Talk Elections

I think the democrats should do what they did in texas back in '03 which is to get 145-150 house democrats (which shouldn't be hard) and to get on a secret bus to Canada. That way they can break quorum and there wouldn't be enough people present. If they could successfully stall repeal it might actually be worth it.

Why wouldnt they?  Its not like its actually going to go anywhere with Democrats holding the Senate and White House. 

They don't have to do that, repeal isn't going anywhere after it passes the House.

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Ah, memories of one of the most massive douchebags of the 2010 cycle...

No need.  So what if a repeal passes the House, it has no chance of passing the Senate.

And even if by some miracle it does (which it won't), it'd NEVER pass a veto override.

Any word on whether Republicans in the House may try to cut off funding for it via committees?

Should they in the grand scheme of things?  Of course not.  Should they in terms of the now insane Republican Party?  Absolutely.

If they want to waste their time in the majority on an issue that will never become law, that's their choice. If I were them, I'd be trying to do something more productive.

Different situation.  The "Killer Ds" were in the minority in both houses of the Texas legislature in 2003, and the executive branch was also controlled by the Republicans.  Denial of a quorum might have actually made a difference there.  Here and now, the US Senate and the Presidency is controlled by Democrats not likely to support repeal, so it would make no sense.

I think the best option for the GOP is not to waste time trying to repeal, but rather to use the power of the purse to force mitigation of the more controversial aspects of the law.  I also think that it is unrealistic to expect much of a change in tone, from either Democrats or Republicans, especially on something as divisive as the medical insurance bill. 

From what I've heard, a better strategy is withholding funding when the time for the budget comes around.

That's our plan B.

Have to look for the article, but from a NPR article I read with how the healthcare bill was passed it would be near impossible to simply withhold the funding.  The only way they could truly block the spending, other than repeal (which has no chance in hell of passing) is a complete government shut down.

Wouldn't it make more sense to get 145-150 house republicans on a secret boat to Gitmo? Just kidding, folks.

Its funny, but I think its an electoral loser to attack it effectively.  It only feeds the base, who are signed on anyway, but it drives away the middle who will be fleeing back to the Dems en masse soon anyway with stabilizing economy.

They should probably just vote for repeal to feed the base, let that be vetoed or overridden by the Senate, and then just let it go.  Messing around with funding interminably will progressively make them look more and more extreme and less and less appealing to the middle.

all of that would make perfect sense if the middle actually supported the bill, wouldn't it.

They don't?

They used to.. then as it progressed towards passage and then into law, support slipped.  I suspect that it will act that way in reverse as well.  Once the Republicans get really ugly in their attempts to kill it, more and more people will think 'hey wait a minute, they're really going to take this away from me'..

Yes and replace it with single payer since that has an equal chance of happening under them (hint).

Welcome to 2009 and cap and trade.

Just now noticed your response.

I don't know, man.  I'm against it generally, but so far I don't think there has been any negative effects on me or my family.  Since its passage, I have taken my son to the pediatrician twice.  Once for a well visit and once for a cold.  And I haven't noticed that we had to put up with any more of the unwashed masses freeloading than we had before.  My son's pediatrician is still as accessible as before.  He doesn't seem any more or less flustered than before.  (He's the chief of pediatrics at a local hospital, and a Republican.  He's a nice guy.  We have had him over for dinner and he and I discuss politics regularly, and he doesn't seem too concerned about changes to his lifestyle.  Not yet anyway, although he recognizes the possibility.)  Our insurance policy hasn't changed.  We still have no co-payment.  No extra-long lines.  We never have to wait more than about 30 minutes for a regular, scheduled well visit.  Still receive excellent service.  And, in spite of all the talk of Americans spending 16% of their aggregate GDP on "health care" I have noticed that we still spend about 8%, just like last year, of our combined gross income on medical stuff.  And I"m including everything I can think of.  Bandaids, vitamins, fish oil, insurance premia, etc., etc.  Anyway, if it continues like this, then I guess none of it really bothers me.  Yes, on some level the Big Brother aspect bothers me, but I'm an old, boring married guy and far past the disillusionment of youth and ideology.  On a practical level, as long as I don't end up having to pay somebody else's bills, and as long as the quality of service doesn't change, and so long as we don't end up with some British level of choices in providers, or some Canadian-style waiting rooms, then I guess I've got better things to worry about.  On some level, though, I can't help but think that something's going to give, and in the not-too-distant future I'll see bigger premia or a diminution in either service or choice of providers.  That's just a gut feeling though.  Hopefully I'm wrong.

You already pay the bills for lots of people, Angus....through free emergency room treatment for the uninsured.

I recognize that.  It gets so complicated, doesn't it.  Does it have to?

I was thinking about all this one day in China, about two years ago, when my son got a little cough.  We walked into a clinic, and thirty minutes later we walked out with a prescription and only fifty yuan poorer.  A very modest sum we paid.  The prescription was provided to us by a very young man, far too young to have completed medical school.  My wife, who speaks Chinese, tried to explain his title to me but there was nothing quite comparable in the English language.  Anyway, the prescription was for a particular mixture of compounds that could have been purchased at any local apothecary without a prescription, such being the laws in China.  But it was really the advice I was paying for, not the prescription.  We followed that advice, and within two days he was right as rain.

No irony.  No paradox in collectivism and its benefits to an erstwhile libertarian.  No admonitions about ancient rhythms and ancient knowledge.  No digression into statism or rhetorical arguments asking to what degree, stereotypes aside, does communism really involve the state in personal matters compared to the great and burdensome degree that our own capitalistic society involves a bureaucracy to dispense even the simplest of elixirs.  Just, a question.  Can you make the boy well? 

He is well today.  This is all that matters.

But angus, you aren't 'paying for' the health care of poors - they are paying for yours.  To take away some of your privilege to pay for basic care for them is a returning of the fruits of their labor to them, not taking yours.

I never know when you're serious.  Let's assume for a moment that you are.  And furthermore that I'm privileged.  (That's quite an assumption.  My wife and I both work.  I expect we'll need to work for many years to come.  I worked full-time as an undergraduate student to pay my own way through university as my mother couldn't afford to and my father died when I was in the eighth grade, and I have maintained gainful employment, out of necessity, for my entire adult life.  Granted, during the time I was completing my graduate degrees it took the form of government stipends, but work I did.  If I have enough money saved to enjoy the occasional luxury or trip abroad with my family, then it is the fruit of my labor and wise investments, but, for the sake of this argument, let's accept your assumptions that the Worker supports the Privileged.)

The worker toils and builds.  He lays the bricks to build the hospital, shovels the coal to power the lights in the infirmary, and cleans the sh()it and vomit off the bodies of the sick and the dying.  All this is true.  But for this he receives a compensation.  His compensation may include medical and dental benefits, or it may not.  This is a matter for him to work out with his employer.  If he does receives these benefits, then he is like me:  he toils, he is compensated, and he has recourse in the event of illness or the pregnancy of his wife.  If he does not receive medical insurance, then he certainly has a little more to worry about.  Having a baby in a proper hospital with an experienced obstetrician making the regular inspections in the months prior to, and following, the delivery costs about ten thousand dollars.  Most workers cannot afford such expenses out of pocket.  this, in fact, is why the insurance market exists.  If his employer does not provide him with insurance, he may elect to purchase it privately.  We have done this, in fact.  For a while, I worked for an employer whose insurance for the three of us would have been quite high.  About six hundred dollars per month, and the deductible was quite high as well.  We did some internet research and found that we could buy a policy to cover us more cheaply with equal, or slightly better, benefits and lower deductibles.  So we elected to do this.  All without the assistance of any legislation, I"m afraid.  And worker can elect to do this.  Also, before I was married, I didn't even have insurance.  From 33 to 37 I had a serious position in California that compensated me handsomely and offered what I understood to be excellent medical insurance.  I would have been charged about a hundred dollars a month, pre-tax, for the policy.  I elected not to accept that insurance, thinking at the time that I would rather have that hundred dollars per month in my pocket.  I imagine that millions of workers, just like me, made the same decision, and this subset accounts for a large number of the uninsured.  This is a choice we make.  And it does not seem to me that it is in the spirit of American law and tradition to take away that choice.  More importantly, I do not think the anti-choice legislation will solve the underlying economic problem.

I guess if I ever saw a sound economic argument against it, I'd let it go.  As I said, I'm old enough not to be blinded by ideology, but as yet I do not think forcing everyone to purchase something will have the effect of decreasing the amount we spend on medical care.  We spend 16% of our aggregate GDP on medical care, and it's a great amount compared to other industrial societies.  But no legislation is going to change that.  You can force everyone to buy insurance, but unless you deal with the underlying causes--obesity, stress, ignorance, willfulness, and our reticence to let the dying die without first spending hundreds of thousands of dollars to extend their existences by a few months--then we will continue to spend a large fraction of our aggregate GDP on medical care.  I wish our politicians would simply admit the truth us and stop the wasteful legislation.  They are smarter than they're letting on, I'm afraid.  And they play up our fears and pass such monstrosities as "Health Care Reform" not because of any humanitarian reasons, but because they like their jobs, and the compensation--including the medical insurance--that those elected offices provide. 

Without free insurance as a floor to rescue the destitute no one except the very rich are really 'insured', angus, for the simple reason that the severely or chronically ill lose their jobs and their assets and thus cannot pay insurance (or are simply bumped from the insurance when they become too problematic, or are denied by clever arguments or claims that their condition was pre-existing).  Private health insurance without careful government regulation and a subsidy for the poor is worthless - just a deception.

certainly all our industries are regulated.  Drugs are far more regulated even than they ought to be, and this, in part, is why it's so damned expensive to obtain them.  For example, in Mexico I can go to a pharmacy and buy a package of fifty 10-mg Vicodin for about 100 pesos.  This is about eight dollars.  Just across the border, say, in Brownsville, I'd have to make an appointment with a physician, tell him all about how my wife left me and my dog died and I lost my job and my father's in prison and I wrecked my pickup truck trying to get away from a cop because there was an outstanding bench warrant for my arrest and if I was caught I'd end up in jail, and maybe after all that depressing stuff he'd write me a prescription for a package of fifty 10-mg Vicodin which I'd then take to the local Eckerd's Drug Store and purchase for about thirty-five dollars, but not before paying his receptionist 90 dollars for the office visit.  So, what would have cost me eight dollars if only I'd driven across the border to Matamoros, is going to cost me 125 dollars in Brownsville.  All precisely because of heavy regulation of "health care" by the government.

You're talking about another issue, angus.  I was talking about insurance.  There's no such thing as secure private insurance, unless it is essentially a regulated public utility.

My frail attempt at misdirection.  It was intentional, I must admit.  The argument is tiresome. 


Regarding pre-existing conditions, I think any company that is in a business to make money--and I can't think of any other kind--really ought to be able to make its business decisions based on revenues and costs.  Insuring folks with pre-existing conditions will, on average, usually by some well-documented probability, increase costs.  In such cases it makes sense to offset these likely greater costs with greater revenue.  Folks should be able to buy insurance, but they can expect to pay more if they already are diagnosed with some degenerative disease.  Just like life insurance costs more if you smoke.  This seems to make perfect business sense.  But it needn't cost everyone more.  And if some of the suggestions I'll try to list are followed, the increased premiums paid by those with pre-existing conditions needn't drive most of them to bankruptcy. 

Let's say you are 20 years old only need a five thousand-dollar procedure, and if you get that, then based on well-documented histories and a solid probability distribution function, it can be shown that there's a 97.3% chance you'll be fine.  I think most folks could get behind that.

Now, let's say you're 65 years old and what you need to make it to 66 is a one hundred-thousand dollars worth of procedures.  And suppose that the best that a team of expert physicians and statisticians can say, based on their histograms, is that you have a 23.4% chance of lasting another year even with the procedure.  Most folks won't get behind that. 

Now, the way it works now is that whichever of these two cases has insurance gets the service.  The other is denied.  Since we generally have economic security as we grow older, chances are that it is the 65-year-old that will get the procedure.  This, in part, is why we are spending so much money.

On the other hand, if the state either takes over the industry, or regulates it much more, then wiser economic decisions will be made.  Thus, the so-called Death Panels.  The name is inflammatory, of course, and they might just have easily been called Actuarial Adjustment Agents.  I like the alliteration on A, don't you?  But that doesn't really fire up the base so much.  It's worth debating, I'd agree.  Ultimately, we have to decide upon the goal.  Is it really to lower costs?  And, if so, does increasing the bureaucracy really do that?  Wouldn't a better strategy be a national education initiative, focusing on healthier lifestyles?  Rescheduling certain prescriptions in order to make some drugs available over the counter would offset costs as well.  As would a greater emphasis on holistic and preventative medicine.  (Of course, these practices are currently at odds with the way insurance payments are structured.  I think most of us, including medical workers, would welcome some mitigation of that problem.)  Additionally, allowing other levels of practice besides licensed physicians and surgeons.  The physician's assistant (PA) program is gaining popularity.  We should also have trained medics, like they have in the military.  Of course, there are EMT types, but the bureaucracy involved with their services drives up costs.  That is largely because we are such a litigious society.  And only some fundamental change in attitudes will change that, and such changes take a long time.  Again, aggressive education would help in this regard.

If you're an American, then there's a good chance that you subsist on Snickers, potato chips, Big Macs and coca-cola, and the only exercise you get is walking to find the remote for the television that you spend, if you're an American, five hours on an average day watching.  If you're an American, there's a good chance that don't even to walk two blocks to buy your cigarettes.  If you're an American, then there's a good chance that your idea of "sport" is watching a monster truck show or a college football game.  It is no surprise that by the time you're 40 you're having heart problems can no longer be insured because you're too fat,  It's 's difficult to expect that the reasonably healthy minority should foot the bill to extend your miserable life by a few years.  I recognize that this doesn't describe every single American who has struggled to pay for medical services, and many folks have gone broke paying for conditions which they contracted through no fault of their own, but a good many have tragically caused their own degeneration as well.  Maybe it's all of our fault.  The purpose of my diatribe isn't to attach blame for the sorry condition of our collective health, but rather to point out that that condition has less to do with the medical insurance structure than with our culture.  We have deeply-rooted health problems in our society and this Medical Insurance Bill isn't going to solve our fundamental problems. 

This massive douchebag was actually right here.

Someone may already have posted this, but yesterday the repeal was defeated, 51 to 47.  All Democrats present voted to keep the law and all Republicans present voted to repeal it, as expected.

The Senate did vote, 81 to 17, to remove a tax-reporting provision of the law, but I think that was expected because it wasn't a very popular item.

Also, don't forget that there have been four lower-court rulings on HCR.  Two courts upheld it, saying it was constitutional.  One court in Virginia said the individual mandate was unconstitutional but did not strike down the rest of the law, and a court in Florida said the entire law was unconstitutional.  And there are still something like 20 lawsuits pending.  I imagine it'll work its way up to the supreme court.

In other words, as the Washington post cleverly writes, "Although politicians are aiming their arguments at a nation of millions, the real audience for these arguments is just nine.  Or maybe just one."  Not a very democratic solution, I suppose, but litigious solutions never are.