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swchandler
Joined: 08 Nov 1993
Posts: 10588
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 Posted: Wed Nov 02, 2016 6:35 pm Post subject: |
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Admittedly, Nixon inherited the war, and truly Kennedy and Johnson wear the guilt and stain of starting and growing the VietNam War for specious reasons. Again that was a different time. It's ironic that Kennedy, and particularly LBJ, successfully pulled off Civil Rights reforms and Medicare. As pointed out by mat-ty, even Nixon comes out as notable for supporting and launching the EPA. Still though, there is a lot under the hood in a presidency that makes things happen, sometimes important things. I think folks don't always think about that.
That's one of my biggest fears in this election. Trump and those that he would have under his administration scare the crap out of me. It would hard to recover from that kind of mistake. Hillary Clinton, no matter how much you hate her, is far more qualified, and I think that she will be able bring more capable and rational folks into her administration. Also, if all of our allies were polled, few if any would support a Trump presidency. Even our right wing voices here would find it hard to deny that. |
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nw30
Joined: 21 Dec 2008
Posts: 6485
Location: The eye of the universe, Cen. Cal. coast
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| Posted: Wed Nov 02, 2016 7:38 pm Post subject: |
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| swchandler wrote: |
That's one of my biggest fears in this election. Trump and those that he would have under his administration scare the crap out of me. It would hard to recover from that kind of mistake. Hillary Clinton, no matter how much you hate her, is far more qualified, and I think that she will be able bring more capable and rational folks into her administration. Also, if all of our allies were polled, few if any would support a Trump presidency. Even our right wing voices here would find it hard to deny that. |
It cannot be the same people that surrounds her now. If there are any indictments, Hillary won't be the only one, remember Watergate scooped up 42 people with indictments. Most all the usual suspects that you've been hearing about will probably be on that list, as well as some we haven't heard of yet.
This shouldn't be taken lightly, no matter how hard you try to.
Our allies?
In most part, we come off like paper tigers anymore, all the bad players have been emboldened. China (south China Sea island building), Russia (buzzing our Navy, running into Croatia, and helping Assad), North Korea (nuke testing), Iran (playing us for fools).
Yeah, there is a concern over what they think of us, they have lost their faith in us. Enter Brexit, enter Trump. |
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swchandler
Joined: 08 Nov 1993
Posts: 10588
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| Posted: Wed Nov 02, 2016 9:35 pm Post subject: |
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NW30, I'm talking about our allies, but maybe you missed that. I have to guess that you're only thinking about "Trump-type" minorities voicing their ugliness in the world. On that, you've really got nothing.
Tell me how those that Donald Trump has brought under his potential core administration fold are far superior to anything that Hillary Clinton can muster. I would love to hear how you spin it. |
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mac
Joined: 07 Mar 1999
Posts: 17748
Location: Berkeley, California
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nw30
Joined: 21 Dec 2008
Posts: 6485
Location: The eye of the universe, Cen. Cal. coast
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| Posted: Thu Nov 03, 2016 12:44 am Post subject: |
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| swchandler wrote: | | NW30, I'm talking about our allies, but maybe you missed that. I have to guess that you're only thinking about "Trump-type" minorities voicing their ugliness in the world. On that, you've really got nothing. |
The countries that I mentioned are the "bad players" not our allies.
I should have added the word "allies" to the last sentence in that part to avoid any confusion, "they" being our allies.
| swchandler wrote: | | Tell me how those that Donald Trump has brought under his potential core administration fold are far superior to anything that Hillary Clinton can muster. I would love to hear how you spin it. |
I doubt if any of them, whoever they will be, are in line for a possible indictment, as are Hillary's. |
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mac
Joined: 07 Mar 1999
Posts: 17748
Location: Berkeley, California
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| Posted: Sun Dec 04, 2016 11:57 am Post subject: |
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Time to watch what the Republicans will do, and why they didn't do it in 2009. We know the answer to that. But somehow there is a substantial body of support for aspects of the ACA, and turtle man is now acknowledging changing will be hard.
| Quote: | More Americans want to keep the Affordable Care Act than see it killed or dialed back — and the law’s major provisions remain quite popular across party lines, according to the first comprehensive, post-election poll on the law.
The new survey, conducted by the Menlo Park-based Kaiser Family Foundation in mid-November, found that 49 percent of the public want to keep the law or see it expanded, versus 43 percent who want lawmakers to eliminate or dial back the law, commonly called “Obamacare.”
On the campaign trail and again at a rally in Cincinnati on Thursday night, President-elect Donald Trump vowed to “repeal and replace” the law, which has insured 20 million Americans since 2014, many of them through an Obamacare provision that expanded Medicaid, the nation’s health care program for the poor.
Republicans, who now control both houses of the Congress, have voted dozens of times to repeal the Affordable Care Act since it was signed into law by President Barack Obama in 2010.
But post-election, according to the poll released Thursday, fewer Republican voters (52 percent) now say they want to see the law repealed, down from 69 percent in October. And 24 percent of Republicans now just want to see the law scaled back, up from 11 percent in October. The poll was taken after Trump told the Wall Street Journal and CBS’ “60 Minutes” three days after the election that he liked some key parts of the law. |
Cost increases in health care and insurance, certainly part of what helped Trump, are far too complicated for sound bites. Very interesting article here:
| Quote: | By RICARDO ALONSO-ZALDIVAR, Associated Press
WASHINGTON (AP) — The nation's health care tab grew at the fastest rate in eight years in 2015, driven by the coverage expansion in President Barack Obama's law and by costly prescription drugs, the government said Friday.
The growth of 5.8 percent in 2015 boosted total health care spending to $3.2 trillion. That's an average of $9,990 per person, although the vast share of that money is spent caring for the sickest patients.
Health spending grew about 2 percentage points faster than the overall economy in 2015, said the report from nonpartisan economic experts at the Department of Health and Human Services. That's a problem because it makes it harder for government programs, employers, and individuals to afford the level of health care that Americans are used to having.
The report was disappointing news for the outgoing Obama administration, which had enjoyed a long stretch of historically low increases in health care spending, and had sought to credit its 2010 health care overhaul for taming costs. It's a reality check for President-elect Donald Trump, who did not focus much on health care during his campaign and implied that problems could be easily fixed.
America has struggled for decades to balance health care cost, access, and quality. Obama's law made significant strides to expand access, and the report found nearly 91 percent of U.S. residents now have coverage. But the problem of costs has re-emerged. That's partly because people with health insurance use more medical care than the uninsured, who tend to postpone going to the doctor. Some of the newly insured turned out to be sicker than those who were already covered.
The report "casts further doubt on the extent of a permanent slowdown in health cost growth," said economist Eugene Steuerle of the nonpartisan Urban Institute.
In a milestone for data-watchers, the report found that the federal government became the largest payer for health care in 2015. Washington accounted for 29 percent of overall spending. That was followed by households (28 percent), businesses (20 percent), and state and local governments (17 percent). In doing the analysis, the HHS experts count the employee share of premiums for job-based insurance as spending by households.
Spending by private health insurance plans increased by 7.2 percent in 2015, and Medicaid spending grew by 9.7 percent. In both cases, the health care law was a driver. Nine million people had private insurance through the health care law's subsidized markets, and nearly 10 million had Medicaid coverage as a result of the law. Increases in Medicaid spending will be a problem for states. Starting next year, states that expanded the program under the health law must gradually pick up a share of the costs.
Spending on prescription drugs dispensed through pharmacies increased by 9 percent in 2015. Although that rate of growth was less than in 2014, the report said drug spending grew faster any other category, including hospitals and doctors. It wasn't only pricey new drugs for hepatitis C infection driving the trend, but also new cancer drugs and price increases for older brand-name and generic drugs.
Medicare was a bright spot in the report, growing only by 4.5 percent, despite roughly 10,000 baby boomers a day reaching eligibility age. Calculated on a per-beneficiary basis, Medicare spending grew by just 1.7 percent.
Former White House official Ezekiel Emanuel said that's partly due to the Obama administration's stewardship. Not only did the health care law cut payments to service providers, it set into motion a series of initiatives that aim to reward quality, improve coordination and penalize poor performance.
Republicans would be foolish to sweep away Obama's Medicare changes, Emanuel said. "In the long term, the only way we get rate of increase down is by experimenting with alternative payment models," he said. "We need to push harder and harder."
Still, there seems to be little to cheer about as health care costs start to accelerate. Two of the major brakes on costs in the Obama health care law — a Medicare spending board and a tax on high-priced insurance plans — are in limbo and likely to be repealed if ascendant Republicans follow through on their promises. It's unclear whether the GOP has better ideas, and even more uncertain whether Democrats would support them.
"You get back to this old problem we have of spending growing faster than the economy," said Douglas Holtz-Eakin, president of the America Action Forum, a center-right think tank. "If you don't solve the cost problem, it will undercut coverage expansions because they get too expensive."
The HHS report was published online by the journal Health Affairs.
HHS report — http://content.healthaffairs.org/lookup/doi/10.1377/hlthaff.2016.1330 |
Three very tough political realities for Trump here. First, Medicare costs have risen much more slowly than other aspects of health care cost, including in the most recent year. Second, aspects of the ACA extend the viability of Medicare substantially. Third, Ryan's plan for privatization of Medicare is very unpopular.
Let's see who grabs that third rail, and what the implications are for mid-term elections if they roll Democrats and gut the law and privatize Medicare. |
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mac
Joined: 07 Mar 1999
Posts: 17748
Location: Berkeley, California
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| Posted: Sat Jan 07, 2017 12:09 pm Post subject: |
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How life gets interesting. GOP is finding that, outside their base, a majority of American's don't want the ACA repealed unless something replaces it. The reason? By any reasonable set of metrics, it is working. See this LA Times article: http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-charts-20170104-story.html
Look in particular at Figure 44, showing a reduction in the rise of health care costs.
You don't need no stinking facts--much less the truth--to craft talking points that stir hate. |
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coboardhead
Joined: 26 Oct 2009
Posts: 4303
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| Posted: Thu Jan 12, 2017 2:15 pm Post subject: |
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Well, today the Senate started the repeal process through budget reconciliation. Probably the worst possible way to repeal the ACA. What do you think will happen when providers quit seeing Medicaid and Medicare patients because the funding system built into ACA makes reimbursement less or not available?
My wife is not the only provider I know who is not accepting new patients until they know what the ACA repeal will involve. I feel for anyone turning 65 this year! This will not just affect seniors. My PCP quit. I have been shopping for a new PCP and no one here is accepting new patients. I am ten years from Medicare.
This has the signs of becoming a complete mess. |
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mat-ty
Joined: 07 Jul 2007
Posts: 7850
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| Posted: Thu Jan 12, 2017 2:50 pm Post subject: |
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| coboardhead wrote: | Well, today the Senate started the repeal process through budget reconciliation. Probably the worst possible way to repeal the ACA. What do you think will happen when providers quit seeing Medicaid and Medicare patients because the funding system built into ACA makes reimbursement less or not available?
My wife is not the only provider I know who is not accepting new patients until they know what the ACA repeal will involve. I feel for anyone turning 65 this year! This will not just affect seniors. My PCP quit. I have been shopping for a new PCP and no one here is accepting new patients. I am ten years from Medicare.
This has the signs of becoming a complete mess. |
I would be a lot more concerned if Ryan was not involved. He's a pretty smart guy. They better have a plan, Lets see what happens. |
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coboardhead
Joined: 26 Oct 2009
Posts: 4303
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| Posted: Thu Jan 12, 2017 3:07 pm Post subject: |
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Matty
They may work something out. But, right now the posturing and threatening that the GOP leadership is doing IS creating havoc in the provider arena. I admit that my perception is based on older physicians who are just sick and tired of the BS. The younger guys and the hospitals have no choice but to wait it out.
The problem is there are shortages of physicians that practice primary care. Disruption of those practices right now could have implications regardless of Ryan's final plan.
BTW, Ryan has been against the expansion of Medicare and has been seeking cuts for a long time. |
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