quote:Originally posted by kmbboots: Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart.
The guy has started naming threads after TV Tropes topics, so I think we're not seeing any attempt at subtlety here.
Which is fine with me- Blayne's gotten funnier since he started reading a little more widely.
posted
I'm just teasing you, Blayne. I watch Jon Stewart, too.
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Blayne Bradley
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I know, but I'm curious which posts were funnier then usual so i can determine if they were intentionally funny or unintentionally funny
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I don't know really, you're just not trying to be funny in the way that wasn't funny before, and thus are naturally funny rather than simply having no one get it. That and you're reading TV Tropes, which is a bottomless bag of funny, so you're just absorbing the mojo.
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posted
So, between Sibelius' CBS interview (where she suggested the public option wasn't essential), Obama's statement in Colorado that it was "just a sliver" of necessary reform, and Sen. Conrad's statement that he wouldn't vote for any bill containing a public option, it seems the public option is dying in the dog days of August (Howard Dean notwithstanding). The Baucus-Conrad co-op compromise seems to be gaining momentum as the most likely structural mechanism for implementing reform.
Now if we could just couple that with Sen. Wyden's Healthy Americans Act, Peter Orzag's IMAC panel, and some rational tort reform to contain defensive medicine costs and I think we'd have a bill that would 1) maintain significant individual autonomy over care 2) provide universal health insurance and 3) decrease the overall amount spent on healthcare in the US.
<edit>I thought the IMAC panel would review the Medicare prescription drug costs; turns out I was wrong. The CBO found the IMAC panel wouldn't significantly impact health costs. What really is needed is for Obama to fulfill his campaign promise to setup a review of drug costs under medicare. Unfortunately, he evidently promised a lobbyist that he wouldn't (in exchange for industry support of the current reform plans). What we need is IMAC, but with a review not only of procedures and fraud cases, but also of the Medicare drug plan. While IMAC as currently stood up would only save $2 billion over the next decade (according to the CBO analysis), the drug review could save as much as 100 times that much (according to candidate Obama's estimate, based on an Institute for America's Future study).</edit>
<edit2>And I should have included electronic medical records (preferably that could travel with the individual on a smart card) as part of the "good idea" plan above. I believe there were some funds within the ARRA to do that, and maybe that was sufficient; but if not, it should be more fully funded.</edit2>
quote: So Conrad has come up with an alternative: public cooperatives. These non-profit groups, run similarly to rural electric co-ops would be given several billion dollars of government money to get started and would -- in theory -- compete with insurance companies to offer better and cheaper medical coverage.
As long as everyone gets covered at affordable rates, I'll be happy.
(And that means I would also be in favor of government subsidies for people who still can't afford whatever options are out there.)
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Blayne Bradley
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Ultimately reasons n+x to not live in the united states unless your making 6 figure.
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quote:Originally posted by Katarain: (And that means I would also be in favor of government subsidies for people who still can't afford whatever options are out there.)
Such subsidies (up to 400% of poverty level) are a part of Sen. Wyden's plan. He essentially funds them by repealing the employer tax <edit>deduction</edit>. Repealing the tax <edit>deduction</edit> is anathema to unions which is why his plan has caught a lot of flak from the Democratic establishment.
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Here's an interesting New Yorker article (linked to in the Slate article from the last post) by a cancer surgeon on the pragmatics of health-care reform. The central premise is that any transformation of the health care system needs to be based around small increments from the current state. Any broad-based change (like a shift to single-payer overnight) is likely to disrupt the system and incur significant transaction costs (like, for instance, lives lost due to paperwork requirements). He points out that of the several nations with UHC, none of them do it exactly the same, and all of them built their particular form of coverage on whatever underlying health care structure already existed.
The author cites Massachusetts' program as one that achieves quality care, on an arc toward universality, while not significantly disrupting the system. He does ding the MA solution, though, for not appropriately reining in costs, and for failing to anticipate the growth in demand for subsidies as people lost their jobs in the recent downturn.
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posted
One note I have heard often recently, though I don't know its validity (Senators were shouting it.) The majority of Health Care Bankruptcies in the US are from people who have health insurance.
Between large co-pays (20% of $1,000,000 is still a lot of money.), Deductibles, and hidden costs--even with insurance in this system, a major illness strips you of everything.
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quote:Originally posted by SenojRetep: Here's an interesting New Yorker article (linked to in the Slate article from the last post) by a cancer surgeon on the pragmatics of health-care reform. The central premise is that any transformation of the health care system needs to be based around small increments from the current state.
What a great article, Senoj. I loved the history of how other countries came to have their systems. I think he's right. I don't think any of those systems would work best for us since we're not in the same situation as any of those countries were.
If the non-profit insurance groups get founded, I wonder if they could carry good insurance plans for just a few months at a better price than Cobra. That might take some of the pressure off people who change jobs, especially if the pre-existing conditions exclusions are outlawed. I agree with the Slate article that employer based coverage leaves something to be desired, but that might be a small fix to keep it relevant.
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The G.O.P. has realized they can no longer filibuster and they are as we speak moving the goalposts.
quote:Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."
quote:Well, we're talking about one sixth of the American economy. This is a pretty important thing. And I always look at bipartisan bills as somewhere between 75 and 80 votes, both Democrats and Republicans. And one reason why I decided to leave the group of seven is because -- well, there were a number of reasons. Number one, I don't think they've given Senator -- the Democrats have given Senator Baucus very good flexibility to really be able to put something together. Eighty of the top Democrats in the House are insisting upon a government option or a government plan. I can't be for that, and I don't think -- I don't know of any Republican who is really for that.
quote:As the senior Republican on the Finance Committee, Grassley has the potential to attract GOP votes by giving his blessing to a bill, and congressional Democrats and the White House consider him the key to winning bipartisan support for President Obama's top domestic priority. In recent days, however, some Democrats have accused Grassley of trying to undermine the reform effort, for example by refusing to debunk rumors that the Democratic health bills would create "death panels" empowered to decide whether the infirm live or die.
On Wednesday, he denied those claims and fired back at Obama, saying the president should publicly state his willingness to sign a bill without a controversial government-run insurance plan. Such a statement, he said, is "pretty important . . . if you're really interested in a bipartisan bill."
"It's not about getting a lot of Republicans. It's about getting a lot of Democrats and Republicans," Grassley said. "We ought to be focusing on getting 80 votes."
I was not expecting unfilibusterability for this reform bill currently? What's going on? The news has been all about the townhalls and the invective, so color me confused as to why it's translated into a worse situation for the GOP.
Is this temporary, or is this bill going to go down painlessly on a party line vote?
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The Republicans have seen this and are now crying for bipartisanship, but as Nate Silver pointed out at 538 today, they have no real interest in bipartisanship with their complete rejection of the co-op proposal as an alternative to the public option. They didn't even give the impression of wanting to compromise. I think that the Democrats are finally wising up and realizing that the Republicans aren't interested in being constructive with health care reform. They just let the misinformation go floating around without unequivocal rejection. By letting lies go uncontested, the democrats and Obama have been losing points in favorability, so why should they stop a good thing for them politically? They're being obstructionists, so the democrats are saying, in slightly more diplomatic terms, "We tried to be nice, but screw you."
Nate Silver thinks this is a bluff, and I think it could very well be. Either way, it is somewhat changing the tides for the moment.
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quote:Originally posted by Vadon: The Republicans have seen this and are now crying for bipartisanship, but as Nate Silver pointed out at 538 today, they have no real interest in bipartisanship with their complete rejection of the co-op proposal as an alternative to the public option. They didn't even give the impression of wanting to compromise.
They did give the impression of wanting to compromise. It was just false. This is because they have no strategic option besides stonewalling any health care reform. If health care reform works, they lose.
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posted
I don't get why being opposed to the current bills means you are against healthcare reform? To make a blanket statement against Democrats like the ones being made against Republicans...this means Democrats are in favor of imposing a tax penalty of 2.5% of your yearly income for being without health insurance for a single day. Is that really what you want? Change jobs and most likely have to pay a whopping penalty because you went without health insurance for a day? How about this scenario...a married couple both work, both companies provide health insurance but the plan for the wife is much better than the plan offered by the husband's company. The husband declines the health care from his company (he is covered by his wife's) and is given $1000 (This is true where I work although YMMV.) Under Obama's plan the husband's company would have to pay 8% of the average pay in his company to the government even though the husband has health insurance. Not 8% of the husband's pay, but 8% of the average pay.... Is this really what you want?
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quote:Originally posted by DarkKnight: Is that really what you want? Change jobs and most likely have to pay a whopping penalty because you went without health insurance for a day?
Why are you so confident that this exact language will be preserved in the final bill, or that should it happen this way, there will not be legislation undertaken to amend such an unfair policy? I mean, I'm against this particular picayune, but it's not a deal breaker for me at all. I believe if this were the only sticking point, congress would be able to smooth it out fairly easily.
See, it's not that I think being against this bill means you are against any reform, but the people against this bill are sure *acting* as if they are against *any* type of reform. What you're pointing out is important, but in what way is this one point a deal breaker, or something you think couldn't or wouldn't be resolved? Do you believe legislation can actually be passed on anything without us having to go back in time and fix things like this so that they work better? Do you think all legislation, no matter how important, should be held up until there is no objection to any fine point? Honest question: how do you think this is a different case from the myriad legislation congress deals with every session?
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quote: Why are you so confident that this exact language will be preserved in the final bill, or that should it happen this way, there will not be legislation undertaken to amend such an unfair policy? I mean, I'm against this particular picayune, but it's not a deal breaker for me at all. I believe if this were the only sticking point, congress would be able to smooth it out fairly easily.
Except that they are not and they plan on $200 BILLION coming from tax penalties against individuals and employers...so how do you remove that and not come up $200 billion short?
quote: What you're pointing out is important, but in what way is this one point a deal breaker, or something you think couldn't or wouldn't be resolved?
It is a deal breaker to me because I am sure the are other small sentences in the bill that are just like that one.
quote: Do you believe legislation can actually be passed on anything without us having to go back in time and fix things like this so that they work better?
Irrelevant point. The issue is not whether this particular bill just needs to be tweaked slightly or not. The issue is that they are trying to tackle a gigantic complex issue in one massive plan which is bound to fail because of unintended consequences. Instead let's do it many smaller steps instead of one big overall sweeping massive reform. Focus on getting people without health insurance coverage first. Start with the people who are eligible for Medicaid but don't have it and get them enrolled. A possible way to do that would be to start at where people without health insurance go to get health care. If you can't pay, you get treated first, and then you are referred to a caseworker who can see if you are one of the millions who are eligible for Medicaid or other government assistance. In the end, the provider can get paid if the individual is supposed to be covered. In another bill, we can work with health insurance companies to provide a low cost catastrophic care plan to young people who are healthy and people who make enough money to have health insurance but choose not to have it. Work on getting electronic records passed as well. These are just smaller first steps which would be much easier to get passed.
quote: Do you think all legislation, no matter how important, should be held up until there is no objection to any fine point?
This is the same question you asked before.
quote: Honest question: how do you think this is a different case from the myriad legislation congress deals with every session?
Honest answer: The Cash for Clunkers program should have been a simple easily run program yet is far behind in payments and is managed terribly. The government couldn't deal with a small, popular, billion dollar program yet they are going to perform well with a gigantic trillion dollar plus program? Start small. Keep going forward but allow the changes you made to take place before you keep throwing changes at a massive system. Sure it will take time but it has a much better chance of being done right
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quote:Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."
"A supermajority is not enough! Your legislation doesn't truly have the public's support unless a superdupermajority voted for it!"
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quote:Originally posted by DarkKnight: Start small. Keep going forward but allow the changes you made to take place before you keep throwing changes at a massive system. Sure it will take time but it has a much better chance of being done right
You are perfectly aware of the political ramifications of either slowing or hurrying the process. In an ideal situation, yes, the administration could afford to enact reform on a longer time scale. However, I'm not entirely sure that would ever work. The pace of reform has raised the collective blood pressure in Washington, but it's also made public and in the open a lot of the handwaving done about reform by conservatives. Given a longer time frame, I would expect conservatives to simply have more time to stonewall and win smaller victories against reform, whereas doing this all at once, in the broad daylight with all eyes focused on the prize, certainly catches public attention and shows people that there is a debate going on, and encourages them to join it. Do you think we'd be discussing this with any vigor if it were yet another of dozens of bills passed slowly over years, for which either party had plenty of time to invent rationales for failure or handwaving dismissals of success?
As Tom said a ways back, we've been waiting 30 years for reform, and in the meantime thousands of people die every year, needlessly, at the hands of a morally corrupt insurance system. I don't want this process to be done when I'm 50, and I think if we try to do it that way, it will never happen.
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posted
There will also necessarily be jumps in reform which cannot be small, such as the inevitable leap towards universal coverage. And I will reiterate that universal coverage will happen; it's only a matter of time.
This is a perfect example of a scenario in which it is worse, policywise, to 'slowly' expand coverage, like if we were to progressively lower the age of medicare enrollment and progressively expand the extent of medicaid coverage. It would expand costs associated with increased coverage but the system would still leave a bulk of our working populace uncovered, so that nothing is being done about their health which centrally allows us to gain access to the overall improvements in quality of life, economic benefits, and reduction in cost that uhc systems provide.
These 'small changes' would be tantamount to looking again at a structure with a weak foundation and attempting to solve that problem by asking "so how many floors should we add to it?"
You don't do this. You go for the big change. You demolish the structure and build the new kind that works so well that every other block in the city has it.
This isn't to say that "many smaller steps instead of one big overall sweeping massive reform" doesn't have its place. I, myself, certainly wished the G.O.P. had chanced upon the idea that this logic should also apply when it comes to their own plans as well, such as the Patriot Act.
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For pages and in threads the Pro-Obama care people have asked for rational debate, not name calling, screaming, or panic.
You offered it, and it seems that some folks try push you off with--"That doesn't matter" or "Its politics"
You have a good point. There will be a fine system for being un-insured. You go without insurance, you pay a fine.
The bill does not make clear if there will be a grace period to allow you to shop and get the insurance that best suits you, or if you will have to grab the closest thing to avoid a big fine.
However, your $20,000,000 in fines and payments is not going to come from charging $20 to millions of people per day they are not insured. It will come from corporations and small businesses that would rather pay the government than go to the efforts of supplying their employees with insurance.
I would argue more, but my son is begging for attention, by sitting on the computer.
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