This is topic Republican Scott Brown wins special election in MA - Analysis of Democratic options in forum Books, Films, Food and Culture at Hatrack River Forum.
Looks like Massachusetts will temporarily have its first Republican senator in 30 years. There's some irony in the fact that Democrats in Massachusetts rushed to change the law to allow the special election, at the posthumous urging of Ted Kennedy, specifically to bolster the Democratic majority in the Senate. Looks like that backfired. Brown will be up for reelection when Kennedy's original term expires in 2012.
Brown has already pledged to oppose the Democratic-backed health care plan in Congress, and without the MA vote, there's virtually zero chance of the measure passing. So, Democrats have a little tree of options now. The first fork in the road is this: Do they go back to the drawing board and attempt to rewrite the measure into something Republicans can accept, or do they use alternative measures to pass the bill despite Republican opposition?
Let's assume that Democrats choose the latter option. There are a number of options available to them. The tree branches off here into another direction: Do they ram the legislation through before Brown is sat, or do they wait until after he takes his office?
If they push it through before he's sat, they have one or two options. 1. The House and Senate finish their closed-door negotiations quickly, and vote on the issue before he takes his oath of office. 2. The House votes to confirm an unamended Senate healthcare plan. If they do so, the measure goes right to Obama, and it never comes up before the Senate again. This is unlikely, given the enormity of the differences, and the outright hatred a lot of House Democrats have for the Senate plan. But, a version of this could still have legs...
If they wait until after he's sat, they almost have to use the reconciliation process, which is a parliamentary loophole that allows a measure to be passed by a simple 51 vote majority so long as it relates to the budget, rather than being subject to a filibuster. The problem with this plan, is that it requires them to start the entire process all over again. The bill would have to come from the Ways and Means Committee, where the money is, in order to be truly be considered a budget measure, which means it will be subjected to further scrutiny at all levels of Congress (subcommittee, committee, and full floor debate). This makes it unlikely to pass before the Spring, but when it reached a vote, its passage would be assured, and likely in a far more liberal format than at present. It would also allow a lot of fence sitting moderate Democrats to vote no while saving face (as well as ending a number of truly atrocious sweetheart deals that Ben Nelson, among others, shoehorned into the present Senate bill).
A modified form of this plan would be to have the House pass the Senate version of the plan now, with the promise that modifications would be made to bring it more in line with the House bill. That modifications bill could follow the reconciliation plan, and pass under the same conditions.
Regardless, if any of these options are used, Republicans are going to claim it's a subversion of democracy. They call anything involving the reconciliation process "the nuclear option" because it denies them their time-honored right (used by BOTH sides to the point of exhaustion over the last few decades) of stymieing legislation they don't like. The problem I see for Democrats is, if they use the option to pass legislation the people don't like, it's going to backfire in bad, bad ways. If they use it to pass legislation the people DO like, then the Republicans will find their claims fall on deaf ears. Knowing exactly what the Republicans will do, it would put the ball entirely in the Democrats' court to actually pass good legislation, knowing full well that bad legislation will kill them in two years, and possibly lose them the White House as well. That is, if they're smart enough to realize that, which isn't a given.
Should be an interesting couple of weeks. Get ready for Washington's Outrage-o-meter to red line and explode over the next month!
Posted by Kwea (Member # 2199) on :
My analysis?
We're borked.
Posted by rollainm (Member # 8318) on :
Yep.
Posted by Mucus (Member # 9735) on :
I gotta invest my RRSP in some HMOs or something.
Posted by BlackBlade (Member # 8376) on :
quote:Originally posted by Kwea: My analysis?
We're borked.
No kidding.
I look forward with dread when tomorrow morning I turn on my talk radio.
我們完蛋了。
我對明天按電臺覺得很可怕。
Posted by Ron Lambert (Member # 2872) on :
The worst thing Democrats could do is delay seating the new senator-elect until after the voting is completed for the health care bill. People all across the country would erupt in fury. They already see Democrats as arrogant. It would be interesting to see what position the other Massachusetts senator, John Kerry, would take if the senate pulled that kind of shenanigan. Harry Reid has just announced that Brown will be seated as soon as his paperwork is received. Whatever that may mean....
Posted by steven (Member # 8099) on :
quote:Originally posted by Ron Lambert: The worst thing Democrats could do is delay seating the new senator-elect until after the voting is completed for the health care bill. People all across the country would erupt in fury. They already see Democrats as arrogant. It would be interesting to see what position the other Massachusetts senator, John Kerry, would take if the senate pulled that kind of shenanigan. Harry Reid has just announced that Brown will be seated as soon as his paperwork is received. Whatever that may mean....
Ron, I sincerely hope, for your sake, you never find yourself unable to afford necessary health care, in a country without a sufficient governmental support system to help you.
Posted by Vadon (Member # 4561) on :
They won't delay seating him.
My bet is they try to have the house pass the senate bill. Yeah, there are many in the house who are adamantly against it, but it's the most desirable option I see on the table. With Obama announcing his economic agenda which includes the bank-tax, the jobs bill, and other things at the State of the Union, I doubt he wants to let those priorities get bogged down with reconciliation or re-writing the bill entirely.
But I'm not an insider, so I have no clue what's going through the leadership's mind.
Posted by rivka (Member # 4859) on :
quote:Originally posted by Vadon: They won't delay seating him.
No need to. Massachusetts law means that it will 2-3 weeks until he can be seated.
Posted by Kwea (Member # 2199) on :
He will be seated....he won fair and square.
I just don't think that it means what you think it does, Ron. Winning, not getting seated, of course. It wasn't a referendum on health care, it was an election between two morons, neither of whom I would have wanted to vote for if I was still living in MA myself.
I doubt any voters would erupt at it anyways, at least not in fury. Not in any serious numbers.
You see Dems are arrogant. I see Reps as ignorant fear mongers.
Not all, for sure, but most of the ones you'd probably like.
[ January 20, 2010, 12:14 AM: Message edited by: Kwea ]
Posted by Flying Fish (Member # 12032) on :
Right now Webb, Warner, Bayh, Nelson, the other Nelson, Carnahan, and Lincoln are telling Obama drop this bill right now, drop it, pivot to something else, say whatever you have to, say this election changed your mind, say Haiti changed your mind, say George Bush stole all our pencils, but drop it! We're not taking anymore bullets for you on this. Add in Leiberman, Reid, and Boxer and you have a senate which will sprint away, not walk away, but bolt away!
Posted by Kwea (Member # 2199) on :
I doubt that as well. It may not pass, but it's still pretty important. Even if MA just borked us on it in the long run.
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Ron Lambert: The worst thing Democrats could do is delay seating the new senator-elect until after the voting is completed for the health care bill. People all across the country would erupt in fury. They already see Democrats as arrogant. It would be interesting to see what position the other Massachusetts senator, John Kerry, would take if the senate pulled that kind of shenanigan. Harry Reid has just announced that Brown will be seated as soon as his paperwork is received. Whatever that may mean....
I think Conspiracy Theory 2.0 is burning out your mental RAM.
There has been zero talk of delaying seating Brown. I think when Reid says they are waiting for his paperwork, he means they are waiting for his paperwork. It usually takes about two weeks. That's bureaucracy, not a concerted effort to hold off seating him.
Posted by Sterling (Member # 8096) on :
Ron is correct about one thing: the Democrats in Congress aren't very popular right now. The thing is, most people continue to think the Republicans are worse.
I don't know... Is there something about Massachusetts that makes Democratic candidates lazy...? This really was a tortoise-and-hare of a race.
The Democrats can try to push the bill through in the two-to-three week gap, but frankly, they've shown precious little ability to come to reasoned concensus up to this point, and I have little reason to believe something as simple as watching the whole agenda go to hell is going to be enough to light fires under the appropriate rear ends. I'm really rather disappointed with them.
Posted by Vadon (Member # 4561) on :
quote:Originally posted by Sterling: ... and I have little reason to believe something as simple as watching the whole agenda go to hell is going to be enough to light fires under the appropriate rear ends. I'm really rather disappointed with them.
You'd think that should be enough. Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by rivka:
quote:Originally posted by Vadon: They won't delay seating him.
No need to. Massachusetts law means that it will 2-3 weeks until he can be seated.
It is 2-3 weeks until the election can be certified. He can (and should) be seated prior to that time, as Ted Kennedy was when he won a similar special election 45 years ago.
I'm sorry for Dems existential angst (it's really not that bad, guys) but being a Republican in MA yesterday was like being a Red Sox fan in October 2004. Watching that map turn red wasn't something I'd imagined would happen for at least another 20 years. I'm not terribly fond of Brown (although I admire his work ethic and his somewhat moderate brand of Republicanism, he's too militaristic and corporate for my taste), but I'm still proud that he'll by my US Senator for at least the next three years.
Posted by DarkKnight (Member # 7536) on :
quote: It wasn't a referendum on health care, it was an election between two morons, neither of whom I would have wanted to vote for if I was still living in MA myself.
I haven't read or heard that it had nothing to do with healthcare, quite the opposite.
Posted by Tresopax (Member # 1063) on :
This seems like a good opportunity to improve the heath care bill...
Posted by DarkKnight (Member # 7536) on :
Nothing like the classy Olbermann apologizing....
quote: Keith Olbermann told viewers on Tuesday's "Countdown that he planned to apologize for remarks made about Scott Brown, which included calling the Republican candidate "an irresponsible, homophobic, racist, reactionary, ex-nude model, tea-bagging supporter of violence against women and against politicians with whom he disagrees.”
"I'm sorry," Olbermann said. "I left out the word sexist."
Posted by Javert (Member # 3076) on :
quote:Originally posted by DarkKnight: Nothing like the classy Olbermann apologizing....
quote: Keith Olbermann told viewers on Tuesday's "Countdown that he planned to apologize for remarks made about Scott Brown, which included calling the Republican candidate "an irresponsible, homophobic, racist, reactionary, ex-nude model, tea-bagging supporter of violence against women and against politicians with whom he disagrees.”
"I'm sorry," Olbermann said. "I left out the word sexist."
Did he back up those claims with evidence, or just made them outright? I only ask as most of those claims he makes about Brown, if true, would be statements of fact as opposed to insults.
Much as when one uses the term 'ignorant' and it is interpreted as an insult. Which it, as long as it's demonstrably true, is technically not.
Posted by DarkKnight (Member # 7536) on :
He did have a response to that too, he said he made the statement and it is up to Brown to prove him wrong...
Posted by Javert (Member # 3076) on :
quote:Originally posted by DarkKnight: He did have a response to that too, he said he made the statement and it is up to Brown to prove him wrong...
Well that's silly. I imagine a quick google search would tell us whether, say, he made any racist or anti-homosexual comments, or was an ex-nude model.
Posted by katharina (Member # 827) on :
What a horrible person. That's just nasty, unprofessional, and weak.
Posted by DarkKnight (Member # 7536) on :
quote: Well that's silly. I imagine a quick google search would tell us whether, say, he made any racist or anti-homosexual comments, or was an ex-nude model.
Would it? If he attended a Tea Party rally that makes him part of "the saddest collection of people who don't want to admit why they really hate since the racists of the South in the '60s insisted they were really just concerned about states' rights” according to Olbermann.
Posted by sinflower (Member # 12228) on :
The GOP has the prettier politicians.
Posted by rivka (Member # 4859) on :
quote:Originally posted by SenojRetep:
quote:Originally posted by rivka:
quote:Originally posted by Vadon: They won't delay seating him.
No need to. Massachusetts law means that it will 2-3 weeks until he can be seated.
It is 2-3 weeks until the election can be certified. He can (and should) be seated prior to that time, as Ted Kennedy was when he won a similar special election 45 years ago.
The implication of something I read yesterday (and I don't recall where) was that it was no longer an option to seat him prior to certification. I was unclear as to precisely why.
Posted by theamazeeaz (Member # 6970) on :
quote:Originally posted by SenojRetep:
quote:Originally posted by rivka:
quote:Originally posted by Vadon: They won't delay seating him.
No need to. Massachusetts law means that it will 2-3 weeks until he can be seated.
It is 2-3 weeks until the election can be certified. He can (and should) be seated prior to that time, as Ted Kennedy was when he won a similar special election 45 years ago.
I'm sorry for Dems existential angst (it's really not that bad, guys) but being a Republican in MA yesterday was like being a Red Sox fan in October 2004. Watching that map turn red wasn't something I'd imagined would happen for at least another 20 years. I'm not terribly fond of Brown (although I admire his work ethic and his somewhat moderate brand of Republicanism, he's too militaristic and corporate for my taste), but I'm still proud that he'll by my US Senator for at least the next three years.
Ugh. I disagree with this man on SO much. Gay marriage, the economy, abortion rights. I don't want him as my senator. He seems the type of Republican that comes off as annoying and misinformed, and not the reasonable opposition they imagine themselves to be.
I didn't vote in the election because I'm still an RI resident, even though I've lived in Massachusetts for most of the past 5.5 years (but I want to become an MA resident after I pass my generals). Though I wouldn't have been able to vote yesterday in all likelihood, because I had a surprise appendectomy this week and have been out of commission.
Posted by Kwea (Member # 2199) on :
quote:Originally posted by DarkKnight:
quote: It wasn't a referendum on health care, it was an election between two morons, neither of whom I would have wanted to vote for if I was still living in MA myself.
I haven't read or heard that it had nothing to do with healthcare, quite the opposite.
I didn't say it had nothing to do with it. I said it wasn't the only reason he won. His opponent was a moron, and I could have won against her, possibly.
And I am not even a resident.
MA already HAS healthcare requirements, and policies in place. This won't change that. There were many problems with this race, and the healthcare issue was only one of them.
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by Tresopax: This seems like a good opportunity to improve the heath care bill...
How? The health care bill is the way it is because of all the compromises that had to be made to get Senators who don't want health care reform to vote for it*. How is having another Senator who doesn't want health care reform an opportunity?
*Not vote for it really. We (people who want health care reform) have plenty of votes to pass it. What we lack is enough votes to keep the anti-health care Senators (a minority) from preventing the bill to come to a vote at all.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by kmbboots:
quote:Originally posted by Tresopax: This seems like a good opportunity to improve the heath care bill...
How? The health care bill is the way it is because of all the compromises that had to be made to get Senators who don't want health care reform to vote for it*. How is having another Senator who doesn't want health care reform an opportunity?
*Not vote for it really. We (people who want health care reform) have plenty of votes to pass it. What we lack is enough votes to keep the anti-health care Senators (a minority) from preventing the bill to come to a vote at all.
Brown has said he supports Health Care Reform (as do many Republican Senators), just not the reform in the current bill.
My hope is the Democratic leadership is sufficiently humble to jettison the bloated, inefficient bill they've written and look to the only proposal with real bipartisan support: the Wyden-Bennett Healthy Americans Act.
Posted by Brian J. Hill (Member # 5346) on :
First of all, let me say that Scott Brown ran a BRILLIANT campaign. Students of political science will analyse this campaign, as they will President Obama's 2008 campaign, for years to come. He found a great mix between retail politics (A LOT of retail politics,) crafting an "outsider" image, while at the same time taking advantage of voters' distrust of national political issues. As radical as Ron's views normally are, he was right when he said Americans view the Democratic leadership in Congress as arrogant. Brown's campaign was able to tap into those feelings. Whether you agree with his genuineness or not, he was able to craft a great image.
quote: Ron, I sincerely hope, for your sake, you never find yourself unable to afford necessary health care, in a country without a sufficient governmental support system to help you.
The problem with this sentiment is (besides the fact that it didn't address a thing Ron actually said) is that I don't believe for a second that anything the Democrats pass will in reality have any effect whatsoever on this hypothetical situation. It's a sentiment that, by all accounts, most Americans share. There is little confidence in the ability of the current Democrat plan to make any real differences. There have been so many "compromizes" that the process itself has become corrupted.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by Brian J. Hill: ...I don't believe for a second that anything the Democrats pass will in reality have any effect whatsoever on this hypothetical situation...
I think that's an odd thing to believe. Both the House bill and the Senate bill would subsidize health care for many people too poor (or too sick) to afford it on their own. I think that's one of the few good things about the Dems effort at reform.
Posted by Christine (Member # 8594) on :
quote:Originally posted by Brian J. Hill:
quote: Ron, I sincerely hope, for your sake, you never find yourself unable to afford necessary health care, in a country without a sufficient governmental support system to help you.
The problem with this sentiment is (besides the fact that it didn't address a thing Ron actually said) is that I don't believe for a second that anything the Democrats pass will in reality have any effect whatsoever on this hypothetical situation. It's a sentiment that, by all accounts, most Americans share. There is little confidence in the ability of the current Democrat plan to make any real differences. There have been so many "compromizes" that the process itself has become corrupted.
This is how I feel about the issue as well. I think I've kind of given up thinking about it, though. It'll pass. It won't pass. Either way, I don't have confidence it will make much of a positive impact. I don't think it will hurt, either, but that's the best I can say about it.
Posted by Alcon (Member # 6645) on :
quote:Originally posted by SenojRetep:
quote:Originally posted by kmbboots:
quote:Originally posted by Tresopax: This seems like a good opportunity to improve the heath care bill...
How? The health care bill is the way it is because of all the compromises that had to be made to get Senators who don't want health care reform to vote for it*. How is having another Senator who doesn't want health care reform an opportunity?
*Not vote for it really. We (people who want health care reform) have plenty of votes to pass it. What we lack is enough votes to keep the anti-health care Senators (a minority) from preventing the bill to come to a vote at all.
Brown has said he supports Health Care Reform (as do many Republican Senators), just not the reform in the current bill.
My hope is the Democratic leadership is sufficiently humble to jettison the bloated, inefficient bill they've written and look to the only proposal with real bipartisan support: the Wyden-Bennett Healthy Americans Act.
The problem with this is that it probably doesn't actually have the support it looks like it does right now. The Republicans have decided they want to do everything in their power to make Obama fail. And because our country is near impossible to govern with out some support from the other side - they can damned near succeed.
As soon as Obama throws his support to HHA - all the Republican support for it will evaporate. I guarantee it.
Posted by Ron Lambert (Member # 2872) on :
How is the administration going to get House Democrats to vote for the Senate version of the health care bill as is? Democrats across the country have to be running terrified--not just scared. It would be political suicide for Representatives up for election this November to vote for a bill that the large majority of Americans are opposed to, and clearly was one of the major factors in Scott Brown taking the senate seat that used to belong to Ted Kennedy away from the Democrats.
The administration is not looking very influential these days. Despite the president's efforts on behalf of Democratic candidates, his party lost in upsets by large margins in special elections in three states now. What will happen in November when all House seats and 36 Senate seats are up for re-election? Democratic candidates may not even want the president to appear in their states to speak on their behalf.
Posted by kmbboots (Member # 8576) on :
How do we pass legislation without "compromizes"? The system is set up so that it is built on compromise. Even with a clear majority, legislators have to compromise with people who want something opposed to what they want. Most legislation is compromise. The country started with compromise. That is how it works - how it has always worked.
Getting the Declaration of Independence through the Continental Congress required compromise on the slavery issue. It was ugly, but it moved forward.
Posted by Ron Lambert (Member # 2872) on :
A national health care plan would be a good idea--but it has to be done right. The best, wisest course for government to follow is to start over again from scratch, and this time include Republicans in the process, so it is bi-partisan. It needs to be an open and truly transparent process, with no meetings behind close doors, no special deals to buy votes, no obvious rewards for political allies. Republicans have proposed an alternate plan, and Democrats should stop ignoring it.
It might be good to study the Massachusetts plan, which is said to cover about 98% of that commonwealth's citizens, and seems to be regarded with favor by people there. This is one reason why the voters there were opposed to the proposed national health care plan. The new Senator-elect, Scott Brown, said he voted in favor of that Massachusetts plan. So if a conservative Republican could vote for a health care plan, then most of them could, if it is really a good plan.
Posted by kmbboots (Member # 8576) on :
So you want a different form of government entirely? Including Republicans (and recalcitrant Dems) in the process is how we ended up with a bad bill.
Posted by TomDavidson (Member # 124) on :
quote: The best, wisest course for government to follow is to start over again from scratch, and this time include Republicans in the process, so it is bi-partisan.
Heh. If you recall, Ron, we tried that. The Republicans wanted nothing to do with it, even after all the best bits of the bills were cut out in an attempt to get them to cooperate.
Posted by Mucus (Member # 9735) on :
quote:Originally posted by Ron Lambert: ... clearly was one of the major factors in Scott Brown taking the senate seat ...
Please show your work.
Posted by scholarette (Member # 11540) on :
The ex nude model is not really disputable. Cosmo is hoping he'll do a follow up now that he is a senator- kind of a then and now thing.
Posted by Chris Bridges (Member # 1138) on :
quote:I have two reactions to the election in Massachusetts. One, I am disappointed. Two, I feel strongly that the Democratic majority in congress must respect the process and make no effort to bypass the electoral results. If Martha Coakley had won, I believe we could have worked out a reasonable compromise between the House and Senate health care bills. But since Scott Brown has won and the Republicans now have 41 votes in the senate, that approach is no longer appropriate. I am hopeful that some Republican senators will be willing to discuss a revised version of health care reform. Because I do not think that the country would be well served by the health care status quo. But our respect for democratic procedures must rule out any effort to pass a health care bill as if the Massachusetts election had not happened. Going forward, I hope there will be a serious effort to change the senate rule which means that 59 are not enough to pass major legislation, but those are the rules by which the health care bill was considered, and it would be wrong to change them in the middle of this process.
Italics mine.
Posted by swbarnes2 (Member # 10225) on :
quote:Originally posted by SenojRetep: It is 2-3 weeks until the election can be certified. He can (and should) be seated prior to that time, as Ted Kennedy was when he won a similar special election 45 years ago.
How many votes did Kennedy cast prior to his certification? How many might Brown be in a position to vote on were he seated immediately, without certification?
If Kennedy were seated when Congress was not in session, and cast not a single vote prior to his certification, and Brown were able to cast votes prior to his certification, do you still believe that comparing their situations to each other is fair?
Posted by kmbboots (Member # 8576) on :
quote: Going forward, I hope there will be a serious effort to change the senate rule which means that 59 are not enough to pass major legislation...
This.
Posted by King of Men (Member # 6684) on :
There's a thread I posted, about halfway down the page, with a poem in it, the refrain of which became a proverb in Norway: "A picket don't stand forever, y'know". The Republicans will be back in power eventually, not this year perhaps, but almost certainly sometime in the next decade. Do you really want to let them pass legislation with 50 Senate votes? A safeguard works two ways. How much dreadful legislation were you very glad to see delayed during the Bush years?
Posted by kmbboots (Member # 8576) on :
Sadly, the Democrats are not as good at obstruction. We didn't take good advantage of the Senate rules. I have little hope that they will do any better in the future.
ETA: I would be happy if they just went back to making filibusters actual filibusters.
Posted by rollainm (Member # 8318) on :
quote:Originally posted by King of Men: There's a thread I posted, about halfway down the page, with a poem in it, the refrain of which became a proverb in Norway: "A picket don't stand forever, y'know". The Republicans will be back in power eventually, not this year perhaps, but almost certainly sometime in the next decade. Do you really want to let them pass legislation with 50 Senate votes? A safeguard works two ways. How much dreadful legislation were you very glad to see delayed during the Bush years?
Agreed.
Posted by Geraine (Member # 9913) on :
quote:Originally posted by TomDavidson:
quote: The best, wisest course for government to follow is to start over again from scratch, and this time include Republicans in the process, so it is bi-partisan.
Heh. If you recall, Ron, we tried that. The Republicans wanted nothing to do with it, even after all the best bits of the bills were cut out in an attempt to get them to cooperate.
Really? Republicans wanted no part in it? Is this why they offered dozens of amendments? Or the reason they presented their own bill which was never heard in the Senate? Or perhaps wanting to be part of the process after it passed, even though they were shut out?
I read the daily digest on Congress.gov every single day to see exactly what was said in the chambers. Not one republican has said they did not want anything to do with reforming health care. What they say is "Lets do this right." "Let's not rush this." "This will affect 1/6 of the entire economy, we need to make sure we do this correctly."
I think they have tried to stand in the way of this bill because they feel it is the wrong way to go about it. I don't think they are against health care reform, just the bill that is currently on the table. I can't fault them for that. If the tables were turned and the Republicans were trying to pass a bill of this magnitude that the Democrats did not agree with, I fully believe they would do the same thing, because they would feel that it would be the right thing to do.
This is a classic play from both sides of the isle. Republicans whine that they were not included, and democrats whine that republicans wanted no part of it anyway.
Do I think Brown being elected is a referrendum on Obama or Health Care? Not really. Coakley was an utterly weak candidate and she really ran a horrible campaign. Brown really did run his campaign very well, and this is why he won.
What I do think though is that people are getting tired of hearing the same old excuses for everything wrong in this country. Blaming Bush for everything wrong in America is only going to take you so far before people start blaming YOU for it. We were promised certain things, and some of them have been kept, others broken. Not televising the Health Care bill on Cspan after the President said he would 8 different times hurt health care reform.
If you run on transparency, you better make sure you follow through. I don't think the reason why the bill is losing support so fast among the general population is because of the content of the bill, it is the method which is being employed.
Part of this could be republicans labeling themselves as victims of the big bad Democratic Party. Heaven knows people love the underdog.
Edit: I just read the quote by Barney Frank. What a great quote. The guy has class. They have all been very nice about the entire process and I think they are owed some kudos.
[ January 20, 2010, 02:25 PM: Message edited by: Geraine ]
Posted by kmbboots (Member # 8576) on :
"Nice". That is a problem when we are faced with stuff like, “If we’re able to stop Obama on [health care] it will be his Waterloo. It will break him.”
Posted by Brian J. Hill (Member # 5346) on :
quote:Originally posted by kmbboots: How do we pass legislation without "compromizes"? The system is set up so that it is built on compromise. Even with a clear majority, legislators have to compromise with people who want something opposed to what they want. Most legislation is compromise. The country started with compromise. That is how it works - how it has always worked.
Getting the Declaration of Independence through the Continental Congress required compromise on the slavery issue. It was ugly, but it moved forward.
First things first, my apologies for the egregious spelling error on "compromise". I was in a hurry and forgot to proofreed.
If the compromise process that brought us the Declaration of Independence and the Constitution bore any resemblance to what is called "compromise" today, then I would agree with kmb. But it doesn't. I used quotations around that word to emphasize that what is going on today isn't true compromise. It's vote-buying. This has a long tradition in both houses of Congress, under both parties' control. However, we're in a 24-hour news cycle, and it's much harder to sweep under the rug. Closed-door, backroom dealings simply aren't flying with the majority of the American public.
quote: If you run on transparency, you better make sure you follow through. I don't think the reason why the bill is losing support so fast among the general population is because of the content of the bill, it is the method which is being employed.
Agreed.
Posted by Bokonon (Member # 480) on :
quote:Originally posted by rivka:
quote:Originally posted by Vadon: They won't delay seating him.
No need to. Massachusetts law means that it will 2-3 weeks until he can be seated.
People will still complain, because it's taken less time in the past.
That said, I'd be surprised if the results weren't certified by Friday. Monday at the latest.
Posted by TomDavidson (Member # 124) on :
quote:Not one republican has said they did not want anything to do with reforming health care.
Not where they'd have their remarks printed in the Congressional Record, certainly. Posted by Bokonon (Member # 480) on :
quote:Originally posted by Kwea: I doubt that as well. It may not pass, but it's still pretty important. Even if MA just borked us on it in the long run.
The irony is we voted for guy that says he'll vote against a system that the state of MA already has (and no one is really complaining about).
Posted by Bokonon (Member # 480) on :
quote:Originally posted by SenojRetep:
quote:Originally posted by kmbboots:
quote:Originally posted by Tresopax: This seems like a good opportunity to improve the heath care bill...
How? The health care bill is the way it is because of all the compromises that had to be made to get Senators who don't want health care reform to vote for it*. How is having another Senator who doesn't want health care reform an opportunity?
*Not vote for it really. We (people who want health care reform) have plenty of votes to pass it. What we lack is enough votes to keep the anti-health care Senators (a minority) from preventing the bill to come to a vote at all.
Brown has said he supports Health Care Reform (as do many Republican Senators), just not the reform in the current bill.
My hope is the Democratic leadership is sufficiently humble to jettison the bloated, inefficient bill they've written and look to the only proposal with real bipartisan support: the Wyden-Bennett Healthy Americans Act.
No offense, but even before Brown's election, lending swagger to Republicans, there have been several attempts at compromise with Republicans, only to end up with them saying, "Eh, on second thought, never mind. Sorry for wasting your time." The Baccus compromise talks come to mind specifically.
EDIT: See also the bit at the end of the wiki page you linked too. It's unclear how much hard support there is for the bill, particularly from the Republicans, but considering how certain members of the Democratic caucus (*cough* Lieberman, Nelson *cough*) will argue for something to change, and then still threaten to vote against the "improved" bill, Democratic hard support is easily questioned as well.
I would support that bill, assuming substantive arguments against didn't show up. I'd certainly pick it over the current bill, if I was forced to.
Posted by Chris Bridges (Member # 1138) on :
quote:Well, here's , here's one thing I know and I just want to make sure that this is off the table. The Senate certainly shouldn't try to jam anything through until Scott Brown is seated. People in Massachusetts spoke. He's got to be part of that process.
Posted by Bokonon (Member # 480) on :
quote:Originally posted by Ron Lambert: How is the administration going to get House Democrats to vote for the Senate version of the health care bill as is? Democrats across the country have to be running terrified--not just scared. It would be political suicide for Representatives up for election this November to vote for a bill that the large majority of Americans are opposed to, and clearly was one of the major factors in Scott Brown taking the senate seat that used to belong to Ted Kennedy away from the Democrats.
The administration is not looking very influential these days. Despite the president's efforts on behalf of Democratic candidates, his party lost in upsets by large margins in special elections in three states now. What will happen in November when all House seats and 36 Senate seats are up for re-election? Democratic candidates may not even want the president to appear in their states to speak on their behalf.
Honestly, it's suicidal to run away at this point, as voters will be left to vote for Republicans, or people who move right towards the Republicans, so why not elect the real thing?
From the rumors on the State of the Union, we may see a more combative White House (and hopefully Democratic Congress). One that is willing to at least get shot in the chest when showing just how obstructionist the Congressional Republicans have been the past year, in the hopes that the public will see this and like the things Democrats will be advocating, versus getting shot in the back, as is the current situation.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by Bokonon: No offense, but even before Brown's election, lending swagger to Republicans, there have been several attempts at compromise with Republicans, only to end up with them saying, "Eh, on second thought, never mind. Sorry for wasting your time." The Baccus compromise talks come to mind specifically.
EDIT: See also the bit at the end of the wiki page you linked too. It's unclear how much hard support there is for the bill, particularly from the Republicans, but considering how certain members of the Democratic caucus (*cough* Lieberman, Nelson *cough*) will argue for something to change, and then still threaten to vote against the "improved" bill, Democratic hard support is easily questioned as well.
I would support that bill, assuming substantive arguments against didn't show up. I'd certainly pick it over the current bill, if I was forced to.
(to Alcon and Tom, too) You may be right that Republican leadership really wouldn't be willing to negotiate a real bipartisan solution. Mostly I just feel Wyden-Bennett is far superior to the current bill and so have a hope that it would succeed. Ron Wyden managed to get Bob Bennett's name on the bill (whereas in the past he's been the sole primary sponsor), which indicates to me that there's at least some interest in the GOP camp.
I think the early bipartisan effort with regards to the current bill (other than within the finance committee) was largely facade; I don't think there was any willingness or motivation within the Dem leadership (again, other than in the finance committee) to fundamentally compromise on the structure of the bill, only on the bells and whistles. The only reason they did end up compromising on the structure (toward the Baucus' exchanges rather than a public option) was because moderates within their own party compelled them to, not because they were trying to incorporate Republican ideas or criticisms. They compromised just enough to get to 60 which isn't bad but isn't, to my reading, a sign of real bipartisanship.
As for the Ezra Klein bit at the end of the wiki, he has his own reasons for wanting to maintain focus on the current bill. He's a good writer worth reading, but certainly isn't unbiased (but then, who is).
Posted by SenojRetep (Member # 8614) on :
The "ping-pong" option where the House passes the Senate's bill seems quite unlikely in the face of Rep. Stupak's vow not to vote for it. Maybe Pelosi et al can whip the Stupak bloc into line, but I doubt it.
Which really leaves, to my mind, only one branch on the tree that Lyrhawn laid out. They need to craft a compromise in reconciliation that can garner both 60 Senate votes and a majority in the House. Mostly that means finding a way to get Snowe or Collins on board, while keeping Nelson, Lieberman and also not losing Dems like Burris who've threatened not to vote for a watered down bill. That's a pretty weak branch; I wouldn't put much weight on it.
Politically, though, I still think it's in the Dems' interest to push through a healthcare bill (and in the interest of the country). But I think the only way they'll be able to do it is to jettison the months of work on the current bill and start fresh.
Luckily HAA is just sitting there waiting to be fleshed out! Keep hope alive!
<edit>I realized I didn't address the reconciliation option. The problem with reconciliation, as Lyrhawn partially points out, is the bill would have to be changed rather dramatically in the process. The budgetary requirements are also much more stringent, and, as I understand it, many of the provisions in the bill would not be able to survive the strictures of such a process. Certainly an option, but not to my mind a good one.
Also, one other that I don't think Lyrhawn mentioned, was to force the filibuster and rely on maintaining a simple majority throughout. I don't know who would come out on top in that fight (inasfar as public opinion is concerned), and a lot of damage would be done in the interim both to the nation and the Senate, but it's at least an option.</edit>
Posted by Bokonon (Member # 480) on :
The reason they were held captive by the moderates in the party, IMO, is because the Republicans were simply going to continue to criticize and vote no. There would always be something the Republicans didn't like in the bill, but rather than saying "okay," and truly negotiating, they just stopped playing the game.
After all, the bill, as it is, is very similar to ideas for a bill proposed by Gingrich, et al., 15 years ago.
Just to show you how far the goalposts have shifted in that time.
Posted by sinflower (Member # 12228) on :
quote: Politically, though, I still think it's in the Dems' interest to push through a healthcare bill (and in the interest of the country). But I think the only way they'll be able to do it is to jettison the months of work on the current bill and start fresh.
Yeah, I agree with this. There hasn't been enough transparency with this process and I think there's a lot of perception out there that the bill is bloated and going to be ineffective. And with the huge cost of it--and I'm sure it'll end up going over the budget they allot for it-- people have to be really convinced to support it, and there's just too much negative drama associated for that to happen right now. The idea of "starting fresh" might appeal to people, along with some more transparency.
Posted by King of Men (Member # 6684) on :
Perhaps, with a bit of luck, the Democrats will learn from this debacle and try to do incremental reforms, instead of One Big Bill that has to be larded up with pork just to pass their own party.
Posted by Juxtapose (Member # 8837) on :
quote:Well, here's , here's one thing I know and I just want to make sure that this is off the table. The Senate certainly shouldn't try to jam anything through until Scott Brown is seated. People in Massachusetts spoke. He's got to be part of that process.
Were the roles switched, there is no way the Republicans would let their bill die. They'd pass it, and worry about selling it after the fact.
I'm a healthy twenty-something who'd have to pay hundreds of dollars out of pocket for a decent plan, which, inevitably, I would use only a few times a year for checkups. Instead I have a crappy catastrophic plan because it's something. And, frankly, I'm lucky - because at the end of all that, I'm healthy.
But, apparently, changing 1% of the senate makes the work of months and months before null and void. And this is the more "democratic" option somehow.
Democrats: You jam it through, somehow, and then come November, you say: "I voted to pass health care reform the way I did because I thought it would be a shame and a tragedy to allow it to die simply because Ted Kennedy couldn't fight off cancer for a few more months."
Posted by rivka (Member # 4859) on :
quote:Originally posted by Bokonon: That said, I'd be surprised if the results weren't certified by Friday. Monday at the latest.
The law in Massachusetts states that no certificate of election can be issued until at least ten days following a special election.
Posted by Kwea (Member # 2199) on :
Notice the talk today. No vote on health care until he is seated is the primary response from BOTH sides of the aisle, as well as the President.
I doubt Bush would have said the same if the situation had occurred during his Presidency.
Posted by Bokonon (Member # 480) on :
Doh! Wel, then amend my statement to append "or the soonest date legally allowed."
Posted by Lyrhawn (Member # 7039) on :
I'm fine with either getting rid of the filibuster, or changing it to the way it used to be so that the party of disruption has to actually visually and vocally hold the floor during the process. I know that at some point in the future Republicans will have a 50 plus 1 majority, but I'm so sick of gridlock over important issues, that I'm find with taking some in the teeth occasionally if it actually means getting stuff done. If people don't like what Republicans are doing, they'll get voted out and Democrats can hopefully fix it. And if people don't hate it, maybe it means they did it right.
Isn't that how things are supposed to work? At present, the system is designed to be systematically counterproductive to good legislation, and certainly to efficient legislation. To get 60 votes, so many side deals have to be made, which means more cost, more compromises, not always for the best, and by the end, if anything can be passed at all, it's full of so many loopholes and addendum that it's virtually useless. The current bill is a mess. It was much less of a mess in its original form. It would be much less of a mess if it hadn't been watered down a dozen different ways to appease a dozen different people.
I'm all for compromise, as it can often either weed out bad ideas, or bring more support to a measure, which itself can be valuable. But compromise that kills the most vital, and sometimes most controversial elements, of a bill, is counterproductive. And that's what I think the current rules lead to. As things are, the party of opposition can stop the process in anonymity, and don't have to be on television being shown as obstructionist. It makes it so neither side has to really answer questions as to what they're trying to do.
Posted by sinflower (Member # 12228) on :
quote:Originally posted by Kwea: Notice the talk today. No vote on health care until he is seated is the primary response from BOTH sides of the aisle, as well as the President.
I doubt Bush would have said the same if the situation had occurred during his Presidency.
Obama is cool. I like him. Posted by AvidReader (Member # 6007) on :
quote:Originally posted by King of Men: Perhaps, with a bit of luck, the Democrats will learn from this debacle and try to do incremental reforms, instead of One Big Bill that has to be larded up with pork just to pass their own party.
I would love to see this. Let's open up the rules about buying plans across state lines, provide some seed money for non-profit insurance co-ops, and give tax incentives to insurance companies and doctors to revise their payment schedules to encourage and focus on maintaining good health instead of waiting until things deteriorate (like the usual example of hospitals getting more money to cut off a diabetic's leg than the doctor does to keep him from needing an amputation) for starters. And if I could get a rule that makes the hospitals do their own bookkeeping instead of expecting me to keep track of all their subcontractors and procedures while my loved one is in the hospital, that'd be gravy.
Juxtapose, I'm curious about this:
quote: I'm a healthy twenty-something who'd have to pay hundreds of dollars out of pocket for a decent plan, which, inevitably, I would use only a few times a year for checkups. Instead I have a crappy catastrophic plan because it's something. And, frankly, I'm lucky - because at the end of all that, I'm healthy.
Why do you consider a plan that would do things you don't need it to to be "decent" and a plan that covers your expenses in an emergency to be "crappy"? If you can afford the $100 a year to see the doctor out of pocket, why spend hundreds to only pay a $20 copay? Unless I'm missing something, and I easily could be, it sounds like you have the appropriate level of insurance for your needs. You just need something in case bad things happen. Posted by DarkKnight (Member # 7536) on :
quote: After all, the bill, as it is, is very similar to ideas for a bill proposed by Gingrich, et al., 15 years ago.
Do you have any links for this?
Posted by DarkKnight (Member # 7536) on :
quote: quote: -------------------------------------------------------------------------------- Originally posted by King of Men: Perhaps, with a bit of luck, the Democrats will learn from this debacle and try to do incremental reforms, instead of One Big Bill that has to be larded up with pork just to pass their own party. --------------------------------------------------------------------------------
I would love to see this.
When I suggested that same thing I had many replies about how the only thing we should do is a massive change and incremental changes will not work. I believe that was mostly from people who want free government care or nothing.
Posted by Tstorm (Member # 1871) on :
Don't generalize too much. I support a sudden, massive change over the incremental process, and I'm willing to pay for it. In my humble opinion, an incremental process will not work; it's more likely to stall out before any significant progress is made.
Posted by Bokonon (Member # 480) on :
I'm looking for a reference, DK. If I don't post again, assume that is a retraction of the point.
Posted by DarkKnight (Member # 7536) on :
quote: In my humble opinion, an incremental process will not work; it's more likely to stall out before any significant progress is made.
As I have said before, I really think that something like electronic health records can and should be done as a separate bill. I do believe that incremental changes that show improvements would be passed easier than a massive bill that you need to bribe senators to vote for ever will.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by Bokonon: The reason they were held captive by the moderates in the party, IMO, is because the Republicans were simply going to continue to criticize and vote no. There would always be something the Republicans didn't like in the bill, but rather than saying "okay," and truly negotiating, they just stopped playing the game.
I think, for all its faults, the bill is quite moderate. But it isn't bipartisan, mainly because there aren't enough moderate Republicans left in the Senate or House who could support a moderate bill in the face of leadership opposition. The last two election cycles have pretty well purged the ranks of the moderate Republicans and swelled the ranks of the moderate Democrats; as a result, any bill that could win bipartisan approval will, of necessity, actually be more conservative than in the past and any Democratic-partisan bill will be forced toward moderation.
None of this is really here or there; just an interesting dynamic that will (it seems to me) tend to produce legislative parity over time. Cognitively people seem to like the idea of bipartisanship and punish parties acting in a partisan fashion, even if those actions are moderate in nature.
<edit>(to add link to Silver's article)</edit>
[ January 21, 2010, 11:26 AM: Message edited by: SenojRetep ]
Posted by Bokonon (Member # 480) on :
I see your point, but I think it still misses (and this is probably just a difference of opinion) that the Republicans want nothing changed with the status quo, so there is no bipartisanship possible. It requires both sides willing to enact change.
DK, I retract my point since I can't find anything on the web about the older plan, only links to Gingrich's more recent plans.
Posted by Juxtapose (Member # 8837) on :
quote:Why do you consider a plan that would do things you don't need it to to be "decent" and a plan that covers your expenses in an emergency to be "crappy"? If you can afford the $100 a year to see the doctor out of pocket, why spend hundreds to only pay a $20 copay? Unless I'm missing something, and I easily could be, it sounds like you have the appropriate level of insurance for your needs. You just need something in case bad things happen.
Well, getting a yearly physical would be a good start. Having my checkups with the eye doctor covered would be even better. Getting cleanings at the dentist covered as well would be fantastic.
At present I'm only actually doing one of those three. Ironically, they would be pretty easily affordable if I weren't shelling out each month for my coverage.
As a side note, I do realize that part of what I'm paying is subsidizing someone who's coverage is monumentally unaffordable. I don't mind that. I was trying, in my last post, to give a brief example of how ridiculous the system is. My situation, as I said, is actually pretty good, but when I saw people saying that passing the bill now would be undemocratic, I thought a reminder of why we needed the bill in the first place was in order.
[ January 21, 2010, 03:08 PM: Message edited by: Juxtapose ]
Posted by King of Men (Member # 6684) on :
I'm in favour of people being allowed to use as much money as they like on political ads, but I'm not convinced it's in our interest to allow them to do so through their ownership in a corporation, because of the good old agent/principal problem. The corporation's managers will presumably try to advance the interests of their stockholders as stockholders, that is, maximising the profits of the corporation. But the stockholders also have interests as citizens, which may well clash with their interests as stockholders.
Posted by fugu13 (Member # 2859) on :
A critique that mostly applies, if to anything, to public corporations, and maybe the small number of private corporations held by a large number of individuals.
Not, notably, to the corporation in this court case, or to most corporations in existence.
Posted by SenojRetep (Member # 8614) on :
Wait, what happened to Alcon's thread on the Supreme Court ruling? Did it suddenly merge with this one?
quote:Originally posted by King of Men: Perhaps, with a bit of luck, the Democrats will learn from this debacle and try to do incremental reforms, instead of One Big Bill that has to be larded up with pork just to pass their own party.
Can you suggest a sequence of incremental reforms that you think would have been passable?
Posted by Ron Lambert (Member # 2872) on :
Harry Reid has said that there will be no vote in the Senate on health care until after Scott Brown has been seated. Nancy Pilosi has admitted that she does not have enough votes to get the House to approve the Senate version without change.
Scott Brown campaigned on the promise that if he were elected, he would stop the Obama health care plan. It was not just "Tea-baggers" who elected him in Massachusetts.
Democrats now have no choice but to wake up to take cognizance of the real will of the people. The November elections are coming, and the prospect is looking more and more like Armageddon to Democrats who stand for re-election. They tried to shrug off or explain away big losses in special elections in New Jersey and Virginia. But Massachusetts cannot be shrugged off or explained away. Forget the silly excuses about the administration "blowing it," or about Coakley running a "lackluster campaign." The win by Brown in Massachusetts was decisive, not close, in a state (commonwealth) that is as Democratic as any state in the union. Even Hyannisport, the home of the Kennedy family compound, went for Brown (according to FNC)!
The Obama administration needs to give up its war against Fox News (and against Freedom of the Press), and start listening to FNC's accurate reporting, and to the will of the people.
Posted by King of Men (Member # 6684) on :
quote:Originally posted by natural_mystic:
quote:Originally posted by King of Men: Perhaps, with a bit of luck, the Democrats will learn from this debacle and try to do incremental reforms, instead of One Big Bill that has to be larded up with pork just to pass their own party.
Can you suggest a sequence of incremental reforms that you think would have been passable?
Step 1: Allow insurance to be sold across state lines. Step 2: Remove the tax exemption on employer-provided health insurance, starting at a future date to give people time to adjust.
Just these two steps would help the situation vastly.
Posted by TomDavidson (Member # 124) on :
My concern with #1, KoM, involves the consolidation of insurers into states with more lenient laws and regulations. I think you'd need consistent federal laws on insurers as step #1 before you took this step, even though I think this step is a good idea.
Posted by natural_mystic (Member # 11760) on :
quote:Originally posted by King of Men:
quote:Originally posted by natural_mystic:
quote:Originally posted by King of Men: Perhaps, with a bit of luck, the Democrats will learn from this debacle and try to do incremental reforms, instead of One Big Bill that has to be larded up with pork just to pass their own party.
Can you suggest a sequence of incremental reforms that you think would have been passable?
Step 1: Allow insurance to be sold across state lines. Step 2: Remove the tax exemption on employer-provided health insurance, starting at a future date to give people time to adjust.
Just these two steps would help the situation vastly.
For 1) to be a positive I think you need to do what Tom said. For a significant improvement I think the removal of the anti-trust protection that the insurance industry currently enjoys is also necessary.
I might be missing something though. If these reforms were enacted how do you think the health care landscape would change for example, in terms of reining in costs, expanding coverage, and dealing with pre-existing conditions?
Posted by King of Men (Member # 6684) on :
Private health insurance cannot deal with pre-existing conditions; this is not insurance, it's redistribution. (I don't say on these grounds that it should not be done; just that it should not be done by regulating private, for-profit insurers.) If you want that, you need state insurance. So for my initial incremental reforms, I'm just throwing that out; can't be done this year, sorry.
As for reining in costs and expanding coverage, what do you think happens when fifty little markets are suddenly consolidated into one big one? You get hella more competition, is what. Competition drives down costs.
Posted by Geraine (Member # 9913) on :
I agree with KoM on this. Take it slow. Pass some things to see how it goes, then worry about more later.
While I do not believe taxes on healthcare solve anything, being able to buy insurance across state lines (if done correctly) would be great.
Juxtapose said that he is a healthy young man that simply does not need the health plan that costs hundreds of dollars. Thats great!
My healthcare costs me around $260 a month. We have a higher plan would cost me $60 more a month but decrease my co-pays by $10 a visit. Emergency coverage is the same on both plans, it is covered 100%. I am 28 and my wife is 22.
I have a brother that is 24 years old, and the only person him and his wife have on their health plan is their 2 year old daughter. I asked him why he didn't get health coverage and he simply replied "I don't think I need it, so it is a waste of money for me."
Thing is, there is a lot of people like this. It is true that there are those that work at places that simply do not offer it or do not have jobs, but there are a lot others that do not feel they need it. In college very few people I knew got the student health plans.
I think the part of the bill mandating that everyone buy healthcare turned off a lot of people. With a lack of the public option, the bill looked like it would be a big boost for insurance companies. The republicans then swept in and said "We are against this bill because they want to force you to buy health coverage!"
I think that is the main reason it has lost so much support.
Posted by natural_mystic (Member # 11760) on :
quote:Originally posted by King of Men: Private health insurance cannot deal with pre-existing conditions; this is not insurance, it's redistribution. (I don't say on these grounds that it should not be done; just that it should not be done by regulating private, for-profit insurers.) If you want that, you need state insurance. So for my initial incremental reforms, I'm just throwing that out; can't be done this year, sorry.
As for reining in costs and expanding coverage, what do you think happens when fifty little markets are suddenly consolidated into one big one? You get hella more competition, is what. Competition drives down costs.
In theory, sure. First, without the additional reforms I and Tom mentioned earlier, you will end up with a race to the bottom i.e. people will buy insurance originating in states with little to no state-mandated consumer protection, as these plans are cheaper. These plans are often not very good when you actually need them.
California is pretty huge. Yet it has high rates of uninsured. Likewise Texas, which is even worse (actually the worst) in this regard. [Disclaimer I don't know if the poll restricts to residents/legal immigrants]. I would be interested in seeing a comparison of health care expenditure between states.
The point of all this being that I am skeptical that simply making the insurance market national will have any meaningful effect without additional reforms (such as removing the anti-trust exemption).
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Juxtapose: As a side note, I do realize that part of what I'm paying is subsidizing someone who's coverage is monumentally unaffordable. I don't mind that. I was trying, in my last post, to give a brief example of how ridiculous the system is. My situation, as I said, is actually pretty good, but when I saw people saying that passing the bill now would be undemocratic, I thought a reminder of why we needed the bill in the first place was in order.
I respect that. Personally, I'm still holding out hope that the government will go back to funding the county health departments to handle routine care for the poor. Why give my money to some guy to give to the insurance company to give to the doctor if my taxes can just go straight to the doctor instead?
quote:Well, getting a yearly physical would be a good start. Having my checkups with the eye doctor covered would be even better. Getting cleanings at the dentist covered as well would be fantastic.
At present I'm only actually doing one of those three. Ironically, they would be pretty easily affordable if I weren't shelling out each month for my coverage.
As a side note, I've never seen dental covered by medical insurance. It's always been seperate and about as much in monthly payments as paying for the two cleanings. I might be saving the $25 extra for my X-rays.
Last year I bought the plan that would give me 20% off cosmetic work, but by the time I'd had it the year I needed we'd switched plans. If my husband didn't need some work done, I'd have cancelled the coverage. If you're not prone to cavities, dental is rarely worth it, in my opinion.
Posted by malanthrop (Member # 11992) on :
If they vote it in prior to Brown's swearing in, the vast majority of Dems will lose reelection in the fall.
If they wait and resort to the reconciliation process, the same result will occur. Reconciliation is reserved for spending bills....the Dems do not want to set this precedent. Even Repubs have avoided using this process. If they do, do not complain when the other side rams through whatever they want with a simple majority. Using legal loopholes sets a very bad precedent.
They need to wake up.....In Mass, Dems outnumber Repubs 3 to 1. Brown won because he gained the votes of Dems and Independents. Obama, Pelosi and Reid want this to be a R vs D argument but in fact it is a Conservative VS Progressive one. They are pushing an extreme left "progressive" agenda.... many Democrats will vote R to stop the progessive agenda. Brown's campaign ads channeled JFK. Brown's ads included video footage of JFK. As I've said before, JFK would be a Republican today. Brown hasn't taken a Kennedy seat, he returned it to the principles of the original Kennedy.
Posted by Dobbie (Member # 3881) on :
Joe Kennedy was a bootlegging hack but Joe wan't the first Kennedy to hold that seat.
Posted by Dobbie (Member # 3881) on :
In his defense Joe Kennedy was also
Wait, why I am defending Joe Kennedy?
Posted by Lyrhawn (Member # 7039) on :
Ron -
You know that the most popular aspect of the health care bill is the public option. Check the polling data. Now what aspect of the health care bill is most vehemently opposed by conservatives?
People aren't against the ideas the left has, they're just against this particular manifestation of them. That's in part because of right wing propaganda, and in part because Democrats really did put together a Frankenstein mishmash bill of crap. It has some good stuff, maybe even a lot, but it seems weighed down by the bad. If they went back and drew up their dream plan, I have a feeling much of the country would likewise support it, but it would never pass, and Republicans would call them partisan and call it a closed, secretive process, and because of process alone, it would die.
That's not a war of ideas. It's smoke and mirrors.
Posted by malanthrop (Member # 11992) on :
I'm not going to defend the Kennedy family. They represent everything America should be against. Same thing goes for the most recent Bush. Just because his daddy was president doesn't mean he is capable or deserving. Same thing goes for Hillary running for president or being our current secretary of state. Being first lady does not make you qualified to be senator of a state you've never lived in or secretary of state. The nepotism of the Kennedy's is hopefully dead but the nepotism is never dead. We founded this nation to escape royals but maybe the worship of royals is in our nature.
I may vote R but if Jebb Bush runs for president, I'm going to puke. Plenty of stupid people will vote for him due to his last name though....like Hillary or Kennedy.
Posted by King of Men (Member # 6684) on :
quote:In theory, sure. First, without the additional reforms I and Tom mentioned earlier, you will end up with a race to the bottom i.e. people will buy insurance originating in states with little to no state-mandated consumer protection, as these plans are cheaper. These plans are often not very good when you actually need them.
Does your theory explain why this does not happen with auto insurance, renter's insurance, and fire insurance? Alternatively, do you assert that it does?
Posted by MattP (Member # 10495) on :
quote:Does your theory explain why this does not happen with auto insurance
Auto insurance must meet certain legally mandated minimum standards of coverage. It's not really possible to get a "not very good" auto insurance plan, though you can elect to have a higher deductible in exchange for lower premiums.
Because of these minimum standards, auto insurance companies generally compete on price and customer service rather than on the actual insurance services provided.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Lyrhawn: You know that the most popular aspect of the health care bill is the public option.
And yet it's the part they should most vehemently oppose. The guy making the rules for the product should not be selling it. It's a conflict of interest, period.
Telling people they have to buy insurance and only offering expensive plans is not good business. Even helping people buy the plans is just throwing money down a hole if we can't rein in the costs. The public option sounds like the answer to those problems, until you watch the government run an insurance pool.
Enter Citizen's Property Insurance. The state would step in and serve as insurance of last resort for people whose homes were being dropped by private insurance. Sounds great, right? Except they're apparently not bounds by the same actuarial rules as everyone else because we recently had a big fight down here with people begging the Legislature to let State Farm raise rates and not leave the state.
quote: The reasons, the company said, were the unrealistic restrictions on rates following a series of hurricanes and competition from the state-run insurance company of last resort, which in most cases was lower than commercial companies.
Our Governor was disappointed when the rate increase passed. Even though it was decided Citizen's needed a 40% rate hike to stay solvent.
I've seen the government get their fingers in the insurance pie, and I don't want to see them play with my health insurance. I'd much rather see the non-profit co-ops. I've worked for a bank; I now work for a credit union. I can't stress enough the difference in culture when the focus is on educating people to make better choices instead of making money for the shareholders.
As long as people think a government option is the only alternative to big corporate insurance, I'm sure they'll continue to support it. That doesn't make it either the only option or the best one.
Posted by Lyrhawn (Member # 7039) on :
Well, no offense, but I think the insurance situation in Florida is screwed regardless. Build that many homes near the coast in an area prone to frequent hurricane hits is a disaster waiting to happen, and the rates will always be high, until you guys start adopting some sort of building standards that equate to California's with regards to earthquakes. Instead, either storm surge or high winds cause immense damage, yearly, and everyone feigns shock when the rates jump. You're a special case. Much of the Gulf Coast is, but Florida in particular.
quote: Telling people they have to buy insurance and only offering expensive plans is not good business. Even helping people buy the plans is just throwing money down a hole if we can't rein in the costs. The public option sounds like the answer to those problems, until you watch the government run an insurance pool.
And I don't buy your premise. Who said that they had to buy only expensive plans? Who said the government plan would be more expensive than other options? Who said private insurance will rein in costs?
I'd like to see, if not national health care, non-profit co-ops become far more prevalent as well. But I still think there needs to be a government set minimum standard of coverage. A non-profit can screw someone just like any other company without it.
Posted by Ron Lambert (Member # 2872) on :
Lyrhawn, the Republicans have put forward their own health care plan. So far Democrats have completely ignored it.
What everyone objects to is the behind-closed-door meetings that result in bribes to certain senators to get their votes, completely unfair to the rest of the country, and the continual effort from the very beginning by the administration to try to get everyone to vote to approve their bill without even reading it.
The people in Massachusetts already have their own health care plan that is said to cover 98% of citizens. So they had extra reasons to reject a national health care plan that they believed would be inferior, or result in them paying extra taxes to keep their present plan.
As for the various provisions of the "public option," there have been many serious criticisms. By this time, the criticisms are not "smoke and mirrors." The public option is simply not passing public scrutiny. It is failing the vetting process.
Scott Brown said that as a state (commonwealth) legislator, he voted in favor of Massachusetts' health care plan--so it is not impossible for a conservative or progressive (non-collectivist) Republican to vote in favor of a public health care plan. It has to be done right, and the nation is not going to let Democrats do it any old way they please.
The public punished the arrogance of Democrats in New Jersey, in Virginia, and now in Massachusetts. Democrats had better start listening seriously to the Republicans and to the public, and stop trying to dismiss their critics as "Tea-baggers." And the Obama administration had better call off its war against Fox News and Freedom of the Press, or the ratings for Fox News are going to go higher still. (They already exceed those of any two other cable news networks put together.)
Posted by TomDavidson (Member # 124) on :
quote:By this time, the criticisms are not "smoke and mirrors."
Why the "by this time?" Do you think criticisms get MORE substantive the longer they are repeated?
Posted by Ron Lambert (Member # 2872) on :
Tom, the more time goes by, the more examination from every angle takes place. It is not a matter of criticisms just being repeated. It is a matter of seeing that those criticisms are well-founded. Do you approve of the deal Democratic Sen. Ben Nelson got for his state of Nebraska, so that his state will forever be exempted from having to pay any of the cost of an expanded Medicaid--just to win his vote for the health care bill? Is that fair to the rest of the nation? The leaders of the Democratic Party approved this deal. So this is the kind of politics Democrats seem to stand for now, as the public sees it. This is what they did! And this is why Tuesday, November 2, 2010, may very well turn out to be Armageddon for Democrats. New Jersey, Virginia, and Massachusetts, are early indicators of this.
Posted by Tresopax (Member # 1063) on :
Ron, as more time has gone by, public opinion polls have consistently shown a majority of people support a public option.
Therefore, the public option has not failed any test of public scrutiny. The only reason it hasn't been passed is it failed the "60 out of 100 Senators Test".
The public option was not included in the Senate bill when the Massachussetts Senate seat election occurred either, so it doesn't really make sense to suggest that is an indicator about the public option either - unless you want to argue that the people of Mass. are angry that after all that they passed a bill in which the public option was excluded.
Posted by TomDavidson (Member # 124) on :
quote:So this is the kind of politics Democrats seem to stand for now, as the public sees it.
But that's completely unrelated to whether or not criticisms of the "public option" are well-founded.
Posted by Lyrhawn (Member # 7039) on :
Ron -
The majority of the complaints against Democrats only came after they gutted their own bill to make it more palatable to moderate Republicans, all of whom jumped ship after being given a virtual blank check to revise as they saw fit. The current Senate bill was written as much by Maine's Senate contingent as by any Democrat. In other words, the more bi-partisan it got, the worse the bill got, and the louder the complaints became. I'm not saying there weren't valid criticisms, but to say that the Republicans are fighting a substantive fight against the legislation in question is simply wrong.
By the by, what do you consider "Armageddon" for the Democrats? Losing the Senate entirely? Losing every seat up for grabs? Losing five seats?
Posted by Katarain (Member # 6659) on :
I had the thought on seeing the acceptance speech of Scott Brown winning the seat (the first time I had seen him) that he is going to be the republican candidate in one of the next 2 elections.
That's my prediction. Since I don't actually care if I'm right, and have nothing to lose, I'm perfectly willing to make that determination.
ETA: For President, that is.
Posted by Ron Lambert (Member # 2872) on :
Lyrhawn, Democrats only sought to make the health care bill more palatable to fellow Democrats, so they could get a filibuster-proof majority. There was nothing remotely bi-partisan about this legislation. Republicans were totally excluded from the process of writing the bill. Their own alternate health care bill was simply ignored.
This is the problem when one party controls both houses of Congress and the White House--especially when that party has a potentially fillibuster-proof majority. They think they do not have to seek bipartisanship in anything.
Tresopax, if all the polls are tending in favor of the public option in the present health care bill, then why do the polls that matter--the ones on election day--seem to be consistently going in the other direction?
Do you really think the majority want some bureaucrats in Washington making all the decisions? Have you heard that people are looking upon this with increasing favor? And are people warming up to the idea of paying higher taxes? Should everyone be required to pay for the health care of people who live careless lifestyles (like smoking, drinking, drugging)? Insurance companies now at least charge more to people with higher-risk lifestyes. And what about allowing people to obtain insurance across state lines, or to obtain equivalent and cheaper medicines from Canada? If the government is going to manage everything in a public option, then people want to be sure they agree with the way government would manage it, and so far that does not look likely to be the case.
If you disagree with this assessment, then please explain why you think voters keep voting down the health care plan and everyone associated with it. You can only blame misleading publicity, Fox News, the previous adminstration, for only so long. Those excuses are no longer credible, besides the fact that they always were silly, and disrespectful to the critics who were and are thoughtful and responsible. Democrats' first mistake was not taking seriously their critics.
Posted by TomDavidson (Member # 124) on :
quote:Democrats only sought to make the health care bill more palatable to fellow Democrats, so they could get a filibuster-proof majority.
No matter how many times partisan pundits repeat this, it still won't be true.
quote:Tresopax, if all the polls are tending in favor of the public option in the present health care bill, then why do the polls that matter--the ones on election day--seem to be consistently going in the other direction?
One suggestion: a widespread, orchestrated campaign of lies and misinformation.
Posted by King of Men (Member # 6684) on :
Your theory does not explain why the opinion polls are not affected the same way as the election-day ones.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Lyrhawn: Build that many homes near the coast in an area prone to frequent hurricane hits is a disaster waiting to happen, and the rates will always be high, until you guys start adopting some sort of building standards that equate to California's with regards to earthquakes.
Post-Andrew, we build to withstand Cat 3 storms. Personally, I figure the more inevitable problem is the erosion of the coastline. It doesn't matter how well you build your house if the ground under it is gone.
quote: Telling people they have to buy insurance and only offering expensive plans is not good business. Even helping people buy the plans is just throwing money down a hole if we can't rein in the costs. The public option sounds like the answer to those problems, until you watch the government run an insurance pool.
quote:And I don't buy your premise. Who said that they had to buy only expensive plans? Who said the government plan would be more expensive than other options? Who said private insurance will rein in costs?
That is not my premise.
The stated objection to current insurance plans is that, on average, they are too expensive. Therefore, telling people they must buy insurance is telling them they must buy something they perceive to be expensive.
There's no one magic bullet to bringing down costs. But I don't think creating a government insurance plan should even be part of the arsenal. It's too easy for the guy making the rules to tilt everything in his own favor - especially if he's doing it for noble reasons.
At the end of the day, an insurance pool has to be actuarily sound or we're just digging a deeper hole. I at least trust the guy making money off it to keep wanting to make money off it in the future.
Posted by SenojRetep (Member # 8614) on :
quote:At the end of the day, an insurance pool has to be actuarily sound or we're just digging a deeper hole. I at least trust the guy making money off it to keep wanting to make money off it in the future.
Why? He's the same guy who is happy to take your money until you come knocking with a medical bill, and then he shuts you down until you die penniless. They don't care about you. They don't even care about your money once you become a liability to them. Insurance companies want healthy people they never have to pay out on, and for those that ninja their way in with expensive bills, they deny coverage or boot them out.
It is not a system designed to provide coverage. It's designed to DENY coverage. Denying coverage means more money, because all that matters is the bottom line, and the bottom line is a financial figure, not a moral one. Government wouldn't have nearly that same disposition.
Posted by King of Men (Member # 6684) on :
Yep. That's why anything more serious than the sniffles is a death sentence around here, as is well known.
Posted by malanthrop (Member # 11992) on :
They are only digging their graves deeper with their interpretation. They believe Obama has failed to speak enough to the people to convince them, although he has given more speeches than any other president. They offend a huge majority of the population by calling Tea Party supporters ignorant, red necked, racist hicks. They hold their noses up and say those opposed to government health care are just too uninformed to know what is best for them. Obama mocks Brown for "driving a truck"....big mistake, the Ford F150 is the top selling vehicle in the country.
The people do not want what they have to offer and their condescending attitude only further alienates them. The voters do not want politicians who express an attitude that the voters are too stupid to know what is best for them. To Obama, a truck is a campaign prop but to Brown it is his vehicle of choice. John Kerry threw on a flannel shirt while campaigning in certain regions but people can tell the difference between a prop and a person.
Posted by Kwea (Member # 2199) on :
quote:Originally posted by King of Men: Your theory does not explain why the opinion polls are not affected the same way as the election-day ones.
Because, as I said on the first page, this election was about more than just health care. Every single person I know who voted for him didn't like him, but thought he was the lesser of two evils. Not because of health care, which MA already has, sort of. If anything, having this in MA, where health care is less of a problem HELPED Brown win, because it wasn't as much of an issue there.
As short sighted as that is for the future of the rest of us. Posted by Kwea (Member # 2199) on :
Mal, it wasn't a truck that was an issue. It was how he tried to play the truck off during the election.
HE brought it up, and HE made it an issue, mainly because he didn't have any real ones.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Lyrhawn: Insurance companies want healthy people they never have to pay out on, and for those that ninja their way in with expensive bills, they deny coverage or boot them out.
That probably depends on the company in question. I've got CHP, supposedly one of the best in the nation. I've never heard anyone claim anything of the sort with them, but they're a non-profit HMO so there's probably less focus on squeezing every penny from the customer for the shareholder.
The other issue with insurance is all the stuff we think it ought to pay for. At some point, there needs to be a rethinking of coverage. We probably ought to be offered plans that break disease and premiums into tiers. Plan A is so much a month and covers the least expensive diseases. Plan B is more a month and covers moderately expensive diseases. Plan C would charge an arm and a leg and cover the most catastrophic.
It's hard to find numbers on how much diseases cost to treat. Maybe it's a big conspiracy and if we just had the government running things prices would drop to a fraction and everyone would be approved for every disease. But I doubt it. I suspect in order to keep folks paying to see the doctor and get a broken arm set, they have to let people die of the more expensive stuff.
I'd like to see us do what we can to keep costs down so there's more available to use fighting disease. But I doubt we'll ever see a day when no claim is denied.
quote: Government wouldn't have nearly that same disposition.
Why not? You're only good to them while you're paying taxes in, not taking taxes out. What magically protects governemnt from seeing the same flow of numbers on the speadsheets?
I don't see health care as an us vs them argument. I see it as a human nature argument. Everyone has some incentive to take your money and let you die. Most of them just don't.
Please don't think I'm arguing the free market will fix all. I'm a big believer in minimum standards and oversight. If insurance really is the wild west, of course it needs reform. But I suspect we the people need a little reform of our expectations of what modern medicine can reasonably accomplish on a budget. Even a really big one.
Posted by scholarette (Member # 11540) on :
When my sister came to visit us, she got very sick and had to go to the ER. As a Canadian, she was concerned because she thought she had no coverage while in the US. When she went to the ER, they smiled and reassured her that it was no problem and she would not be paying a penny. They routinely bill Canada and Canada pays up. Now that is the insurance I want.
Posted by kanelock1 (Member # 12230) on :
quote:Originally posted by TomDavidson:
quote:Democrats only sought to make the health care bill more palatable to fellow Democrats, so they could get a filibuster-proof majority.
No matter how many times partisan pundits repeat this, it still won't be true.
quote:Tresopax, if all the polls are tending in favor of the public option in the present health care bill, then why do the polls that matter--the ones on election day--seem to be consistently going in the other direction?
One suggestion: a widespread, orchestrated campaign of lies and misinformation.
And yet how much of the "negotiations" and "meetings" have been televised on c-span, as Obama stated no less than EIGHT TIMES would be the case? Or is this more "lies and misinformation?"
Posted by Lyrhawn (Member # 7039) on :
quote:Why not? You're only good to them while you're paying taxes in, not taking taxes out. What magically protects governemnt from seeing the same flow of numbers on the speadsheets?
I don't see health care as an us vs them argument. I see it as a human nature argument. Everyone has some incentive to take your money and let you die. Most of them just don't.
Please don't think I'm arguing the free market will fix all. I'm a big believer in minimum standards and oversight. If insurance really is the wild west, of course it needs reform. But I suspect we the people need a little reform of our expectations of what modern medicine can reasonably accomplish on a budget. Even a really big one.
Government is answerable to the people in ways corporations are not. Sob stories don't move corporations, but they do move congress. All it takes is one decently publicized story to scare the crap out of Congress. Corporations can bury you in paperwork and bureaucracy, and you might think, "well, so can the government!" but that hasn't been my experience.
[anecdote time] When my brother was in the Marines, he had a mess of medical problems as a result of his basic training. He was eventually diagnosed with MRSA, fibromyalgia, and some sort of flesh eating bacteria that ate a hole in his thigh. He was treated pretty bad for awhile, but they fixed most of the surface issues and told him to get back to work, more or less. But when my Mom heard what was going on, she went into crazy Mom mode, called congressmen, called senators, called anyone and everyone. And it worked. He ended up with a medical discharge, and when the VA hospital denied him coverage after he got out for related problems, all it took was one phone call and our senator's office fixed that too.
Now, that might have been a special case because it's more of a third rail to mess with members of the military than with ordinary citizens, but I think if it was a government run option, and the situation had been similar, it would have been sorted out. It's a matter of self-preservation. Either they figure out a system that works, or all of Congress is going to become a massive national complaint center for people who can't get the system to work. And as far as costs go, how does every other first world nation in the world manage to do it, and for HALF of what we spend?
We aren't talking about some impossible dream. Others have done it. There's no special reason why we can't. We just aren't doing it. The pay for services structure of our health care system needs to be overhauled into a pay for performance system. That would cut a lot of waste out, and improve care while dropping cost. I'm a very vocal supporter of tying national health insurance into a plan of revamping the entire national health care infrastructure, because it sorely needs it.
I don't think corporations are actively out to kill people, but I do think that most of them don't give a damn whether we live or die, and don't much care at all what role they play in that outcome. They have a long history to back it up, and it might not be all of them, but it seems like it's all the ones that really matter. Despite that, I'm not necessarily anti-corporation. But when it comes to things like the health of the nation (this applies to polluters as well), I don't much care to kowtow to the altar of corporate independence. We do whatever we need to do as a nation to make sure we're healthy. If that means corporations suffer, then tough cookies.
Posted by kanelock1 (Member # 12230) on :
The problem is this, corporations are not the only ones to suffer. Anyone with at least a little common sense should realize that when a business of any kind has their costs go up, they either have to raise prices, lower quality,or cut back on employees. That sounds like a lot of suffering for a lot of people to me. Of course I could be wrong.
Posted by Samprimary (Member # 8561) on :
I'm really not anti-corporation or anti-business or w/e, it's just that this is something that government is realistically going to have to do, sooner or later. And the longer we wait, the more money we waste on the actuarial model.
See:
quote:And as far as costs go, how does every other first world nation in the world manage to do it, and for HALF of what we spend?
We aren't talking about some impossible dream. Others have done it. There's no special reason why we can't.
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by kanelock1: The problem is this, corporations are not the only ones to suffer. Anyone with at least a little common sense should realize that when a business of any kind has their costs go up, they either have to raise prices, lower quality,or cut back on employees. That sounds like a lot of suffering for a lot of people to me. Of course I could be wrong.
Why are those the only options? Maybe it means they have to get used to the idea that health insurance shouldn't be a specially protected industry, and insurance companies shouldn't expect to make billions of dollars in profits every year on account of those protections.
Insurance companies are not suffering right now. And if their costs went up, it might eat into their profits, but it isn't going to put them out of business. You're basing your assumptions on the idea that we have to protect insurance profits. I'm operating under no such restriction.
Posted by kanelock1 (Member # 12230) on :
Let me respond with a question. Do you own stock or have a 401K? Because if you do, those things are affected to by a lose in profits. It is all linked.
Posted by Lyrhawn (Member # 7039) on :
It would be a one time loss. Once the industry adjusts to the new profit structure, the losses would be normal relative to what losses were before hand.
I would be okay with Congress apportioning funds to help offset losses for individuals retirement funds due to health insurance reform.
Posted by kanelock1 (Member # 12230) on :
Were would congress get those funds from? Oh, right. Raising taxes. Nothing like taking money from people to pay them back for money that was lost by those same people.
Posted by Lyrhawn (Member # 7039) on :
It's an investment. You're against spending some money now to save money later?
Hell, it'd be a drop in the bucket of total spending on healthcare in this country.
Are you arguing based on ideology, or pragmatism? In other words, are you arguing because you honestly think your way would be the way to provide the best care for the least amount of money, or do you just have some natural distrust of the government handling it, but no empirical basis for that belief?
Posted by kanelock1 (Member # 12230) on :
A little of both, actually. Most people I know are satisfied with their health care, except the people,like my mother, who are on Medicaid and Medicare. When your doctor has to call and get approval for a med that you need to survive, that's wrong. I am not saying private insurance is perfect, but I will not vilify a company for doing what all of us are trying to do. Make money.
Posted by Lyrhawn (Member # 7039) on :
I care more about getting people healthy without bankrupting them than I do about kowtowing to corporate profits. When there's an entire industry built around excluding those who need health care the most so they can make more money, I don't think my vilification of them means much. They earn it themselves.
But if you want to argue that it's not the fault of insurance companies, that's fine, and it's even valid. It's not the responsibility of private corporations to ensure that people are healthy. I actually agree with that. But if it's not their job, then whose job is it? All that remains is government.
What is your third option? You don't like the government, but corporations have already left a black hole that tens of millions of Americans fall into because they're either too sick, or too poor to afford the private options. What's your solution?
Posted by theamazeeaz (Member # 6970) on :
For me the idea that everyone has some sort of guarantee for health coverage is the most important. This needs to be independent of who you are, what you do and how much money you have.
I'm 23, a non-smoker, a non-drinker, don't drink soda, not sexually active, not over-weight, never broke a bone, I live in a city where I walk everywhere and I'm not sick that often. On occasion, I've been know to eat vegetables. And I'm insured.
Well, last week I had my appendix out. Who'da thunk? Not me, that's for sure- I've never been to a hospital (as a patient) before in my life. Might I forgo health insurance for some other expense if I were in a different situation? Might I avoid a doctor's visit for a lethal condition? Absolutely. I'm less worried about people who are going to burden the system than the people who aren't getting what they need. It will even out.
I think health care is one of those things that everyone needs in a way that shouldn't be optional- like an education. We aren't set up that way and it's going to take a lot of work and there are going to be mis-steps, but by God it need to happen.
Posted by scholarette (Member # 11540) on :
quote:Originally posted by kanelock1: A little of both, actually. Most people I know are satisfied with their health care, except the people,like my mother, who are on Medicaid and Medicare. When your doctor has to call and get approval for a med that you need to survive, that's wrong. I am not saying private insurance is perfect, but I will not vilify a company for doing what all of us are trying to do. Make money.
My experience with health insurance and medicaid were the complete opposite. On medicaid, I never had a problem getting anything the doctor signed off on. With private insurance, I waited four years for my problems to get severe enough to warrant the surgery for them. The doctor would have had me do the surgery earlier, but until I was actually missing work at least once a month for the pain, the insurance wouldn't pay. Long term, things probably would have turned out better if I had surgery a few years earlier. In retrospect, I should have just lied and said I had to miss work do the pain regularly.
Posted by Launchywiggin (Member # 9116) on :
quote:Originally posted by scholarette:
quote:Originally posted by kanelock1: A little of both, actually. Most people I know are satisfied with their health care, except the people,like my mother, who are on Medicaid and Medicare. When your doctor has to call and get approval for a med that you need to survive, that's wrong. I am not saying private insurance is perfect, but I will not vilify a company for doing what all of us are trying to do. Make money.
My experience with health insurance and medicaid were the complete opposite. On medicaid, I never had a problem getting anything the doctor signed off on. With private insurance, I waited four years for my problems to get severe enough to warrant the surgery for them. The doctor would have had me do the surgery earlier, but until I was actually missing work at least once a month for the pain, the insurance wouldn't pay. Long term, things probably would have turned out better if I had surgery a few years earlier. In retrospect, I should have just lied and said I had to miss work do the pain regularly.
My experience with Medicaid was good, too. Now I can't get any health insurance because of pre-existing conditions. People's lives and health shouldn't be a money-making business.
Posted by Kwea (Member # 2199) on :
We ALREADY pay for this crap, people! Most of our nations hospitals are on the brink of bankruptcy because of the burden of non-paying clients who don't come in for help until they are critical. It's a horrible system, because early care costs less, prevents complications, and doesn't tie up hospital beds needed for actual critical patients.
We all pay the price for these people. A public option, even a partial one, who cost less than what we already pay, and would improve care for 95% of those people as well.
Medicare and Medicade are part of the problem, as they change the regulations and rules yearly just to keep hospitals from being reimbursed out of their funds. It takes the hospital about 2-3 months of training their staff each year just to get things right.....and for first 1-2 months they can deny reimbursement to the hospitals for not following the new rules on documentation.
We already have rationing of care for everyone who can't afford to go to the doctor or hospital. So those people stay home, get more ill, then come in when it's too late to help them.
It's pathetic.
Posted by Samprimary (Member # 8561) on :
quote:We ALREADY pay for this crap, people!
Correct! In fact, since the system has been collapsing, we've been socializing it anyway. But we socialize it in terrible ways because we don't want "government takeover" — so taxpayer money gets wasted anyway and we don't fix the system at all.
EXA: the dakotas have to bribe doctors to stay there.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Lyrhawn: And as far as costs go, how does every other first world nation in the world manage to do it, and for HALF of what we spend?
This to me is the million dollar question, and until someone can definitively answer it, I'm going to be really skeptical of any plan to fix things. Bad data in, and all that.
If the Dems can show me that the bulk of what we spend on healthcare is because of insurance companies' profit margins, I'll switch parties and take to the streets demanding we go Canadian tomorrow. But no one's explained the "twice as much" or "one-third" wasted numbers. And we all know Twain's theory on statistics.
I think there's a morass of issues that need to be untangled and improved. Maybe simplier contracts when you buy your insurance would be a start so we'd know exactly what's covered and what's not. Maybe a nice database comparing how diseases are treated in different states with a total cost and success rate so you can see if your course of treatment is likely to work efficiently.
I'm not opposed to the mandatory insurance rule and no pre-existing conditions rule in general terms. I just think we're screwing people over if we start there. I think the first step needs to be improving the product or you're demanding that people destroy their budgets for something that may not do them any good anyway.
Posted by The White Whale (Member # 6594) on :
quote:Originally posted by kanelock1: I am not saying private insurance is perfect, but I will not vilify a company for doing what all of us are trying to do. Make money.
I'm going to go ahead and call you on this one. Profit is not the penultimate motive for everyone. Sure, I want money to buy food, pay my rent, maintain my car, save a little, and have a little fun, but I do not exploit others or justify all of my actions based on money. I have not chosen my career on the amount of money I'd make. I will not support actions that will prevent people from obtaining basic needs, especially when these needs are denied so that others can make a bigger profit. I give back to my community, because many, many people need a little help more than I need a little profit.
Posted by fugu13 (Member # 2859) on :
I think you meant profit is not the ultimate motive . Penultimate is the motive that comes just before the ultimate motive.
Also, I think you misinterpret. While profit is not everyone's ultimate motive, pretty much everyone is trying to make money, somehow, at least in limited quantity (and usually they'd prefer to make it in less limited quantity, and are willing to make at least moderate amounts of personal sacrifice in order to do so).
And, since health insurance company profit margins are pretty much normal for all sorts of businesses, it is a little hard to accuse them of being more out to make money.
Btw, I hope people know that, even if the bill going through Congress is passed in one of the current forms, and all the projected savings happen perfectly, insurance rates on anyone under 65 will be going up quite a bit. Right now insurance for older people is much more expensive; the bills in Congress generally require the ratio to be much more favorable to old people (which doesn't make sense. They are an easily identifiable more expensive to insure group; the way to handle those who cannot afford the more expensive insurance is subsidy. This approach is idiocy). The calculations are fairly simple, using the ratios and current expenditures by people at different ages.
Posted by The White Whale (Member # 6594) on :
Yes, that's what I meant. Didn't yet have my morning caffeine.
And yes, I have no problem with people making money. I just don't like it when that becomes a goal that overwhelms the decision-making process.
Posted by Darth_Mauve (Member # 4709) on :
quote:When your doctor has to call and get approval for a med that you need to survive, that's wrong.
Yes it is, and when they get put on hold by the insurance company, get put off by the insurance company, or get denied by the insurance company that is wrong. How can we fix it.
quote:I think there's a morass of issues that need to be untangled and improved.
True.
And when the Democrats try to do this, they are shot down every single step they take.
For each step you suggest there are a large group of flag waving, tea bag tossing, rabble rousers claiming that this is a socialist plot to create death panels all to keep their profits from disappearing.
quote:when a business of any kind has their costs go up, they either have to raise prices, lower quality,or cut back on employees.
Or has been stated before, they can cut their profits.
No company will cut their profits while other options such as raising fees or lowering quality are possible.
So we need to remove those possibilities the fairest way--with the market. That means not allowing monopolies or near monopolies of two or three health insurance companies in a given state.
And you can do that by providing a public option to compete.
Critics claim that such a public option would be unfair since they don't need to make a profit, so they will be much cheaper.
These same critics say that a government run health care will be much more expensive since the government is know for waste and poor service.
Seems to me they should go one way or the other. Either Government Run Health Care will be cheaper since it doesn't need to make a profit, or it will be more expensive and less of quality so that it won't be a dangerous competitor.
Posted by dabbler (Member # 6443) on :
I think cost conciousness can no longer be vilified in the health care industry. But I'm not talking cost cutting for profits' sake. I'm talking about eliminating tests and expensive medications that aren't evidence based. Think of the huge scandal with the breast cancer screening. The data supported their recommendations. They were good recommendations.
There needs to be more transparency on the physician's end. The cost for every test ordered in the hospital and the price for every prescribed med should be clearly shown. Most people to whom I tell the cost of a comprehensive toxicology screen are shocked (roughly $1000). The cost/benefit rarely favors ordering the test: will it improve the outcome sufficiently? Enough doctors will change their habits with the knowledge of the effects of their actions.
Another example of bad prescribing is the habit of ordering seroquel for insomnia. This is a very expensive brand name medication whose overt purpose is antipsychotic. It has significant side effects but the pharmaceutical company has been very effective in encouraging this irresponsible off label use.
Posted by kanelock1 (Member # 12230) on :
Darth, There is another way to stop those same monopolies. Allow people to buy insurance across state lines.
Posted by scholarette (Member # 11540) on :
quote:Originally posted by kanelock1: Darth, There is another way to stop those same monopolies. Allow people to buy insurance across state lines.
If my choice is Cigna in Arizona or Cigna in Texas, how does that help me? And since I get insurance through my husband's employer, it isn't like as a consumer I actually have any choice in where I shop. Now, decoupling insurance and employment would be a useful step. After all, the people in most need of health insurance are sick people and children- the two groups that have the hardest time finding a good stable job.
Posted by DarkKnight (Member # 7536) on :
quote: If my choice is Cigna in Arizona or Cigna in Texas, how does that help me? And since I get insurance through my husband's employer, it isn't like as a consumer I actually have any choice in where I shop. Now, decoupling insurance and employment would be a useful step.
It helps you because if you remove the barriers then you could choose between more insurance companies although the problem of being limited by your company would also need to be changed. Changing either one of those is not in the current health care proposals.
EDIT: Children are covered under CHIP so not having a job is not an issue
Posted by Tresopax (Member # 1063) on :
quote:If you disagree with this assessment, then please explain why you think voters keep voting down the health care plan and everyone associated with it.
The health care plan has not appeared on any ballot. If the Massachussetts ballot had included a question that said "Public option or no public option" I strongly suspect that the public option would have gotten more votes in that state.
The Massachussetts Senate race is the only one that seems directly connected to health care in any way, and in that case the public option was already out of the bill before election day occurred. Therefore, I think its safe to say the voter anger was not because voters hate the idea of a public option, and much more because the voters hate that the Senate Democrats spent almost a year to create a bill that was so watered down and beaurocratic that it is hardly worth it. (Even Howard Dean was against the Sentate bill, and one definitely could not argue that this shows Howard Dean is against a public option.)
Posted by Geraine (Member # 9913) on :
I still don't get it. The only "study" I ever see on here for why we need to overhaul the system is "The US ranks lower in Health Care than countries with socialized medicine."
Could I get a little more information on this ranking? Who performs the study? Where are these people from? What are their feelings on the health care systems? Are they biased in any way?
Personally I am against it for the same reason I am against other entitlement programs. The more we give up our freedom and place that freedom in the control of the government, the less freedom we actually have. If we only rely on the government, they have all the power over us.
I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
Let's just all work for free and have the government take care of everything for us. If the government can run everything better, why not?
I understand the mistrust of health insurance companies, but can you honestly say you would trust the government more? One you can opt out of if you don't like the price, the other you are forced to pay through your paycheck.
Posted by The White Whale (Member # 6594) on :
quote:Originally posted by Geraine: Let's just all work for free and have the government take care of everything for us. If the government can run everything better, why not?
quote: I understand the mistrust of health insurance companies, but can you honestly say you would trust the government more? One you can opt out of if you don't like the price, the other you are forced to pay through your paycheck.
I mistrust anything (or I guess "anyone") who is required by law to maximize the profits of its shareholders, especially when this maximization is at odds with my interests. In this case, I'd rather have some non-profit-maximizing entity make these decisions.
Posted by TomDavidson (Member # 124) on :
quote:I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
You're pretty sure about that?
Posted by natural_mystic (Member # 11760) on :
quote:I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
I'm guessing you're in the "CRA caused the Great Recession" camp?
Posted by MattP (Member # 10495) on :
quote:Most people I know are satisfied with their health care, except the people,like my mother, who are on Medicaid and Medicare.
That may be the case for the people you know, but in national polling Medicare actually has a very high satisfaction rate - well above most private insurance, and it is much less expensive to run, with only about 2% or so in administrative costs - a fraction of what private insurance spends.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Geraine: I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
Oh, really? Heh. I'd like to see the scholarly explanation of that one.
quote:Let's just all work for free and have the government take care of everything for us. If the government can run everything better, why not?
I am sure you understand pretty well by now what a strawman is.
Posted by Darth_Mauve (Member # 4709) on :
Kane: The problem with removing state line boundries is the rush to the bottom that would happen. Each state sets its own guidelines and has its own set of examiners to make sure that the insurance companies are honest (there are historical reasons for this, as insurance is not to far removed from gambling).
So if we let people buy from whichever state they want, the control goes to the state that the insurance comes from, then which ever state has the most Insurance Friendly laws--lowest oversight, fewest regulators, least financial safety requirements, strongest laws against lawsuits for malpractice by the insurance company, etc, will be the state that all the insurance companies call home--and send their taxes to.
The result will be less stable, less reliable and less helpful insurance companies--that will be cheaper.
Germ: Here is another argument. The rates I pay for health care increase at 10 times the rate of the rest of the economy. It now costs me more money to buy insurance than it does to pay for my house, and that insurance has a large deductible and copays so that I can't afford to get sick.
The reason that I keep hearing NOT to fix health care is that it will increase taxes and that will slow down business. HEALTH COSTS ARE IDENTICAL TO TAX, except they don't go to the government. They do negatively effect every business in this country accept the Insurance Companies. As they continue to spiral upward they stop productivity, reduce employment, and eat up our savings.
Posted by DarkKnight (Member # 7536) on :
quote: it is much less expensive to run, with only about 2% or so in administrative costs - a fraction of what private insurance spends.
There is a reason why the always boast about the percent of the administrative costs when compared to the total outlay of money. Typically, Medicare pays for very expensive items which makes it appear their admin costs are very low when the percentage is figured. I will look for some links later about this but that low admin cost is misleading.
Posted by BlackBlade (Member # 8376) on :
quote:I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
If that were true, the Articles of Confederation would have sufficed just fine.
Also, I don't think the founding fathers had any sort of real consensus on what our founding principles were. I think it would have been hilarious to pass out a survey and see what their responses were.
Contrary to your opinions, the founding fathers did not view government as poison, unless you were Thomas Jefferson before he actually became president. The role of government in our lives has increased ever since The Articles of Confederation were ratified. There has never been a prolonged dis-institutionalization of the government, there has always been a recognition of what is and is not working in the private sector followed by a governmental take over.
The military works better if it's controlled centrally by the government, roads work better when regulated by the government, the postal system, civil rights, the economy, education, and now health insurance. Every single one of those concepts had a period of time where the government did not control it, and it had huge problems that people got frustrated enough to use the government to help them fix it.
Your welcome to ask for people to vote for the days of local militias, dirt roads, month long correspondence, segregation, small business, illiterate coal mining childhoods, and right now death panels for every uninsured American.
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: it is much less expensive to run, with only about 2% or so in administrative costs - a fraction of what private insurance spends.
There is a reason why the always boast about the percent of the administrative costs when compared to the total outlay of money. Typically, Medicare pays for very expensive items which makes it appear their admin costs are very low when the percentage is figured. I will look for some links later about this but that low admin cost is misleading.
Hmm, that's weird...I think I heard that the administrative costs of healthcare are a much, much higher portion of the total amount spent in the US versus other industrialized countries.
Got any thoughts there? I bet not.
Posted by Kwea (Member # 2199) on :
Maybe because it's hard to discuss or refute something you "think you heard", without any proof or background on who you heard it from, any clue what the context was, or any discussion about their actual credentials or access to such information.
Posted by kanelock1 (Member # 12230) on :
quote:Originally posted by BlackBlade:
quote:I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
If that were true, the Articles of Confederation would have sufficed just fine.
Also, I don't think the founding fathers had any sort of real consensus on what our founding principles were. I think it would have been hilarious to pass out a survey and see what their responses were.
Contrary to your opinions, the founding fathers did not view government as poison, unless you were Thomas Jefferson before he actually became president. The role of government in our lives has increased ever since The Articles of Confederation were ratified. There has never been a prolonged dis-institutionalization of the government, there has always been a recognition of what is and is not working in the private sector followed by a governmental take over.
The military works better if it's controlled centrally by the government, roads work better when regulated by the government, the postal system, civil rights, the economy, education, and now health insurance. Every single one of those concepts had a period of time where the government did not control it, and it had huge problems that people got frustrated enough to use the government to help them fix it.
Your welcome to ask for people to vote for the days of local militias, dirt roads, month long correspondence, segregation, small business, illiterate coal mining childhoods, and right now death panels for every uninsured American.
[ January 26, 2010, 01:47 AM: Message edited by: kanelock1 ]
Posted by Darth_Mauve (Member # 4709) on :
I hear people arguing for proof that the American health system is broken. Every proof they find they are able to chip away at with innuendo, anecdotes, and odd statistics.
The only argument that I've heard claiming our system is working well is, "Well since we all aren't dieing every time we catch a cold, it must be OK."
That's a very low bar to meet. Haiti is doing that well.
I'm interested in finding proof that our free enterprise system of health care is doing well for those who are ill, not those who make the medicines, the insurance, or the medical decisions.
Come on those of us who are pro-health care. Stop sitting on the defensive and go on the offensive.
Posted by TomDavidson (Member # 124) on :
quote:That's a very low bar to meet. Haiti is doing that well.
I know that's meant to be a joke, but just for reference: at the moment, no, they're not. Conditions in Haiti are still pretty dire.
Posted by DarkKnight (Member # 7536) on :
quote: Got any thoughts there? I bet not
Such anger....
quote: Maybe because it's hard to discuss or refute something you "think you heard", without any proof or background on who you heard it from, any clue what the context was, or any discussion about their actual credentials or access to such information.
quote:Even with Litow’s manipulation of the numbers, Medicare seems like a better deal. Let’s see why:
Economies of scale: There are large economies of scale in the insurance business; however ,large insurance companies can certainly replicate the majority of the scale economies Medicare enjoys. Cost of Capital: Medicare incorrectly counts its cost of capital as 0. The true cost would take into account the direct cost of hiring IRS workers to collect the taxes which pay for Medicare as well as taking into account the distortionary effects of income taxation on workers labor supply decisions. For the private sector, the costs of capital is transparent: it is simply the interest rate. Demographics: Medicare serves the elderly population and thus has a high cost per enrollee. In 2003, the average medical cost for Medicare was $6,600 per person per year, while the same figure for private insurance was $2,700. Thus, if public and private health insurance had the same administrative cost per person, Medicare would still be seen as ‘more efficient’ since Medicare’s administrative cost ratio would be less than half the size of the private insurance’s cost ratio.
interesting! even with our system hardly being the paragon of medical system efficiency, it still beats out private.
Posted by BlackBlade (Member # 8376) on :
quote:Originally posted by kanelock1:
quote:Originally posted by BlackBlade:
quote:I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
If that were true, the Articles of Confederation would have sufficed just fine.
Also, I don't think the founding fathers had any sort of real consensus on what our founding principles were. I think it would have been hilarious to pass out a survey and see what their responses were.
Contrary to your opinions, the founding fathers did not view government as poison, unless you were Thomas Jefferson before he actually became president. The role of government in our lives has increased ever since The Articles of Confederation were ratified. There has never been a prolonged dis-institutionalization of the government, there has always been a recognition of what is and is not working in the private sector followed by a governmental take over.
The military works better if it's controlled centrally by the government, roads work better when regulated by the government, the postal system, civil rights, the economy, education, and now health insurance. Every single one of those concepts had a period of time where the government did not control it, and it had huge problems that people got frustrated enough to use the government to help them fix it.
Your welcome to ask for people to vote for the days of local militias, dirt roads, month long correspondence, segregation, small business, illiterate coal mining childhoods, and right now death panels for every uninsured American.
I'm moderately interested in knowing what your post was before you edited it. Was it, ?
Posted by Mucus (Member # 9735) on :
Further note, even using CAFI(an advocacy group for insurance companies)'s numbers for Medicare's costs which more than doubles the normal estimate for Medicare's costs from 2% to 5.2% and bizarrely omitting sales commissions, taxes, AND profits from the private insurance calculations, the private solution still ends up being roughly 70% more expensive in that post at 8.9% overall.
It was actually Uh, What? , as I just didn't get what you were trying to point out.
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: Got any thoughts there? I bet not
Such anger....
quote: Maybe because it's hard to discuss or refute something you "think you heard", without any proof or background on who you heard it from, any clue what the context was, or any discussion about their actual credentials or access to such information.
To clarify, I heard this information on an NPR interview.
Here is a quote from the Wiki on "Health Care in the United States" (exact title)--
"The health care system in the U.S. has a vast number of players. There are hundreds, if not thousands, of insurance companies in the U.S.[64][138] This system has considerable administrative overhead, far greater than in nationalized, single-payer systems, such as Canada's. An oft-cited study by Harvard Medical School and the Canadian Institute for Health Information determined that some 31% of U.S. health care dollars, or more than $1,000 per person per year, went to health care administrative costs, nearly double the administrative overhead in Canada, on a percentage basis.[139]"
And another quote, from the same Wiki:
According to a report published by the CBO in 2008, administrative costs for private insurance represent approximately 12% of premiums. Variations in administrative costs between private plans are largely attributable to economies of scale. Coverage for large employers has the lowest administrative costs. The percentage of premium attributable to administration increases for smaller firms, and is highest for individually purchased coverage.[144] A 2009 study published by the Blue Cross and Blue Shield Association found that the average administrative expense cost for all commercial health insurance products was represented 9.18% of premiums in 2008.[145] Administrative costs were 11.12% of premiums for small group products and 16.35% in the individual market.[145]
Here's my question--if economy of scale is the issue, (as the second bolded quote seems to point to), why wouldn't the biggest economy of scale, a government-run option, have the lowest administrative cost?
DarkKnight, kanelock, et al, were you aware of these numbers?
Posted by King of Men (Member # 6684) on :
quote:Originally posted by Darth_Mauve: I hear people arguing for proof that the American health system is broken. Every proof they find they are able to chip away at with innuendo, anecdotes, and odd statistics.
The only argument that I've heard claiming our system is working well is, "Well since we all aren't dieing every time we catch a cold, it must be OK."
The post I was objecting to claimed that anyone with anything remotely serious is kicked from their insurance program and, presumably, either dies or goes bankrupt. Would you like to defend that claim? Or can we both recognise that, while the system can use some reform, we're not talking immediate-action-required, asteroid-hitting-the-Earth style disaster?
Posted by AvidReader (Member # 6007) on :
I don't even dispute that for some people, it really is end of the world disaster time. My question is, how big is the raft we can put them on? I hate to be a Vulcan about it, but sinking the raft and killing everyone doesn't help.
People in Europe spend less and die less. Ok. Is that because of their healthcare or because of a variety of factors including genetics, lower fat diets, more walking, or any number of cultural factors? Which bits of American health are broken and how do we fix them?
I just feel like the current proposals have us running off half-cocked after the answers we think we should get. I guess I love science too much to be swayed by that. What are the facts? What will really help, not what should help?
Posted by Darth_Mauve (Member # 4709) on :
Nope. Can't recognize that.
Immediate action is required.
While this is not the "Earth-hitting-the-Earth" style disaster, there are people dieing out there because they can't afford to go to the doctor.
Bankruptcy is bad.
Taxes and costs are something that we can debate and worry about down the road.
But right now people are debating whether they can afford the deductible and see that doctor about the twitch in their face, or they should wait and pray it goes away. When that twitch continues onto a stroke--that's it.
We can talk about politics.
We can talk about humiliating liberals or Democrats or President Obama.
But the issue is people, children in many cases, who are dieing because they can't afford the doctor...
or the doctor can't afford to see them...
or the medication they are on is too expensive so they go without...
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by AvidReader: I don't even dispute that for some people, it really is end of the world disaster time. My question is, how big is the raft we can put them on? I hate to be a Vulcan about it, but sinking the raft and killing everyone doesn't help.
People in Europe spend less and die less. Ok. Is that because of their healthcare or because of a variety of factors including genetics, lower fat diets, more walking, or any number of cultural factors? Which bits of American health are broken and how do we fix them?
I just feel like the current proposals have us running off half-cocked after the answers we think we should get. I guess I love science too much to be swayed by that. What are the facts? What will really help, not what should help?
Honestly?
I think we know most of that. I've read way too many reports and studies of what is wrong, and what we think will be the best solution to fix it. It requires a massive and fundamental overhaul not only of how we pay for health care, but of how we provide it at the ground level.
And generally, most of those reports say the same thing.
We have to stop paying for care based on services provided and have to start paying based on the CARE provided. In other words, don't pay for 20 tests that a doctor order, pay for how healthy he made you. It's been tried in a number of smallish test cases, and in every case, it cut down on costs, cut down on waste, increased the quality of care, reduced complications, and satisfied everyone. Hospitals didn't lose money, doctors weren't paid less, customers paid less, and everyone went home healthy at the end of the day.
That should both bring costs down and make us healthier. And frankly, I think we should get the ball rolling on that before we discuss health insurance, but I guess I don't see why we can't do both at once.
The problem isn't that we don't know what to do. We've been studying the issue for what, more than 20 years? 30 years? We have information and statistics coming out of our ears. This is an ideological fight, not an empirical one. It's not evidence based. It's feelings based. Until we get over that hurdle, I'm not sure how we fix the problem at the procedural level.
Posted by DarkKnight (Member # 7536) on :
quote: We have to stop paying for care based on services provided and have to start paying based on the CARE provided. In other words, don't pay for 20 tests that a doctor order, pay for how healthy he made you. It's been tried in a number of smallish test cases, and in every case, it cut down on costs, cut down on waste, increased the quality of care, reduced complications, and satisfied everyone. Hospitals didn't lose money, doctors weren't paid less, customers paid less, and everyone went home healthy at the end of the day.
Links?
Posted by Geraine (Member # 9913) on :
quote:Originally posted by Darth_Mauve: Nope. Can't recognize that.
Immediate action is required.
Taxes and costs are something that we can debate and worry about down the road.
But right now people are debating whether they can afford the deductible and see that doctor about the twitch in their face, or they should wait and pray it goes away. When that twitch continues onto a stroke--that's it.
We can talk about politics.
We can talk about humiliating liberals or Democrats or President Obama.
But the issue is people, children in many cases, who are dieing because they can't afford the doctor...
or the doctor can't afford to see them...
or the medication they are on is too expensive so they go without...
1) So pass something now, even though we have no way of paying for it, and just worry about costs and taxes down the road?
So I guess we should just spend more money we do not have, which will then lead to higher taxes on individuals and businesses, and result in less jobs and pay? Isn't spending one of the reasons people hated Bush so much, and one of the reasons our current administration has been losing support?
2) Do you go to the hospital for routine tests and procedures? Usually dedectibles are for hospital procedures and stays. A twitch in your face can usually be tested by a regular doctor or specialist for a co-pay.
3) Health care reform isn't about politics or trying to humiliate democrats or Obama. It is about two different ideals. One that promotes reliance on the government or one that promotes personal responsibility.
4)Poor children are covered under CHIP, so I am a little confused what you are referring to. It is easily obtainable if you need it.
5) Doctors could afford to see a lot more patients if they didn't have to worry about getting sued for trivial things or pay a ton of money into malpractice insurance.
6) Last time I checked Wal-Mart has a ton of generics for $7 a piece without insurance. If you have something more serious and there isn't a generic, there are progams out there to help you already.
I want health care reform, but I want the right kind of health care reform. We are talking about 1/6th of our entire economy here. Doing it now and worrying about the cost later doesn't cut it for me.
Posted by Kwea (Member # 2199) on :
Lyr, I would also like links to those. I'd like to see how it worked, and what tehir methodoligy was to be honest. I agree wiht it, but I am not sure how we would implament it.
Posted by scholarette (Member # 11540) on :
#4- Poor children covered under chip- I knew a family who made less then $50 over the chip standards (which are different depending on what state you live in). Paying $10,000 a year for health insurance is probably still not affordable for them, even with that $50 over what the state said made health care an option. (The $10k figure comes from the minimum it would have cost at the time to insure a family of four).
#5- Texas has a lot of limits on what you can sue your drs for. Guess what- our docs still overprescribe and overtest. I know one city in Texas has the highest level of health care spending- significantly higher then that of similar populations in other states. This is a nice myth to toss out (because it seemingly makes so much sense), but as long as medicine is a business, drs are going to try to convince you to do more tests then you need (not all, but enough to be an issue.)
#6- Not all meds are available and sometimes a program for your drug does not exist. We had student insurance and my husband spent about $200 a month on drugs. The insurance helped on the first $500 of that (well, after your $100 prescription deductible). We qualified for CHIP for our daughter, so our income pretty low (first year was medicaid). After the $500 was up, we had to decide which drugs we cut and which he paid for. He needed all, but we still ended up cutting them. Because our student insurance covered some part of the drugs, we could not find any programs to help us. We were "insured". This was a few years ago, but depending on your situation, it is very easy top find yourself unable to pay for your meds.
Posted by Lyrhawn (Member # 7039) on :
DK and Kwea -
None of what I've read has been online. Actually, one of them might be, but I'll have to remember where I read it. Off the top of my head.
If you want a bare bones version of what I'm talking about, check this out. I've read the Dartmouth studies mentioned in this article as well, and I'm sure you can find them with a little googling. The article isn't the hard data you're looking for, but it's a primer on the sort of care I'm referencing, and the direction I think we need to go. TIME had a similar article that involved the Mayo Clinic and Geisinger in Pennsylvania about using a sort of standardization in medical procedures. It drastically cut down on in-hospital stay time, post-surgery complications, and overall costs by creating a sort of step-by-step guide for basic procedures, rather than the haphazard way they were performed. Doctors balked at following something so rigid, but when interviewed after it was implemented, they all agreed it was a positive change that made their jobs easier and their patients healthier.
Unfortunately, that sort of evidence based standardization is the sort of thing that leads some to trot out the Death Panel like criticism of Democrats as being robots out to deny care based on charts, graphs and tables. The problem really stems from the fact that people want the right to demand tests, even when doctors say they don't need them. We have to ask ourselves whether we should be trusting 300 million plus non-doctors when they demand treatments and tests that doctors say they don't need. And if we don't trust them to basically be their own doctors, is it really unreasonable to demand that they pay for those procedures out of pocket?
Check out that TIME article, there's some good stuff, and it'll give you some good ideas on where to look for more information. I'll try to comb through the material I have to see if any of it has an online counterpart that I can link for you guys.
Posted by theamazeeaz (Member # 6970) on :
quote:Originally posted by Geraine: 1) So pass something now, even though we have no way of paying for it, and just worry about costs and taxes down the road?
So I guess we should just spend more money we do not have, which will then lead to higher taxes on individuals and businesses, and result in less jobs and pay? Isn't spending one of the reasons people hated Bush so much, and one of the reasons our current administration has been losing support?
3) Health care reform isn't about politics or trying to humiliate democrats or Obama. It is about two different ideals. One that promotes reliance on the government or one that promotes personal responsibility.
I want health care reform, but I want the right kind of health care reform. We are talking about 1/6th of our entire economy here. Doing it now and worrying about the cost later doesn't cut it for me. [/QB]
In the short term, isn't this better for the economy?
By nature, much of the money that will be spent implementing this bill CANNOT be outsourced. Americans* will be need to fill the administrative jobs required to keep track of the millions of people newly insured, and Americans will be the ones getting more jobs taking on more cases of sick people. Americans will also get jobs educating the people in these professions.
The wonderful thing about the medical field is that it will never be obsolete. It's also impractical to outsource, unlike, say manufacturing and phone support.
*people living in the US, independent of citizenship.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Lyrhawn: We have to stop paying for care based on services provided and have to start paying based on the CARE provided.
I fully support this. I'm just not sure we need the government passing a ginormous bill full of other stuff to get it.
And even at that, I'm not sure it will completely negate the effects of our higher saturated fat diet and dependance on cars. There are probably a lot of things we should be doing to improve our health. I see healthcare as just one piece in the puzzle.
quote: The problem really stems from the fact that people want the right to demand tests, even when doctors say they don't need them. We have to ask ourselves whether we should be trusting 300 million plus non-doctors when they demand treatments and tests that doctors say they don't need. And if we don't trust them to basically be their own doctors, is it really unreasonable to demand that they pay for those procedures out of pocket?
I love this idea. If you really think the doctor's wrong, you can still over ride him. And if you're a crazy hypochondriac who wants a magic pill instead of taking care of yourself, you're your own problem.
Posted by BlackBlade (Member # 8376) on :
I don't love that idea. Some tests in of themselves are dangerous, a doctor shouldn't have to perform a procedure they are morally against performing.
Posted by Samprimary (Member # 8561) on :
Unlimited testing at the convenience of patients without any sort of oversight by medical specialists is both economically infeasible as well as procedurally irresponsible.
Posted by Lyrhawn (Member # 7039) on :
Severe limitations would make it impossible to be much of a hindrance. Doctors perform a battery of unnecessary tests as a matter of course. It's a shotgun versus rifle approach. The basic tests might turn up something, so they do them all and hope it hits, rather than taking a more focused approach and only ordering the tests they actually think, based on the evidence, that might help the patient.
If a new evidence based policy was enacted, a lot of this testing would go away. I'm not suggesting that people should be allowed to schedule their own X-Rays or invasive procedures without the guidance of a doctor, I'm merely talking about a payment structure.
If I go to the doctor and insist on a certain test and he says there's nothing to justify the test based on the evidence, but, that doing the test wouldn't hurt me, and that if I really want it, he'll okay it, but won't authorize funding for it, then I think that's fine. Why? Private hospitals do and always will exist that will allow people who have the money to get whatever they want done. Outlawing them isn't going to increase the care of the nation as a whole. Very few people would be able to afford these sort of tests anyway. Who has $10,000 for an X-Ray that a doctor says you don't need? Only the wealthy. And if they want to waste their money, I don't see the harm in letting them do so, especially if it keeps the idea politically viable by not appearing to restrict access based on voodoo science, which is what opponents will paint it as.
Posted by BlackBlade (Member # 8376) on :
quote:If I go to the doctor and insist on a certain test and he says there's nothing to justify the test based on the evidence, but, that doing the test wouldn't hurt me, and that if I really want it, he'll okay it, but won't authorize funding for it, then I think that's fine.
I could get behind that.
Posted by steven (Member # 8099) on :
Is my second post invisible?
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by BlackBlade:
quote:If I go to the doctor and insist on a certain test and he says there's nothing to justify the test based on the evidence, but, that doing the test wouldn't hurt me, and that if I really want it, he'll okay it, but won't authorize funding for it, then I think that's fine.
I could get behind that.
Yes, I should have specified within reason.
Posted by DarkKnight (Member # 7536) on :
I'm not against the care based outcome but I have had and my wife currently has issues that we come in for, they run a battery of tests which find nothing, and we have to come back for more tests. We never insisted on any tests to be done. I'm not sure it is always patients who insist on overtesting. I've read that doctors do it to be thorough...and probably pad thier pockets some.
Posted by Lyrhawn (Member # 7039) on :
Read the article I linked to above DarkKnight.
The extra testing comes from different sources depending on who you ask. Doctors clamoring for tort reform claim it's defensive medicine to make sure no one sues them.
The people who actually make the machines, and by the way who wield a decent chunk of power in the lobbying effort, say that this testing is necessary to make sure nothing is missed and it's better to overtest than undertest.
Still there remains the fact that in a pay per service health care system, there's an extreme amount of money to be made in simply running up the bill as high as you possibly can for the health insurance company. But that pay doesn't always or even generally go to doctors, it goes to the hospital, which is itself overburdened by paying for the uninsured and for a large gap in medicare and medicaid repayments from the government. The Mayo Clinic, and other hospitals experimenting with new forms of care, are radically changing the way the hospitals do business, and it's drastically cutting costs while improving care, but while it cuts costs for the process as a whole, it cuts it's own income too much to be sustainable. Someone has to make up the difference somewhere (and it's mostly because medicare and medicaid short them in repayments).
DarkKnight, the problems you're describing are the direct result of a pay per service system, well, maybe with a little bit of a lawsuit happy culture that likes to sue for everything and doctors who are sort of caught up in the whole thing. Care based outcomes would fix some of that.
Posted by Darth_Mauve (Member # 4709) on :
quote:1) So pass something now, even though we have no way of paying for it, and just worry about costs and taxes down the road?
Actually most of the bills do have ways of paying for it, but those ways are debated and who ever ends up having to pay for any part of it screams louder than the hospital patient. Your argument that there is "No way" of paying for it is hyperbole and wrong.
quote: So I guess we should just spend more money we do not have, which will then lead to higher taxes on individuals and businesses, and result in less jobs and pay?
An out of control health care system costs individuals and businesses much more than higher taxes, and results in less jobs and pay. Taxes are not the only expenses individuals and companies have to pay.
quote: Isn't spending one of the reasons people hated Bush so much, and one of the reasons our current administration has been losing support?
Spending is one of the reasons Conservatives hated President Bush. Most economists agree that spending is required to get out of a recession.
quote: 2) Do you go to the hospital for routine tests and procedures? Usually dedectibles are for hospital procedures and stays. A twitch in your face can usually be tested by a regular doctor or specialist for a co-pay.
Last time I went in for migraine headaches. I was sent to get an MRI to make sure it wasn't a tumor. This was done at an "imaging center" down the street. Cost--the bill sent to my insurance was over $4,500. They argued 20% had to come out of my deductible.
Stress test was ordered in conjunction with a CT skan. Same result with a different fee.
quote:3) Health care reform isn't about politics or trying to humiliate democrats or Obama. It is about two different ideals. One that promotes reliance on the government or one that promotes personal responsibility.
Oh I agree that I, not my government, not my doctor, or my insurance company is responsible for my health. But I am not responsible for most of the illnesses that hit me. They are random acts of chance--whether I get a stroke or a rare disease or hit by a bus. Some diseases we can label with fault--smoking, drinking, sins of health of one kind or the other. Still most are random. Insurance is supposed to help me financially survive random disasters. At present that system is broken--becoming a planned financial disaster that I pay for every month.
quote:4)Poor children are covered under CHIP, so I am a little confused what you are referring to. It is easily obtainable if you need it.
Really? Ever try to get it? It was being cut under President Bush, and only back up to pre-Bush standards under President Obama.
quote: 5) Doctors could afford to see a lot more patients if they didn't have to worry about getting sued for trivial things or pay a ton of money into malpractice insurance.
That is totally uninformed.
The reason they must rush through patients is the very limited fees insurance companies pay for patient care combined with the large amounts of paperwork they are required to maintain.
For a political party that pushes personal responsibility over everything else, and the power of the market to fix things, there is this big call to limit lawsuits on doctors. Why? If a doctor screws up, and has a pattern of screwing up, shouldn't they have to pay for it?
quote:6) Last time I checked Wal-Mart has a ton of generics for $7 a piece without insurance. If you have something more serious and there isn't a generic, there are progams out there to help you already.
Yes, $7 generics for the most common medicines. Too bad that people have to take the less common ones on a very common basis. My mother spends over $400-$600 a month on medication for her and my father. Some of that, thankfully, is covered by the VA. But once they hit their insurance limit the $200/month medications mean they have No Discretionary Fund, and start going in debt with the phone company and other utilities.
quote:I want health care reform, but I want the right kind of health care reform. We are talking about 1/6th of our entire economy here. Doing it now and worrying about the cost later doesn't cut it for me.
Doing it later is fine, as long as you can guarantee me that the later will get here. We've been working on Health Care Reform for 60+ years, since Truman. How much longer do you want to take? You say later, but all I hear is "Tomorrow" and we all know that "Tomorrow" never comes.
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight: I'm not against the care based outcome but I have had and my wife currently has issues that we come in for, they run a battery of tests which find nothing, and we have to come back for more tests. We never insisted on any tests to be done. I'm not sure it is always patients who insist on overtesting. I've read that doctors do it to be thorough...and probably pad thier pockets some.
I'd just be happy if you'd answer the post where I quoted the wiki article. I'd take anything, even something without substance, if you'd just respond.
I really don't think I'm being treated fairly...
Posted by malanthrop (Member # 11992) on :
I hear a lot about how bad the American health care system is. The Florida hospitals are full of Haitians right now. Where's Cuba? According to Michael Moore, Cuba is better than the US.
Posted by Lyrhawn (Member # 7039) on :
What's your point?
You just said three things that are perhaps tangentially related, but failed to apply any sort of analysis that might make those three things worthwhile to mention in concert.
Posted by DarkKnight (Member # 7536) on :
quote: Here's my question--if economy of scale is the issue, (as the second bolded quote seems to point to), why wouldn't the biggest economy of scale, a government-run option, have the lowest administrative cost?
Destroying hundreds, if not thousands, of businesses and unemploying thousands and thousands of people to save some administrative costs is not a very good arguement to me. You are making a valid arguement for gigantic corporations though, like WalMart and so on. For healthcare doing things like allowing businesses to compete across state lines will increase competition and lower costs.
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: Here's my question--if economy of scale is the issue, (as the second bolded quote seems to point to), why wouldn't the biggest economy of scale, a government-run option, have the lowest administrative cost?
Destroying hundreds, if not thousands, of businesses and unemploying thousands and thousands of people to save some administrative costs is not a very good arguement to me.
Those people can find other jobs...and if they can't, that's how it goes. I've been laid off before. It's a learning experience.
Posted by DarkKnight (Member # 7536) on :
quote: Those people can find other jobs...and if they can't, that's how it goes. I've been laid off before. It's a learning experience.
Using similar logic, we don't need fix healthcare at all. People can afford it...and if they can't, that's how it goes.
Posted by DarkKnight (Member # 7536) on :
quote: DarkKnight, the problems you're describing are the direct result of a pay per service system, well, maybe with a little bit of a lawsuit happy culture that likes to sue for everything and doctors who are sort of caught up in the whole thing. Care based outcomes would fix some of that.
I'm not against care based outcomes, I just want to make sure that we have something in place so that we don't run into the opposite problem of symptom X equals test Y and that is it. Medicine is not always an exact science.
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: Those people can find other jobs...and if they can't, that's how it goes. I've been laid off before. It's a learning experience.
Using similar logic, we don't need fix healthcare at all. People can afford it...and if they can't, that's how it goes.
I'm tired of paying ridiculous amounts for my healthcare. I can't afford insurance, even though I work more than 40 hours a week.
Posted by Kwea (Member # 2199) on :
Blackblade and Lyr...thanks for the links, both of you. I'll check them out later when I have some time to do so.
BB....I work in health care, and have seen a lot of things first hand, but it's not like I don't worry about costs or starting a public option myself.
I wouldn't promise to change my mind overnight, but I am always interested in hearing someone else's views on things, as long as they listen to my points as well. They don't have to agree, just listen.
Thank you for doing so. Posted by DarkKnight (Member # 7536) on :
quote: I'm tired of paying ridiculous amounts for my healthcare. I can't afford insurance, even though I work more than 40 hours a week.
Your earlier comments are still coming back to haunt you... Find another job that has health benefits, it can be a learning experience. EDIT: I'm actually trying to help you with this question... How much would insurance cost you?
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: I'm tired of paying ridiculous amounts for my healthcare. I can't afford insurance, even though I work more than 40 hours a week.
Your earlier comments are still coming back to haunt you... Find another job that has health benefits, it can be a learning experience. EDIT: I'm actually trying to help you with this question... How much would insurance cost you?
My job HAS health benefits. I can't AFFORD my portion. Or, to put it another way, I'd rather eat and put gas in my car than pay my $180-a-month portion. Food and gas come first. Shocker, huh?
Posted by DarkKnight (Member # 7536) on :
quote: My job HAS health benefits. I can't AFFORD my portion. Or, to put it another way, I'd rather eat and put gas in my car than pay my $180-a-month portion. Food and gas come first. Shocker, huh?
Just to clarify, your company has a health insurance plan but your monthly contribution is $180? Does your company provide any money towards health care and your share is $180? Or is it the company plan costs $180 per month, take it or leave it?
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: My job HAS health benefits. I can't AFFORD my portion. Or, to put it another way, I'd rather eat and put gas in my car than pay my $180-a-month portion. Food and gas come first. Shocker, huh?
Just to clarify, your company has a health insurance plan but your monthly contribution is $180? Does your company provide any money towards health care and your share is $180? Or is it the company plan costs $180 per month, take it or leave it?
$180 a month is my portion. They would pay the other half, if I were to choose it.
Posted by DarkKnight (Member # 7536) on :
quote: $180 a month is my portion. They would pay the other half, if I were to choose it.
Have you looked at getting health insurance outside of your company? I did a google search and this is the first link that came up so I'm not endorsing it, just providing it to see if it might help you find cheaper insurance. eheatlhinsurance Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: $180 a month is my portion. They would pay the other half, if I were to choose it.
Have you looked at getting health insurance outside of your company? I did a google search and this is the first link that came up so I'm not endorsing it, just providing it to see if it might help you find cheaper insurance. eheatlhinsurance
Actually, my parents pay for a policy for me, an excellent one, for about $200 a month. I'm a healthy white male, mid-30s, non-smoker, drink very little, no drugs, eat healthy, height/weight proportionate...and my parents STILL have to pay $200 a month for me.
The company policy is more expensive because it has to average in the cost of 400-pound black women who smoke 2 packs a day and eat junk food.
Posted by DarkKnight (Member # 7536) on :
quote: Actually, my parents pay for a policy for me, an excellent one, for about $200 a month. I'm a healthy white male, mid-30s, non-smoker, drink very little, no drugs, eat healthy, height/weight proportionate...and my parents STILL have to pay $200 a month for me.
So you do have excellent health care so I am not sure what your why you have a complaint? You could find a cheaper plan if you looked around though.
quote: The company policy is more expensive because it has to average in the cost of 400-pound black women who smoke 2 packs a day and eat junk food.
And we are done... Wow. Was that necessary? Really?
Posted by fugu13 (Member # 2859) on :
DK: of course, all the cheaper plans would have much higher deductibles.
Posted by steven (Member # 8099) on :
quote:Originally posted by DarkKnight:
quote: Actually, my parents pay for a policy for me, an excellent one, for about $200 a month. I'm a healthy white male, mid-30s, non-smoker, drink very little, no drugs, eat healthy, height/weight proportionate...and my parents STILL have to pay $200 a month for me.
So you do have excellent health care so I am not sure what your why you have a complaint? You could find a cheaper plan if you looked around though.
quote: The company policy is more expensive because it has to average in the cost of 400-pound black women who smoke 2 packs a day and eat junk food.
And we are done... Wow. Was that necessary? Really?
Hey guess what! You just made the troll list.
Posted by Mucus (Member # 9735) on :
quote:Originally posted by steven: ... cost of 400-pound black women who smoke 2 packs a day and eat junk food.
Seriously not cool.
Posted by DarkKnight (Member # 7536) on :
quote: Hey guess what! You just made the troll list.
Is that supposed to mean I am troll? or that you are trolling and I am now on your list?
Posted by steven (Member # 8099) on :
quote:Originally posted by Mucus:
quote:Originally posted by steven: ... cost of 400-pound black women who smoke 2 packs a day and eat junk food.
Seriously not cool.
I don't love saying things like that, but it most definitely is factual. Black people do have higher incidences of heart disease, etc.. Do you deny this?
Posted by Juxtapose (Member # 8837) on :
If you were actually interested in that conversation you would not have started it the way you did.
Posted by Samprimary (Member # 8561) on :
I have a good and cheap health plan. This is because I'm a young male in good health. The availability is subjective to the individual. Some of my friends are in the same health boat but are just too poor right now to have continued coverage. Some of my friends are financially able to get coverage but have conditions that they cannot get covered. So I can't approve of the system just because it works well for me in the short-term. Nor can I expect the system to cover me if my insurer really needs to screw me.
Nor, for that matter, does it mean I escape having to cover other people. We do. We all do.
Posted by Samprimary (Member # 8561) on :
also lol at the COVERIN THEM BLACK WIMMINS
Posted by Mucus (Member # 9735) on :
quote:Originally posted by Juxtapose: If you were actually interested in that conversation you would not have started it the way you did.
Indeed.
Posted by sinflower (Member # 12228) on :
quote:Originally posted by steven:
quote:Originally posted by Mucus:
quote:Originally posted by steven: ... cost of 400-pound black women who smoke 2 packs a day and eat junk food.
Seriously not cool.
I don't love saying things like that, but it most definitely is factual. Black people do have higher incidences of heart disease, etc.. Do you deny this?
I see steven's point here. I mean, why is "black women" offensive necessarily? If black women really do cost more to insure, then it's the same thing as mentioning "400-pound." It's not weight discrimination or weightism if it's true that they cost more to insure.
Posted by malanthrop (Member # 11992) on :
Statistics are selectively applied in insurance situations. It's perfectly acceptable to charge a 16 year old female less than a 16 year old male for car insurance. It's understandable to charge a 25 year old asian with good credit less than a 25 year old white with bad credit. Why does insurance diverge when it comes to other categories? Sex and age are fine discriminatory factors, but race is out of the question. Strange when genetics plays a huge part in ones susceptibility to certain diseases and life expectancy. African Americans have a much higher level of heart disease, cholesterol problems, high blood pressure, cycle cell anemia, and a lower life expectancy. If males can be charged more for car insurance, blacks should be charged more for health insurance and asians charged the least. Women should be charged more for health insurance as they are susceptible to pregnancy and a whole host of additional illnesses. For that matter, blacks should be able to collect social security benefits at a lower age....they are being screwed out of benefits since they do not live as long on average. It's only acceptable to charge white males more....mirroring the other social policies of protected classes....even when the females and minorities cost more.
[ January 30, 2010, 02:24 AM: Message edited by: malanthrop ]
Posted by Lyrhawn (Member # 7039) on :
quote:susceptible to pregnancy
This made me laugh.
By the by, I suspect that lower life expectancies for black males, and for that matter, minorities in general, has far less to do with genetics than it does with lifestyle factors. Minorities as a whole are far poorer than whites as a whole. The state of the health of the poor is far worse than that of the middle and upper classes. Poor access to adequate health care, or adequate nutrition, is one of the less talked about (but still mentioned) negative aspects of the crushing cycle of poverty that many inner city (and outside the inner city) minorities find themselves in.
I find myself fascinated by how interconnected all our problems are. It seems like most of our biggest problems are really just the accumulation of the negative effects of seven or eight smaller problems. Generally we don't tackle things one by one though. We wait for them to get so bad that they require a massive plan of attack to cover the problem as a whole.
Posted by theamazeeaz (Member # 6970) on :
I'm just utterly appalled at the selfishness that crops up immediately in these debates, especially given how much having a healthier population helps people here and now.
Sickness isn't always one of those things that people bring upon themselves. Our country was founded on the promise of life, liberty and the pursuit of happiness.
People talk about how Thomas Jefferson wanted small government, but do we really know what he would have thought if he was alive today? In his time anesthesia was getting drunk before surgery, no one knew what bacteria and viruses were at all, and leeches were considered good medical practice. People died young more often than now, more diseases were not curable, and bad accidents happened in the course of most people's work.
Would Jefferson approve of using tax money to make sure everyone could get to the doctors? Well, according to this site (which is pretty cool, if accurate), he didn't trust them, and I don't blame him. Would he have felt different today? Probably.
You know, it's a little known fact that, in New England anyway, people regularly lived into their 60s, and even 70s. Life expectancy as a whole was lower because you had to make it into your 20s, which was comparatively difficult with the high degree of adolescent deaths. But someone who survived into their 20s could expect to live for decades longer.
And seriously, who could blame Jefferson? Doctors were basically guessing back then. Medical "science" then, and medical science now, barely compare. I think the problem with small government of the 1780s in general, especially with guys like Jefferson, is two-fold. One, life in the early 1800s was NOTHING like life was in the Gilded Age, or especially now. Philosophies constructed in an age where every one was a farmer and could live miles and miles away from other people without needing anything, let alone a helping hand from government, have almost nothing to do with the way our country works today. Clinging to those ideas ideologically, without realizing the changes that have occurred from the time they were created to now, continues to amaze me.
Secondly, Jefferson was often either an idiot, or a hypocrite. He went from attacking government power, especially that of the executive branch, to being the architect of the Louisiana Purchase, which many at the time questioned the constitutionality of. Furthermore, when he made his oft-quoted 'refresh the tree of liberty with the blood of martyrs' quote, he was living comfortably in France, with no real appreciation of what was happening in America. I've always kind of wanted to punch him in the mouth for making such a flippant statement.
I agree with a certain level of respecting the Founder's intentions, but our world is not their world, and trying to apply their ideas of government and life to a world so different as if they fit, lock and key, is I think very dangerous. When ideology gets in the way of facts and reason, we have a problem.
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