Here's the full text, which I suggest everyone read, but here's my reading-between-the-lines take.
To Republicans/conservatives: One big, giant F*** YOU! I won, you lost, get over it because if we're gonna get anything done, it will be my way. In your face!
To Democrats/liberals: As close to a "red meat" major speech as he has given in the last 5 years.
To moderates/anyone who wants something to actually get done: Might as well start despairing now, because the gauntlet has been thrown down, and ain't nothing productive gonna get done in the next 4 years, unless something big changes.
I mean for reals, the absolute lack of conciliatory message towards the opposition was, IMHO, both frightening and REALLY bad for our country's future. Not to mention a grave political miscalculation.
Posted by TomDavidson (Member # 124) on :
quote:I mean for reals, the absolute lack of conciliatory message towards the opposition was, IMHO, both frightening and REALLY bad for our country's future.
I disagree. Obama's constant attempts to work with the Republican Party seriously weakened his position, and it's an enormous relief to see him attempting to make an argument from principle instead of what he thinks is political expediency. Here's hoping he sticks to it.
Posted by Lyrhawn (Member # 7039) on :
Better he throw down a gauntlet than pussyfoot around and pretend everything is great. Those speeches just piss me off, because we all know everything isn't fine.
He laid out an agenda, which is completely his prerogative to do. He's not going to get all of it done, but he's told us what he's going to try to do. Too often in recent history presidents have failed to say what they plan to do for fear of losing the message war when they inevitably fail to do so. So we get a lot of feel-good crap that means nothing. So he gets a lot of credit, in my book, for laying out clear specific goals.
He just won an election. If the winner of an election can't push an agenda and expect to get some of it passed, then why do we even bother having them?
Maybe this is a sign that he's finally grown a real backbone now that he doesn't have to play nice to get re-elected.
Posted by Parkour (Member # 12078) on :
quote:Originally posted by Brian J. Hill: To moderates/anyone who wants something to actually get done: Might as well start despairing now, because the gauntlet has been thrown down, and ain't nothing productive gonna get done in the next 4 years, unless something big changes.
Your statement does not make sense. If you want something productive to get done, why would you want a conciliatory tone to the most obstructionist minority in history deadlocking congress more than ever?
Posted by Blayne Bradley (Member # 8565) on :
Being conciliatory has been proven to be a dead end, why try again when the definition of insanity is to do the same thing over and over and expecting different results?
Posted by scifibum (Member # 7625) on :
quote:To Republicans/conservatives: One big, giant F*** YOU! I won, you lost, get over it because if we're gonna get anything done, it will be my way. In your face!
Could you be more specific? Where did he say anything quite so gloating?
Posted by Parkour (Member # 12078) on :
Truly the greatest trick the Devil ever pulled was making today's conservatives think that they were the ones negotiating in good faith and trying to cross the aisle, and it was Obama doing the stonewalling.
Posted by happymann (Member # 9559) on :
quote:Originally posted by Parkour:
quote:Originally posted by Brian J. Hill: To moderates/anyone who wants something to actually get done: Might as well start despairing now, because the gauntlet has been thrown down, and ain't nothing productive gonna get done in the next 4 years, unless something big changes.
Your statement does not make sense. If you want something productive to get done, why would you want a conciliatory tone to the most obstructionist minority in history deadlocking congress more than ever?
When you say "congress" do you mean the Senate or the House since one has one minority and the other has the other...
Posted by Parkour (Member # 12078) on :
I consider Republicans to be a minority. They represent a minority of votes, nationwide, in both houses. The Republican minority in the Senate is the most obstructionist in our history, compliments of the filibuster, and the Republican majority in the House exists only because of massive nationwide gerrymandering giving them disproportionate represenation.
Either way today's conservatives are the most obstructionist minority in this country's history. Not even the Do Nothing Congress had nothing on what happens today.
Posted by Darth_Mauve (Member # 4709) on :
Yes, the Republicans would never even think of obstructing anything. Lets look at Healthcare. When President Obama came into office he had a health care plan--Single Payer, Government Backed Health Care for Everyone.
Republicans said NO!
He then compromised with a plan created by the conservative Heritage Foundation, and instituted by one of the leading Republican Governors in that Governors state, but with an option for people to choose a single payer plan if it was better.
Republicans cried NO!
So finally he forced through the Heritage Foundations plan, that the Republican Governor had backed.
Then, even after it passed, they labelled it "Obamacare" and have been attacking, denying, and trying to revoke it ever since.
He asked for Republican input. Their input was, "Limit liability lawsuits on bad doctors, and leave the rest alone." Other than that--nothing.
Or lets take "Cap and Trade" legislation.
When air pollution and carbon dioxide based global warming was considered a problem in the 1990's, the Democratic President wanted legislation to cap the amount of pollution a company could make.
The REPUBLICANS and the Heritage Foundation suggested a market solution, creating a market for pollution, and called it Cap and Trade. The Democrats said "No". It was way to capitalistic a solution for them.
President Obama tried to put limit on Carbon and Pollution. The Republican's said "NO". President Obama went against the wishes of the left and said, "We have to do something. Lets compromise. We'll try your Cap and Trade Plan."
A firestorm was created as the Republicans rebranded Cap and Trade as a liberal attempt to kill industry.
I've heard a Republican caller on a radio show blame the President for being an obstructionist. He said, "We've tried to work with the President, but he refuses to do everything we tell him to. How can we compromise if he won't vote our way?"
Posted by Stone_Wolf_ (Member # 8299) on :
As a Cali resident, I don't get a voice as to who is president...thanks electoral college...but Obama, no matter that his politics are not the same as my own, is a dynamic leader, who is clearly very intelligent and well spoken, is honest about his goals for the country and his office, and then tries his hardest to fulfill said goals. While we may or may not be on the road to hell, I for one do not question his best intentions, while I definitely questioned W's, same for his ability to lead.
I will take Obama, a leader who I respect even if I disagree with over W who I did not respect, even though he had more conservative views.
Posted by Boris (Member # 6935) on :
quote:Originally posted by Darth_Mauve: Yes, the Republicans would never even think of obstructing anything. Lets look at Healthcare. When President Obama came into office he had a health care plan--Single Payer, Government Backed Health Care for Everyone.
Republicans said NO!
He then compromised with a plan created by the conservative Heritage Foundation, and instituted by one of the leading Republican Governors in that Governors state, but with an option for people to choose a single payer plan if it was better.
Republicans cried NO!
So finally he forced through the Heritage Foundations plan, that the Republican Governor had backed.
Then, even after it passed, they labelled it "Obamacare" and have been attacking, denying, and trying to revoke it ever since.
He asked for Republican input. Their input was, "Limit liability lawsuits on bad doctors, and leave the rest alone." Other than that--nothing.
Or lets take "Cap and Trade" legislation.
When air pollution and carbon dioxide based global warming was considered a problem in the 1990's, the Democratic President wanted legislation to cap the amount of pollution a company could make.
The REPUBLICANS and the Heritage Foundation suggested a market solution, creating a market for pollution, and called it Cap and Trade. The Democrats said "No". It was way to capitalistic a solution for them.
President Obama tried to put limit on Carbon and Pollution. The Republican's said "NO". President Obama went against the wishes of the left and said, "We have to do something. Lets compromise. We'll try your Cap and Trade Plan."
A firestorm was created as the Republicans rebranded Cap and Trade as a liberal attempt to kill industry.
I've heard a Republican caller on a radio show blame the President for being an obstructionist. He said, "We've tried to work with the President, but he refuses to do everything we tell him to. How can we compromise if he won't vote our way?"
Because it's apparently impossible to, in a period of nearly 20 years, look at an idea you used to think was great, consider the realities surrounding it, and suddenly realize what a phenomenally moronic idea it was in the first place. There's a reason those ideas were never actually brought before a Republican congress before Obama took office. But I guess democrats are the only ones allowed to change their minds...I mean evolve...on some subjects.
Taking the worst ideas a group came up with nearly two decades before, proposing them as a evidence of "working with the opposition," and then bitching about it when the opposition says it's a bad idea is probably not the best way to lead. Particularly when those ideas are used as little more than wrapping paper for the jumbled mess of bureaucracy and taxes that were included in that healthcare package. For instance, Obamacare allows for massive loopholes wherein a person can choose to pay the tax penalty (which is less expensive than many good insurance plans) until they suddenly come down with a debilitating and life threatening illness. Then, because they can't be denied for having waited to get insurance until they were about to die from something, they can sign up for insurance and have the insurance company pay all the million dollar bills, at which point they can then cancel their policy after they've been cured (if they've been cured) and continue on paying the penalty. In the heritage plan, there was no penalty for not having insurance other than, "Oh hey guess what. You have cancer. Guess you shoulda gotten insurance before now".
I mean, if I were to offer you a giant pile of manure for dinner, would you eat it? If I then covered the manure with bacon, cilantro, and cheese, would you eat it? Would you not think it stupid for me to complain that you aren't eating the pile of crap I served you despite the fact that I covered it with things that would be enjoyable on just about anything other than a pile of manure? That's basically what you're doing here. Republicans see a bunch of bacon covered in fecal matter and are saying, "Why did you do that to our bacon? We don't want that bacon anymore."
Then, I'm also wondering if you've actually *read* the Heritage Foundation's paper on health care from 1989 that the health care mandate comes from. That paper also recommended a lot of other measures. Of particular interest is the removal of tax exemptions for medical insurance plans. The idea there was this, most people who have insurance receive it from their employers, and most employers either pay for the entire cost of the plan or the vast majority of it. This results in both patients and doctors being completely disconnected from the financial issues inherent in medical care. For instance, most Americans don't realize just how much their insurance costs have increased over the past 20 years. Their bills get paid, and that's all they care about. It's when the bills *don't* get paid that they get angry, and the person they are angry at is the person paying the bills (insurance companies), not the person setting the price (medical industry).
Posted by Destineer (Member # 821) on :
quote:In the heritage plan, there was no penalty for not having insurance other than, "Oh hey guess what. You have cancer. Guess you shoulda gotten insurance before now". ... Then, I'm also wondering if you've actually *read* the Heritage Foundation's paper on health care from 1989 that the health care mandate comes from.
I'm confused. In what sense did the Heritage plan recommend a mandate, if there was no penalty for not having insurance?
Posted by Destineer (Member # 821) on :
quote:Of particular interest is the removal of tax exemptions for medical insurance plans. The idea there was this, most people who have insurance receive it from their employers, and most employers either pay for the entire cost of the plan or the vast majority of it. This results in both patients and doctors being completely disconnected from the financial issues inherent in medical care. For instance, most Americans don't realize just how much their insurance costs have increased over the past 20 years. Their bills get paid, and that's all they care about. It's when the bills *don't* get paid that they get angry, and the person they are angry at is the person paying the bills (insurance companies), not the person setting the price (medical industry).
I'm all in favor of getting rid of tax exemptions to improve efficiency in the market. But the idea of acquainting people with the financial costs of their health care, in the hopes that they will make cheaper decisions on that basis, seems like a pipe dream to me.
If people started having to pay the full cost of their plans themselves, I imagine there would be even more uninsured people.
Posted by Boris (Member # 6935) on :
The Text of the plan is here. It's about 12 pages long. The mandate explanation is on page 5, and actually seems like a very offhand suggestion, rather than a "let's do this! it'll work!" recommendation. It makes no mention of tax enforcement of a mandate to require the purchase of insurance. The enforcement tax was an idea developed during the deliberations on the entire package, one that I immediately thought was a terrible and stupid idea.
I should also mention that the original plan for Massachusetts' Health Care Reform package defined the penalty for not acquiring affordable coverage as the loss of the Personal Exemption on the individual's state tax return. This was changed to a tax penalty of up to half the cost of an "affordable" insurance package as determined by the state. The change was made a year after Governor Romney left office. So Obamacare doesn't really match what was instituted in Massachusetts at the time Romney was in office. So while the original framework resembles his work in Massachusetts, the federal bill that was built around that framework is significantly different(especially when you consider the piles of garbage that were also included in Obamacare).
I gather from the tone of the text provided by the Heritage Foundation that the mandate would basically mean that everyone has the ability to obtain health insurance, but if you don't get insurance, the fact that you didn't get it is your own fault, and noting that individuals who fail to get insurance is a net drain on society. Using taxation or penalties as enforcement was never mentioned. I recall the idea of a tax being applied to non-compliance for the Mandate in Obamacare being mentioned by a Democratic congressman. I don't recall his name, however. I also recall very few people thinking it was a good idea.
Posted by Boris (Member # 6935) on :
quote:Originally posted by Destineer:
quote:Of particular interest is the removal of tax exemptions for medical insurance plans. The idea there was this, most people who have insurance receive it from their employers, and most employers either pay for the entire cost of the plan or the vast majority of it. This results in both patients and doctors being completely disconnected from the financial issues inherent in medical care. For instance, most Americans don't realize just how much their insurance costs have increased over the past 20 years. Their bills get paid, and that's all they care about. It's when the bills *don't* get paid that they get angry, and the person they are angry at is the person paying the bills (insurance companies), not the person setting the price (medical industry).
I'm all in favor of getting rid of tax exemptions to improve efficiency in the market. But the idea of acquainting people with the financial costs of their health care, in the hopes that they will make cheaper decisions on that basis, seems like a pipe dream to me.
If people started having to pay the full cost of their plans themselves, I imagine there would be even more uninsured people.
Everything I gather from the Heritage Foundation's document is that it was a kind of, "Well, here's what we see as some current problems with the existing system. Here are some ways we could combat those problems." The idea that conservatives were pushing for these as solid solutions at the national level is really just revisionist history.
They were recommendations from a conservative think-tank. They were issued, for the most part, as a counter to the recommendations for a single-payer system that were just starting to pop up at the time. The idea that they came from a right wing source and should therefore cause conservatives to jump at the opportunity to get such measures enacted is pretty arrogant, and a good example of the complete disconnect between the values of the two parties and how the parties view one another.
Posted by Destineer (Member # 821) on :
quote:The mandate explanation is on page 5, and actually seems like a very offhand suggestion, rather than a "let's do this! it'll work!" recommendation. It makes no mention of tax enforcement of a mandate to require the purchase of insurance.
I don't see what makes it offhand. It's about half a page in a document that has 10 pages of text.
They don't mention any specific enforcement plans, but it's clear from the text that it's supposed to be a requirement in the same sense that car insurance is a requirement. Violating state auto insurance requirements is normally punished by a fine.
Posted by Destineer (Member # 821) on :
They also don't use any hedging language when they put the idea forward. They don't say "Here's something that's worth a try." The line is "Under the Heritage plan, there would be such a requirement."
Posted by Destineer (Member # 821) on :
It's also ridiculous to say this was just a think-tank idea and not a mainstream Republican one. There was a bill proposed by Dole, among others, according to the Wikipedia page on this.
If the conservatives or Republicans would have come out and said, "That plan is 20 years to late and lame and not going to work." or "That plan is based on our idea, but you've added terrible things to it" I would agree with you.
Instead they come out and say, "That is a Socialist Plan to steal our freedoms. We can't let the Democrats have any victory so we'll kill this bill. What ever we do we will partake of no part of it. It is evil and must be completely destroyed. Oh, the mandate? that seems the easiest to make illegal so we'll start there."
One is logical disagreement. The other is obstructionism.
Posted by Brian J. Hill (Member # 5346) on :
quote: Instead they come out and say, "That is a Socialist Plan to steal our freedoms. We can't let the Democrats have any victory so we'll kill this bill. What ever we do we will partake of no part of it. It is evil and must be completely destroyed. Oh, the mandate? that seems the easiest to make illegal so we'll start there."
One is logical disagreement. The other is obstructionism.
Clearly, the Evil Straw Man Republican whom you are quoting is practicing obstructionism.
When you look at facts through a partisan lens, that's all you're bound to see.
Posted by Brian J. Hill (Member # 5346) on :
To clarify that last point: I'm simply making the observation that it is partisans who tend to make the argument that the other side is being obstinate and obstructionist. When it's your side that's doing it, it's framed as standing firm on principles. Washington has become so hyper-partisan that compromise and statesmanship have gone out the window.
Posted by MrSquicky (Member # 1802) on :
quote:I'm simply making the observation that it is partisans who tend to make the argument that the other side is being obstinate and obstructionist.
In this particular case, even leaving aside the overwhelming data showing them being obstructionist, the Republican leadership has come out and said that this is what they are doing. It's not like they've been shy about that.
Posted by Boris (Member # 6935) on :
quote:Originally posted by Destineer:
quote:The mandate explanation is on page 5, and actually seems like a very offhand suggestion, rather than a "let's do this! it'll work!" recommendation. It makes no mention of tax enforcement of a mandate to require the purchase of insurance.
I don't see what makes it offhand. It's about half a page in a document that has 10 pages of text.
They don't mention any specific enforcement plans, but it's clear from the text that it's supposed to be a requirement in the same sense that car insurance is a requirement. Violating state auto insurance requirements is normally punished by a fine.
Only if you get caught, and such laws with their accompanying fines are handled at the state level, not nationally. With auto insurance, if you don't have insurance, you are required to pay all damages associated to accidents that you cause, and may be held liable for damage if you didn't cause the accident (I don't know all the laws on the matter. I don't know if that's the case, but I'm putting that out there as a possible result of not having auto insurance). You can also be ticketed by any police personnel that respond to the accident. You don't just get a blanket fine if you don't provide proof that you got insurance every year (Also important, you can't get a car loan without proof of insurance to a level demanded by the lending institution).
It's not unreasonable to think that taxation would be an enforcement option, but the fact that they leave out any recommendations on enforcement is important for the context in which it was used and the argument that Republicans were just trying to stop everything from going forward, including stuff they came up with. It's just as possible that you could enforce the mandate by making it unlawful for individuals without proof of medical insurance to purchase alcohol or cigarettes. There are a thousand ways you could enforce a mandate that don't demand a blanket fine on people who don't get insurance. And the Heritage Foundation certainly doesn't recommend allowing people who don't have insurance to purchase it *after* contracting a severe illness.
In addition, the mandate section was the least detailed of the recommendations given in the plan. That leads me to conclude it was also the least thought out of the recommendations. Rather than outlining what such a requirement would do, they only explain why the requirement would be necessary.
Contrast that with the recommendation on tax exemption, which takes 3 pages and includes information on financial impact, and the other two recommendations have a lot more information as well. That's what leads me to believe the Mandate wasn't really fleshed out or thought of in depth at the time of publication, and instead cast out as an idea that any future plan developed by the Heritage Foundation would use. I've read in several places that the Heritage Foundation made many changes to their plan in the following years, but I can't really find any specifics on *how* it was changed.
Posted by theamazeeaz (Member # 6970) on :
quote:Originally posted by MrSquicky:
quote:I'm simply making the observation that it is partisans who tend to make the argument that the other side is being obstinate and obstructionist.
In this particular case, even leaving aside the overwhelming data showing them being obstructionist, the Republican leadership has come out and said that this is what they are doing. It's not like they've been shy about that.
quote:Originally posted by Darth_Mauve: If the conservatives or Republicans would have come out and said, "That plan is 20 years to late and lame and not going to work." or "That plan is based on our idea, but you've added terrible things to it" I would agree with you.
Instead they come out and say, "That is a Socialist Plan to steal our freedoms. We can't let the Democrats have any victory so we'll kill this bill. What ever we do we will partake of no part of it. It is evil and must be completely destroyed. Oh, the mandate? that seems the easiest to make illegal so we'll start there."
One is logical disagreement. The other is obstructionism.
And the democrats sold it to the public by saying it would decrease medical costs. It hasn't. Quite the opposite. My contribution to my health insurance has increased by 50 bucks a month, and it's just me on it. If I had a family I'd be on the hook for over 200 bucks a month more this year than last year. So the democrats in congress were either incorrect in their estimates of what the plan would do, or they deliberately mislead the population. In either case, the Republican party was very much in the right to do everything they could to stop it from happening. Everything about that plan was offensive to conservative sensibilities and the dangling of recommendations made two decades prior as a means of appearing cooperative was insulting.
This is particularly important to remember when you consider that many Republicans felt that Obamacare's entire purpose was to completely destroy the Medical Insurance system so people would clamber for a Single Payer system. That was the purpose of introducing the public option. To decrease demand for public insurance by undercutting private corporations. I would not trust in the government's ability to keep costs down after all the insurance companies go bankrupt if that actually happened.
I've read comments from individuals on this forum stating they *hope* to see people clambering for a Single Payer system when the costs of Obamacare become completely noticeable. Personally, the idea of Bait and Switch government is repugnant to me. Passing legislation you *know* will cause problems in the hopes that it makes people beg you for the solution you want to sell them smacks of deceit and arrogance. I do not want this country's government to turn into a legislative system that has more in common with Chinese water torture than proper government.
Posted by twinky (Member # 693) on :
quote:Originally posted by Boris: So the democrats in congress were either incorrect in their estimates of what the plan would do, or they deliberately mislead the population.
False dichotomy. Two possible alternatives, just off the top of my head:
End user insurance costs are not the only costs associated with health care.
Not all provisions of the ACA are in force yet.
Posted by Rakeesh (Member # 2001) on :
It is something of a marvel to hear someone repudiating the idea of laws and policies advanced with the idea that they won't work or will cause harm, in pursuit of some other end...in defense of the modern GOP.
Posted by Boris (Member # 6935) on :
quote:Originally posted by MrSquicky:
quote:I'm simply making the observation that it is partisans who tend to make the argument that the other side is being obstinate and obstructionist.
In this particular case, even leaving aside the overwhelming data showing them being obstructionist, the Republican leadership has come out and said that this is what they are doing. It's not like they've been shy about that.
And if Obama had any real leadership qualities to speak of, they wouldn't have been like that. I mean, half the time his own party won't do what he asks. He is just not an authoritative person. He insulted the Republican party with his attempts at placation and they decided to oppose him completely out of spite (and strangely enough, the country seems to be doing *better* with all the gridlock than without it). Is that attitude childish? Sure it is. But if Obama had any kind of real leadership experience, knowledge, or talent, he could have kept them in line. He's not the first president to face an opposition party. He's just been among the worst at doing so.
Part of good leadership is trying to understand the motivations and desires of the people you are leading. Obama doesn't seem interested in even *trying* to understand conservative ideals. He seems like he feels doing such a thing would require him to wear waders and an air filter. He thinks conservatives are all just bitter rednecks that "cling to guns or religion or antipathy to people who aren’t like them or anti-immigrant sentiment or anti-trade sentiment as a way to explain their frustrations." Tell me why I should be following someone who doesn't give a crap about what *actually* motivates me?
Posted by MrSquicky (Member # 1802) on :
I'm not a big fan of the ACA or how the White House and Democrats pursued getting it passed, but I can't see how a responsible adult can objectively look at the GOPs actions during that with anything other than shame.
We have a severe health care crisis in our country and it behooved our leaders to have a responsible dialog about it and what can be done about it. The GOP took this as primarily an opportunity to try to defeat the President politically and came to the debate with dishonesty, screamed slogans, and seemingly intentional blindness.
Posted by TomDavidson (Member # 124) on :
quote:And if Obama had any real leadership qualities to speak of, they wouldn't have been like that.
Why do you think so?
Posted by Boris (Member # 6935) on :
quote:Originally posted by twinky:
quote:Originally posted by Boris: So the democrats in congress were either incorrect in their estimates of what the plan would do, or they deliberately mislead the population.
False dichotomy. Two possible alternatives, just off the top of my head:
End user insurance costs are not the only costs associated with health care.
Not all provisions of the ACA are in force yet.
1. You're right. Bureaucracy costs money too. People have to fill out paperwork, file claims, enter data into databases, transcribe information, etc. All of that bureaucracy costs money. In fact, the majority of costs associated with medical care can be attributed to administrative costs incurred by bureaucracy. 2. Also correct. Unfortunately, the provisions most likely to increase the cost of insurance and medical care are the ones that haven't been implemented yet.
quote: It is something of a marvel to hear someone repudiating the idea of laws and policies advanced with the idea that they won't work or will cause harm, in pursuit of some other end...in defense of the modern GOP.
Vague sniping without a lick of supporting information suggests that you probably have no data to back this claim up. Please cite some examples of the GOP running a bait and switch on the American people and I'll explain how it pisses me off just as much. But thank you for continuing to be an arrogant, snarky douchebag in political discourse.
My entire purpose here has been to point out that what you and others are providing as evidence of Obama attempting to be accommodating and working with Republicans to develop a working solution is not even remotely what you believe. There's this thing called confirmation bias. I'm trying to remove it. If you think I'm wrong in my assertion that he has not been as accommodating as you seem to think, either contribute with your own facts to support that idea, or shut the hell up, Rakeesh. I will not respond to snark from you in the future except to call you out on it.
Posted by TomDavidson (Member # 124) on :
quote:Please cite some examples of the GOP running a bait and switch on the American people...
Well, there's always the Clean Air Act. Or the PATRIOT Act. Or, well....Everything? Everything they've done in the last 15 years? We can start there.
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:And if Obama had any real leadership qualities to speak of, they wouldn't have been like that.
Why do you think so?
A strong leader would have attempted to understand and appeal to the motivations of the Republican party. That's how you influence people. Obama never even tried that. His closest attempt was to just tack on something a Republican in a very left wing state implemented to a festering pile of garbage and called it cooperation. A couple of the recommendations Republicans made at the start (Exchanges, for example) were added at the very end, once the super-majority was gone, but by then it was too late.
Posted by Rakeesh (Member # 2001) on :
Ahh, tough Internet talk.
Anyway, as for your complaints, multiple people in this thread *today* have already offered what you claim to be asking for or asking the questions you claim to wish to respond to. So mark me down as disinterested in a serious discussion along those lines with you, when you are showing-as we speak-little willingness to engage in what you claim to want.
The name calling and direct personal attacks are a good sign that you're worth talking to, though. And I'll note they were in response to neither of those from me. Another sign of...something.
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:Please cite some examples of the GOP running a bait and switch on the American people...
Well, there's always the Clean Air Act. Or the PATRIOT Act. Or, well....Everything? Everything they've done in the last 15 years? We can start there.
And please explain *how* they were what you say they are? And no, I'm not going to accept your typical "Go look it up" because we're dealing with a matter of perception here. I won't perceive the same things you do right off the bat. But the PATRIOT act is something I'm not particularly fond of, either. But it's nice that you're comparing Obamacare to that wonderful pile of excrement. I am also not fond of how the GOP went lockstep with GWB, particularly towards the end of his tenure.
And to be clear, I'm not going to argue that the modern Republican Party is all sunshine and rainbows. All I am arguing is that the assertion that Obama actually made a concerted effort to work with Republicans is not particularly realistic, given the apparent lack of evidence provided to suggest that he did anything other than thumb his nose at them.
Posted by TomDavidson (Member # 124) on :
quote:A strong leader would have attempted to understand and appeal to the motivations of the Republican party. That's how you influence people.
Given that their stated priorities within literally days of his swearing-in were to prevent him from passing any legislation, which motivations do you think Republicans have that it would have helped to understand?
-------
quote:And please explain *how* they were what you say they are? And no, I'm not going to accept your typical "Go look it up" because we're dealing with a matter of perception here. I won't perceive the same things you do right off the bat. But the PATRIOT act is something I'm not particularly fond of, either. But it's nice that you're comparing Obamacare to that wonderful pile of excrement.
We're talking about bait-and-switch, right? Compare the reasons Bush gave for the Clean Air Act in his SotU address to what the bill does. Then compare the stated justification for the PATRIOT Act with what the bill does. In neither case do we see any obvious overlap.
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:A strong leader would have attempted to understand and appeal to the motivations of the Republican party. That's how you influence people.
Given that their stated priorities within literally days of his swearing-in were to prevent him from passing any legislation, which motivations do you think Republicans have that it would have helped to understand?
Uhh...How about any of them? You would be surprised what can happen when you actually make an effort to understand people who don't like you or are out to defeat you. If you respond to obstinance with obstinance, guess what happens.
Posted by TomDavidson (Member # 124) on :
quote:How about any of them?
Give me one. What motivation do you personally have, for example, that you do not believe Obama understands and would help him better negotiate with Republicans determined to block any attempt at success?
Posted by theamazeeaz (Member # 6970) on :
$50 bucks a month? Now, I'm curious about this one: calculate the annual increase (monthly) for each of the preceding years up to this one.
My understanding is that Obamacare will decrease medical costs by decreasing externalities. Externalities like the fact that we pay more because many people don't have insurance but still get sick and hospitals pass that cost on to everyone because those people never pay. Externalities like people waiting far too long to get something checked out. Externalities like babies being born because people are too stupid to budget for the pill (ca-ching) or can't pull enough cash together to get an IUD. Externalities like medical bankruptcy, which causes a lot of bankruptcies, by the way.
My understanding is that Obamacare also limits the percentage profit to the insurance company and that if the insurance company exceeds that profit margin, it must return money to the individuals.
As I also understand it, it will take TIME for the health care system to recover from the rapid influx of people who hadn't been getting certain things checked out, but are going to do that now. But if there are fewer medical bankruptcies, illnesses get caught earlier, costs WILL stop accelerating at their alarming rate.
I am also happy to pay more to know that people who have lousy jobs are serving me, their customer, better because the are not working in spite of an injury they should be getting treated.
I am very proudly one of the people who hope Obamacare will pave the way for single payer insurance. Having what treatment is available to me decided by a for-profit company who has the right to drop me at a whim makes me really uncomfortable. I think single-payer health care will allow for more people to free-lance, to make risker financial moves. However, it would have decimated an entire industry with lobbyists and a crazy congress just isn't possible. I also don't think Obamacare is perfect, but I don't think people made it horrible to make people want single payer. I think they made it to solve as many problems with our health care system as they could. It's just that you can't fix everything in one bill. Period.
Is it fundamentally dishonest to pass a moderate bill, hope it becomes the norm, and that a more progressive bill will be easier to swallow?
What do you think about Don't Ask Don't Tell? Like Obamacare it was a compromise bill that passed after a very progressive attempt had failed. Do you think it was dishonest for people to agree to it, it hopes it would be repealed someday? Was it better than an outright ban of gay people in the military? Yes. Should it have not ever been passed in hopes that the full ban have been lifted wholesale?
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:A strong leader would have attempted to understand and appeal to the motivations of the Republican party. That's how you influence people.
Given that their stated priorities within literally days of his swearing-in were to prevent him from passing any legislation, which motivations do you think Republicans have that it would have helped to understand?
-------
quote:And please explain *how* they were what you say they are? And no, I'm not going to accept your typical "Go look it up" because we're dealing with a matter of perception here. I won't perceive the same things you do right off the bat. But the PATRIOT act is something I'm not particularly fond of, either. But it's nice that you're comparing Obamacare to that wonderful pile of excrement.
We're talking about bait-and-switch, right? Compare the reasons Bush gave for the Clean Air Act in his SotU address to what the bill does. Then compare the stated justification for the PATRIOT Act with what the bill does. In neither case do we see any obvious overlap.
Do you mean the Clear *Skies* Act? If that's the law that forced me to start using these retarded HFA inhalers, I hate it. PATRIOT wasn't a very good piece of legislation either. Of course, Obama still hasn't done squat to get rid of it.
But, still, you're stuck in GOP = GWB mode. Bush is not the GOP and the GOP is not Bush. The GOP followed him pretty blindly after 9/11, so I can see how you can confuse the two. Can you provide any examples that don't involve George Bush deceiving the people?
Posted by Xavier (Member # 405) on :
quote:A strong leader would have attempted to understand and appeal to the motivations of the Republican party.
I think the overwhelming motivation for Republican politicians after 2008 was "make sure Obama is perceived as a failure as a president". Any other motivations were eclipsed by that one, big time.
And you're right, I don't think he initially understood the strength of that motivation very well at first. He does now though, I suspect.
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:How about any of them?
Give me one. What motivation do you personally have, for example, that you do not believe Obama understands and would help him better negotiate with Republicans determined to block any attempt at success?
How about the desire to curb run-away government spending? The desire to not have the government digging its nails into daily life? The desire to prevent the money we spend on taxes from being wasted on people who are gaming the system? Democrats never even tried to address some of the glaring possibilities for abuse that exist in it. Or how about just not being told we should do this because it's "In your best interest" as if the government was our parents?
Posted by Boris (Member # 6935) on :
quote:Originally posted by theamazeeaz: $50 bucks a month? Now, I'm curious about this one: calculate the annual increase (monthly) for each of the preceding years up to this one.
My understanding is that Obamacare will decrease medical costs by decreasing externalities. Externalities like the fact that we pay more because many people don't have insurance but still get sick and hospitals pass that cost on to everyone because those people never pay. Externalities like people waiting far too long to get something checked out. Externalities like babies being born because people are too stupid to budget for the pill (ca-ching) or can't pull enough cash together to get an IUD. Externalities like medical bankruptcy, which causes a lot of bankruptcies, by the way.
My understanding is that Obamacare also limits the percentage profit to the insurance company and that if the insurance company exceeds that profit margin, it must return money to the individuals.
As I also understand it, it will take TIME for the health care system to recover from the rapid influx of people who hadn't been getting certain things checked out, but are going to do that now. But if there are fewer medical bankruptcies, illnesses get caught earlier, costs WILL stop accelerating at their alarming rate.
I am also happy to pay more to know that people who have lousy jobs are serving me, their customer, better because the are not working in spite of an injury they should be getting treated.
I am very proudly one of the people who hope Obamacare will pave the way for single payer insurance. Having what treatment is available to me decided by a for-profit company who has the right to drop me at a whim makes me really uncomfortable. I think single-payer health care will allow for more people to free-lance, to make risker financial moves. However, it would have decimated an entire industry with lobbyists and a crazy congress just isn't possible. I also don't think Obamacare is perfect, but I don't think people made it horrible to make people want single payer. I think they made it to solve as many problems with our health care system as they could. It's just that you can't fix everything in one bill. Period.
Is it fundamentally dishonest to pass a moderate bill, hope it becomes the norm, and that a more progressive bill will be easier to swallow?
What do you think about Don't Ask Don't Tell? Like Obamacare it was a compromise bill that passed after a very progressive attempt had failed. Do you think it was dishonest for people to agree to it, it hopes it would be repealed someday? Was it better than an outright ban of gay people in the military? Yes. Should it have not ever been passed in hopes that the full ban have been lifted wholesale?
I wouldn't be able to tell you what the increases over the past would have been, because I haven't stayed with any single company long enough to get hit with Insurance rate increases more than once. Most of the companies I've worked for cover the entire bill. That is becoming less feasible and the year prior to being hired for the company I work for individuals were covered fully by the company. Single employees must now pay about 180 a month. The company covers the remainder, which comes out to about 500 dollars a month. The company I worked for previously chose to switch insurance providers rather than face increased costs. The plan we ended up with was significantly worse than the one we had, but my costs remained the same. Every company I worked with up to that point paid insurance costs in full going back to when I was in college, where I had student insurance going back to when I was covered under my parents' plan. I have no idea how much it cost them.
The fact that Obamacare was built to address "as many problems as they could" is a major failing. We've already seen numerous unintended consequences from portions of it, many of which had to be removed through congressional action. It's a 1300 page bill, for crying out loud. If you really need all of that to fix the problem, you aren't being very creative. Republican proposals were to make a small number changes to the system that would have a large impact. Democrats proposed a large number of changes that would have very little impact individually. The excessive complexity of Obamacare is likely to bring the medical industry to its knees in such a way that it would be difficult at best to fix.
If your goal is Single payer, that's fine, but telling the American people that you're going to pass a law that will greatly decrease medical costs, knowing it will actually increase costs, and deliberately lying about it in hopes that people will clamor for what you really want to give them in the future is just arrogant. What's also likely to happen is people blame Obamacare for out of control costs and go on the warpath to get it repealed outright.
And going back to externalities...You realize that Obamacare doesn't really remove any of those things you mention? We will still end up paying for all of those people who can't afford care to get care. The only difference is that the hospitals and other medical companies will make a lot more money (Don't even think about expecting them to drop their prices. They provide life saving services whose value is hard to quantify. Good luck convincing them they shouldn't charge as much as they do now. We can't even control the costs involved in our existing government contracting system, and insurance companies have a hard time controlling costs already. What makes you think the government can do it better?).
Having people wait to get checked until something explodes? You'll actually see that increase as doctors have to spend more time doing paper work and less time working with patients. With more people trying to see the doctors and the number of family doctors decreasing in this country, expect to be forced to wait longer to see a doctor. The actual cost of doctor visits will end up increasing as well. Everyone likes to gloss over the fact that time sensitive illnesses like cancer are much more survivable in the US in great part because of the wait time required to see a doctor in many single-payer health care systems. And people will still put off going to the doctor because they just don't have time to or because they don't want to or because it's a pain in the butt.
And people will still be stupid about having kids, not because they can't afford the pill (seriously? Ca-ching? Sprintec costs 9 bucks a month. Ask your doctor to prescribe the cheap stuff instead of letting them up sell you to the stuff under patent), but because they choose not to take it, just like they do now. It *may* stop medical bankruptcy, but I think I'd choose a bankruptcy over death if presented with the choice. Wouldn't you?
As for the medical industry taking time to adapt to the influx of people, that's a pretty bad cop out, don't you think? "Well, maybe the prices will increase for a while until all these people who have been sick for ages start getting covered by insurance, but they'll go down eventually." No. No they won't. Medicine's various industries have no incentive to keep costs to patients down under Obamacare. There was nothing done to reduce the profiteering in the medical industry. Because of the nature of what they provide, it is nearly impossible to convince them that what they charge is more than they should be charging. In the situation where costs for doctor visits start getting heavily controlled, expect to see doctors start refusing insurance payments outright. I have a doctor that won't take insurance from anyone, charges 200 bucks, and lets you file your own insurance claim. Because she's out of network, I get maybe 30% back from them. If she were in network, she would be limited to charging about 75 dollars for a visit.
And DADT didn't really get sold as one thing and turn out to be the exact opposite. Its enforcement was fairly severe, but it wasn't an outright lie. Accepting a partial measure in hopes of getting a full measure is acceptable, just don't lie blatantly about what's going to happen with your half measure and pretend it's not a stepping stone.
Posted by TomDavidson (Member # 124) on :
quote:How about the desire to curb run-away government spending? The desire to not have the government digging its nails into daily life? The desire to prevent the money we spend on taxes from being wasted on people who are gaming the system?
Do you believe that Obama does not understand that many -- far from all -- Republicans genuinely care about these principles? If not, how do you believe he would govern differently if he did?
Posted by TomDavidson (Member # 124) on :
quote:But, still, you're stuck in GOP = GWB mode. Bush is not the GOP and the GOP is not Bush.
Very true. Can you name something constructive the GOP has done at the federal level since the Bush Administration?
------
quote:Having people wait to get checked until something explodes? You'll actually see that increase as doctors have to spend more time doing paper work and less time working with patients.
I think you'll find this is precisely wrong. Once the various exchanges are set up, I fully expect preventative care to skyrocket in demand.
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:How about the desire to curb run-away government spending? The desire to not have the government digging its nails into daily life? The desire to prevent the money we spend on taxes from being wasted on people who are gaming the system?
Do you believe that Obama does not understand that many -- far from all -- Republicans genuinely care about these principles? If not, how do you believe he would govern differently if he did?
I don't think he even acknowledges these as legitimate issues with modern government. How would he govern differently if he did? I couldn't say, primarily because doing so would be a very radical shift from his current style. I imagine he would begin to resemble Clinton's style a little more, but I couldn't say for certain because I was a teenager in the Clinton years and the only thing I paid attention to then was BBSes and Computers.
Posted by theamazeeaz (Member # 6970) on :
quote:Originally posted by TomDavidson:
quote:But, still, you're stuck in GOP = GWB mode. Bush is not the GOP and the GOP is not Bush.
Very true. Can you name something constructive the GOP has done at the federal level since the Bush Administration?
But that's about it.
Posted by TomDavidson (Member # 124) on :
And that was a Democratic bill originally. Posted by TomDavidson (Member # 124) on :
quote:I don't think he even acknowledges these as legitimate issues with modern government.
Now we've gone from the need to understand that some Republicans believe these are legitimate issues to believing -- and agreeing with them -- that they are issues which demand his attention. Are you suggesting that a good leader must believe the same things his opposition believes?
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:But, still, you're stuck in GOP = GWB mode. Bush is not the GOP and the GOP is not Bush.
Very true. Can you name something constructive the GOP has done at the federal level since the Bush Administration?
Has the Senate allowed passed anything the House has passed in the past 2 years? Remember that the GOP was the minority party from 2006-2010, and nothing they would have wanted would have gotten through after Bush left. But then, I admit that I haven't really paid a whole lot of attention to things in the past couple years. CSPAN isn't good for people with ADD (The only reason I am even on this site discussing things right now is because the ADD meds I just got started on a couple months ago are doing some weird stuff to my brain and its grabbing on to the strangest subjects that I normally don't care about and amphetamines!) and I trust news outlets about half as far as I can throw them.
Posted by MattP (Member # 10495) on :
quote:How about the desire to curb run-away government spending? The desire to not have the government digging its nails into daily life? The desire to prevent the money we spend on taxes from being wasted on people who are gaming the system?
Does it need to be pointed out that these desires are not exclusive to Republicans and that, when in power, Republicans haven't necessarily done much better at addressing them than Democrats?
Posted by TomDavidson (Member # 124) on :
I didn't want to bring it up, but it's hard to find a single speech Obama has made in the last three years that does not specifically point out that he shares and acknowledges the desire to restrain the growth and cost of government. One can argue that he's lying, just saying what he thinks people want to hear -- but even that would put paid to the argument that he doesn't understand what they want to hear. He quite clearly does.
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson:
quote:I don't think he even acknowledges these as legitimate issues with modern government.
Now we've gone from the need to understand that some Republicans believe these are legitimate issues to believing -- and agreeing with them -- that they are issues which demand his attention. Are you suggesting that a good leader must believe the same things his opposition believes?
A good leader would at least acknowledge the fact that his opponents are also people with beliefs that are worth acknowledging as potentially legitimate. Heck, that's just basic rhetorical theory.
Were I to give an example of good leadership, I would point you to MLK Jr.'s Letter from Birmhingham Jail. If you read through that, note that his audience is a group of clergymen from different faiths. A Jewish Rabbi, some catholic priests and a bishop, and some protestant leaders. Throughout the letter he takes special care to appeal to the beliefs of each individual. He references Jewish History and stories from the Talmud. He speaks about the teachings of Jesus Christ. He also makes note of the actions of Martin Luther. He references beliefs he knows are held by each of the people who are attempting to distance themselves from the cause of civil rights out of public perception. By showing he knows what they believe and why they believe it, he is able to frame those beliefs into a convincing argument for why the civil rights movement was so important and have it firmly impact each of the people who were opposing him.
I have yet to see Obama acknowledge that conservatives are anything other than bitter old people who hate the world around them.
Posted by Boris (Member # 6935) on :
quote:Originally posted by TomDavidson: I didn't want to bring it up, but it's hard to find a single speech Obama has made in the last three years that does not specifically point out that he shares and acknowledges the desire to restrain the growth and cost of government. One can argue that he's lying, just saying what he thinks people want to hear -- but even that would put paid to the argument that he doesn't understand what they want to hear. He quite clearly does.
Except that his actions belie a different view than he provides in those speeches. You can tell me a dog is a cat and I might believe you. Until it barks. And if you pull try to pull that on me more than once I'm not likely to pay attention to you. I was willing to believe that he cared about our spending problem, until he added 600 billion dollars to spending his first year in office. And only decreased that level of spending by about 15 percent the next year. And didn't drop at all the next. And it hasn't gone below a 1 trillion dollar shortfall since.
Also, it's important to point out that knowing what people want to hear is very different from understanding their reasons for wanting something. I can tell you the things I want clearly enough. Explaining why I want those things is much more difficult. Getting you to understand my views is even more difficult, because you aren't me.
Posted by Destineer (Member # 821) on :
quote:
I have yet to see Obama acknowledge that conservatives are anything other than bitter old people who hate the world around them.
WTF? He is constantly saying how much he admires Reagan, for example.
Posted by Lyrhawn (Member # 7039) on :
Tom is giving an excellent clinic in Socratic questioning.
Boris is giving an excellent clinic in Republican obfuscation.
Carry on.
quote:I have yet to see Obama acknowledge that conservatives are anything other than bitter old people who hate the world around them.
Please tell me you're not really buying into the cartoon version of Obama. If this is really true, then you just aren't looking hard enough. Or really, you aren't looking at all. Even a little bit.
Posted by Boris (Member # 6935) on :
quote:Originally posted by Lyrhawn: Tom is giving an excellent clinic in Socratic questioning.
Boris is giving an excellent clinic in Republican obfuscation.
Carry on.
And you've given a great example of why I quit visiting this forum. Being a dismissive jerk is a great way to clear the forum of all dissenting opinion, but it's a really lousy way of coming to some realistic solutions.
quote: Please tell me you're not really buying into the cartoon version of Obama. If this is really true, then you just aren't looking hard enough. Or really, you aren't looking at all. Even a little bit.
Patronizing people is a really fantastic way to convince them that you are correct. Oh wait, no it isn't. See my previous comment on snarky responses.
Posted by Boris (Member # 6935) on :
quote:Originally posted by Destineer:
quote:
I have yet to see Obama acknowledge that conservatives are anything other than bitter old people who hate the world around them.
WTF? He is constantly saying how much he admires Reagan, for example.
And this has meaning because...?
Posted by Destineer (Member # 821) on :
Reagan was a conservative. He says he admires Reagan. That's him acknowledging that conservatives are something other than bitter old people who hate the world around them.
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Boris:
quote:Originally posted by Lyrhawn: Tom is giving an excellent clinic in Socratic questioning.
Boris is giving an excellent clinic in Republican obfuscation.
Carry on.
And you've given a great example of why I quit visiting this forum. Being a dismissive jerk is a great way to clear the forum of all dissenting opinion, but it's a really lousy way of coming to some realistic solutions.
quote: Please tell me you're not really buying into the cartoon version of Obama. If this is really true, then you just aren't looking hard enough. Or really, you aren't looking at all. Even a little bit.
Patronizing people is a really fantastic way to convince them that you are correct. Oh wait, no it isn't. See my previous comment on snarky responses.
Forgive me if I'm wrong, but the impression I've gotten from your posting in this thread that you're a right-wing troll. If you're actually arguing from an honest place of disbelief, then I apologize, but really, your statements leave me profoundly flummoxed if they're to be taken at face value.
Posted by TomDavidson (Member # 124) on :
Hey, let's cool down a sec. Boris, you've acknowledged that Obama talks the talk; he knows what conservatives want to hear and says it. But you believe that his actions demonstrate that he does not understand the motivations that underlie those statements. By way of evidence, you cite a spending cycle on par with the previous president, at the bottom of a recession. Granted that Obama is a moderate Keynesian and can be expected to try to govern as a moderate Keynesian when given the opportunity, what else has he done that gives you this impression?
Posted by Parkour (Member # 12078) on :
Boris is not a troll. He is arguing from the very real and very depressingly common position of someone who can really say "I have yet to see Obama acknowledge that conservatives are anything other than bitter old people who hate the world around them". Because his media filters or personal filters succeeded in making sure he has not seen this over the narrative.
Posted by Blayne Bradley (Member # 8565) on :
Boris do you understand what the Bretton-Woods framework is and how it pertains to the US Dollar as the world's reserve currency?
Posted by steven (Member # 8099) on :
Is anyone still arguing that Republicans have any credibility in the area of fiscal restraint?
Please. Republicans are only arguing for cutting spending because
1. Tea Partiers are up in arms about TARP and bank bailouts
2. Obama can't cut spending right now, because the economy is still too fragile.
It's as cynical a political ploy as I've ever seen. It's a bunch of scam artists trying to get re-elected.
Posted by steven (Member # 8099) on :
quote:Originally posted by Parkour: ... ... conservatives are anything other than bitter old people who hate the world around them". ...
To be fair, that IS the Republican base. Take away the votes of oldest, whitest, most racist, and most xenophobic 15% of the electorate, and almost no conservatives would get elected to national office.
Of course, most of the Intermountain West and the rural South would be completely removed from voting. However, I don't think that's a bad thing. They're fricking killing the rest of the country. They think they're electing mavericks and people with an individualistic spirit, when really they're just electing people who kowtow to the tobacco, firearms, and defense industries.
If we manage to survive as a species with no major debilitating wars or major acts of terrorism over the next 20 years, it will be largely because we enact the opposite of the policies these most conservative voters want most.
it's pretty messed-up that gun-toting racists hiding out in rural Idaho have as much power over the entire WORLD as they do, due to the Senate and the electoral college.
We don't need to encourage xenophobia ANYWHERE, nor give xenophobes a voice. In a globally-connected world like this, that's self-genocide.
Posted by Swampjedi (Member # 7374) on :
quote:Originally posted by steven:
quote:Originally posted by Parkour: ... ... conservatives are anything other than bitter old people who hate the world around them". ...
To be fair, that IS the Republican base. Take away the votes of oldest, whitest, most racist, and most xenophobic 15% of the electorate, and almost no conservatives would get elected to national office.
It's a distressingly large part of the base, but it's not fair at all to say that IS the base. On top of that, I don't see what was added by using "oldest, whitest". What point were you trying to make? I'd assume that it wasn't "old white people suck."
Posted by twinky (Member # 693) on :
quote:Originally posted by Boris:
quote:Originally posted by twinky:
quote:Originally posted by Boris: So the democrats in congress were either incorrect in their estimates of what the plan would do, or they deliberately mislead the population.
False dichotomy. Two possible alternatives, just off the top of my head:
End user insurance costs are not the only costs associated with health care.
Not all provisions of the ACA are in force yet.
1. You're right. Bureaucracy costs money too. People have to fill out paperwork, file claims, enter data into databases, transcribe information, etc. All of that bureaucracy costs money. In fact, the majority of costs associated with medical care can be attributed to administrative costs incurred by bureaucracy. 2. Also correct. Unfortunately, the provisions most likely to increase the cost of insurance and medical care are the ones that haven't been implemented yet.
0. Most importantly: Congressional Democrats were not necessarily either wrong or deliberately lying about the ACA's cost implications. That was my main point: your two proposed explanations were not in fact the only two possibilities.
1. Yes, that's true. You have redundant bureaucracy in part as a consequence of having fifty hojillion different insurers doing more or less the same thing. That's one of the downsides of a market-based health care system.
2. Which provisions are those? Here's a summary timeline of ACA provision implementation. Some cost-related measures came into effect in 2012 -- in fact, I just spent the last several days playing with the outcome data mentioned in the first 2012 item as part of a course I'm taking in my spare time. Others take effect in 2013 or 2014.
Posted by Rakeesh (Member # 2001) on :
I'm still waiting to hear, as are others, what potential political strategies Obama could actually have employed to negotiate with people who had decided *before he was President* that they were committed to thoroughly disrupting any of his efforts and destroying him politically. What viable political strategy could Obama have employed, other than capitulation? Which incidentally if one actually asks the liberal Democrats Obama is supposedly a member of, he in fact *did* on quite a few occasions (Gitmo, immigration policy, deportations, wars, drone strikes, targeting Americans, fiscal cliff negotiations, debt ceiling negotiations, just for some of the biggest).
No. It's just a little twist on the old 'well this guy did something bad, but the other party...' argument of equivalence. No one can seriously claim that Republicans weren't committed to wrecking Obama's term for longer-term political gain because, well, more than a few are on record as saying exactly that. Hard to get equivalence there, so something else must be found. Hmmm. Wait! If Obama had been a better leader, Republicans would not have *started out* with the wish to utterly hamstring him and Congress in his first term-to ensure it was his only term. Equivalence!
Posted by Lyrhawn (Member # 7039) on :
In trying to puzzle through Boris' response to the inaugural, I came across this article by CNN's David Gergen and it really left me quite puzzled.
Gergen attacks Obama for not issuing the normal blather about bi-partisanship and lambastes him for saying its his way or the highway. And I guess I'm just flummoxed as to what sort of amnesia you have to have if you don't think that's what we've had for the last 3 years on the Republican side. Compromise means caving as far as the GOP has been concerned for the last few years. Obama bent over backwards and was crushed every time.
I read another Op-Ed elsewhere that made a good point I think. First Term Obama believed that everyone was basically on his side, and that America really agreed on most issues, but politics got in the way. Second Term Obama believes we have radical divisions on major issues and we do not in fact agree, so he's decided to join the message war in trying to convince people he's right. I don't see the problem with that. If you aren't trying to convince people you're right, why bother?
I just can't fathom Gergen's response to the speech in the face of what the last few years have been like. I know Republicans love to say that Obama doesn't compromise, but it flies in the face of every major policy negotiation that's happened since he took office.
Posted by Boris (Member # 6935) on :
Did you people ever think that it was possible for two different people with different backgrounds to look at the same thing and have two different responses to it?
What I see from this thread is a lot of "This is what I see, and you're stupid for not seeing it. I can't be wrong because I'm a rational human being. You don't agree with me, therefore you are not a rational human being." You guys probably don't realize you're coming across like that, but trust me, you are.
Rakeesh, are you bullying people who disagree with you just to silence them, or do you actually think your attitude and debate tactics of snark and sarcasm are likely to convince people of your position's superiority?
steven...The Aryan nations were sued out of existence in Idaho in the late 90s. And you are also ignoring the fact that most White Supremacists can't vote to begin with because they are ex cons. The remainder are so far out there that they wouldn't vote for anyone that doesn't wear a swastika on their sleeves. Those aren't Republicans. And old white people? Are you a racist geriatrophobe? Because the attitude that you show in your posts is no different in substance than what you accuse Republicans of. My skin color has as much to do with how I and most other Republicans vote as my shoe size does to what kind of car I drive. But since we're considering racism and xenophobia as disqualifications for joining national political discourse...What do you suppose would happen if all the Hispanic and African American racists in this country couldn't vote? Which party do you think would come out ahead if all the racists (and by racists, I mean people who think members of other races are inferior or who just generally hate people of a different race, not the pseudo-intellectual social justice version of racism where every white person is racist and everyone else is a kindly little lamb of love and affection) in this country weren't allowed to vote?
Lyrhawn, I don't see how Obama has tried to compromise in a meaningful way. But I will admit that I haven't paid a lot of attention to him in the past few years, what with me working to improve my career. ACA was the last thing I really paid attention to outside of the election and his handling of that was horrendous. His campaign during the election did nothing to improve my opinion of him. Particularly since he sat behind a shield of journalists trying to spin him out of trouble at every step (funny that it was MSNBC that first announced what he really meant with his "You didn't build that" speech and not Obama himself). He spent the whole campaign shooting the messenger. If you want to ask me whether I buy into Cartoon Obama, didn't you buy into Cartoon Romney? I'll admit that Romney wasn't the best candidate, but I at least agree with him on Fiscal strategy. I'm not going into why, because that's another 5 page explanation. But I didn't get to vote anyway, since the Tucson election board waited until December to send my absentee ballot to my new address (moving to a new location across the state 1 month before election day is a pain in Arizona). I could go all conspiracy theory on the subject and say they held on to it because I was registered Republican and Tucson is a very liberal city...But I'd just be joking around if I did. Mostly. At any rate, rather than just saying I'm not looking hard enough for evidence that he's trying to cooperate and being a snarktard about it, why don't you consider that maybe other people don't have the same experiences as you and provide some evidence to support your claims and explain why it does so. The only evidence of Obama's supposed attempts at cooperation I've seen in this thread is the rant on the Heritage Foundation plan, which, as I've already explained, isn't exactly strong evidence of honest cooperation on his part. Particularly since adding the mandate to the plan was a suggestion from his side of the argument and not one provided by Republicans at the time. And the idea that Obama doesn't compromise only flies in the face of what you have perceived from every major policy negotiation since he took office. His actions might appear to be compromise to you and not appear to be honest attempts at compromise to someone else.
Twinky, Government bureaucracy is a wonder of inefficiency. 37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government. In addition, when the exchanges go into effect and millions of people who have no interest in taking care of themselves (and would normally be declined for insurance as a result) start getting insurance, or paying the fines and waiting until something on them blows up before they get insurance, you can expect the prices of care to begin skyrocketing. Not to mention the fact that the scarcity of healthcare providers caused by increased use will drive prices up as well. ACA does nothing to address the existing shortfall of Primary Care Providers. It will do a lot to exacerbate that problem, though.
Destineer, Obama's speeches about how he admires Reagan are short on specifics and long on vague references to the Reagan Mythos. There is very little substance in what Obama has said about Reagan that suggests Obama even knows what the man did in office, let alone truly admires him. Further, saying that he admires a prominent conservative does not mean that he doesn't see conservatives as anything other than frothing racist morons. Hell, it doesn't even mean he doesn't see *Reagan* as a frothing racist moron.
Posted by Rakeesh (Member # 2001) on :
Wait, so you'll openly admit that you haven't been paying attention for 'the last few years' (put another way, almost his entire first term), and then you've got the nerve to whine about other people treating you in a snarky and unfair way? Your hypocrisy and entitlement is breathtaking.
In any event, I just listed quite a few major issues on which Obama compromised. Others have too of course, and they've been repeating themselves, but I expect you'll continue to speak as though they haven't, and spend as much time complaining about how you're spoken to as about the actual things you claim to wish to talk about.
Bullying. I never tire of that one, particularly since it so often comes from those with a strident, confrontational and angry tone themselves. You and I have precisely the same amount of power here. Please stop pretending to be a victim.
As to Romney's fiscal strategy...boy, I'm all ears on that. Would love to hear more.
Posted by NobleHunter (Member # 12043) on :
quote:37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government.
Cite please.
Though I suppose it may be article of faith for you.
Do you know how many bureaucrats that I, as a Canadian, have to deal when getting health care (except for the stuff not covered by the government)?
Posted by Boris (Member # 6935) on :
quote: Wait, so you'll openly admit that you haven't been paying attention for 'the last few years' (put another way, almost his entire first term)
What, beyond the midterm elections, has there been to pay attention to? Nothing actually happened from 2010 to 2012. I think I acknowledge earlier that I was happy he made concessions on the increased tax rate as to who it should apply to. Perhaps you ignored it. As for confrontational attitudes, let's go back to the reels and look to see that I didn't get confrontational until you felt like rearing your snarky head for a good baseless snipe. I am sick to death of snark masquerading as a debate tactic, so I'm sure as hell going to confront you on it when you use it against me. If you want to continue being snarky in response, that's just you being an arrogant ass. I don't care if I piss you off. Besides. I'm not coming back to this forum after this discussion. Being dogpiled with snark isn't my idea of a good time. I am not particularly good at explaining what I mean, and I'm sure people aren't understanding what I'm saying, but that isn't a reason to act the way you do here. As for romney's fiscal policy...Let's ask a question...If you had a business that could operate anywhere in the world...where would you open your doors? Personally, I'd go somewhere that let me keep the largest portion of my profits. Guess what. That isn't the US. Go look at the corporate tax code to see what's wrong with it. Obama has no intention of addressing its shortfalls.
quote: Do you know how many bureaucrats that I, as a Canadian, have to deal when getting health care (except for the stuff not covered by the government)?
How many people work in your doctor's office besides the doctor? Those are what we refer to as Bureaucrats. They do paperwork. They fill out forms. They submit reports. So you deal with them. But the work they have to do adds a massive cost to medical care. As for how I know that all the insurance company bureaucracy can't be as inefficient as the federal government, I worked for the federal government. I spent two months trying to get one network security report for *one laptop* through the bureaucracy. I got a new job before that report was accepted. If it was accepted. I don't know if it was.
By the way, I'm not responding anymore. I'm done with this crap. So go ahead and commence with the chest pounding and hooting over driving another conservative off so you can return to the circle jerk.
Posted by NobleHunter (Member # 12043) on :
I would hate to visit a doctor's office that employed no one besides a doctor. No receptionist? No cleaners?
I think your definition of bureaucrats is too expansive.
Posted by Lyrhawn (Member # 7039) on :
Boris -
I'll get to your larger paragraph addressed to me a bit later on, but this paragraph jumped out at me.
quote:Twinky, Government bureaucracy is a wonder of inefficiency. 37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government.
Every study I've ever seen comparing administrative costs between government and private sector insurance companies says that Medicare is vastly more efficient at administrative costs.
quote: In addition, when the exchanges go into effect and millions of people who have no interest in taking care of themselves (and would normally be declined for insurance as a result) start getting insurance, or paying the fines and waiting until something on them blows up before they get insurance, you can expect the prices of care to begin skyrocketing.
Well, first of all, a lot of those people don't have coverage because they can't afford it, not because they don't care about themselves. That's a little silly blanket statement to make. And you fail to recognize that what you're describing is the status quo. People already use the emergency room as a care provider when, as you note, things "blow up." It's the absolute most expensive form of care possible.
quote:Not to mention the fact that the scarcity of healthcare providers caused by increased use will drive prices up as well. ACA does nothing to address the existing shortfall of Primary Care Providers. It will do a lot to exacerbate that problem, though.
You're right, there is a problem with a scarcity of PCPs, one that probably won't be solved until the government meddles in the field to artificially create a draw to the profession. No one wants to be a PCP because the pay is too low for what you have to do, and specialty services pay two and three times as much. That's what happens in a free market, but it's not particularly helpful to people as a whole.
But what you seem to be suggesting is that care rationing, which we're already doing, is an absolutely necessary way of keeping costs down for the small majority who can afford care at all. Nothing about that strikes you as wrong? They have to suffer to keep prices lower for everyone else?
Posted by Lyrhawn (Member # 7039) on :
quote:By the way, I'm not responding anymore. I'm done with this crap. So go ahead and commence with the chest pounding and hooting over driving another conservative off so you can return to the circle jerk.
I don't think that's what anyone here was trying to do. Now that I know you're serious, I'm more interested in hearing you explain your views.
Posted by TomDavidson (Member # 124) on :
quote:If you had a business that could operate anywhere in the world...where would you open your doors? Personally, I'd go somewhere that let me keep the largest portion of my profits. Guess what. That isn't the US.
It's probably Equatorial Guinea, although there are some great Caribbean tax havens as long as you don't actually live there.
Posted by Parkour (Member # 12078) on :
quote:Originally posted by Boris: Did you people ever think that it was possible for two different people with different backgrounds to look at the same thing and have two different responses to it?
Yes. And in this case, only one of those responses is based on factually sound interpretations.
If someone today really thinks that the Republicans were the ones trying to compromise and Obama was the problem because he was inflexible, they're wrong. Nobody should care that it is a perspective "from a different background". It's wrong.
Posted by Parkour (Member # 12078) on :
quote:Originally posted by NobleHunter:
quote:37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government.
Cite please.
Though I suppose it may be article of faith for you.
Do you know how many bureaucrats that I, as a Canadian, have to deal when getting health care (except for the stuff not covered by the government)?
Probably so many that it explains why your country gets better care than ours for less than a third of the cost per head, right? I assume you have to wade through bureaucrats. Whole rooms full. And plenty of paperwork, unlike Americans.
Posted by steven (Member # 8099) on :
quote:Originally posted by Swampjedi:
quote:Originally posted by steven:
quote:Originally posted by Parkour: ... ... conservatives are anything other than bitter old people who hate the world around them". ...
To be fair, that IS the Republican base. Take away the votes of oldest, whitest, most racist, and most xenophobic 15% of the electorate, and almost no conservatives would get elected to national office.
It's a distressingly large part of the base, but it's not fair at all to say that IS the base. On top of that, I don't see what was added by using "oldest, whitest". What point were you trying to make? I'd assume that it wasn't "old white people suck."
When I used to install TV/internet/phone service, some customers would annoy me by watching everything I did. The solution? Find their addiction, and give it to them fast. For elderly customers, 99 times out of a hundred, it was Fox News. No matter how irritating and micro-manage-y they were being, as soon as I'd put Fox News on, they'd leave me alone. It's like SpongeBob for the elderly.
Most of them just stopped thinking at some point in their lives. (My mom is a perfect example of this. In fact, it's so bad with my mom, I'm honestly not sure if she stopped thinking 30 years ago, or if she just doesn't really have much short-term memory left, due to aging-related mental decline.) They stopped examining their opinions/beliefs/assumptions, and Fox News plays to that. So do Rush Limbaugh, Michael Savage, etc..
So yeah, I have very little respect for people who refuse to examine their assumptions. They're screwing things up for the rest of us, and, because the US is so powerful, the rest of the world too, by extension.
Combine these voters with our Senate-dominated Congress, and you get a mess.
And as for the "whitest" part of my comment, it's not elderly black/Hispanic voters that are putting today's Jesse Helmses in office.
Posted by twinky (Member # 693) on :
quote:Originally posted by Boris: Twinky, Government bureaucracy is a wonder of inefficiency. 37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government.
Can't possibly be as inefficient as the federal government, because...?
That's just an assertion, not an argument. Can you support this claim in some way -- with logic, data, or both? Is the US federal government somehow uniquely inefficient among governments of industrialized countries, all of whom manage to deliver care for a fraction of the cost?
In fairness, I will note that since moving to the US from Canada and witnessing a state government shutdown as well as the federal debt ceiling and fiscal cliff debacles, I'm somewhat sympathetic to the argument that America is uniquely bad at governance. Nonetheless, I reject the argument that government is inherently less efficient than private enterprise. If you want to persuade me that this is true in all cases, you'll need to provide pretty compelling evidence.
quote:Originally posted by Boris: In addition, when the exchanges go into effect and millions of people who have no interest in taking care of themselves (and would normally be declined for insurance as a result)...
Do you have any evidence that a majority or significant minority of those who are currently uninsured are uninsured because they have no interest in taking care of themselves?
quote:Originally posted by Boris: ...start getting insurance, or paying the fines and waiting until something on them blows up before they get insurance, you can expect the prices of care to begin skyrocketing.
The price of care has already skyrocketed in the US, for a number of reasons. One of those reasons is that hospital ERs end up providing not just acute care to the uninsured, but non-acute care as well. For more detail, here's a CDC report.
The intended effect of expanded insurance is to shift people from the pool of uninsured people who go to the ER because they have no other option into the pool of insured people, who are much less likely to go to the ER first. While that will obviously increase expenditures on primary care, it will also obviously decrease expenditures on ER care, which is generally quite a bit more costly.
How well it works remains to be seen, but I don't think it's credible to argue that it will inherently increase cost.
quote:Originally posted by Boris: Not to mention the fact that the scarcity of healthcare providers caused by increased use will drive prices up as well. ACA does nothing to address the existing shortfall of Primary Care Providers. It will do a lot to exacerbate that problem, though.
The US already has a scarcity problem with health care providers, which is another part of why your pre-ACA system was already so much more expensive than all other systems in industrialized countries, both per capita and as a percentage of GDP. The solution there is to expand the number of care providers, not deny care to people. While that will cost money, it will also contribute to alleviating the overload on ERs by both uninsured and insured patients, which will save money.
Posted by Swampjedi (Member # 7374) on :
quote:Originally posted by steven: Most of them just stopped thinking at some point in their lives. (My mom is a perfect example of this. In fact, it's so bad with my mom, I'm honestly not sure if she stopped thinking 30 years ago, or if she just doesn't really have much short-term memory left, due to aging-related mental decline.) They stopped examining their opinions/beliefs/assumptions, and Fox News plays to that. So do Rush Limbaugh, Michael Savage, etc..
I'm not sure that most people, regardless of age or political orientation, really examine opinions/beliefs/assumptions. My experience is that it's rare.
As a conservative, though, I'd be glad to agree that the current Republican party has elevated such behavior to an art form.
Posted by Blayne Bradley (Member # 8565) on :
quote:Originally posted by NobleHunter:
quote:37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government.
Cite please.
Though I suppose it may be article of faith for you.
Do you know how many bureaucrats that I, as a Canadian, have to deal when getting health care (except for the stuff not covered by the government)?
e: Actually I'm not sure what your saying.
quote: Twinky, Government bureaucracy is a wonder of inefficiency. 37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government.
But you trust the government to handle organizing and training a military more than contracting it out to the private sector?
quote: How many people work in your doctor's office besides the doctor? Those are what we refer to as Bureaucrats. They do paperwork. They fill out forms. They submit reports. So you deal with them. But the work they have to do adds a massive cost to medical care. As for how I know that all the insurance company bureaucracy can't be as inefficient as the federal government, I worked for the federal government. I spent two months trying to get one network security report for *one laptop* through the bureaucracy. I got a new job before that report was accepted. If it was accepted. I don't know if it was.
This is false, Canadian doctors deal with significantly less paper work as they don't have to go through various middlemen to give their patients care.
Posted by theamazeeaz (Member # 6970) on :
quote:Originally posted by Boris: I have yet to see Obama acknowledge that conservatives are anything other than bitter old people who hate the world around them. [/QB]
Now now, based on my Facebook feed, they can also be bitter young people who hate the world around them.
Posted by Darth_Mauve (Member # 4709) on :
Guys....look at Boris's argument on the big picture, and laugh.
Boris: Obama was the obstructionist. Republicans were not.
Most of us: That's not how we remember it. The Republicans obstructed the Healthcare laws while President Obama gave in and compromised.
Boris: Well, Obama care, and basically any change to our current health care system is WRONG and will result in terrible things.
Me: So, to stop those terrible things the Republicans did everything in there power to Stop it. That is the definition of obstruction.
If you have a reason or an excuse to obstruct everything that is going on--you are still the obstruction.
Posted by CT (Member # 8342) on :
quote:Originally posted by Boris:
quote:Do you know how many bureaucrats that I, as a Canadian, have to deal when getting health care (except for the stuff not covered by the government)?
How many people work in your doctor's office besides the doctor? Those are what we refer to as Bureaucrats. They do paperwork. They fill out forms. They submit reports. So you deal with them. But the work they have to do adds a massive cost to medical care.
As a side note, I have worked as a physician on both sides of the border. It is laughably insane how easy it is to bill in Canada.
quote:Originally posted by Blayne Bradley: This is false, Canadian doctors deal with significantly less paper work as they don't have to go through various middlemen to give their patients care.
Blayne is right. I have a sheet or two (or on busy days, three ) of paper with each patient's name, time of appointment, and two blanks: one for billing code (amount of complexity, which is essentially 1 of 3 numbers), and one for primary diagnosis. If I did any procedures like flushing ears or giving shots, I scribble that at the side of the diagnosis. Takes less than 10 seconds per patient.
My office manager converts that sheet into formal billing by spending about 15-30 seconds each patient typing in the complexity code and translating the diagnosis into ICD-9 (a formalized system of numbers, sorta/kinda like Dewey decimal system for medicine). She knows most of the ICD-9s we use by heart. If she doesn't, it takes an extra minute or so to look it up in the codebook. Billing for each procedure takes an extra 5-10 seconds each.
I've watched her do this -- she can fly through billing for 30 patients in less than 10-15 minutes.
Some bills get questioned or denied, but that's a very low percentage in Canada. Maybe 1% need any additional time to sort out. No fighting with documentation for coverage or sending multiple letters, as in the US. The office manager either recodes the entry or clicks to accept a lower rate. Maybe once or twice a month she makes a phone call.
Honest to god, that's it. And the bill is always paid like clockwork. It is flippin' dead easy to bill as a physician in Canada. In contrast, there have been a series of studies on the amount of time physicians spend on nonclinical paperwork in the US, averaging around 20-25%:
[ January 25, 2013, 07:24 PM: Message edited by: CT ]
Posted by Lyrhawn (Member # 7039) on :
Out of curiosity, are there any studies that suggest a benefit from all that paperwork? I mean, what exactly IS all that work? What is the stated purpose of the additional forms and paperwork you're required to submit?
I'm guessing it's all for insurance purposes, but why do they want it? What's in the way of streamlining it?
PS: Thanks for that second link CT. I'm browsing through the report and it's making for very interesting reading.
Posted by Mucus (Member # 9735) on :
quote:Originally posted by twinky:
quote:Originally posted by Boris: Twinky, Government bureaucracy is a wonder of inefficiency. 37 insurance companies with their own systems and ways of doing things can't *possibly* be as inefficient as the federal government.
Can't possibly be as inefficient as the federal government, because...?
... Is the US federal government somehow uniquely inefficient among governments of industrialized countries, all of whom manage to deliver care for a fraction of the cost?
In fairness, I will note that since moving to the US from Canada and witnessing a state government shutdown as well as the federal debt ceiling and fiscal cliff debacles, I'm somewhat sympathetic to the argument that America is uniquely bad at governance. ...
Reminds me of the gun control argument, where someone was arguing that the US can't have a low homicide rate because the US is culturally too much like a third world country (and not one of those low crime third world countries either).
Sometimes these days it seems like American conservatives have us actual foreigners beat in terms of disliking America.
Posted by Mucus (Member # 9735) on :
quote:Originally posted by Lyrhawn: Out of curiosity, are there any studies that suggest a benefit from all that paperwork? ...
I distinctly suspect that the paperwork helps in slowing down doctors and uncovering/manufacturing problems that can be used to deny coverage, and thus save money.
There's efficiency and then there's efficiency.
Posted by CT (Member # 8342) on :
Partly what Mucus said, partly because negotiating different systems means fulfilling different requirements. When I worked in the US, that group served 5 different HMO/PPOs plus Medicaid. There was a large flowchart on the wall to explain what you needed to fulfill in the paperwork to bill for each provider.
For a level 2 care visit, one provider might require 3 elements of the acute medical history, 2 of the social history, 3 from physical exam, and 2 items of differential diagnosis. Those numbers might vary amongst all 5 of the providers.
If you billed as a level 2 but did not hit that particular provider's marks (say, you had only one element of social history), the bill could be flagged for audit. It was all electronic at that point.
Or, say you needed to use a particular drug because the patient hadn't tolerated other drug options for that condition. It might be on the formulary (approved list) for 2 of the HMO/PPOs, but not the other 3. So you'd have to spend time each visit figuring out what that person's insurance was (and it could change as their or their parents' jobs changed! and they might forget to tell you!), then figure out what needed to be in the documentation, then figure out which treatment from THAT formulary or approved list of procedures would be accepted, then deal with any bounceback.
That's part of it. Another part is maintaining the paperwork for being an accepted provider in all those networks, including reviewing the audits of your performance within their parameters (are you spending too much time per patient? ordering too many throat swabs by THOSE criteria? etc.)
Exponential growth in inefficiency.
Posted by Lyrhawn (Member # 7039) on :
What would happen if Congress tried to pass legislation to standardize the paperwork apparatus? In other words, if it was mandated that everyone use the same system?
Posted by Darth_Mauve (Member # 4709) on :
It would be called a Governmental Takeover of Healthcare. How dare the Government think that it knows better than the Insurance Companies what information they needed. Why, it must be the next step toward job killing communism
Posted by Lyrhawn (Member # 7039) on :
I know that's what would happen politically.
I'm wondering what would actually happen on the ground.
Posted by Blayne Bradley (Member # 8565) on :
From SA:
quote: Since nobody answered your question yet, I guess I'll give it a shot even though I know little about Congress.
Congress is a big huge game full of the spergiest people who have ever lived, only with access to both power and money. There are two main factions, the Horde and the Alliance, and the only way that they can actually do battle is through legislation. Some people are on P2P servers, but that's mainly during election years, unless the player is really into griefing (Michele Bachmann, for example, is one of the more successful and hilarious congressional griefers). As such, while one might imagine that the two groups mostly spend their time engaging in massive, semi-scripted battles over big issues, they really spend most of their time grinding by spatting over bullshit for the sole purpose of gaining XP and leveling up.
Because legislation is the means of battle, this results in a lot of idiotic and repetitive legislation. Strategically, fighting in a way that forces your opponents to spend resources is equally as good as voting for something that actually benefits you. For example, a member of the Horde from Cooperstown, New York wants to look good, so he fires out a little proposal about commemorating his local baseball museum. Nobody but him really gives a shit about this, but half of the people don't want to appear like they hate baseball. The Alliance folks decide that they can't let this guy and the Horde have that tiny prize for free, so they pretend to be against it and force the Horde to invest a lot of political GP in a small battle that they don't really care about.
A good deal of taunting is involved throughout the process. In the battle itself, you usually have some high level players on both sides casting buffs on the newbies and drawing on large mana pools of public support to do so. Obama is a sorcerer, for example. This is similar to a mage or a wizard, but the sorcerer class permits a larger variety of races and skills, which is why President Obama does quite well as a bard Dunmer halfgiant sorcerer. There are also Tanks, like Bill Clinton, who can take a lot of damage but don't perform many attacks. Tanks generally serve to purposely annoy the enemy and draw aggro so that the rest of the team can secretly get away with a lot of bullshit. Usually, there are DPS characters standing right near the tanks. The DPS group serves to dish out political damage to the opposition as rapidly as possible. They are typically classes that can use AP/mana-based skills to sustain their rate of damage. Class types are not exclusive; Strom Thurmond was one of the most amazing combination Tank/DPS rogue characters ever to play the game. He could take 50 critical hits in a row, 10 being accidentally self-inflicted, and he would not ever die. This is because he had a surplus of buffers and a nearly-infinite mana pool. There was no way that Strom Thurmond would ever lose a reelection and leave the game. Eventually he just got bored and left, handing the mantle to Lindsey Graham, who plays one of the newer ninja DPS classes and favors using short-blade chain combos while being buffed by wealthy shamans.
Rangers, in my opinion, are assholes who take potshots and cheerlead from afar while never actually ever doing much of anything. They're also sometimes known as "pundits". Each team has a few rangers who focus on keeping their own team members in line. These guys are armed with giant whips.
In the game, there are guilds which are also known as "subcommittees" or "caucuses". Guilds, oddly enough, often contain characters of both factions. Sometimes a guild member who doesn't play very much has a sudden realization that he's about to get booted, so he quickly gets involved with a bunch of bullshit minor resolutions. That way, he can say that he took part in some raids. It's busywork, but you can also do this kind of raiding to earn political GP. Pro-Panamanian donors, to take an example from your post, will give valuable rare drops toward your guild's coffers if you take part in a Panama trade raid. This is why some players will do the same raid again and again, in slightly different ways, despite not giving a crap about Panama.
In public chat channels there's a lot of griefing, posturing, name-calling, and generally behaving like assholes. The game is designed to make players feel like they're important. Everybody perceives themselves to be a good guy on a team of good guys, just like in America's Army. You are always on the side of America. Nobody wants to play a game if they're not a big damn hero, so players take on these sorts of asshole personas and call other people names while simultaneously pretending to be greatly offended. Typically, they argue about ideas that neither side has any actual knowledge of. They are professional arguers, you see, not debaters, if you can understand the distinction. It's the difference between a town crier and a print journalist. The actual subject of the argument, be it tax reform or the Border Tunnel Prevention Act, doesn't matter because it's all just a battle on ****ing Hamburger Hill. There are a few GMs, however, but they are mainly for show. In theory, GMs like the Senate Pro Tem have a lot of power over the game, but the reality is that they can't actually use the power in unpopular ways or else they'll get accused of nerfing.
Every 2 or 4 years, there's a server reset that often accompanies an expansion, which adds new quest lines, events, and raids. A new race was added in 2008. The 2012 expansion was all about fixing the buggy trade system. Big expansions might include server-wide events such as hurricanes or entire wars with previously unheard-of nations, started for dubious reasons. The 2001 game expansion featured the fictional in-game nation of Afghanistan, and both the Horde and the Alliance had to temporarily join forces in fighting this new foe. It had fantastic sales (practically everyone bought it!) and was initially a critical success. It seemed well written at the time, but in retrospect, most people now think that this game expansion and the later Iraq sequel were idiotic. However, these areas of the game are still available as ongoing platforms for the occasional legislative quest or raid.
If you're new to the game but plan on sticking to it for a while, then a worthy goal is to get yourself an epic mount. This is when you get to co-sponsor a big, important bill and harp on a single issue for the rest of your career, even if it means riding it right into the ground every chance that you get. Generally, you'll see only high-level or wealthy players with epic mounts. A notable exception is Paul Ryan, who is low-level but rides a flying epic pro-life pig. By contrast, Joe Biden has no mount, but instead chooses to summon them depending on the situation. He's been riding a Gun Control Panda lately, but usually he summons a Flying ****, but only so he can not overtly give it to someone. Last week, it was a dead horse. You do need a mount, though, or you won't get anywhere very fast--Even if it's a level 4 Pesticide-Registration Mule, which you asked about. Everyone knows that this is a worthless mule that, as you pointed out, shouldn't even be in the game. But someone is riding it because they just need some sort of mount.
One final note: The legislation is both the means of execution and primary ammunition in this never ending war. However, the idea that the legislation actually affects non-player lives in meaningful ways does not matter or even occur to the majority of congressional players. They do not give a shit about us, the NPCs. If this idea matters, it does so only temporarily and in election years when they are busy questing. When questing, we NPCs can start to seem like we're real, live humans. Then they go right back to the game and we're all just cannon fodder--technically part of the game, but held as worthless.
Therefore, it's a common misconception that these players are acting unselfishly and in our best interests. Sometimes, you'll hear about a player poopsocking and hogging the battlefield waiting for something like a rare drop. This is known as a "filibuster." You might think that someone filibustering is nobly standing up for his beliefs. In reality, he's probably just poopsocking while ganking someone on the other team.
Posted by dabbler (Member # 6443) on :
I strongly believe that insurance bureaucracy is there to maximize profit. For example:
The HMO brand of my insurance panel automatically pays for the first 12 visits a year before requiring documentation to authorize more visits. However, my second session with the HMO carrying client gets rejected every time. Why? Because they create an internal authorization number after the first visit, before the 2nd visit. But their program isn't creating that number correctly. This means every week I check my payments to see which ones got rejected, call the insurance panel, and request them to fix these claims. If I don't tell them, they would never tell me they messed up. They would never pay me. Instead of fixing it, they get me to waste 20 mins a week hounding them. Ever since I joined 3 months ago, this has been broken.
It's cheaper for them to wait and "accidentally" not pay doctors than to fix the problem.
Posted by scholarette (Member # 11540) on :
Having had my first pregnancy initially rejected as a preexisting condition by insurance because I saw my obgyn two years prior, I am convinced that the insurance company simply rejects everything. One of my friends was denied her food poisoning claim as a preexisting condition. I spent probably 6 months fighting that since I had insurance before, I had prior coverage and therefore my preexisting stuff should be covered. When I called the insurance company and read them the applicable parts in my insurance paperwork, as well as hippa, that proved I was in the right, they told me neither applied to my insurance policy. I was reading from the plan info they had sent me and was listed on their webpage and they told me no, you are confused. Only when I had my sister send the same info with her law firms header did they actually pay up. I imagine that a lot of people stop arguing at the first rejection or the second. Or after the letter and the first review.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by dabbler: I strongly believe that insurance bureaucracy is there to maximize profit. For example:
The HMO brand of my insurance panel automatically pays for the first 12 visits a year before requiring documentation to authorize more visits. However, my second session with the HMO carrying client gets rejected every time. Why? Because they create an internal authorization number after the first visit, before the 2nd visit. But their program isn't creating that number correctly. This means every week I check my payments to see which ones got rejected, call the insurance panel, and request them to fix these claims. If I don't tell them, they would never tell me they messed up. They would never pay me. Instead of fixing it, they get me to waste 20 mins a week hounding them. Ever since I joined 3 months ago, this has been broken.
It's cheaper for them to wait and "accidentally" not pay doctors than to fix the problem.
What is being described here is also known as "fraud," and is a criminal offense, aside from being bad business.
Posted by twinky (Member # 693) on :
I didn't realize until last night that insurance companies in the US are actually exempt from antitrust law -- i.e. they're free to collude, manipulate pricing, etc.
Posted by dabbler (Member # 6443) on :
Doctors are not exempt. We cannot share information about how to negotiate with insurance companies, discuss how to set our rates, or agree to take/refuse particular insurance companies.
![[Smile]](smile.gif)
Or the PATRIOT Act. Or, well....Everything? Everything they've done in the last 15 years? We can start there.
![[Wave]](graemlins/wave.gif)