Talk Elections

I've noticed that even some of the marginally left-leaning (although generally not very informed) people that I talk to once in a while are scared of Obama's health care plan. Ask them for specifics as to why they are scared and most will spout wildly inaccurate information or nothing at all. Still, I'm not very hopeful. It is starting to feel like the 90s all over again only without the soothing sounds of Nirvana and Alice in Chains to help us through these dark times.

I fear this as well, though one advantage we have is that we can (hopefully) learn from the mistakes of before.

In addition, Congress overall is quite a bit more progressive now than it was during Clinton's first two years. We have a more Democratic Senate, and while the numbers in the House are about the same, there are far fewer conservative Southern Democrats, so that alone makes the likelihood of passage quite a bit higher.

The Facebook status updates from people I know on it disturb me.

Check this out: "John Doe thinks that this health care plan sucks. Sorry I voted for some dummy who could possibly put people I love out of work!" wtf, seriously?

Anyway, maybe it's just me. This sucks though, it'd be nice if my 53-year-old father could get some health coverage.

My god do we need good music again.....

I suppose you are right, Nym. It'd be nice if they could pull their heads out of their asses, fall in line and get this thing over with though.

Yeah, it is scary at how much the "OMG Big Government!!!" thing scares people. For some reason that logic doesn't apply to things like national defense or public safety, but yeah.

After tomorrow (maybe Thursday), I'll read the health care bills and give you my opinion.  I know what to expect but I am curious as to the details.

Just as a simple political pointer, over each week of the last 6 weeks (at least) I have seen a different tax trotted out in the news to pay for the health care legislation.  Politically, that means that different ideas are being tested to see which ones people react less negatively to.

As in terms of numbers (without reading the bill, but I am close to certain) it translates rather simply also...  The health care legislation proposed will cost the proverbial "arm and a leg" and given the fact that it is health care, I would think it rather fair to project that it will also cost "a couple of unknown eyeballs in the future" as well unless there is a certain amount of rationing.

The math doesn't lie.

The trillion dollar number floating around cannot help, particularly in this economy and with spending out of control on seemingly everything else. It would have been wiser to focus on targeted insurance premium subsidies, and taking some action to make health insurance more transparent and portable.

But of course. I actually saw that you posted something to that effect on facebook too. Heh.

I would argue that the costs of doing nothing are far greater than those of taking action, but of course those are less directly quantifiable.

But if y'all want to argue that Medicare/Medicaid have been colossal failures and that we'd be much better off without them, feel free to make that argument to the public, including citing such figures as poverty rates among the senior population today compared to 1965 to help prove your case. People in poverty don't pay much in taxes of course, hence my argument in paragraph 1 about the costs of doing nothing....that's even leaving aside any quality of life/moral arguments of course.

I like how Democrats here make claims as if it were the complete truth.

New Alice in Chains and Pearl Jam albums will be released this September. It is 1994 again, my friend.

What are you expecting?

From the last poll I could find:

Who do you trust to do a better job handling health care reform: Obama or the Republicans in Congress?

Obama 54%
Republicans 34%

I enjoy their latest claim: It's a plot to put old people to death.

Alice In Chains does not exist without Layne Staley, imho.

... such as?

We all know what the end game of this, don't we, which is absolutely necessary. The word I am thinking of starts with an "r."  The trick is how to effect "r" politically, which is damn tough. Do you get my drift?

Ya, my party is singularly ineffectual at present, so the rating is deserved.

I'd like to know what the Republicans are pushing for healthcare reform?

The party of no is fresh out of ideas.

Yes, reform is always difficult, as the deck is stacked strongly in favor of the status quo.

No the "r" word is "rationing."  Write it down.

They are pushing for more competition and transparency, and have some good ideas about it, but can't get their arms around how to deal with the uninsured, and if you don't deal with that, along with the skyrocketing cost of all these new medical technologies, you just aren't in the game, but nibbling around the edges. It is pathetic really.

They need to sell the accurate fact that nationalized medicine will squash medical innovation. The uninsured are a small segment of the population. Why should we destroy the healthcare of the vast majority of Americans to cover 10-15 million Americans?

Well, I don't agree with the first part of your post to begin with but don't you find the fact that millions are uninsured a little, err, morally disturbing?

Insurance =/= medical treatment. Insurance should exist for only catastrophic circumstances. The way that health insurance exists now is the major reason why we are having the problems we're having now.

Haha, I can assure you that for many it means exactly that.

No ER can turn you down.

Medical treatment should really extend beyond an emergency room.

I agree but don't you think that medical insurance should really only be for disastrous situations?

No, not really. Obviously we disagree on that.

Let's agree on a compromise.

Free dental for all and call it a day?

Do I get to pick what color my new toothbrush will be?

No, but you do get choice of flavor for the free floss you won't use.

Of course, I'm kidding as this is plan is lunacy and will only lead to the rationing of the free Colgate and Crest samplers just like in Canada.

And make it easier for dentists to force their evil torturous procedures on people?
These people live to cause pain!

There are several problems with the process of health care reform this time, along with one considerable problem with real long-term reform.

The first problem is the conduct of the White House.  These guys are so scared to repeat the Clinton mistake of ramming their own plan through that they take a totally hands-off approach to the writing of the legislation.  They declare a few preferences and lobby for public approval and declare deadlines, but they don't set legislative parameters of their own.  The president doesn't need to present them a ready-made plan and say "stick with me or die," but he does need to set more specific parameters than have been set so far.  If this really is the president's number one domestic agenda item, he has to have more of a hand in the crafting of the legislation he wants to sign.  Congress is kicking the president's butt all over the place, and the White House, outside of begging and pleading with Congresspeople and reducing the president to the role of a mere public cheerleader, is letting it happen.  Don't get me wrong, it's good the president is out there lobbying for public support, so long as the people who want the plan turn on the heat with their own Congressional representatives.  But a president, if they want legislation, has to have a baseline for what it will include and push it with his party members, whose own success is tied to his.

The second problem is the complete lack of party discipline in the Democratic camp.  The party made their Faustian pact in 2006 by retaking majorities in both houses by supporting lots of southern conservative Democrats and Blue Dogs, and now they are paying the price of the bargain.  When Republicans held a one or two vote majority in the Senate and a slim lead in the House, they exerted incredible party discipline and, while it did backfire now and then, made them look like they held absolute power.  The Democrats, with a massive majority in the House and a virtual super-majority in the Senate, act like they have no power over their own caucuses.  You don't let your own party members give the president a full moon in public over his number one domestic policy initiative, you find ways to make the bridge creek under their feet or pledge support for them on other things as long as they come along on this one.  This is a failure of the leadership, and it sets a lousy precedent for the party's effectiveness as a whole.  The Democratic party has the discipline of a parade of cats, and the display is pathetic.

Finally, while some version of the current legislation will probably bring premiums down over time by bringing more people under coverage, which is a good thing to be sure, none of this this addresses cost inflation.  One of the major reasons that other industrialized countries are able to manage their health care systems as efficiently as they do is because the governments are empowered to negotiate prices with the suppliers, the hospitals and pharmas.  If we cannot find a way to control costs on the suppliers' end, either the way everyone else does it or in our own novel way, we will continue to be plagued by the massive costs of this problem, both through inefficient private insurers or through increased government expenditures.  But, it looks like the United States will have to go actually broke, not just hang on the verge of financial ruin, before we learn that lesson.

'Tis enough to give me the blues...

The point, anyway, of my long-winded post is that, if health care reform does not pass, the Democrats have only themselves to blame.  They control the White House and Congress, which means they have the biggest mandate in government then they've had in decades.  They have a considerably popular president.  They have outspent their opposition about 3-1 in tv ads supporting the plan, which has majorities of people polled supporting the basic contours of the bill they want.  If Democrats can't pass a decent plan, it won't be because Republicans said "boo!", it will be because Democrats couldn't find a way to walk in a straight line.

An attempt to centralize the health insurance process (i.e. coverage) and individual decision-making, probably through the back-door.  I'm sure this can result in us having universal coverage of some sort, though.

A dramatic increase in costs, which will probably be severely understated unless care is rationed to a great extent.

Torie is quite right on the rationing point - it is inevitable.  The point I would make is that there are different kinds of rationing available.  States mentions one not-so-obvious type immediately - rationing of health-care availability to persons. 

But in any type of system that is "government-centered", I expect them to focus one particularly effective (if not the most-effective) type of rationing - namely care in the last year of a person's life.  In other words, the elderly and the terminally ill (or thought to be terminally ill). 

In other words, basically, if the tables say that you are unlikely to survive past one year with X cancer, you don't get chemo.  This type of rationing probably will eliminate a certain amount of "exotic" treatments as well for other types of diseases that may not be terminal within one year.  Now, this doesn't mean that you wouldn't be able to get it (either in the US if privately allowed or elsewhere), so long as you can pay, but generally it would be out of most people's grasp.

Anyway, this has been and what I continue to expect will occur.  Myself, I would prefer what States is proposing to this, but that is not what I expect to happen, since most people don't see this occuring (or maybe want it to occur - your choice).

Oh, and yes, there are ways to pick off around the edges in terms of costs.  But that will not fix anything, even in the short-term, unless we can get another major private debt expansion, a possibility I consider close to nil.

While the Republicans have done their job as the counter-force on the legislation, I think the mere scope and discontinuity between the Democrats in Congress have had a greater hand in "scaring" people.  There is no reason for a 1000+ piece of legislation.  Congress needs to step back, toss out the crap they've currently worked up, and begin a series of smaller bills to target key areas of the health issue.  That would gain a bipartisan level of support, it will be easier for everyone to digest, and it would have less of a shock to the industry.

A major reason why costs are so high is because people who are uninsured are not going in for preventative measures and other more basic procedures, and this is then leading to larger problems down the road that are more costly. This also increases the likelihood they will then not pay the larger bill later and thus drives up the cost for everyone else.

Another large contributor is people making unhealthy lifestyle choices, but obviously trying to legislate "good behavior" is (for good reason) taboo, though I think we should incentivize healthier choices as much as possible. Otherwise we simply have to accept expensive health care as being one of the consequences of our actions.

Well, we have rationing in the current system, too.....just from a different source.

Well it isn't working very well. My dad was diagnosed with a cancer at 84 that after a week of research I knew was 100% fatal, and after surgery and all the rest, it cost the state 150K in 1991 dollars.  He was a medicare. That is insane. The only rationing really is efficacy, or certain therapies that are not covered, like the one's I am on to make an old body feel young again. That is just not enough. Sure the uninsured are rationed to qualifying for the emergency room (also insane), but they are what - 20% of the population?  Something will change, and soon, because the current system is collapsing without more rational rationing, and the issue now is how to get there, without freaking out the public - which is why politicians don't talk about it. They are scared sh**tless.

Yeah. There is simply no way around rationing, really.

Preventive care helps.  Although, not for cancer.

I've read about 100 pages of the Senate and House version now.  I was originally going to read them straight on through, with each one separate, but the House version is so vague in so many areas that I had to go and read the Senate version to compare so I could make heads or tails of the damn thing in certain places.  Both plans are surprisingly similar.

My impression on what I've read so far:  Both bills are essentially a disaster waiting to happen in terms of health care quality and health care costs. 

On the costs side, the language of the legislation (since taxes and expenditures are generally undefined) is all I have to go on generally, but I can put 2+2 together and come up with the massive funding needed.  In fact, it may actually be worse than I expected. 

In terms of employment, there are some weirdly perverse disincentives going on for the both the employer (e.g. don't hire full-time workers) and the employee (eg don't ever switch jobs) that I find fascinating and which, btw, were probably never thought out before writing.

As for the health care quality itself, that will require oodles of time (and I have to read about 1500 more pages), but as basics become familiar with 1) what a "qualified plan" is and 2) the fact that it would have to cover "essential medical benefits" as defined by the Medical Advisory Council (or MAC) under the Secretary of Health and Human Services.  The House bill also implies such standards may be "set in statute", which means health care lobbyists have someone else to go after - the Senate bill does not. 3) Become familiar with the term "cost-sharing" - it is essentially a fancy term for rationing the essential medical benefits within qualified plans, as would be defined by the MAC.

Oh, and Torie, both the House and Senate bills explicitly forbid "qualified plans" from charging more for "health status" (i.e. risky behaviors) and forbid said plans from imposing any pre-existing condition exclusions.  To connect, that is but one of an (almost unimaginable) number of provisions that I have read in the first 100 pages that I can translate (without numbers) into meaning "this bill will cost a ton of money" (because the expansion of government subsidies for private health insurance goes into upper middle-class households) and "private/employer costs to insure themselves or their employees respectively will skyrocket".  A similar type of system has been instituted in New Jersey and New York and, needless to say, it caused premiums in both states to skyrocket ridiculously.

I'll do the rest over the next couple of days and see if I can describe how the thing works in plain English.  By that time, we may have another piece of legislation to throw on the health care pyre for examination.

Has the GOP earned your trust?

No. Just commenting on the usual "our opponents are resorting to extreme scare tactics to win" kind of argument. Why is it that whenever people start disagreeing with Democrats lately it's due to some "far right wing plot" and not just people getting cold feet about ideas?
Don't worry, I was making these kind of observations whenever Bush was president too (with Republicans almost unamiously defending everything he did and blaming everything on some evil liberal plot).

Dude, you don't have health care - you'd be fired and kicked off your insurance in a matter of months if you got really sick.

Um, you propose that spending $150,000 on a citizen's cancer treatment is a lot of money?  Dude, that is nothing.

In the interest of accurate facts, the number of uninsured Americans is close to 50 million, not 10-15 million.  50 million people is 15% of the population, and 15% is not a small segment of the population.  When you have that many people out of the coverage pool, it raises costs for the insured, both because there are fewer people paying premiums so the generic premium costs are higher, and because when one of those 50 million people goes to an emergency room for care, the hospital has to care for them, but then passes the uncompensated cost onto taxpayers.  It would be cheaper for everyone if far more people were covered.

Secondly, it is really a myth that medical innovations in the United States are due to private industry alone.  National Institute of Heath grants are crucial for laboratories to conduct their research.  And pharmaceutical companies get massive tax credits, expensing of research expenditures and even tax breaks for direct-to-consumer advertising.  I agree that these companies are highly innovative, but they get incredible help from the government.  If you don't believe me, just look at how much the industry spends on campaign contributions to members of tax writing committees in the congress every year, and you'll see how much these industries depend on government favor.  Or, go to your nearest research university lab and ask them how they finance their cancer and spinal cord research.  The government of this country deserves lots of credit for supporting innovation in the medical industry.

The party of no has ideas, if you consider "ideas" to be a freeze in spending save on defense and veteran affairs, extending the Bush tax cuts, more tax cuts and even more tax cuts

Proven myth. Try again.

http://newsbusters.org/stories/40-million-uninsured-myth

http://www.gopusanj.com/wordpress/?p=7645

http://mentalhiccups.blogspot.com/2009/06/47-million-uninsured-myth.html

Yes, about 7 million people in the country who are uninsured are not American citizens, but they are legal residents (that's how they end up getting counted in the census), and legal residents are legally eligible to be covered.  If you insist on not counting them (which I think would be wrong unless you are going to take a stand against legal immigration), that leaves 40 million American citizens outside of coverage, which is more than 13% of the population. 

Yes, a pretty large segment of the uninsured population have household incomes of over $50,000 a year.  But how many people are in those households?   And how many of that population, more than likely having two adults with full-time jobs, lack health insurance because their employers dropped their coverage, or because their coverage was dropped after a half year because of limitations on catastrophic care?  A pretty significant portion, I would guess, because I would not as a parent purposefully fail to purchase medical insurance for my children, because not doing so would be much more expensive for me, not to mention grossly irresponsible to my children.

And the fact remains that, when anyone from these population segments goes to an emergency room, the costs are passed on to the taxpayers and the insured.

I'll remember this, StatesRights, if the unemployment rate gets out of control.

"50 million Americans out of work... but 1 million are Mexicans so it doesn't matter."

IF it gets out of control? 16.4% unemployment is certainly out of control in my book. And why the hell should I have to pay for some non-citizen to get free healthcare?

You already do pay for a non-citizen's healthcare.  No non-citizen goes to a doctor's office.  They go to the emergency room.

Unfortunately for nationalists (and I mean that in the pure sense not the racist version of the term), the hippocratic oath doesn't recognize political borders.

I'm fine with covering an emergency situation but to get the same benefits as a nationalized health care? Hell no.

The opposition is always gonna make the majority's proposal seem more dire than it could possible be.  Its good politics and in this country usually the only way for the opposition to gain traction.  However, in my opinion this debate has gone past the normal asinine discourse into some hellish area in which no one wins in especially the uninsured.  I'm currently watching the daily show and listening to the questions asked of the president it just boggles the mind.  It amazes me that people with any intellect what so ever could possible imagine that someone would propose the legislation they way the have interpreted it. Most of us on here are able to actually read legislation and dissected it so we can actually perceive what its penitential will be.  However, that is not the case for the vast majority of Americans, many of which would not want take the time to read it anyways.  These people then go to sources for whom they trust to decipher it for them.  That is why I think this debate has gotten so deplorable, the sources the conservative members of this group have turned to have mutated the various proposals so greatly as to shut down all debate.  

We need insurance reform i don't think anyone would argue against that point.  So, who is helped when people on the right make claims about the Democrats wanting death.  You here republicans go on the floor and claims this, then their puppets in the media continue this line of "reasoning" on their respective outlets.  Who is helped when you paint one side as killers.  I mean seriously to go on the radio or TV and say the people would have to choose how they would like to die.  Equally as bad saying that people of medicare age would be "put out to pasture." I don't know or care to find out which conservative pundit said this however these were questions asked of obama and these people clearly got these questions from some source.  So once again i would ask who does the rhetoric help and if you believe this stuff well seriously don't have children heck you probably couldn't afford to anyways as your premiums are probably sky rocketing as it is.  Too mean but seriously this stuff is pissing me off.

We can find common ground in this debate around things like out state health care providers and group negations for medication and medical products.   Its not much but it is a start, so instead of painting each other, the left does spout bad rhetoric on this as well though not as deplorable as the right, as in human or killers.  If we can sit down and rationally discussing things we could actually make a difference.  But, maybe that just what i believe right now cause my pipe is half empty.  JK

Problem is that emergency room treatment isn't always an emergency situations.

I can't tell you how many times I've been to the hospital, walked in the emergency rooms, and have seen Mexican women with children who appear to only have simple colds waiting in the emergency room.

We are paying for these people regardless.


And a thing Republicans seem to be leaving out of this: this isn't free healthcare.  This is cheaper healthcare.  These non-citizens are still going to have to pay money to receive it.  And if this plan is cheaper than the private plans, the private plans costs go down which means you end up paying less.  Maybe not less tax dollars, but less overall.

If you're not in the top 10%, you won't be paying more in taxes anyway.

If he's in New York as well, ship him to Canada, where health care is so great that you'll die before you get to see the doctor.

Proof?

This statement is the exact thing that make this debate so pathetic.  I am guessing that you(a. hamiliton) have never discussed health care with a Canadian or taken the time to research the statement you just made.  But, you heard some one say something like this or this exact line and suddenly is it gospel.  You are dumb if you actually believe that people are dying constantly due to "long lines" and "rationing" in Canada.  If you would actually take the time to do any research on this you would find out how asinine that statement was.  I don't really mean to attack you but seriously man come on.  You can't believe that politicians all over the world and in our country would purposely pass legislation that killed people unnecessarily. Plus, say this was a consequence of legislation that had passed they would not over turn it for what would have to be a political point or ideological purism.  I feel you don't but that is pretty much what you are implying by making that dumbfounded statement.  So lets debate fact and not conjecture.  As I said previously no one can arguing that we need health care reform so lets have a real debate without these stupid assertions.  No offense to you personally just to the statement that you made because to attack ones opponent personally is to end debate right then and there.  

Just reading over States' sources out of curiosity. I found them amusing.

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As for the substance of the articles, they just elicit a big "so?" So what if some of the 47 million uninsured are in a certain income group or aren't citizens? They're still legal residents, and they're still uninsured. Nothing in those links dispelled any "myth," they just knitpicked.

Hey, at least the Republican party didn't call us homosexuals this time around....though they called us baby and old people killers.

I hope States realizes that legal non-citizens pay taxes just like he does...

And I hope he also realizes that the bill won't be raising his taxes, since he's not a rich.

He has none.  In fact there is hardly any proof that the healthcare systems of Canada or any of the European countries for that matter, are failures.  I've never gotten why people like him are so against the less well off being healthy, because that's the impression I'm getting right now.  ::)

A tax paying resident shouldn't get the same benefits as everyone else? Wow.

Also from a cost perspective your little plan is pretty dumb. Emergency care is the most expensive type of health care out there. It would be much cheaper if we gave them access to basic preventative care instead of treating them on their death bed.

I join you in your bafflement.  Other developed nations spend half of what the U.S. does on health care both in absolute terms and in relative GDP, and have longer life expectancies, lower infant mortality rates and a number of other measures, while their populations are in polls much more satisfied with health care in their countries than Americans are.  So, some Americans look at everybody else, see that others are outperforming it, and then accuse everyone else of failure.  It's about as smart as watching a baseball game where team A beats team B by a score of 8-4 and saying: "wow, that team A really can't play."

I'm also baffled as to why some in this country want large segments of the population walking around uninsured and ill.  That wish defies both compassion and self-interest.  It defies compassion for obvious reasons.  It defies self-interest too, since it means that everyone will pay higher insurance premiums both for themselves and their workers, that larger percentages of their tax dollars will be spent on addressing the problem, that the workforce will be less productive because of increased rates of illness in the worker's family, and that consumers will be spending more and more money on health care costs and will therefore buy less of other goods and services.

The point: those who do not support some form of health care reform in this country are willfully self-destructive. 

That's something often forgotten. Also that that pay Social Security as well that they likely won't ever get to use.