to put tubes in her ears after she had three ear infections.
To be honest I questioned whether she really needed it because her hearing seemed fine to me, she has always been very responsive to sounds and my voice.
But I'm not a doctor and was I going to take chances with her language development?
Of course not.
Do I feel like I sort of got scammed by the entire ordeal?
A little bit.
Paying $100 for the next 60 years, so she can hear for those 60 years doesn't seem like a scam to me... But like I said, "wrong" is relative...
Intertestingly enough, my cousin and her daughter are exactly there now... She's had several ear infections, and they are debating tubes... But Chad's mom said, "Chad had the same thing and he's fine!" So now Nikki and Chad are mulling it over...
Want to know my story??? We paid $4000 to get have an ER Doctor check Cody's temp (105+), prescribe an anti-biotic, bitch at us for not following recommended vaccinations practices, and treat us like a bunch of mexicans... I told my wife that we should wait one day (we took Cody to ER on a Sunday) so she could take Cody to the family doctor, but she was freaking out... Was the medical treatment worth $4000??? Hell no! She blew our entire HSA in one shot to make herself feel better... That's "wrong"...
Terry
Heh, do I really need to type out the liberal response to where more money needs to come from? :hereitisyousentimentalbastard
Quote from: runawayjimbo on March 29, 2012, 04:01:19 PM
Quote from: mirthbeatenworker on March 29, 2012, 03:14:33 PM
1. how is it out of context?
Because you chopped off several sentences of a coherent argument into a one liner that you took offense too. You're fucking O'Keef-ing me, and I think you're better than that.
Quote from: mirthbeatenworker on March 29, 2012, 03:14:33 PM
2. thats a shit analogy
Why? Your point was that health insurers profit from people's misery. Doesn't a flaming wreck due to, I don't know, shitty brake pads, also cause misery? And if so, are the producers of that product responsible for that? Maybe you'd have taken less offense to my statement if I had qualified it as "no one profits from intentionally causing other's misery", but then you'd probably harp on the fact that health insurers willfully destroy people's live despite the evidence I provided above that, on the aggregate, completely blows that argument to shit.
Quote from: mirthbeatenworker on March 29, 2012, 03:14:33 PM
3. alcohol is heavily regulated by the gov't
So what, so's health care? I don't think there's any disputing that alcohol causes misery (probably much more than health insurers who deny a whopping 2-3% of claims for apparently no other reason than to wipe their asses with $100s). But, following your logic, if they are profitting from people's misery, aren't they inherently evil?
Quote from: aphineday on March 29, 2012, 03:16:18 PM
3.) All of this talk about regarding healthcare denying claims as a "business protecting itself from a loss" is exactly the mindset I'm opposed to. Before you call me out (medical procedures aren't free, training doctors isn't free etc..), I get it. I forgot that Docs don't pay anything out of their pockets or take loans. IF we are going to pay for their training, then that's a completely different ballgame.
Now you want to pay for medical school too?!? You seem like a good dued, aphineday, so please take this with the sarcasm it is intended, but can I please get a hit of what you're smoking because it must be some sweet shit.
Let's take a different approach, since I agree that it would be great to give everyone the greatest healthcare in the world. But here's a quick and dirty calculation to illustrate my skepticism with single payer: since 1950, tax revenues have averaged 18% of GDP regardless of tax rates. Coincidentally, healthcare spending runs around 15% (not since 1950, but that's what it currently is). So, if you want the gov't to take over all healthcare spending, what do we get rid of? Hicks made the very salient point yesterday that maybe we should stop blowing shit up all over the world and we could save a buck or two. So let's cut the defense budget by more than half to roughly $350B (I assume you recognize the need to have some level of defense spending). Now let's say the efficiencies of a gov't provided plan cuts healthcare spending by half (I can hardly type that with a straight face, but let's go for it), bringing total healthcare spending to around a trillion dollars. That brings healthcare and defense spending to about $1.35T or almost two-thirds of the entire budget (note if you are less generous with the cost reductions and assume only 1/4 reduction in healthcare spending, the two amount to 95% of current tax revenues). So you guys tell me: what do you want to start cutting in order to provide this glorious healthcare regime you're talking about? This is all assumes that having a monopoly in healthcare has no other adverse effects like stifiling innovation or the politicization of every individual's healthcare decisions (which I believe would have very severe outcomes on people's health). So while it's all good to talk in broad vagueries like our current presiednt likes to do, just do the math. This shit doesn't add up.
I said IF...
I wasn't advocating this, just making a "what if" statement.
Quote from: twatts likes ghoti on March 29, 2012, 04:03:56 PM
Want to know my story??? We paid $4000 to get have an ER Doctor check Cody's temp (105+), prescribe an anti-biotic, bitch at us for not following recommended vaccinations practices, and treat us like a bunch of mexicans... I told my wife that we should wait one day (we took Cody to ER on a Sunday) so she could take Cody to the family doctor, but she was freaking out... Was the medical treatment worth $4000??? Hell no! She blew our entire HSA in one shot to make herself feel better... That's "wrong"...
Terry
yes, it seems your wife is the correct person to blame for the grossly inflated cost of taking a temperature and writing a prescription.
Quote from: twatts likes ghoti on March 29, 2012, 04:03:56 PM
Quote from: Hicks on March 29, 2012, 03:38:23 PM
Quote from: twatts likes ghoti on March 29, 2012, 03:33:38 PM
Quote from: aphineday on March 29, 2012, 03:16:18 PM
$6,000 for Hicks to take his child to the ER is absurd, and should not be how it's handled period. The argument of "isn't $6000 worth bettering your kid's life" is insane. He did it to help his child, but (as he said, but I just want to reiterate) OF COURSE IT'S "WORTH IT", but it's also inherently fucking wrong.
1) He said OR, not ER. That was my mistake.
2) "Wrong" is relative. He never stated what the procedure was, so we make a lot of assumptions. If he said he paid a $6000 deductible to treat his child's cancer, it would totally be "right". If he paid $6000 to have a wart removed, then its "wrong"... But like I asked before, if paying $6000 wasn't worth it, why do it???
UNLIKE the hostage scenario he brought up before, taking your kid to the hospital is not involutary. They did not kidnap his kid, do the procedure, then demand payment. He walked in said here is my kid ready for surgery, where do I sign up???
Terry
*sigh*
You know what the details don't really matter, but it was a procedure to put tubes in her ears after she had three ear infections.
To be honest I questioned whether she really needed it because her hearing seemed fine to me, she has always been very responsive to sounds and my voice.
But I'm not a doctor and was I going to take chances with her language development?
Of course not.
Do I feel like I sort of got scammed by the entire ordeal?
A little bit.
Paying $100 for the next 60 years, so she can hear for those 60 years doesn't seem like a scam to me... But like I said, "wrong" is relative...
Intertestingly enough, my cousin and her daughter are exactly there now... She's had several ear infections, and they are debating tubes... But Chad's mom said, "Chad had the same thing and he's fine!" So now Nikki and Chad are mulling it over...
Want to know my story??? We paid $4000 to get have an ER Doctor check Cody's temp (105+), prescribe an anti-biotic, bitch at us for not following recommended vaccinations practices, and treat us like a bunch of mexicans... I told my wife that we should wait one day (we took Cody to ER on a Sunday) so she could take Cody to the family doctor, but she was freaking out... Was the medical treatment worth $4000??? Hell no! She blew our entire HSA in one shot to make herself feel better... That's "wrong"...
Terry
LOL The tubes only stay in her ears for 9 months, so there's a 20% chance we will have to have it done again in the next couple of years.
So much for your 60 years calculation.
Quote from: mirthbeatenworker on March 29, 2012, 04:19:36 PM
Quote from: twatts likes ghoti on March 29, 2012, 04:03:56 PM
Want to know my story??? We paid $4000 to get have an ER Doctor check Cody's temp (105+), prescribe an anti-biotic, bitch at us for not following recommended vaccinations practices, and treat us like a bunch of mexicans... I told my wife that we should wait one day (we took Cody to ER on a Sunday) so she could take Cody to the family doctor, but she was freaking out... Was the medical treatment worth $4000??? Hell no! She blew our entire HSA in one shot to make herself feel better... That's "wrong"...
Terry
yes, it seems your wife is the correct person to blame for the grossly inflated cost of taking a temperature and writing a prescription.
LOL! Like I told her (you can see it above), she just bought a lamborghini to drive to the mall... If she had waited until the next day, we would have only had to pay for a Yugo... We (she) made the decision to use emergency services, and so we have to pay. Its really that simple...
Did you pay the $6k / go through the procedure yet? Did you get a second opinion from another doctor outside of your first doctor's practice?
Terry
Quote from: Hicks on March 29, 2012, 04:23:37 PM
Quote from: twatts likes ghoti on March 29, 2012, 04:03:56 PM
Quote from: Hicks on March 29, 2012, 03:38:23 PM
Quote from: twatts likes ghoti on March 29, 2012, 03:33:38 PM
Quote from: aphineday on March 29, 2012, 03:16:18 PM
$6,000 for Hicks to take his child to the ER is absurd, and should not be how it's handled period. The argument of "isn't $6000 worth bettering your kid's life" is insane. He did it to help his child, but (as he said, but I just want to reiterate) OF COURSE IT'S "WORTH IT", but it's also inherently fucking wrong.
1) He said OR, not ER. That was my mistake.
2) "Wrong" is relative. He never stated what the procedure was, so we make a lot of assumptions. If he said he paid a $6000 deductible to treat his child's cancer, it would totally be "right". If he paid $6000 to have a wart removed, then its "wrong"... But like I asked before, if paying $6000 wasn't worth it, why do it???
UNLIKE the hostage scenario he brought up before, taking your kid to the hospital is not involutary. They did not kidnap his kid, do the procedure, then demand payment. He walked in said here is my kid ready for surgery, where do I sign up???
Terry
*sigh*
You know what the details don't really matter, but it was a procedure to put tubes in her ears after she had three ear infections.
To be honest I questioned whether she really needed it because her hearing seemed fine to me, she has always been very responsive to sounds and my voice.
But I'm not a doctor and was I going to take chances with her language development?
Of course not.
Do I feel like I sort of got scammed by the entire ordeal?
A little bit.
Paying $100 for the next 60 years, so she can hear for those 60 years doesn't seem like a scam to me... But like I said, "wrong" is relative...
Intertestingly enough, my cousin and her daughter are exactly there now... She's had several ear infections, and they are debating tubes... But Chad's mom said, "Chad had the same thing and he's fine!" So now Nikki and Chad are mulling it over...
Want to know my story??? We paid $4000 to get have an ER Doctor check Cody's temp (105+), prescribe an anti-biotic, bitch at us for not following recommended vaccinations practices, and treat us like a bunch of mexicans... I told my wife that we should wait one day (we took Cody to ER on a Sunday) so she could take Cody to the family doctor, but she was freaking out... Was the medical treatment worth $4000??? Hell no! She blew our entire HSA in one shot to make herself feel better... That's "wrong"...
Terry
LOL The tubes only stay in her ears for 9 months, so there's a 20% chance we will have to have it done again in the next couple of years.
So much for your 60 years calculation.
Oh, so the effects of placing tubes in her ears only last 9 months??? After that she just goes stone deaf??? Or maybe the effects last a life-time...
So much for your counter...
Terry
It's done, I didn't pay 6K, that was the bill before insurance.
As bvaz pointed out part of that gets written off, but how the fuck does that much get invoiced in the first place is my whole point.
Quote from: twatts likes ghoti on March 29, 2012, 04:27:17 PM
Quote from: Hicks on March 29, 2012, 04:23:37 PM
Quote from: twatts likes ghoti on March 29, 2012, 04:03:56 PM
Quote from: Hicks on March 29, 2012, 03:38:23 PM
Quote from: twatts likes ghoti on March 29, 2012, 03:33:38 PM
Quote from: aphineday on March 29, 2012, 03:16:18 PM
$6,000 for Hicks to take his child to the ER is absurd, and should not be how it's handled period. The argument of "isn't $6000 worth bettering your kid's life" is insane. He did it to help his child, but (as he said, but I just want to reiterate) OF COURSE IT'S "WORTH IT", but it's also inherently fucking wrong.
1) He said OR, not ER. That was my mistake.
2) "Wrong" is relative. He never stated what the procedure was, so we make a lot of assumptions. If he said he paid a $6000 deductible to treat his child's cancer, it would totally be "right". If he paid $6000 to have a wart removed, then its "wrong"... But like I asked before, if paying $6000 wasn't worth it, why do it???
UNLIKE the hostage scenario he brought up before, taking your kid to the hospital is not involutary. They did not kidnap his kid, do the procedure, then demand payment. He walked in said here is my kid ready for surgery, where do I sign up???
Terry
*sigh*
You know what the details don't really matter, but it was a procedure to put tubes in her ears after she had three ear infections.
To be honest I questioned whether she really needed it because her hearing seemed fine to me, she has always been very responsive to sounds and my voice.
But I'm not a doctor and was I going to take chances with her language development?
Of course not.
Do I feel like I sort of got scammed by the entire ordeal?
A little bit.
Paying $100 for the next 60 years, so she can hear for those 60 years doesn't seem like a scam to me... But like I said, "wrong" is relative...
Intertestingly enough, my cousin and her daughter are exactly there now... She's had several ear infections, and they are debating tubes... But Chad's mom said, "Chad had the same thing and he's fine!" So now Nikki and Chad are mulling it over...
Want to know my story??? We paid $4000 to get have an ER Doctor check Cody's temp (105+), prescribe an anti-biotic, bitch at us for not following recommended vaccinations practices, and treat us like a bunch of mexicans... I told my wife that we should wait one day (we took Cody to ER on a Sunday) so she could take Cody to the family doctor, but she was freaking out... Was the medical treatment worth $4000??? Hell no! She blew our entire HSA in one shot to make herself feel better... That's "wrong"...
Terry
LOL The tubes only stay in her ears for 9 months, so there's a 20% chance we will have to have it done again in the next couple of years.
So much for your 60 years calculation.
Oh, so the effects of placing tubes in her ears only last 9 months??? After that she just goes stone deaf??? Or maybe the effects last a life-time...
So much for your counter...
Terry
Uh the tubes fall out after nine months (unless they don't and have to be surgically removed :frustrated:) so there is a 20% chance that we are back to square one after that happens.
She was never stone deaf in the first place so I really don't know what you are getting at here.
Quote from: twatts likes ghoti on March 29, 2012, 04:25:19 PM
Quote from: mirthbeatenworker on March 29, 2012, 04:19:36 PM
Quote from: twatts likes ghoti on March 29, 2012, 04:03:56 PM
Want to know my story??? We paid $4000 to get have an ER Doctor check Cody's temp (105+), prescribe an anti-biotic, bitch at us for not following recommended vaccinations practices, and treat us like a bunch of mexicans... I told my wife that we should wait one day (we took Cody to ER on a Sunday) so she could take Cody to the family doctor, but she was freaking out... Was the medical treatment worth $4000??? Hell no! She blew our entire HSA in one shot to make herself feel better... That's "wrong"...
Terry
yes, it seems your wife is the correct person to blame for the grossly inflated cost of taking a temperature and writing a prescription.
LOL! Like I told her (you can see it above), she just bought a lamborghini to drive to the mall... If she had waited until the next day, we would have only had to pay for a Yugo... We (she) made the decision to use emergency services, and so we have to pay. Its really that simple...
and by then maybe your kids brain would have been cooked like an egg on the hood of an overheated Jeep Sahara in the Sahara.
Quote from: sunrisevt on March 29, 2012, 03:25:19 PM
First, Santorum's not a faith healer or Christian Scientist; he's a cafeteria Catholic. He's not even been consistent in his adult life on his application of Catholic principles. But no, that's not the point...
You're right, it was a cheap shot at Santorum and I'll gladly do it again!! But like you said, on to the merits of the argument.
Quote from: sunrisevt on March 29, 2012, 03:25:19 PM
A sane national health plan would definitely cover contraception and reproductive health care broadly and at low cost to consumers, because it's a guaranteed cost-cutting measure. Unplanned pregnancies are much, much more costly to society than lots of rubbers, pills, IUDs, Plan Bs, etc.
I agree with you that bringing the gov't futher into health care is scary. But the corporate state has proved itself a miserably poor steward of the common good--in fact is was always insane to expect legal entities whose only raison d'etre is profit for shareholders to voluntarily keep the public good in mind in their pursuit of profit. I'm willing to consider models based on those of the UK & Western Europe as viable, sane alternatives.
Couldn't we provide those services in other ways? I'm married so I haven't bought condoms in years (because I don't get laid, get it!), but what do they run, $1 a piece? It was widely acknowledged that Fluke was pretty heavy handed with her estimate of how much birth control costs, especially when it was pointed out that she could have gone to the Target down the street and gotten it for $9/month. Seems to me that shit's already pretty cheap. Birth control could be even cheaper if we sold it OTC as it has no more harmful side effects than shit we can already get. Have you ever taken Mucinex? That shit gets my heart racing (but god damn does it clear the sinuses). But I didn't bring up contraception to say whether or not it should be covered, only to point out that every decision will be politicized when it comes to single payer, and that to me is a much more dangerous bed to sleep in.
Quote from: sunrisevt on March 29, 2012, 03:25:19 PM
And no, I'm not saying corporations are evil. I'm saying they need to get the fuck out of the businesses of providing health care, running prisons, providing military services, etc. Certain vital social functions should necessarily be the sole purview of the government, and I think health care has moved into that category over the last century.
I absolutely agree there are certain vital functions of the gov't, but I disagree that providing health care is one of them. We should certainly strive to provide universal coverage, but I'd rather it be done by lowering the cost of care through competition and innovation rather than by presidential fiat.
Quote from: Hicks on March 29, 2012, 03:38:23 PM
You know what the details don't really matter, but it was a procedure to put tubes in her ears after she had three ear infections.
To be honest I questioned whether she really needed it because her hearing seemed fine to me, she has always been very responsive to sounds and my voice.
Hey, my daughter just had that too. Did she freak out inconsolably when she woke up from anesthesia? Mine screamed like she was in pain and seemed like she didn't even recognize us. That shit sucked.
Quote from: Hicks on March 29, 2012, 04:10:54 PM
Heh, do I really need to type out the liberal response to where more money needs to come from? :hereitisyousentimentalbastard
Lemme guess, lapsed Bush tax for rich and the Buffet rule and some shit like that? Those two items would raise about $800B over ten years or less than the amount of all healthcare spending in 1 yr under my rosiest of assumptions. So you're gonna have to keep taxing the shit out of people to get anywhere close to gov't run healthcare.
Quote from: Hicks on March 29, 2012, 04:29:38 PM
Uh the tubes fall out after nine months (unless they don't and have to be surgically removed :frustrated:) so there is a 20% chance that we are back to square one after that happens.
She was never stone deaf in the first place so I really don't know what you are getting at here.
What I'm getting at is that I feel it is worth $6000 so that your daughter hearing/ears can be "fine" and would gladly pay it. You feel that it isn't and had a hard time paying it.
In otherwords, what one person thinks is "right" or "wrong" about insurance doesn't mean the next has the same opinion...
Terry
Quote from: Hicks on March 29, 2012, 04:27:58 PM
It's done, I didn't pay 6K, that was the bill before insurance.
As bvaz pointed out part of that gets written off, but how the fuck does that much get invoiced in the first place is my whole point.
you have a valid point. ti is just so second nature to me at this point.
there are issues with the health care payment structure. I'll just leave it at that.
Yep, she was really upset for about a half hour, wouldn't even nurse really which is very uncharacteristic of her.
Shit man, jack dem tax rates back up to Eisenhower levels that should make a bigger dent.
Quote from: mirthbeatenworker on March 29, 2012, 04:29:41 PM
and by then maybe your kids brain would have been cooked like an egg on the hood of an overheated Jeep Sahara in the Sahara.
Or maybe the fever would have broken in a couple of hours, like it did...
But if it came down to that, we would have been in the ER - that's what its for.
To make my wife feel better when she's in a panic, that is not what its for...
Terry
Quote from: Hicks on March 29, 2012, 04:41:23 PM
Yep, she was really upset for about a half hour, wouldn't even nurse really which is very uncharacteristic of her.
Shit man, jack dem tax rates back up to Eisenhower levels that should make a bigger dent.
Glad to hear she's doing well!!! As for not nursing, the swallowing action probably hurt her ears...
Terry
Quote from: Hicks on March 29, 2012, 04:41:23 PM
Yep, she was really upset for about a half hour, wouldn't even nurse really which is very uncharacteristic of her.
Yeah, mine was screaming and head butting us for like 30 mins or so too. Then she just snapped out of it and by the time we got home she was like nothing ever happened. Fucking kids are resilient.
Quote from: Hicks on March 29, 2012, 04:41:23 PM
Shit man, jack dem tax rates back up to Eisenhower levels that should make a bigger dent.
YOU REALLY ARE A FUNNY GUY!!!!!
Anyway, this has been fun afternoon of shirking nearly all my responsibilities for tooling around on here. I haven't done that in a while.
Quote from: twatts likes ghoti on March 29, 2012, 04:43:42 PM
Quote from: Hicks on March 29, 2012, 04:41:23 PM
Yep, she was really upset for about a half hour, wouldn't even nurse really which is very uncharacteristic of her.
Shit man, jack dem tax rates back up to Eisenhower levels that should make a bigger dent.
Glad to hear she's doing well!!! As for not nursing, the swallowing action probably hurt her ears...
Terry
Heh, they gave her a bottle of sugar water, she took that just fine. :hereitisyousentimentalbastard
Quote from: twatts likes ghoti on March 29, 2012, 04:42:24 PM
Quote from: mirthbeatenworker on March 29, 2012, 04:29:41 PM
and by then maybe your kids brain would have been cooked like an egg on the hood of an overheated Jeep Sahara in the Sahara.
Or maybe the fever would have broken in a couple of hours, like it did...
But if it came down to that, we would have been in the ER - that's what its for.
To make my wife feel better when she's in a panic, that is not what its for...
Terry
hillariously scary that you would defend a system in which:
1. they obviously wildly inflate costs
2. the same treatment costs you a tenth one day later
3. has you blaming your wife for wanting the best for your kid.
glad it all is well however.
Quote from: mirthbeatenworker on March 29, 2012, 04:52:13 PM
Quote from: twatts likes ghoti on March 29, 2012, 04:42:24 PM
Quote from: mirthbeatenworker on March 29, 2012, 04:29:41 PM
and by then maybe your kids brain would have been cooked like an egg on the hood of an overheated Jeep Sahara in the Sahara.
Or maybe the fever would have broken in a couple of hours, like it did...
But if it came down to that, we would have been in the ER - that's what its for.
To make my wife feel better when she's in a panic, that is not what its for...
Terry
hillariously scary that you would defend a system in which:
1. they obviously wildly inflate costs
2. the same treatment costs you a tenth one day later
3. has you blaming your wife for wanting the best for your kid.
glad it all is well however.
I'm not trying to defend the system, I have my own issues with it. I'm just pointing out that paying for medical procedures is expensive and we should expect them to be, and that what you might think is an outrageous cost in a relative terms is insignificant to the non-treatment of certain things. In the case of ear-tubes, paying $6000 is worth having a life-time of good hearing, etc, but that's IMO...
1. we could discuss the costs, though I'm not prepared... but it ties in with #2. If you want, I can get a whole speal on the subject since my father works in the insurance field. I'm sure he has first-hand opinion concerning the costs of insurance...
2. It was NOT the same treatment per se. One involved Emergency Services, the other did not. I paid for the "convenience" of being able to walk into an ER instead of waiting. You would treat the Lamborghini in my analogy the same as the Yugo. It's obviously not, although they both provide the same service (a ride to the mall).
3. again, "best" is relative. Paying our entire HSA out for one ER call was not "best", when the same service is available the next day for 1/10 the cost, and especially now that our HSA is flat broke and we are pregnant again...
And yeah, I'm glad it worked out too...
So, the question is, how to pay for single-payer (if that's the objective).
Here are the assumptions to be met in order for such a hypothetical discussion to be relevant:
1. There is suitably widespread popular support for implementing such a system -- important because people will also need to be accepting of how to pay for it
2. Such a system would be more efficient than the current system -- i.e. it will lead to lowering the cost of care
3. Such a system would replace the current system
Well, if you implement a tax to pay for a new system that costs less than the old, and you no longer have to pay for the old one, then in theory you save money in the tradeoff. Raise taxes (yes, everyone hates that) but relieve people of paying for expensive private insurance (yay). Net win, if in fact assumption #2 is correct (otherwise, why bother, correct?).
Now, we have to take into account that "Medicare for all" would also be designed to cover the uninsured. I heard on the radio the other day that caring for the uninsured (which, unfortunately for Tea Partiers, healthcare providers are legally and ethically bound to do) costs the average insurance-carrying family an extra $1,000 a year. Don't know if that's true, but it was on NPR so Rick Santorum would probably call it bullshit. Assuming that when we spread around the cost to care for the poor under a single-payer gov't system, if it comes in at less than $1,000 in "freeloader underwriting" per household, that's still a win.
Whether or not the above is actually my preference, I haven't decided, but the question was posed, how do we pay for it, and I say that's how you pay for it.
Oh and by the way, the tax would have to be structured in such a way so that the poor people who can't afford insurance today wouldn't instead be hit with an extra tax that they also couldn't afford. In other words, good luck meeting assumption #1, because this will come across as expanding welfare for freeloaders at the expense of the job-creators. Despite the fact that we end up paying for it anyway.
Quote from: twatts likes ghoti on March 29, 2012, 05:12:29 PM
In the case of ear-tubes, paying $6000 is worth having a life-time of good hearing, etc, but that's IMO...
To clarify (since I'm tired of watching you guys butcher this :wink:), the tubes are (generally) not about hearing. Infants/toddlers have a difficult time draining fluid behind their ear drums because their stupid inner ears slope the wrong way (they gradually move up and point to your throat as we grow). That's why they often get ear infections after common colds. The tubes are drilled in the ear drum to help them clear the fluid.
Where the hearing concerns come in is that this fluid can dampen a kid's hearing which, at this age (mine is almost 2, I think Hicks' is a little younger) is a very important for language development. The tubes (in theory) allow them to process speech and develop their own language skills. To Hicks' other point about the necessity, I also wasn't sure how the fuck you can accurately test a 1-2 yr old's hearing, but that's why we (a) rely on competent doctors and (b) make the decision as parents about the best course of action for our kids.
Parenting is some scary shit.
Quote from: runawayjimbo on March 29, 2012, 05:27:25 PM
Quote from: twatts likes ghoti on March 29, 2012, 05:12:29 PM
In the case of ear-tubes, paying $6000 is worth having a life-time of good hearing, etc, but that's IMO...
To clarify (since I'm tired of watching you guys butcher this :wink:), the tubes are (generally) not about hearing. Infants/toddlers have a difficult time draining fluid behind their ear drums because their stupid inner ears slope the wrong way (they gradually move up and point to your throat as we grow). That's why they often get ear infections after common colds. The tubes are drilled in the ear drum to help them clear the fluid.
Where the hearing concerns come in is that this fluid can dampen a kid's hearing which, at this age (mine is almost 2, I think Hicks' is a little younger) is a very important for language development. The tubes (in theory) allow them to process speech and develop their own language skills. To Hicks' other point about the necessity, I also wasn't sure how the fuck you can accurately test a 1-2 yr old's hearing, but that's why we (a) rely on competent doctors and (b) make the decision as parents about the best course of action for our kids.
Parenting is some scary shit.
Exactly, I was never convinced that the hearing test was very accurate for a pre-verbal child like her (she's turning one in a couple of weeks), so I was completely at the mercy of the doc's judgement.
Just jumping in again to validate VB's post above, and agree: the biggest challenge of a single-payer system in the US would be getting the necessary political support from the general electorate. Too many people vote against their own interests for it to be realistic, I'm afraid.
Quote from: sunrisevt on March 29, 2012, 05:40:26 PM
Just jumping in again to validate VB's post above, and agree: the biggest challenge of a single-payer system in the US would be getting the necessary political support from the general electorate. Too many people vote against their own interests for it to be realistic, I'm afraid.
That and the insurance companies would never allow it to happen. It would eliminate an entire industry.
just jumping in after spending too much time here this AM
-the medical billing system is a totally fucked up game. The payment for anything delivered in the hospital is a fraction of what the bill is - the average is between 40 and 50 % for someone with insurance, less then 33% for Medicaid, depending on the state. But - if yo have no insurance or medicaid, you are expected to pay the entire amount.
-the cost of the procedure goes to everyone involved - docs, nurses, hospital, etc. Given that, if you look at what something actually costs to deliver and what the reimbursement is, they don't always correlate. medicare and the private insurance cos go after high profile, high volume procedures and knock the prices down (imaging for one). the reimbursment for quick procedures like Hicks daughter had, cataract surgery, is imo inflated above what it should be. meanwhile, if I spend 1/2 hour talking to a pt on the phone, or an hour looking up a tough problem in the literature, I get paid nothing. I don't care (well, maybe a little :wink:), it's my job, and I don't let it deter me, but the system is fucked. It's a problem that is slowly being adressed, but it will take years before it's corrected.
-emergency rooms are the most expensive place to deliver care. One thing universal coverage will do to lower costs is provide more access to get people into the docs office and out of the ER.
Quote from: slslbs on March 29, 2012, 06:37:09 PM
just jumping in after spending too much time here this AM
-the medical billing system is a totally fucked up game. The payment for anything delivered in the hospital is a fraction of what the bill is - the average is between 40 and 50 % for someone with insurance, less then 33% for Medicaid, depending on the state. But - if yo have no insurance or medicaid, you are expected to pay the entire amount.
-the cost of the procedure goes to everyone involved - docs, nurses, hospital, etc. Given that, if you look at what something actually costs to deliver and what the reimbursement is, they don't always correlate. medicare and the private insurance cos go after high profile, high volume procedures and knock the prices down (imaging for one). the reimbursment for quick procedures like Hicks daughter had, cataract surgery, is imo inflated above what it should be. meanwhile, if I spend 1/2 hour talking to a pt on the phone, or an hour looking up a tough problem in the literature, I get paid nothing. I don't care (well, maybe a little :wink:), it's my job, and I don't let it deter me, but the system is fucked. It's a problem that is slowly being adressed, but it will take years before it's corrected.
-emergency rooms are the most expensive place to deliver care. One thing universal coverage will do to lower costs is provide more access to get people into the docs office and out of the ER.
I wanted to avoid the specific details on payment because people on here would flip if they ever knew it.
it's a bit anti-liberal and definitely structured as republican big corporation rules.
that aspect definitely needs reform. I just hope (for my own beliefs) there is an acceptable median between what we have now and single payer.
Some good stuff here, VDB. Of course, it's somewhat irrelevant since that's not what we ended up with but I am at least glad to see that we've seem to have come to grips with the fact that the current law blows and we should start dicussing ways to actually reform the fucked up system. Now, to your points:
Quote from: V00D00BR3W on March 29, 2012, 05:16:11 PM
Well, if you implement a tax to pay for a new system that costs less than the old, and you no longer have to pay for the old one, then in theory you save money in the tradeoff. Raise taxes (yes, everyone hates that) but relieve people of paying for expensive private insurance (yay). Net win, if in fact assumption #2 is correct (otherwise, why bother, correct?).
Obviously this hinges on #2 (insert scat joke here) i.e., that a gov't run system would reduce total medical spending and leave the incentives for innovation unchanged. I am highly suspect of this assumption. But more importantly, there's a very strong possibility (I'd even say certainty) that politicians would soft sell the tax and just finance the shortage with more debt as they are wont to do. So the bigger question to me is not will the net effect be less money out of people's pockets in the short term but the impact on the debt and deficit over the long run. Paying less in gov't premiums now for widespread financial ruin doesn't see like a fair tradeoff to me. Plus, you have the same issues we have with Social Security: growing elderly population who consumes more medical care, less workers to pay for them, and politicians too scared to tell people we can't afford it. Just seems pretty unsustainable to me (especially in light of the $15T in current debt, 60% of which is due in the next 5 yrs).
Quote from: V00D00BR3W on March 29, 2012, 05:16:11 PM
Now, we have to take into account that "Medicare for all" would also be designed to cover the uninsured. I heard on the radio the other day that caring for the uninsured (which, unfortunately for Tea Partiers, healthcare providers are legally and ethically bound to do) costs the average insurance-carrying family an extra $1,000 a year. Don't know if that's true, but it was on NPR so Rick Santorum would probably call it bullshit. Assuming that when we spread around the cost to care for the poor under a single-payer gov't system, if it comes in at less than $1,000 in "freeloader underwriting" per household, that's still a win.
This is a good point and one that I forgot to account for in my dirty calculation (I was double counting current Medicare/aid spending). But here's an alternative to consider: uncompensated care in 2011 was $41B (I can't find the link now but I'll dig it up later if interested), which is about 3% of total spending (historically it's between 3-6%). Similarly, lawyers generally provide 3-6% annually in pro bono services. It seems to me if the dirty scumbag lawyers (:wink:) can provide this level of "free" services, why couldn't medical providers? Have some kind of risk pool for uncompensated care that insurers, hospitals, providers all kick in to. In an $2T industry, I gotta believe they have enough capital to come up with $40B a year. It just seems to me there are more effective ways to achieve universal coverage (if that's the ballgame) without forcing people to hand over their personal healthcare decisions to a central planner.
Quote from: V00D00BR3W on March 29, 2012, 05:16:11 PM
Whether or not the above is actually my preference, I haven't decided, but the question was posed, how do we pay for it, and I say that's how you pay for it.
It's a start, but I think you're still a long way from covering the cost of an entire gov't run program. Plus, what's missing from the analysis is the effect of higher tax rates on the economy (cue Hicks with the "we did just fine with Clinton" argument), the distortions in market pricing that could be caused by a monopoly healthcare provider, the potential loss of new technologies that enhance health outcomes, and the likelihood that a gov't who already spends 12% more than they've collected (average since 1950; 22% in the past decade) would have any success in trimming the fat.
Quote from: sunrisevt on March 29, 2012, 05:40:26 PM
Just jumping in again to validate VB's post above, and agree: the biggest challenge of a single-payer system in the US would be getting the necessary political support from the general electorate. Too many people vote against their own interests for it to be realistic, I'm afraid.
Can you at least acknowledge that there is no basis to decree as you did that a single payer system would be in the best interest of everyone? You can say that
you would prefer single payer and that
you believe it would bring down costs and increase quality and not bust the budget, but I don't think it's fair to say anyone who doesn't agree with your conclusions is too stupid to know what's good for them.
Here's an interesting question for you, sunrise: during oral arguments, the SG had a difficult time articulating if there was any limit to Congress' power under the Commerce Clause; my question is, can you think of anything that Congress should not be authorized to do? Or do liberals really believe that the Congress should have the ultimate power to make any decision they deem too complicated for the rest of us commonfolk to understand?
Quote from: bvaz on March 29, 2012, 07:55:14 PM
Quote from: slslbs on March 29, 2012, 06:37:09 PM
just jumping in after spending too much time here this AM
-the medical billing system is a totally fucked up game. The payment for anything delivered in the hospital is a fraction of what the bill is - the average is between 40 and 50 % for someone with insurance, less then 33% for Medicaid, depending on the state. But - if yo have no insurance or medicaid, you are expected to pay the entire amount.
-the cost of the procedure goes to everyone involved - docs, nurses, hospital, etc. Given that, if you look at what something actually costs to deliver and what the reimbursement is, they don't always correlate. medicare and the private insurance cos go after high profile, high volume procedures and knock the prices down (imaging for one). the reimbursment for quick procedures like Hicks daughter had, cataract surgery, is imo inflated above what it should be. meanwhile, if I spend 1/2 hour talking to a pt on the phone, or an hour looking up a tough problem in the literature, I get paid nothing. I don't care (well, maybe a little :wink:), it's my job, and I don't let it deter me, but the system is fucked. It's a problem that is slowly being adressed, but it will take years before it's corrected.
-emergency rooms are the most expensive place to deliver care. One thing universal coverage will do to lower costs is provide more access to get people into the docs office and out of the ER.
I wanted to avoid the specific details on payment because people on here would flip if they ever knew it.
it's a bit anti-liberal and definitely structured as republican big corporation rules.
that aspect definitely needs reform. I just hope (for my own beliefs) there is an acceptable median between what we have now and single payer.
yea, but as the people here see more medical bills and more EOBs they'll figure it out.
and I agree, I'm hoping for a median between single payer and current system. Switzerland seems to have done it.
QuoteSimilarly, lawyers generally provide 3-6% annually in pro bono services. It seems to me if the dirty scumbag lawyers () can provide this level of "free" services, why couldn't medical providers? Have some kind of risk pool for uncompensated care that insurers, hospitals, providers all kick in to. In an $2T industry, I gotta believe they have enough capital to come up with $40B a year. It just seems to me there are more effective ways to achieve universal coverage
we write off about 3% in "bad debt", ie free care, not counting the fact that the health care system has a "free care" system for people who don't quite qualify for public funding. What's different about this biz (compared to law or other professions) is that health care reimbursement is regulated. Even though Medicare is a minority player compared to privates (about 35 - 40% give or take), private insurance companies use Medicare reimbursement as a guide.
Regardless, my guess is that lawyers "make up" the charity cases from the profit they make on the paying customers, they just don't know it. Likewise, the health care system gets a bit more back from the private payers to make up for the losses from Medicaid and bad debt.
Quote from: slslbs on March 29, 2012, 09:05:53 PM
we write off about 3% in "bad debt", ie free care, not counting the fact that the health care system has a "free care" system for people who don't quite qualify for public funding. What's different about this biz (compared to law or other professions) is that health care reimbursement is regulated. Even though Medicare is a minority player compared to privates (about 35 - 40% give or take), private insurance companies use Medicare reimbursement as a guide.
Regardless, my guess is that lawyers "make up" the charity cases from the profit they make on the paying customers, they just don't know it. Likewise, the health care system gets a bit more back from the private payers to make up for the losses from Medicaid and bad debt.
I LOL'd at make up cases.
I can't agree or disagree. it was just funny.
the two professions can;t be compared.
lawyers are smart and then we have doctors :wink:
- dreams about a country that reduces defense spending to invest in good healthcare -
:smoke:
Quote from: bvaz on March 29, 2012, 09:23:44 PM
Quote from: slslbs on March 29, 2012, 09:05:53 PM
we write off about 3% in "bad debt", ie free care, not counting the fact that the health care system has a "free care" system for people who don't quite qualify for public funding. What's different about this biz (compared to law or other professions) is that health care reimbursement is regulated. Even though Medicare is a minority player compared to privates (about 35 - 40% give or take), private insurance companies use Medicare reimbursement as a guide.
Regardless, my guess is that lawyers "make up" the charity cases from the profit they make on the paying customers, they just don't know it. Likewise, the health care system gets a bit more back from the private payers to make up for the losses from Medicaid and bad debt.
I LOL'd at make up cases.
I can't agree or disagree. it was just funny.
the two professions can;t be compared.
lawyers are smart and then we have doctors :wink:
not make up cases, but fees for paying customers are increased to cover the cost of biz.
may not be true in the legal profession, but if you owned a store and new that you had losses of 5% of your merch in theft, you would charge more to make up for it.
then again, you may be right
Quote from: slslbs on March 29, 2012, 10:17:11 PM
Quote from: bvaz on March 29, 2012, 09:23:44 PM
Quote from: slslbs on March 29, 2012, 09:05:53 PM
we write off about 3% in "bad debt", ie free care, not counting the fact that the health care system has a "free care" system for people who don't quite qualify for public funding. What's different about this biz (compared to law or other professions) is that health care reimbursement is regulated. Even though Medicare is a minority player compared to privates (about 35 - 40% give or take), private insurance companies use Medicare reimbursement as a guide.
Regardless, my guess is that lawyers "make up" the charity cases from the profit they make on the paying customers, they just don't know it. Likewise, the health care system gets a bit more back from the private payers to make up for the losses from Medicaid and bad debt.
I LOL'd at make up cases.
I can't agree or disagree. it was just funny.
the two professions can;t be compared.
lawyers are smart and then we have doctors :wink:
not make up cases, but fees for paying customers are increased to cover the cost of biz.
may not be true in the legal profession, but if you owned a store and new that you had losses of 5% of your merch in theft, you would charge more to make up for it.
then again, you may be right
I'm not disagreeing with you, but don't we all base everything to a point off our bottom line.
I can volunteer 5 days a week at the soup kitchen or work and pay my bills.
I'm exaggerating your point but lawyers have lives outside of their job too. they need to bring in x amount to make ends meat or more just like doctors. at the end of the day, aren't physician charges base don free care as well? isn't a construction workers rate of pay based on a 15 minute break given during the shift?
maybe I am naive but a business is a business.
yes - that's exacly what I was saying.
I'm not saying it's a conscious, mathematical decision, but it goes into fee structure / pricing
free anything isn't really free. someone winds up paying.
a cynic's view, taken a bit to the extreme to make a point
Quote from: slslbs on March 29, 2012, 09:05:53 PM
What's different about this biz (compared to law or other professions) is that health care reimbursement is regulated. Even though Medicare is a minority player compared to privates (about 35 - 40% give or take), private insurance companies use Medicare reimbursement as a guide.
But that's exactly my point. If the reimbursement is regulated, how can anyone ever compete on price? And at a third of the industry, I wouldn't say Medicare is a minority player; WellPoint may be bigger, but not too many others, right?. But becuase it is the benchmark for private insurers it becomes the determining factor in setting the price. Medicare is the Fed of the healthcare industry. Also, isn't a large portion of the cost shifting that eventually ends up being borne by the consumer directly attributable to Medicare? I just can't look at Medicare and believe we will be able to do it better on a much larger scale.
Oh yeah, and Switzerland is smaller than NY City.
Agreed.
I'm not arguing for single payer (like I said before, I consider myself left - center)
but the health care market is different than other consumer markets. As much as I don't believe in single payer I don't think it should be left up to the free market.
and, the regulation to some degree is good. yes, I said it - we need to be regulated to some degree.
Quote from: Dean Lambrecht on Taperssection http://taperssection.com/index.php?topic=154502.msg1954752#msg1954752
...First, the federal government has the power to regulate things that have a substantial effect on interstate commerce. Under that regulatory power and germane to the case before the Court now, the Court has held that the federal government may prohibit medical marijuana growing for private consumption because of how quickly that marijuana could make its way into the illegal, federally controlled interstate market (Raich). They've held that a farmer growing wheat to feed to his cattle in violation of a federal quota was within the power of the feds to prohibit (Wickard). There's a number of other important Commerce Clause cases, but those are the one's primarily involved in this decision because the fact pattern is somewhat analogous - that persons who choose to wait to purchase insurance (or fail to at all) until the point where they need health care are having a negative and substantial effect on interstate commerce. And there's little dispute that that's the case, not even from the plaintiffs. The plaintiffs are arguing that it's an overreach because, according to their theory, the government is forcing people into commerce who aren't otherwise in commerce. Personally, I see that argument, but I think that's not different than saying a light switch isn't a light switch unless someone's actually switching it. It's clear from my experience that people are in the health care market from the moment they draw their first breath, so I think the federal power here is perfectly legit (there's much more to it than that, of course, but I'm just providing a sketch).
Next, the government has made us purchase things before, though not under the commerce power. But I think it's disingenuous to pretend that while the government could make you purchase something via taxation or other means that they can't circumvent the middleman - here, the government - and have taxpayers go straight to the insurer of their choice. How that's considered to be socialism is beyond me - I think that argument is a stretch. If the government taxed you for the service and provided a doctor and clinic and nursing staff of their own choosing, THAT would be socialism. (As it is, socialized medicine doesn't exist in any "westernized" nation, unless you count Cuba - Canada, Europe, etc., all rely primarily on private doctors, nurses, hospitals and clinics, with England being the closest to a socialized system). Anyway, back to the point, they make us purchase retirement (SSI), Medicare, and unemployment insurance through payroll taxes from the moment we start working, and in programs we don't get to choose. And the funniest part is, Republicans and Conservatives are hoping to do exactly what Obamacare does when they talk about privatizing SSI. That is, SSI privatization is a scheme by which you're mandated by the government to purchase and fund an annuity from a private seller instead of paying into the general fund via SSI. It will be important to remember that the next time they mention the privatized SSI idea (which isn't, by the way, entirely without merit, if narrowly tailored for maximum safety).
What's most ironic, if the SCOTUS strikes the mandate, is that the primary contribution to the ACA that Republicans and conservatives made - the individual mandate, which they devised during the George H.W. Bush administration and offered as an alternative to Hillarycare - will be the part of the bill that was never supportable.
Finally, if it's struck, the even more ironic thing is that it sets us on an even faster trajectory to a health care system, 20 years or so away, yes, but that's much, much more likely to look like single-payer or Medicare for all than today's Republicans and conservatives would ever care to contemplate. But it's inevitable, given the growth rate of medical care and the growing problem of the uninsured that the market and the states have proven utterly incapable of solving (with the curious exception of Massachusetts).
Quote from: Dean Lambrecht on Taperssection http://taperssection.com/index.php?topic=154502.msg1954760#msg1954760
...the mandate wasn't a mandate so much as it was a choice. Either purchase health care insurance or pay the tax penalty of, IIRC, $695 dollars annually. What's funny is that's far cheaper than actual health insurance, but Congress went out of its way to make sure the penalty wasn't too onerous such that it would be attacked as some sort of monstrous socialism. There was no criminal penalty attached or any such thing, just a tax hit to cover a small portion of the cost of free riders, since persons up to 130(ish)% of the poverty level would receive a proportionate government subsidy to support the cost of insurance (not entirely unlike Paul Ryan's "premium support" idea for Medicare, which, by the way, is a terrible idea the way he has the bill designed at the moment).
http://taperssection.com/index.php?topic=154502.0
God damn it, T, I really should be working now.
Anyway, I'm curious: was this posted before Tuesday's arguments or after? Because it starts off with the same cases Breyer tried to argue but came up painfully short. And liberals have used these cases since the bill's passage (starting when Pelosi openly laughed when a reporter asked if the law was constitutional) to justify the mandate. Some people thought even Scalia would have to uphold it because he voted for an expansion of Commerce Clause powers in Raich. But the thing Lambrecht misses is that the gov't was not forcing anyone to do a goddamned thing in either Raich or Wickard (no biggie, Breyer fucked it up too). Because the gov't can compel you to play by the rules if you CHOOSE to enter into commerce. But no one was forcing Filburn to grow wheat and Raich could choose not to grow weed. To me, there is a fundamental difference when the gov't tells a person they need to do a specific action under penalty of fines or imprisonment.
I'll concede the point that the law is not socialism because, as you know, I think it's corporatism at it's worst.
His next point was made by Ginsberg, who just babbled about SS all goddamned day long on Tuesday. You made a similar point about Medicare the other day. I'd be happy to have a discussion on the constitutionality of the SS programs but there's really no point because it's already been established that they are valid exercises of Congress' power (unfortunately, some would say). He mischaracterizes privatization of SS by saying "SSI privatization is a scheme by which you're mandated by the government to purchase and fund an annuity..." Again, he seems to miss the point that nothing is mandated. In every current SS privatization scheme there is an option: do you want to stay in SS or put your money in a private fund. You still have to pick one, but I'd suggest that having a choice is itself a better option than not.
He's right that the mandate was devised as a way to block HillaryCare. Romney often points out that Gingrich supported the Heritage Foundation sponsored mandate to justify his own in MA. And while that's all well in good, it has no bearing on the constitutionality of the law. Pointing out that Republicans are hypocrites is like saying Tim Tebow is gay; it's so obvious it really doesn't need to be mentioned.
I don't agree with his last conclusion that we gradually transition to single payer if the law is overturned (others on the left have made similar threats). The reason the law would be on cruise control to Medicare for All is because of the guaranteed issue and community rating regulations. His point is valid if only the mandate is thrown out but the rest of the law stands. But even Obama is saying if the mandate goes, so do those provisions because it's destined to fail at that point. So even if the Court doesn't throw out the whole thing (which I'm inclined to think that they will), Obama will have to remove those provisions (including the pre-existing condition regs) or the health insurers and pharma companies say "INTO THE FUCKING OVEN YOU GO!!!!" The we Etch-a-Sketch this bitch and start all over again in 15 yrs. Can't wait.
I think it's funny to see people are jumping on the SG for doing such a shitty job (and it was freakin' horrifically cringeworthy), but I just feel like the administration has been making the same arguments since the passage and it just falls apart the closer you look at it. The gov't should never be allowed to force every citizen into a private contract. There's simply no defense that I see for that and, unlike Breyer, I don't believe Congress has the power to create commerce so they can regulate it.
It's funny how his second quote tries to frame it as a choice, but the administration has changed it's tune so many times it's hard to take them seriously. "We have the authority because it is a tax." "But it's not a tax...it's a penalty. See the difference?" And, my personal favorite, "It's not a tax because I said I wouldn't raise taxes on people making under $250k, which this clearly does."
Paul Ryan's plan is shit because it doesn't balance the budget until 2040; I don't know how you can be expected to be taken seriously when your working on a 30 yr horizon. And, leaving his slimy GOP hands all over it, he doesn't touch defense so I'll have to punch out with that. Still, as bad as it is, it's somehow better than Obama's; Ryan's at least pretends to appear to make an effort to bring the debt down (Geithner had a great exchange with Ryan a couple of months ago, famously ending "We're not coming before you to say we have a plan to address the debt; what we are saying is that we don't like yours."). However, while the premium support idea may not be the best option the way it is structured, it is the first idea to reform a system that needs to be fixed now or it will go down in a flaming fucking wreck.
That was fun. Give Lambrecht a +k for me.
Quote from: runawayjimbo on March 30, 2012, 02:08:11 AM
God damn it, T, I really should be working now.
Anyway, I'm curious: was this posted before Tuesday's arguments or after? Because it starts off with the same cases Breyer tried to argue but came up painfully short. And liberals have used these cases since the bill's passage (starting when Pelosi openly laughed when a reporter asked if the law was constitutional) to justify the mandate. Some people thought even Scalia would have to uphold it because he voted for an expansion of Commerce Clause powers in Raich. But the thing Lambrecht misses is that the gov't was not forcing anyone to do a goddamned thing in either Raich or Wickard (no biggie, Breyer fucked it up too). Because the gov't can compel you to play by the rules if you CHOOSE to enter into commerce. But no one was forcing Filburn to grow wheat and Raich could choose not to grow weed. To me, there is a fundamental difference when the gov't tells a person they need to do a specific action under penalty of fines or imprisonment.
I'll concede the point that the law is not socialism because, as you know, I think it's corporatism at it's worst.
His next point was made by Ginsberg, who just babbled about SS all goddamned day long on Tuesday. You made a similar point about Medicare the other day. I'd be happy to have a discussion on the constitutionality of the SS programs but there's really no point because it's already been established that they are valid exercises of Congress' power (unfortunately, some would say). He mischaracterizes privatization of SS by saying "SSI privatization is a scheme by which you're mandated by the government to purchase and fund an annuity..." Again, he seems to miss the point that nothing is mandated. In every current SS privatization scheme there is an option: do you want to stay in SS or put your money in a private fund. You still have to pick one, but I'd suggest that having a choice is itself a better option than not.
He's right that the mandate was devised as a way to block HillaryCare. Romney often points out that Gingrich supported the Heritage Foundation sponsored mandate to justify his own in MA. And while that's all well in good, it has no bearing on the constitutionality of the law. Pointing out that Republicans are hypocrites is like saying Tim Tebow is gay; it's so obvious it really doesn't need to be mentioned.
I don't agree with his last conclusion that we gradually transition to single payer if the law is overturned (others on the left have made similar threats). The reason the law would be on cruise control to Medicare for All is because of the guaranteed issue and community rating regulations. His point is valid if only the mandate is thrown out but the rest of the law stands. But even Obama is saying if the mandate goes, so do those provisions because it's destined to fail at that point. So even if the Court doesn't throw out the whole thing (which I'm inclined to think that they will), Obama will have to remove those provisions (including the pre-existing condition regs) or the health insurers and pharma companies say "INTO THE FUCKING OVEN YOU GO!!!!" The we Etch-a-Sketch this bitch and start all over again in 15 yrs. Can't wait.
I think it's funny to see people are jumping on the SG for doing such a shitty job (and it was freakin' horrifically cringeworthy), but I just feel like the administration has been making the same arguments since the passage and it just falls apart the closer you look at it. The gov't should never be allowed to force every citizen into a private contract. There's simply no defense that I see for that and, unlike Breyer, I don't believe Congress has the power to create commerce so they can regulate it.
It's funny how his second quote tries to frame it as a choice, but the administration has changed it's tune so many times it's hard to take them seriously. "We have the authority because it is a tax." "But it's not a tax...it's a penalty. See the difference?" And, my personal favorite, "It's not a tax because I said I wouldn't raise taxes on people making under $250k, which this clearly does."
Paul Ryan's plan is shit because it doesn't balance the budget until 2040; I don't know how you can be expected to be taken seriously when your working on a 30 yr horizon. And, leaving his slimy GOP hands all over it, he doesn't touch defense so I'll have to punch out with that. Still, as bad as it is, it's somehow better than Obama's; Ryan's at least pretends to appear to make an effort to bring the debt down (Geithner had a great exchange with Ryan a couple of months ago, famously ending "We're not coming before you to say we have a plan to address the debt; what we are saying is that we don't like yours."). However, while the premium support idea may not be the best option the way it is structured, it is the first idea to reform a system that needs to be fixed now or it will go down in a flaming fucking wreck.
That was fun. Give Lambrecht a +k for me.
duh... IDK... re-post this on TS and see what he says...
He posted this evening...
Terry
Quote from: Hicks on March 28, 2012, 08:13:02 PM
the single payer system with a taxpayer funded healthcare system is the only way out of this mess.
Looking at my bills today and the best part is the aforementioned 6K, which is actually $6600, is just the hospital bill.
The doctor's fee of $700 is an entirely separate bill! :frustrated:
Jack Spong was the bishop in my diocese growing up. He had a lasting impact on how I think about things. Here he addresses healthcare in a thoughtful manner. It's worth the read...
QuoteThe Health Care Debate: Is It Possible to Reach Conclusions That Are Satisfactory?
The argument before the Supreme Court as to whether the Federal government can mandate health insurance for all citizens represents a fascinating dance around shifting realities. It is an argument that totters between the values inherent in an interdependent society and those cherished by an individualistic society. The reality is, however, that in an ever-shrinking world, individuals are of necessity interdependent. There is no such thing as pure individualism in an interdependent world. Individuals sacrifice their individual desires to the corporate well being every time we stop at a red light, drive on the assigned side of the road or accept the fact that we are not allowed to operate an automobile on public roads without insurance. When sidewalks are installed in a neighborhood, property owners are assessed to pay for them whether they want them or not. The principle of bending the individual will to the corporate well being is well established. The issue now before the court is not about its reality, but rather about the degree of interdependence that a society can order. This means that the questions asked by the Justices, which suggest that if health care is mandated so might the eating of broccoli, the requirement of burial insurance and a host of other things that appear to meet universal needs, are diversions and are not really in touch with the issue before that body. To suggest that healthcare cannot be mandated on the basis of the fact that all of us will sooner or later use healthcare and would be like mandating the purchase of broccoli because we all eat is "cute," but it is little more than smoke screening and misses the point rather dramatically.
When I was the Bishop of Newark between 1976 and 2000, I was responsible for a large, church-affiliated, urban hospital in Jersey City. As a public hospital, supported, as all hospitals are, by taxpayer money, we were mandated to treat any person who came to us for medical assistance whether or not they had insurance. It was a mandate we accepted as part of our vocation to serve that community's needs. No one questioned this policy. About 40% of our patients were uninsured. Our emergency room was their primary health care facility. We staffed it and operated it on a 24-hours a day basis, seven days a week. We regularly filed reports to the state outlining our costs and applying for tax dollars designated for uncompensated care. We were reimbursed from these tax payer sources, which meant that the public shared our costs. This repayment, however, was never at the rate that covered our expenses. This meant that at this hospital we flirted with bankruptcy for each of those 24 years and I learned that the hospital finally filed for bankruptcy protection in January of this year. If this hospital is ever forced to close because of insolvency, the patient load would simply be transferred to other medical facilities in the area. People do not stop needing health care because hospitals close. The fact is, however, that resources in urban areas are far slimmer than they are in the suburbs and all hospitals serving an urban constituency are struggling to keep afloat. With inadequate payments for uncompensated care, there is no doubt that our costs were and are inflated on those who had insurance. That was a common practice and without it every urban hospital would have had to close its doors. Those with health care have thus already been subsidizing those without it.
My point is that if we are to mandate that hospitals be required to treat any patient who shows up on its doorstep then we are also mandating that those costs will ultimately be borne by taxpayers and those who do have health insurance, so the issue before the Court has already been decided. We have already accepted the principle that health care is a basic right and must be universally offered and paid for by the whole society.
The only alternative to universal mandates is to become a nation in which those without insurance are simply not treated. Are we prepared to abandon our fellow citizens to that fate? At one public debate involving Republican presidential candidates earlier in the political season that issue was posed and the response of the crowd was to shout "let them die! Is that the will of this nation or of its highest court? If that were the question before the court or before the electorate, I wonder what the vote would be.
Without the universal mandate, the price of health insurance for everyone would rise substantially, which means that those who have health insurance will continue to subsidize those who do not. Without the mandate insurance companies, for their own economic well being, would have to cancel insurance for high risk patients and those with pre-existing conditions. Without the mandate, many hospitals serving the poor would be forced to close and both the quality and the availability of health care for all could be diminished. So the questions before the court are far more complex than the public seems yet to understand. Does the well being of the society trump the rights of the individual? Is this a battle, as conservatives suggest, between the expanding power of the federal government and the freedom of the individual? If the government can require health care what further government mandates will follow? If population growth begins to exhaust the resources necessary to sustain life for everyone, will the government have a right to limit population? Is there any other power besides the federal government that is capable of forcing that decision on the whole society? When we focus on the issues beneath the political oratory, we discover that the definition of what this nation is and will be is before the highest court of this land. Until universal health care is established, it will continue to be the subject of rancorous and divisive debate.
In an article published in the Journal of American Medical Associations in March of 2012, Dr. David Naylor and Ms. Karline Naylor proposed seven proactive principles for health care reform in America. They are realistic, but they also make it clear that some of the problems we face will never be solved by political rhetoric.
Their first principle was to recognize that there is no perfect health care system. Every system balances availability against affordability and quality. In the year 2009, Canada spent 11.4 % of its GNP on health care while the United States spent 17.4%, but no measurable superiority in terms of satisfaction by health care recipients was revealed.
The second principle was that every nation must recognize that it must adapt health care to its own constituency, but there is wisdom in adopting things that have worked well in other nations without the ideological bias that so often accompanies the health care debate. Americans who like to demonize Canada's health care system, for example, do not realize that the vast majority of Canadian hospitals are privately owned and that most Canadian physicians work as private practitioners. Canadian commentators regularly ignore America's superb clinical care and advanced use of information technology. Both have something to gain from the other.
Third, in designing national health care programs, simplicity always trumps complexity. The more changes a program initiates the greater the risk of unintended consequences. Canada built its system on a single payer premise that had been developed in the Canadian provinces and adapted it to its national constituency. The originating bill was over 14 pages long. Compare that with the Affordable Health Care Act now before the Supreme Court that, which when passed by the Congress and signed by the President, was close to 2000 pages long.
Fourth, we will all need to face the fact that every health care bill has limits and engages in rationing health care services. The question is who will make the decision on who gets what care. In a single payer system, a single authority usually makes that decision. In the more complex American system, those decisions are made by many people on many different levels. The myth is that there is no rationing. In no system are all conditions covered. It is, however, far more expensive, more difficult and politically more compromised to make it on local levels.
Fifth, every system is designed to achieve fairness and all promise to deliver fairness, but no one is yet able to define what fairness means or to describe how it looks. When efforts are made to do so, some one is always hurt and the political debate becomes heated and those with vested interests combine with political power to force decisions in their favor.
Sixth, there appears to be little correlation between the amount of spending and the quality of health care that is provided. America's heath care costs per capita are the highest in the developed world while America's health care falls far short of being the best for all its citizens by almost every objective statistical measure.
Seventh, micromanagement has been demonstrated not to be optimal whether the system is administered by public or private agencies. Administrative costs in the United States are far higher than they are in Canada. Most Canadian health care decisions are made by clinicians, while in the United States, a massive industry to accomplish micromanaging has been developed to "contain costs." Perhaps the clinicians are better equipped to do this than the bureaucrats.
The real question that this survey raises is whether our democratic form of government, which seems to have become dysfunctional in recent years, can ever implement a national or universal health care program. This is an area of life in which every citizen has a significant vested interest and in which other clearly identified constituencies like doctors, lawyers and insurance companies conduct active and well financed lobbying efforts to protect their profits. These are some of the reasons that healthcare seems intractable and remains polarizing.
I am still convinced that a single payer universal national health service is both inevitable and, in the last analysis, the best system for the vast majority of our people. Before this nation arrives at that, however, we must stagger over the terrain and live with mistakes and shortcomings and the issue will be political red meat for years to come.
~John Shelby Spong
many good points
what was lost in the debate is, as he said, there is already rationing.
Bump
Supreme Court to rule on the ACA this week, as early as tomorrow. They still have to rule on AZ's immigration law too which I gotta believe they'd announce before healthcare, but who knows what those batty old fucks are thinking.
Strap in, kids...
No decision today, Thursday is the day.
So, I find it a little odd that this decision was actually made months ago but they wait a while to announce it. I understand they have to write up their thoughts, but still... the court could be saying "We've decided there are unconstitutional laws on the books but we're just going to let them ride for a little while."
What if the issue was something where lives hung in the balance, like abortion or the death penalty? Or arrests/jail sentences/etc.? People could conceivably get caught up in the status quo even after the high court decided it needs to be changed.
Long read, but interesting... I read this today...
From the New Yorker:
Quote
Unpopular Mandate
Why do politicians reverse their positions?
by Ezra Klein
June 25, 2012
On March 23, 2010, the day that President Obama signed the Affordable Care Act into law, fourteen state attorneys general filed suit against the law's requirement that most Americans purchase health insurance, on the ground that it was unconstitutional. It was hard to find a law professor in the country who took them seriously. "The argument about constitutionality is, if not frivolous, close to it," Sanford Levinson, a University of Texas law-school professor, told the McClatchy newspapers. Erwin Chemerinsky, the dean of the law school at the University of California at Irvine, told the Times, "There is no case law, post 1937, that would support an individual's right not to buy health care if the government wants to mandate it." Orin Kerr, a George Washington University professor who had clerked for Justice Anthony Kennedy, said, "There is a less than one-per-cent chance that the courts will invalidate the individual mandate." Today, as the Supreme Court prepares to hand down its decision on the law, Kerr puts the chance that it will overturn the mandate—almost certainly on a party-line vote—at closer to "fifty-fifty." The Republicans have made the individual mandate the element most likely to undo the President's health-care law. The irony is that the Democrats adopted it in the first place because they thought that it would help them secure conservative support. It had, after all, been at the heart of Republican health-care reforms for two decades.
The mandate made its political début in a 1989 Heritage Foundation brief titled "Assuring Affordable Health Care for All Americans," as a counterpoint to the single-payer system and the employer mandate, which were favored in Democratic circles. In the brief, Stuart Butler, the foundation's health-care expert, argued, "Many states now require passengers in automobiles to wear seat-belts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement." The mandate made its first legislative appearance in 1993, in the Health Equity and Access Reform Today Act—the Republicans' alternative to President Clinton's health-reform bill—which was sponsored by John Chafee, of Rhode Island, and co-sponsored by eighteen Republicans, including Bob Dole, who was then the Senate Minority Leader.
After the Clinton bill, which called for an employer mandate, failed, Democrats came to recognize the opportunity that the Chafee bill had presented. In "The System," David Broder and Haynes Johnson's history of the health-care wars of the nineties, Bill Clinton concedes that it was the best chance he had of reaching a bipartisan compromise. "It should have been right then, or the day after they presented their bill, where I should have tried to have a direct understanding with Dole," he said.
Ten years later, Senator Ron Wyden, an Oregon Democrat, began picking his way back through the history—he read "The System" four times—and he, too, came to focus on the Chafee bill. He began building a proposal around the individual mandate, and tested it out on both Democrats and Republicans. "Between 2004 and 2008, I saw over eighty members of the Senate, and there were very few who objected," Wyden says. In December, 2006, he unveiled the Healthy Americans Act. In May, 2007, Bob Bennett, a Utah Republican, who had been a sponsor of the Chafee bill, joined him. Wyden-Bennett was eventually co-sponsored by eleven Republicans and nine Democrats, receiving more bipartisan support than any universal health-care proposal in the history of the Senate. It even caught the eye of the Republican Presidential aspirants. In a June, 2009, interview on "Meet the Press," Mitt Romney, who, as governor of Massachusetts, had signed a universal health-care bill with an individual mandate, said that Wyden-Bennett was a plan "that a number of Republicans think is a very good health-care plan—one that we support."
Wyden's bill was part of a broader trend of Democrats endorsing the individual mandate in their own proposals. John Edwards and Hillary Clinton both built a mandate into their campaign health-care proposals. In 2008, Senator Ted Kennedy brought John McDonough, a liberal advocate of the Massachusetts plan, to Washington to help with health-care reform. That same year, Max Baucus, the chairman of the Senate Finance Committee, included an individual mandate in the first draft of his health-care bill. The main Democratic holdout was Senator Barack Obama. But by July, 2009, President Obama had changed his mind. "I was opposed to this idea because my general attitude was the reason people don't have health insurance is not because they don't want it. It's because they can't afford it," he told CBS News. "I am now in favor of some sort of individual mandate."
This process led, eventually, to the Patient Protection and Affordable Care Act—better known as Obamacare—which also included an individual mandate. But, as that bill came closer to passing, Republicans began coalescing around the mandate, which polling showed to be one of the legislation's least popular elements. In December, 2009, in a vote on the bill, every Senate Republican voted to call the individual mandate "unconstitutional."
This shift—Democrats lining up behind the Republican-crafted mandate, and Republicans declaring it not just inappropriate policy but contrary to the wishes of the Founders—shocked Wyden. "I would characterize the Washington, D.C., relationship with the individual mandate as truly schizophrenic," he said.
It was not an isolated case. In 2007, both Newt Gingrich and John McCain wanted a cap-and-trade program in order to reduce carbon emissions. Today, neither they nor any other leading Republicans support cap-and-trade. In 2008, the Bush Administration proposed, pushed, and signed the Economic Stimulus Act, a deficit-financed tax cut designed to boost the flagging economy. Today, few Republicans admit that a deficit-financed stimulus can work. Indeed, with the exception of raising taxes on the rich, virtually every major policy currently associated with the Obama Administration was, within the past decade, a Republican idea in good standing.
Jonathan Haidt, a professor of psychology at New York University's business school, argues in a new book, "The Righteous Mind," that to understand human beings, and their politics, you need to understand that we are descended from ancestors who would not have survived if they hadn't been very good at belonging to groups. He writes that "our minds contain a variety of mental mechanisms that make us adept at promoting our group's interests, in competition with other groups. We are not saints, but we are sometimes good team players."
One of those mechanisms is figuring out how to believe what the group believes. Haidt sees the role that reason plays as akin to the job of the White House press secretary. He writes, "No matter how bad the policy, the secretary will find some way to praise or defend it. Sometimes you'll hear an awkward pause as the secretary searches for the right words, but what you'll never hear is: 'Hey, that's a great point! Maybe we should rethink this policy.' Press secretaries can't say that because they have no power to make or revise policy. They're told what the policy is, and their job is to find evidence and arguments that will justify the policy to the public." For that reason, Haidt told me, "once group loyalties are engaged, you can't change people's minds by utterly refuting their arguments. Thinking is mostly just rationalization, mostly just a search for supporting evidence."
Psychologists have a term for this: "motivated reasoning," which Dan Kahan, a professor of law and psychology at Yale, defines as "when a person is conforming their assessments of information to some interest or goal that is independent of accuracy"—an interest or goal such as remaining a well-regarded member of his political party, or winning the next election, or even just winning an argument. Geoffrey Cohen, a professor of psychology at Stanford, has shown how motivated reasoning can drive even the opinions of engaged partisans. In 2003, when he was an assistant professor at Yale, Cohen asked a group of undergraduates, who had previously described their political views as either very liberal or very conservative, to participate in a test to study, they were told, their "memory of everyday current events."
The students were shown two articles: one was a generic news story; the other described a proposed welfare policy. The first article was a decoy; it was the students' reactions to the second that interested Cohen. He was actually testing whether party identifications influence voters when they evaluate new policies. To find out, he produced multiple versions of the welfare article. Some students read about a program that was extremely generous—more generous, in fact, than any welfare policy that has ever existed in the United States—while others were presented with a very stingy proposal. But there was a twist: some versions of the article about the generous proposal portrayed it as being endorsed by Republican Party leaders; and some versions of the article about the meagre program described it as having Democratic support. The results showed that, "for both liberal and conservative participants, the effect of reference group information overrode that of policy content. If their party endorsed it, liberals supported even a harsh welfare program, and conservatives supported even a lavish one."
In a subsequent study involving just self-described liberal students, Cohen gave half the group news stories that had accompanying Democratic endorsements and the other half news stories that did not. The students who didn't get the endorsements preferred a more generous program. When they did get the endorsements, they went with their party, even if this meant embracing a meaner option.
This kind of thinking is, according to psychologists, unsurprising. Each of us can have firsthand knowledge of just a small number of topics—our jobs, our studies, our personal experiences. But as citizens—and as elected officials—we are routinely asked to make judgments on issues as diverse and as complex as the Iranian nuclear program, the environmental impact of an international oil pipeline, and the likely outcomes of branding China a "currency manipulator."
According to the political-science literature, one of the key roles that political parties play is helping us navigate these decisions. In theory, we join parties because they share our values and our goals—values and goals that may have been passed on to us by the most important groups in our lives, such as our families and our communities—and so we trust that their policy judgments will match the ones we would come up with if we had unlimited time to study the issues. But parties, though based on a set of principles, aren't disinterested teachers in search of truth. They're organized groups looking to increase their power. Or, as the psychologists would put it, their reasoning may be motivated by something other than accuracy. And you can see the results among voters who pay the closest attention to the issues.
In a 2006 paper, "It Feels Like We're Thinking," the political scientists Christopher Achen and Larry Bartels looked at a National Election Study, a poll supported by the National Science Foundation, from 1996. One of the questions asked whether "the size of the yearly budget deficit increased, decreased, or stayed about the same during Clinton's time as President." The correct answer is that it decreased, dramatically. Achen and Bartels categorize the respondents according to how politically informed they were. Among the least-informed respondents, Democrats and Republicans picked the wrong answer in roughly equal numbers. But among better-informed voters the story was different. Republicans who were in the fiftieth percentile gave the right answer more often than those in the ninety-fifth percentile. Bartels found a similar effect in a previous survey, in which well-informed Democrats were asked whether inflation had gone down during Ronald Reagan's Presidency. It had, but many of those Democrats said that it hadn't. The more information people had, it seemed, the better they were at arranging it to fit what they wanted to believe. As Bartels told me, "If I'm a Republican and an enthusiastic supporter of lower tax rates, it is uncomfortable to recognize that President Obama has reduced most Americans' taxes—and I can find plenty of conservative information sources that deny or ignore the fact that he has."
Recently, Bartels noticed a similar polarization in attitudes toward the health-care law and the Supreme Court. Using YouGov polling data, he found that less-informed voters who supported the law and less-informed voters who opposed it were equally likely to say that "the Supreme Court should be able to throw out any law it finds unconstitutional." But, among better-informed voters, those who opposed the law were thirty per cent more likely than those who supported it to cede that power to the Court. In other words, well-informed opponents realized that they needed an activist Supreme Court that was willing to aggressively overturn laws if they were to have any hope of invalidating the Affordable Care Act.
Orin Kerr says that, in the two years since he gave the individual mandate only a one-per-cent chance of being overturned, three key things have happened. First, congressional Republicans made the argument against the mandate a Republican position. Then it became a standard conservative-media position. "That legitimized the argument in a way we haven't really seen before," Kerr said. "We haven't seen the media pick up a legal argument and make the argument mainstream by virtue of media coverage." Finally, he says, "there were two conservative district judges who agreed with the argument, largely echoing the Republican position and the media coverage. And, once you had all that, it really became a ballgame."
Jack Balkin, a Yale law professor, agrees. "Once Republican politicians say this is unconstitutional, it gets repeated endlessly in the partisan media that's friendly to the Republican Party"—Fox News, conservative talk radio, and the like—"and, because this is now the Republican Party's position, the mainstream media needs to repeatedly explain the claims to their readers. That further moves the arguments from off the wall to on the wall, because, if you're reading articles in the Times describing the case against the mandate, you assume this is a live controversy." Of course, Balkin says, "if the courts didn't buy this, it wouldn't get anywhere."
But the courts are not as distant from the political process as some like to think. The first judge to rule against the individual mandate was Judge Henry Hudson, of Virginia's Eastern District Court. Hudson was heavily invested in a Republican consulting firm called Campaign Solutions, Inc. The company had worked with the Presidential campaigns of John McCain and George W. Bush, the Republican National Committee, the Swift Boat Veterans for Truth, and Ken Cuccinelli—the Virginia state attorney general who is one of the plaintiffs in the lawsuits against the Affordable Care Act.
The fact that a judge—even a partisan judge in a district court—had ruled that a central piece of a Democratic President's signature legislative accomplishment was unconstitutional led the news across the country. Hudson's ruling was followed by a similar, and even more sweeping, ruling, by Judge Roger Vinson, of the Northern District of Florida. Vinson declared the entire bill unconstitutional, setting off a new round of stories. The twin rulings gave conservatives who wanted to believe that the mandate was unconstitutional more reason to hold that belief. Voters who hadn't thought much about it now heard that judges were ruling against the Administration. Vinson and Hudson were outnumbered by other district judges who either upheld the law or threw out lawsuits against it, but those rulings were mostly ignored.
At the Washington Monthly, Steve Benen kept track of the placement that the Times and the Washington Post (where I work) gave to stories about court rulings on the health-care law. When judges ruled against the law, they got long front-page stories. When they ruled for it, they got shorter stories, inside the paper. Indeed, none of the cases upholding the law got front-page coverage, but every rejection of it did, and usually in both papers. From an editorial perspective, that made sense: the Vinson and Hudson rulings called into question the law's future; the other rulings signalled no change. But the effect was repeated news stories in which the Affordable Care Act was declared unconstitutional, and few news stories representing the legal profession's consensus that it was not. The result can be seen in a March poll by the Kaiser Family Foundation, which found that fifty-one per cent of Americans think that the mandate is unconstitutional.
What is notable about the conservative response to the individual mandate is not only the speed with which a legal argument that was considered fringe in 2010 had become mainstream by 2012; it's the implication that the Republicans spent two decades pushing legislation that was in clear violation of the nation's founding document. Political parties do go through occasional, painful cleansings, in which they emerge with different leaders who hold different positions. This was true of Democrats in the nineteen-nineties, when Bill Clinton passed free trade, deficit reduction, and welfare reform, despite the furious objections of liberals. But in this case the mandate's supporters simply became its opponents.
In February, 2012, Stuart Butler, the author of the Heritage Foundation brief that first proposed the mandate, wrote an op-ed for USA Today in which he recanted that support. "I've altered my views on many things," he wrote. "The individual mandate in health care is one of them." Senator Orrin Hatch, who had been a co-sponsor of the Chafee bill, emerged as one of the mandate's most implacable opponents in 2010, writing in The Hill that to come to "any other conclusion" than that the mandate is unconstitutional "requires treating the Constitution as the servant, rather than the master, of Congress." Mitt Romney, who had both passed an individual mandate as governor and supported Wyden-Bennett, now calls Obama's law an "unconstitutional power grab from the states," and has promised, if elected, to begin repealing the law "on Day One."
Even Bob Bennett, who was among the most eloquent advocates of the mandate, voted, in 2009, to call it unconstitutional. "I'd group us"—Senate Republicans—"into three categories," he says. "There were people like me, who bought onto the mandate because it made sense and would work, and we were reluctant to let go of it. Then, there were people who bought onto it slowly, for political advantage, and were immediately willing to abandon it as soon as the political advantage went the other way. And then there's a third group that thought it made sense and then thought it through and changed their minds." Explaining his decision to vote against the law, Bennett, who was facing a Tea Party challenger in a primary, says, "I didn't focus on the particulars of the amendment as closely as I should have, and probably would have voted the other way if I had understood that the individual mandate was at its core. I just wanted to express my opposition to the Obama proposal at every opportunity." He was defeated in the primary, anyway.
But, whatever the motives of individual politicians, the end result was the same: a policy that once enjoyed broad support within the Republican Party suddenly faced unified opposition—opposition that was echoed, refined, and popularized by other institutions affiliated with the Party. This is what Jason Grumet, the president of the Bipartisan Policy Center, a group that tried to encourage Republicans and Democrats to unite around policy solutions, calls the "think-tank industrial complex"—the network of ideologically oriented research centers that drive much of the policy debate in Washington. As Senator Olympia Snowe, of Maine, who has announced that she is leaving the Senate because of the noxious political climate, says, "You can find a think tank to buttress any view or position, and then you can give it the aura of legitimacy and credibility by referring to their report." And, as we're increasingly able to choose our information sources based on their tendency to back up whatever we already believe, we don't even have to hear the arguments from the other side, much less give them serious consideration. Partisans who may not have strong opinions on the underlying issues thus get a clear signal on what their party wants them to think, along with reams of information on why they should think it.
All this suggests that the old model of compromise is going to have a very difficult time in today's polarized political climate. Because it's typically not in the minority party's interest to compromise with the majority party on big bills—elections are a zero-sum game, where the majority wins if the public thinks it has been doing a good job—Washington's motivated-reasoning machine is likely to kick into gear on most major issues. "Reasoning can take you wherever you want to go," Haidt warns. "Can you see your way to an individual mandate, if it's a way to fight single payer? Sure. And so, when it was strategically valuable Republicans could believe it was constitutional and good. Then Obama proposes the idea. And then the question becomes not 'Can you believe in this?' but 'Must you believe it?' "
And that means that you can't assume that policy-based compromises that made sense at the beginning will survive to the end, because by that time whichever group has an interest in not compromising will likely have convinced itself that the compromise position is an awful idea—even if, just a few years ago, that group thought it was a great one. "The basic way you wanted to put together a big deal five years ago is that the thoughtful minds in one party would basically go off and write a bill that had seventy per cent of their orthodoxy and thirty per cent of the other side's orthodoxy and try to use that to peel off five or six senators from the other side," Grumet says. "That process just doesn't work anymore." The remarkable and confusing trajectory of the individual-mandate debate, in other words, could simply be the new norm.
I asked Ron Wyden how, if politicians can so easily be argued out of their policy preferences, compromise was possible. "I don't find it easy to answer that question, because I'm an elected official and not a psychiatrist," he said. "If somebody says they sincerely changed their minds, then so be it." But Wyden is, as always, optimistic about the next bipartisan deal, and, again, he thinks he knows just where to start. "To bring about bipartisanship, it's going to be necessary to win on something people can see and understand. That's why I think tax reform is a huge opportunity for the economy and the cause of building coalitions." Perhaps he's right. Or perhaps that's just what he wants to believe. ♦
Interesting read.
the unfortunate fact is that if Obama goes out in the Rose garden when it's 80 degrees and sunny and says "it's a beautiful day", within 5 minutes the Republican leadership will argue, disagree, and find something anti-American about his comment.
nothing of substance is going to happen in DC for a long, long time.
(https://sphotos.xx.fbcdn.net/hphotos-prn1/544986_399753663394180_268846734_n.jpg)
Very pleasantly surprised
+K to Roberts
(http://a57.foxnews.com/www.foxnews.com/images/root_images/0/0/062812_obamacaresurvives_20120628_102932.jpg)
Damn. I did not honestly expect that. Obama has to be grinning ear to fucking ear right about now.
Quote from: slslbs on June 28, 2012, 10:44:51 AM
Very pleasantly surprised
+K to Roberts
Same here.
Quote from: PIE-GUY on June 27, 2012, 10:47:51 AM
(https://sphotos.xx.fbcdn.net/hphotos-prn1/544986_399753663394180_268846734_n.jpg)
This argument is pretty hackneyed at this point, imo. My healthcare is through my employer, their healthcare is through their employer (in this case the government).
That said, I'm glad to see some progress
Quote from: slslbs on June 28, 2012, 10:44:51 AM
Very pleasantly surprised
+K to Roberts
Yeah but they have their jobs for life and the healthcare until death. Do you?
Anyway, it was upheld.
CNN & Fox fucked up their coverage badly.
http://www.youtube.com/watch?v=OiXV_1X-PRo
Quote from: rowjimmy on June 28, 2012, 11:15:48 AM
Yeah but they have their jobs for life and the healthcare until death. Do you?
Touche. But I'm never going to die. I'm 22 years old aka invincible.
Seems like Roberts may be evolving the ability to think outside party lines and is leaning more toward the center with these last two rulings.
Interesting development.
Quote from: phil on June 28, 2012, 11:18:25 AM
Quote from: rowjimmy on June 28, 2012, 11:15:48 AM
Yeah but they have their jobs for life and the healthcare until death. Do you?
Touche. But I'm never going to die. I'm 22 years old aka invincible.
If you are never gonna die then I've got bad news for you, eternal retirement is gonna be expensive.
Quote from: Hicks on June 28, 2012, 11:33:24 AM
Quote from: phil on June 28, 2012, 11:18:25 AM
Quote from: rowjimmy on June 28, 2012, 11:15:48 AM
Yeah but they have their jobs for life and the healthcare until death. Do you?
Touche. But I'm never going to die. I'm 22 years old aka invincible.
If you are never gonna die then I've got bad news for you, eternal retirement is gonna be expensive.
Dude's gonna need a bigger mattress.
Quote from: Hicks on June 28, 2012, 11:32:43 AM
Seems like Roberts may be evolving the ability to think outside party lines and is leaning more toward the center with these last two rulings.
Interesting development.
yea - he's actually doing his job.
being open minded, judging the case on it's merits.
a rare thing in DC these days
It's funny.. I listened to a lot of the Roberts confirmation hearings on NPR and was impressed with him... then he started falling into party line once on the court and I was supremely disappointed. Now I see a glimmer of hope.
Quote from: rowjimmy on June 28, 2012, 11:39:18 AM
Quote from: Hicks on June 28, 2012, 11:33:24 AM
Quote from: phil on June 28, 2012, 11:18:25 AM
Quote from: rowjimmy on June 28, 2012, 11:15:48 AM
Yeah but they have their jobs for life and the healthcare until death. Do you?
Touche. But I'm never going to die. I'm 22 years old aka invincible.
If you are never gonna die then I've got bad news for you, eternal retirement is gonna be expensive.
Dude's gonna need a bigger mattress.
I moved my stash to a hole in the back yard. Currently trying to find a leprechaun so I can steal his gold and be set for life.
I am still pretty stunned by this (obviously). The ruling feels to me more like Roberts, aware of the backlash over Citizens United, wanted to protect whatever legacy he has left and didn't want to be seen as heading up the "most radical right-wing court in history". I mean, he plainly rejects the Commerce Clause argument (which was the gov'ts primary justification) but allows the ACA to stand based on the taxing power which was barely discussed (although in hindsight I do remember during orals Roberts was much more pressing on day 3 in the taxing arguments than he was on the Commerce Clause on day 2). Like most everything in DC, it seems (to me) more like a political calculation than really deciding by the merits of the case.
In the end, it probably was unrealistic to think the Supreme Court would rule against a policy pushed by sitting president like that, something it hasn't done since Nixon. If there's a silver lining for me, it's that the limits placed on the Commerce Clause in the opinion potentially have more far reaching consequences than the result of the case itself.
It will be interesting to see the effect on the election. Like I said earlier, I think (unlike most everyone else) this may actually help Romney by giving independents who oppose the law a reason to vote for a guy they don't like. Then again, November is a long way away and the economy will likely be the determining factor in the general.
Also, LOL at the networks for having no clue what they are doing.
And of course (for VDB)...In the end.
Various experts in my office (a DC lawfirm) had predicted that it would be upheld based on the tax powers despite the fact that it wasn't pushed in the filings or arguments.
They're very pleased with themselves today.
Lulz at the "that's it, I'm moving to Canada" tweets!
http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)
Quote from: PIE-GUY on June 28, 2012, 02:46:44 PM
Lulz at the "that's it, I'm moving to Canada" tweets!
http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)
I sure hope they do move.
Quote from: PIE-GUY on June 28, 2012, 02:46:44 PM
Lulz at the "that's it, I'm moving to Canada" tweets!
http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)
HAHAHAHAHAHAHAHAHAHA!!!!
Quote
Jason A. Quest · Top Commenter · Works at Holy Comics
I am sick of this hot weather! I'm moving to Ethiopia!
For the hell of it, here's the e-mail I received from Jim DeMint, entitled "Freedom Alert: [that's the regular title of his e-mail screeds] My Response to the Obamacare Ruling"
QuoteDear Friend,
The Supreme Court may have failed to stop this government takeover of health care, but the American people will not. Since the day this law was rammed through Congress, the American people have demanded repeal, and today's ruling doesn't make Obamacare any less dangerous to our nation's health. Freedom-loving Americans are disappointed, but we cannot be discouraged.
The President's health care law must be fully repealed as all of its promises have proven false. We were told it was not a tax hike, but this ruling confirms it is an unprecedented and enormous tax on the poor and middle class Americans. President Obama needs to explain why he is enacting this middle class tax hike over the objections of the American people during the worst economic recovery since the Great Depression.
We were told it would lower health costs, but health care premiums are exploding. We were told that Americans could keep their personal health plans, but millions will now lose it. We were told it would improve our economy, but it is now the largest obstacle to employers hiring new workers.
This government takeover of health care remains as destructive, unsustainable, and unconstitutional as it was the day it was passed, unread, by a since-fired congressional majority. Now as then, our first step toward real health care reform and economic renewal remains Obamacare's full repeal, down to the last letter and punctuation mark.
I urge every governor to stop implementing the health care exchanges that would help implement the harmful effects of this misguided law. Americans have loudly rejected this federal takeover of health care, and governors should join with the people and reject its implementation.
The Presidents health care law will not reform anything, but is already undermining what does still work in America's health care system. We cannot build a free market health care system on this flawed structure of centralized government control, we must repeal all of it and start over with commonsense solutions that make health care more affordable and accessible for every American. We can allow Americans to purchase lower cost plans from other states, support state high-risk pools to cover those with pre-existing conditions, medical-malpractice reform to end frivolous lawsuits, and tax equity so Americans who don't get their health insurance from an employer are not penalized.
Today's decision, however unfortunate, nonetheless represents an opportunity to all Americans, to claim their right to create a health care system of, for, and by the people, not government or special interests. The American people now have the chance and Congress has the responsibility to fully repeal this Washington takeover and reform health care ourselves, together, around the principles of individual liberty, not government mandates.
The same freedom that made America strong and prosperous will make us healthier, too, so long as politicians remember that the health care system is supposed to serve our people, and not the other way around.
Some not-so-surprisingly alarmist and inaccurate rhetoric in there...
Quote from: PIE-GUY on June 28, 2012, 02:46:44 PM
Lulz at the "that's it, I'm moving to Canada" tweets!
http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)
Get a brain morans!!
QuoteWe were told it would lower health costs, but health care premiums are exploding
This statement is very accurate and very alarming to me. Still waiting to see, but concerned that no matter what direction it is still going to continue to increase.
Quote from: UncleEbinezer on June 28, 2012, 03:00:18 PM
QuoteWe were told it would lower health costs, but health care premiums are exploding
This statement is very accurate and very alarming to me. Still waiting to see, but concerned that no matter what direction it is still going to continue to increase.
Yes and yes. But in terms of DeMint's statement, seeing as how enlarging insurance rolls via the individual mandate is to be the main mechanism of bringing down costs, and this hasn't yet gotten to take hold, it's premature and misleading of him to declare the entire cost-savings premise as being discredited.
spelling/clarity
Quote from: PIE-GUY on June 28, 2012, 02:46:44 PM
Lulz at the "that's it, I'm moving to Canada" tweets!
http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)
too funny.
Quote from: V00D00BR3W on June 28, 2012, 03:04:23 PM
Quote from: UncleEbinezer on June 28, 2012, 03:00:18 PM
QuoteWe were told it would lower health costs, but health care premiums are exploding
This statement is very accurate and very alarming to me. Still waiting to see, but concerned that no matter what direction it is still going to continue to increase.
Yes and yes. But in terms of DeMint's statement, seeing as how enlarging insurance rolls via the individual mandate is to be the main mechanism of bringing down costs, and this hasn't yet gotten to take hold, it's premature and misleading of him to declare the entire cost-savings premise and being discredited.
Understood. That's why I mentioned the "still waiting to see" but right now there is definite upward pressure on premiums which is a problem for companys.
Having insight into our health insurance negotiations and how many millions of dollars my company spends to support our employees, it makes it really hard right now to hire more people AND try to help our employees more. Things may change, but we'll see.
Of course insurance premimums were already going up exponentially before Obamacare and the laws haven't fully taken effect yet.
Quote from: rowjimmy on June 28, 2012, 02:49:25 PM
Quote from: PIE-GUY on June 28, 2012, 02:46:44 PM
Lulz at the "that's it, I'm moving to Canada" tweets!
http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)
I sure hope they do move.
Hmmm, fuck you, no thanks. :hereitisyousentimentalbastard
Rand Institute crunched the numbers and:
with Obama Care: premiums increase 7%
without passing: premiums increase 9%
Quote from: Hicks on June 28, 2012, 04:03:30 PM
Of course insurance premimums were already going up exponentially before Obamacare and the laws haven't fully taken effect yet.
exactly.
health care expenses have been rising faster than the GNP since the 70s. The increases we are seeing now is a byproduct of health care being expensive, not the ACA
as a point of reference, I wrote an economics paper when I was a junior in college about exploding health care costs, how health care costs were rising out of control, how health care would bankrupt the economy, and the pros and cons of single payer (called socialized medicine back then).
the year - 1978
It's only gotten worse
we are all paying the price for the failure of the "free market", insurers, government, and medical establishment from appropriately addressing the problem.
btw, I wasn't predicting the future back then any better than anyone else - it was a major concern in the press and politics. One of Ted Kennedy's major campaign issues in 1980 (he tried to get the nomination after Carter's 1st term) was health care.
Quote from: runawayjimbo on June 28, 2012, 02:02:19 PM
It will be interesting to see the effect on the election. Like I said earlier, I think (unlike most everyone else) this may actually help Romney by giving independents who oppose the law a reason to vote for a guy they don't like. Then again, November is a long way away and the economy will likely be the determining factor in the general.
But isn't the ACA based on the blueprint set forth in Romney's MA healthcare reform? It seems like the Dems, if they play this right (which never happens), could take all that anti-"Obamacare" venom and use it against Romney. And if he backpedals away from the MA reform, then he takes away his only positive accomplishment while governor or he looks like a flip-flopper. This really seems like a win-win for the Dems, which means that Romney will likely get elected...
Quote from: runawayjimbo on June 28, 2012, 02:02:19 PM
I am still pretty stunned by this (obviously). The ruling feels to me more like Roberts, aware of the backlash over Citizens United, wanted to protect whatever legacy he has left and didn't want to be seen as heading up the "most radical right-wing court in history". I mean, he plainly rejects the Commerce Clause argument (which was the gov'ts primary justification) but allows the ACA to stand based on the taxing power which was barely discussed (although in hindsight I do remember during orals Roberts was much more pressing on day 3 in the taxing arguments than he was on the Commerce Clause on day 2). Like most everything in DC, it seems (to me) more like a political calculation than really deciding by the merits of the case.
In the end, it probably was unrealistic to think the Supreme Court would rule against a policy pushed by sitting president like that, something it hasn't done since Nixon. If there's a silver lining for me, it's that the limits placed on the Commerce Clause in the opinion potentially have more far reaching consequences than the result of the case itself.
It will be interesting to see the effect on the election. Like I said earlier, I think (unlike most everyone else) this may actually help Romney by giving independents who oppose the law a reason to vote for a guy they don't like. Then again, November is a long way away and the economy will likely be the determining factor in the general.
Also, LOL at the networks for having no clue what they are doing.
And of course (for VDB)...In the end.
Yeah you're nuts, no way a dude who will likely be serving for another 20+ years is letting "legacy" concerns drive his decisions at this point.
He just alienated all his buddies and supporters, if that's political calculation sounds like he forgot to carry the one and something tells me dude isn't that dumb.
Quote from: Hicks on June 28, 2012, 08:06:50 PM
Quote from: runawayjimbo on June 28, 2012, 02:02:19 PM
I am still pretty stunned by this (obviously). The ruling feels to me more like Roberts, aware of the backlash over Citizens United, wanted to protect whatever legacy he has left and didn't want to be seen as heading up the "most radical right-wing court in history". I mean, he plainly rejects the Commerce Clause argument (which was the gov'ts primary justification) but allows the ACA to stand based on the taxing power which was barely discussed (although in hindsight I do remember during orals Roberts was much more pressing on day 3 in the taxing arguments than he was on the Commerce Clause on day 2). Like most everything in DC, it seems (to me) more like a political calculation than really deciding by the merits of the case.
In the end, it probably was unrealistic to think the Supreme Court would rule against a policy pushed by sitting president like that, something it hasn't done since Nixon. If there's a silver lining for me, it's that the limits placed on the Commerce Clause in the opinion potentially have more far reaching consequences than the result of the case itself.
It will be interesting to see the effect on the election. Like I said earlier, I think (unlike most everyone else) this may actually help Romney by giving independents who oppose the law a reason to vote for a guy they don't like. Then again, November is a long way away and the economy will likely be the determining factor in the general.
Also, LOL at the networks for having no clue what they are doing.
And of course (for VDB)...In the end.
Yeah you're nuts, no way a dude who will likely be serving for another 20+ years is letting "legacy" concerns drive his decisions at this point.
He just alienated all his buddies and supporters, if that's political calculation sounds like he forgot to carry the one and something tells me dude isn't that dumb.
Yeah, I gotta believe Roberts made this call on actual legal grounds... that's a good sign.
Quote from: Superfreakie on June 28, 2012, 04:10:07 PM
Rand Institute crunched the numbers and:
with Obama Care: premiums increase 7%
without passing: premiums increase 9%
YAY!!! The status quo wins again!!!
Quote from: slslbs on June 28, 2012, 04:14:13 PM
we are all paying the price for the failure of the "free market", insurers, government, and medical establishment from appropriately addressing the problem.
Don't forget soul-sucking lawyers!!!!
However, I'd be remiss if I didn't point out that it's not really a "free market" if the "gov't" is the most dominant player (which I now realize may be what you meant with the quotes).
Quote from: pcr3 on June 28, 2012, 05:18:04 PM
But isn't the ACA based on the blueprint set forth in Romney's MA healthcare reform? It seems like the Dems, if they play this right (which never happens), could take all that anti-"Obamacare" venom and use it against Romney. And if he backpedals away from the MA reform, then he takes away his only positive accomplishment while governor or he looks like a flip-flopper. This really seems like a win-win for the Dems, which means that Romney will likely get elected...
Do I expect Romney to repeal Obamacare if he's elected? Fuck no. But I think it could move the needle for independents in key states (CO, FL, VA) who would vote for Obama if the ACA was struck down.
Quote from: Hicks on June 28, 2012, 08:06:50 PM
Yeah you're nuts, no way a dude who will likely be serving for another 20+ years is letting "legacy" concerns drive his decisions at this point.
He just alienated all his buddies and supporters, if that's political calculation sounds like he forgot to carry the one and something tells me dude isn't that dumb.
True, "legacy" probably wasn't right. More like "public perception."
But I agree with you guys from earlier that this may be Roberts signaling a move to become more of a moderate voice on the Court. So I don't think he cares that he may have alienated his corporate overlords. (Although did he really alienate them? Let's not forget, by voting to uphold the law he created a captive set of customers for the health insurance, pharma, & device industries.)
Quote from: PIE-GUY on June 28, 2012, 09:00:06 PM
Yeah, I gotta believe Roberts made this call on actual legal grounds... that's a good sign.
Here's the thing about that: the first question was whether the Anti-Injunction Act applied, in which case the states would not have the standing to bring suit against the gov't until someone paid the tax in 2015. To this, all the justices (I believe) agreed the mandate was not a tax so the Anti-Injunction Act was not applicable. Roberts then rejects, rather sternly apparently, the gov'ts main argument that Congress can compel you under the Commerce Clause to engage in an activity (in this case, buying a product from a private company). But then he turns around and says "well you can't
compel people to do something but you most certainly can
tax them if they don't do what you want them to do." The logic is just so convoluted to me that it feels like it's being shoe-horned in, which is what leads me believe he backed into the result.
Quote from: runawayjimbo on June 28, 2012, 10:19:30 PM
"well you can't compel people to do something but you most certainly can tax them if they don't do what you want them to do." The logic is just so convoluted to me that it feels like it's being shoe-horned in, which is what leads me believe he backed into the result.
I think he opined that you can't be "compelled" to do something under the Commerce Clause (at least in this case), but you certainly could under Congress' ability to "penalize" a certain action (or inaction in this case)...
But yeah, I agree that it seems like he was searching for a way to make it work, and gave Obamacare a freebie by offering this particular solution... Then again the idea of a Mandate via Taxing has been around for a while, and I think OB avoided using that argument for fear of seeming to "raise taxes" on the poor and unemployed... In some sense, he has given the Right a victory in that they can now say OBCare raises taxes...
So messed up, yet I'm glad it was upheld...
Terry
Can't believe I forgot about the lawyers
And, by "free" I meant not only govt influence but the undue influence of large insurance cos that rig the game. that all said, the market for health care imo should not resemble the market for typical consumer items like tvs, computers, etc
Obviously, only 1 person knows what Roberts was thinking. Maybe he likes the idea of universal health care and his goal was to fine a way to make it work.
Although I kinda get "the govt can't make me buy insurance", I find the other side more compelling - those who can afford insurance and choose not to buy it are costing me money and therefore impinging on my liberty.
As far as what this will mean in November, IMO most people against ACA were gonna vote for Mitt regardless of SCOTUS.
The vid of Mitt defending the mandate to the press and not calling it a tax has been all over the news around here. I suspect many in the middle will look at that vid, look at Mitt now, and say really, wtf Mitt?
That said, IMO the most important predictor of the race will be the state of the economy on November 1
Quote from: slslbs on June 28, 2012, 11:02:56 PM
As far as what this will mean in November, IMO most people against ACA were gonna vote for Mitt regardless of SCOTUS...
...That said, IMO the most important predictor of the race will be the state of the economy on November 1
Mitt needs to trend lightly on ACA, them DNC only has to point their finger at Mass and say "you did it too"... His best shot is the state of the economy...
But with WW3 looming (Iran/Syria poking at Turkey and the Euro collapsing), I'm not sure if it really matters... :-P
Terry
That's the thing your average voter isn't against Obamacare because of what it means in terms of policy, because who the fuck knows what this thing is actually going to do in the end anyway. They are against Obamacare because they hate Obama. . . and probably puppies and ice cream too. Those miserable dickbags are going to vote for Romney no matter what.
Quote from: twatts likes ghoti on June 28, 2012, 11:00:20 PM
Quote from: runawayjimbo on June 28, 2012, 10:19:30 PM
"well you can't compel people to do something but you most certainly can tax them if they don't do what you want them to do." The logic is just so convoluted to me that it feels like it's being shoe-horned in, which is what leads me believe he backed into the result.
I think he opined that you can't be "compelled" to do something under the Commerce Clause (at least in this case), but you certainly could under Congress' ability to "penalize" a certain action (or inaction in this case)...
But yeah, I agree that it seems like he was searching for a way to make it work, and gave Obamacare a freebie by offering this particular solution... Then again the idea of a Mandate via Taxing has been around for a while, and I think OB avoided using that argument for fear of seeming to "raise taxes" on the poor and unemployed... In some sense, he has given the Right a victory in that they can now say OBCare raises taxes...
So messed up, yet I'm glad it was upheld...
Terry
But penalizing people for their actions (or worse, in this case, inactions) has apparently not been upheld under any SC interpretation of Congress' power to tax (according to Scalia in the dissent). But they can't call it a tax because then it would violate the AIA question. It's such faulty, circular logic to me. Roberts also cited Ben Franklin's "death & taxes" line as legal precedent in his opinion. It just doesn't add up IMO.
Interestingly, the part that was struck down - the Medicaid expansion - is most likely to make the Act far more costly. The CBO has already said it is reviewing the score but it will clearly raise the price tag when states start refusing to expand coverage and the federal gov't has to pick up the tab. I just don't understand how we'll ever pay for this thing.
There will probably also be some election year grandstanding between Obama and the governors (LA, IN, FL, VA maybe) who will refuse the expansion, and it will also likely make the GOP dig in even harder in resisting anything a second-term Obama would do so the polarization and politicaztion live on (or get worse). I'm not saying these are reasons why it should have been struck down, just that they are potential consequences of the decision that I'm unhappy about.
But, as always, sls is the voice of reason:
Quote from: slslbs on June 28, 2012, 11:02:56 PM
That said, IMO the most important predictor of the race will be the state of the economy on November 1
Quote from: runawayjimbo on June 29, 2012, 12:03:52 AM
But penalizing people for their actions (or worse, in this case, inactions) has apparently not been upheld under any SC interpretation of Congress' power to tax (according to Scalia in the dissent). But they can't call it a tax because then it would violate the AIA question. It's such faulty, circular logic to me. Roberts also cited Ben Franklin's "death & taxes" line as legal precedent in his opinion. It just doesn't add up IMO.
Well, that's why its called an "opinion"...
It'll be interesting how this all plays out...
Terry
Man, never knew how educational the paug can be.
I can't say I have much input, other than knowing multiple students that are now covered and weren't before. I've got my own plan, but most of my buddies are covered under their parents.
Also diggin on the revamps in women's care, I dont have children yet, but I plan to be a midwife, and they've made some serious changes in the types of reimbursement that are required for care of the childbearing woman under Medicaid. The law requires reimbursement of birth attendants who are recognized by states for care within their scope of practice, which has always been a problem for midwives.. and also specifies that the Medicare fee schedule will reimburse certified nurse-midwives at the rate of 100 percent of the physician rate, replacing a prior 65 percent rate of reimbursement - Badass! For me, anyways.
Also pretty excited that it prohibits exclusion of coverage for preexisting conditions.. Did you guys know that some insurance plans have denied women coverage for their current pregnancy if they've had a prior C-Section? Or denied them coverage of pelvic floor dysfunction treatments after an episiotomy (that they probably didn't even know they were getting)? I mean, that is some fucked up shit! Glad there's some moves in place to have these rediculous provisions removed.
Welcome.
All that stuff you mentioned is extrememly important, but got lost in the Tea Party noise because this whole thing is obviously a govt plot to control our lives. The WH needs to do a MUCH better job in communicating this other than saying "there's a war on women"
so - did a little bit of checking after hearing conflicting claims about health care costs in MA since the implementation of RomneyCare.
in 08, MA had the highest premiums in the country
in '10, 9th highest
healtblog.org rated MA as #1 for "cost effective" coverage, somehow rating amount and quality of coverage per health care dollar spent.
also, one needs to consider that MA, in particular Boston, has the highest concentration of teaching/ University hospitals in the country. This will almost invariably lead to higher costs
-teaching hospitals are more expensive for almost anything
-they tend to get more difficult cases, more unusual diseases, presentations
-they tend to get sicker patients
-the fact that there are 6 in boston alone makes is virtually impossible for a private, tertiary center (ie Washington Heart Center, Cedars) to establish roots and compete.
when my wife had her medical issues a few years ago, I was VERY happy we live here because of the choice of care and availabilty of high quality care even in the community hospitals out in the burbs
Quote from: slslbs on June 29, 2012, 11:16:51 AM
Welcome.
All that stuff you mentioned is extrememly important, but got lost in the Tea Party noise because this whole thing is obviously a govt plot to control our lives. The WH needs to do a MUCH better job in communicating this other than saying "there's a war on women"
so - did a little bit of checking after hearing conflicting claims about health care costs in MA since the implementation of RomneyCare.
in 08, MA had the highest premiums in the country
in '10, 9th highest
healtblog.org rated MA as #1 for "cost effective" coverage, somehow rating amount and quality of coverage per health care dollar spent.
also, one needs to consider that MA, in particular Boston, has the highest concentration of teaching/ University hospitals in the country. This will almost invariably lead to higher costs
-teaching hospitals are more expensive for almost anything
-they tend to get more difficult cases, more unusual diseases, presentations
-they tend to get sicker patients
-the fact that there are 6 in boston alone makes is virtually impossible for a private, tertiary center (ie Washington Heart Center, Cedars) to establish roots and compete.
when my wife had her medical issues a few years ago, I was VERY happy we live here because of the choice of care and availabilty of high quality care even in the community hospitals out in the burbs
Exactly. I was going mention that the whole individual mandate isn't much of a big deal to me, as I live in Boston and have it anyways! I actually work as a Primary Care Triage Nurse at Brigham and Women's, one of the largest teaching hospitals, and not only adore my health insurance plan (price and quality), but see the amazing quality of care we're able to provide to our patients.
Speaking of our higher costs, though, thought it would be interesting to mention what we're trying to do about it, so far... In recent years, the Brigham's begun moving towards a new model of care in Primary Care called "The Medical Home" thats aimed at leveling out health care costs, assuring positive outcomes for patients with chronic conditions (Diabetes, Hypertension, etc.) and prevention, prevention, prevention. One of the components of it is that their reimbursing MD's for positive patient outcomes instead of just SEEING the patient or ordering a test. They're paying much closer attention to long-term outcomes and prevention strategies in a move to lower health care costs overall. While this is a wonderful goal, its made a hell of a lot more work for me! - Though I must say its raised my confidence in the care we provide. I can clearly see how keeping track of these patients with the worst medical problems is slowly working to reduce ER visits and expensive interventions down the road. I have a lot of patients who are very grateful for our close management as well, and think its a wonderful model to work from (though it needs some work..)
yep - the payment model needs to be changed, medical homes and ACOs will hopefully help in both quality and efficiency
Quote from: slslbs on June 29, 2012, 11:16:51 AM
so - did a little bit of checking after hearing conflicting claims about health care costs in MA since the implementation of RomneyCare.
in 08, MA had the highest premiums in the country
in '10, 9th highest
healtblog.org rated MA as #1 for "cost effective" coverage, somehow rating amount and quality of coverage per health care dollar spent.
Sorry, I missed this.
While the growth in premiums has slowed, that can also be attributed to lower growth in total healthcare spending due to the 3 yr recession we're living through rather than cost savings brought about by increasing coverage. The problem, however, is that the amount of money MA spends on healthcare is currently crowding out other programs as healthcare spending will account for more than half of MA's budget for FY2012.
I know I sound like a broken record, but I am not opposed to reducing healthcare costs and providing greater access to care for everyone, I just don't believe you can do it cost effectively by giving gov't more control over these types decisions (unless you are prepared to allow gov't to start making your healthcare choices for you, which I am not).
pretty great that many of the uninsured/underinsured colorado shooting victims have to beg on the internet to help with their hundreds of thousand to millions of dollars of hospital bills!
http://video.msnbc.msn.com/rock-center/48347105
Quote from: mirthbeatenworker on July 27, 2012, 06:17:56 PM
pretty great that many of the uninsured/underinsured colorado shooting victims have to beg on the internet to help with their hundreds of thousand to millions of dollars of hospital bills!
http://video.msnbc.msn.com/rock-center/48347105
Let the free market sort it out!
Quote from: Hicks on July 27, 2012, 06:25:58 PM
Quote from: mirthbeatenworker on July 27, 2012, 06:17:56 PM
pretty great that many of the uninsured/underinsured colorado shooting victims have to beg on the internet to help with their hundreds of thousand to millions of dollars of hospital bills!
http://video.msnbc.msn.com/rock-center/48347105
Let the free market sort it out!
AND let me buy a rocket launcher damnit!
Tax the guns and bullets to pay for universal healthcare!
Quote from: rowjimmy on July 31, 2012, 12:55:43 PM
Tax the guns and bullets to pay for universal healthcare!
If the gov't wasn't so big already, they wouldn't need more taxes. It's all inefficient waste.
Quote from: goodabouthood on July 31, 2012, 01:23:04 PM
Quote from: rowjimmy on July 31, 2012, 12:55:43 PM
Tax the guns and bullets to pay for universal healthcare!
If the gov't wasn't so big already, they wouldn't need more taxes. It's all inefficient waste.
You want small gov't?
Go to Somalia.
Quote from: rowjimmy on July 31, 2012, 12:55:43 PM
Tax the guns and bullets to pay for universal healthcare!
Now you're talking. 500%, retroactive.
My sister is senior counsel for a prominent Massachusetts politician. I will write up a bill and submit it to her.
Quote from: rowjimmy on July 31, 2012, 01:26:42 PM
Quote from: goodabouthood on July 31, 2012, 01:23:04 PM
Quote from: rowjimmy on July 31, 2012, 12:55:43 PM
Tax the guns and bullets to pay for universal healthcare!
If the gov't wasn't so big already, they wouldn't need more taxes. It's all inefficient waste.
You want small gov't?
Go to Somalia.
I thought he wanted small Asian women?
QuotePHOENIX – An Arizona woman is wondering what hurt more: getting stung by a scorpion or seeing her hospital bill after treatment.
Marcie Edmonds says the bill from Chandler Regional Medical Center was more than $83,000. That includes two doses of anti-venom at nearly $40,000 per dose.
The Arizona Republic says Edmonds' insurer has paid more than $57,000 and the suburban Phoenix hospital is asking Edmonds for the balance of about $25,000.
The 52-year-old Ahwatukee Foothills resident was stung in June while opening a box of air conditioner filters in her garage.
Edmonds says an emergency room doctor told her about the Mexican anti-venom Anascorp that could quickly relieve her symptoms, but she was never told about the cost.
Chandler Regional says Edmonds' bill represents the out-of-network costs for her treatment.
via (http://www.foxnews.com/health/2012/09/05/scorpion-sting-leaves-arizona-woman-with-huge-bill-and-bite/?test=latestnews#ixzz25bLl3hnS)
she should have called ahead, found out how much it cost to get anti - venom.
when she found out the price she should have called around to try and get a better deal.
this is, after all, a free market society.
Quote from: slslbs on September 05, 2012, 05:40:18 PM
she should have called ahead, found out how much it cost to get anti - venom.
when she found out the price she should have called around to try and get a better deal.
this is, after all, a free market society.
She should have had the forethought to fumigate.
Quote from: rowjimmy on September 06, 2012, 07:53:18 AM
Quote from: slslbs on September 05, 2012, 05:40:18 PM
she should have called ahead, found out how much it cost to get anti - venom.
when she found out the price she should have called around to try and get a better deal.
this is, after all, a free market society.
She should have had the forethought to fumigate.
I don't see what the big deal is. She's obviously rich, I mean, she has air conditioning! She probably has a tv and fridge too. Bitch needs to pay up.
Free market society/healthcare system, LOL
What does "out of network" mean in a free market society anyway?
But I'm sure you guys are right that this is just a case of a greedy (Mexican) drug company gouging consumers (which totally explains why the drug costs $100 in Mexico (http://capsules.kaiserhealthnews.org/index.php/2011/11/treating-a-scorpion-sting-100-in-mexico-or-12000-in-u-s/)).
Quote from: runawayjimbo on September 06, 2012, 01:38:31 PM
Free market society/healthcare system, LOL
What does "out of network" mean in a free market society anyway?
But I'm sure you guys are right that this is just a case of a greedy (Mexican) drug company gouging consumers (which totally explains why the drug costs $100 in Mexico (http://capsules.kaiserhealthnews.org/index.php/2011/11/treating-a-scorpion-sting-100-in-mexico-or-12000-in-u-s/)).
They're in cahoots with the air conditioning people. I'd bet you a dose of anti-venom (mexican cost, not US) that those air conditioning filters were made in Mexico. How else did the scorpions get into this country? It's a full blown conspiracy between drug company/insurance company/hospital/AC filter company/scorpions/border patrol/and libertarians.
Quote from: goodabouthood on September 06, 2012, 01:49:48 PM
Quote from: runawayjimbo on September 06, 2012, 01:38:31 PM
Free market society/healthcare system, LOL
What does "out of network" mean in a free market society anyway?
But I'm sure you guys are right that this is just a case of a greedy (Mexican) drug company gouging consumers (which totally explains why the drug costs $100 in Mexico (http://capsules.kaiserhealthnews.org/index.php/2011/11/treating-a-scorpion-sting-100-in-mexico-or-12000-in-u-s/)).
They're in cahoots with the air conditioning people. I'd bet you a dose of anti-venom (mexican cost, not US) that those air conditioning filters were made in Mexico. How else did the scorpions get into this country? It's a full blown conspiracy between drug company/insurance company/hospital/AC filter company/scorpions/border patrol/and libertarians.
:hereitisyousentimentalbastard
Just trying to keep the world safe from the dangers of anti-venom. You know they put mercury in that shit?!?
Quote from: runawayjimbo on September 06, 2012, 02:28:37 PM
Quote from: goodabouthood on September 06, 2012, 01:49:48 PM
Quote from: runawayjimbo on September 06, 2012, 01:38:31 PM
Free market society/healthcare system, LOL
What does "out of network" mean in a free market society anyway?
But I'm sure you guys are right that this is just a case of a greedy (Mexican) drug company gouging consumers (which totally explains why the drug costs $100 in Mexico (http://capsules.kaiserhealthnews.org/index.php/2011/11/treating-a-scorpion-sting-100-in-mexico-or-12000-in-u-s/)).
They're in cahoots with the air conditioning people. I'd bet you a dose of anti-venom (mexican cost, not US) that those air conditioning filters were made in Mexico. How else did the scorpions get into this country? It's a full blown conspiracy between drug company/insurance company/hospital/AC filter company/scorpions/border patrol/and libertarians.
:hereitisyousentimentalbastard
Just trying to keep the world safe from the dangers of anti-venom. You know they put mercury in that shit?!?
And where do you think the mercury comes from? TUNA! That's right. The Mexicans are depleting the world's fisheries in order to hoard all the mercury in the world for their anti-venom and cheaply made thermometers.
:shakes fist at cloud:
http://www.bloomberg.com/news/2012-09-25/health-care-price-rise-poses-challenge-for-u-s-overhaul.html
Quote
Health-Care Price Rise Poses Challenge for U.S. Overhaul
Medical prices accelerated faster than some projections last year and the number of uninsured is rising, according to data that show the U.S. goal of expanding health care is veering onto a more difficult road.
Costs for people with employer-sponsored insurance plans jumped 4.6 percent in 2011, more than the government's 3.9 percent estimate for the entire health system, the Health Care Cost Institute, which analyzed claims from UnitedHealth Group Inc. (UNH), Aetna Inc. (AET) and Humana Inc. (HUM), said today. A study by the U.S. Centers for Disease Control and Prevention found the number of people without insurance climbed 1.7 percent in the first quarter of 2012.
The data pose a challenge for the Obama administration as it carries out the 2010 Affordable Care Act, which promises to expand coverage to 30 million Americans starting in 2014 and trim health costs. The CDC reported that 47.3 million people lacked insurance, and the health institute said hospitals and doctors raised prices at a clip that outstripped demand.
"If you don't bend the cost curve, ultimately insurance gets more expensive," said Douglas Holtz-Eakin, the president of the American Action Forum, a Washington-based advocacy group that opposes the health law. "It's a big problem for the Affordable Care Act."
The overhaul law may be contributing to higher costs, said Martin Gaynor, an economics professor at Carnegie Mellon University and chairman of the Washington-based Health Care Cost Institute. The act tries to limit insurers' administrative expenses and profits by requiring companies to spend at least 80 percent of their premium revenue on medical services. To meet that threshold, they may be letting prices rise, he said.
'Unintended Consequences'
"Like anything else, sometimes these things can have unintended consequences," Gaynor said in a telephone interview.
Health-care costs for 40 million workers covered by UnitedHealth, Aetna and Humana -- three of the four largest U.S. health insurers by revenue -- increased to $4,547 a person, from $4,349 a year earlier, according to the institute. The group, created last year to analyze claims data from major insurers, found that charges for hospital emergency rooms rose 9.1 percent in 2011, after adjusting for a reduction in the intensity of care they delivered.
That means emergency rooms "did less for more money," said David Newman, executive director of the institute.
The law also has encouraged consolidation among hospitals and doctors, which may lead to greater pricing power, said Holtz-Eakin, who once who ran the nonpartisan Congressional Budget Office after leaving the Bush administration in 2003.
A White House spokesman, Nick Papas, referred questions to the Department of Health and Human Services.
Incomplete Picture
Erin Shields, a spokeswoman for the department, said the institute's report looked at a segment of the health-care system. "In recent years, overall health-care cost growth has reached record lows and the health-care law drives costs down," she said in an e-mail.
Rising costs in 2011 may have been a one-time phenomenon, said Charles Roehrig, director of the Altarum Institute's Center for Sustainable Health Spending in Ann Arbor, Michigan. His group calculates that spending for the health system increased 5.2 percent in 2011, and this year will rise about 4 percent, similar to the rates in 2010 and 2009.
"I might be dismayed if the data for 2012 showed it was going up even faster still," Roehrig said by telephone.
More Uninsured
The report from the Atlanta-based CDC showed the number of people without health insurance rose to 47.3 million in the first quarter, from 46.5 million a year earlier. The finding contrasts with a Sept. 12 Census Bureau report that said the number of uninsured Americans declined by more than 1 million in 2011 from 2010.
The CDC data, collected from a survey of about 35,000 households conducted throughout the year, is considered "preliminary" and the first-quarter sample has "larger variances" than full-year data, Karen Hunter, a CDC spokeswoman, said in an e-mail.
While the two federal agencies use different methodology to gather their data, both documented a decrease in the number of people ages 19 to 25 who lack insurance. The CDC said that 27.5 percent of people in that age group were uninsured in the first quarter.
these articles are in this weeks NE J of Medicince
QuoteSecuring the Future of American Health Care
Barack Obama
September 26, 2012 (10.1056/NEJMp1211514)
Comments open through October 17, 2012
ArticleComments
The editors asked the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, to describe their health care platforms and their visions for the future of American health care. Their statements follow.
From the moment I took office, the central challenge we have confronted as a nation has been to recover and rebuild from the worst economic crisis since the Great Depression. We've taken extraordinary steps to repair the immediate damage and lay the foundation for an economy built to last. And a critical first step on this journey has been taking action to restore health care as a basic pillar of middle-class security.
Because of you, America is blessed with the world's most talented health care professionals, who do a heroic job serving and saving our citizens. But for years you have faced a health care system that was increasingly fractured. Insurance companies had unchecked power to dictate care and cap and cancel your patients' insurance. Tens of millions of Americans were left uninsured and underinsured. Health care costs were growing at an unsustainable rate, and our delivery system rewarded quantity of care over quality of care. You were spending more of your time on insurance forms and appeal letters — and less time doing what you trained to do: care for patients. But after a century of trying, a broad coalition of doctors, nurses, hospitals, businesses, AARP, and patients helped me sign into law the Affordable Care Act.
Supporters and detractors alike refer to the law as Obamacare. I don't mind, because I do care. And because of Obamacare we're moving forward toward a health care system that broadly provides health security.
For the majority of Americans who get health insurance through their employer, the law won't change that, but it will make their coverage more secure and affordable. Today, 105 million people have seen a lifetime cap on their coverage lifted, so your patients no longer face the tragedy of approaching a lifetime limit in the middle of a round of chemotherapy or an episode in the ICU. Most of your patients can now get preventive care without paying deductibles and copays, care that you know saves lives, from early colon- and breast-cancer screenings to cardiovascular tests and flu shots. Because of new limits on insurance overhead costs, 13 million Americans got more than $1 billion in rebates — and by 2019, economists believe, family premiums will be about $2,000 less.
The law also roots out waste and fraud in Medicare and Medicaid, gets rid of insurance overpayments, reinvests those savings back into the system, and adds 8 years to the solvency of Medicare. Obamacare is closing the Medicare doughnut hole — saving people an average of $600 last year — and bolstering your efforts to get your patients to adhere to their medications. More than 3 million young adults who would otherwise be uninsured have coverage on their parents' plan until they are 26 years old, and up to 17 million children with preexisting conditions are no longer at risk of being denied coverage. Small-business owners are getting tax credits to provide coverage for their workers and will soon be able to pool together to leverage better rates, just like big corporations.
As you surely experience every day, we are also seeing substantial movement in the emergence of new care models. Everyone understands the limits of our current system, which rewards increases in the quantity of care, not improvements in the quality. Still, change has been difficult — and that's why my administration has been so encouraged by the response to the reforms in the health care law. Across the country, provider groups are working with us to form accountable care organizations, and more and more hospitals are moving toward bundled payments. We are partnering with hospitals across the country to prevent health care–associated infections and avoid preventable readmissions — and meeting our goals together could save $35 billion and 60,000 lives over 3 years. And we are building our health care workforce, recognizing the demands of an aging population as well as the needs of people who will become newly insured. As we move forward, we will remain a partner in working together to strengthen our system and help you deliver the best possible care.
Of course, there is more to come, since many of the law's provisions take effect in 2014, when 30 million currently uninsured people will finally begin to find affordable coverage. Our insurance market will be strengthened so insurance companies cannot deny coverage or charge anyone more on the basis of a preexisting condition, and middle-class families that don't get insurance at work can receive tax credits to finally make coverage affordable. As a result, for the first time in American history, people who lose their jobs, change jobs, start a business, or retire early will know that they can find insurance for themselves and their families.
If I am elected for a second term, I will follow through on all the work we have started together to implement the Affordable Care Act. I have also been clear that additional steps are needed. We need a permanent fix to Medicare's flawed payment formula that threatens physicians' reimbursement, rather than the temporary measures that Congress continues to send to my desk. I support medical malpractice reform to prevent needless lawsuits without placing arbitrary caps that do nothing to lower the cost of care. I also know we must continue to support life-sciences research and ensure that our regulatory system helps bring new treatments and tools to pharmacies, doctors' offices, and hospitals across the country. I will keep Medicare and Medicaid strong, working to make the programs more efficient without undermining the fundamental guarantees.
My opponent in this election, Mitt Romney, has a radically different vision for the future of our health care system — even if it means running from his past as the architect of health reform in Massachusetts. He would begin by repealing Obamacare on day 1. Your patients would once again be charged excessive copays for preventive care, and millions of Americans would be one illness or injury away from bankruptcy. He would undo the progress we are making toward a more coordinated delivery system. Romney and his running mate, Congressman Paul Ryan, have proposed a budget that could force drastic cuts to investment in medical research, eliminating 1600 National Institutes of Health grants and slowing our progress on scientific and medical breakthroughs. They have pledged to turn Medicaid into a block grant and slash its funding by a third — plunging tens of millions more Americans into the ranks of the uninsured and leaving our hospitals and health care providers to grapple with an increasing burden of uncompensated care. And they are committed to ending Medicare as we know it by turning it into a voucher program, with insurance companies set to make millions while seniors and people with disabilities are forced to pay thousands more every year.
This election offers a fundamental choice between those two very different visions for the future of our country. Although the debate over Obamacare has been divisive, I signed the legislation not because it was good politics, but because it was good for the country. It enshrines a core principle that makes us who we are as Americans: that everybody should have some basic security when it comes to their health care.
We will implement the law and work together to improve where we can. But our country simply can't afford to refight old political battles, reopen old wounds, and return to the way things were. We are a nation that does what is hard and what is necessary and what is right. And we will be better off 5, 10, 20 years from now because we had the courage and foresight to keep moving forward.
Quote
Replacing Obamacare with Real Health Care Reform
Mitt Romney
September 26, 2012 (10.1056/NEJMp1211516)
Comments open through October 17, 2012
ArticleComments
The editors asked the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, to describe their health care platforms and their visions for the future of American health care. Their statements follow.
Health care is at once among our nation's greatest strengths and most serious challenges. People come from around the world to receive treatment in America's top medical centers, yet too many of our own citizens have difficulty gaining access to basic services. No issue is of deeper or more personal concern than guaranteeing the health of our loved ones. No American should ever have to fear being left uncared for in the middle of the world's most advanced health care system.
Unfortunately, our challenges grow worse every year. Higher premiums cut sharply into paychecks that never seem to increase. Losing a job means losing insurance coverage at the moment a family can least afford it, and those with preexisting conditions can be left with nowhere to turn, despite needing the greatest care. The sheer volume of red tape overwhelms even the most savvy consumers, while taking too much of each doctor's time and slowing innovation in life sciences. Through it all, experts continue to warn that the current path is unsustainable — that for all its frustrations, the system is becoming more expensive and will eventually bankrupt our government.
President Obama's 2700-page federal takeover does not solve our problems. His $1 trillion in tax increases hits the middle class hard and drives medical innovation overseas. His $700 billion in Medicare cuts "will not be viable," according to the program's trustees, jeopardizing access to care for senior citizens and throwing millions of beneficiaries off the coverage they rely on. Millions of other Americans who were told they could keep their coverage will lose it, and more than one third of new coverage will come through the dramatic expansion of a broken Medicaid system. After all this, his plan still fails to control costs (according to Medicare's chief actuary) or to provide a long-term solution to the nation's entitlement crisis (according to the Treasury Secretary), so he leaves those tasks to a board of 15 unelected bureaucrats empowered to sidestep Congress and impose drastic cuts.
If elected President, I will repeal Obamacare and replace it — not with another massive federal bill that purports to solve all our problems from Washington, but with common-sense, patient-centered reforms suited to the challenges we face.
In the health care system that I envision, costs will be brought under control not because a board of bureaucrats decrees it but because everyone — providers, insurers, and patients — has incentives to do it. Families will have the option of keeping their employer-sponsored coverage, but they will also be empowered to enjoy the greater choice, portability, and security of purchasing their own insurance plans. As a result, they will be price-sensitive, quality-conscious, and able to seek out the features they want. Insurers will have to compete for their business. And providers will find themselves operating in a context where cost and price finally matter. Competition among providers and choice among consumers has always been the formula for better quality at lower cost, and it can succeed in health care as well.
To achieve this aim, we must end tax discrimination against persons purchasing insurance, we must strengthen and expand health savings accounts, and we must establish strong consumer protections. The result will be patients who can confidently choose the coverage that is right for them, who know and care what health care costs, and who reward providers that deliver effectively. For this choice to be meaningful, insurance market reforms must promote competition by eliminating onerous mandates, facilitating purchasing pools, and opening up an interstate market. Regulation must prevent insurers from discriminating against people with preexisting conditions who maintain continuous coverage.
A strengthened system must also be one where America continues to lead the world in innovation and where we continue to attract the best and the brightest, both from our own towns and from around the world, to the practice of medicine. Doctors should spend more time treating patients and less time practicing defensive medicine or processing paperwork. Innovators should increase their investments in new cures, and those cures should reach the market faster. Achieving these goals requires medical malpractice reform, a streamlined regulatory framework to support the interoperability of information technology, and strong Food and Drug Administration leadership committed to a practical and predictable approval process that appropriately evaluates risk.
Finally, for our health care system to work for all Americans, we must have government programs that effectively serve our senior citizens and people in need without breaking the bank. In other words, we need genuine entitlement reform.
I will make no changes to Medicare for those enrolled in the program today or enrolling during the next 10 years. For younger Americans, I will implement a system similar to that used by members of Congress. Future beneficiaries will have a set of Medicare-approved, guaranteed-coverage plans to choose from, including today's traditional fee-for-service option. Plans will participate in a competitive bidding process to establish the premiums they will charge, as they do in the Medicare prescription drug plan that has so effectively controlled cost. The government will then provide premium support, set relative to the competitively bid premiums and made more generous for the poor and the sick than for the wealthy, which ensures that each beneficiary can afford high-quality coverage. This approach will guarantee senior citizens the financial support and high-quality care they deserve while relying on competition and choice — not bureaucrats — to deliver significant savings.
Nor can our society ever turn its back on those who cannot afford the care they need. We will provide support for low-income Americans and those uninsured persons whose preexisting conditions push the cost of coverage too high for them to pay themselves. But my experience as a governor and the lessons from the President's attempt at a one-size-fits-all national solution convince me that it is states — not Washington — that should lead this effort. I will convert Medicaid into a block grant that properly aligns each state's incentives around using resources efficiently. Each state will have the flexibility to craft programs that most effectively address its challenges — as I did in Massachusetts, where we got 98% of our residents insured without raising taxes.
Everyone can agree on the goal of health care reform: ensuring affordable access to high-quality care for all Americans. The question is how. Whenever President Obama claims that only Obamacare helps those with preexisting conditions, I am reminded of the woman in Iowa who found affordable coverage in a high-risk pool despite a preexisting condition. The President's campaign took credit, but as it turned out, the high-risk pool created by Obamacare had actually turned her away . . . at which point she discovered that her state already offered a high-risk pool that met her needs. Whenever he claims that only Obamacare helps those under the age of 26 stay on their parents' insurance, I am reminded that some of our nation's largest insurers have already announced they would offer this option regardless of what the law requires . . . because they are responding to consumer demands in the market.
President Obama believes the answer lies in a bigger government that decides what care Americans should receive and how much providers should be paid for it. But his plan has already failed to deliver on virtually every promise he made, and its components are failing as quickly as they go into effect. It must be repealed. I believe the answer lies with patients and families, with reformed insurance markets and fair competition, with strong consumer protections and real entitlement reform. My plan tackles our health care challenges without a federal takeover of the entire system. Instead, it relies on markets over regulations, doctors and patients over bureaucrats, and tailored state programs over a 2700-page "solution" from Washington.
(http://www.imgjoe.com/x/billionthfuc.jpg)
http://www.theonion.com/articles/insurance-company-celebrates-50-billionth-fucking,29709/
from the NEJM - a good critique pointing out the shortfalls of both plans
http://www.nejm.org/doi/full/10.1056/NEJMp1210265?query=featured_home
QuoteWhen Mitt Romney campaigned in 2002 to become governor of Massachusetts, he offered no hint that he would lead the enactment of the most consequential state health care reform law in U.S. history. Yet as early as February 2003, Governor Romney began to intimate his intention to engineer the law promising near-universal health insurance coverage that was enacted in 2006. Though plans touted in campaign rhetoric often differ from subsequent policy actions, this gap is especially relevant in considering potential federal health policy under a President Romney.
Though Romney has offered many opinions and comments as a presidential candidate, he has not provided any detailed blueprint of his plans for U.S. health system reform, and his proposals provoke questions more than they provide answers. But a review of Romney's campaign website, public addresses, debates, interviews, and other statements1 reveals five essential elements of his health policy intentions. Romney would seek repeal of large portions of the Affordable Care Act (ACA), especially the provisions that expand health insurance coverage for the uninsured through private health plans and Medicaid. He would attempt to move Medicare toward a defined-contribution (or premium-assistance, or voucher) model beginning in 2023. He would turn Medicaid into a block-grant program, capping the federal funds provided to state governments. He would seek to make individually purchased health insurance tax-deductible (like employer-based coverage) and preempt much state regulation of the private health insurance market. And he would oversee massive reductions in federal spending on all health programs as a byproduct of his budget and tax proposals.
How might these policy directions play out? Although Romney pledges to repeal the ACA,2 complete repeal would be difficult because Republicans would need to maintain control of the House of Representatives and increase their numbers in the Senate from 47 to 60 to achieve a filibuster-proof majority. Failing that, if Republicans win the White House, maintain control of the House, and win a simple majority of Senate seats, they could dismantle substantial components of the ACA using budget-reconciliation rules that require only 51 Senate votes. Because reconciliation is limited to provisions with direct federal budget consequences, many ACA sections would be untouchable. However, the elements that would have the greatest impact and cost the most (e.g., Medicaid expansion and health insurance subsidies) could be repealed.
Whether Romney would seek repeal of bipartisan and popular ACA provisions, such as closing of the gap ("doughnut hole") in Medicare Part D prescription-drug coverage, consumer insurance protections, the Indian Health Care Improvement Act, calorie labeling in chain restaurants, efforts to reduce fraud and abuse, and many others, is unclear. In September, Romney said on Meet the Press, "I'm not getting rid of all of health care reform. Of course there are a number of things that I like in health care reform that I'm going to put in place."3 The "replace" portion of his "repeal and replace" commitment is undefined.
Also uncertain is whether a Romney administration would seek repeal of the $716 billion in Medicare savings that would be used to finance about half the ACA's cost. Though Romney has committed to repealing these savings, his running mate, Congressman Paul Ryan (R-WI), incorporated them into his House budget resolutions in 2011 and 2012, with overwhelming support from the House Republican Caucus.4 Rescinding these savings would advance the insolvency of the Medicare Part A Hospital Insurance Trust Fund from 2024 to 2016 and trigger an average increase of $323 in the premiums paid by most Medicare beneficiaries between 2013 and 2022. Romney has pledged not to change Medicare for current enrollees.2 However, premium increases for future enrollees, plus the elimination of ACA-created Medicare benefits such as no-cost preventive services, will test that pledge.
Romney and the Republican National Platform also endorse Ryan's proposal to convert Medicare from a defined-benefit to a defined-contribution program.2,4 Under this plan, new senior and disabled Medicare enrollees (beginning in 2023) would receive a capped subsidy ("premium support") to purchase individual coverage from competing private and public (traditional Medicare) health plans.2,4 Romney also proposes to increase Medicare's eligibility age from 65 to 67 and to provide less premium support to wealthier seniors.2 These changes would reduce future federal Medicare spending beginning in 2023 and would shift growing costs to beneficiaries.
Romney also endorses Ryan's proposal to modify the federal–state Medicaid partnership by turning the program into block grants and capping the federal contribution.2,4 The corresponding budget resolution calls for cuts (beyond those effected by ACA repeal) of $810 billion over 10 years (2013 through 2022).4 These cuts would mean curtailing benefits, reducing provider payments, tightening eligibility, shrinking enrollee rolls, and swelling the ranks of the uninsured by 14 million to 27 million people, according to the Kaiser Commission on Medicaid and the Uninsured.5 Though Romney outlines countermeasures such as state-sponsored high-risk pools and insurance subsidies, both options are costly and contingent on flush state coffers.
Regarding health insurance reform, Romney declares, "Free enterprise is the way America works. We need to apply that to health care." He believes that health care goods and services should be traded in an open marketplace where competition drives choice, efficiency, quality, and price.2 He endorses state authority for private health insurance ("health care is a states' rights issue"), de-emphasizing federal involvement so each state can "craft a health care reform plan that is best for its own citizens."2 His proposals include revising the federal tax code to make nongroup (individual) health insurance premiums federally tax-deductible, establishing an interstate commercial health insurance market that allows policies to be sold across state lines, forming interstate purchasing pools and association health plans, relaxing rules for high-deductible health savings accounts, promoting coinsurance, and instituting federal caps on medical liability suits.2
Changing the tax treatment for individually purchased health insurance is an inefficient means of expanding coverage for the uninsured, because the most generous benefits accrue to people in higher tax brackets but most uninsured Americans are in low tax brackets (or tax-exempt) because of limited incomes. Also, many of Romney's reform proposals, such as interstate sales of health insurance and medical liability changes, run counter to his expressed commitment to state sovereignty.
Of fundamental consequence would be Romney's tax and budget policies. If his proposals for a balanced budget, defense spending hikes, and nondefense spending reductions are achieved, all nondefense programs except Social Security would require cuts averaging 29% in 2016 and 59% in 2022. Included would be Medicare, Medicaid, the National Institutes of Health, the Centers for Disease Control and Prevention, the Veterans Health Administration, and every other federal health program. Absent the balanced-budget requirement, cuts of 40% would still be required by 2022. It is difficult to contemplate federal health spending reductions at such unprecedented levels. As Kaiser Family Foundation tracking polls show, public support for Medicare and Medicaid surpasses 80%, with strong support even among Republican and Tea Party–identified voters.
Which brings us back to Romney's record. His fundamental policy proposal is to undo the ACA, the nation's most consequential health care reform law. His replacement proposals would provide no meaningful security to people who would lose the law's coverage protections. His Medicare and Medicaid proposals would irrevocably transform these programs. His budget and tax proposals would threaten the country's basic health infrastructure as few in living memory have done. One can only hope that if elected President, Romney would surprise the United States as he did Massachusetts.
http://www.nejm.org/doi/full/10.1056/NEJMp1210763?query=featured_home
QuoteU.S. health care suffers from three major problems: millions of people go without insurance, health care costs are rising at unaffordable rates, and the quality of care is not what it should be. The Affordable Care Act (ACA) primarily addresses the first — and easiest — of these problems by expanding coverage to a substantial number of the uninsured. Solutions to the other two remain aspirations and promises.
The ACA's primary accomplishment is that approximately 30 million previously uninsured people may end up with coverage — about half with subsidized private coverage purchased in the mostly yet-to-be-formed state insurance exchanges and the other half through Medicaid expansions.
The law's most controversial provision remains the individual mandate, which requires people either to have insurance coverage or to pay a penalty. The objective is to "encourage" people who might have decided not to buy insurance to do so. Unfortunately, the mechanisms put in place may instead encourage people to postpone buying insurance until they're sure it will be needed. Insurers will not be able to refuse coverage to anyone and cannot charge higher rates to people who wait until they clearly need care. The penalty for not having insurance is very small, particularly for younger people with modest incomes. Given the choice, many people may put off buying insurance to save thousands of dollars in premium payments.
A mandate cannot work without a credible threat that noncompliance will be costly. It would have been smarter to mimic Medicare's policies: seniors who don't purchase the voluntary parts of Medicare covering physician services and outpatient prescription drugs during the first year in which they lack comparable coverage must pay a penalty for every month they have gone without coverage whenever they finally do purchase it. This system has produced high rates of Medicare enrollment without creating the firestorm generated by a mandate.
Moreover, although the ACA expands coverage, it ignores the structural problems in the organization and reimbursement of care — a limitation that is disappointing but not surprising: adding more people to the insurance rolls is politically and technically easier than finding a way to ensure that care is effective, high-quality, and affordable for both the recipients and taxpayers.
Despite widespread recognition that fee-for-service reimbursement rewards providers for the quantity and complexity of services and encourages fragmentation in care delivery, the ACA retains all the predominantly fee-for-service reimbursement strategies currently used in Medicare. Much of the coverage expansion is financed through Medicare budget savings, which are produced by reducing the fees paid by Medicare to institutional providers such as hospitals, home care agencies, and nursing homes — but using the same perverse reimbursement system currently in place. Reducing payments to institutional providers should not be confused with lowering the cost of providing care.
The ACA also provides Medicare "productivity adjustments," which assume that inflation adjustments can be reduced over time because institutions will become more productive, whether or not hospitals and other providers actually find ways to increase their productivity. Unless these institutions find ways to reduce costs, lower Medicare reimbursements will force providers to bargain for higher payments from private insurers. And eventually, seniors' access to services will be threatened. The Medicare actuary expects that 15% of institutional providers will lose money on their Medicare business by 2019, and the proportion will increase to 25% by 2030 — a situation that he calls unsustainable.1
Most troubling, the ACA contains no reform of the way physicians are paid, which is the most dysfunctional part of the Medicare program.2 Through the Resource-Based Relative Value Scale, physicians are reimbursed on the basis of more than 8000 different service codes, and payment for each physician service is reduced whenever aggregate spending on physician services exceeds a prespecified limit. This system rewards the provision of highly reimbursed services without consideration of whether clinicians are providing low-cost, high-value care for patients. Given physicians' key role in providing patient care, it's impossible to imagine a reformed delivery system without a more rational way of paying physicians — one that encourages and rewards them for providing clinically appropriate care efficiently.
Some modest payment reforms, such as value-based purchasing and accountable care organizations (ACOs), are included in the legislation. Value-based payment bonuses are being phased in for hospitals and nursing homes in 2012 and 2013 and for physicians starting in 2016. In principle, tying payment to quality indicators could promote greater quality and efficiency, but the bonus payments are very modest, which reduces the chances that clinical and institutional behavior will be substantially affected.
ACOs allow hospitals and physicians who are not formally affiliated with each other to work together and share savings. It might have made more sense to pursue this model as a pilot project, since there are many uncertainties about how these organizations should be structured and whether they will produce the hoped-for outcomes.
Most of the payment- and delivery-system reforms in the ACA are part of pilot projects being initiated by the Center for Medicare and Medicaid Innovation (CMMI), a unit of the Centers for Medicare and Medicaid Services. CMMI initiatives include strategies for promoting primary care, as well as bundled-payment initiatives in which a single payment is made to cover more of the services delivered in an episode of care. Unfortunately and inexplicably, none of the initiatives focus on alternative reimbursement arrangements for physicians separate from institutional payments or on ways to promote the formation of multispecialty group practices, a known strategy for producing high-quality care.3
Pilot projects may seem like an attractive way to try out innovative ideas, but they have not led to much change in Medicare policy. Successful pilots may need to be repeated on a larger scale to see if the results are scalable and replicable — all of which takes time. The sense of urgency that should surround these activities has not seemed to be present thus far.
Finally, as Medicare has since its inception, the ACA focuses all its pressure to reduce spending and improve quality of care on clinicians and institutional providers through regulatory means, rather than trying to harness market forces. If the envisioned spending reductions don't materialize, the ACA authorizes an Independent Payment Advisory Board (IPAB) to reduce payments to clinicians and institutions until the desired spending levels are achieved. Although Congress can override the IPAB's recommendations, it can do so only if it acts within a limited time and comes up with comparable savings.
Some supporters of the ACA characterize it as "market-friendly" — presumably because it encourages exploration of a reimbursement system with better incentives than the current one — but they fundamentally misunderstand what it takes to be market-friendly.4 Having Medicare choose which pilot project should become the law of the land or which bundled-payment strategy should be used to pay for services does not bring market forces into play.
What is needed are reforms that create clear financial incentives that promote value over volume, with active engagement by both consumers and the health care sector. Market-friendly reforms require empowering individuals, armed with good information and nondistorting subsidies, to choose the type of Medicare delivery system they want. Being market-friendly means allowing seniors to buy more expensive plans if they wish, by paying the extra cost out of pocket, or to buy coverage in health plans with more tightly structured delivery systems at lower prices if that's what suits them. If market-friendly Medicare reform is your aim, a good place to look is the plan proposed by Senator Ron Wyden (D-OR) and Representative (and vice-presidential candidate) Paul Ryan (R-WI) — not the ACA.5
Not sure where this belongs so I guess here is good enough.
Interesting (albeit simplistic) analysis showing how unsustainable healthcare entitlements are overwhelmingly driving our debt: if you eliminate federal healthcare spending from the creation of Medicare, the debt would be negligible. So the question becomes, if the federal gov't is to provide healthcare to all citizens because it is an obvious societal good (note I don't dispute the second part of that, it's the first part I have a problem with), we will ALL need to pay a lot more for it. Per the analysis, the 2011 Medicare shortfall was $775B, almost exactly the amount raised by allowing Bush tax cuts to expire for only those making $250k or more over TEN years. In other words, Clinton level taxes on the rich only covers one-tenth of Medicare's deficit for ONE year, so in order to make the program sustainable, the remaining 95ish percent of taxpayers will have to see substantial increases as well.
http://www.mcsweeneys.net/articles/why-we-have-debt
Quote
WHY WE HAVE DEBT.
I was originally going to write this column about income inequality, but I am going to save that topic for the next post, because there is an issue that is pressing in light of the election less than one month away. One of the central topics of political discourse over the past several years has been the sizeable Federal deficit and resulting growth of national debt. This issue has been of particular concern to political conservatives and Tea Party advocates, who blame President Obama for spending too much and bankrupting the country. While I do not consider myself to be a political conservative, the deficit and the debt concern me as well. I worry that the level of deficit spending is unsustainable, and may result in significant detriment to our future welfare. Unfortunately, I do not think that it is particularly well recognized why we have deficits, and the political discussion surrounding them is, at best, misleading.
(http://assets.mcsweeneys.net/uploads/production/851/1350781455/original/Figure1.jpg?1350781455)
Let's start out with a little background and look at the current and cumulative levels of the Federal government deficit. For this discussion, I am going to use statistics compiled by the Bureau of Economic Analysis (BEA). The BEA is kind of the government's accountant, and publishes statistics on all sorts of interesting economic information. In Figure 1, I plot the current and cumulative levels of the deficit as reported by the BEA.1 The Federal deficit, plotted in blue, represents the difference in government receipts and expenditures each year. The green line is the cumulative deficit, which is the running total of accumulated deficits. This is approximately, but not exactly, the amount of net Federal debt outstanding. By the end of 2011, the running total was approximately $9 trillion, about the amount of net Federal government debt outstanding at that time.
The picture is a bit alarming. Up until about 1970, the government more or less balanced its budget. There were surplus years and deficit years, but on average, the government ran a surplus of about $2 billion over the period 1929 through 1969. Starting in 1970, the government began to run sustained deficits, and by 1982, the government had spent a cumulative total of about $80 billion in excess of revenues received since 1929. At this point, what was essentially a flat line accelerates into what looks like exponential growth in debt. The deficit really starts to go off the cliff in 2008 with a $600 billion deficit, and the government outspends its revenues in excess of $1 trillion in each of the final three years of data. So where is this deficit and debt coming from? Is it entirely due to the fact that the government provided a fiscal stimulus, or perhaps due to the bailout of the banking system? Do we have a deficit because income tax revenues are too low? Is there a mass of wasteful spending, or is the government spending too much on defense?
While all of these sources may contribute to the deficit, and our resulting national debt, they miss the elephant in the room. The main contribution to the deficit is that how much we pay into government social insurance programs is disconnected from how much the government pays back to us. In particular, we contribute far less into social insurance for health care than the government pays out. I don't know about you, but when the topic of health care and health care policy comes up, my eyes glaze over. I still don't know what the "donut hole" is, and find it hard to believe that I will ever get the motivation to find out. In addition, although I can't legitimately call myself young any more, I'm still young enough that health care and health care expenses just don't register on my radar. However, when it comes to talking about deficits, health care expenses are pretty much the entire ball game.
(http://assets.mcsweeneys.net/uploads/production/852/1350781518/original/Figure2.jpg?1350781518)
Figure 2 shows the difference between government receipts for Medicare and the amount paid out for Medicare and Medicaid.2 Just like the debt and deficit depicted in Figure 1, spending on medical care in excess of revenues shows exponential growth. In 2011, Medicare and Medicaid payments totaled $949 billion, while receipts for Medicare totaled $174 billion. This means that government spending on medical expenditures outstripped revenues by $775 billion, which represents 58% of the 2011 Federal deficit. Other revenue and spending mismatches account for the remaining 42%, but the medical expenditure mismatch is the overwhelming source of the Federal government's deficit. Probably even more telling is the cumulative amount of the excess of expenditures over revenues. By 2011, this difference had cumulated to—you probably guessed it—about $9 trillion.
(http://assets.mcsweeneys.net/uploads/production/853/1350781585/original/Figure3.jpg?1350781585)
As a thought experiment, let's suppose that medical expenditures had been self-financed since the inception of government health care in the 1960s. What would our debt and deficit look like today? To answer this question, I simply added the medical care expenditure deficit back into the total government deficit. The result is depicted in Figure 3 and is astounding (at least to me). Outside of medical expenditures and revenues, the Federal government sometimes ran a surplus and sometimes ran a deficit from 1966 until 1980. Starting in 1980, and lasting until 1994, the government consistently ran a deficit outside of medical spending, but from 1995 until 2010, it consistently ran a surplus. In 1994, the cumulative excess spending would have reached a bit over $1 trillion. But by 1999, debt due to sources other than medical spending would have been completely eliminated by surpluses! The government wouldn't have needed to borrow again until 2011.
At least some of the issue is the fact that health care costs have risen at a rate faster than overall inflation. Based on the BEA's price indices, average health care costs rose by 2% more than overall inflation in consumption expenditures over the past 30 years. These costs have moderated somewhat over the past 10 years, rising on average by 0.75% more per year than overall inflation. But another source of the problem is our unwillingness to pay for medical benefits. FICA tax rates were regularly increased for the first 35 years of the Medicare/Medicaid program. However, the rate has not increased since 1990. Since wages have grown at a much slower rate than health care costs, the result is a massive deficit and debt attributable to health care spending.
My point in all this is that we should not be distracted from the source of our fiscal problems. If a candidate for national office says that the deficit and Federal debt is a crisis and out of control, but does not provide a plan to rectify the differences in healthcare spending and revenues, that candidate is being disingenuous. I do not profess to have the solution to fixing healthcare in terms of taxation or cost control. I can simply say that under the status quo, what we pay for health care vastly outstrips the revenue generated to pay for it. As a nation, we need to decide whether health care is a benefit that is worth paying for. If we conclude that it is, we need to commit to a plan other than borrowing to fund expenditures on health care.
Well, I guess we'll be moving forward with the Affordable Care Act. What's everyone think?
Quote from: goodabouthood on November 07, 2012, 11:05:36 AM
Well, I guess we'll be moving forward with the Affordable Care Act. What's everyone think?
It's the least we can do, really.
Quote from: goodabouthood on November 07, 2012, 11:05:36 AM
Well, I guess we'll be moving forward with the Affordable Care Act. What's everyone think?
There's still some fairly significant legal and logistical challenges ahead for the law: there's a lawsuit in OK challenging (a) whether federal gov't can tax employers in states that refuse to set up exchanges and (b) whether the exchange subsidies can be provided by the Feds in those states; setting up the federal insurance exchanges is proving to be more difficult than anticipated, leading to potential conflicts of interests; and even in the 15ish states that are working to create the state run exchanges, the states are not going to be ready by the beginning of 2013 as required by the law.
In other words, while the law is not at risk of being repealed (although are we really gonna pretend the guy who created the law was gonna repeal it?), it is at risk of being crushed under the weight of the practical problems associated with getting something this massive up and running in the timeframe they gave themselves.
so I just got a phone call from an elderly pt who was concerned - now that Obamacare won't be repealed, the panel will decide that she won't be able to get any treatment
:frustrated:
Quote from: slslbs on November 09, 2012, 05:50:53 PM
so I just got a phone call from an elderly pt who was concerned - now that Obamacare won't be repealed, the panel will decide that she won't be able to get any treatment
:frustrated:
where would she get a silly idea like that??
Quote from: slslbs on November 09, 2012, 05:50:53 PM
so I just got a phone call from an elderly pt who was concerned - now that Obamacare won't be repealed, the panel will decide that she won't be able to get any treatment
:frustrated:
You told her that the panel would contact her re: her time to go, right? I'd be like "I know a couple guys on the
panel, and you're pissing me off right now"
Quote from: kellerb on November 09, 2012, 07:04:11 PM
Quote from: slslbs on November 09, 2012, 05:50:53 PM
so I just got a phone call from an elderly pt who was concerned - now that Obamacare won't be repealed, the panel will decide that she won't be able to get any treatment
:frustrated:
You told her that the panel would contact her re: her time to go, right? I'd be like "I know a couple guys on the panel, and you're pissing me off right now"
The old bag's gotta go!
Just got my notice from my employer this morning regarding the new healthcare exhange. As expected, Maryland is rolling out their exchange, effective 10/1. It's going to be really interesting to see how successful these exchanges are. So far, around here at least, the "Affordable Care Act" is getting blasted by the local media because the exchange is currently more expensive than what an individual can find on his or her own.
ETA: I am hopeful that this works overall, and I know that MD's healthcare system is vastly different from places like NY. I am guessing the exchanges will be a very nice option for states where the individual plans are more expensive than the employer sponsored plans. That is just not the case here in MD. Hopefully, this "competition" will drive the cost of healthcare down, overall, and make it even more affordable for everyone.
If the exchange is more expensive than what someone can do on his / her own, it won't last unless they cut the price.
I see the problem there with the insurance cos pricing, not the ACA
(not that the ACA doesn't have problems, it does - I don't define this as one of them)
This thing is just a wobbly stepping stone to the only reasonable fix which is single-payer.
Good health requires necessary maintenance activities that should not be relegated to luxury.
we need an ignore thread option here :evil:
Quote from: rowjimmy on August 21, 2013, 09:34:51 AM
This thing is just a wobbly stepping stone to the only reasonable fix which is single-payer.
Good health requires necessary maintenance activities that should not be relegated to luxury.
THIS.
^^
true.
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
Quote from: slslbs on August 21, 2013, 10:47:04 AM
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
And legislation like the NYC Soda Ban are "un-Amurakin"...
Terry
Quote from: slslbs on August 21, 2013, 10:47:04 AM
^^
true.
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
Absolutely.
Having access to medical treatment is not license to chunk up because the insulin will be paid for.
Quote from: rowjimmy on August 21, 2013, 12:35:52 PM
Quote from: slslbs on August 21, 2013, 10:47:04 AM
^^
true.
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
Absolutely.
Having access to medical treatment is not license to chunk up because the insulin will be paid for.
Also, Dude. "Chunk" is not the preferred nomenclature. Husky-American, please.
Quote from: PG on August 21, 2013, 01:16:29 PM
Quote from: rowjimmy on August 21, 2013, 12:35:52 PM
Quote from: slslbs on August 21, 2013, 10:47:04 AM
^^
true.
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
Absolutely.
Having access to medical treatment is not license to chunk up because the insulin will be paid for.
Also, Dude. "Chunk" is not the preferred nomenclature. Husky-American, please.
I was using it as a verb.
Quote from: rowjimmy on August 21, 2013, 12:35:52 PM
Quote from: slslbs on August 21, 2013, 10:47:04 AM
^^
true.
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
Absolutely.
Having access to medical treatment is not license to chunk up because the insulin will be paid for.
I definitely agree, but it would be/is so hard to regulate.
So much I want to say but lucky for youz guyz I'm on vacation and been drinking on the beach all day. But this,
Quote from: PG on August 21, 2013, 01:16:29 PM
Quote from: rowjimmy on August 21, 2013, 12:35:52 PM
Quote from: slslbs on August 21, 2013, 10:47:04 AM
^^
true.
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
Absolutely.
Having access to medical treatment is not license to chunk up because the insulin will be paid for.
Also, Dude. "Chunk" is not the preferred nomenclature. Husky-American, please.
Damn near made me shit myself.
Oh yeah, and
Quote from: twatts likes ghoti on August 21, 2013, 11:44:54 AM
Quote from: slslbs on August 21, 2013, 10:47:04 AM
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
And legislation like the NYC Soda Ban are "un-Amurakin"...
Terry
Boo.
Quote from: runawayjimbo on August 21, 2013, 10:59:02 PM
So much I want to say but lucky for youz guyz I'm on vacation and been drinking on the beach all day. But this,
Quote from: PG on August 21, 2013, 01:16:29 PM
Quote from: rowjimmy on August 21, 2013, 12:35:52 PM
Quote from: slslbs on August 21, 2013, 10:47:04 AM
^^
true.
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
Absolutely.
Having access to medical treatment is not license to chunk up because the insulin will be paid for.
Also, Dude. "Chunk" is not the preferred nomenclature. Husky-American, please.
Damn near made me shit myself.
Oh yeah, and
Quote from: twatts likes ghoti on August 21, 2013, 11:44:54 AM
Quote from: slslbs on August 21, 2013, 10:47:04 AM
it also requires some responsibility on the individual's part (ie not over eating, smoking, etc), but no one is willing to talk about that publicly.
And legislation like the NYC Soda Ban are "un-Amurakin"...
Terry
Boo.
Jimbo finally posts to politiw00k and this is all we get?
(http://www.toptenz.net/wp-content/uploads/2012/06/two-thumbs-down.jpg)
Dude, you know it's only cause I'm on holiday. I can't wait to have some fun in the coming months with the train wreck that is the ACA, despite its inevitability.
But that's sweet that you missed me.
:wink:
HealthCare.gov (https://www.healthcare.gov/) is now open.
(https://pbs.twimg.com/media/BVdo-yICEAAALYD.png)
Quote from: runawayjimbo on October 01, 2013, 12:27:46 AM
HealthCare.gov (https://www.healthcare.gov/) is now open.
(https://pbs.twimg.com/media/BVdo-yICEAAALYD.png)
Sweet!
Quote from: runawayjimbo on October 01, 2013, 12:27:46 AM
HealthCare.gov (https://www.healthcare.gov/) is now open.
(https://pbs.twimg.com/media/BVdo-yICEAAALYD.png)
Ironic timing is ironic.
Not as ironic as this, taken just minutes after midnight.
(https://pbs.twimg.com/media/BVdpaKtCcAAnv9O.png)
I spent some time on CA's site last night (PA didn't create one and federal exchange, as per above, was temporarily down) and they seem to have done a pretty nice job. The interface is really clean and easy to use. I think they could probably do a better job explaining the implications of the different plans and the various cost sharing measures but they give a nice side-by-side comparison that makes it easy to see what you're getting. Of course, web design was probably the easiest part of the implementation process but so far so good.
It's up now.
Quote from: runawayjimbo on October 01, 2013, 08:21:50 AM
I think they could probably do a better job explaining the implications of the different plans and the various cost sharing measures but they give a nice side-by-side comparison that makes it easy to see what you're getting. Of course, web design was probably the easiest part of the implementation process but so far so good.
of course, buying insurance is never easy - the fine print must be reviewed, comparing apples to oranges isn't easy.
whatever goes wrong (and it will) will be blamed on the gov't though, not the insurance companies that are trying to rip people off.
This makes me sick, seriously. Not that we are providing a means to get healthcare for all, more how poorly designed it was and the fact that the cost could be so much lower by applying common sense.
The U.S. Government already pays more per capita in Healthcare than any other nation and yet doesn't provide healthcare. Because of the way they pushed everything out in this federated model they lost their bargaining power with the insurance companies.
Why not do what other countries do. Hey, Pacemaker manufacturer, if you give us the best price on Pacemakers for the govt insured you get the contract. By doing that with manufacturers, insurance companies and others we could provide healthcare for all and actually save money in the current budget, not increase it or steal from other programs.
agree
Congress wouldn't do that with drug or device companies the last round of Medicare "Reform" (GWB was pres, the GOP controlled both houses) and wouldn't do it now. Stifling competition is how they labelled it. Of course, they have no problem dictating terms to health care providers.
This is potentially fixable (without dismantling the entire system), if the assholes in DC would actually sit down and talk to each other w/o getting into a pissing contest.
I wish this was a joke
(http://gotinsurancecolorado.org/images/18.jpg)
LOL
it is real
whatever works
Obama administration knew millions could not keep their health insurance (http://investigations.nbcnews.com/_news/2013/10/29/21222195-obama-administration-knew-millions-could-not-keep-their-health-insurance?lite)
Rut-roh...
Quote from: V00D00BR3W on October 29, 2013, 02:33:22 PM
Obama administration knew millions could not keep their health insurance (http://investigations.nbcnews.com/_news/2013/10/29/21222195-obama-administration-knew-millions-could-not-keep-their-health-insurance?lite)
Rut-roh...
Anyone with two braincells to rub together should have seen that one coming. You can't change the rules of the game for everyone and expect the rules to stay the same for some, or can you?
Yep, I got my cancellation notice last week. It's really not a big deal. I just need to find a new plan for our family before my plan renews in March.
Quote from: nab on October 29, 2013, 02:45:08 PM
Quote from: V00D00BR3W on October 29, 2013, 02:33:22 PM
Obama administration knew millions could not keep their health insurance (http://investigations.nbcnews.com/_news/2013/10/29/21222195-obama-administration-knew-millions-could-not-keep-their-health-insurance?lite)
Rut-roh...
Anyone with two braincells to rub together should have seen that one coming. You can't change the rules of the game for everyone and expect the rules to stay the same for some, or can you?
Apparently not.
The problem* is that the president and the administration so adamantly and repeatedly pushed the line that "if you like your health insurance, you can keep it" and dismissed suggestions to the contrary as fear-mongering or misinformation, when this NBC News report suggests that they knew all along it was going to prove to be untrue for lots of people.
* Well, it's not the only problem. Another would be when people are forced into more expensive plans, although I suppose with tax credits and whatnot it remains to be seen whether and how badly that will be a big issue for all these people.
We finally get to the bottom of how many people enrolled in the first couple of days of the ACA rollout. The answer: not many.
http://www.cbsnews.com/8301-18563_162-57610328/obamacare-early-enrollment-numbers-very-small-documents-show/
Quote
Obamacare enrollments got off to very slow start, documents show
(CBS News) WASHINGTON - For 31 days now, the Obama administration has been telling us that Americans by the millions are visiting the new health insurance website, despite all its problems.
But no one in the administration has been willing to tell us how many policies have been purchased, and this may be the reason: CBS News has learned enrollments got off to an incredibly slow start.
Early enrollment figures are contained in notes from twice-a-day "war room" meetings convened within the Centers for Medicare and Medicaid Services after the website failed on Oct. 1. They were turned over in response to a document request from the House Oversight Committee.
The website launched on a Tuesday. Publicly, the government said there were 4.7 million unique visits in the first 24 hours. But at a meeting Wednesday morning, the war room notes say "six enrollments have occurred so far."
They were with BlueCross BlueShield North Carolina and Kansas City, CareSource and Healthcare Service Corporation.
By Wednesday afternoon, enrollments were up to "approximately 100." By the end of Wednesday, the notes reflect "248 enrollments" nationwide.
The health care exchanges need to average 39,000 enrollees a day to meet the goal of seven million by March 1. The war room notes give a glimpse into some of the reasons customers had problems:
-- "Direct enrollment (signing up directly on an insurer's website) is not working for any issuers."
-- "Experian" credit reporting agency is "creating confusion with credit check information."
-- "Issuer phone numbers are not appearing correctly on the Pay Now page."
The notes leave no doubt that some enrollment figures, which the administration has chosen to keep secret, are available.
"Statistics coming in," said notes from the very first meeting the morning of Oct. 2. Contractor "QSSI has a daily dashboard created every night."
But head of CMS Marilyn Tavenner would not disclose any figures when Rep. Dave Camp, chair of the House Ways and Means Committee, asked earlier this week.
"Chairman Camp, we will have those numbers available in mid-November," she said.
Health and Human Services told CBS News Thursday it's in no position to confirm or discuss enrollment figures because it doesn't have any. A spokesman suggested the numbers obtained by CBS News may not include all the different ways to enroll, such as paper applications. The spokesman also said that enrollment figures in Massachusetts' health care plan started off negligible but then skyrocketed as a deadline neared.
It's clear that the admin did a pitiful job rolling this out. Hopefully, they can get their shit together and get it fixed.
You wonder though, the states that are not participating also tend to have the highest number of uninsured. Things may have been different if they co operated (not an excuse for admin's lame job so far)
It gets worse: the administration sandbagged itself because it was fearful of political blowback prior to the election. The May 2010 memo from David Cutler (http://www.scribd.com/doc/181039999/Memo-from-David-Cutler-on-health-reform-implementation) mentioned in the first paragraph is a pretty damning (and prescient) too.
http://www.washingtonpost.com/politics/challenges-have-dogged-obamas-health-plan-since-2010/2013/11/02/453fba42-426b-11e3-a624-41d661b0bb78_story.html
Quote
HealthCare.gov: How political fear was pitted against technical needs
In May 2010, two months after the Affordable Care Act squeaked through Congress, President Obama's top economic aides were getting worried. Larry Summers, director of the White House's National Economic Council, and Peter Orszag, head of the Office of Management and Budget, had just received a pointed four-page memo from a trusted outside health adviser. It warned that no one in the administration was "up to the task" of overseeing the construction of an insurance exchange and other intricacies of translating the 2,000-page statute into reality.
Summers, Orszag and their staffs agreed. For weeks that spring, a tug of war played out inside the White House, according to five people familiar with the episode. On one side, members of the economic team and Obama health-care adviser Zeke Emanuel lobbied for the president to appoint an outside health reform "czar" with expertise in business, insurance and technology. On the other, the president's top health aides — who had shepherded the legislation through its tortuous path on Capitol Hill and knew its every detail — argued that they could handle the job.
In the end, the economic team never had a chance: The president had already made up his mind, according to a White House official who spoke on the condition of anonymity in order to be candid. Obama wanted his health policy team — led by Nancy-Ann DeParle, director of the White House Office of Health Reform — to be in charge of the law's arduous implementation. Since the day the bill became law, the official said, the president believed that "if you were to design a person in the lab to implement health care, it would be Nancy-Ann."
Three and a half years later, such insularity — in that decision and others that would follow — has emerged as a central factor in the disastrous rollout of the new federal health insurance marketplace, casting doubt on the administration's capacity to carry out such a complex undertaking.
"They were running the biggest start-up in the world, and they didn't have anyone who had run a start-up, or even run a business," said David Cutler, a Harvard professor and health adviser to Obama's 2008 campaign, who was not the individual who provided the memo to The Washington Post but confirmed he was the author. "It's very hard to think of a situation where the people best at getting legislation passed are best at implementing it. They are a different set of skills."
The White House's leadership of the immense project — building new health insurance marketplaces for an estimated 24 million Americans without coverage — is one of several key reasons that the president's signature domestic policy achievement has become a self-inflicted injury for the administration.
Based on interviews with more than two dozen current and former administration officials and outsiders who worked alongside them, the project was hampered by the White House's political sensitivity to Republican hatred of the law — sensitivity so intense that the president's aides ordered that some work be slowed down or remain secret for fear of feeding the opposition. Inside the Department of Health and Human Services' Centers for Medicare and Medicaid, the main agency responsible for the exchanges, there was no single administrator whose full-time job was to manage the project. Republicans also made clear they would block funding, while some outside IT companies that were hired to build the Web site, HealthCare.gov, performed poorly.
These interwoven strands ultimately caused the exchange not to be ready by its Oct. 1 start date. It was not ready even though, on the balmy Sunday evening of March 21, 2010, hours after the bill had been enacted, the president had stood on the Truman Balcony for a champagne toast with his weary staff and put them on notice: They needed to get started on carrying out the law the very next morning. It was not ready even though, for months beginning last spring, the president emphasized the exchange's central importance during regular staff meetings to monitor progress. No matter which aspects of the sprawling law had been that day's focus, the official said, Obama invariably ended the meeting the same way: "All of that is well and good, but if the Web site doesn't work, nothing else matters."
Fragmented oversight
The White House was in charge, but the on-the-ground work of carrying out the law fell largely to HHS. At first, a new unit responsible for building the statute's insurance marketplaces was created inside the office of Secretary Kathleen Sebelius.
Soon, however, it became evident that the office — with more than 200 people — would not survive on its own. It lacked tools, such as the ability to award grants and outside contracts, that were vital to its mission, said Richard Foster, Medicare's chief actuary for nearly two decades before he retired early this year. So the office, with a slightly new name, moved in early 2011 into the Centers for Medicare and Medicaid Services (CMS), a large agency spread among locations in the District, Bethesda and Baltimore.
The move had a political rationale, as well. Tucked within a large bureaucracy, some administration officials believed, the new Center for Consumer Information and Insurance Oversight would be better insulated from the efforts of House Republicans, who were looking for ways to undermine the law. But the most basic reason was financial: Although the statute provided plenty of money to help states build their own insurance exchanges, it included no money for the development of a federal exchange — and Republicans would block any funding attempts. According to one former administration official, Sebelius simply could not scrounge together enough money to keep a group of people developing the exchanges working directly under her.
Bureaucratic as this move may sound, it was fateful, according to current and former administration officials. It meant that the work of designing the federal health exchange — and of helping states that wanted to build their own — became fragmented. Technical staff, for instance, were separated from those assigned to write the necessary policies and regulations. The Medicaid center's chief operating officer, a longtime career staffer named Michelle Snyder, nominally oversaw the various pieces, but, as one former administration official put it: "Implementing the exchange was one of 39 things she did. There wasn't a person who said, 'My job is the seamless implementation of the Affordable Care Act.' "
In the West Wing, the president put his trust in DeParle, who joined the White House two months after Obama took office in 2009 and had overseen the health-care legislation from its infancy. Earlier in her career, she had been a health-care administrator under President Bill Clinton and worked on the issue at the Office of Management and Budget.
Well-versed as she was, DeParle immediately recognized that she needed help, according to a former senior administration official. She tried — but failed — to lure to the White House one of the nation's top experts, Jon Kingsdale, who had overseen the building of a similar insurance exchange in Massachusetts.
DeParle convened meetings twice a week in the Old Executive Office Building, bringing together representatives of agencies as far-flung as the Internal Revenue Service, the Centers for Disease Control and Prevention and OMB's regulatory office — all of which had a role in putting the law into practice. They pored over spreadsheets and hashed out difficult policy questions. The work was "highly specific," recalled Donald Berwick, who was CMS's administrator through 2011 and now is a Democratic gubernatorial candidate in Massachusetts. "There was an implementation chart. Regulation by regulation, we would say, where is it now, who was developing it?"
A higher-level monthly meeting, intended to work through tough regulatory questions, was attended at first by Sebelius, Treasury Secretary Timothy Geithner, Chief of Staff Rahm Emanuel and Domestic Policy Council Director Melody Barnes. By late summer and early fall of 2010, the meetings petered out after some of the participants stopped attending, according to a former senior administration official.
At the White House and inside CMS, the initial focus was not on building the online marketplace but rather on rules to let young adults stay on their parents' insurance policies and new insurance pools for Americans who were being rejected by insurance companies because they were ill.
The exchange "was in the future," Berwick said, explaining that the Web site was, during his tenure, a matter of "conceptualization," along with "the many other regulations we were batting out."
Wary of GOP reaction
From the beginning, the administration worked in a venomous political climate. "You're basically trying to build a complicated building in a war zone, because the Republicans are lobbing bombs at us," the White House official said.
White House officials contend that the political sensitivities did not influence the substance or pace of the work. But others who were involved say otherwise.
According to two former officials, CMS staff members struggled at "multiple meetings" during the spring of 2011 to persuade White House officials for permission to publish diagrams known as "concepts of operation," which they believed were necessary to show states what a federal exchange would look like. The two officials said the White House was reluctant because the diagrams were complex, and they feared that the Republicans might reprise a tactic from the 1990s of then-Sen. Bob Dole (R-Kan.), who mockingly brandished intricate charts created by a task force led by first lady Hillary Clinton.
In the end, one of the former officials said, the White House quashed the diagrams, telling CMS, instead, to praise early work on those state exchanges that matched the hidden federal thinking.
By then, DeParle was no longer directly in charge, since she had been promoted in February 2011 to be the president's deputy chief of staff for policy. Her successor, Jeanne Lambrew, worked on the law's passage in Sebelius's office and, years earlier, had worked on health reform under the Clinton White House.
That spring, CMS had begun writing specifications for the IT contracts to build the federal exchange, but the White House again insisted on caution. A larger number of states than expected were signaling that, under Republican pressure, they would refuse to build their own online insurance marketplaces and would rely on the federal one. The more states in the federal exchange, the more complex the task of building it. Yet, according to several former officials, White House staff would not let this fact be included in the specifications. Their concern, one former official said, was that Republicans would seize on it as evidence of a feared federal takeover of the health-care system.
So that September, when the administration issued the "scope of work" for the largest IT contract, the specifications skirted the question — saying only that "CMS will not know for certain how many states will apply" to run their own insurance exchanges.
After the contract was awarded to CGI Federal, the administration kept giving states more and more time to decide whether to build their own exchanges; White House officials hoped that more would become willing after the 2012 election. So the technical work was held up. "The dynamic was you'd have [CMS's leaders] going to the White House saying, 'We've got to get this process going,' " one former official recalled. "There would be pushback from the White House."
Meanwhile, the White House also slowed down important regulations that had been drafted within CMS months earlier, appearing to wait until just after Obama's reelection. Among the most significant were standards for insurance coverage under exchanges. The rules for these "essential health benefits" were proposed just before Thanksgiving last year and did not become final until February. Another late regulation spelled out important rules for insurance premiums.
Such delays were "a singularly bad decision," said Foster, the former Medicare chief actuary. "It's the president's most significant domestic policy achievement," he said, and the very aides who had pushed the law through Congress were risking bad implementation "for a short-term political gain."
After the election, Cutler, the Harvard professor, renewed his warnings that the White House had not put the right people in charge. "I said, 'You have another chance to get a team in place,' " he recalled.
Nothing changed.
'A dynamic we can't change'
On Dec. 19, Obama met with roughly a dozen senior White House and HHS officials, including Sebelius. They discussed important policy issues, such as how to persuade more young, healthy Americans to sign up for insurance. But the president had a deeper message. The health-care law, he told the gathering, according to participants, was "the most important thing" in his presidency. "We've got to do it right."
Yet by early this year, White House allies on Capitol Hill were deeply frustrated by how little administration officials would tell them about how the work was going.
On Valentine's Day, Senate Finance Committee Chairman Max Baucus (D-Mont.) convened a hearing on the federal and state marketplaces. The HHS office in charge of the federal exchange was on its third director in as many years, Gary Cohen, who testified that "we are on track and we will be ready" by Oct. 1.
Baucus pressed him: "I want data here, I don't want just goals." The next week CMS provided a one-page "marketplace timeline," showing 16 items left to be accomplished, such as finalizing a few rules and a streamlined application.
This unwillingness to share information extended to private discussions, as well, according to congressional aides.
For three years, roughly two dozen Democratic aides have gathered to discuss health care each Monday at 1 p.m. in House Minority Whip Steny H. Hoyer's conference room, under a ceiling featuring images of winged cherubs and wheat harvesting in Constantino Brumidi's fresco "The Four Seasons." The gathering includes White House officials, who set the agenda, along with HHS officials and aides to Hoyer, Senate Majority Leader Harry M. Reid (Nev.), House Minority Leader Nancy Pelosi (Calif.) and seven relevant committees.
During the regularly scheduled meeting June 24, Lambrew from the White House gave no hint that the administration might delay a requirement that businesses with more than 50 employees provide insurance. Instead, administration officials informed Reid, Pelosi, Hoyer, Baucus and Sen. Charles E. Schumer (D-N.Y.) by phone about a half-hour before the news became public eight days later.
One White House official blamed the secrecy on the climate of GOP hostility to the law. "It's very hard for a staffer to talk to a member of Congress about a decision that's not made yet," the official said.
Inside CMS, meanwhile, some staffers were aware by late 2012 that the work of building the federal exchange was lagging, according to a former HHS official — a much earlier timeline than has been previously disclosed. Some employees in the main office involved with building the exchange repeatedly warned at meetings late last year and in January that so many things were behind schedule that there would be no time for adequate "end to end" testing of how the moving parts worked together, the former HHS official said.
"People were just like, well . . . it's a dynamic we can't change," the former official said. "There wasn't a way to push back or challenge it up the line. You had the policy people, largely at the White House, pushing the deadlines and tinkering with the policy, rather than the people who had to run the critical operating path design and program the system."
By late summer, CMS officials were frustrated with CGI Federal, which repeatedly said that certain features of the exchange were ready when they were not, several officials said.
CGI was issuing warnings of its own. On Aug. 17, about six weeks before the launch date, a company employee sent an e-mail to a CMS staffer — with copies to more than a dozen other CMS staff members — detailing an "updated schedule" for work on the exchange. The e-mail, obtained by The Post, said that, for the tasks that CGI was responsible for, the exchange was 55 percent complete.
White House officials say they were focused on whether there would be enough insurance plans for sale in the new marketplaces and on whether enough people would enroll. They say they didn't have a clue how troubled the Web site's operation was.
Only during the weekend after HealthCare.gov's Oct. 1 opening did the president's aides begin to grasp the gravity of the problems, the White House official said. Obama soon began getting nightly updates on the performance of the Web site, which has still been unavailable to Americans for hours at a stretch over the past week.
But that was still to come. A month earlier, on Sept. 5, White House officials visited CMS for a final demonstration of HealthCare.gov. Some staff members worried that it would fail right in front of the president's aides. A few secretly rooted for it to fail so that perhaps the White House would wait to open the exchange until it was ready.
Yet on that day, using a simplified demonstration application, the Web site appeared to work just fine.
Obama came out and apologized tonight for the disaster that is his healthcare reform. Hilarious.
it appears the wife and I are going to save about $300 or more a month, with 'free' generic prescriptions and better coverage. no worries about pre-existing conditions or being dropped due to illness. total disaster.
Quote from: mbw on November 07, 2013, 11:42:37 PM
it appears the wife and I are going to save about $300 or more a month, with 'free' generic prescriptions and better coverage. no worries about pre-existing conditions or being dropped due to illness. total disaster.
No such thing as 'free' drugs.
Quote from: mbw on November 07, 2013, 11:42:37 PM
it appears the wife and I are going to save about $300 or more a month, with 'free' generic prescriptions and better coverage. no worries about pre-existing conditions or being dropped due to illness. total disaster.
Sounds awful to me.
Funny, I'm having the complete opposite experience. I'll be paying more for worse coverage. That wasn't even what I was referring to though. This roll out is embarrassing. One would think that our government would take pride in implementing what could have been one of the greatest advancements in our history. Instead, it's a mess and we're once again a laughing stock in the international community.
Quote from: antelope19 on November 08, 2013, 12:14:23 AM
Funny, I'm having the complete opposite experience. I'll be paying more with worse coverage. That wasn't even what I was referring to though. This roll out is embarrassing. One would think that our government would take pride in implementing what could have been one if the greatest advancements in our history. Instead, it's a mess and we're once again a laughing stock in the international community.
In terms of your personal experience, is that with your current plan or did you get a quote on healthcare.gov?
And one would think that, too bad there are so many politicians, well, a whole political party and its various minions, bought and paid for by mega corporations with a lot of $$ to lose, who want nothing more than for this to fail and nut their pants with every issue which arises, and have zero desire to help make it work. That is indeed very sad.
Quote from: mbw on November 08, 2013, 12:26:05 AM
Quote from: antelope19 on November 08, 2013, 12:14:23 AM
Funny, I'm having the complete opposite experience. I'll be paying more with worse coverage. That wasn't even what I was referring to though. This roll out is embarrassing. One would think that our government would take pride in implementing what could have been one if the greatest advancements in our history. Instead, it's a mess and we're once again a laughing stock in the international community.
In terms of your personal experience, is that with your current plan or did you get a quote on healthcare.gov?
And one would think that, too bad there are so many politicians, well, a whole political party and its various minions, bought and paid for by mega corporations with a lot of $$ to lose, who want nothing more than for this to fail and nut their pants with every issue which arises, and have zero desire to help make it work. That is indeed very sad.
For the record, I am 100% FOR healthcare reform. I think that changes needed to be made a long time ago.
I'm stating outright that this roll out is a disaster, and comes across as a joke to the rest of the world. That is all. If one party doesn't like it, or believe in it, why should they help? Just because you believe that this is the correct course of action, it doesn't make it so. This is their job. Would you help another company with their bid to get a job?
As for my own experience, I've explored both healthcare.gov AND the Maryland website. Neither provides an option that is "better" than our current plan options that would be more affordable. It's going to be painful, but I'm willing to pay a little more if it means that we, as a country, can move forward. But it's really difficult to compare experiences when healthcare law, prices, etc. vary so much from state to state.
Quote from: mbw on November 08, 2013, 12:26:05 AM
Quote from: antelope19 on November 08, 2013, 12:14:23 AM
Funny, I'm having the complete opposite experience. I'll be paying more with worse coverage. That wasn't even what I was referring to though. This roll out is embarrassing. One would think that our government would take pride in implementing what could have been one if the greatest advancements in our history. Instead, it's a mess and we're once again a laughing stock in the international community.
In terms of your personal experience, is that with your current plan or did you get a quote on healthcare.gov?
And one would think that, too bad there are so many politicians, well, a whole political party and its various minions, bought and paid for by mega corporations with a lot of $$ to lose, who want nothing more than for this to fail and nut their pants with every issue which arises, and have zero desire to help make it work. That is indeed very sad.
I'm pretty sure the pants nutting is a two way street here. Otherwise, we might have a workable solution. Instead, we have one very expensive political football game, played on an uneven field, with the cheers from the uncertain crowd directed mainly at the cheerleaders and confused about the task at hand.
Maybe I'm just a pessimist though.
Go Team!
Quote from: antelope19 on November 08, 2013, 12:14:23 AM
Funny, I'm having the complete opposite experience. I'll be paying more for worse coverage. That wasn't even what I was referring to though. This roll out is embarrassing. One would think that our government would take pride in implementing what could have been one of the greatest advancements in our history. Instead, it's a mess and we're once again a laughing stock in the international community.
Our system was even more laughable to the international community before the passage of the ACA. As for the ACA itself, what's 'laughable' to me isn't so much the subpar implementation, but the fact that we couldn't even get a public option included.
you contradict yourself. first you say:
Quote from: antelope19 on November 08, 2013, 12:14:23 AM
One would think that our government would take pride in implementing what could have been one of the greatest advancements in our history.
and they you say, why should our government take pride in it?!
Quote from: antelope19 on November 08, 2013, 12:45:13 AM
If one party doesn't like it, or believe in it, why should they help? Just because you believe that this is the correct course of action, it doesn't make it so. This is their job. Would you help another company with their bid to get a job?
your last sentence there is very telling of the problem, and your comparisons to companies. ours is, or at least was set up to be, "of, by and for the people." The first words of the constitution are "We the People".
All opposition to health care reform boils down to one thing, of course, corporate profits, not the welfare of our citizens. All that these insurance companies who are cancelling policies and jacking up rates are doing is exposing their evil even more, and it baffles me where some people choose to lay blame. All corporate money needs to be out of our government.
Which leads to this:
Quote from: ytowndan on November 08, 2013, 01:00:53 AM
Our system was even more laughable to the international community before the passage of the ACA. As for the ACA itself, what's 'laughable' to me isn't so much the subpar implementation, but the fact that we couldn't even get a public option included.
much less single payer.
Quote from: mbw on November 08, 2013, 01:22:52 AM
Quote from: ytowndan on November 08, 2013, 01:00:53 AM
Our system was even more laughable to the international community before the passage of the ACA. As for the ACA itself, what's 'laughable' to me isn't so much the subpar implementation, but the fact that we couldn't even get a public option included.
much less single payer.
Quote from: Winston ChurchillYou can always count on Americans to do the right thing - after they've tried everything else.
We'll get there one day. It would be ten times easier and twenty times faster if we got the money out of politics, as you mentioned above. If we had publicly-financed elections, many of our problems would be far easier to fix. But, that's a whole 'nuther can of worms.
Pretty awesome of Obama to admit that mistakes have been made in the implementation.
Stand up and admit that you aren't perfect.
That's how you lead. Why, I remember another former president who started a war that killed over a hundred thousand civilians and after the WMDs proof were disproven, he landed on an aircraft carrier near the war zone, boldly strode to the mic and apologized to the world with the words, "Mission Accomplished."
Wait.
So Obama tries to help Americans with what can only be a flawed system because he had to fight tooth and nail and compromise over ever paragraph and when a WEBSITE doesn't run smoothly he mans up and apologizes and he's still the worst guy ever but GWB isn't on trial for fucking war crimes?
This nation's sense of scale is fucked.
Quote from: rowjimmy on November 08, 2013, 08:27:48 AM
Pretty awesome of Obama to admit that mistakes have been made in the implementation.
Stand up and admit that you aren't perfect.
That's how you lead. Why, I remember another former president who started a war that killed over a hundred thousand civilians and after the WMDs proof were disproven, he landed on an aircraft carrier near the war zone, boldly strode to the mic and apologized to the world with the words, "Mission Accomplished."
Wait.
So Obama tries to help Americans with what can only be a flawed system because he had to fight tooth and nail and compromise over ever paragraph and when a WEBSITE doesn't run smoothly he mans up and apologizes and he's still the worst guy ever but GWB isn't on trial for fucking war crimes?
This nation's sense of scale is fucked.
I know that this is far from your point, but I'm pretty sure the "Mission Accomplished" photo-op was close to San Diego/Miramar... or maybe Pearl Harbor, but definitely in the Pacific, nowhere near the action. Which is the approporiate setting for a bullshit photo-op for a draft dodging fratboy cokehead. If you let him near the action, he might have caused real trouble, I mean if he was in a position to...
Wait...
Shit.
:shakehead:
Quote from: sunrisevt on November 08, 2013, 08:47:07 AM
Quote from: rowjimmy on November 08, 2013, 08:27:48 AM
Pretty awesome of Obama to admit that mistakes have been made in the implementation.
Stand up and admit that you aren't perfect.
That's how you lead. Why, I remember another former president who started a war that killed over a hundred thousand civilians and after the WMDs proof were disproven, he landed on an aircraft carrier near the war zone, boldly strode to the mic and apologized to the world with the words, "Mission Accomplished."
Wait.
So Obama tries to help Americans with what can only be a flawed system because he had to fight tooth and nail and compromise over ever paragraph and when a WEBSITE doesn't run smoothly he mans up and apologizes and he's still the worst guy ever but GWB isn't on trial for fucking war crimes?
This nation's sense of scale is fucked.
I know that this is far from your point, but I'm pretty sure the "Mission Accomplished" photo-op was close to San Diego/Miramar... or maybe Pearl Harbor, but definitely in the Pacific, nowhere near the action. Which is the approporiate setting for a bullshit photo-op for a draft dodging fratboy cokehead. If you let him near the action, he might have caused real trouble, I mean if he was in a position to...
Wait...
Shit.
:shakehead:
Really makes my point even stronger, don't you think?
Quote from: mbw on November 08, 2013, 01:22:52 AM
you contradict yourself. first you say:Quote from: antelope19 on November 08, 2013, 12:14:23 AM
One would think that our government would take pride in implementing what could have been one of the greatest advancements in our history.
and they you say, why should our government take pride in it?!
Quote from: antelope19 on November 08, 2013, 12:45:13 AM
If one party doesn't like it, or believe in it, why should they help? Just because you believe that this is the correct course of action, it doesn't make it so. This is their job. Would you help another company with their bid to get a job?
your last sentence there is very telling of the problem, and your comparisons to companies. ours is, or at least was set up to be, "of, by and for the people." The first words of the constitution are "We the People". All opposition to health care reform boils down to one thing, of course, corporate profits, not the welfare of our citizens. All that these insurance companies who are cancelling policies and jacking up rates are doing is exposing their evil even more, and it baffles me where some people choose to lay blame. All corporate money needs to be out of our government.
I think we mis-understood each other. I thought you were blaming the idiot republicans who are throwing up roadblocks as often as possible. I was saying that they're allowed to oppose the idea of healthcare reform. I may not agree with how they went about it though.
Quote from: rowjimmy on November 08, 2013, 08:27:48 AM
Pretty awesome of Obama to admit that mistakes have been made in the implementation.
Stand up and admit that you aren't perfect.
That's how you lead. Why, I remember another former president who started a war that killed over a hundred thousand civilians and after the WMDs proof were disproven, he landed on an aircraft carrier near the war zone, boldly strode to the mic and apologized to the world with the words, "Mission Accomplished."
Wait.
So Obama tries to help Americans with what can only be a flawed system because he had to fight tooth and nail and compromise over ever paragraph and when a WEBSITE doesn't run smoothly he mans up and apologizes and he's still the worst guy ever but GWB isn't on trial for fucking war crimes?
This nation's sense of scale is fucked.
Why does it always go back to Bush? That man was a terrible president.....He'll ultimately go down as one of the worst in our history. But that has absolutely nothing to do with the fact that our current administration underestimated what it was going to take to implement this new healthcare coverage. Yes, it is impressive that he came out and apologized and admitted his mistakes. I'll admit I let my frustrations get the best of me last night. I guess I am left wondering why roll out a rush job? So many of the states have opposed the exchanges. Why not take some extra time to get more people on board and do it right? This could have been a homerun and he could have been a hero. Instead, this is a going to be a struggle with no end in sight.
Quote from: mbw on November 08, 2013, 12:26:05 AM
And one would think that, too bad there are so many politicians, well, a whole political party and its various minions, bought and paid for by mega corporations with a lot of $$ to lose, who want nothing more than for this to fail and nut their pants with every issue which arises, and have zero desire to help make it work. That is indeed very sad.
You're deluding yourself if you think only one political party is beholden to "mega corporations." The ACA is a giveaway to health insurers, pharma, and device manufacturers (who will eventually get their way and repeal the taxes levied on them in the ACA).
Quote from: mbw on November 08, 2013, 01:22:52 AM
All opposition to health care reform boils down to one thing, of course, corporate profits, not the welfare of our citizens. All that these insurance companies who are cancelling policies and jacking up rates are doing is exposing their evil even more, and it baffles me where some people choose to lay blame. All corporate money needs to be out of our government.
Maybe you're just playing the obtuse card like KYJ likes to do, but surely you know that opposition to the law has a lot more to do than corporate profits. The law has never been more popular than less (http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html) (never even broke 45%). People have never trusted the gov't to be able to do such a massive and complex overhaul of 15% of the country's economy. People feared there would be unintended consequences which were not understood and would be far more costly than imagined. People don't like being told they have to purchase a contract from a private company. There are literally 100s of reasons why people opposed the ACA, none of which having the least to do with corporate profits.
The bit about how it's the insurer's fault is rich, too.
Quote from: rowjimmy on November 08, 2013, 08:27:48 AM
Pretty awesome of Obama to admit that mistakes have been made in the implementation.
Stand up and admit that you aren't perfect.
But not until you are caught. And then stall and obfuscate and revise prior statements until you absolutely can't anymore.
ETA: he wasn't admitting that mistakes had been made in implementation, he was apologizing for lying - repeatedly - for 3 years about his famed "if you like your plan you can keep your plan. Period." line. What it morphed into during the course of the interview, however, is probably something completely different.
Quote from: rowjimmy on November 08, 2013, 08:27:48 AM
That's how you lead. Why, I remember another former president who started a war that killed over a hundred thousand civilians and after the WMDs proof were disproven, he landed on an aircraft carrier near the war zone, boldly strode to the mic and apologized to the world with the words, "Mission Accomplished."
Wait.
So Obama tries to help Americans with what can only be a flawed system because he had to fight tooth and nail and compromise over ever paragraph and when a WEBSITE doesn't run smoothly he mans up and apologizes and he's still the worst guy ever but GWB isn't on trial for fucking war crimes?
This nation's sense of scale is fucked.
Pretty sure I remember GWB being excoriated for the Mission Accomplished, even to this day. And rightly so.
Quote from: antelope19 on November 08, 2013, 09:32:39 AM
Why does it always go back to Bush? That man was a terrible president.....He'll ultimately go down as one of the worst in our history. But that has absolutely nothing to do with the fact that our current administration underestimated what it was going to take to implement this new healthcare coverage. Yes, it is impressive that he came out and apologized and admitted his mistakes. I'll admit I let my frustrations get the best of me last night. I guess I am left wondering why roll out a rush job? So many of the states have opposed the exchanges. Why not take some extra time to get more people on board and do it right? This could have been a homerun and he could have been a hero. Instead, this is a going to be a struggle with no end in sight.
They didn't underestimate it: they deliberatly slowed development of the website and critical regulations because they were scared the big bully Repoublicans were going to use it against them in the 2012 election (http://www.washingtonpost.com/politics/challenges-have-dogged-obamas-health-plan-since-2010/2013/11/02/453fba42-426b-11e3-a624-41d661b0bb78_story.html). And now they are paying the consequences of that inaction. And rightly so.
I agree with you it should have been delayed. THAT would have been leadership. Apologizing for fucking it up and promising to fix it is, at best, incompetnece. It's like Andy Reid saying "I gotta do a better job there" after he passes 80% of the time for the 600th straight game. Fucking Andy Reid.
It goes back to Bush because the same assholes who are all melty over a WEBSITE gave that guy a free pass on the slaughter of over a hundred thousand people.
Let me be clear:
THE SLAUGHTER OF OVER A HUNDRED THOUSAND PEOPLE
Really? The Tea Party caucus are the same people as Bush?
Bush is the poster boy for big government conservatives among the small government conservatives.
Quote from: rowjimmy on November 08, 2013, 09:55:01 AM
It goes back to Bush because the same assholes who are all melty over a WEBSITE gave that guy a free pass on the slaughter of over a hundred thousand people.
Of course, you know it's about much more than just a WEBSITE. The website is merely the embodiment of an unpopular and poorly designed law.
Then again, I'm all melty about "the website" AND I think Bush is an asshole for the slaughter of over a hundred thousand people. Then again, I also think a Nobel Peace prize winner shouldn't say things like "I'm pretty good at killing people (http://washington.cbslocal.com/2013/11/03/book-alleges-obama-told-aides-about-drone-strikes-im-really-good-at-killing-people/)," even if it's in jest. But hey, that's just me.
Quote from: nab on November 08, 2013, 10:03:53 AM
Really? The Tea Party caucus are the same people as Bush?
Bush is the poster boy for big government conservatives among the small government conservatives.
First let me say that I agree with RJ 100% here. You have to remember that the Tea Party was not even really around during the Bush II years. There were some people maybe trending that way, but they weren't even a real movement until 2009. The overwhelming majority of Tea Partiers did vote for Bush, because they were just thought of as conservatives prior to the movement. So in a way, yeah they are the same people as Bush.
On a second note, I read an article the other day talking about Bush now that he's no longer president. Other than his new love for painting, they basically said he spends time with his dad privately worrying that the Tea Party is going to ruin his party... He's very much correct.
Quote from: aphineday on November 08, 2013, 10:18:41 AM
First let me say that I agree with RJ 100% here. You have to remember that the Tea Party was not even really around during the Bush II years. There were some people maybe trending that way, but they weren't even a real movement until 2009. The overwhelming majority of Tea Partiers did vote for Bush, because they were just thought of as conservatives prior to the movement. So in a way, yeah they are the same people as Bush.
That's true. Hey, what was the catalyst that spawned the Tea Party? Probably something about corporate profits.
Pretty sure the Tea Party is an astroturfed "movement" spurred by conservatives and bigots trying to make sure their oil dollars and religious nutbag ideals are in control.
Quote from: rowjimmy on November 08, 2013, 10:52:23 AM
Pretty sure the Tea Party is an astroturfed "movement" spurred funded by billionaire conservatives and bigots trying to make sure their oil dollars and religious nutbag ideals are in control.
Fyp.
Quote from: rowjimmy on November 08, 2013, 10:52:23 AM
Pretty sure the Tea Party is an astroturfed "movement" spurred by conservatives and bigots trying to make sure their oil dollars and religious nutbag ideals are in control.
George Soros says LOL
Quote from: runawayjimbo on November 08, 2013, 10:57:14 AM
Quote from: rowjimmy on November 08, 2013, 10:52:23 AM
Pretty sure the Tea Party is an astroturfed "movement" spurred by conservatives and bigots trying to make sure their oil dollars and religious nutbag ideals are in control.
George Soros says LOL
Truth can be funny.
Quote from: rowjimmy on November 08, 2013, 11:05:04 AM
Quote from: runawayjimbo on November 08, 2013, 10:57:14 AM
Quote from: rowjimmy on November 08, 2013, 10:52:23 AM
Pretty sure the Tea Party is an astroturfed "movement" spurred by conservatives and bigots trying to make sure their oil dollars and religious nutbag ideals are in control.
George Soros says LOL
Truth can be funny.
Exactly.
Tea Party, LOL.
Dirty money at the top of the political world is a problem that no one but the beneficiaries of the practice supports.
Its as pervasive and as old a problem as the imbalance between number of idea people and the number of apologists on either side of the political spectrum.
Quote from: antelope19 on November 08, 2013, 12:14:23 AM
Funny, I'm having the complete opposite experience. I'll be paying more for worse coverage. That wasn't even what I was referring to though. This roll out is embarrassing. One would think that our government would take pride in implementing what could have been one of the greatest advancements in our history. Instead, it's a mess and we're once again a laughing stock in the international community.
I contend that this issue is largely independent of ACA. For years, there hasn't been enough money. Reimbursement to docs and hospitals is going up less than inflation or going down (for the same procedure), but utilization has been going up. Drug prices are going up, and technology prices are going up. The cost of doing business is going up (I suspect the medical software industry is doing quite well, despite the fact that the products suck). Insurance premiums have been going up for years despite trying to find ways to reduce costs.
and yes, the rollout was well beyond a disaster. I respect BO for apologizing (sort of) but he should have never let this happen. A total fuck up beyond fuck ups
We need old people to start dying quickly, and STAT.
Quote from: mbw on November 07, 2013, 11:42:37 PM
it appears the wife and I are going to save about $300 or more a month, with 'free' generic prescriptions and better coverage. no worries about pre-existing conditions or being dropped due to illness. total disaster.
Wait, you're married, T?
Quote from: runawayjimbo on November 10, 2013, 12:34:57 AM
Quote from: mbw on November 07, 2013, 11:42:37 PM
it appears the wife and I are going to save about $300 or more a month, with 'free' generic prescriptions and better coverage. no worries about pre-existing conditions or being dropped due to illness. total disaster.
Wait, you're married, T?
Yes sir. Still waiting for your gift. Oh, and I will get to some of your previous BS, I just need to get a bigger shovel. :lol:
Quote from: mbw on November 10, 2013, 12:58:27 AM
Quote from: runawayjimbo on November 10, 2013, 12:34:57 AM
Quote from: mbw on November 07, 2013, 11:42:37 PM
it appears the wife and I are going to save about $300 or more a month, with 'free' generic prescriptions and better coverage. no worries about pre-existing conditions or being dropped due to illness. total disaster.
Wait, you're married, T?
Yes sir. Still waiting for your gift. Oh, and I will get to some of your previous BS, I just need to get a bigger shovel. :lol:
Bulldozer
Congrats. Gift is in the mail.
This Tweezer
The website sucks because the US government by and large thinks the internet is a series of tubes that can get clogged and thus doesn't know the first thing about hiring a competent contractor to a build a gargantuan site.
It really has nothing to do with the ACA program itself, it's a systematic failure on the part of the way these types of projects are awarded and executed.
Quote from: Hicks on November 10, 2013, 01:39:52 AM
The website sucks because the US government by and large thinks the internet is a series of tubes that can get clogged and thus doesn't know the first thing about hiring a competent contractor to a build a gargantuan site.
It really has nothing to do with the ACA program itself, it's a systematic failure on the part of the way these types of projects are awarded and executed.
Bullshit, the liberals knew that this would happen; Obama created Obamacare so he could trick all of us into giving up our guns.
Quote from: runawayjimbo on November 08, 2013, 09:54:52 AM
The bit about how it's the insurer's fault is rich, too.
rich, good choice of words. well, nothing i can say that isn't said better here by my favorite news source........ Fox News!?! :crazy:
Insurance cancelled? Don't blame Obama or the ACA, blame America's insurance companies (http://www.foxnews.com/opinion/2013/11/05/insurance-cancelled-dont-blame-obama-or-aca-blame-america-insurance-companies/)
QuoteThe fact is if you are one of the estimated 2 million Americans whose health insurance plans may have been cancelled this month, you should not be blaming President Obama or the Affordable Care Act.
You should be blaming your insurance company because they have not been providing you with coverage that meets the minimum basic standards for health care.
Let me put it more bluntly: your insurance companies have been taking advantage of you and the Affordable Care Act puts in place consumer protection and tells them to stop abusing people.
The government did not "force" insurance companies to cancel their own substandard policies.The insurance companies chose to do that rather than do what is right and bring the policies up to code.
This would be like saying the government "forces" chemical companies to dispose of toxic waste safely rather than dumping it in the river.
Or the government "forces" people to drive with intact windshields and working brake lights.
How dare they "force" drivers to pay money to get those things fixed if they are broken?
Quote from: runawayjimbo on November 08, 2013, 09:54:52 AM
Quote from: mbw on November 08, 2013, 12:26:05 AM
And one would think that, too bad there are so many politicians, well, a whole political party and its various minions, bought and paid for by mega corporations with a lot of $$ to lose, who want nothing more than for this to fail and nut their pants with every issue which arises, and have zero desire to help make it work. That is indeed very sad.
You're deluding yourself if you think only one political party is beholden to "mega corporations." The ACA is a giveaway to health insurers, pharma, and device manufacturers (who will eventually get their way and repeal the taxes levied on them in the ACA).
I of course know that 'both' political parties are beholden to these companies, and that it is a handout to these companies in terms of the sheer number of customers it will bring them. However, the added risk and policy improvements they are being forced to include are the reason they are fighting it. I know you know this, you just love defending this profit above all else system.
Quote from: runawayjimbo on November 08, 2013, 09:54:52 AM
Quote from: mbw on November 08, 2013, 01:22:52 AM
All opposition to health care reform boils down to one thing, of course, corporate profits, not the welfare of our citizens. All that these insurance companies who are cancelling policies and jacking up rates are doing is exposing their evil even more, and it baffles me where some people choose to lay blame. All corporate money needs to be out of our government.
Maybe you're just playing the obtuse card like KYJ likes to do, but surely you know that opposition to the law has a lot more to do than corporate profits. The law has never been more popular than less (http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html) (never even broke 45%). People have never trusted the gov't to be able to do such a massive and complex overhaul of 15% of the country's economy. People feared there would be unintended consequences which were not understood and would be far more costly than imagined. People don't like being told they have to purchase a contract from a private company. There are literally 100s of reasons why people opposed the ACA, none of which having the least to do with corporate profits.
Maybe your not a soulless demon and you just like playing one for debate, surely you know I was talking about political/corporate opposition to this bill. You know, $$. You then talk about citizens opposition to the bill, which is a totally different subject. High polls numbers opposing this have been around before anyone even knew what the law would be, and this law ps just barely started to be implemented. Why? Barack Hussein Obama, that's why. I can't think of a another piece of legislation which has been up against such a smear campaign full of lies and disinformation, funded and fueled by mega-rich who cant stand being a little bit less mega rich, especially when it is being done to them by a black guy. When citizens are polled on the ACA the numbers are significantly different depending on if they were asked about the 'Affordable Care Act', or whether they were asked about 'Obamacare.'
http://politix.topix.com/homepage/8159-poll-more-people-against-obamacare-than-affordable-care-act
And when polled on individual policy changes included in the bill people want them. (http://www.theguardian.com/commentisfree/2012/jun/26/obamacare-healthcare-reform-americans-want) They don't even know what they're opposing. The opposition has not been, 'The website won't work! (which has worked perfectly fine every time I have been on it), or, "My shitty policy might be cancelled and I will be forced to get a better one!" ... It has been "Obama is a Socialist(but I don't know what that even means, it's just bad) Muslim Terrorist who is trying to destroy 'Murica!" There is a very good reason the name was methodically and relentlessly changed to Obamacare by its political opposition. To keep keep that name fresh in people's minds so they will oppose it. Its just blatant scare tactics which feed on racism and ignorance. Period.
(http://upload.wikimedia.org/wikipedia/commons/4/41/Washington,_D.C._-_Tea_Bag_Protest.jpg)
(http://bloggingblue.com/wp-content/uploads/2009/09/Obamacare_Child.png?6b854b)
(http://ivoter.com/wp-content/uploads/2013/08/616px-Obama-Nazi_comparison_-_Tea_Party_protest.jpg)
(http://media.salon.com/2012/03/obamacare.jpg)
(http://blogs-images.forbes.com/kenrapoza/files/2012/11/300x1941111.jpg)
(http://transitionvoice.com/wp-content/uploads/2011/06/Tea-Party-arrogant-Kenyan-Flickr-Fibonacci-Blue.jpg)
So being out of work I'm looking around at my options and it looks like I can buy a personal plan with a $500 deductible and $5000 out of pocket max for $258 a month.
That seems pretty reasonable.
Admittedly I've always had employer healthcare before, but it seems to me that the prices are in fact dropping as a a result of the ACA.
That's a pretty big step in the right direction.
Quote from: Hicks on November 10, 2013, 01:39:52 AM
The website sucks because the US government by and large thinks the internet is a series of tubes that can get clogged and thus doesn't know the first thing about hiring a competent contractor to a build a gargantuan site.
It really has nothing to do with the ACA program itself, it's a systematic failure on the part of the way these types of projects are awarded and executed.
This idea that the exchanges are somehow unrelated to the functioning of the law is really bizarre to me. There are only two truly fundamental reforms to the health care market: (1) the individual mandate and (2) the exchanges (because if they're gonna require people have insurance, they have to make it easy for people to get it; otherwise the tax for not having coverage would be a straight up jack (you know, more so than usual)). The other "reforms" are extensions of existing law (e.g., Medicaid expansion) or rule changes (some very important ones, to be sure) governing the way insurers do business. But it's exchanges are one of the only changes in the way health insurance is bought, and as such they are arguably the most critical component of the law's eventual success or failure.
It was the administration's decision to make the exchanges an online platform, like Amazon or eBay, as the president was fond of saying. They could have chosen plenty of different ways to set the exchanges up: they could have made them physical locations, with trained staff to talk people through their options; they could have done direct mail marketing, with people sent preliminary information on various plans and a number to call (think of all those refinance offers that used to come when rates were 100bps lower). But the administration, who used technology so successfully in two campaigns, decided to go with a website.
I totally agree with you that the failure with the website can be attributed at least in part in the way that gov't contracts are procured. But I don't think that is the prevailing reason for the failure and I certainly don't think it makes sense to dismiss the importance of the exchanges as "just a website."
Quote from: mbw on November 10, 2013, 03:17:58 PM
Quote from: runawayjimbo on November 08, 2013, 09:54:52 AM
The bit about how it's the insurer's fault is rich, too.
rich, good choice of words. well, nothing i can say that isn't said better here by my favorite news source........ Fox News!?! :crazy:
Insurance cancelled? Don't blame Obama or the ACA, blame America's insurance companies (http://www.foxnews.com/opinion/2013/11/05/insurance-cancelled-dont-blame-obama-or-aca-blame-america-insurance-companies/)
QuoteThe fact is if you are one of the estimated 2 million Americans whose health insurance plans may have been cancelled this month, you should not be blaming President Obama or the Affordable Care Act.
You should be blaming your insurance company because they have not been providing you with coverage that meets the minimum basic standards for health care.
Let me put it more bluntly: your insurance companies have been taking advantage of you and the Affordable Care Act puts in place consumer protection and tells them to stop abusing people.
The government did not "force" insurance companies to cancel their own substandard policies.The insurance companies chose to do that rather than do what is right and bring the policies up to code.
This would be like saying the government "forces" chemical companies to dispose of toxic waste safely rather than dumping it in the river.
Or the government "forces" people to drive with intact windshields and working brake lights.
How dare they "force" drivers to pay money to get those things fixed if they are broken?
Of all the arguments made by the law's supporters, this "the ACA didn't cancel your plan, the insurance company did" is one of the most cynical, condescending, blatantly deceptive one's I've heard. It's been trumpted by the WH's offical spokespeople like Valerie Jarrett and Jay Carney for a while now (well, not a while, since people started receiving cancellation notices), and now it's being repeated by the unofficial spokespeople like NYT and MSNBC and yes, in an opinion column on Fox News by Juan Williams. There's spin, and then there's bullshit, and this idea is complete and utter bullshit.
Quote from: mbw on November 10, 2013, 03:17:58 PM
Quote from: runawayjimbo on November 08, 2013, 09:54:52 AM
Quote from: mbw on November 08, 2013, 12:26:05 AM
And one would think that, too bad there are so many politicians, well, a whole political party and its various minions, bought and paid for by mega corporations with a lot of $$ to lose, who want nothing more than for this to fail and nut their pants with every issue which arises, and have zero desire to help make it work. That is indeed very sad.
You're deluding yourself if you think only one political party is beholden to "mega corporations." The ACA is a giveaway to health insurers, pharma, and device manufacturers (who will eventually get their way and repeal the taxes levied on them in the ACA).
I of course know that 'both' political parties are beholden to these companies, and that it is a handout to these companies in terms of the sheer number of customers it will bring them. However, the added risk and policy improvements they are being forced to include are the reason they are fighting it. I know you know this, you just love defending this profit above all else system.
But health insurers are not opposing it. Neither is pharma. The device manufacturers may be mainly because of the tax on them (don't worry, Elizabeth Warren has been pushing relentlessly since she was elected to have this repealed) or perhaps because they believe that the law will reduce the demand for their products (because if HHS can dictate whether or not your plan is "substandard" they clearly can dictate whether you need an MRI or an X-ray). But the device lobby is far less powerful the health insurers and pharma, so it'll take them longer to get what they want. But be clear, insurers are NOT pushing back against the law. They are speaking out that enrollment problems associated with "just a website" could lead to significant ramifications, like insurers pulling out of exchanges/markets or rapid rate increases next year if only high cost patients are added. But they are not now, nor have they ever, opposed the full implementation of the law, which, as we agree, would benefit them substantially by mandating 315M+ captive customers.
As for your last bit, I guess you are saying that since I oppose the law, I am either a racist or I'm too stupid to see that I am being manipulated by right-wing billionaires. Thanks for the tip. Got it.
Quote from: Hicks on November 10, 2013, 10:10:45 PM
So being out of work I'm looking around at my options and it looks like I can buy a personal plan with a $500 deductible and $5000 out of pocket max for $258 a month.
That seems pretty reasonable.
Admittedly I've always had employer healthcare before, but it seems to me that the prices are in fact dropping as a a result of the ACA.
That's a pretty big step in the right direction.
Your experience does not a trend make. According to an analysis by the conservative Manhattan Institute (
obviously skewed), premiums will increase in 41 states (http://www.forbes.com/sites/theapothecary/2013/11/04/49-state-analysis-obamacare-to-increase-individual-market-premiums-by-avg-of-41-subsidies-flow-to-elderly/) (see below). But even the liberal Brookings Institution has admitted, "well, we don't know what the effects will be (http://www.brookings.edu/research/opinions/2013/09/12-health-insurance-obamacare-affordable-kocot)." I think are both acceptable answers: rates will go up, as expected, because more services are mandated (not sure why the WH would try to deny this; you don't get drugs for free); and we don't know what the long-term effect on rates will be because it will depend on how many young & healthy customers sign up and stay in the system. If there are not enough healthy customers to subsidize those who need expensive treatments, the law will undoubtedly collapse. That is an actuarial certainty. But, if they can get enough of a healthy cohort enrolled, it could help reduce rates (temporarily, at least). Coincidentally, that's why at least a few of the ACA regs are in direct contradiction with each other: allowing "kids" to stay on their parent's insurance until 26 may sound like a good idea, but you are losing a lot of young healthy customers who would otherwise be paying into the system; by guaranteeing coverage for people with pre-existing condition, while a noble and worthy aim, you are explicitly putting higher cost individuals into the system, which will need to be offset by healthier individuals, otherwise health care spending and premiums will go up.
To me, the biggest failing of the law is that it equates "health care security" (as Sebelius likes to say) with health insurance attainability, even though there is little impact on health outcomes for people with insurance vs. those without (http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/01/study-medicaid-reduces-financial-hardship-doesnt-quickly-improve-physical-health/?wprss=rss_ezra-klein). It doesn't reduce health care spending, it doesn't "bend the cost curve downward," and it only furthers the opacity in health care pricing that contribute to higher costs. As I've said before, although I don't support single payer, that's a true health care reform. But that's not what we got, so there's no point debating the potential merits of that (at least not in a discussion about the law as crafted). What we got was a more centralized version of the current shitty system, so I don't know why we would expect any different results. Whether that's the fault of the GOP for opposing it or the president's fault for not pushing harder for it really doesn't matter to me. We can only talk about what is on the table now and to me, it doesn't look very good. But it will take some time for the true costs of the law to make their way into the system, and only then will we know whether or not it was a success.
(http://b-i.forbesimg.com/theapothecary/files/2013/11/Rate-map-3-27-40-67.png)
Quote from: runawayjimbo on November 11, 2013, 09:43:42 AM
Quote from: mbw on November 10, 2013, 03:17:58 PM
Quote from: runawayjimbo on November 08, 2013, 09:54:52 AM
The bit about how it's the insurer's fault is rich, too.
rich, good choice of words. well, nothing i can say that isn't said better here by my favorite news source........ Fox News!?! :crazy:
Insurance cancelled? Don't blame Obama or the ACA, blame America's insurance companies (http://www.foxnews.com/opinion/2013/11/05/insurance-cancelled-dont-blame-obama-or-aca-blame-america-insurance-companies/)
QuoteThe fact is if you are one of the estimated 2 million Americans whose health insurance plans may have been cancelled this month, you should not be blaming President Obama or the Affordable Care Act.
You should be blaming your insurance company because they have not been providing you with coverage that meets the minimum basic standards for health care.
Let me put it more bluntly: your insurance companies have been taking advantage of you and the Affordable Care Act puts in place consumer protection and tells them to stop abusing people.
The government did not "force" insurance companies to cancel their own substandard policies.The insurance companies chose to do that rather than do what is right and bring the policies up to code.
This would be like saying the government "forces" chemical companies to dispose of toxic waste safely rather than dumping it in the river.
Or the government "forces" people to drive with intact windshields and working brake lights.
How dare they "force" drivers to pay money to get those things fixed if they are broken?
Of all the arguments made by the law's supporters, this "the ACA didn't cancel your plan, the insurance company did" is one of the most cynical, condescending, blatantly deceptive one's I've heard. It's been trumpted by the WH's offical spokespeople like Valerie Jarrett and Jay Carney for a while now (well, not a while, since people started receiving cancellation notices), and now it's being repeated by the unofficial spokespeople like NYT and MSNBC and yes, in an opinion column on Fox News by Juan Williams. There's spin, and then there's bullshit, and this idea is complete and utter bullshit.
I was of the understanding that noncompliant plans got cancelled only if they had been changed after the implementation of the ACA. Plans left untouched but nonetheless at odds with the law were to be grandfathered in. That's what Obama meant by "if you like your plan you get to keep it" correct? (Not that he shouldn't have anticipated what would have happened and gotten out in front of that. Egg on his face for failing to do so.)
So in effect, it's true: the insurance company changed your plan to something that they should have known wouldn't meet the standard of the ACA. They could have left it as-is and you'd be fine. So how does the insurance company not bear some (or all) responsibility for your plan being cancelled? But this does raise the question: Why would an insurance company change your plan to one that they'd then have to cancel? Possibly to give them an excuse to kick you off the plan and then sell you something more expensive?
edit: spelling..
Quote from: runawayjimbo on November 11, 2013, 09:43:42 AM
As for your last bit, I guess you are saying that since I oppose the law, I am either a racist or I'm too stupid to see that I am being manipulated by right-wing billionaires. Thanks for the tip. Got it.
C'mon. I know its not as simple as those 2 reasons. There is a 3rd, of course: Having great coverage and not giving a fuck about anyone else. It's the Ron Paul way. What's his solution for the poor and uninsured? Oh yeah, doctors to magically treat people for free out of the goodness of their hearts.
Quote from: V00D00BR3W on November 11, 2013, 10:50:49 AM
Quote from: runawayjimbo on November 11, 2013, 09:43:42 AM
Quote from: mbw on November 10, 2013, 03:17:58 PM
Quote from: runawayjimbo on November 08, 2013, 09:54:52 AM
The bit about how it's the insurer's fault is rich, too.
rich, good choice of words. well, nothing i can say that isn't said better here by my favorite news source........ Fox News!?! :crazy:
Insurance cancelled? Don't blame Obama or the ACA, blame America's insurance companies (http://www.foxnews.com/opinion/2013/11/05/insurance-cancelled-dont-blame-obama-or-aca-blame-america-insurance-companies/)
QuoteThe fact is if you are one of the estimated 2 million Americans whose health insurance plans may have been cancelled this month, you should not be blaming President Obama or the Affordable Care Act.
You should be blaming your insurance company because they have not been providing you with coverage that meets the minimum basic standards for health care.
Let me put it more bluntly: your insurance companies have been taking advantage of you and the Affordable Care Act puts in place consumer protection and tells them to stop abusing people.
The government did not “force” insurance companies to cancel their own substandard policies.The insurance companies chose to do that rather than do what is right and bring the policies up to code.
This would be like saying the government “forces” chemical companies to dispose of toxic waste safely rather than dumping it in the river.
Or the government “forces” people to drive with intact windshields and working brake lights.
How dare they “force” drivers to pay money to get those things fixed if they are broken?
Of all the arguments made by the law's supporters, this "the ACA didn't cancel your plan, the insurance company did" is one of the most cynical, condescending, blatantly deceptive one's I've heard. It's been trumpted by the WH's offical spokespeople like Valerie Jarrett and Jay Carney for a while now (well, not a while, since people started receiving cancellation notices), and now it's being repeated by the unofficial spokespeople like NYT and MSNBC and yes, in an opinion column on Fox News by Juan Williams. There's spin, and then there's bullshit, and this idea is complete and utter bullshit.
I was of the understanding that noncompliant plans got cancelled only if they had been changed after the implementation of the ACA. Plans left untouched but nonetheless at odds with the law were to be grandfathered in. That's what Obama meant by "if you like your plan you get to keep it" correct? (Not that he shouldn't have anticipated what would have happened and gotten out in front of that. Egg on his face for failing to do so.)
So in effect, it's true: the insurance company changed your plan to something that they should have known wouldn't meet the standard of the ACA. They could have left it as-is an you'd be fine. So how does the insurance company not bear some (or all) responsibility for your plan being cancelled? But this does raise the question: why would an insurance company change your plan to one that they'd then have to cancel? Possibly to give them an excuse to kick you off the plan and then sell you something more expensive?
That would be fine, but for the fact that regulations written by HHS were designed specifically to make sure very few (if any) plans retained grandfathered status. A plan undergoes various changes (some cosmetic, some more overarching) from year to year let alone over the course of several years. Has your copay gone up in the past 3 years? Any changes to benefits provided? Did your plan change the formulary to charge more for brand name and less for generic drugs? Guess what, there goes your grandfathered status. Insurers will almost always make changes to plans based on new data, competitive analysis, strategic positioning. Expecting a plan to be virtually identical to one that was bought in 2010 is, IMO, not only unreasonable, it is willfully dishonest (as the NBC article you posted which showed that they did in fact know that this would happen). Also, if you can find me a single occasion where Obama used the "if you like your plan, you can keep it" with the all-important caveat "as long as they don't make changes to it" from any point before last week, I will eat a flaming pile of dogshit.
The insurance companies are cancelling plans because the ACA changed the rules and they are no longer allowed to offer those plans. Period. This was by design, and not some unintended consequence that lawmakers didn't see coming (despite what Mary Landrieu says as she tries to amend the law to allow any plan to continued being offered). But hey, these are HHS rules right, so if the administration is so outraged over this development, why not just have HHS set new rules to allow more plans to be grandfathered? Oh no, that would never work.
ETA:
Quote from: mbw on November 11, 2013, 11:04:26 AM
Quote from: runawayjimbo on November 11, 2013, 09:43:42 AM
As for your last bit, I guess you are saying that since I oppose the law, I am either a racist or I'm too stupid to see that I am being manipulated by right-wing billionaires. Thanks for the tip. Got it.
C'mon. I know its not as simple as those 2 reasons. There is a 3rd, of course: Having great coverage and not giving a fuck about anyone else. It's the Ron Paul way. What's his solution for the poor and uninsured? Oh yeah, doctors to magically treat people for free out of the goodness of their hearts.
So now I'm a racist moron who doesn't know what's good for him AND I don't give a fuck about anyone else. Thanks for clearing that up.
PS - how do know whether or not my coverage is "great?"
Credit where credit is due, this is the post of one of my friends who works in hospital adiministration:
"So one of the big things going through the news right now is the story about people losing their current health insurance because it's not "Obamacare approved", and how Obama is breaking his promise and how "Some people don't want a Cadillac, some people want a Ford.
1) These standards were published in the legislation years ago. Plans would be grandfathered in if they were close enough, and some plans weren't if they didn't measure up. If you're surprised and shocked, SHOCKED by this now, you haven't been paying attention.
2) This isn't the difference between a Cadillac and a Ford, or maybe it is, but the people losing their plans are not driving Tauruses, or even Fiestas. If they're in a Ford, it's a Model T. These plans have low premiums, but almost no benefits. The will pay a flat amount TOWARDS a doctor visit and TOWARDS a few services, but not much else. To continue the car metaphor, they don't have seat belts, windshield wipers, windshields, turn signals, or anything like that. The benchmark set by the ACA set minimum standards that plans need to meet, and don't pretend that this is unheard of because it's done in literally every other industry that legally operates in this country."
Fair enough counterpoints, Jimbo. And no, I can't recall ever hearing Obama tack on that caveat when selling/defending the ACA on the stump. And shame on him/the administration for either not fully knowing what would happen or not being forthright with us about it. That's a big hit to the ol' credibility there, for sure.
Quote from: V00D00BR3W on November 11, 2013, 12:49:45 PM
Fair enough counterpoints, Jimbo. And no, I can't recall ever hearing Obama tack on that caveat when selling/defending the ACA on the stump. And shame on him/the administration for either not fully knowing what would happen or not being forthright with us about it. That's a big hit to the ol' credibility there, for sure.
The administration wasn't even sure his it would work. They had ideas, but that's all they were. With something on this scale is not logical to assume that the rollout would be completely without issue.
Here's a shock: the administration wasn't completely transparent about what was happening. That's something the Obama administration has gotten away from that makes me fume. Bush II, Clinton, Bush, Reagan (go as far as you like); they've all been overwhelmingly transparent. Oh wait...
I agree that I'd like the climate to change, but while bullshit like Citizens United still rules the day, we aren't going to change that. The parties only matter to an extent, and I'll continue to vote for the lesser of the evils. Period. I love Jill Stein, but I'm not deluded enough to think she has a shot. I'll go ahead and put a sock in the "well if you don't vote, it can't happen" bullshit right now. You want true change? Kick the money out.
Sure I'm a data point of one, but this is a health insurance plan that anyone could buy on the open market. I'm no different than anyone else.
If health insurance premiums have actually gone up by 40% in my state that would mean you could buy a $500 deductible, $5000 out of pocket max plan for $184 a month before?
LOL.
Quote from: aphineday on November 11, 2013, 12:45:00 PM
1) These standards were published in the legislation years ago. Plans would be grandfathered in if they were close enough, and some plans weren't if they didn't measure up. If you're surprised and shocked, SHOCKED by this now, you haven't been paying attention.
The regs were not in the legislation; they were issued by HHS sometime after the passage of the law. And while those in the health care industry (like your friend) have obviously been paying attention, most people probably haven't. So your buddy's response, which seems to be "tough shit for being too stupid to understand" doesn't really do much for the obviously stupid person who just received a cancellation notice after being told 37 times by the president alone that "if they liked your plan, you can keep your plan. Period."
Quote from: aphineday on November 11, 2013, 12:45:00 PM
2) This isn't the difference between a Cadillac and a Ford, or maybe it is, but the people losing their plans are not driving Tauruses, or even Fiestas. If they're in a Ford, it's a Model T. These plans have low premiums, but almost no benefits. The will pay a flat amount TOWARDS a doctor visit and TOWARDS a few services, but not much else. To continue the car metaphor, they don't have seat belts, windshield wipers, windshields, turn signals, or anything like that. The benchmark set by the ACA set minimum standards that plans need to meet, and don't pretend that this is unheard of because it's done in literally every other industry that legally operates in this country."
The car metaphor makes zero sense. First, the proximate cause of injury to oneself or others from driving a car without the safety features that are federally mandated are obvious: driving without a windshield or a seat belt (I can't believe I'm even typing that, as if that automakers would suddenly start selling cars without safety features but for the infinite wisdom of our federal benefactors) is profoundly dangerous. However, as the Oregon study I posted above makes clear, having insurance does not correlate with better health outcomes (at least in the early returns from the only controlled study available). Same goes for stupid Juan Williams' "companies dumping toxic waste" nonsense: federal regs protecting people from being harmed by no fault of their own (valid function of gov't) is not the same thing as ACA regs preventing insurance companies from offering something that people deem to be in the best interest of them or their family. Did I mention that those "Ford Model-T's" are already extensively regulated by the states? That these junk policies that are obviously so deficient they should be regulated out of existence were approved by state regulators who are far more familiar with the wants and needs of the people in their state than the federal gov't is? Oh never mind.
Finally, the minimum standards set by the ACA is hardly equivalent to those on "every other industry that legally operates in this country." In no other industry (that I know of) does the federal gov't dictate how much of a private company's revenue needs to go to its cost of goods sold (medical loss ratio requirement). In no other industry does the federal gov't specify the rules for pricing a product (community rating; 3:1 age bands). And in no other industry does the federal gov't say you cannot refuse a customer (guaranteed issue). Well, that last one's not entirely true: the Community Reinvestment Act stipulated how much of Fannie & Freddie's book had to be allocated to sub-prime borrowers, encouraging reckless lending practices and securitization mania; how'd that work out?
Liberals are fond of saying the health insurance market is very different than other industries. I agree (kind of). So can we please stop making bullshit comparisons to other industries?
Quote from: Hicks on November 11, 2013, 01:34:44 PM
If health insurance premiums have actually gone up by 40% in my state that would mean you could buy a $500 deductible, $5000 out of pocket max plan for $184 a month before?
The 40% increase is not for you, it is the average increase for all ages in your state. There will be some winners and some losers (congrats if you're one of the winners), but on average, premiums will increase in your state.
But like I said, it doesn't even matter if that is true or not for this year since the insurers have no experience from which to draw when setting rates. If total health care spending increases more slowly and can be spread around enough people (preferably of the young and healthy variety), premiums will go down; if the exchanges encourage more people requiring expensive treatments (i.e., those who need insurance the most) to sign up, rate hikes next year will be explosive.
Actually that's a plan that goes into effect next year.
Somehow my daughter was a winner too, her plan is only going to be $134/month, down from the $157/month we currently pay.
I really think those numbers are bunch of horseshit projections that have no basis in reality.
Quote from: Hicks on November 11, 2013, 04:03:26 PM
Actually that's a plan that goes into effect next year.
Somehow my daughter was a winner too, her plan is only going to be $134/month, down from the $157/month we currently pay.
I really think those numbers are bunch of horseshit projections that have no basis in reality.
No, I meant in 2015 (next year's enrollment period). Insurers will recalculate rates for 2015 based on their experience in 2014. If not enough young healthy people sign up, insurers' cost per member will increase and they will raise premiums for the following year. The administration has estimated it needs at least 2.7M people age 18-35 to sign up on federal exchanges (of the 7M expected) in order to help keep premiums affordable. Now, that's a made-up number so whether or not they hit is is largely irrelevant (and either side will use it as "evidence" that the law is/is not working). But if people buying insurance on the exchanges is made up of less healthy people and more people requiring expensive treatments, I promise you you will not be paying $258/mo.
Quote from: Hicks on November 10, 2013, 10:10:45 PM
So being out of work I'm looking around at my options and it looks like I can buy a personal plan with a $500 deductible and $5000 out of pocket max for $258 a month.
That seems pretty reasonable.
Admittedly I've always had employer healthcare before, but it seems to me that the prices are in fact dropping as a a result of the ACA.
That's a pretty big step in the right direction.
Wait, what?
Oregon Health Care Exchange Has Yet To Enroll A Single Person (http://seattle.cbslocal.com/2013/11/11/oregon-health-care-exchange-has-yet-to-enroll-a-single-person/)
Quote from: Hicks on November 11, 2013, 04:03:26 PM
I really think those numbers are bunch of horseshit projections that have no basis in reality.
I am shocked at the notion that someone would make up or fudge numbers for political gain.
Also, while we're calling out liars (OBAMA!), I'm sure all those people talking about Death Panels are fixing to stand up and apologize for lying to America now, aren't they?
Speaking of fudging numbers for political gain, the WH has settled on an expanded definition of the word "enrolled" when they release statistics later this week. Actual enrollment not necessary to be included.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/11/who-counts-as-an-obamacare-enrollee-the-obama-administration-settles-on-a-definition/
Quote
Who counts as an Obamacare enrollee? The Obama administration settles on a definition.
The fight over how to define the new health law's success is coming down to one question: Who counts as an Obamacare enrollee?
Health insurance plans only count subscribers as enrolled in a health plan once they've submitted a payment. That is when the carrier sends out a member card and begins paying doctor bills.
When the Obama administration releases health law enrollment figures later this week, though, it will use a more expansive definition. It will count people who have purchased a plan as well as those who have a plan sitting in their online shopping cart but have not yet paid.
"In the data that will be released this week, 'enrollment' will measure people who have filled out an application and selected a qualified health plan in the marketplace," said an administration official, who requested anonymity to frankly describe the methodology.
The disparity in the numbers is likely to further inflame the political fight over the Affordable Care Act. Each side could choose a number to make the case that the health law is making progress or failing miserably.
On Monday, the Wall Street Journal, citing anonymous sources, said insurance companies have received about 50,000 private health plan enrollments through HealthCare.gov. Even combined with state tallies, the figure falls far short of the 500,000 sign-ups the administration initially predicted for both private sign-ups and those opting for the expansion of Medicaid.
In recent weeks, administration officials have warned that the enrollment figures for October would be low, given the tumultuous launch of the health Web site.
The administration plans to use this count of enrollees because that's where their interaction with the healthcare.gov site ends, the administration official said. Insurance plans, rather than the federal government, are responsible for collecting the first month's premium.
The shopping cart on healthcare.gov only contains space for one health plan, meaning the consumer must have gotten far enough to settle on a specific option.
Addressing the Wall Street Journal's report, Health and Human Services spokeswoman Joanne Peters said: "We cannot confirm these numbers. More generally, we have always anticipated that initial enrollment numbers would be low and increase over time. . . . The problems with the Web site will cause the numbers to be lower than initially anticipated."
States that have so far released enrollment data also tend to use this wider definition. The 14 states running their own insurance marketplaces have reported 49,000 enrollments in private health insurance plans, according to an analysis released Monday by consulting firm Avalere Health. They have also enrolled many thousands more into the Medicaid program, which the health-care law expanded.
"The idea that people are going to do layaway purchasing three months out goes against the American way," Rhode Island exchange director Christine Ferguson said in late September, shortly before the health law's rollout.
Different definitions of enrollment lead to vastly different estimations of who will gain coverage under the Affordable Care Act. In the District of Columbia, for example, health insurance plans reported signing up five people during the health law's first month.
But the city's exchange, DC Health Link, estimates that 321 people in the District have dropped a specific health insurance plan into their shopping cart. Of those, 164 have requested an invoice for their first month's premium from the insurance carrier.
"We recognize that most people do not have the luxury of paying for coverage in October, months before a bill is due," exchange spokesman Richard Sorian said Friday. "I hope that all consumers here in the District remember that they have until Dec. 15 to finalize their selection by paying their first month's premium in order to have coverage on Jan. 1, 2014."
Who fucking cares?
The last guy didn't even put WAR in his budget.
Quote from: rowjimmy on November 12, 2013, 10:24:02 AM
Who fucking cares?
The last guy didn't even put WAR in his budget.
Right, but this is a discussion about health care, so...
Quote from: rowjimmy on November 12, 2013, 09:16:49 AM
I'm sure all those people talking about Death Panels are fixing to stand up and apologize for lying to America now, aren't they?
Of course not. If there's one thing you can take to the bank when it comes to American politics, it's double standards.
And lying.
So, two things.
Quote from: runawayjimbo on November 12, 2013, 10:51:26 AM
Quote from: rowjimmy on November 12, 2013, 10:24:02 AM
Who fucking cares?
The last guy didn't even put WAR in his budget.
Right, but this is a discussion about health care, so...
It's a non-issue promoted to national headlines because we mustn't talk about anything important.
Quote from: rowjimmy on November 12, 2013, 11:37:27 AM
Quote from: runawayjimbo on November 12, 2013, 10:51:26 AM
Quote from: rowjimmy on November 12, 2013, 10:24:02 AM
Who fucking cares?
The last guy didn't even put WAR in his budget.
Right, but this is a discussion about health care, so...
It's a non-issue promoted to national headlines because we mustn't talk about anything important.
I fail to see how the WH systematically lying (repeatedly) about the first available data we have with respect to the president's signature legislative achievement is a non-issue.
Quote from: runawayjimbo on November 12, 2013, 12:19:24 PM
Quote from: rowjimmy on November 12, 2013, 11:37:27 AM
Quote from: runawayjimbo on November 12, 2013, 10:51:26 AM
Quote from: rowjimmy on November 12, 2013, 10:24:02 AM
Who fucking cares?
The last guy didn't even put WAR in his budget.
Right, but this is a discussion about health care, so...
It's a non-issue promoted to national headlines because we mustn't talk about anything important.
I fail to see how the WH systematically lying (repeatedly) about the first available data we have with respect to the president's signature legislative achievement is a non-issue.
Are they lying?
It's not some kind of state secret.
It's also early receipts on a system that has had a slow start for a variety of reasons. Anyone who puts too much stock in how many people have enrolled at this point is overthinking it.
But I know you love to point out every spot on Obama's tie, so have at it.
Quote from: rowjimmy on November 12, 2013, 12:34:20 PM
Quote from: runawayjimbo on November 12, 2013, 12:19:24 PM
Quote from: rowjimmy on November 12, 2013, 11:37:27 AM
Quote from: runawayjimbo on November 12, 2013, 10:51:26 AM
Quote from: rowjimmy on November 12, 2013, 10:24:02 AM
Who fucking cares?
The last guy didn't even put WAR in his budget.
Right, but this is a discussion about health care, so...
It's a non-issue promoted to national headlines because we mustn't talk about anything important.
I fail to see how the WH systematically lying (repeatedly) about the first available data we have with respect to the president's signature legislative achievement is a non-issue.
Are they lying?
It's not some kind of state secret.
It's also early receipts on a system that has had a slow start for a variety of reasons. Anyone who puts too much stock in how many people have enrolled at this point is overthinking it.
But I know you love to point out every spot on Obama's tie, so have at it.
First, they said they didn't have enrollment data when it turned out they did. Now they are padding enrollment stats to deflect criticism. How is that not lying? It doesn't have to be a state secret to be a lie, you know.
I agree with you (somewhat) the actual number doesn't much matter; of course, if people cannot access before the December 15th deadline (for Jan. 1 plans), then these lost weeks will indeed matter and the pool of insured on the exchanges will be significantly more expensive than initially thought, which is a big problem.
I could care less about Obama's tie or any other spots. I would just like, for once, to be treated like an adult by my gov't and be given the truth and not some politically spun bullshit.
Why should they start now?
Quote from: rowjimmy on November 12, 2013, 03:02:56 PM
Why should they start now?
A valid yet depressing point.
Quote from: rowjimmy on November 12, 2013, 09:16:49 AM
Also, while we're calling out liars (OBAMA!), I'm sure all those people talking about Death Panels are fixing to stand up and apologize for lying to America now, aren't they?
Dude, that's totally different. They were lying in the name of freedom, he was lying in the name of socialism.
Quoteas if that automakers would suddenly start selling cars without safety features but for the infinite wisdom of our federal benefactors)
Really??????
in my lifetime, cars came without seatbelts. and headrests. and airbags (auto manufacturers wanted no part of air bags - fought it for years). there were no emissions standards. cars used leaded gasoline.
Just because a reg comes from the govt, doesn't mean that it's bad or stupid.
One of the many frustrating things about this to me, is that pts ask and or complain about ACA on a regular basis. I try not to discuss politics in the office, among other things it sets me back. I tell pts that on a regular basis, paitients have to decide between medication and food, or can't come to the doctor because they lost their insurance, or won't go to the hospital when they're sick because of no insurance (yes, all of this really happens), and I don't think that should happen in this country. As much as they may hate Obamacare or whatever, they all agree with that.
If you ask people in general if they think people should be excluded for pre exisiting conditions, or adult children should be covered by their parents if needed, most will agree with the actual changes that have been made (just don't tell them that they actually agree with ACA)
I don't know the answers, but I don't think covering the population is affordable without everyone buying in, and I don't think you can do that without the govt.
Other than that, I don't think anyone has the answers. I see ACA as a starting point to be tinkered with and adjusted, not a final product. Of course, I don't think that congress can do anything at this point, so I'm not sure how much tinkering can be done.
Yes, the opponents of ACA are blowing everything out of proportion to make Obama, ACA, and the Dems look bad
but, there are problems, the WH should have known that everyone and his brother were going to be loaded for bear, and they should have been better prepared. Much better prepared.
Considering all the the stock Obama put in this law, and that he wants it to be his legacy (other than being the 1st African American pres), this is a significant fuck up.
Quote from: slslbs on November 12, 2013, 08:16:17 PM
Quoteas if that automakers would suddenly start selling cars without safety features but for the infinite wisdom of our federal benefactors)
Really??????
in my lifetime, cars came without seatbelts. and headrests. and airbags (auto manufacturers wanted no part of air bags - fought it for years). there were no emissions standards. cars used leaded gasoline.
Just because a reg comes from the govt, doesn't mean that it's bad or stupid.
Paging Ralph Nader.
(http://www.autolife.umd.umich.edu/Design/Gartman/Books/Book_Front-cover_Nader.gif)
Quote from: runawayjimbo on November 11, 2013, 11:35:26 AM
Quote from: mbw on November 11, 2013, 11:04:26 AM
Quote from: runawayjimbo on November 11, 2013, 09:43:42 AM
As for your last bit, I guess you are saying that since I oppose the law, I am either a racist or I'm too stupid to see that I am being manipulated by right-wing billionaires. Thanks for the tip. Got it.
C'mon. I know its not as simple as those 2 reasons. There is a 3rd, of course: Having great coverage and not giving a fuck about anyone else. It's the Ron Paul way. What's his solution for the poor and uninsured? Oh yeah, doctors to magically treat people for free out of the goodness of their hearts.
So now I'm a racist moron who doesn't know what's good for him AND I don't give a fuck about anyone else. Thanks for clearing that up.
PS - how do know whether or not my coverage is "great?"
Ah, some self realization. That's good. now the healing can begin.
Seriously though, you'd don't think that a large proportion of the who are against the ACA have one of these 3 things affecting their mindset?
Quote from: runawayjimbo on November 11, 2013, 11:35:26 AM
PS - how do know whether or not my coverage is "great?"
I don't know, try getting bone cancer and see if your insurance company drops you or denies the needed care.
Oh, thats right, they can't do that now. Terrible consequence of this law.
They wouldn't have done that before though, right? Right??
Private business will always do whats right if only the government would leave them alone.
No one profits off other people's misery. :wink:
Quote from: ytowndan on November 12, 2013, 07:29:02 PM
Quote from: rowjimmy on November 12, 2013, 09:16:49 AM
Also, while we're calling out liars (OBAMA!), I'm sure all those people talking about Death Panels are fixing to stand up and apologize for lying to America now, aren't they?
Dude, that's totally different. They were lying in the name of freedom, he was lying in the name of socialism.
Are you guys really saying a statement (on a cable news show) by Sarah Palin carries the same weight as one from the President of the US? I get it, everyone lies (that's my defult position, actually). But one of those people was a crazy lady from Alaska, and the other was Sarah Palin. :sad trombone:
Quote from: slslbs on November 12, 2013, 08:16:17 PM
Quoteas if that automakers would suddenly start selling cars without safety features but for the infinite wisdom of our federal benefactors)
Really??????
in my lifetime, cars came without seatbelts. and headrests. and airbags (auto manufacturers wanted no part of air bags - fought it for years). there were no emissions standards. cars used leaded gasoline.
Just because a reg comes from the govt, doesn't mean that it's bad or stupid.
Sure, and I didn't ride in a carseat as a child. Seems crazy now. But what I was saying was that there wouldn't be a market for those deathtraps
now so automakers wouldn't produce them no matter how much they could save on production costs.
Do you think that cars wouldn't have gotten safer as technology improved? Yes, industry fought back against mandated change as they always do. But I don't believe that it wouldn't have happened without federal regs. People didn't become awakened to climate change because the gov't started restricting emmission standards. Science built that.
Quote from: mbw on November 12, 2013, 10:09:19 PM
Quote from: runawayjimbo on November 11, 2013, 11:35:26 AM
Quote from: mbw on November 11, 2013, 11:04:26 AM
Quote from: runawayjimbo on November 11, 2013, 09:43:42 AM
As for your last bit, I guess you are saying that since I oppose the law, I am either a racist or I'm too stupid to see that I am being manipulated by right-wing billionaires. Thanks for the tip. Got it.
C'mon. I know its not as simple as those 2 reasons. There is a 3rd, of course: Having great coverage and not giving a fuck about anyone else. It's the Ron Paul way. What's his solution for the poor and uninsured? Oh yeah, doctors to magically treat people for free out of the goodness of their hearts.
So now I'm a racist moron who doesn't know what's good for him AND I don't give a fuck about anyone else. Thanks for clearing that up.
PS - how do know whether or not my coverage is "great?"
Ah, some self realization. That's good. now the healing can begin.
Seriously though, you'd don't think that a large proportion of the who are against the ACA have one of these 3 things affecting their mindset?
Yes, some most certainly do. I have no idea if it's a large proportion, but I would seriously doubt it's a majority.
Quote from: mbw on November 12, 2013, 10:09:19 PM
Quote from: runawayjimbo on November 11, 2013, 11:35:26 AM
PS - how do know whether or not my coverage is "great?"
I don't know, try getting bone cancer and see if your insurance company drops you or denies the needed care.
Oh, thats right, they can't do that now. Terrible consequence of this law.
They wouldn't have done that before though, right? Right??
Private business will always do whats right if only the government would leave them alone.
No one profits off other people's misery. :wink:
You've gotten a lot of mileage out of that one. You should be thanking me.
the auto industry was pushed to safer cars by federal regs and fear of liability lawsuits. Laws, written by - the G word. they would have made some progress in the name of safety alone (see volvo). They want to do well on the crash tests. Who runs those crash tests anyway? Oh, that's right, the feds.
So - you don't like ACA. Fine, it's flawed. You don't like single payer. That's OK too. Do you think that people who can't afford insurance shouldn't get coverage? If not, what do we do about it? Do you think that the free market alone will take care of it?
Quote from: runawayjimbo on November 12, 2013, 10:58:47 PM
Quote from: ytowndan on November 12, 2013, 07:29:02 PM
Quote from: rowjimmy on November 12, 2013, 09:16:49 AM
Also, while we're calling out liars (OBAMA!), I'm sure all those people talking about Death Panels are fixing to stand up and apologize for lying to America now, aren't they?
Dude, that's totally different. They were lying in the name of freedom, he was lying in the name of socialism.
Are you guys really saying a statement (on a cable news show) by Sarah Palin carries the same weight as one from the President of the US? I get it, everyone lies (that's my defult position, actually). But one of those people was a crazy lady from Alaska, and the other was Sarah Palin. :sad trombone:
You are aware that she's not the only one to make that claim, right?
Quote from: slslbs on November 13, 2013, 05:30:05 AM
the auto industry was pushed to safer cars by federal regs and fear of liability lawsuits. Laws, written by - the G word. they would have made some progress in the name of safety alone (see volvo). They want to do well on the crash tests. Who runs those crash tests anyway? Oh, that's right, the feds.
So - you don't like ACA. Fine, it's flawed. You don't like single payer. That's OK too. Do you think that people who can't afford insurance shouldn't get coverage? If not, what do we do about it? Do you think that the free market alone will take care of it?
Free market takes care of the market, not the customers.
Quote from: slslbs on November 13, 2013, 05:30:05 AM
So - you don't like ACA. Fine, it's flawed. You don't like single payer. That's OK too. Do you think that people who can't afford insurance shouldn't get coverage? If not, what do we do about it? Do you think that the free market alone will take care of it?
Obviously it's an extremely complex problem with no easy solutions (which is why it never gets fixed). But the underlying issue - that health care is too expensive in this country (for reasons good and bad) - will not be fixed by trying to make incremental changes to a broken system. So while IMO the ideas I believe in (not solutions, more like a framework) would help lower the overall cost of care, they would also be politically untenable. I've probably mentioned some or all of these before, but since you asked, it would entail some combination of the following:
1. Get rid of employer provided coverage - this is an archaic notion that only became popular to get around wage controls imposed in WWII. It encourages complacency on the part of the end-user and makes proper risk classification (and thus pricing) impossible. Remove state boundaries for marketing plans and allow people to shop for plans that best suit their needs, including plans with a la carte options. I think there could be support for this although I'm sure Congress would find a way to F it up. It also, as I've mentioned before, would be a far more reaching structural change to the health insurance market than anything in the ACA.
2. Make prices more transparent - people need to be encouraged to understand the true cost of health care, which is currently shielded from them in the third party/managed care environment. I don't know if higher deductible plans are the answer or not because I concede they may encourage people not to seek care when they should (although I haven't seen any empirical evidence this is true, only anecdotal). But I think people should take more of a stake in the cost of their care as it would create better aligned incentives. To do this, though, people would have to be given the tools to compare prices and shop accordingly. To be sure, you are not always given a choice in the type of care you need, but many procedures and nearly all preventative care (which is one of the major benefits of universal coverage, right?) should be more consumer driven. I'd also eliminate the idea of provider networks and rely on more choice and competition to help lower prices. There's a reason Lasik prices have declined so dramatically (there's also a reason why elective procedures can be much more unregulated than life threatening ones).
3. High risk pools - not everyone would be offered or could afford the coverage they needed in this system. High risk pools would address this problem. Funded jointly by the entire health care complex (insurers, pharma, device, hospitals, etc.) and contributed to by the policyholder, these pools would cover people insurance companies deem too risky or who couldn't afford the premiums charged. Would this cover everybody? No, but even the CBO estimates something like 30M people still won't have coverage under the ACA. I think (with no data behind me to back it up) that high risk pools could help achieve at least the same results.
4. Reduce administrative burden - one problem the ACA correctly diagnoses is that administrative costs are way too high in health care. Insurers should not have to spend $0.30 of every premium dollar on administration. But where the ACA gets it wrong (IMO) is in trying to eliminate those costs through the medical loss ratio mandate. Simply dictating a "reasonable" MLR won't lower premiums by itself and could actually have the opposite effect (insurers raise rates to meet MLR requirements while maintaining the same absolute level of profits). The reason administrative costs are so high (across the health care industry, not just for insurers) is that there is a lot of duplicative effort just to process all the paperwork (as I'd imagine you are acutely aware). Contrary to popular belief, insurers don't spend so much money on overhead just to deny claims; selling, processing, and maintaining policies costs money because of the complexity of the health insurance market (as the WH is undoubtedly discovering). This need to be more efficient, but I would take a bottom-up approach as opposed to the ACA's top-down mandate.
5. Patent reform - pharma makes about 20% in profit for every dollar of sales; insurance makes about 2.5%. Now, I am totally cool with a higher profit margins for higher risk businesses, and I am also cautious to make changes that would stifle innovation. But I don't see how anyone can justify the manipulation that goes on in the patent/exclusivity space. Ending gov't sanctioned monopolies would help reduce one of the most costly drivers of health care spending and would (hopefully) have the indirect and bonus benefit of reducing the influence of one of the most powerful lobbies in the country. Win-win.
6. Medical malpractice reform - this is something that the GOP has been harping on for years and while I don't believe this would have a significant impact on total health care spending, it doesn't mean we shouldn't do it. Med mal premiums are outrageous (again, don't have to tell you that), but more importantly, it should lead to a reduction in the practice of defensive medicine. Quality of care tradeoffs must be considered, but I don't see how you can lower total spending without providing some sort of protection for the people providing the care.
7. MOAR doctors - you'll know more about this than me, but I have heard there is a de facto self-imposed shortage in doctors due to overly stringent admission standards. Again, quality must be considered as you don't want an army of Dr. Nicks running around. But I gotta believe that getting through medical school should be harder than getting in, not the other way around. More doctors (especially in the not-so-hot and critically important fields like Family Medicine) means more choices means lower prices. Period. RNs are also fabulous resources as well.
I'm sure I'm forgetting some stuff that would be on my wish list but I have to get back to work. Is the above an oversimplification? Probably (like I said, this shit is complex). But do I believe it would lead to better outcomes in a more efficient manner? Absolutely. You'll also notice nothing I said above mentions telling the old or the poor to go screw (although I do believe the Medicare/SGR fiasco illustrates quite clearly how gov't intervention distorts costs and contributes to rising spending). I do believe gov't has a role to play in the health care market, but I think it is one that should be significantly diminished from its current form. But again, it would have to be done in an very gradual fashion to ensure an orderly transition. On the other hand, I also believe if the problem of rising costs is not addressed soon, we will be forced to make a change very quickly and it will be chaotic, making the "just a website" affair seem like goddamn child's play.
BaBaBooey, BaBaBooey, BaBaBooey
Quote from: rowjimmy on November 13, 2013, 09:45:27 AM
Quote from: runawayjimbo on November 12, 2013, 10:58:47 PM
Quote from: ytowndan on November 12, 2013, 07:29:02 PM
Quote from: rowjimmy on November 12, 2013, 09:16:49 AM
Also, while we're calling out liars (OBAMA!), I'm sure all those people talking about Death Panels are fixing to stand up and apologize for lying to America now, aren't they?
Dude, that's totally different. They were lying in the name of freedom, he was lying in the name of socialism.
Are you guys really saying a statement (on a cable news show) by Sarah Palin carries the same weight as one from the President of the US? I get it, everyone lies (that's my defult position, actually). But one of those people was a crazy lady from Alaska, and the other was Sarah Palin. :sad trombone:
You are aware that she's not the only one to make that claim, right?
Yes, but she was the main proponent. But even if you take everyone who ever uttered the phrase combined, they have far less influence than the president.
Quote from: rowjimmy on November 13, 2013, 09:45:27 AM
Quote from: slslbs on November 13, 2013, 05:30:05 AM
the auto industry was pushed to safer cars by federal regs and fear of liability lawsuits. Laws, written by - the G word. they would have made some progress in the name of safety alone (see volvo). They want to do well on the crash tests. Who runs those crash tests anyway? Oh, that's right, the feds.
So - you don't like ACA. Fine, it's flawed. You don't like single payer. That's OK too. Do you think that people who can't afford insurance shouldn't get coverage? If not, what do we do about it? Do you think that the free market alone will take care of it?
Free market takes care of the market, not the customers.
Obvious exaggeration is obvious.
Quote from: runawayjimbo on November 12, 2013, 09:16:20 AM
Quote from: Hicks on November 10, 2013, 10:10:45 PM
So being out of work I'm looking around at my options and it looks like I can buy a personal plan with a $500 deductible and $5000 out of pocket max for $258 a month.
That seems pretty reasonable.
Admittedly I've always had employer healthcare before, but it seems to me that the prices are in fact dropping as a a result of the ACA.
That's a pretty big step in the right direction.
Wait, what?
Oregon Health Care Exchange Has Yet To Enroll A Single Person (http://seattle.cbslocal.com/2013/11/11/oregon-health-care-exchange-has-yet-to-enroll-a-single-person/)
Yeah I wasn't using the exchange it was a private plan, but I have to assume their rates are affected by the anticipated effects of the ACA.
In any event, it don't matter no more to me, lasers will be picking up my tab.
So I guess that means I'm a Republican now. :tte:
You sure can run on at the keyboard.
tl;dc
(too long; don't care)
Here's the deal:
1) You can argue against reforming health care, and you'd be on the wrong side of morality and history (eventually).
2) You can argue that the ACA is not the solution to the problem and you'd be right. Single payer, public healthcare is the solution. The "free market" had its chance and it kills people.
C) You can say that the ACA isn't movement in the correct direction. But you'd be wrong. Covering more people is the right direction. And, when this phase of changing healthcare in the country proves out its imperfections, the nation will know which way to push. (see point 2)
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
You sure can run on at the keyboard.
tl;dc
(too long; don't care)
He asked, I answered (while putting off actual work I have to do). I honestly didn't expect you to read, nor do I care (but thanks for making it clear).
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
1) You can argue against reforming health care, and you'd be on the wrong side of morality and history (eventually).
Since I just spelled out how I'd reform heath care, I am obviously not against it. Not sure what this point means.
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
2) You can argue that the ACA is not the solution to the problem and you'd be right. Single payer, public healthcare is the solution. The "free market" had its chance and it kills people.
Ooh, shock value, that's a good way to win an argument.
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
C) You can say that the ACA isn't movement in the correct direction. But you'd be wrong. Covering more people is the right direction. And, when this phase of changing healthcare in the country proves out its imperfections, the nation will know which way to push. (see point 2)
Covering people for the sake of covering people does not reduce costs. Unfortunately for your side, when this phase ends, people will be going the other way. Because for as much as people dislike GOP, more of their predictions about the consequences of the ACA are proving true than the WH's. Single payer is not an option this country will entertain. And thank goodness for that. Otherwise you wouldn't be able to use your "death panels are stupid (http://www.slate.com/articles/news_and_politics/jurisprudence/2013/10/canada_has_death_panels_and_that_s_a_good_thing.html)" line. Among other things.
I agree with almost everything that you said. Those things will help to control costs.
We also need to reduce overutilization (on everyone's part) - easier said than done.
what is left out, though, is universal coverage, something that I think we need and won't happen if the system got reformed the way you said it. That is, unless you make people buy catastrophic insurance (an idea that got floated in the 70s and didn't get very far)
I have very mixed feelings about single payer - I've seen what the feds have done to the VA system so I'm a skeptic.
Regardless, I think that single payer is not a political reality in this country.
I also think that removing the ties between insurance and employer (historical vestige that the tax system has helped prolong) is almost as policitally unrealistic as single payer.
Quote from: runawayjimbo on November 13, 2013, 11:41:41 AM
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
You sure can run on at the keyboard.
tl;dc
(too long; don't care)
He asked, I answered (while putting off actual work I have to do). I honestly didn't expect you to read, nor do I care (but thanks for making it clear).
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
1) You can argue against reforming health care, and you'd be on the wrong side of morality and history (eventually).
Since I just spelled out how I'd reform heath care, I am obviously not against it. Not sure what this point means.
That point is a general position. After the TL,DC, my post was directed to the universe not just you.
You are not the only person out there.
Quote from: runawayjimbo on November 13, 2013, 11:41:41 AM
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
2) You can argue that the ACA is not the solution to the problem and you'd be right. Single payer, public healthcare is the solution. The "free market" had its chance and it kills people.
Ooh, shock value, that's a good way to win an argument.
I'm not trying to win an argument. What would be the point, no one on this board has any interest in being or capacity to be swayed.
Also, if the truth shocks you, you aren't paying attention.
Quote from: runawayjimbo on November 13, 2013, 11:41:41 AM
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
C) You can say that the ACA isn't movement in the correct direction. But you'd be wrong. Covering more people is the right direction. And, when this phase of changing healthcare in the country proves out its imperfections, the nation will know which way to push. (see point 2)
Covering people for the sake of covering people does not reduce costs. Unfortunately for your side, when this phase ends, people will be going the other way. Because for as much as people dislike GOP, more of their predictions about the consequences of the ACA are proving true than the WH's. Single payer is not an option this country will entertain. And thank goodness for that. Otherwise you wouldn't be able to use your "death panels are stupid (http://www.slate.com/articles/news_and_politics/jurisprudence/2013/10/canada_has_death_panels_and_that_s_a_good_thing.html)" line. Among other things.
"Covering people for the sake of covering people"? What the fuck?
It's called covering people so that they have an opportunity to live and even thrive without the burden of going bankrupt for or being denied what should be a given right: good health.
I don't know where in your ideology you find "let 'em fight it out" but it doesn't fit into mine.
Health care should not be a business.
Well said, rj.
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
I'm not trying to win an argument. What would be the point, no one on this board has any interest in being or capacity to be swayed.
Also, if the truth shocks you, you aren't paying attention.
I disagree with this statement. Personally, my own opinions and stances have been altered(swayed) numerous times over the years based on useful content and discussions I have found on this board.
STFU Neely.
Quote from: antelope19 on November 13, 2013, 02:18:01 PM
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
I'm not trying to win an argument. What would be the point, no one on this board has any interest in being or capacity to be swayed.
Also, if the truth shocks you, you aren't paying attention.
I disagree with this statement. Personally, my own opinions and stances have been altered(swayed) numerous times over the years based on useful content and discussions I have found on this board.
I thought that was just RJ's way of calling us all stupid.
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
Quote from: runawayjimbo on November 13, 2013, 11:41:41 AM
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
You sure can run on at the keyboard.
tl;dc
(too long; don't care)
He asked, I answered (while putting off actual work I have to do). I honestly didn't expect you to read, nor do I care (but thanks for making it clear).
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
1) You can argue against reforming health care, and you'd be on the wrong side of morality and history (eventually).
Since I just spelled out how I'd reform heath care, I am obviously not against it. Not sure what this point means.
That point is a general position. After the TL,DC, my post was directed to the universe not just you.
You are not the only person out there.
You (RJ, not the collective "you") use this tactic a lot.
"You [generally condescending comment]."
"[pushback]"
"I wasn't talking about
you."
It's frustrating.
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
Quote from: runawayjimbo on November 13, 2013, 11:41:41 AM
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
2) You can argue that the ACA is not the solution to the problem and you'd be right. Single payer, public healthcare is the solution. The "free market" had its chance and it kills people.
Ooh, shock value, that's a good way to win an argument.
I'm not trying to win an argument. What would be the point, no one on this board has any interest in being or capacity to be swayed.
Also, if the truth shocks you, you aren't paying attention.
Sorry, contribute to a (formerly) good natured exchange of ideas.
Here's the truth: private corporations - including health insurance companies - have contributed far more to the improvement of living standards and health outcomes than gov't ever has. It's not even close.
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
Quote from: runawayjimbo on November 13, 2013, 11:41:41 AM
Quote from: rowjimmy on November 13, 2013, 11:22:13 AM
C) You can say that the ACA isn't movement in the correct direction. But you'd be wrong. Covering more people is the right direction. And, when this phase of changing healthcare in the country proves out its imperfections, the nation will know which way to push. (see point 2)
Covering people for the sake of covering people does not reduce costs. Unfortunately for your side, when this phase ends, people will be going the other way. Because for as much as people dislike GOP, more of their predictions about the consequences of the ACA are proving true than the WH's. Single payer is not an option this country will entertain. And thank goodness for that. Otherwise you wouldn't be able to use your "death panels are stupid (http://www.slate.com/articles/news_and_politics/jurisprudence/2013/10/canada_has_death_panels_and_that_s_a_good_thing.html)" line. Among other things.
"Covering people for the sake of covering people"? What the fuck?
It's called covering people so that they have an opportunity to live and even thrive without the burden of going bankrupt for or being denied what should be a given right: good health.
I don't know where in your ideology you find "let 'em fight it out" but it doesn't fit into mine.
Health care should not be a business.
Failing to reduce costs will continue to bankrupt people along with the gov't. Then everyone loses. That is why coverage should not be the goal of reform but bringing down the cost of health care in this country. Then people will be able to afford better options and the gov't can continue to provide a safety net for the neediest people without putting the entire system at risk. Which is what the both ACA and single payer would do.
Health care is a business. If it wasn't, we wouldn't have improvements and technological achievements. The private sector is the only way to allocate capital efficiently (see "just a website"). Scarcity dominates all economics, even health care. Benefits are not free, they come with tradeoffs, some obvious and some unseen. This should be embraced, not feared.
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
You (RJ, not the collective "you") use this tactic a lot.
"You [generally condescending comment]."
"[pushback]"
"I wasn't talking about you."
It's frustrating.
I'm sorry if you can't separate yourself from generalizations.
Maybe get your ego out of the way.
(THAT's for you, personally.)
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Here's the truth: private corporations - including health insurance companies - have contributed far more to the improvement of living standards and health outcomes than gov't ever has. It's not even close.
Yep. That's probably true. Especially if one rules out government mandated health standards.
But it's only because the government has only had a few toes in these waters up to now.
This goes right back to the automobile analogy. Private industry has systematically screwed the impoverished and disadvantaged because they're unprofitable. But certainly the wealthy have had their health standards raised over the years. Good for them.
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Health care is a business. If it wasn't, we wouldn't have improvements and technological achievements. The private sector is the only way to allocate capital efficiently (see "just a website"). Scarcity dominates all economics, even health care. Benefits are not free, they come with tradeoffs, some obvious and some unseen. This should be embraced, not feared.
I didn't say that Health care "isn't" a business.
I said,
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
Health care should not be a business.
Big difference.
Quote from: nab on November 13, 2013, 02:23:36 PM
Quote from: antelope19 on November 13, 2013, 02:18:01 PM
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
I'm not trying to win an argument. What would be the point, no one on this board has any interest in being or capacity to be swayed.
Also, if the truth shocks you, you aren't paying attention.
I disagree with this statement. Personally, my own opinions and stances have been altered(swayed) numerous times over the years based on useful content and discussions I have found on this board.
I thought that was just RJ's way of calling us all stupid.
Nope. I was saying that, ime, most folks here are fairly locked into their positions and this exercise is generally one of futility.
Which is why I take long breaks from this part of the site.
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Sorry, contribute to a (formerly) good natured exchange of ideas.
I'm at fault here. My apologies if it appeared I was trying to be good natured.
Quote from: rowjimmy on November 13, 2013, 02:58:55 PM
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
You (RJ, not the collective "you") use this tactic a lot.
"You [generally condescending comment]."
"[pushback]"
"I wasn't talking about you."
It's frustrating.
I'm sorry if you can't separate yourself from generalizations.
Maybe get your ego out of the way.
(THAT's for you, personally.)
I'm not buying this at all. You are way too crafty with your words to pretend you can't see how what you are saying could be taken this way. It's your passive-aggressive way of zinging people. Own up to it and tell me I'm an idiot for not agreeing with you. I promise, my ego can take it.
Quote from: rowjimmy on November 13, 2013, 02:58:55 PM
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Here's the truth: private corporations - including health insurance companies - have contributed far more to the improvement of living standards and health outcomes than gov't ever has. It's not even close.
Yep. That's probably true. Especially if one rules out government mandated health standards.
But it's only because the government has only had a few toes in these waters up to now.
Lulz
Quote from: rowjimmy on November 13, 2013, 02:58:55 PM
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Health care is a business. If it wasn't, we wouldn't have improvements and technological achievements. The private sector is the only way to allocate capital efficiently (see "just a website"). Scarcity dominates all economics, even health care. Benefits are not free, they come with tradeoffs, some obvious and some unseen. This should be embraced, not feared.
I didn't say that Health care "isn't" a business.
I said,
Quote from: rowjimmy on November 13, 2013, 01:36:34 PM
Health care should not be a business.
Big difference.
I know, and I was clarifying why we should be thankful that it is.
Quote from: mbw on November 13, 2013, 03:02:06 PM
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Sorry, contribute to a (formerly) good natured exchange of ideas.
I'm at fault here. My apologies if it appeared I was trying to be good natured.
You are an idiot.
No, not
you.
Back on topic...
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/13/69359/
Quote
About 106,000 people enrolled in Obamacare last month
Just over 106,000 people selected insurance plans during the health care law's first month of open enrollment, the Obama administration announced Wednesday.
Approximately 27,000 of those sign-ups came from 36 states where the federal government is running the exchange, which has been beset with technical difficulties. The additional 79,000 came through the 15 marketplaces run by states and the District of Columbia.
"There is no doubt the level of interest is strong. We expect enrollment will grow substantially throughout the next five months, mirroring the pattern that Massachusetts experienced," Health and Human Services Secretary Kathleen Sebelius said. They're also numbers that will grow as the website, HealthCare.gov, continues to make steady improvements."
The numbers represent a fraction of the half-million health sign-ups the Obama administration had initially projected, before healthcare.gov's rocky roll out thwarted many shoppers' attempts to sign up for insurance. Budget forecasters previously projected that 7 million people would enroll in coverage during this year's open enrollment period, which runs until March 31.
The Obama administration expects that as the technical issues get sorted out enrollment will increase.
"The numbers are effected by the website issues," a senior administration official said. "So its no surprise they're lower than projections."
The administration's sign-up account includes shoppers who have selected a plan through the online exchange. The federal government does not have data on who, among those people, has paid the first month's premium for January.
The federal government also counted just over 396,000 people who have been determined eligible for Medicaid, the public program for low-income Americans that the health care law expanded.
The full report is below.
You are not an idiot for disagreeing with me but you might be if you take everything I say personally.
The dance continues...
http://politicalticker.blogs.cnn.com/2013/11/14/breaking-obama-to-make-statement-on-health-care/?hpt=hp_t2
Quote
Obama to push administrative fix for insurance cancellations
(CNN) - President Barack Obama will lay out an administrative solution to address the problem of people getting cancellation notices from their health insurance providers, a senior Democratic source familiar with the plan tells CNN's Chief Congressional Correspondent Dana Bash.
Obama will deliver remarks at 11:35 a.m. ET in the White House Press Briefing Room, the White House announced Thursday morning.
The plan will in part call for insurance policies to be renewed for one year for those who already have insurance policies in the individual market, the source said.
Also, the source added, insurance companies will be required to notify policyholders of alternative coverage and what benefits they would be losing by keeping their existing plan.
When selling Obamacare, the President repeatedly assured Americans they would be able to keep their plans if they liked them. However, many Americans have been getting dropped from their providers because their existing policies don't work with the new regulations.
Obama has since apologized for people losing their coverage and pledged to find a solution.
Quote from: runawayjimbo on November 13, 2013, 03:10:14 PM
Quote from: mbw on November 13, 2013, 03:02:06 PM
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Sorry, contribute to a (formerly) good natured exchange of ideas.
I'm at fault here. My apologies if it appeared I was trying to be good natured.
You are an idiot.
No, not you.
(http://i.imgur.com/re2eznQ.gif)
Quote from: mbw on November 14, 2013, 12:09:07 PM
Quote from: runawayjimbo on November 13, 2013, 03:10:14 PM
Quote from: mbw on November 13, 2013, 03:02:06 PM
Quote from: runawayjimbo on November 13, 2013, 02:30:02 PM
Sorry, contribute to a (formerly) good natured exchange of ideas.
I'm at fault here. My apologies if it appeared I was trying to be good natured.
You are an idiot.
No, not you.
(http://i.imgur.com/re2eznQ.gif)
(http://2.bp.blogspot.com/-G5s1vX73vh8/UYd0gLBy-pI/AAAAAAAADVc/9rLfnjHUbY4/s1600/95b79268a3413146ffdb4897dfecb748.jpg)
I applaud the president for addressing the public today, owning up to this mess, and laying out a solution. I am optimistic that this will be fixed sooner than later. But I'm sorry, stating that you underestimated how difficult and complex a process it is to purchase an insurance policy? Apparently no one has attempted to navigate the Medicare system? Have you not learned anything from the complaints and struggles of the existing infrastructure?
Quote from: antelope19 on November 14, 2013, 02:05:44 PM
I applaud the president for addressing the public today, owning up to this mess, and laying out a solution. I am optimistic that this will be fixed sooner than later. But I'm sorry, stating that you underestimated how difficult and complex a process it is to purchase an insurance policy? Apparently no one has attempted to navigate the Medicare system? Have you not learned anything from the complaints and struggles of the existing infrastructure?
I (shockingly) take a more cynical view. This was not an apology and definitely not a solution. It will be extremely difficult for insurers to reissue cancelled policies given that they have been making changes to systems for months (maybe years). This looks to me an attempt to shift blame to insurers.
The original tactic was having official spokespeople run out the "ACA didn't cancel your plan, the insurers did!" line. That failed, mostly because pundits on both the right and the left called it for what it was (BS). So they moved to plan B, which was allow (retroactively) insurers to reissue plans even though I am quite sure the WH is aware of the logistical nightmare that will be (actually, I'm not quite sure as they don't appear to be aware of anything). Now if they insurers push back it will be all their fault. I gotta hand it to him, it's a brilliant political move. Unfortunately, the political fix is only short-term; assuming insurers can get the policies reissued, this will create a much more difficult long-term adverse selection problem.
If people can keep their old, presumably cheaper limited plans, who is going to sign up for ACA plans? People who need the more expansive coverage the most. Since rates were set under the assumption that everyone would be buying the ACA-approved plans, they will be woefully inadequate as the pool insureds buying exchange policies are more costly than the general population. Rates will have to rise (possibly dramatically) and insurers may even pull out of the exchanges all together (especially if they feel they've been thrown under the bus by this latest move). That is the ACA death spiral.
Oh by the way, this is a one-year extension which, shockingly, just happens to be a mid-term election year. What are the odds?!?
Fucking dick can't even apologize correctly.
Quote from: rowjimmy on November 14, 2013, 02:46:37 PM
Fucking dick can't even apologize correctly.
:hereitisyousentimentalbastard
Quote from: runawayjimbo on November 14, 2013, 02:46:21 PM
Oh by the way, this is a one-year extension which, shockingly, just happens to be a mid-term election year. What are the odds?!?
1 in 4
Quote from: rowjimmy on November 14, 2013, 02:46:37 PM
Fucking dick can't even apologize correctly.
Did he apologize? I must have missed that.
Quote from: mbw on November 14, 2013, 03:08:51 PM
Quote from: runawayjimbo on November 14, 2013, 02:46:21 PM
Oh by the way, this is a one-year extension which, shockingly, just happens to be a mid-term election year. What are the odds?!?
1 in 4
ZING!
"An estimated 70% of doctors are boycotting Obamacare in California"
http://m.washingtonexaminer.com/doctors-boycotting-californias-obamacare-exchange/article/2540272?utm_content=bufferd40a1&utm_source=buffer&utm_medium=twitter&utm_campaign=Buffer
Effective today
Quote
Employers with fewer than 100 workers won't have to provide health insurance until 2016 under Obamacare, as the administration said it would again delay a key requirement of the health law.
:shakehead:
Quote from: antelope19 on December 09, 2013, 11:29:34 PM
"An estimated 70% of doctors are boycotting Obamacare in California"
http://m.washingtonexaminer.com/doctors-boycotting-californias-obamacare-exchange/article/2540272?utm_content=bufferd40a1&utm_source=buffer&utm_medium=twitter&utm_campaign=Buffer
I'd click on your link but it goes to one of the most biased and least reputable sources of "news" in this town.
Quote from: rowjimmy on February 11, 2014, 02:20:23 PM
Quote from: antelope19 on December 09, 2013, 11:29:34 PM
"An estimated 70% of doctors are boycotting Obamacare in California"
http://m.washingtonexaminer.com/doctors-boycotting-californias-obamacare-exchange/article/2540272?utm_content=bufferd40a1&utm_source=buffer&utm_medium=twitter&utm_campaign=Buffer
I'd click on your link but it goes to one of the most biased and least reputable sources of "news" in this town.
That's from 2 months ago, but yes, I'd have to agree with you. It's mostly garbage.
The more recent info I posted today is really disheartening, IMO.
from the New England Journal of Medicine
Quote
Beyond Repeal — A Republican Proposal for Health Care ReformTimothy Stoltzfus Jost, J.D.
By voting repeatedly to repeal the Affordable Care Act (ACA) over the past 4 years, Republicans have risked being identified as a party without a positive health policy agenda. On January 27, 2014, however, three Republican senators — Orrin Hatch (UT), Tom Coburn (OK), and Richard Burr (NC) — unveiled a proposal that would not only repeal the ACA, but also replace it with comprehensive legislation based on Republican health policy principles.1 Although the proposal recycles long-standing Republican prescriptions, it also offers new ideas.
The proposal would not entirely repeal the ACA. Republicans seem to be coming to terms with the fact that the ACA has permanently changed the health policy landscape. The proposal would, for example, retain the ACA's Medicare provisions in recognition, no doubt, of the difficulty of rolling back all the ACA's provider-payment changes or reopening the doughnut hole in Part D coverage of prescription drugs but also apparently in order to use the ACA's $700 billion in Medicare payment cuts to finance Republican initiatives. The proposed legislation would retain popular ACA insurance reforms, including the ban on lifetime insurance limits, required coverage for children up to 26 years of age on their parents' policies, mandated disclosure of insurance benefits and limitations, and a ban on canceling an enrollee's insurance policy except in the case of fraud. It would retain limits on age rating of insurance premiums, but insurers could charge five times as much for an older as for a younger enrollee, as opposed to the three-to-one ratio limit in the ACA.
The proposal would, like the ACA, use premium tax credits to make health coverage affordable for lower-income Americans. Unlike the ACA's tax credits, which are available to families with incomes of up to 400% of the federal poverty level ($95,400 for a family of four) and are based on the actual cost of health insurance in particular markets, the Republican proposal would help families with incomes of up to only 300% of the poverty level ($71,550), with phasing out beginning at 200%. The proposal would go beyond the ACA, however, by allowing employees of small businesses to use tax credits to purchase insurance through their employer, which would make small-group coverage more affordable.
The tax credits would be for flat dollar amounts, adjusted for age but not for regional cost variations. The amounts proposed would be adequate to purchase high-deductible coverage in some parts of the country but would fall far short of the actual cost of coverage in others.2 With the repeal of the ACA's cost-sharing reduction payments — which reduce deductibles and coinsurance — low-income families might find high-deductible insurance affordable but have trouble paying for actual health care services. Individuals would also still have to disclose personal information to the government to establish eligibility.
The proposal would reinstate premiums based on health status, with an important limit: such "medical underwriting" would not be permitted for any individual who maintained "continuous coverage" when moving from group to individual coverage or between individual or group plans. Americans who are currently uninsured would be given only a one-time opportunity to purchase coverage at a rate not based on their health status. The proposal would also provide federal support for state high-risk pools, although it would not ensure that premiums for those pools were affordable. Insurers could once again charge women more than men.
The proposal would repeal the unpopular individual mandate to obtain insurance coverage. The continuous-coverage requirement, however, would effectively impose another penalty for remaining uninsured: instead of paying a tax, individuals who failed to remain insured would risk facing increased — perhaps unaffordable — insurance premiums for the rest of their lives. There would be no exemption from this penalty for people who couldn't afford coverage, as there is from the ACA mandate.
The proposal would also allow states to "auto-enroll" individuals who were eligible for premium tax credits in health insurance plans, effectively signing them up for coverage without their consent, though allowing them subsequently to opt out. States would be responsible for working with insurers to create auto-enrollment plans that could be purchased for the value of the premium tax credit. The proposal also assumes that the states could auto-enroll people in Medicaid.
Auto-enrollment is an interesting idea. Although it would be technically challenging, it could result in significant coverage expansion. It is likely, however, that in many areas people would be auto-enrolled in very-high-deductible plans with limited benefits.
The proposal would eliminate the ACA's benefit mandates, including its limit on out-of-pocket costs. Eliminating mandates could make coverage more affordable but would also probably reduce the availability of some forms of coverage (e.g., coverage for maternity care, habilitation care, or mental health and substance-use-disorder care and, of course, for preventive services). Getting rid of out-of-pocket caps would increase Americans' financial insecurity and providers' uncompensated-care costs, although the ACA, with its high-cost-sharing plans, has not eliminated these problems.
The proposal would turn Medicaid into a block-grant program, refocusing it on "the low-income mother with children, or the elderly blind person — the kinds of individuals who Medicaid was originally designed to help."1 States would continue to receive federal matching funds for acute care coverage for the aged, blind, and disabled, but funding for pregnant women, children in low-income families, and long-term care would be capped, as would increases in future federal contributions. Medicaid for the working poor would be canceled. The proposal also calls for resurrecting Medicaid "health opportunity accounts" (which resemble health savings accounts), despite the fact that the 2005 demonstration project meant to test them was implemented only by South Carolina, which succeeded in signing up only two adults and three children.3
States would probably welcome greater flexibility for Medicaid programs but not decreased federal funding, which, unlike current funding, will not increase in economic downturns. Many current Medicaid recipients would be dropped from coverage (although they would most likely be eligible for premium tax credits), and those who remained would most likely face higher cost sharing.
The Republican proposal contains many long-standing Republican health care reform projects — more health savings accounts, association health plans for small businesses, interstate insurance sales, and malpractice reform. The proposal's estimate of the cost of "excessive tort litigation," at $589 billion, is more than 40 times the 0.5% of health care costs that the Congressional Budget Office (CBO) estimates could be saved by malpractice reform, but the proposal does focus on providing compensation to victims and not just liability protections for providers.4
The most controversial element of the proposal is its cap on the currently unlimited exclusion from an employee's taxes of the cost of employer-sponsored coverage. The proposal would cap the tax exclusion at 65% of the cost of an average health plan. The employer-sponsored coverage exclusion is currently the largest tax expenditure in the federal budget, and economists have long argued that it distorts the market for health insurance coverage and is more beneficial for higher-income than lower-income taxpayers.
Capping the exclusion would result in a reduction in employer coverage and a substantial tax increase for individuals who retained such coverage. The CBO estimates, for example, that capping the exclusion at 50% of average health plan cost would mean that 6 million Americans would no longer have job-related coverage (comparable to projected employer-coverage losses under the ACA) and an average annual tax increase of about $500 per person by 2019.5
Our health care system is unfathomably complex. Any reform will inevitably disrupt current arrangements and create winners and losers, as we are seeing with the ACA. The Republican proposal will give an advantage to some Americans and will put others at a disadvantage. In my opinion, Senators Hatch, Coburn, and Burr are to be commended, however, for moving beyond simply demanding repeal and putting out a proposal, the effects of which can now be debated.
k, i'm going to post in this thread even though im not sure if it is 100% relevant to the topic, but i just saw a piece on STEWART i hope some of you might have caught tonight.
The piece on Medicare expansion in conservative states is actually something i have been wishing i would have written in to the Daily Show about in hopes they would talk about it. luckily they did it on their own. go John! :clap:
anyway, i'll try and repost my own topic later when i have the strength, but i just wanted to get something down here while i was thinking about it.
basically people like myself are getting fucked up the a$$ by conservatives in our red states just to make a political point. nothing new i guess, smh.
but as the piece said, these are treatable conditions many of us have but we have absolutely no way of getting treatment on our own through clinics or whatever other BS the conservatives suggest. we simply have been relegated to going to the emergency room over and over again until we are dead.
the most idiotic part of the whole situation is that many of us would actually be able to regain function with simple treatments and therefore be able to re-enter a more productive role in society, IE working and paying taxes. so in the long run this is actually much much more of a burden on the economics of the country.
i know im not being very eloquent here, i apologize, my focus is thin ATM, but the fact my state, a relatively poor state, is turning down Gov't funding (millions) that has already been approved to expand medicade for the sole purpose of sticking it to OBAMA, should be considered criminal, if not seditious action IMO.
we're talking about TAX dollars every person in my state pays to the FEderal Gov't that they are trying to giving back to us to save hundreds of thousands of sick people but b/c of a few fucking pieces of shit backed by corporations we are being marginalized into death.
simple HUMAN COMMODITIES, pawns in a game.
when i first lost my physical ability to function and work 4 years ago, if i had been given very inexpensive treatment and care such as physical therapy, there could have been a insanely better chance of me recovering and rejoining the workforce.
instead i have been bounced around, fastracked through a public health system designed to eject patients as fast as possible, and denied disability b/c i was unable to prove to a judge my condition when the catch 22 is that i could not afford to discover the proper evidence needed b/c i cant get any care. (srry for the run on)... hopefully you could follow.
k, pain is too much, ill try and revise later,.
i just hope people are aware that this is complete insanity. we are killing off our workforce and tax payers. this model of bullshit has literally zero sustainability.
eventually these idiots will have no more of us to take advantage of and then what will they do for commodities?
What a mess......
Quote
After five and a half months of dragging feet, dodging accountability, wasting hundreds of millions of taxpayer dollars, allowing nearly 80,000 Marylanders to lose their health coverage, AND even claiming the site is 'functional for most people', the O'Malley-Brown administration will now "likely dump all or part of the state's health insurance exchange website and adopt Connecticut's system, a move that could make it the first state to abandon an dysfunctional site.
Slim, you are 100% correct
and, to both posts above, this is not a failure of ACA/ Obamacare but a failure of local implentation (in the case of MD) combined with the SC ruiling and politicians doing things for political and idealogic purposes as opposed to what is best for the residents of the state.
Not that I'm against local control, etc, I'm not. I'm just making the point that if the Feds say you can do something on you're own instead of us doing it, and the solution by local business or local govt sucks, that's not the Feds fault.
Tennessee state senator compares signing up for Obamacare to Nazi 'train rides for Jews' (http://www.rawstory.com/rs/2014/05/05/tennessee-state-senator-compares-signing-up-for-obamacare-to-nazi-train-rides-for-jews/)
QuoteTennessee state Senator Stacey Campfield is coming under bipartisan fire for his "Thought of the Day" post on his blog.
"Democrats bragging about the number of mandatory sign ups for Obamacare is like Germans bragging about the number of manditory [sic] sign ups for 'train rides' for Jews in the 40s," he wrote today.
Tennessee Democratic Party Chairman Roy Herron responded in a statement that "Senator Campfield's blog post this morning is just the latest example of Tea Party Republican extremism. To compare attempts to save American lives through access to healthcare with Nazis killing European Jews is outrageous, pathetic, and hateful."
"Sen. Campfield and other Tea Party Republicans," he continued, "ought to look at the 5,000 Tennesseans who will die within the next 3 years because Tea Party Republicans refused to take the 100% federal funding to expand Medicaid and have denied working Tennesseans access to healthcare."
Campfield's fellow Republicans were no more supportive. In a statement, GOP Chairman Chris Devaney wrote that "[w]hile Stacey Campfield routinely makes remarks that are over the top, today's comments are ignorant and repugnant."
"No political or policy disagreement should ever be compared to the suffering endured by an entire generation of people. Those comments have no place in our public discourse. He should offer an apology to members of the Jewish faith immediately."
At this time, Campfield has yet to issue an apology, but he did speak to WKRN, saying that he "is not minimizing loss of life" in Nazi Germany," but that "it is not an accurate portrayal for the administration to brag and signups for Obamacare when it's mandatory."
"When you control people's health, you control their lives and if they live or die," he added.
wow
at least the states GOP chairman called him out.
I also have issues with the last sentence, but it pales compared to his main point.
Quote from: slslbs on May 06, 2014, 03:06:17 PM
I also have issues with the last sentence
Say what you will about compelling people to buy health insurance and whether that violates some inalienable freedom of ours, but it's still a far cry from "government-run healthcare" and "death panels" -- not that you'd know it from listening to the right.
the irony is that the "ethics panel / end of life consultation" which became "the death panel" was proposed by a republican. Not that any of them would come clean at this point
And the bigger irony is that the individual mandate was proposed by Republicans and even implemented by one.
Hobby Lobby may have been the hot button case, but it's impact on the ACA is negligible. But a lesser known case that could come out from the DC Circuit Court today (or Friday), Halbig v. Sebelius (http://www.newsweek.com/case-could-topple-obamacare-224747?piano_t=1), is a more serious threat to the overall fate of the law.
Quote from: V00D00BR3W on May 06, 2014, 10:38:45 AM
Tennessee state senator compares signing up for Obamacare to Nazi 'train rides for Jews' (http://www.rawstory.com/rs/2014/05/05/tennessee-state-senator-compares-signing-up-for-obamacare-to-nazi-train-rides-for-jews/)
QuoteTennessee state Senator Stacey Campfield is coming under bipartisan fire for his "Thought of the Day" post on his blog.
"Democrats bragging about the number of mandatory sign ups for Obamacare is like Germans bragging about the number of manditory [sic] sign ups for 'train rides' for Jews in the 40s," he wrote today.
Tennessee Democratic Party Chairman Roy Herron responded in a statement that "Senator Campfield's blog post this morning is just the latest example of Tea Party Republican extremism. To compare attempts to save American lives through access to healthcare with Nazis killing European Jews is outrageous, pathetic, and hateful."
"Sen. Campfield and other Tea Party Republicans," he continued, "ought to look at the 5,000 Tennesseans who will die within the next 3 years because Tea Party Republicans refused to take the 100% federal funding to expand Medicaid and have denied working Tennesseans access to healthcare."
Campfield's fellow Republicans were no more supportive. In a statement, GOP Chairman Chris Devaney wrote that "[w]hile Stacey Campfield routinely makes remarks that are over the top, today's comments are ignorant and repugnant."
"No political or policy disagreement should ever be compared to the suffering endured by an entire generation of people. Those comments have no place in our public discourse. He should offer an apology to members of the Jewish faith immediately."
At this time, Campfield has yet to issue an apology, but he did speak to WKRN, saying that he "is not minimizing loss of life" in Nazi Germany," but that "it is not an accurate portrayal for the administration to brag and signups for Obamacare when it's mandatory."
"When you control people's health, you control their lives and if they live or die," he added.
in bold-- same issue i face in Nebraska.
Trust me, the only people worthy of a Nazi comparison are the lying Republicans that have signed my death warrant by denying the Federal money we pay for in taxes already.
Quote from: runawayjimbo on July 01, 2014, 09:39:23 AM
Hobby Lobby may have been the hot button case, but it's impact on the ACA is negligible. But a lesser known case that could come out from the DC Circuit Court today (or Friday), Halbig v. Sebelius (http://www.newsweek.com/case-could-topple-obamacare-224747?piano_t=1), is a more serious threat to the overall fate of the law.
Quote@ReutersUS #BREAKING: U.S. Appeals Court throws out IRS regulation that implements key Obamacare health insurance subsidies
This will obviously head to Supreme Court, but this is a big deal.
Supreme Court grants cert in
King v. Burwell challenging the legality of subsidies in states where federal gov't operates exchanges, which many are saying is a more serious threat to the law than even the challenge to the individual mandate.
http://www.nytimes.com/2014/11/08/us/politics/supreme-court-to-hear-new-challenge-to-health-law.html
Quote
Supreme Court Accepts New Challenge to Health Law
WASHINGTON — The Supreme Court on Friday agreed to hear a new challenge to the Affordable Care Act, potentially imperiling President Obama's signature legislative achievement two years after it survived a different challenge in the court by a single vote.
The case, King v. Burwell, No. 14-114, concerns tax subsidies that are central to the operation of the health care law. According to the challengers, those subsidies are improperly being given in states that have decided not to run the marketplaces for insurance coverage known as exchanges. Under the law, the federal government has stepped in to run exchanges in those states.
If the challengers are right, millions of people receiving subsidies would become ineligible for them, destabilizing and perhaps dooming the law.
The central question in the case is what to make of a provision in the law limiting subsidies to "an exchange established by the state."
The challengers say the provision means that only people in states with their own exchanges can get subsidies. Congress made the distinction, they say, to encourage states to participate.
But the Internal Revenue Service has issued a regulation saying subsidies are allowed whether the exchange is run by a state or by the federal government. The challengers say that regulation is at odds with the law.
In response, Solicitor General Donald B. Verrilli Jr. told the justices that the I.R.S. interpretation was correct. The one offered by the challengers, he said, is "contrary to the act's text and structure and would render the act unrecognizable to the Congress that passed it."
The case the Supreme Court agreed to hear is from Virginia. It was brought by four people who said they did not want to be subject to the law's requirement that they buy insurance or pay a penalty. But for the subsidies, they said, they would have been eligible for a hardship exemption.
In July, the United States Court of Appeals for the Fourth Circuit, in Richmond, Va., ruled against the challengers. Judge Roger L. Gregory, writing for a three-judge panel of the court, said the contested phrase was "ambiguous and subject to multiple interpretations." That meant, he said, that the I.R.S.'s interpretation was entitled to deference.
That same day, the United States Court of Appeals for the District of Columbia Circuit ruled the other way, agreeing with the challengers that only people in states that run their own exchanges are eligible for subsidies.
The Supreme Court often steps in when federal appeals courts have disagreed. But the split between the two courts was wiped out in September when the full District of Columbia Circuit vacated the July ruling and set the case for argument in December.
It takes only four votes to add a case to the Supreme Court's docket. They may have come from the four members of the court who were ready in 2012 to strike down the Affordable Care Act: Justices Antonin Scalia, Anthony M. Kennedy, Clarence Thomas and Samuel A. Alito Jr. Once again, it seems, the fate of the law may rest with Chief Justice John G. Roberts Jr.
Vermont gives up (for now) on becoming first state to implement single-payer. Turns out free healthcare is a lot more expensive than initially thought.
http://www.politico.com/story/2014/12/vermont-peter-shumlin-single-payer-health-care-113653.html
Quote
Vermont bails on single-payer health care
Vermont Gov. Peter Shumlin on Wednesday dropped his plan to enact a single-payer health care system in his state — a plan that had won praise from liberals but never really got much past the framework stage.
"This is not the right time" for enacting single payer, Shumlin said in a statement, citing the big tax increases that would be required to pay for it.
Shumlin faced deep skepticism that lawmakers could agree on a way to pay for his ambitious goal and that the feds would agree to everything he needed to create the first state-based single-payer system in 2017.
And that was all before Shumlin, a Democrat, almost lost reelection last month in one of the country's most liberal states. And it was before MIT economist Jonathan Gruber, the now notorious Obamacare consultant who also advised Vermont until his $400,000 contract was killed amid the controversy, became political poison.
Shumlin had missed two earlier financing deadlines but finally released his proposal. But he immediately cast it as "detrimental to Vermonters." The model called for businesses to take on a double-digit payroll tax, while individuals would face up to a 9.5 percent premium assessment. Big businesses, in particular, didn't want to pay for Shumlin's plan while maintaining their own employee health plans.
"These are simply not tax rates that I can responsibly support or urge the Legislature to pass," the governor said. "In my judgment, the potential economic disruption and risks would be too great to small businesses, working families and the state's economy."
And that was for a plan that would not be truly single payer. Large companies with self-insured plans regulated by ERISA would have been exempt. And Medicare also would have operated separately, unless the state got a waiver, which was a long shot.
Shumlin added that federal funds available for the transition were $150 million less than expected.
He also has a lot less political capital than before November. Shumlin, chairman of the Democratic Governors Association, still hasn't even officially won his own reelection bid: The Legislature will settle the outcome of the November race in January because Shumlin failed to win more than 50 percent of the vote. He's leading his Republican challenger by just a few thousand ballots.
And the substance of the plan isn't its only politically problematic aspect. Gruber, now infamous for his blunt assessments of the Affordable Care Act and his remarks about "stupid" voters, was until recently a state consultant. Days after the election, video emerged of him dismissing criticism of Vermont's plan in 2011 by asking, "Was this written by my adolescent children, by any chance?" State officials said they would cut off his contract.
Advocates of a single-payer plan said Shumlin should not be able to cast aside Act 48, the 2011 law that called for the creation of Green Mountain Care, without repealing it. A group planned to hold a rally in front of the statehouse on Thursday to protest his decision.
"The governor's misguided decision was a completely unnecessary result of a failed policy calculation that he pursued without Democratic input," the group Healthcare Is a Human Right Campaign said in a statement.
The pool was too small.
Quote from: rowjimmy on December 18, 2014, 10:59:49 AM
The pool was too small.
None of us have any real faith in Shumlin, anyways. "The pool is too small" might as well refer to the talent pool of small-state politics.
Quote from: sunrisevt on December 18, 2014, 11:24:10 AM
Quote from: rowjimmy on December 18, 2014, 10:59:49 AM
The pool was too small.
None of us have any real faith in Shumlin, anyways. "The pool is too small" might as well refer to the talent pool of small-state politics.
I was deliberately vague.
Quote from: rowjimmy on December 18, 2014, 10:59:49 AM
The pool was too small.
It's single payer; there is no pool.
The issue is simply one of health care costs and the required amount of taxes to fund the them. Thankfully (for Vermonters), the governor realized that the financing mechanism was an exorbitant increase in taxes which would put a severe burden on the state's residents and businesses (mostly of the smaller variety since the largest employers would continue to self-fund their plans). I mean, I know the costs don't matter to single-payer proponents, but it is something that practitioners have to reconcile. Reality just caught up with the VT experiment in the end.
Preliminary 2016 rate proposals for exchanges are starting to roll in and the results are not good. This makes the decision in King v. Burwell (http://week4paug.net/index.php?topic=13151.msg763781#msg763781) (which is coming down in a couple of weeks) all the more significant.
Full CMS list to see what your state looks like here (https://ratereview.healthcare.gov/)
http://money.cnn.com/2015/06/02/news/economy/obamacare-rates
Quote
Obamacare sticker shock: Big rate hikes proposed for 2016
Hold onto your wallets ... many insurers want to substantially hike rates on Obamacare policies for 2016.
Many are proposing double-digit premium increases for individual policies, with some companies looking to boost rates more than 60%, according to a list posted Monday by the federal Centers for Medicare & Medicaid Services.
In Florida, for instance, United Healthcare (UNH) wants to raise the rates of plans sold on the Obamacare exchange by an average of 18%. Individual policies available outside the exchange through United Healthcare or through a broker would go up by 31%, on average, with hikes as high as 60% for certain plans in certain locations.
In Texas, insurer Scott & White is looking for a 32% increase for exchange-based plans, while Humana (HUM) is asking for an average 30% boost for its exclusive provider organization policies, which generally cover only in-network services.
Insurers say they want to hike rates because enrollees are going to the doctor, getting lab work and filling prescriptions more than they had originally anticipated.
"We've seen a great pent-up demand for services," said Aaron Billger, spokesman for Highmark, a Blue Cross Blue Shield licensee offering plans in Pennsylvania, Delaware and West Virginia. Enrollees in Obamacare exchange plans use more healthcare than those in job-based policies, he noted.
Insurers submitted their proposed rate hikes for individual policies sold both on and off Obamacare exchanges for review by state officials. The government's list includes insurers that requested increases of 10% or more. Insurers can opt to offer plans on the exchanges, directly or via both methods, but policies with similar coverage must be priced the same.
Rates for Obamacare plans have been closely watched -- and their affordability hotly debated -- since the exchanges first opened in 2014. Insurers had a tough time setting rates in the first two years because they didn't have a lot of data on how much customers would visit the doctor. Now they can base their prices on actual usage, said David Axene, fellow at the Society of Actuaries, an industry group. Some insurers may have underestimated and set their prices too low in 2014 and 2015.
Blue Cross and Blue Shield of North Carolina cited hospital in-patient care, particularly cancer and heart conditions, emergency room visits and specialty drugs as major contributors to its proposed 26% hike.
Insurers, however, probably won't be granted all that they seek. Insurance commissioners in 36 states have the power to deny the rate requests, though they usually negotiate smaller hikes with insurers.
Also, the requested rate changes for 2016 can vary widely based on the specific plan. United Healthcare, for instance, noted it's only asking for a 1.2% increase on some of its plans. This reinforces the need for consumers to shop around when open enrollment begins in November and not just renew their existing plan.
While the proposed rate hikes seem steep, they won't hit Obamacare enrollees as hard since most receive federal subsidies. But even subsidized enrollees will have to pay more depending on the plan they select. Those signing up for individual coverage outside an exchange will pay full freight since they aren't eligible for subsidies.
Rates will be finalized in coming weeks, but consumers may not learn the final prices until just before enrollment opens.
Court rules subsidies available in states with federal exchanges, to which the GOP candidates say "Thank freaking Jeebus."
http://www.bloomberg.com/news/articles/2015-06-25/obamacare-tax-subsidies-upheld-by-u-s-supreme-court-ibc9o863
Quote
Obamacare Tax Subsidies Upheld by Divided U.S. Supreme Court
The U.S. Supreme Court upheld the nationwide tax subsidies that are a core component of President Barack Obama's health-care law, rejecting a challenge that had threatened to gut the measure and undercut his legacy.
The 6-3 ruling is the high court's second in three years to preserve Obamacare in the face of Republican-backed legal attacks. It averts a collapse in state insurance markets and lets millions of Americans keep using federal tax credits designed to make policies affordable.
Chief Justice John Roberts and Justice Anthony Kennedy joined the court's four Democratic appointees in the majority. They said the 2010 Affordable Care Act allows tax credits in all 50 states, not just the 16 that have authorized their own online insurance exchanges.
"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote.
The decision eliminates what was probably the most potent legal challenge to the landmark health-care law that was designed to expand coverage to at least 30 million uninsured Americans. Republican opponents now must look to winning the White House in the 2016 election if they hope to roll back the law.
A ruling against the administration might have forced more than 6 million people to drop Obamacare policies because of tripling and even quadrupling premiums.
Ruling the other way would have been disastrous for so many people, including a handful of politicians on either side of the spectrum.
Yay, almost 2 years of my own personal work not flushed down the toilet...yet.
The Donald, in his address to the Governor's Association
Quote"I have to tell you, it's an unbelievably complex subject. Nobody knew that health care could be so complicated."
Quote from: slslbs on February 28, 2017, 03:44:54 PM
The Donald, in his address to the Governor's Association
Quote"I have to tell you, it's an unbelievably complex subject. Nobody knew that health care could be so complicated."
Anyone with any form of experience would have know. :shakehead:
Quote from: slslbs on February 28, 2017, 03:44:54 PM
The Donald, in his address to the Governor's Association
Quote"I have to tell you, it's an unbelievably complex subject. Nobody knew that health care could be so complicated."
And by nobody, he meant himself.
:shakehead:
http://time.com/4690837/donald-trump-seema-verma/?xid=newsletter-brief
QuoteIf Trump's Medicare Chief Is Approved, You'll Need to Be on Your Best Behavior
Jauhar is a cardiologist and the author of Doctored: The Disillusionment of an American Physician.
Some years ago, surgeons in Australia were refusing to provide heart and lung surgeries to smokers, even those who needed the operations to stay alive. "Why should taxpayers pay for it?" one surgeon argued in the policy's defense. "It is consuming resources for someone who is contributing to their own demise."
Though some were outraged — the Australian Medical Association called it "unconscionable" to ration services based on personal habits — many agreed with this stance. They saw nothing wrong with patients paying for the consequences of their actions.
Seema Verma, President Trump's pick to lead the Centers for Medicare and Medicaid Service, sees things the same way. Verma, a health policy consultant, helped to reform Indiana's Medicaid program, working with then-Gov. Mike Pence. With an eye toward competition and personal responsibility, her program, known as Healthy Indiana Plan, mandated monthly contributions from beneficiaries, even individuals at the federal poverty line. There were stiff penalties for missed payments: termination of coverage or transfer to a pared-down plan that offered limited services.
Donald Trump Promises 'Insurance for Everybody' With Obamacare Replacement Plan
President-elect Donald Trump says his plan to replace the nation's health care law will include "insurance for everybody."
Verma has written that personal contributions are a way for Medicaid recipients to have "skin in the game." She has said that traditional Medicaid regulations "disempower individuals from taking responsibility for their health, allow utilization of services without regard for the public cost, and foster dependency."
Verma's views are in line with those of many Americans. A majority say it is fair to ask people with unhealthy habits, like smoking and overeating, to pay more for health insurance. Even President Obama has said that Americans should be "doing something about their own care."
At some level, this makes sense. People should be agents of their own wellbeing. I myself am sometimes put off by patients who don't seem to care about their health and then demand a quick fix.
HEALTH CARE
Republicans' Health Care Bill Unlikely to Quell National Debate
But personal responsibility is a complex notion when it comes to health. Individual choices always take place within a broader, untidy context. Demanding personal accountability often ignores that context and can lead to discrimination against the people least equipped to defend themselves.
I once took care of a young man with severe congestive heart failure who had a toddler at home but no reliable child care. We were supposed to start him on a blood thinner early in his hospitalization, but it got overlooked. Then, rushing to get his blood thinned, we overshot and had to stop the drug completely, leading to frustrating delays in getting him home. In the end he signed out of the hospital against medical advice. He told me he had to care of his baby.
He came to the clinic a week later looking embarrassed. He had left without prescriptions, so he had been taking no medications since discharge, leaving him short of breath. But the attending physician I was working with refused to give him prescriptions. She said he had to go to a walk-in clinic. She said he had to learn "personal responsibility."
Patients should be encouraged to make healthy choices, but punitive measures to force those choices can backfire. They also presuppose more control over health and sickness than really exists.
Representative Roger Marshall, a Kansas Republican, said in a recent interview: "Just like Jesus said, 'The poor will always be with us.' There is a group of people that just don't want health care and aren't going to take care of themselves." When the interviewer asked him to elaborate, he said, " I think just morally, spiritually, socially, [some people] just don't want health care. The Medicaid population, which is [on] a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising."
Consistent with Marshall's views, under Verma's program in Indiana, missing two payments can get you kicked out of Medicaid for six months. We don't know why some patients in Indiana are delinquent on their payments, in part because little data has been made publicly available. (The Center on Budget and Policy Priorities, a left-leaning organization, says Indiana has not cooperated with attempts to assess the program independently.) But a Medicaid experiment in West Virginia in the late 2000s suggests people often fail to comply with such requirements because of mundane, if no less demanding, life pressures.
In the West Virginia program, Medicaid patients who signed pledges to enroll in a wellness plan and follow their doctors' orders were rewarded with special benefits, including unlimited prescription-drug coverage, diabetes care, and nutritional counseling. Even so, many patients still did not sign up. Those with limited transportation options or childcare responsibilities could not commit to regular office visits. Sadly, patients who could benefit most from the additional services were often least able to comply with the requirements, rendering them ineligible.
Irresponsibility can lead to unhealthy habits and thus poor health. But so can social status, income, family dynamics, education, access to healthy foods and genetics. It is reasonable to demand personal responsibility, but patient noncompliance is as much a function of poor communication, medication costs, cultural barriers, psychiatric illness and inadequate resources as it is of willful disregard of medical advice.
Americans are right to worry about rising health insurance premiums, and there is no denying that the relatively healthy majority will continue to pick up the tab for the sick minority, even those whose misfortune appears to derive from lifestyle choices. That is the nature of insurance: The fortunate among us subsidize care for those less fortunate.
But punitive measures like the kind Verma espouses will not improve the health of the vulnerable populations she is supposed to help. They will also probably lead to higher costs in the long run. Championing personal responsibility is fine, but punishing patients who make poor choices will only worsen this country's health.Jauhar is a cardiologist and the author of Doctored: The Disillusionment of an American Physician and Intern: A Doctor's Initiation
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
It doesn't exactly feel like a "victory." More like "catastrophe temporarily avoided." But it's something.
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
Good, now that you haven't been able to replace it, fund it so it can work as intended.
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
Good, now that you haven't been able to replace it, fund it so it can work as intended.
I'd laugh at your funny joke but it's depressingly true.
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
Good, now that you haven't been able to replace it, fund it so it can work as intended.
I'd laugh at your funny joke but it's depressingly true.
100% serious.
Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
Good, now that you haven't been able to replace it, fund it so it can work as intended.
I'd laugh at your funny joke but it's depressingly true.
100% serious.
Yeah, I know.
Quote from: rowjimmy on March 24, 2017, 10:35:05 PM
Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
Good, now that you haven't been able to replace it, fund it so it can work as intended.
I'd laugh at your funny joke but it's depressingly true.
100% serious.
Yeah, I know.
It's fun to dream.
I am happy to report that I completed my employer's ACA reporting requirements for 2016 today. I gotta say it was a good day. 8-)
(https://scontent.xx.fbcdn.net/v/t1.0-9/17458114_10155006117480928_5497161971472613709_n.jpg?oh=4cf7d3fa7829a9938d23ca97a3fb6d29&oe=59539FAF)
Thank God for those obstructionist wing nuts in the House Freedom Caucus, amirite?!?!
Quote from: rowjimmy on March 24, 2017, 10:35:05 PM
Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
Good, now that you haven't been able to replace it, fund it so it can work as intended.
I'd laugh at your funny joke but it's depressingly true.
100% serious.
Yeah, I know.
Serious question: what haven't they funded? I don't mean like what you would like gov't to pay for, I mean what funding has been stripped from the law that was passed that is preventing it from working as intended?
Quote from: runawayjimbo on March 28, 2017, 10:36:02 AM
Thank God for those obstructionist wing nuts in the House Freedom Caucus, amirite?!?!
Quote from: rowjimmy on March 24, 2017, 10:35:05 PM
Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill (http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill)
Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.
The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.
"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."
Good, now that you haven't been able to replace it, fund it so it can work as intended.
I'd laugh at your funny joke but it's depressingly true.
100% serious.
Yeah, I know.
Serious question: what haven't they funded? I don't mean like what you would like gov't to pay for, I mean what funding has been stripped from the law that was passed that is preventing it from working as intended?
well, risk corridors for one.
Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.
Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.
Quote from: runawayjimbo on March 28, 2017, 12:51:12 PM
Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.
Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.
Well, i certainly dont support that, but if that is that is the way it is... for now, it should have been funded as intended.
Little Marco, however, slipped a provision in a spending bill that ultimately only funded the corridors to the tune of about 13 cents on the dollar. That way the repubs could go on the campaign trail and scream, "Look, premiums have gone up! What a disaster!"
In addition to funding it properly, they could have also put an extention on them until they were more solvent, but, you know, politics.
Quote from: runawayjimbo on March 28, 2017, 12:51:12 PM
Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.
Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.
It may have "ended" in 2016, but there were many not for profit co-ops, and regular insurance companies, that were promised millions that never arrived last year. If the money had been disbursed as planned, I might still have my $1000 deductible plan that I had at this time last year.
If the money is passed on to policy holders in the form of benefit rich plans for sick people, then I'm all for it. Who wouldn't be?
Quote from: mbw on March 28, 2017, 01:10:24 PM
Quote from: runawayjimbo on March 28, 2017, 12:51:12 PM
Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.
Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.
Well, i certainly dont support that, but if that is that is the way it is... for now, it should have been funded as intended.
Little Marco, however, slipped a provision in a spending bill that ultimately only funded the corridors to the tune of about 13 cents on the dollar. That way the repubs could go on the campaign trail and scream, "Look, premiums have gone up! What a disaster!"
The irony is that if the risk corridor program never existed, premiums would not have had to rise as much. The reason the risk corridor program failed so spectacularly was not due to whatever Rubio did (and to be clear, he didn't say "only pay out 13% of the claims"), it was cause the program, by definition, encouraged companies provide low priced plans in a bid to coax young/healthy people to join. When that didn't happen, prices were inevitably going higher. Had they not included this in the law, premiums likely would have been moderately higher in the first year (to account for the risk pool uncertainty) but grown at a slower rate. Of course, the GOP would still be kicking and screaming, but it would have been pretty meritless (you know, more so than it already was).
Quote from: mbw on March 28, 2017, 01:10:24 PM
In addition to funding it properly, they could have also put an extention on them until they were more solvent, but, you know, politics.
Extending the program changes it from risk corridors to something else. It was meant to provide some stability through a turbulent period when the uncertainty around the risk pools was very high. But after a couple years when insurers had enough claims data, they should be able to adequately price their products or GTFO. Risk corridors were meant to smooth out the volatility of those first couple of years; extending it truly would have been an insurer bailout.
Quote from: Hicks on March 28, 2017, 01:15:02 PM
Quote from: runawayjimbo on March 28, 2017, 12:51:12 PM
Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.
Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.
It may have "ended" in 2016, but there were many not for profit co-ops, and regular insurance companies, that were promised millions that never arrived last year. If the money had been disbursed as planned, I might still have my $1000 deductible plan that I had at this time last year.
If the money is passed on to policy holders in the form of benefit rich plans for sick people, then I'm all for it. Who wouldn't be?
The risk corridor "default" wasn't the primary reason nearly every co-ops failed IMO; shit, Vermont closed theirs before it even started (http://www.dfr.vermont.gov/press-release/vermont-health-co-op-fails-state-insurance-standards). The co-op failure is much more attributable to poor management and poorly crafted rules governing them. They never had a chance.
And of course I have no problem in principle with rich benefits. The problem is *someone* has to pay for them. Higher premiums or higher taxes, but one way or another, the cost was going up.
Welp I think you are just wrong about the co-ops, here in Oregon it closed immediately after they got a bill from the Feds served to them for 900k instead of expected funds.
As for who pays for it, are you really so naive to believe that the US government "pays" for things like a normal entity? If they can just magically institute three rounds of QE to bail out banks and other wall street scumbags, why not do it for healthcare too?
Quote from: Hicks on March 28, 2017, 05:28:59 PM
Welp I think you are just wrong about the co-ops, here in Oregon it closed immediately after they got a bill from the Feds served to them for 900k instead of expected funds.
Sorry, I didn't mean to say it had nothing to do with their closings; of course when you are expecting $5M from the feds and you only receive $900k it's going to have an impact on your ability to remain a going concern. What I was suggesting was that this was more of a symptom of the issues and not the cause, which was mismanagement and poor planning. Actuarially speaking, pricing the plans such that your ability to remain solvent is dependent on receipt of risk corridor funds was insane. I cannot believe they would actually include in their rates a provision for payments from Congress, especially this Congress, which is why I see pointing to risk corridor default more as an exercise in blame shifting than anything else.
Quote from: Hicks on March 28, 2017, 05:28:59 PM
As for who pays for it, are you really so naive to believe that the US government "pays" for things like a normal entity? If they can just magically institute three rounds of QE to bail out banks and other wall street scumbags, why not do it for healthcare too?
Well, I was referring more to the consumer paying for it, either directly through higher premiums or indirectly through higher deductibles, more restrictive networks, etc. But to your point, I was and remain adamantly opposed to QE of all forms, as I believe you do. So the question isn't "why not do it for healthcare" it's "why are we doing this bullshit at all?" There's also practical problems (e.g., the transmission mechanism used by the Fed to create the money and move it to the banks is far more seamless than to do so with insurers), but in the end, if it's wrong it's wrong. And there is no goddamned doubt in my mind that QE is very fucking wrong.
I dunno man, yeah in theory QE is fucking batshit insane, but I'm coming around to the idea that federal deficits don't really matter.
The national debt has been exploding for my entire life and when the shit finally hit the fan, it didn't really have anything to do with government spending or monetary policy. Economics is such black magic, anyone who pretends to truly understand it is a fool IMO. But the fact is, we haven't seen out of control inflation in the overall economy and the dollar is as strong as ever, so at this point it seems like we should just keep the money presses spinning, but this time we should be the beneficiaries and I think government subsidized healthcare is where the money needs to go.
Here's a great piece on the whole Repubs vs. the ACA fight of the last decade...
https://www.theatlantic.com/politics/archive/2017/03/the-republican-waterloo/520833/ (https://www.theatlantic.com/politics/archive/2017/03/the-republican-waterloo/520833/)
It's a long one and the following quote is near the end. I think this is actually a really important perspective:
QuoteWhatever else the 2016 election has done, it has emancipated Republicans from one of their own worst self-inflicted blind spots. Health care may not be a human right, but the lack of universal health coverage in a wealthy democracy is a severe, unjustifiable, and unnecessary human wrong. As Americans lift this worry from their fellow citizens, they'll discover that they have addressed some other important problems too. They'll find that they have removed one of the most important barriers to entrepreneurship, because people with bright ideas will fear less to quit the jobs through which they get their health care. They'll find they have improved the troubled lives of the white working class succumbing at earlier ages from preventable deaths of despair. They'll find that they have equalized the life chances of Americans of different races. They'll find that they have discouraged workplace discrimination against women, older Americans, the disabled, and other employees with higher expected health-care costs. They'll find that their people become less alienated from a country that has overcome at last one of the least attractive manifestations of American exceptionalism—and joined the rest of the civilized world in ameliorating and alleviating our common human vulnerability to illness and pain.
^^
great quote
the national debt has really only been exploding the last 8-10 years.
it affects us because the govt has to pay interest on it, taking away money for things like health care (or guns, depending upon what your preference is)
I don't think this country will have single payer health in my lifetime, for better or worse.
Quote from: slslbs on March 29, 2017, 03:46:06 PM
^^
great quote
the national debt has really only been exploding the last 8-10 years.
it affects us because the govt has to pay interest on it, taking away money for things like health care (or guns, depending upon what your preference is)
I don't think this country will have single payer health in my lifetime, for better or worse.
Well it did triple under Reagan.
As for interest, just keep the Fed rates low forever, wheeeeeeeeeeeee!
I kinda thought it before, but now I'm quite sure you're trolling me, Hicks. But I just can't help myself...
Quote from: Hicks on March 29, 2017, 12:28:38 PM
I dunno man, yeah in theory QE is fucking batshit insane, but I'm coming around to the idea that federal deficits don't really matter.
Objection: conflating QE (money creation/debt monetization) and deficits (debt creation).
The only reason deficits don't matter is because our superpower status as well as the dollar as the world's reserve currency. But even if that were to continue indefinitely (it won't, but never mind that), debt service alone will crowd out other spending at some point. So unless you're willing to cut spending in other areas (not slower growth of future increases, actually CUT spending), deficits do in fact matter. Debt is the accumulated deficit, so by definition it doesn't happen all at once. It's a very long fuse...
Quote from: Hicks on March 29, 2017, 12:28:38 PM
The national debt has been exploding for my entire life
Bill says no.
Quote from: Hicks on March 29, 2017, 12:28:38 PM
and when the shit finally hit the fan, it didn't really have anything to do with government spending or monetary policy.
Well, indirectly through an extended policy of low interest rates which helped fuel a housing related boom and bust. But do we really need a crisis to prove the overall efficacy of a given policy?
Quote from: Hicks on March 29, 2017, 12:28:38 PM
Economics is such black magic, anyone who pretends to truly understand it is a fool IMO.
Word, although I do think you can look retroactively and assess the issues empirically; projecting forward is total voodoo. But you're right, you can even empirically find "evidence" to back into whatever you answer to which you were ideologically predisposed to in the first place.
Quote from: Hicks on March 29, 2017, 12:28:38 PM
But the fact is, we haven't seen out of control inflation in the overall economy and the dollar is as strong as ever, so at this point it seems like we should just keep the money presses spinning, but this time we should be the beneficiaries and I think government subsidized healthcare is where the money needs to go.
Oh, Hicks
I'm trying to get outta here early but I do need to point out:
(1) dollar comment somewhat addressed above, buoyed by the fact the rest of the world continues to wade into monetary shenanigans and weak growth (brought on at least in part by, you guessed it, too much debt!);
(2) inflation has been nonexistent largely because the Fed PAID banks not to flood the system with their newly created "money," thereby restraining (or rather, delaying) the inevitable devaulation that comes with a quadrupling of a central bank's balance sheet; and
(3) you mean you want gov't to subsidize healthcare (which they already do for exchange plans) by creating new money and sending it directly to taxpayers to be used on health insurance (or, just cut out the middle man and send it directly to the health insurers)? I thought you wanted to reduce health insurer power; HCQE would be a fat ass blank check.
Incidentally, people did propose a QE for the people, the so called "helicopter money" (cause it would be like dropping money from a helicopter), where instead of sending QE minted dollars to the banks it would go right to you. And there was a lot of thoughtful analysis around it to come up with what is so patently obvious on it's face: weakening the currency is not a way to get prosperity. I understand and respect your desire to help people, but QE is fundamentally flawed and should be removed from the toolkit.
Quote from: PIE-GUY on March 29, 2017, 01:48:28 PM
Here's a great piece on the whole Repubs vs. the ACA fight of the last decade...
Quoteby: David Frum
Easy pass
Quote from: Hicks on March 29, 2017, 04:16:42 PM
Quote from: slslbs on March 29, 2017, 03:46:06 PM
^^
great quote
the national debt has really only been exploding the last 8-10 years.
it affects us because the govt has to pay interest on it, taking away money for things like health care (or guns, depending upon what your preference is)
I don't think this country will have single payer health in my lifetime, for better or worse.
Well it did triple under Reagan.
forgot about that - getting old
Yeah I did kinda co-mingle QE and the deficit my bad, although now that I think about it, we'll just do another QE and this time we'll make the banks service US debt, genius!
As for some other currency replacing the dollar as the dinero fraca, I just don't see that happening anytime soon, who's gonna do it, the Euro? (lol!)
Low interest rates were a very small piece of mortgage backed security shitstorm and let's be honest, those wolves would've underwritten shitty loans regardless of the rates and in fact many of the ARMs they sold did become outrageously high.
I think a single payer system is the only real solution to the problem we face, and that's the system I would like to see our government pump money into. Oh surely there would be massive waste, but I have to believe it would be an improvement from the parasitic insurance industry literally sucking the life out of the populace.
I'll go on record and say that I want the government involved as little as possible in healthcare.
hell, wait and see what medicare is like 10 years from now.
Quote from: DoW on March 30, 2017, 08:33:39 AM
I'll go on record and say that I want the government involved as little as possible in healthcare.
hell, wait and see what medicare is like 10 years from now.
I'll go on record and say that I want the grubby hands of the insurance industry involved as little as possible in healthcare. I've seen what the last 50 years of their bullshit has done to the cost trying to stay healthy.
Quote from: PIE-GUY on March 30, 2017, 09:12:21 AM
Quote from: DoW on March 30, 2017, 08:33:39 AM
I'll go on record and say that I want the government involved as little as possible in healthcare.
hell, wait and see what medicare is like 10 years from now.
I'll go on record and say that I want the grubby hands of the insurance industry involved as little as possible in healthcare. I've seen what the last 50 years of their bullshit has done to the cost trying to stay healthy.
the government has been heading into the direction of acting like an insurance company.
I have no love for insurance companies.
my point on the government lies in that we are in a state of the two parties inability to work together which results in nothing getting done.
I have always been against the repeal of the ACA. now that ti is at least temporarily stalled, I still see nothing that shows that will work on improving the "law of the land." if you give the government all the power on healthcare, it will just lead to more of a power struggle between the two parties. at least currently there is a free market option for people.
I get the single payer argument. I just don't happen to agree with it.
fwiw, Medicare regulations are independent of Congress and apolitical.
They also often make no medical sense.
Funding Medicare, of course if very political, and, that of course, as pointed out, will become more problematic as time goes by
Insurance company regs ALSO often make no sense, but in my experience they are quicker to change than Medicare because they have to respond to the market. On the other hand, they have more hoops to jump through that increase business expense and delay care. Some of those hoops are actually good things, because there is no doubt that the system IS overutilized, by everyone
Personally, I hate them both
the lesser of 2 evils is still evil
USA needs a Tommy Douglas.
(http://storage.canoe.ca/v1/dynamic_resize/sws_path/suns-prod-images/1305156377213_ORIGINAL.jpg?quality=80&size=650x)
Quote from: Hicks on March 29, 2017, 05:00:47 PM
Yeah I did kinda co-mingle QE and the deficit my bad, although now that I think about it, we'll just do another QE and this time we'll make the banks service US debt, genius!
You joke but some super serious people argued during QE3 just that: gov't should borrow long at historically low rates, fund infrastructure spending, and have the Fed pay kick the printers into overdrive to fund the debt. It's a tempting (if extremely shortsighted) proposition for sure, but it's led to ruin every other time it's been tried. Which is the logical conclusion; there's no other possible outcome of trying to pay for something with nothing.
Quote from: Hicks on March 29, 2017, 05:00:47 PM
As for some other currency replacing the dollar as the dinero fraca, I just don't see that happening anytime soon, who's gonna do it, the Euro? (lol!)
Not anytime soon, but in our lifetimes? Yeah, I think we will see that. And no, I don't think it'll be the Euro, but rather the yuan (China is set to overtake our economy in the next 15-30 years) or possibly a basket of currencies as a world benchmark.
Quote from: Hicks on March 29, 2017, 05:00:47 PM
Low interest rates were a very small piece of mortgage backed security shitstorm and let's be honest, those wolves would've underwritten shitty loans regardless of the rates and in fact many of the ARMs they sold did become outrageously high.
I'm not saying rates were the sole or even primary cause of the crisis; there's plenty of blame to go around and I don't think any one factor contributed more than the other. I was just disagreeing with your point the monetary policy "didn't really have anything to do with it." Monetary policy was the fuel (or at least one component of it); greed and the over-financialization of the economy (among other things) was the match.
Quote from: Hicks on March 29, 2017, 05:00:47 PM
I think a single payer system is the only real solution to the problem we face, and that's the system I would like to see our government pump money into. Oh surely there would be massive waste, but I have to believe it would be an improvement from the parasitic insurance industry literally sucking the life out of the populace.
As I've said, I think single payer is wrong and your view of the insurance industry obviously hyperbolic. However (to bring it back around to where we started), I would prefer single payer to the ACA. The system is broken and needs a full scale overhaul. Single payer would do that, so would elimination of tax favored/employer provided health care (which I favor). The ACA tries to put 1,000 band-aids on it and call it a day. Obviously a total upending of the existing system would be extraordinarily difficult/impossible. But that's the only way you get back to some semblance of sanity IMO.
Quote from: PIE-GUY on March 30, 2017, 09:12:21 AM
Quote from: DoW on March 30, 2017, 08:33:39 AM
I'll go on record and say that I want the government involved as little as possible in healthcare.
hell, wait and see what medicare is like 10 years from now.
I'll go on record and say that I want the grubby hands of the insurance industry involved as little as possible in healthcare. I've seen what the last 50 years of their bullshit has done to the cost trying to stay healthy.
50 years you say? Hmmm, what other monumental shift in health care happened around then? Can't quite place my finger on it. Oh well, it's probably nothing.
We'll see what the CBO says, but it seems like the AHCA is a big win for rich, healthy people.
If you have a chronic illness (or get one in the future) you may be fucked.
Quote from: slslbs on May 05, 2017, 08:36:13 AM
We'll see what the CBO says, but it seems like the AHCA is a big win for rich, healthy people.
I'm shocked.
QuoteWe'll see what the CBO says
- Republican lawmakers
jk
"New" (same) bill comes out in the morning.
Keep your eye on the ball and make your voice heard.
Senate bill fails
Repeal only has already died
ACA remains intact (for now)
Trump says he's disapointed and will just let Obamacare fail
The problem, Donald, is that you don't know the 1st thing about health care policy, and you really don't give a shit. You just want to reverse and erase anything associated with Obama
/rant
https://www.collins.senate.gov/newsroom/sen-collins-statement-health-care-vote
QuoteSenator Susan M. Collins
Statement on Health Care Reform
July 27, 2017
Few issues are as important or personal to the American people as health care, which is why this debate has been so fervent and ignites such passion.
On the one hand, the Affordable Care Act (ACA) has allowed millions of individuals and families to obtain health insurance for the first time. It has also brought important patient protections like those for people with pre-existing conditions and prohibitions on annual and lifetime limits on insurance payments for needed care.
On the other hand, too many Americans face skyrocketing premiums and unaffordable deductibles coupled with mandates that give them few, if any, choices. Some insurance plans have become so restrictive that families find they can no longer go to the doctor or hospital of their choice. In addition, the ACA's employer mandate discourages businesses from creating jobs or giving their workers more hours, while its tax credits and subsidies are designed so poorly as to cause "wage lock" – where working harder to get ahead can instead make some Americans fall further behind.
Despite President Obama's campaign promise that his health care plan "would save the average family $2,500 on their premiums" per year, the opposite has happened as premiums are increasing in nearly every state, with an average increase of 25 percent nationally last year. And today, despite the implementation of the ACA, 28 million Americans remain uninsured.
These problems require a bipartisan solution. The Democrats made a big mistake when they passed the ACA without a single Republican vote. I don't want to see Republicans make the same mistake.
Earlier this week I voted against proceeding to health care reform legislation – the American Health Care Act of 2017 – that passed the House of Representatives last May without a single Democratic vote. For many Americans, this bill could actually make the situation worse. Among other things, the bill would make sweeping changes to the Medicaid program – an important safety net that for more than 50 years has helped poor and disabled individuals, including children and low-income seniors, receive health care. The non-partisan Congressional Budget Office (CBO) projects that the number of uninsured Americans would climb by 23 million under this bill.
Senate Leaders, recognizing that the House bill did not have sufficient support, advanced their own substitute proposal that would make similar structural changes to the Medicaid program, as well as many other changes. CBO estimates that this plan would reduce the number of people with insurance by 22 million, cause premiums and other out-of-pocket costs to soar for Americans nearing retirement, and shift billions of dollars of costs to state governments. It also would undermine the financial stability of rural hospitals and long-term care facilities and likely lead to the loss of important consumer protections for many Americans, while doing virtually nothing to address the underlying problem of escalating health care costs. Earlier this week, this body struck down that proposal by a vote of 43 to 57.
A separate proposal that would simply repeal the ACA without a replacement also failed, by a vote of 45 to 55. That legislation, according to CBO, would result in 32 million people losing their insurance, bringing the total number of uninsured Americans to 60 million a decade from now. Clearly, that is going in the wrong direction.
In a final effort to reach consensus, Republican Leaders have pieced together a plan that would repeal key portions of the ACA while punting on many of the more difficult questions. While I support many of the components of this plan, this approach will not provide the market stability and premium relief that is needed. In fact, a bipartisan group of Governors wrote Senate Leaders this week urging rejection of this so-called "skinny" plan, which they say "is expected to accelerate health plans leaving the individual market, increase premiums, and result in fewer Americans having access to coverage." I ask consent that the letter be entered into the record.
Also included in all of these plans is a misguided proposal that would block federal funds, including Medicaid reimbursements, from going to Planned Parenthood. Millions of women across the country rely on Planned Parenthood for family planning, cancer screening, and basic preventive health care services. Denying women access to Planned Parenthood not only runs contrary to our goal of letting patients choose the health care provider who best fits their needs, but it also could impede timely access to care.
If Planned Parenthood were defunded, other family planning clinics in Maine, including community health centers, would see a 63 percent increase in their patient load. Some patients would need to drive greater distances to receive care, while others would have to wait longer for an appointment.
Let me be clear that this is not about abortion. Federal law already prohibits the use of federal funds to pay for abortion except in cases of rape, incest, or when the life of the mother is at risk.
This is about interfering with the ability of a woman to choose the health care provider who is right for her. This harmful provision should have no place in legislation that purports to be about restoring patient choices and freedom.
We need to reconsider our approach. The ACA is flawed and in portions of the country is near collapse. Rather than engaging in partisan exercises, Republicans and Democrats should work together to address these very serious problems. In their letter to Senate Leaders, the bipartisan group of Governors correctly notes that, "True, lasting reforms can only be achieved in an open, bipartisan fashion."
Health care is extraordinarily complex, and we must work together systematically in order to "do no harm" and improve our health care system. In developing legislation, our focus should be on the impact on people, premiums, and providers.
We're dealing with an issue that affects millions of Americans and one sixth of our economy, and we need to approach reforms in a very careful way. That means going through the regular process of committee hearings; receiving input from expert witnesses such as actuaries, governors, advocacy groups, and health care providers; and vetting proposals with our colleagues on both sides of the aisle. It needs to be a much more deliberative process, and I am pleased that Chairman Alexander has expressed a willingness to begin hearings in the Senate Health Committee.
Neither party has a monopoly on good ideas, and we must work together to put together a bipartisan bill that fixes the flaws in the ACA and works for all Americans.
:clap:
The only thing I'll say is Republicans LOVE to slam the Dems for passing the ACA with zero Repub votes, but it was a bipartisan bill that they just didn't vote for for partisan reasons.
yes, they forget that the initial ideas came from a GOP think tank in the 90s, got incorportated into Romney care, and the so called "death panel" (actually ethics panel) came from a GOP Senator
So this is interesting... everyone was pissed at McCain this week for voting yes on Tuesday but I think he knew what he was doing. Seems to me, he's legacy shopping (don't want to forever be remembered as the guy who introduced Palin to the country).
(http://i.imgur.com/ifXLnsv.jpg)
^^^ I saw that earlier, and it definitely makes sense. I wasn't aware of all the details of the rules.
I'm glad he did it, no matter his reason(s). He'll be remembered for many things, especially elevating that simpleton to the national stage, but he will definitely be remembered for this, too. And he deserves credit for it.