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The obstructionist party, GOP, being flushed out? Healthcare
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mac



Joined: 07 Mar 1999
Posts: 17736
Location: Berkeley, California

PostPosted: Thu Feb 11, 2010 3:24 pm    Post subject: Reply with quote

I don't understand. Iso says it is every CEO's job to try to deliver unconscionable profits. The fact that it consumes 17% of our GDP (far more than debt service) is just bad choices by consumers--isn't it?

Show me a reform that the Republicans have proposed or voted for--except liability reform, which limits penalties for bad medical behavior--and increases profits for insurance companies--and I'll believe that they have something to say.
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isobars



Joined: 12 Dec 1999
Posts: 20935

PostPosted: Thu Feb 11, 2010 5:49 pm    Post subject: Reply with quote

jpbassking wrote:
We're all crazy for supporting anything that Mike has not personally benefited from.


Huh? I've criticized the hell out of Medicare, SS, and the VA, right here and in formal complaints to the entire VA chain of command right up to its federal director. Federal employees hired before 1986 are denied much or all of their SS payments even if they totally funded their SS benefits in private industry jobs, and lose all their spouse's SS, just because part of their career was in federal service.

The difference between earned rights and freebie entitlements is that people like my wife and I paid, big time, for decades, in cash and benefits and risk and hassles and onerous restrictions you can't even imagine, for our health care insurance, and combat veterans pay infinitely more and get more benefits for it.

The Gimme generation wants it given to them, no strings attached. Their jealousy is misplaced, however, because they can access the same federal benefits I do the same way I did; all you have to do is:
• Spend a career in the military.
• Pay full price in cash for Medicare.
• Use the downright scary and wildly inept VA system for simple problems that can wait several months, but only after researching your problem thoroughly so you can educate your VA providers and/or know when to run, not walk, to more competent care. [This is not hyperbole; it is based on scores of pages of very serious problems with many VA providers in many VA facilities.]
• Maintain your own medical records, because the VA loses them with alarming regularity.
• Buy your own medical insurance policies to plug some of the holes in the federal policies you bought.
• Pay full price in cash for SS.
• Pay a lot of cash for decades to extend your small pension to your widow.
• Make sure you have living wages coming in from some source after you retire from the military.

See how easy it is? Good, because only after you take that entire path and still feel shafted do you have any right to whine about it. Anything less and you sound like a baby.

And “Gimmie!” is even more egregious --- and flat-out crazy -- when it demands destruction of one of the world’s greatest economies AND one of the world’s greatest health care systems just so the Bassman can be required by an anti-constitutional law to buy into WORSE care than he has right now at insurance premiums increased by >53%. How can “Gimmie!” be so thoroughly force-fed into even an average mind -- let alone one which knows how to spell “benefited” -- that it abandons all logic and self-preservation?
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mrgybe



Joined: 01 Jul 2008
Posts: 5180

PostPosted: Thu Feb 11, 2010 5:59 pm    Post subject: Reply with quote

swchandler wrote:
1.The very few, rather insignificant ideas that they have been kicking around lately like tort reform and interstate competition........

2. Now, regarding all the accusations blaming Obama for not requiring Congress to broadcast the healthcare debate on CSPAN, can Obama actually demand it? I don't think so........

3. Would broadcasting healthcare reform to the American public on CSPAN really make a difference? While healthcare reform is an interesting and very complex topic.......

4. In my opinion it's all about requiring folks to buy healthcare, and that's simply a "no go" with Republicans and tea partiers. They consider a requirement to buy healthcare coverage to be a tax

5. That's why the Bush Administration didn't propose or require a tax surcharge to pay for our two wars in the Middle East.


I have edited and numbered your comments for ease of response.

1. Allowing health insurance companies to compete across state lines is not insignificant, it is huge. Buyers would have the option of buying from thousands of companies rather than a handful which is usually the case. Competition would drive price down. Tort reform.........ask any physician or hospital administrator if they consider tort reform to be insignificant.

2. You're surely not suggesting the the President repeatedly promised something he couldn't deliver?

3. Health care is, indeed, a complex topic. That's why some of us were a little taken aback when the President demanded a sweeping reform bill be on his desk for signature before the August recess (and why isn't there an "e" in naive"?)

4. I think it is a safe bet that the majority of Republicans already buy healthcare coverage. However, I believe they question the constitutionality of a govt. requirement to buy it. I agree with them on that.

5. At last we agree.........while I generally don't support feeding the govt. trough with more taxes, I would support a surcharge to pay for war. We should all feel some direct pain, in my view. That would ensure that the merit of any conflict is kept at the forefront of our minds.
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isobars



Joined: 12 Dec 1999
Posts: 20935

PostPosted: Thu Feb 11, 2010 7:16 pm    Post subject: Reply with quote

mrgybe wrote:
Tort reform.........ask any physician or hospital administrator if they consider tort reform to be insignificant.

I would support a surcharge to pay for war. We should all feel some direct pain, in my view. That would ensure that the merit of any conflict is kept at the forefront of our minds.


Many estimates agree that tort reform's cost savings would run about 2%, maybe up to 5%, of our annual health care costs. DoD costs run <5% of our GDP. If tort reform's savings are insignificant -- which is quite arguable in percentage terms -- it could also be argued that DoD expenses are too small to warrant special consideration. Within reason, the financial cost of a necessary war should not be a factor; a war's necessity is a far bigger issue.

The bigger question regarding tort reform, it seems to me, is why the Democratic legislators flatly refuse the demands of Republican legislators and most of the population to include tort reform in the health care bills. The obvious answer is the fact that lawyers, including tort lawyers, largely fund the Democratic party. Why else would the Dems refuse a clause that would reduce annual medical legal action costs by $50B?


Last edited by isobars on Fri Feb 12, 2010 8:58 am; edited 1 time in total
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swchandler



Joined: 08 Nov 1993
Posts: 10588

PostPosted: Thu Feb 11, 2010 7:52 pm    Post subject: Reply with quote

I'm glad we agree on the last point. However, I would offer response to the other points for some consideration.

1. Although I framed the couple of issues that Republicans favor as insignificant, I know they aren't that simple. I have no idea how difficult reforming tort reform would be, but I assume it must be immense.

I have some recent experience with my cardiologist retiring because his malpractice insurance being equal with the income from his historically declining caseload (he was probably in his mid to late 70s). It was a business decision for him.

How simple is tort reform to accomplish, especially considering the legal system and lawyers on either side of the issue? There's little doubt that astronomical money in that arena will shred the situation to pieces.

The interstate competition thing is a whole different ball of wax. Not every state fits into the same price structure, population statistics, capability and circumstances, and as a result, insurance companies price according to local issues and requirements. It's no easy task to work around the huge differences.

Have Republicans fleshed out how they would accomplish those tasks, to include credible peer review support that highlights their positions? Honestly, no.

2. Hey, the way that Obama approached healthcare reform was to propose a series of core concerns that his administration recommended that could be addressed and resolved the American way. The job of accomplishing that is in Congress, and after the Clinton's Presidency's failed attempt, that realistically was the most practical approach today.

This idea of the literal promise is just BS offered by those that don't have the balls to do something challenging. It's easy to lob nonsense into the picture and try to cast a deep shadow.

3. Perhaps you're right that the Obama Administration was a bit too demanding in it's timetable. Realistically though, the focus on Obama's naiveness is simply a weak ploy. When anybody wants to unleash anything challenging and compelling, it's imperative to set aggressive goals and timetables. Anything less would be considered weak. Strength comes from adaptability as things unfold. Nothing is a simple as a beginning, no matter how earnest and heartfelt.

4. To be quite honest, it irritates the hell out of me that my personal healthcare insurance costs, and the costs for care are based on the model where the unpaid for costs for the uninsured are simply passed off to me and other responsible folks. While it can be argued that the uninsured can be turned away at the door, that's not going to be a reality.

It only makes sense that Americans be responsible for the health of themselves and their family. All the crap about living a healthy lifestyle and not needing reasonable healthcare is a pantload. If you've ever been involved in a serious costly accident or event (I've experienced both) where you can't simply sue someone else to death, you'll appreciate what I'm trying to say. Responsibility sometimes must be demanded and enforced (maybe that might be as Republican as I can get). In a country as large, expensive and complex as ours, it's becoming more and more a necessity.

In the end though, I have to say that something needs to be accomplished and agreed on that ends up controlling costs for health insurance and care. That's where I don't think that the quick run to the goal line necessarily resulted in the optimum healthcare reform legislation.
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mrgybe



Joined: 01 Jul 2008
Posts: 5180

PostPosted: Thu Feb 11, 2010 11:49 pm    Post subject: Reply with quote

swchandler wrote:
In the end though, I have to say that something needs to be accomplished and agreed on that ends up controlling costs for health insurance and care. That's where I don't think that the quick run to the goal line necessarily resulted in the optimum healthcare reform legislation.


I concur with much of what you say. I do, however, worry that President Obama and his closest advisors are out of their depth......these are very complex challenges and their rosy image of the ease with which things can be changed has been simplistic, and symptomatic of little real world experience. Lofty rhetoric on Guantanamo, on transparency, on jobs, on healthcare, on the war, on foreign relations have all shown little result. It's still relatively early, but the President can fail to deliver on promises and demands only so often before the population and the rest of the world see him as weak (if you read the foreign press, as I do, you will know that skepticism about President Obama's ability to effect change is sharply on the rise overseas).

Specifically on healthcare, if were President (sadly for you all, not possible) I would have clearly framed the key issues and challenges to the populace in manner that we can understand...... not hours of speechifying, just 10 bullet points on a couple of charts........and set about tackling those issues in a phased manner. Attempting to do it all at once was a mistake....it just seemed too overwhelming and there were too many opportunities for criticism. It's still not too late to go down a sensible and logical progression towards reform, but I suspect we are going to get a mish-mash of compromises just to get something passed.
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isobars



Joined: 12 Dec 1999
Posts: 20935

PostPosted: Fri Feb 12, 2010 8:56 am    Post subject: Reply with quote

Knowingly or not, you just summarized a year of Fox News, TEA parties, and the rational arm of talk radio.

Mike
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boggsman1



Joined: 24 Jun 2002
Posts: 9110
Location: at a computer

PostPosted: Fri Feb 12, 2010 10:14 am    Post subject: Reply with quote

mrgybe wrote:
swchandler wrote:
In the end though, I have to say that something needs to be accomplished and agreed on that ends up controlling costs for health insurance and care. That's where I don't think that the quick run to the goal line necessarily resulted in the optimum healthcare reform legislation.


I concur with much of what you say. I do, however, worry that President Obama and his closest advisors are out of their depth......these are very complex challenges and their rosy image of the ease with which things can be changed has been simplistic, and symptomatic of little real world experience. Lofty rhetoric on Guantanamo, on transparency, on jobs, on healthcare, on the war, on foreign relations have all shown little result. It's still relatively early, but the President can fail to deliver on promises and demands only so often before the population and the rest of the world see him as weak (if you read the foreign press, as I do, you will know that skepticism about President Obama's ability to effect change is sharply on the rise overseas).

Specifically on healthcare, if were President (sadly for you all, not possible) I would have clearly framed the key issues and challenges to the populace in manner that we can understand...... not hours of speechifying, just 10 bullet points on a couple of charts........and set about tackling those issues in a phased manner. Attempting to do it all at once was a mistake....it just seemed too overwhelming and there were too many opportunities for criticism. It's still not too late to go down a sensible and logical progression towards reform, but I suspect we are going to get a mish-mash of compromises just to get something passed.

Mr G ...you've stated here that you are not a Republican, but I'm not buying 1 share. I would like a seat next to you in the peanut gallery, it must be nice.
Tort reform, Interstate portability, its all a lot harder than it seems. Look what happened with McCain-Feingold at the Supreme Court....most people think corporations are allowed to spend way too much money to influence politicians, but Constituional Law says otherwise. I suspect the same Constituion would dissalow a citizens right to sue for punitive damages if a doctor clipped the wrong limb. But , hey its a great tag line for the repubs , because it would weaken one of the Dems biggest lobbys.
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mrgybe



Joined: 01 Jul 2008
Posts: 5180

PostPosted: Fri Feb 12, 2010 11:34 am    Post subject: Reply with quote

boggsman1 wrote:
Mr G ...you've stated here that you are not a Republican, but I'm not buying 1 share.......Tort reform, Interstate portability, its all a lot harder than it seems.


You can choose to call me a liar if you wish, but keep your powder dry because that only leaves you with stupid, bigot and racist in your arsenal of liberal responses to a reasoned argument (oh, I forgot the ultimate insult, tea-bagger which encompasses all the above).

I never said it was easy.......quite the reverse.......it is complex and will require a large effort by people with in-depth knowledge of the issues. So do we just give up because it's difficult?.......and continue to whine about the inequities of the current system? Allowing the multitude of companies, who are already in the business of providing health insurance, to compete with each other seems a much more intelligent approach to me than creating yet another inefficient federal bureaucracy from scratch. Which would you prefer......having the choice of hundreds of insurance offerings from established healthcare companies, with the inevitable price competition that would bring.......or choosing from a handful of companies allowed to do business in your state, including the heathcare equivalent of the DMV, whose inefficiency and inexperience is propped up by your tax dollars? Give all those greedy, profit hungry capitalists the green light to compete across state lines and I assure you they will find a way to do it.....and quickly. Federal regulation of the industry could then replace the 57, oh sorry, 50 independent state regulatory mechanisms......another efficiency step.

Tort reform suffers more from special interests than from complexity. Finding a middle ground between the contingent fee basis of compensating lawyers, and the loser pays method which is prevalent in most other countries would protect those who have truly been harmed while penalizing those who bring frivolous law suits. Show me a case of medical malfeasance and I will show you some idiot who thinks it's the fault of someone else that that he dropped coffee in his lap.

Finally, with regard to the Constitution, we cannot pound our collective chests in support of the bits we like, and ignore, or disparage the bits we don't. It is the governing document. If there are words that no longer serve us well.......amend them.

One can be disappointed with the current administration without being a Republican. Democrats dismiss the opinions of independents at their peril.
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boggsman1



Joined: 24 Jun 2002
Posts: 9110
Location: at a computer

PostPosted: Fri Feb 12, 2010 12:18 pm    Post subject: Reply with quote

Im not calling anyone a liar, or a bigot, or a racist, dont put words in my mouth, its very Sean Hannityesque. Im just calling them as i see them, you're critique of Obama is straight out the Weekly Standard, very Repub. Nor do I claim to parse the constitution for my own interests. Its funny how one defends the Tea Baggers. I work in finance, a 9-1 repub-dem ratio, and yet Ive never met one person who has attended an event, EVER! maybe the people in my industry are not that pissed off, and dont feel the need to go yell and scream. Independants are the lifeblood of the Democratic whitewahes of 2006, and2008, iM sure Nancy and Harry will squash the remaining support amongst them.
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