Healthcare Bill

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lejeunesage said:
Actually, it's because it'd be hard to get the votes for the student loan bill that they're tacking it on to something that they're sure to pass, health care reform.
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Ehhh ... I wouldn't go that far. I think they are scrambling for votes a bit right now. The last time I looked, I didn't think Pelosi had the seats, and I'm pretty sure Obama delayed his trip to Asia a few days to help get it passed asap. However, the initial article I read (don't remember the source, I think CNN) stated that no Republican in the senate was slated to vote for the financial aid overhaul (not shocking) so again, I don't think they have the votes.
 
7starmantis said:
:laugh::laugh::laugh: Wow, seriously? You my friend win the most blind faith in an agenda award.
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You know, it's a real cop-out, and pretty obnoxious, to accuse of someone of "drinking the Kool-Aid" (Tutmos), being a "talking points billboard" (Tutmos), and having "blind faith in an agenda" (7starmantis), whenever that person expresses an opinion you disagree with. And when you dismiss with a :laugh: an argument that has, in fact, been voiced by a variety of commentators in leading publications, you're only (as one of my HS teachers would say) advertising your ignorance.

In this case, XxNemesis29xX's point was that the health-care reform bills, despite being politically partisan, are substantively moderate -- especially when one considers the history of the debate on this issue. It's an argument that has been made frequently in respected corners of both the Blogosphere and the mainstream media. It also is probably true. Here are some helpful sources that make the case:

http://voices.washingtonpost.com/ezra-klein/2010/02/five_compronises_in_health_car.html

http://www.nytimes.com/2010/01/20/business/economy/20leonhardt.html

http://www.fivethirtyeight.com/2010/01/post-partisanship-epic-fail.html

http://www.nytimes.com/2010/03/12/opinion/12brooks.html

http://www.time.com/time/politics/article/0,8599,1903705-1,00.html

Money quotes:
"At this point, I don't think it's well understood how many of the GOP's central health-care policy ideas have already been included as compromises in the health-care bill. But one good way is to look at the GOP's "Solutions for America" homepage, which lays out its health-care plan in some detail. It has four planks. All of them -- yes, you read that right -- are in the Senate health-care bill." --Ezra Klein (first link)

"The current bills, for better and worse, are akin to a negotiated settlement to this six-decade debate. It would try to end our status as the only rich country with tens of millions of uninsured people, as liberals have long urged. And it would do so using private insurers and government subsidies, as conservatives prefer.. On cost control, the bill is similarly centrist. In 1993, Mr. Clinton pushed for putting a cap on the growth of insurance premiums — an idea similar to having a national health budget, which conservative governments in other countries have done. Today’s Democrats saw that move as too radical. Instead, they have borrowed Nixon’s old push for prepaid group practices, which are now called accountable care organizations." -- David Leonhardt (second link)


I've posted a couple of these links before on earlier threads. They were never substantively responded to. They probably won't be here either. It's much easier to just respond with a :laugh:.
 
More links!

http://healthaffairs.org/blog/2009/...democratic-health-bills-are-republican-roots/

http://www.tnr.com/blog/the-treatment/bill-already-bipartisan-contd
(which cites http://www.kaiserhealthnews.org/Graphics/2010/022310-Bill-comparison.aspx)

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Since I don't like to be cherry-picking links from trustworthy experts, here's a (partially) dissenting voice, which may in fact give the most accurate picture:

http://douthat.blogs.nytimes.com/2010/03/10/the-rockefeller-republican-health-care-bill/

(Yeah, I know, this is from the Times too. But Ross Douthat is very much a conservative and also opposes the health care reform bills.)

Money quote: "If you're a liberal looking to put a bipartisan gloss on the proposed legislation, then, you're much better off describing it as a "moderate Republican" package than as a semi-conservative one. This is a rhetorical tack that progressives often take, and they have a point: The Senate legislation is the kind of bill that the early-1970s Richard Nixon might have backed, or the early-1990s John Chafee (who crafted a Republican alternative to Clintoncare), or (self-evidently) the Mitt Romney of 2005.
But keep in mind that the kind of "moderate Republicanism" (or "Rockefeller Republicanism," to use a better term of art) that bound all of those figures together was often closer to a liberal Republicanism — a pro-business version of the prevailing liberal paradigm, that is, rather than a intellectually-distinct alternative.... Nelson Rockefeller might well have liked the current health care bill. So would Jacob Javits, Lowell Weicker and a whole generation of politicians for whom the point of being a Republican was to head in the same direction as the Democratics, but more slowly, with more attention to the concerns of corporate America, and with a greater zeal for balancing the nation's books. But while I have all kinds of problems with what the contemporary Republican Party has become, and where it might be going, I can't say I'm sorry that Rockefeller Republicanism no longer plays a major role in shaping the G.O.P.'s agenda. In the end, the country is better off with an opposition party that offers Americans a real choice — whether on health care or any other issue — rather than being content to supply a "moderate" and business-friendly echo."
 
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This is great...no no stop, your killing me.
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Yeah, seriously man, if I'm making points to which you have no comeback, just say it. A :laugh: (2 or 3 times) isn't cutting it for me.
 
And yes, the bill IS moderate. The biggest thing about it is, NO public option (democratic idea) and YES insurance exchange (republican idea), and bans on pre-existing conditions, life-time caps, drops on coverage (all of which Republicans want), not to mention the 4 GOP ideas Obama implemented, yeah, it's a moderate bill. Because of government set standards to the exchange, it might be a center-left bill, not dead center, but guess what? Dem. pres, and Dem. congress - be happy it's a center-left bill.

Now can you tell me how it's NOT a moderate bill, with a 🙂😀🙄😎:laugh::laugh::laugh::laugh:D?

It is a moderate bill, and the only reason Republicans won't vote for it is because it's a victory for Obama. The fact that it's right for the American people doesn't matter.

rnc.jpg


...is essentially what they're following.
 
JaggerPlate said:
Ehhh ... I wouldn't go that far. I think they are scrambling for votes a bit right now. The last time I looked, I didn't think Pelosi had the seats, and I'm pretty sure Obama delayed his trip to Asia a few days to help get it passed asap. However, the initial article I read (don't remember the source, I think CNN) stated that no Republican in the senate was slated to vote for the financial aid overhaul (not shocking) so again, I don't think they have the votes.
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We shall just have to see, shan't we?
 
Tutmos said:
I can't find a single poll anywhere that has Obamacare within even 10 points, let alone less than 5 that you're quoting, that uses registered or likely voters.
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1) Check out Rasmussen from late Feb.
2) The point was just to respond to the idea of 3:1 opposition to the legislation. It's actually 5:4 at most. There's a world of difference between those two things.

Tutmos said:
If you can't be troubled to vote, I'm sorry your opinion doesn't matter.
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Why?

Listen, I'd agree with you in the sense that, if someone is too lazy/apathetic to vote, I basically view them as having ceded their right to complain about politics for the next few years. It's also probably a safe bet that they're not very well informed -- meaning that their opinion isn't a very reliable indicator of what government should do. Thing is, you could say this about the vast majority of the American public. I think that when you're talking about "what the American people want," you have to take what you get... lumps and all. It doesn't make sense to ask a subset.

Also, the LV screens used by polling agencies tend to exclude most young people (including many of the politically passionate people on this thread, I'm sure) because of the requirement that you have voted in past non-Presidential elections, and because many polling agencies do not call cell-phone users.
 
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lejeunesage said:
We shall just have to see, shan't we?
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Definitely. I assumed she'd actually have the votes for the senate bill + reconciliation pretty easily, but if that was the case, I think a bill would have been on Obama's desk earlier in March. Wasn't there something about a hold up with the CBO getting some numbers released too though??? I don't know.
 
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XxNemesis29xX said:
And yes, the bill IS moderate. The biggest thing about it is, NO public option (democratic idea) and YES insurance exchange (republican idea), and bans on pre-existing conditions, life-time caps, drops on coverage (all of which Republicans want), not to mention the 4 GOP ideas Obama implemented, yeah, it's a moderate bill. Because of government set standards to the exchange, it might be a center-left bill, not dead center, but guess what? Dem. pres, and Dem. congress - be happy it's a center-left bill.

Now can you tell me how it's NOT a moderate bill, with a 🙂😀🙄😎:laugh::laugh::laugh::laugh:D?

It is a moderate bill, and the only reason Republicans won't vote for it is because it's a victory for Obama. The fact that it's right for the American people doesn't matter.

rnc.jpg


...is essentially what they're following.
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Here's the problem ... and I can honestly see it both ways:

1. You're right that the GOP is going to absolutely crap on anything and vote no on ANY bill that comes from this administration. It's lame. However, the GOP was ignored pretty badly when piecing this whole thing together, BUT it's impossible to say that they wouldn't have done the same thing to the dems if the super majority role was reversed. It's just politics, and I get that. I'm not happy about it and I wish this bill was more bipartisan ... but such is life.

2. Let me be very clear when stating this next point ... this isn't my point of view on the bill. I'm regurgitating what I've heard coming from mouth's of GOP members regarding some of the issues you brought up like insurance exchanges. The GOP feels like the dems have sprinkled a couple of their ideas into a huge, huge piece of legislation they disagree with completely. A few sprinkles on an extra large turd sundae in their eyes. Again ... they want to rip it down and start from scratch for more core input ... dems don't want this. And AGAIN ... if the roles were reversed, the GOP would either being doing the same thing, or not even budging.
 
JaggerPlate said:
However, the GOP was ignored pretty badly when piecing this whole thing together,
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Hmmm, how long did Baucus (D), Bingaman (D), and Conrad (D) sit in that room with Enzi (R), Snowe (R), and Grassley (R) last year?
 
XxNemesis29xX said:
And yes, the bill IS moderate. The biggest thing about it is, NO public option (democratic idea) and YES insurance exchange (republican idea), and bans on pre-existing conditions, life-time caps, drops on coverage (all of which Republicans want), not to mention the 4 GOP ideas Obama implemented, yeah, it's a moderate bill. Because of government set standards to the exchange, it might be a center-left bill, not dead center, but guess what? Dem. pres, and Dem. congress - be happy it's a center-left bill.

Now can you tell me how it's NOT a moderate bill, with a 🙂😀🙄😎:laugh::laugh::laugh::laugh:D?

It is a moderate bill, and the only reason Republicans won't vote for it is because it's a victory for Obama. The fact that it's right for the American people doesn't matter.

rnc.jpg


...is essentially what they're following.
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that, is completely your opinon.
 
Hmmm, how long did Baucus (D), Bingaman (D), and Conrad (D) sit in that room with Enzi (R), Snowe (R), and Grassley (R) last year?
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Over 100 bipartisan meetings I think.
 
Parts Unknown said:
Hmmm, how long did Baucus (D), Bingaman (D), and Conrad (D) sit in that room with Enzi (R), Snowe (R), and Grassley (R) last year?
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I'm not sure the GOP, as a whole, would look at Snowe as a shining example of their core beliefs. Also, didn't those meetings result in getting the "moderate" from Maine to support the bill and move that version along in the Senate?????
 
JaggerPlate said:
I'm not sure the GOP, as a whole, would look at Snowe as a shining example of their core beliefs. Also, didn't those meetings result in getting the "moderate" from Maine to support the bill and move that version along in the Senate?????
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The problem is that the Republicans are offering no way of covering the extra 30million people that the Dems want to cover. How do you compromise on something like that? Do you cover 15million? Which ones? Even so, the Reps would still oppose it. Sometimes, you just have to pass things with reconciliation (that's how the Bush tax cuts were passed) and submit yourself to the judgment of the electorate in the next elections.
 
lejeunesage said:
The problem is that the Republicans are offering no way of covering the extra 30million people that the Dems want to cover. How do you compromise on something like that? Do you cover 15million? Which ones? Even so, the Reps would still oppose it. Sometimes, you just have to pass things with reconciliation (that's how the Bush tax cuts were passed) and submit yourself to the judgment of the electorate in the next elections.
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I think you showed up to the thread a little bit after I quit ... but I'm sorry, I simply cannot have this type of discussion any further. I have no problem throwing in a comment here and there, but I can't get into the full blown break down, what I would do, what I don't like, why I don't support the bill, etc. My opinion and ideas are pretty well documented out there, but I can't keep repeating them over and over ... too exhausting.
 
JaggerPlate said:
I think you showed up to the thread a little bit after I quit ... but I'm sorry, I simply cannot have this type of discussion any further. I have no problem throwing in a comment here and there, but I can't get into the full blown break down, what I would do, what I don't like, why I don't support the bill, etc. My opinion and ideas are pretty well documented out there, but I can't keep repeating them over and over ... too exhausting.
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It's all good; I don't expect you to.
 
lejeunesage said:
The problem is that the Republicans are offering no way of covering the extra 30million people that the Dems want to cover. How do you compromise on something like that? Do you cover 15million? Which ones? Even so, the Reps would still oppose it. Sometimes, you just have to pass things with reconciliation (that's how the Bush tax cuts were passed) and submit yourself to the judgment of the electorate in the next elections.
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What republicans want, basically, is the system that Singapore has: everyone has high decutible catastrophic coverage and an HSA which they personally pay for (independent of their job). The liberal concession in a system like this, to make sure that most people get covered, is that catastrophic coverage is deductible from taxes (even to the point where it's basically a refund) and some of your salary gets put into the HSA automatically in the same way that some of your salary is already automatically put toward social security (except that unlike social security YOU control how you invest your HSA). They reasonably argue that this system has produced one of the world's healthiest countries and, much more importantly, that their healthcare costs are only 4% of their GDP and stable, unlike the European countries where healthcare costs are skyrocketing at basically the same rate as ours (the current cost is lower, but the trajectory is the same). This is also the key to opening up healthcare to regular working class families: allowing free market forces to push the price down to a point where regular people can afford it. Despite all of the government and medical communty's opinion that regular people are simply too uneducated to know how to cut down on their healthcare costs without damaging their care, they seem to do a surprisingly good job of it when it's their own money involved rather than a government's or insurance company's.

Some of this, though, is also a difference in philosophy. Democrats tend to believe that anyone in need has a right to help from their government, while Republicans tend to believe that only those who are victims of random chance deserve aid. Healthcare for children, or those with congenital medical illnesses, generally has bipartisan support. Healthcare for those who are underinsured at least in part because of their own decisions is more of a democratic platform. You're right that the republicans often aren't really trying to get everyone covered.

Finally the argument against using reconcilliation for something like this, vs. the bush tax cuts, is that at least with the tax cuts if the next election went badly they could easily be reversed. A new arm of the government, on the other hand, is basically indestructible. As soon as you create it hundreds of thousands of people depend on it for work, while tens of millions more will be absolutely dependent on it to live (having thrown away their private insurance plans). Waiting until after the bill passes to see if everyone likes it is like waiting until after your flight takes off to decide if you want to get off the plane.
 
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Perrotfish said:
What republicans want, basically, is the system that Singapore has: everyone has high decutible catastrophic coverage and an HSA which they personally pay for (independent of their job)...

They reasonably argue that this system has produced one of the world's healthiest countries and, much more importantly, that their healthcare costs are only 4% of their GDP and stable, unlike the European countries where healthcare costs are skyrocketing at basically the same rate as ours (the current cost is lower, but the trajectory is the same). This is also the key to opening up healthcare to regular working class families: allowing free market forces to push the price down to a point where regular people can afford it.
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Eh, that's part of the story. Singapore does have compulsory savings into HSA-like accounts, but they also have a high level of government subsidy for basic health services, strict government enforced price controls, price transparency, and competition between public and private hospital systems.

That's right, the public ones haven't run all the private ones out of business.

Singapore also has a high proportion of young "guest workers" who are relatively healthy and increase GDP while not dragging health expenditure very much. The percentage of Singaporeans 65+ is much smaller than the US (8.3% vs. 12.8%).

So yes, it's a free market paradise if you consider government price controls and subsidies to be a free market. Actually, I suppose it's about as close as you're going to get.
 
Perrotfish said:
What republicans want, basically, is the system that Singapore has: everyone has high decutible catastrophic coverage and an HSA which they personally pay for (independent of their job). The liberal concession in a system like this, to make sure that most people get covered, is that catastrophic coverage is deductible from taxes (even to the point where it's basically a refund) and some of your salary gets put into the HSA automatically in the same way that some of your salary is already automatically put toward social security (except that unlike social security YOU control how you invest your HSA). They reasonably argue that this system has produced one of the world's healthiest countries and, much more importantly, that their healthcare costs are only 4% of their GDP and stable, unlike the European countries where healthcare costs are skyrocketing at basically the same rate as ours (the current cost is lower, but the trajectory is the same). This is also the key to opening up healthcare to regular working class families: allowing free market forces to push the price down to a point where regular people can afford it. Despite all of the government and medical communty's opinion that regular people are simply too uneducated to know how to cut down on their healthcare costs without damaging their care, they seem to do a surprisingly good job of it when it's their own money involved rather than a government's or insurance company's.

Some of this, though, is also a difference in philosophy. Democrats tend to believe that anyone in need has a right to help from their government, while Republicans tend to believe that only those who are victims of random chance deserve aid. Healthcare for children, or those with congenital medical illnesses, generally has bipartisan support. Healthcare for those who are underinsured at least in part because of their own decisions is more of a democratic platform. You're right that the republicans often aren't really trying to get everyone covered.

Finally the argument against using reconcilliation for something like this, vs. the bush tax cuts, is that at least with the tax cuts if the next election went badly they could easily be reversed. A new arm of the government, on the other hand, is basically indestructible. As soon as you create it hundreds of thousands of people depend on it for work, while tens of millions more will be absolutely dependent on it to live (having thrown away their private insurance plans). Waiting until after the bill passes to see if everyone likes it is like waiting until after your flight takes off to decide if you want to get off the plane.
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Phrased so perfectly.
 
Perrotfish said:
Finally the argument against using reconcilliation for something like this, vs. the bush tax cuts, is that at least with the tax cuts if the next election went badly they could easily be reversed. A new arm of the government, on the other hand, is basically indestructible. As soon as you create it hundreds of thousands of people depend on it for work, while tens of millions more will be absolutely dependent on it to live (having thrown away their private insurance plans). Waiting until after the bill passes to see if everyone likes it is like waiting until after your flight takes off to decide if you want to get off the plane.
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First off, the health reform bill isn't going to pass by reconciliation. It has already received 60 votes in the Senate. Reconciliation only serves to make a number of "fixes" so that the Senate bill is palatable to the House.

Secondly, what is this new arm of Government?
 
Perrotfish,

1) I think the catastrophic coverage + HSA kind of plan is actually a really good one, at least in theory. I should read more about this, because right now I'm pretty ignorant on the subject. I guess, for me, a lot would hinge on what catastrophic coverage includes. I still would like to live in a society where someone with chest pain can go talk to a cardiologist, regardless of their financial situation, and even if their financial situation was caused by bad choices and not bad luck.

2) I don't quite agree with your characterization of the Republican philosophy. I WISH Republicans consistently believed in aid for victims of bad luck (which is a pretty reasonable ideology), but their opposition to programs like SCHIP is inconsistent with this (how can children be responsible for their parents' finances?). Whatever, I'm glad this is your stance. The only problem I see with it (and why I'm a little to the Left of you) is that the individual -- his/her choices and abilities -- are not so easily divorced from the society in which the individual grew up. We're so much a product of the schools we went to, the kind of lifestyle our parents could afford, the opportunities made available to us based on our unique circumstances, that it's almost impossible to quantify to what extent YOU, as some distinct entity, are responsible for how successful you are. Now, I'm not saying we abandon personal responsibility simply because the metaphysics of free will are complicated, I'm just saying that I'm reluctant to jump to the conclusion that a poor person became poor because they were lazy or imprudent (even if that's the case some of the time). The practical impact of this is that I tend to support policies that reduce the disparities in outcomes produced by an unregulated market, while still trying to preserve as much as possible the positive incentives (and consequent efficiency and higher standard of living) created by the market. As always, it's a balancing act.

3) This is the real reason I wanted to respond. Re: your avatar. Dr. Horrible's Sing-Along Blog is AMAZING.
 
JaggerPlate said:
I'm not sure the GOP, as a whole, would look at Snowe as a shining example of their core beliefs.
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Not to worry, perhaps she'll have a massive stroke and fall in line with the rest of her party.
 
Perrotfish said:
What republicans want, basically, is the system that Singapore has: everyone has high decutible catastrophic coverage and an HSA which they personally pay for (independent of their job). The liberal concession in a system like this, to make sure that most people get covered, is that catastrophic coverage is deductible from taxes (even to the point where it's basically a refund) and some of your salary gets put into the HSA automatically in the same way that some of your salary is already automatically put toward social security (except that unlike social security YOU control how you invest your HSA). They reasonably argue that this system has produced one of the world's healthiest countries and, much more importantly, that their healthcare costs are only 4% of their GDP and stable, unlike the European countries where healthcare costs are skyrocketing at basically the same rate as ours (the current cost is lower, but the trajectory is the same). This is also the key to opening up healthcare to regular working class families: allowing free market forces to push the price down to a point where regular people can afford it. Despite all of the government and medical communty's opinion that regular people are simply too uneducated to know how to cut down on their healthcare costs without damaging their care, they seem to do a surprisingly good job of it when it's their own money involved rather than a government's or insurance company's.

Some of this, though, is also a difference in philosophy. Democrats tend to believe that anyone in need has a right to help from their government, while Republicans tend to believe that only those who are victims of random chance deserve aid. Healthcare for children, or those with congenital medical illnesses, generally has bipartisan support. Healthcare for those who are underinsured at least in part because of their own decisions is more of a democratic platform. You're right that the republicans often aren't really trying to get everyone covered.

Finally the argument against using reconcilliation for something like this, vs. the bush tax cuts, is that at least with the tax cuts if the next election went badly they could easily be reversed. A new arm of the government, on the other hand, is basically indestructible. As soon as you create it hundreds of thousands of people depend on it for work, while tens of millions more will be absolutely dependent on it to live (having thrown away their private insurance plans). Waiting until after the bill passes to see if everyone likes it is like waiting until after your flight takes off to decide if you want to get off the plane.
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Somehow I doubt Republicans (or Democrats, for that matter) would truly support this plan, as it would involve basically destroying the comprehensive health insurance business, or at least taking away many of its customers.
 
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Parts Unknown said:
Ummmmm, because your boys haven't put up anyone worth voting for since 1994?
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Wheww, you have spiraled from someone who at least put up well-researched, insightful opinions, to a child (especially because your reply made no sense on multiple levels).
 
yeastfan21 said:
You know, it's a real cop-out, and pretty obnoxious, to accuse of someone of "drinking the Kool-Aid" (Tutmos), being a "talking points billboard" (Tutmos), and having "blind faith in an agenda" (7starmantis), whenever that person expresses an opinion you disagree with.
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Actually, I've been very accepting of differing opinions. Whats a true cop-out is trying to pass off something factually incorrect as "common knowledge". I've explained my point very heavily in this and other threads, I have no desire to do it again. If someone misunderstands my posts because they haven't read the entire thread, thats their own fault.

XxNemesis29xX said:
Yeah, seriously man, if I'm making points to which you have no comeback, just say it. A :laugh: (2 or 3 times) isn't cutting it for me.
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See above post. Re-read the thread. What I'm responding to is the comment about bipartisan meaning only one party votes for it. Thats just a farce and to try and pass it off as truth is ridiculous and worthy of any of the little emoticons you apparently hate.
 
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Parts Unknown said:
First off, the health reform bill isn't going to pass by reconciliation. It has already received 60 votes in the Senate. Reconciliation only serves to make a number of "fixes" so that the Senate bill is palatable to the House.
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Government lesson:

Alright, again, no one seems to understand what reconciliation is. First, the old bill, the one that already passed through the Senate, that's gone. It didn't have enough votes to avoid a filibuster and it can't switch over to reconciliation half way through. Reconciliation is a process that happens internal to the Senate that allows them to avoid a filibuster, but they have to start over with a brand new bill to do it. It just so happens that the new bill is basically the same as the old bill, which is why it's easy to get confused. Conference committee, which is what you're confusing reconcilliation with, is where the a bill goes when it passes the Senate (with or without reconcilliation) and the House so they can match up the Senate bill to the house bill. Then the compromise bill goes back to the house and senate again and they both need to vote on it again to get it made into a law.

Somehow I doubt Republicans (or Democrats, for that matter) would truly support this plan, as it would involve basically destroying the comprehensive health insurance business, or at least taking away many of its customers.
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Republicans, and insurance companies, would support any plan that would keep health care dollars in the private sector. Moving from comprehensive to catastrophic insurance might kill some of the dedicated HMOs like Kaiser, but for most of the big guys it would just mean shifting their emphasis from one product to another.

2) I don't quite agree with your characterization of the Republican philosophy. I WISH Republicans consistently believed in aid for victims of bad luck (which is a pretty reasonable ideology), but their opposition to programs like SCHIP is inconsistent with this (how can children be responsible for their parents' finances?). Whatever, I'm glad this is your stance. The only problem I see with it (and why I'm a little to the Left of you) is that the individual -- his/her choices and abilities -- are not so easily divorced from the society in which the individual grew up.
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I 100% agree the the social justice here is much more complicated than Republicans like to make it out to be. Also, of course, the downside to the system I describe is obviously that healthcare would be much more tierd than it currently is. Comprehensive insurance, for all it's faults, basically means that I can recieve the exact same medical care as the CEOs and Senators who lived in my area. At least in terms of comfort, though hopefully not outcome, HSAs would definitely stratify the hospital by income.
 
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Perrotfish said:
Government lesson:

Alright, again, no one seems to understand what reconciliation is. First, the old bill, the one that already passed through the Senate, that's gone. It didn't have enough votes to avoid a filibuster and it can't switch over to reconciliation half way through. Reconciliation is a process that happens internal to the Senate that allows them to avoid a filibuster, but they have to start over with a brand new bill to do it. It just so happens that the new bill is basically the same as the old bill, which is why it's easy to get confused. Conference committee, which is what you're confusing reconcilliation with, is where the a bill goes when it passes the Senate (with or without reconcilliation) and the House so they can match up the Senate bill to the house bill. Then the compromise bill goes back to the house and senate again and they both need to vote on it again to get it made into a law.
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Reality lesson:

The House passed its bill, the Senate passed its bill. The original plan was to negotiate a unified bill and send it back to each chamber. They both vote yes, it goes to Obama's desk, game over.

However, once Mark Brown was seated a unified bill would be subject to filibuster. One way around this is for the House to pass the Senate bill unchanged (the Sudden Victory option). Problem is the House doesn't like some of what's in the Senate bill.

So, the tentative agreement (if you could call it that) is for the House to pass the Senate bill (Sudden Victory), and then for the Senate to pass a separate bill via reconciliation that would fix much of what the House doesn't like about it.

If you don't believe me, take it from the Christian Science Monitor:

In this case, the House would pass the version of reform already approved by the Senate on Dec. 24, then both houses would pass follow-up legislation aimed at fixing the bill to reflect changes Democrats have agreed upon.
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Tutmos said:
Didn't Clinton win with only 43% of the vote?
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Sure did, and after a dreadful year in office I was excited at the prospect of having some pre-Reagan conservatives ride back into DC with a real agenda.

Didn't Bush lose with only 37.5% of the vote?
 
Perrotfish said:
Republicans, and insurance companies, would support any plan that would keep health care dollars in the private sector. Moving from comprehensive to catastrophic insurance might kill some of the dedicated HMOs like Kaiser, but for most of the big guys it would just mean shifting their emphasis from one product to another.
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I suppose you are right, I just kinda assumed catastrophic insurance might not be as profitable, don't know why.


Perrotfish said:
I 100% agree the the social justice here is much more complicated than Republicans like to make it out to be. Also, of course, the downside to the system I describe is obviously that healthcare would be much more tierd than it currently is. Comprehensive insurance, for all it's faults, basically means that I can recieve the exact same medical care as the CEOs and Senators who lived in my area. At least in terms of comfort, though hopefully not outcome, HSAs would definitely stratify the hospital by income.
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Do you think this could be minimized through income-adjusted subsidies to HSAs?
 
hqt said:
Do you think this could be minimized through income-adjusted subsidies to HSAs?
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Probably, but isn't the point of adding the HSAs to drive down costs by not giving everyone the ability to spend like CEOs? Arguably the problem with our healthcare is that, for this one section of our economy, we have decided that money is no object and it is bankrupting everything else. The idea of an HSA is that there should be a significant gap in between when the HSA runs out and the catastrophic insurance sets in, forcing patients to make real decisions about how much their healthcare is worth when it's their actual savings and posessions are at stake. If we just subsidize everyone to the point where they never need to make that choice I don't see how this is a lot different from comprehensive coverage.
 
This is a little off topic but I was wondering if someone can clear this up for me. So this new healthcare bill costs about 950 billion dollars. Where exactly is this money being spend. From my understanding this bill is forcing people to buy their own insurance, putting strict regulation on insurance companies, and providing help to the roughly 20-35 million Americans who truly cannot afford insurance. The only thing I see that costs money is providing healthcare for 25-35 million americans. That cannot possibly cost 950 billion dollars. Where is the rest of the money being spend?
 
Perrotfish said:
Probably, but isn't the point of adding the HSAs to drive down costs by not giving everyone the ability to spend like CEOs? Arguably the problem with our healthcare is that, for this one section of our economy, we have decided that money is no object and it is bankrupting everything else. The idea of an HSA is that there should be a significant gap in between when the HSA runs out and the catastrophic insurance sets in, forcing patients to make real decisions about how much their healthcare is worth when it's their actual savings and posessions are at stake. If we just subsidize everyone to the point where they never need to make that choice I don't see how this is a lot different from comprehensive coverage.
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It would probably still be less expensive than Medicare/Medicaid.

EDIT: I see what you mean, you're saying that subsidies wouldn't help costs go down. But you don't need to subsidize the entire population, and plus, people would probably still try to spend less of their HSA even if it is subsidized.
 
Parts Unknown said:
Reality lesson:

The House passed its bill, the Senate passed its bill. The original plan was to negotiate a unified bill and send it back to each chamber. They both vote yes, it goes to Obama's desk, game over.

However, once Mark Brown was seated a unified bill would be subject to filibuster. One way around this is for the House to pass the Senate bill unchanged (the Sudden Victory option). Problem is the House doesn't like some of what's in the Senate bill.

So, the tentative agreement (if you could call it that) is for the House to pass the Senate bill (Sudden Victory), and then for the Senate to pass a separate bill via reconciliation that would fix much of what the House doesn't like about it.


If you don't believe me, take it from the Christian Science Monitor:
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This is also my understanding of it.
 
Perrotfish said:
Probably, but isn't the point of adding the HSAs to drive down costs by not giving everyone the ability to spend like CEOs? Arguably the problem with our healthcare is that, for this one section of our economy, we have decided that money is no object and it is bankrupting everything else. The idea of an HSA is that there should be a significant gap in between when the HSA runs out and the catastrophic insurance sets in, forcing patients to make real decisions about how much their healthcare is worth when it's their actual savings and posessions are at stake. If we just subsidize everyone to the point where they never need to make that choice I don't see how this is a lot different from comprehensive coverage.
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Republicans are really in love with HSAs. Fine, let them then produce a plan that is based primarily on HSAs that can cover $30million people. Up to now, though, they haven't, which either means that they can't devise such a plan or are not interested in doing so. I don't really care what the reason for this is, but it's something we just can't compromise on. You mentioned earlier that because it will create a new arm of government -debatable at best- we can't just enact it and have people roll it back if they don't like it. Well, this is just an extension of PRIVATE health insurance to the uninsured. I'm really not sure how it ties into the whole Bolshevik takeover narrative. In fact, it's remarkably similar to the bill the Republicans proposed in 1993. Anyway, at this point it's pretty much done. You might as well get used to it.
 
Parts Unknown said:
Sure did, and after a dreadful year in office I was excited at the prospect of having some pre-Reagan conservatives ride back into DC with a real agenda.

Didn't Bush lose with only 37.5% of the vote?
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It was a perfect example of divide and conquer. A candidate that couldn't win managed to because the expected winner's voting block was split in half. With Perot's votes it combined for over 56% of the electorate. I wasn't a fan of either Bush btw, they were both "democrat-lite" like McCain. Let's just hope they've learned their lesson and don't nominate another milk toast candidate.

The most entertaining thing this year will be to hear how the media spins the huge losses democrats suffer in the fall election. If I remember correctly Obama was trying to claim Brown was elected because people were mad that it was taking so long to pass Obamacare. ROFL
 
lejeunesage said:
Republicans are really in love with HSAs. Fine, let them then produce a plan that is based primarily on HSAs that can cover $30million people. Up to now, though, they haven't, which either means that they can't devise such a plan or are not interested in doing so. I don't really care what the reason for this is, but it's something we just can't compromise on. You mentioned earlier that because it will create a new arm of government -debatable at best- we can't just enact it and have people roll it back if they don't like it. Well, this is just an extension of PRIVATE health insurance to the uninsured. I'm really not sure how it ties into the whole Bolshevik takeover narrative. In fact, it's remarkably similar to the bill the Republicans proposed in 1993. Anyway, at this point it's pretty much done. You might as well get used to it.
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Where did this truism come from that the government is obligated to cover this ill defined 30 million people? (Was that a Freudian typo adding the $ in front of 30 million btw?) Was there some part of the Constitution I missed that guarantees health care for all? Maybe it was the Life, Liberty and pursuit... bit? :laugh:
 
Parts Unknown said:
Ummmmm, because your boys haven't put up anyone worth voting for since 1994?
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right on point. i honestly think if Mccain didt fail so hard, obama wouldnt have made it.

i remeber watching the presidential debate on youtube, obama forms his speech and argument pretty well, i had a good feeling about what ever he was going to do. now you listen to mccain, i honestly have no idea what he is saying nor what he was trying to say, its like he came unprepared or something. at mid of second debate i knew pretty much good old Mccain wasn't going to make it lol.
 
Tutmos said:
It was a perfect example of divide and conquer. A candidate that couldn't win managed to because the expected winner's voting block was split in half. With Perot's votes it combined for over 56% of the electorate.
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Yep. Last time I checked that's how our electoral process works.

Tutmos said:
The most entertaining thing this year will be to hear how the media spins the huge losses democrats suffer in the fall election.
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There is a political eternity before the November elections. Let's see how bad the losses are before we start crowing, eh?
 
Tutmos said:
Where did this truism come from that the government is obligated to cover this ill defined 30 million people?
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That point is debatable, or course, but the argument for ensuring universal insurance (by whatever means) is compelling.

Maggie Mahar wrote an excellent piece on this topic, and as you seem very open to new ideas, I would invite you to read it. Be sure to follow the link to Shadowfax's blog.
 
Wow, I can't believe people really think this way. Go move to Britain and work for the NHS or China and give all your money back to the poor Robin Hood.

Why do you think the US is so successful? Because the rich drive the economy. If incentives aren't in place to keep people rich, the industry crumbles. Yes that includes healthcare you hippy. The quality of doctors would plummet and general welfare would decrease, negligence would increase, clinical innovation would decrease, etc etc etc. Look at the public education system in the US. What a joke. The government took over education, teachers get paid s*** and the quality of public education in general sucks.



lejeunesage said:
Then what are you waiting for? Go ahead right now and enroll into nursing school. If your primary aim is to be rich, then go work on Wall Street. If you want to be a physician, then study medicine. The currently high salaries of physicians are the result of the fee-for-service method of reimbursement that was instituted when Medicare was passed under LBJ. It was a colossal mistake and, although it is by no means the only cause of this, it has, in no small part, contributed to the astronomical rise of health care costs. Physicians would see what the average charge was for a given service and, being of course better than average, would charge a little more. Putting some kind of rational mechanism in place to determine what the reimbursement rate should be would be good policy. In fact, this has been recognized for a long while, which is why William Hsiao's Resource-Based Relative Value Scale (RBRVS) was adopted more than 20 years ago now as a way to decide what reimbursement rates should be under Medicare. RBRVS may not be the best way to decide what physicians should be paid - it rewards complicated procedures rather than outcomes - but it at least uses a rational basis for its prescriptions. This is what we need. And the govt. is not trying to drop Medicare reimbursement rates for the hell of it. It was decided more than 10 yrs ago that these should not rise faster than inflation. But cuts have been postponed year after year since 1998, which is why the looming cut now - which no politician will have the balls to enact - is 21%. What will happen - again - is that we will balance the budget by pretending that the cuts will go into effect next year, as we have done every year since 1998. Eventually, the pill will have to be swallowed and it will be a very large and bitter one. Taxes will have to be raised, services cut, or both.

But I digress. Doctors make more than enough money. Under the current health care reform proposal, their salaries would probably cease to rise as fast, but I doubt that they will decrease significantly, because physicians will continue to be a very important interest group with significant financial resources. If new reimbursement methods are designed, it will be with their input, and they will continue to protect their interest with as much vigor as they have heretofore done. But, supposing that I am wrong and that Congress is able to out-muscle doctors and effect drastically lower reimbursement rates, it would still not be a disaster. Physicians in France and Britain live very well, without necessarily being rich. And given the choice if, as I do not believe for a second, this really be a zero-sum game, if giving health care to the needy really need come at the expense of physician salaries, than I would rather take a large pay cut than see my countrymen, especially those who can least afford it, remain without health care insurance.
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When has anything the Government ran worked? I may sound selfish [because I am] but all I want to know is whether they will lower Doctors salaries and by how much. I may sound greedy and evil [because I kinda am..] but I do not want to be a RN working 11pm-7am to 3pm-11pm week days like my mother and struggling to give her kids lunch money...
 
she woolf said:
When has anything the Government ran worked? I may sound selfish [because I am] but all I want to know is whether they will lower Doctors salaries and by how much. I may sound greedy and evil [because I kinda am..] but I do not want to be a RN working 11pm-7am to 3pm-11pm week days like my mother and struggling to give her kids lunch money...
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I don't want to enter this Healthcare debate on SDN, but she woolf, I can guarantee you that you will have enough food to eat, and be able to give enough food to your children as a physician.
 
Tutmos said:
Where did this truism come from that the government is obligated to cover this ill defined 30 million people? (Was that a Freudian typo adding the $ in front of 30 million btw?) Was there some part of the Constitution I missed that guarantees health care for all? Maybe it was the Life, Liberty and pursuit... bit? :laugh:
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:laugh:Maybe I wished it would only cost $30million. But in all seriousness, the govt. doesn't have to do anything. It doesn't have to provide Medicare and Medicaid; it doesn't have to provide social security; it doesn't have to subsidize student loans; it doesn't have to build any type of infrastructure; it doesn't have to provide education; it doesn't have to have pollution standards; in fact, there's very little that the government has to do, strictly speaking. But if it stopped doing many of the things it does, I suspect, you'd be clamoring back for your benefits. It does those things because as a society we believe in some amount of social justice.
 
Tutmos said:
It was a perfect example of divide and conquer. A candidate that couldn't win managed to because the expected winner's voting block was split in half. With Perot's votes it combined for over 56% of the electorate. I wasn't a fan of either Bush btw, they were both "democrat-lite" like McCain. Let's just hope they've learned their lesson and don't nominate another milk toast candidate.

The most entertaining thing this year will be to hear how the media spins the huge losses democrats suffer in the fall election. If I remember correctly Obama was trying to claim Brown was elected because people were mad that it was taking so long to pass Obamacare. ROFL
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1. That's how Lincoln got elected.
2. Huge losses? You'd better take a look at electoral maps. I'd be very surprised if the democrats didn't retain majorities (albeit small ones) in both chambers.
 
Are you more interested in politics or healthcare? Do you feel there is any room for both to co-exist? I don't.
 
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